Objective To discuss the clinical efficacy of surgery for chronic subdural hematoma assisted by rigid neuroendoscope and its surgical techniques. Methods Clinical data of 161 patients with chronic subdural hematoma from August 2009 to December 2015 was analyzed retrospectively. 74 of them experienced surgeries assisted by rigid neuroendoscope (endoscope group) and other 87 cases were operated without neuroendoscope (routine group) during the same period. Results Although there were significant difference in operative duration between the two groups, complications, ratio of total removal of hematoma after surgery, postoperative inpatient duration and recurrent rate of hematoma were more advantageous in endoscope group. The operative duration of endoscope group with (112.68 ± 34.86) min was longer than that of routine group with (74.11 ± 28.23) min (t = 7.75, P = 0.000), while the postoperative inpatient duration of endoscope group with (8.23 ± 2.01) d was shorter than that of another group with (10.79 ± 5.02) d (t = -4.12, P = 0.000). There were no surgical associated complications in endoscope group, but 1 patient in routine group experienced intracerebral hematoma of frontal lobe and associated aphemia. Total removal of hematoma was confirmed in endoscope group with 98.65% (73/74), which was higher than that in routine group with 86.21% (75/78) (χ2 = 8.34, P = 0.004). Hematoma recurrence was found in 16 cases of routine group (18.39%), but more superiority in endoscope group with 1.35% (χ2 = 12.29, P = 0.000). Outpatient follow-up was carried out in all patients from 6 to 38 months with an average duration of 30.06 months. In 17 cases with recurrent hematoma during follow-up, 15 of them were cured by a second surgery, and another 2 patients were cured by atorvastatin. Conclusion As a simple, safe and effective technique, the application of rigid neuroendoscope during surgery for chronic subdural hematoma is more advantage than routine surgery. A self-made suction with adjustable soft curved tip is suitable for such procedure.

UNLABELLEDObjective: In order to assess the integrative cardiopulmonary function after percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD), we used symptom limited maximum cardiopulmonary exercise testing (CPET).

METHODSAll 59 patients diagnosed stable CAD by coronary angiography and echocardiography from August to December of 2014 in our hospital, were divided two groups. PCI group, 31 patients received PCI and drugs. Control group, 28 patients received drugs therapy only. All patients performed CPET before and after the treatment.

RESULTSAll patients safely completed CPET without any complications. The control group, all functional parameters were unchanged (P > 0.05). PCI group, the anaerobic threshold, peak oxygen uptake and peak oxygen pulse increased significantly (P < 0.05) from baseline,but not for others (P > 0.05). For individual analysis, PCI group had higher rates of increase (≥ 10% of baseline) in both peak oxygen uptake and peak oxygen pulse than those of control group (P < 0.05).

CONCLUSIONCPET is an objective, quantitative, safe and effective method to evaluate the clinical therapeutic efficiency. PCI can improve the integrative cardiopulmonary function in CAD patients.

Anaerobic Threshold ; Coronary Angiography ; Coronary Artery Disease ; surgery ; Exercise Test ; Heart Rate ; Humans ; Oxygen ; Oxygen Consumption ; Percutaneous Coronary Intervention

Objective To explore the association between ankylosing spondylitis(AS)with the poly- morphism in -308 site of tumor necrosis factor(TNF)-?promoter region. Methods The literature about AS and polymorphism in -308 site of TNF-?promoter region were searched and the meta analysis as performed. Results Eight studies enrolled 987 AS patients and 922 controls in total. The analysis showed that the fre- quencies of alleles and the genotypes had no statistical difference between AS group and the control group [OR=0.86(0.53, 1.38), P=0.53; OR=0.90(0.52, 1.55), P=0.69]. But the frequencies of alleles of western origin had statistical difference between AS group and the control group [OR=0.75(0.59, 0.96), P=0.02]; The TNF-?gene promoter polymorphism may play a role in the severity of sacroiliitis[OR=0.37(0.15. 0.90), P=0.03]. Conclusion The meta-analysis reveales that the alleles of -308 site of TNF-?promoter region may be associated with AS in western ethnical group and play a role in the severity of saeroiliitis.

