Predictors of restenosis after carotid endarterectomy and carotid artery stenting / 国际脑血管病杂志

Carotid artery stenosis is an important cause of ischemic stroke. Carotid endarterectomy and carotid artery stenting are the effective methods for treating carotid artery stenosis, but postoperative restenosis remains a challenge. The pathogenesis of postoperative restenosis is currently not fully understood. However, multiple factors, including biomarkers, imaging features, and surgical related factors, have been proven to be associated with postoperative restenosis and can predict the occurrence of postoperative restenosis. This article reviews the predictors of restenosis after carotid endarterectomy and carotid artery stenting.

Pathological components of thrombi retrieved with endovascular mechanical thrombectomy in patients with acute ischemic stroke / 国际脑血管病杂志

Endovascular mechanical thrombectomy (EMT) has become the main treatment of acute ischemic stroke, but the pathological study of thrombi retrieved with EMT is still very limited. This article reviews the routine staining, special components, expression of immune factors, electron microscopic morphology, imaging features of the pathological components of thrombi retrieved with EMT, and their correlation with the etiological differentiation and outcomes of stroke.

Selection and optimization of nutritional risk screening tools for esophageal cancer patients in China

Analysis of risk factors for the rupture of small intracranial aneurysms by four?dimensional CT angiography / 中华放射学杂志

Objective Electrocardiographic (ECG) gated 4?dimensional CT angiography (4D?CTA) was performed to analyze the morphological characteristic differences between ruptured and unruptured intracranial aneurysms less than 5 mm to predict the rupture risk of small intracranial aneurysms. Methods A total of 118 patients with intracranial aneurysms less than 5 mm who underwent 4D?CTA examinations in our hospital from May 2014 to May 2017 were retrospectively analyzed. The whole study population was divided into ruptured group and unruptured group. Seventy?two patients were in the ruptured group and 46 patients were in the unruptured group. Original scanning data were reconstructed to produce 20 data sets of cardiac cycles with 5% time intervals. In addition, 20 groups of images and dynamic graphs were generated using three?dimensional software. We concluded the convex was point of impulse if small bubble or small pointed convex could be found in continuous three or more images at the same location. The morphological characteristics and clinical features of the two groups of aneurysms were firstly analyzed by univariate analysis, and then the meaningful indicators were analyzed by logistic regression, and the optimal diagnostic cutoff values were calculated using ROC curves. Results Univariate analysis showed that women, smoking history, location of aneurysm at the bifurcation, pulsation point, aspect ratio (AR) and size ratio (SR) were statistically significant different between the two groups of small aneurysms (P<0.05), but age, hypertension, type 2 diabetes, family history, history of multiple aneurysms, history of drinking, location, size, neck and tumor height had no significant differences between the two groups (P>0.05). Multivariate regression analysis showed that pulsation point (odds ratio=8.843, 95% confidence interval: 2.800—27.925) and large SR value (odds ratio=4.484, 95% confidence interval: 1.094—18.385) were independent risk factors for the aneurismal rupture. when the SR value was greater than 1.65, the area under the ROC curve was 0.832, the sensitivity to diagnose the risk of small aneurysm rupture was 76%, and the specificity is 70%. Conclusion The occurrence of pulsation point and SR value greater than 1.65 are independent predictors of the risk of intracranial aneurysm rupture less than 5 mm.

Signaling pathways of cerebral vasospasm after aneurysmal subarachnoid hemorrhage / 国际脑血管病杂志

Aneurysmal subarachnoid hemorrhage (aSAH) has high disability and mortality.Cerebral vasospasm is the main cause of ischemic neurological deficit and even cerebral infarction after aSAH.At present,there are many studies on molecular signaling pathways of cerebral vasospasm.This article reviews the signaling pathways of cerebral vasospasm after aSAH.

