Objective To explore specific risk factors in the early seizures after acute moderate and severe head injuries and understand incidence of nonconvulsive status epilepticus (NCSE) under coma. Methods Eighty-six patients with acute moderate and severe head injuries were monitored with video-electroencephalogram (video-EEG) for one week. Results (1) Of all, 7 cases (8.14%) had clinical seizures and 6 (6.98%) NCSE. (2) In patients with severe head injuries especially intracranial hemorrhage, post-traumatic seizures especially NCSE were more likely to occur, with no significant difference in sex and age. Conclusions Severe and critical head injuries and intracranial hemorrhage are specific risk factors for early post-traumatic seizures, especially NCSE. After brain injury, EEG should be used to evaluate traumatic coma even if clinical seizure does not appear.

Objective To explore the effectiveness of bilevel positive airway pressure(Bipap)ventilation via nasal/ mouth mask in patients with respiratory failure secondary to the acute exacerbation of chronic obstructive pulmonary diseases(COPD).Methods 40 patients were randomly submitted either to standard therapy(consisting of medical,oxygen and physical therapy)plus BiPAP or to standard therapy.Clinical manifestation were comparatively analyzed before and after 4 hours and 7 days of treatment in each group.Results After 4 hours and 7 days of treatment by BiPAP,patients showed a significant improvement in PaCO_2,and clinical manifestation,and there was a significant difference between the two groups.Conclusion Bipap ventilation is effective in patients with respiratory failure during acute exacerbation of COPD.

Objective To investigate the value of prevention of cerebral ischemia with multi-modality neuroelectrophysiological monitoring in intracranial aneurysm embolization. Methods The clinical data of 44 patients with intracranial aneurysm treated with endovascular embolization from May 2013 to June 2014 were analyzed retrospectively. The patients were divided into two groups according to whether they used intraoperative neuroelectrophysiological monitoring. There were 21 patients in a monitoring group and 21 in a non-monitoring group. According to the site of the aneurysms,somatosensory evoked potential ( SEP),motion evoked potential( MEP),scalp electroencephalogram,and brainstem auditory evoked potential (BAEP)were monitored,and at one day after procedure,their newly developed neurological deficits and the follow up observation after 3 months in both groups were compared and analyzed. Results The intraoperative SEP,MEP,and scalp EEG changes in the monitoring group were observed in 9,3 and 4 patients,respectively. Timely preventive measures were taken for 9 of the patients with cerebral ischemia revealed by neuroelectro-physiological monitoring. At the first day after procedure,the incidence of patients with new neurological deficit was 17. 4%(4/23)in the monitoring group,and that was 47. 6%(10/21)in the non-monitoring group. There was significant difference between the 2 groups(χ2 =4. 623;P<0. 05). There was significant difference in the good prognosis rates(87. 0%[20/23]vs. 57. 1%[12/21])after 3-month follow-up (χ2 =4. 919;P<0. 05)between the 2 groups. There were no deaths in both groups. Conclusion Multimode in combination with neuroelectrophysiological monitoring may decrease ischemic complications in aneurysm interventional treatment and improve the safety of procedure.

[Objective]To verify the clinical outcome of cervical arthroplasty in the treatment of spondylotlc myelopathy exclusively.[Method]From January 2004 to August 2003,twelve spondylotic myelopathy patients who underwent cervical arthroplasty were included in this study.Preoperative and final follow-up Nuriek grade,Oswestry neck disability index(ONDI)score,neck and arm pain VAS score of patients were recorded and compared.Surgical outcome was also measured using odom' s criteria.[Result]100% of patients had good or excellent outcomes using Odom' s criteria,while the final follow-up Nurick grade,ONDI score,neck and arm pain VAS score were improved significantly compared with the preoperative valule.[Conclusion]Cervical arthroplasty is effective in the treatment of spinal cord compression secondary to spondylotic disease with interveterbral movement being preserved.

Objective To evaluate the middle and short-term effects of integrative cognitive training on mild cognitive impairments(MCI).Methods All the participants with MCI aged over 70 years were selected from one sub-district of Putuo District,Shanghai and divided into cognitive intervention group (n=46) and control group (n=35).The integrative cognitive training was conducted in 24 sessions for 12 weeks.All subjects were assessed by Neuropsychological Test Battery for Elderly (NTBE) and by a questionnaire of Shanghai Health Survey for the Elderly (VER2006)at baseline,follow-up and one-year follow up phases.Results At baseline phase,semantic relations test in NTBE was better (t=2.13,P=0.037),verbal fluency test (vegetables) in NTBE was worse(t =-2.25,P=0.038) in intervention group than in control group,while there were no significant differences in scores of other neuropsychological tests between intervention group and control group(all P＞0.05).At follow up phase,16 subscales in reasoning test of NTBE were improved (t=-2.70,P=0.010)and 2 subscales were declined in cognitive intervention group(all P＜0.05).9 subscales in semantic relations test of NTBE (t=-2.27,P=0.013) were improved and 5 subscales were declined in control group (all P＜ 0.05).Comparison between groups at one year follow-up showed that 5 subscales in reasoning test of NTBE (F=16.80,P=0.000) were better in intervention group than in control group(all P＜0.05).General linear model (GLM) with repeated measures at three time points showed that 4 subscales in reasoning test of NTBE had a time-by group interaction (F=5.16,P=0.01).Conclusions Integrative cognitive training can improve cognitive function in patients with mild cognitive impairments,and the validity of reasoning ability can sustain one year.

