Objective To investigate anticoagulation and security of heparin and low molecular weight heparin applied to the carotid artery after CASA, to provide a reference for clinical anticoagulation. Methods From January 2010 to December 2013,120 cases of implementation of CASA surgical patients with carotid artery were selected,according to anticoagulation method they were divided into control group and observation group, control group had 54 patients, the implementation was continuous intravenous infusion of heparin for 3 days; observation group had 66 patients with sub-cutaneous low molecular weight heparin anticoagulation, one injection for 12 h, lasted for three days, before surgery,24 h,72 h after surgery,anti-Xa activity were detected in patients,activated partial thromboplastin time(APTT),pro-thrombin time (PT), complications were compared between the two groups. Results Anti-Xa activity of observation group and control group after 24 h were (1.204±0.413) IU/mL, (1.428±0.512) IU/mL, the difference was statistically significant(t=3.189,P=0.037), anti-Xa activity levels after 72 h of observation group and control group were (1.314±0.533)IU/mL,(1.684±0.687) IU/mL, the difference was statistically significant (t=4.218, P=0.030); in observation group,before surgery,24 h, 72 h after surgery APTT were(27.93±3.86)s,(37.97±5.14)s,(37.73±4.28)s, differences were statistically significant before and after surgery (t=6.453, P=0.009; t=6.449,P=0.010); in the control group,be-fore surgery,24 h,72 h after surgery APTT were(27.64±3.24)s,(38.34±4.55)s,(38.21±4.41)s,differences were statisti-cally significant before and after surgery(t=6.534,P=0.007;t=6.530,P=0.007);preoperative and 24 h,72 h postoper-ative at the same period for observation group and control group there were no significant difference(t=0.927,P=0.197;t=1.023, P=0.143; t=0.993, P=0.176); in observation group before surgery,24 h,72 h after surgery for PT compared with the control group the difference was not statistically significant (P>0.05); in observation group complication rate was 9.09%(6/66)and the control group was 7.41%(4/54)the difference was no statistically significant(χ2=1.034,P=0.114).Conclusion Low molecular weight heparin and unfractionated heparin used in carotid surgery CASA have similar anti-coagulant effect,low molecular weight heparin is slightly lower in anti-Xa activity,but it's easy to monitor and control to ensure the safety of the treatment.

Objective:To obtain the parameters associated with hematoma morpholoy by finite element analysis(FEA) and investigated their performance on predicting and diagnosis hematoma expansion(HE) in patients with spontaneous intracrebral hemorrhage(SICH).Methods:Patients with SICH who met research criteria were retrospective enrolled between June 2015 and December 2017. Clinical parameters on admission were collected, Perform 2 independent methodology on same patient to analysis the hematoma shape base on computed tomography(CT): Clinical routine method that performed by clinical investigator to identified margin irregularity of hematoma by CT ,and calculated the volume of hematoma by simplify Tada formula(ABC/2);The FEA method performed by FEA investigator and gain the hematoma 3 dimensional morphology and variables, include Volume, Surface area, and The quantity of triangles per square milimet surface(TQOT/mm 2). The HE was defined as volume enlargement of >33% compared with that on addmission. All patients were divided into HE and none HE group ,respectively, ABC/2 and FEA generated thire own HE and none HE group as different volume calcuation. The HE risk factors of ABC/2 and FEA were assessed in univariate and multivariable Logistic regression models. and the risk fators diagnosis value for HE were determined by the receiver operating characteristic(ROC) curves. Results:Total of 127 patients were enrolled, The mean time of symptom onset to hospital admitted was 3.08±1.34 h. There were 34(26.77%) cases HE identifed by ABC/2 and 31(24.41%)by FEA. Althought there are significant different (pearson χ2=53.66, P<0.01) of HE identification between ABC/2 and FEA, the 2 methods has moderate consistency (Kappa=0.65). All patients’ hematoma 3D reconstruction were performed by FEA and general observation show that TQOT/mm 2 