BACKGROUND:The nervous reconstruction and repair after spinal cord injury have become a research hotspot.
OBJECTIVE:To investigate the change rule of neurogliocyte reactive hyperplasia after spinal cord injury.
METHODS:Forty-two adult male Sprague-Dawley rats were selected and equivalently randomized into seven groups:normal control group (no intervention), sham operation group (lamina decompression) and operation groups (postoperative 1, 7, 14, 21 and 28 days). After the establishment of spinal cord injury models, the rats were sacrificed at each corresponding time point. The functional recovery of the rat hind limbs was evaluated by Basso, Beattie and Bresnahan scores, and complete spinal cord tissue was removed to undergo hematoxylin-eosin staining, immunohistochemistry staining and immunofluorescence staining.
RESULTS AND CONCLUSION:(1) Basso, Beattie and Bresnahan scores showed that rats in the normal control and sham operation groups had normal neurologic function. Rats at 1 day after spinal cord injury paralyzed completely, the neurologic function of hind limbs began to recover gradual y at the 7th day, and the recovery became most obvious at the 14th day, which had no significant differences compared with the 21st and 28th days. (2) Hematoxylin-eosin staining found that the diffuse hemorrhage and neuronal necrosis were observed in the injured area at 1 day after operation;inflammatory cel infiltration and some vacuoles appeared at the 7th day, and the hemorrhage was absorbed gradual y;the hemorrhage disappeared completely and capsule cavity formed at the 14th day;up to the 28th day, spinal cord structure was completely destroyed and that was replaced by cicatricial tissue accompanying with a large cavity. (3) Immunohistochemistry staining showed that the astrocyte in damaged area proliferated with the cel synapse increasing, which was most overt at the14th day;the axon clearance widened and the structure was in disorder at the 7th day, and the myelin sheath in the damaged area was destroyed at the 21st day. (4) Immunofluorescence staining showed that there were numerous visible glial fibril ary acidic protein+/nestin+cel s in the injured area at 14 days after operation. (5) These results suggest that glial cel hyperplasia and hypertrophy, the up-regulated expressions of glial fibril ary acidic protein and nest protein are advantageous to the early repair of spinal cord injury.

Objective To explore the feasibilities and clinical applications for sharing the medical resources and recycles by applying digital medicine technology and making the most of medical CT films from other hospitals.Methods Based on scanning data of medical CT films from other hospitals,which were in 85 cases of undergo retroperitoneal laparoscopic surgery,the 3D models were reconstructed in the computer,then were verified and navigated during operations.Meanwhile,coincidence rates were compaired between group A (slice thickness =5 mm) and group B (slice thickness ＞5 mm) in 53 cases whose renal pedicle blood vessels were exposed during the operations.Results All the 85 procedures were successfully completed.The 3D models,which could be observed freely,were consistent with intraoperative screenshots and participated in intraoperative guidance.Coincidence rates were 82.4％ (28/34) in group A and 52.6％(10/19) in group B (x2 =5.306,P =0.021).Conclusions Based on medical CT films of 5 mm slice thickness,the 3D models which are verified to have some accuration and fineness can be successfully reconstructed.The method not only can effectively avoid unnecessary repeated inspection,but also directly render in 3D form to participate in preoperative planning and intraoperative guidance.

Objective To discuss the experience of open heart operation on beating in complex and severe congenital heart diseases. Method This kind of operation was put to use in 48 cases of the heart diseases in order to observe the effect of myocardial protection, prevention from air embolism,exposure of the operative field, and cardiopulmonary bypass. Results Operation field exposure was clear enough to finish the manipulation. One cases was eventiful postoperatively and died(2.08%). Conclusion Open heart operation on beating with slight hypothermia might have much feasibility in the part of complicated and severe congenital heart diseases.

