Posterior reduction for treatment of acute severe traumatic lumbar spondylolisthesis / 中华创伤骨科杂志

Objective:To evaluate the clinical effects of posterior reduction in the treatment of acute severe traumatic lumbar spondylolisthesis.Methods:A retrospective study was conducted to analyze the clinical data of 12 patients with acute severe traumatic lumbar spondylolisthesis who had been treated by posterior reduction at Department of Spinal Surgery, Zhengzhou Orthopaedic Hospital from June 2010 to December 2018. There were 7 males and 5 females with an age of (25.7±1.8) years. The spondylolisthesis was at L4 in 4 cases and at L5 in 8 cases, and grade Ⅲ in 7 cases, grade Ⅳ in 4 cases and grade Ⅴ in 1 case according to the Meyerding classification. By the American Spinal Injury Association (ASIA) grading, the preoperative neurological function was at level B in 6 cases, at level C in 4 cases, and at level D in 2 cases. All the 12 patients underwent posterior reduction and internal fixation with pedicle screws, as well as intervertebral bone graft fusion. Operation time and intraoperative blood loss were recorded. Clinical efficacy was evaluated by visual analogue scale (VAS) and Oswestry disability index (ODI) before and after surgery, and neurological function was evaluated by ASIA grading. X-ray, CT plain scan and reconstruction were used to observe internal fixation and bone grafting.Results:All patients were followed up for (18.5±2.1) months. The operation time was (165.7±42.3) min and the blood loss (497.7±75.3) mL. The VAS pain scores [(2.7±0.3) points and (1.8±0.2) points] and ODIs (18.2%±2.3% and 14.5%±2.6%) at 2 weeks after operation and at the last follow-up were significantly lower than the preoperational values [(8.5±0.6) points and 72.3%±12.3%] ( P<0.05), but there was no statistically significant difference between 2 weeks after operation and the last follow-up ( P>0.05). At the last follow-up, X-rays and CT scans showed good fixation and adequate bone grafting; the spondylolisthesis was grade 0 in 10 cases and grade I in 2 cases; the ASIA level of neurological function was C in 2 cases, D in 3 cases, and E in 7 cases. Healing of surgical incision was delayed in 2 patients but responded to symptomatic treatment. Follow-ups observed no such complications as loosening or pulling out of internal fixation. Conclusion:In the treatment of acute severe traumatic lumbar spondylolisthesis, posterior reduction can effectively restore the spondylolisthesis sequence and restore spinal stability, leading to satisfactory curative outcomes.

Progress in clinical application of targeted temperature management / 中国综合临床

Targeted temperature management (TTM) is referred to as the reducing of the core body temperature to a specific temperature to repair or mitigate tissue damage caused by inadequate blood perfusion. It is a promising treatment method. However, as it is widely used in clinical practice, more and more disputes have been made about the scope and effect of TTM. This paper will review the mechanism of TTM,the method of its implementation and its application in the disease, so as to provide references for further understanding of TTM and optimizing the clinical application of TTM.

Mechanobiological Response and Network Formation in Central Nervous Development / 医用生物力学

In the process of central nervous system (CNS) development and maturation, the biomechanical factors have not been highly valued for a long time. In recent years, a large number of studies have shown that mechanical environment strongly affects the migration, differentiation and maturation of nerve cells, as well as the cell-cell interactions. Mechanical factors play an important role in realization of the structure and function of the brain and spinal cord. This review briefly summarized the role of biomechanics in CNS perception, path-finding, regulation and network shaping during CNS development. The effects of static and dynamic mechanics on mechanobiological response of nerve cells were also introduced, hoping to provide some ideas for CNS reconstruction and repair in future.

