Objective To investigate the operative methods and their efficacy of the modified decompressive craniectomy in combination with indirect revascularization for the treatment of massive cerebral infarction. Methods The clinical data of 15 patients with massive cerebral infarction who underwent modified decompressive craniectomy in combination with encephaloduroarteriomyosynangiosis were analyzed retrospectively. The clinical efficacy was assessed according to the mortality, Barthel Index and modified Rankin scale. Results All the patients were followed up, and 12 patients survived 3 months after operation, of those, 4 had a good functional outcome; 11 patients survived 6 month after operation, of those, 7 had a good functional outcome. Conclusions The modified decompressive craniectomy in combination with indirect revascularization for the treatment of massive cerebral infarction could effectively treat massive cerebral infarction and increase the survival rate and life quality of patients, however, the surgical timing, surgical indications and surgical skills are needed to master accurately.

Objective To study the drifting law of floats and potential risks of Oncomelania hupensis diffusion in the water diversion rivers of the east route of South?to?North Water Diversion Project. Methods The O. hupensis snails in the river chan?nels were monitored by the salvage method and snail luring method with rice straw curtains,and the diffusion possibility of snails along with water was assessed through the drift test of floats with GPS. Results In the flood seasons from 2006 to 2013, totally 8 338.0 kg of floats were salvaged,and 2 100 rice straw curtains were put into water in the Li Canal and Jinbao shipping channel,but no Oncomelania snails were found. The drift test of floats with GPS before water diversion showed that the flow ve?locity on water surface(northbound)was 0.45 m/s,the average drift velocity of the floats was 0.56-0.60 m/s,and the average drift distances each time were 999.70- 1 995.50 m in the Gaoshui River section,while there were no obvious drift in Jinbao shipping channel section. During the water diversion period,the flow velocity on water surface(northbound)was 0.45 m/s,the average drift velocity of the floats was 0.35-0.41m/s,and the average drift distances each time were 1 248.06-1 289.44 m in the Gaoshui River,while in Jinbao shipping channel section,the flow velocity on water surface was 0.28 m/s,the average drift velocity of the floats was 0.25- 0.27 m/s,and the average drift distances each time were 477.76- 496.38 m. The drift test showed that the floats gradually closed to the river bank as affected by water flow,wind direction and ship waves,when blocked by the reeds,water plants or other obstacles,and they would stopped and could not continue to drift without outside help. Con?clusions There are no Oncomelania snails found in the river channels of the east route of South?to?North Water Diversion Proj?ect. The drifting distance of the floating debris along with the water is restricted by the flow rate and shore environment.

OBJECTIVETo study the mechanism of restenosis after angioplasty and to clarify the effect of thrombin and its receptor on restenosis development.

METHODSBalloon catheter-induced injury was adopted to induce intimal hyperplasia of the carotid arteries in rats. Antisense thrombin receptor (ATR) cDNA was transfected by perfusing recombinant LXSN ATR plasmid/nanoparticle complex into the segment of the injured carotid artery.

RESULTSPCR result showed integration of the recombined gene. Dot blot showed the expression of antisense TR mediated by recombinant LXSN ATR plasmid/nanoparticle complex in the wall of common carotid arteries of the experimental group rats, which enabled to inhibit TR gene expression and intimal hyperplasia of the injured arteries.

CONCLUSIONSThrombin and its receptor play an important role in the formation of neointima after the injury, which provides a potential clue in developing a new approach for prevention and treatment of restenosis after angioplasty.

Animals ; Carotid Arteries ; Hyperplasia ; Rats ; Receptors, Thrombin ; metabolism ; Thrombin ; pharmacology ; Tunica Intima ; metabolism

OBJECTIVETo evaluate the possibility and efficiency of nanoparticle as a new vector in specific gene transference.

METHODSNanoparticle-DNA complex was prepared with Poly-dl-lactic-co-glycolic acid (PLGA) bearing anti-sense monocyte chemotactic protein-1 (A-MCP-1), a specific expression gene, and the package efficiency, release progress in vitro, and the size of the complex were determined. The possibility of the new vector was evaluated with genomic DNA PCR by transferring gene into cultured smooth muscle cells (SMC), cationic lipids as a control. For study in vivo, jugular vein-to-artery bypass grafting procedures were performed on 20 New Zealand white rabbits, of which 6 grafts were transferred with nanoparticle-A-MCP-1 (200 microg), 6 with A-MCP-1 (200 microg) by cationic liposome, 4 with LNCX plasmid, and 4 as control. Fourteen days after the grafts were harvested, the expression of A-MCP-1 and its effect on MCP-1 in vein grafts were detected by dot blot, and the morphologic evaluation of grafts was performed.

RESULTSThe package efficiency of the nanoparticle-DNA complex was 0.9%, release progress in vitro lasted 2 weeks, and the size ranged from 150 to 300 nm. SMC genomic DNA PCR showed that A-MCP-1 gene could be successfully transfected into cells by nanoparticle. The study in vivo indicated that A-MCP-1 mRNA was expressed in both local gene delivery groups, nanoparticle and liposome, meanwhile, MCP-1 expression in vein grafts was significantly inhibited and neointimal hyperplasia was notably reduced.

CONCLUSIONNanoparticle can act as a vector to transfect specific gene.

Animals ; Chemokine CCL2 ; biosynthesis ; genetics ; DNA, Antisense ; biosynthesis ; genetics ; Drug Carriers ; Gene Expression ; Genetic Therapy ; Genetic Vectors ; Lactic Acid ; Nanotechnology ; Particle Size ; Polyglycolic Acid ; Polymers ; Rabbits ; Transfection

Objective:To evaluate the medical service quality of psychiatric hospitals in Beijing based on diagnostic related group (DRG), analyze the evaluation effect, for refences to constructe a DRG performance evaluation system suitable for psychiatric hospitals.Methods:This study extracted data such as the number of DRG groups, etc. of hospitalized patients in 14 tertiary and secondary psychiatric hospitals in Beijing from 2018 to 2020 from the Beijing inpatient medical performance evaluation platform, and analyzed data on DRG performance evaluation indicators, as well as the average length of hospital stay and average cost of DRG enrolled cases. All data were analyzed using descriptive research methods, and inter group comparisons were conducted using the Mann Whitney U-test. Results:From 2018 to 2020, the average number of DRG groups in tertiary hospitals (28) was higher than that in secondary hospitals (10) ( P<0.05), and the average CMI values of both were the same(1.79); The average cost consumption index (1.15) of tertiary hospitals was higher than that of secondary hospitals (0.65) ( P<0.05), while the average time consumption index (1.11) was slightly lower than that of secondary hospitals (1.30); The mortality rate of the low-risk group in tertiary hospitals (0.01%) was generally lower than that in secondary hospitals (0.88%), and the average percentage of DRG admitted inpatients (82.8%) was significantly higher than that in secondary hospitals (27.3%) ( P>0.05). The average length of stay and cost per case for DRG enrolled inpatients in tertiary and secondary hospitals were lower than the overall hospital discharge cases ( P<0.05). Conclusions:The number of DRG groups, CMI value, and low-risk mortality rate could be used for evaluating the medical service capacity and safety of psychiatric hospitals, but the cost and time consumption index could not objectively reflect the efficiency of hospital medical services. DRG performance evaluation indicators are more suitable for evaluating short-term hospitalization of psychiatric patients. The proportion of DRG enrolled cases might be a potential indicator for evaluating the service quality of psychiatric hospitals.