Objective: To examine the prevalence of depression and anxiety symptoms, and the related factors in family members of schizophrenic patients in a Shanghai community. Methods: From March to May 2017, the family members of 206 schizophrenic patients registered in Xuhui district Kangjian community of Shanghai were enrolled in this cross-sectional survey. The participants were evaluated with Patient Health Questionnaire Self-rating Depression Scale (PHQ-9) and the Anxiety Screening Scale (GAD-7). The factors related to depression and anxiety symptoms were analyzed. Results: The detection rates of depressive symptoms and anxiety symptoms in the family members of schizophrenia patients were 40.3%(83/206) and 37.9%(78/206), respectively.Univariate analysis showed that the relationship with the patient, education levels were the influencing factors of depressive symptoms (χ²=17.045, 9.702; P<0.01); while age, relationship with the patient, education levels were factors related to the occurence of anxiety symptoms (χ²=11.862, 22.042, 15.060; P<0.01). Multivariate regression analysis showed that the parents of patient was more prone to depressive symptoms than spouses (OR=2.861, P<0.01); higher education was more prone to be depressive than primary education (OR=10.071, P<0.01). Age group 18-40 years were more prone to anxiety than the age group ≥66 years (OR=0.060, P<0.05); sibling relationship is more prone to anxiety than spouse relationship (OR=10.018, P<0.01), followed by parental relationship (OR=7.467, P<0.01); higher education was more prone to anxiety than primary education (OR=5.119, P<0.05). Conclusions There is high prevalence of depression and anxiety symptoms in family members of schizophrenic patients, which is related to the relationship with the patient, the education level of family members and other factors.

Objective To observe the effects of 3 neuroprotective measures on the expressions of apoptosis-related factors and their ligands (Fas and FasL) in brain tissue of neonatal rats with hypoxic ischemic brain injury. Methods One hundred and twenty Wistar rats 7 days old were selected as experimental subjects, the rats were divided into four groups: neural stem cell, erythropoietin (EPO), ω-3 unsaturated fatty acid treatment groups and hypoxic ischemic brain damage model group according to random number table method, with 30 rats in each group. Neural stem cell group, EPO group and ω-3 unsaturated fatty acid group were respectively injected with neural stem cells, EPO and ω-3 unsaturated fatty acid, each 5 mL via tail vein after modeling; the hypoxic ischemic brain damage model group was given equal volume of normal saline. At 6, 12, 24, 48 and 72 hours after administration of drug, 6 rats were sacrificed in each group, brain tissue was taken, the mRNA expression levels of Fas/FasL, protein expression levels of Toll-like receptor 4 (TLR4), nuclear transcription factor-κB (NF-κB), tumor necrosis factor-α (TNF-α), interleukin (IL-1β, IL-6) and cell apoptotic rate in hippocampus tissue were measured. Results ① mRNA expressions: the mRNA expressions of Fas and FasL of the 3 experimental groups were significantly lower than those of the hypoxic ischemic brain damage model group, the degrees of descent after administration for 24 hours were the most significant, neural stem cell treatment group < EPO treatment group < ω-3 unsaturated fatty acid treatment group < hypoxic ischemic brain damage model group [Fas mRNA expression (2-ΔΔCt): 140.5±2.9, 156.4±2.5, 165.2±2.7 vs. 173.7±2.8, FasL mRNA expression (2-ΔΔCt): 143.1±4.3, 154.6±1.5, 160.7±1.4 vs. 174.7±2.8], the differences were statistically significant (all P < 0.05). ② Protein expressions: the protein expressions of TLR4, NF-κB, TNF-α, IL-1β, IL-6 of the 3 experimental groups were significantly lower than those of the hypoxic ischemic brain damage model group (TLR4/GAPDH: 0.7±0.2, 0.6±0.1, 0.2±0.1 vs. 1.4±0.1; NF-κB/GAPDH: 6.7±0.4, 5.3±0.1, 1.1±0.2 vs. 11.2±0.3; TNF-α/GAPDH: 14.3±1.4, 11.2±1.2, 3.2±2.1 vs. 23.2±0.5; IL-1β/GAPDH: 9.4±0.2, 7.4±0.3, 2.2±0.3 vs. 13.4±0.1; IL-6/GAPDH: 36.2±4.4, 39.3±1.5, 26.2±2.1 vs. 51.4±1.4, all P < 0.05), the protein expression levels of above indexes in neural stem cell treatment group < those of EPO treatment group < those of ω-3 unsaturated fatty acid treatment group < those of hypoxic ischemic brain damage model group. ③ Apoptotic rates:after drug administration, the apoptotic rates of the ω-3 unsaturated fatty acid group, EPO treatment group, neural stem cell treatment group were obviously lower than the rate of model group [(3.7±0.3)%, (3.4±0.2)%, (2.5±0.1)% vs. (5.5±0.4)%, all P < 0.05]. Conclusion The mRNA expressions of Fas/FasL in the brain of neonatal rats with hypoxic-ischemic brain damage are high, and the treatment with each of the following agents; neural stem cells, EPO and ω-3 unsaturated fatty acid can reduce the mRNA expressions of Fas/FasL in such rats' brain tissues.

