Objective To analyze and evaluate the clinical effect of CT guided percutaneous semilunar ganglion radiofrequency thermocoagulation for treatment of trigeminal neuralgia.Methods 52 patients with trigeminal neuralgia treated in our hospital were selected.They underwent the CT three-dimensional guidance on trigeminal neuralgia Ⅱ,Ⅲ,Ⅱ + Ⅲ neuralgia neuralgia patients with anterior foramen ovale puncture semilunar ganglion,verify the operative target,and a standard radiofrequency target temperature damage under general anesthesia.Results Of the 52 patients,the treatment effect was excellent in 49 cases,good in 1 patient,the effect of other 2 cases was poor,the excellent and good rate was 96.15％.Conclusion CT guided percutaneous puncture semilunar ganglion radiofrequency thermocoagulation in the treatment of patients with trigeminal neuralgia is simple,safe,and easy to be accepted by patients,the cure rate is high,it is worth learning and promotion.

Objective To investigate the efficacy of bundle care under the supervision of professionals in preven-ting ventilator-associated pneumonia(VAP). Methods Patients who received mechanical ventilation between July 2013 and June 2014 in the intensive care unit(ICU)of a hospital were selected,July-December 2013 was as control group (n= 150),patients received bundle care,but without special supervision;January-June 2014 was as special supervision group (n= 177),patients received bundle care under the supervision of professionals,incidence of VAP,duration of mechanical ventilation,and length of ICU stay were compared between two groups. Results In special supervision group,141 patients received invasive mechanical ventilation,mechanical ventilation day were 1937 days,9 patients developed VAP,incidence of VAP was 4.65‰ ;in control group,127 patients received inva-sive mechanical ventilation,mechanical ventilation day were 1965 days,21 patients developed VAP,incidence of VAP was 10.69‰ ,difference was statistically significant between two groups(χ2= 5.68,P= 0.042). In special su-pervision group,overall compliance rate of bundle management strategies,duration of average invasive mechanical ventilation,and length of ICU stay were 94.92% ,(11.11±2.57)days,and(15.11±2.88)days respectively,in con-trol group were 48.67% ,(14.67±4.35)days,and(19.33±5.81)days respectively,difference was statistically sig-nificant between two groups (all P<0.05). Conclusion Bundle care strategies supervised by professionals can ef-fectively prevent the occurrence of VAP,the implementation of bundle care strategies should be set up according to the clinical practice.

Objective To investigate the effects of HO/CO pathway on inflammation cytokines in a rat model of incisional pain. Methods Thirty-six rats were executed to collect ipsilateral spinal cord tissues for HO-1 detection by Western blot assay, and cytokines tumor necrosis factor (TNF)-a, interleukin (IL)-1b, IL-6 and high mobility group box (HMGB)1 were detected by ELISA before and at 1, 4, 8, 12 and 24 h after establishing incisional pain model. Additionally, 36 rats without establishment of incisional pain model were used as control group. A total of 144 model rats of incisional pain were divided into incisional pain (IP) group, IP+hemin group (100 mg/kg hemin was injected by i.p. before operation), IP+Znpp-IX group (45μmoL/kg Znpp-IX was injected by i.p. before operation) and IP+CORM-2 group (10 mg/kg CORM-2 was injected by i.p. before operation). Values of paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were detected, and expressions of TNF-a, IL-1 b, IL-6 and HMGB1 were measured by ELISA before and at 1, 4, 8, 12 and 24 h after operation. Results Compared with pre-operation of incisional pain in rats, expression levels of HO-1 protein and cytokines TNF-a, IL-1 b, IL-6 and HMGB1 were increased at 1, 4, 8, 12 and 24 h after operation (P<0.05). Compared with control group, values of PWMT and PWTL were obviously decreased, and expression levels of IL-1β, TNF-α, IL-6 and HMGB1 were increased at 1, 4, 8, 12 and 24 h after operation in IP groups (P<0.05). Compared with IP groups, values of PWMT and PWTL were significantly increased and cytokines TNF-a, IL-1 b, IL-6 and HMGB1 were decreased at 1, 4, 8, 12 and 24 h after operation in IP+hemin group and IP+CORM-2 group (P<0.05). Values of PWMT and
PWTL were decreased and cytokines TNF-α, IL-1β, IL-6 and HMGB1 were increased in IP+Znpp-IX group (P<0.05). Conclusion Incisional pain can increase the expression of HO-1, and HO-1/CO pathway exists the regulatory effect on inflammatory cytokines in the rat model of incisional pain.