Application and research progress in the role of brain computer interface technology in neural function repairment after traumatic brain injury / 中华创伤杂志

Objective The incidence of traumatic brain injury (TBI) has been on the rise year by year around the globe.According to the latest Guidelines for the Management of Severe Traumatic Brain Injury (Fourth Edition) released by the Brain Trauma Foundation (BTF),there is no sufficient evidence that related medicine can promote the repairment of neural injury in the treatment of central nerve damage.The clinical treatment of TBI is facing multiple difficulties.In recent years,brain computer interface (BCI) technology has developed rapidly and shown enormous potential in TBI repairment,especially in visual and auditory restoration,neural function recovery,and cognitive restoration.BCI provides a new approach to improve the quality of life for patients.This paper reviews the application and prospect of BCI in sense,motion,and cognitive function repairment after TBI,so as to provide new insights for the treatment of TBI nerve function.

Neuroprotective effects ofβ-aescinate on brain edema in rat model of traumatic brain injury / 天津医药

Objective To explore the neuroprotective effects ofβ-aescinate on brain edema in rats of traumatic brain injury (TBI). Methods A total of 78 male SD (Sprague Dawley) rats were randomly divided into three groups: sham-operation group (Sham), traumatic brain injury group (TBI) andβ-aescinate group, with 26 rats in each group. Rats of Sham group were anesthetized and surgically prepared only, but were not induced by cortical contusion. Electronic brain cortical damage impactor (eCCI) was used for establishing TBI model in TBI group and β-aescinate group after opening the bone window. TBI group was only established TBI model, but no intervention. After establishment of TBI model in β-aescinate group, β-aescinate (5 mg/kg body weight) was intraperitoneally injected, once every 24 hours. The modified neurological severity scores (mNSS) was used for evaluating changes of neurological function. After 48 hours, SD rats were sacrificed for hematoxylin and eosin (H&E) staining (n=6). Additionally, water content of the brain tissue was evaluated using the wet-to-dry weight ratio (n=10). Evans blue assay was performed to investigate the blood-brain barrier (BBB) permeability (n=4). The expression of aquaporin 4 (AQP4) was measured by Western blot assay (n=6). Results Compared with the Sham group, neurologic deficit, increased brain water content and the expression of AQP4 were found in TBI group (all P<0.05). Moreover, BBB permeability was destroyed. However, β-aescinate can improve the neurological function, reduce the brain water content and significantly decrease the expression of AQP4 in TBI rats. The BBB permeability was significantly improved in treatment group (all P<0.05). Conclusion These findings suggest that β-aescinate can reduce cerebral edema and improve neurological outcome in SD rats after TBI. This neuroprotection may be related with the down-regulation of AQP4 protein.

Inhibitory effects of N-acetylcysteine on inflammatory factors after acute spinal cord injury / 天津医药

Objective To investigate the inhibitory effects of N-acetylcysteine (NAC) on inflammatory factors after acute spinal cord injury, and the mechanisms thereof. Methods A total of 54 clean and healthy adult female SD rats were divided into three groups according to the principle of randomization:simple laminectomy group (Sham group), spinal cord injury group (SCI group) and N-acetylcysteine group (NAC group), with 18 rats in each group. The Sham group was treated with T9-10 laminectomy only without spinal cord injury. Aneurysm clamp was used to establish rat model of T9-10 spinal cord injury in SCI group and NAC group. At the time of 15 min and 12 h after injury, the rats of NAC group were injected N-acetylcysteine intraperitoneally (150 mg/kg). At the time of 24 h post modeling, 12 rats were sacrificed in each group for observing the severity of tissue injury by using hematoxylin-eosin (HE) staining (6 rats), and detecting the contents of inflammation factors including tumor necrosis factor (TNF)- α and interleukin (IL)- 6 by using enzyme- linked immunosorbent assay (ELISA) (6 rats). The remaining 6 rats in each group were raised for 8 weeks. During the first week, the ones in NAC group were injected NAC twice a day at 12 h intervals for 7 d. Additionally, the neurological function evaluation was performed at week 1, week 2, week 4, week 6 and week 8 after injury in rats by using the spinal cord injury motor function score (BBB) and the inclined plate test. Results The results of HE staining showed that the spinal cord was intact without hemorrhage and inflammatory cell infiltration in Sham group. The morphology and inflammatory status were significantly worse in SCI group than those in NAC group and Sham group. The results of ELISA showed that the expressions of TNF-αand IL-6 were significantly higher in SCI group and NAC group than those in Sham group (P<0.05), while the expression levels of TNF-αand IL-6 were significantly lower in NAC group than those of SCI group (P<0.05). The BBB scores and inclined plate test showed that both were significantly lower in SCI group and NAC group than those of Sham group (P<0.05), and the results were better in NAC group than those of SCI group. Conclusion NAC may promote the recovery of neurological function in rats by reducing the local inflammatory response through diminishing the contents of TNF-αand IL-6 in spinal cord.

