Neonatal mortality has been significantly decreased because of the development of neo-natal respiratory support techniques. Nevertheless,constant and high frequency ventilators have some limita-tions to solve all problems in neonatal respiratory failure. Special mechanical ventilation,mainly including he-liox and partial liquid ventilation,provides new respiratory support for newborn infants. The clinical signifi-cance of heliox and partial liquid ventilation need further investigation.

Objective:To review the inactivation effect of high-voltage pulsed electric field on microorganism to provid theoretical basis for the further research and sterilization application of high-voltage pulsed electric field. Methods:The combination of high-volt-age pulse electric field, microbiology and pulse electric field as the keywords, the research results of high-voltage pulsed electric field on microbial inactivation in PubMed, CNKI, VIP Chinese journal full text database and Wanfang database during 2010 and 2015 were retrieved, summarized and reviewed. Results:As a non-thermal sterilization technology, high-voltage pulsed electric field not only had the characteristics of short sterilization time, narrow increasing extent of temperature and low energy consumption, but also could keep the original flavor of food. Conclusion:With the development of related technology, high-voltage pulsed electric field is expected to re-alize industrialization.

Objective To explore the clinic value and efficacy of color Doppler ultrasound guided percutaneous microwave/radiorequency thermoablation for secondary hyperparathyroidism. Methods Fifty-six cases of secondary hyperparathyroidism who came from nephrology department of Beijing Friendship Hospital in the period of September 2012 to September 2013 were treated by color Doppler ultrasound guided percutaneous microwave/radiorequency thermoablation. One hundred and thirty-eight glands underwent this treatment and were evaluated by contrast enhanced ultrasound before, during and after operation. The levels of serum parathyroid hormone (PTH) were measured before and at 1 week, 1 month, 6 months and 1 year after treatment. Results The whole 56 cases achieved 1 month follow-up and 34 cases and 12 cases achieved 6 months and 1 year follow-up, respectively. Two special cases had been excluded. The PTH levels of 54 cases were signiifcantly different between after and before treatment [(369.5±183.4) ng/L vs (1321.6±471.4) ng/L, t=10.727, P=0.000]. The PTH levels continued to fall at the ifrst week after treatment, but there was no statistical signiifcance between the ifrst week and the ifrst day after treatment [(324.6±172.8) ng/L vs (369.5±183.4) ng/L], while there was signiifcantly different between the ifrst week after treatment and before treatment [(324.6±172.8) ng/L vs (1321.6±471.4) ng/L, t=9.364, P=0.000]. The PTH levels increased from (324.6±172.8) ng/L to (332.5±164.9) ng/L at 1 week and 1 month after ablation, while there was no signiifcant difference.But there is signiifcantly different between 1 month after treatment and before treatment (t=11.348, P=0.000). The PTH level at 6 months after treatment [(205.2±136.3) ng/L] and 1 year after treatment [(177.1±171.5) ng/L] had signiifcant difference compared with the value before treatment (t=8.737, P=0.000; t=7.655, P=0.017). Conclusion Color Doppler ultrasound guided percutaneous microwave/radiorequency thermoablation can be considered as a feasible and effective nonsurgical alternative treatment for secondary hyperparathyroidism patients.

Objective To observe the therapeutically effect of kangnao liquid on Pi3k mRNA and Aktm RNA ex-pressions in rats with focal cerebral ischemia-reperfusion (I/R) injury. Methods 180 male SD rats were randomly divided into 6 groups:sham operated group, model group, three kangnao liquid groups (high-dose, medium-dose and low-dose) and nimodipine group. Rats in kangnao liquid groups were administrated with kangnao liquid of 24 g/(kg · d), 12 g/(kg · d) and 6 g/(kg · d), orally once a day. Rats in nimodipine group were given nimodipine 1 mg/(kg · d). Rats in model group and sham group were treated with the same volume of distilled water for 7 days. The animal model of middle cerebral artery occlusion (MCAO) was established by a monofilament method from right internal carotid artery. The neurological evaluation was per-formed 24 h after reperfusion. The in situ hybridization was used to investigate the expression levels of Pi3k mRNA and Akt mRNA in rats on 12 h, 24 h, 48 h, 72 h and 168 h after ischemia for 2 h. Results Compared with model group, neurological functions were improved significantly in kangnao liquid groups. The expression levels of Pi3k mRNA and Akt mRNA were al-so significantly higher in kangnao liquid groups than those of model group. The expression levels of Pi3k mRNA and Akt mRNA were significantly higher in nimodipine group than those of model group, but which were lower compared with those of high-dose and medium-dose kangnao liquid groups. Conclusion Kangnao liquid can protect nerve cells by enhancing the expressions of Pi3k mRNA and Akt mRNA in rats with cerebral ischemia-reprefusion injury.