Objective To observe the hemodynamic variations of both the mother and fetus when the pregnancy was complicated with early-onset of severe preeclampsia, and to evaluate the role of monitoring the blood flow with Doppler in the management and prognostic value in the same condition. Methods A prospective case-control study was conducted in 36 pregnant women admitted for early-onset of severe preeclampsia (S-PE). The control group included 72 healthy pregnant women matched with the S-PE group. All had color Doppler sonography monitored during this study period. Data were collected for the umbilical artery (UA) pulsatility index (PI) and systolic/diastolic ratio (S/D) , the middle cerebral artery (MCA) PI and S/D and the maternal mean uterine artery (UtA) PI and S/D. Those subjects with adverse perinatal outcomes were followed up after birth. Results The mean Doppler indices(S/D and PI) of fetal UA, MCA and maternal UtA were all declined gradually with the advancing gestational ages in both groups. The values of UA-S/D, UA-PI, UtA-S/D, and UtA-PI in the early-onset S-PE group were significantly higher than those of the control(P

Objective To evaluate the influence of autophagy on pain behavioristics and astrocytic activation in rats with inflammatory pain.Methods Seventy-eight clean male Sprague-Dawley (SD) adult rats were randomly divided into four groups: control group (n = 12), model group (n = 42), autophagy inducer rapamycin (Rap) pretreatment group (n = 12) and autophagy inhibitor 3 methyladenine (3-MA) pretreatment group (n = 12). The inflammatory pain rat model was reproduced by subcutaneous injection of freund's complete adjuvant (CFA) 100μL at foot sole, whilein control group, the same volume 0.9% normal saline 100μL was injected at the same site. One hour before modeling, Rap 10 mg/kg and 3-MA 15 mg/kg were intraperitoneally injected in rats in Rap and 3-MA pretreatment groups respectively, and the same volume of 0.9% normal saline was injected intraperitoneally in rats of control and model groups. Before modeling and 6, 12, 24 hours and 3 days after modeling, the L4-L6 spinal cord tissue was harvested from 6 rats in model group, and autophagy protein membrane microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ) and autophagy related gene Beclin-1 expressions were detected by Western Blot in the tissue; the changes of pain behavioral indexes mechanical withdraw threshold (MWT) and thermal withdrawal latency (TWL,n = 6), were observed at6, 12, 24 hours and 3 days, 7 days after modeling in the 6 rats taken from each group; in another 6 rats in each group, 24 hours after modeling, L4-L6 spinal cord tissue was collected, immunofluorescence staining was used to observe the changes of astrocytes and the positive expression of glial fibrillary acidic protein (GFAP) under a confocal microscopy, and the protein expression quantity of GFAP was detected by Western Blot in the tissue.Results ① The inflammatory pain could induce the increase of rat autophagy protein LC3Ⅱ and Beclin-1 expressions in spinal cord tissue, reaching their peaks at 24 hours (A value: 0.59±0.07, 0.51±0.06, respectively), and then they were gradually decreased. ② With the prolongation of time, in the model group MWT was gradually decreased, TWL was gradually shortened, they reached their valley values at 24 hours after modeling [MWT (g): 17.8±1.9, TWL (s): 6.8±0.4], and from 12 hours they were significantly decreased compared with those in control group [12hours MWT (g): 21.5±2.4 vs. 43.4±5.1, TWL (s): 12.0±1.1 vs. 17.6±1.2, bothP < 0.05], after modeling for 3 days they were increased; Compared with model group, 12 hours after autophagy inducer Rap was given, MWT was significantly increased (g: 36.8±4.9 vs. 21.5±2.4,P < 0.05), TWL was significantly prolonged (s: 14.3±1.1 vs. 12.0±1.1,P < 0.05); from 12 hours after autophagy inhibitor 3-MA was given, MWT was further reduced (g: 18.6±1.9 vs. 21.5±2.4, P<0.05), TWL was further shortened (s: 8.4±0.6 vs. 12.0±1.1,P < 0.05). ③ Confocal microscopic findings showed, there was no significant acstrocytic change, and only litter GFAP expression was seen in control group. In model group, the inflammatory pain induced astrocyte activation, manifesting glial cell hypertrophy, hyperplasia, gelatinousnetwork deformation, and GFAP expression was obviously increased compared with that in the control group (A value: 0.54±0.09 vs. 0.16±0.02,P < 0.05). Since autophagy inducer Rap can decrease astrocyte activation and inhibit GFAP expression, there was statistical significant difference between Rap pretreatment and model groups (A value: 0.33±0.06 vs.0.54±0.09,P < 0.05); autophagy inhibitor 3-MA can further aggravate astrocytes activation and up-regulate GFAP expression in 3-MA pretreatment group (A value: 0.73±0.08 vs. 0.54±0.09,P < 0.05).Conclusion Autophagy participates in the process of astrocytic activation and pain behavioristics in rats with inflammatory pain.

