OBJECTIVETo explore the effect of dexmedetomidine combined electrical stimulation on cognitive function of neurosurgical diseases patients treated by extracerebral intervention.

METHODSTotally 122 patients with neurosurgical diseases who underwent selective intervention were randomly assigned to the observation group and the control group, 61 cases in each group. Patients in the control group recieved anesthesia by dexmedetomidine. Those in the observation group received electrical stimulation at Baihui (DU20), Yintang ( EX-HN3), and Neiguan (PC6) before dexmedetomidine anesthesia. The cognitive function of patients at preoperative day 1 and postoperative day 1 was respectively evaluated by Mini-Mental State Examinations (MMSE). Serum NSE, S-100β, IL-1β, IL-6, and TNF-α levels were detected in the two groups before intervention and immediately after intervention using ELISA.

RESULTSMMSE scores of two groups were significantly reduced at post-intervention day 1, as compared with one day before intervention. MMSE score of the observation group at post-intervention day 1 was (23.15 ± 1.87) points, significantly higher than that of the control group [ (19.34 ± 1.64) points , (P < 0.05)]. The postoperative cognitive dysfunction (POCD) incidence rate of the observation group was 16.4% (10/61), significantly lower than that of the control group [39.3% (24/61); P < 0.05]. Compared with before intervention, NSE and S-100β protein levels, IL-1β, IL-6 and α-TNF levels of the two groups increased (P < 0.05). Post-intervention NSE and S-100β protein levels, IL-1β, IL-6 and α-TNF levels were significantly lower in the observation group than in the control group (P < 0.05).

CONCLUSIONDexmedetomidine combied electrical stimulation could effectively prevent the occurrence of postoperative cognition, and reduce levels of NSA, S-100β, IL-1β, IL-6 and TNF-α.

Acupuncture Points ; Anesthesia ; methods ; Cognition ; Cognition Disorders ; prevention & control ; Dexmedetomidine ; therapeutic use ; Electric Stimulation Therapy ; Humans ; Interleukin-1beta ; blood ; Interleukin-6 ; blood ; Neuropsychological Tests ; Neurosurgical Procedures ; Phosphopyruvate Hydratase ; blood ; Postoperative Complications ; Postoperative Period ; S100 Calcium Binding Protein beta Subunit ; blood ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo discuss the efficacy of the myogenic elephant skin cream combining with VSD for treating severe bedsores.

METHODSTwenty-nine cases of III and IV degree bedsores were treated from June 2009 to June 2013. Among them, 15 cases were treated by myogenic elephant skin cream combined with VSD (VSD group) including 7 males and 8 females with an average age of (69.0±5.3) years old ranging from 17 to 96 years;other 14 cases were treated by the treatment of conventional dressing change (control group) including 6 males and 8 females with an average age of (71.0±4.2) years old ranging from 40 to 86 years. At 7, 14, 21, 28 d after treatments, specimens of wound two groups were respectively taken to examine immunohistochemical CD34 adopted SABC, the number of wild vascular cross were observed as capillary density value under high magnification microscope. It was used to assess the hyperplasia of granulation tissue of wound. The capillary density value and the visual wound observation were indicators for evaluation of clinical efficacy.

RESULTSSeventeen of 19 cases got complete data of specimens of wound at 7, 14, 21, 28 d,included 9 cases of VSD group,8 of control group. In the microscope view, the capillary density of VSD group was higher than that of control group significantly (P<0.05), it showed the application of VSD technology improved hyperplasia of granulation tissue much faster than conventional dressing change. In VSD group, 13 cases with 15 wounds healed, 2 cases with 3 wounds improved; in control group,3 cases with 3 wounds healed,7 cases with 9 wounds improved, 4 cases with 5 wounds were unhealed.

