Objective To study the diagnosis and treatment for the syndrome of inappropriate antidiuretic hormone secretion in neurosurgery.Methods Retrospective analyze clinical situation, treatment, and process of final diagnosis in 6 SIADH cases.Result Diagnosis of SIADH and differential diagnosis with CSWS is very difficult.In clinic the experimental therapy of restricting water and natrium is a important method of differential diagnosis,but also a effective therapy.Conclusion Speciality of SIADH is (1)hyponatremia(Na +≤128 mmol/L),natriuresis(Na +≥80 mmol/24h),(2)ADH assay is no significant for SIADH and CSWS,(3)no hypervolemia and edema exhibition,(4)restrict water is effective in treatment.

Objective To investigate the effects of injecting allogeneic mesenchymal stem cells(MSCs) on the cellular immunity in rat in vivo.Methods Bone marrow-derived MSCs were isolated from Wistar rats.The purity of MSCs was identified by morphological examination with microphotography,and the phenotypes were identified with flow cytometry.Twenty SD rats were randomly divided into 4 groups.Different concentrations of MSCs(5?106/ml for group A,5?105/ml for group B,and 5?104/ml for group C,respectively) and PBS(for group D) were given to allogeneic SD rats via intravenous infusions.The suppressive effect of MSCs on lymphocytes proliferation in recipient rat was analyzed using mixed lymphocyte cultures(MLR) 10 days after cultivation.At the same time,proportions of CD4+,CD8+ and CD4+CD25+/CD4+ T-lymphocytes in peripheral blood and spleen were analyzed with flow cytometry.Results Proliferation rate of splenic lymphocytes in group A(5?106/ml MSCs,8.58%?0.27%) was markedly lowered compared with that in group D(PBS,24.40%?5.21%,P

Objetive To investigate the effect of Fasudil on the hepatic ischemia repeffusion injury on rats of obstructive jaundice.Methods 160 mature SD rats were randomly assigned into 2 large groups,namely experimental group (Group A) and control group (Group B).While each large group was subdivided into 4 subgroups,including sham operation subgroups(Group A1 and B1),obstructive jaundice model subgroups(Group A2 and B2),ischemia reperfusion model subgroups (Group A3 and B3)and obstructive jaundice plus ischemia reperfusion model subgroups (Group A4 and B4).In Group A2 and B2,obstructive jaundice models were made on rats by double ligating and cutting the common bile ducts.In Group A3 and B3,the ischemia reperfusion injury models were built by blocking the hepatic portal vessel for 30 minutes before reperfusion.In Group A4 and B4,the ischemia reperfusion injury models were built in 1 week after building the obstructive jaundice models.For Group A,10 mg/kg fasudil was intraperitoneally injected at 30 minutes before ischemia.For Group B,equal amount of physiological saline was injected.Samples were gained on zero hour,1 hour,2 hour and 6 hour post reperfusion.The serum indexes for liver function and serum Endothelin 1 level were tested and analyzed through SPSS.Pathological changes of liver were viewed correspondingly.Results Compared to control groups (Group Bs),experimental groups (Groups As) have better liver function,lower Endothelin 1 level (P ＜ 0.05),as well as less severe microscopic histological damage.Conclusion Fasudil can effectively protect rats of obstructive jaundice from hepatic ischemia reperfusion injury.

Objective To study the resuscitative effect of hypertonic electrolyte glucose solution (HEGS) on the haemodynamics pa-rameters in enteral resuscitation of burn shock. Methods Eighteen beagle dogs with 35% TBSA third degree burned were used in this stud-y. They were random divided into no-resuscitation group (NR group), enteral resuscitation with HEGS group (EH group) and intravenous resuscitation with isotonic electrolyte glucose solution (lEGS) group (Ⅱ group). The fluid resuscitation was given from half an hour after TBSA). The haemodynamics parameters (cardiac index, mean arterial pressure, intrathoracic blood volume index, and systemic vascular re-sistance index) were continuously assessed by PICCO. Result The cardiac output index reduced markedly after bum in the three groups, and then returned after 2h in two resuscitation groups, which were higher than that in the NR group( P<0.05). The mean arterial pressure reduced in the three groups, which was higher in the two resuscitation groups than that in NR group(P < 0.05). The intrathoracic blood volume index was rapidly reduced in the three groups. It returned in EH group from 2 hours after burned, which was still higher than that in the other two groups (P < 0.05). Meanwhile the systemic vascular resistance index was increased quickly. It was reduced in EH group from 2 hours after burned, which was lower than that in the other two groups (P < 0.05). Conclusion The results show that it was feasible for 35% TBSAⅢ° burn-injury dogs to be resuscitated with 1.8% hypertonic electrolyte-glucose solution by enteral, which can markedly reduce liquid quantity needed.

