The current treatment of medical implant-associated infections is still challenging.The infections are particularly persistent because the bacteria attaching to the implant surfaces produce a protective matrix which establishes itself as biofilms,shielding the bacteria from antibiotics.Biofilm bacteria are resistant to antimicrobics at levels 500 to 5,000 times higher than those needed to kill non-biofilm bacteria.In vitro experiments have shown that electric current has anti-infection effect and can enhance the activity of some antimicrobial agents against certain bacteria in the biofilms.Direct electrical stimulation has already been safely used in humans for fracture healing.In this article,we review the current state and development in research on the anti-infection effect of electrical stimulation.

Objective To study the clinical and MRI features of central pontine myelinolysis(CPM).Methods The MRI findings of 11 cases with central pontine myelinolysis verified by clinic and imagings were analyzed.Results There were history of drink wine long term in 7 cases,undernourishment in 4 cases,low-blood-sodium in 10 cases.Long T 1 and T 2 signal intensity was showed on MR in central pontine,focus presented under cortex cerebri and in nucleus basalis area in 4 cases.3 cases enhanced around focus,2 cases enhanced in center and 4 cases no enhanced on postcontrast MRI.Conclusion There are characteristic MRI features in central pontine myelinolysis,it is not difficult to diagnoses CPM in early stage if its clinical manifestations and testing treatment with hormone is associated with MRI features.

Nasopharyngeal carcinoma (NPC) is a malignant carcinoma that is closely associated with Epstein Barr virus (EBV) infection. After the comprehensive treatment based on modern intensity-modulated radiation therapy, the oncological outcomes can be further improved. The main target of treatment is to increase the efficacy of patients with high risk and recurrent/metastatic (R/M) NPC. Recently, continuous progress has been made in the application of immunotherapy in the field of cancer treatment. Based on the accumulated knowledge on EBV antigen and immune checkpoint inhibitors, significant progress has been made in use of immunotherapy in treating R/M-NPC. Immunotherapy combined with radiotherapy or chemoradiotherapy will become the hot spot in the clinical management of patients with newly-diagnosed high-risk NPC.

Objective To investigate the MRI features of intracranial lymphoplasmacyte-rich meningioma and the corelation between the MRI features and pathologic findings. Methods The MRI and pathologic data of 7 patients with lymphoplasmacyte-rich meningioma were reviewed retrospectively. All cases were proved by surgery and pathological examinations. Results All lesions were solitary. The tumors crawled along meninges in 6 cases and in 5 cases the tumors did not appear as mass lesions. In 2 cases, the tumors appeared as half-moon. The boundary of all of the tumors was unclear, accompanying heavy peritumoral brain edema. The brain invasion can be seen in 7 cases. The lesions showed hypo-isointense signal on T1 WI in 7 cases, hyper-isointense signal in 5 cases and hypo-isointense in 2 cases on T2 WI.Enhancement scan demonstrated marked enhancement in 7 cases. Extensive thickening of the meninges was observed in 6 cases. Pathological results showed that the cells were abundant and diversified, with a great quantity of lymphoplasmacytes, and there were typical meningeal epithelial cells area in the surgical specimen. Conclusion The MRI findings of lymphoplasmacyte-rich meningioma show some features different from other common meningiomas, which would be helpful to the diagnosis and differential diagnosis.