Keep up with the pace of the times, comprehensively improve the level of treatment for nerve trauma / 天津医药

With the emergence of new technologies such as brain imaging, bio-sensing, human-computer interaction, cloud computing and large data, the treatment of traumatic brain injury has entered a new era. However, it must be clearly recognized that the central nervous system (CNS) trauma remains a worldwide medical problem. Based on the existing medical knowledge, it is important for promoting CNS trauma treatment levels including nerve trauma standardized treatment, professional management team, multi modal monitoring and data analysis, actively participating in domestic and international multi-center clinical research. Medical workers should dare to explore and innovate, keep up with the pace of the times, and truly achieve the overall improvement of nerve trauma.

Hypothermia regulates the internal environment following spinal cord injury: the underlying mechanisms / 中国组织工程研究

BACKGROUND: Spinal cord injury is a damage to the spinal cord with a high morbidity that can be divided into primary and secondary injury. Secondary injury does more harm to the body than primary injury, which can be regulated and improved through proper interventions. In addition to the drugs, surgical decompression and other traditional treatments, hypothermia is an important physical intervention that has been shown to regulate secondary injury following spinal cord injury, and hold neuroprotective effect.OBJECTIVE: To introduce different hypothermia treatments for spinal cord injury and the effect on the disordered environment after spinal cord injury, as well as summarize the latest progression. METHODS: A computer-based search of CNKI and PubMed databases was conducted for the articles addressing the application of hypothermia in spinal cord injury published from January 2001 to June 2016, using the keywords of therapeutic hypothermia or low temperature, spinal cord injury in Chinese and English, respectively. RESULTS AND CONCLUSION: Hypothermia is divided into systematic and local hypothermia, and the former is simple and convenient, but it may lead to complications. Local hypothermia can quickly reach the target temperature, to make deep hypothermia at injury site and stablize the core temperature in the body, but it is invasive, and the necessary time of locating and maintaining effective temperature is a challenge. In general, hypothermia can improve the disordered microenvironment after spinal cord injury, reduce inflammatory infiltration, regulate the expression of relative genes and proteins, and promote the proliferation and differentiation of endogenous nerve cells. There are basic and clinical studies on hypothermia neuroprotection against spinal cord injury from various aspects; thereafter, hypothermia is a promising treatment strategy for spinal cord injury.

Study on the correlation between the copy number of mitochondrial DNA of peripheral blood leukocytes in traumatic brain injury and the degree of neurologic impairment in rats / 中华行为医学与脑科学杂志

