Objective To investigate the effect of diosmin on the pain and wound healing after modified anal fissure resection .Methods 98 patients from January 2015 to July 2016 in our hospital who were admitted to meet the inclusion criteria and improved anal fissure resection patients were selected and randomly divided into control group and study group, 49 cases in each group.And the control group was given routine postoperative treatment, the study group was treated with diosmin tablets on routine postoperative therapy , two groups were treated for seven days for a course of treatment, the wound pain, wound width and wound healing were observed and recorded before and after treatment, blood samples were taken to determine changes in serum inflammatory factors, the clinical efficacy and complications were compared.Results After treatment, the two groups of wound pain, the width of the wound and wound healing rate were decreased, the serum TNF-α, IFN-γ, IL-6 levels were decreased, the difference was statistically significant (P<0.05), compared with the control group, the degree of pain, the width of the wound and wound healing rate were lower, the serum TNF-α, IFN-γ, IL-6 content were lower, the average healing time and granulation growth time and remove decay time were shorter, the difference was statistically significant (P<0.05).The effective rate of the study group was 91.83%, higher than the control group 75.51%, the difference was statistically significant (P<0.05).All patients were followed up, no case falls off phenomenon, there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Diosmin tablets on the improvement of anal fissure after resection of wound healing has a role in promoting inflammation, reduce the severity of pain conditions.

Objective To observe the changes of SS activity and regulation of GH surrounding cerebral hemorrhage and the hypothalamus,and explore the disorder of SS GH to the affect of local neuronal internal circumstances in stress.Methods With intracerebral hemorrhage model in rats, SS GH content in the hypothalamus and cerebral hemorrhage periphery was determined using the radioimmunoassay.Results The SS content in the hypothalamus far from hematoma and the area surrounding cerebral hematoma elevated obviously, and reached its peak along with the hematoma content,meanwhile the GH content of relevant area trended to upregulate remarkably too.Conclusion While the SS content in the hypothalamus and the area surrounding cerebral hematoma elevated, the GH content of relevant area trended to rise remarkably too, the phenomenon indicated the stress disorder of SS GH axis during the highest peak of hematoma.

Objective To observe the effects of sleep deprivation(SD)on learning and memory and phos-phorylated cyclic AMP responsive element binding protein(pCREB) expression in hippocampus of mice,and to explore the mechanism of cognitive change after SD. Methods Twenty female C57BL/6J mice were randomly divided into sleep deprivation group(SD, n = 10) and normal cage control group (CC,n = 10). Touch method was used to establish the sleep deprivation model. 30 days after SD,all the animals were subjected for Morris Water Maze (MWM) to test mean escape latency and percentage of time spent in the target quadrant. pCREB level in hippocampus was tested with Western blot. Results The mean escape latency in SD group in the second and third day of MWM was (29.31 ±4.93) s and (25.33 ±5.06)s, respectively, and was longer than that in CC group ((26.05 ±5.96)s and (19.35 ±7. 85)s,respectively). Mice in SD group spent less time in the target quadrant than that in CC group((23.61 ±9.86)% and (37.46 ±7. 51)%,.respectively, P<0.05). Results of Western blot for pCREB revealed that the pCREB level in hippocampus in sleep deprivation group was significantly lower than that in control group(0.71 ±0.03 and 0.82 ±0.06, respectively, P<0.01) . Conclusion The impairment of spatial learning and memory ability in sleep deprivation animals may be associated with the reduction of pCREB in hippocampus.

Objective To establish the normative screening model and apply it to screen and manage the stroke risk group ,and to observe its application effect .Methods The screening management team in our department was set up for establishing the norma-tive stroke screening model .Then the stroke screening works were carried out in the outpatient department and the community pop-ulation .The screened groups of stroke high risk were implemented the 1-year control according to the guidelines of stroke screening and intervention .Results 9 631 individuals of stroke risk were screened ,among them 1 786 high-risk patients were screened out with a rate of 18 .55% .The interventions on the risk factors existing in the high-risk patients were implemented .The comparison of blood glucose ,blood pressure ,blood fat ,fat index ,smoking ,physical exercise and reasonable diet before and after interventions in the high-risk patients showed statistically significant differences (P<0 .05) .Conclusion Establishment of the normative manage-ment model of stroke screening is the important guarantee to do a good job of stroke screening and control for high risk group ,and significantly decreases the risk factors for high risk group .

Objective:To determine the effect of apatinib combined with Xiaoyan decoction for the treatment of non-squamous non-small cell lung cancer. Methods:Thirty-eight patients with non-squamous non-small cell lung cancer were randomly categorized into apatinib group (group A, 18 cases) and apatinib combined with Xiaoyan decoction group (group B, 20 cases). All patients did not under-go surgical treatment, radiotherapy, or chemotherapy during the study. Results:The median progression free survival (mPFS) of ad-vanced non-squamous non-small cell lung cancer patients reached up to 3 months. The mPFS, objective response rate, and disease control rate of the apatinib combined with Xiaoyan decoction group showed no significant difference and statistical significance (P>0.05). The apatinib combined with Xiaoyan decoction group was superior to the apatinib group with regard to alleviating clinical symp-toms and adverse reactions (P<0.05). Conclusion:Xiaoyan decoction combined with apatinib can improve the clinical symptoms of pa-tients and reduce the incidence of adverse reactions in the treatment of advanced non-squamous non-small cell lung cancer.

