Objective To observe the interaction between the extreme stress and mild traumatic brain injury in the patients surviving Wenchuan earthquake.Methods Forty survivors in Wenchuan earthquake were selected for the psychological status survey 2-30 days after the disaster,among them 20 survivors were suffering from mild traumatic brain injury,and the remainders were in normal physical conditions.The Symptom Checklist-90(SCL-90),which consisted of 90 items with 5 grades for each item(0-4 grade,grade zero as none and grade 4 as severe),including 9 symptom factors,was adopted to perform the evaluation for all the subjects in both groups,and the subscales were compared.Results Five subscales of SCL-90,including somatization,depression,anxiety,hostility and fear,which averaged 2.12?0.50,1.83?0.60,1.99?0.40,1.80?0.70 and 2.20?0.8,respectively,were significantly increased in mild traumatic brain injury group than that in control group(P0.05).Conclusions Mild traumatic brain injury occurred among survivors of severe earthquakes is strongly associated with psychological problems.A higher incidence of psychological disorder in survivors of earthquake with mild traumatic brain injury indicates that one must be cautious when attributing a health problem to mild traumatic brain injury,since the post-traumatic stress disorder and depression may be the primary problem.The high-risk population with psychological obstacle consists of the survivors with mild traumatic brain injury,and the interactions of both psychological stress and traumatic brain injury may lead to more complex clinical symptoms,so psychotherapy should be emphasized in the treatment of patients with mild traumatic brain injury.

Objective To observe the inhibit effect of triplex forming oligonucleotide (TFO)(platelet-derived growth factor-B chain, PDGF) on tumor growth and angiogenesis in rats with glioma.Methods 1?10~6 C_6 glioma cells with high-flow microinfusion were seed into right caudate putamens of 18 rats by stereotaxic technique. TFO was injected in situ 1 week after glioma cells inoculation. Treat group Ⅰ and treat group Ⅱ received TFO at dose of 1.5 mg/20 ?l and 3.0 mg/20 ?l, respectively. The same doses were given again at 8, 11 and 14th day after glioma cells inoculation. The control group was treated with 20 ?l normal saline at same time like treat groups. Three weeks after glioma cells inoculation, all the rats were killed. The expressions of, PDGF-B, vascular endothelial growth factor (VEGF) and proliferating cell nuclear antigen (PCNA) were detected with microscopic histology.Results The inhibition rate of tumor growth was 66.0% in treat groupⅠand 92.2% in treat group Ⅱ. There was significant difference between the two groups ((P

Objective To study the efficacy and safety of nanometer perfluorocarbon (PFC) in the treatment of hemorrhagic shock, and its role in protecting cerebral cortex nerve cells.Methods Hemorrhagic shock was induced in New Zealand rabbits by arterial bleeding. In the course of the experiment, heart rate, respiratory rate, blood pressure, blood gases, hepatic and renal function, and pathological changes in cerebral cortex were observed. Results The survival rate of animals in the experimental group at 12 hours was higher than that of control group, respiration was deeper and respiratory rate was faster, blood pressure and PaO 2 were significantly higher than that in animals of the control group. There was a tendency of acidosis in the control group. Pupil reflex was more sensitive in the experimental group, and hepatic and renal functions were better in the experimental group than that in control group. Pathological observation showed the cerebral cortex was less damaged in the treatment group than that in control group. Conclusions Nanometer PFC was effective in combating hemorrhagic shock, showing no toxicity to liver and kidney, and it could also be used as an effective neuroprotective agent.

Objective To study the occurrence of the extraintestinal manifestations of inflammatory bowal disease.Methods By the retrospective study,the data of 201 IBD patients was analysed.Results A total of 21.43%of patients with ulcerative colitis(UC) and 15.79% of patients with Crohn's disease(CD) showed at least one kind of EMIs.In UC patients with EIM,the activity of disease was active phase in 89.74% and remassion phase in 10.26%.Tree CD patients were all in active phase. Musculoskeletal manifestation was the most frequent EIM,the second was dermatological manifestation,EIMs involving the genitourinary、thyroid、hepatobiliary were rarely. EN and/or PG and arthritis were more frequent coexisting other EIMs.Conclusion The prevalence of EIM was not rarely.EIM was most common among female and young patients.Arthritis and dermatological manifestations were most frequent of all assessed.The patient could have multiple EIMs and there was a tendency that EIM was more likely among patients in active phase、severe severity and with pancolitis.

