With the emergence of new technologies such as brain imaging, bio-sensing, human-computer interaction, cloud computing and large data, the treatment of traumatic brain injury has entered a new era. However, it must be clearly recognized that the central nervous system (CNS) trauma remains a worldwide medical problem. Based on the existing medical knowledge, it is important for promoting CNS trauma treatment levels including nerve trauma standardized treatment, professional management team, multi modal monitoring and data analysis, actively participating in domestic and international multi-center clinical research. Medical workers should dare to explore and innovate, keep up with the pace of the times, and truly achieve the overall improvement of nerve trauma.

Mass point-spring model is one of the commonly used models in virtual surgery. However, its model parameters have no clear physical meaning, and it is hard to set the parameter conveniently. We, therefore, proposed a method based on genetic algorithm to determine the mass-spring model parameters. Computer-aided tomography (CAT) data were used to determine the mass value of the particle, and stiffness and damping coefficient were obtained by genetic algorithm. We used the difference between the reference deformation and virtual deformation as the fitness function to get the approximate optimal solution of the model parameters. Experimental results showed that this method could obtain an approximate optimal solution of spring parameters with lower cost, and could accurately reproduce the effect of the actual deformation model as well.
Algorithms ; Models, Theoretical ; Surgery, Computer-Assisted ; Tomography

Objective To evaluate the treatment of acute cerebral infarction of 4 kinds of drug cost-effective-ness.Methods A retrospective analysis was performed on 207 patients with acute cerebral infarction,according to the drug formulation of patients treatment,they were divided into four groups: group A (alprostadil),group B(Oza-grel),group C(Dan red injection),group D(Xuesaitong),the curative effects and adverse reactions were observed and analyzed by using pharmacoeconomic cost-effectiveness method.Results The costs of groups A,B,C and D were 5 248.6,4 253.7,4 475.8,3 501.2 yuan,respectively;The effective rates were 92.2%,83.7%,87.5%,76.9%, respectively;The cost effectiveness ratio(C/E) were 56.93,50.82,51.15,45.53,respectively;A,B,C group compared with the incremental cost-D group,the effect of ratio(△C/△E) were 107.2,110.7,91.9;The incidence of adverse reactions were 3.9%,6.1%,12.5%,11.5%.Conclusion Alprostadil group scheme was the best treatment scheme.

Objective:To investigate the serum level of miR-224 in hepatocellular carcinoma (HCC) patients and its clinical diag-nostic significance. Methods:The serum level of miR-224 was detected by real-time quantitative PCR. This study included 42 cases of patients with HCC, 36 patients with liver cirrhosis (LC), 55 patients with chronic hepatitis B (CHB), and 40 healthy persons (NC). The relative expressions of miR-224 were calculated. The receiver operating characteristic (ROC) curves were analyzed to determine the sensitivity and specificity of miR-224 expression levels in HCC diagnosis. Results:Result shows that the relative miR-224 expression was higher in the serum of HCC patients than that in the CHB, LC, and NC groups. The difference was statistically significant (P<0.05 or P<0.01). The relative miR-224 expression in the serum of HCC patients and alpha fetoprotein (AFP) were positively correlated (P<0.05). By comparison, the tumor size, TNM stage, tumor differentiation, and lymph node metastasis were not correlated with mirR-224 expression (P>0.05). ROC analysis shows that the best critical value of the relative expression levels of miR-224 was 3.47, with sensi-tivity of 82.2%, specificity of 92.8%, and area under the curve of 0.935. Conclusion:The serum level of miR-224 in HCC patients has high specificity, and miR-224 has great potential to become a new serological marker for the diagnosis of HCC.