Objective To analyze and evaluate the final examination paper of Neurology and Phychiatry.Methods We randomly selected 65 examination papers for year 2003 students specializing in clinic medicine and analyzed them.Results The students'scores were normally distributed,with the mean score being 77.03?8.25,the average degree of difficulty being 0.778,and discrimination being 0.426.Conclusion The examination paper could make an assessment of students'command of the course,with moderate difficulty and reasonable score distribution.

Objective To construct the sequential management model of networked drug-cognitive behavior in patients with chronic insomnia,and to explore the effects of this model on treatment and management of patients with chronic insomnia. Methods A total of 160 patients with chronic insomnia treated from January 2014 to June 2015 were randomly divided into the experimental group and the control group. The experimental group was treated with networked drug-cognitive behavior sequential therapy and management. Through the establishment of patient management files in the network management system,the disease was assessed,treatment programs were developed, remote implementation of 8 weeks of drug-cognitive behavior sequential treatment was conducted,12 months of net-work remote dynamic management and efficacy evaluation was performed. The control group received 8 weeks of traditional medical care with face-to-face drug-cognitive behavior sequential treatment and 12 months outpatient fol-low-up management. Results Comparison of management core indicators:there were significant differences between two groups in number of visiting hospital,exit status,treatment completion and documentation,sleep diary comple-tion,sleep scale completion and patient satisfaction. Comparison of sleep quality:after 2 months of treatment,there was no difference in quality of sleep between two groups; after 12 months of treatment,there were significant dif-ferences in sleep latency,awakening time after sleep,total sleep time and sleep efficiency between two groups. Scale score:after 12 months of treatment,there were significant differences in Pittsburgh sleep quality index,sleep personal beliefs and attitude scale score between two groups. Conclusion Network-based management improves the compliance of patients with chronic insomnia,reduces the loss of follow-up rate,improves sleep cognition,increases sleep quality,saves patients' time and cost,increases patient satisfaction,which is worth promoting in clinical application.

Objective To evaluate the clinical efficacy of vertebroplasty using vertebral pedicle screw technique combined with calcium sulfate cement injection in the treatment of thoracolumbar vertebrae fractures.Methods Twenty-eight patients with thoracolumbar vertebrae fractures admitted in our department in recent 2 years were enrolled in this study,including 21 cases of type A,3 cases of type B,and 4 cases of type C.All patients were fixed with vertebral pedicle screw,and then verteplasty was performed using calcium sulfate cement injection.Results All patients were followed up for an average time of 16 months.Within the follow-up,there was no complication noted,such as loosening or breakage of internal fixation,chronical lumbar back pain,and loss of effected vertebral height.Artificial bones injected into vertebrae were absorbed in about 3 months.Conclusion Vertebroplasty using vertebral pedicle screw technique combined with calcium sulfate cement injection is an effective and safe procedure for thoracolumbar vertebrae fractures,which renders it possible to bear weight early and to maintain corrected vertebral height postoperatively.

Objective To summerize the clinical experience of 23 cases of carotid cavernous fistula(CCF) and discuss the treatment strategy. Methods Retrospectively analyzed 23 patients(11 males and 12 females) of CCF,including 14 patients with Barrow type A,1 with type B,1 with type C and 7 with type D. Results Vascular approach for embolization was undertaken in 20 cases by transarterial access and 2 via venous route while 1 case was given up. Among them,9 cases obtained complete occlusion by simple balloon embolization and 5 were treated by direct occlusion of internal carotid artery. Another 5 cases used NBCA glue for the occlusion,1 case was embolized by gelatin-sponge particulates combined with compression of carotid artery,2 cases were treated by coil embolization of cavernous sinus and 1 case was only managed by carotid compression maneuver. We achieved satisfactory clinical results with 21 patients cured and 2 patients improved. Conclusion Complexity and refractory are the characteristic of CCF,and endovascular treatment should be the major choice of treatment. (J Intervent Radiol,2006,15: 323-326)

Objective To investigate the different effects of internal and external biliary drainage on the levels of TNF-α,NO in blood serum and NO,inducible nitric oxide synthase(iNOS) in gastric mucosa with obstructive jaundice and explore the mechanism of gastric mucosa damage and compare the quality of internal and external drainage.Methods To establish the animal model:one hundred male adult Sprague-Dawley rats were randomly assigned to five groups:obstructive jaundice for 7 days group (OJ-7 d group),obstructive jaundice for 14 days (OJ-14 d group),internal biliary drainage group(ID group),external drainage group(ED group)and sham operation group(SH group).The OJ-7 group rats were executed 7 days after the first operation,the rest four groups were executed 7 days after the secondary surgery,leaving serum and gastric mucosa.Tested the levels of INF-α,NO in blood serum and NO,iNOS in gastric mucosa and did pathological biopsy of gastric mucosa.Results The levels of TNF-α,NO in blood serum and NO,iNOS in gastric mucosa significantly increased in OJ-7 group.The levels of TNF-α,NO in blood serum and NO,iNOS in gastric mucosa continued to rise in OJ-14 group,and was significantly higher than OJ-7 group,the gastric mucosa was obviously impaired.The levels of TNF-α,Internal drainage can significantly NO in blood serum and NO,iNOS in gastric mucosa were significantly lower in ID group,gastric mucosal damage significantly reduced.Conclusions After internal drainage,iNOS expression was inhited in gastric mucosal,NO production was significantly reduced,led to protect the gastric mucosa,which provide experimental basis for choice in OJ clinical treatment.