AIM: To explore the expressions and significance of angiopoietin-2 (Ang-2) and tyrosine kinase with immunoglobulin and epidermal growth factor homology domains-2 (Tie-2) receptors in a rat model of acute lung injury (ALI). METHODS: Wistar rats (n=42) were divided into control group (n=12) and cecal ligation and puncture (CLP) group (n=30). Control group underwent sham operation, and CLP group underwent cecal ligation and puncture to make the model of ALI. 12 h after sham operation or CLP, 6 rats in each group were killed, and arterial blood gas analysis and lung coefficient were tested. The expressions of Ang-2 and Tie-2 receptors in lung tissue were observed by immunohistochemical method. Blood samples of the rest rats were collected from vena caudalis, and Ang-2 levels were measured by enzyme linked immunosorbent assay (ELISA). The mortality rate in each group within 36 h was compared. The lung architecture was observed under microscope. RESULTS: The lung architecture in control group was clear and intact. Alveolar septum was thicker, blood capillary was congested, and neutrophils and macrophages were infiltrated in the lung tissue in CLP group. Tie-2 receptors were expressed in bronchial epithelial cells, smooth muscle cells and endothelial cells in control group. Besides the similar expression as control group, high expression of Tie-2 on neutrophils and macrophages in CLP group was observed. In the adhesion location of Tie-2 receptors positive inflammatory cells, there was stronger staining in endothelial cells. Ang-2 was expressed in smooth muscle cells, bronchial epithelial cells and endothelial cells in control group. The Ang-2 level in CLP group were higher than that in control group [(8.14±1.74) μg/L vs (4.63±0.49) μg/L, P<0.01], and the Ang-2 level of dead rats was higher than that of survival rats within 36 h in CLP group [(8.95±1.61)μg/L vs (6.80±0.96)μg/L, P<0.01]. Oxygen partial pressure in control group was lower (P<0.01) and lung coefficient was higher (P<0.01) than that in CLP group. CONCLUSION: Ang-2 and Tie-2 receptors may participate in the pathophysiology of ALI, and Ang-2 level is correlated with mortality.

BACKGROUND:Xenogeneic bone structure and biological characteristics are similar to human bone tissue, and the xenogeneic bone has a decreased antigenicity after physicochemical treatment, with a natural porous structure and rich source, and can be kept for a long time, which is considered to be an effective way to solve the shortage of the autogenous bone and al ograft bone.
OBJECTIVE:To compare the physical and chemical properties of xenogenic bone materials prepared by two different methods.
METHODS:Sheep cancellous bone treated with chemical method was placed into the muffle furnace at 1 000 ℃for 2 hours to prepare calcined bone. Another cancellous bone was placed into an 80 ℃ refrigerator for 4 weeks and then placed into a vacuum instrument to prepare freeze-dried bone. Cancellous bone rinsed with ultra-pure water served as controls.
RESULTS AND CONCLUSION: Three groups of samples retained three-dimensional porous structure which similar with human bone tissue under microscopic observation. The framework was stil intact, with a smal pore of 55-650μm and high porosity of 65%-80%. For the calcined bone, the toughness was decreased and the brittleness increased significantly, but the freeze-dried bone had a little changes in the mechanical properties. Through diffraction analysis, hydroxyapatite was the main composition of the three groups. However, there was a smal amount ofβ-tricalcium phosphate in the calcined bone. Spectrum analysis confirmed that calcium and phosphorus content in these three groups were al close to the human body. The results suggest the cancellous bone treated with these two methods is similar to human bone structure, and the major elements are close to the body. In addition, the cancellous bone after processing has enough smal pore and higher porosity. However, calcination process has a more influence on the mechanical property of scaffold materials, and the freeze-dried bone has a little change but the antigen cannot be completely removed that can reach the basic requirements.

BACKGROUND:Many in vivo and in vitro experiments indicate that implantation of exogenous basic fibroblast growth factor can significantly promote the process of bone formation, but the in vivo degradation of exogenous basic fibroblast growth factor affects the therapeutic efficacy.
OBJECTIVE:To observe the effects of basic fibroblast growth factor-transfected mesenchymal stem cells which transfected using molecular biology techniques combined with al ogeneic bone in the repair of critical-size bone defects in sheep.
METHODS:Al ogeneic bone with basic fibroblast growth factor-transfected bone marrow mesenchymal stem cells, bone marrow mesenchymal stem cells combined with al ogeneic bone material stents, al ograft bone material,β-tricalcium calcium material were respectively implanted into critical-size bone defects in sheep. After 4, 8 and 12 weeks, histological and immunohistochemical staining was performed.
RESULTS AND CONCLUSION:At 12 weeks after implantation of al ogeneic bone with basic fibroblast growth factor-transfected bone marrow mesenchymal stem cells as tissue engineering bone, there were many cartilage-like structures in the operative binding region and a large amount of osteoblast-like cells in the center of operative region, and there was more material degradation in the entire operative area as compared with other groups;there were fibrous connective tissues ful of the pores, and osteoclast-like cells were commonly seen around the implant material;bone sialoprotein and col agen type Ⅰ expression were strongly positive. In the other three groups, although the cartilage-like structure appeared in the binding region, dead bone structure was found in the central area, and bone sialoprotein and type Ⅰ col agen expression was weak. These findings indicate that al ogeneic bone with basic fibroblast growth factor-transfected bone marrow mesenchymal stem cells can basical y repair critical-size bone defects in sheep.