Objective To improve the operative outcome of parasagittal meningiomas in central area. Methods Twenty patients with parasagittal meningiomas were treated with microsurgery. Of them, 16 cases were taken DSA exzamination before operation to evaluate the blood supplies of the tumor, compensation of venus return around the tumor after obstruction of the sagittal sinus. During the operation, the parasagittal blood supplies were blocked first, the tumors were resected piece by piece. Rolandic veins, other compensative venous pathways and normal brains around the tumors were protected, and the involved sagittal sinuses were appropriately treated. Results Total removal of the tumor was reached in 17 cases, nearly total removal in 3 cases, no death. Postoperatively, 1 patient developed hemiparesis, 2 had paresis of both lower extremities. No tumor recurrence was found in 13 patients during the follow-up of 3～7 years. Conclusion Using microsurgical techniques in the resection of parasagittal meningioma in central area may improve the percentage of total tumor resection, decrease the injuries of important functional area of the brain, reduce complications and improve survival outcome.

Objective This study analyzes the expression and clinical significance of Gli1 and Gli3 proteins in hepatocellular carcinoma.Methods 36 patients with hepatocellular carcinoma were studied.The expressions of Gli1 and Gli3 in the carcinoma and adjacent non-tumor tissues were detected with immunohistochemical assay,and their correlations with clinicopathological factors were statistically analyzed.Results Expression rates of Gli1 in hepatocellular carcinoma and adjacent nontumor tissues were 75 ％ and 36.1％,respectively.Expression rates of Gli3 in hepatocellular carcinoma and adjacent non-tumor tissues were 58.3％ and 30.6％,respectively.Expression rates of Gli1 and Gli3 in hepatocellular carcinoma were significantly higher than in adjacent non-tumor tissues (P＜0.05),and a positive correlation was found between the expression of Gli1 and Gli3 (r=0.423,P＜0.05).There was no association between the expression of Gli3 and clinicopathological factors such as age,tumor size,tumor differentiation and lymphatic metastasis.The expression of Gll1 was not related witha patient's age and tumor size,hut there were significant associations with tumor differentiation and lymphatic metastasis.Conclusions Therefore,the expression rate of Gli1 was positively correlated with tumor malignancy,which makes the detection of Gli1 and Gli3 valuable for the diagnosis and prognosis of hepatocellular carcinoma.

OBJECTIVETo study the biomechanical change of the craniovertebral junction in conditions of atlas assimilation.

METHODSMimics software was used to process CT data of the craniovertebral junction in a health adult to obtain the three-dimensional reconstruction and the cloudy points of C1, C2 and part of the occipital bone. Then the cloudy points were imported into the Abaqus 6. 8 software to establish the occipito-atlantoaxial finite element model in normal structure. According to the established model in normal structure, the model in conditions of atlas assimilation was set by changing the model parameters. Both models of normal structure and atlas assimilation were loaded with 1. 5 N . m static moment to simulate four motions of flexion, extension, lateral bending and axial rotation respectively. The movement characteristics,joint stress force and ligament deformation was analyzed.

RESULTSUnder 1. 5 N . m moment, in model of atlas assimilation the C1-C2 range of movement decreased from 13. 55° to 11.88° in flexion,increased from 13. 22° to 15. 24° in extension and from 4. 05° to 4. 23° in lateral bending and remained unchanged in axial rotation when compared with the normal model. In flexion movement, the contact force of the atlanto-dental joint increased from 1. 59 MPa to 3. 28 MPa and the deflection of apical ligament, tectorial membrane and alar ligament increased 129. 1%, 157. 6% and 75. 1% respectively when compared with the normal model.

CONCLUSIONSThe normal C1-C2 motion mode is destructed in conditions of atlas assimilation, leading to the changes of the range of movement,joint stress force and the ligament deformation at C1 C2 junction. The atlantoaxial instability will likely occur in flexion motion.

Atlanto-Axial Joint ; physiology ; Biomechanical Phenomena ; Cervical Atlas ; physiology ; Cervical Vertebrae ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Joint Instability ; Ligaments, Articular ; Occipital Bone ; Range of Motion, Articular ; Rotation

