Objective:To compare the efficacy of body posture combined with pharmacotherapy and pharmacotherapy alone in the treatment of chronic subdural hematoma(CSDH).Methods:Firstly, retrospective case series study was conducted. Thirty cases of CSDH that had received body posture combined with pharmacotherapy at Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University from December 2016 to October 2020 were studied retrospectively. Twenty-seven patients were male, and 3 patients were female. The age of patients ( M(IQR)) was 66(16) years (range:28 to 84). Nineteen patients had unilateral hematoma, and 11 patients had bilateral hematoma. All patients received pharmacotherapy and body posture therapy that was to raise their lower limbs 20 to 30 cm with leg lift pad and get abdominal compressed with customized abdominal belt in supine position. Patients were required to maintain the body posture as much as possible, with the maximum to 16 to 18 hours per day. Patients with unilateral hematoma should tilt the head to the affected side and avoid tilting it to the opposite side. For patients with bilateral hematoma, there was no need for head lateralization. Patient were treated with oral dexamethasone and atorvastatin simultaneously. The preliminary efficacy of body posture combined with pharmacotherapy was determined by hematoma improvement rate which was analyzed by Clopper-Pearson method. Then, the multi-center, prospective, randomized controlled trial had carried out in 9 medical centers from August 2020 to November 2021. The stratified block randomization method was adopted. Patients were randomized in a ratio of 1∶1 to either receive pharmacotherapy alone(the control group) or body posture combined with pharmacotherapy(the experiment group) for 3 months and followed up for 6 months. Effective treatment was defined as complete absorption of hematoma, or the hematoma volume decreased by more than 10 ml and Markwalder grading scale score had improved by more than 1 point compared to the baseline. The efficacy rate and surgery conversion rate at 3 months and recurrence at 6 months were observed. Comparison between groups was performed with paired sample t test, Mann-Whitney U test, χ2 test, corrected χ2 test, or Fisher exact probability method. Logistic regression was used to compare the effective rate and operation rate between the two groups. Results:In the respective study, 30 patients completed follow-up 13 to 353 days after treatment. At the last follow-up, the incidence of almost complete absorption or significantly absorption of hematoma (hematoma volume was significantly reduced accompanied by symptom improvement) was 93.3%. The 95% CI for the incidence that analyzed by the Clopper-Pearson method was 77.9% to 99.2%. One hundred and six patients were enrolled in the multicenter study. Fifty-five patients underwent body posture combined with pharmacotherapy. The age was 74(17) years (range:26 to 92). Thirty-nine patients were males and 16 were females. Fifty-one patients underwent pharmacotherapy alone. The age was 69(12) years (range:48 to 84). Thirty-seven patients were males and 14 were females. The length of body posture recorded in diary card was (15.7±2.3) hours(range:7.6 to 19.3 hours). The efficacy rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 83.6% (46/55) and 56.9% (29/51), respectively at 3 months. The result of the logistic regression analysis showed that the efficacy of body posture combined with pharmacotherapy group was better than that of pharmacotherapy alone group ( OR=3.88,95% CI:1.57 to 9.58, P=0.003). Surgery rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 5.5% (3/55) and 21.6% (11/51) respectively. The result of Logistic regression showed that the pharmacotherapy alone group was more likely to be converted to surgery ( OR=0.21,95% CI:0.05 to 0.80, P=0.023). At the 6 months, no recurrence of cases was found in the body posture combined with pharmacotherapy group. However, the recurrence rate of pharmacotherapy alone group was 6.3% (3/48), there was no significant difference between the two groups ( P>0.05). Conclusion:The effect of body posture combined with pharmacotherapy for chronic subdural hematoma is better than that of pharmacotherapy alone.