To introduce professor s experience that different stages of refractory facial paralysis should be treated with different acupuncture methods.In early stage of facial paralysis,identifcation is important. Electroacupuncture is applied to connect Qianzheng (Extra) with Cuanzhu (BL 2), Sibai (ST 2) and Jiachengjiang (Extra), by observing the twitches of facial muscles, it is determined whether it is easy to develop into refractory facial paralysis, in order to actively take preventive treatment. In the recovery stage of refractory facial paralysis, comprehensive therapy including acupuncture, acupoint injection, quick cupping and auricular point pressure are adopted, and penetration needling is applied at three points of mouth, three points of cheek and three points of forehead.In the sequelae stage of refractory facial paralysis，on the basis of comprehensive therapy, targeted treatment is adopted according to different sequelae.

Mitochondrial dysfunction after spinal cord injury (SCI) is recognized as a crucial pathological mechanism for secondary SCI. Studies have indicated that mitochondrial transfer plays a significant role in the process of neural regeneration following injury. After mitochondria migrating to injured neurons, they mainly function via enhancing the energy metabolism level of damaged neurons and reducing oxidative stress. In this article, we present an exhaustive overview on mechanism of mitochondrial transfer, and impact on neural regeneration after mitochondrial transfer so as to provide valuable insights for further exploring the role of mitochondrial transfer in SCI progression and offer innovative perspective on potential therapeutic strategies for SCI.

Objective: To investigate the clinical value of intraoperative radiofrequency ablation (RFA) in the treatment of colorectal liver metastasis (CLM). Methods: A retrospectively analysis of 187 patients with CLM who underwent liver resection with or without RFA from January 2009 to August 2016 in Department of Hepatobiliary Surgery, Cancer Hospital, Chinese Academy of Medical Sciences was performed. According to whether RFA was used intraoperatively, patients were divided into resection only group and combined treatment group. The clinical and pathological characteristics of the two groups were compared to explore factors influencing survival and recurrence. Imbalance of background characteristics between the two groups was further overcome by propensity score matching method (PSM). Results: The number of liver metastases (267), simultaneous liver metastases (100%), bilobar involvement (73.3%) and preoperative chemotherapy (93.3%) rates were significantly higher in the combined treatment group than those in the resection only group(471, 74.7%, 42.0% and 63.1%)(all P<0.05). In the combined treatment group, median overall survival (OS) was 25.7 months; and 3-year and 5-year OS were 47.9% and 28.8%, respectively. In the resection only group, the median survival time was 46.9 months; and 3-year and 5-year OS rate was 59.1% and 42.4%, respectively (χ²=4.579, P=0.034). Median disease-free survival (DFS) was 5.4 months in the combined treatment group, and 10.1 months in the resection only group (χ²=5.399, P=0.023). In multivariate analysis, intraoperative RFA was not an independent prognostic factor for OS and DFS (HR=0.98, 95%CI: 0.47-2.08, P=0.965; HR=1.21, 95%CI: 0.71-2.07, P=0.465). After PSM, the median OS of the resection only and the combined treatment groups were 30.2 and 25.7 months (χ²=0.876, P=0.350). The median DFS in the two groups was 5.3 and 4.2 months, respectively (χ²=0.199, P=0.650). Conclusion In patients with similar tumor burden, liver resection combined with intraoperative RFA for unresectable CLM can achieve long-term outcomes similar to hepatectomy alone for resectable CLM.