most likely correlate to irregularity of hematoma 3D shape. Multivariable Logistic regression models indicated that ICH score( OR=1.79, 95% CI:1.19~2.68)was independent HE risk factor for ABC/2, respectively, TQOT/mm 2≥1.95/mm 2 ( OR=16.99,95% CI:5.98~48.33)and Ultraearly Hematoma Growth,(uHG) ( OR=1.05, 95% CI:1.01~1.09)were independent HE risk factor for FEA. With ROC analysis, both the ICH score of ABC/2 and uHG of FEA have low HE predictive and diagnosis value ,the area under the curve (AUC) were 0.64 and 0.67 respectively. However, TQOT/mm 2 was found to have excellent diagnosis value (AUC:0.9), sensitivity and specificity were 77% and 83% when the cut-off value was 1.95. Panel parameter model (TQOT/mm 2+uHG) was not be found to have a significant higher AUC than single parameter on FEA and the clinical routine parameters panel model (ICH +SB P>180 mmHg on addmission) have a unacceptable AUC(<0.7) as well as single parameters. Conclusions:Hematoma shape could be reconstructed and analysis by FEA and TQOT/mm 2 was likely relevance to hematoma morphology. TQOT/mm 2≥1.95 was indicate to have a better HE predicting and diagnosis value than any other risk factors and clinical parameters panel models in our reaserch.

Objective To investigate the role of three-dimensional (3D) reconstruction based parameters of hematoma cavity and encephalocoele in predicting hematoma expansion and hospitalized poor outcome in patients with primary brainstem hemorrhage (PBH). Methods Thirty-two PBH patients met research criterion were enrolled from intensive care unit (ICU) between June 2015 and December 2017. Baseline clinical characteristics, CT images on admission and within 48 h of admission were collected. The 3D reconstruction of hematoma cavity and encephalocoele based on CT images was performed by Mimics10.0, and quantity of triangles per square milimet surface (TQOT/mm2), and hematoma volume (HV) and encephalocoele volume (EV) were obtained. All patients were divided into hematoma expansion group and non-hematoma expansion group according to whether hematoma expansion appeared (hematoma expanded>33％ within 48 h of admission as compared with that on admission), and hospitalized poor outcome group and hospitalized non-poor outcome group according to whether hospitalized poor outcome appeared (modified Rankin scale scores>4 at discharge or hospitalized deaths), respectively. The risk factors of hematoma expansion were investigated by multivariable Logistic regression analysis. Multivariable Cox hazard regression was used to analyze the risk factors of poor outcome; Kaplain-Meier survival curve analysis and Log-rank test were used to compare the differences in survival curves between independent risk factors screened by Cox regression analysis. Results There were 11 patients (34.4％) with hematoma expansion and 14 (43.8％) with ventriculomegaly in 32 patients; in these 11 patients with hematoma expansion, 8 had ventriculomegaly, and the two had positive correlation (rp=0.423, P=0.016). Fifteen patients (46.9％) had poor outcome, in which 11 (34.4％) died in hospital; 5 had hematoma expansion and 8 had ventriculomegaly. Multivariate Logistic regression analysis showed that baseline lactate >2.0 mmol/L (OR=11.986, 95％CI: 1.084-132.552, P=0.043) and TQOT/mm2>2 (OR=10.223, 95％CI: 1.424-73.396, P=0.021) were independent risk factors of hematoma expansion. Baseline HV (HR=1.102, 95％ CI: 1.020-1.143, P=0.002) and EV (HR=3.485, 95％ CI:1.071-11.463, P=0.040) were risk factors of hospitalized poor outcome identified by multivariable Cox analysis. Kaplan-Meier survival analysis showed that the hospitalization days of hospitalized poor outcome were (74.0±10.6) d and (25.5±7.0) d between patients have hematoma expansion Cut-off value of 7 mL, with significant difference (Log-rank: χ2=11.832, P=0.001), and the hospitalization days of hospitalized poor outcome in patients with and without ventriculomegaly were (68.1±9.0) d and (29.9± 8.8) d, respectively, with significant difference (Log-rank: χ2=7.483, P=0.006). Conclusions There is correlation between hematoma expansion and ventriculomegaly; patients with TQOT/mm2>2 might have high risk of hematoma expansion; patients with baseline HV>7 mL and ventriculomegaly would sooner have hospitalized poor outcome.

