Application of horns percutaneous tracheostomy in critically ill neurosurgical patients / 实用医学杂志

Objective To introduce the experience of applying horns percutaneous tracheostomy in critically ill neurosurgical patients. Methods The size of operative incision, operation time, amount of blood loss, incision healing time , and incidence of complications were analyzed retrospectively in 95 patients with GWCH and 83 with ST. Results There were smaller size of operation incision [(1.6 ± 0.4) cm vs. (3.8 ± 0.9) cm], shorter operation time [(4.4 ± 2.8) min vs. (20.5 ± 5.2) min], less blood loss [(4.5 ± 0.8) mL vs. (8.5 ± 4.5) mL] and shorter incision healing time [(3 ± 0.5) d vs. (5 ± 1.5) d] in GWCH group than that in ST group and the difference was statistical significant (P 0.05). Conclusions When compared with traditional ST, horns percutaneous tracheostomy is with smaller incisions , shorter operation time , less blood loss , faster healing and lower incision sputum leaking and is worthy of popularization in critically ill neurosurgical patients.

The value of diffusion weighted combined susceptibility weighted imaging in evaluation of traumatic axonal injury / 中华老年医学杂志

Objective To explore the value of diffusion weighted imaging (DWI) in combination with susceptibility weighted imaging (SWI) in prognosis prediction of traumatic axonal injury (TAI).Methods A retrospective study of 75 patients with TAI was performed to analyze the clinical data and the follow-up prognosis in the 6 months after injury.The detection rate of TAI lesion by DWI,SWI and conventional MRI was compared.Multiple factors analysis applied logistic regression analysis to analyze the relationship between associated factors and prognosis.Results The average detected TAI lesions were (19.92 ± 8.62) by DWI and (22.17 ± 11.72) by SWI,which had no significant differences (t=1.24,P＞0.05),but there was a significant difference bettween by conventional MRI and by DWI or SWI (all P＜0.05).DWI was more sensitive to non-hemorrhagic lesions and SWI was more sensitive to hemorrhagic lesions.However,the lesions revealed by them existed the overlap of location and pathology of lesions.Patients with poor outcomes had more number of central lesions than those patient with good outcomes (t=2.455,P＜ 0.05).Logistic regression analysis revealed that the predictive accuracy provided by the combination with imaging and clinical factors was 95.7 ％.Conclusions DWI and SWI both are sensitive to TAI lesions,and have ability to detect the lesions with different pathological characteristics,separately.Accurate prognosis prediction for patients with TAI may be provided by the combination of clinical and imaging factors.

Establishment and evaluation of model of depression after traumatic brain injury / 中华急诊医学杂志

Objective To discuss about the establishment of mental depression model by traumatic brain injury in rats,and to evaluate the validity of this model.Methods The study was carried out in the experiment center of Wuhan University.A total of 48 male adult Wistar rats were randomized ( random number) into four groups ( n =12,each):( 1 ) in sham operation group,six rats were fed normally in one cage; (2) in model group,the model of the left frontal lobe contusion was made up by hitting with free-fall method on the left cortex of the rat,and subsequently the each of model rats were separately fed in a cage and put them in a lonely environment with chronic stress one week after traumatic brain injury in order to induce them into models of mental depression; ( 3 ) in brain trauma group,the trauma model of the left frontal lobe contusion was set up by the same procedure as in model group,and six rats were fed together in one cage; (4) in CUMS group,each rat was fed normally in one cage in a lonely environment after brain trauma made and chronic mild chaotic stress unpredictable to rats was given to induce mental depression.The consumption of sucrose water and the change of animal behavior were observed and the high performance liquid phase electrochemical with fluorescence detector was used to detect the biogenic monoamine neurotransmitter content (dopamine,serotonin and norepinephrine) in the hippocampus,prefrontal cortex,hypothalamus and striatum area in each group.Experimental data were processed with single factor analysis or t test of variance by Statistical Program for Social Sciences Version 13.0 (SPSS13.0) software.P ＜0.05 was considered as statistically significant difference.Results After modeling,the rats of four groups were examined by behavioral tests.It was found that the amount of sugar-water consumption by the rats in the model group and CUMP group decreased,implying the absence of interest in eating and anhedonia of the rats in these groups.In open-field test,the rats in the model group,CUMP group and brain trauma group showed reduction in square crossing and rearing,implying the under-activity and absence of interest in activity.In the water maze test,it was found that the rats in the model group,CUMP group and brain trauma group needed much time to reach the end-point and made many errors,implying the lowering ability to learn and memorize.Levels of dopamine,serotonin and norepinephrine in the hippocampus,prefrontal cortex,hypothalamus and striatum area decreased in these rats with traumatized brain in three groups especially in model group and CUMP group.Conclusions It is a valid method for establishing the mental depression model in rats by traumatic brain injury with separately feeding in the lonely environment and given chronic mild chaotic stress unpredictable to rats on the setting of the left frontal lobe contusion.

