Objective To investigate the injury characteristics and prognostic risk factors of patients with craniocerebral injury so as to provide some suggestions for the improvement of medical prevention,intervention and treatment measures.Methods Trauma database system was applied to collect the medical records of 661 patients with traumatic brain injury admitted to the Department of Neurosurgery of 105th Hospital of Hefei in 2009.Their general conditions,injury characteristics and outcomes were analyzed and the risk factors affecting their outcomes were investigated by Logistic regression analysis.Results Of the patients with craniocerebral injury,the males accounted for 70％ (463/661).The patients at 45 years old or so had the highest incidence of craniocerebral injury.Patient number in the second half of one year was 1.65 times more than that in the first half of one year (412/249 ).Most patients were injured from traffic accidents (87.7％,580/661 ) and 512 patients (77.5％) suffered from multiple injuries.ISS,injury causes,age and injury incidence quarters showed close correlation with the final outcome.Conclusions The patients with craniocerebral injury demonstrates distinctive characteristics in aspects of gender,age,incidence time,injury causes,and multiple injuries,but the ultimate outcomes are related to the injury severity,injury causes,age and other factors.

Objective To investigate the CT characteristics of anaplastic thyroid carcinoma and evaluate the diagnostic value of CT in this disease.Methods The CT findings of 10 patients with pathologically proved anaplastic thyroid carcinoma were retrospectively reviewed.The patients included 7 females and 3 males.Their age ranged from 25.0 to 78 years with median of 61 years.Multi-slices plain and post contrast CT scans were performed in all patients.Results Unilateral thyroid was involved in 6 patients.Unilateral thyroid and thyroid isthmus were both involved in 2 patients due to big size.Bilateral thyroid were involved in 2 patients.The maximum diameter of anaplastic thyroid carcinoma ranged from 2.9-12.8 cm with mean of (4.5 ± 1.4) cm.All lesions demonstrated unclear margins and envelope invasion.The densities of all lesions were heterogeneous and obvious necrosis areas were noted on precontrast images.Seven lesions showed varied calcifications,and coarse granular calcifications were found in 5 lesions among them.All lesions showed remarkable heterogenous enhancement on post-contrast CT.The CT value of solid portion of the tumor increased 40 HU after contrast media administration.The ratios of CT value which comparing of the tumor with contralateral sternocleidomastoid muscle were 0.69-0.82 (0.76 ± 0.18)and 1.25-1.41 (1.33 ± 0.28)on pre and post CT,respectively.Enlarged cervical lymph nodes were found in 6 cases (60.0％).It showed obvious homogeneous enhancement or irregular ring-like enhancement on post-contrast images and dot calcifications were seen in 1 case.Conclusions Relative larger single thyroid masses with coarse granular calcifications,necrosis,envelope invasion,remarkable heterogeneous enhancing and enlarged lymph nodes on CT are suggestive of anaplastic thyroid carcinoma.

BACKGROUND:After acute myocardial infarction(AMI),there is still surviving myocardium in and around the infarcted area,which plays an important role in the occurrence of arrhythmia. OBJECTIVE:To study the alterations of the activities of Na+ channel current(INa),L-calcium current(ICa-L),transient outward K+ current(Ito) and inward rectifying K+ current(IK1) in the cardiomyocytes in the infarcted area after AMI. DESIGN: A randomized controlled study. SETTING:Department of Cardiology,Bethune International Peace Hospital. PARTICIPANTS:The experiment was finished in the Central Laboratory of the Department of Cardiology,Bethune International Peace Hospital from January to June 2003.Twenty New Zealand pure big-ear rabbits were randomly divided into AMI group(n=10) and control group(n=10). INTERVENTIONS:Rabbit AMI models were established by ligation of the left anterior descending coronary artery.The ventricular myocytes were separated with the method of enzymatic dissociation technique,and the changes of the ion currents were recorded with the whole cell patch-clamp techniques. MAIN OUTCOME MEASURES:The changes of INa,ICa-L,Ito and IK1 in the cardiomyocytes taken from the infarcted area of epicardium 24 hours after AMI in both the AMI and control groups. RESULTS:Twenty-four hours after AMI,the peak current densities of INa,ICa-L and IK1 in the AMI group [(28.48± 3.53) pA/pF,n=16;(3.91± 0.95) pA/pF,n=12;(26.93 ± 3.48) pA/pF,n=16]were all significantly reduced as compared with those in the control group [(45.50± 5.33) pA/pF,n=12;(5.58± 1.53) pA/pF,n=10;(34.12± 4.21) pA/pF,n=10] (t=3.026,P< 0.01;t=2.985,P< 0.01;t=2.706,P< 0.05).There was no significant difference in the Ito density between the AMI group and control group (P >0.05). CONCLUSION:The reduce of INa,ICa-L and IK1 caused by AMI can result in the decrease of myocardial conduction velocity,the shortening of action potential-time,abnormal repolarization,which is possibly the ionic mechanism for the reentrant ventricular arrhythmia after AMI.

