As a special type of subarachnoid hemorrhage,the prognosis of non-aneurysmal perimesencephalic subarachnoid hemorrhage (NAPSAH) is good.In recent years,with the development and popularization of neuroimaging technology,people have gradually deepened the awareness of the disease.This article reviews the progress in the diagnosis and treatment of NAPSAH.

Projections from substance P (SP)-and cholecystokinin (CCK) containing neurons in the periaqueductal gray(PAG)and Edinger-Westphal(E-W)nucleus to the spinal cord were studied by means of the combining method of HRP tracing with immunocytochemistry in rats. The results showed that a few neurons in the ventrolateral region of PAG projected bilaterally to the cervical, thoracic and lumbar segments of the spinal cord, with the predominant projections from the ipsilateral side. The authors reported that these descending projection neurons showed SP-like immunoreactivity for the first time(account for 48%). The neurons of E-W nucleus projected diffusely to all segments of the spinal cord contained SP (70%) or CCK (73%) respectively, suggesting that at least a part of E-W neurons projecting to the spinal cord contain both SP and CCK.

BACKGROUND:Knee osteoarthritis can be treated by total knee arthroplasty. To improve therapeutic effect and promote postoperative recovery, we should take effective measures to improve the joint space and postoperative range of motion.
OBJECTIVE:To explore the effectiveness and feasibility of posterior composite release of the knee joint after total knee arthroplasty.
METHODS:118 knee osteoarthritis patients undergoing unilateral total knee arthroplasty in two hospitals from December 2009 to December 2013 were selected, and were randomly divided into control group (59 cases) and observation group (59 cases). After osteotomy during operation, the control group underwent bone removal of conventional condylar hyperplasia. Observation group underwent posterior composite release of the knee joint. Postoperative extension, flexion gap and the time required for postoperative active flexion 90° and 120° were observed in the two groups. Hospital for Special Surgery Knee Score and maximum flexion angle were recorded in 3 months of fol ow up, and compared between the two groups. RESULTS AND CONCLUSION:Through the statistics and comparison, no significant difference in flexion gap was found between the two groups (P>0.05). However, significant differences in extension gap, the time for active flexion 90° and 120°and the maximum flexion angle were detectable between the two groups, and above indexes were better in the observation group than in the control group (P<0.05). Hospital for Special Surgery Knee Score of each index and total score were significantly higher in the observation group than in the control group (P<0.05). These results suggest that rear joint composite release after total knee arthroplasty has certain validity and feasibility, can effectively improve knee extensor gap and the postoperative range of motion during replacement, but does not impact flexion gap during replacement.

The relationship between CCK-and VP-neurons in the rat retrochiasmatic area was studied at ultrastructural level by means of pre-embedding(PAP) double immunoelectron microscopic labeling technique. First, the VP-immunoreactivity was demonstrated by DAB method. After thoroughly washing, the CCK-immuno- reactivity was revealed by ammonium molybdate-TMB method. Being stabili- zed by DAB-cobalt chloride, the sections were embedded in Epon 812. Under ele- ctron microscope, it was observed that in the retrochiasmatic area, the VP-LI products distributed diffusely as high electron dense granular or flocculent depo- sits, whereas the CCK-LI products distributed sparsely as needle-or mass-like deposits. VP-LI perikarya were small in size with oval shape and CCK-LI peri- karya were medium in size with polygonal shape. CCK-LI perikarya and dendri- tes received afferent synapses from non-CCK- and non-VP-axonal terminals VP- LI axons received afferent synapses from VP and non-VP-axonal terminals It was interesting that the VP-LI axonal terminals formed efferent axoaxonic syna- pses with CCK-LI axonal endings and, vice versa, the CCK-LI axonal terminals established also efferent axoaxonic synapses with VP-LI axonal endings. The above mentioned results identified for the first time that in the rat retrochiasma- tic area not only there were CCK- and VP-neurons, but also there were reciprocal synaptic regulations between above two kinds of peptidergic neuron, providing new ultrastructural basis for the regulatory mechanism of the neuroendocrine in hypothalamus.