Objective To investigate the change of the distribution of peripheral blood lymphocyte subsets,before and after treated by infliximab (IFX) in patients with inflammatory bowel disease (IBD).Methods From September 2008 to January 2013,a total of 20 patients with IBD accepted more than three times of IFX treatment and on time follow-up were collected,11 cases of ulcerative colitis (UC) and nine of Crohn's disease (CD).At same time,20 healthy individuals were enrolled as healthy control group.The efficacy of IFX on patients with UC or CD was evaluated according to Mayo score and simplified Crohn's disease active index (CDAI) before and after treatment.Fasting blood of healthy control group,one day before IFX treatment and in 24 to 72 hours after the third time of IFX injection of IBD patients was collected.The percentage of total T lymphocyte,total B lymphocyte,CD4+ T lymphocyte,CD8+ T lymphocyte and natural killer (NK) cell in lymphocyte was determined by fluorescent labeled monoclonal antibodies and flow cytometry.Independent sample t-test was performed for comparison between two groups.Analysis of variance was for comparison among three groups.Results Three of 11 patients with UC achieved clinical remission,three cases were clinical improved and five cases were ineffectiveness.Among nine CD patients,one achieved clinical remission,six cases were clinical improved and two cases were ineffectiveness.Of UC patients,the percentage of total T lymphocyte before and after treatment ((84.2±8.1) ％ and (82.1±6.2)％),the percentage of CD8+ T lymphocyte before treatment ((40.0± 13.2)％) were all higher than that of healthy control group ((74.7±10.7)％ and (30.5±11.9) ％),while the percentage of NK cell before and after treatment ((5.1±2.8)％ and (7.8±4.3)％) were all lower than that of healthy control group ((13.7 ±7.8)％) and the differences were statistically significant (t=2.540,2.074,2.251,3.464 and 2.063,all P＜0.05).Compared with healthy controls,there were no significant differences in the percentage of total B lymphocyte and CD4+ T lymphocyte of UC patients before and after treatment,the percentage of total T lymphocyte,total B lymphocyte,CD4+ T lymphocyte,CD8+T lymphocyte and NK cell of CD patients before and after treatment (all P＞0.05).Before treatment,there were significant differences among effective treatment group,ineffective treatment group and healthy control group in the percentage of total T lymphocyte,CD8+ T lymphocyte and NK cell (F=4.095,4.571 and 7.432,all P＜0.05),of those there were significant differences between ineffective treatment group ((88.3 ± 8.2) ％,(44.4 ± 11.5) ％ and (4.6 ± 3.2) ％) and healthy control group (t=2.902,2.105 and 3.647,all P＜0.05).Conclusion The percentage of peripheral blood total T lymphocyte and CD8+T lymphocyte increase in active IBD patients with ineffective IFX treatment,however the percentage of NK cell decreases.

Objective To evaluate the accuracy of electromyography (EMG) in localizing the compressed nerve root in lumbar intervertebral disc protrusion (LIDP) pre-operatively.Methods Data were collected on 198 cases of LIDP.Of those,152 cases had positive EMG findings and were treated surgically to relieve compression of the nerve roots caused by LIDP.The intra-operative findings were compared with the pre-operative EMG findings.Results The sensitivity of EMG in detecting radiculopathy was 76.8％ (152/198).Among those 152 EMG positive cases,140 were confirmed in the subsequent operation (92.1％),24 clinically suspected cases of single L5 or S1 compression had indicated of both L5 and S1 damage by EMG and subsequently confirmed on surgical exploration.Conclusions Almost all preoperative EMG findings were confirmed in the subsequent operations (92.1％).Moreover,the indication of combined double nerve root damage by EMG was valuable for guiding the surgical procedure.

Objective To discuss the value of amplitude integrated electroencephalographic(aEEG) monitoring in early neonatal brain injury and prognosis of asphyxia neonatal.Methods Seventy-two subjects of asphyxia children were divided into mild asphyxia group and severe asphyxia group.We selected 45 cases of full-term healthy children born in our hospital as control group in the same term.All the objects were observed by aEEG monitoring within 6 hours.According to the aEEG results,all the samples were redivided into normal aEEG group,mildly abnormal aEEG group and severely abnormal aEEG group.All subjects were followed-up to observe their physical growth and the nervous system development at one-year-old.Results Incidence of abnormal aEEG in mild asphyxia group and severe asphyxia group was significantly higher than that of control group(x2 =26.996,47.07,P ＜ 0.01,respectively),and incidence of abnormal aEEG in severe asphyxia group was significantly higher than that of mild asphyxia group (x2 =7.76,P ＜ 0.05).There was no significant difference in all subjects about physical development (height and weight) (P ＞ 0.05),all of their mental index and developmental quotient were lower in severely abnormal aEEG group (x2 =13.450,15.285,P ＜ 0.01,respectively).Conclusion aEEG can be used to assess the early neonatal brain injury of asphyxia neonatal,and it can be used to predict the prognosis of neonatal asphyxia based on the abnormal degree of aEEG.