Objective To explore the relationship between different hemorrhage position,hemorrhage volume,surgical time and outcome of treatment with surgical methods of HICH.Methods A total of 1310 patients were admitted from six hospitals from January 2004 to January 2008,the 1310 patients were divided into six groups according to different operation:craniotomy through bone flap (group A),craniotomy through small bone window (group B),stereotactic drilling drainage (group C1 and group C2),neuron-endoscopy operation (group D) and external ventricular drainage (group E),considering hemorrhage position,hemorrhage volume,surgical time and result of surgical methods were reviewed and analyzed.Results ①Craniotomy through bone flap should be selected with the case of superficial or deep hematoma volume (＞ 80 mL),median line structure distinct motion,metaphase or advanced stage of hernia of brain.②Craniotomy through small bone window and neuron-endoscopy should be selected with the case of moderate hematoma volume (50-80 mL) ③Drilling drainage should be selected with the case of small hematoma volume in superficial or deep hematoma volume (20-50 mL) ④Extemal drainage should be selected in dealing with ventricular hemorrhage.Small bone window or neuron-endoscopy should be selected in ventricular casting mould.⑤The appropriate operation time for patients with hematoma volume less than 80 mL should be 6-12 hours and large hematoma should be immediately operated to save lives.The operation time should depend on patients detail condition.Conclusions Craniotomy through bone flap was suitable for large hematoma and hernia of brain; Stereotactic drilling drainage should be selected in patients with hematoma volume less than 80mL; and the operation results in dealing with HICH would be improved via suitable operation time and surgical methods and adividual according to Hemorrhage position and Hemorrhage volume.

Objective:To discuss the clinical feature, diagnosis, and treatment course of pancreatic acinar cell carcinoma (ACC) to guide clinical practice and improve prognosis of patients. Methods:Clinical data of 15 patients with pathologically confirmed pancreatic acinar cell carcinoma between December 1994 and March 2014 in Tianjin Medical University Cancer Institute and Hospital were retro-spectively studied. Results:The patients include eight males and seven females with a median age of 44. Tumors in these patients appeared in different parts of the pancreas. Eight patients had tumor in the head, six in the body and tail, and one in the uncinate process. The tumor size ranged from 3 cm to 18 cm, with an average diameter of 6.67 cm. The patients presented less jaundice and the tumor markers remained constant, specifically, no increase was reported. Six patients had metastasis before their operation. Twelve patients received radical resection, while the other three received palliative treatment. The preoperative and intraoperative diagnoses were not exact. The final diagnosis depended on pathologic confirmation after surgery or puncture. The immunohistochemical results of trypsin and chymotrypsin were positive in the patients who were examined. The postoperative chemotherapy was usually based on gemcitabine. The average survival time was 20.6 months. Conclusion:Pancreatic acinar cell carcinoma has special clinical features, and clinicians tend to regard it as low-grade malignancy. The attitude towards ACC should be positive.

OBJECTIVETo study the etiology, diagnosis and treatment of transverse testicular ectopia (TTE).

METHODSA case of TTE was treated with orchidopexy.

RESULTSSix months after the operation, both of the two testes were in proper positions with normal vascular supply.

CONCLUSIONTTE is a rare congenital abnormality of the male reproductive system with unknown etiology, and surgical correction remains the best option for treatment.

Child ; Humans ; Male ; Testicular Diseases ; diagnosis ; therapy ; Testis ; abnormalities

Objective: To develop a brief version of Quality of Life of College Students Questionnaire(QOLCS-51) to measure the quality of college students conveniently in time. Methods: Qualitative research and two investigations were applied to shorten and verify the brief questionnaire, and SPSS 22.0 and Lisrel 9.20 were used to analyze the reliability and validity of 2 questionnaires. Results: Quality of Life of College Students Questionnaire-bref was developed by deleting 22 items through qualitative research and 6 items by the first investigation. 952 college students from Jiangsu, Anhui and Shanxi Province were selected to participate in the second investigation, which consisted of five domains and 23 items (QOLCS-23). All 23 items were accepted by analysis of difficulty(0.44-0.68), and all have passed the test of critical ratio(P<0.01), the general related index was 0.33-0.60(P<0.01). 78.3% items distinguished the students with/without dyssomnia. Reliability was tested by test-retest reliability coefficient(0.71-0.86), homogeneity reliability coefficient (Cronbach α=0.845) and exploratory factor analysis (6 factors, i.e. physics domain, three subdomains of psychology domain, behavior domain, social domain and environment domain). Validity was tested by correlations of five domains between QOLCS-51 and QOLCS23(greater than 0.8) and confirmatory factor analysis(χ2/df=12.17, RMSEA=0.05, SRMR=0.07, GFI=0.84, AGFI=0.83, CFI=0.92, IFI=0.92, NFI=0.85, NNFI=0.91). Conclusion QOLCS51 consists of 23 items of QOLCS23, after deleting 28 items, to assess 5 dimensions of physiology, psychology, behavior, environment and social support with good construction validity and criterion-related validity, and good homogeneity reliability and re-test reliability.

