The changes of immunoreactive TRH (TRH-ir) in cerebrospinal fluid (CSF) and plasma before and after acute traumatic head injury were determined with radioimmunoassay (RIA) on a feline model of acute experimental head trauma. The results showed that the concentrations of TRH-ir in experimental animals pre- and 2, 4, and 6h post-injury were 119.48?51.77, 460.71 ?178.72, 377.27? 139.33, and 280.17?110.46pmol/L in CSF, and 122.58?28.87,1158.89?163.18, 909.69?160.55, and 545.38?132.80pmol/L in plasma, respectively, while those in control animals measured at the corresponding time were 112.22?53.42, 105.36?49.64, 100.63?52.89, and 104.52?52.42pmol/L in CSF, and 113.57 ?25.79, 107.32?26.60, 119.84?31.53, and 117.21?28.95pmol/L in plasma, respectively. The contents of TRH-ir in CSF and plasma in the experimental group after traumatic head injury were significantly higher than those, in the control group (P

ObjectiveTo identify the relevant factors of expansion of contusive cerebral hemorrhage following unilateral decompressive craniectomy in patients with severe craniocerebral injury and discuss their relation with prognosis.MethodsA total of 161 consecutive patients with craniocerebral injury undergoing unilateral decompressive craniectomy were prospectively studied.Their initial cranial CT data (data after injury,data before operation,and data after first operation) were recorded.Mortality or Glasgow Outcome Scale (GOS) at 6 months after injury was used as the criteria for evaluation of prognosis.ResultsThe volume of increased contusive cerebral hemorrhage among the patients after craniectomy was (18.66 ± 22.69) ml.The Rotterdam score of their initial cranial CT after injury was significantly associated with the occurrence or not of expanded contusive cerebral hemorrhage following decompressive craniectomy and the expanded hematoma volume.The expanded volume of contusive cerebral hemorrhage ( ＞ 20 ml) after craniectomy showed significant relevance to mortality and poor prognosis six months later.The magnitude of external cerebral herniation ( ECH ) on the initial post-operative CT was associated with the prognosis. ConclusionsThe severity of patients with craniocerebral injury manifested by the initial cranial CT may predict the risk of expansion of contusive cerebral hemorrhage following decompressive craniectomy.The expansion volume of contusive cerebral hemorrhage and ECH are correlated with mortality and poor prognosis.

The fetal spleen cells were transplanted following the injection of S180 carcinosarcoma into the muscle,abdominal cavity,peripheral veins and portal vein in mice.The size inhibitory rate of the transplanted tumor and natural killer activity were evaluated 30 and 60 days after the injection.It was found that the growth of transplanted tumor was dramatically inhibited and natural killer activity was increased 30 days after the transplantation.But 60 days after the transplantation only portal venous transplanted tumor showed a satisfactory function of inhibiting tumor growth and natural killer activity maintained at a high level.These results indicated that portal vein was the best approach for the spleen cell transplantation

To improve the AIDS's knowledge level and intervention ability of peer lecturers in college, from the accumulation idea and activity type of experience value on Moso Teach, the author carried out systematic resource construction around the course design principles and objectives, at the same time one quantitative scoring system including learning degree and sharing degree was constructed. Through voluntary enrollment and selection among the students, the first group of peer lecturer training on AIDS prevention were set up, and 28 students were collected to experience the "mixed" application of the course. After the evaluation, it was found that there were positive functions in promoting the ability of AIDS prevention in the peer lecturer training course based on experience value of Moso Teach as the driving force and quantification. According to the problems exposed in the construction, the author put forward improvement strategies from the aspects of scoring system, off-line activities and resource optimization.

BACKGROUND:Studies suggested that blood loss was great during total knee arthroplasty, even blood transfusion was needed. Application of the tourniquet wil destroy the coagulation system, and is not conducive to hemostasis after replacement. Recently, tranexamic acid has been extensively used to reduce blood loss during total knee arthroplasty, because of low price, simple administration pathway, and effective effects on hemostasis. OBJECTIVE:To summarize the application and safety of tranexamic acid in total knee arthroplasty. METHODS:The first author retrieved PubMed and Chinese Journal Ful Text Database for articles from inception to October 2015. The key words were tranexamic acid, total knee arthroplasty, hemorrhage. More than 200 articles were retrieved, and finaly 50 articles met the inclusion criteria. RESULTS AND CONCLUSION:Tranexamic acid is a fibrinolytic inhibitor, can reversibly block the binding of plasminogen to fibrin, effectively inhibit fibrinolysis, and reduce hemorrhage after total knee arthroplasty. Nevertheless, there were significant differences in the use, dose and effect of tranexamic acid on hemostasis among different studies. Tranexamic acid was an effective drug for hemostasis during total knee arthroplasty. During total knee arthroplasty, tranexamic acid had been used to reduce dominant blood loss and hidden blood loss after arthroplasty, and could not increase the risk for venous thrombosis of lower limb. Currently, the timing of use, dosage, route of administration, and possible complications of tranexamic acid remain controversial.

