Objective To review the features of diagnosis and treatment of craniocerebral firearm wounds in peacetime. Methods A total of 86 cases with various kinds of firearm wounds were retrospectively analyzed for discussing the characteristics of diagnoses and treatment of firearm wounds so as to provide the best treatment methods for firearm wounds of the brain. Results Of all, 80 cases (93%) won full recovery and four (5%) partial recovery but two (2%) were died of massive vascular damage and severe cerebral injuries within 24 hours after operation. Conclusions Craniocerebral firearm wounds are among the most devastating causes for morbidity and mortality in the civilian population. It is important to remove all foreign bodies, especially broken bones and necrotic tissues, and turn the open injury to the close injury. Stereotactic technique, localization of foreign bodies, culture of foreign body bacteria, drug allergy test and correct use of antibiotic and antiepileptic drugs are also critical for eliminating mortality and complications of craniocerebral firearm wounds.

To explore the application of Problem-Based Learning( PBL) method in the clinical teaching of dermatology,we discuss the specificity in teaching and problems in application of dermatology and venereology from the relations between dermatology and venereology and other subjects,between summary and each chapters,and the relationships between each diseases.

Objective To investigate the changes of IL-8 in peripheral blood of patients with pustular psoriasis after acitretin treatment.Methods Dual antibody sandwich enzyme-linked immunosorbent assay (ELISA)was performed to measure the IL-8 levels in the peripheral blood of 30 patients with pustular psoriasis and 30 patients with psoriasis vulgaris before and after treatment,and in 30 normal human controls.The relationship between the IL-8 level and disease severity was assessed for patients with pustular psoriasis.Results After acitretin treatment,the condition was improved greatly in patients with pustular psoriasis,together with a significant decrease in the level of IL-8 in the peripheral blood(57.07 ± 12.02 pg/ml vs.96.84 ± 14.68 pg/ml,P ＜ 0.05).Conclusion IL-8 may be involved in the therapeutic mechanism of acitretin in pustular psoriasis.

Objective To explore the effect of atorvastatin on postoperative complications after the burr hole drainage of chronic subdural hematoma (CSDH). Methods The clinical data of 172 CSDH patients who had underwent the burr hole drainage were retrospectively analyzed. Among them 82 patients were given atorvastatin (atorvastatin group), and 90 patients were not given atorvastatin (control group). The postoperative complications were compared between 2 groups. Results All patients were followed up for 6 months. The total incidence of postoperative complications in control group was significantly higher than that in atorvastatin group:47.78%(43/90) vs. 31.71%(26/82), and the recurrent rate of subdural hematoma and incidence of subdural effusion in control group were significantly higher than those in atorvastatin group: 22.22% (20/90) vs. 8.54% (7/82) and 28.89% (26/90) vs. 12.20%(10/82). There were statistical differences (P<0.05). There were no statistical difference in the incidences of pneumocephalus, acute epidural/subdural hematoma and brain damage induced by drainage tube (P>0.05). Conclusions Atorvastatin can improve the prognosis of CSDH patients, especially in reducing the incidence of recurrent subdural hematoms and subdural effusion.

OBJECTIVE:To determine the valsartan concentration in human plasma METHODS:The plasma sample was extracted with a liquid-solid method and determined with HPLC,stationary phase was Hypensil ODS C18(4 6nm?200nm,5?m),mobile phase consisted of acetonitrile and 0 01mol/L KH2PO4 buffer(pH 2 8)(50∶50) The flow rate was 1 5ml/min Detection was performed with fluorescence detector at ?ex 265nm,?em 378nm RESULTS:The retention time of valsartan was about 5 4 minutes,and the linear range of quantity was 0 05～5?g/ml The recoveries of methodology were more than 90%(n=5) Inter-day and intra-day RSD were less then 10%(n=5) CONCLUSION:This method is rapid and accurate It can be applied to determining the plasma valsartan concentration and studying on pharmacokinetics

Objective To determine the levels of plasma histamine and oxidative status in patients with dermatographism before and after the treatment with anti-histamine drugs. Methods Totally, 85 patients with dermatographism were randomly divided into two groups to receive oral desloratadine and cetirizine respectively for 4 weeks. Enzyme linked immunosorbent assay (ELISA) was performed to detect the plasma level of histamine, superoxide dismutases (SOD), glutathion peroxidase (GSH-PX) and malondialdehyde (MDA) in all the patients before and after the treatment and in 15 normal human controls. The efficacy of desloratadine and cetirizine for dermatographism was estimated. Results The response rate was 83.72% and 78.57% in patients treated with desloratadine and those with cetirizine, respectively (x2 = 0.369, P> 0.05). The untreated patients with dermatographism showed an elevation in the plasma level of histamine (3.87 ± 1.21 ng/ml vs. 1.76 ± 0.56 ng/ml, P< 0.05) and MDA (3.86 ± 1.03 nmol/ml vs. 2.19 ± 0.82 nmol/ml, P< 0.05), but a decline in the activity of SOD (86.29 ± 19.9 U/ml vs. 112.12 ± 27.88 U/ml, P< 0.05) and GSH-PX (74.52 ± 47.67 vs.915.06 ± 115.96, P< 0.05) compared with the normal human controls. The treatment with antihistamine induced a reduction in the plasma level of histamine (1.61 ± 0.47 ng/ml vs. 3.87 ± 1.21 ng/ml, P< 0.05) and MDA (2.65 ± 0.77 nmol/ml vs. 3.86 ± 1.03 nmol/ml, P< 0.05), but an increment in the activity of GSH-PX (921.46 ± 157.37 vs.74.52 ± 47.67, P < 0.05) with no changes of SOD in patients with dermatographism. Conclusions In patients with dermatographism, plasma histamine is increased and there is an imbalance of oxidation-antioxidation.Desloratadine and cetirizine are effective for the treatment of dermatographism.