BACKGROUND: The present study aimed to explore the relationship between surgical methods, hemorrhage position, hemorrhage volume, surgical timing and treatment outcome of hypertensive intracerebral hemorrhage (HICH). METHODS: A total of 1310 patients, who had been admitted to six hospitals from January 2004 to January 2008, were divided into six groups according to different surgical methods: craniotomy through bone flap (group A), craniotomy through a small bone window (group B), stereotactic drilling drainage (group C1 and group C2), neuron-endoscopy operation (group D) and external ventricular drainage (group E) in consideration of hemorrhage position, hemorrhage volume and clinical practice. A retrospective analysis was made of surgical timing and curative effect of the surgical methods. RESULTS: The effectiveness rate of the methods was 74.12％ for 1310 patients after one-month follow-up. In this series, the disability rate was 44.82％ 3–6 months after the operation. Among the 1310 patients, 241 (18.40％) patients died after the operation. If hematoma volume was >80 mL and the operation was performed within 3 hours, the mortality rate of group A was significantly lower than that of groups B, C, D, and E (P<0.05). If hematoma volume was 50–80 mL and the operation was performed within 6–12 hours, the mortality rate of groups B and D was lower than that of groups A, C and E (P<0.05). If hematoma volume was 20–50 mL and the operation was performed within 6–24 hours, the mortality rate of group C was lower than that of groups A, B and D (P<0.05). CONCLUSIONS: Craniotomy through a bone flap is suitable for patients with a large hematoma and hernia of the brain. Stereotactic drilling drainage is suggested for patients with hematoma volume less than 80 mL. The curative effect of HICH individualized treatment would be improved via the suitable selection of operation time and surgical method according to the position and volume of hemorrhage.

Objective To observe the effect of agmatine on brain ede-ma and examine the relation between blood brain barrier ( BBB) per-meability and aquaporin 4 ( AQP4 ) and aquaporin 9 ( AQP9 ) in rats with cerebral ischemic reperfusion.Methods Health male Sprague-Dawley rats were randomly divided into sham group , model group and test ( agmatine ) group.And 2 h after middle cerebral artery occlusion, giving agmatine ( 50 mg · kg -1 ) in test group or 0.9%NaCl in sham and model groups by intraperitoneal injection, respec-tively.Brain edema and the size of the brain infarct were assayed by brain water content and BBB permeability and 2,3,5 -triphenyltet-razoliumchloridstaining( TTC).The morphological changes of neurons were observed by hematoxylin and eosin staining and transmission electron microscopy.And the expression of AQP4 and AQP9 were assessed by Western -blotting.Results The BBB permeability de-creased significantly and the morphological changes of neurons were reduced significantly and the expression of AQP4 and AQP9 decreased significantly in rats with agmatine.Conclusion Agmatine reduce the injury of the BBB by decreasing the expression of AQP4 and AQP9 , and relieve the neuron injury induced by brain edema.

OBJECTIVETo evaluate the efficacy and safety of video-assisted thoracoscopic (VATS) esophagectomy in the treatment of esophageal cancer.

METHODSFrom June 2004 to October 2007, video-assisted thoracoscopic esophagectomy was performed in 36 patients, including 29 men and 7 women with median age of 58.9 years old. The cancer located at upper segment in 5 cases, middle 25 cases and lower 6 cases. VATS approach was used to mobilize the intrathoracic esophagus and stomach was mobilized by open approach. Esophagogastric anastomosis was performed in the left neck.

RESULTSThe mean operative time was 250 minutes (190-330 min) and average time of VATS was 70 minutes. The mean hospital stay was 8.7 days. Mean lymph node harvest was 14.3 nodes. Post-operative complications occurred in 11 patients(30.6%), but no perioperative death occurred.

CONCLUSIONVideo-assisted thoracoscopic esophagectomy is technically feasible and safe with lower morbidity and shorter hospital stay as compared to open procedure, and may replace the open esophagectomy in selected patients.

Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Female ; Humans ; Male ; Middle Aged ; Thoracic Surgery, Video-Assisted

OBJECTIVETo investigate and analyze a case of acute norovirus gastroenteritis outbreak in a hospital.

METHODSData were collected through the on-the-spot investigation and faecal specimens were tested by polymerase chain reaction-reverse transcription (RT-PCR). Serum specimens were tested by Western blot.

RESULTSThe outbreak lasted 26 days. A total of 87 cases were reported, including 65 inpatients, 15 healthcare workers, 6 accompanies, and 1 pantryman. Twelve (60%) of 20 stool specimens were norovirus-positive by RT-PCR and 19 of 24 blood samples were norovirus-positive by Western blot. The outbreak was effectively controlled by isolating and treating the patients, extensive disinfection, and health education.

CONCLUSIONThe gastroenteritis outbreak was caused by norovirus with unkown infection source.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Caliciviridae Infections ; epidemiology ; virology ; China ; epidemiology ; Cross Infection ; epidemiology ; virology ; Disease Outbreaks ; Female ; Gastroenteritis ; epidemiology ; virology ; Humans ; Male ; Middle Aged ; Norovirus ; genetics ; isolation & purification ; Young Adult

Objective To compare metabolite ratios in the basal ganglia regions between preterm and term neonates and analyze the correlation between metabolite ratio and postmenstrual age(PMA)using 2D magnetic resonance spectroscopy(MRS)at 3.0T,so as to explore the value of MRS in evaluating neonatal brain development.Methods Normal neonates who underwent 3.0T MRS exam ination were recruited.Axial 2D MRS was performed with the point-resolved spectroscopy sequence(PRESS)(echo time/repetition time,144 ms/1 000 ms) through the basal ganglia covering three regions of interest(ROI)(i.e.bilateral lenticular nucleus,thalamus and white matter beside the anterior horn of lateral ventricle).The peak areas ratios of Cho/Cr,NAA/Cho and NAA/Cr were calculated.Metabolite ratios were compared between preterm and term neonates,and between three ROIs. Correlation between metabolite ratio and PMA was further analyzed.Results Totally 54 neonates were included(preterm/term,27/27).In all the three ROIs,preterm neonates presented significantly higher Cho/Cr(P＜0.05) and significantly lower NAA/Cho ratios(P＜0.001)than those of term neonates;higher NAA/Cr ratio was only observed in the lenticular nucleus of preterm neonates(P＜0.001).Significant differences in metabolite ratios were detected among the three ROIs in preterm group(P＜0.05).For term group,metabolite ratios differed between lenticular nucleus and white matter beside the anterior horn of the lateral ventricle(P＜0.01),while no difference between lenticular nucleus and thalamus was found(P＞0.05).Significant correlation between metabolite ratio and PMA was found in all the three ROIs except NAA/Cr ratio in the white matter beside the anterior horn of the lateral ventricle.To be specific,we found linear negative correlation of Cho/Cr ratio(r= -0.325,-0.633,-0.438) and positive correlation of NAA/Cho ratio(r = 0.604,0.773,0.483)in all the three ROIs,but negative correlations of NAA/Cr ratio(r=0.487,0.367)in lenticular nucleus and thalamus with PMA.Conclusion Our findings suggest the tempo-spatial pattern of neonatal brain metabolite development in terms of anatomic location and PMA.Besides,the multi-voxel MRS presents potentials in establishing the normal topologic and age-matched reference in neonates and thus making brain maturation assessment and detection of early abnormal metabolism.

Objective To investigate the residents' acceptance and the influencing factors of the hierarchical medical system in Xuzhou, and to suggest on effective system implementation. Methods Xuzhou residents free of cognitive impairment and over 18 years old were sampled for questionnaire survey in July-August 2016, to study their acceptance of their basics and acceptance of the system. 1 550 questionnaires were distributed, and 1 473 valid ones were recovered. The count data were expressed as constituent ratio, and χ2test was used for single-factor analysis, with binary logistic regression analysis for multi-factor analysis. Results 71. 0% of the residents embraced this system. Their acceptance varies significantly with their age, place of residence, education, annual average monthly income, self-rated health status, physical examination experience, conditions of chronic diseases, medical visit experience at primary healthcare institutions, and their awareness of the system (P<0.05). Conclusions The acceptance of the system by Xuzhou residents needs to be elevated, by means of greater promotional efforts, capacity building for primary institutions, so as to fully leverage the system to serve the residents.