Activation of GABAergic neurons in the zona incerta accelerates anesthesia induction with sevoflurane and propofol without affecting anesthesia maintenance or awakening in mice / 南方医科大学学报

OBJECTIVE@#To explore the regulatory effects of GABAergic neurons in the zona incerta (ZI) on sevoflurane and propofol anesthesia.@*METHODS@#Forty-eight male C57BL/6J mice divided into 8 groups (n=6) were used in this study. In the study of sevoflurane anesthesia, chemogenetic experiment was performed in 2 groups of mice with injection of either adeno-associated virus carrying hM3Dq (hM3Dq group) or a virus carrying only mCherry (mCherry group). The optogenetic experiment was performed in another two groups of mice injected with an adeno-associated virus carrying ChR2 (ChR2 group) or GFP only (GFP group). The same experiments were also performed in mice for studying propofol anesthesia. Chemogenetics or optogenetics were used to induce the activation of GABAergic neurons in the ZI, and their regulatory effects on anesthesia induction and arousal with sevoflurane and propofol were observed; EEG monitoring was used to observe the changes in sevoflurane anesthesia maintenance after activation of the GABAergic neurons.@*RESULTS@#In sevoflurane anesthesia, the induction time of anesthesia was significantly shorter in hM3Dq group than in mCherry group (P < 0.05), and also shorter in ChR2 group than in GFP group (P < 0.01), but no significant difference was found in the awakening time between the two groups in either chemogenetic or optogenetic tests. Similar results were observed in chemogenetic and optogenetic experiments with propofol (P < 0.05 or 0.01). Photogenetic activation of the GABAergic neurons in the ZI did not cause significant changes in EEG spectrum during sevoflurane anesthesia maintenance.@*CONCLUSION@#Activation of the GABAergic neurons in the ZI promotes anesthesia induction of sevoflurane and propofol but does not affect anesthesia maintenance or awakening.

Effect of minimally invasive transpedicular bone grafting additional vertebral pedicle screw fixation in the treatment of thoracolumbar fracture / 中国基层医药

Objective To explore the effect of minimally invasive transpedicular bone grafting additional ver -tebral pedicle screw fixation in the treatment of thoracolumbar fracture .Methods 60 patients with thoracolumbar fracture were randomly divided into the observation group and the control group ,30 cases in each group .The control group received traditional open inter vertebral four nail pedicle screw fixation combined with posterolateral bone graft fusion for treatment while the observation group was treated by minimally invasive transpedicular bone grafting addi -tional vertebral pedicle screw fixation ,to analyze the clinical effects .Results The imaging parameters of postopera-tion[the sagittal index(1.9 ±7.1)°,Cobb's angle(4.2 ±3.5)°,change of vertebral body height (90.2 ±6.5)%]in the observation group were significantly better than those of the control group (t=6.78,6.80,7.02,all P<0.05). The imaging parameters 3 months after operation[the sagittal index(4.9 ±3.2)°,Cobb's angle(7.0 ±2.7)°,change of vertebral body height (87.6 ±4.1)%] in the observation group were significantly better than those of the control group(t=6.78,6.80,7.02,all P<0.05).The operation time,incision length,bleeding volume,postoperative drain-age,postoperative hospital stay of the observation group were (141.9 ±14.2)min,(10.8 ±1.7)cm,(105.7 ±12.3)mL, (5.6 ±4.1)mL,(6.6 ±1.1)d,respectively,which were significantly better than those of the control group (t=7.72,7.89,5.68,all P<0.05).Conclusion Minimally invasive transpedicular bone grafting additional vertebral pedicle screw fixation has a significant effect in the treatment of thoracolumbar fractures ,which is safe and reliable .

The ten essential elements about building the improving long-term mechanism of modern medical quality / 中华医院管理杂志

Medical quality management is the core of hospital management.Concerning how to build the improving long-term mechanism of modem medical quality,the article is guided with the theory of modern medical quality management,and tested with the reform of medical quality management about one hospital.It puts forward 10 essential elements on how to construct the long-term mechanism on improving the medical quality,which is based on consulting all kinds of experts.Namely,“qualifications,responsibilities,complete path,reverence for life,reverence for integrity,reverence for rules,value on evaluation,value on case history,value on sum-up,value on teamwork”.Then it will take active effect on hospital workers and hospital managers in strengthening medical quality control,and improve the medical quality persistently.