Objective:To explore the action mechanism of suppressing expression of mitogen- activated protein kinase 14（MAPK14）to alleviate glutamate excitatory toxicity and its neuronal protection effect.Methods:Lentivirus-mediated MAPK14 interference vector was synthetized by Shanghai Jikai Gene Chemical Technology Co.，Ltd. Astrocytes were obtained from SD rats 48 hours after birth，which were cultured in vitro and transfected by lentivirus-mediated transfection. According to the random number table，the cells were divided into three groups：（1）un-transfected group（normal group）with normal astrocytes and the cells were cultured in regular medium composed of Dulbecco's?modified Eagle's?medium（DMEM）；（2）negative control group with astrocytes transfected by MAPK14 no-loaded interference vector；（3）lentivirus transfected group with astrocytes transfected by MAPK14 interference vector. Seventy-two hours after transfection，astrocytes were co-cultured with neurons for 48 hours，and then they were cultured in a medium containing glutamate for 2 hours. The detection indexes included the optimal multiplicity of infection（MOI）value for astrocytes transfected by lentivirus vector，mRNA levels of MAPK14 and glial glutamate transporter 1（GLT-1）detected by rPCR 72 hours after transfection，protein levels of MAPK14 and GLT-1 detected by Western blot 72 hours after transfection，level of lactate dehydrogenase（LDH）and mortality of neurons measured by spectrophotometry and flow cytometry 2 hours after culturing in the medium with glutamate. Results:（1）The optimal MOI value for lentivirus transfecting astrocytes was 30，and astrocytes grew well after transfection.（2）Seventy-two after transfection，the mRNA level of MAPK14 in lentivirus transfected group（0.005 7±0.000 6）was significantly decreased as compared with un-transfected group（0.013 1±0.001 1）and negative control group（0.013 9±0.001 0）（ P<0.01），the mRNA level of GLT-1 in lentivirus transfected group（0.009 1±0.001 2）was not significantly changed as compared with un-transfected group（0.008 7±0.000 3）and negative control group（0.008 9±0.001 1）（ P>0.05）.（3）Seventy-two hours after transfection，the protein level of MAPK14 in lentivirus transfected group（0.29±0.04）was significantly decreased as compared with non-transfected group（0.61±0.05）and negative control group（0.63±0.01）（ P<0.01），the protein level of GLT-1 in lentivirus transfected group（0.73±0.06）was significantly increased as compared with un-transfected group（0.20±0.03）and negative control group（0.23±0.09）（ P<0.01）.（4）After astrocytes were co-cultured with neurons and subsequently cultured in the medium containing glutamate for 2 hours，the level of LDH in lentivirus transfected group［（109.67±2.40）U/L］was significantly lower than that in un-transfected group［（141.52±3.88）U/L］and negative control group［（141.29±3.61）U/L］（ P<0.01）. The mortality of neurons in lentivirus transfected group［（38.72±0.26）%］was significantly lower than that in un-transfected group［（52.94±1.36）%］and negative control group［（54.30±1.23）%］（ P<0.01）. Conclusions:The transfection with lentivirus-mediated MAPK14 interference vector can increase expression of GLT-1 in astrocytes to increase glutamate re-uptake and relieve the glutamate excitatory toxicity in neurons，which may provide a new experimental basis for future use of astrocyte gene regulation to alleviate neuronal injury caused by glutamate excitatory toxicity after traumatic brain injury.

The feasibility and safety of intracardiac echocardiography (ICE)-guided catheter ablation for atrial fibrillation (AF) using a minimal/zero-fluoroscopy approach have recently been reported. This approach helps to reduce ionizing radiation exposure and orthopedic complications resulting from using lead aprons. The objectives of this planned prospective, multicenter randomized controlled trial (RCT) (paroxysmal AF (PAF)-ICE trial; ChiCTR2000033624) are to evaluate the efficacy and safety of ICE-guided minimal-fluoroscopy ablation in patients with PAF and the impact on occupational hazards among lab staff.Patients will be randomized in a 1:1 ratio to 2 groups: minimal fluoroscopy group ( n = 216) and traditional approach group ( n = 216). In the minimal fluoroscopy group, an ICE catheter will be used for geometry/anatomic construction, transseptal puncture, catheter tracking, and effusion monitoring. Pulmonary vein isolation (PVI) will be performed using an open-irrigated radiofrequency SmartTouch Surround Flow or SmartTouch catheter (Biosense Webster, Diamond Bar, California, USA), and confirmed by a multipolar Lasso or PentaRay catheter (Biosense Webster). In the traditional approach group, an ICE catheter will not be used. Transseptal puncture will be performed under fluoroscopic guidance, with all geometries constructed by mapping the catheters. The primary efficacy endpoint is freedom from AF recurrence (without antiarrhythmic medications) at 12 months after ablation. Other endpoints include duration of lead apron use, measures of intra-procedural efficiency, and peri-procedural complications. This RCT will evaluate the efficacy and safety of ICE-guided minimal-fluoroscopy ablation in patients with PAF, also evaluate the benefits to lab staff (regarding reducing occupational hazards) related to this "minimal/zero-fluoroscopy" and "leadless" mode.

