Objective To investigate the treatment function and dominance of Ommaya reservoir,which was used to treat postoperative intracranial infection combined with hydrocephalus in patients with severe traumatic brain injury. Methods Thirty-four patients suffered intracranial infection combined with hydrocephalus after operations. They were randondy divided into 2 groups.Thirleen patients were treated with Ommaya reservoir, the others were treated with external ventricular drainage. The 24-hour mean drain quantum, the mean days from implantation pumps or htbes to ventriculo-peritoneal (V-P) shunt operation,the rate of secondary operation and the rate of getting V-P shunt operation were analyzed, then the Glasgow outcome scale ( GOS ) of patients were observed at 3 months. Results Compared with patients treated with external ventriular drainage, patients with Ommaya reservoir had the less24-hour mean drain quantum and shorten time to get the V-P shunt operation,the mean days from implantation pumps to get V-P shunl was(57.00 ± 8.06) days. In 13 patients with Ommaya reservoir, 10 patients finished V-P shunt operation finally,3 patients gave up the shunt operation, shunt rate was 76.9%.In the treatment period , 4 patients had to change the Ommaya reservoir, secondary operation rate was 30.8%. Thirteen patients had the chance to get V-P shunt operation among 21 patients which got external ventricular drainage, 3 patients gave up the shunt operation, 5 patients died, shunt rate was 61.9%, 16 patients changed the ventricular drainage tube, sec-ondary operation rate was 76.2%. There was no significant difference in 3-month GOS between them (P ＞0.05 ). Conclusions Compared with external ventricular drainage, Ommaya reservoir has similar shunt rate.Ommaya reservoir has the less secondary operation rale, shorten the treatment days postoperative intracranial infection combined with hydrocephalus in patients with severe traumatic brain injury, so it should be popularized in clinic.

At the present,systemic lupus erythematosus is a heterogeneous disease in which diagnosis,especially early diagnosis,is always rather difficult.Because of this,the systems of classification criteria for clinical diagnosis,which include recommendations of the American college of rheumatology and the systemic lupus international collaborating clinics,have been utilized since 1971.However,there is still no single biomarker that is pathognomonic for the disease.Currently,the diagnosis still requiresold-fashioned clinical acumen with the assistance of standardized clinical and laboratory criteria.In the light of the commentary,future research may lead us to define subtypes of lupus from a genomic and proteomic standpoint.

The success of total hip replacement relies on detailed preoperative pla nning and reliable localization during operation.Currently,great advances have been made in the research and application of localization s ystem.The traditional preoperative planning is based on plain radiographs of the p elvis and femur as well as the profile outline of each prosthetic component.Now image-gu ided system(IGS)is used to perform virtual implantation.Surgeons used to localize during total hip replacement only wi th eyes or unreliable localization d evices,but now they begin to use imag e-guided system for surgical navigation during operation.[

Objective: To explore the anatomy of tibiofibular syndesmosis for the clinic treatment of tib-iofibular syndesmosis injury. Methods: Twelve embalmed adult lower legs were selected. The configurations , structures and plane which ligaments attached to were observed. Results:Tibiofibular syndesmosis consists of ligaments, plica and synostosis. It's tower-shaped. The plane which ligaments attached to has a shape of swallow's tail. Conclusion:Tibiofibular syndesmosis is strong and elastic. The fixation of injuried tibiofibular syndesmosis should be elastic.

Objective To study the mechanism of acute lung injury secondary to isolated severe head injury.Methods Twenty-two male SD rats were randomly divided into normal group(NG,n=4),and trauma group(TG,n=18)which were sacrificed respectively on day 1,3,7.The pathomorphological changes were observed by light and electron microscope.The levels of tumor necrosis factor-alpha(TNF-?)and interleukin-8(IL-8)in bronchoalveolar lavage fluid(BALF)were investigated by radioassay(RIA).The level of soluble intercellular adhesion molecule-1(sICAM-1)in BALF was measured by enzyme linked immunosorbent assay(ELISA).Results Capillary congestion,inflammatory cell infiltration and thickening of alveolar septum were detected in TG from day 1 to 7 by light microscope.The histological score of lung on day 3 in TG was significantly higher than that on day 1 and 7.The ultramicroscopic structure of lung showed swelling of vascular endothelial cells,infiltration of polymorphonuclear neutrophil and monocyte,injury of pulmonary epithelial cells in TG from day 1 to 7.The levels of TNF-?,IL-8 and sICAM-1 in BALF in TG were significantly higher than that in NG and the peak values were on day 3.The histologic score in TG was positively correlated with the levels of TNF-?,IL-8 and sICAM-1 in BALF.Conclusion Isolated severe head injury could induce acute lung injury that reached the most severe degree on day 3.The elevation of such proinflammatory cytokines as TNF-?,IL-8 and sICAM-1 in BALF plays an important role in the development of excessive inflammatory response of lung injury secondary to isolated severe head injury.

