Nontraumatic convexal subarachnoid hemorrhage is a rare type of nonaneurysmal subarachnoid hemorrhage.Its etiologies and clinical manifestations are diverse.This article reviews nontraumatic convexal subarachnoid hemorrhage from the aspects of etiology, clinical manifestation, imaging, diagnosis, treatment, and prognosis.

Objective To study the protein components of the secretion of the proximal trunk of transected peripheral nerve and the effect of the secretion on the growth of motor neuron.Methods After the sciatic nerves of rats were transected, the proximal trunk secretion collecting compartment (P-SCC), distal trunk SCC (D-SCC) and (proximal) plus distal trunk SCC (PD-SCC) were set up. The protein components of the solution in the 3 types SCC were analyzed by two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) and mass spectrum. And the effect of 3 kinds solution on the growth of motor neuron was tested by the motor neuron culture respectively. (Results) All the P-SCC, D-SCC and PD-SCC were filled with light yellow, clear fluids. The protein (concentration) was (5.45?1.2)mg/ml,(3.87?0.7)mg/ml and (5.68?1.5)mg/ml in the solution of PD-SCC, P-SCC and D-SCC (respectively). The protein patterns of the 3 solution were similar, and the detected (protein) spots were 1098?34,985?47 and 1021?36 spots in the solution of P+D-SCC, P-SCC and D-SCC (respectively). Most of the protein spots (distributed) in the rangs of MV 25-90KD and PH 4-8. The results of motor neuron culture demonstrate that the number of survival cells, cell area, neurite length and OD value of experimental groups(including mix group, (proximal) group and distal group) are generally higher than control group. But there is no obvious difference between the three experimental groups. Conclusions (1)The proximal trunk of transected sciatic nerve had the similar secretive ability as the distal nerve trunk.(2)(Protein) image of the 3 kinds of SCC solution showed that proteins from the three SCC solution were homologous. (3)All the 3 kinds of SCC solution could promote the growth and activity of motor neuron, and there was no difference in function between P-SCC and D-SCC solution.

A case of a fibrous histiocytoma (FH) of the larynx in a 54-year-old male is reported. Laryngeal fibrous histiocytoma is uncommon. The case recurred several times over 4-year period. Its pathology is described including arguments on potential malignancy and the way of management.

OBJECTIVE:To investigate the cardiac-protective effects and safety of dexmedetomidine on cardiac muscle of elder-ly patients with non-coronary artery bypass grafting (OPCABG). METHODS:50 elderly patients underwent OPCABG were se-lected and randomly divided into observation group and control group,with 25 cases in each group. Both groups received mor-phine 0.2 mg/kg+scopolamine 0.3 mg/kg intramuscularly 30 min before operation,and were given sulfentanyl 1 μg/kg+etomidate 0.1-0.2 mg/kg+pipecurium bromide 0.1 mg/kg for anesthesia induction. Observation group was given Dexmedetomine hydrochloride injection 1 μg/kg,ivgtt,within 15 min,and then by pump injection at 0.5 μg/(kg·h) till the end of operation;control group was given constant volume of 0.9% Sodium chloride injection,ivgtt. cTnⅠ,IMA,SOD and MDA levels and the occurrence of ADR were observed in 2 groups after entering the operation room(T1),at the end of vascular anastomosis(T2),6(T3),12(T4),24 h (T5) after operation. RESULTS:IMA of observation group at T2,T3 and T4 were significantly lower than those of control group, and cTnI at T2,T3,T4 and T5 were significantly lower than those of control group,with statistical significance (P<0.05). There was no statistical significance in SOD level at T1,T2,T3,T4 and T5 between 2 groups(P>0.05). Serum level of MDA in 2 groups at T4 and T5 were decreased significantly,and the observation group was lower than the control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Dexmedetomidine can protect cardiac muscle of elderly pa-tients with OPCABG to certain extent,and relieve myocardial injury with good safety.

Purpose: To describe the clinical manifestations of hepatic myelopathy (HM) after transjugular intrahepatic portosystemic stent shunts (TIPSS)in five patients. Materials and Methods: Four men and one woman, age ranging from 41 to 54 years, had history of hepatitis B and recurrent bleeding from gastroesophageal varices. Obvious liver atrophy was found in the five patients before TIPSS procedure and shunt patency was by color Doppler US after TIPSS. Spinal cord MRI was performed in 4, CT and myelography were performed in lcase. Lumbar puncture was done in 5 patients. Results: Spastic paralysis in the lower extremities occurred progressively during 4 weeks to 4 months after TIPSS in the five patients. Weakness of the upper extremities presented in one patient, and urinary incontinence was in another one. HE following TIPSS occurred more than once (1~6 times) in these patients. Physical ex- amination revealed that hyperreflexia of tendons and positive reaction of ankle clonus were seen in all patients. Superficial sensation was normal in 5, decreasing in deep sesation in 1. Muscular atrophy in the paralytic lower extremities was not obvious in all but one patient. No mass effect or other abnormalities were found in the suspected spinal cords on the imaging studies. Lumbar puncture and cerebrospinal fluid examination were normal. The abnormalities of laboratory tests included hyperammonemia and hypoal- buminemia. Conclusion: Spastic paralysis with intact of superficial sensation in the lower extremity fol- lowing TIPSS should be considered as HM. The potential risk factors of TIPSS related HM were obvious liver atrophy, refractory hyperammonemia and HE follwing TIPSS.

