Objective To explore the clinical effectiveness of urokinase perfusion and drainage in patients with hypertension cerebral hemorrhage broken into ventricles.Methods Patients with hypertension cerebral hemorrhage broken into ventricles(35 cases)underwent urokinase perfusion and drainage.Clinical effect was observed and the nursing point was summarized.Results Of the 35 patients,20 cases acquired good recovery,13 cases were mildly disabled,2 case were severely disabled,no death occurred.The complications mostly consisted of secondary hemorrhage,infection,disfunction.Conclusions The early lateral ventricle drilling operation,postoperative urokinase perfusion and drainage,active complications prophylaxis and treatment,rehabilitation training can reduce mortality and improve the quality of patients' life.

By literature and network investigation,the paper sorts out development modes and typical practices of Internet medical treatment in China,sums up 6 kinds of modes existing domestically,analyzes the advantages and disadvantages of each mode.It is necessary to further probe into suitable operating modes and to give support on aspects of policies,laws and regulations and supervision,and provides reference for better promoting Internet medical treatment in different places.

Objective To investigate the influence of acupuncture on promoting rat blastocyst nidation with Cx43 expression at the acupoints silenced, and to relate Cx43 with acupuncture's effects. Methods Ma-ted female rats were randomly divided into five groups: normal control, model, acupuncture, interference-control and interference. Mifepristone was used to induce a model of nidation disorder, and RNA interference technology was used to silence the expression of Cx43 at acupoints. P-Cx43-shRNA (1) was injected locally into the acu-points of rats in the interference group, and P-con-shRNA was injected in the interference-control group. Acu-puncture was administered to the acupuncture, interference-control and interference groups for 7 days. On the 8th day of pregnancy, the quality of blastocysts, pregnancy rates, and the average amount of blastocysts in each group were observed. Results ①The mRNA and protein level of Cx43 at the zusanli (ST36) acupoints in the interference group were significantly lower than in the acupuncture group ( P<0.05, P<0.01). There was no significant difference between the interference-control group and the acupuncture group. ② Compared with the normal control group, the quality of blastocysts in the model and interference groups was bad, and the amount was less. Their size was comparatively small, they were inhomogeneous, poorly distributed and had poor blood supply. The results improved in the acupuncture group and the interference-control group compared with the model group. ③The pregnancy rates in the normal control, model, acupuncture, interference-control and inter-ference groups were 100% , 50% , 75% , 75% , and 50% respectively, but these differences were not statisti-cally significant. ④The average amount of blastocysts in the model and interference groups was significantly less than in the normal group (P≤0.01). Compared with the acupuncture group, the average amount of blastocysts in the interference group was lower (P≤0.05). Conclusion Acupuncture can improve the quality and quan-tity of blastocysts in a rat model of nidation disorder. Local injection of Cx43 shRNA expression vector can si-lence the expression of Cx43 in acupoints and markedly influence acupuncture's effect. This demonstrated that Cx43 was involved in acupuncture's effects.

Objective To observe the clinical efficacy of Qingre Liangxue Recipe (QLR), a herbal prescription with the actions of clearing heat and cooling blood, for the treatment of gouty arthritis. Methods Sixty-five cases of gouty arthritis patients were randomly divided into treatment group (N=32) and control group (N=33). Both groups were given oral use of colchicine during the acute stage and being suspended when the pain was relieved, and then were given oral use of allopurinol tablets during the remission stage. Additionally, the treatment group was given oral use of QLR all through the acute stage and remission stage. The treatment lasted for 4 weeks in both groups. After treatment, clinical efficacy was evaluated in the two groups. The number of acute relapse cases and the changes of blood uric acid level were observed. Results At the end of the first treatment week, the treatment group had a total effective rate of 96.9%, significantly higher than that (81.8%) of the control group. At the end of the fourth treatment week, the treatment group had a total effective rate of 100.0%, significantly higher than that (90.9%) of the control group. The treatment group had better therapeutic effect than the control group at the end of the first or the fourth treatment week, the difference being significant ( P<0.01). The number of acute relapse cases and the serum uric acid level were lower in the treatment group than those in the control group during 4 treatment weeks or 12 weeks after treatment suspension, the difference being significant ( P<0.01). Conclusion QLR combined with anti-gout medicines can effectively relieve symptoms of gouty arthritis, reduce incidence of acute relapse, and have long-term effect on lowering blood uric acid level.

