Objective To investigate the risk factors of aggravated cerebral edema after meningioma surgery.MethodsRespectively analyze the clinical data of 187 patients received neurosurgery operation in our hospital from January 1, 2016 to February 5, 2018 and their postoperative aggravated cerebral edema, the related risk factors for brain edema after meningioma surgery was summarized.Results The incidence of aggravated cerebral edema in patients without preoperative edema (26.23％) was higher than that in patients with preoperative edema (13.8％), the difference was not statistically significant, probably due to the small number of cases or other related factors.Multivariate analysis of all related factors found that preoperative edema was the influencing factor for the increase of brain edema after meningioma surgery (P=0.005).It was found by single factor analysis that tumor site was a risk factor for the aggravation of cerebral edema after meningioma surgery.Multivariate analysis and multiple rate comparisons revealed that the sagittal sinus falx area was an independent risk factor for the aggravation of cerebral edema after meningioma surgery.ConclusionThe presence of peritumoral edema before surgery may be a protective factor for the postoperative brain edema.The incidence of postoperative cerebral edema was significantly higher in meningiomas located near the sagittal sinus falx than that of other sites.Therefore, meningiomas located near the sagittal sinus falx should be attached great importance.During the operation, the venous drainage should be protected, the perioperative management should be strengthened, and hormone and subsequent dehydration should be given timely to improve the prognosis of patients.

Objective To evaluate the effect of hydrogen on the expression of matrix metalloproteinase-9 (MMP-9) in brain tissues of mice with sepsis-associated encephalopathy (SAE).Methods A total of 212 clean-grade healthy male C57BL/6J mice,aged 6-8 weeks,weighing 20-25 g,were divided into 4 groups (n =53 each) using a random number table method:sham operation group (group Sham),sham operation plus hydrogen group (group Sham+H2),group SAE and SAE plus hydrogen group (group SAE+ H2).The sepsis model was established by intraperitoneally injecting human fecal suspension.Sham+H2 and SAE+H2 groups inhaled 2％ hydrogen for 1 h at 1 and 6 h after establishing the model,respectively.Postoperative 14-day survival rate was recorded.Evans blue (EB) was injected into the tail vein at 24 h after establishing the model,and the content of EB in brain tissues was calculated.Brain tissues were taken for determination of brain water content.The expression of tumor necrosis factor-alpha (TNF-α),interleukin-6 (IL-6) and high-mobility group box 1 protein (HMGB1) in hippocampal tissues was detected by enzymelinked immunosorbent assay.The expression of MMP-9 and ZO-1 protein and mRNA in hippocampal tissues was determined by Western blot and real-time polymerase chain reaction,respectively,at 6,12 and 24 h after establishing the model.Results Compared with Sham group,the 14-day survival rate was significantly decreased,the EB content in brain tissues,brain water content,and contents of TNF-α,IL-6 and HMGB1 were significantly increased,the expression of MMP-9 protein and mRNA was up-regulated,and the expression of ZO-1 protein and mRNA was down-regulated in SAE and SAE+H2 groups (P＜0.05),and no significant change was found in the parameters mentioned above in group Sham+H2 (P＞0.05).Compared with group SAE,the 14-day survival rate was significantly increased,the EB content in brain tissues,brain water content,and contents of TNF-α,IL-6 and HMGB1 were significantly decreased,the expression of MMP-9 protein and mRNA was down-regulated,and the expression of ZO-1 protein and mRNA was up-regulated in group SAE+H2 (P＜0.05).Conclusion The mechanism by which hydrogen attenuates the blood-brain barrier damage may be related to inhibiting MMP-9 expression and to reducing inflammatory responses in brain tissues of SAE mice.

