Objective To investigate the related risk factors for progress of the elderly frontal lobe contusions. Methods The clinical data of 118 cases of elderly frontal lobe contusions from August 2012 to August 2014 were retrospectivelyanalyzed.118 patients were given conventional therapy after admission,received dynamic review of brain CT.The progress of patients were performed surgery of frontal coronary approach,removed contusion brain tissue by bone flap of single frontal or double the frontal lobe.No progress of patients were given conventional conservative treat-ment.Selected seven indicators combining with hypertension,oral aspirin,diabetes mellitus,contrecoup injury,Cushing response,sylvian cistern exist or not and subdural hematoma did a statistical analysis.Results This group of 118 patients,68 cases (57.6%)had progress and 50 cases (42.4%)had no progress.Statistical analysis showed that oral aspirin (P =0.006 ),sylvian cistern exist or not (P =0.001 ),Cushing response (P =0.025 )were independent risk factors of progress of the elderly frontal lobe contusions.Conclusion For elderly patients with fron-tal lobe contusion,oral aspirin,sylvian cistern exist or not,whether there is any Cushing response were risk factors for deterioration of disease progression.If one or more risk factors appeared,clinical need to prevent disease progression.

Objective To investigate the influence of breast pure mucinous carcinoma size on sonographic characteristics and diagnostic accuracy.Methods Sonographic characteristics of 101 breast pure mucinous carcinoma in 1 00 patients were analyzed retrospectively.All lesions were divided into three groups according to maximum diameter at ultrasound.These were group Ⅰ with lesions less than 20 mm,group Ⅱwith lesions greater than or equal 20 mm,less than 40 mm,and group Ⅲ with lesions greater than or equal 40 mm.The relationship between lesions size and ultrasound parameters were analyzed.Results There were 38 lesions in group Ⅰ,52 lesions in group Ⅱ and 1 1 lesions in group Ⅲ.The patients age in group Ⅲwere older than that in group Ⅰ(F=3.442,P =0.036).Among these sonographic appearances,only shape (χ2=9.813,P =0.005)and blood flow (χ2=27.952,P =0.000)indicated significant differences.The accuracy of ultrasound diagnosis of breast cancer was 85.1%,the smaller the lesions were,the higher misdiagnosis rate the lesions were.Conclusions With lesions size increased,the lobular and internal blood flow of pure mucinous carcinoma increased.More smaller the lesions were,more higher misdiagnosis rate of lesions were.

Objective To investigate the clinical effect of operation of superficial temporal artery-middle cerebral artery(STA -MCA)bypass combined with temporal muscle sticking in the treatment of adult moyamoya disease.Methods A retrospective analysis was the data of operation,including preoperative evaluation,operation method,postoperative follow -up.Results Postoperative complications occurred in 5 cases,including 3 cases of intracranial hemorrhage,2 cases of cerebral infarction.During the follow -up of 6 -35 months,no recurrent hemor-rhage cases,1 cases of cerebral infarction,TIA remission rate was 93.5%.Postoperative cerebral blood flow of 38 cases significantly improved compared with preoperative by SPET,accounted for 86.3%.Cerebral blood flow of 41 cases was well compensated by vascular bridge,accounted for 91%.Conclusion Operation of STA -MCA bypass combined with temporal muscle sticking can significantly reduce the incidence of stroke,fewer complications,which is an ideal method in the treatment of adult moyamoya disease.

Objective To discuss the function of respiratory exerciser tri‐ball in pulmonary rehabilitation (PR) patients with chronic obstructive pulmonary disease(COPD) .Methods Prospectie case‐control study was used in COPD patients ,the patients were randomly divided into three groups ,60 COPD patients (group A) using respiratory exerciser TRI‐BALL ,58 COPD patients (group B) using traditional pursed lips ventral breathing training ,and 58 COPD patients(group C) using general internal medicine treatment .Results Group A :compared with before breath training ,the increases of FEV1/FEV1 predicted (% ) and MVV/MVV predicted (% ) and the decrease of quality of life score (QOL) were statistically significant after breath training (P<0 .01) ,but not for FEV1/FVC(% )(P>0 .05) .Group B :compared with before breath training ,the decrease of QOL was statistically significant (P<0 .01) ,but not for FEV1/FEV1 predicted (% ) ,MVV/MVV predicted (% ) and FEV1/FVC (% )(P>0 .05) .Compared with control group after breath training ,the increases of FEV1/FEV1 predicted (% ) and MVV/MVV predicted (% ) and the decrease of quality of life score (QOL) were statistically significant in group A (P<0 .01) .Compared with control group after breath training , the decrease of quality of life score (QOL) were statistically significant in group B (P<0 .01) ,but not for FEV1/FEV1 predicted (% ) and MVV/MVV predicted (% ) (P>0 .05) .Compared the changes of pulmonary function test(PFT) index and QOL between group A and B ,the increments of FEV1/FEV1 predicted (% ) and MVV/MVV predicted (% ) were statistically significant in group A(P<0 .01) ,but not for QOL(P>0 .05) .Conclusion It is useful to improve the pulmonary function and quality of life in patients with COPD using respiratory exerciser tri‐ball .It is more effective than traditional pursed lips ventral breathing training ,due to the equipment is very small ,cheap ,easy to quantify training and convenient for household use ,it is worth to be popularized in primary hospital .

