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BackgroundRecently, minimal invasive surgery (MIS) has been applied as a common therapeutic approach for treatment of hypertensive intracerebral hemorrhage (HICH). However, the efficacy and safety of MIS is still controversial compared with conservative medical treatment or conventional craniotomy. This meta-analysis aimed to systematically assess the safety and efficacy of MIS compared with conservative method and craniotomy in treating HICH patients.MethodsPubMed, Embase, Web of Science, and Cochrane Controlled Trials Register were used to identify relevant studies on MIS treatment of HICH up to November 2017. This study evaluated Glasgow Outcome Scale (GOS) score, Activities of Daily Living (ADL) score, pulmonary infection rate, mortality rate, and rebleeding rate for patients who underwent MIS, or conservative method, or craniotomy. Subgroup analyses were performed to compare randomization versus non-randomization and large hematoma versus small or mild hematoma. Begg’s test and Egger’s test were used to determine the potential presence of publication bias.ResultsSixteen studies consisting of 1912 patients were included in this study to compare the efficacy and safety of MIS to conservative method or craniotomy. MIS contributed to a significant improvement on the prognosis of the patients comparing with conservative group or craniotomy group. Patients undergoing MIS had a lower mortality rate when compared to those receiving conservative method. Also, MIS led to a notable reduction of rebleeding rate and an effective improvement of the patient’s quality of life by contrast with craniotomy. No obvious difference was found in terms of the pulmonary infection rate among the comparisons of three treatment methods. Randomization is not the potential source of heterogeneity, but hematoma volume may be a risk factor for post-operative mortality rate. No statistical evidence of publication bias among studies was found under most of comparison models.ConclusionThis meta-analysis suggests that minimal invasive surgery is an efficient and safe method for the treatment of hypertensive intracerebral hemorrhage, which is associated with a low mortality rate and rebleeding rate, as well as a significant improvement of the prognosis and the quality life of patients when compared with conservative medical treatment or craniotomy.

Franchetine, a unique 7,17-seco type of norditerpenoid alkaloid, possesses a highly congested polycyclic architecture coupled with nine stereogenic centers. Here we present an efficient synthetic approach for the intact hexacyclic framework of franchetine from the known tricyle 16 in 20 steps. The synthesis features a diastereoselective 6-exo-tet radical cyclization for construction of ring A and a unique oxidative Wagner-Meerwein-type rearrangement to realize the functionalized [3.2.1] bridging ring CD.

Theory of transaction costs and its measurement has been regarded as the focus since its being put forward by scholars. Additionally, researches on the measurement are relatively less in China. This paper devotes to reviewing and analyzing present advanced methodologies of transaction costs measurement. And it summarizes the difficulties of measurement based on the concept of transaction costs. Furthermore, it introduces three difficulties of measuring. They are unclear definition of transaction costs, unobservable costs in non-market and the unable replacement of opportunity costs. It concludes the measuring methods both on the macro and micro aspects. On macro aspect, it introduces methods as direct measuring, model-built measuring and margin analysis measuring. On micro aspect, it introduces methods as buy-sale price margin, typical reference quantities method, investigating method and data statistics method.