[Abstract ] Objective Ubiquitin carboxyl hydrolase L1(UCH-L1) is a neuron cytoplasm protein and increased UCH-L1 lev-el in cerebrospinal fluid( CSF) indicates brain injury.The study aimed to indentify UCH-L1 level in CSF of patients with subarachnoid hemorrhage(SAH) and assess the prognosis value of UCH-L1. Methods Retrospective analysis was made on 40 aneurismal SAH patients hospitalized in our department from August 2014 to February 2015.In the experiment group, CSF was taken by lumbar punc-ture in day1-day3, day5-day7, and day8-day10 after subarachnoid hemorrhage.In the control group, a single CSF sample was collect-ed during spinal anesthesia before surgery in 10 patients without neurologic disease.ELISA was applied to determine the concentration of UCH-L1 in CSF followed by comparison.Analysis was also made on relationship of the changes of UCH-L1 and modified rankins scale( MRS) 6 months later. Results CSF UCH-L1 concentrations in all SAH patients were significantly increased in day1-day3 ( P<0.05) after SAH, peaked in day5-day7 (P<0.01) and elevated un-til days 8-10 ( P<0.01 ) .MRS at 6 months showed a significant correlation with CSF levels of UCH-L1 in day5-day7 ( correlation co-efficient CC=0.691, P=0.001) and day8-day10 (CC=0.583,P=0.03), but not in days1-day3 (CC=0.364,P=0.08).SAH pa-tients with a good outcome at 6 months ( MRS<4) had much lower UCH-L1 levels in day5-day7 ( P=0.001) and day8-day10 ( P=0.041) than those with a poor outcome (MRS≥4).Higher UCH-L1 level at day5-day7 was a predictive marker of poor outcome in bi-nary logistic regression analysis (P=0.003); Conclusion The study suggests that increased CSF UCH-L1 level in day5-day7 after SAH is correlated with higher MRS and predicts an adverse clinical outcome 6 months after SAH.

Objective To summarize the methods of operative treatment for complex proximal humeral fractures and its clinical results. Methods 40 cases with complex proximal humeral fractures underwent operation from December 1999 to February 2002. Of 40 cases, 29 were followed up with a mean of 25 months (11 to 40 months). Using Neer system, Constant-Murley rating system and questionnaire were adopted to classify the fractures and evaluated postoperative functions of the daily life and work. A deltoid-pectoral approach was used in all patients. The surgical neck fractures were fixed with the terminal threaded pin or modified Ender's nail. The tubercle fragments were sutured with non-absorbable Ethibond No.5 or "8" figure tension band wire. Results The average absolute Constant-Murley score was 81.7(54 to 96), the excellent and good rate was 65%(19/29), fair 24%(7/29), and poor 11%(3/29). The average forward elevation was 142.5?(60? to 180?). The average pain VAH score was 12(9 to 15). The humeral head avascular necrosis, detected by the follow-up X-ray film, was diagnosed if the humeral head was completely or partially absorbed or reduced. In three-part fractures, 71% cases were excellent or good results, no poor result, and 17% had humeral head necrosis; in four-part fractures, 58% cases were excellent or good results, 25% poor, and 67% were found with humeral head necrosis. The extent of the humeral head necrosis was one of main causes to the poor function for complex proximal humeral fractures. All of the fractures healed at 6 to 8 weeks postoperatively without delayed union and nonunion. Conclusion For complex proximal humeral fractures, a good clinical result can be obtained on condition of the anatomical reduction of the tubercle fragments, as well as the stable fixation of the surgical neck fracture with appropriate suture materials and proper post-operative rehabilitation. Satisfactory result is possible even while the humeral head avascular necrosis happened.

