Objective:To investigate the effect of fibrinogenase combined with aspirin on blood viscosity and clinical efficacy in patients with acute cerebral infarction.Methods:Senventy patients with mild to moderate acute cerebral infarction from October 2016 to June 2020 were collected from the Third People′s Hospital of Dalian. Patients were divided into control group and treatment group according to the random number table method, with 35 cases in each group. The control group was given oral aspirin plus an intravenous drip of normal saline equal to the treatment group, while the treatment group was given aspirin plus fibrinogenase by intravenous drip. Both groups were given symptomatic treatment such as management of blood glucose, blood pressure, arteriosclerosis plaque stabilization and improvement of circulation for 10 d. Blood viscosity and neurological deficit score were measured before and after treatment.Results:Compared with baseline values, WBV showed a slight decrease in all shear rates in the control group after treatment compared with that before treatment, but the difference was not statistically significant ( P>0.05). In the treatment group, all shear rates decreased compared with that before treatment ( P<0.05), and the effect of WBV was significant compared with that of the control group ( P<0.05). The improvement of neurological function in the treatment group was better than that in the control group. The significant efficiency and the total effective rate in the treatment group were significantly higher than those in the control group: 34.3% (12/35) vs. 25.7% (9/35), 88.6% (31/35) vs.71.4% (25/35). Conclusions:Fibrinogenase combined with aspirin in the treatment of acute cerebral infarction patients can safely and effectively reduce blood viscosity and improve clinical symptoms.

Objective Using serum pharmacology method to assess the optimal dose of Rhodiolasachalinensis extract (RSE)and Codonopsispilosula extract (CPE)combination as well as the effects of the combination on the immune function of mice.Methods Using the 3×3 facterial design,nine medicated serum of CPE and RSE mixture were made to assess the optimum combinational dose of CPE and RSE by detecting the T,B lymphocyte proliferation abilities and NK cell activity in vitro .Using the optimum combinational dose and reducing 2.5,5 and 10 times as high,middle and low doses of RSE+CPE groups,and the T,B lymphocyte proliferation abilities and the activity of NK cells in the mice were detected in vivo .Results The result of serum pharmacology indicates that compared with control group,the proliferation abilities of T,B lymphocytes and the activity of NK cells inducing by ConA and LPS in 200 mg· kg-1 RSE + 790 mg· kg-1 CPE group were increased (P < 0.05).The result of in vivo experiment indicated that compared with cyclophosphamide group,the spleen indexes (SI)in middle and high doses of RSE+CPE groups were significantly increased (P <0.05);compared with low dose of RSE+CPE group,the WBC number in middle dose of RSE + CPEgroup was significantly increased (P < 0.05 ). Compared with cyclophosphamide group,the T and B cell proliferation abilities induced with ConA and LPS and killing activities of NK cells in low,middle and high doses of RSE+CPE groups and positive drug CVT-200 group were significantly increased (P <0.05).Compared with CVT-200 group,low and high doses of RSE+CPE groups,the T and B cell proliferation abilities induced with ConA and LPS and the activity of NK cells in middle dose of RSE+CPE group were significantly increased (P <0.05).Conclusion RSE and CPE mixture can enhance the immune function of mice;RES 200 mg·kg-1 and CPE 790 mg·kg-1 are the optimal doses.

Objective To evaluate the clinical value of double-balloon enteroscopy( DBE)in as-sessing the effect of mucosal healing in patients with moderate small bowel Crohn's disease( CD)treated with low-dose azathioprine. Methods CD patients who were naive to any immunomodulators or biological a-gents with lesions mainly located in ileu were screened by multislice CT enterography and anal-route DBE at baseline. Lesions at 150 cm proximal to ileocecal valve were assessed by DBE with Simple Endoscopic Score for CD( SES-CD)after 12 and 24 months of low-dose azathioprine treatment,respectively. Results A total of 36 patients were enrolled and the average tolerated dose of azathioprine was(61. 8 ± 17. 2)mg/day. The total rates of complete,near-complete,partial and no mucosal healing in 36 patients were 19. 4%(7/36), 5. 6%(2/36),27. 8%(10/36),and 47. 2%(17/36)at month 12 and 30. 6%(11/36),25. 0%(9/36), 33. 3%(12/36),and 11. 1%(4/36)at month 24,respectively. The baseline SES-CD score(OR=2. 71, 95%CI:1. 11-6. 63,P=0. 029)and duration of disease(OR=1. 27,95%CI:1. 10-1. 47,P =0. 001) were two relevant factors associated with mucosal healing of small bowel CD. Conclusion DBE has a signif-icant advantage in assessing post-therapy mucosal healing for patients with small bowel CD. The optimal time point for the first follow-up by DBE is at least 12 months after low-dose azathioprine treatment.