Objective: To observe the therapeutic effect of vertigo treated by pinching the spine. Methods: In the treatment group, 80 cases of vertigo were treated by pinching the spine and An-pressing and Rou-stationary circular pressing. In the control group, 66 cases were treated by An-pressing and Rou-stationary circular pressing. Results: The total effective rate was 95.0% in the treatment group, and 66.7% in control group. The therapeutic effect in treatment group was better than that in control group (P＜0.01). Conclusions: Pinching the spine to treat the vertigo could get rapid and good therapeutic effect, and may avoid the toxic and side effect of drug treatment.

Hepatocellular carcinoma (HCC)is a common malignant tumor in the world,and surgical resection and liver transplantation are two radical treatment modalities,but only 10%-20%of all patients can receive such treatments.In recent years,local therapies including radiofrequency ablation,microwave ablation,cryoablation,and the irreversible electroporation ablation which appeared recently have gradu-ally become the alternative therapies for the patients who are unable to undergo surgery.In addition to local tumor growth control and im-provement in survival outcomes,the ablation technology also helps to downgrade tumor for secondary resection.This article focuses on the re-search progress in radiofrequency ablation alone and in combination with other therapies in the treatment of HCC,compares radiofrequency ablation with other local ablative therapies,and briefly introduces the application of intelligent navigation technology in adjuvant ablation. With the development of medical imaging and progress in related fields,the ablation technology will be widely applied in clinical practice in the future.

Much progress has been made in the diagnosis and treatment of Hodgkin's lymphoma, which has become a highly curable malignancy.However, prolonged survival makes clinicians pay more attention to long-term toxicities of treatment.Consequently, individualized treatment based on disease stage and risk factors is a research hotspot at present.This article reviews recent advances in the individualized treatment of early-stage classical Hodgkin's lymphoma.

BACKGROUND:Studies have shown that neural stem cells isolated from embryonic rat cerebral cortex can proliferate and differentiate into neurons, astrocytes and oligodendrocytes in col agen gels.
OBJECTIVE:To investigate the effect of neural stem cells combined with col agen gel on the apoptosis of nerve cells in the brain of rats after spinal cord injury.
METHODS:Forty-five spinal cord injury rat models were made through spinal cord hemisection and randomly divided into three groups. At 1 week after modeling, rats in the celltransplantation group were injected al ogeneic neural stem cellsuspension into the injured site, rats in the combination group were administered with al ogeneic neural stem cells/col agen gel suspension into the injured site, and rats in the model group received no treatment. RESULTS AND CONCLUSION:From 1 to 8 weeks after injury, the Basso, Beattie and Bresnahan (BBB) locomotion scores in the combination group were significantly higher than those in the other two groups (P<0.05). Hematoxylin-eosin staining showed that at 1 week after transplantation, there were a few necrotic cells and Bcl-2 positive cells, but a large amount of Bax positive cells in the three groups. Then, the number of Bax-and Bcl-2-positive cells was reduced gradual yin the three groups. At 8 weeks after transplantation, the number of Bax-positive cells was significantly higher in the model group than the other two group (P<0.05), but the number of Bcl-2-positive cells were dramatical y lower (P<0.05). Meanwhile, there were no necrotic cells in the three groups. These findings indicate that neural stem celltransplantation combined with col agen gel scaffold can arrest apoptosis of nerve cells in the brain of rats after spinal cord injury, and promote functional recovery after spinal cord injury.

Objective To discuss the application effect of joint remifentanil propofol anesthesia on upper gastrointestinal peristalsis in the painless gastroscopy.Methods 130 patients who taken painless gastroscopy were choosed,and using the random number table method,they were divided into the observation group and control group. Propofol anesthesia was used in the control group,joint remifentanil anesthesia was used in the observation group,and the anesthetic effect were recorded.Results In the observation group group,the excellent rate of anesthesia was 93.85%,the control group was 80.00%,there was statistically significant difference between the two groups (χ2 =5.481,P <0.05).The propofol dosage in the observation group was (1.73 ±0.24)mg/kg,patients awake time was (5.91 ±1.03)min,and departure from the hospital time was (14.58 ±2.79)min,while in the control group,the propofol dosage was (3.06 ±0.57)mg/kg,patients awake time was (9.44 ±1.87)min,and departure from the hospi-tal time was (22.05 ±4.86)min,there were statistically significant difference between the two groups (t =17.337, 13.330,10.747,all P <0.05).24 cases of observation group of patients with mild 36 cases,moderate,severe in 5 cases;23 cases of control group in patients with mild and moderate 27 cases,15 cases were severe,there was statistically significant difference between the two groups (χ2 =5.376,P <0.05).Conclusion Joint remifentanil propofol used in painless gastroscopy of anesthesia is better than only propofol anesthesia,and with little impact on patients with upper gastrointestinal system,it can reduce the dosage of propofol,shorten the patient awake time and time of departure from the hospital,so it is worth popularization and application in clinic.