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.

Objective To explore the expression and effect of transforming growth factors-β1 (TGF-β1) and heat shock protein (HSP47) on gluteal muscle contracture (GMC). Methods We collected contraction band and adjacent muscle from GMC patients and explored the expression of TGF-β1 and HSP47 using immunohistohemistry, reverse transcription and polymerase chain reaction (RT-PCR), and Western blot analysis. Results TGF-β1 and HSP47 were intensely expressed in fibroblast cells and vascular endothelial cells. The expression of them increased 8.1-fold and 3.6-fold at the mRNA level, respectively (P<0.05). The same changes were found at the protein level, which increased 11.2-fold and 7.6-fold, respectively (P<0.05). Conclusion Up-regulation of TGF-β1 and HSP47 may initiate fibrotic cascade in the gluteal muscles of GMC patients.

BACKGROUND:Previous study has found that hsa-miR-182 is probably related to the apoptosis-related genes such as cytochrome C (Cycs C) and calcineurin subunit CnB (PPP3R1) in nucleus pulposus cells.
OBJECTIVE:To determine whether miR-182 plays a regulatory role in nucleus pulposus cel apoptosis by detecting the relative gene expression levels after transfecting miR-182 with Cycs C and PPP3R1 into nucleus pulposus cel s via plasmid delivery.
METHODS:After a bioinformatics prediction about miR-182, miR-182 and target genes were transfected into the nucleus pulposus cel s, and at the same time, blank control group was established. Then the expression levels of the target genes were detected through cel lysis.
RESULTS AND CONCLUSION:miR-182 significantly inhibited the expression of Cycs C in nucleus pulposus cel s compared with the blank control group (P<0.05). Compared with the blank control group, miR-182 made no inhibitory effect on the expression of PPP3R1. These findings suggest that miR-182 may play a regulatory part in nucleus pulposus cel apoptosis by inhibiting the expression of Cycs C.

