Phenolic constituents from Wikstroemia chamaedaphne / 中国中药杂志

The phenolic constituents of Wikstroemia chamaedaphne were investigated by various column chromatographic methods including silica gel,Sephadex LH-20,ODS and preparative HPLC,and their chemical structures were identified by physico-chemical properties and spectral analyses. Thirteen phenolic compounds were isolated and elucidated,including five flavonoids: luteolin 7-O-β-D-glucopyranoside(1),luteolin 4'-O-β-D-glucopyranoside(2),kaempferol 3-O-β-D-glucopyranoside(3),chrysoeriol 4'-O-β-D-glucopyranoside(4),chrysoeriol(5); and eight lignans:(-)-secoisolariciresinol(6),acanthosessilin A(7),(-)-nortrachelogenin(8),(+)-isolariciresinol(9),sesamin(10),syringaresinol(11),(+)-epipinoresinol(12),and [3,3',4,4'-tetrahydro-6,6'-dimethoxy-3,3'-bi-2 H-benzopyran]-4,4'-diol(13). Compounds 1, 3, 5-8, 10, 11 and 13 were obtained from the plants of W. chamaedaphne for the first time,and compounds 1,5,7,10 and 13 were obtained from the Wikstroemia genus for the first time.

Meta-analysis of risk factors of the surgical site infection through lumbar posterior approach / 中国组织工程研究

BACKGROUND: Surgical site infection is the main complication after posterior lumbar surgery, which not only increases the patient's hospitalization time, financial burden and physical pain, but also increases the difficulty for the clinical medical staff, delays the recovery of postoperative patients, even leads to deaths. Therefore, it is important to analyze the factors related to the infection of the surgical site after posterior lumbar surgery. OBJECTIVE: To analyze the risk factors of the surgical site infection after lumbar posterior approach in China. METHODS: Studies about the surgical site infection after lumbar posterior approach were retrieved by computer. The quality of the studies was evaluated by reading the full text. Heterogeneity was analyzed using RevMan 5.3 software. Meta analysis was used to analyze the combined effect. RESULTS AND CONCLUSION: (1) Totally 20 studies with 423 cases of surgical site infection and 13 995 cases of non-infection were included. (2)Meta-analysis univariate analysis results:body mass index ≥ 27 kg/m2[OR=3.82,95%CI(2.47,5.91),P<0.000 01],age ≥ 60 years [OR=1.99,95%CI(1.44,2.76),P<0.000 1],intraoperative blood loss ≥ 300 mL[OR=3.98,95%CI(2.50,6.33),P<0.000 01],subcutaneous fat thickness[MD=5.35,95%CI(3.58,7.12),P<0.000 01],number of segments ≥ 3[OR=3.83,95%CI(2.02,7.26),P<0.000 1],operation time ≥180 minutes[OR=2.96,95%CI(2.06,4.27),P<0.000 01],preoperative serum protein<35 g/L[OR=2.37,95%CI(1.63,3.46),P<0.000 01],and diabetes[OR=2.88,95%CI(2.22,3.74),P<0.000 01]were risk factors for surgical site infection after lumbar posterior approach.(3)Multivariate analysis results:body mass index ≥ 27 kg/m2[OR=3.21,95%CI(1.97,5.22),P<0.000 01],subcutaneous fat thickness[MD=5.35,95%CI(3.58, 7.12),P<0.000 01],preoperative serum protein<35 g/L[OR=3.73,95%CI(2.30,6.04),P<0.000 01],and diabetes[OR=3.35,95%CI(1.75,6.42), P=0.003]were independent risk factors for surgical site infection after lumbar posterior surgery.(4)Results showed that body mass index ≥27 kg/m2, subcutaneous fat thickness, preoperative serum protein < 35 g/L, and diabetes are independent risk factors for surgical site infection after lumbar posterior approach in China. Due to the number of cases of surgical site infection and its methodological quality during the study, the above conclusions still need to be confirmed by more large-scale, high-quality studies to provide reliable evidence for perioperative management.