Objective To explore the value of preoperative spleen-liver volume ratio for predicting recurrence of primary liver cancer after hepatectomy.Methods Clinical data of 75 cases of hepatocellular carcinoma undergoing hepatectomy were analyzed retrospectively.According to the preoperative spleen-liver volume ratio,these patients were divided into 2 groups:those with spleen-liver volume ratio ＜ 0.8,and spleen-liver volume ratio≥0.8.Patients were followed-up until March 2014.Cox ratio risk pattern analysis was used for the recurrent correlative factors.Results Univariate analysis showed that preoperative AFPL3％ ≥ 10％,the maximum diameter of the tumor ＞ 5 cm,the number of tumor ＞ 3,spleen-liver volume ratio ≥0.8,vascular invasion,positive resection margin and hepatic or portal vein tumor thrombus were all risk factors of poor disease-free survival (P ＜ 0.05).Cox regression analysis revealed that spleen-liver volume ratio ≥0.8,AFP-L3％ ≥10％,the maximum diameter of the tumor ＞5 cm and hepatic or portal vein tumor thrombus were independent predictors of poor disease-free survival after hepatectomy for hepatocellular carcinoma(P ＜ 0.05).Conclusions Preoperative spleen-liver volume ratio ≥0.8 was an independent adverse predictor of poor disease-free survival.

Objective To evaluate the efficacy of emergency endoscopic intervention in acute obstructive suppurative cholangitis (AOSC) complicated with septic shock.Methods A total of 54 patients with AOSC and septic shock who underwent therapeutic emergency ERCP were included in this retrospective study,and were evaluated by the shock index (SI).Results ERCP was performed for all patients in 24hours after hospitalization,and the average ERCP operation time was 23.8 ± 12.5 min.All 54 patients underwent EST,46 of whom received ENBD,7 biliary stenting and 1 transferred to surgery due to bleeding.The post-ERCP mortality rate was 0,and the complications included 1 case of pancreatitis and 2 cases of pneumonia.The positive rate ofGram-Negative bacillus before ERCP was 46.9％ (15/32).The SI before ERCP was 1.250 ±0.200,which decreased to 0.950 ±0.119 at 2hr after the procedure (P ＜0.001 ),and decreased further to 0.598 ± 0.099 ( P ＜ 0.001 ) at 24 hours after ERCP.Conclusion Therapeutic emergency ERCP is of great importance in the treatments for AOSC complicated with septic shock.

Objective: To compare the diagnosis and treatment experience of brain abscesses and improve prognosis. Methods: The data of 302 patients of brain abscess at Department of Neurosurgery in Tianjin Medical University General Hospital from 1980 to 2014 was analyzed retrospectively. There were 215 male and 87 female patients aged from 11 to 82 years with mean age of (30±8) years. The patients was divided into 1980-2001 group and 2002-2014 group according to different diagnosis and the treatment methods. The therapy methods include operation and conservative treatment. There were 196 cases received operation, including 95 cases of excision, 89 cases of ventriculopuncture, 12 cases of excision after ventriculopuncture, 106 cases received drug conservative therapy. Two groups of information including clinical manifestation, abscess location, therapeutic effect and prognosis were compared by χ² test. Results: Compared to 1980-2001 group, adjacent infection incidence declined(χ²=8.000, P=0.005). The ratio of single abscess declined and multiple abscess increased(χ²=11.060, P=0.001), the infection proportion of frontal lobe and temporal lobe decreased(χ²=9.080, P=0.003; χ²=15.440, P=0.000). The ratio of headache and vomit and papilledema declined significantly(χ²=23.290, P=0.000; χ²=21.020, P=0.000; χ²=2.290, P=0.001). Total mortality of 302 patients were 23 cases and 5 cases of 1980-2001 group and 2002-2014 group (10.4% vs. 6.3%, χ²=1.180, P=0.277). However, there were statistical difference in postoperative mortality between both groups (14.4% vs. 4.0%, χ² =3.880, P=0.049). Conclusion With the application of antibiotics and the development of neurosurgical techniques, the prognosis of brain abscess has been improved.

