Objective To investigate the correlation between serum S100B, IL-6 and intracranial pressure in patients with severe craniocerebral injury.Methods 81 cases of patients with severe brain injury in our hospital from August 2012 to April 2016 were selected,intracranial pressure was monitored immediately after admission to calculate the average daily ICP level ,and venous blood were collected after craniocerebral injury 6,12,24,48, 72 hours.Detection of serum S100B protein and IL-6 levels,and the correlation analysis with the level of intracranial pressure.Results Patients with severe craniocerebral injury S100B levels increased gradually after injury, reached the peak at 24 hours, then decreased gradually; while patients with IL-6 and intracranial pressure after injury gradually increased, the difference was statistically significant in different time points among the S100B,IL-6 and intracranial pressure levels (P<0.05).Conclusion The changes of intracranial pressure after severe craniocerebral injury were proportional to the levels of serum S100B and IL-6,S100B and IL-6 can reflect the changes of intracranial pressure,intracranial pressure changes predicted by S100B plasma concentration in 48 hours were more sensitive than those in the same concentration of IL-6.

Objective To explore the influence of minimally invasive puncture drainage on blood brain barrier (BBB) function and its mechanism.Methods Ninety-two patients with hypertensive intra-cerebral hemorrhage (HICH) in the Department of Neurosurgery of Jiaxing Affiliated Second Hospital of Zhejiang Province were divided into a control group and an observation group, according to random number table method, 46 cases in each group. In the control group, the conventional craniotomy was performed, while in the observation group, minimally invasive puncture drainage was carried out to remove the hematoma. The National Institute of Health Stroke Scale (NIHSS) were used to evaluate the neural function, the level of serum myelin basic protein (MBP) was detected by enzyme linked immunosorbent assay (ELISA), the central nervous specific serum protein S100 level was measured by electrochemical luminescence method, the albumin levels in serum and cerebrospinal fluid were determined by automatic biological analyzer, and the BBB index was calculated. After 14 days of surgery, the curative effect and incidence of complications of two groups were observed.Results After surgery, the NIHSS scores of two groups were obviously lower than those before surgery, and the degree of descent in observation group was more significant than that in the control group (score: 3.68±2.39 vs. 5.43±3.89,P < 0.05); after surgery, the levels of MBP, S100, albumin in cerebrospinal fluid and BBB in two groups were higher than those before surgery [MBP (μg/L): 3.02±0.28 vs. 3.81±0.29, S100 (μg/L): 0.95±0.24 vs. 1.34±0.27, cerebrospinal fluid albumin (μg/L): 9.89±0.78 vs. 21.43±1.14, BBB index: 0.22±0.04 vs. 0.48±0.05], the differences being statistically significant (allP < 0.05), but the change values in the observation group were less significant than those in the control group. The total effective rate in observation group was significantly higher than that in the control group [84.78% (39/46) vs. 65.22% (30/46),χ2 = 4.696,P = 0.030]. The incidence of wound infection, gastrointestinal bleeding in observation group was markedly lower than that in the control group [16.67% (6/46) vs. 36.96% (17/46), χ2 = 4.120,P = 0.042].Conclusion The minimally invasive puncture drainage has unequivocal clinical curative effect in treatment of patients with HICH, it can protect the nerve and BBB functions and reduce the incidence of complications.