Objective To evaluate the radiological signs of synovial chondromatosis and the diagnostic value of radiology.Methods 36 cases with synovial chondromatosis confirmed by histology were retrospectively analyzed.All 36 cases underwent radiography and 13 of them underwent CT examinations,10 of them underwent MRI.Results The knee in 22 cases,hip in 5 cases,ankle in 3 cases,shoulder in 2 cases,elbow in 2 cases,carpal joint in one case and temporomandibular joint in one case were involved in 36 cases.Of them,one joint involved in 31 cases and bilateral knee joints involved in 5 cases.Multiple calcareous loose bodies with different sized(from several diameter to 2.7 cm)were seen inside or surrounding the joints on X-ray and CT images.In 10 cases with MR examination,the calcareous nodules were low signal intensity on both T_1WI and T_2WI in 8 cases.In other 2 cases,the center of calcareous nodules showed as high signal intensity while the rim showed as low signal intensity.Conclusion X-ray,CT and MRI are of significant value in diagnosis of synovial chondromatosis.

OBJECTIVE:To evaluate effects of dexmedetomidine hydrochloride on cardiovascular response of middle aged and elderly patients during tracheal extubation period. METHODS:110 general anesthesia patients with colorectal cancer were collected and randomly divided into observation group and control group,with 55 cases in each group. All patients received general anesthe-sia with same dose. Observation group was given intravenous pump of dexmedetomidine hydrochloride 0.5 μg/kg after surgery,and control group was given intravenous pump of propofol 0.5 μg/kg. HR and MAP of 2 groups were compared 10 min before tracheal extubation,at the moment of tracheal extubation,5 and 10 min after tracheal extubation. The oxygen saturation of blood,the time of respiration recovery,opening eyes and extubation were recorded in 2 groups. RESULTS:There was no statistical significance in HR and MAP between 2 groups 10 min before extubation and 10 min after extubation (P>0.05). HR and MAP of observation group were significantly lower than those of control group at the moment of extubation and 5 min after extubation,the levels of HR and MAP were significantly increased in the 2 groups with statistical significance (P<0.05). There was no statistical signifi-cance in oxygen saturation of blood,the time of respiration recovery and extubation between 2 groups(P>0.05). The time of open-ing eyes in observation group was significantly shorter than in control group,with statistical significance (P<0.05). CONCLU-SIONS:Dexmedetomidine hydrochloride could significantly decrease cardiovascular stress response and shorten recovery time of middle age and elderly patients with colorectal cancer during tracheal extubation period.

Objective To discuss the effect of “practice teaching methods ” in musculoskeletal ultrasound diagnosis training process .Methods Thirty refresher doctors for a month with the method training .The effect training is evaluated by objective exam and questionnaire survey .Results Thirty refresher doctors received tests before and after the training .Test results showed that the accuracy after the training was significantly higher than that of before ( P<0.05 ) .Refresher doctors survey about satisfaction of the training method showed that whole satisfaction is 100%, in which 70%were very satisfied , 30%were satisfied .The self-assessment results for the improvement of the level of diagnosis musculoskeletal ultrasound showed that 45%doctors are very satisfied ,40%doctors are satis-fied, and 15%is not satisfied .Conclusions With the implementation of “teaching by practice” method, refresher doctors could master the knowledge of musculoskeletal anatomy as soon as possible , and have the ability to diagnose common musculoskeletal diseases independently .

Objective To study the methylation status of p16 gene in peripheral blood mononuclear cell (PBMC) of patients with plaque psoriasis, and to study its significance in the pathogenesis of the disease. Methods Thirty-four cases of psoriatic patients and 35 healthy controls were measured for the status of promoter methylation in p16 gene by methylation specific PCR (MSP). A region containing CpG site in p16 gene promoter was amplified by MSP. The severity of psoriasis was evaluated by PASI scores. Results The methylation rates of p16 gene in PBMC were significantly higher (P

Objective To study the effect of qiangguixishu pills in the treatment with knee osteoarthritis and influence in miR of circulating and inflammatory factor index.Methods 50 patients with KOA from October 2014 to October 2015 were randomly divided into two groups,the observation group and the control group,with 25 cases in each group.The control group using Diacerein capsules for treatment,the observation group received the Qiangguixishu pills for treatment,compared the WOMAC score and clinical efficacy before and after treatment between two groups,and changes of miR and inflammatory factors circulating.Results There was no difference in WOMAC score between the two groups before treatment;pain,joint stiffness, daily activities and comprehensive scores were decreased after treatment in two groups(P<0.05),and it was lower in the observation group than in the control group(P<0.05);There was no significant difference at blood miR-146a,miR-140,miR-21,IL-6,IL-1beta,TNF-alpha contents between the two groups,miR-21 beta,IL-6,IL-1 beta,TNF-alpha were lower than that before treatment in the two groups after treatment(P<0.05),miR-140,miR-146a were higher than before treatment(P<0.05),and compared with the control group,the above indicators at the observation group were had significant difference(P<0.05).Conclusion There were the therapeutic effect in the treatment with KOA by Qiangguixishu pills and its mechanism maybe realized by regulating the miR and inflammatory factor.