The brain edema is a secondary cerebral injury in intracerebral hemorrhage(ICH) and one of the main causes of deterioration and death.The toxic effect of blood clots is involved in the formation of brain edema.The article reviews the commonly used antiedema drugs including mannitol,glycerol,hypertonic saline,furosemide,albumin,glucocorticoids,sodium aescinate and aprotinin,and introduces such hopeful drugs as edaravone,deferoxamine,argatroban and celecoxib in the treatment of ICH.

OBJECTIVE:To determine the residues of 9 kinds of organochlorinated pesticides in Polygonum multiflorum.ME-THODS:Samples were extracted with ethyl acetate by ultrasonic wave assistant extraction and purified on Florisil solid-phase extraction column.The residues of organochlorinated pesticides were determined with capillary gas chromatography with GC-MS.The separation was performed on DB-5MS(30 m?0.25 mm,0.25 ?m) fused-silica capillary column with injector temperature of 230 ℃.The initial column temperature was 100 ℃,then raised to 220 ℃ at the rate of 8 ℃?min-1.The column temperature was ra-ised at 250 ℃ at the rate of 5 ℃?min-1 for 10 min.The column flow was 1 mL?min-1 and injection volume was 1 ?L.RESULTS:9 kinds of organochlorinated pesticides were completely separated within 30 minutes.The average recoveries ranged from 80.4% to 97.2%(RSD ranged from 3.5% to 7.4%,n=6).CONCLUSION:The method is sensitive and accurate for the content determination of the residues organochlorinated pesticides.

OBJECTIVE:To explore the risk factors for nosocomial infection of multidrug-resistant organism (MDRO) in ICU,and to provide reference for preventing and controlling MDRO in ICU. METHODS:In retrospective study,246 patients with nosocomial infection from ICU of Xi'an Aerospace General Hospital (hereinafter referred to asour hospital) during Jan. 2011-Dec. 2015 were selected and divided into non-MDRO infection group (140 cases) and MDRO infection group (106 cases). The detection and drug resistance of MDRO were analyzed in MDRO group. Univariate analysis and binary Logistic regression anal-ysis were used to explore risk factors for nosocomial infection of MDRO. RESULTS:During 2011-2015,435 strains of MDRO were isolated from 106 MDRO infection patients,in which Gram-negative bacteria accounted for 89.43%,showing severe drug re-sistance. Univariate analysis showed that the following 13 factors were related to nosocomial infection of MDRO,such as ICU ad-mission time,hypoproteinemia,acute cerebrovascular diseases,renal abnormalities,mechanical ventilation time,arterivenous cath-eterization time,urethral catheterization time,indwelling gastric tube time,type and time of using antibiotics,combined use of an-tibiotics,application of carbapenems and the third generation caphalosporins(P<0.05). Binary Logistic regression analysis showed that acute cerebrovascular diseases,type and time of using antibiotics were the independent risk factors for nosocomial infection of MDRO in ICU [odds ratios were 2.816,1.582,1.265,95%CI were (1.540,5.151),(1.085,2.306),(1.131,1.415)]. CONCLU-SIONS:Some prevention and control measures should be taken actively for high-risk MDRO infection patients in ICU to reduce the incidence of nosocomial infection of MDRO and improve the quality of health care.

Gastrointestinal bleeding in children is a potentially life threatening medical emergency requiring an appropriate diagnostic and therapeutic approach.The causes of hemorrhage are numerous and varies with age.The clinical presentation of gastrointestinal bleeding in children ranges from asymptomatic microcytic anemia to hypovolemic shock.Therefore,the primary focus in a child with gastrointestinal bleeding is rapid assessment,stabilization,and resuscitation followed by a diagnostic modalities.

Objective To investigate the clinical significance of plasma prothrombin activity (PTA) and serum alpha fetoprotein (AFP), prealbumin (PALB) in severe hepatitis patients treated with artificial liver plasma exchange. Methods The clinical data of 31 patients with severe hepatitis were retrospectively analyzed. The patients were treated with artificial liver plasma exchange based on the comprehensive treatment. The patients were divided into survival group (17 cases) and death group (14 cases) according to the clinical outcome. The plasma prothrombin time (PT) and serum AFP, PALB levels were detected before treatment, 3rd, 9th and 18th day after treatment and at the last time (prior to discharge/ in extrimis), and the PTA was counted. Results There was no statistical difference in PTA before treatment and 3rd day after treatment between 2 groups (P>0.05). The PTA levels 9th and 18th day after treatment and at the last time in death group were significantly lower than those in survival group:(30.17 ± 4.79)％vs. (39.74 ± 4.77)％, (25.47 ± 6.46)％vs. (42.79 ± 6.88)％and (21.40 ± 9.17)％vs. (47.17 ± 5.46)％,and there were statistical differences (P<0.05). There was no statistical difference in AFP before treatment between 2 groups (P>0.05);the AFP levels 3rd, 9th and 18th day after treatment and at the last time in death group were significantly lower than those in survival group:(121.9 ± 31.7)μg/L vs. (134.6 ± 31.8)μg/L, (88.7 ± 40.8)μg/L vs. (169.9 ± 41.7)μg/L, (56.9 ± 29.7)μg/L vs. (176.8 ± 48.1)μg/L and (29.8 ± 15.7) μg/L vs. (204.3 ± 41.2) μg/L, and there were statistical differences (P<0.05). There was no statistical difference in PALB before treatment between 2 groups (P>0.05); the PALB levels 3rd, 9th and 18th day after treatment and at the last time in death group were significantly lower than those in survival group: (107.2 ± 17.4) mg/L vs. (126.3 ± 33.2) mg/L, (91.2 ± 11.9) mg/L vs. (137.9 ± 35.7) mg/L, (54.7 ± 14.8) mg/L vs. (151.9 ± 27.9) mg/L and (43.3 ± 19.7) mg/L vs. (159.3 ± 41.2) mg/L, and there were statistical differences (P<0.05). Conclusions The plasma PTA and serum AFP, PALB levels are closely related with curative effect of artificial liver plasma exchange in severe hepatitis patients, and dynamic observation of its changes can help to determine the condition.