Objective To explore the correlation between the changes of mitochondrial DNA (mtDNA) copy number of peripheral blood leukocytes and the degree of neurological impairment after traumatic brain injury (TBI).Methods A total of 40 Sprague Dawley rats were randomly divided into 4 groups:control group (n=10),mild TBI group (n=10),moderate TBI group (n=10) and severe TBI group (n=10).The cortical impact injury method to construct TBI rat model of different damage degree.The neurological score (mNSS,screen test,open field test) after TBI 24 h,48 h,72 h was performed and the orbital venous plexus blood genomic DNA was extracted.The real-time PCR method to measure the relative mitochondrial DNA copy number.After the experiment,the rats were euthanized,and the brain tissue was stained with hematoxylin-eosin staining(HE).Results There were significant differences in the HE staining findings of brain tissue pathology (P＜ 0.05).Each group of rats with brain injury after peripheral blood mtDNA copy number in 24 h (9.63±3.62,P＜0.05) and 48 h (9.80±3.58,P＜0.05) increased,began to decline at 72 h (4.97±2.68,P＜0.05).The rats mNSS scores were related with the mtDNA copy number after TBI 24 h (r=0.578,P＜0.05) and 48 h (r=0.559,P＜0.05),and not related to TBI 72 h (r=0.487,P＞0.05).The rats screen test scores were related with the mtDNA copy number after TBI 24 h (r=0.573,P＜0.05) and 48 h (r =0.501,P＜0.05),and not related to TBI 72 h (r=0.273,P＞0.05).The rats level scores of open field test were negatively correlated with the mtDNA copy number after TBI24 h (r=-0.662,P＜0.05) and 48 h (r=-0.507,P＜0.05),and not negatively correlated to TBI 72 h (r=-0.410,P＞0.05).The rats vertical scores of open field test were negatively correlated with the mtDNA copy number after TBI 24 h (r=-0.662,P＜0.05)and 48 h (r =-0.607,P＜ 0.05),and not negatively correlated to TBI 72 h (r =-0.141,P＞ 0.05).Conclusion TBI is related with the copy of early peripheral white blood cell number and mtDNA of rat nerve function damage,and mtDNA copy number of peripheral white blood cell may become a clinical evaluation of TBI neural function damage degree of a potential biomarker.

Advances in surgical treatment of Parkinson′s disease / 中国综合临床

Parkinson′s disease(PD)is a neurodegenerative disease,there is no effective means of curative treatment.The purpose of treatment is to control the clinical symptoms of patients and delay the development of the disease.The clinical treatment is based on levodopa-based drug treatment as a gold standard, but long-term drug treatment will reduce the efficacy of treatment,and movement fluctuations,dysmotility and other complications would occur at the same time.In recent years,brain deep electrical stimulation,stem cell transplantation,gene therapy and other surgical treatment have been gradually applied in the clinical practice,the technology become more and more mature.In this paper,based on the recent literature,the study of PD surgical treatment of the status quo and progress were reviewed.

Research status of skull repair materials and the prospect of three-dimensional printing technology / 中国组织工程研究

BACKGROUND:Skul repair materials cannot only restore the normal shape of the skul , but also play an important role in brain functional recovery. OBJECTIVE:To summarize the research status of polyetheretherketone (PEEK), titanium al oy and tissue engineering technique in cranioplasty and the prospect of three-dimensional (3D) printing technology. METHODS:Literatures related to skul repair materials were retrieved in databases of CNKI and PubMed published from 1995 to 2016, using the keywords of“bone regeneration material in calvarial, 3d printing bone scaffold”in Chinese and English, respectively. RESULTS AND CONCLUSION:Although titanium and PEEK have been used in clinic, titanium holds conductivity, thermal conductivity, while PEEK that may be displaced or lost is not involved in osseointegration. Tissue engineering technology participates in the skul tissue reconstruction, achieving satisfactory repair outcomes, but the problems of scaffold selection and preparation, seed cel obtainment, and growth factor release need to be overcomed. 3D printing technology can print personalized shape, fit the defect precisely, but the raw materials should have good biocompatibility and biomechanical property. Combination of tissue engineering technology with 3D printing technology shows a broad prospect in cranioplasty.