Objective To explore the CT features of infantile hepatic hemangioendothelioma (IHH).Methods CT imaging features of 16 IHH patients confirmed by surgical pathology and clinical diagnosis were retrospectively reviewed.Results Of 16 patients,there were single lesion in 10 cases and multiple lesions in 6 cases.All the lesions were rich in blood supply,and the arterial phase showed obviously rings enhanced.Some linear enhancement towards to the center below the annular enhancement of solitary lesions were found.There were patchy enhancement in annular enhancement center area,and the area of enhancement obvious increasing in venous phase and delayed phase in 4 cases with multiple lesions,enhancement mode was similar to single lesion in 1 case with multiple lesions.The lesions of IHH Ⅱ were small and multiple,and showed intermittent line shaped edge enhancement;some lesions below the linear enhancement showed small nodular enhancement and the area of nodular enhancement enlarged in venous phase,the range of linear enhancement was not obvious.Conclusion CT manifestations of IHH have some characteristics,and the enhancement of CT is more important in the diagnosis of this disease.

BACKGROUND: The characteristics of cervical anatomy and pedicle screw, operational specification, and individual screw implantation are the key factors of a successful implantation treatment.OBJECTIVE: This study was designed to investigate the cervical pedicle screw and host response as well as the recovery of spinal nerve functions during the surgery and follow-up period of cervical spine fracture-dislocation.DESIGN: A case analysis.SETTING: Department of Orthopaedics, General Hospital of Shenyang Military Area Command of Chinese PLA, Shenyang, Lianning Province, China.PARTICIPANTS: A total of 41 patients with cervical spine fracture-dislocation, who have complete follow-up data, were admitted to the Department of Orthopaedics, General Hospital of Shenyang Military Area Command of Chinese PLA between February 2002 and February 2006. Of the included patients, 18 were complicated by spinal cord injury (according to Frankel classification system, 6 were graded as A, 1 as B, 4 as C, and 7 as D.METHODS: Forty-one patients with cervical spine fracture-dislocation were treated by implanting a screw through the cervical pedicle and fixing it. Prior to surgery, all patients were subjected to X-ray, CT and MRI examinations. According to measurements, each cervical pedicle screw was individually implanted. The entire surgery was accomplished by Xiang Liang-bi, chief physician, whose qualification corresponds to the responsibilities.MAIN OUTCOME MEASURES: Material and host response during and after screw implantation as well as in the follow-up period. Recovery of spinal nerve function after screw implantation.RESULTS: All patients were followed up for 6-12 months and all incisions were healed primarily. Material and host response during the process of screw implantation: A total of 218 screws were implanted. After initial implantation, 12 screws were loosened, and such a phenomenon disappeared in 11 screws by adjusting inserting point and inserting direction or/and increasing screw diameter or length. The remaining 1 screw was stabilized by increasing the fixed segments. After drilling, poles of 10 screws bled much and treated by hemostasis. C1-2 venous plexus hemorrhage was caused in 3 patients and stopped by compression, and Apofix internal fixation was used in 1 of 3 patients due to unclear surgical visual field. Material and host response after surgery and during the follow-up: A total of 218 screws were inserted. Of the 218 screws, 196 were in correct position, and 22 were deviated to different degrees. Deviation of 1 screw caused injury to nerve root and that of another screw led to injury to blood vessel. Thirty-eight patients acquired satisfactory reduction and bone union. Three patients presented with symptoms of nerve root irritation due to incomplete reduction in the old fracture-dislocation. Among the 3 patients, 1 was subjected to anterior approach due to screw removed, and neither injury to vertebral artery, spinal cord, and nerve root nor internal fixation destroy was found in any other patients. Recovery of spinal nerve function after implantation: Among the 18 patients complicated with spinal cord injury, 6 patients, who were assessed as grade A spinal cord injury, did not exhibit improvement in spinal cord function, while the remaining 12 presented with 1 or 2 grades of improvement.CONCLUSION: There is a lower probability for biocompatibility reaction, and spinal nerve function recovers better after implantation of cervical pedicle screw. So implantation of a cervical pedicle screw system is an effective and relatively safe method for treatment of cervical spine fracture-dislocation.