Value of MR diffusion tensor imaging in the assessment of the changes of trigeminal nerve and its correlation with the degree of vascular compression / 中华放射学杂志

Objective To investigate the value of MR diffusion tensor imaging(DTI)in assessment of the microstructural changes of the trigeminal nerve,and analyze it's correlation with the degree of vascular compression. Methods Thirty-four patients with trigeminal neuralgia from November 2015 to April 2017 were retrospectively analyzed in this study.And they were treated by microvascular decompression(MVD). There were 11 cases of gradeⅠ,16 cases of gradeⅡand 7 cases of gradeⅢaccording to the severity of the contact between nerves and vessels during the operation. All of them were scanned with three dimensional time-of-flight(3D-TOF)sequences, three dimensional fast imaging employing steady state acquisition(3D-FIESTA)sequences and DTI before undergoing surgical decompression. According to the preoperative MR scans,the trigeminal nerves were divided into the healthy side without neurovascular contact (25 cases) and the healthy side with a neurovascular contact (9 cases).The DTI parameters of the trigeminal nerve,including the anisotropic fraction(FA)and the ADC values were obtained.Comparison of the FA and ADC values of the trigeminal nerve between the different stages of the affected side was performed with single factor analysis of variance, and the paired samples t test was used to compare the difference of FA and ADC values of bilateral trigeminal nerve. The difference of FA and ADC values between the asymptomatic side with or without vascular contact was compared with independent sample t test. Spearman correlation analysis was used to evaluate the correlation between DTI parameters and the degree of compression. Results The FA values of patients with grades Ⅰ,ⅡandⅢwere 0.311±0.009, 0.308±0.007 and 0.299±0.009 respectively,and there was significant difference among different levels(F=5.269,P<0.05).The ADC values of the three grades were(2.298 ± 0.309)×10-3,(2.214 ± 0.175)×10-3and (2.259 ± 0.248)×10-3mm2/s respectively, showing no statistically significant difference(F=0.402,P>0.05). The FA values of bilateral trigeminal nerves in healthy side without neurovascular contact and in healthy side with neurovascular contact were statistically significant (t=-32.528,-25.178,P<0.05). There was significant difference in the ADC value of bilateral trigeminal nerves in the group without neurovascular contact(t=2.162,P<0.05).There was no statistically significant difference in the ADC values of bilateral trigeminal nerves in the healthy side of the neurovascular contact group(P>0.05).There were no statistically significant differences in the FA and ADC values between the two groups on the healthy side of the trigeminal nerve(P>0.05).The FA value was negatively correlated with the degree of vascular compression (r=-0.453,P<0.05),while the ADC value was not correlated with the degree of vascular compression(P>0.05). Conclusion DTI imaging can be used to evaluate the degree of trigeminal nerve injury. More obvious vascular compression leads to lower FA value.

3.0T MR three-dimensional time-of-flight and fast imaging employing steady state acquisition sequences in pre-operative evaluation on spatial relationship among trigeminal nerve, facial nerve and peripheral vessels / 中国医学影像技术

Objective To investigate the value of three dimensional time-of-flight (3D-TO)F) and three dimensional fast imaging employing steady state acquisition (3D-FIESTA)sequences in evaluation on spatial relationship among trigeminal nerve,facial nerve and peripheral vessels before microvascular decompression(MVD)with 3.0 T MR.Methods Data of MRI of 36 patients with trigeminal neuralgia (TN) and 31 with hemifacial spasm (HFS) before MVD were analyzed retrospectively.The intra-observer agreement for the spatial relationship among trigeminal nerve,facial nerve and adjacent blood vessels were observed.The differences of occurrence rates of neurovascular compression (NVC) of symptomatic side and asymptomatic side in TN and HFS patients were compared.Taking surgical results as the gold standards,the diagnostic efficacy for neurovascular relationships of symptomatic side with 3D-TOF and 3D-FIESTA sequences were calculated.Results The consistency between two observers in assessing relationship of trigeminal nerve,facial nerve and adjacent blood vessels of symptomatic and asymptomatic was good (all Kappa≥0.75,all P＜0.001).In both of TN and HFS patients,the occurrence rates of NVC of symptomatic side were significantly higher than those of asymptomatic side (x2=26.13,20.81,both P＜ 0.001).The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of 3D-TOF and 3D-FIESTA sequences in displaying relationship of trigeminal nerve and vascular was 97.22％ (35/36),97.06％ (33/34),100％ (2/2),100％ (33/33)and 66.67％ (2/3),respectively,of relationship between facial nerve and vascular was 93.55％ (29/31),96.55％ (28/29),50.00％ (1/2),96.55％ (28/29) and 50.00％ (1/2),respectively.Conclusion 3D-TOF and 3D-FIESTA sequences can clearly display the spatial relationship of nerve and adjacent vessels,therefore providing imaging evidences for MVD.