CONCLUSIONUsing the VSD technology with continuous high pressure suction to clean the drainage of wound and lacuna thoroughly can effectively control infection,promote the growth of granulation tissue, and then applying myogenic elephant skin cream to improve partial blood supply while prompting rapid growth of new granulation tissue and epithelial cell. The risk of this treatment is low,and the course of treatment is short, this provides a safe and effective method for treating bedsores.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Pressure Ulcer ; therapy ; Skin Cream ; therapeutic use

Alanine Transaminase ; metabolism ; Animals ; Liver ; drug effects ; Male ; Mice ; Plant Extracts ; pharmacology

Objective To discuss the clinical effect of dynamic hip screw(DHS)and microtrauma dynamic hip screw(MTDHS)in treatment of comminuted intertrochanteric femur fractures in the elderly patients.Methods From September 2006 to July 2009,42 patients with comminuted intertrochanteric femur fractures were treated by DHS and MTDHS.According to Evans classification,there were 16 patients with type Ⅲ fractures and six with type Ⅳ fractures in MTDHS group and 15 patients with type Ⅲ fractures and five with type Ⅳ fractures in DHS group.The operation time,amount of bleeding,hospital stay and postoperative hip function were evaluated.Results All patients were followed up for 9-17 months(average 13 months).Harris score was 76.4 points in 20 patients treated by DHS and 89.8 points in 22 patients treated by MTDHS,with better functional restoration,shorter operation time and less amount of bleeding in MTDHS group than DHS group.Conclusions Compared with DHS,MTDHS has advantages of minimal invasion,minor trauma,sound recovery of hip joint function and low incidence of complications and hence is a good choice for treating intertrochanteric femur fractures.

Objective To explore the characteristics of gait and surface electromyography (sEMG) of underwater treadmill training (UWTT). Methods From January to September, 2015, gait and sEMG parameters of ten healthy adults were synchronously collected using three-dimensional gait analysis system and sEMG systems on land and UWTT. Results When walking in self comfortable speed, compared with walk on land, there was significant increase in gait cycle (t=-11.411, P<0.001) and percentage of the swing phase (t=-5.252, P<0.05), significant reduction in walking speed (Z=-2.803, P<0.01) and step frequency (t=7.421, P<0.001). There was no significant difference in step strength (Z=-0.357, P>0.05). The integral electromyography of biceps femoris, gastrocnemius, tibialis anterior muscle were significant less than iEMG on land (t>3.984, P<0.01), but no significant difference of rectus femoris (t=0.054, P>0.05). Conclusion There are signifi-cant differences in gait and muscle contraction intensity between land walking and UWTT. The dynamic physiology and neural control of UWTT need further study.

Objective To investigate the trend of antimicrobial resistance and the prevalence of resistant genes in Pseudomonas aeruginosa strains isolated from Hangzhou First People's Hospital.Methods Antimicrobial susceptibilities of 1489 Pseudomonas aeruginosa strains isolated from 2003 to 2007 were statistically analyzed using WHONET.MICs of 11 antimicrobisis to 36 multi-drug-resistant Pseudomonas aerugionosa strains were determined by agar dilution method.Genes of β-lactamases(BLA)and aminoglycoside-modifying enzymes(AMEs)were detected by PCR and the PCR products were sequenced.Results The resistant rates to aztreonam,imipenem,ceftazidime,cefepime,piperacillin,piperacillin/tazobactam.cefoperazone/sulbactam,ciprofloxacin,levofloxacin,gentamicin and amikacin were increased from 13.4%,10.6%,8.7%,7.9%,12.7%,12.7%,6.7%, 15.8%,20.5%,24.7% and 10.9%in 2003 to 35.3%,40.9%,18.4%, 32.4%,32.9%,32.0%,21.9%,37.8%,38.6%, 39.4% and 34.8% in 2007.respectively.Hish MICs of 11 antimicrobiMs for multi-drug resistant Pseudomonas aerouginosa were determined with MIC90≥128 μg/mL.In 36 multi-drug resistant Pseudomonas aeruginosa strains,21(58.3%)strains carried β-lactamase genes and 32 strains(88.9%)carried aminoglycosidemodifying enzyme genes,while the deletion rate of oprD2 was 80.6%(29/36).Conclusions The resistant rates to common antibiotics of Pseudomonas aeruginosa have increased.resulting in multi-drug resistance.Genes of β-lactamases and aminoglycoside-medifying enzymes are prevalent in multi-drug resistant Pseudomonas aeruginosa strains,with the common deletion of oprD2.

