Objective To explore the related factors of early hematoma enlargement in patients with spontaneous intracerebral hemorrhage.Methods The clinical data of 142 patients with spontaneous intracerebral hemorrhage were analyzed.The first CT was performed within 6 h of onset and the second within 24 h of onset.Single factor analysis and multiple Logistic regression analysis were performed to determine the related factors of early hematoma enlargement.Results The incidence of early hematoma enlargement was 24.6％ (35/142).Multiple Logistic regression analysis revealed that the following four factors were independently associated with early hematoma enlargement:age (OR =1.069,P =0.003),systolic pressure (OR =1.865,P =0.026),sharp of hematoma (OR =2.712,P =0.028),using mannitol (OR =2.939,P =0.020).Location of hemorrhage and volume of hemorrhage were not associated with early hematoma enlargement (P ＞ 0.05).Conclusions Age,systolic pressure,sharp of hematoma and using mannitol are the important predictors of early hematoma enlargement with spontaneous intracerebral hemorrhage.In patients with older age,higher systolic pressure,irregularly shaped hematoma,close observation of hematoma enlargement should be made CT-scanning check.And the caution in the early use of dehydrating agent should be careful.

Brain-derived neurotrophic factor (BDNF) is one of the most prevalent growth factors in the central nervous system (CNS).In the development and maturation processes of the nervous system,BDNF plays an important role in maintaining neuronal function,promoting neuronal regeneration after injury,and preventing neuronal degeneration,etc.At present,many researchers are being dedicated to the research of BDNF for treatment of brain ischemia and have achieved some progress.This article reviews the molecular biological characteristics and biological function of BDNF,roles and mechanisms in cerebral ischemia,and the possibility as an intervention target of cerebral ischemia.

OBJECTIVE To study the expression of the level of tumor necrosis factor alpha(TNF-?) and total IgE in Mycoplasma pneumoniae(MP) infection and bronchial asthma,and to analyze its relation with disease severity.METHODS The enzyme-linked immunosorbent assay(ELISA) was adopted to measure the level TNF-? and radioimmunoassay(RIA) to measure IgE in 42 children patients with asthma and MP infection as a test group,and 36 healthy children as a control group.RESULTS Among patients with asthma and MP infection TNF-? [(37.96?9.76)?g/L] and IgE [(310.57?30.39) mg/ml] had a significantly higher level than control group [(16.39?6.87)?g/L and (201.50?16.98)mg/ml],the statistical differences were significant(t=11.23;t=19.56 P

Objective To observe the clinical efficacy and safety of local injection of botulinum toxin type A (BTX-A) in the treatment of Migraine.Methods 31 patients in the treatment group were injected BTX-A 25 U at 10 positions at the muscles.30 patients in the control group were given 2％ lidocaine 1 ml plus prednisolone acetate 1 ml at the same muscle sites as in the treatment group.Days,frequency,and intensity of headache were evaluated by visual analogue scale (VAS),migraine disability was evaluated by migraine disability assessment guestionnaire (MIDAS),and adverse reactions were assessed on 1 month before the treatment and 1st,2st,3st months after the treatment.Results The therapeutic effect between the treatment and control groups was significantly different in terms of days,frequency,and intensity of headache and migraine disability.Compared with preinjection,days and frequency of headache and migraine disability were decreased significantly after injection in treatment group,lasting more than 2 months.No patients in two groups reported any serious treatment-related adverse event.Conclusions Botulinum toxin type A in the treatment of Migraine is effective and relative safe,and can decrease migraine disability.

