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Objective To explore the predictive value of serum hypoxia-inducible factor-1α (HIF-1α) and interleukin-6 (IL-6) at admission on short-time 6-month prognosis of patients with severe traumatic brain injury (sTBI). Methods Seventy-two sTBI patients with Glasgow coma score (GCS) 3-8 points in our hospital were selected from September 2016 to January 2018 and divided into the group with good prognosis and group with poor prognosis according to Glasgow outcome score (GOS) after injury 6 months. Serum HIF-1α and IL-6 at admission were detected by using ELISA. The levels of plasma biochemistry indexes, acute physiology and chronic health evaluationⅡ(APACHEⅡ) scores and GCS scores were evaluated. Univariable and Multivariable COX proportional hazards models were performed to analyze the risk factors for short-time prognosis of patients with sTBI. Receiver operating characteristic (ROC) curve was built to analyze the predictive value of APACHEⅡ scores, HIF-1α and IL-6 on short-time prognosis of patients with sTBI. Results After 6-month followed up, there were 33 patients with good prognosis and 39 patients with poor prognosis. There was statistical difference of the baseline values of ages, serum HIF-1α and IL-6 at admission, APACHEⅡscores and GCS scores, the interval from injury to admission, the size of traumatic brain injury between two groups (t=2.312,14.132,16.628,3.172,3.644,3.073,4.284, P＜0.05). The serum HIF-1α [HR (95%CI)=2.645 (1.710-4.679), P＜0.05] and IL-6 [HR(95%CI)=1.821(1.674-2.957), P＜0.05] at admission, APACHEⅡscores [HR(95%CI)=1.789(1.105-2.928), P＜0.05] and the size of traumatic brain injury [HR (95%CI)=6.256 (1.727-10.834), P＜0.05] were the independent influence factors of short-time 6m prognosis of sTBI patients. The area under ROC curve and Youden＇s index of HIF-1α, IL-6 and APACHEⅡscores at admission on prediction of prognosis of sTBI patients were 0.94 (95% CI: 0.81-0.99) and 0.85, which was higher than separate predictive value of HIF-1α, IL-6 and APACHEⅡ scores. Conclusion The present study demontrated that serum HIF-1α and IL-6 at admission may be the early sensitive predictors of short-time prognosis in sTBI patients.
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Objective To investigate the biomechanical properties and clinical effects of the unilateral/bilateral percutaneous vertebroplasty (PVP) on the treatment of osteoporotic vertebral compression fractures in elderly patients. Methods The finite element models of the unilateral/bilateral percutaneous vertebroplasty (PVP) in osteoporotic vertebral compression fractures were established to evaluate changes in strain and stress of the fractured vertebra after surgery. Eighty patients with osteoporotic vertebral compression fractures underwent unilateral or bilateral PVP were collected for retrospective analysis. The operation time,intraoperative fluoroscopy times,injected bone cement volume, bone cement leakage rate and visual analogue scales (VAS) score between the two groups were analyzed. Results The maximum strain and stress in unilateral PVP group were 1.18 times and 1.15 times of those in bilateral PVP group,respectively.The operation time and intraoperative fluoroscopy times in unilateral PVP group were obviously smaller than those in bilateral PVP group (P0.05).Conclusions The biomechanical effect of unilateral PVP was similar to that of bilateral PVP. The puncture needle localization of unilateral PVP for treating elderly patients with osteoporotic vertebral compression fractures had the advantage of less operation time and limited X-ray exposure.