The feasibility and safety of intracardiac echocardiography (ICE)-guided catheter ablation for atrial fibrillation (AF) using a minimal/zero-fluoroscopy approach have recently been reported. This approach helps to reduce ionizing radiation exposure and orthopedic complications resulting from using lead aprons. The objectives of this planned prospective, multicenter randomized controlled trial (RCT) (paroxysmal AF (PAF)-ICE trial; ChiCTR2000033624) are to evaluate the efficacy and safety of ICE-guided minimal-fluoroscopy ablation in patients with PAF and the impact on occupational hazards among lab staff.Patients will be randomized in a 1:1 ratio to 2 groups: minimal fluoroscopy group ( n = 216) and traditional approach group ( n = 216). In the minimal fluoroscopy group, an ICE catheter will be used for geometry/anatomic construction, transseptal puncture, catheter tracking, and effusion monitoring. Pulmonary vein isolation (PVI) will be performed using an open-irrigated radiofrequency SmartTouch Surround Flow or SmartTouch catheter (Biosense Webster, Diamond Bar, California, USA), and confirmed by a multipolar Lasso or PentaRay catheter (Biosense Webster). In the traditional approach group, an ICE catheter will not be used. Transseptal puncture will be performed under fluoroscopic guidance, with all geometries constructed by mapping the catheters. The primary efficacy endpoint is freedom from AF recurrence (without antiarrhythmic medications) at 12 months after ablation. Other endpoints include duration of lead apron use, measures of intra-procedural efficiency, and peri-procedural complications. This RCT will evaluate the efficacy and safety of ICE-guided minimal-fluoroscopy ablation in patients with PAF, also evaluate the benefits to lab staff (regarding reducing occupational hazards) related to this "minimal/zero-fluoroscopy" and "leadless" mode.

OBJECTIVE: To evaluate the treatment outcome of patients with idiopathic sudden sensorineural hearing loss (ISSHL) with concomitant benign paroxysmal positional vertigo (BPPV). METHOD: Out of 252 ISSHL patients, 96 patients were diagnosed with complicating vertigo and examined using electronystagmography. All patients were divided into three groups, namely, ISSHL without vertigo group (n=156), ISSHL with non-BPPV vertigo group (n=70) and ISSHL with BPPV group (n=26). All patients received daily intravenous infusion of 200,000 U urokinase for 3 consecutive days and 100,000 U for 3 additional days. Concomitant medications included intravenous Ginkgo biloba leave compound and vitamin B6 and intramuscular vitamins B1 and B12 for 2 weeks. Twenty-six patients diagnosed with BPPV on electronystagmography positioning test also received canalith repositioning maneuver. RESULT: Vertigo-associated symptoms completely resolved after canalith repositioning maneuver in ISSHL patients with complicating BPPV. With respect to post-treatment hearing, ISSHL patients without vertigo exhibited a similar improvement as compared to those with BPPV, while those with non-BPPV vertigo had a significantly less improvement than those without vertigo and with BPPV. CONCLUSION ISSHL patients with complicating BPPV exhibit a relatively favorable outcome with respect to hearing and vertigo-associated symptoms after medical and repositioning treatment.
Adult ; Aged ; Aged, 80 and over ; Benign Paroxysmal Positional Vertigo ; complications ; therapy ; Female ; Hearing Loss, Sudden ; complications ; therapy ; Humans ; Male ; Middle Aged ; Prognosis

ObjectiveTo investigate the correlation of brainstem auditory evoked potentials(BAEP) and somatic evoked potentials (SEP) with therapeutic outcome of brain stem hemorrhage patients.MethodsBAEP and SEP were detected in the early period of 25 caees with brain stem hemorrhage by evoked potential instrument,and were surveilled dynamically.ResultsThere was good prognosis in the patients whose BAEP and SEP were normal in the first time and repeated detection.Poor prognosis happened in ones whose BAEP and SEP were abnormal in the first time and repeated detection.The difference was significant between them(P＜0.05).ConclusionCombined detection and dynamic surveillance of BAEP and SEP could predict accurately the curative result of patients with brain stem hemorrhage.

OBJECTIVE: To explore the curative effect of endoscopic myringoplasty with modified sandwich technique. METHOD: Endoscopic myringoplasty was performed with modified sandwich technique for traumatic perforation of tympanic membrane and chronic suppurative otitis media (simple type) of 43 patients. RESULT: All the perforating tympanic membranes were repaired successfully in one time. Six months after the operation, 1 case was out of follow-up and 2 cases were failed: one got a small perforation when the transplantation shifted and the transplantation of the other one was lost because of infection. The closure rate of tympanic membrane perforations was 95.2%. The air-bone gap of speech frequency of 28 ears increased by > 15-20 dB, 8 ears were enhanced by 10-15 dB, while 6 ears (including 2 failed cases) without improvement. The acoustic immittance test showed that "Type A", "Type As", "Type Ad", "Type B" and "Type C" tympanogram were in 30 ears,12, 4, 6 and 4, respectively. CONCLUSION The endoscopic myringoplasty with modified sandwich technique has the advantages of simple operation, better security, less trauma and better efficacy, and it is worth popularizing.
Adolescent ; Adult ; Aged ; Ear ; surgery ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Myringoplasty ; methods ; Tympanic Membrane Perforation ; surgery ; Young Adult

Objective To explore the curative effect of standard craniotomy with large bone flap of the treatment for frontal-temporal severe craniocerebral injury patients.Methods Standard craniotomy with large bone flap was performed on 63 patients with frontal-temporal severe craniocerebral injury.All postoperative patients were followed up.The curative effect was assessed according to GOS.Results All patients were followed up for 1 year.According to the GOS,28 cases recovered well,12 cases became moderately disabled,4 cases were severely disabled,3 cases was in vegetative state and 16 cases died.The mortality rate was 25.4%.Conclusions Standard craniotomy with large bone flap is the best method of the treatment for frontal-temporal severe craniocerebral injury.Timely and thoroughly standard craniotomy with large bone flap for frontal-temporal severe craniocerebral injury patients can significantly improve the the curative effect of the patients and reduce the rate of mortality.