Development of brain computer interface technology and its application prospect in brain control animals / 军事医学

The study of brain-machine interfaces ( BMI) based on humans or animals is expected to improve the living conditions of patients with brain injury, nervous system disease and limb movement disorders.Considerable progress has been made over the past ten years, which is gradually being used to address the long-term and stability issues of BMIs technology.The result of study on safety and security of BMIs has led to the appearance of brain control animals.In this paper, the development of BMI technology and the application prospects of brain control animals are reviewed.

Optimization of culture conditions for oligodendrocytes of the rat cerebral cortex / 中国组织工程研究

BACKGROUND:Oligodendrocytes are mostly differentiated from oligodendrocyte precursor cel s. A suitable medium and cel seeding density have a significant impact on the process of the isolation of oligodendrocyte precursor cel s to obtain oligodendrocytes. OBJECTIVE:To explore the optimization of oligodendrocyte culture conditions. METHODS:Oligodendrocyte precursor cel s isolated from the newborn rats 48 hours after birth were cultured in DMEM/high glucose medium or DMEM/F12 medium using seeding densities of 2×104 cel s/cm2, 4×104 cel s/cm2, 8×104 cel s/cm2, 16×104 cel s/cm2, 32×104 cel s/cm2, and 64×104 cel s/cm2, respectively. Oligodendrocyte precursor cel s were induced to differentiate into oligodendrocytes at 72 hours after cel adhesion. Morphology of differentiated oligodendrocyte precursor cel s were observed under a light microscope, and the differentiation results were identified by immunofluorescence staining after 7-day induced differentiation. RESULTS AND CONCLUSION:Morphology of oligodendrocyte precursor cel s were recognized when cultured in DMEM/high glucose medium or DMEM/F12 medium using seeding densities of 2×104 cel s/cm2, 4×104 cel s/cm2, and 8×104 cel s/cm2, respectively. Immunofluorescence staining showed that myelin basic protein-positive cel s were found after 7-day induced differentiation, and the positive cel number were 16.40±3.30, 49.95±2.33, and 76.95±4.86 in DMEM/F12 medium, and 12.65±2.53, 32.10±1.17, and 54.05±1.56 in DMEM/high glucose medium (P<0.05). These findings indicate that DMEM/F12 medium is more suitable for culturing oligodendrocyte precursor cel s compared with DMEM/high glucose medium to some extent. The number of differentiated oligodendrocytes was gradual y increased with the enhanced seeding density of oligodendrocyte precursor cel s, and the seeding densities from 4×104 to 8×104 cel s/cm2 were appropriate for the observation of cel morphology.

Preparation and performance of a bionic spinal catheter / 中国组织工程研究

BACKGROUND:The traditional method of preparing tissue-engineered conduit has the defects of complex shape manufacturing and uncontrolable inner space structure, which cannot meet the requirements of some micro-catheters. OBJECTIVE:To prepare a bionic spinal catheter and analyze its performance. METHODS:The data model of the conduit was established using Solid Works software, and platform scan path was generated onthree-dimensionalprinter to produce the bionic spinal catheter with fibroin and colagen as raw materials. Then the water absorption, porosity, mechanical properties and celular compatibility of the conduits were detected. Next, the conduits were implanted into the subcutaneous tissue of rats and taken out at 1, 2, 3 and 4 weeks after surgery, respectively, to observe the degradation. RESULTS AND CONCLUSION:The porosity of the conduit was (53.6±1.0)%, the water absorption was (1347±19.4)%, and the compression modulus was (0.60±0.12) MPa. The micropores distributed uniformly with different size ranging from 10 to 240 μm. Spherical or fusiform stem cels survived in the pores and densely adhered to the conduit with pseudopodia. The degradation rate ofthe conduit was 20%, 59%, 74%and 100% at 1, 2, 3 and 4 weeks after surgery, respectively. These findings indicate that the artificial bionic spinal catheter has good biocompatibility and degradability.