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OBJECTIVE@#To investigate the safety and short-term efficacy of stent on 17 patients with very small intracranial aneurysms. @*METHODS@#A total of 17 patients with very small intracranial aneurysms were treated by LVIS stent from October 2014 to November 2015. The location, size of the aneurysms and the branch around aneurysms were evaluated by digital subtraction angiography (DSA). The metal coverage for aneurysms was enhanced by using deployment technology ("compression" mode). The safety and efficacy were assessed after operation. @*RESULTS@#LVIS stents-assisted treatments for very small aneurysms were carried out in 17 cases, including 7 cases of paraclinoid aneurysms, 4 cases of posterior communicating artery aneurysms, 3 cases of anterior communicating artery aneurysms, 2 cases of carotid bifurcation aneurysms, 1 case of the superior cerebellar artery aneurysm. The stents for 17 patients with very small intracranial aneurysms were released completely (100%); Raymond grade I embolization was seen in 13 cases (76.5%); Raymond grade II embolization was seen in 4 cases (23.5%); during the follow up from a month to a year, 16 patients showed good curative effect (with the mRS score at 0-2), 1 showed poor effect (with the mRS score at 3-6), and the efficacy rate was 94.1%; no perioperative hemorrhagic and ischemic complications happened. @*CONCLUSION@#LVIS stent-assisted therapy for very small intracranial aneurysms by using deployment technology was safe and feasible, which can significantly improve the embolization rate for very small aneurysms.
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Humans , Basilar Artery , Embolization, Therapeutic , Intracranial Aneurysm , Safety , StentsABSTRACT
Objective To investigate the anti-fatigue activity of fermented grain-containing blueberry anthocyanins ( LANHE,LH) in mice.Methods Experiments were conducted in two phases .In the first phase , forty mice were randomly divided into four groups:control group(distilled water,dw) and three LH administration groups (8.75,17.5 and 35.08 ml/kg body mass).In the second phase, mice were randomly divided into two groups:high-dose LH group (35.08 ml/kg body mass) and control group (dw 35.08 ml/kg body mass).After four weeks, a forced swimming test was performed and the biochemical parameters related to fatigue were examined .Results and Conclusion The administration groups showed a significant increase of swimming time to exhaustion compared with the control group , especially the high-dose group ( P0.05).LH could significantly increase the liver glycogen contents and decrease the serum contents (P<0.05).These data indicate that LH has anti-fatigue activity and can elevate the exercise tolerance in mice .
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OBJECTIVE@#To explore the effect of long-term video-electroencephalography (VEEG) monitoring and intracranial electrode EEG monitoring in the surgical treatment of temporal lobe epilepsy.@*METHODS@#We compared the preoperative long-term VEEG and intraoperative intracranial electrode EEG in 44 patients undergoing surgical treatment of temporal lobe epilepsy.@*RESULTS@#The 44 patients were followed up for 1 to 5 years. The clinical attack was controlled completely in 36 patients (81.8%), the time of clinical attack was decreased significantly in 6 patients (13.6%), 2 patients (4.5%) still had epileptic seizure, but the degree was relieved and the seizure time shortened. The nerve psychological function was improved to different extent in 40 patients (90.9%).@*CONCLUSION@#Preoperative long-term VEEG and intraoperative intracranial electrode EEG are accurate in the localization of the focus, which is important in the surgical treatment of temporal lobe epilepsy.
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Adolescent , Adult , Child , Female , Humans , Male , Young Adult , Anterior Temporal Lobectomy , Methods , Electrodes, Implanted , Electroencephalography , Methods , Epilepsy, Temporal Lobe , General Surgery , Monitoring, Intraoperative , Methods , Video RecordingABSTRACT
Objective To explore the diagnostic value of MRI special use of breast and uhrasonography in axillary lymph node metastasis of early breast cancer.Methods Clinical data of 136 Ⅰ-Ⅲ A breast cancer patients accepted MRI examination before surgery had been retrospectively studied,analysing diagnostic value of MRI and ultrasonography in axillary lymph node metastasis of early breast cancer.Results The sensitivity,specificity,and accuracy obtained by MRI were 83.3％,88.6％ and 86.3％.And these data of ultrasonography were 73.1％,76.7％ and 75.0％.The sensitivity,specificity,and accuracy obtained MRI were better than that of ultrasonography.The sensitivity,specificity,and accuracy of ≥ 50 years old patients were 70.0％,77.8％ and 75.0％.And ＜ 50 years old patients were 85.7％,92.3％ and 88.9％.The sensitivity,specificity,and accuracy of ＜ 50 years old patients were better than ≥ 50 years old patients.Conclusions The MRI special use of breast have an important value in axillary lymph node metastasis of early breast cancer,especially to gounger than 50 years old patients.It can provide a scientific basis of the clinical accurate treatment for early breast cancer patients.
