ObjectiveTo observe the effect of lappaconitine (LA) on brain water content and serum IL-I,IL-2 and TNF-α levels in rats with traumatic brain injury (TBI) as well as its cerebral protective function.MethodsA total of 24 male SD rats were involved in the study and randomly divided into control group,TBI group and TBI +LA group,with eight rats per group.The rats in the TBI group and TBI + LA group were inflicted with fluid percussion injury ( FPI ).The rats in the TBI + LA group were treated with LA (4 mg/Kg/d,ip,for 10 consecutive days).The neurological score,brain water content and serum IL-I,IL-2 and TNF -α concentrations were detected at time points including TO ( before FPI ),T1 (one day after FPI),T2 (five days after FPI) andT3 (10 days after FPI).Results At each time point after FPI,the neurological dysfunction was observed in both the TBI group and TBI + LA group.The neurological dysfunction was gradually alleviated from TI to T3 in the FPI + LA group,which showed significant lower neurological score as compared with the TBI group (P ＜0.05 or 0.01 ).The brain water content in the TBI group and TBI + LA group was significantly higher than that in the control group at each time point after FPI.Meanwhile,the water content of the TBI + LA group was significantly lower than that of the TBI group ( P ＜ 0.01 ).The serum IL-1,IL-2 and TNF-alpha concentrations in the TBI group and TBI + LA group were significantly higher than those in the control group at each time point after FPI,and the serum IL-I,IL-2 and TNF-αt concentrations of the TBI + LA group were significantly lower than those of the TBI group ( P ＜ 0.01 ).Conclusions LA exerts cerebral protective effects of TBI rats by relieving the neurological dysfunction and cerebral edema and reducing the serum IL-1,IL-2 and TNF-α concentrations.

Objective: To observe the relieving cough and reducing sputum effects of total alkaloid in Atalantia buxifolia and evaluate the safety preliminarily.Methods: The relieving cough and reducing sputum effects of total alkaloid in Atalantia buxifolia were studied by the cough model caused by the irritation of ammonia water and the phenol red output of trachea in mice.The acute toxicity test and maximum tolerance test were carried out to evaluate the safety.Results: The total alkaloid in Atalantia buxifolia at low dose could obviously prolong cough incubation period and decrease cough times in mice, and that at high dose could significantly increase the secretion of phenol red in respiratory tract, and compared with those in the blank group, the differences were statistically significant (P<0.05).In the acute toxicity test, no death showed after the administration with maximum tolerance dosage, and the rate of weight growth had no difference between the blank group and the model group (P>0.05).Conclusion: The relieving cough and reducing sputum effects of total alkaloid in Atalantia buxifolia are notable in the cough model caused by the irritation of ammonia water and the phenol red output of trachea in mice.The maximum tolerable dose test shows the total alkaloid in Atalantia buxifolia is safe.

Based on the requirements of military professional education reform and in view of the problems existing in the operation and maintenance of first-aid medical equipment in grass-roots forces. We put forward a construction scheme of online course which named operation and maintenance of first-aid medical equipment in grass-roots forces, and then expound the scheme from teaching content construction and teaching mode construction. The teaching content construction consists of two parts: the management theory of conventional medical equipments and the operation and maintenance teaching of specific first-aid medical equipments. In the construction of teaching mode, we elaborate on the organization forms of teaching, answering questions, training and examination units in detail. The design scheme of the online course is in line with the learning characteristics and meets the demand of learning the knowledge of the operation and maintenance of first-aid medical equipment systematically, so as to improve the post competency of the grass-roots forces.

Objective To observe the effect of acute hypervolemic hemodilution (AHH) with two kinds of hydroxyethyl starches including Voluven and HES on the renal function of emergency surgery patients with brain injury.Methods This study involved 54 brain injury patients treated with emergency surgery,who were randomly divided into Voluven group ( AHH130 group),HES group ( AHH200 group) and Ringer's lactate group (LR group),with 18 patients in each group.All the patients were managed with inhalation anesthesia.ECG,MAP,CVP and SpO2 were observed in operation.The blood urea nitrogen (BUN),urine creatinine ( BCr,UCr),urinary albumin (ALB) and urinary α1-microglobulin ( α1-MG) were detected before AHH ( T0 ),at the end of operation ( T1 ),at 4 hours ( T2 ),day 1 ( T3 ),day 2 (T4) and day 3 (T5) after operation.The creatinine clearance (CCr) and fractional sodium clearance (FSC) were calculated and the urine output,fluid replacement,blood loss and blood transfusion recorded.Results The HR,CVP and MAP in the three groups were within the normal range of variation at all time points,with statistical difference for comparison between groups and within group ( P ＞ 0.05 ).There was no significant difference in urine output and blood loss,while the intraoperative fluid volume and blood transfusion in the AHH130 group and the AHH200 group were significantly less than those in the LR group (P ＜ 0.01 ).There was no statistical difference in aspects of BUN,BCr and urinary ALB at each time point between and within the three groups ( P ＞ 0.05 ).After treatment with AHH,the urinary α1-MG level in the AHH130 group and AHH200 group was significantly increased ( P ＜0.01 ),which was decreased at T5 but was still higher than that at T0 ( P ＜ 0.01 ),and was higher than that in the LR group at all time points (P＜0.05).After treatment with AHH,CCr was decreased in the AHH130 group and AHH200 group,which reached the lowest level at T2,with statistical difference compared with the levd at T0 ( P ＜0.01 ).Then,CCr was recovered to normal at T5.FSC in the three groups after AHH treatment was increased slightly and the most significantly at T2,which was not statistically different compared with that at T0 ( P ＞ 0.05) and FSC was not statistically different between and within groups at other time points (P ＞0.05).All the values about the renal function in all the groups changed within the normal range at each time point.Conclusions AHH with Voluven or HAES is a feasible and safe blood conservation measure that can significantly reduce the allogeneic blood transfusion but exert insignificant effect on renal function of the brain injury patients with normal renal function before emergency surgery.

Objective To evaluate the clinical effect of different surgical approaches for treating cervical ossification of the posterior longitudinal ligament (OPLL) with spinal cord signal change. Methods Thirty-eight patients with OPLL with spinal cord signal change were treated from January 2005 to January 2011. Surgical removal via an anterior approach or partial decompression was performed in 10 cases (group A), posterior approach open-door laminoplasty with decompression, bone grafting and internal fixation was performed in 12 cases (group B), and opening the cervical spinal meninges to relieve the pressure was performed in 16 cases (group C) on the basis of the procedures in group B. All the patients were followed up and the pre- and postoperative JOA scores, improvement ratio and inter-body implant fusion were evaluated. Imaging examinations including X-rays, CT and MRI were also performed pre- and postoperatively, and the surgical complications were recorded. Results At 12 months postoperatively, the mean improvement rates in groups A, B, and C were 52.39%, 55.15%, and 60.32%, respectively, with the mean JOA scores of 13.54 ± 0.56, 13.56 ± 1.26, and 14.70 ± 1.41, respectively. The JOA scores and improvement rates significantly increased after the surgeries. One patient in group A became paraplegic after the operation with cerebrospinal fluid leakage, and one patient in group B and one in group C reported numbness of the upper limb. Group C showed a shorter postoperative recovery time without severe complications. Conclusion Posterior open-door laminoplasty, decompression, bone grafting and internal fixation can be an effective approach for treatment of cervical OPLL with spinal cord signal change and requires shorter rehabilitation time after the operation.

Objective To evaluate the clinical effect of different surgical approaches for treating cervical ossification of the posterior longitudinal ligament (OPLL) with spinal cord signal change. Methods Thirty-eight patients with OPLL with spinal cord signal change were treated from January 2005 to January 2011. Surgical removal via an anterior approach or partial decompression was performed in 10 cases (group A), posterior approach open-door laminoplasty with decompression, bone grafting and internal fixation was performed in 12 cases (group B), and opening the cervical spinal meninges to relieve the pressure was performed in 16 cases (group C) on the basis of the procedures in group B. All the patients were followed up and the pre- and postoperative JOA scores, improvement ratio and inter-body implant fusion were evaluated. Imaging examinations including X-rays, CT and MRI were also performed pre- and postoperatively, and the surgical complications were recorded. Results At 12 months postoperatively, the mean improvement rates in groups A, B, and C were 52.39%, 55.15%, and 60.32%, respectively, with the mean JOA scores of 13.54 ± 0.56, 13.56 ± 1.26, and 14.70 ± 1.41, respectively. The JOA scores and improvement rates significantly increased after the surgeries. One patient in group A became paraplegic after the operation with cerebrospinal fluid leakage, and one patient in group B and one in group C reported numbness of the upper limb. Group C showed a shorter postoperative recovery time without severe complications. Conclusion Posterior open-door laminoplasty, decompression, bone grafting and internal fixation can be an effective approach for treatment of cervical OPLL with spinal cord signal change and requires shorter rehabilitation time after the operation.

OBJECTIVETo evaluate the clinical effect of different surgical approaches for treating cervical ossification of the posterior longitudinal ligament (OPLL) with spinal cord signal change.

METHODSThirty-eight patients with OPLL with spinal cord signal change were treated from January 2005 to January 2011. Surgical removal via an anterior approach or partial decompression was performed in 10 cases (group A), posterior approach open-door laminoplasty with decompression, bone grafting and internal fixation was performed in 12 cases (group B), and opening the cervical spinal meninges to relieve the pressure was performed in 16 cases (group C) on the basis of the procedures in group B. All the patients were followed up and the pre- and postoperative JOA scores, improvement ratio and inter-body implant fusion were evaluated. Imaging examinations including X-rays, CT and MRI were also performed pre- and postoperatively, and the surgical complications were recorded.

RESULTSAt 12 months postoperatively, the mean improvement rates in groups A, B, and C were 52.39%, 55.15%, and 60.32%, respectively, with the mean JOA scores of 13.54∓0.56, 13.56∓1.26, and 14.70∓1.41, respectively. The JOA scores and improvement rates significantly increased after the surgeries. One patient in group A became paraplegic after the operation with cerebrospinal fluid leakage, and one patient in group B and one in group C reported numbness of the upper limb. Group C showed a shorter postoperative recovery time without severe complications.

CONCLUSIONPosterior open-door laminoplasty, decompression, bone grafting and internal fixation can be an effective approach for treatment of cervical OPLL with spinal cord signal change and requires shorter rehabilitation time after the operation.

Aged ; Cervical Vertebrae ; pathology ; Decompression, Surgical ; methods ; Female ; Humans ; Male ; Middle Aged ; Ossification of Posterior Longitudinal Ligament ; pathology ; surgery ; Spinal Cord Compression ; etiology ; surgery ; Treatment Outcome

Objective:To explore the differences of clinical features and surgical efficacy between the elderly and the middle-aged and young patients with meningiomas in the central cortex area.Methods:Forty-three elderly patients with meningiomas in the central cortex area (≥60 years old) and 63 middle-aged and young patients with meningiomas in the central cortex area (18-59 years old), accepted surgery in Department of Neurosurgery, Guangdong 999 Brain Hospital from January 2011 to December 2020, were chosen. The differences of symptom, gross tumor volume, peritumoral edema degrees, intraoperative blood loss, tumor resection degrees, complications, and hospital stays between the 2 groups were analyzed.Results:The elderly patients had significantly higher proportion of preoperative muscle strength decline, lower proportion of preoperative headache, larger preoperative tumor volume, more severe peritumoral edema degrees before and after surgery, small volume of intraoperative blood loss, and longer hospital stays compared with the middle-aged and young patients ( P<0.05). However, no significant differences in distributions of tumor resection Simpson grades, proportion of new neurological dysfunction, incidence of postoperative complications, and proportions of reoperations and tumor recurrence were noted between the 2 groups ( P>0.05). Significant difference in distributions of peritumoral edema degrees among patients with different WHO grades was noted in the elderly group ( P<0.05), and significant difference in distribution of peritumoral edema degrees among patients with different tumor volumes was noted in the middle-aged and young group ( P<0.05). Conclusions:Although differences in clinical characteristics exist between the elderly and the middle-aged and young patients with meningiomas in the central cortex area, no significant difference in surgical efficacy is noted between the 2 groups. The peritumoral edema degree in the elderly patients is related to tumor pathological grades, while that in middle-aged and young patients is related to tumor volumes.

Objectives:To compare the efficiacy of retro-auricular single-site endoscopic thyroidectomy (RASSET) and that of transoral endoscopic thyroidectomy vestibular approach (TOETVA).Methods:In Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 10 patients underwent RASSET from June 2021 to August 2021, and 21 patients underwent TOETVA from January 2016 to August 2021. All the 21 patients′ clinical data was analyzed retrospectively. There were 2 males and 8 females in the RASSET group, aging (48.2±13.9) years (range: 28 to 67 years). There were 5 males and 16 females in the TOETVA group, aging (31.3±8.2) years (range: 21 to 49 years). All patients underwent thyroid lobectomy. A 3 cm in length incision was cut on single auricula posterior sulci to creat the approach in the RASSET group. Then a Trocar made with of a glove was inserted. Retaining the omohyoid, the sternocleidomastoid muscle and anterior cervical muscle were pulled apart, exposing a single lobe of the thyroid gland and lymphatic tissue of zone Ⅵ, for en-bloc resection. The clinical data of the two groups were collected and analyzed by t test, Mann-Whitney U test, Fisher exact test or χ 2 test. Clinical data and postoperative efficacy indexes such as operation time, postoperative C reactive protein level, and postoperative complications were recorded. Results:Compared with the TOETVA group, the operation time was longer in the RASSET group ((256.8±77.0) minutes vs. (201.2±54.9) minutes, t=2.31, P=0.028), and increase of postoperative C reaction protein (24 hours postoperative vs. preoperative) was lower in the RASSET group (8.58(13.24) mg/L vs. 46.24(48.88) mg/L, Z=-4.311, P<0.01). But there was no significant difference between the RASSET group and TOETVA group in the number of lymph nodes dissection (2(5) vs. 2(3), Z=-0.326, P=0.759). Besides, there were no complications in the RASSET group. Conclusion:Retro-auricular single-site endoscopic thyroid loectomy is easy to achieve the en-bloc resection of tumors with a well-concealed scar and less traumatic dissection.

Objectives:To compare the efficiacy of retro-auricular single-site endoscopic thyroidectomy (RASSET) and that of transoral endoscopic thyroidectomy vestibular approach (TOETVA).Methods:In Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 10 patients underwent RASSET from June 2021 to August 2021, and 21 patients underwent TOETVA from January 2016 to August 2021. All the 21 patients′ clinical data was analyzed retrospectively. There were 2 males and 8 females in the RASSET group, aging (48.2±13.9) years (range: 28 to 67 years). There were 5 males and 16 females in the TOETVA group, aging (31.3±8.2) years (range: 21 to 49 years). All patients underwent thyroid lobectomy. A 3 cm in length incision was cut on single auricula posterior sulci to creat the approach in the RASSET group. Then a Trocar made with of a glove was inserted. Retaining the omohyoid, the sternocleidomastoid muscle and anterior cervical muscle were pulled apart, exposing a single lobe of the thyroid gland and lymphatic tissue of zone Ⅵ, for en-bloc resection. The clinical data of the two groups were collected and analyzed by t test, Mann-Whitney U test, Fisher exact test or χ 2 test. Clinical data and postoperative efficacy indexes such as operation time, postoperative C reactive protein level, and postoperative complications were recorded. Results:Compared with the TOETVA group, the operation time was longer in the RASSET group ((256.8±77.0) minutes vs. (201.2±54.9) minutes, t=2.31, P=0.028), and increase of postoperative C reaction protein (24 hours postoperative vs. preoperative) was lower in the RASSET group (8.58(13.24) mg/L vs. 46.24(48.88) mg/L, Z=-4.311, P<0.01). But there was no significant difference between the RASSET group and TOETVA group in the number of lymph nodes dissection (2(5) vs. 2(3), Z=-0.326, P=0.759). Besides, there were no complications in the RASSET group. Conclusion:Retro-auricular single-site endoscopic thyroid loectomy is easy to achieve the en-bloc resection of tumors with a well-concealed scar and less traumatic dissection.