Insertion of external ventricular drainage (EVD) is an effective neurosurgical treatment approach. The accuracy of EVD insertion is related to potential complications, and the precise placement of the catheter tip can reduce the incidence of complications. With the progress of medical technology, the research and application of EVD catheterization technology are developing rapidly. This paper reviews the traditional blind catheterization, computed tomography, ultrasound guidance, mixed reality navigation system, laser positioning neural navigation, mobile device neural navigation, stereotactic system, and the visualization technology of the whole process of neuroendoscope assisted ventricle puncture to guide EVD catheterization to provide references for clinical decision-making by medical staff.
Humans ; Drainage/methods* ; Catheterization/methods* ; Cerebral Ventricles/surgery*

Collagen contains abundant cell binding motifs, which are conducive to adhesion, migration, and differentiation, maintain cell vitality and promote cell proliferation. However, pure collagen hydrogel has some shortcomings such as poor mechanical properties, poor thermal stability and fast degradation. Numerous studies have shown that the properties of collagen can be improved by combining it with natural polysaccharides such as alginate, chitosan, hyaluronic acid and cellulose. In this paper, the research status and biological application fields of four kinds of composite hydrogels, including collagen-alginate composite hydrogels, collagen-chitosan hydrogels, collagen-hyaluronic acid hydrogels and collagen-cellulose hydrogels, were summarized. The common preparation methods of four kinds of composite hydrogels were introduced, and the future development direction of collagen-based composite hydrogels was prospected.
Hydrogels/chemical synthesis* ; Collagen/chemistry* ; Polysaccharides/chemistry* ; Alginates/chemistry* ; Hyaluronic Acid/chemistry* ; Chitosan/chemistry* ; Biocompatible Materials/chemistry* ; Humans ; Tissue Engineering/methods* ; Cellulose/chemistry* ; Tissue Scaffolds

BACKGROUND: Ventricular remodeling after acute anterior wall ST-segment elevation myocardial infarction (AAMI) is an important factor in occurrence of heart failure which additionally results in poor prognosis. Therefore, the treatment of ventricular remodeling needs to be further optimized. Compound Danshen Dripping Pills (CDDP), a traditional Chinese medicine, exerts a protective effect on microcirculatory disturbance caused by ischemia-reperfusion injury and attenuates ventricular remodeling after myocardial infarction. OBJECTIVE: This study is designed to evaluate the efficacy and safety of CDDP in improving ventricular remodeling and cardiac function after AAMI on a larger scale. METHODS: This study is a multi-center, randomized, double-blind, placebo-controlled, parallel-group clinical trial. The total of 268 patients with AAMI after primary percutaneous coronary intervention (pPCI) will be randomly assigned 1:1 to the CDDP group (n=134) and control group (n=134) with a follow-up of 48 weeks. Both groups will be treated with standard therapy of ST-segment elevation myocardial infarction (STEMI), with the CDDP group administrating 20 tablets of CDDP before pPCI and 10 tablets 3 times daily after pPCI, and the control group treated with a placebo simultaneously. The primary endpoint is 48-week echocardiographic outcomes including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVI), and left ventricular end-systolic volume index (LVESVI). The secondary endpoint includes the change in N terminal pro-B-type natriuretic peptide (NT-proBNP) level, arrhythmias, and cardiovascular events (death, cardiac arrest, or cardiopulmonary resuscitation, rehospitalization due to heart failure or angina pectoris, deterioration of cardiac function, and stroke). Investigators and patients are both blinded to the allocated treatment. DISCUSSION This prospective study will investigate the efficacy and safety of CDDP in improving ventricular remodeling and cardiac function in patients undergoing pPCI for a first AAMI. Patients in the CDDP group will be compared with those in the control group. If certified to be effective, CDDP treatment in AAMI will probably be advised on a larger scale. (Trial registration No. NCT05000411).
Humans ; ST Elevation Myocardial Infarction/therapy* ; Stroke Volume ; Ventricular Remodeling ; Prospective Studies ; Microcirculation ; Ventricular Function, Left ; Myocardial Infarction/etiology* ; Treatment Outcome ; Percutaneous Coronary Intervention/adverse effects* ; Heart Failure/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic

Objective:To investigate the relationship between NOD-like receptor pyrin domain containing 3(NLRP3)/cysteine aspartate-specific protease(Caspase)-1 signaling pathway and esophageal inflammation by observing the effect of Xuanfu Daizhe Tang on the composition of inflammatory body and the expression of relevant inflammatory factors in rats with reflux esophagitis (RE), so as to explain the mechanism of Xuanfu Daizhe Tang in treating RE. Method:Sixty healthy male Wistar rats were randomly divided into four groups:the normal control group, the model control group, the Xuanfu Daizhe Tang group (9.89 g·kg^-1) and the positive control group (omeprazole enteric-coated tablets+mosapride, 2.58 mg·kg^-1), with 15 rats in each group. Except for the blank control group, the remaining rats were operated by " 4.2 mm pyloric clip+2/3 gastric fundus ligation" to establish models. Since the 8^th day after the operation, the rats were given corresponding drugs twice a day for 14 days. The arterial blood and esophageal tissues were taken out at the 15^th day after the intervention. The pathological morphology of esophagus was observed by naked eyes and under light microscopy. The secretion of cytokines Caspase-1 and interleukin(IL)-1β in serum was detected by enzyme linked immunosorbent assay(ELISA). The expressions of NLRP3, Caspase-1 and IL-1β in esophagus were detected by Western blot. Result:Compared with the normal group, the injury of esophageal mucosa in the model group was the most serious. Compared with the normal group, the levels of Caspase-1 and IL-1β in serum and the expression of NLRP3 protein in esophageal tissue of the model group were significantly increased (P<0.05, P<0.01). Compared with the model group, Xuanfu Daizhe Tang could significantly reduce the contents of Caspase-1 and IL-1β in serum of rats, and down-regulate the expressions of NLRP3, Caspase-1 and IL-1β protein in esophageal tissue (P<0.05, P<0.01). Conclusion:Xuanfu Daizhe Tang can regulate the expressions of NLRP3 and Caspase-1, and reduce the content of IL-1β, suggesting that it may antagonize esophageal inflammatory response, reduce esophageal inflammatory injury and treat RE by inhibiting the activation of NLRP3/Caspase-1 signaling pathway.

Objective: To observe the effect of anti-inflammatory by preventative moxibustion at Tianshu Acupoint (ST25) on UC rats, and to investigate the protective mechanism of preventative moxibustion at Tianshu Acupoint (ST25) onintestinal mucosal barrier in UC rats. Methods: A total of 28 male Sprague-Dawley rats were randomly divided into thenormal group (NC), the ulcerative colitis group (UC), the herb-partitioned moxibustion pretreatment group (HM+P), thewarming moxibustion pretreatment group (WM+P), with 7 in each group. The HM+P and the WM+P were treated withherb-partitioned moxibustion and warming moxibustion for 7 days before the model was established. After pretreatment, the UC, the HM+P and the WM+P were given 4％ dextran sodium sulfate solution for 7 days. Observe the rat pathologicalchanges of colon tissue by HE staining, detect the protein expression in rat colon tissue by immunohistochemistry andwestern blot. Results: compared with the NC group, the pathological scores were increased, the expression of occludin, JAM1, MUC2, ZO-1 were decreased and the expression of NF-κBp65, IL-1βincreased in UC group (P ＜ 0.05);compared with the UC group, the pathological score decreased, the protein expression of occludin, JAM1, MUC2, ZO-1 increased, the protein expression of NF-κBp65, IL-1βdecreased in HM + P group (P ＜ 0.05), the Pathological scoredecreased, the Protein expression of occludin, MUC2, ZO-1 increased, the Protein expression of IL-1β decreased inWM + P group (P ＜ 0.05) . Conclusion: The herb-partitioned moxibustion pretreatment and the warming moxibustionpretreatment could increase the expression of intestinal barrier related proteins in UC rats, it may be one of themechanisms of moxibustion to relieve colonic inflammation of UC.