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Objective To investigate the effects of methylthioadenosine phosphorylase (MTAP) on invasion and migration in breast cancer cells.Methods Human breast cancer cell line MCF-7 cells were treated with MTAPtargeted siRNA to diminish MTAP mRNA.MCF-7 cells proliferation was evaluated by cell counting kit-8,the analysis of cells invasion and migration was performed using Transwell chamber.The expressions of MTAP and matrix metalloproteinase 1 (MMP1) in cell extracts were detected by Western blotting.The experimental divided into blank contrd group,negative control group,MTAP-siRNA experimental group.Results The MCF-7 cells growth was promoted after knockdown the MTAP mRNA.MATP-siRNA experimental group 450 nm absorbance values at 24h,48 hand72 h of the control group were (112.3±11.9)％,(144.4±8.4)％,(169.3±9.4)％ respectively.Cell invasion analysis by Transwell chamber showed 570 nm absorbance values were 0.49 ± 0.06 (control),0.45 ± 0.07 (negative control) and 0.87 ± 0.07 (MTAP-siRNA) respectively.Cell migration analysis by Transwell chamber showed 570 nm absorbance values were 0.46 ± 0.06 (control),0.49 ± 0.08 (negative control)and 0.75 ± 0.07 (MTAP-siRNA) respectively.The expression of MMP1 in MCF-7 cells was upregulated after knockdown the MTAP mRNA.Conclusion The knockdown of MTAP in MCF-7 cell can increase the cells invasion and migration,and this may involve the the MMP1.
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Objective To analyse clinical features of 86 cases of intracranial arteriovenous malformation (AVM) and explore strategies and methods of the microsurgical treatment of intracranial arteriovenous malformations.Methods The clinical data of 86 intracranial arteriovenous malformation from January 2010 to January 2013 were retrospectively reviewed.For diagnosis,computed tomography (CT) with angiography (CTA),and DSA were used,which could provide real size,location,feeding arteries and draining veins of AVM,and apply NEPM to evaluate the nerve function,assess the qualitative and quantitative flow rate of AVM and surrounding blood vessels by Doppler ultrasonography and fluorescein angiography,and reveal opography of AVM.Operative techniques were used including embolization,feeding artery control.Results Eighty-six cases of AVM were resected successfully under mutitechnology.Following-up demonstrated excellent neurological outcomes in 70 cases,nine case had mild disability,five cases had severe disability,two dead cases.DSA shows resected completely,and long-term follow-up was still in progress,conclusion Multi-technology combined microsurgical techniques which can effective improve the outcomes of intracranial arteriovenous malformations.
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OBJECTIVE@#To evaluate the usefulness of monitoring transcranial electrically stimulated motor evoked potential (MEP) and its impact on postoperative motor function after surgical clipping of intracranial aneurysms.@*METHODS@#A total of 69 aneurysm patients were monitored for MEP during surgery. The postoperative and preoperative neurological function variation and the correlation between them were compared.@*RESULTS@#MEP deteriorated in 9/68 patients, 6 of the deteriorated MEP returned to normal within 1-40 min, and no new motor deficit emerged. 3 of MEP failed to return to the baseline, which were consistent with postoperative motor function deficit.@*CONCLUSION@#Changes in MEP could serve as early indication of the cerebral ischemia, predicting postoperative motor function and providing a guide to a safe time for temporary clipping. FNMEP monitoring is a safe and reliable tool for the integrity of facial nerve pathway in giant aneurysm surgery.