Objective:To compare the efficacy of body posture combined with pharmacotherapy and pharmacotherapy alone in the treatment of chronic subdural hematoma(CSDH).Methods:Firstly, retrospective case series study was conducted. Thirty cases of CSDH that had received body posture combined with pharmacotherapy at Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University from December 2016 to October 2020 were studied retrospectively. Twenty-seven patients were male, and 3 patients were female. The age of patients ( M(IQR)) was 66(16) years (range:28 to 84). Nineteen patients had unilateral hematoma, and 11 patients had bilateral hematoma. All patients received pharmacotherapy and body posture therapy that was to raise their lower limbs 20 to 30 cm with leg lift pad and get abdominal compressed with customized abdominal belt in supine position. Patients were required to maintain the body posture as much as possible, with the maximum to 16 to 18 hours per day. Patients with unilateral hematoma should tilt the head to the affected side and avoid tilting it to the opposite side. For patients with bilateral hematoma, there was no need for head lateralization. Patient were treated with oral dexamethasone and atorvastatin simultaneously. The preliminary efficacy of body posture combined with pharmacotherapy was determined by hematoma improvement rate which was analyzed by Clopper-Pearson method. Then, the multi-center, prospective, randomized controlled trial had carried out in 9 medical centers from August 2020 to November 2021. The stratified block randomization method was adopted. Patients were randomized in a ratio of 1∶1 to either receive pharmacotherapy alone(the control group) or body posture combined with pharmacotherapy(the experiment group) for 3 months and followed up for 6 months. Effective treatment was defined as complete absorption of hematoma, or the hematoma volume decreased by more than 10 ml and Markwalder grading scale score had improved by more than 1 point compared to the baseline. The efficacy rate and surgery conversion rate at 3 months and recurrence at 6 months were observed. Comparison between groups was performed with paired sample t test, Mann-Whitney U test, χ2 test, corrected χ2 test, or Fisher exact probability method. Logistic regression was used to compare the effective rate and operation rate between the two groups. Results:In the respective study, 30 patients completed follow-up 13 to 353 days after treatment. At the last follow-up, the incidence of almost complete absorption or significantly absorption of hematoma (hematoma volume was significantly reduced accompanied by symptom improvement) was 93.3%. The 95% CI for the incidence that analyzed by the Clopper-Pearson method was 77.9% to 99.2%. One hundred and six patients were enrolled in the multicenter study. Fifty-five patients underwent body posture combined with pharmacotherapy. The age was 74(17) years (range:26 to 92). Thirty-nine patients were males and 16 were females. Fifty-one patients underwent pharmacotherapy alone. The age was 69(12) years (range:48 to 84). Thirty-seven patients were males and 14 were females. The length of body posture recorded in diary card was (15.7±2.3) hours(range:7.6 to 19.3 hours). The efficacy rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 83.6% (46/55) and 56.9% (29/51), respectively at 3 months. The result of the logistic regression analysis showed that the efficacy of body posture combined with pharmacotherapy group was better than that of pharmacotherapy alone group ( OR=3.88,95% CI:1.57 to 9.58, P=0.003). Surgery rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 5.5% (3/55) and 21.6% (11/51) respectively. The result of Logistic regression showed that the pharmacotherapy alone group was more likely to be converted to surgery ( OR=0.21,95% CI:0.05 to 0.80, P=0.023). At the 6 months, no recurrence of cases was found in the body posture combined with pharmacotherapy group. However, the recurrence rate of pharmacotherapy alone group was 6.3% (3/48), there was no significant difference between the two groups ( P>0.05). Conclusion:The effect of body posture combined with pharmacotherapy for chronic subdural hematoma is better than that of pharmacotherapy alone.

Objective:To describe and analyze the epidemiological characteristics of premature death (death before age of 70 years) and related risk factors in approximate 100 000 adults recruited from 10 regions of China during a 10-year follow-up.Methods:Data, including demographic characteristics, lifestyle and physical indicators as well as health outcomes as of December 31, 2017, were obtained from baseline survey and long-term follow-up of the China Kadoorie Biobank (CKB) study. All-cause and cause-specific premature death in different areas, in men and women and in people with different lifestyles were analyzed. Cox proportional risk model was used to analyze the associations between baseline factors and premature death.Results:A total of 99 993 participants aged 56-69 years were included in the study. During 10 years of follow-up, 7 530 premature deaths were recorded and the premature death rate was 7.15 per 1 000 person-years. The main causes of premature death were cancer and cardiovascular and cerebrovascular diseases. The premature mortality rate was higher in rural areas, in northern region and in men, and decreased with age ( P<0.05). Premature death was more likely to occur in smokers, and a dose-response relationship was observed. Compared with non-drinkers, the risk for premature death was higher in ex-drinkers ( HR: 1.25 [95% CI:1.16-1.36]) and heavy drinkers (average alcohol consumption ≥60 g/d) ( HR: 1.20 [95% CI:1.08-1.34]). The risk for premature death decreased with the increase of physical activity. Low body weight and central obesity were independently associated with increased risk for premature death ( HR: 1.67 [95% CI:1.55-1.81] and 1.13 [95% CI:1.05-1.21], respectively). Conclusions:The main causes of premature death in adults aged 56-69 years in China during 10-year follow-up were cancer and cardiovascular and cerebrovascular diseases. The premature mortality rate varied with socioeconomic and demographic characteristics. The risk for premature death was influenced by multi factors, such as lifestyle and physical conditions.