Objective To introduce the surgical strategy of enlarged laminectomy (with partial facet joint dissection to expose the nerve root), and to discuss its benefit for cervical ossification of the posterior longitudinal ligament(OPLL) with myelopathy. Methods Totally 82 patients with cervical OPLL were treated by enlarged laminectomy from January 1998 to December 2005. There were 47 males and 35 females, with an average age of 57 years (ranged, 39-84 years). Among them, there were 31 cases of the solitary type, 40 cases of the continuous type, and 11 cases of the mixed type. JOA scoring system and the visual analogue scale (VAS) scoring were applied to evaluate the neurological function and neck/shoulder pain respectively.Ishihara method was employed to measure cervical curvature index(CCI). The degree of spinal cord backward expanding and displacement were calculated in MR1. Results The mean decompression length was 5.2 (4-6) segments. The mean follow-up duration was 41 months (ranged, 13-58 months). JOA score has improved from 10.9(7-15) preoperatively to 13.9(11-17) postoperatively (t=14.65, P＜0.01). The excellent and good rate was 98.7%. The palsy of C5 nerve root occurred in only 2 patients, both recovered after surgery. Zhe mean postoperative VAS score was 1.4(1-3), comparing with the preoperative score of 5.3 (4-6). The pain in neck/shoulder was alleviated obviously (t=15.46, P＜0.01 ). CCI decreased from 18.8% to 10.5%(t=5.03, P＜0.01 ),but did not follow by neuron function deterioration. MRI indicated that the cross-sectional area at the level of maximum compression of the dural sac increased from 85.4 mm2 preoperatively to 153.8 mm2 postoperatively (t=16.33, P＜0.01), and the mean spinal cord posterior shift was 6.2 mm (t=15.35, P＜0.01). Conclusion The enlarged laminectomy is proved to be effective in treating cervical OPLL, in terms of significant posterior shift of the spinal cord, relief of cervical/shoulder pain, lower rate of the palsy of C5 nerve root, with no recurrence of spinal cord compression symptom.

Objective To evaluate the surgical strategy of decompression via posterior-anterior approach and anterior fixation in treatment fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation. Methods This study retrospectively reviewed 37 cases of lower cervical spine fracture with bilateral joints dislocation. There were 21 males and 16 females with an average age of 42 years (19-58). Distraction-flexion stage 3(DFS 3) were found in 24 cases and DFS 4 in 13 cases. All the cases were diagnosed by X-ray, CT and MRI and confirmed during the surgery. Decompression via posterior-anterior approach and anterior fixation had been adapted as the surgical strategy. The NASCIS and IMSOP standard were applied to definite the level of cervical spinal cord injury. The ASIA grading was used for evaluation the spinal cord function and the recovery rate. The X-ray and CT were used to observe reduction and bone fusion. Results The mean operative time was (4.5:±0.5) h, and the mean amount of blood loss was 360 ml (200-500 ml). All the incision healed. The two segments fixation was used in 23 cases, 3 segments fixation in 13 cases, and 4 segments fixation in 1 case. The mean follow-up period was 32 months (16-45 months).Postoperative X-ray and CT showed that bone fusion was achieved in all patients within 4-8 months, without graft displacement, or failure of implants. Spinal cord function did not aggravate, and sensory recovery ranged from 7 to 20 levels (averaged, 12.7). The ASIA grade were improved with an average of one grade. Conclusion To treat fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation, the posterlor-anterior approach and anterior fixation/fusion was benefit to preservation the cervical spinal cord function and reconstruction biomechanical stability of the cervical spine.

Objective To describe the pathological unit and octagonal en bloc resection for the treatment of ossification ligamentum flavum(OLF)in thoracic spine with spondylotic myelopathy.Methods Ninety-five patients from January 2002 to January 2007 were diagnosed as thoracic OLF,61 males and 34 females with an average age of 53.9 years(range,31-78 years).There were upper thoracic spine OLF in 32 cases,middle thoracic spine OLF in 24 cases and lower thoracic spine OLF in 39 cases.Single-segment OLF was found in 53 cases,double segments OLF was found in 38 cases and three segments OLF was found in 4 cases.CT scan multiplanar co-localized reconstruction was employed to detect the structure of spine with OLF.The Japanese Orthopaedic Association(JOA)lower limb motor function score,sphincter function score and motor function improvement rate were used to evaluate the outcomes.Results CT scan was engaged to observe 141 OLF pathological unite.The OLF pathology unit was defined as all the spine structures between the extension lines of the lower margin of the OLF two adjacent pedicles.Each OLF associates with an OLF pathology unit.The mean follow up duration was 38.3 months(range,24-60 months).Among 86 patients with sensations disturbance before operation,67 totally recovered and 19 relieved after operation.Trunk restrictions in 69 cases before operation were completely recovered after operation.Postoperative JOA sphincter function score was 2.651±0.334,comparing with preoperation score(2.262±0.561),and the difference was statistically significant.Postoperative JOA motor function score was 3.694±0.429,which was significantly increased than preoperative score 1.539±0.873,and motor function recovery rate was 87.57%.There was excellent in 71 cases,good in 17 cases and fair in 5 cases.The excellent and good rate was 94.74%.Conclusion The octagonal en block resection is relative safe for treatment thoracic OLF with myelopathy.Pathological unit of OLF in thoracic spine is more accurate to summarize the pathological contents and features of the OLF and its adjacent structure.

