Stress ulceration are common occurrence in patients with severe traumatic brain injury, which can result in alimentary tract hemorrhage, perforation and obviously increase mortality. To prevent the occurrence of stress ulceration and control upper gastrointestinal hemorrhage is meaningful for prognosis of critical disease. This article reviews pathogenesis of stress ulceration as well as the relationships preventive treatment, early enteral nutrition, hospital acquired pneumonia and related complications.

Retroviral vectors are the most used gene delivery vehicle in human gene therapy.When the therapeutic gene is packagedfrom producer cell line, one has to determined whether thereplication-competent retrovirus(RCR) is being generated. In this study, two methods, namely the marker rescue assay and RT/PCR, were employed to detect RCR in the cells. While the marker rescue assay can detect RCR with a limit at 6?102CFU/ml, RT/PCR can be used to detect RCR at as low as lCFU/103ml. Combining the specificity of the marker rescue assay and the sensitivity of RT/PCR, both assays together should serve as an adequate test for detecting the generation of RCR in retroviral producer cell lines.

0. 05). Conclusion: The HCAPl can be expressed in both normal peripheral white blood cells and the leukemic cells, and there is no difference in the protein levels between them.

Objective To study the effect of mild hypothermia on β2- microglobulin (MG) level in cerebrospinam(CSF) of traumatic brain injury (TBI) patients.Methods Thirty-six severe TBI patients were divided into two groups randomly,mild hypothermia treatment group and normathermia treatment group,and the β2- MG level and GOS score in CSF of these patients in different time- point were evaluated.Results β2-MG level increased at first,then decreased gradually,and MBP level in mild hypothermia group decreased greater than the control group( P ＜ 0.05 ),moreover,patients in mild hypothermia treatment group had better outcome than the control group( P ＜ 0.05).Conclusion Mild hypothermia may act as neuroprotection by inhibiting inflammatory response or improving immune regulation.

Objective To study the effect of mild hypothermia on MBP level in the CSF of TBI patients.Methods We investigated 36 patients with severe traumatic brain injury and randomized them into two groups,mild hypothermia treatment group and normathermia treatment group.The MBP levels in CSF and ICP and GOS scores in different time-points were evaluated.Results There was no significant difference between the two groups in the MBP level on the 1st day after treatment(P ＞ 0.05).The MBP levels in mild hypothermia group decreased greater than that in the control group on the 7th and 14th day after treatment(P ＜ 0.05).ICP decreased more in mild hypothermia group than in the control group(P ＜ 0.05)on the 7th and 14th day after treatment.Moreover,patients in mild hypothermia treatment group have better outcome than those in the control group(P ＜ 0.05),but there was no significant difference in the death rate between the two groups.Conclusion Mild hypothermia may provide neuroprotection by reducing MBP degradation and stabilizing medullary sheath,thus improving the prognosis of TBI patients.

After more than3 years of pilot (since 2010), standardized training of resident physicians in Shanghai has made great progress, however, it still needs to be improved. Cerebral and spinal vascular diseases are main types of neurological diseases and they seriously influence people's life and health. Interventional neuroradiology plays an important role in the diagnosis and treatment of cerebral and spinal vascular diseases. However, in the current residency training system in Shanghai or other provinces of China, the training of interventional neuroradiology is not included. In this paper, the authors analyzed the important role of interventional neuroradiology in diagnosis and treatment of cerebral and spinal vascular disorders and discussed the feasibility, method, and time arrangement of including interventional neuroradiology curriculum into the schedule of neurology standardizedresidency training and hoped to provide reference for the relevant departments to formulate a future policy.

Objective To investigate the antimicrobial susceptibility of Pseudomonas aeruginosa (P. aeruginosa) isolated from Zhenjiang area to 13 routinely used antibiotics and identify the structure and dissemination of class Ⅰ integron. Methods K-B test was used to determine the resistant rate of 71 strains of P. aeruginosa. DNA template was extracted by boiling method, PCR method was utilized to detect class Ⅰintegron, and subsequently gene cassettes were analyzed by sequencing. Results The resistant rates to 13 routinely used antibiotics were quite different from 18. 3 to 77.5% among 71 strains of P. aeruginosa. The prevalence of class Ⅰ integron was 38%. These integrons include 5 gene cassettes ( aadB, aac (6) - Ⅱ , PSE-Ⅰ , dfrA17 and aadAS), in which dfrA17 and aadA5 gene cassette were frequently found. Comparing with the negative strains of integron, the positive strains of integron has obviously higher resistance to ten the antibiotics including piporacillin, piperacillin-tazobactam, ceftriaxone, cefepime, ceftazidime, gentamicin,amikacin, tobmmycin, levofloxacin, and ciprofloxacin. Conclusions The resistant rates of P. aeruginosa to 13 drugs were different, and the resistant rates of integron positive strains were obviously higher than integron negative strains, which indicates that integron may play an important role in multidrug reisistance of P. aeruginoosa.