Objective Off-pump coronary artery bypass (OPCAB),minimally invasive direct coronary artery bypass (MIDCAB) and robotic-assisted coronary artery bypass (RA-CAB) are all used to treat isolated left anterior descending artery (LAD) disease.The aim of this study is to compare the early outcomes after these three procedures.Methods From February 2009 to May 2012,102 consecutive patients underwent revascularization of LAD.31 patients were treated by OPCAB,45 by MIDCAB and 26 by RA-CAB.Patients received sternotomy in the OPCAB procedures.The MIDCAB procedures were performed through a 10-cm anterolateral muscle-sparing minithoracotomy.In the RA-CAB procedures,left internal mammary arteries (LIMA) were harvested with the aid of da Vinci surgical system and sewing of the anastomoses was performed under direct vision by a 3-cm anterolateral minithoracotomy.Results No significant difference was observed in graft flow,pulse index,renal failure,reoperation for hleeding,new onset of arterial fibrillation and deep wound infection between these three groups.There was also no significant difference in peri-operative mortality,major adverse cerebro-cardiovascular events (MACCE) between these three groups.Compared with OPCAB,MIDCAB and RA-CAB significantly reduced the need of blood transfusion (4.4％ vs.32.3％,P＜ 0.05; 7.7％ vs.32.3％,P＜0.05).The patients receiving RA-CAB had shorter length of postoperative stay than whom receiving OPCAB[(8.8 ± 3.2) days vs.(12.4 ± 7.7) days,P ＜ 0.05)].There is no significant difference between the outcomes of MIDCAB and RA-CAB.Conclusion These findings indicated that MIDCAB and RA-CABwere feasible,effective and safe options for revascularization of isolated LAD disease.MIDCAB and RA-CAB showed the advantage of less invasive and faster recovery,compared with OPCAB.Therefore,MIDCAB and RA-CAB should be the routine treatment for patients with isolated LAD disease.In some advanced centers,RA-CAB will be the preferred method.The mid-and long-term outcomes of these three methods should be further investigated.

Objective To explore the clinical curative effect and complications of digital three-dimensional molding of titanium mesh for repairing skull defect. Methods The clinical data of 42 patients having underwent repairing skull defect with three-dimensional molding of titanium mesh were retrospectively analyzed. Results The average operation time was about 2 h, and 42 patients were operated successfully. The bilateral skull was symmetry and the appearance was good. In 42 patients, subcutaneous dropsy occurred in 1 case, epilepsy occurred in 3 cases, and intracranial bleeding again surgery occurred in 1 case. Patients were satisfied with the results of cranioplasty. Conclusions Repairing skull with digital three-dimensional molding of titanium mesh is simple, with shorter operation time, lower operation risk, and lower postoperative complication, and the clinical curative effect is satisfactory.

Objective:To investigate the clinical efficacy of oxcarbazepine versus carbamazepine combined with baclofen in the treatment of trigeminal neuralgia. Methods:A total of 74 patients with trigeminal neuralgia who received treatment in Haiyang People's Hospital from May 2019 to May 2021 were prospectively included in this study. They were randomly divided into an observation group and a control group ( n = 37 per group). The observation group was treated with oxcarbazepine combined with baclofen, while the control group was treated with carbamazepine combined with baclofen. Both groups were treated for 4 successive weeks. Clinical efficacy, adverse reactions, Visual Analogue Scale (VAS) scores before and after treatment, levels of pain transmitters [substance P (SP), 5-hydroxytryptamine (5-HT), β-endorphin (β-EP)], and quality of life were compared between the two groups. Results:The total effective rate in the observation group was 97.3% (36/37), which was significantly higher than 83.8% (31/37) in the control group (χ 2 = 3.95, P < 0.05). Before treatment, there were no significant differences in VAS score, SP, 5-HT, β-EP levels, and EQ-5D Health-Related Quality of Life Questionnaire (EQ-5D) score between the two groups (all P > 0.05). After treatment, VAS score, SP, 5-HT levels, and EQ-5D score in each group were significantly decreased compared with those before treatment. After treatment, VAS score, SP and 5-HT levels in the observation group were significantly lower than those in the control group [(3.1±0.8) points vs. (4.2±0.9) points, (240.1 ± 34.1) ng/L vs. (314.1±40.1) ng/L, (38.2 ± 6.1) ng/L vs. (52.1±9.1) ng/L, all P < 0.001]. After treatment, β-EP level in each group was significantly increased compared with that before treatment ( P < 0.001). After treatment, β-EP level in the observation group was significantly higher than that in the control group [(268.1 ± 38.1) ng/L vs. (214.1 ± 29.0) ng/L, P < 0.001]. After treatment, EQ-5D scores in the observation group were significantly lower than those in the control group (all P < 0.001). There was no significant difference in incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Oxcarbazepine combined with baclofen has superior efficacy in the treatment of trigeminal neuralgia to carbamazepine combined with baclofen. The former can more obviously relieve pain, reduce pain neurotransmitter levels, improve quality of life, and has less adverse reactions.

Post-traumatic hydrocephalus (PTH) is one of the common secondary lesions after severe craniocerebral injury.Shunt surgery is the most important surgical treatment in clinic.There are many kinds of shunt methods,but there is no uniform standard for method selection.Lumboperitoneal shunt (LP),as an important alternative operation,has gradually become one of the mainstream shunt operations.This article reviews the new operative indications of LP,the advantages of LP over traditional ventriculoperitoneal shunt (VP),the latest preoperative evaluation system and preoperative evaluation score of Huaxi LP,the technical points of LP operation,follow-up key points,common postoperative complications and management,so as to provide reference for exploring better technical routes and operative concepts of LP.