Objective To explore the expression of c-fos gene at early stage and changes of focal cerebral blood flow (CBF) in brain tissue after intracerebral hemorrhage(ICH) in rats.Methods The rat models with ICH were made by Nath improvement method;fos protein in brain tissue and the expression of c-fos mRNA were measured by immunohistochemistry and RT-PCR method;its focal cerebral blood flow (CBF) was measured by hydrogen clearing method.Results The expression of fos protein was found at 1 h after ICH in the ipsilateral basal ganglia after ICH,it peaked at 3 h;c-fos mRNA peaked at 1 h after ICH,and had still expression of higher level after 3 h;cBF was reduced at 1 h after ICH,and returned to the level of the control group by 3 h and maintained to 24 h after ICH,and then appeared the reduction of CBF during 24 h again.Conclusion The increase and long induction expression of c-fos gene were showed in brain tissue of hematoma periperal zone and contralateral cortex one.Although focal CBF reduced after ICH in rats,it wasn't consistent with the expression of c-fos gene.

Objective To investigate the relationship between levels of serum matrix metalloproteinases(MMPs)and brain edema and neurologic impairment in patients with intracerebral hemorrhage(ICH).Methods The levels of serum MMP-9 and MMP-2 in 31 patients with ICH were tested with ELISA for at 1 d,3 d,7 d and 2 weeks after onset.The volumes of hematoma and its peripheral edema were evaluated by CT,the neurologic impairment was evaluated by NIHSS at 1 d and 14 d after onset.Results Levels of serum MMP-9 and MMP-2 were significant higher in ICH group at each time point after onset than those in normal control group(allP

Objective To explore the utilization of laparoscopy in the diagnosis and treatment of Meckel’s diverticulum in children. Methods A total of 16 children with Meckel’s diverticulum underwent laparoscopic procedures between June 1999 and February 2003. With the help of celioscopy, the focus of the intestines is detected and pulled out through the umbilical port. The wedge resection of diverticulum or enterectomy with anastomosis was then performed. Results The operative time was 75 ～ 150 min, with a mean of 92 min. The patients began to take food on the third postoperative day. No operative complications occurred. The postoperative hospital stay was 5～7 d, with a mean of 5.8 d. Follow-up for 4～44 months (mean, 19.4 months) in the 16 patients showed no intestinal adhesion. Conclusions Laparoscopy is safe and effective in the diagnosis and treatment of Meckel’s diverticulum.

Objective To investigate the relationship between microalbuminuria (MAU) and the risk factor for acute ischemic stroke,the severity of the disease and outcomes.Methods A total of 156 consecutive patients with acute ischemic stroke were enrolled prospectively.They were randomly divided into either an MAU positive group (≥ 30 mg/g) or an MAU negative group (＜ 30 mg/g) according to urinary albumin/creatinine ratio (UACR).They were also randomly divided into either a good outcome group (0-2) or a poor outcome group (＞2) according to the modified Rankin scale (mRS) scores.The various demographic and clinical data were compared,and the poor outcome of acute ischemic stroke and the independent factors of positive MAU were analyzes.Results A total of 156 patients with acute ischemic stroke were enrolled,including 84 males and 72 female; aged 53 to 78 years (mean 65.4 ± 6.2); the time from onset to admission was 1.5 to 28 h; 94 patients had good outcomes,62 had poor outcomes,and no one died; MAU was positive in 76 patients and MAU was negative in 80 ones.Multivariate logistic regression analysis showed that advanced age (odds ratio [OR] 1.992,95％ confidence interval [CI] 1.108-2.374; P =0.015),complicated with diabetes (OR 2.497,95％ CI 1.177-5.298; P =0.017) and atrial fibrilhtion (OR 2.338,95％ CI 1.062-5.148; P =0.035),high serum homocysteine (Hcy) level (OR 2.541,95％ CI 1.073-6.02; P =0.047) and UACR (OR 2.130,95％ CI 1.396-3.017; P =0.001),MAU positive (OR 3.291,95％ CI 1.681-6.444; P =0.001),high baseline National Institutes of Health Stroke Scale (NIHSS) score (OR 9.196,95％ CI 2.828-19.815; P＜ 0.001) were the independent risk factors for poor outcomes in patients with acute ischemic stroke.There were significant differences in the proportion of the patients complicated with diabetes (P =0.038) and fasting blood glucose level (P =0.025),serum Hey level (P =0.022),and carotid intima-media thickness (IMT) (P =0.019) between the MAU positive group and the MAU negative group.The proportion of anterior circulation infarction was lower (P =0.033),the rates of the baseline NIHSS score (P =0.003) and poor outcome were higher in the MAU positive group (P ＜ 0.001).Multivariate logistic regression analysis showed that increased diabetes (OR 2.237,95％ CI 1.036-4.829; P =0.040) and fasting blood glucose (OR 1.223,95％ CI 1.145-1.673; P =0.027),the increased Hey level (OR 2.542,95％ CI 1.047-6.612; P=0.025),carotid artery IMT (OR 1.295,95％ CI 1.106-1.362; P =0.023) and baseline NIHSS score (OR1.206,95％ CI 1.044-1.219; P =0.023) were correlated independently with the positive MAU in patients with acute ischemic stroke.Conclusions Positive MAU is one of the independent risk factors for poor outcomes of acute ischemic stroke,it is closely associated with some risk factors for acute ischemic stroke,and it has a significant impact on the severity of acute ischemic stroke and outcomes.

