0 05).There wasn't side reaction in YXL.Conclusion YXL has better effect of antiepilepsia and resuming consciousness.

Long-term prognosis of stroke rehabilitation is associated with a number of factors, such as age, sex, race, lesion sites and sides, lesion nature and various complications. Under-standing these related factors not only contribute to clinical judgement of prognosis, but also provide the basis for the targeted rehabilitation therapy.

Objective To analysis the correlation of the anti-β2 glycoprotein 1 antibodies in female infertility and threatened a-bortion.Methods Selected 547 patients with female infertility,229 patietns with threatened abortion,229 patietns with ir-regular menses and 31 normal female between August 2013 to January 2014.All the anti-β2 glycoprotein 1 antibodies (Ig-G/Ig-M)were detected by ELISA.Detected the anti-β2 glycoprotein 1 antibodies (Ig-G/Ig-M)of 114 patients who treated with aspirin and prednisone combined with gamma globulin.Results The positive rate of anti-β2GP1 antibodies (Ig-G/Ig-M)of female infertility,threatened abortion,irregular menses and normal female were 0.36%,0.43%,1.6%,0% and 20.29%, 19.21%,8.3% and 3.2%,respectively.The positive rate of aβ2GP1-IgM of female infertility,threatened abortion,irregular menses were higher than normal female.The anti-β2GP1-IgM of the treated female infertility were 47.14± 34.85 RU/ml and 31.14±27.64 RU/ml,respectively.The anti-β2GP1-IgM of the treated threatened abortion were 37.75±31.20 RU/ml and 24.34±24.48 RU/ml,respectively.The levels of anti-β2GP1-IgM of the treated patietns were significantly lower than before.Conclusion There was a close relationship between anti-β2GP1-IgM antibodies and female infertility and threatened abortion,anti-β2GP1-IgM antibodies maybe one of the immune factors for female infertility and threatened abortion.

Objective Toexplore the application value of diffusion tensor imaging (DTI) in evaluating evaluation offunctional changes of the in patients with primary trigeminal neuralgia caused (PTN) by neurovascular compression. Methods 40 unilateral PTN patients and 40 healthy volunteers were enrolled in ourstudy.They allAll patients underwent the general sequences and DTI ,and then to measured the ADC and FA values of the trigeminal nerves. Results (1) Compared with contralateral side (0.408 ± 0.054)and bilateral sides in control group(0.423 ± 0.057), FA value of the ipsilateral side in PTN group(0.330 ± 0.056) was significant lower (P< 0.05)compared with the contralateral side (0.408 ± 0.054) and bilateral sides in control group (0.423 ± 0.057).The ADC value of ipsilateralside (2.052 ± 0.473)× 10-3 mm2/s was significantly higher (P < 0.05) thancompared withthe contralateral side (1.541 ± 0.266) ×10-3 mm2/s and bilateral sides in control group(1.431 ± 0.308) ×10-3 mm2/s. (2) An There's a nnegative correlation was found (r = -0.613,P < 0.001) between the loss of FA and the increase of ADC (r = -0.613,P < 0.001). Conclusion DTI could be used to evaluate the changes of neuratrophy and demyelination ,so it canmight be used of in diagnosis and treatment of PTNin further way.

Objective To evaluate HRCT typing of solitary pulmonary nodule with resected.Methods 30 cases with solitary plumonary nodules (totally 41) were undergone CT and HRCT scan befor operation.HRCT appearances were retrospectively analyzed and categorized into two types: typeⅠ ground-glass opacity (pure ground-glass opacity, mixed lower opacity, central high opacity with ground opacity ), typeⅡ pure solid opacity.Results TypeⅠ:14 nodules included bronchioloalveolar cell carcinoma (9 nodules) , adenocarcinoma (3 nodules),inflammatory granuloma (1 nodule) and adenoma (1 nodule).TypeⅡ : 27 nodules included adenocarcinoma(13 nodules),bronchioloalveolar cell carcinoma(4 nodules), squamous cell carcinoma(3 nodules),small cell lung cancer(1 nodule),adenoma(2 nodules),tuberculosis(2 nodules), inflammatory granuloma(1 nodule) and hamartoma(1 nodule). Among nodules with resected, ground-glass opacity was found more frequently in bronchioloalveolar cell carcinoma than in non- bronchioloalveolar cell carcinoma (P=0.002).No significant difference in ground-glass opacity existed between tumor lesions and non-tumor lesions (P=0.282) or adenocarcinoma and non-adenocarcinoma (P=0.146).Conclusion In the findings of HRCT in solitary pulmonary nodules,the nodules of ground-glass opacity find more frequently in bronchioloalveolar cell carcinoma than that in other lesions.

Objective To research the significance of the levels of neuron-specific enolase(NSE), S100B and myelin basic protein(MBP) in predicting the severity and prognosis in patients with subarachnoid hemorrhage (SAH). Methods The serum levels ofNSE, SI00B and MBPwere measured within 72 hours after the injury in 36 patients with SAH(SAH group), then the severity of illness and prognosis was evaluated by world federation of neurosurgical societies(WFNS) grade and Glasgow outcome scale(GOS) respectively. Twenty healthy persons were selected as controls(control group). Results After the injury, the serum levels of NSE,SI00B and MBP in SAH group increased significantly compared with those in control group. Moreover, there were significant difference in the serum levels of NSE, S100B and MBP among different groups in different severity of illness and prognosis. Assessed the severity and prognosis by serum levels of NSE 25 μg/L, S100B 1.2 μg/L and MBP 10.0 μg/L after 72 hours of SAH, the specificity of assessing the severity by NSE, SI00B and MBP was 71.43%,61.90%, 66.67%, and the sensitivity was 73.33%,86.62% and 73.33%. At assessment of prognosis,the specificity of NSE, S100B, MBP was 69.57%, 60.87%,65.22%, and the sensitivity was 61.54%,76.92% and 69.23%. Conclusion There are higher specificity and sensitivity in evaluating the severity of illnoss and prognosis in patients with SAH by serum levels of NSE, S100B and MBP.

