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Objective To investigate the regulation on extracellular signal regulated kinase (ERK )1/2 and p38 signaling pathways and immune expression by moist exposed burn therapy/moist exposed burn ointment(MEBT/MEBO)in diabetic foot and their relationship ,to explore the repair mechanism of MEBT/MEBO on diabetic foot ulcers .Methods Totally 40 diabetic foot pa‐tients were treated by MEBT/MEBO ,to take wound tissue before and after treatment and detect the expression of ERK 1/2 ,p38 , MAPKK6 ,c‐myc ,Akt ,ATF2 ,IgA ,IgM ,IgG ,C3c and C4c by immunohistochemistry ,to investigate their relationship .Results Af‐ter treatment with MEBT/MEBO ,the area of foot wounds in 39 patients was reduced in different degree .Only one patient had no obvious change .14 patients(35 .00% ) were markedly effective ,25 patients(62 .50% ) and 1 patient(2 .50% ) were ineffective .Before andaftertreatment,allpositiveexpression,positiveimmunoreactivity(anyindex)andpositiveexpression(specificindex)ofsignal pathway molecules were statistically significant (P<0 .05) .While the positive rate of molecular expression in wound pathway in‐creased ,the positive expression rate of immune factor increased .Before treatment ,a small amount of immune factors were found in the wound tissue .After treatment ,the immune factors IgA ,IgM ,IgG ,C3c ,C4c were distributed widely and diffusely .Before treat‐ment ,the wound tissue showed a very small number of signal molecules .After treatment ,the signal pathway molecules MEBT/MEBO and p38 ,MAPKK6 ,c‐myc ,Akt ,ATF2 showed broad and diffuse distribution .Conclusion MEBT/MEBO may promote the expression of ERK1/2 and p38 signaling molecules and immune in diabetic foot ,p38 and ERK1/2 signaling pathway may promote the healing of diabetic foot wound by increasing the expression of immune .
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Objective:To evaluate the analgesic effects of two kinds of preoperative peripheral nerve block drug in patients with tri-geminal neuralgia undergoing radiofrequency thermocoagulation(RFT)of gasserian ganglion.Methods:90 patients with classic trigemi-nal neuralgia of the 3rd branch were scheduled to undergo RFT of the gasserian ganglion and were randomly divided into 3 groups(n =30).The patients in group N without nerve block were served as the controls.The patients in group A and B were treated by the nerve block of inferior alveloar with 2 ml of 2% lidocaine hydrochloride and 2 ml of compound lidocaine hydrochloride for each respectively 2 d before RFT.The pain control was studied by VAS method before and 24,48 h after nerve blocking and during pucture for RFT.Re-sults:Compared with the control group,24 h after nerve blocking,the average pain and the most pain VAS value of group A and B were significantly reduced(P <0.01);sleep quality and analgesia satisfaction were improved in group A and B(P <0.05).48 h after nerve blocking the pain relief and sleep quality improvement of group B were more than those of group A(P <0.05).In addition,during RFT puncture the pain intensity of group A and B were less than that of group N(P <0.05).The pain control in group B was more effective than that in group A.Conclusion:A single peripheral nerve block with long-term narcotic compound lidocaine hydrochloride can be an effective way to relieve preoperative and operative pain for RFT of trigeminal neuralgia.
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Objective To compare the clinical effects and safety of surgical clipping and intravascular interventional therapy in treatment of intracranial wide-necked aneurysm.Methods The clinical data of 158 patients with intracranial wide-necked aneurysm from February 2010 to February 2013 were retrospectively analyzed,all patients were divided into two groups:surgical clipping group with 92 cases and intravascular interventional therapy group with 66 cases,the postoperative curative effects,treatment time,hospital stay,hospital expenses and postoperative complications between two groups were compared.Followed up for 10-46 months,the recurrence rate were compared.Results The good prognosis and defective rates between surgical clipping group and intravasular interventional therapy group had no significant difference [90.2％(83/92) vs.90.9％(60/66),9.8％(9/92) vs.9.1％ (6/66)] (x2 =0.298,P ＞ 0.05).The preoperative Hunt-Hess classification and CT Fisher classification between two groups had no significant difference (P ＞ 0.05).Six months after discharge,mRS score was used to evaluate the curative effect,the defective rates in same level patients between two kinds of treatment methods had no significantdifference (P ＞ 0.05).The treatment time,hospital stay in surgical clipping group were significantly longer than those in intravascular interventional therapy group [(4.03 ± 1.01) h vs.(1.61 ± 0.98) h,(15.90 ± 2.03) dvs.(13.20 ± 1.95) d],hospital expenses was significantly lower than that in intravascular intervention therapy group [61 829.4 ±320.6) yuan vs.(99 876.2 ±371.5) yuan] (P ＜0.05).The postoperative complications rate between two groups had no significant difference (P ＞ 0.05).Followed up for 31.3 (10-46) months,the recurrence rate in surgical clipping group was significantly lower than that in intravascular intervention therapy group [1.1％ (1/94) vs.8.8％ (6/68)] (P ＜ 0.05).Conclusion Surgical clipping and intravascular interventional therapy in treatment of intracranial wide-necked aneurysm has their own different characteristics,so patients' treatment methods should be based on their preoperative status (especially preoperative Hunt-Hess and Fisher classification) and patients' economic conditions.
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Objective To discuss the clinical effects of using CT positioning keyhole approach to treat hy-pertensive intracerebral hemorrhage (HICH).Methods 85 cases of patients with hypertensive intracerebral hemor-rhage(HICH) were chosen and divided into two groups according to the operation methods:the observation group had 55 cases given CT positioning keyhole approach ,while the control group had 30 cases treated with traditional cranioto-my hematoma removal operation .All patients were supplemented by postoperative blood pressure control and nutrition -al support treatment .The average operation time ,hematoma disappearing time ,the length of hospital stay and re-bleed-ing rates and postoperative ability of daily life ( ADL) scores of the two groups were all carefully recorded and com-pared.Results The average operation time,hematoma disappearing time and hospital stay of the observation group were (66.5 ±12.8)min,(3.4 ±1.3)d,and (9.3 ±1.7)day which were all significantly lower than those of the con-trol group(193.5 ±23.7)min,(5.8 ±2.1)d and (15.2 ±3.8)d;T-test values of the two groups were 2.874,3.125 and 3.433 separately(P0.05).6 months′follow-up after opera-tion,in the control group 2 cases were lost to follow-up while in the observation group 3 cases were lost to follow-up;Using ADL to evaluate the two groups of patients with survival and continuous follow-up,we found that the observation group′s postoperative quality of life was better than that of the control group′s(μ=3.325,P<0.05).Conclusion Using CT positioning keyhole approach has smaller trauma , shorter operation time and faster postoperative recovery and other characteristics,which is an effective method for the treatment of hypertensive intracerebral hemorrhage(HICH).