Objective:To explore the clinical effect and safety of modified microvascular decompression (MVD) on the recurrent trigeminal neuralgia.Methods:50 patients with recurrent trigeminal neuralgia from 2010 to 2015 in the Center of Cranial Nerve of Shanghai Jiaotong University (including Shanghai Tongren Hospital and Xinhua Hospital) were retrospectively analyzed,patients before 2012 were given regular MVD (MVD group,n=22),patients after 2012 were given improved MVD (modified MVD group,n=28).MVD group was given trigeminal nenre root decompression by traditional MVD,the method was described as follows:the skin,myofascial was cutted in turn along the first incision,the scar tissue on the edge of bone window was separated,and the bone window was appropriately expanded until the dura mater was fully exposed.Then dura mater was cutted open to sharply dissect the arachnoid,Meckel cavity was probed up to neurological brain regions (REZ),the trigeminal nerve segment was closely examined to separate the responsible blood vessels of oppressive nerve and the Teflon pad of cotton imbedding at the first operation.Modified MVD group was given detection of intracranial trigeminal nerve and its surrounding structures,dissection of brainstem extended segment of trigeminal neuralgia,and the compression of superior cerebellar artery to brainstem extended segment of trigeminal neuralgia was fended off.The postoperative remission rate,recurrence and complications between two groups were compared.Results:The postoperative remission rate in modified MVD group was 100.0％,which was significantly higher than that of the MVD group (P＜0.05).There was no statistical significance in the incidence of postoperative complications between two groups (P＞0.05).The recurrence rate at 1 year after surgery in modified MVD group was 0％,which was significantly lower than that of the MVD group (22.7％,P＜0.05).Conclusions:Decompression of trigeminal nenrerootcombined with brainstem extended segment of trigeminal neuralgia in MVD for recurrent trigeminal neuralgia could effectively relieve the pain,reduce the risk of postoperative recurrence,and wouldn't increase the postoperative complications.

Objective To compare the effects of propofol versus midazolam on serum hydrocortisone in the aged traumatic brain injury. Methods 64 patients (aged 65-72 years) with traumatic brain injury during mechanical ventilation were divided into propofol group (n=32) and midazolam group(n=32).The hemodynamics data,intracranial pressure(ICP) and the calculated cerebral perfusion pressure(CPP) were recorded.The serum hydrocortisone of patients was detectedby enzyme linked immunosorbent assay (ELISA) at 24 h,72 h and 4 weeks in intensive care unit(ICU). Results There was no differences in partial pressure of carbon dioxide,heart rate,meanartery pressure,pulse biood oxygen saturation (SpO2 ),armpit temperature,endexpiratory gas(PEr CO2),intraeranial pressure (ICP) and cerebral pertusion pressure (CPP) between the two groups (P＞0.05).The serum hydrocortisone in propofol group at 24 h and 72 h [(269.7±43.2) nmol/L and (235.0±67.0) nmol/L] were lower than in midazolam group [(278.0±75.5) nmol/L and (243.2±42.4) nmol/L] (t=5.312 and 5.919,both P=0.000).The serum hydrocortisone in propofol and midazolam group at 4 weeks were (209.1±73.9) nmol/L and (210.8±66.6) nmol/L,respectively,no significant difference was found(t=0.075,P =0.938). Conclusions There is a significant difference in the effects of propofol and midazolam on the early level of hydrocortisone in the aged patients with traumatic brain injury.

In total, 607 bedridden patients aged 60 years and over at Tianlin community hospital and four other hospitals or at home-care in Shanghai were investigated with questionnaire, physical examinations and related laboratory tests. Contents of investigation include general situation, medical conditions, 24-hour recall of diet, intake of nutritional supplement preparation, and so on. As compare to the reference for nutrient intake of the elderly set in the Guide to Diet for Chinese Residents (2007), total nutritional intake was obviously insufficient and three nutrients in diet were imbalanced for most bedridden elderly patients. Intake of most nutrients (including proteins, dietary fiber, calcium, iron, zinc, selenium,copper, magnesium, phosphor, retinol equivalent, vitamin B1 , vitamin B2, vitamin C) was obviously low in bedridden elderly patients, with a larger gap from the requirements of the Dietary Guide.