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Evoked Potentials, Motor , Physiology , Forecasting , Intracranial Aneurysm , General Surgery , Motor Neurons , Physiology , Neurosurgical Procedures , Methods , Postoperative Period , Surgical InstrumentsABSTRACT
Objective To study the methods and significance of motor and sensory areas mapping by optical intrinsic signal imaging (IOSI) and neuromonitoring (IOM) during the operation on the lesions near the central sulcus. Methods Intraoperative neuromonitoring were firstly used to map the central sulcus and motor cortex in 5 patients with glioma undergoing surgery. Then, intrinsic optical signals imaging were used to locate the postcentral gyrus. According to the results of mapping, microsurgical operation was chosen for the resection of glioma and postoperative functional results were evaluated. Results All the patients acquired accurate location of central sulcus, motor cortex and somatosensory cortex. The enhanced MRI performed within 24 hours postsurgery showed total resection in 5 cases. The motor and somatosensory function of 5 patients returned to normal after 3-12 months. Conclusion Intraoperative location of the somatosensory area and motor area by optical intrinsic signal imaging and neuromonitoring is a reliable and safe method.
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ObjectiveTo discuss the application of neurophysiological monitoring (NEPM), intraoperative color Doppler ultrasonography, fluorescein angiography and neuroendoscope in clinical effects of intracranial giant aneurysm microsurgey. MethodsTo retrospectively review the clinical data of 17 intracranial giant aneurysm. Pre-operative imaging were used, including 3D- CTA, MRI and DSA, to make dectection and delineation of the aneurysm.The NEPM to evaluate the nerve function,assess the qualitative and quantitative flow rate of aneurysm and surrounding blood vessels by Doppler ultrasonography and fluorescein angiography,and reveal opography of aneurysm,protect the considerable perf.vessels and nerves by neuroendoscope.Operative techniques were used including parent artery control,aneurysm neck forming,aneurysm decompression and resection,obliteration of aneurysm with multiple clips and vasospasm protection.Results Seventeen cases of giant aneurysms were clipped successfully under muti-technology, follow-up demonstrated excellent neurological outcomes in 15 cases, one case had mild disability, one case had severe disability, no dead cases. DSA showed clipping completely, parent artery clear, and long-term follow-up was still in progress.Conclusion Multi-technology combined microsurgical techniques which can effective improve the outcomes of intracranial giant aneurysms.
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Objective To summarize the method and experience of microsurgical treatment of intracranial aneurysms in anterior circulation. Methods The clinical data, the skills and experience of 171 cases with aneurysmso of anterior circulation within the latest 2 years. Results One hundred and seventy-one patients under surgery, including 67 PCOA aneurysm, 56 ACoA aneurysm, 32 MCA aneurysm, 10 ICA aneurysm, OphA aneurysm and 3 haimess aneurysm. Accoring to Glasgow Prognostic Scale, there were 3 cases of grade Ⅰ, 6 cases of grade Ⅲ, 14 cases of grade Ⅳ and 148 cases of grade Ⅴ. Conclusion The key points to cure intracranial aneurysms successfully is favourable exposure and the skills of microsurgery; the factors of intluent surgery include forcejudgement in surgery, reasonable choice of aneurysm clips, correctly block in arterious.