Objective: To evaluate the effect of hydrogen on mitochondrial biosynthesis in the hippocampus of mice with sepsis-associated encephalopathy (SAE). Method: Two hundred and twenty-four healthy clean-grade male C57BL/6J mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups (n=56 each) using a random number table method: sham operation group (group SH), sham operation plus hydrogen group (group SH+ H₂), group SAE, and SAE plus hydrogen group (group SAE+ H₂). The model of SAE was established by cecal ligation and puncture in anesthetized mice.Group SH+ H₂ and group SAE+ H₂ inhaled 2% hydrogen for 1 h starting from 1 and 6 h after operation, respectively.Twenty mice were selectde to record the postoperative 7-day survival rate.The remaining animals were sacrificed at 24 h after operation, and brain tissues were taken for examination of the pathological changes in hippocampal CA1 region (with a light microscope) and for determination of neuronal apoptosis (by TUNEL), mitochondrial membrane potential (MMP) (by fluorescence spectrophotometry) and ATP content (by a bioluminescence assay). The apoptosis rate was calculated.The expression of peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1α) in hippocampus was determined by Western blot at 6, 12 and 24 h after operation. Results: Compared with group SH, the postoperative 7-day survival rate was significantly decreased, the apoptosis rate of hippocampal neurons was increased, the contents of MMP and ATP were decreased, and the expression of PGC-1α was up-regulated in SAE and SAE+ H₂groups (P<0.05), and no significant change was found in the parameters mentioned above in group SH+ H₂(P>0.05). Compared with group SAE, the postoperative 7-day survival rate was significantly increased, and the apoptosis rate of hippocampal neurons was decreased, the contents of MMP and ATP were increased, and the expression of PGC-1α was up-regulated (P<0.05), and the pathological changes of hippocampal tissues were significantly attenuated in group SAE+ H₂. Conclusion The mechanism by which hydrogen mitigates SAE may be related to promoting mitochondrial biosynthesis in mice.

Objective To understand the prevalence of Clonorchis sinensis infection among residents in two communities of Zhongshan City,and evaluate the effect of albendazole treatment,so as to offer the evidence for formulating the strategy of clo-norchiasis prevention and control.Methods The stool specimens were collected from the residents of two comprehensive dem-onstration areas,and the eggs of C.sinensis were detected by Kato-Katz technique.Those who were tested positive were treated with albendazole(0.4,twice a day for 4 days in adults,and half dosage for children aged 16 years or below).Three weeks after the treatment,the stool specimens were recollected and retested to evaluate the effect. Results A total of 532 people were in-vestigated and 96 were tested positive,with an infection rate of 18.05%.The infection rate was 28.63%(69/241)in the males and 9.28%(27/291)in the females,and there was a significant difference between them(Χ2=334.99,P<0.01).The infection rate increased with the increase of the age(Χ2=63.84,P<0.01).Among the 96 positive residents,94 received the albendazole treatment,and 86 were retested after the treatment with a negative conversion rate of 91.86%(79/86).Of the 7 residents without the conversion,5 had irregular medication.No severe adverse reactions were reported during the period of treatment. Conclu-sions The infection rate of C.sinensis among residents in the two communities of Zhongshan City is high,especially among the males and aged people.The effect of albendazole is good in the treatment of C.sinensis infection.In the future,the general sur-vey and treatment should be strengthened in order to lower the infection rate.

Objective To study the efficacy and safety of carotid endarterectomy ( CEA) in the treatment of carotid artery stenosis with different neurological deficits .Methods The clinical data of 59 patients with carotid stenosis treated by carotid endarterectomy in the department of neurosurgery of affiliated hospital of Xuzhou medical university from September 2015 to February 2017 were analyzed retrospectively ,a total of 62 operations were performed in these patients ( including 3 patients accepted bilateral operation ) .According to the preoperative 1 day nerve function which evaluated by the modified Rankin scale (mRS)score,they were divided into mRS <3 group(n=47),mRS≥3 group (n=15).They were followed up for 6 to 24 months,the neurological function of 62 patients was scored again by mRS at 6 months after sur-gery.The clinical data and the difference of surgical efficacy and safety of perioperative period between the 2 groups were analyzed and com-pared.Results The 62 times of operations were successful in patients .The neurological function of the 2 groups were significantly improved compared with the preoperative,the difference was statistically significant(P<0.05).In the mRS≥3 group,there were 1 patients with perio-perative cerebral infarction died of cerebral hernia ,1 case of consciousness disorder caused by high perfusion and 1 cases of postoperative in-tracranial hemorrhage caused by high perfusion .In the mRS<3 group,there was 1 case left contralateral hemiplegia caused by a large area of cerebral infarction .The incidence of cerebral apoplexy within 30 days after procedure in the mRS≥3 group was significantly higher than that in the mRS<3 group.There was no new stroke in 61 patients during the long-term follow-up.Conclusion Mild(mRS<3) and severe(mRS≥3) of patients has improved nervous function from CEA;perioperative risk of patients with severe neurological deficits is relatively higher , but the preventive effect for the prevention of ischemic stroke recurrence is worthwhile .