Objective: To investigate the experience of patients in the implementation of enhanced recovery after surgery (ERAS) strategy after radical gastrectomy and the factors affecting the treatment experience. Methods: A prospective cohort study was carried out. Patients who were diagnosed with gastric cancer by pathology and underwent radical gastrectomy at the Xijing Digestive Disease Hospital from December 2019 to December 2020 were consecutively enrolled. Those who received emergency surgery, residual gastric cancer surgery, preoperative neoadjuvant chemotherapy, non-curative tumor resection, intraperitoneal metastasis, or other malignant tumors were excluded. Patients' expectation and experience during implementation were investigated by questionnaires. The questionnaire included three main parts: patients' expectation for ERAS, patients' experience during the ERAS implementation, and patients' outcomes within 30 days after discharge. The items on the expectation and experience were ranked from 0 to 10 by patients, which indicated to be unsatisfied/unimportant and satisfied/important respectively. According to their attitudes towards the ERAS strategy, patients were divided into the support group and the reject group. Patients' expectation and experience of hospital stay, and the clinical outcomes within 30 days after discharge were compared between the two groups. Categorical data were reported as number with percentage and the quantitative data were reported as mean with standard deviation, or where appropriate, as the median with interquartile range (Q₁, Q₃). Categorical data were compared using the Chi-squared test or Fisher's exact test, where appropriate. For continuous data, Student's t test or Mann-Whitney U test were used. Complication was classified according to Clavien-Dindo classification. Results: Of the included 112 patients (88 males and 24 females), aged (57.8±10.0) years, 35 patients (31.3%) were in the support group and 77 (68.7%) in the reject group. Anxiety was detected in 56.2% (63/112) of the patients with score >8. The admission education during the ERAS implementation improved the patients' cognitions of the ERAS strategy [M(Q₁, Q₃) score: 8 (4, 10) vs. 2 (0, 5), Z=-7.130, P<0.001]. The expected hospital stay of patients was longer than the actual stay [7 (7, 10) days vs. 6 (6, 7) days, Z=-4.800, P<0.001]. During the ERAS implementation, patients had low score in early mobilization [3 (1, 6)] and early oral intake [5 (2.25, 8)]. Fifty-eight (51.8%) patients planned the ERAS implementation at home after discharge, while 32.1% (36/112) preferred to stay in hospital until they felt totally recovered. Compared with the reject group, the support group had shorter expected hospital stay [7 (6, 10) days vs. 10 (7, 15) days, Z=-2.607, P=0.009], and higher expected recovery-efficiency score [9 (8, 10) vs. 7(5, 9), Z=-3.078, P=0.002], lower expected less-pain score [8 (6, 10) vs. 6 (5, 9) days, Z=-1.996, P=0.046], expected faster recovery of physical strength score [8 (6, 10) vs. 6 (4, 9), Z=-2.200, P=0.028] and expected less drainage tube score [8 (8, 10) vs. 8 (5, 10), Z=-2.075, P=0.038]. Worrying about complications (49.1%) and self-recognition of not recovery (46.4%) were the major concerns when assessing the experience toward ERAS. During the follow-up, 105 patients received follow-up calls. There were 57.1% (60/105) of patients who experienced a variety of discomforts after discharge, including pain (28.6%), bloating (20.0%), nausea (12.4%), fatigue (7.6%), and fever (2.9%). Within 30 days after discharge, 6.7% (7/105) of patients developed Clavien-Dindo level I and II operation-associated complications, including poor wound healing, intestinal obstruction, intraperitoneal bleeding, and wound infection, all of which were cured by conservative treatment. There were no complications of level III or above in the whole group after surgery. Compared with the support group, more patients in the reject group reported that they had not yet achieved self-expected recovery when discharged [57.1% (44/77) vs. 22.9% (8/35), χ²=11.372, P<0.001], and expected to return to their daily lives [39.0% (30/77) vs. 8.6% (3/35), χ²=10.693, P<0.001], with statistically significant differences (all P<0.05). Only 52.4% (55/105) of patients returned home to continue rehabilitation, and the remaining patients chose to go to other hospitals to continue their hospitalization after discharge, with a median length of stay of 7 (7, 9) days. Compared with the reject group, the support group had a higher proportion of home rehabilitation [59.7% (12/33) vs. 36.4% (43/72), χ²=4.950, P=0.026], and shorter time of self-perceived postoperative full recovery [14 (10, 20) days vs. 15 (14, 20) days, Z=2.100, P=0.036], with statistically significant differences (all P<0.05). Conclusions: Although ERAS has promoted postoperative rehabilitation while ensuring surgical safety, it has not been unanimously recognized by patients. Adequate rehabilitation education, good analgesia, good physical recovery, and early removal of drainage tubes may improve the patient's experience of ERAS.
Enhanced Recovery After Surgery ; Female ; Gastrectomy ; Humans ; Length of Stay ; Male ; Pain ; Patient Outcome Assessment ; Postoperative Complications/surgery* ; Prospective Studies ; Retrospective Studies ; Stomach Neoplasms/surgery* ; Treatment Outcome

Objective To investigate the changes of plantar pressure distributions in children with the unilateral developmental dysplasia of the hip (DDH) who underwent the Pemberton’s pericapsular osteotomy (PPO) at early age, so as to provide valuable references for clinical therapy and rehabilitation of such patients. Methods Eighteen child patients who underwent PPO before 4 year old were selected as the PPO group, while 18 healthy children at the same age with normal feet were selected as the control group. Footscan system was used to measure the plantar pressure of these subjects during walking. The parameters, i.e. contact area percentage of the total foot contact area (CA%), pressure-time integral (PTI) and contact time percentage of the stance time (CT%) in both PPO group and control group were compared to evaluate changes of the plantar pressures during walking. Results Compared with the sound limb in control group and the unaffected limb in PPO group, the affected limb in PPO group showed higher PTI in the 2nd to 5th toe zone and lower PTI in the medial heel zone. The affected limb in PPO group had a higher CA% in the 4th and 5th metatarsals than the unaffected limb in PPO group and the sound limb in control group, and a lower CA% in the 1st and 2nd metatarsals than the unaffected limb. Compared with the unaffected limb in PPO group and the sound limb in control group, CT% of the affected limb in PPO group increased in the forefoot push-off phase and decreased in the initial contact phase, and the total contact time of the affected limb was shorter than that of the unaffected limb in PPO group and the sound limb in control group. Conclusions There exist residual plantar pressure deviations during walking in DDH patients following PPO at early age, thus a longer period of intensive rehabilitation may be required to change the residual abnormality.