In the course of medical education for academic degree, reforming our teaching course by trying bilingualteaching in surgery to different students is an effective way to enhance the medical staff's English level and their abilityto use English. This article has summarized the experience of our bilingual teaching from the design, preparation andimplementation of the teaching.[

In this paper the basic feature of the participating teaching approach is elaborated,and the problems needing to be paid attention to in the process of its application and fulfillment are also discussed.

Objective To analyze and classify the characteristic of plain X-ray, CT scan, MRI and pathologic findings in ossification of the ligamentum flavum of the thoracic spine. Providing the clinic criterion to verify the extent and progression of ossification of ligaments based on medical imaging findings. Methods Twenty-four patients with thoracic myelopathy due to ossification of the ligamentum flavum underwent surgical decompression posteriorly. There were 18 males and 6 females with age ranging from 42-76 years (mean, 57.9 years). The morphology of ossification on the CT scan was divided into isotype and non-isotype. The signal intensity of ossification was compared with that of spinal cord on T2 stage in MRI, whose results were divided into four types, such as no signal, low signal, iso signal and high signal. There were two types of ossification in pathologic findings, the mature and immature ossification. 73 segments of ossified ligaments removed from surgery were evaluated and classified individually on the base of their X-ray, CT scan, MRI and pathologic findings. 27 segments of ossified ligaments were examined immunohistochemically by use of TGF-?1 antibody. The relationship between classification of X-ray, CT scan, MRI and pathology of the ossified ligaments were compared on the basis of individual segment, to determine whether there was correlation between these findings. Results The relationship between the pathologic findings of the 73 ossified fragments and the manifestation for the CT classification and MRI signal showed: 18 isotype ossification on CT scan turn out to be mature; and among the 55 non-isotype ossification, 51 were immature and 4 were mature. 22 no signal ossifications on MRI were confirmed as mature type; all the 50 low signal ossifications were immature type; and 1 iso signal ossification was immature type. 100% were matched between MRI and pathological findings, 94.5% matched between CT and pathological findings. Conclusion The extent and progression of ossification of ligaments may be verified and predicted clinically on the base of CT scan and MRI findings, which provide the clinic criterion to guide the extent and timing of decompression.

Melatonin has a significant inhibitory effect on various cancers,especially on breast cancer.In estrogen receptor (ER)-positive human breast cancer,anti-cancer effects ofmelatonin on breast cancer cells and transplanted tumors mainly achieve by suppressing ER mRNA expression and ER transcriptional activity via the MT1 receptor.In addition,melatonin regulates the transactivation of other members of the nuclear receptor super-family,estrogen metabolizing enzymes,and the expression of related genes.Furthermore,melatonin also suppresses tumor aerobic metabolism,critical cell-signaling pathways relevant to cell proliferation,survival,metastasis,and drug resistance.Melatonin demonstrates both cytostatic and cytotoxic activity in breast cancer cells that appears to be cell-type specific.Studies on animal and human models indicate that disruption of the circadian nocturnal melatonin signal promotes the growth,metabolism,and signaling of human breast cancer,resulting in invalid hormone therapy and chemotherapeutic resistance in breast tumors.

Objective To dynamically observe the expressions of Toll like-receptor 2 (TLR-2),TLR-4 and inflammatory cytokine IL-1 beta and TNF alpha,and analyze the correlation between TLR-2,TLR-4 and inflammatory response on rat cornea alkali burn.Methods Forty SPF healthy SD rats were excluded the anterior segment disease,the right eye was set as burn experiment and the left eye as normal control,Ⅲ level corneal alkali burn model was established with concentration of 1 mol · L-1 NaOH(At the establishment and after the establishment of the model,the inconsistent degree of corneal bums,the corneal perforation and hyphema in rats,etc.,were removed,and finally randomly selected 32 eligible rats),then were randomly grouped into 3 days,7 days,14 days and 21 days group,8 eyes in each group.The rats were observed and photographed anterior segment of each group,evaluated the corneal inflammation index,then removed the eyeball of the rats in the corresponding time points.The eyeballs were made into pathological tissue section and stained with HE method.The number of inflammatory cells in the cornea was calculated,and the expression of TLR-2,TLR-4,IL-1 beta and TNF alpha was detected in the rat cornea with method of Western blot protein detection at the same time.The differences of each group were analyzed,and the correlation was assessed between TLRs and inflammatory factor.Results There were the expressions of TLR-2,TLR-4,IL-1 beta and TNF alpha in the normal rat cornea,and its expressions were gradually increased after alkali burn,reached the peak at the 7 days,then decreased gradually,the difference of each group (the 3 day,the 7 day,the 14 day,the 21 day) was statistically significant (all P ＜ 0.05).The expressions of TLR-2 and IL-1 beta (r =0.986,P ＜ 0.05),TNF alpha (r =0.986,P ＜ 0.05) were positive correlated.The expressions of TLR-4 and IL-1 beta(r =0.975,P ＜ 0.05),TNF alpha (r =0.990,P ＜0.05) were positive correlated.Conclusion TLRs participates and may start immune inflammatory response after corneal alkali burn,mediates the production of inflammatory cytokine.