Objective To investigate the effects of early physiotherapy in combination with atorvastatin on the levels of serum brain-derived neurotrophic factor (BDNF) and neurological function in patients with acute ischemic stroke.Methods Fifty patients with acute ischemic stroke were randomly divided into either an atorvastatin group (monotherapy group,n =25) or a early physiotherapy + atorvastatin group (combination treatment group,n =25).All patients received the prescribed drugs according to the diagnosis and treatment guidelines for ischemic stroke.The monotherapy group added atorvastatin calcium (20 mg,1 tablet every night orally).On the basis of the monotherapy group,the combination treatment group also conducted early physical therapy.At 2 and 6 weeks before and after treatment,a double-antboody sandwich enzyme-linked immunosorbent assay was used to detect the serum BDNF levels.The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the degree of neurological deficit.Barthel index (BI) was used to evaluate the activities of daily living.The modified Rankin scale (mRS) was used to assess the degree of disability.Results There was no significant difference in demographics and baseline data between the monotherapy group and the combination treatment group.The scores of NIHSS,BI,and mRS in both groups after treatment were significantly better than those before treatment (all P ＜ 0.001).There were no difference in the scores of NIHSS,BI and mRS at 2 weeks before and after treatment,but at 6 weeks after treatment,the scores of NIHSS (2.40 ± 1.38 vs.3.36 ± 1.73; P =0.035) and mRS (1.40 ± 0.87 vs.1.96 ±0.94; P =0.047) of the combination treatment group were significantly lower than those of the monotherapy group,and the BI scores (92.60 ±7.50 vs.85.20 ± 11.68; P=0.011) were significantly higher than those of the monotherapy group.After treatment,the serum BDNF levels were increased significantly in both groups.There were significant differences among all the time points (all P＜0.001).At 2 weeks after treatment,the serum BDNF levels (3.07 ±0.93 ng/ml vs.2.45 ±0.76 ng/ml; t =2.559,P =0.014) and at 6 weeks after treatment,those (2.90 ± 0.93 ng/ml vs.2.31 ± 0.77 ng/ml; t =2.433,P =0.019) in the combination treatment group were significantly higher than those in the monotherapy group.Spearman correlation analysis showed that the serum BDNF levels were significantly negatively correlated with the scores of NIHSS (r =-0.738,P ＜ 0.001) and mRS (r =-0.654,P ＜ 0.001),but they were significantly positively correlated with the BI scores (r =0.716,P ＜ 0.001).No serious adverse reaction occurred in both groups.Conclusions Early physiotherapy in combination with atorvastatin for the treatment of acute ischemic stroke can more effectively promote the recovery of neurological function,and its mechanism may be associated with the increased serum BDNF levels.

Objective To evaluate the urodynamic and functional characteristics of 26 patients who had underwent orthotopic contient globular ileal neobladder. Methods The clinical date of 26patients who underwent radical cystectomy were reviewed. The neobladder pressure, capacity, urethral pressure and urinary flow rate were collected at 3-12 months after operation. Results The neobladders average pressure was less than 15 cm H2O when the volume was 400 ml. The pressure was 22.4 cm H2O at 100% capacity. The mean pressure of contractions was less than 40 cm H2O. The mean filling pressure after operation was relative stable while the difference between 3 months and 6 months was statistically significant. The difference between 6 and 9 and 12 month showed no statistical significance. The mean post-void residual was 42 ml. A mean voiding flow rate of 19. 6 ml/s could be obtained by Valsalva. Conclusion The neobladder not only could offer adequate capacity at low pressures but also could give a satisfied continent.

Objective To determine the level and clinical significance of 5-hydroxytryptamine (5-HT) and intestinal fatty acid binding protein (iFABP) in patients of severe acute pancreatitis (SAP) with intestinal dysfunction. Methods The serum and urine in 42 cases of SAP with intestinal dysfunction were collected at day 1, 3 and 7 after admission, respectively. The numbers of bowel sounds were recorded. 20 health subjects were selected as the control. Results The numbers of bowel sounds in health subjects were 5.6 ± 2.3/min. The numbers of bowel sounds in SAP patients at day 1,3 and 7 were 2.3 ± 0.7/min, 1.7 ± 0.2/min and 3.1 ± 1.1/min, respectively;which were significantly lower than that in the control group (P < 0.01). The level of 5-HT in the control group was(86.7 ± 9.5)ng/ml, while the levels of 5-HT in the SAP patients at day 1, 3 and 7 were (112.0 ± 17.8) ng/ml, (130.5 ± 19.7) ng/ml, (107.9 ± 16.3) ng/ml. The level of urine iFABP in the control group was (90.5 ± 19.8) pg/ml, while the levels of urine iFABP in the SAP patients were (1250.2 ± 425.3) pg/ml, (1586.9 ± 523.4) pg/ml, (1154.6 ± 394.0) pg/ml. The levels of 5-HT and urine iFABP in the SAP patients all were significantly higher than those in the control group (P <0.01). The levels of 5-HT and urine iFABP in the SAP patients at day 3 were significantly higher than those in the day 1 and day 7, while there was no significant difference between the two groups. Conclusions Determination of serum 5-HT and urine iFABP in patients with early SAP could effectively evaluate the intestinal function, and it may have potential clinical significance.