Objective To determine the drug-resistance rates of bacteria isolated from 7 hospitals located at different areas of China.Methods 1 111 pathogenic strains were isolated for susceptibility test using agar dilution method from Sep 1,204 to Aug 3 1,2005.According to the criteria of guideline of CLSI (2007),MIC50 and MIC90 were detected for antibacterial activity of antimicrobial agents and resistant rate (R%),intermediate rate(I%)and sensitive rate(S%)were calculated based on susceptibility tests.Results The detectable rates of methiciltin-resistant Staphylococcus anreus(MRSA)and methicilllin- resistant Staphylococcus epidermidis(MRSE)were 39.3%and 74.0% respectively.The total resistant rate of penicillin resistant Streptococcus pneumoniae(R%+I%) was 33.3%(R%=5.6%,I%=27.7%). 91 strains of Enterococcus were isolated.The resistant rate of penicillin resistant E.faecalis Was 40.8%.and E.faecium Was 100%.Neither strains of S.aureus nor strains of S.epidemidis were found resistant to vancomycin.No strains of Enterococcus were found resistant to vancomycin.644 strains of gram-negative bacilli were isolated.The most common gram-negative bacilli were E.coli,k pneumoniae,Acinetobacter spp,P.aeruginosa,and E.cloacae,respectively.The ESBLs-producing strains accounted for 38.6% and 26.7% in E.coli and K. pneumoniae.respectively.Meropenem and imipenem were the most potent antimicrobial agents.Cefoperazone/sulbactam demonstrated excellent activity agent of gram-negative bacilli.Most of the gram-negative bacillus still susceptible to ceftazidime.The new fluroquinotones, moxifloxacin and levofloxacin showed strong and broad spectrum activity against the most gram-positive and gram-negative bacteria.Conclusions This surveillance in 2004-2005 together with the surveillance in 2002-2003,were similar in the bacterial resistance pattern and the trend of rising resistant rates for some pathogens.

Objective To investigate the protective effect of meglumine adenosine cyclosphosp (MAC) on the cerebral ischemia-reperfusion (I/R) injury in rabbits.Methods Twenty four healthy rabbits were randomly divided into control group (n =6),I/R group (n =6),MAC pretreated group (n =6),and MAC treated group (n =6).Cerebral ischemia-reperfusion injury model was made by separating and electrocoagulating vertebral arteries and clipping common carotid arteries in the latter 3 groups after anesthesia.The sham-operated group underwent vessel separation without clipping.L/R group was administered with nothing,while MAC pretreated group with MAC before ischemia,and MAC treated group with MAC just after ischemia.Blood was gathered from jugular vein before ischemia,and 30 min,1 h,and 2 h after reperfusion for testing IL-8,superoxide dismutase (SOD) and malondialdehyde (MDA).The brain tissue slice was observed by optical microscope.Results Compared to control group and before ischemia,the levels of IL-8 and SOD in serum were significantly increased and decreased,and the levels of MDA was significantly increased at 30 min after reperfusion in I/R group; the levels of IL-8 and MDA in serum were significantly increased,and the levels of SOD in serum was significantly decreased at 1 h and 2 h after reperfusion in I/R group.The levels of IL-8 in serum was less at 30 min and 1 h and 2 h after reperfusion in MAC pretreated group than in I/R group.At 1 h and 2 h after reperfusion,the levels of MDA in serum was less and the levels of SOD in serum was higher in MAC pretreated group than in I/R group.At 1 h and 2 h after reperfusion,the levels of IL-8 in serum were less and the levels of SOD in serum were higher in MAC treated group than in I/R group.The levels of MDA in serum were less at 2 h after reperfusion in MAC treated group than in I/R group.Compared to I/R group,pathological change was lighter in the MAC pretreated and MAC treated group.Conclusions MAC has a fine cerebral-protective effect and has no side effect.

Objective To explore the clinical significance and gene mutation profiles of renal transplant patients with unconjugated hyperbilirubinemia (Gilbert's syndrome).Methods Genomic DNA was extracted from peripheral blood samples of 8 renal transplant patients with Gilbert'S syndrome.UGT1A1 * 6 and UGT1A1 * 28 genotypes were identified through digital fluorescence molecular hybridization and DNA sequencing.Results There are 2 cases of UGT1A1 * 28 heterozygous mutant,3 cases of UGT1A1 * 6 homozygous mutant,2 case of UGT1A1 * 6 heterozygous mutant,1 case of UGT1A1 * 28 heterozygous mutant combined with UGT1A1 * 6 heterozygous mutant.Conclusion There is a higher heterozygous or homozygous gene mutation rate of UGT1A1 * 6 and UGT1A1 * 28 in renal transplant patients with Gilbert's syndrome.Genetic mutation of UGT1A1 * 6 and UGT1A1 * 28 may be the reason of Gilbert's syndrome after renal transplant.