OBJECTIVE To investigate in vitro activities of 12 antimicrobial agents including cefmetazole against extended-spectrum beta-lactamases-producing Escherichia coli(528 strains),Klebsiella pneumoniae(311 strains) and Proteus mirabilis(15 strains).METHODS They all collected from 15 teaching hospitals in China during 2005 and 2006 and included in the study.The levels of minimal inhibitory concentration(MIC) of 12 antimicrobial agents were determined by agar dilution method.WHONET 5.4 Software was used to analyze the data.RESULTS Against ESBLs-producing E.coli and ESBLs-producing K.pneumoniae,carbapenems were the most active antimicrobial agents(all 100.0% susceptible),followed by cephamycins(80.1-97.3%).Piperacillin/tazobactam(78.5-95.1%)showed a higher activity than cefoperazone/sulbactam(44.1-56.2%).The susceptible rate to ceftazidime against ESBLs-producing E.coli was remarkably higher than the other three cephalosporins,however the differences did not happen to ESBL-producing K.pneumoniae obviously.The susceptible rate to cefuroxime was below 1.6%.ESBLs-producing K.pneumoniae showed high sensitivity to carbapenems,cephamycins and ?-lactam/lactamase inhibitor combinations(all 100% susceptible),however the susceptible rates to cephalosporins were relatively lower.CONCLUSIONS Carbapenems and cephamycins remain the relatively high activity against ESBLs-producing Enterobacteriaceae.

Objective:To compare the clinical manifestations of ocular toxoplasmosis (OT) in adult and children, and to preliminarily explore the role of intraocular fluid detection in the early diagnosis of OT.Methods:A retrospective study. From January 2018 to October 2019, 60 cases of OT patients with 60 eyes diagnosed in the Department of Ophthalmology of Beijing Chaoyang Hospital Affiliated of Capital Medical University were included in the study. The medical history information of patients was collected in parallel with slit-lamp microscopy, indirect ophthalmoscope examination, and canine toxoplasma antibody detection in aqueous or vitreous fluid. Fifty-eight cases underwent visual inspection; 2 cases did not underwent visual inspection, who were children. The visual acuity examination was carried out using the new version of the standard logarithmic visual acuity chart, which was converted into the logarithmic minimum angle of resolution(logMAR) visual acuity during statistics. According to age, the patients were divided into adult group and child group, with 12 eyes in 12 cases and 48 eyes in 48 cases, respectively. The clinical characteristics and main points of diagnosis and treatment of the two groups of patients were compared and observed. The comparison among the measurement data groups conforming and the normal distribution was performed by the independent t test. The comparison between the measurement data groups of the skewed distribution was performed by the Kruskal- Wallis test. The qualitative data were compared with χ 2 test. Results:Among the adult group and the child group, 7 (58.3%, 7/12) and 34 (70.8%, 34/48) patients with a clear history of contact with dogs and cats were in the adult group and the child group, respectively. The adult group was significantly lower than the child group, however, there was no different statistical significance ( χ 2=0.236, P=0.627). At the first visit, the self-reported blurred vision of the adult group and the child group was 10 (83.3%, 10/12) and 22 (45.8%, 22/48) cases, respectively. In the adult group and the child group, 3 (25.0%, 3/12) and 20 (43.5%, 20/46) eyes with logMAR visual acuity greater than 1.85, 8 (66.7%, 8/12) and 22 (45.8%, 22/46) eyes with logMAR visual acuity less than 0.3. The visual acuity of the adult group was better than that of the child group, and the difference was statistically significant ( Z=2.162, P=0.031). There was no statistically significant difference in the composition ratio of different clinical types of the two groups of eyes ( χ 2=1.908, P=0.385). The incidence of inflammation in the anterior segment of the eye in the adult group and the child group were 25.0% (3/12) and 56.3% (27/48), respectively; there was no statistically significant difference between the two groups ( χ 2=3.750, P=0.053). The concentration of antibodies in the vitreous humor of the affected eye in the adult group and the child group was greater than that of aqueous humor. The antibody concentrations of vitreous humor and aqueous humor were 36.51 (22.58) and 19.94 (21.78) U/ml in the children group; 45.95 (56.44) and 32.20 (38.64) U/ml in the adult group. Comparison of antibody concentrations in the vitreous humor and aqueous humor of the affected eyes in the child group showed statistically significant differences ( Z=-1.984, P=0.047). Conclusions:Compared with children with OT, adult patients with OT have better vision and mild inflammation or hyperplasia of the vitreous cavity. The detection of antibodies related to toxoplasma in the intraocular fluid is helpful for early diagnosis.