1.Application value of ventricular intracranial pressure monitoring in the treatment of unilateral temporal lobe cerebral contusion
Xu ZHANG ; Yingying DING ; Liang ZHANG ; Xu REN ; Yunfei LI ; Xiaoming ZHU ; Junhui CHEN ; Tao CHEN ; Likun YANG ; Yuhai WANG
Chinese Journal of Trauma 2023;39(1):23-30
Objective:To explore the application value of ventricular intracranial pressure monitoring (V-ICPM) in the treatment of unilateral temporal lobe cerebral contusion.Methods:A retrospective cohort study was conducted to analyze the clinical data of 295 patients with unilateral temporal lobe cerebral contusion admitted to 904th Hospital of PLA Joint Support Force from January 2014 to August 2021, including 172 males and 123 females; aged 14-78 years [(46.3±14.7)years]. V-ICPM was used in 136 patients (V-ICPM group), who received surgical or non-surgical treatment according to the monitoring, while not in 159 patients (non-V-ICPM group), who received routine surgery or non-surgical treatment. The two groups were compared in terms of the rates of intracranial hematoma clearance by craniotomy, decompressive craniectomy (DC) and dehydration and osmotic therapy during hospitalization, use time of 20% mass fraction of mannitol and 30 g/L hypertonic salt, displacement rate of brain midline structure of head CT≥10 mm after discharge, rate of intracranial infection, hydrocephalus and epilepsy, and Glasgow Outcome Scale (GOS) at 6 months after discharge.Results:All patients were followed up for 6-12 months [(8.9±2.1)months]. During hospitalization, the rate of intracranial hematoma clearance by craniotomy and the rate of DC in V-ICPM group were 35.3% (48/136) and 8.1% (11/136), lower than 47.2% (75/159) and 22.0% (35/159) in non-V-ICPM group ( P<0.05 or 0.01). There was no significant difference between the two groups in the rate of dehydration and osmotic therapy or the use time of mannitol (all P>0.05). The use time of hypertonic salt in V-ICPM group was (7.2±2.5)days, more than (4.1±1.8)days in non-V-ICPM group ( P<0.05). After discharge, the displacement rate of brain midline structure of head CT in V-ICPM group was 29.4% (40/136), lower than 42.8% (68/159) in non-V-ICPM group ( P<0.05). There was no significant difference between the two groups in the rate of intracranial infection, hydrocephalus and epilepsy (all P>0.05). Six months after discharge, the good rate of GOS in V-ICPM group was 91.2% (124/136), significantly better than 81.8% (130/159) in non-V-ICPM group ( P<0.05). Conclusion:For unilateral temporal lobe cerebral contusion, V-ICPM is associated with reduced rate of craniotomy exploration and DC, decreased incidence of complications and improved prognosis of the patients in spite of longer use time of hypertonic salt.
2.Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus disease 2019 (version 2023)
Zeli ZHANG ; Shoujia SUN ; Yijun BAO ; Li BIE ; Yunxing CAO ; Yangong CHAO ; Juxiang CHEN ; Wenhua FANG ; Guang FENG ; Lei FENG ; Junfeng FENG ; Liang GAO ; Bingsha HAN ; Ping HAN ; Chenggong HU ; Jin HU ; Rong HU ; Wei HE ; Lijun HOU ; Xianjian HUANG ; Jiyao JIANG ; Rongcai JIANG ; Lihong LI ; Xiaopeng LI ; Jinfang LIU ; Jie LIU ; Shengqing LYU ; Binghui QIU ; Xizhou SUN ; Xiaochuan SUN ; Hengli TIAN ; Ye TIAN ; Ke WANG ; Ning WANG ; Xinjun WANG ; Donghai WANG ; Yuhai WANG ; Jianjun WANG ; Xingong WANG ; Junji WEI ; Feng XU ; Min XU ; Can YAN ; Wei YAN ; Xiaofeng YANG ; Chaohua YANG ; Rui ZHANG ; Yongming ZHANG ; Di ZHAO ; Jianxin ZHU ; Guoyi GAO ; Qibing HUANG
Chinese Journal of Trauma 2023;39(3):193-203
The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.