-2,and T)was detected on exon 11 in the mutational analysis of GABRG2.Our results indicate that genomic variations of GABRG2 are not likely to be substantially involved in the etiology of GEFS+in this family. Conclusion Our study fails to provide evidence supporting a causal relation between the SCN1A,SCN1B, GABRG2 mutation and the etiologic genes in this family,which indicates that GEFS+has with phenotypic and genotypic heterogeneity.

Objective To understand the status and influential factors of those neglect of left-behind children in rural area,and to provide bases for the development of intervention measures.Methods 2917 students were selected as the study subjects from Changfeng county of Anhui province with cluster sampling method and were evaluated by a Parents-Child Conflict Tactics Scales and questionnaire on influential factors.Results 1694 left-behind children,accounted for 58.1％ of the total students,were surveyed in this investigation.The prevalence rates of neglect,among total children,left-behind children,non-left-behind children were 67.4％,70.2％,63.5％,respectively.The prevalence of neglect among left-behind children was higher than that among non-left-behind children (x2=14.322,P＜0.000).There were no significant associations with the neglect rate of left-behind children regarding gender or age differences.Result from multivariate logistic regression analysis indicated that the neglect among the left-behind children were associated with family dysfunction(OR values of moderate and serious family dysfunctions compared to good family function were 1.628 and 2.341,respectively)and the rate of keeping in touch with parents(OR values of sometimes and seldom keeping in touch compared to regular in touch were 1.299 and 1.844,respectively).The starting age of being left-behind(OR values of starting age that being left-behind from 6 to 10 and ≤5 years relative to starting age of left-behind ≥11 years were 0.703 and 0.630,respectively)appeared to be the protection factor to the neglect of those left-behind children.Conclusion Our findings indicated that the status of neglect among the left-behind children was serious.Prevention programs on the issue should target on a number of factors,including the characteristics of the chldren them-selves,as well as on the family of the children.

Objective To investigate the effects of pioglitazone on glucose metabolism,circulating resistin and adiponectin concentrations,and tissue resistin levels in rats with insulin resistance induced by free fatty acid (FFA).Methods A hyperinsulinaemic-euglycaemic clamp and[3-~3H]-glucose tracing technique were used in awake rats.Insulin-mediated peripheral and hepatic glucose metabolism,plasma resistin and adipenectin levels, resistin levels in tissues were assessed by hyperinsulinaemic-euglycaemic clamp with elevation of FFA by lipid infusion over 4 h in rats pretreated with or without pioglitazone.Results During steady-state of clamp,there was a significant increase in plasma FFA in lipid-infused group(L group)and pioglitazone-pretreated lipid-infused group(P/L group)compared to control rats(P＜0.01).The glucose infusion rate(GIR)in P/L group was significantly reduced as compared with controls[(20.6?0.9 vs 33.6?1.5)mg?kg~(-1)?min~(-1),P＜0.01], whereas the GIR was lower in L group than in P/L group[(12.6?0.8 vs 20.6?0.9)mg?kg~(-1)?min~(-1),P＜0.01].As compared with baseline,the hepatic glucose production(HGP)was significantly suppressed by 85% [(18.3?2.1 vs 2.7+2.4)mg?kg~(-1)?min~(-1) and (17.5?2.6 vs 2.6?1.0)mg?kg~(-1)?min~(-1),both P＜0.01]during the hyperinsulinaemic clamp in control and P/L groups.The suppressive effect of insulin on HGP was significantly blunted in L group[(17.3?2.1 vs 15.8?1.5]mg?kg~(-1)?min~(-1)].The rate of glucose disappearance(G_(Rd))was reduced in L group and P/L group compared with controls(P＜0.01).Baseline plasma resistin level was lower in P/L group than that in the controls[(7.8?1.3 vs 29.1?3.1)?g/L,P＜0.01].After lipid infusion,plasma resistin levels significantly increased in P/L group,but remained lower than that of L group [(18.1?3.8 vs 47.0?2.2)?g/L,P＜0.01].Baseline adiponectin level was higher in P/L group than those in the controls and L groups[(3.9?0.2 vs 2.8?0.1 and 2.6?0.2)mg/L,P＜0.01].After clamp,plasma adiponectin levels were decreased in L group and L/P group compared with baseline(both P＜0.05).In addition, the resistin level in the liver of P/L group decreased compared with the controls and L groups(both P＜0.05), whereas significantly increased in the muscle of L group.Conclusion Lipid infusion induces an acute insulin- resistance in vivo.Pioglitazone pretreatment partly prevents FFA-induced insulin resistance possibly by changing resistin and adiponectin levels.