To promote quality of the whole nursing,build harmonious relation of nurse and patient is basement.Nurse how to make language art utilize at the interflow of nurse and patient,to promote understanding and sustain between nurse and patient,improve cure,nursing effect,reduce contradictory of nurse and patient is the key of building harmonious relation of nurse and patient.

Objective To investigate the effects of antioxidant response element (ARE) activator- 5,6-dihydrocyclopenta[ C ]-1,2-dithiole-3-thione (CPDT) on organotypic spinal cord cultures and to study whether this activation can protect motor neurons from oxidative stress.Methods Organotypic spinal cord cultures were prepared using lumbar spinal cord slices from 8-day-old rat.Threo-hydroxyaspartate (THA) was continuously added into the culture medium for 3 weeks,which caused selective motor neuron death. Thus,the in vitro model of amyotrophic Lateral sclerosis (ALS) was established.15,30 ?mol/L of CPDT were added into the culture medium respectively.Ventral motor neurons survival was evaluated by immunohistochemical staining with monoclonal antibody SMI-32,a nonphosphorylated neurofilament marker. Ultrastructure was observed with electronic microscope.Results The pretreatment of organotypic spinal cord cultures with different concentrations of CPDT significantly increase the total number of ventral motor neurons (15?mol/L:(15.81?6.97) perexplant;30?mol/L:(16.25?6.74) perexplant respectively) compared with THA group ((5.31?5.76) perexplant) and the former had plentiful neurite extensions (n= 15,P

Both sides of the picornavirus genome have 5'-untranslated region (5'UTR) and 3'- untranslated region (3'UTR). This study demontrated that both the 5'-and 3'-UTR can form complex structures, such as stem-loop, clover and pseudoknot structure, These structures play an important role in the regulaton of the replication and translation of the viruses. This article reviewed the progress of research on the structure and function of picornavirus' 3'-UTR over recent years.
3' Untranslated Regions ; Animals ; Humans ; Nucleic Acid Conformation ; Picornaviridae ; chemistry ; genetics ; metabolism ; Picornaviridae Infections ; virology ; RNA, Viral ; chemistry ; genetics ; metabolism

Objective To compare the mutation sites in human immunodefieiency virus type 1 (HIV-1) vpr gene via of HIV-1 infected individuals from different regions in China with the previous studies, and to provide information for the further study on the relationship between HIV-1 vpr gene mutations and clinical conditions of the patients. Methods Reverse transcription-polymerasc chain reaction (RT-PCR) and nested PCR were used to amplify HIV-1 vpr gene of 398 HIV-1 infected individuals. The amino acid sequences were analyzed to determine polymorphisms, deviation rate and common mutation sites of HIV-1 vpr gene. Meanwhile, the viral load, subsets of lymphocytes and clinical course of patients infected with mutated HIV-1 were analyzed. Results One hundred and fifty three positive samples which were obtained from 398 HIV-1 infected individuals were available for further analysis. The amino acids sequence typing of HIV-1 Vpr were showed that CRF01 AE was 51.63%, subtype C 24.84%, subtype B 17.65%, CRF03_ AB 3.92% and CRF08 BC 1.31%. Eighty four point three percent of 77th amino acid of HIV Vpr sequence was glutamic acid which was significantly different from what overseas researches reported that the R77Q mutation was correlated with long-term non-progression (LTNP) of AIDS. The mutations of the, 63th, 70th, 85th, 86th, 89th and 94th amino acids of HIV Vpr were likely related to the clinical remission of HIV-1 infected individuals. Conclusions M group is the main type of HIV Vpr typing in China, and CRF01 AE is predominant. Some amino acid mutation sites of HIV-1 Vpr are possibly correlated with clinical manifestations of HIV-1 infected individuals.