3.Effect of eIF4B knockout on apoptosis of mouse fetal liver cells.
Guoqing WANG ; Biao CHEN ; Yuhai CHEN ; Qianwen ZHU ; Min PENG ; Guijie GUO ; Jilong CHEN
Chinese Journal of Biotechnology 2022;38(9):3489-3500
Eukaryotic translation initiation factor 4B (eIF4B) plays an important role in mRNA translation initiation, cell survival and proliferation in vitro, but the in vivo function is poorly understood. In this study, via various experimental techniques such as hematoxylin-eosin (HE) staining, flow cytometry, Western blotting, and immunohistochemistry, we investigated the role of eIF4B in mouse embryo development using an eIF4B knockout (KO) mouse model and explored the mechanism. We found that the livers, but not lungs, brain, stomach, or pancreas, derived from eIF4B KO mouse embryos displayed severe pathological changes characterized by enhanced apoptosis and necrosis. Accordingly, high expression of cleaved-caspase 3, and excessive activation of mTOR signaling as evidenced by increased expression and phosphorylation of p70S6K and enhanced phosphorylation of 4EBP1, were observed in mouse embryonic fibroblasts and fetal livers from eIF4B KO mice. These results uncover a critical role of eIF4B in mouse embryo development and provide important insights into the biological functions of eIF4B in vivo.
Animals
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Apoptosis/genetics*
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Caspase 3
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Eosine Yellowish-(YS)
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Eukaryotic Initiation Factors/metabolism*
;
Fibroblasts
;
Hematoxylin
;
Liver/metabolism*
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Mice
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Ribosomal Protein S6 Kinases, 70-kDa/genetics*
;
TOR Serine-Threonine Kinases
4.Periosteum-covered iliac crest autografts for treatment of severe osteochondral lesions of talus
Yuhai MA ; Yu LIU ; Changsong CHEN ; Xiaohua HU ; Huadong YIN ; Jianxin HE ; Xiaofeng ZHU ; Chunhu WU
Chinese Journal of Trauma 2021;37(7):635-640
Objective:To explore the clinical efficacy of periosteum-covered iliac crest autografts for treatment of severe osteochondral lesions of talus (OCLTs).Methods:A retrospective case series study was used to analyze the clinical data of 26 patients with severe OCLTs treated at Zhejiang Armed Police Corps Hospital from January 2013 to October 2019. There were 21 males and 5 females,aged 17-49 years [(36.3 ± 10.9)years]. All patients were treated using periosteum-covered iliac crest autografts. The visual analogue scale (VAS),American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and ankle joint range of motion (ROM) were assessed before operation,6 months after operation and at the last follow-up (≥ 12 months). The area of talus injury with MRI at the same level was recorded before operation and at the last follow-up. The healing of talus and joint surface was detected with CT at the last follow-up. The healing of the incision and osteotomy site and complications were observed.Results:All patients were followed for 12 to 22 months[(15.1 ± 3.2)months]. The VAS was (2.4 ± 0.9)points and (1.7 ± 0.6)points at postoperative 6 months and at the last follow-up,significantly lower than the preoperative (5.4 ± 1.2)points ( P < 0.01). Meanwhile,the VAS at the last follow-up was significantly lower than that at postoperative 6 months ( P < 0.01). The AOFAS ankle-hindfoot score was (71.7 ± 7.8)points and (87.8 ± 6.2) points at postoperative 6 months and at the last follow-up,significantly lower than the preoperative (66.5 ± 7.5) points ( P < 0.01). Meanwhile,the AOFAS ankle-hindfoot at the last follow-up was significantly lower than that at postoperative 6 months ( P < 0.01). The ankle ROM was (58.4 ± 5.5)° and (70.0 ± 4.9)° at postoperative 6 months and at the last follow-up,significantly improved when compared to the preoperative (42.3 ± 8.1)° ( P < 0.01). Meanwhile,the ankle ROM at the last follow-up was significantly improved when compared to that at postoperative 6 months ( P < 0.01). The area of talus injury with MRI at the same level was 0.67(0.55,0.89)cm 2 at the last follow-up,significantly improved when compared to preoperative 2.64(1.98,3.68)cm 2 ( P < 0.01). The transplantation had neither obvious defects nor joint surface steps based on CT findings. All surgical incisions were healed by first intention. There were no complications such as incision infection,skin necrosis,nonunion of osteotomy,malunion or severe ankle joint disorder except that 8 patients had residual local subchondral bone?marrow?edema-like?signal?and 2 patients showed delayed healing of medial malleolus osteotomy. Conclusion:For patients with severe OCLTs,periosteum-covered iliac crest autografts can effectively relieve ankle pain,improve ankle function,and reduce the area of injury.