Objective To discuss the clinical value of the suture of sacral ligament and pubovaginalis fascia plus sacrospinous ligament fixation in the treatment of moderate and severe pelvic organ prolapse ( POP) . Methods Thirty-two cases with moderate or severe POP,who were treated by the suture of sacral ligament and pubovaginalis fascia besides sacrospinous ligament fixation,were retrospectively analyzed. Results The locations of POP in the 32 patients were mainly in the anterior and middle pelvis cavity. The degree of uterine prolapse was not less than POP-Q Ⅲ phase. The anterior and/or posterior vaginal walls were also prolapsed. The patients were treated by the transvaginal panhysterectomy,vaginal wall neoplasty,sacrospinous ligament fixation and the suture of sacral ligament and pubovaginalis fascia. Those with stress incontinence were also treated with urethral posterior ligament plication. The operation time was 60~120 min,and the hemorrhage vol-ume was 100~300 mL. There were no severe complications or recurrence in all patients. Conclusion The suture of sacral ligament and pubovaginalis fascia could greatly reduce the hazard rate of the recurrence of anterior pelvic organ defects in POP patients treated by sacrospi-nous ligament fixation. The suture operation could strengthen the anterior pelvis cavity,and was proven to be simple,secure and effective. Therefore,the operation is valuable to be used in clinical application.

Astract:Objective To compare the clinical efficacy of minimally invasive percutaneous osteosynthesis and supercutaneous plating with closed reduction in the treatment of distal tibial comminuted fractures. Methods A total of 40 patients with close distal tibial comminuted fractures in our hospital from April 2012 to April 2014 were divided into minimally invasive percutaneous osteosynthesis group and external fixation group. External fixation group were treated by supercutaneous plating,while the minimally invasive percutaneous osteosynthesis group were treated by minimally invasive percutaneous osteosynthesis. And the operative duration,hospital stay,the time of weight loading and frac-ture healing,postoperative complications and function of ankle were compared between the two groups. Results In the supercutaneous plating group,the operative duration was (60. 17 ± 5. 64) minutes,the hospital stay was (8. 651 ± 2. 21) days,the time of weight loading was (49.26 ±9.85)days,the time of fracture healing was (13.82 ±4.23)weeks,the incidence of postoperative complications was 5.00%,and the excellent and good rates was 95. 00%. In the minimally invasive percutaneous osteosynthesis group,the operative duration was (74. 64 ± 6. 82)minutes,the hospital stay was (18. 22 ± 2. 32)days,the time of weight loading was (57. 56 ± 11. 32)days,the time of fracture healing was (17. 47 ± 2. 31)weeks,the incidence of postoperative complications was 25. 00%,and the excellent and good rates was 80. 00%. There were significant differences in operative duration(χ2 =9. 922,P=0. 007),hospital stay(χ2 =10. 48,P=0. 015),time of weight loading (χ2 =14. 618,P=0. 001) and fracture healing(χ2 =40. 16,P=0. 000) between the two groups. The AOFSA score of supercutaneous plating group was (89. 1 ± 3. 9)point,compared with (90. 5 ± 4. 1)point of minimally invasive percutaneous osteosynthesis group,and the difference was statistically significant(χ2 =0. 463,P=0. 793). Conclusion Distal tibial fractures may be treated successfully with minimally invasive plate osteosynthesis or supercutaneous plating. However,supercutaneous plating offers multiple advantages in terms of mean operative dura-tion,hospital stay,the time of weight loading and fracture healing.