BACKGROUND:Col agen and silk fibroin materials for construction of spinal cord scaffolds have been proven to repair or partial y repair damaged spinal cord nerve function. OBJECTIVE:To introduce partial characteristics of the col agen and silk fibroin and to review the recent progress and application as scaffolds in spinal cord tissue engineering. METHODS:A computer-based search of CNKI and PubMed databases (2003-01/2012-10) was performed for articles addressing the application of col agen and silk fibroin scaffolds in spinal cord injury with the keywords of“col agen, silk fibroin, scaffold, spinal cord injury”in Chinese and English, respectively. RESULTS AND CONCLUSION:Col agen has low antigenicity, good biocompatibility and biodegradability. Col agen and its degradation products can cause no inflammatory reactions in the body, but have the disadvantages of rapid degradation and poor mechanical properties. Silk fibroin has good biocompatibility and excellent mechanical properties, but its degradation is slow. The col agen and silk fibroin are compounded using an electrostatic spinning technology to improve the physical properties of the material on the basis of maintaining good biocompatibility. At present, fibroin or col agen materials in terms of nervous system repair have been studied, laying some foundation for spinal cord tissue engineering. Considering the similar characteristics and mechanics performance to the spinal cord tissue, col agen/silk fibroin composite materials are expected to become the ideal scaffold materials for spinal cord tissue engineering.

Spontaneous intracerebral hemorrhage (SICH) refers the primary, non-traumatic parenchymal hemorrhage. In China, SICH accounts for about 20%-30%of total strokes. SICH is a kind of disease affected by multiple factors includ?ing environmental and genetic factors. The high morbidity and mortality cause serious damage to human health. Therefore, it is important to find etiology and risk factors of SICH. The article reviewed the progress of SICH pathogenesis in the perspec?tive of genetics and molecular biology.

Objective To establish the electric controlled cortical impact (eCCI)-induced traumatic brain injury (TBI) model in rats with different severity in degree,which may serve as a suitable platform to provide experimental evidence for the pathophysiological following TBI.Methods A total of 40 male Wistar rats were randomly divided into 3 experimental groups and sham group.TBI rats (n=10/group) were positioned beneath the controlled cortical impactor device (eCCI) and subjected to impact injury at 2 mm depth of penetration,for a sustained depression of 200 ms,at 4 m/s,5 m/s,6 m/s velocity for mild,moderate,and severe TBI,respectively.Sham-operated rats (n=10) underwent identical surgical procedures,including craniotomy,without receiving the cortical impact.Neurological function and regional cerebral flow (24 h after CCI),contusion volume,histopathological,and ultrastructural changes (48 h after CCI) were measured,respectively.Results The severity of the pathological changes in rats was increased as the injury aggravated.The eCCI device impacted the brain at 4 m/s,5 m/s,6 m/s velocity for mild,moderate,and severe TBI,respectively.TBI groups showed impaired neurological function,and decreased rCBF lower than that of sham-operated group (all P＜0.01).Furthermore,neuronal pathological abnormalities in TBI groups,including neuron shrinking,perineuronal vacuole,and structural abnormalities of mitochondria.Increased severity of injury was apparent following the increased level of the impacted velocity,and significant differences were observed between TBI groups (P＜0.05).Conclusion The TBI animal model with mild,moderate,and severe brain injury can be established successfully by 4 m/s,5 m/s,and 6 m/s of impact velocity respectively with the eCCI-6.3 device.The novel eCCI-induced TBI model in rats possibly serves as a novel useful approach in the development of TBI models.