OBJECTIVETo compare the effect of massage alone or in combination with pricking collateral blood therapy (PCBT) on mild carpal tunnel syndrome (CTS).

METHODSSixty cases with mild CTS were randomly assigned into two groups, the control group treated with massage therapy alone, and the treated group with PCBT at the six Jing points of the affected upper limb combined with massage, 30 cases in each group. The therapy was conducted in all patients for 3 courses. The therapeutic effect was observed and the differential value (D-value) of sensory conduction velocity (SCV) between the median and ulnar nerves of the fourth digit (D4) was detected before and after each course of therapy.

RESULTSAfter 3 treatment courses, excellent, therapeutic effect was shown in 26 patients and good effect in 4 of the treated group, while in the control group, the effect was excellent in 8, good in 20, and improved in 2. The effect was better in the former group than that in the latter (P<0.05). Marked difference in the D-value of SCV was shown at the end of each course in both groups (P<0.05). As compared it between the two groups, significant difference was shown at the end of the 1st and 3rd course respectively (P<0.05).

CONCLUSIONCombined treatment of massage and PCBT showed better effect on mild CTS than massage therapy alone, and the onset time may positively correlated to the frequency of applying PCBT.

Acupuncture Therapy ; methods ; Adult ; Carpal Tunnel Syndrome ; therapy ; Combined Modality Therapy ; Female ; Humans ; Male ; Massage ; Middle Aged

Objective:Recent studies have shown that in contrast to decrease in distal gastric adenocarcinoma (DGA), incidence of adenocarcinoma of the esophagogastric junction (AEG) has increased noticeably in numerous counties. However, the reasons remain unclear. This study evaluated the possible differences in the expression of KLF4, SP1, and Cyclin D1 in AEG and DGA, and explored the potential carcinogenesis of AEG. Methods:Immunohistochemistry was performed on paraffin-embedded tissues to evaluate the pu-tative differences in the expressions of KLF4, SP1, and Cyclin D1 at protein level between AEG (n=58) and DGA (n=47). The patholog-ical significance of these markers between the two groups was also compared and analyzed. Results:The percentage of positive KLF4 expression was significantly lower in DGA than in AEG (P<0.05). Lower KLF4 expression was found both in well-or moderately dif-ferentiated cases and in poorly differentiated cases with DGA compared with their AEG counterparts (P<0.05). However, positive stain-ing for SP1 was significantly higher in DGA (P<0.05). No significant difference was found in the expression of Cyclin D1 between the two groups. Further analysis showed that in DGA, the positive expression of KLF4, SP1, and Cyclin D1 were significantly correlated with lymph node metastasis. In AEG, only Cyclin D1 expression was correlated with lymph node metastasis (P<0.05). No correlation was found among the expression of KLF4, SP1, and Cyclin D1 in AEG. In DGA, KLF4 was inversely correlated with SP1 and Cyclin D1 (r=-0.334 and r=-0.341, respectively, P<0.05), and SP1 was positively correlated with Cyclin D1 expression (r=0.340, P<0.05).Conclusion:Different expression patterns and clinicopathological significance of KLF4, SP1, and Cyclin D1 were observed between AEG and DGA, suggesting the putative difference in the carcinogenesis and progression of AEG and DGA.

Objective To observe the effects of family cognitive training on patients with vascular cognitive impairment but without dementia.Methods Sixty patients with non-dementia type vascular cognitive impairment were divided at random into a group which received family cognitive training (30 cases) and a control group (30 cases).The 2 groups all took routine drugs and exercise.The family cognitive training group received cognitive training additionally.Before treatment and after 1 and 6 months of treatment,all of the patients of both groups were assessed using the mini-mental state examination (MMSE),the Montreal cognitive assessment (MoCA) and the modified Barthel index (MBI).Results After 1 month of treatment there was no significant difference between the 2 groups in any of the assessments.After6 months the scores on each item of the MMSE,MoCA and MBI had improved significantly more in the family cognitive training group than in the control group.Conclusion Family cognitive training is effective in treating non-dementia type vascular cognitive impairment.It can delay disease progression and improve cognitive function and ability in the activities of daily living.