BACKGROUND:Previous studies have shown that bone marrow mesenchymal stem cels in the treatment of neurological diseases have achieved some success, which can promote neurological alterations; however, there is no breakthrough on gene and drug regulation. OBJECTIVE:To investigate the influence of ginsenosides-induced differentiation of bone marrow mesenchymal stem cels on nerve regeneration after traumatic brain injury. METHODS: A traumatic brain injury model was built in rats using hydraulic shock method, and then rat models were randomly divided into model group (traumatic brain injury group), bone marrow mesenchymal stem cel group, ginsenosides group (ginsenosides induced differentiation of bone marrow mesenchymal stem cels). At 2 weeks after transplantation, western blot assay was used to detect protein expression levels of nerve growth factor and brain-derived neurotrophic factor, immunohistochemistry assay used to detect the number of BrdU-positive cels. At 1, 3 days and 1, 2 weeks after transplantation, modified neurological severity scores were recorded. RESULTS AND CONCLUSION: The expression levels of nerve growth factor and brain-derived neurotrophic factor protein were significantly higher in the ginsenosides group than the bone marrow mesenchymal stem cel group and model group (P < 0.05). The number of BrdU positive nerve cels was also higher in the ginsenosides group than the bone marrow mesenchymal stem cel group and model group (P < 0.05). At 3 days and 1, 2 weeks after transplantation, the modified neurological severity scores in the ginsenosides group were lower than those in the bone marrow mesenchymal stem cel group and model group (P< 0.05). These findings indicate that ginsenoside-induced bone marrow mesenchymal stem cel transplantation can promote nerve regeneration in rats with traumatic brain injury, which has better outcomes than bone marrow mesenchymal stem cel transplantation alone.

BACKGROUND:Bone marrow mesenchymal stem cels (BMSCs) can promote nerve regeneration, but there are no better results because of the limitations of treatment methods. BMSC transplantation alone is not enough to achieve desired therapeutic effects. OBJECTIVE:To investigate the effect of fibroblast growth factor (FGF)-modified BMSC transplantation on functional recovery and expression of glial fibrilary acidic protein after traumatic brain injury. METHODS:Animal models of traumatic brain injury were established in Sprague-Dawley rats using hydraulic shock method, and then randomized into control group (traumatic brain injury group), BMSC group and FGF-BMSC group (FGF-modified BMSC group). After isolation and culture, BMSCs were modified by adenovirus vector-mediated FGF gene. Western blot assay was used to detect transfection efficiency and glial fibrilary acidic protein expression; immunohistochemical detection was used to detect distribution and number of BrdU positive cels in the brain; Longa score was used to evaluate the neurologic function of rats at 1, 3 days, 1, 2 weeks after transplantation; TUNEL assay was used to detect cel apoptosis in the brain. RESULTS AND CONCLUSION:Western blot results showed that FGF gene was successfuly transferred to the adenovirus vector, and capable of expressing in BMSCs; moreover, the glial fibrilary acidic protein expression of FGF-BMSC group was significantly higher than that in the other two groups (P < 0.05). The number of BrdU positive cels in the brain was significantly higher in the FGF-BMSC group than the other two groups (P < 0.05). Two weeks after transplantation, the Longa scores in the FGF-BMSC group were significantly lower than those in the other two groups (P < 0.05). TUNEL results showed that the number of apoptotic cels in the FGF-BMSC group was significantly lower than that in the other two groups (P < 0.05). These findings indicate that FGF-modified BMSCs transplantation is able to improve neurological damage after traumatic brain injury and promote neurological recovery, which is better than BMSC transplantation alone.

