Objective To improve spiral CT diagnosis and differential diagnosis of small amounts of traumatic subarachnoid hemorrhage(TSAH).Methods SCT features of 105 cases with small amounts of TSAH , which were demonstrated by SCT reexaminations , were retrospectively analyzed. Results The distributions of small amounts of TSAH included cerebral longitudinal fissure cistern in 47 cases, cerebral lateral fissure cistern in 30 cases , cerebral surface sulcus in 22 cases, tentorium of cerebellum in 6 cases. There were 12 cases of small amounts of TSAH with contusion and laceration of brain , Subdural hematoma or bone fracture of skull.Conclusions Spiral CT scan has important value in qualitation and level diagnosisa of small amounts of TSAH.

Background and purpose:Bladder carcinoma is the most common tumor in the urogenital system in China. For patients with non-invasive bladder cancer, intravesical therapy is an important part of treatment after complete transurethral resection (TURBt). Bacillus Calmette-Guerin (BCG) remains the most effectively used immune agent, and epirubicin (EPI) has been reported to have an improved antitumor activity and high remission rate. However, the results differed significantly from study to study. To compare the efficacy and treatment-induced side effects of intravesical epirubicin versus BCG on postoperative recurrence of non-invasive bladder carcinoma, we completed a meta-analysis of the published literature. Methods:According to the criteria in the paper, we retrieved published comparative studies on intravesical epirubicin versus BCG for non-invasive bladder carcinoma. Data were extracted from each identified paper and Revman4.2 software was used for statistical analysis.Results:6 trials including 1 288 patients were eligible according to the eligibility criteria. Of 657 cases that were treated with epirubicin and 631 with BCG, recurrence occurred in 253 and 184 respectively. Pooling data of a meta-analysis indicated that BCG statistically reduced the incidence of tumor recurrence (Peto OR=1.60, 95%CI=[1.26, 2.03], P=0.000 1). With regard to tumor progression, BCG was also statistically superior to epirubicin (Peto OR=1.70, 95%CI=[1.16, 2.49], P=0.006). 5 studies reported the comparison on main local side effects in terms of hematuria, cystitis or irritative symptoms. Combined results showed that the incidence of hematuria (Peto OR=0.47, 95%CI=[0.35, 0.62], P

The cytolytic effect of perforin is a mechanism of anti-virus,killing microbial-infected cells and tumor cells.Perforin is a very important non-specific immune factors in fish.In order to understand the function of perforin,the cDNA of grass carp perforin C-terminal peptide was amplified from grass carp liver and kidney cDNA library.It contains a protein kinase C conserved region 2(C2).The cDNA was connected with pET32a,and transformed to expression bacteria DE3.PFP-C was expressed by a prokaryotic expression system and then purified by affinity chromatography.It showed a significant haemolytic activity when tested with rabbit red cells,the optimal pH for haemolytic activity was 7.5,and its haemolytic function dependents on Ca2+ apparently.

To explore the model of the standardized training for health management talents by referring to the standardized training for resident-doctors.This article analyzed the necessities of the model of the standardized training for health management talents from two aspects.After that,it elaborated on the significance of standardized training.At last,it proposed some ideas about constructing the standardized training for health management talents.

Objective To compare the internal fixation methods for treatment of intertrochanteric fractures in elderly patients.Methods One hundred and sixty four elderly patients with intertrochanteric fractures were treated from June 2006 to September 2011.The fractures were fixed with dynamic hip screws (DHS,n =42),locking proximal femur plate (LPFP,n =40),Gamma nails (n =36) or proximal femoral nail anti-rotation (PFNA,n =46),respectively.The clinical data were collected and the operative time,blood loss,time of clinical healing,postoperative complications and Harris hip scores of 6 months after surgery were compared among groups.Results All patients were followed-up for 6 to 36 months.The operative times of DHS,LPFP,Gamma nails and PFNA groups were (103 ± 15),(90 ± 13),(79 ± 11)and (65 ±9)min,respectively(F =2.87,P ＜0.05).The blood loss of 4 groups was (202 ±23),(181 ±23),(98 ± 13) and (87 ± 11) ml,respectively (F =3.21,P ＜ 0.05).The times of clinical fracture healing were (16.1±1.9),(14.6±1.8),(12.9±1.7) and (11.5±1.4) weeks,respectively(F=2.66,P＜0.05).The postoperative complications of 4 groups were 4/42,3/40,2/36 and 1/46,respectively (x2 =5.67,P ＜0.05).The Harris hip scores of 6 months after surgery of 4 groups were 81％ (34/42),85％ (34/40),89％ (32/36)and 93％ (43/46),respectively(H =20.03,P ＜0.05).Conclusions In treatment for intertrochanteric fractures in elderly patients,the efficacy of intramedullary fixation (Gamma nails and PFNA) is better than extramedullary fixation DHS and LPFP).PFNA is more effective than other 3 methods and should be preferentially chosen.

Objective To assess clinical results between proximal-first sequential anastomosis technique (POPCAB) and conventional technique off-pump coronary artery bypass grafting(COPCAB) in 72 patients over 65 years old.Methods Between Jan 2008 and Oct 2012,72 patients with multiple vessel coronary artery disease underwent off-pump coronary artery bypass grofting.They were divided into two groups,POPCAB and COPCAB groups.Preoperative and postoperative variables of two groups were compared.Results There were no significant difference in sex,age,history of acute myocardium infarction,hypertension,diabetes and number of bypass grafts between two groups.The ICU stay time in POPCAB group was less than in COPCAB group(P ＜0.05).There were lower creatine kinase MB and cardiac trop I after operation in POPCAB group compared with COPCAB group(P ＜ 0.05).Conclusion The results confirm that promixal-first sequential anastomosis technique remains a valuable option of surgical myocardial revascularization,and may optimize the outcome in the aged.