OBJECTIVE: To explore the olfactory abilities in patients with allergic rhinitis (AR), analyze the correlation between olfactory bulb (OB) volume with depth of olfactory sulcus (OS) and olfactory function in patients with AR. METHOD: One hundred patients with AR were compared with one hundred controls in terms of olfactory function T&T testing, OB volume and depth of OS assessed with magnetic resonance imaging (MRI). T&T testing and MRI were done after a year in 100 AR patients,the results were compared with the initial results. RESULT: The OB volume in AR patients was (29.53±3.95) mm3 on the left, (29.67±14.21)mm3 on the right, (29.61±4.05) mm3 on average; The OB volume in controls was (48.93±6.73)mm3 on the left side, (48.81±7.43)mm3 on the right side, (48.85±7.11)mm3 on average; The OB volume in AR patients was less then the control group(t= 6.321, 6.141, 6.221, P<0.01). The OS depth had no statistical difference between AR patients and controls (t=1.032, 0.972, 0.991, P>0.05). Olfactory discriminate threshold was negatively correlated with OB volume in AR patients (r=-0.46, P<0.05); and it was no correlated with depth of OS (r=-0.012,P>0.05). Among 100 followed-up AR patients, 43 showed increased in OB volume and olfactory function after a year, but there was no statistical difference (t= 0. 811,0. 843, 0.826, P>0.05; Z=1.911, P>0.05) ,and the other 57 showed no significant changes of OB volume and olfactory function. CONCLUSION In AR patients, the OB volume and olfactory function decreased, but the depth of OS had no significant changes. The OB volume is correlated with olfactory function, while the depth of OS is no correlated with olfactory function. Conservative treatment had some clinical significance on the recovery of olfactory function in patients with AR.
Humans ; Magnetic Resonance Imaging ; Olfaction Disorders ; etiology ; Olfactory Bulb ; pathology ; physiopathology ; Prefrontal Cortex ; Rhinitis, Allergic ; complications ; Smell

Objective To investigate the clinical value of the precision liver surgery in the liver graft procurement for pediatric living donor liver transplantation.Methods The clinical data of 58 living donors of left hepatic lobe graft who were admitted to the Renji Hospital of Shanghai Jiaotong University from December 2012 to January 2014 were retrospectively analyzed retrospectively from December 2012 to January 2014.All the donors donated voluntarily and gratuitously and were approved by the ethics committee of the hospital.All the donors received computed tomography (CT),and the two dimensional data were converted to three dimensional images for evaluating the intrahepatic bile ducts and blood vessles,and the typs of the left hepatic arteries and veins were determined.The donor's liver graft volume was assessed by CT before operation.The standard liver volume of the donors and the recipients,and the volume of liver to be reseeted and the total liver volume were measured.A virtual surgery was conducted for designing the actual surgery.The liver graft was resected with the precision liver surgery technique.Patients were followed up by the out-patient examination and phone call till April 2014.Results The results of CT angiography confirmed that 28 donors were with type Ⅰ left hepatic artery,10 with type Ⅱ left hepatic artery and 20 with type Ⅲ left hepatic artery; 35 patients were with type Ⅰ left hepatic vein and 23 with type Ⅱ left hepatic vein.The left-lobe volume estimated by CT was (243 ± 65) mL.Liver graft procurement was successfully carried out on the 58 donors,including 7 left hemihepatectomy and 51 left lateral lobectomy.Two donors received cholecystectomy concomitantly.The actual volume of liver resected was (255 ±59) mL,and the error rate of the liver volume to be resected was 4.94％.The weight of the liver graft to the body weight of the recipient was 3.3％ ± 1.0％.The operation time and the volume of blood loss were (260 ± 89) minutes and (181 ± 35)mL,respectively.One donor received red blood cell infusion of 2 U.The time for gastrointestinal function recovery was (2.0 ± 1.1) days,and the time of drainage tube pull-off was (3.0 ± 1.2) days.The duration of postoperative stay was (7 ± 3) days.The white blood cells,hemoglobin,alanine transaminase,aspartate transaminase,total bilirubin,direct bilirubin and albumin were at the normal levels at the discharge.Two donors were complicated by incisional bleeding and fat liquefaction,and they were cured by symptomatic treatment.All the donors were followed up for a median time of 8.7 months.The donors were recovered well without complications during the follow-up.Conclusions Liver graft procurement guided by precision liver surgery has the advantages of high accurate rate,little injury to the liver of the donors,few postoperative complications and quick recovery of the donors.

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Stem cells refer to undifferentiated or inad equately differentiated cells that have the ability to become a variety of tissues,regenerate organs,and self expand.There is strong evidence that stem cells have abilities of self renewal differentiation,immune regulation,and a potential for targeted therapy,which all together support development of stem cell transplantation.Stem cell transplantation thera py has become a hot topic in recent years,and the basic theory and clinical application have made great progress.The a bilities of stem cells make their transplantation ideal to pro mote liver regeneration,inhibit liver fibrosis,and provide treatment for many diseases.This article will review the cur rent status and outlook of stem cell transplantation.

