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 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 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.

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.

Objective To fully understand the medicinal plants of Fritillaria L. , the physicochemical properties of starch in two species of Fritillaria L. , F. thunbergii and F. ussurensis. were investigated by means of various analytical methods. Methods The properties of starch in the two different species of Fritillaria L. were compared by X-ray diffraction, scanning electron microscope (SEM) and themogravimetric analysis (TGA). Results The crystal type of starch in the two species of Fritillaria L.was the characteristic B-type which was in consistent with that of potato starch. The degrees of crystallinity of F. thunbergii starch and F. ussurensis starch were about 29.9% and 20.1%, respectively. However,the degree of crystallinity of the potato starch was 44.9%. From the crystallinity degree of the starch in two species of Fritillaria L. , it could be concluded that the content of amylose in F. ussurensis starch was higher than that in F. thunbergii starch. The granule size of the starch in two species of Fritillaria L.ranged from 5 to 40 μm, which were all smaller than that of the potato. The starch granule in two species of Fritillaria L. was in cycloidal or elliptic-shape. It could be concluded that the thermal stability of the starch in two species of Fritillaria L. was different due to the different structures of different starch in various plants by TGA. Conclusion The physicochemical properties of starch in two different species of Fritillaria L. differ a lot due to their geographical origin.

Objective To investigate the effect and prevention of complications of selective posterior enlarged decompression and lateral mass screw fixation for multisegmental cervical spondylotic myelopathy with kyphosis.Methods From January 2008 to January 2011,43 patients with multisegmental cervical spondylotic myelopathy combined with kyphosis,aged from 42 to 74 years (average,59.6 years),underwent selective posterior enlarged decompression and lateral mass screw fixation.The JOA (Japanese Orthopaedic Association) scoring system and Neck Disability Index (NDI) were applied to evaluate the neurological function and axial neck/shoulder pain before and after surgery,respectively.The Ishihara method was employed to measure the cervical curvature index (CI).The expanding and shifting of the spinal cord was calculated in MRI.Results The decompression range was 3 to 5 segments (average,3.91±0.86 segments).All patients were followed up for 20 to 60 months (average,38 months).There were significant differences between preand post-operative JOA score (8.16±1.11 vs.14.31±1.33),CI (7.36％±9.69％ vs.15.30％±3.18％),anteroposterior diameter of the dural sac at the level of maximum stenosis in MRI [(2.92±1.49) mm vs.(6.10±0.89)mm],and NDI score (19.36±8.61 vs.4.90±2.46).The mean spinal cord posterior shift was (4.59±1.20) mm (range,2.97 to 6.68 mm).The complete bone graft fusion was achieved in all patients 3 to 6 months after surgery.No C5 nerve root palsy or instrument failure occurred.Conclusion The selective posterior enlarged decompression and lateral mass screw fixation is effective in treating multisegmental cervical spondylotic myelopathy with kyphosis,which can improve neurological function,recover and maintain the normal cervical curvature,and decrease the incidences of axial symptoms and C5 nerve root palsy

Diterpenes, an important class of natural compounds, are widely distributed in nature. As the valuable diterpenoids continue to be found, diterpene synthase in the course of diterpene synthesis get as much attention as possible. The multiformity of end-product-diterpenoids were also due to the diversity of diterpene synthase. This paper focuses on the advances in recent biosynthesis pathway of diterpene and types, cloning, catalytic mechanism, synthetic biology application.

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.