Objective To determine the biological traits and optimal condition for the induction and differentiation of endothelial progenitor cells from peripheral blood in healthy adults. Methods Mononuelear cells were isolated from peripheral blood of healthy adults by Ficoll-density eentrifugation. The isolated ceils were cultured in 1640 medium supplemented with VECF165 and bFGF. The EPC specific surface mark CD34 and KDR were assessed by fluorescence activated cell sorter(FACS)analysis: EPC were characterized as adherent cells double positive for DiL-acLDL uptake and lectin binding by direct fluorescent staining under a hser scanning confocal microscope. EPC migration were assayed by MTr assay. Result The number and migration ability of EPC were increased by VEGFl65 and bFGF. Conclusion Endothelial progenitors cells can be derived from mononuclear cells of peripheral blood at specific conditions.

Objective The aim of the study is to discuss the application value of HA330-Ⅱ microporous resin plasma adsorption in liver support and the treatment of complications of chronic severe hepatitis.Methods The treatment group has 41 patients of chronic severe hepatitis B,which were treated for 3 times by HA330-Ⅱ microporous resin plasma adsorption.We compared the improvement of symptom,the fadeamay and rebound of icterus,the change of hepatic encepllalOpathy and brain oedema,the change of blood routine test,blood ammonia level,blood-gas analyzing result,cruor index,inflammatory factors(IL-1b,IL-6,IL-8,TNF-α,etc.),side effects,etc.The control group has 37 patients of the same type.Results HA330-Ⅱ microporous resin plasma adsorptioin is partly effective for the improvement of symptom,improvernent rate 43.9%,and without new discomfort due to the treatment. It obtains some extent fadeaway of icterus which has a low rebound,reduce TBiL(17.83±3.65)% and there be no statistics difference of rebound.It lowers the blood ammonia level and improves the hepatic encephalopathy and brain oedema.It absorbs cytokine IL-8.Atthough it has some extent effect to albunfin,blood paltelet,haemoglobin.Conclusion HA330-Ⅱ microporous resin plasma adsorption has good application value in the treatment of chronic severe hepatitis B.It is a new treatment choice of severe hepatitis.

Objective To discuss the safety and advantages of prone-straddle position applied in transvaginal hysteromyomectomy of the posterior wall of the uterus. Methods The clinical data of patients who were admitted into our hospital from March 2013 to Janaury 2015 and received transvaginal hysteromyomectomy were retrospectively analyzed. They were divided into group A ( prone-straddle position, 30 cases) and group B (traditional lithotomy position,24 cases). The exposure of operative field, convenience of operation, time of the placement, time of operation, patient satisfaction, as well as patients’ heart rate, blood pressure, and oxyhemoglobin saturation were observed and ana-lyzed. Results Compared with the lithotomy position, there were significant differences in the time of the placement and the time of opera-tion in the patients treated by prone-straddle position. The patients with prone-straddle position cooperated well, and there was no obvious discomfort. Their vital signs were stable during the operation. The operative field during prone-straddle position exposed better and it was more convenient which make the operation became easier for both the operators and nurses. Conclusion Prone-straddle position applied in transvaginal hysteromyomectomy of the posterior wall of the uterus is safe and practicable, and it is valuable for clinical application.

Objective To evaluate the effect of preoperative intravenous drip of tranexamic acid(TXA) on perioperative bleeding in proximal femoral nail anti-rotation(PFNA) operation of elderly intertrochanteric fracture.Methods A total of 115 elderly patient with intertrochanteric fracture undergoing PFNA internal fixation were selected and divided into the treatment group(58 cases) and control group (57 cases).The treatment group was intravenously dripped with 20mg/kg TXA before operation,while the control group had no special treatment.Hemoglobin (Hb) and hematocrit(Hct) were recorded before operation and on postoperative 1,3 d.The total amounts of perioperative blood loss were calculated by using the Gross equation and Nadler equation.The blood transfusion rate and thromboembolic complications occurrence situation in the two groups were performed the statistics.Results The total amounts of perioperative blood loss were (872.21±312.53) mL in the treatment group and (1 162.41±368.64) mL in the control group,the difference was statistically significant(P<0.01).The blood transfusion rate was 3.45% in the treatment group and 17.5% in the control group,the difference was statistically significant (P<0.01).No deep vein thrombosis and pulmonary embolism occurred in both groups.The occurrence rate of venous thrombus was 5.1% in the treatment group and 7.0% in the control group without statistical difference(P>0.05).Conclusion Preoperatively intravenous drip of 20mg/kg TXA in PFNA internal fixation of elderly intertrochanteric fracture can effectively decrease perioperative blood loss without increasing the risk of thrombus formation.