Objective:To investigate the effect of anterior or posterior debridement on infections of the lumbar vertebral fusion with cage and pedical screw system.Methods:A total of 10 cases (3 males and 7 females, age 49.80±13.29 years) with infections in the lumbar fusion device were admitted from January 2013 to December 2019. The cases were diagnosed with deep infections after the preview surgery at 10.80±13.24 months, including 10 cases with 12 cages infections and 8 cases with screw system infections. 7 cases were done with debridement and removal of the cages via the anterior approach. And another 3 cases underwent posterior debridement and removal of lumbar fusion cages. The changes in laboratory examination such as WBC count, ESR, CRP, visual analogue scale (VAS) and Oswestry Disability Index (ODI) score were compared preoperatively, 2 months and 6 months postoperatively.Results:No patients were lost in the follow-up. The average follow-up time periods is 16.30±5.10 months (range 9-24 months). There was no significant difference in WBC count between 2 and 6 months after surgery compared with preoperation ( F=0.855, P=0.436). The ESR, CRP, VAS and ODI scores decreased in 2 months and 6 months after sugery, which has significant differences compared preoperation ( P<0.05). The abnormal signals in the lambar vertebral showed a gradual fading trend in the postoperative MRI. The completely fading time was 5.00±1.33 months (range 3-7 months). One-stage bone grafting was performed in 6 cases with 8 spaces via anterior approach, 5 cases with 7 spaces showed the intervertebral fusion after postoperative with 6.80±2.28 months (range 4-10 months), 1 case wirh 1 space was not fused. One-stage bone grafting was performed in 2 cases via posterior approach: 1 case was fused after postoperative and the other patient was not, which due to bone graft area infection. Postoperative bone graft displacement occurred with 1 case and 1 case with L 5 nerve root pulling injury during the operation. Conclusion:The fusion cage can be removed by debridement via posterior approach, but it is difficult to done the completely debridement, which the main reason is the obstruction of the posterior nerve and bone structure. Posterior approach also have risks of infection recurrence and nerve root injury. Cage removal via anterior approach was relatively easy and debridement was thoroughly, which has the risk of injury of important adjacent vessels.

Objective To explore the effect of hypertonic saline combined with magnesium sulfate on severe craniocerebral injury.Methods Patients with severe craniocerebral injury admitted to our hospital from September 2017 to February 2019 were selected prospectively.With the informed consent of the patients' families,the patients were divided into control group and experimental group according to the random number table.Patients in the two groups accepted intracranial pressure monitoring;patients in the experimental group additionally accepted magnesium sulfate combined with hypertonic saline for a continuous use of 7 d.Incidences of high intracranial pressure,epilepsy,low intracranial perfusion,cerebral vasospasm,cerebral infarction,and intracranial pressure rebound,total mannitol dosages one week after injury,serum neuron specific enolase (NSE) level,and Glasgow outcome scale (GOS) scores and mortality rate 3 months after injury were analyzed and compared between the two groups.Results A total of 93 patients were enrolled;47 were into the control group and 46 into the experimental group.There were no significant differences in age,gender,Glasgow coma scale (GCS) scores and NSE levels at admission,and percentages of patients accepted craniotomy evacuation of hematoma or bone flap decompression between the two groups (P＞0.05).As compared with those in the control group,the total mannitol dosage one week after injury and serum NSE concentration were significantly lower,and GOS scores 3 months after injury in the experimental group were significantly higher(P＜0.05).Patients in the experimental group had significantly lower incidences of high intracranial pressure,cerebral vasospasm and intracranial pressure rebound as compared with patients in the control group (P＜0.05).Conclusion Hypertonic saline combined with magnesium sulfate can improve the prognoses of severe craniocerebral injury;it has few side effects and is cheap;it might be an effective cerebral protective agent.

OBJECTIVE: To explore the genetic basis for a fetus suspected for congenital nephrotic syndrome of Finland (CNF). METHODS: Genomic DNA was extracted from peripheral and umbilical cord blood samples derived from both parents and the fetus. Potential variants were detected by using next-generation sequencing. Suspected variants were confirmed by Sanger sequencing. RESULTS: The fetus was found to carry compound heterozygous variants c.1440+1G>A and c.925G>T of the NPHS1 gene, which were respectively inherited from its mother and father. CONCLUSION Identification of the compound heterozygous NPHS1 variants has enabled diagnosis of CNF in the fetus and genetic counseling for the affected family.
Female ; Fetus ; Finland ; Heterozygote ; Humans ; Membrane Proteins ; genetics ; Nephrotic Syndrome ; congenital ; diagnosis ; Pregnancy ; Prenatal Diagnosis

Objective: To explore the genetic basis for a fetus suspected for congenital nephrotic syndrome of Finland (CNF). Methods: Genomic DNA was extracted from peripheral and umbilical cord blood samples derived from both parents and the fetus. Potential variants were detected by using next-generation sequencing. Suspected variants were confirmed by Sanger sequencing. Results: The fetus was found to carry compound heterozygous variants c. 1440+ 1G>A and c. 925G>T of the NPHS1 gene, which were respectively inherited from its mother and father. Conclusion Identification of the compound heterozygous NPHS1 variants has enabled diagnosis of CNF in the fetus and genetic counseling for the affected family.