Objective To study the expression of Toll-like receptor-2 (TLR-2) and caspase-3 in the intestine of premature rats with necrotizing enterocolitis (NEC),and to explore the protective effects and possible regulatory mechanism of glutamine (Gln) in the NEC.Methods Sixty premature rats (gestational age 21 d) were divided into three groups (n = 20 each) according to the random number table: control group,model group and Gln intervention group.Rats in model group were given formula feeding,hypoxia and cold stress.Rats in Gln intervention group were given Gln 0.3 g/kg to the formula feeding,hypoxia and cold stress.All the premature rats were sacrificed and the intestine tissues were obtained on the third day after birth.The histological changes of ileal tissues were scored after HE staining.The expression of TLR-2 and caspase-3 in jejunum,ileum and colon were detected by inmunohistochemistry,and the expression of TLR-2 mRNA in jejunum,ileum and colon were detected by real-time fluorescence quantitative reverse transcription-polymerase chain reaction.Results Pathology score of ileum in model group,Gln intervention group and control group were 3.10 ±0.99,2.40 ± 0.69 and 0.30 ±0.48,respectively.The expressions of TLR-2 protein in ileum were 2.53±0.94,2.15±0.82 and 1.57 ± 0.62 in the three groups respectively,and the expression of caspase-3 protein were 2.83 ± 0.45,2.70 ± 0.04 and 0.91 ± 0.29.The content of TLR2 mRNA in model group was 1.46 times higher than that of Gln intervention group and was 2.10 times higher than that of control group.Compared with the control group,the pathology score,expression of TLR-2 and caspase-3 protein,and TLR-2 mRNA in model group were significantly higher,P＜0.01.However,compared with the model group,those changes were improved in Gln intervention group,P＜0.05.Expression of TLR-2 mRNA positively correlated to the expression of caspase-3 protein (r=0.71,P＜0.01) and pathology score (r = 0.69,P＜ 0.01).Expression of caspase-3 protein positively correlated to the intestine injury pathology score (r=0.81,P＜0.01).Conclusions TLR-2 may be involved in the pathogenesis of NEC.Gln might reduce the expression of TLR-2 in the intestine,and decrease the apoptosis of intestinal epithelial cells to protect the intestine of preterm birth rats.

Objective To investigate the effects of laporoscopic resection applied to colorectal cancer patients on metabolism. Methods According to patients' choice of operation, either laparoscopic-assisted (n = 22, experimental group) or open(n = 27, control group) resection of colorectal cancer was performed. The levels of electrolyte were assayed preoperatively, postoperatively and on the time of 24 hours after opera-tion. Rseults There was no significant difference in the level of electrolyte before operation between the two groups (P > 0. 05). Compared with the preoperative period, the level of serum potassium in the both groups were significantly increased after operation(P < 0. 05), and 24 hours later, the levels of electrolyte was not significantly different in both the two groups (P > 0. 05). During the postoperative period, the level of serum potassium in the experimental group was lower than the control group(P <0. 05), while the level of HCO_3~- was higher than the control group(P <0. 05), and there were no significant differences in the level of serum sodium, chloride and calcium between the two groups(P > 0. 05). Conclusions Laparoscopic-assisted re-section of colorectal cancer gives lower levels of stress responses compared to open surgery. However, it shows higher effect on the level of HCO_3~- , and must be paid more attention during operative and postopera-tive period.

