BACKGROUND:So far steroid pulse therapy andsurgical decompressionarethe main accepted therapiesfor spinal cord injury, but these methods make no effects on injured neurons. Nerve growth factors and endogenous neural stem cels play a role in theneuronalregeneration and remyelination, which provides a newidea for spinal cord injury treatment.
OBJECTIVE:To explore the effect of the basic fibroblast growth factor on proliferation of endogenous neural stem cels after spinal cord injury and to analyze its relationship with the increased fluoro-gold labeled neurons.
METHODS:Totaly 48 Kunming mice were randomly divided into four groups including normal, spinal cord injury, treatment and sham operation groups. Acute spinal cord injury models were establishedin the spinal cord injury and treatment groups, andthe normal group was subjected to operationthat did not damage the spinal cord. At 2hoursafter regaining consciousness, the treatment group was givendailyinjection of MTPBS containing 25 μg/kg basic fibroblast growth factors and 1% album. And at 7 days, laminectomy was carried out again at the L1segment in the former three groups and a smal piece of sterile gelfoam soaked with fluoro-gold was inserted into the incision. The sham operation group was given no processing. Afterwards, mouse motor behavior was assessed using Rotarod and Platform Hang tests; neurons in the corticospinal and rubrospinal tracts were labeled with fluoro-gold; the number of endogenous neural stem cels positive for nestin was detected by immunohistochemistry method. Besides, the correlation betweenthe number offluoro-gold labeled neurons andthe number ofendogenous neural stem cels was assessed.
RESULTS AND CONCLUSION:The basic fibroblast growth factor could significantly improve the mouse motor behavior after spinal cordinjury. And the number of endogenous neural stem cels was significantly increased after the basic fibroblast growth factor injection, which was related to the increased fluoro-gold labeled neurons.In conclusion, basic fibroblast growth factors play an important role in the proliferation of endogenous neural stem cels after spinal cord injury. Furthermore, endogenous neural stem cels improve locomotive behaviors by encouraging the neuronalproliferation.

0.05).At the same time,loss of ranges of neck motion was 4.6??4.0?in group A and 11.6??7.8?in group B,significant difference was also seen(P

Objective Through studying change of serum level of IL-10 in patients of severe trauma with haemorrhagic shock,to investigate effect of severe trauma with haemorrhagic shock bypass on anti-infiammatory reaction in patients.Methods Menbers of experimental group are 43 patients of Severe trauma(ISS scope≥16).43 patients scheduled for attending with haemorrhagic shock are divided into simple severe trauma group(group B)and severe trauma with haemorrhagic shock(group C);and healthy control group(group A)is made up of randomly seleeted 20 healthy people of medical examination.Blood samples for cytokines and organ function were collected from the vetn of menbers of experimental group(B and C)with limosis at the following time:that day of injury,(T1),3th (T2),5th(T3),and 14th(T4)day after injury;blood samples of healthy control group(A)with limosis were collected at that day of examination;serum level of IL-10 was measured by radioimmunoassay.Results In experimental group(B and C),the serum peak level of IL-10 emerged on T3 and then stepped down;the serum peak level of them increased abviously compared with group A(P＜0.05 or P＜0.01).Furthermore,the serum level of them in C group was usually higher than that on the same time in group B.Conclusion It was longer and severer in time and degree that effects of severe trauma with haemorrhagic shock bypass on IL-10 of body compared with that of simple severe trauma.

Objective To evaluate the preliminary outcome of cannulated screw internal fixation in treatment of the tarsometatarsal joint injuries.Methods From January 2005 to October 2010,21 patients(14 males and 7 females)with the tarsometatarsal joint injuries were treated.Their age ranged from 21 to 62 years(average 38.2 years).According to anatomical three-column classification,there were four patients with single medial column injury,four with medial and middle column injuries,three with middle and lateral column injuries,two with single lateral column injury and eight with three column injuries.The injury causes included traffic injury in nine patients,machine injury in eight and fall from height injury in four.The period from injury to admission was 2-15 hours(mean 5 hours).During operation,open reduction was performed,followed by internal fixation with the cannulated screw.X-ray examination was done in the regular follow-up and function was evaluated by using Maryland scoring system.Results Of all,19 patients were followed up for 4-47 months(mean 20 months),which showed no infection,loosing or breakage of the internal fixation.According to the Maryland scoring system,the clinical outcome was rated as excellent in eight patients,good in seven,fair in two and poor in two,with excellence rate of 79％.Conclusions The three-column theory plays an important role in clinical diagnosis and therapy of the tarsometatarsal joint injuries.Open reduction and cannulated screw internal fixation may attain satisfactory clinical results in treatment of the tarsometatarsal joint injuries.