OBJECTIVETo compare the clinical effects and radiographic outcomes of mini-open trans-spatium intermuscular and percutaneous short-segment pedicle fixation in treating thoracolumbar mono-segmental vertebral fractures without neurological deficits.

METHODSFrom August 2009 and August 2012, 95 patients with thoracolumbar mono-segmental vertebral fractures without neurological deficits were treated with short-segment pedicle fixation through mini-open trans-spatium intermuscular or percutaneous approach. There were 65 males and 30 females, aged from 16 to 60 years old with an average of 42 years. The mini-open trans-spatium intermuscular approach was used in 58 cases (group A) and the percutaneous approach was used in 37 cases (group B). Total incision length, operative time, intraoperative bleeding, fluoroscopy, hospitalization cost were compared between two groups. Visual analog scale (VAS) and radiographic outcomes were compared between two groups.

RESULTSAll patients were followed up from 12 to 36 months with an average of 19.6 months. No complications such as incision infection, internal fixation loosening and breakage were found. In group A, fluoroscopy time was short and hospitalization cost was lower than that of group B (P<0.05). But the total incision length in group B was smaller than that of group A (P<0.05). There was no significant differences in operative time, intraoperative bleeding, postoperative VAS and radiographic outcomes between two groups (P>0.05). Postoperative VAS and radiographic outcomes were improved than that of preoperative (P<0.05).

CONCLUSIONThe mini-open trans-spatium intermuscular and percutaneous short-segment pedicle fixation have similar clinical effects and radiographic outcomes in treating thoracolumbar mono-segmental vertebral fractures without neurological deficits. However, in this study, the mini-open trans-spatium intermuscular approach has a short learning curve and more advantages in hospitalization cost and intraoperative radiation exposure times, and is recommendable.

Adolescent ; Adult ; Female ; Fluoroscopy ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Visual Analog Scale

Objective: To investigate the value of neuronavigation system in the keyhole microsurgical operation for distal intracranial artery aneurysms(DIAA). Methods: The clinical data of 16 cases with DIAA who were treated by via keyhole approaches, from January, 2013 to December, 2018, were analyzed retrospectively. Ten aneurysms located in anterior cerebral artery(ACA), 3 in posterior inferior cerebellum artery(PICA) and 3 in perforator artery(PA). The optimal skin incision and craniotomy were designed with assistence of neuronavigation system preoperatively, and lesions were located precisely under the guidance of neuronavigation system during microsurgery before clipping or resection. Angiography was performed before discharge, and clinic followed-up was conducted monthly till 6 months after surgery. Results: The systematic error of neuronavigation system ranged from 0.5 mm to 1.0 mm, with an average of 0.6 mm. All 16 aneurysms were explored and managed successfully with the guidance of neuronavigation system without aneurysm premature rupture nor neuronavigation-related complications. Absolute occlusion of all aneurysms was documented angiographically after surgery. Of all cases, 2 experienced shunt procedure due to delayed hydrocephalus. During 6 months follow-up period, all 16 cases recovered well. Conclusion Neuronavigation system can precisely locate the deep-seated DIAA, contribute to the preoperative planning of microsurgery via keyhole approaches and avoid evitable injury during excessive manipulation. The noninvasive, rapid and contrast-enhanced CT images of head was an ideal data source for the neuronavigation system.