Objective To investigate the types and distributions of allergens, and the responsiveness to these allergens SIgE and tIgE as related to allergic disorders in patients with allergies in Guangdong. Methods Serum samples were obtained from patients with allergic disorders (n = 7 144) who visited our hospital between 2009 and 2014. The sera were subjected to analysis of 15 common allergens. Results The positive rates of sIgE and tIgE were 62.4%and 54.6%, respectively. Dermatophagoides pteronyssinus(Der p) had the highest prevalence of aeroallergen-specific IgE and milk the highest prevalence of food allergen-specific IgE. Other aeroallergens and food allergens produced mild responses except Der p and Der f. The sensitization peak of Der p and Der f appeared at the age of 10 to 12 years. The sensitization peak of milk appeared at the age of less than 3 years and that of eggs did at the aged of 4 to 6 years. The averaged tIgE positive rate went up with the increase in the number of allergen sensitization. Conclusion Der p, Der f, milk and eggs are major sensitizers responsible for common allergic disorders in Guangdong. Knowledge concerning allergen characteristics at various age groups may be helpful for early diagnosis and intervention for allergies.

Objective To investigate the efficacies of preoperative location with titanium clip and methylene blue staining in laparoscopic colectomy.Methods The clinical data of 31 patients with colorectal polyps which could not be resected under endoscope were admitted to the Third Affiliated Hospital of Sun Yat-Sen University from August 2006 to September 2012 were retrospectively analyzed.According to the methods of preoperative location of colorectal polyps,all patients were divided into the titanium clip group (18 patients) and the methylene blue group (13 patients).Titanium clip group:enteroscopic and pathological examination were firstly performed,and then 1 or 2 titanium clips were placed at the superior and inferior part of the polyps.After enteroscopic examination,abdominal X ray examination was performed to detect the position of polyps according to the positions of the titanium clips.Methylene blue group:after colonoscopy,methylene blue of 1 mL was injected into the adjacent mucosa of the polyps,and 4 positions around the polyps were selected for the injection of methylene blue.If the 2 locating methods were failed,intraoperative enteroscopy was performed.Laparoscopic resection for intestine or mesenterium was performed according to the treatment principle of colorectal neoplasms,and the location efficacy of the 2 methods and the treatment of the 2 groups were analyzed.The measurement data and the count data were analyzed using the t test and chi-square test,respectively.Results The success rates of the titanium clip group and the methylene blue group were 15/18 and 8/13,with no significant difference between the 2 groups (x2=0.284,P ＞0.05).The polyps in 8 patients which were failed to be localized by titanium clip or methylene blue were localized by intraoperative enteroscopy,while the operation time was prolonged to (44 ± 13)minutes.No positioning errors were detected in all the 31 patients.Laparoscopic right colectomy was performed on 4 patients,laparoscopic left colectomy on 11 patients,laparoscopic sigmoid colectomy on 9 patients,laparoscopic anterior resection of rectum on 7 patients.No morbidity or mortality was detected in the 2 groups.The length of specimen,distance between the proximal margin and the superior margin of the tumor,distance between the distal margin and the inferior margin of the tumor (patients with colonic polyps),distance between the distal margin and the inferior margin of the tumor (patients with high rectal polyps),and the number of lymph node resected were (20 ± 7) cm,(11 ± 4) cm,(8.6 ± 3.1) cm,4.2 ± 1.1,8 ± 5 in the titanium clip group,and (20 ± 5) cm,(9 ± 3) cm,(9.1 ± 2.8) cm,4.6 ± 0.5,7 ± 6 in the methylene blue group,with no significant difference between the 2 groups (t =0.053,0.918,0.213,1.486,0.267,P ＞0.05).Fifteen patients had cancerization of the polyps,including 8 patients with TNM Ⅰ stage,6 with TNM Ⅱ] stage and 1 with TNM Ⅲ stage.Conclusions For patients with colorectal polyps located at the intestine above the descending colon,titanium clip locating is easy,safe and effective,and it could be the first choice for locating the colorectal polyps.Endoscopic methvlene blue staining is simple but high technique demanding.Intraoperative enteroscopy is precise for locating the polyps at the intestine below the descending colon.