Objective To investigate the treatment strategy of operation in torcular herophili meningiomas.Methods Retrospectively analyzed the treatment strategy of operation and follow-up data of 16 cases torcular herophili meningiomas patients.Results Grade Ⅰ resection was 9 cases,grade Ⅱ resection was 5 cases,grade Ⅳ resection was 2 cases.One patient appeared transverse thrombosis in postoperative.Followed up for 26-61 months,all patients had no recurrence.Conclusion By detailed preoperative evaluation,selection of appropriate operative approach,reasonable treatment of venous sinus adhesion tumor,supplemented by the necessary radiotherapy,can reduce the risk of operation and recurrence rate to torcular herophili meningiomas.

BACKGROUND: Hibiscus Mutabilis L. Is a very effective Chinese traditional herb for non-specific inflammation in the clinic adopted by Professor Wei Zhixin, the eminent expert in Traumatology Department in China, lasting for near 60 years. In order to explain its pharmaceutical mechanism, the research of Hibiscus Mutabilis L. Was carried on in the model of ischemic reperfusion injury to explain its mechanism on anti-inflammation.OBJECTIVE: To observe the protection of the effective fraction of Hibiscus Mutabilis L. (MFR) on renal ischemic reperfusion injury in rats to probe into the mechanism of MFR on anti-inflammation.DESIGN: Randomized and controlled study on experimental animal.SETTING: A Municipal Institute of Traumatology and Orthopedic Department.MATERIALS: The experiment was performed in the Key Experiment Room (Institute of Traumatology and Orthopedic Department, Shanghai) of State Administration of Traditional Chinese Medicine, in which, 55 male Wistar rats were employed.METHODS: The rat model of renal ischemic reperfusion was adopted and MFR was applied for gastric perfusion to determine serum blood urea nitrogen(BUN) and serum creatinine(Scr) and the level of interleukin-1 (IL-1).MAIN OUTCOME MEASURES: ① Changes in serum BUN and Scr; ②Effect of MFR on level of serum IL-1.RESULTS: After MFR treatment, the renal function was improved remarkably after ischemic reperfusion in rats. In sham-operation group, serun BUN was (6.72 ± 1.30) mmol/L and serum Scr was (38.40 ± 6.23) μmol/L. In 24hours of reperfusion after one-hour ischemia, BUN was(60. 72±4.64)mmol/L in the control and(47.34 ± 8.32) mmol/L in the MFR treatment group, and the significant difference presented between two groups(t=2.562, P ＜ 0.05) .Serum Scr was(347.95±95) μmol/L and(518.20 ± 41.15) μmol/L in the treatment group and the control respectively, indicating significant difference ( t = 3.69, P ＜ 0.01 ) . Concerning to the effect on IL-1, in 1 hour of reperfusion after 1 hour renal ischemia,IL-1 was( 122.79 ±27.56) ng/L in the MER treatment group,(180. 28 ±33. 15) ng/L in the control group, indicating that IL-1 level in the treatment group was remarkably superior to that in the control group(t = 2.98, P ＜ 0.05). In 3 hours of reperfusion after 1 hour ischemia, level of IL-1 in the treatment group and control group was(15.58±8.59) ng/L and (34. 13±± 10. 02) ng/L respectively, indicating significant difference( t = 3.14, P＜ 0.05).CONCLUSION: MFR provides protection on renal ischemic reperfusion injury, which probably is related to its inhibition on IL-1 formation.