Objective To describe the current epidemiological characteristics of injuries among primary and middle school students in one rural area of Anhui province and to explore the relationship between the ways of coping and related injuries.Methods Through cluster sampling methods,all students from 3 to 9 grades in 5 primary schools and 3 middle schools in Changfeng county of Anhui province were investigated with questionnaire.All participants completed an anonymous questionnaire concerning their experiences with injuries during the 12 months preceding the survey.The ways of coping to injuries were evaluated by Trait Coping Style Questionnaire.Factors associated with injuries were identified using a negative binomial regression analysis.Results Of 2917 students,the annual event-based rate of injuries was 17.4 per 100 students.Positive coping score had no significant differences between the injury and non-injury groups (33.98 ± 6.38 vs.33.66 ± 6.37) (t=0.979,P=0.328).The score of negative coping style was higher in injury group than in non-injury group (27.65 ± 7.79 vs.26.54 ± 7.62) (t=2.775,P=0.006).Statistically,the annual injury rates were significantly different in three groups on their negative styles of coping (x2=6.131,P=0.013 ).Data from the multivariable negative binomial regression analysis,after adjusted for demographic characteristics,showed no significant difference on the relationship between positive coping style and injury incidence.Those with moderate negative style of coping had lower risks compared to those with highly negative one (IRR＝0.77,95％ CI:0.63-0.94).Conclusion Negative ways of coping was an important risk factor for injuries.Data from our research suggested that psychological preventive measure need to be taken to improve the style of coping.It was also important to promote the related personality development in planning the strategies for future prevention on injuries.

OBJECTIVEHydrogen sulfide (H(2)S) dilates blood vessels in vivo and in vitro probably by opening vascular smooth muscle K(+)-ATP channels. The study was designed to observe the role of mitochondria membrane K(ATP) channel blocker (5-HD) in the regulation of cardiac function isolated perfused heart of rat with H(2)S.

METHODSThe isolated rat heart was perfused in a Langendorff apparatus. After 20 minutes of stabilization, physiological concentration of NaHS (H(2)S donor, 100 micromol/L) was continuously perfused for 20 min in group A (n = 6), isolated hearts in group B (n = 6) and C (n = 7) were pretreated with nonspecific K(ATP) channel blocker glibenclamide (100 micromol/L) or 5-HD (100 micromol/L) for 5 minutes then perfused with NaHS (100 micromol/L) for 10 minutes. Heart rate (HR), left ventricular developed pressure (DeltaLVP), dp/dt(max) and dp/dt(min) and coronary perfusion flow (CPF) were measured.

RESULTSPost continuous perfusion of NaHS at physiological concentration for 20 minutes, DeltaLVP, dp/dt(max) and dp/dt(min) all significantly decreased while HR and CPF remained unchanged compared to baseline levels (all P < 0.05). The negative inotropic effect of H(2)S could partly be blocked by nonspecific K(ATP) channel blocker glibenclamide and mitochondria membrane K(ATP) channel blocker 5-HD.

CONCLUSIONPresent findings suggested that H(2)S at physiological concentration could produce negative inotropic effect in isolated hearts and this effect was mediated by K(ATP) channel and mitochondria membrane K(ATP) channel.

Animals ; Heart ; drug effects ; Hydrogen Sulfide ; pharmacology ; In Vitro Techniques ; KATP Channels ; metabolism ; Mitochondrial Membranes ; drug effects ; metabolism ; Potassium Channel Blockers ; pharmacology ; Rats ; Rats, Wistar ; Ventricular Function, Left ; drug effects