Progress of radiomics and radiogenomics in lung cancer / 国际肿瘤学杂志

Radiomics and radiogenomics are used to provide comprehensive tumor biological characte-ristics and further clinical information by extracting,screening and analyzing the most valuable quantitative ra-diomics features. In recent years,numerous studies have shown that radiomics plays a role in the diagnosis, treatment and predicting efficacy and prognosis of lung cancer. Radiogenomics shows a great value in the pre-diction of lung cancer gene phenotype and individualized precision treatment by combining radiomics features with genomics,proteomics and so on. Radiomics and radiogenomics are non-invasive,quantitative,and repro-ducible,and they can provide multidirectional tumor biological characteristics,which are expected to be widely used in the precise medical treatment of lung cancer in the future.

Inhibitory effects and mechanism of Triticum aestivum on OVA-induced anaphylaxis in mice / 中华微生物学和免疫学杂志

Objective@#To investigate the inhibitory effects and mechanism of Triticum aestivum (TA) on anaphylaxis in ovalbumin (OVA)-sensitized mice.@*Methods@#Twenty-five female BALB/c mice were randomly divided into five groups (n=5), including control group, OVA group, 100 mg/kg TA group, 200 mg/kg TA group and DEX (dexamethasone) group. OVA (20 μg) and aluminum hydroxide (1 mg) were dissolved in 100 μl of PBS solution and injected into the abdominal cavity of each experimental mouse, while the mice in the control group were injected with 100 μl of 0.9% normal saline. All mice were given drinking water. The above processes were repeated two weeks later, and different concentrations of experimental drugs were diluted in 1% CMC (carboxymethyl cellulose) solution to feed mice. Allergic symptoms and behaviors of each mouse were scored in the process of feeding. On the 12th day after first sensitization, mice in the control and experimental groups were subcutaneously injected in the auricle with 20 μl of 0.9% saline solution and OVA, respectively. The thickness of each mouse′s auricle was measured 6 and 24 hours later. Histopathologic changes in auricle tissues were observed by hematoxylin-eosin(HE) staining 24 hours later. The mice were euthanized by cervical dislocation in the 6th week after first sensitization. Abdominal aorta serum samples were collected and tested for specific inflammatory cytokines (IgE, IgG1, TNF-α, IL-4) and anti-OVA antibodies (IgE, IgG1) by ELISA. ELISA and RT-PCR were used to detect the expression of IFN-γ, IL-4, IL-5, IL-12 and IL-13 after spleen lymphocytes were stimulated with different concentrations of drugs.@*Results@#Both the score of allergic symptoms and behavior and the thickness of the auricle of the OVA group were the highest among all groups (P<0.05). A TA dose-dependent decrease was found in both of the two parameters, which was confirmed by histopathological analysis. ELISA results showed that the plasma levels of IgE, IgG1, IL-4 and TNF-α in the experimental groups were significantly higher than those in the control group, but all of them were decreased in a TA dose-dependent manner. TA at the high concentration of 200 mg/kg was similar to DEX in inhibiting the expression of IgE and TNF-α. RT-PCR results showed that Th1 cytokines (IFN-y and IL-12) in the experimental groups increased significantly as compared with those in the control group (P<0.05). Expression of IFN-y and IL-12 was not significantly affected by TA at various concentrations, but markedly inhibited by DEX. The levels of Th2 cytokines (IL-4, IL-5 and IL-13) in the experiment groups were significantly higher than those in the control group (P<0.05). Compared with the OVA group, the levels of IL-4, IL-5 and IL-13 were significantly reduced in TA groups, especially in the TA 100 μg/ml group in which the expression of the three cytokines was decreased by about 60%, 18% and 20%, respectively.@*Conclusion@#TA helps to maintain immune balance by selectively inhibiting the expression of Th2 cytokines (IL-4, IL-5, IL-13), IgE and IgG and not influencing Th1 cytokines (IFN-γ and IL-12). It has an anti-allergic effect as it effectively suppresses allergic responses. This research provides both theoretical and experimental basis for further development of novel anti-anaphylactic treatment with TA.