ObjectiveTo explore the relationship of blood volume changes and postoperative delirium in elderly patients undergoing surgery for hip fracture.Methods One hundred and fifty elderly patients who underwent surgery for hip fracture were enrolled in the study.Delirium was diagnosed by Confusion Assessment Method(CAM).Preoperative,intraoperative and postoperative data were collected,and the correlation of postoperative delirium and blood volume changes were analyzed by logistic regression analysis.ResultsA total of 59 patients(28 males and 31 females)had delirium after surgery and the occurrence rate of postoperative delirium was 39.3％ (59/150).The average age in delirium group was significantly older than that in the control group[ (77.71 ±6.63)years old vs(73.79 ±5.42) years old,t =-3.958,P ＜0.001 ].The average hemoglobin concentration and hematocrit in delirium group were both less than that in control group whether before surgery or at 7 days after surgery( before surgery:average hemoglobin concentration:[ ( 117.80 ± 16.59)g/L vs( 123.92 ±14.61 ) g/L,t =2.378,P =0.019; hematocrit:(0.355 ± 0.154) vs(0.372 ± 0.210),t =2.291,P =0.023 ;7days after surgery:average hemoglobin concentration:(98.15 ± 11.51 ) g/L vs ( 102.33 ± 9.88 ) g/L,t =2.369,P =0.019; hematocrit:(0.296 ± 0.040 ) vs (0.306 ± 0.030),t =-3.958,P ＜ 0.001 ].There was no significant difference on gender,fracture type,surgical approach,operative time,blood loss and hemoglobin concentration at 1,3 days after surgery between the two groups( P ＞0.05 ).Logistic regression analysis showed that age ( OR 3.280 ),education ( OR 0.389 ),and hemoglobin concentration at 7 days after operration ( OR 1.097) were significantly related to the occurrence of postoperative delirium ( P ＜ 0.05 ).Conclusion Our findings suggest that the risk for postoperative delirium is the result of more than one factor.Older age,continued postoperative low hemoglobin concentration and low degree of education present high risk of delirium in patients underwent surgery for hip fractures.

Objective To evaluate the regional cerebral metabolic changes in different episodes by magnetic resonance spectroscopy (MRS) after explosive brain injury in rabbits. Methods Fortyfive New Zealand white rabbits were randomly divided into eight groups, ie, normal control group( 10 rabbits) and trauma group (35 rabbits). The explosive injury in trauma group was induced by explosion of 600 mg TNT equivalent of paper detonators at 6.5 cm above the rabbit brain. The rabbits in trauma group was divided into 1,6, 12, 24 hours, 3, 7, 14 days subgroups (6 rabbits per group). The survival rate was observed at different time points after explosive injury. The MRS was used to detect the regional cerebral metabolic changes including N-acetylaspartate (NAA)/creatine (Cr) ratio and choline(Cho)/Cr ratio as well as evolution of blast injuries over time. Results The rabbits survived for overseven days in the trauma groups, with typical brain contusion manifested by pathological and conventional MRI. Compared with the normal control group, the NAA/Cr ratio was markedly decreased at one hour after injury, slightly rose again at 24 hours and fell again after seven days. The Cho/Cr ratio was markedly increased at one hour after injury, slightly fell again at 12 hours and rose again at three days after injury.Conclusions MRS can manifest the regional cerebral metabolic changes of rabbits with explosive injury at different time points and hence provide a theoretical basis for understanding the local tissue changes and determining the type of tissue damage after blast injury.

Objective To observe the correlation of MRI findings with treatment outcome of percutaneous kyphoplasty (PKP) in the acute phase of osteoporotic vertebral compression fracture (OVCF).Methods A total of 101 patients with single-segment OVCF undergone PKP in the acute phase were included in the study.There were 19 males and 82 females, at age range of 61 to 89 years (mean, 69.3 years).According to the T2WI signal intensity, the patients were divided into low signal group (Group A), low-medium signal group (Group B), medium signal group (Group C), and mediumhigh signal group (Group D).visual analogue scale (VAS) was used to evaluating the pain relief.Correlations of MRI signal with vertebral height, vertebral compression ratio, Cobb's angle change in each group were determined.Results All MRI images were shown as low signal in T1WI and high signal in FS-T2WI.On the T2WI images, the signal was medium-high in 14 vertebrae, medium in 18 vertebrae, low-medium in 31 vertebrae, and low in 38 vertebrae.Among four groups, the VAS score, vertebral body height, vertebral compression ratio and Cobb's angle changes before operation showed no statistical difference compared with those after operation (P ＜ 0.05).Conclusions MRI findings are primarily low or medium signal on T2WI images in the acute phase of OVCF, which shows insignificant correlation with effect of PKP.However, PKP is effective in the treatment of OVCF.

AIM: To study the current density and function of Na + channel in cells from the epicardial border zone of the 1-week infarcted rabbit heart. METHODS: Rabbits were infarcted by ligation of the left anterior descending coronary artery. 1 week later, I Na was recorded using whole cell patch-clamp techniques in ventricular myocytes from infarcted heart(IZs) and compared with the I Na from noninfarcted heart(NZs). RESULTS: Peak I Na current density(at -30 mV) was significantly reduced in IZs(22 48?4 62 PA/PF, n= 14) compared with NZs(45 50?5 33 PA/PF, n= 12), P