Application of diffusion weighted imaging in severity assessment and prognosis prediction of diffuse axonal injury / 中华创伤杂志

Objective To discuss the value of diffusion weighted imaging (DWI) in severity assessment and prognosis prediction of diffuse axonal injury (DAI). Methods A retrospective study was performed on the clinical imaging data and the follow-up results at six months after injury in 29 patients with DAI. The detection rate of DAI lesion by DWI and conventional MRI was compared by means of one-way ANOVA. The correlation between the number of lesion in different areas with GCS and GOS was analyzed with Spearman rank correlation test. Results (1)The average detected DAI lesions were 19.24±5.72 on DWI, 14.41 ±4.50 on FLAIR, 10.58±3.79 on T2WI and 4.83 ±2. 11 on TIWI, with the highest detection number of DAI lesion on DWI (P < 0, 05). (2) There was a significant correlation of the number of central lesions (in corpus callosum, basal ganglia and brain stem) with GCS and COS (P < 0. 05), but there was no correlation of total lesion number or periphery lesion with GCS and COS (P > 0.05). Conclusions DWI is a potentially useful imaging modality in detecting DAI lesion, when the number of central lesion on DWI can be served as an objective marker in severity assessment and prognosis prediction of DAI.

Comparative study of device labeling regulation in U.S.A. and China / 中国医疗器械杂志

<p><b>OBJECTIVE</b>To provide references for the evolvement of medical devices labeling and manual administration in China,</p><p><b>METHODS</b>By content analysis, 10 juristic documents relevant to device labeling and manual were collected from FDA website, compared to which, the federal regulation was mainly analyzed.</p><p><b>RESULTS</b>There are five main differences of device labeling regulation between U.S.A. and China: juristic system, administrative scope, administrative target, characteristics and practice,</p><p><b>CONCLUSIONS</b>A set of comprehensive juristic system for device labeling has been established by FDA. from which China should draw experience, to administrate the prescription devices and the over-the-counter devices in classification, and set up device labeling guidance, thus guarantee the safety and efficacy of device.</p>

Experimental study of diffusion weighted imaging in diagnosis of diffuse axonal injury / 上海交通大学学报（医学版）

Objective To observe the changes of diffusion weighted imaging (DWI) after diffuse axonal injury (DAI) in rats. Methods Models of various degrees of DAI (mild, moderate and severe) were established in 135 SD rats by Marmarou method, and MRI examinations were performed 4, 8 and 24 h after injury. Another 8 rats were served as control group. The findings of MRI were analysed, and the apparent diffusion coefficient (ADC) values were compared among each group. Results No clear traumatic lesion was found from MRI in rats after injury. Four hours after injury, ADC values decreased in each DAI group, and there were significant differences between moderate DAI group and control group, and between severe DAI group and control group (P<0.05). Eight hours after injury, ADC values increased in each DAI group, and there was no significant difference between DAI groups and control group (P>0.05). There were significant differences in ADC values between 8 h after injury and 4 h after injury in severe DAI group (P<0.05), while there was no significant difference in moderate and mild DAI groups (P>0.05). Twenty-four hours after injury, ADC values continuously increased, especially in severe trauma group. Conclusion ADC values may reveal traumatic changes that can not be demonstrated by MRI. ADC values decrease in acute phase of DAI in rats, then increased, and the degree of variation may be related to the severity of DAI.