目的探讨胸腰段椎体骨折脊髓损伤患者康复治疗效果。方法65例脊髓损伤患者，其中T11 3例，T11-12 5例，T12 12例，T12-L1 5例，L1 31例，L2 9例。入院时检查患者感觉损伤平面和运动损伤平面，记录在脊髓损伤积分评定表中，评定日常生活活动能力(ADL)，制订康复计划，进行心肺功能、肌力、二便功能、转移、配戴矫形器站立、行走及ADL指导性训练。结果中途有5例患者脱落。出院后患者ADL等级提高到良30例、中30例。根据ADL变化，显著有效50％，有效50％。步行能力达到社区功能性步行29例，家庭功能性步行31例。结论胸腰段脊髓损伤患者经过系统康复训练，配备支具、使用辅助具，对恢复患者步行能力及ADL水平的提高有满意的效果。

Objective To study the distribution characteristics and drug resistance of non-fermenting bacterial infection in intensive care unit (ICU) at a tertiary hospital during seven consecutive years,and to provide evidence for rational use of antibiotics in ICU.Methods A retrospective analysis was conducted.The related data about non-fermentative bacteria obtained from clinical specimens,collected from lower respiratory tract,blood,urine,bile and other secretions of ICU patients admitted to Binzhou Medical University Hospital from January 2009 to December 2015 were retrospectively analyzed.The distribution characteristics and drug resistance of non-fermentative bacteria,and isolation rate of multiple drug resistance (MDR) strains were analyzed.Results 2 672 strains of nonfermentative bacteria were isolated during seven consecutive years,accounting for 57.9％ gram negative (G-) bacilli (2 672/4 613),and 35.2％ of all bacteria (2 672/7 587).The top five were Acinetobacter baumannii (38.4％),Pseudomonas aeruginosa (34.6％),Onion burkholderia cepacia (9.9％),Stenotrophomonas maltophilia (6.2％),and Pseudomonas fluorescens (5.6％).Non-fermentative bacteria were mainly isolated from the lower respiratory tract (60.9％).Isolation of the non-fermentative bacteria accounted for over 50％ of G-bacilli during seven consecutive years,and the isolation rate of the top five types of bacteria showed no obvious change,while positive rate of Acinetobacter baumannii showed a tendency to increase (obviously from 26.5％ in 2009 to 50.2％ in 2015),and a lowering trend of positive rate of Onion burkholderia cepacia,Stenotrophomonas maltophilia,and Pseudomonas fluorescens was obvious (from 15.6％,10.6％,13.0％ in 2009 to 5.6％,7.4％,1.4％ in 2015 respectively) was observed.The isolation rate of Pseudomonas aeruginosa was stable (about 30％) during seven consecutive years.The drug susceptibility results showed that the resistant rates of Acinetobacter baumannii against imipenem,meropenem,aminoglycosides and third-generation cephalmsporins were all higher than 70％,while its resistant rate to cefoperazone-sulbactam was relatively lower (40.2％-68.1％)with relatively higher sensitivity rate (23.6％-46.0％).In contrast,the resistant rates of Pseudomonas aeruginosa against antibiotics were low,while the sensitivity rate to fourth-generation cephalmsporins cefepime (58.3％-87.7％)and third-generation cephalmsporins was high (ceftazidime:55.6％-79.3％,piperacillin-tazobactam:62.5％-86.2％,cefoperazone-sulbactam:46.0％-89.8％).From 2009 to 2015,the incidence of MDR strains of Acinetobacter baumannii showed an obvious increasing tendency (from 68.0％ to 84.1％);in contrast,the incidence of MDR strains of Pseudomonas aeruginosa did not show an obviously increase in incidence from 2009 to 2012,on the other hand,it showed a decreasing tendency from a peak 68.6％ in 2012 to 23.5％ in 2015.Conclusions The isolation rate of non-fermentative bacteria was high and the drug resistance situation was serious.Therefore,it is important to grasp the knowledge regarding distribution characteristics,drug resistance and variation of non-fermentative bacteria in ICU.It is not only beneficial for both rational use of antibiotics,improve efficacy but also helpful in reducing the emergence of drug resistance stains.