In order to clarify the regulatory mechanism of the neurohormone releasing in the neurohypophysis, the immunohistochemical and chemical lesion method were combined to demonstrate the vasopressin (VP)-and catecholamine (CA)-containing nerve terminals, and their distribution and relationship were observed under electron microscopic level. The results showed that in the rat neurohypophysis there were not only widely distributed VP nerve terminals, but also there were many 6-OHDA induced degenerated nerve endings. The close relationship even synapse-like contacts existed between the CA-ergic endings and pituicytes as well as microglial cells. It was very interesting that the CA-ergic boutons formed axoaxonic synapses with VP-containing boutons. In this case, the CA-bouton was presynaptic element whereas the VP-bouton served as postsynaptic element. The above mentioned results probably provided ultrastructural evidence for the regulatory mechanism of the neurohormone releasing in the neurohypophysis for the first time.

Using immunoelectron microscopic technique the SPergic autoregulatory synapses in the nucleus raphe magnus were studied. The results showed that there were SPlike perikarya and nerve fibers. The positive perikarya mainly were large polypolar cells. The positive fibers appeared as beaded-like and formed axodendritic synapses with SP-positive dendrites besides synapses formed with SP-negative structures. In the autoregulatory synapses the pre- and postsynaptic element were both labeled with immunoreactive products which precipitated at the periphery of small clear synaptic vesicles and the dendritic tubes, on the outer membrane of mitochondria, and in the cytoplasmic matrix. The pre- and postsynaptic membrane were symmetrical, and the synaptic vesicles aggregated near the presynaptic membrane. The synaptic cleft was about 20 nm in width and contained electron dense materials. The generality, structural characteristics and functional significance of the autoregulatory sysnapses were discussed.

Objective To summarize the causes of death and to analyze the risk factors in a surgical intensive care unit (SICU).Methods The relevant information of patients died in the SICU of Xijing Hospital of Fourth Military Medical University in past 15 years (from December 1999 to February 2015) was retrospectively analyzed.The gender,age, reason and date of hospitalization, date of transfer SICU, past medical history, whether or not admitted directly from emergency department, or transferred from other department, operated or not, date of death, the main cause of death, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, the history of undergoing mechanical ventilation, continuous renal replacement therapy (CRRT), or antifungal therapy, as well as the ratio of the patients with body temperature higher than 39 ℃, white blood cell (WBC) count higher than 10 × 109/L, platelet (PLT) count below 100 × 109/L, albumin (Alb) below 35 g/L of two periods, namely from December 1999 to July 2007 (the first period),and from August 2007 to February 2015 (the second period) were compared.The above parameters were compared with those of 201 survivors in SICU, and the risk factors leading to death were analyzed by logistic regression.Results From December 1999 to February 2015, 4 317 patients were taken care of in the SICU.Among them, the number of death was 186, and the mortality rate was 4.3％.In the first time period (from December 1999 to July 2007), the total number of patients was 1 356, and the number of death were 109 (the mortality rate was 8.0％).In the second period, i.e.from August 2007 to February 2015, the number of SICU patients was 2 961, and 77 died (the mortality rate was 2.6％).The difference of mortality rate between the two periods was statistically significant (x2 =66.707, P =0.001).The death rate of patients transferred directly from emergency department in tle first period was 79.8％ (87/109), and it was lower in the second period (51.9％, 40/77, x2 =16.181, P =0.001).The death rate of the patients with blood Alb below 35 g/L in the second period (59.7％, 46/77) was higher than that of the first period (41.3％, 45/109, x2 =6.151, P =0.017).The top three causes of death from December 1999 to February 2015 were sepsis (38.2％), trauma (16.7％), and operation for cancer (14.0％).In the first period, the top three causes of death were sepsis (35.8％), trauma (22.0％),and operation for cancer (13.8％).In the second period, the top three causes of death were sepsis (41.6％), damage of the central nervous system (16.9％), and operation for cancer (14.3％).Top three reasons for SICU admission were trauma (29.03％), abdominal pain (20.97％) and other reasons (18.82％).Top three departments from which the patients were transferred were the emergency department (19.35％), orthopedics department (17.20％), and hepatobiliary department (16.13％).Logistic regression analysis showed that age [odds ratio (OR) =2.025, 95％ confidence interval (95％CI) =1.500-2.734, P =0.000], mechanical ventilation (OR =3.514, 95％CI =1.701-7.259, P =0.001), CRRT (OR =5.604,95％CI =3.003-10.459, P =0.000), body temperature higher than 39 ℃ (OR =1.992, 95％CI =1.052-3.771, P =0.034) were the risk factors of death in SICU patients.Conclusion Sepsis and severe trauma are the leading causes of death in severe SICU patients, to whom with risk factors of death enough attention should be given.