Quantitative contrast study of sellar region by lateral orbital keyhole approach and conventional keyhole ap-proach / 中华显微外科杂志

Objective To compare lateral orbital keyhole approach(LOK) with conventional keyhole approach including supraorbital keyhole approach (SOK) and pterional approach(PTK) for exposuring the sellar region and oper-ation ability, to provide theoretical and practical basis for the clinic. Methods From January, 2017 to Feburary, 2018, 15 cadaver head specimens of Chinese (30 sides) fixed by formalin were randomly divided into 3 groups, simu-lating SOK, LOK and PTK, application of frameless neuronavigation system, intersection of the posterior margin of the optic chiasma and the lamina terminalis served as the base point. Six different reference points were selected to radi-ate into the parasellar region of the skull base. The direction of the 2 adjacent reference points were connected to the base point to form a triangle. Six triangles constituted the sellar region to represent the total area. The supratentorial area, ipsilateral area, inferior area and contralateral area were calculated by stacking triangle. The comparison was made between groups. The Salma operation exposure scale was used to simulate the aneurysms of the common parts in the brain and the quantitative scores were performed. Results The total parasellar regions by SOK, LOK and PTK respectively were:(1641.6±295.6)mm2, (1782.3±294.6)mm2 and (1552.5±307.4)mm2. There was no statistical differ-ence(P>0.05); To compare the supratentorial region, SOK and LOK were both bigger than PTK ( P<0.05); To compare the ipsilateral and infratentorial area, LOK and PTK were both bigger than SOK respectively ( P<0.05);To compare the contralateral area, SOK, LOK and PTK were increased in turn (P<0.05). Salma operation exposure scale was used to get the scores:the score of SOK was 29.7 (39.08％), LOK was 37.0 (48.68％), and PTK was 36.1 (47.50％). Conclusion Anatomical analysis displayed that the 3 keyhole approaches showed different exposure of each part the parasellar re-gions, the LOK had a good exposure to the parasellar region and so as the higher maneuverability. But the clinical appli-cation should be comprehensive analysis, pay attention to specific lesions and make an appropriate choice. It has impor-tant clinical significance to improve the prognosis of patients.

Application of diffusion weighted imaging in the diagnosis and treatment of nasopharyngeal carcinoma / 国际肿瘤学杂志

The judgment of early curative effect is important to the treatment of nasopharyngeal carcinoma and the prognosis of the patients.As a rapid imaging technique,magnetic resonance diffusion weighted imaging (DWI) is used to quantitatively analyze the changes of water molecules in the tissue by means of apparent diffusion coefficient (ADC),so as to diagnose the small lesions of nasopharyngeal carcinoma accurately,evaluate the early curative effect and observe the prognosis.With the continuous improvement and progress of MRI and data analysis technology,DWI in the diagnosis and treatment of nasopharyngeal carcinoma shows a broader application prospect.

Endovascular treatment of iliac femoral artery occlusive disease with TASC C, D lesions in elderly patients / 中国介入影像与治疗学

Objective To investigate the effect of endovascular treatment in iliac femoral artery occlusive disease of TransAtlantic Inter-Society Consensus (TASC) C,D lesions in elderly patients.Methods Totally 104 elderly TASC C,D patients with iliac femoral artery occlusion were treated,including TASC C (n =73),TASC D (n =31).Occlusive length range were 4.25-17.61 cm,with an average of (13.46±1.24)cm.The curative effect,complications and following up after surgery were analyzed.Results Ninty-four patients were treated successfully,and the technical success rate was 90.38％ (94/104);12 patients underwent balloon dilation,92 patients underwent balloon dilation combined stent.There were 8 cases (8/104,7.69 ％) with periprocedural complications,included arterial thrombosis (n =2),pseudoaneurysm (n=1),heart failure (n=4),and radiographic contrast nephropathy (n=1).Doppler ankle-brachial index increased from 0.32±0.12 to 0.81±0.11 (P＜0.01) at 1 week after treatment.The patency rates were 88.46 ％ (69/78) and 81.13％ (43/53) at 6 and 12 months followed-up respectively.Conclusion Minimally invasive endovascular treatment has high technical success rate,low complication rate,and satisfactory clinical curative effect for iliac femoral artery occlusive disease of TASC C,D lesions in elderly patients.