Objective To compare the clinical efficacies of polypropylene-polyglactic composite mesh, polyester mesh, polypropylene mesh in Lichtenstein repair for inguinal hernia.Methods The clinical data of 1 080 patients with primary unilateral inguinal hernia who were admitted to the Tianjin People's Hospital from February 2012 to May 2013 were prospectively analyzed.A randomized controlled study was performed based on a random numble table.All the patients were allocated into the ProGrip group (Parietex ProGripTM Self-Fixating Mesh), PET group (ParietexTM Lightweight Monofilament Polyester Mesh) and PP group (BardTM Soft Mesh).Patients received standard Lichtenstein tension-free repair under local anesthesia and were followed up by outpatient examination and telephone interview till May 2014.The indexs observed during the follow-up included occurrence of complications, post-operative pain and postoperative health-related quality of life.The following indexes were recorded : time of mesh fixation, operation time, hernia recurrence, pain degree at postoperative week 1 and month 1, 6, 12 by numerical rating scale (NRS), quality of life at postoperative month 1 by SF-36 questionnaire survey including physical function, role physical, body pain, general health, vitality, social function, role emotional,mental health.Measurement data with normal distribution were presented as x ± s.Comparisons among groups were analyzed by ANOVA and pairwise comparison by t test.Measurement data with skewed distribution were presented as M (range) and repeated measurement data were analyzed using the repeated measures ANOVA.Count data were evaluated by the chi-square test and Fisher exact probability.Postoperative moderate and severe pain rates were evaluated by the Kaplan-Meier method and analyzed by the Log-rank test.Results There were 1 022 patients screened for eligibility including 367 patients in the ProGrip group, 346 patients in the PET group and 309 patients in the PP group.The time of mesh fixation and operation time were (1.3 ± 0.5) minutes and (30 ± 5) minutes in the ProGrip group, (4.9 ± 0.9) minutes and (45 ± 7) minutes in the PET group, (5.0 ± 0.9) minutes and (44 ± 7)minutes in the PP group, respectively, showing significant differences among the 3 groups (F =6.21, 4.33,P ＜ 0.05).There were significant differences in the time of mesh fixation and operation time between the ProGrip group and the PET group (t =1.36, 4.39, P ＜ 0.05), and also between the ProGrip group and the PP group (t =2.67, 2.99, P ＜ 0.05).There was no significant difference in the time of mesh fixation and operation time between the PET group and the PP group (t =0.98, 0.63, P ＞ 0.05).Nine hundred and nine patients were followed up for a median time of 13 months (range, 12-26 months) , with a follow-up rate of 88.943％ (909/1 022).The number of recurred hernia in the ProGrip group, the PET group and the PP group was 1, 0, 0,showing no significant difference (P ＞ 0.05).The NRS scores of pain from postoperative week 1 to postoperative month 12 were ranged from 0 (0-2) to 0 (0-0) in the ProGrip group, from 2(0-5) to 0(0-0) in the PET group and from 1 (0-4) to 0 (0-0) in the PP group.The number of patients with moderate and severe pain was ranged from 52(14.17％) to 0(0) in the ProGrip group, from 87 (25.14％) to 0 (0) in the PET group and from 89 (28.80％) to 0(0) in the PP group.There were no significant differences in the changing trends of NRS scores of pain and number of patients with moderate and severe pain among the 3 groups (F =1.66, x2=1.52, P ＞ 0.05).The scores of physical function in the ProGrip group, PET group, PP group at postoperative month 1 were 52 ± 4,50 ± 6, 50 ± 6, the scores of role physical were 50 ± 6, 50 ± 6, 50 ± 5, the scores of body pain were 52 ± 7, 52 ± 7, 52 ± 7, the scores of general health were 63 ± 4, 57 ± 9, 58 ± 8, the scores of vitality were 63 ± 5, 62 ± 6,63 ± 6, the scores of social function were 58 ± 4, 58 ± 8, 57 ± 8, the scores of role emotional were 59 ± 4, 57 ± 8,58 ± 8, and the scores of mental health were 65 ± 4, 63 ± 5, 63 ± 6, respectively, showing no significant differences in above indexes among the 3 groups (F =2.36,3.65,1.98,2.41, 6.32, 2.33, 4.21, 3.52, P ＞ 0.05).Conclusion Patients undergoing Lichtenstein repair for inguinal hernia with polypropylene-polyglactic composite mesh, polyester mesh and polypropylene mesh have comparative of incidence of postoperative complications, postoperative pain, quality of life, and present postoperative long-term low recurrence, low incidence of pain and relatively high quality of life.

