Objective To compare clinical outcome of microvascular decompression (MVD) and percutaneous balloon compression (PBC) by using a prospective cohort study in order to provide a reliable evidence for the clinical decision-making. Methods Patients with trigeminal neuralgia hospitalized at Hangzhou First People′s Hospital in 2010 were chosen as database for cohort study. The patients were divided into MVD group (30 cases) and PBC group (30 cases). The clinical efficacy was followed by independent observers for 36 months after surgery. Chi-square test for hierarchical data, t test for quantitative data, and Kaplan-Meier plot for clinical outcomes were applied in the research. The endpoint was follow-up accomplishment or severe occurrence. Results Sixty patients were included in the research till the endpoint. The general records before surgery were almost the same with the literature records. By comparing painless period, mild and severe relapse, MVD group was superior to PBC group (P < 0.05). As for the painless survival period, MVD group was 96.7% of pain free after 1 year, 93.3% after 3 years, while PBC group was 90.0% after 1 year and 83.3% after 3 years. Regarding 3 years of follow-up, the relapse seemed occurred after 1 year in both groups. Conclusions As a curative and nondestructive procedure , MVD is more effective and has longer lasting pain free period , which should be considered as the first choice of treatment for trigeminal neuralgia in healthy people.

Objective To evaluate the clinical effects of percutaneous micro-balloon compression (PBC) trigeminal ganglion for the treatment refractory trigeminal neuralgia. Methods Surgical results of 452 patients with trigeminal neuralgia treated by PBC from October 2009 to May 2013 were analyzed retrospectively. 125 cases aged over 80 years old and 70 cases′ pain belongs to the first branch neuralgia. Such procedures as Meckle′s cave cannulated with No.4 Forgarty catheter and the balloon inflated and compressed the gasserian ganglion monitored by X-ray were observed by PBC. Follow-up interview and curative effects were recorded. Results The average hospitalization was 6.1 days. Among them, 432(95.6%) cases had immediate relief from pain. The overall pain relief rate was 97.8% in our group without serious surgical complications. Postoperative complications include hemifacial numbness in 385 patients (85.2%), mild masseter muscle weakness in 248 patients (54.9%), diplopia in 2 patients. All symptoms relived or disappeared within 1 ~ 6 months. The average follow-up intervier period is 23.5 months. The recurrence rate is 10.2% (46 cases). Conclusion PBC is a safe and effective method with high pain relief rate in the treatment of refractory trigeminal neuralgia , especially for the treatment of the high risk patients , patients with recurrent symptoms or the patients suffered from the first branch neuralgia.

Objective:To investigate the effect of sodium butyrate (NaB) on renal and intestinal injury after cardiac arrest and cardiopulmonary resuscitation (CA-CPR) and its related mechanism.Methods:Twenty-four domestic healthy male swines were randomly divided into 3 groups: sham group ( n=6), CA-CPR group ( n=10) and NaB group ( n=8). The animals only underwent operational preparation in the sham group. The animal model of CA and CPR was established by 9 min of ventricular fibrillation induced by electrical stimulation in the ventricle and then 6 min of CPR in the CA-CPR and NaB groups. At 5 min after resuscitation, a dose of 75 mg/kg of NaB was intravenously infused for 1 h in the NaB group, and meanwhile the same volume of vehicle was intravenously infused in the sham and CA-CPR groups. At 1, 2, 4, and 24 h after resuscitation, blood samples were collected to detect the renal and intestinal injury biomarkers, such as creatinine (Cr), blood urea nitrogen (BUN), intestinal fatty acid binding protein (IFABP), and diamine oxidase (DAO). At 24 h after resuscitation, renal and intestinal tissue specimens were harvested to detect the protein markers of cell autophagy including microtubule-associated protein light chain 3 Ⅱ (LC3Ⅱ) and p62 expression, and also renal and intestinal apoptosis. Statistical analysis was performed by SPSS software, and continuous variables were compared with one-way analysis of variance among the groups. Results:After CA-CPR, the renal and intestinal injury biomarkers including Cr, BUN, IFABP, and DAO were significantly increased at all time points after resuscitation in the CA-CPR and NaB groups compared with the sham group (all P<0.05). The injury biomarkers mentioned-above were significantly lower at all time points after resuscitation in the NaB group than in the CA-CPR group [Cr (μmol/L): (90±5) vs. (127±9) at 1 h, (135±14) vs. (168±9) at 2 h, (174±10) vs. (211±12) at 4 h, (192±10) vs. (253±13) at 24 h; BUN (mmol/L): (10.5±1.0) vs. (12.3±1.0) at 1 h, (12.2±1.2) vs. (15.3±0.9) at 2 h, (13.6±1.3) vs. (18.3±1.2) at 4 h, (15.4±1.4) vs. (21.5±1.4) at 24 h; IFABP (pg/mL): (502±33) vs. (554±32) at 1 h, (574±52) vs. (644±41) at 2 h, (646±44) vs. (732±43) at 4 h, (711±42) vs. (828±42) at 24 h; DAO (U/mL): (8.6±1.0) vs. (10.5±0.9) at 1 h, (10.6±1.2) vs. (12.8±1.0) at 2 h, (12.1±1.0) vs. (15.0±1.0) at 4 h, (14.1±1.1) vs. (17.6±1.0) at 24 h, (all P<0.05)]. Renal and intestinal tissue detection indicated that cell autophagy and apoptosis were significantly increased after resuscitation in the CA-CPR and NaB groups compared with the sham group, which was indicated by significantly increased LC3Ⅱ and decreased p62 expression, and markedly elevated apoptosis index (all P<0.05). However, cell autophagy and apoptosis in the kidney and intestine were significantly milder after resuscitation in the NaB group than in the CA-CPR group [renal LC3 Ⅱ: (1.15±0.17) vs. (2.23±0.31), p62: (1.60±0.10) vs. (1.17±0.08), apoptosis index (%): (21.2±5.3) vs. (50.9±7.9); intestinal LC3 Ⅱ: (1.03±0.17) vs. (1.71±0.21), p62: (1.30±0.29) vs. (0.79±0.29), apoptosis index (%): (25.6±6.1) vs. (61.7±10.7), all P<0.05]. Conclusions:NaB could alleviate the severity of renal and intestinal damage after CA-CPR in swine, and its protective mechanism may be related to the inhibition of cell autophagy and apoptosis.