Objective To identify the factors enhancing the contusive brain hemorrhage following unilateral decompression craniectomy in patients with severe traumatic brain injury (TBI),and to explore the relationship between the initial Rotterdam CT score and clinical outcomes.Methods A prospective study of 291 consecutive patients with TBI admitted from Jan 2008 through Dec 2012 was carried out.Patients treated with unilateral decompression craniectomy were enrolled for study.Patients without preoperative or postoperative cranial CT imaging were excluded.Of them,235 patients were followed up.Gender,age,the causes of injury,preoperative general condition including Glasgow Coma Scale (GCS) score,pupillary response,laboratory data and the initial CT scans before operation,contusion hematoma size in CT scans following operation and Glasgow Outcome Scale (GOS) score were recorded.With t test,x2 test and nonparametric rank sum test,differences in the above listed variables were compared between patients with enlarged hematoma size group and those without change in hematoma size.A Classification And Regression Tree (CART) was used to predict the size of hematoma.Correlation analysis was used to find the relationship between the Rotterdam CT scores and GOS scores.Results The differences in age (t =2.034,P =0.043),first Rotterdam CT score (Z =4.838,P ＜ 0.01),GCS score (Z =4.440,P ＜ 0.01),pupillary response (Z =3.235,P =0.001),the length of time elapsed between the trauma occurred and the decompressive craniectomy (Z =3.874,P ＜ 0.01),glucose level (Z =3.880,P ＜ 0.01) and cerebrum hernia magnitude (Z =2.529,P =0.012) were significant between the patients with hematoma expanded (n =120) and those without change in hematoma size (n =115).The results of the CART indicated that Rotterdam score got from the initial head CT,glucose level and the length of time elapsed between trauma occurred and decompressive craniectomy were strong predictors of the risk for expanded hemorrhagic contusions following decompressive craniectomy.Both age and size of the removed bone-flap also could predict the risk of postoperative expansion of hemorrhagic contusions.The overall predictive accuracy of the CART model was 83.3％.Correlation analysis results indicated that Rotterdam CT score was negatively correlated with GOS (r =-0.333,P ＜ 0.01).Conclusions Initial Rotterdam CT scores,glucose level and the length of time between trauma and decompressive craniectomy may predict the risk of contusions expansion following decompressive craniectomy.Rotterdam CT score was negatively correlated with GOS.

Objective:To observe expression and diversity of glycogen synthase (GSK)-3 and ribosome S6 protein kinase (P70S6K) in skeletal muscle of insulin resistance (IR) rat induced by high fat food and to approach the effect and significance of GSK-3 and P70S6K in IR occurrence.Methods:Forty Wistar rats aged four-week were randomly divided into normal control, high-glucose, high-fat and high-fat high-glucose groups. 8 weeks after feeding, insulin sensitivity of the rats was evaluated by hyperinsulinism euglycaemic clamps technique (ring clamp experiment), GSK-3 and P70S6K in rat skeletal muscle were measured by Western blot and epididymis fat pad weight, blood glucose, insulin, triglyceride (TG), cholesterin (TC), free fatty acids (FFAs) and hsCRP levels were also determined.Results:IR was induced, body weight (P

0.05). The 1,3 and 5-year regional control and survival rates in both groups were concordant, demonstrating that the prognosis of these two groups was similar. The 5-year survival rate in pre-operative radiotherapy group was 37%. The results of retrospective analysis by Log-rank and Cox proportional regression methods demonstrated that whether the tumor resected or not were the major factors affecting pre-operative radiotherapy effect.

Objective To investigate the safety and efficacy of placement of self expandable metallic stent within right atrium and inferior vena cava (ICV) in patients with malignant ICV obstruction involving right atrium. Methods There were 5 male patients with advanced hepatocellular carcinoma, aged from 42 to 65 years (mean 56 3 years). The malignancies invaded right atrium and ICV simultaneously, and caused obstruction of ICV. These patients presented symptoms and signs of obstruction of ICV such as hepatomegaly, ascites, edema of lower extremities. “Z” type stainless steel stents (7 5～10.0 cm in length and 2 5 cm in diameter) were selected for these patients. Part (1.0～3.0 cm in length ) of stent was placed in right atrium and the rest was in ICV. Results All of stents were placed successfully and obstructed ICV reopened. The symptoms of obstruction of ICV relieved or disappeared. There were no recurrence of symptoms of obstruction of ICV and any cardiac complication related to placement of stents in follow up period (67～188 days). Conclusion Placement of self expandable metallic stent within right atrium and ICV in treatment of patients with malignant ICV obstruction involving right atrium is one of the safe and effective methods.

Objective To explore the surgical treatment for acute ulceration of gastric carcinoma.Methods The clinical data of 68 patients with ulceration of gastric carcinoma were analyzed retrospectively.All the cases,60 male patients and 8 females with average age of 58 years,were admitted from Jan.1990 to Jan.2007,and divided into three groups randomly,i.e.repair gastrectomy group(control,n=27),partial gastrectomy group(n=21) and radical cure group(n=20).Of the 68 patients,30 cases were diagnosed as ulceration of gastric carcinoma before surgical operation,25 cases were diagnosed as suspected ulceration of gastric carcinoma and 13 cases were misdiagnosed as gastric ulcer.All the cases were undergone operation.The ulcerations located at the superior part(6 cases),middle part(12 cases) or inferior part(50 cases) of stomach.38 cases were on Borrmann Ⅱ,and the other 30 cases were on Borrmann Ⅲ.The postoperative survival time of the patients in partial and radical gastrectomy groups was compared with that of the patients in repair group.Results Twenty-seven patients underwent repair of ulceration;21 patients received partial gastrectomy and 20 received radical gastrectomy(R2 distal subtotal gastrectomy 8 cases,R3 distal subtotal gastrectomy 12 cases).Postoperative complication occurred in 7.4% of the total cases and the mortality was 5.9%.One-,3-and 5-year survival rates were 3.7%,0 and 0 in repair gastrectomy group;52.4%,23.8% and 0 in partial gastrectomy group;and 75.0%,55.0% and 10% in radical cure group.Their Survival time were 5.93?4.95 months in repair gastrectomy groups,28.33?16.44 months in partial gastrectomy groups and 35.25?20.36 months in radical cure groups,respectively(P