ObjectiveTo investigate the clinical significance of posterior spinal cord shifting after two different types of laminoplasty for multilevel cervical myelopathy.Methods From June 2004 to September 2007,65 patients with cervical spondylotic myelopathy were reviewed in this study,including 41 males and 24 females with an average age was 56.3 years(range,39-75).Among them,33 patients underwent selective laminoplasty and 32 patients underwent open-door laminoplasty.There were no significant differences of preoperative JOA scores and cervical curvature index between two groups.After one year follow -up,the posterior shifting of spinal cord,Japanese Orthopaedics Association (JOA) recovery rate,loss of curvature index and axial symptom for each patient were calculated.ResultsAll cases were followed up for average 34 months(range,26-47).There was significant difference of the postoperative posterior shifting between the two groups,which was(1.4±0.6) mm in selective laminoplasty group and(3.3±1.2) mm in opendoor laminoplasty group,respectively.The average JOA recovery rate was 60.5％±21.3％ and 61.1％±17.9％ in selective laminoplasty and open-door laminoplasty group,respectively.There was no significant difference of JOA recovery rate between the two groups.Loss of cervical curvature indices was 3.3％±1.7％ and 3.1％± 2.4％ in selective laminoplasty and open-door laminoplasty group,respectively,with no significant difference between the two groups.The rate of patients with evident axial symptoms was 18.2％ and 33.3％ in selective laminoplasty group and open-door laminoplasty group,and the difference of the scores of cervical axial symptom was statistically significant.ConclusionThe degree of the postoperative posterior shifting of the spinal cord in open-door laminoplasty group was greater than that in selective laminoplasty group.The posterior shifting of the spinal is correlated with cord,axial symptom but not the recovery rate and curvature index.

Objective To evaluate the effects of compositive cognitive training on reasoning ability for healthy community elderly.Method All the participants were selected from one district in Shanghai by every 50 samples.151 community healthy elderly who accorded with the standard were collected at last.They were divided into cognitive intervention group ( n =90) and control group ( n =61 ) by sequence.The interventions ( includes reasoning,memory training,et al) were conducted in 24 sessions over 12 weeks.All individuals were assessed by Neuropsychological Test Battery for Elderly (NTBE) at baseline,follow-up,half a year follow-up and one year follow-up phase,and Raven' s Standard Progressive Matrices on reasoning classes.Results The scores of Raven' s Standard Progressive Matrices were significantly higher after reasoning training in intervention group( (15.54 ±5.70),(10.35 ± 5.10),t =3.595,P ＜ 0.01 ).Compared with baseline,the reasoning test scores of NTBE were significantly higher after cognitive intervention in treatment group at follow-up phase,and were also significantly higher than control group (P ＜ 0.05 or P ＜ 0.01 ).Conclusion Results support the effectiveness of compositive cognitive training in improving reasoning ability are positive,and can last for one year.

Objective To investigate the chemical constituents of Lappula echinata and determine the antibacterial activity.Methods A new quinolone alkaloid was isolated from the BuOH extract of L.echinata by silica gel column chromatography and gel column chromatography.Its structure was identified by 1H-NMR, 13C-NMR, 2D-NMR, HR-MS, UV, and IR spectral data analysis.Its antibacterial activity was determined by KB method.Results A new quinoloe alkaloid named 8-methoxy-4-quinolone-2-caboxylic acid was isolated from L.echinata and was found to have antibacterial activity on Pseudomonas pyocyanea ATCC 27853, EPEC O111, pneumobacillus and Staphylococcus epidermidis.Conclusion This is a new compound with antibacterial activity.

BACKGROUND: Applying naloxone in acute brain injury can sustain the cerebral perfusion pressure(CPP), alleviate the cerebral edema and prevent the secondary brain damage to a certain degree. But the dosage and the administration of naloxone in clinical practices vary substantially according to the literatures.OBJECTIVE: To investigate the effect of different doses of naloxone on the changes in the absolute power values of electroencephalography(EEG) in acute brain injury, and study the protective effects of naloxone at different doses.DESIGN: Case-control study based on patients.SETTING: Neurosugery department of a hospital affiliated to a university PARTICIPANTS: From January 2002 to April 2003, at the Intensive Care Unit(ICU) of theNeurosugery Department of the First Hospital Affiliated to the Chongqin Medical University, 86 patients with moderate or severe acute closed brain injury were selected. Of all the patients, 59 were male and 27 were female, aged between 18 - 65.METHODS: According to the degree of injury graded by Glasgow Coma Scale(GCS), the 86 patients bearing acute brain injury were divided into 3 groups: GCS 3 - 5 group, GCS 6 - 8 group and GCS 9 - 12 group. Each group contained a naloxone treatment group and a matched control group. The naloxone treatment group consisted of a low-dose naloxone subgroup and a large-dose naloxone subgroup. The changes in the total power value of EEG before treatment and at the time of 30 minutes, 1, 2, 24, 48, 72 and 120 hours after treatment were measured respectively using quantitative EEG monitor.MAIN OUTCOME MEASURES: The changes in the total power value of the patients' EEG before and after treatment were observed and recorded.RESULTS: The difference between the total power of EEG of the GCS 9 - 12naloxone treatment group 1 hour after a naloxone treatment and that of the matched control group was statistically significant(P ＜ 0.05); The same comparison between the low-dose and the large-dose naloxone subgroups within the GCS 9 - 12 naloxone treatment group yielded no significant difference. In the GCS 6 - 8 naloxone treatment group, the difference between the total power of EEG 1 hour after a naloxone treatment and that of the matched control group was statistically significant, and the large dose subgroup was more significant than the low-dose group. In the GCS 3 - 5 naloxone treatment group, no significant difference between the total power of EEG of the naloxone group and that of the control group could be observed.CONCLUSION: The low-dose naloxone treatment is helpful enough on the intervention for moderate brain injury, and the large-dose naloxone treatment is better than the low-dose on severe brain injury. For the patients with exceptionally severe brain injury, both the two treatments are proved to have no therapeutic effects.