Objective To investigate the value of ionic-contrast esophagogram in diagnosis of intrathoracic anastomotic leakage after oesophagectomy.Methods The data of 728 patients suffered esophagectomy were retrospectively collected.723 patients without clinical manifestations of anastomotic leakage were divided into group A(esophagogram before eating,n=465) and group B(non-esophagogram before eating,n=258).The incidence of anastomotic leakage was compared between the two groups.Results The discovery rates of anastomotic leakage in group A and B were 0.43%(2/465) and 0.78%(2/258),respectively,the difference was no statistically significant between the two group(P=0.55).The total incidence rates of anastomotic leakage in group A and B were 0.65%(3/465) and 0.78%(2/258),respectively,the difference was no statistically significant between the two groups(P=0.84).5 patients with clinically suspected anastomotic leakage,all had loculated pleural effusion,4 cases had fever,and 2 cases had abnormal chest drainage.Finally,4 cases(80%) were confirmed to be anastomotic leak by esophagogram.Conclusion Routine ionic-contrast esophagogram before eating do not improve intrathoracic anastomotic leakage detection rate after esophagectomy,but when patients have fever,loculated pleural effusion and abnormal chest drainage,esophagogram is necessary and can improve the detection rate of esophageal anastomotic leak.CT radiography may detect smaller anastomotic leakage than conventional esophagogram.

Objective To explore the clinical and pandemic features and respiratory pathogen co-infection characteristics of children infected with influenza virus A (Flu A) in year 2009.Methods A retrospective study of hospitalized children with flu-like clinical symptoms in 2009 was conducted.The peripheral blood serum was analyzed to detect common respiratory agents,inclucding Flu A,respiratory syncytial virus,adenovirus,influenza virus B,parainfluenza virus 1,2 and 3,chlamydia pneumonia and mycoplasma pneumonia,klebsiella pneumonia (KP),haemophilus influenza and legionella pneumophila by using indirect immunofluorescence test for the antibody detection (IgM).And a standard medical history was recorded,including epidemiological data,clinical manifestation,and the length of hospital stay,white blood count and chest X-ray elsewhere.All specimens were collected in Department of Pediatrics,Zhongnan Hospital of Wuhan University,from Jan.2009 to Dec.2009.Results Flu A was detected in 234 of the 599 (39.1％,234/599 cases) flu-like children.The mean age was 48.8 months (range from 3 to 167 months).The detection rate in less than 1-year-old group (11.1％,18/162 cases) was obviously lower than that of the older groups (P ＜ O.001).Especially for the group ＜ 6 months,there was only 1 infant (1.43％,1/70 cases) with Flu A positive.Compared with Flu A negative group,the main clinical features of children with Flu A positive group were fever(78.2％,183/234 cases,P =0.013) and cough(76.5％,179/234 cases,P =0.04),however asthma (14.1％,33/234 cases,P =0.003)and diarrhea (6.0％,14/234 cases,P ＝ 0.001) cases were less.The detection rates of Flu A reached a peak of 57.0％ in November and December,and a secondary peak of 45.0％ in May and June.Flu A infection children less than 1 year old were simple in etiology.The children were older,the etiology was more complex.The primary coinfection pathogen was KP (53.8％,126/234 cases) and Flu B(48.3％,113/234 cases).Compared Flu A coinfection with or without KP,there was no difference between these 2 groups in the clinical features.Conclusions Intfluenza A is the main pathogen of hospitalized children with flu-like symptoms in 2009.Children over 1 year old age were the major infection groups of Flu A.The detection rates of Flu A reached peaks in May to June and November to December.Flu A positive children were prone to KP coinfection.