Objective To measure the financial burden incurred by hypertension to urban patients in Beijing, Nanjing and Hangzhou cities. Methods Two communities were sampled from the three cities randomly, and 300 hypertension patients were sampled randomly from hypertension control files in each community for questionnaire survey. Results Health expenditure of the families with hypertension patients accounts for 14. 4% of the family's income, and 18. 2% of the family's expenditure, a ratio far beyond the national average (10.6 %). However, the majority of them report the burden as affordable.The basic medical insurance for urban residents helps alleviate the financial burden of hypertension patients and the extent of such burden has a close bearing on the outcome of hypertension treatment and prevention. Conclusion Effective community-based blood-pressure monitoring and control system is key to reducing the financial burden of hypertension. The reimbursement policy for hypertensive patients within the basic medical insurance is expected to be further improved.

Objective To compare the changes of physiological parameters after cardiac arrest caused by asphyxia with that of cardiac arrest induced by ventricular fibrillation in rats and assess the values of the parameters on predicting ROSC and 24 h survival rate. Method Two groups of Sprague-Dwaley rats, which randomly (ramdom number) included 30 animals in each group, were investigated. Cardiac arrest were induced by asphyxia (AS group) or ventricular fibrillation(VF group). PETCO2, aortic pressure, left ventricular pressure and ECG of limb lead Ⅱ were recorded continuously, dP/dt4o was calculated with the windaq software. The parameters were compared between the two groups at baseline, precordial compression(PC) 10 s, PC 1 min, PC 3 min, ROSC 1 h and ROSC 2 h. The relations were explored between the parameters and ROSC/24 h survival rate. Results PETCO2,aortic pressure, left ventricular pressure and ECG have distinctive changes in the two groups. In group VF, PETCO2 of ROSC rats at BL, PC 1 min and PC 3 min were higher than those of Non-ROSC rats (P ＜ 0.05); PETCO2of 24 h survival rats at ROSC 1 h and ROSC 2 h were higher than those of 24 h death rats (P ＜ 0.05), which were not observed in the group AS. dP/dt40 and - dP/dt40 at ROSC 1 h and ROSC 2 h in group VF were higher than those in group AS (P ＜ 0.05). Conclusions Physiological parameters after cardiac arrest caused by asphyxia or that of cardiac arrest induced by ventricular fibrillation in rats have unique features respectively. PETCO2 in cardiac arrest caused by ventricular fibrillation may predict ROSC and 24 h survival rate. Researchers have to select the appropriate cardiac arrest model according their research purposes and clinical requirments.

Objective To review the authors′ experience in the diagnosis and management of Hirschsprung′s disease (HD) in newborn during a 7 year′s period (1995～2002),and evaluate a new therapeutic regime. Methods Clinical data of all 155 newborn HD cases were analyzed. Protocols were compared before and after May 2000. Results Barium enemas, anorectic manometry and rectal biopsies confirmed the diagnosis of HD in 155 newborn cases. Two stage radical procedure was performed in 107 cases , and one stage in 48 cases. One hundred and forty-seven cases were cured. Postoperative pneumonia occurred in 25 cases, wound dishences in 8 cases with 8 deaths. There was substantial difference in the incidence of complications, hospital stay and mortality between the two periods. Conclusions (1) Gastrointestinal perforation in neonatal HD cases should be managed by rectal biopsies during the exploration. (2)Different surgical treatment should be adopted in HD cases less than one month of age.