Objective To investigate the clinical imaging features and immune manifestations of clear cell carcinoma and papillary renal cell carcinoma at the same time in one side of the kidney,in order to increase the awareness of the disease and improve the clinical diagnosis and treatment.Methods This study retrospectively analyzed the clinical data of 7 patients with unilateral renal clear cell carcinoma combined with papillary cell carcinoma admitted to the Department of Urology,People's Hospital of Xinjiang Uygur Autonomous Region from January 2007 to June 2017.The general data,images performance,surgical methods,immunohistochemical results of the patients were observed.Results In 7 patients with multiple tumors of ipsilateral kidney,6 were males,accounting for 85.71％ (6/7);1 female,accounting for 14.29％ (1/7).Ages 45-78 years old,average 63 years old;4 cases were found by physical examination,accounting for 57.14％ (4/7);2 cases were admitted to hospital with obvious oncological symptoms,accounting for 28.57％ (2/7);1 case of renal nonfunction,accounting for 14.29％ (1/7).The tumor was located in 6 cases of left kidney,accounting for 85.71％ (6/7),and the tumor was located in 1 case of right kidney,accounting for 14.29％ (1/7).Preoperative imaging examination clearly indicated multiple tumors in 3 cases,and the remaining 4 cases only showed placeholders.Lesions,of which the maximum diameter of the tumor 7.5 cm,2 patients with a diameter of ＞ 4 cm;4 cases of radical renal resection and partial nephrectomy;3 cases of clear cell carcinoma Fuhrman Ⅰ grade,Fuhrman Ⅱ grade 5 cases postoperative pathology report There were 4 cases of papillary renal cell carcinoma in Fuhrman grade Ⅰ and 3 cases in Fuhrman grade Ⅱ,all of them were type Ⅰ cell carcinoma.Conclusions Ipsilateral kidney associated with papillary renal cell carcinoma and clear cell carcinoma is rare clinically,its formation is unknown.Readings should be repeated before surgery.If you can identify multiple tumors,you will be able to choose the surgical procedure.Partial nephrectomy or radical nephrectomy may be performed depending on the size of the tumor.Radical nephrectomy is recommended.

Objective To evaluate the clinical effect of iliac artery interventional chemotherapy combination with bladder perfusion for high level of bladder urothelial carcinoma after transurethral bladder tumor electricity cut operation for those who intend to retain the bladder.Methods From February 2010 to December 2016,a total of 74 cases high-grade urothelial carcinoma of the bladder,giving chemotherapy and suitted support were retrospectively analyzed.The patients were divided into two groups according to different chemotherapy methods.Artery perfusion chemotherapy group:43 cases treated by transurethral bladder tumor cutting + bilateral iliac artery interventional perfusion chemotherapy + bladder perfusion in combination therapy;Intravenous chemotherapy group:31 cases underwent transurethral bladder tumor cut method + cisplatin,vein gemcitabine + bladder perfusion chemotherapy combined therapy.According to the ((x) ± s) between the groups.The method of count data is represented by chi-square test.Kaplan-meier method was used to describe the survival time of two groups of patients after operation.Results Two groups of patients with postoperative there was no statistically significant difference in disease-free survival time.In the bone marrow suppression (x2 =4.956,P =0.029);gastrointestinal tract reaction (x2 =5.912,P =0.012);dermatitis,mucositis (x2 =4.276,P =0.013),etc.,has the advantages in the iliac artery interventional perfusion chemotherapy (P ＜ 0.05).Conclusion Via efficient iliac arterial infusion chemotherapy in patients with venous chemotherapy patients,to the retention of the bladder has a certain value,and the incidence of adverse reactions after surgery is low,have certain advantages.

The technology of water-jet is an advanced technology of cold cutting which is widely used in industry, espe-cially in the cutting of metal, glass, ceramics and paper. Its character and classification are introduced, especially basic prineiple, development and application. The technology of water-jet will paly an important role in medicine.

Summary: To investigate the difference in expression of hTERT gene between HbsAg-positive human hepatocellular carcinoma (HCC) and HbsAg-negative HCC and to explore the relationship between HBV infection and hTERT gene expression in HCC. The expression of hTERT protein in 30 cases of HbsAg positive HCC and 17 cases of HbsAg negative HCC was detected by immunohistochemistry (SP method), and the expression of hTERT mRNA was analyzed by reverse transcription polymerase chain reaction (RT-PCR). t-test, Chi-squared test and cochran- armitage trend test were used to see whether there was an interrelation between HBsAg and hTERT gene in HCC. The expression of hTERT protein was mostly located in plasm and occasionally in the nucleus of liver cancer cells. The positive rate of hTERT protein and hTERT mRNA in HbsAg positive HCC- 93.33 % (28/30) and 83.33 % (25/30) respectively which were much higher than those in HbsAg negative HCC- 52.94 % (9/17), 47.06 % (8/17) (P<0.01) respectively. HbsAg is related to hTERT gene expression in human hepatocellular carcinoma. The hTERT gene activated by the efficacious ingredient of HBV may play an important role in hepatocellular transformation and carcinogenesis.

Objective To study the expression of integrin ?1 in hepatocellular carcinoma (HCC) and its significance. Methods Integrin ?1 expression was detected in 38 cases of HCC, 8 cases of hepatic cirrhosis (HC) and 7 cases of normal liver tissues(NL) using immunohistochemical SP method. The relationship between the integrin ?1 expression and HCC clinico-pathological features was analyzed. Results The positive rate of integrin ?1 expression in the HCC was much higher than that in the HC and NL tissues (P

Objective To explore the expression of tenascin in hepatocellular carcinoma (HCC). Methods With the method of immunohistochemical staining, specimens from 42 HCC patients, 10 hepatic cirrhotics and 7 normal liver controls were studied. The relationship between the tenascin expression and pathological features as well as microvessel density (MVD) was evaluated. Results The expression of tenascin in the HCC tissues was much higher than that in the non-HCC tissues ( ? 2=4.15, P