Comparison of intracranial pressure monitoring and routine monitoring in treatment of severe craniocerebral trauma / 局解手术学杂志

Objective To retrospectively analyze the significance of dynamic intracranial pressure monitoring and routine monitoring in the treatment of severe traumatic brain injury.Methods Forty-two patients with severe craniocerebral trauma who were admitted into our hospital from March 2013 to December 2015 and underwent intracranial pressure monitoring were enrolled in this study as the observation group.Thirty-nine patients with severe traumatic brain injury who were routinely monitored within 3 hours after admission were selected as the control group in the corresponding period.Timely take drugs or surgical treatment according to the monitoring results,and analyzed the clinical efficacy,craniotomy cases,time of admission to craniotomy,and complications of the two groups.Results The cases with good prognosis in the control group was 24 (61.5％) while it was 31 (73.8％) in the observation group,and the difference was statistically significant (P ＜ 0.05).The cases with poor prognosis in the control group was 15 (38.5％) while it was 11 (26.2％) in the observation group,and the difference was statistically significant(P ＜0.05).Therer were 13 cases (30.1％) of craniotomy in the control group and 5 cases (12.8％) in the observation group with statistically significant difference (P ＜ 0.05).The time of admission to craniotomy in the control group was (24.5 ± 1.7) hours,and it was (18.3 ± 2.4) house in the observation group with statistically significant difference (P ＜ 0.05).The incidence of intracranial infection complication was 9.5％ in the control group and 8％ in the observation group.There was no significant difference between the two groups (P ＞ 0.05).Conclusion Invasive intracranial pressure monitoring can reflect the changes of patients in time,which can improve the clinical curative effect and would not increase the incidence of intracranial infection.

Early Diagnosis and Management of Cerebral Venous Flow Obstruction Secondary to Transsinus Fracture after Traumatic Brain Injury

BACKGROUND AND PURPOSE: Cerebral venous flow obstruction (CVFO) is a fatal complication of traumatic brain injury. To compare the outcomes of patients with CVFO secondary to traumatic-brain-injury-induced transsinus fracture who were diagnosed early versus those diagnosed late in the therapeutic course. METHODS: In total, 403 patients with transsinus fracture were reviewed retrospectively. The patients were divided into an early-diagnosis group (n=338) and a delayed-diagnosis group (n=65). The patients submitted to 2D time-of-flight magnetic resonance venography (2D-TOF MRV) and/or CT venography (CTV), depending upon the findings of intracranial pressure monitoring, in order to identify potentially complicated CVFO. These examinations took place within 3 days of the onset of malignant intracranial hypertension symptoms in the early-diagnosis group, and after an average of 7 days in the delayed-diagnosis group. Once diagnosed, patients received intravenous thrombolytic therapy with low-dose urokinase. Patients with massive transsinus epidural hematoma, depressed fracture, or cerebral hernia were treated surgically to relieve the compression and repair any damage to the venous sinuses. RESULTS: Cerebral venous flow obstruction was much more severe in the delayed-diagnosis group than in the early-diagnosis group (p<0.001), and hence patients in the former group were given a higher dose of urokinase (p<0.001) for thrombolytic therapy. They were also significantly more likely to need surgery (48.1% vs. 20.6%, p=0.003) and had a higher mortality rate (37.0% vs. 4.1%, p<0.001). However, patients in both groups experienced a similarly favorable prognosis, not only with regard to functional outcome but also with respect to neuroradiological improvement, as evaluated by 2D-TOF MRV/CTV at the final follow-up (p=0.218). CONCLUSIONS: Delayed diagnosis can result in increased risk of surgery and death in the acute phase. Thrombolytic therapy with low-dose urokinase resulted in promising improvements in both functional and neuroradiological outcomes in all of the patients in this study, regardless of the time to diagnosis.

Safety and efficacy of frameless stereotactic brain biopsy techniques / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To explore the safety and efficacy of frameless stereotactic brain biopsy.</p><p><b>METHODS</b>Diagnostic accuracy was calculated by comparing biopsy diagnosis with definitive pathology in 62 patients who underwent frameless stereotactic brain biopsy between January 2008 and December 2010 in Xiamen University Southeast Hospital. Preoperative characteristics and histological diagnosis were reviewed and then information was analysed to identify factors associated with the biopsy not yielding a diagnosis and complications.</p><p><b>RESULTS</b>Diagnostic yield was 93.5%. No differences were found between pathological diagnosis and frozen pathological diagnosis. The most common lesions were astrocytic lesions, included 16 cases of low-grade glioma and 12 cases of malignant glioma. Remote hemorrhage, metastasis, and lymphoma were following in incidence. Multiple brain lesions were found in 17 cases (27.4%). Eleven cases were frontal lesions (17.7%), 8 were frontotemporal (12.9%), 6 were frontoparietal (9.7%), and 5 each were temporal, parietal, and parietotemporal lesions (8.1%). Postoperative complications occurred in 21.0% of the patients after biopsies, including 10 haemorrhages (16.1%) and 3 temporary neurological deficits (1 epilepsy, 1 headache, and 1 partial hemiparesis). No patient required operation for hematoma evacuation.</p><p><b>CONCLUSION</b>Frameless stereotactic biopsy is an effective and safe technique for histologic diagnosis of brain lesions, particularly for multifocal and frontal lesions.</p>