Neural stem cells on a novel composite scaffold:growth and differentiation / 中国组织工程研究

BACKGROUND:Neural stem cel s with self-proliferation and differentiation potential are the ideal seed cel s for central nervous tissue engineering. Although col agen and silk fibroin as biological scaffold materials have been widely used, both of them used alone have certain shortcomings. Is it possible to combine the two materials to build a novel neural tissue-engineered scaffold? What is the effect of this novel scaffold on the growth and differentiation of neural stem cel s? OBJECTIVE:To observe the growth and differentiation of neural stem cel s seeded onto the novel composite scaffold. METHODS:The rat embryonic neural stem cells were inoculated onto new composite scaffolds, and then, their growth and differentiation were observed by light microscopy and scanning electron microscopy. Neural stem cells were cultured in conventional suspension culture as control group. Cell counting kit-8 assay was used to detect viability of neural stem cells in the two groups. Three-dimensional composite scaffolds carrying neural stem cells were slic ed into paraffin sections to observe the growth and differentiation of neural stem cells by hematoxylin-eosin staining and immunofluorescence staining. RESULTS AND CONCLUSION:Neural stem cel s cultured on the new composite scaffold grew and differentiated wel , and interconnected synapses were observed. Cel counting kit-8 assay showed that neural stem cel s on the scaffold grew wel , and the cel viability was significantly higher in the composite scaffold group than that in the control group (P<0.05). Hematoxylin-eosin staining and immunofluorescence staining of paraffin sections further provided evidence for good growth and differentiation of neural stem cel s on the scaffold. These results indicate that the novel composite scaffold with good biocompatibility benefits the growth and differentiation of neural stem cel s, promising a favorable application prospect.

Research on the relationship between characteristics of aneurysm after aneurysmal subarachnoid hemorrhage and its clinical classification / 天津医药

Objective To explore the relationship between the size and location of the aneurysm after subarachnoid hemorrhage (aSAH) and its clinical classification. Methods A retrospective study was performed in patients with aSAH from January 1, 2008 to December 31, 2014. The relevant clinical data were collected including age, gender, aneurysm size, location, and Hunt-Hess (H-H) classification. The aneurysms were classified by size (A group d<5.00 mm, B group 5.00 mm≤d<10.00 mm, C group d≥10.00 mm), location and H-H classification according to the results of CT, digital subtrac?tion angiography (DSA), and magnetic resonance angiography (MRA). The relationship between size, position of aneurysm and H-H classification was observed and analyzed. Results There were 750 cases included in this study, with average age (56.14 ± 11.88), male 292 and female 458. The total number of aneurysms was 903, and the number of multiple aneurysms was 91 (12.13%). There was one case with multiple aneurysms that can be included in A, B and C groups. There were two cases with multiple aneurysms that can be included in A and B groups, two cases can be included in A and C groups, and three cases can be included in B and C groups. The number of aneurysms and the ratios of groups A, B and C were 20(3.9%), 12 (3.8%), 5 (7.5%), 70 (13.6%), 39 (12.2%), 10(14.9%), 2 (0.4%), 4 (1.3%), 2 (3.0%), 165 (32.0%), 94 (29.4%), 6 (9.0%), 130 (25.2%), 90 (28.1%), 6 (9.0%), 17 (3.3%), 11 (3.4%) and 2 (3.0%) for the location in the anterior cerebral artery, the middle cerebral artery, the posterior cerebral artery, the internal carotid artery, the anterior communicating artery, the posterior communicating artery, and the vertebral basilar artery, respectively. The number of aneurysms and the ratios of H-H classificationⅠ,Ⅱ,Ⅲ,ⅣandⅤin groups A, B and C were 48 (9.3%), 45 (14.1%), 12 (17.9%), 228 (44.2%), 150 (46.9%), 14 (20.9%), 68 (13.2%), 54 (16.9%), 30 (44.8%), 142 (27.5%), 43 (13.4%), 9 (13.4%), 30 (5.8%), 28 (8.8%) and 2 (3.0%). There was a negative correlation between the size of aneurysm and the H-H grade (rs=-0.075, P=0.024). Conclusion The anterior communicating artery and posterior communicating artery are high-risk areas for smaller aneurysms. The internal ca?rotid artery is high-risk areas for larger aneurysms. The size of aneurysm is negatively correlated with H-H classification.