Objective:To analyze the disaster vulnerability of hospitals in Macao Special Administrative Region to assess the disaster risk objectively, so as to provide reference for Macao hospitals to formulate their emergency plans and improve their emergency response and handling capacity.Methods:From December 2021 to February 2022, 118 medical staff were selected for a questionnaire survey using the method of departmental stratified random sampling from three general hospitals in Macao. At the same time, 7 full-time medical staff and 2 experts in the field of health care were selected for expert consultation. The main content of the questionnaire was the hospital disaster risk assessment based on the Kaiser model, and three-round expert consultation method was used to determine the model indicators. The risk value of each indicator was calculated to analyze the hospital disaster vulnerability.Results:107 valid questionnaires were collected. The top five events in the hospital disaster risk value were typhoon(52.42%), large-scale public health events/epidemic outbreaks(47.55%), strong thunderstorm convective weather(38.68%), extreme temperature(37.31%) and information system failure(33.75%). As ranked by the total risk value, the categories of hospital disasters were natural disasters(35.69%), information security(29.49%), medical technology accidents(29.36%), equipment technology accidents(26.25%), dangerous goods injuries(25.13%) and personnel injuries(19.98%).Conclusions:Macao hospitals are exposed to the highest total risk value in natural disasters, followed by information security. In addition, the risk value of large-scale public health events and epidemic outbreaks of personal injury is also so high as to deserve attention. Macao hospitals should formulate effective emergency response plans according to the risk values of various disasters and the actual situation of each medical department, so as to minimize the losses caused by disasters to both hospitals and patients.

Objective: To evaluate the association of short-term fine particulate matters (PM2.5) exposure and blood pressure in children and adolescents. Methods: A total of 144 813 junior and senior middle school students who participated in the physical examination in the 2017-2018 academic year in a northern city of China, with complete record of demographic characteristics, blood pressure and no history of heart and other important organ diseases were selected as the study subjects. Data on PM2.5 and other pollutants and meteorological data were obtained from the nearest air quality and meteorological monitoring stations of each schools. A generalized linear mixed effect model was used to analyze the association between short-term exposure of PM2.5 and blood pressure. Results: The 6 day average concentration of PM2.5 (lag05) increased by 10 μg/m 3 was associated with an increase of 0.177(95%CI=0.148-0.207)mm Hg (1 mm Hg=0.133 kPa) in systolic blood pressure and 4.4%(OR=1.044, 95%CI=1.030-1.058) increase of the prevalence of high systolic blood pressure. And it was also associated with -0.021(95%CI=-0.040--0.002)mm Hg decrease in diastolic blood pressure, but had no significant correlation with the prevalence of high diastolic blood pressure. In general, a 10 μg/m 3 increase of PM2.5 was associated with 3.3% increase in the prevalence of high blood pressure (OR=1.03, 95%CI=1.02-1.05), and difference of boys and girls were found in different lagged days (P<0.05). Conclusion Short-term exposure of PM2.5 is associated with increased systolic blood pressure and prevalence of high blood pressure among children and adolescents. Attention should be paid to the prevention of short-term exposure of PM2.5 to protect the health of children and adolescents.

Objective: To analyze the relationship between short term exposure of PM 2.5 and the vital capacity of children and adolescents and the modification effect of overweight and obesity, and to provide a scientific reference for appropriate outdoor activities and strengthening prevention of air pollution. Methods: A total of 1 036 273 students who qualified in the annual health examination data of primary and secondary school students in a city from 2017 to 2018 were selected; the meteorological factors and air quality of the study area were obtained by inverse distance weighted interpolation method; the generalized linear mixed model was used to estimate the individual lag effect and average lag effect of PM 2.5 short term exposure on lung capacity with in 7 days, and to analyze the modification effect of overweight and obesity on the relationship between short term PM 2.5 exposure and vital capacity in children and adolescents. Results: From September 1, 2017 to June 30, 2018, the average PM 2.5 concentration in this city was 66.36 μg/m 3, the detection rate of overweight and obesity was 33.38%, and the average lung capacity was (2 286.72±956.77)mL. The single lag effect of PM 2.5 on vital capacity was the biggest when lag6, the average daily PM 2.5 concentration increased by 10 μg/m 3 and the decrease of vital capacity of children and adolescents by 2.81(95% CI =2.60-3.03)mL. The average lag effect of PM 2.5 on lung capacity was the largest when lag07, the average concentration of PM 2.5 sliding was significantly correlated with the decrease of lung capacity of children and adolescents by 5.82(95% CI =5.37-6.27)mL every 10 μg/m 3 increase. The prevalence of PM 2.5 short term exposure to pulmonary capacity decreased in overweight and obese children and adolescents was higher ( P ＜0.01). Conclusion The short term exposure of PM 2.5 has a significant negative correlation with the lung capacity of children and adolescents, and there is a lag effect. The decrease of the vital capacity of overweight and obese children and adolescents after PM 2.5 short term exposure is more significant.