Objective To investigate the effect of Da-Cheng-Qi decoction on enteric functional disturbance in rats with acute experimental pancreatitis and its potential mechanism. Methods Seventy-two SD rats were randomly divided into sham operation group, acute pancreatitis (AP) group and Da-Cheng-Qi decoction treated group with 24 each. The AP model was induced by retrograde injection of sodium taurocholate (0.1 ml/100 g) into bitiopancreatic duet. Before modeling, the rats in treatment group received Da-Cheng-Qi decoction (2 g/100 g), and the rats in other two groups received 0.9% NaCl solution. The rats were sacrificed at 3, 6 and 12 hours with 8 each, and the blood samples were taken for detecting the level of amylase and the contents of 5-hydroxytryptamine (5-HT) by enzyme-linked immunosorbent assay. The colonic tissues 10 cm apart from trans-ligament incluing jejunum, terminal ileum and sigmoid colon were collected for examining the expressions of 5-HT_3 and 5-HT_4mRNA and proteins by RT-PCR and Western blotting respectively. Results ① The levels of serum amylase and 5-HT in AP group and treatment group were significantly higher than those in sham operation group (P<0. 01), but they were lower in treatment group than in AP group at each time points (P<0. 05). The level of 5-HT was increased in the initial stage and then decreased gradually both in AP group and treatment group. ③ The expressions of 5-HT_3 and 5-HT_4 mRNA and proteins were significantly decreased in the jejunum, terminal ileum and sigmoid colon in AP group compared with sham operation group (P<0. 01). Whereas the expressions of 5-HT_3 mRNA and protein,but not 5-HT_4, were increased in the treatment group in comparison with AP group (P<0.05). Conclusions The level of 5-HT is significantly increased in acute pancreatitis, but its receptors (5-HT_3 and 5-HT_4) are decreased, which may induce enteric functional disturbance. The Da-Cheng-Qi decoction may improve enteric dynamic failure by increasing the expression of 5-HT_4 and may be a choice for treatment of acute pancreatitis with enteric dynamic failure

Objective To evaluate the intervention effect of Yi?Han bilingual health education of schistosomiasis control. Methods Baimiao Village in Daqing Town,Xichang City,where Yi Nationality inhabited,was chosen as a pilot to carry out Yi?Han bilingual health education of schistosomiasis control from 2012 to 2015. The villagers and students in the pilot area were in?vestigated by questionnaires before and after the intervention to understand their awareness and correct behavior status on schis?tosomiasis control. Results After the intervention of Yi?Han bilingual health education of schistosomiasis control for 3 years, the awareness rate and the correct rate of behavior on schistosomiasis control of the villagers in the pilot area improved from 45.79%and 51.12%in 2012 to 97.80%and 98.78%in 2015. As for the students,the two rates mentioned above improved from 64.16%and 60.83%in 2012 to 100%and 98.89%in 2015 respectively,and all the differences between the rates before and af?ter the intervention were statistically significant( all P<0.01). Conclusion The intervention of Yi?Han bilingual health educa?tion of schistosomiasis control can obviously improve the knowledge awareness rates and the correct rates of behavior of the resi?dents and students in the gathering area of Yi Nationality.

Objective To evaluate the clinical application of female orthotopic ileal neobladder.Methods Modified radical cysteetomy plus orthotopic ileal neobladder was performed on 19 female pa-tients with bladder cancer from June 1999 to January 2008.The mean age of the patients was 52(45-66) years,mean course of disease was 4.4 months (16 days-1.9 years).Of all the patients,there were 10 cases with grade 1,7 cases with grade 2 and 2 cases grade 3.According to the UICC stage system,5 patients were T1 stage,12 T2 and 2 T3a.All the patients received modified radical cystecto-my without resection of uterus and anterior vagina,meanwhile the nerves around urethra were protec-ted.0.8-1.2 cm proximal end of the urethra was excised and 30 cm distal ileum was used for the re-construction of the neobladder.Results Sixteen cases were followed up for 6-102 months,mean 71 months.Fifteen patients survived without disease recurrence,1 patient died of myocardial infarc-tion 17 months postoperation.The daytime and night continent rate was 100$,93% at 9 months postoperative.The average voiding volume of the 15 patients was 519.0 ml.The average residual vol-ume was 29.2 ml,and Qmax was 18.6 ml/s.The average filling and voiding pressure was 16.7 cm H2O and 53.0 cm H2O.Intravenous urography showed slight hydronephrosis in 1 case.Conclusion Female orthotopic ileal neobladder could be a good choice because of the continence,fewer complica-tions,lower pressure and enough bladder capacity.