The advances of genetic factors in spontaneous intracerebral hemorrhage and molecular mechanisms / 天津医药

Spontaneous intracerebral hemorrhage (SICH) refers the primary, non-traumatic parenchymal hemorrhage. In China, SICH accounts for about 20%-30%of total strokes. SICH is a kind of disease affected by multiple factors includ?ing environmental and genetic factors. The high morbidity and mortality cause serious damage to human health. Therefore, it is important to find etiology and risk factors of SICH. The article reviewed the progress of SICH pathogenesis in the perspec?tive of genetics and molecular biology.

Comparison of extent of postoperative hydrocephalus in patients between intervertional therapy with embolism and craniotomy occlusion in Hunt-HessⅢ-Ⅳ level aneurysm induced subarachnoid hemorrhage and their prognosis / 中华危重病急救医学

ObjectiveTo analyze and compare the difference and prognosis between vascular embolization and craniotomy occlusion in patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) with Hunt-Hess levelⅢ-Ⅳ, and acute postoperative hydrocephalus.Methods A retrospective study was conducted on 767 patients who had undergone vascular embolization (vascular embolization group,n = 403) or craniotomy occlusion operation (craniotomy occlusion operation group,n = 364), and the patients with postoperative acute hydrocephalus were screened. The clinical data of patients of both groups was analyzed. By judging short-term prognosis in patients with hydrocephalus with Glasgow outcome scale (GOS) score estimated at discharge, the advantages and disadvantages of two surgical procedures were compared.Results The number of cases with postoperative hydrocephalus in vascular embolization group was 56 (13.90%), while that in craniotomy occlusion group was 33 (9.07%). The difference between the two groups of incidence of hydrocephalus was statistically significant (χ2= 4.350,P = 0.037 ). In 767 patients with aSAH, the incidence of hydrocephalus among the patients after the hematoma removal operation was significantly lower than that of patients without hematoma removal [3.07% (11/358) vs. 19.07% (78/409),χ2 = 47.635,P = 0.000]. The incidence of hydrocephalus among the patients after ventricular drainage was significantly lower than that of patients without the drainage [2.77% (19/685) vs. 85.37% (70/82),χ2 = 487.032,P = 0.000]. In 403 cases of vascular embolization group, the incidence of hydrocephalus in the patients after the hematoma removal operation was lower than that of patients without it [8.06% (5/62) vs. 14.96% (51/341),χ2 = 2.082,P = 0.168]. The incidence of hydrocephalus in the patients after the ventricular drainage was lower than that of patients without drainage [2.59% (9/347) vs. 83.93% (47/56),χ2 = 266.599,P = 0.000]. In 364 cases of craniotomy occlusion operation group, the incidence of hydrocephalus in the patients after hematoma removal operation was significantly lower than that of patients did not receive [2.03% (6/296) vs. 39.71% (27/68),χ2 = 95.226,P = 0.000]. The incidence of hydrocephalus among the patients after the ventricular drainage was significantly lower than that of patients without drainage [2.96% (10/338) vs. 88.46% (23/26),χ2 = 203.852,P = 0.000]. The difference in incidence of hydrocephalus between the patients who had hematoma removal surgery between vascular embolization group and craniotomy occlusion operation group was statistically significant [8.06% (5/62) vs. 2.03% (6/296),χ2 = 4.411,P = 0.027], while no statistically difference was present in ventricular drainage patients [2.59% (9/347) vs. 2.96% (10/338),χ2 = 0.085,P = 0.819]. There were 23 patients (41.07%) with good outcome (GOS score 4-5), while 33 (58.93%) with poor outcome (GOS score 1-3) in 56 patients undergone vascular embolization operation. Good result (GOS score 4-5) was shown in 21 (63.64%) and 12 (36.36%) with poor outcome (GOS score 1-3) among 33 patients with hydrocephalus after craniotomy occlusion operation, and the difference was statistically significant (χ2 = 4.230,P = 0.039).Conclusions Hematoma is one of the main factor contributing to the differences in the incidence of postoperative hydrocephalus of Hunt-Hess gradeⅢ-Ⅳ patients either receiving vascular embolization or craniotomy occlusion operation. Lateral ventricle drainage may not be the factor that contributes to the difference in incidence of hydrocephalus formation between the vascular embolization and craniotomy occlusion operation groups in Hunt-Hess levelⅢ-Ⅳ patients. The short term prognosis in the craniotomy occlusion operation group is superior to that of endovascular intervention embolization group.