Objective To construct 3D finite element model of the thoracolumbar spinal cord, and study the mechanism of spinal cord injury caused by burst fracture through biomechanical experiments. Methods The compression simulation on burst fracture was performed using finite element technology, and the results were verified by comparing the tested models with the in vivo and in vitro experimental results. Results The strain distribution in white matter of the spinal cord was higher than that in grey matter at the initial stage of burst fracture. As the displacement of bony fragments increased, the strain distribution in grey matter increased subsequently. But when the displacement of bony fragments finally reached the maximum, the strain in white matter was higher than that in grey matter. Conclusions Traumatic severity of the spinal cord during burst fracture is dependent on the posterior encroachment, and the traumatic procedure order for ventral horn (motor function) or dorsal horn (sensory function) of cord tissue also plays an important role in the evaluation. In clinical practice, the patient’s condition can be evaluated more accurately by assessing severity of the spinal motor and sensory functions. Further understanding on strain distribution in the spinal cord during the injury may inspire new strategies for treating or preventing spinal cord injury.

BACKGROUND:We have designed and manufactured a novel artificial cervical vertebra and intervertebral complex (ACVC) which combines the cervical titanium cage with the artificial cervical disc, and also developed the ACVC with a hydroxyapatite biocoating (ACVC-HA). OBJECTIVE:To evaluate biomechanical properties of the joint system, and the role of HA coating in promoting osseointegration and long-term stability. METHODS:Twenty-four goats were randomly divided into three groups and underwent the anterior C2/3 and C3/4 discectomy, and C3 subtotal corpectomy, fol owed by ACVC implantation (group 1) and ACVC-HA implantation (group 2), and given no intervention (black control group), respectively. group. At 12 weeks after surgery, C1-5 samples were col ected to undergo biomechanical tests and histological staining. RESULTS AND CONCLUSION:Prior to the fatigue test, compared with the blank control group, the range of motion and neural zone of groups 1 and 2 in the directions of flexion-extension and lateral bending showed no significant differences, but the above indicators were significantly increased in the direction of rotation (P<0.05). Additional y, the stiffness in al three directions was significantly lower than that in the blank control group (P<0.05). There were no significant differences in the range of motion and neural zone in al directions between groups 1 and 2. Similar results were found after the fatigue test. The histological staining showed that both two implants had good biocompatibility and abradability, but more new bone formed on the ACVC-HA. These results suggest that ACVC can effectively reconstruct the motor function of the cervical spine after decompression. Furthermore, HA coating can markedly improve bone-implant interface to promote osseointegration.

OBJECTIVEStatins inhibit hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase activity and lower total serum cholesterol levels. We investigated the effects of Pravastatin on neuroprotection and neurogenesis in the dentate gyrus (DG), subventricular zone (SVZ) and striatum after cerebral ischemia in rats.

METHODSThe filament method was used for temporary middle cerebral artery occlusion (tMCAO). Pravastatin or saline post-ischemically were administered at subsequent time points: 6 h after tMCAO, and then on every subsequent day up to day 14 after tMCAO. Neurological outcome was investigated by using a neuroscore, the beam balance test and the rotarod test. Cholesterol and triglycerides levels were determined by blood sample analysis prior to sacrifice. Infarct area was calculated by microtubule-associated protein 2 (MAP2) staining. Neurogenesis was evaluated by triple staining with bromodeoxyuridine (BrdU), doublecortin (DCX), and neuronal nuclei (NeuN).