To determine the optimal condition of pollen germination. The pollen of Prunella vulgaris was cultured in vitro. Pollen germination rates were recorded using 10% H3BO4, 30% Ca(NO3)2, 20% MgSO4 and 10% KNO3 as the basic mineral medium with PEG of different molecular weight, sucrose of various density and multiple pH value. The rates were also measured under different cultivation temperature and pollen acquisition time. The optimal condition of pollen germination is 10% H3 BO4, 30% Ca(NO3)2, 20% MgSO4, 10% KNO3, and 25% PEG-4000 as the medium, with pH about 6. 5 and pollen acquired at the beginning of blossom.
Flowers ; physiology ; Pollen ; physiology ; Prunella ; physiology

OBJECTIVETo evaluate the effect and complication of surgical treatment for Pilon fracture using the posterolateral approach.

METHODSFrom August 2009 to March 2011, 15 patients with Pilon fractures (2 in B3,13 in C) and with a separate displaced posterior malleolar fragment was treated in two-stage: the first stage management was on stabiliztion of the soft tissue envelope with temporary external fixator of spanning arthritis, and the second stage management was open reduction and internal fixation with posterolateral approach and anteromedial or anteralateral approach.

RESULTSAll patients were followed-up for 12 to 17 months (14.2 months in average). Thirteen of the 15 fractures healed, but 2 fractures needed autologous bone graft procedure duo to nonuion. There was no wound complication related to poterolateral incion. Fourteen fractures had less than 2 mm of incongruity of distal tibia joint. According to Baired-Jackson criteria, the results were excellent in 2 cases, good in 7, fair in 4, and poor in 2.

CONCLUSIONThe posterolateral approach offers direct visualization for the reduction and fixation of the fibula and posterior distal fragment of the tibia Pilon fractures, faciliate the management of this difficult fracture pattern.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; surgery

OBJECTIVEIntravenous anesthetics, such as propofol, are widely used in general anesthesia. Neurodegeneration and neurocognitive impairment after exposure to propofol in neonatal rats have raised concerns regarding the safety of pediatric anesthesia. We examined the effects of neonatal propofol exposure on brain cell viability, as well as expression of hippocampal survivin and Caspase-3 mRNA and protein.

METHODSOne hundred male Sprague-Dawley rats aged 7 d that were weighed 10-15 g were randomly divided into 4 groups (n = 25 each group). Group A: the rats were injected with no drugs. Group B: the rats were intraperitoneally injected with 50 mg/kg propofol. Group C: the rats were first intraperitoneally injected with 50 mg/kg propofol and another 50 mg/kg propofol was used when the dynamic response of rats appeared again. Group D: the rats were first intraperitoneally injected with 50 mg/kg propofol and another 50 mg/kg propofol was used three times once the dynamic response of rats appeared. To study the effects of propofol exposure on respiratory and metabolic function, arterial blood was aspirated from the left ventricle of neonatal rats 2 h after discontinuation of propofol. pH, PaO(2), PaCO(2), HCO(3)(-), BE and SaO(2) were detected by blood gas analyzer. Moreover, to examine the effects of propofol exposure on short-term cellular viability, the ultrastructure of neurons was observed by transmission electron microscope and Fluoro-Jade B (FJB) staining was performed to examine neuronal degeneration in hippocampal CA1 region of neonatal rats. Survivin and Caspase-3 mRNA and protein expression in hippocampus were detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) and Western blotting 2 h after discontinuation of propofol.