Intracranial aneurysms will lead to subarachnoid hemorrhage, which has a high mortality and morbidity risk. Screening high-risk aneurysms for preventive intervention has a positive effect, considering the widespread presence of unruptured aneurysms in the general population, this article reviews the risk factors of aneurysm rupture from the aspects of epidemiology, pathology, morphology and hemodynamics. In terms of epidemiology, smoking history, hypertension, age, gender and family inheritance are all closely related to the risk of aneurysm rupture. In terms of pathology, inflammation on the wall of intracranial aneurysm may be related to the risk of aneurysm rupture. In imaging, the size of intracranial aneurysms, location, the characteristics of the artery wall and some morphological and hemodynamic parameters can be used as evaluation index of fracture risk factors, at the same time the growth of intracranial aneurysm is one of the high risk indicators, the indicators for us in the future to establish intracranial unruptured aneurysms rupture risk factors evaluation model is of great significance.

Objectives To research clinical effects of severe brain injury patients treated by acupuncture and herb combine mild hypothermia,discuss the new approach of severe brain injury patients treatment combine Chinese traditional and Western medicine.Methods Investigated 68 severe traumatic brain injured patients,randomly divided into three groups,acupuncture and herb combine mild hypothermia group (n =22),mild hypothermia group (n =24) and normal temperature routine treatment group (n =22).Dynamic intracranial pressure,brain damage index (cytoskeletal protein),immunologic function (IL-6,β2 microglobulin),combine rate of complications (including irritable ulcer,lung infection,epilepsy,sugar metabolism disorder,and so on),and long-term GOS score were analyzed.SPSS12.0 software was used for statistical processing,and the standard deviation of the measurement data were expressed as the standard deviation.The counting data were expressed as apercentage,and the chi-square test was used for the comparison between group.Results There were significant differences between three groups of intracranial pressure,immunologic function,complication occurring rate (P ＜0.05),but there had no significant difference between acupuncture and herb combine mild hypothermia group and mild hypothermia group of brain damage index and GOS,and there have significant difference between these two groups and normal temperature routine treatment group.Conclusions Acupuncture and herb combined mild hypothermia might be better in reducing intracranial pressure,the incidence of complication,and improving immune function of severe brain injury,than mild hypothermia group and normal temperature routine treatment group.

Objective:To explore and analyze the selection of surgical methods for supratentorial intracerebral hemorrhage.Methods:A total of 260 patients with spontaneous intracerebral hemorrhage who underwent surgery in Department of Neurosurgery, Suzhou Hospital Affiliated to Nanjing Medical University from January 2017 to December 2021 were included in the study by retrospective case analysis. According to different surgical methods, they were divided into three groups: large bone flap group ( n=116), conventional bone flap group( n=89)and stereotactic group( n=55). The large bone flap group underwent standard supratentorial large bone flap craniotomy, the conventional bone flap group underwent conventional bone flap craniotomy, and the stereotactic group underwent stereotactic hematoma puncture suction + drainage. Clinical indicators such as operation time, intraoperative bleeding, pulmonary infection, length of hospital stay, and Glasgow outcome scale (GOS) at 6 months of postoperative follow-up, and the proportion of good prognosis (GOS 4-5) were calculated. Measurement data with normal distribution were expressed as mean±standard deviation( ± s), count data were expressed as cases and percentages (%). Results:In the large bone flap group, the operation time, intraoperative bleeding, hospital stay, pulmonary infection, postoperative rebleeding were(193±24) min, (625±65) mL, (46±11) d, 102 patients(87%), 9 patients(7.8%), and (124±17) min, (297±35) mL, (32±9) d, 29 patients(33%), 4 patients(4.4%)in the conventional bone flap group, and (73±11) min, (53±15) mL, (21±4) d, 10 patients(18%), 2 patients(3.6%)in stereotactic group. All patients were followed up for 6 months, and 165 patients (63.5%) had good prognosis (GOS 4-5), including 36 patients (31%) in the large bone flap group, 82 patients (93.2%) in the conventional bone flap group, and 47 patients (85.5%) in the stereotactic group.Conclusion:Standard large craniectomy has sufficient effect of decompression, and is suitable for serious life threatening hematoma; Conventional craniotomy has advantages in the treatment of secondary intracerebral hemorrhage. Stereotactic surgery has the characteristics of short operation time, less intraoperative bleeding, short hospital stay and low incidence of pulmonary infection, which is worthy of promotion in the treatment of primary intracerebral hemorrhage.