Objective To investigate the effects of α7 nicotinic acetylcholine receptor (α7nAChR) on the inflammatory response induced by lipopolysaccharide (LPS) in RAW264.7 macrophages and its molecular mechanisms. Methods RAW264.7 macrophages were culturedin vitro. Inflammatory cell model was constructed by LPS stimulation. Cells were challenged by LPS (1, 10, 100 and 500μg/L) for 5 hours or 100μg/L LPS for 0, 2, 4, 8, 12, 24, 48 and 72 hours, and the release of tumor necrosis factor-α (TNF-α) was detected by the enzyme linked immunosorbent assay (ELISA). The location of α7nAChR was examined in RAW264.7 macrophages by immunofluorescence. Then the cell proliferation and toxicity kit (CCK-8) was used to detect 1, 10, 100, 1000μmol/L GTS-21, a α7nAchR agonist, on the cell viability after LPS stimulation. ELISA was used to detect 1, 10, 100, 1000μmol/L GTS-21 on the levels of TNF-α, interleukin 1β (IL-1β) after LPS stimulation. Cells were challenged with 100μg/L LPS and 100μmol/L GTS-21, then, the level of high mobility group box 1 (HMGB1) was detected by Western Blot and the intracellular location of HMGB1 and nuclear factor-κB p65 (NF-κB p65) was tested by immunofluorescence.Results LPS increased the level of TNF-α to a peak at the concentration of 100μg/L and at 24 hours after stimulation. Theα7nAChR expressed on the macrophages. The cell viability was decreased in a dose-dependent manner [(96.2±1.0)%, (92.0±1.1)% vs. (86.5±2.2)%, bothP < 0.05]. Compared with the control group, the levels of TNF-α and IL-1βin the supernatant of LPS group were significantly increased [TNF-α (ng/L): 453.0±60.6 vs. 100.8±3.2, IL-1β(μg/L): 8.21±0.31 vs. 0.87±0.16, bothP < 0.05]. TNF-α and IL-1β were significantly decreased by 10μmol/L and 100μmol/L GTS-21 in a dose-dependent manner [TNF-α (ng/L): 227.5±17.5, 81.0±8.8 vs. 453.0±60.6;IL-1β (μg/L): 4.86±0.72, 2.32±0.45 vs. 8.21±0.31, allP < 0.05]. GTS-21 significantly reduced the expression of HMGB1 which was induced by LPS management (gray value: 0.788±0.130 vs. 2.061±0.330,P < 0.05) and reversed LPS-induced HMGB1 cytoplasmic transfer. GTS-21 also reversed LPS-induced nuclear translocation of NF-κB p65. Conclusion GTS-21 reduces the inflammatory response via inhibiting the activation of NF-κB.

Avian influenza virus H6N1 subtype has been circulating in aquatic bird and terrestrial bird,and is the most frequently detected subtype of influenza A virus in those hosts.Genetic analysis results suggested that this virus might be the progenitor of the highly pathogenic avian influenza H5N1 virus,as seven of eight gene segments of those viruses had a common source.As continuing evolution of H6N1,it could spread across species barriers to mammals and had strong infection ability in mice,swine and ferrets.Serological epidemiological survey showed that a few people were positive for H6 avian influenza virus antibody and then the world's first human infection with influenza virus H6N1 subtype was reported in May 2013.Therefore,with the expansion of the host range of the virus,gene mutation and gene reassortment of H6N1 virus can occur in these hosts,and then it may evolve into novel variant strain with infected human potential.

This paper introduces the means and characteristics of signal acquisition of the non-contact life parameters detection system as well as the design of preprocessor circuit.The results show that the preprocessor is designed reasonably,which can provide the computer with high quality signals.