ObjectiveTo investigate the risk factors and pathogenic characteristics of catheterrelated infection (CRI) in intensive care unit (ICU),so as to find a better way for its treatment.Methods Retrospective analysis was performed on 247 deep-venous catheter (DVC) from January 2007 to December 2010.ResultsAmong 247 patients,positive results of 41 patients diagnosed CRI,negative results of 206 patients undiagnosed CRI.Compared with undiagnosed CRI patients,found the correlation of the underlying infectious diseases,indwelling time of catheter and puncture sites associated with CRI occurred(P ＜ 0.05 ).CRI major pathogen was gram-positive bacteria (58.5％,24/41 ),in which Staphylococcus epidermis was the major pathogenic bacteria(22.0％,9/41).The drug resistance occurred in most pathogen.Conclusions The occurrence of CRI is related with multiple clinical factors.The gram-positive bacteria is the major pathogen.The etiological monitor should be enforced in patients with DVC.

Aim To investigate the effect of polysac-charide of Cistanche deserticola ( CDPS) on the impro-ving ability of synaptic plasticity in memory acquisition impairment model mice induced by scopolamine. Methods The KM mice were randomly divided into six groups:scopolamine group, control group, CDPS-treated (25, 50, 100 mg·kg-1 ) group and donepezil group. Memory acquisition impairment model in mice was established with i. p. scopolamine (4 mg·kg-1 ) only once, and orally administered CDPS (25, 50, or 100 mg · kg-1 ) daily for 6 weeks before scopolamine injection. Experimental groups were subjected to step-down test and Morris water maze test. Western blot and RT-PCR analysis were used to examine the expression of GAP-43 , SYP and PSD-95 . Transmission electron
microscope was used to observe the change of synaptic number and structures. Results CDPS (25,50,100 mg·kg-1 ) could shorten the incubation period of mice in the water maze test. Control group and CDPS-treated group swam longer in Q3 than scopolamine group. Mo-reover, CDPS (50,100 mg·kg-1 ) could significantly reduce the error times and extend the incubation period in the step-down test. The results of Western blot and RT-PCR showed that CDPS significantly improved the expression of GAP-43 at the dose of 25 ,50 mg · kg-1 and SYP at the dose of 25,50, 100 mg·kg-1 in hip-pocampus of mice. However, the biochemical assays did not reveal a significant difference in the basal hipp-ocampal levels of the PSD-95 . The ultra-thin speci-mens of hippocampus showed that the number of syn-
apse was increased in CDPS-treated group. Conclu-sions Scopolamine can induce the learning and mem-ory deficits in mice to make related protein expression abnormalities in hippocampus mice, thus this causes the change of synaptic plasticity, which leads to a change in the ability of learning and memory. And CDPS can improve the expression of SYP and GAP-43 ,
increase number of synapses, recover synaptic plastici-ty, and improve the ability of learning and memory in mice.

Objective To investigate the MRI features of intracranial solitary fibrous tumors/hemangiopericytomas (SFT/HPC),and to compare these findings with those of intracranial meningiomas.Methods The clinical features and MRI findings in 28 patients of intracranial SFT/HPC (SFT/HPC group)and 68 patients of meningiomas (meningiomas group) confirmed by operation and pathology were retrospectively analyzed.The indicators of two groups were compared.Results Shape of tumor,signal homogeneous,signal voids of vessel in tumor,hypointense signal nodules on T2WI and enhanded,cystic or necrosis in tumor,meningeal tail sign,changes of the nearby bone,sex,Ki-67％ level,blood lose in surgery had significant differences between SFT/HPC group and meningiomas group (all P＜0.05).Conclusion There are some differences between intracranial SFT/HPC and meningiomas.It is helpful in diagnosis and differential diagnosis through the comparative analysis of the imaging signs.

Objective To analyze prevention and management of lymphatic fistula after cervical lymph node dissection in thyroid carcinoma.Methods Clinical data of 9 cases of lymphatic fistula following neck dissection were analyzed retrospectively from Jan.2004 to Apr.2009.Results Of the 9 cases,4 cases had chylous fistula(3 were on the leftside and 1 was on the rightside),1 case had chylotborax,1 case had pleural effusion lymph,and 3 cases showed light yellow lymph.AII patients were cured finally by conservative methods.Conclusions Most lymphatic fistula can be cured by non-surgical treatment.Surgeons need to be familiar with the anatomic structure of neck lymphatic vessels.

Tendon injuries often need surgical treatment, which enables to repair the structure and stability of the tendons to a certain extent, whereas it is difficult to restore to their normal strength. The primary reason is that the natural healing ability of tendons is limited and the functions of the repaired tendons cannot be restored completely. As further researches on tendon healing are conducted, biological technology provides a novel orientation for tendon repair. One of the research hotspots of tendon repair currently is to facilitate tendon healing using biological auxiliaries, including tendon stem /progenitor cells(TSPCs) and growth factors. The authors review the research progress in mechanism of TSPCs and growth factors accelerating tendon healing in order to provide a reference for the biological treatment of tendon injuries.