Detection of pulsation in unruptured cerebral aneurysms by electrocardiographic-gated 4-dimensional computed tomographic angiography and follow-up evaluation / 中华放射学杂志

Objective To evaluate the electrocardiographic(ECG)-gated 4-dimensional computed tomographic angiography (4D-CTA) in the determination of pulsation of unruptured cerebral aneurysms (URCAs).Methods This study included 48 patients with 62 URCAs.Examinations of ECG gated 4D-CTA of dual-source CT were performed.Twenty sets of image data with the time intervals of 5％ in a cardiac cycle were obtained after postprocessing on the workstation.The convex was defined as the point of pulsation if small bubble or small pointed convex could be found in continuous three or more images at the same location.The 62 URCAs were divided into two groups based on whether having a point of pulsation.All the URCAs were scanned at the follow-up by 3D-CTA or ECG gated 4D-CTA more than 120 days later.The diameters of aneurysms and aspect ratio between the two groups were compared with independent t test,while neck of aneurysms and follow-up time were compared with two-independent samples Mann-Whitney U test.The other variables including history of hypertension,type 2 diabetes,smoking et al between the two groups were analyzed by x2 test.The sensitivity and specificity of aspect ratio for diagnosis of pulsation were analyzed by receiver operating characteristic (ROC) curve.Results Pulsation was observed in 28 of the 62 URCAs.Aspect ratios in whose pulsation was or was not detected were 1.5±0.3 and 1.1±0.3,respectivelyThe difference between the two groups was statistically significant (t=-2.274,P＜0.001).The sensitivity and specificity of the aspect ratio were 75.0％ and 70.6％.After follow-up more than 3 months,of the 28 URCAs in which pulsation was observed,11 showed a change in shape,while in 34 URCAs without visible pulsation,5 showed a change in shape.The aneurysms with detectable pulsation were more likely to show a change in shape (x2=4.891,P=0.027),with an odds ratio of 3.753.Conclusions URCAs with a large aspect ratio are easily to show the pulsation by ECG gated 4D-CTA.Besides,the aneurysms with visible pulsation are more likely to show a change in shape after follow-up,which suggests a higher risk of rupture.

Establishment and assessment of a facial nerve ischemic model in rats via the mastoid process approach / 中华显微外科杂志

Objective To estabhsh an ischemic model of intratemporal facial nerve (IFN) via the mastoid process approach.Methods From February,2015 to December,2015,45 SD rats were divided randomly into an operation group (n=35) and a shame group (n=10) in random,the right side facial nerve was used for the operation and the left side served as the control in both groups.Establish the IFN ischemia model by interrupting the petrosal artery through the mastoid process approach.Facial nerve function were evaluated at the 12h and everyday postoperatively for 28 days.The degree of IFN swelling were studied by taking paraffin sections of the decalcified temporal bone containing the IFN instantly and at the 1st,3rd,7th,14th and 21st days postoperatively.Then calculated the ratio of the cross-sectional area of the IFN and the facial canal (FN/FC).The data of behavior assessment and FC/FN were analyzed using ANOVA.Twenty-eight days after the insult,took continuous sections of brainstem containing facial nucleus,then counted the number of the facial neurons.At last,analysed the results of both operation and control sides in each group by using the student-t test.Results Facial nerve paralysis developed at 12 hour after surgery,then continued deteriorated till the 7th day.By the 28th day postoperatively,all rats in surgery group recovered and data showed no significance statistically when compared with the shame group (P＜0.05).From the value of FN/FC in different groups,the nerve were found swelling in the facial canal was increasing from the 1st postoperatively and reach the peak value at the 7th day after surgery.By the 21st day,the FN/FC come to steady but remain significant statistically when compared with the contralateral side(P＜0.05).In the operation group,facial neurons of injury side exhibited significantly loss [(41.5±3.8)％] when compared with the shame group [(98.1±4.0)％](P＜0.05).Conclusion Rats with petrosal artery interrupted exhibited significant deficits.This approach involved less tissue injury,studies on the mechanisms and therapy could become more reliable using this approach.