OBJECTIVETo discuss the operative techniques of endoscopic endonasal transsphenoidal surgery and perioperative management for treatment of acute pituitar y apoplexy (PA).METHODS A retrospective analysis was conducted on the clinical data of 51 pathologically diagnosed acute PA after transsphenoidal endoscopic endonasal resection at the TianJin HuanHu hospital between January 2000 and December 2013. There were 28 males and 23 females,with median age of 47 and disease course of 4h-7d.The typical clinical manifestations included headache, visual interference and pituitary dysfunction. CT scan, MRI scan and endocrinological examinations were performed in all cases before operation. Glucocorticoids were used during perioperatve period, The postoperation symptoms and the results follow-up visit after operation were recorded. RESULTS The tumors were totally removed in 42 cases and sub-totally removed in 9 cases without operative death and serious complications. The follow-up period was 1 year to 14 years. Of 47 patients with headaches before the operation, all patients were resolved after the operation; In 38 patients with sight disturbance before the operation,the sight was recovered very well in 34 patients after the operation. The visual field was recovered very well in all patients. Of 28 patients with endocrine disturbance before the operation, 22 were improved in endocrine symptom after the operation. No patient recurred.CONCLUSION The endoscopic endonasal transsphenoidal operation is safe and effective for treatment of acute PA.Appropriate perioperative management is important for the success of operation.

OBJECTIVE To explore the curative effect of Eucalyptol on the treatment of chronic rhinosinusitis (CRS). METHODS CRS patients were randomly divided into treatment group (conventional medications plus Eeucalyptol) and control group (conventional medications). The therapeutic effect of Eucalyptol were objectively and subjectively evaluated after treatment. RESULTS Evaluation at 3, 6 and 12 month after treatment, we found that the curative effect of the treatment group was better than that of the control group. There was a significant difference. CONCLUSION Eucalyptol as a kind of mucus dissolving medication, it has good treatment effect for CRS and is worth popularizing.

Objective T o establish a gas chrom atography-m ass spectrom etry (G C-M S ) m ethod for the determ ination of sulfide ion in blood and apply it to the practical cases. Methods T he 1, 3, 5-tribro-m obenzene w as selected as an internal standard, and 0.2 m L blood sam ple w as collected and analyzed using G C-M S after α-B rom o-2, 3, 4, 5, 6-pentafluorobenzyl brom ide derivatization. Results T he m ass concentration of sulfide ion in blood had good linearity in the range of 0.2-40μg/m L w ith a lim it of detection (L O D ) of 0.05μg/m L . T he m ass concentration of sulfide ion w as less than 0.05μg/m L in blank blood from different sources such as healthy subjects and dead cases. In 3 sulfide poisoning cases, sul-fide ion w as detected in the blood sam ples of 6 victim s, and the m ass concentration range w as 1.02-3.13μg/m L . Conclusion T his study establishes a m ethod for investigation of sulfide ion in blood w hich has been applied successfully to the cases of fatal sulfide poisonings.

OBJECTIVETo compare the clinical effect and complications of subfascial breast augmentation and submammary breast augmentation.

METHODFrom Sept. 2009 to May 2012 , 25 patients with subfascial breast augmentation and 31 patients with submammary breast augmentation were observed. The postoperative results including visible implant edge or ripple, upper pole of the implant and long-term implant ptosis were compared respectively. The complications including hematoma, infection and capsular contraction were also recorded.

RESULTS56 cases were followed up for 2 months to 26 months. The incidence rate of visible implant edge or ripple was 4.0% (1/25 ) in the subfascial group and 29.0% (9/31) in the submammary group, showing a significant difference between them ( PC 0.05). The incidence rate of convex upper pole of the implant was 8.0% (2/25) in the subfascial group and 35.5% (11/31) in the submammary group, showing a significant difference between them ( P < 0.05). Long-term implant ptosis was not found in the two groups. The incidence rate of hematoma was 4.0% (1/25) in the subfascial group and 6.5% (2/31) in the submammary group, infection was not found. The incidence rate of capsular contraction was 8.0% (2/25) in the subfascial group and 12.9% (4/31) in the submammary group, showing no statistical difference between them ( P > 0.05 ).

CONCLUSIONSSubfascial breast augmentation has more clinical advantages compared with submammary breast augmentation, but no evident difference was found in the common complication rate, such as capsular contraction.

Adult ; Female ; Humans ; Mammaplasty ; adverse effects ; methods ; Middle Aged ; Postoperative Complications ; Treatment Outcome ; Young Adult