Objective To investigate the clinical value of stereotactic biopsy in the diagnosis of the multiple intracranial lesions, and explore the operation methods, technical points and clinical experiences to reduce surgical complications. Methods Twenty-three patients in the first affiliated hospital of Kunming Medical University underwent stereotactic biopsy from January 2009 to June 2013 were analyzed retrospectively. The patients were aged between 11 and 73 years (the mean age of 34.6 years) . There were 12 males and 11 females. Operations were performed by thin thickness of spiral CT scan, ASA-602S and Leksell-Frame-G stereotactic frame, Sedan side-cutting needle, Backlund side-cutting needle and neuroendoscope of STORZ. Routine histopathological examinations of specimens were conducted. The immunohistochemical staining of the histopathological section of specimens was performed if necessary. Results The diagnostic yield was 91.3% (21 cases) . The result of pathological diagnosis was inflammatory granuloma in 1, inflammatory lesion in 1, calcification in 1, hyperplasia of colloid cells in 6, astrocytoma in 1 (WHOⅠ-Ⅱ), astrocytoma in 2 (WHOⅡ), astrocytoma in 1 (WHOⅡ-Ⅲ), mixed oligoastrocytoma in 1 (WHOⅠ-Ⅱ), glioblastoma multiforme in 3 (WHOⅣ), germinoma in 1, brain metastases in 1, diffuse large B-cell lymphoma in 1, intracranial granulomatousarteritis in 1 and negative in 2. There were no serious complications, such as coma, hemiparalysis, infection and intracranial hematoma. Conclusion Stereotactic biopsy is an important method in the diagnose of multiple intracranial lesions. It has the advantages of precise location, less damage, safe performance, and reducing the complication effectively. It is worth promoting.

BACKGROUND:Osteosarcoma combined with pathological fracture was often treated by amputation. With clinical application of neoadjuvant chemotherapy and improvement of technology and material of the prosthesis, the limbs of patients with osteosarcoma combined with pathological fracture were reserved. OBJECTIVE:To evaluate the effect of the application of custom-manufactured artificial total knee prosthesis replacement in limb salvage treatment for patients with osteosarcoma combined with pathological fracture. METHODS:A total of 11 patients with pathological fracture with osteosarcoma located in adjacent knee Joint were enrol ed from June 2002 to September 2012. In accordance with individual condition of the patient, limb salvage treatment was designed for knee prosthesis for a tumor. Fol ow-up results were retrospectively analyzed. There were six males (54.5%) and five females (45.5%) and their age ranged from 11 to 50 years old with an average age of 25.4 years old. Onset regions:seven tumors were located in the distal femur and four tumors were in the proximal tibia. Al patients received neoadjuvant chemotherapy, and limb salvage treatment with custom-manufactured artificial knee prosthesis. The fol ow up was performed for 9 to 105 months. RESULTS AND CONCLUSION:In 11 patients after prosthesis replacement, the regional recurrence rates were 18%, lung metastasis rates were 36%. The five-year survival rate was 58%. Four patients developed lung metastases and died in 9 to 24 months postoperatively. During the last fol ow-up, Enneking score of the affected limbs was 11 to 30 points, averagely 23.3 points, with an excellent and good rate of 82%. Results indicated that combined with neoadjuvanet chemotherapy, the application of custom-manufactured artificial total knee prosthesis replacement in the treatment of osteosarcoma located in adjacent knee joint and pathological fracture achieved an ideal outcomes of the limb salvage treatment in the near future. The lone-term effectiveness was expected to be evaluated.

Clopidogrel can inhibit platelet aggregation and reduce the risk of recurrent stroke.However,it is a great difference in antiplatelet inhibition in different populations.This article reviews the mechanism of clopidogel resistance and its countermeasures in the prevention of ischemic stroke.

OBJECTIVE:To systematically review the related evidence-based guidelines of purulent meningitis in children,and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,CBM,Wanfang Data-base,CJFD and VIP,NGC,GIN,TRIP and websites of domestic and international medical associations and industry bodies,the treatment guidelines about purulent meningitis in children were collected. Evidence-based evaluation was performed after data extrac-tion and quality evaluation. RESULTS:Finally 3 guidelines were enrolled in total,with development time ranging from 2004 to 2012,from USA,Britain and Australia,respectively. All of the recommendations were level B,scope and purpose and clarityshowed the higher scores in AGREEⅡ,more than 70%,and applicability showed generally low scores. Penicillin and cefotaxi-me were recommended in purulent meningitis of neonates,and vancomycin combined with cefotaxime or ceftriaxone were recom-mended for infants and children(it was combined with vancomycin when Streptococcus pneumoniae infection was suspected). The dose and duration of each guideline were certain different,and the period of treatment should be longer in neonates. In addition, the glucocorticoid was recommended in all guidelines. CONCLUSIONS:The recommendations of medicines for the treatment of pu-rulent meningitis are basically unanimous,with no regional difference,but there are some differences about dose and the course of treatment. In addition,the classification criteria of the levels of evidence and recommendation are still suboptimal,which needs fur-ther improvement. And guidelines on purulent meningitis should be improved inrigourandapplicabilityin future.