Objective: To analyze the association between short term PM 2.5 exposure and high blood pressure in adolescents and its modification effect of overweight and obesity, and to provide a reference for the refined management of students physical health and the scientific prevention and controlling of air pollution. Methods: A total of 148 956 junior high school students and senior high school students who passed the annual physical examination data of middle school students in Beijing from 2017 to 2018 were selected; The inverse distance weighted interpolation method was used to get the meteorological elements and air quality of the research area; Linear mixed effect model was used to estimate the cumulative lag effect of short term PM 2.5 exposure on systolic and diastolic blood pressure within 7 days, and analyze the modification effect of overweight and obesity on the association between short term PM 2.5 exposure and high blood pressure in adolescents. Results: From September 1, 2017 to June 30, 2018, the average concentration of PM 2.5 was (56.53±45.85)μg/m 3; The detection rate of overweight and obesity was 34.22%, and the detection rate of high blood pressure was 8.03%. The cumulative lag effect of PM 2.5 on systolic blood pressure in overweight and obesity group was the largest at lag07, that is, the daily average concentration of PM 2.5 increased by 10 μg/m 3 was significantly correlated with higher systolic blood pressure ( OR =1.05,95% CI =1.03-1.07); the cumulative lag effect of PM 2.5 on systolic blood pressure in non overweight and obese group was the largest at lag05, that is, the daily average concentration of PM 2.5 increased by 10 μg/m 3 was significantly correlated with higher systolic blood pressure ( OR =1.04,95% CI =1.02-1.06). Short term exposure to PM 2.5 did not affect the high diastolic blood pressure in adolescents. Overweight and obese adolescents were more susceptible to high blood pressure caused by short term PM 2.5 exposure within 3 days of cumulative lag (lag01-lag03). Conclusion The short term exposure of PM 2.5 has a significant positive correlation with adolescent blood pressure, and shows a lag effect. Overweight and obese adolescents have higher blood pressure after PM 2.5 short term exposure.

OBJECTIVETo summarize the experience of minimally invasive treatment in 520 patients with intracranial aneurysms on a retrospective study.

METHODSThe measures used in the treatment of 520 patients were reviewed in terms of timing of surgery, induced-hypotensive anesthesia, brain protection combined with temporal occlusion of the feeding artery, external drainage of CSF, dynamic monitoring of intracranial pressure, blood flow velocity, serum osmolality and CT scanning, anti-vasospasm therapy as well as selected interventional endovascular embolization of aneurysms.

RESULTSOf the 520 patients, 485 were treated with either direct clipping or endovascular embolization and 35 patients were treated non-surgically. In 449 patients undergoing direct clipping and 36 undergoing endovascular embolization, intraoperative rupture of aneurysm occurred in 27 (6.0%) and 0%, respectively. Death occurred in 13 (2.6%), hemiplegia in 8 (1.6%), and vegetative state in 2 (0.4%). The operative mortality of direct clipping was 3.8% in 210 patients before 1990 and 1.8% in 275 patients after 1990 (36 patients undergoing endovascular embolization, the operative mortality was 0%).

CONCLUSIONThe outcome of patients with intacranial aneurysms can be markedly improved and the operative mortality can be lowered by minimally invasive treatment.

Adult ; Aneurysm, Ruptured ; mortality ; therapy ; Embolization, Therapeutic ; Female ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; mortality ; surgery ; Intraoperative Complications ; mortality ; Male ; Microsurgery ; Middle Aged ; Minimally Invasive Surgical Procedures ; Retrospective Studies ; Survival Rate ; Treatment Outcome