Objective To observe the turnaround time(TAT) of biochemistry laboratory in a certain hospital of Chongqing city,and to improve the quality of the laboratory by shortening the TAT.Methods TAT was analyzed by analyzing the daily workload,average TAT and failure rate of outpatient clinics,outpatient emergency,inpatient clinics,and inpatient emergency subjects from 2013 to 2015.The reasons for TAT prolongation were analyzed.Results The biochemical test samples were 77 060,97 129 and 105 304 from 2013 to 2015,and the annual growth rate was 26.0％ and 8.4％ respectively.TAT of the routine outpatient department samples were (78.55nu48.47)、(69.18± 37.20)、(62.82 ±21.62)min,which decreased year by year,and the difference were statistically significant(P＜0.05),and the TAT of the outpatient emergency were (64.13 ± 31.16),(59.22 ± 23.51),(66.01±37.73)min.TAT of inpatient clinics were (92.34± 53.41),(95.03±55.73) and (122.92±78.94)min from 2013 to 2015,which increased year by year,and the difference were statistically significant(P＜0.05),and the TAT of the inpatient emergency were(65.29±36.06),(62.41±30.18),(61.48±30.12)min,which decreased year by year,and the difference were statistically significant (P＜0.05).The substandard rate of samples aforementioned were 0.04％,2.99％,0.63％ and 3.69％,respectively.Conclusion TAT increases with the samples increase,it is necessary that making sure staffs more responsible in daily work,optimizing the procedure of daily biochemistry tests,improving ability of serving for clinic and patients.

Objective To discuss bilateral percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) using inside and outside intravertebral vacuum cleft (IVC) respectively with bone cement injection for the treatment of Kümmell disease.Methods From January 2008 to October 2015,16 cases of Kümmell disease patients were treated with bilateral PVP or PKP with inside and outside IVC perfusion of bone cement respectively.Of 16 cases,6 were male and 10 were female,aged from 63 to 94 years,with a disease duration from 2 to 15 months.The bone mineral density of every patient was measured by dual-energy X-rayabsorptiometry.The T value ranged from-4.3 to-2.6.Fractures located from T10 to L4,including 2 cases of multiple fractures.Postoperative X-ray was used to observe the vertebral bone cement leakage and anterior height changes of affected vertebrae.Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate pain status and functional activity.Results All cases were followed up for 12-96 months.Cement leakage occurred in 4 patients without nerve complications.The anterior height of affected vertebrae before operation,2 d after operation and at the last follow-up was (50.3 ± 8.3)％,(67.1 ± 8.1)％ and (65.2 ± 6.4)％.The anterior height of affected vertebrae 2 d after operation and at the last follow-up were significantly improved compared with those before operation (P ＜ 0.05),but there were no significant differences between 2 d after operation and at the last follow-up (P ＞ 0.05).The scores of VAS before operation,2 d after operation and at the last followup was (8.63-± 1.23),(2.56 ± 3.48) and (1.38 ± 0.92) scores,and the scores of ODI was (82.1 ± 6.7)％,(28.5 ± 7.3)％ and (22.1 ± 8.2)％.The scores of VAS and ODI 2 d after operation and at the last follow-up were significantly decreased compared with those before operation (P ＜ 0.05),but there were no significant difference between 2 d after operation and at the last follow-up (P ＞ 0.05).There was no postoperative in situ or adjacent vertebral fracture.Conclusions Using internal and external IVC bone cement injection for treatment of Kümmell disease has a good clinical curative effect.It can effectively relieve back pain symptoms,reduce intraoperative and postoperative bone cement leakage and recurrent adjacent or in situ vertebral fracture.

Objective:To share the practice of medical care and rescue in the 2017-2019 Amne Machin extreme cross-country challenge.Methods:At the invitation of the Organizing Committee of Amne Machin extreme cross-country challenge of Maqin County of Qinghai Province. More than 150 medical personnel were sent to make the rescue plan and implement the medical security for three consecutive years. The support was divided into leading command group, expert consulting group, on-site medical support group, rear medical support group, and medical material support group. The on-site medical support group was equipped with the ambulance, corresponding emergency medical equipments and medicines to provide medical support at eight medical stations from the starting point to the endpoint and along the route between each station.Results:There were no cardiac arrest and sudden death cases during the three competitions. A total of 56 patients (5 cases of combined injuries) were received, including 21 cases of mild altitude reaction, 8 cases of abrasions, 13 cases of muscle spasm and strain, 11 cases of hypoglycemia, and 3 cases of abdominal pain. All the injured were treated and observed in time. Each patient achieved a complete remission.Conclusions:To achieve the success of medical security of the highest average altitude cross-country race certified by International Trail Running Association (ITRA), we must formulate a scientific and perfect medical security work plan in the first place: pre competition physical examination, especially the application of sports cardiopulmonary function test, screen out athletes who may have medical accidents; during the competition, focus on monitoring and tracking the players who may have problems; each support point is closely connected with the support vehicle; do a good job of first aid training for all kinds of personnel, so that medical accidents can be found, aided, and transferred at the first time. The medical care and rescue of Amne Machin extreme cross-country challenge have played a good role in the security of the international plateau sports events, which provides a reference for the security of similar events.