Objective:To investigate the safety and efficacy of robot-guided ventricular partition puncture drainage in severe intraventricular hemorrhage.Methods:A total of 23 patients with severe intraventricular hemorrhage who underwent robot-guided ventricular partition puncture drainage (experimental group) and 19 patients who underwent robot-guided bilateral ventricular puncture drainage (control group) at Department of Neurosurgery, People's Hospital of Baise from January 2021 to December 2021 were included. The differences in residual hematoma volume within 24 h of surgery, drainage tube retention time, mortality rate within 30 d of surgery, incidence of complications (re-bleeding, intracranial infection, pulmonary infection, hydrocephalus) within 6 months of surgery, and scores of Glasgow coma scale (GCS), activity of daily living (ADL), and National Institutes of Health stroke scale (NIHSS) at 6 months after surgery were compared between the 2 groups.Results:Compared with the control group, the experimental group had significantly lower residual hematoma volume within 24 h of surgery ([8.854±3.519] mL vs. [5.668±2.873] mL), shorter drainage tube retention time ([6.580±1.981] d vs. [4.910±2.763] d), lower incidence of hydrocephalus within 6 months of surgery (42.105% vs. 8.696%), and significantly higher GCS and ADL scores and lower NIHSS scores at 6 months after surgery (8.790±2.898 vs. 11.610±2.948; 69.470±12.899 vs. 78.480±12.861; 13.950±5.265 vs. 9.870±4.124, P<0.05). Conclusion:Robot-guided ventricular partition puncture drainage is a safe and effective surgical method for severe intraventricular hemorrhage.

Objective To investigate the causes of infertility and its pathological mechanism in female SD rats with spontaneous dwarfism(short stature rat,SSR).Methods Adult wildtype and SSR female SD rats were used in this study.A vaginal smear was used to observe changes in the motile cycle.Ovulation promotion was compared using the simultaneous estrus supernumerary ovulation method.Ovarian and uterine weight and body weight,and ovarian and uterine indices were measured.AMH,E2,FSH,LH,and FSH/LH levels in serum were measured.Transcriptome sequencing of ovarian tissues was performed to analyze gene expression differences.Results No abnormalities were observed in the estrous cycle of SSR female rats.The body weight of SSR female rats was significantly lower than that of wildtype rats,and their ovarian and uterine indices were significantly higher than that of wildtype rats.The mean number of ovulations was significantly higher in wildtype rats than in SSR female infertile rats(P<0.001).Serum AMH(P<0.01)and E2(P<0.05)levels were significantly higher in wildtype rats than in SSR female infertile rats,and serum levels of FSH,LH,and FSH/LH(P<0.05)were significantly lower in SSR infertile females than in SSR infertile rats,while PROG showed no significant difference.Transcriptome sequencing yielded 250 differentially expressed genes,including 190 upregulated and 60 downregulated genes.p53 signaling pathway and cytokine-cytokine receptor interaction.The MCC,MNC,EPC,and degree calculations of the CytoHubba plug-in were used to screen the top 10 significant nodes.The intersection was used to finally obtain nine hub genes,namely Cxcl1,Cxcl2,IL1a,IL1b,Cd80,Mmp13,Mmp8,Fgf3,and Ptgs2.Conclusions Infertility in SSR female rats may be related to a decreased ovarian reserve function and poor ovarian response.Cxcl1,Cxcl2,IL1a,IL1b,Cd80,Mmp13,Mmp8,Fgf3,and Ptgs2 were associated with infertility,laying a theoretical foundation to further explore infertility mechanisms.