Expression of serum cystatin C(Cys C) and urinary N-acetyl-beta-D-glucosaminidase(NAG) in elderly diabe-tes patients with early renal injury / 中国基层医药

Objective To explore the expression of serum cystatin C ( Cys C ) and urinary N-acetyl-beta-D-glucosaminidase ( NAG) in elderly diabetes patients with early renal injury .Methods 127 cases of diabetes were di-vided into the pure diabetic group ,early diabetic nephropathy group ,diabetic nephropathy ,and the other 38 cases of healthy persons as the control group.The serum Cys C,and serum Creatinine(Scr)concentration by automatic bio-chemical analyzer were detected ,urinary NAG activity was detected by colorimetric determinate ,24 hours albumin ex-cretion rate(UAER/24h)was tested.Results The serum Cys C,urinary NAG,Scr,UAER/24h showed an increasing trend in four groups of patients respectively ,the difference was statistically significant (P<0.05 or P<0.01).The se-rum Cys C and urinary NAG showed a positive correlation with Scr and UAER /24 h respectively .The accuracy ,sensi-tivity,specificity of serum Cys C in diagnosis of early diabetic nephropathy group were 86.8%,76.1%,97.8% re-spectively,The accuracy,sensitivity,specificity of NAG in diagnosis of early diabetic nephropathy group were 83.5%, 71.7%,95.6%.Conclusion The serum Cys C and urinary NAG could sensitively reflect early elderly diabetic renal damage,which were the ideal endogenous indicators of glomerular filtration rate (GFR).

Application of collagen and silk fibroin scaffolds in spinal cord tissue engineering / 中国组织工程研究

BACKGROUND:Col agen and silk fibroin materials for construction of spinal cord scaffolds have been proven to repair or partial y repair damaged spinal cord nerve function. OBJECTIVE:To introduce partial characteristics of the col agen and silk fibroin and to review the recent progress and application as scaffolds in spinal cord tissue engineering. METHODS:A computer-based search of CNKI and PubMed databases (2003-01/2012-10) was performed for articles addressing the application of col agen and silk fibroin scaffolds in spinal cord injury with the keywords of“col agen, silk fibroin, scaffold, spinal cord injury”in Chinese and English, respectively. RESULTS AND CONCLUSION:Col agen has low antigenicity, good biocompatibility and biodegradability. Col agen and its degradation products can cause no inflammatory reactions in the body, but have the disadvantages of rapid degradation and poor mechanical properties. Silk fibroin has good biocompatibility and excellent mechanical properties, but its degradation is slow. The col agen and silk fibroin are compounded using an electrostatic spinning technology to improve the physical properties of the material on the basis of maintaining good biocompatibility. At present, fibroin or col agen materials in terms of nervous system repair have been studied, laying some foundation for spinal cord tissue engineering. Considering the similar characteristics and mechanics performance to the spinal cord tissue, col agen/silk fibroin composite materials are expected to become the ideal scaffold materials for spinal cord tissue engineering.