Objective To investigate the influential factors for refracture of the adjacent vertebral body following percutaneous vertebroplasty (PVP) treatment of patients with osteoporotic vertebral compression fractures (OVCFs).Methods A retrospective analysis was conducted on OVCFs patients undergone mono-segmental PVP from July 2007 to March 2010.Patients' age,gender,bone density,bone cement infusion dosage,bone cement leakage and pre-and post-operative fracture reduction were documented.Kaplan-Meier remaining rate curve was used to predict the trend of time to refracture.The related factors for adjacent vertebral body refracture following PVP were analyzed.Results In all,216 patients (98 males and 118 females; age range of 55-76 years,average 65.4 years) were enrolled in this study.Follow-up lasted for 12-18 months.Ninety-two patients sustained refracture including 68 patients with refracture of the adjacent vertebral body.Refracture of the adjacent vertebral body presented time-concentrated tendency and 66％ (45/68) occurred within 100 days followed by a notably lower incidence.Whereas the time to refracture of the non-adjacent vertebral body was not obviously centralized.Bone cement infusion dosage and vertebral body reset condition were strongly associated with the refracture incidence of the adjacent vertebral body,while opposite results were observed in regard of age,gender,bone density and bone cement leakage (or not).Conclusion PVP predisposes OVCFs patients to refracture of the adjacent vertebral body and its influential factors may be associated with bone cement infusion dosage and vertebral body reduction condition.

This study reported the analysis of plasma phospholipid metabolism of the rats and the pathological biomarkers between the type 2 diabetes model control group (MC) and the normal control group (NC). SD rats were randomly divided into 2 groups: NC and MC. To investigate state of plasma metabolite profiling in normal body, type 2 diabetes mellitus (T2DM) model group using UPLC-Q-TOF/MS which was used as analysis tool in this research. The compounds were identified by UPLC-Q-TOF/MS based on MS/MS fragment ions information, element composition in MassLynx 4.1 and the Lipid Maps database. The sign of two groups of samples in specific markers for screening was through a software package in R software (BioMark software). The results show that the pathological markers were mainly phosphatidylcholine (PC) and triglycerides (TG); the 2-acyl PC in the MC group was less more obviously than that in the NC group; high carbon number and high degree of unsaturation of the TG was reduced under the condition of type 2 diabetes. In the state of type 2 diabetes, metabolic changes occurred in rat plasma phospholipids obviously, which had a close relationship with the occurrence and development of T2DM.

Objective To investigate the placental transfer and neonatal effects of dexmedetomidine during the cesarean section under general anesthesia.Methods Thirty-eight nulliparous parturients,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 22-37 yr,weighing 56-82 kg,who were at full term with a singleton fetus,scheduled for elective caesarean section under general anesthesia,were randomly divided into 2 groups (n=19 each) using a random number table:dexmedetomidine group (group D) and normal saline group (group N).In group D,dexmedetomidine was infused in a loading dose of 0.6 μg/kg starting from 10 min before induction of anesthesia,followed by an infusion of 0.4 μg · kg-1 · h-1 until peritoneal closure.Group N received the equal volume of normal saline.Blood samples were collected from the maternal artery (MA),umbilical vein (UV),and umbilical artery (UA) for blood gas analysis and for determination of plasma dexmedetomidine concentrations (CMA,CUV and CUA) by high-performance liquid chromatography-mass spectrometry,and CUV/CMA and CUA/CUV were calculated.Apgar scores were recorded at 1 and 5 min after delivery,and the occurrence of respiratory depression was also recorded.The I-D interval (the time from administration of anesthetics to delivery) and U-D interval (the time from incision of the uterus to delivery) were recorded.Results There were no significant differences in the blood gas analysis parameters in blood samples collected from the MA,UV and UA,I-D interval,U-D interval,and Apgar scores between the two groups (P＞0.05).No neonatal respiratory depression was found in both groups.In group D,CMA,CUV and CUA were 471±119,359±88 and (321±78) ng/ml,respectively,CUV/CMA was 0.76±0.06,and CUA/CUV was 0.89±0.03.Conclusion Although the metabolism of dexmedetomidine is little after easy placental transfer,dexmedetomidine has no adverse effects on the newborn during the cesarean section under general anesthesia.

To observe the curative effect of treating small -incision cataract extraction by intraocular lens implantation combined with trabeculectomy for primary angle-closure glaucoma with cataract.
●METHODS: Totally 44 cases (52 eyes) of primary angle-closure glaucoma combined with cataract were selected to undergo the combined surgery, in order to observe the patients' pre - and postoperative eyesights, intraocular pressures and the postoperative complications.
●RESULTS: The postoperative eyesight was improved significantly as compared with the preoperative eyesight. The intraocular pressure was declined dramatically. The result was of statistical significance (P<0. 05). All the 52 cases' surgeries were performed by the same surgeon. The surgeries were processed smoothly, with 6 postoperative eyes of anterior chamber inflammation cell response, 3 eyes of anterior chamber fibrinoid exudate, 2 eyes of shallow anterior chamber through mydriasis and treatment with glucocorticoids and non - steroidal eyedrops before absorption, and no complications like malignant glaucoma, cyclodialysis, etc. were reported through mydriasis and pressure bandaging before recovery.
● CONCLUSlON: Treating the primary angle - closure glaucoma combined with cataract through the combined surgery has high reliability and desirable curative effect. The surgical method is simple to learn and applicable for promotion on the basic level.