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Objective To study the clinical effect of microsurgical treatment of craniopharyngioma by modified pterional approach.Methods Forty-one patients were carried out a retrospective case study with craniopharyngioma who underwent microsurgieal treatment via modified pterional approach at our department.Preoperative preparation mainly included hormone replacement therapy and prevention of epilepsy.The modified pterional approach was adopted.The patients' clinical indications were monitored postoperatively such as consciousness, blood pressure, in and out quantity of water, urine specific gravity, electrolytes, CT and MRI, and prompt prevention and treatment of the complications including diabetes insipidus and disorder of electrolytes were carried out after the surgery.Meanwhile, measures were taken to prevent postoperative epilepsy and low level of hormone.Results Thrrty-three patients had total craniopharyngioma resection, 5 had subtotal craniopharyngioma resection and 3 had partial craniopharyngioma resection, and all of them survived from the surgery.2 to 19 months postoperative follow-up showed that 32 patients could normally live,study and work, while 9 patients had to be assisted for normal lives.There was a recurrence of the tumor in 3 patients out of 8 patients that had subtotal and partial craniopharyngioma resection within 12 months postoperatively.Conclusion Adopting modified pterional approach plus efficient and effective perioperative management can reduce the damage rate of hypothalamus and improve the total resection rate of the craniopharyngioma, and achieve good results of the treatment.
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Objective:To study the expression of suppressor of cytokine signaling 1(SOCS1) and cellular myelocytomatosis oncogene(c-myc)in hepatocellular carcinoma(HCC),and to inves-tigate the relation between the expression of SOCS1 and c-myc in HCC.Methods:The expressions of SOCS1 and c-myc protein of 41 HCC tissues and surrounding tissues,as well as the tissues of 11 normal cases,were detected by immunohistochemical(IHC)staining using SP method.The expression of SOCS1 mRNA was detected by RT-PCR.And the clinical and pathological data were analysed.Results:Compared with the para-carcinoma and normal liver tissue,the levels of SOCS1 and SOCS1 mRNA in HCC tissues were significantly lower(P
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Objective To investigate the clinical manifestation,pathological characteristics,neurological imaging,indications,operative approach and microsurgieal technique of surgery for brain stem tumor.Methods 17 cases of brain stem tumor treated by applying microsurgical skills were retrospectively analyzed from Jan.2002 to Dec.2007.Ten cases were operated via the suboccipito-retromastoid approach,among which 5 situated in pons,3 in medulla oblongata and 2 invoved both pens and medulla oblongata;4 cases were performed via the posteromedian-suboccipital approach,among which 2 located in pens,1 in medulla oblongata and 1 involved both midbrain and pens;3 lesions situated in varying sites of mesencephalon were operated by the suboceipito-supratentorial,infratemporal approach and pterional approach respectively.Results In the series of the patients,lesion was totally excised in 6 cases,subtotally in one,without surgical mortality.All patients were followed up for years ranging from 5 months to 4 years.During the follow-up period,seven patients resumed work and normal life;4 patients could perform physical labor;3 patients obtained self care capability;2 patients needed to be taken care of,1 patient died from pneumonia after discharge.Conclusion Fine therapeutic efficacy and low disability rate could be obtained while applying microsurgical techniques to resect brain stem tumors with correct indication,appropriate approach and elaborate microneurosurgical skills.