Objective To evaluate the effects of mild-hypothermia therapy on coagulation and prognosis in patients with severe traumatic brain injury(sTBI). Methods Forty sTBI patients with Glasgow coma score(GCS) 3-8 were randomly divided into normal temperature-treatment control group(NT group)and hypothermia-treatment group(HT group),each 20 cases. Both groups were given conventional therapy,and HT group was additionally given mild-hypothermia therapy. The values of prothrombin time(PT),activated partial thromboplastin time(APTT), thrombin time(TT) and concentrations of plasma fibrinogen(Fg),D-dimer(DD)in two groups were monitored dynamically. The incidences of frequently seen blood coagulation related complications,such as delayed hematoma, hyper-fibrinolysis,cerebral infarction were counted,and 3 months after injury,the standard glasgow outcome scale (GOS)was applied to assess the prognosis. Results The values of PT,APTT and TT were significantly shorter and reached their valley values after 12 hours in NT group〔PT(s):10.6±0.8 vs. 11.6±1.2,APTT(s):16.7±1.2 vs. 20.8±1.4,TT(s):9.8±0.8 vs. 13.6±0.8〕,the concentrations of plasma Fg,DD were obviously increased and reached their peak values after 12 hours〔Fg(g/L):3.2±0.9 vs. 2.5±0.8,DD(μg/L):4 126.7±1 170.3 vs. 873.5±140.2〕,which showed that hypercoagulability appeared in the first 12 hours after injury in NT group,and after 12 hours turned into hyper-fibrinolysis. However,the values of PT,APTT,TT extended slowly until 12 hours reaching to their peak values〔PT(s):14.4±0.9 vs. 10.9±1.0,APTT(s):45.4±1.0 vs. 20.2±1.0,TT(s):25.3±1.2 vs. 13.0±0.6〕,the concentration of plasma Fg declined gradually until 12 hours to its valley value(g/L:1.8±0.7 vs. 2.3±0.6)and then back to normal,the concentration of DD rose gradually until 12 hours reaching to its peak value(μg/L:3 079.8±947.6 vs. 795.6±120.7)and then back to normal at 72 hours in HT group. The time of recovery for above indexes in HT group was earlyer than that in NT group. The incidence of delayed hematoma in NT group was higher than that of HT group(10%vs. 5%),but there was no statistical significant difference between the two groups(P>0.05),and the incidences of hyper-fibrinolysis(5% vs. 35%,P<0.05)and cerebral infarction (0 vs. 25%,P<0.05)in HT group were obviously lower than those in NT group. The rate of good therapeutic effect was higher(30% vs. 5%,P<0.05),and mortality lower(10% vs. 25%,P<0.05)in HT group than that of NT group. Conclusion Mild-hypothermia therapy can ameliorate coagulation dysfunction, reduce morbidity of coagulation related complications,and can improve the prognoses of patients with sTBI.

BACKGROUND:Skul repair materials cannot only restore the normal shape of the skul , but also play an important role in brain functional recovery. OBJECTIVE:To summarize the research status of polyetheretherketone (PEEK), titanium al oy and tissue engineering technique in cranioplasty and the prospect of three-dimensional (3D) printing technology. METHODS:Literatures related to skul repair materials were retrieved in databases of CNKI and PubMed published from 1995 to 2016, using the keywords of“bone regeneration material in calvarial, 3d printing bone scaffold”in Chinese and English, respectively. RESULTS AND CONCLUSION:Although titanium and PEEK have been used in clinic, titanium holds conductivity, thermal conductivity, while PEEK that may be displaced or lost is not involved in osseointegration. Tissue engineering technology participates in the skul tissue reconstruction, achieving satisfactory repair outcomes, but the problems of scaffold selection and preparation, seed cel obtainment, and growth factor release need to be overcomed. 3D printing technology can print personalized shape, fit the defect precisely, but the raw materials should have good biocompatibility and biomechanical property. Combination of tissue engineering technology with 3D printing technology shows a broad prospect in cranioplasty.

BACKGROUND:Neural stem cel s with self-proliferation and differentiation potential are the ideal seed cel s for central nervous tissue engineering. Although col agen and silk fibroin as biological scaffold materials have been widely used, both of them used alone have certain shortcomings. Is it possible to combine the two materials to build a novel neural tissue-engineered scaffold? What is the effect of this novel scaffold on the growth and differentiation of neural stem cel s? OBJECTIVE:To observe the growth and differentiation of neural stem cel s seeded onto the novel composite scaffold. METHODS:The rat embryonic neural stem cells were inoculated onto new composite scaffolds, and then, their growth and differentiation were observed by light microscopy and scanning electron microscopy. Neural stem cells were cultured in conventional suspension culture as control group. Cell counting kit-8 assay was used to detect viability of neural stem cells in the two groups. Three-dimensional composite scaffolds carrying neural stem cells were slic ed into paraffin sections to observe the growth and differentiation of neural stem cells by hematoxylin-eosin staining and immunofluorescence staining. RESULTS AND CONCLUSION:Neural stem cel s cultured on the new composite scaffold grew and differentiated wel , and interconnected synapses were observed. Cel counting kit-8 assay showed that neural stem cel s on the scaffold grew wel , and the cel viability was significantly higher in the composite scaffold group than that in the control group (P<0.05). Hematoxylin-eosin staining and immunofluorescence staining of paraffin sections further provided evidence for good growth and differentiation of neural stem cel s on the scaffold. These results indicate that the novel composite scaffold with good biocompatibility benefits the growth and differentiation of neural stem cel s, promising a favorable application prospect.