Objective: To explore the feature and influencing factors of anhedonia in schizophrenia. Methods: A total of 71 schizophrenia patients and 50 healthy controls were recruited during December 2018 and December 2019. Positive and Negative Syndrome Scale (PANSS) was used for assessing psychotic symptoms. Temporal Experience of Pleasure Scale (TEPS) and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were applied to the evaluation of anhedonia and cognitive function respectively for each subject. Results: The evaluation result of TEPS showed both anticipatory and consummatory pleasure scores were lowered in patients with schizophrenia than those in healthy people (P=0.000). Stepwise linear regression analysis showed that negative subscale score of PANSS (B=-0.895, P=0.002) and delayed memory score of RBANS (B=0.265, P=0.001) were associated with anhedonia in schizophrenia. Conclusion: Patients with schizophrenia exhibit anticipatory and consummatory anhedonia, both of which are influenced by negative symptoms and delayed memory in schizophrenia.

Depression is a common mental disorder and causes great disease burden. To date people's understanding of genetic mechanisms of depression is lagging far behind that of other psychiatric disorders such as schizophrenia and bipolar disorder. Recently, with the accumulation of clinical samples and the advances of methodology and technology, certain progress in genetics of depression has been made. This review summarizes the genetic research progress in candidate genes, common variants, rare variants and chromosome structure variations of depression.

Objective: To investigate the association between early growth response gene 1 (EGR1) and Alzheimer's disease (AD) in Han Chinese people. Methods: A total of 715 AD patients and 760 health controls were recruited in two independent samples from Eastern China (382 AD patients and 426 normal individuals) and Southwest China (333 AD patients and 334 normal individuals). SNaPshot technique was utilized to analyse the single nucleotide polymorphism (SNP) of rs11743810. A public database was used to explore whether EGR1 gene was differentially expressed in the brain of AD patients and health controls. Then the protein-protein interaction (PPI) assessment was conducted using the STRING database, and the brain eQTL (expression quantitative trait loci) analysis was used to explore the difference in rs11743810 expression between different genotypes in different brain regions. Results: Cross-platform normalized data showed that there was significant difference of EGR1 expression in temporal cortex between AD patients and control subjects (|log2FC|=0.780, P=0.000 before FDR corrected; P=0.001 after FDR corrected). PPI analysis revealed that EGR1 was physically connected with amyloid precursor protein (APP) and clusterin (CLU) protein in the network. However, different genotypes of rs11743810 showed no significant difference in expression in 10 brain regions, and no significant difference in the genotype and allele frequency of rs11743810 between AD patients and controls were found in our two independent samples. Conclusion: The rs11743810 in EGR1 may not be major susceptibility gene site for AD in Han Chinese people.

Objective To detect the type of gene mutation of thalassemia in Kunming city.Methods Sixty-three cases highly suspec-tive of thalassemia were determined with the methods of ploymerase chain reaction(PCR) and reverse dot blot(RDB) for the type of gene mutation.Results According to gene analysis,35 cases were final diagnosed from 63 cases suspective of thalassemia.Among the total,4 cases were gene deficiency ?-thalassemia,and 30 cases were gene deficiency ?-thalassemia,and there was 1 case both ?-thalassemia and ?-thalassemia.There were 9 types of gene mutation with 15 gene combinations in 35 samples.The main type of ?-thalassemia was--SEA/??,there were 6 types with 11 gene combinations from the types of genes of ?-thalassemia,the highest incidence of gene mutation was 17 site,including 17 site homozygote,heterozygote and double heterozygote.Conclusions The thalassemia invasion of Yunnan has its characters,and it is valuable to launch further research.In the same patient,there are ?-thalassemia and ?-thalassemia,it signifies that those 2 types should be diagnosed in the same time,to prevent missed diagnosis.