Background Retinal microvascular pericytes (RMPs) have been played increasing attention as an emerging key in pathogenesis of various retinal angiogenic diseases including diabetic retinopathy,and RMPs are thought to be a potential target for treatment.Yet the study has been hindered by the difficulty of obtaining source of tissue and isolating pure population.Objective This study was to establish a simple method of isolation,purification and cultivation of primary RMPs for rat.Methods Eyeballs were extracted from clean male Sprague Dawley rats and immersed by 75％ alcohol for 1 minute.The retinas were isolated and mechanical morcel.Trypsin (2.5 g/L) was firstly used and followed by type Ⅰ collagenase (2 g/L) for the digestion of the retina for 15 minutes,respectively.Retinal microvascular fragments were screened by 100 μm and 55 μm filter screen.DMEM containing 20％ fetal bovine serum was added for the cultivation and passaged of the cells.The cells were purified by exchanging medium and partial enzymatic digestion.The morphology and growth status were monitored under the phase contrast microscope,and α-smooth muscle actin (α-SMA),platelet-derived growth factor receptor-β (PDGFR-β),yon Willebrand factor (vWF),glial fibrillary acidic protein (GFAP) antibodies were used for the identification of RMPs.Results RMPs migrated out of fragments after 24-48 hours of plating.On day 7,RMPs appeared in primary cultures as loose colonies.The cells reached confluence to about 80％-90％ on day 14-16.The subcultures grew faster than the primary and reached confluence on day 12-14.The culture showed typical morphology of pericyte with large irregular triangular cell body and multiple long processes,and they could be repeatedly passaged 9 times without obvious loss of characteristic phenotype.Fluorescence assay exhibited that 96％ of the cells showed positive immunofluorescence for α-SMA and PDGFR-β,confirming the purity of RMPs in culture.However,only a few of them were positive for GFAP and the cells response for vWF was absent.Conclusions High purity of rat RMPs can be obtained easily by our method without high cost-consuming.Hcrc wc cstablished a simple mcthod for the primary culture of rat RMPs.

To investigate the protective effects of eplerenone on adriamycin-induced renal injury and the possible mechanisms involved, 36 male Sprague-Dawley rats were randomly divided into control group, adriamycin nephropathy (AN) group and eplerenone-treated group (100 mg·kg(-1)·d(-1) eplerenone). Blood pressure, 24-h urinary protein, serum potassium, sodium and creatinine were measured 28 days after adriamycin injection (a single tail intravenous injection of 6.5 mg/kg adriamycin). The morphological changes of renal tissues were observed by light and electron microscopy. Immunohistochemistry and Western blotting were performed to examine the expression of TGF-β(1) and desmin in renal cortex. The results showed that 28 days after adriamycin injection, there were no significant changes in the level of serum potassium, sodium, creatinine concentrations and blood pressure values in the rats of the three groups. Meanwhile, the 24-h proteinuria excretion in the AN group was significantly higher than that in the control group (P<0.01), but that in the eplerenone-treated group was substantially reduced when compared with that in the AN group (P<0.05). Mild mesangial cell proliferation and matrix expansion, diffuse deformation and confluence of foot processes in podocytes were found in the AN group. By contrast, rats in the eplerenone-treated group exhibited obvious attenuation of these morphological lesions. The protein expression of TGF-β(1) and desmin in the AN group was markedly up-regulated in contrast to that in the control group (P<0.01), whereas that in the eplerenone-treated group was much lower than in the AN group (P<0.05). It was concluded that eplerenone may ameliorate the proteinuria and the development of pathological alteration in adriamycin-induced nephropathy presumably via the inhibition of cytokine release, and restore the morphology of podocytes independent of its blood pressure-lowing effects.

This study investigated the mental health status of medical students in China, and analyzed the influencing factors in order to provide evidence for mental health education for medical students. A stratified cluster sampling method was used to recruit medical students from Huazhong University of Science and Technology, China. The questionnaire survey on general information and Symptom Checklist 90 (SCL-90) were used for investigation and analysis. The results showed among the 1137 valid questionnaires, 278 (24.45%) participants had SCL-90 score ≥ 160. The top three mental problems of medical students were obsessive-compulsive disorder, interpersonal sensitivity and depression in terms of the factor score ≥ 2.5 and the number of participants who reflected on the diseases. The third-year medical students had the worst mental health status, and fifth-year medical students had the best mental health status. Students from rural area had more psychological problems than those from urban area; furthermore, students with high professional satisfaction, those who were the single child of the family, non-poor students, and those whose parents had high education level had better mental health status. It was concluded that the mental health of medical students is not optimistic in China. Medical students have some mental health problems of different degrees. Factors that influence the mental health of medical students include academic pressure, professional satisfaction level and family environment.