5.Development of hair transplantation
Baoliang ZHANG ; Yun SHI ; Lihong CAO ; Yuhai ZHU ; Kun GAO ; Xiaoting LI ; Hong CHEN ; Ningning CUI ; Weiwei WANG ; Jianzhong HU
International Journal of Biomedical Engineering 2020;43(1):80-85
Hair loss is a common problem encountered by both male and female in social life. A variety of systemic diseases, skin diseases, trauma, etc. can lead to hair loss, but androgenetic alopecia is its main cause. Hair loss can cause a series of influences, such as affecting one's self-esteem and emotional health. Healthy and beautiful hair is very important for a person's external image, and the external image can affect a person's work and life to some extent. Hair transplantation surgery has gradually evolved, and its surgical effect is remarkable. However, hair transplantation technology is still not perfect and still faces many challenges, including the supply of hair, the survival rate of the hair, the length of the operation and the concealment of marks after the operation. In this paper, the current status of hair transplant surgery and some important challenges and possible solutions were discussed.
6. Effects of sinusoidal electromagnetic fields at different exposure times on osteoblastic activity and the underlying signal transduction mechanisms
Yuhai GAO ; Jian ZHOU ; Baoying ZHU ; Yuanyuan WANG ; Wenyuan LI ; Zhenlong WEI ; Keming CHEN
Chinese Journal of Geriatrics 2019;38(10):1168-1172
Objective:
To investigate the signal transduction mechanisms of time-dependent effects of 50 Hz 1.8 mT sinusoidal electromagnetic fields(SEMFs)on osteoblastic activity.
Methods:
Newborn rat calvarial osteoblasts(ROBs)were treated with 50 Hz 1.8mT SEMFs for 30, 60, 90, 120, and 150 min, respectively.Intracellular alkaline phosphatase(ALP)activity was assayed, and protein expression of Runt-related transcription factor 2(Runx2), Smad1/5/8 and mitogen-activated protein kinases(MAPKs)were examined by Western blot.The Dual-Luciferase Reporter Assay System was used to measure the activity of the Wnt pathway.Immunofluorescence staining and laser confocal microscopy were applied to examine the nuclear translocation of Smad1/5/8 and β-catenin.Changes in ALP activity were determined after inhibiting p38 MAPK using a specific inhibitor.
Results:
ALP activity of ROBs increased after 30, 60, 90, 120 and 150 min of SEMFs treatment, compared with the control group(51.41±5.21, 59.47±4.02, 67.56±4.68, 63.69±3.92, and 58.16±3.61
7.Effect of low frequency low intensity electromagnetic fields on maturation and mineralization of rat skull osteoblasts in vitro.