Objective To compare the safety and the clinical outcomes between proximal femoral nail antirotation (PFNA) and InterTan nail in treatment of femoral intertrochanteric fracture using a Meta analysis.Methods A computer-based online search was performed of the Cochrane library,Medline database,CNKI,Wan Fang database,the Chinese Biomedical Literature Database,PubMed,Ovid database for clinical trials regarding PFNA and InterTan nail in the treatment of femoral intertrochanteric fractures.A Meta analysis was done to compare operation time,intraoperative bleeding,time for fracture healing,postoperative Harris hip score,and postoperative complications between the 2 groups using statistical software RevMan 4.2.Results A total of 7 studies were included (one of 7 points and 6 of 2 points by Jadad quality grading),involving 491 patients (all one-sided).PFNA was used in 266 patients and InterTan nail in 225.The operation time in the PFNA group was significantly shorter than in the InterTan nail group [WMD=-15.58,95％ CI (-21.60,-9.56),P ＜0.001].The Harris hip score at the last follow-up was significantly lower in the PFNA group than in the InterTan nail group[WMD =-2.33,95％ CI (-4.14,-0.53),P =0.01].There were no statistically significant differences between the 2 groups in bleeding volume [WMD =-33.89,95％ CI (-71.88,4.11),P =0.08],bone healing time [WMD =1.60,95％ CI (-2.32,5.52),P =0.42],or postoperative complications [OR =1.90,95％ CI (0.98,3.69),P =0.06].Conclusions Although InterTan nail may lead to longer operation time than PFNA,the risk of surgery may not be much increased and the former has an advantage of better hip functional recovery than the latter.

Objective To analyze the MRI features of intracranial ectopic germinomas compared with pathologic findings.Methods MRI manifestations of intracranial ectopic germinomas in 24 cases verified by operation and pathology were retrospectively analyzed.Results Tumors were located at suprasellar region in 5 cases,basal nucleus region in 6 cases,round lateral ventriculus in 2 cases,pellucid septum and lateral ventriculus in 1 case,3 cases suprasellar and pineal region in 3 cases,basal nucleus and pineal region in 3 cases,pineal region and round lateral ventriculus in 2 cases,lateral ventriculus,and third ventricles as well as pineal region in 2 cases.Lesions were showed marked enhancement in 22 cases and 10 cases had cystic degeneration on MRI.Pathologically,18 of 24 cases were seen clear border,cystic degeneration 11 cases,hemorrhage 2 cases and calcification 2 cases.Conclusion Intracranial ectopic germinomas are common in male children and are of MR characteristics,its MRI findings are correlated with pathology.

Objective To evaluate the effect of tourniquet on incisional infection based on animal model,and evaluate the effect of ischemia preconditioning on incisional infection,so as to provide experimental basis for the ra-tional use of tourniquet in clinic.Methods 100 BALB/c mice were randomly divided into 4 groups,with 25 mice in each group.Group A:tourniquet+methicillin-resistant Staphylococcus aureus (MRSA)incisional infection;group B:ischemic preconditioning+ MRSA incisional infection ;group C :MRSA incisional infection;group D:blank control.The survival rates,temperature,routine blood testing,and change in soft tissue beside femoral incision were compared among 4 groups.Results During observation period ,the survival rate in group A was 68%,in group B,C,and D were all 100%,group A was lower than group B,C,and D (P <0.05).The temperature at each time point was significantly different among group A,B,and C (P <0.01 );temperature curves of 4 groups were significantly different (P <0.01 );except basal body temperature,temperature at the other time points among 4 groups were significantly different(all P <0.01);routine blood testing results (white blood cell count,total granu-locyte count,and total lymphocyte count)among 4 groups on the third,and seventh day were significantly different (all P <0.05);on the seventh day,routine blood testing results of 4 groups all returned to normal level,but group A was slightly higher than group B,C,and D.Section of epithelial tissue revealed that epithelial tissue in group A was not healed,inflammatory response of peripheral tissue was most serious;epithelial tissue in 10 mice in group B was healed,partial peripheral tissue revealed inflammatory response;epithelial tissue in 4 mice in group C was healed,most peripheral tissue revealed inflammatory response.Conclusion Mice incisional infection will be aggrava-ted by using lower limb tourniquet,incision healing and body function recovery time will be delayed,even lead to death.Ischemic preconditioning before making an incision model can reduce the severity of incisional infection,and shorten wound healing time.