The effect of apoptosis-2 ligand on irradiation-induced apoptosis in lung adenocarcinima H1975 cells resistant to EGFR-TKI / 中华放射医学与防护杂志

Objective To investigate whether the apoptosis-2 ligand (Apo-2L),known as tumor necrosis factor-related apoptosis-inducing ligand (TRAIL),could enhance irradiation-induced apoptosis in lung adenocarcinima H1975 cells that are resistant to the epithelial growth factor receptor (EGFR)-TKI.Methods Adenocarcinima H1975 cells were randomly divided into four groups:the control group,Apo2L group,irradiation group,and both Apo-2L and irradiation group.H1975 cells were pretreated with Apo2L under different concentrations of 200 and 228 ng/ml at 24 h before irradiation with doses of 1,1.5,2,2.5,3,3.5 and 4 Gy.The apoptosis rates of all groups were analyzed by flow cytometry 24 h post-irradiation.The inhibition rates of cell proliferation were measured by the MTT assay.Results MTT assay showed that the Apo-2L treatment significantly inhibited cell proliferation(x2 =136.17,P ＜ 0.05).The apoptosis rates of the four groups were different significantly,and the apoptosis rate of radiation combined with drug group was significantly higher than the other three groups(x2 =78.02,P ＜0.05).Conclusions The Apo-2L could not only inhibit the proliferation but also promote radiation-induced apoptosis of adenocarcinoma H1975 cells.

Comparison of preoperative PET-CT and pathological analyses in diagnosis of pulmonary tumors / 实用医学杂志

Objective To investigate the consistency in 18F-deoxyglucose positron emission tomography (18F-FDG PET-CT) examination and histopathological analyses in the diagnoses of resectable lung tumors. Methods Retrospective reviews over the clinical data of lung tumor patients by preoperative PET-CT diagnosis and postoperative histopathological diagnosis were conducted to investigate the effects of the two diagnostic methods in terms of lung tumor properties , mediastinal lymph node metastasis , and pulmonary hilar lymph node metastasis. Results The diagnoses by preoperative PET-CT was consistent in differentiation of non-malignancy and malignancy of pathologic lung tumors by 87.3%, at a medium level (κ = 0.401, P < 0.001). McNemar test showed P = 0.508, indicating the two diagnostic methods were insignificantly different in the diagnosis of pulmonary tumors. The preoperative PET-CT was consistent in the diagnosis of the metastasis of pathologic mediastinal lymph node by 85.9%, at a medium level (κ = 0.697, P < 0.001). McNemar test showed P =0.754, indicating no significant difference between the diagnostic methods. The preoperative PET-CT was consistent with postoperative pathological examinations in the differentiations of the metastasis of pulmonary and hilar lymph node by 77.4%, at a medium level (κ=0.523, P < 0.001). McNemar test showed P = 0.454, indicating the two diagnostic methods were no significantly different. Conclusion Preoperative PET-CT and histopathologic examinations may be consistent in lung tumor diagnosis , which provides a basis for a certain significance in the surgical options.

Impact of surgical resection on stage Ⅱ-ⅢA small-cell lung carcinoma patients ’ prognosis / 实用医学杂志

Objective To investigate the impact of surgical resection on patients with Ⅱ-Ⅲ A stage small cell lung carcinoma (SCLC). Method Data of 61 in-patients who diagnosed as Ⅱ-ⅢA stage SCLC from Jan 1st 2009 to Feb 1st 2014 were analyzed. 23 patients underwent surgical resections were enrolled as the treatment group, while 38 patients without surgical resection were enrolled as the control group. Disease progression was confirmed by monthly examination. The grouping is balanced by propensity score match. The progression-free survival (PFS) time and overall survival(OS) were analyzed with Kaplan-Meier survival method and Cox regression is applied to analyze the covariates. Fisher's exact test was applied to compare one-year survival rate and two-year survival rate. Results The PFS and OS of the treatment group is longer than that of the control group (P < 0.05). Both one-year and two-year survival rates of the treatment group outnumber those of the control group (P < 0.05). Cox regression indicates that surgical resection is an independent prognostic factor (P < 0.05). Conclusion Surgical resection on tolerable patients with stage Ⅱ-Ⅲ A small-cell lung carcinoma is effective on improving the progression-free survival time,one-year and two-year survival rates,and also shows a propensity of a higher overall survival time.