Objective:To investigate the application value of sound touch quantification (STQ) in screening high risk group of non-alcoholic steatohepatitis(NASH).Methods:From February 2019 to January 2020, 98 patients with non-alcoholic fatty liver disease(NAFLD) and 36 healthy volunteers were included in this study. NAFLD patients were divided into NASH high risk group and NASH low risk group. The liver Young′s modulus were measured by STQ and compared among the three groups. The ROC curve was used to analyze the effectiveness of STQ in screening NASH high risk population. When the maximum value of Jordan index was selected, the best boundary threshold was selected to analyze its sensitivity, specificity and accuracy. Liver biopsy was performed in 15 patients with abnormal liver function as validation group.Results:There were significant differences in the mean values of Young′s modulus among high risk group, low risk group and control group ( F=33.068, P<0.01). The Young′s modulus of NASH high risk group was significantly higher than those in NASH low risk group and control group ( P<0.05). The Young′s modulus between NASH Low risk group and control group was not significantly different( P=0.443). The best screening threshold was 6.46 kPa, the sensitivity was 89.2%, the specificity was 85.2%, and the accuracy was 88.6%. In the verification group, when the Young′s modulus≥6.46 kPa, the accuracy was 73.3%, the sensitivity was 75.0%, and the specificity was 66.7%. Conclusions:As a screening index, STQ elastic imaging technology has certain value in screening NASH high risk group.

Intramesorectal lymph node metastasis after radical surgery of prostate cancer is rare in clinical practice. This paper reported 2 cases of intramesorectal lymph node metastasis and resection after operation for prostate cancer. Patient 1 underwent laparoscopic radical prostatectomy 5 years ago, who was followed up closely after surgery, and was diagnosed with mesorectal lymph node metastasis by MRI examination. Patient 2 underwent robot-assisted laparoscopic radical prostatectomy 2 months ago, who was followed up by pelvic MRI and mesorectal lymph node metastasis was revealed. Both patients underwent fluorescence laparoscopic mesenteric lymphadenectomy in our department. With 4 to 6 month of follow-up after surgery, MRI examination showed no recurrence of tumor.

Objective:To investigate the value of short-time transcutaneous carbon dioxide pressure (TcPCO 2) and transcutaneous oxygen pressure (TcPO 2) monitoring in critically ill preterm infants. Methods:From January to December 2018, 62 critically ill neonates receiving respiratory support at Guangzhou Women and Children's Medical Center were retrospectively enrolled. A total of 348 sets of paired data including TcPCO 2/TcPO 2 and arterial carbon dioxide pressure (PaCO 2)/arterial oxygen partial pressure (PaO 2) were analyzed. The patients were divided into different groups based upon birth weight (23 cases>1 000 g-≤1 500 g, 129 sets of paired data; 18 cases≤1 000 g, 130 sets of paired data) and gestational age (16 cases born at ≤28 gestational weeks, 127 sets of paired data; 29 cases born at 28-34 gestational weeks, 159 sets of paired data) and the differences between groups were compared. The correlation and consistency of TcPCO 2/TcPO 2 and PaCO 2/PaO 2 were evaluated using Pearson's correlation and Blan-Altman scatter plots. Receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic efficacy of TcPCO 2 in neonates with hypercapnia. Results:There was a positive correlation between TcPCO 2 and PaCO 2 in all patients ( r=0.913, 95% CI:0.894-0.929, P<0.05). In patients whose birth weight was>1 000 g-≤1 500 g or≤1 000 g, TcPCO 2 and PaCO 2 were positively correlated and the consistency were good ( r=0.909, 95% CI:0.874-0.935; r=0.934, 95% CI:0.908-0.953; both P<0.05), and the same finding was also observed in patients born at≤28 gestational weeks or 28-34 weeks of gestation ( r=0.938, 95% CI:0.913-0.956; r=0.871, 95% CI: 0.827-0.904; both P<0.05). The sensitivity, specificity and area under curve of TcPCO 2 in the diagnosis of hypercapnia were 90.91%, 85.85%, and 0.942, respectively. There was a poor correlation between TcPO 2 and PaO 2 in all patients and those with birth weight >1 000 g-≤1 500 g or gestational age 28-34 weeks (all r<0.75, all P<0.05). There was no correlation between TcPO 2 and PaO 2 in the birth weight ≤1 000 g and gestational age ≤28 weeks groups (both P>0.05). Conclusions:Short-time TcPCO 2 monitoring can accurately assess PaCO 2 in critically ill neonates requiring respiratory support and is of high diagnostic value for hypercapnia. However, TcPO 2 has limitation in evaluating PaO 2 and other indicators may need to be involved.