Objective In cerebral aneurysm clipping and embolization, blood pressure control and temporary parent artery blocking are common methods to prevent aneurysm rupture. Their influence on the prognosis is uncertain. In this study, we try to find out the association between methods above and prognostic indicators.Methods We held a retrospective analysis on patients' medical records of cerebral aneurysms surgical clipping and endovascular coiling , and recorded gender, age, diagnosis, Hunt-Hess grade, Glasgow coma scale score, treatment methods, a history of hypertension, preoperative systolic blood pressure, with or without controlled hypotension, systolic blood pressure difference before and after controlled hypotension, with or without temporary artery blocking, with or without hypertension after treated aneurysm, prognostic indicators including mortality after 1 month, intensive care unit (ICU) stay time of survivors, discharged Glasgow outcome scale (GOS) score. Prognostic indicators were regarded as dependent variable, all the factors were regarded as independent variable, and the strength analysis of influence factors on prognostic indicators was made by binary logistic regression.Results Total cases were 165, including 68 males and 97 females, with an average age of 56 (12-85) years. The mortality after 1 month was 10.9% (18 cases). The ICU stay time of survivors was 7.35 (0-67) days. GOS score at discharge was 1-3 in 40 (24.2%) patients and 4-5 in 125 (75.8%) patients. Systolic blood pressure difference before and after controlled hypotension was an independent factor influencing mortality (t=2.273, P=0.024), and the greater the difference was, the higher the mortality would be. Timely hypertension after aneurysm treated was an independent factor affecting ICU stay time of survivors and patients with hypertension had shorter ICU stay time (χ=10.017, P=0.001). Blood pressure control (χ=0.088, P=0.767) and temporary blocking (χ=1.307, P=0.253) did not show significant influence on GOS score at discharge.Conclusions Timely controlled hypertension after aneurysm clipping and embolization can significantly shorten the stay time in ICU. The degree of controlled hypotension associates with postoperative mortality, the greater systolic blood pressure difference before and after antihypertensive treatment is, the higher the mortality will be.

OBJECTIVETo observe the effects of expansive pedicle screws fixation combined Wright artificial bone implantation in treating thoracolumbar burst fracture of the elderly.

METHODSFrom March 2007 to July 2009, 12 patients with thoracolumbar burst fractures were treated with surgery in the study. There were 7 males and 5 females, with an average age of 62.3 years (from 56 to 71 years). Nerve functions of all patients were ASIA classified grade E. According to TLICS score system, 6 points were in 5 cases and 7 points were in 7 cases. Expansive pedicle screw system was used and Wright artificial bone was injected into the injuried vertebrae. The anterior border height of vertebral body and Cobb angle were observed at the preoperation, postoperation and final follow-up.

RESULTSAll patients were followed up from 10 to 15 months with an average of 12 months. Wounds healed well, pain in the chest-back abated, no the expansive pedicle screws loosened or broke down. The anterior border height of vertebral body increased from (32.3 +/- 9.1)% preoperatively to (95.3 +/- 3.2)% postoperatively; and the Cobb angle decreased from (31.6 +/- 6.8) degrees preoperatively to (4.5 +/- 3.2) degrees postoperatively. There was significant difference between two groups (P<0.01). After 3 months, the anterior border height of vertebral body was (94.7 +/- 3.3)% and the Cobb angle was (4.6 +/- 3.4) degrees; at the final follow-up, the anterior border height of vertebral body was (93.2 +/- 3.6)% and the Cobb angle was (5.3 +/- 3.7) degrees. There was no significant difference between the two data (P>0.05).

CONCLUSIONThe combination of expansive pedicle screws fixation and Wright artificial bone injection is a good treatment for thoracolumbar burst fracture, with advantages such as easy operation and good effect, which mainly applied to patients with no obvious nerve injuries.

Aged ; Bone Screws ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; diagnostic imaging ; injuries ; surgery ; Male ; Middle Aged ; Spinal Fractures ; diagnostic imaging ; surgery ; Thoracic Injuries ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

OBJECTIVETo observe the outcome of ACL reconstruction with tibial-remnant preserving technique using hamstring autograft.

METHODSFrom January 2007 to June 2009,18 patients, including 11 male and 7 female with an average age of 28.2 years (from 18 to 42 years), received ACL reconstruction in Kunshan traditional Chinese medicine hospital, Jiangsu province. All cases were confirmed that the remnant of torn ACL were more than 1/3 by arthroscopic observation. The gracillis and semitendinosus tendons harvested from the patient were folded and weaved as a graft, which was pulled into the femoral and tibia tunnel through the sheath formed by the remnant preserved carefully, then fixed by Rigidfix at femoral side and Intrafix at tibial side respectively. The Lysholm scores were recorded at the last follow-up to evaluate the postoperative knee function. The knee stability, range of motion (ROM), and proprioception were evaluated by physical examination.

RESULTSThe average duration of follow-up of all 18 patients was 17.3 months (ranged from 15 to 24 months), no synovitis, graft tear, and ROM limitation were found. The average postoperative Lysholm score was (91.56 +/- 4.60) improved from preoperative (49.43 +/- 2.85) (P < 0.05). There were no differences between bilateral knees on the knee flexion (P > 0.05).

CONCLUSIONTo preserve the tibial remnant of torn ACL during ACL reconstruction had good outcomes, and contributed to recovery of knee proprioceptive function.

Adolescent ; Adult ; Anterior Cruciate Ligament Reconstruction ; methods ; Female ; Humans ; Male ; Range of Motion, Articular ; Transplantation, Autologous