Objective To evaluate the effect of tranexamic acid (TXA ) in medical treatment of chronic subdural hematoma (CSDH) .Methods A total of 19 patients with CT-confirmed CSDH in our department from Mar 2014 to Aug 2015 received an in-travenous dose of 1g TXA in the first week ,and followed by a maintenance oral dose of 250 mg TXA three times a day for 1 - 5 months (2 .73 ± 1 .05) months .These patients received a follow-up period of 6 - 10 months .Hematoma volume and neurological functions were compared before and after treatment .Results The therapeutic outcome was divided into effectiveness and ineffec-tiveness .Thirteen cases (68 .4% ) were effective ;six cases (31 .6% ) were ineffective .Among them ,three patients (15 .8% ) whose neurological functions deteriorated underwent surgery ,one patient (5 .3% ) who did not show any improvement with initial one month of TXA underwent surgery ,one patient (5 .3% ) stopped the treatment due to the side-effect of drug ,one patient (5 .3% ) lost .Conclusion Results of this preliminary study show that the administration of TXA is effective and safe in treating CSDH .

Objective To explore the neurovascular distribution around multifidus muscles in the low back and its clinical significance via regional dissection.Methods Five cadavers were dissected in the low back.The anatomical relationships between the longissimus thoracis,iliocostalis and the start-stop,direction and position of multifidus muscles were observed.Branches,distribution and the characteristics of the erector spinae muscle,the lateral branches of spinal nerves and blood vessels were examined.Then measured the distances from the emerging point of the lateral cutaneous branches of spinal nerves to the spinous processes.Results After removed the deep fascia,the longissimus thoracis was found medially and the iliocostalis was found laterally.The muhifidus muscles located deeply to the longissimus and the iliocostalis muscles.The lateral branches of the posterior rami of the spinal nerves and the dorsal branches of lumbar blood vessels run in the multifidus muscle gaps.Conclusion The multifidus muscle gaps contain plenty of neurovascular bundles.Surgery involving the low back often takes the advantage of the gaps between multifidus muscles.Therefore,surgeons should take caution to avoid damaging the lateral branches of the posterior rami of the spinal nerves and the dorsal branches of lumbar vessels during low back surgery.

Objectives To compare the effectiveness and safety of local anesthesia and epidural anesthesia with ureteroscopic pneumatic lithotripsy at distal ureteral stone. Methods A total of 160 patients with distal ureteral stone treated with ureteroscopic pneumatic lithotripsy from December 2013 to February 2014 were included. They were divided equally into 2 groups by method of random sampling. Patients in group A (n=80) treated with local anesthesia were compared to those in group B(n=80),who were dealt with epidural anesthesia. Results The statistical difference was significant in terms of hospital stay after operation and overall cost of therapy(P<0. 05) respectively,on the other hand,it was not significant in respect of the operation time,the operation successful rate,the stone clearance rate and the complications incidence rate (P>0. 05)respectively. Conclusion For the identified patients,the local anesthesia in ureteral ureteroscopic pneumatic lith-otripsy is a safe,effective and economical method for distal ureteral stone.

Objective: To clone , express and purify of Dermatophagoides farinae ( Der f 11 ) , and then test its immunogenicity.Methods:The gene coding for Der f 11 was synthesized ,and was then linked with the pET-32a vector.The expression plasmid pET32a(+)-Der f 11 was induced by IPTG.After purification of recombinant allergens Der 11 proteins through the Ni +affinity chromatography ,immunological allergic patients serum as the Primary antibody.Results: We obtain high purity recombinant Der f 11 protein.The results of SDS-PAGE show that the expression product is about 118 KD.Recombinant allergen Der f 11 test 15 dust mites allergic patients serum specific IgE , positive rate was 20%.Conclusion: Recombinant allergen Der f 11 obtained has the similar immunologic activity to natural Der f 11 protein.It can lay the foundation for the specific diagnosis ,treatment and further experimental studies of the dust mite allergy disease.

Objective To evaluate the value of 320 row CT upper abdominal computed tomography angiography (CTA) in the follow up of transjugular intrahepatic portosystemic shunt(TIPSS) .Methods 21 cases after TIPSS therapy underwent upper ab-dominal CTA .Post-processing images ,including MPR ,VR ,MIP ,and CPR ,were used to determine the position and patency of the stent .The best images of the portal veins were obtained .Results Among the 21 cases ,CPR image clearly demonstrated endovascu-lar stent thrombosis in 3 cases(14 .29% ) with stent occlusion and 1 case(4 .76% ) with stent stenosis ;there were no stent stenosis or occlusion in 17 cases(80 .95% ) ,their CPR image showed the contrast agent was filled completely in the stent and no low-density thrombosis was found .The best phase of the portal vein was 45 s .Conclusion 320 row CT upper abdominal CTA can clearly dis-play the stent position and patency situation in patients ,therefore ,should be regarded as the first choice for the follow-up of patients after TIPSS therapy .