Efficacy and clinical nursing of thymopentin combined with ceftriaxone on patients with early syphilis serum fixation / 中国基层医药

Objective To evaluate efficacy of thymopentin combined with ceftriaxone on patients with early syphilis serum fixation.Methods A total of 108 patients with early syphilis serum fixation were chosen and divided into observation group and control group by the number of tables (54 cases in each group).The control group were underwent conventional sodium penicillin with benzathine with nursing treatment,the observation group were treated with ceftriaxone thymopentin combined with nursing treatment,changes in the relevant indicators before and after treat-ment were observed.Results After treatment,IL -2,IL -10 and other indicators in the observation group were improved compared to the control group[IL -2:the control group before treatment (20.8 ±4.9)μg/L,after treatment (42.7 ±7.3)μg/L;the observation group before treatment(19.8 ±5.1)μg/L,after treatment (54.6 ±8.3)μg/L;IL -10:the control group before treatment (76.3 ±16.1)μg/L,after treatment (51.3 ±5.4)μg/L;the observation group before treatment(78.3 ±4.1)μg/L,after treatment(23.8 ±5.1)μg/L],the differences of the two groups after treatment were statistically significant (t =3.923,8.832,all P <0.05);after treatment,the RPR negative rates of the observation group at 3,6,12 months after treatment(72.2%,85.2%,96.3%)was significantly higher than those of the control group(53.7%,57.4%,63.0%),the differences were statistically significant (χ2 =4.932,11.372, 22.842,all P <0.05);the efficacy of the observation group at 3,6,12 months after treatment(75.9%,79.6%, 75.9%)were significantly better than those of the control group (72.2%,64.8%,57.4%),the differences were statistically significant (χ2 =5.232,6.183,all P <0.05 ).Conclusion Thymopentin combined with ceftriaxone treatment of early syphilis can significantly improve its fixed immunological parameters,which coordinated with nursing measures can strengthen patient care awareness,then the efficacy will be better,so it is worthy of clinical further promotion.

Scientific publications in critical care medicine journals from East Asia: a 10-year survey of the literature

Objective: The quantity and quality of publications in critical care medicine from East Asia haven't been reported. This study aimed to investigate the contribution of publications from East Asia

Methods: Articles from China, Japan and South Korea in 2005 to 2014 were retrieved from Web of Science and Pubmed. The number of publications, impact factor, citation, and article types were analyzed

Results: There were 3076 publications from East Asia [1720 from China, 913 from Japan, and 443 from South Korea]. There were a significant decrease in publications from Japan [p = 0.024] and significant increases from China [p = 0.000] and South Korea [p = 0.009]. From 2006, the number of articles from China exceed Japan. China had the highest total impact factor [6618.48] and citation [18416], followed by Japan [4566.03; 15440] and South Korea [1998.19; 5599]. Japan had the highest mean impact factor [5.00] and citations [16.91], followed by South Korea [4.51; 12.64] and China [3.85; 10.71]

Conclusions: China and South Korea`s contributions to critical care medicine had significant increases during the past 10 years, while Japan had a significant decrease. China was the most productive region in East Asia since 2006. Japan had the highest quality research output

Clinical analysis of lateralorbital keyhole approach for microsurgical treatment of ruptured tiny aneurysms / 中国综合临床

Objective To investigate the clinical application and surgical techniques of lateral-orbital keyhole approach to clip ruptured tiny aneurysms.Methods A retrospective analysis was performed on the clinical data of 56 patients with ruptured tiny aneurysms, including examination methods, imaging features, diagnosis and treatment process, and operation effect, which underwent lateral-orbital keyhole approach from January 2013 to April 2014.Results Among 56 patients with a total of 61 aneurysms(56 tiny aneurysms) was examined by CT angiography (CTA) and/or digital stubtraction angiography (DSA), all achieved successful clipping with a rupture rate of 16％(13 cases).Forty-two cases got a good recovery,8 cases owned the self-care ability, and 6 cases could carry out daily lives with help.There was no rebleeding and mortality, according to a 2-28 months' follow-up of 49 patients.Conclusion As a surgical approach for Willi'S cycle aneurysm,the lateralorbital approach is simple,rapid,minimally-invasive way.It is available in the clipping of ruptured tiny anterior communicating aneurysms.The option of operative time, perfect microdissection and exquisite intraoperative microinvasive operative skills, will be the key point of clipping aneurysms, preventing and controlling of intraoperative bleeding.