RESULTSThe time of anesthesia maintaince in newborn rats was the longest in Group D and the time of anesthesia maintaince in Group C was longer than that in Group B. Two hours after discontinuation of propofol, pH, PaO(2), PaCO(2), HCO(3)(-), BE and SaO(2) of arterial blood in rats were not significantly different among groups A, B, C and D (P > 0.05). The structure of hippocampal neurons was normal in Group A and Group B while 100 mg/kg propofol resulted in nuclear blebbing and 200 mg/kg propofol led to nuclear fragmentation, chromatin condensation and apoptotic bodies. Cellular degeneration, as measured by Fluoro-Jade B staining, significantly increased in hippocampal CA1 region in the anesthesia groups compared with littermates in the no anesthesia group. FJB-positive stained degenerative neurons in groups B, C and D were (2.5 ± 1.3), (7.1 ± 2.3) and (9.4 ± 2.6), which were different from that in Group A (0.6 ± 0.3) (P < 0.05). Moreover, the number of FJB-positive neurons was the highest in Group D, that in Group C was more than that in Group B. At the same time point, apoptosis was measured by expression of Caspase-3 and Survivin mRNA and protein in hippocampus of rats. Caspase-3 mRNA in groups A, B and C was (0.78 ± 0.12), (0.84 ± 0.17) and (0.89 ± 0.19), while Caspase-3 protein in groups A, B and C was (0.22 ± 0.05), (0.26 ± 0.07) and (0.21 ± 0.06). Survivin mRNA in groups A, B and C was (0.56 ± 0.12), (0.58 ± 0.15) and (0.53 ± 0.16), while Survivin protein in these 3 groups was (0.24 ± 0.07), (0.21 ± 0.05) and (0.23 ± 0.06). Compared with that in Group A, Caspase-3 and Survivin mRNA and protein were not significantly different among Group B and Group C (P > 0.05). However, Caspase-3 mRNA and protein in Group D were (1.21 ± 0.14) and (0.42 ± 0.12), which were higher than that in the other 3 groups (P < 0.05). Survivin mRNA and protein in Group D were lower than that in the other 3 groups (P < 0.05).

CONCLUSIONSA high dose of propofol exposure may destroy the structure of neurons, induce neurodegeneration, increase Caspase-3 activity and inhibit survivin expression in hippocampus of newborn rats in vivo.

Anesthetics, Intravenous ; administration & dosage ; pharmacology ; Animals ; Animals, Newborn ; Blood Gas Analysis ; Caspase 3 ; genetics ; metabolism ; Dose-Response Relationship, Drug ; Gene Expression Regulation ; drug effects ; Hippocampus ; drug effects ; metabolism ; Injections, Intraperitoneal ; Male ; Microtubule-Associated Proteins ; genetics ; metabolism ; Neurons ; metabolism ; pathology ; Propofol ; administration & dosage ; pharmacology ; RNA, Messenger ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo explore clinical effects of three nonparallel screws in treating femoral neck fractures.

METHODSFrom September 2008 and May 2009, 29 patients were treated, including 12 males and 17 females with an average age of 52 years (ranged from 27 to 62 years). Before operation, according to Garden classification system, 2 cases were Garden type II (undisplaced fracture), 18 cases were Garden type III (partial displaced fracture) and 9 cases were Garden type IV (complete displaced fracture). After fracture reduction in operation, Pauwels classification system was used to classify the type, and 12 cases were type II, 17 cases were type III Closed reduction and internal fixation with three non-parallel screws were used to treat. The surgery X-ray and follow-up X-ray were compared to observe whether femoral neck abbreviate and screw exit appeare. Harris scoring was used to evaluate function.

RESULTSAll patients were followed-up from 34 to 44 months with an average of 38 months. The mean time of bone union was 7 (ranged, 3 to 12) months. Nonunion occured in 4 cases with Garden IV, and femoral head necrosis occurred in 2 cases. For Harris scoring, two cases with nondisplaced fracture were 100. Among 27 cases with displaced fractures, 23 cases achieved bone union without femoral head necrosis, average Harris scale was 91.35 +/- 8.00, and the average Harris scale of 4 cases with bone nonunion was 61.23 +/- 5.12. For all but one, there was no femoral neck crispation after bone union.

CONCLUSIONNonparallel screws for femoral neck fractures can effectively control abbreviation and screw tail exit after fracture healing.

Adult ; Bone Screws ; Female ; Femoral Neck Fractures ; diagnostic imaging ; surgery ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed