Objective:To seek better treatments for abnormal pelvic floor muscle tension and pelvic floor dysfunction after spinal cord injury.Methods:The morphology of pelvic floor muscle fibers of rats with spinal cord injury at different levels was observed under the electron microscope. Thirty female adult Sprague-Dawley rats were randomly divided into a suprasacral (SS) cord injury group, a group with spinal cord injury at or below the sacral level (SC) and a normal group (NG), each of 10. The relevant spinal cord injury models were established in the SS and SC groups through spinal cord disconnection. Four weeks later, the pixel area of ATPase-positive fibers was used to quantify the content of type I fibers in the pubococcygeus muscle of each rat through observation under the electron microscope after hematoxylin and eosin staining.Results:The average content of type I muscle fibers in both the SS and SC group was significantly lower than in the normal group. The SC group′s average level was significantly lower than that of the SS group. Under the microscope the stained myofibers were tortuous, deformed in appearance and with proliferated nuclei. Capillary dilation could be seen locally in the SS group 4 weeks after the injury. In the SC group at 4 weeks after the injury the pubococcal fibers were seriously "dissolved" , or disordered, with spherical nuclei and mild hyperplasia. Under the electron microscope, the sarcomeres of the SC group were obviously dissolved, atrophied and broken, though the basic structure persisted, with mild mitochondrial proliferation. The sarcomeres of the SC group were extremely dissolved and broken, completely losing basic structure, with abundant connective tissue proliferation but without obvious mitochondrial proliferation.Conclusions:After suprasacral cord injury, the content of type I muscle fibers in the pubococcygeus muscle of the pelvic floor decreases somewhat, with the basic structure of the muscle fibers remaining intact. However, after spinal cord injury at or below the sacral level, type I muscle fibers decrease significantly in the pubococcygeus muscle of the pelvic floor, and the basic structure is seriously damaged.

Objective To investigate the clinical effect of edoravone combined with escin monosodium on the treatment of acute cerebral hemorrhage .Methods 60 patients suffered from acute cerebral hemorrhage were randomly divided into control group and observation group .Each group had 30 patients.The control group was conventionally treated by the internal medicine .On the basis of the research on the control group ,the observation group were treated by edoravone combined with escin monosodium intravenous drip .After the treatment of 14 days,28 days,the recovery of neural function,focus volume,clinical effect were evaluated.Results Comared with the control group,after the treatment of 14 days,28 days,NIHSS score was obviously lower than that of the control group ,the difference was sig-nificant (t=2.136,t=4.117,P<0.05,P<0.01).After the treatment of 14 days,hematoma and edema of the differences were not statistically significant (t=1.395,t=0.737,all P>0.05).After the treatment of 28 days,hema-toma and edema of the differences were statistically significant (t=3.140,t=2.367,P<0.01,P<0.05).The com-parison of the clinic effect of the two groups ,the total effect was statistically significant (χ2 =6.650,P <0.01). Conclusion Edaravone combined with escin monosodium on the treatment of cerebral hemorrhage can significantly improve neurologic impairment and cerebral hematoma .Clinical effect is definite and safe .

Objective To observe of different facemask pressure controlled ventilation yongon gastric insufflation evaluated by ultrasound in infants during anesthesia induction.Methods Sixty ASA Ⅰ infants aged 1-3 yr,undergoing elective surgery,were randomly assigned to three groups ac-cording to facemask ventilation pressure:10 cm H 2 O (P10),1 5 cm H 2 O (P1 5 )and 20 cm H 2 O (P20)with twenty in each group.Infants were injected with propofol 2 mg/kg,fentanyl 0.002 mg/kg,cis-atracurium 0.1 5 mg/kg for general anesthesia induction until consciousness lost,then face-mask pressure controlled ventilation was applied for 120 s.Some respiratory parameters (SpO 2 , PET CO 2 )were recorded at the time of loss of consciousness (T0 )and after facemask pressure con-trolled ventilation for 30 s(T1 ),60 s(T2 ),90 s(T3 ),120 s(T4 )and after tracheal intubation(T5 ). The cross-sectional transverse and longitudinal diameter and area were measured respectively using ul-trasound at T0 and T4 .Results In all groups,SpO 2 was greater than or equal to 99% at all time points.PET CO 2 at T1-T5 was significantly higher than that at T0 and PET CO 2 at T5 was higher than that at T4 in all three groups.There were statistically significant increases in the values of the antral cross sectional area before and after facemask pressure controlled ventilation in group P20 (P <0.05). Conclusion During anesthesia induction in infants,1 5 cm H 2 O facemask ventilation pressure can guarantee adequate ventilation,and avoid gastric insufflation.

Objective To investigate the effects of dexmedetomidine pretreatment on lung injury for patients after liver surgery. Meth-ods Sixty patients who had liver surgery in our hospital from August 2009 to February 2014 were equally divided into the treatment group and the control group, with 30 patients in each group. Both of the two groups were given one-lung ventilation anesthesia. Patients in the treatment group were given continuous intravenous infusion of dexmedetomidine after induction of anesthesia while paitents in the control group were not. In the time of before induction of anesthesia (T0), closed chest (T1), immediately after surgery (T2), all patients were given the gas analysis, expression of inflammatory cytokines and lung function testing and analysis. Results The diastolic blood pressure and heart rate at time points of T0, T1 and T2 in the two groups showed no significant difference (P> 0. 05). And the expression of TNF-αand SP-D at time points of T1 and T2 in the two groups were significantly higher than those at T0 (P<0. 05);while the expression of TNF-αand SP-D in the treatment group were significantly lower than those in the control group at time points of T1 and T2 (P<0. 05). The plateau air-way pressure and airway resistance in the treatment group at T2 and T3 were significantly lower than that at T1 (P<0. 05), and there were statistically significant differences compared with the control group (P<0. 05). Conclusion The dexmedetomidine pretreatment for the liver surgery patients can inhibit the inflammatory response, while improve lung airway plateau pressure and airway resistance. It has no significant effect for blood, so it can play a protective role for lung function.

During the foreign aid mission against Ebola,the 302 Military Hospital of PLA strengthened emergency science research management according to the features of this task and the reality,and toke effective measures in research direction selection,human resources concordance,scientific potential transformation and other aspects,which contributed to the successful completion of this mission.They gathered experiences in emergency science research management and gave recommendations for similar tasks in the future.

Objective To investigate the treatment and clinical outcomes in developmental dislocation of the hip in chil?dren above 8 years old. Methods We retrospectively reviewed the results of operation treatment for developmental dislocation of the hip in 94 children (112 hips) from 2006 to 2012. The age of the patients ranged from 8.2 to 13.6 years at the time of treatment, with an average age 9.8 years. In 94 patients, there are 18 males and 76 females. The patients were classified into three group based on the age at time of operation:Group 8-9 years old, Group 10-11 years old, Group 12-13 years old. The dislocation of hip was classified by T?nnis classification system:gradeⅡ34 hips, gradeⅢ29 hips, gradeⅣ49 hips. Surgery was performed in all the patients. The procedures consisted of open reduction of the hip, capsulorraphy, shortening and derotational osteotomy of proxi?mal femur, and acetabular osteotomy which include Pemberton osteotomy (66 hips), Salter osteotomy (30 hips), Ganz osteotomy (3 hips), Triple osteotomy (5 hips) and Chiari osteotomy (8 hips). McKay and Severin modified criteria were used to assess the func?tion and radiographic results of the hip. Results The average follow?up was 2.3 years ranged from 1 to 7 years. According to McKay modified criteria at final follow?up, 75 hips (67%) had excellent (22 hips) and good (53 hips) clinical results, 32 hips (29%) were fair and 5 hips (4%) were poor. According to the Severin criteria, the outcomes of T?nnis grade Ⅳgroup was significantly worse than T?nnis gradeⅡ,Ⅲgroup. There is no significant differences between T?nnisⅡandⅢtype groups. If the patients were classified by age at time of operation, the function of group 8-9 years old was significantly better than others group according to the McKay criteria; the group 12-13 years old was significantly worse than others group according to Severin criteria. Conclu?sion Open reduction with proximal femoral osteotomy and acetabular osteotomy was an effective procedure for the treatment of developmental dislocation of the hip in children above 8 years old. The surgical results were related to the age at time of treatment and T?nnis classification system; low dislocation (T?nnis Ⅱ, Ⅲ) and young age (younger than 10 years old) had better function and radiographic results compared with high dislocation (T?nnisⅣ) and elder age group.

Objective To study the pro-invasive effect of irradiation on human glioblastoma cell line U87 and its possible mechanism.Methods Cultured U87 cells received different doses of irradiation (0,2,and 4 Gy).The change in cellular invasiveness was measured using the real-time cell analyzer system.The activities of matrix metalloproteinase-2 (MMP2) and matrix metalloproteinase-9 (MMP9) in U87 ceils were measured by gelatin zymography before and after irradiation.The content and distribution of intracellular β-catenin after irradiation were determined by immunohistochemistry.The mRNA levels of Wnt/β-catenin target genes were measured by real-time quantitative PCR.Results After irradiation,the invasiveness of U87 cells increased significantly (P ＜ 0.01),which was dose-dependent within a certain dose range; the activities of MMP2 and MMP9 in U87 cells increased significantly (P =0.031 for MMP2 ; P =0.004 for MMP9) ;the content of β-catenin in U87 cells increased significantly (P ＜ 0.01),with translocation from the cell membrane and adherens junctions to the nucleus; the mRNA levels of Wnt/β-catenin-related genes (FZD7 and TCF1) increased significantly (P ＜ 0.01),and the transcription of Wnt/β-catenin target genes,especially those related to migration and invasion such as MMP2,MMP7,MMP9,and CD44,was significantly enhanced (P ＜ 0.05).Conclusions Irradiation can promote the invasion of glioblastoma U87 cells,possibly by activating the Wnt/β-catenin pathway and enhancing the transcription of migration-and invasion-related genes.

Objective To evaluate the effects of different depths of anesthesia with sevoflurane on cerebrovascular autoregulation in infants.Methods Twenty pediatric patients,of ASA physical status Ⅰ,aged 1-3 yr,undergoing elective hypospadias plasty surgery,were enrolled in the study.Single tube laryngeal mask was inserted after anesthesia was induced with 6％ sevoflurane inhalation.Caudal block was performed with 1 ml/kg of 0.2％ ropivacaine.Anesthesia was maintained with sevoflurane inhalation.The end-tidal sevoflurane concentration was adjusted to 1.8％,2.5％,3.3％ and 4.0％,and each concentration was maintained at this level for 15 min.The cerebral blood flow was collected from the middle cerebral artery immediately before adjusting the next concentration to record the Doppler spectrum and transient hyperemic response ratio (THRR) was measured.Results THRR at different depths of anesthesia with sevoflurane was larger than 1.09,and was within the normal range.THRR was significantly lower when the end-tidal concentration was 2.5％,3.3％ and 4.0％ than that obtained when end-tidal concentration was 1.8％.No significantdifference was detected in THRR between 2.5％ and 3.3 ％.THRR was significantly lower when the end-tidal concentration was 4.0 ％ than that obtained when the end-tidal concentration was 2.5％ and 3.3％.Conclusion Although the inhibitory effect on cerebrovascular autoregulation provided by sevoflurane anesthesia provides no obvious clinical significance,it shows statistical significance in infants.

Objective To evaluate the safety and diagnostic accuracy of preoperative endoscopic ultrasound-guid﹣ed fine-needle aspiration in patients with pancreatic cancer. Methods 256 patients with pancreatic cancer from Jan﹣uary 2010 to December 2014, 82 were considered resectable on the basis of cross-sectional imaging findings. Of these patients, 54 underwent EUS-FNA before surgery (FNA+group) and 28 underwent surgery without preoperative EUS-FNA (FNA- group), the diagnosis result of EUS-FNA and the survival time of the two groups were observed. Results All 54 lesions were visible on EUS, and all 54 attempts at FNA were technically successful. The diagnostic accuracy according to cytology and histology findings was 94.44 % (51/54) and 88.89% (48/54), respectively, and the total accuracy was 94.44 % (51/54). Two patients developed mild pancreatitis and two hemorrhage after EUS-FNA but were successfully treated by conservative therapy. No severe complications occurred after EUS-FNA. In the FNA+and FNA- groups, the median relapse-free survival (RFS) was 282 and 265 d, respectively (P>0.05), and the median overall survival (OS) was 568 and 557 d, respectively (P>0.05). RFS and OS were therefore not inferior in the FNA+group. These data indicate that the usage of EUS-FNA did not influence RFS or OS, nor did it increase the risk of other complications. Conclusions Preoperative EUS-FNA is a safe and accurate diagnostic method.

OBJECTIVETo summarize the clinical manifestation and diagnosis of ganglioneuroma in spine and investigate the clinical effect of surgical treatment.

METHODSThe clinical data of 6 patients underwent a surgery for ganglioneuroma in spine from January 2008 to January 2015 were retrospectively analyzed. There were 4 males and 2 females, aged from 2 to 63 years old with an average of 34.6 years. The courses of disease were from 3 days to 17 years. Five patients complicated with superficial hypesthesia in correlative level of tumor, and the muscle strength under tumor plane had decreased at different levels, with the strength of grade II-IV. Two cases complicated with hypermyotonia and positive bilateral Hoffmann's and Babinski sign. Five cases were sporadic lesion in correlative spinal canal and one case complicated with the giant occupying lesion in thoracic cavity.

RESULTSSix operations had been performed including 5 en bloc and 1 subtotal resection. Postoperative pathological results showed tumor cells scattered or fasciculated inserted into Schwann cells in the stroma. In 2 patients complicated with radiculalgia before operation, 1 case was relieved and 1 was invariant after operation. All 4 patients with preoperative dyscinesia in the limbs obtained improvement after operation. All the patients were followed up from 0.3 to 6.8 years with an average of 2.5 years. At the final follow-up, according to ASIA grade, 5 cases were good and 1 case was invariant. During the follow-up, only 1 patient experienced chemoradiation because of merging ganglioneuroblastoma and receiving subtotal resection. No recurrence in other 5 cases.

CONCLUSIONGanglioneuroma is a benign and rare tumors in spine. Clinically, radicular pain and sensory-motor disorders are the main manifestations. Its diagnosis depends on pathological examination. Prognosis of surgical treatment is good.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Ganglioneuroma ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spinal Neoplasms ; diagnosis ; surgery