Objective To investigate the effects of omega-3 polyunsaturated fatty acids (ω-3 PUFA) on inflammatory response,nerve damage,and outcomes in patients with severe traumatic brain injury (sTBI).Methods Altogether 120 sTBI patients were selected from January 2013 to September 2014 in Jinjiang Hospital of Traditional Chinese Medicine and divided with a random number table into experimental group (with ω-3 PUFA supplementation,n =60) and control group (without ω-3 PUFA supplementation,n =60).Sixty blood samples from healthy people visiting the physical examination clinic were collected as normal controls.The serum levels of tumor necrosis factor-α (TNF-α),interleukin (IL)-1,IL-6,S100B and neuron-specific enolase (NSE) were detected with enzyme-linked immunosorbent assay (ELISA).Glasgow Coma Scale (GCS) score,Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score and outcomes of the two groups were compared.Results The serum levels ofTNF-α,IL-1,IL-6,S100B,and NSE protein significantly increased in patients with sTBI compared with the normal controls (all P ＜ 0.05).Compared with the control group,the serum levels of inflammatory related factors (TNF-α,IL-1,IL-6) in the experimental group were significantly decreased on the 3rd day [(213.81 ±29.33) μg/L vs.(267.76 ±31.35) μg/L,(121.81 ± 10.63) μg/L vs.(152.60 ± 11.45) μg/L,(81.89 ± 8.34) μg/L vs.(106.62 ± 10.35) μg/L,all P ＜ 0.05],S100B and NSE protein expressions were significantly decreased on the 7th day [(1.32 ± 0.09) μg/L vs.(1.67 ± 0.12) μg/L,(12.57 ± 1.53) μg/L vs.(17.57 ±2.30) μg/L,both P ＜0.05].Compresd with the control group,the experimental group showed significantly higher GCS scores (9.32 ± 1.64 vs.7.14 ± 1.30,P =0.02) and significantly lower APACHE Ⅱ scores (14.37 ± 2.27 vs.17.00 ± 1.85,P =0.04) on the 14th day.Compresd with the control group,the experimental group showed lower mortality during the follow-up [11.7％ (7/60) vs.15.0％ (9/60)],but with no significant differences (P =0.49).Conclusion Supplementation of ω-3 PUFA could exert neuroprotective effect by effectively regulating inflammatory response and reducing the damages to glia and neurons in patients with sTBI,which is a promising agent for clinical application.

OBJECTIVE To explore the relationship between intubation of general anesthesia and lower respiratory tract infection.METHODS Totally 947 cases were divided into bronchial intubation group(groupⅠ,541 cases) and(tracheal) intubation group(groupⅡ,406 cases) for a retrospective analysis about lower respiratory tract(infection).The(sputum) samples of(infected) patients were took germiculture and antibiotic susceptibility.RESULTS There were 26 cases arisen lower respiratory tract infection in group Ⅰ and there were 18 in group Ⅱ.The(incidence) was 4.81% and 4.43%,respectively.86.36% pathogens of sputum samples were non-zymophytes,it was a direct proportion between high(antimicrobial) resistance rate and lower respiratory tract infection rate.The infection rate of 60-70 years old and under 49 years patients was 9.56% and 2.04%,respectively.The infection rate of(patients) undergoing anesthesia less 3h and over 3h was 3.26% and 6.14%,respectively,with significant(differences)(P

OBJECTIVE: To investigate the safety of the controllable ileostomy with pipe in view of histology. METHODS: Twenty-eight Beagle dogs undergoing controllable ileostomy with pipe were studied. The special fistula tube with balloon was placed into the hole locating at the cecal root opposing the mesenteric side, and fixed by double knot compression method. RESULTS: The fistula tube was removed 14 days after surgery, then the safety of the procedure was preliminarily evaluated by gastrointestinal radiography and anatomical observation. The small intestine tissue at the compression suture was used as the experimental segment, and the small intestine tissue at the proximal non-compression suture was used as the control segment. The histological staining and the immunohistochemical staining of S-100 protein, c-kit protein and α-smooth muscle actin(α-SMA) protein between two segment were compared, while quantitative comparison of myenteric plexus, intestinal Cajal cell(ICC) and smooth muscle cells in intestinal wall was carried out. After removal of fistula tube at 14 days postoperative, the dogs were normal in feeding and defecation. The digestive tract radiography showed that the intestine was patent without obvious stenosis and obstruction. The dogs were dissected 21 days after operation. The abdominal sinus ostium was well healed and the internal sinus was well formed. Under gross inspection, blood supply, morphology and motor function of experimental intestine segment were similar from the proximal and distal segments of control intestine. S-100 immunohistochemical staining showed that the morphology and distribution of S-100 protein positive cells and "blank area" cells in the experimental and control segments were consistent. Myenteric plexus counting showed that the experimental segment was 3.62±1.82/field and the control segment was 3.27±1.62/field, whose difference was not statistically significant(t=1.30, P=0.20). Immunohistochemical staining of c-kit showed that the distribution of c-kit positive cells in both segments was consistent. Counting of the number of ICCs in myenteric plexus revealed that experimental segment was 2.96±2.57/plexus, and control segment was 2.49±1.80/plexus without significant difference(t=1.81, P=0.07). Immunohistochemical staining of α-SMA showed that the morphology and distribution of smooth muscle cells in whole intestinal wall(muscle layer, longitudinal muscle, ring muscle) in experimental and control segments were consistent. The average absorbance(A) value of α-SMA staining in ring muscle layer was detected and quantified. The experimental segment was 0.15±0.03 and control segment was 0.14±0.04 without significant difference(t=1.16, P=0.25). CONCLUSION The technique of controllable ileostomy with pipe is safe in view of histology, which may replace the traditional protective ileostomy.
Animals ; Dogs ; Ileostomy ; methods ; standards ; Intestine, Small ; surgery ; Models, Animal ; Proto-Oncogene Proteins c-kit ; metabolism ; Treatment Outcome

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.