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Objective To explore the relationship between the expression of E-cadherin catenin complex(CCC) and the invasiveness of pituitary adenoma.Methods The expession of E-cadherin catenin complex was determined by immunohistochemistry in 45 cases of human pituitary adenomas by random sampling,including invasive adenoma 27 cases,noninvasive adenoma 18 cases.The relativity of their expression with hormone-producing,pituitary apoplexy and necrosis or cystoid change,tumor diameter was analyzed.Results The invasive group had a significantly lower expression of E-cad and ?-cat than that of noninvasive group(?2=8.551,P0.05).Moreover,the expression of E-cad was significantly lower in endocrine inactive group than that in endocrine active group(?2 =5.020,P
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Objective: To study the protective effect of enteral nutrition with Salvia miltiorrhiza on injuries multiple organs in rabbits. Method: Forty-four rabbits were randomly divided into four groups: Normal control group (N) 8 rabbits, Endotoxin group (LPS), Enteral nutrition group (LPS+EN) and Enteral nutrition with Salvia miltiorrhiza group (LPS+DS),each 12 rabbits. Three days before given endotoxin, LPS+DS group was fed enteral nutrition fluid with Sallvia miltiorrhiza 80 ml/kg bw (15g salvia per 100 ml fluid) and LPS+ EN group was fed enteral nutrition only.N group was fed the same quantity of normal saline. At the end of 10 d, the rabbits were killed and serum SOD, MDA, endotoxin and intestinal mucus SIgA contents were determined. Small intestine, liver, lung, kidney and heart were taken for pathological examination. Results: Serum MDA of LPS+DS group was much lower than LPS group, endotoxin level also lower , but intestinal SIgA content higher LPS group . The pathological examination showed that the intestinal villi were shortend, injured , and necrotic in LPS group; liver was hemorrhagic at portal area with cytoplasmic vacuolization, lung and kidney were also injuried pathologically. These pathological features were comparatively mild in LPS+EN group and much better in LPS+ DS group. Conclusion: Enteral nutrition with Salvia miltiorrhiza may reduce the oxidative damages of multiple organs induced by endotoxin as shown by increased SIgA of small intestine, maintenance of intestinal mucosa integrity and alleviation of pathological changes of multiply organs in rabbits.
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Objective To study the techniques and methods of the treatment for large acoustic neuroma with endoscope assisted microneurosurgery Methods Sixteen patients were treated with endoscope assisted microneurosurgery Results Tumors were totally removed in 13 cases and were subtotally removed in 3 cases,facial nerves were reserved in 14 cases short period complications happened in 4 cases The function of defective nerves recovered to some extent in all cases Concliusions Microneurosurgery treatment assisted with neuroendoscope may increase the total removal rate and it is effective and minimally invasive
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Objectives:In this study,the effects of glutamine(Gln) and branched chain amino acids(BCAA) enriched formulas on free radical metabolism and immunity in traumatized rats were investigated. Methods:After injury,twenty one male Wistar rats were randomly divided into three groups,and fed with rations containing casein,a commercial amino acids(17AA),and a new amino acids formula(20 AA) respectively.The rations were isonitrogenous and isocaloric.Before operation and on days 3,7,14 postoperation,body weight,dietary intake,the concentrations of MDA,the activities of SOD in plasma were measured.At last,the animals were killed,the hydroyproline and spleen lymphocyte blastogenesis were determined. Results:①After injury,body weight of rats were reduced significantly,the concentrations of MDA in plasma were increased,while the SOD activities were decreased. ②Compared with 17AA group, the levels of hydroyproline in sponge were increased in 20AA group.③There were better effects of reducing plasma MDA levels and enhancing plasma antioxidase activities in 20 AA group than 17 AA group.④The weight of thymus and spleen and spleen lymphocyte blastogenesis were more obviously increased in 20AA group than in 17AA group. Conclusions:The new amino acids preparations can increase the antioxidase activities,enhance immunity and promote wound healing.
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AIM: To investigate the antagonistic effect of zinc on hepatic ischemia- reperfusion (HIR) injury and the effect of zinc on the expression of adhesion molecules in rat liver to clarify the mechanisms involved. METHODS: After zinc supplementation (5 ?mol/kg bw,po) , the changes in hepatocellular morphology,ALT and AST activities in serum,MDA levels in serum,and expression of ICAM-1,VCAM-1 in liver of the animals subjected to HIR were examined. RESULTS: The results showed that HIR (30 minutes of ischemia followed by 90 minutes of reperfusion) significantly increased ALT, AST activities and MDA levels in serum. The destruction of hepatic structure was observed in HIR rats. In the mean time, the expression of adhesion molecule was enhanced.After zinc administration, ALT and AST activities in serum and MDA levels in serum were all decreased. The structure of hepatocyte was nearly normal.The further experiment showed that adhesion molecule expression was suppressed.CONCLUSION: These results indicate that zinc may protect liver against ischemia-reperfusion injury by inhibiting the production of free radicals and the expression of adhesion molecule.