RESULTSCompared with the control groups, Pravastatin treated animals were significantly improved in neurological outcome in rotarod test, with smaller infarct size. Pravastatin increased BrdU-positive cells number in the DG (P = 0.0029) and the SVZ (P = 0.0280) but not in the striatum (P = 0.3929). Furthermore, Pravastatin increased BrdU-labeled DCX positive cells number in the DG (P = 0.0031), SVZ (P = 0.0316) and striatum (P = 0.0073). We also observed a DCX-positive cells stream from the SVZ to the striatum, suggesting a migration route of those immature neurons. No significant differences of total serum cholesterol and triglycerides were observed between groups.

CONCLUSIONThe Pravastatin administration strategy is safe and could promote neurological recovery in ischemic stroke. Pravastatin induces neurogenesis in the DG and SVZ, and increases the number of migration cells in the striatum. These effects are independent of the cholesterol-lowering property of Pravastatin.

Animals ; Brain Ischemia ; drug therapy ; pathology ; physiopathology ; Bromodeoxyuridine ; metabolism ; Cell Count ; methods ; Cell Proliferation ; drug effects ; Disease Models, Animal ; Male ; Microtubule-Associated Proteins ; metabolism ; Neurologic Examination ; methods ; Neurons ; drug effects ; physiology ; Neuropeptides ; metabolism ; Neuroprotective Agents ; therapeutic use ; Phosphopyruvate Hydratase ; metabolism ; Pravastatin ; therapeutic use ; Rats ; Rats, Wistar ; Time Factors

Objective To find out an effective therapeutic method for and observe whether there is any synergistic action or not between fetal spinal cord transplantation (FST) and methylprednisolone (MP).Methods Fifty male adult SD rats were randomly divided into group A,B,C,D and E,10 in each group.Group A was treated with both large dosage of MP and FST,group B with MP only, grop C with FST only and group D without any treatment.Group E served as blank control.Fetal spinal cord was obtained from 14-day pregnant rats .Spinal cord Somatosensory evoked potential (SSEP) examination and behavior observation were performed in 24 hours and in 8 months after treatment By the way of reduced silver staining, the condition of nerve plerosis and regeneration could be observed.Results There were significant differences in the latent period and amplitude of N1 wave in SSEP between group A and group B,C and D (P＜0.05).No obvious behavior changes were found except partial sensory recovery in the left lower limbs in Group A.Histologically,more nerve fibers contacting with branches at injury area could be found in Group A than in Group B,C and D.Conclusion The combination of large dosage of MP and FST can produce synergistic effect in the recovery of the injured spinal cord.

Objective To study the proliferation and apoptosis of endothelia cells in cavernous hemangioma of liver(CHL),and to find their relation with the occurrence and development of CHL.Methods Twenty two CHL speciments of resection or biopsy in our hospital were collected.Another 10 speciments of small blood vessel in portal area of normal liver tissues and 10 speciments of strawberry hemangioma were collected as contrasts .The expression of proliferating cell nuclear antigen(PCNA) was assessed with monoclonal antibody of PCNA by immunohistochemical ABC method.The apoptosis of cells was assessed by end labeling method(TUNEL).Results Proliferation index(PI) of endothelia cells in CHL was 13.27?5.79.There wasn't significant difference from PI of endothelia cells of small blood vessels in portal aera of normal liver(10.85?4.79),while significant difference did exist compared with PI of tumor cells in strawberry hemangioma ( 29.31 ?8.55). Apoptosis index(AI) of endothelia cells in CHL was (3.49?1.36).There wasn't significant difference from AI of endothelia cells of small blood vessels in portal aera of normal liver(2.65?1.06),while significant difference did exist compared with AI of tumor cells in strawberry hemangioma ( 11.38 ?2.66,t=11.18,P