The effect of recombinant human erythropoietin on the function of brain mitochondria after brain injury / 中华急诊医学杂志

Objective To investigate the therapeutic effects of recombinant human erythropoietin(rhEPO)on brain mitochondrial energy metabolism and mitachondrial respiratory functionin after brain injury in rats.Method A total of 63 Sprague-Dawley rats were divided randomly into three groups:the rhEPO treated group(n =28),the control group(n=28),the shanl group(n=7).The models of contusion of brain caused by freefalling were set up in rhEPO treated group(n=28).The recombinant human erythropoietin was intraperitoneally injected in dose of 10 U/g immediately after brain injury and it was repeated every 10 hours in rhEPO group treated.The same models of contused brain were made without rhEPO treatment as control group(n=28).In control group,the same volume of normal saline was used in replacemem of rhEPO.Aburr hole was made on the skull of the sham group(n=7),but the brain tissue was not wounded.The mitochondria were isolated at 6 h,12 h,24h,48 h after trealment,respectively.The activity of ATPase and SOD,the content MDA and brain mitochondrial respiratory function were measured by biochemical technique.The data were analyzed with the F-test and t-test.Results The activity of ATPase(P＜0.05),SOD(P＜0.01)and brain mitochondrial respiratory function(P ＜0.05)were increased.and the levd of MDA in brain mitochondria was reduced markedly in rats treated with rhEPO.Conclusions Treatment with rhEPO can alleviates the secondary brain injury by affecting mitochondrial function.

Construction and Expression of DNA Vaccine pIRES-Sj97-Sj14-Sj26 and Its Immunogenicity in Mice / 华中科技大学学报（医学）（英德文版）

To find a new preventive strategy for the infection of Schistosoma japonica, plasmid pIRES-Sj97-Sj14-Sj26 that contains fatty binding protein (Sj14), GST (Sj26) and paramyocin (Sj97) that are expressed on the membrane, was constructed. RT-PCR was used to detect the expression of Sj14 mRNA, Sj26 mRNA and Sj97 mRNA in the Hela cells, the indirect immunofluorescent test was employed for the detection of the expression of trans-membrane Sj26 after the plasmid was trans-fected into Hela cells. Fifty BALB/c mice were randomly divided into 5 groups and pIRES-Sj97-Sj14-Sj26 plasmid DNA, pIRES-Sj14-Sj26 plasmid DNA, plRES-Sj26 plasmid DNA,plRES blank vector and normal saline were respectively injected into the quadriceps muscles of thigh.Eight weeks after the immunization the mice were killed and significantly higher level of IgG was detected in the pIRES-Sj97-Sj14-Sj26 group as compared with the plRES blank vector, normal saline and pIRES-Sj26 groups (P<0.01) and the pIRES-Sj14-Sj26(P<0.05). Single splenocyte suspension was prepared to detected the level of IFN-γ by ELISA and the lymphocyte stimulating index (SI) by MTT SI was significantly higher of in the pIRES-Sj97-Sj14-Sj26 group than in other groups (P<0.01), while the IFN-γ, level was significantly higher the pIRES-Sj97-Sj14-Sj26 group than in pIRES blank vector and normal saline groups (P<0.01), but no significant differences were found when compared with pIRES-Sj14-Sj26 and pIRES-Sj26 groups. Flow cytometery showed that the percent-ages of CD4+ and CD8+ T cells were much higher in the pIRES-Sj97-Sj14-Sj26 group (P<0.01,P<0.05). It was concluded that pIRES-Sj97-Sj14-Sj26 vaccine may induce stronger immune response in BALB/c mice.

The effect of Huangqi on the activity of enzyme in brain mitochondria after brain trauma in rats / 临床神经病学杂志

Objective To investigate the effects of Huangqi on the activity of enzyme,in brain mitochondria after brain trauma in rats.Methods The models of laceration of brain incluced by free falling were set up.The Huangqi was intraperitoneally injected immediately after brain trauma. The mitochondria were isolated at 4 h,24 h and 48 h after treatment respectively while the activity of ATPase and SOD and the content of MDA were measured by biochemical technique.Results Activity of ATPase( P