Objective:To observe the effects of ultrasound intermediate frequency acupoint targeted drug guiding technology on the recovery of gastrointestinal function and serum gastrin levels in elderly patients after lumbar spine surgery under general anesthesia.Methods:This study used prospective research methods.A total of 90 elderly patients undergoing lumbar spine surgery after general anesthesia in the orthopaedic ward of Beijing Geriatrics Hospital from June 2019 to June 2021 were randomly divided into blank control group, drug control group, and drug-guided treatment group, with 30 cases each group. After the operation, no intervention was given to the blank control group, the drug control group received oral mosapride citrate tablets, the drug-guided treatment group used the D patch to guide the medicine at the two acupoints of Zusanli and Zhongwan with ultrasound medium frequency guided medicine instrument for 1 week each. The serum gastrin levels of the patients in each group were detected 1 d before operation, 3 d after operation, and 1 week after operation, and the time of first exhaust and first defecation after operation were recorded.Results:The results showed that the level of serum gastrin preoperativein the three groups was not significantly different ( P>0.05). On the third day after operation, the levelof serum gastrin in the drug guide treatment group, drug control group and blank control group were lower than those at 1 d before operation: (66.51 ± 5.34) ng/L vs. (69.36 ± 6.50) ng/L, (58.34 ± 5.71) ng/L vs. (68.75 ± 5.13) ng/L, (55.76 ± 6.23) ng/L vs. (70.20 ± 6.71) ng/L, the differences were statistically significant ( P<0.05), and showed a decreasing trend in turn. Among them, the level of serum gastrin in the drug guide treatment group was higher than that in the drug control group and blank control group, the difference was statistically significant ( P<0.05). One week after operation, the level of serum gastrin in the three groups increased compared with the third day after operation ( P<0.05), and the drug guiding treatment group was higher than the drug control group and the blank control group: (72.38 ± 6.78) ng/L vs. (67.15 ± 6.27) ng/L, (63.52 ± 5.38) ng/L, the differences were statistically significant ( P<0.05). The time of first exhaust and defecation after the operation of the three groups of patients, the drug-guided treatment group was significantly shorter than the drug control group and the blank control group: (15.25 ± 3.10) h vs. (20.38 ± 4.21) h and (28.52 ± 3.69) h, (24.14 ± 3.53) h vs. (36.15 ± 3.54) h and (49.51 ± 4.37) h, the differences were statistically significant ( P<0.05). Conclusions:Ultrasound intermediate frequency acupoint drug guiding technology can increase the patient′s serum gastrin level and promote the recovery of gastrointestinal function in elderly patients with lumbar spine surgery after general anesthesia.

Objective To explore the effect of oral-muscle biofeedback system training on the rehabilitation of cognitive dysfunction in patients with obstructive sleep apnea (OSA) after ischemic stroke.Methods A total of 60 cases of poststroke OSA patients with cognitive dysfunction admitted to the rehabilitation center of deAn hospital in changzhou city from June 2017 to March 2018 were selected.On the basis of routine rehabilitation treatment,the control group was given positive pressure ventilation treatment,and the observation group was given oral muscle biofeedback system training.The changes of polysomnography (PSG) parameters,Montreal cognitive assessment (MoCA) score,serum matrix metalloproteinase-9 (MMP-9) and plasma homcysteinemia (Hcy) expression levels in the two groups before and after treatment were compared.Results Apnea hypopnea index and maximum apnea time of the two groups were significantly decreased after treatment compared with those before treatment,and the lowest SpO2 and average SpO2 were significantly higher than those before treatment(P＜0.05).After treatment,MoCA total score and the dimensions score of patients in the observation group were significantly higher than those in the control group at the same time (P＜0.05).After treatment,the levels of Hcy((12.38±4.54) μmol/L) and MMP-9((124.52± 12.94) μg/L) in the observation group were significantly lower than those in the control group at the same time(Hcy(17.52±6.27) μmol/L,MMP-9(268.25±20.5 7)μg/L),and the difference was statistically significant (Hcy:t=3.637,P＜0.05;MMP-9:t =32.395,P＜0.05).Conclusions Positive pressure ventilation and oral muscle biofeedback system training have the same effect on OSA after stroke,but oral muscle biofeedback system training can also effectively improve patients' cognitive function.