BACKGROUND: Recently, trans-pedicle screw internal fixation has markedly improved the rigidity of spinal fixation and hence the fusion rate. But when placed incorrectly, the pedicle screw can injure the spinal cord and/or nerve roots, resulting in serious complications.OBJECTIVE: To evaluate the application value of preoperative CT scans-based navigation technique in the spinal pedicle screw internal fixation surgery.DESIGN, TINE AND SETTING: A prospective, randomized, and controlled observation was performed at the Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences between January 2006 and December 2008.PARTICIPANTS: A total of 95 patients who underwent pedicle screw internal fixation due to spine diseases were randomly assigned to a navigation group (n = 45) and a conventional group (n = 50).METHODS: In the navigation group, patients were subjected to pedicle screw insertion with the assistance of computer navigation technique and while in the conventional group, patients underwent pedicle screw insertion using the conventional anatomic landmark combined with fluoroscopy.MAIN OUTCOME MEASURES: Screw channel preparation time, excellent and good rate of screw position, and postoperative complications.RESULTS: In the navigation group, totally 206 pedicle screws were inserted under navigation guidance, with an excellent and good rate of 96.1%; and navigation could not be continued in 9 patients for a three-dimensional registration error. In the conventional group, altogether 285 pedicle screws were inserted, and the excellent and good rate was 100%. No significant difference was found between the two groups (P > 0.05). The navigation group exhibited longer screw channel preparation time than the conventional group [(360±22) seconds vs. (56+8) seconds, P < 0.01]. No postoperative complications were found in each group.CONCLUSION: The preoperative CT scans-based navigation technique produces similar accuracy of pedicle screw insertion, but markedly prolonged operation time, compared with the conventional anatomic landmarks, exhibiting limited application value in the spinal pedicle screw internal fixation.

Objective:To probe the exploration and integration of ideological and political teaching resources for College English by medical students' teams, and to build a College English ideological and political teaching resource database in medical colleges, so as to provide feasible experience for the integration of medical students' College English and ideological and political education.Methods:A questionnaire survey was conducted among 1 030 students in a medical college, and SPSSAU statistical software was employed to analyze the results to investigate the attitudes and demands of students towards the integration of English teaching and ideological and political education, the construction methods of College English ideological and political teaching resource database, and the presentation methods and types of resources. Based on the questionnaire results, textbook themes, teaching modules and students' majors, the content analysis and classification method were employed to construct a College English ideological and political teaching resource database that meets the expectations of medical students.Results:① A total of 836 students agreed with the necessity to integrate College English with ideological and political education, hoping to build an ideological and political resource database with videos and audios related to daily life ( n = 731), medical knowledge ( n = 664), social practice ( n = 622), news and current affairs ( n = 604) and guide the students to learn the above resources through the methods "teacher instruction + classroom discussion" ( n = 528). ② The ideological and political integration points in the questionnaire results were matched according to the subjects of the textbook, and further divided into two categories: universal and medically specific ideological and political teaching elements according to the content of the unit modules. Finally, the resource database of College English ideological and political teaching in medical colleges was built. Conclusion:Outstanding courses and resources are jointly explored and built by teachers and students.

Increased microglial activation and neuroinflammation within autonomic brain regions such as the rostral ventrolateral medulla (RVLM) have been implicated in stress-induced hypertension (SIH). Prorenin, a member of the brain renin-angiotensin system (RAS), can directly activate microglia. The present study aimed to investigate the effects of prorenin on microglial activation in the RVLM of SIH rats. Rats were subjected to intermittent electric foot-shocks plus noise, this stress was administered for 2 h twice daily for 15 consecutive days, and mean arterial pressure (MAP) and renal sympathetic nerve activity (RSNA) were monitored. The results showed that MAP and RSNA were augmented, and this paralleled increased pro-inflammatory phenotype (M1) switching. Prorenin and its receptor (PRR) expression and the NLR family pyrin domain containing 3 (NLRP3) activation were increased in RVLM of SIH rats. In addition, PLX5622 (a microglial depletion agent), MCC950 (a NLRP3 inhibitor), and/or PRO20 (a (Pro)renin receptor antagonist) had antihypertensive effects in the rats. The NLRP3 expression in the RVLM was decreased in SIH rats treated with PLX5622. Mito-tracker staining showed translocation of NLRP3 from mitochondria to the cytoplasm in prorenin-stimulated microglia. Prorenin increased the ROS-triggering M1 phenotype-switching and NLRP3 activation, while MCC950 decreased the M1 polarization. In conclusion, upregulated prorenin in the RVLM may be involved in the pathogenesis of SIH, mediated by activation of the microglia-derived NLRP3 inflammasome. The link between prorenin and NLRP3 in microglia provides insights for the treatment of stress-related hypertension.