Objective In order to investigate the feasibility of surgical clipping of all bilateral supratentorial aneurysms via a unilateral approach. Methods Fontotemporal Craniotomies were performed on 20 cadavers to study the contralateral exposure for five common aneurysm sites in the anterior circulation such as the ophthalmic artery (OA) segment,the posterior communicating artery (PCOA) segment,theinternal carotid artery (ICA) terminal segment,the anterior communicating artery (ACOA) segment,as well as the middle cerebral artery (MCA) bifurcation. Results The contralateral OA segment was successfully exposed in 65% of specimens,the PCOA segment in 50%,the ICA terminai segment in 100%,the ACOA segment in 100% and the MCA bifurcation in 65%. Conclusion In this study,we select seriously surgical signs,it is very feasible and effective for neurosurgeon to clip successively all aneurysms of bilateral supratentorial via a approach.

BACKGROUND:Neural stem cells(NSCs)have the potential of self-proliferation and multiple directional differentiation,and can differentiate into various cells in the neural system under a certain condition.Therefore,NSCs have good prospect in repair of nerve injury.However,RNA interference avoids the abuse of permanent gene silencing,and is hopeful to combine with NSC transplantation for treating craniocerebral injury.OBJECTIVE:To determine whether the Nogo-66 receptor(NgR)gene silencing in NSCs can enhance curative effects of stereotaxic intracerebral transplantation of NSCs on traumatic brain injury(TBI)in rats.METHODS:A total of 60 male Wistar rats following TBI establishment were randomly assigned to 3 groups(n = 20).In the experimental group,NgR gene silencing NSC suspension(6 μL)was injected into rat brain tissue following 24 hours of model induction.In the control group,an equal volume of NSC suspension was infused by the same method.In the blank group,an equal volume of medium without stem cells was infused by the same method.At 24 hours,3 days,1 and 2 weeks following injury,neurological deficits were scored.Two weeks later,animals were sacrificed and subjected to immunohistochemistry and hematoxylin-eosin staining.RESULTS AND CONCLUSION:Following transfection of small interfering RNA,compared with control group,NgR gene protein expression was significantly reduced in the experimental group.At 1 and 2 weeks following transplantation,neurological deficit score was significantly leas in animals undergoing NSC transplantation in the experimental group compared with the control group(P＜0.05).Moreover,neuron number in the brain tissue sections of experimental group was significantly more than in the control group(P＜0.01).At 2 weeks following injury,hematoxylin-eosin staining showed that brain tissue breakage at damaged site as scar connection,remarkable porosis in the blank group;typical morphological changes as neural cells at the transplanted site in the control group;typical morphological changes as neural cells without cavity in the experimental group.Immunohistochemistry showed(37.92±16.02)BrdU-labeled positive cells/high-power field in the blank group,(89.68±15.34)cells/high-power field in the control group,and(102.67±13.52)cells/high-power field in the experimental group.Significant differences were detected between groups(P＜0.01).The above-mentioned results indicated that the NSCs of NgR gene silencing transplanted into the injured cerebral tissues can significantly improve the neurological function in rats with TBI.

Objective To understand the knowledge,attitudes and impact factors related to voluntary counseling and testing(VCT)for HIV/AIDS among migrants in Minhang district of Shanghai.Method Using a convenience sampling strategy,74 migrants,27 key informants and 20 community service providers were selected to participate in in-depth interviews and focus group discussions.Results Most migrants were young,less educated and poorly aware of HIV prevention.Only one third of the migrants heard of VCT,but few of them knew where to seek VCT or had any personal VCT experience.Nearly half of the interviewees took a negative attitude towards those who participated in VCT service.The main factors influencing the participation in VCT service among the migrants were the knowledge of VCT,having risk behavior and perception,supportive environments and availability of HIV/VCT services.Conclusions There is an urgent need to promote extensive health education about HIV/VCT,adopt flexible and available approaches to VCT service and provide appropriate care following the HIV test among migrants.

BACKGROUND:Research has been proved that Fasudil,a Rho kinase inhibitor,can effectively inhibit the onset of secondary spinal cord injury.OBJECTIVE:To investigate the synergistic effect of bone marrow masenchymal stem cell (BMSC) transplantion and Fasudil on motor functional recovery following spinal cord injury.DESIGN,TIME AND SETTING:A randomized controlled animal experimant was performed at institute of Endocrinology,Tianjin Medical University from November 2008 to March 2009.MATERIALS:A 1-month-old SD rat was obtained to extract BMSCs.Another 30 healthy female SD rats were used to establish spinal cord injury models,and they were then randomly divided into single injury group,cell transplantation group,and cell transplantation + Fasudil group,with 10 rats for each group.Fasudil was provided by Tianjin Hongri Pharmaceutical Co.,Ltd.METHODS:One week after modeling,spinal cord injury was exposed in the cell transplantation group and cell transplantation+Fasudil group,and 10 μL BMSC suspension was inserted into the injured region.Otherwise,6 hours later rats in the cell transplantation +Fasudil group were treated with an intraperitoneal injection of 10 mg/kg Fasudil,twice a day for one successive week.MAIN OUTCOME MEASURES:Hindlimb motor function was detected using inclined plane test.The Phosphorylated-ERM protein expression was detected by hernatoxylin-eosin staining,pathology and horseradish peroxidase (HRP) nerve trace,and Western blot.RESULTS:Eight weeks after modeling,degree of inclined plane was significantly increased in cell transplantation group and cell transplantation + Fasudil group compared with single injury group (P ＜ 0.05,P ＜ 0.01);while the increased value in the cell transplantation group was significantly greater than cell transplantation + Fasudil group (P ＜ 0.05).Broken myeloid tissue and cavitation were observed in the single injury group;a few of neuraxis-like structures were observed in the cell transplantation group and cell transplantation + Fasudil group,but the cavity in the cell transplantation group was larger than cell transplantation + Fasudil group.HRP-pesitive nerve fibers were detected at T_8 segment or even above in the single injury group and increased in cell transplantation group,in particular in cell transplantation + Fasudil group.Phospho-ERM protein expression in the single injury group and cell transplantation group was significantly greater than cell transplantation + Fasudil group (P ＜ 0.05).CONCLUSION:BMSC transplantation can promote hindlimb motor functional recovery following spinal cord injury,while the combined application of cell transplantation and Fasudil may cause a synergistic effect.

Objective:To summarize the application of pectoralis major flap in complex defects after maxillofacial " frozen neck" surgery.Methods:The clinical data of 7 patients with maxillofacial " frozen neck" admitted to the Department of Stomatology of the Xuzhou Central Hospital from October 2020 to October 2022 were retrospectively analyzed. The pectoralis major flap was used to repair the complex defects after surgery and the treatment effect was observed.Results:All 7 patients had survived flap transplantation with no serious complications. After 3 to 24 months of follow-up, the patients were basically satisfied with the treatment effect.Conclusions:The pectoralis major flap has reliable blood supply, abundant tissue, and can be applied flexibly with a high survival rate and significant repair effect. It is a good choice for repairing complex defects after " frozen neck" surgery, and it has clinical application value.