Objective To compare the safety and clinical outcome between minimally invasive internal fixation and open reduction in treatment of calcaneus fracture based on Meta analysis.Methods A computer-based online search of the Cochrane library,Medline database,CNKI,Wan Fang database,the Chinese biomedical literature database,PubMed,Ovid database and all was performed for clinical trials regarding minimally invasive internal fixation and open reduction in treatment of calcaneus fracture.Meta analysis was used to analyze the postoperative local soft tissue,calcaneal last follow-up Bohler angle and Gissane angle.Results A total of 17 studies were included(used Jadad quality grading,one is 7 points,two is 4 points,four is 3 points,ten is 2 points),involving 1138 patients,including 569 patients used minimally invasive internal fixation and 569 used open reduction.Meta analysis showed that the incidence of postoperative local soft tissue poor healing used minimally invasive internal fixation is lower than used open reduction about,the difference was statistically significant [OR =0.26,95％ CI:(0.14,0.47),P ＜ 0.01].Meta analysis showed that the calcaneal last follow-up Bohler angle of minimally invasive internal fixation was lower than open reduction,the difference was statistically significant [WMD =-1.29,95％ CI:(-2.39,-0.19),P =0.02].There were no statistically significant differences in the calcaneal last follow-up Bohler angle between minimally invasive internal fixation and open reduction[WMD =1.01,95％CI:(-3.02,5.04),P =0.62].Conclusions Regardless of the calcaneal fracture type,minimally invasive internal fixation or open reduction,the postoperative Bohler angle and Gissane angle at the calcaneus mechanical recovery characteristics are the same.However,the postoperative soft tissue healing of minimally invasivc internal fixation is less better than open reduction.

Objective To study the CT and MRI features of meningiomas at special locations.Methods CT and MRI findings of meningiomas at special locations (lateral ventricle,diaphragma sellae,frontal sinus) in 11 cases confirmed by pathology were analyzed retrospectively.8 patients were evaluated with MRI,3 patients were evaluated with CT.Results 11 cases were all singular lesion.The lesions were at lateral ventricle in 4, at diaphragma sellae in 4,at frontal sinus in 3.Of total 11 cases,8 cases showed isointensity or slight hypointensity signal on T 1WI ,tumors had isointensity or slight hyperintensity signal or slight hypointensity signal on T 2WI,homogeneous or inhomogeneous enhancement were found on Gd-DTPA enhanced MRI scanning.3 cases were showed homogeneous density or slight highly density on plain CT scanning.Pathological diagnosis was as follows:fibroblastic type in 4,angioblastic type in 3,syncytial type in 1,psammomatous type in 3.There were 9 cases were misdiagnosed before operation.Conclusion It is a fact that improving the imaging correct diagnostic rate of meningioma at special locations will play an important role in deciding correct operative route of entry and increasing cure rate.

AIM: To study the signal pathway involved in up-regulation of LPS-induced HO-1 expression by CCK-8. METHODS: Forty-two SD rats were divided into 7 groups (six rats each) randomly as follows: control group, LPS group, LPS+SP600125 (JNK-specific inhibitor) group, CCK-8+LPS group, CCK-8+LPS+SP600125 group, CCK-8 group and CCK-8 +SP600125 group. Lungs from the rats in these 7 groups were excised 6 h after the agents were administered. HO-1 mRNA expression was examined by RT-PCR. The protein expression of HO-1 was detected by Western blotting and immunofluorescence flow cytometry (FCM). RESULTS: There were significant positive expression of HO-1 mRNA in LPS group compared to control group. CCK-8 enhanced LPS-induced HO-1 mRNA expression and CCK-8 alone induced HO-1 mRNA expression as well. The mRNA expressions of HO-1 in LPS group, CCK-8+LPS group and CCK-8 group were 3.01 (P<0.01), 5.88 (P<0.01) and 3.45 (P<0.01) times as many as that in control group, respectively. SP600125 inhibited the mRNA expression of HO-1 induced by CCK-8 and (or) LPS. The change of HO-1 protein expression was in accordance with that of HO-1 mRNA expression by Western blotting and immunofluorescence FCM. CONCLUSION: These results suggest that JNK/c-Jun signal pathway plays an important role in the up-regulation of LPS-induced HO-1 expression by CCK-8.