Objective To investigate the effects of cold preservation on the expression of GATA in intrahepatic bile duct.Methods The intrahepatic bile duct tissues of SD rats were obtained by collagenase perfusion combined with mechanical separation.After being cut into fragments,the intrahepatic bile duct tissues were cultured in rat tail collagen gel for 48 hours before experiment.All the rats were divided into the control group,cold preservation 1 hour (CP1 h) group and cold preservation 12 hours (CP12 h) group.There were 5 rats in each group.The mRNA and protein expressions of GATA were detected by Real-Time polymerase chain reaction and Western blot.Measurement data with normal distribution were presented as (x) ± s.Comparison among 3 groups was done by ANOVA and pairwise comparisons were done by LSD test.Results The mRNA expressions of GATA3,GATA4,GATA6 were detected,while the mRNA expressions of GATA1,GATA2 and GATA5 were undetectable in intrahepatic bile duct tissue of the control group.The mRNA expressions of GATA4 in the CP1 h group,CP12 h group and the control group were 0.72 ± 0.08,0.56 ± 0.07 and 0.96 ± 0.06,with significant difference among the 3 groups (F =38.981,P ＜0.05).The mRNA expression of GATA4 in the CP12 h group was significantly lower than that in the CP1 h group and the control group,and the mRNA expression of GATA4 in the CP1 h group was significantly lower than that in the control group (P ＜ 0.05).The mRNA expression of GATA6 in the CP1 h group,CP12 h group and the control group were 0.83 ± 0.07,0.68 ± 0.12 and 0.98 ± 0.12,with significant difference among the 3 groups (F =10.175,P ＜ 0.05).The mRNA expression of GATA6 in the CP12 group was significantly lower than that in the CP1 h group and the control group,and the mRNA expression of GATA6 in the CP1 h group was significantly lower than that in the control group (P ＜ 0.05).The mRNA expressions of GATA3 in the CP1 h group,CP12 h group and the control group were 0.92 ± 0.06,0.89 ± 0.05 and 0.98 ± 0.11,with no significant difference among the 3 groups (F =1.674,P ＞ 0.05).The protein expressions of GATA4 in the CP1 h group,CP12 h group and the control group were 0.78 ± 0.07,0.64 ± 0.06 and 0.99 ± 0.10,with significant difference among the 3 groups (F =24.211,P ＜ 0.05).The protein expression of GATA4 in the CP12 h group was significantly lower than that in the CP1 h group and the control group,and the protein expression of GATA4 in the CP1 h group was significantly lower than that in the control group (P ＜ 0.05).The protein expressions of GATA6 in the CP1 h group,CP12 h group and the control group were 0.90 ± 0.04,0.75 ±0.06 and 0.98 ±0.11,with significant difference among the 3 groups (F=11.651,P＜0.05).The protein expression of GATA6 in the CP12 h group was significantly lower than that in the CP1 h group and the control group (P ＜ 0.05).Conclusion The expressions of GATA4 and GATA6 in the intrahepatic bile duct tissues are decreased significantly after cold preservation,which indicate that GATA4 and GATA6 might be involved in the pathophysiological process of the bile duct after cold preservation.

Objective To compare the clinical curative effect of percutaneous nephrolithotomy (PCNL) and flexible uretero‐scope lithotripsy (FURL) for the treatment of renal calculus ≤2 cm .Methods Totally 148 patients with kidney stone ≤2 cm whom have taken operation treatment in our hospital were chosen from January 2014 to December 2014 .Among them ,81 patients were taken PCNL treatment (PCNL group) and 67 patients were taken FURL treatment (FURL group) .Clinical curative effect were compared .Results There was no statistically significant difference in the comparison of stone clearance rate ,fever rate and postoperative WBC increase (P>0 .05);the operation time of PCNL group (64 .21 ± 11 .71)min was shorten than the FURL group (107 .32 ± 16 .35)min ,the postoperative hospital stay of PCNL group (6 .51 ± 1 .92)d was longer than the FURL group (3 .28 ± 1 .24)d ,the Hb decrease after operation of PCNL group (13 .31 ± 2 .71)g/L was higher than the FURL group (3 .88 ± 2 .10)g/L , the postoperative hs CRP increase of PCNL group (14 .21 ± 1 .62)mg/L was higher than the FURL group (5 .23 ± 1 .14)mg/L ,the differences were statistically significant (P<0 .05) .Conclusion For the treatment of renal calculus ≤2 cm ,the FURL has a great advantage on reducing postoperative complications ,decreasing the trauma of operation and shorten postoperative hospital stay .

As a member of nuclear receptor superfamily, farnesoid X receptor (FXR) has been shown to regulate numerous metabolic pathways, which include playing an important role in bile acid metabolism, maintaining lipid and glucose homeostasis when FXR is activated. With the prevalence of the glucose and lipids disorder, FXR attracts increasing attention. It may be a potential target for the treatment of type 2 diabetes mellitus and lipid disorders.

AIM:To prepare the Lyophiled Royal Jelly Soft Capsule and study its stability and Influential factors.METHODS:The suspending agent and processing method were optimized using sedimentation volume rate as the index.Soft capsules were prepared and product stability under high temperature and high humidity environment was studied according to the determination of the content of 10-HAD by HPLC.RESULTS:The finished product yield in pilot test was more than 90%,the soft capsule products stored in cold were stable,while those stored under room temperature or high temperature and high humidity were unstable with a noticeable decrease in quality.Water content in capsule shell affects the 10-HDA content of the finished product.CONCLUSION:The preparative process is feasible and the products should be storaged in cold enviroment.

Objective To explore the concentration of pregnancy associated plasma-A(PAPP-A),insulin-like growth factor-1(IGF-1)in indicating the instability of atherosclerotic plaques in patients with non-ST elevation acute coronary syndromes(NSTEACS).Methods Totally 65 patients with confirmed NSTEACS were subjected,including 30 non-ST elevation myocardial infarction(NSTEMI)and 35 unstable angina(UA)patients.Another 28 stable angina pectoris verified with vascular stenosis by coronary angiography(CAG)and 30 healthy matched individuals served as control.Serum levels of PAPP-A,C-reactive protein(CRP)and cTnT were measured respectively by enzyme linked immunosorbent assays(ELISA),rate nephelometry(RN),and microparticle enzyme immunoassay(MEIA).Correlation analysis was made among different groups.Results Serum PAPP-A,IGF-1 and CRP levels in NSTEACS group were significantly increased in comparison to SAP group and control group(P