Baoying ZHU ; Jian ZHOU ; Yuhai GAO ; Wengui SHI ; Zhenlong WEI ; Wenyuan LI ; Yuanyuan WANG ; Keming CHEN
Journal of Zhejiang University. Medical sciences 2017;46(6):585-592
Objective: To compare the effects of 50 Hz 1.8 mT sinusoidal magnetic field (SEMF) and 50 Hz 0.6 mT pulsed electromagnetic field(PEMF) on the maturation and mineralization of rat calvaria osteoblasts. Methods: Primary cultured rat calvarial osteoblasts were divided into 3 groups:blank control group, SEMF group and PEMF group. The rats in SEMT and PEMT groups were treated with 50 Hz 1.8 mT SEMF or 50 Hz 0.6 mT PEMF for 90 min/d, respectively. Western blotting and Real-time RT-PCR were used to detect the protein and mRNA expressions of Collagen-1, bone morphogenetic protein 2 (BMP-2), osterix (OSX) and Runt-associated transcription factor 2(Runx-2). The alkaline phosphatase(ALP) activity was detected by ALP test kits at d6 and d9 after treatment, and by ALP staining using azo coupling at d10 after treatment. The formation of calcium nodules was observed by alizarin red staining. Results: Compared with blank control group, the protein and mRNA expressions of Collagen-1, BMP-2, OSX and Runx-2 in SEMT and PEMT groups were significantly increased (P <0.01 or P <0.05); while the mRNA expressions of Collagen-1 and BMP-2 in PEMF group were significantly higher than those in SEMF group. After 6 days treatment, the activity of ALP in PEMF group was significantly higher than that in blank control group (P<0.05), while such difference was not observed in SEMF group (P0.05); after 9 days treatment, the activities of ALP in both PEMF and SEMP groups were significantly higher than that in blank control group (all P<0.05), but the difference between PEMF and SEMF groups was not significant (P0.05). After 10 days treatment, ALP staining was increased in both PEMF and SEMF groups compared with that in blank control group (all P<0.01), and the stained area was bigger in PEMF group than that in SEMF group (P<0.05). After 12 days treatment, calcium nodules were increased in PEMF and SEMF groups compared with that in blank control group (all P<0.01), and more calcium nodules were observed in PEMF group than SEMF group (P<0.05). Conclusion: Both 50 Hz 1.8 mT that in SEMF and 50 Hz 0.6 mT PEMF can promote the maturation and mineralization of osteoblasts, and the effect of PEMF is more marked.
Animals
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Calcification, Physiologic
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drug effects
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Cell Differentiation
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Cells, Cultured
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Electromagnetic Fields
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Gene Expression Regulation, Developmental
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radiation effects
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Magnetic Fields
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Osteoblasts
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cytology
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radiation effects
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Rats
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Skull
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drug effects
8.Population Distribution and Incidence Analyses of Hyperuricemia in Zhoushan Island
Yinghong AN ; Yuhai WENG ; Youyi CHEN ; Yujin XU ; Hongyu MA ; Meicai ZHU
Journal of Modern Laboratory Medicine 2016;31(3):102-104,107
Objective To investigate the distribution and incidence of hyperuricemia for the Zhoushan island residents in Zhe-jiang province and provide scientific advice for health management.Methods The uric acid reports of island residents were analyzed by a retrospective statistical analysis in the Physical Examination Center of the 413 Hospital from October 2013 to October 2015.The patients with metabolic diseases (such as diabetes,chronic renal failure and other people,etc.)were ex-cluded.According to the different gender and different age groups,the average level of uric acid,hyperuricemia occurrence rate and the difference among the groups were performed statistical analyses.The single factor analysis of variance was used by Microsoft 2003 Excel software.Results The average serum uric acid level of 7 310 island residents was 283±82μmol/L and the incidence of hyperuricemia was 21.2%.The incidence of hyperuricemia was 33.6% in 31~40 years group,and the average level of uric acid was 343±86μmol/L and significantly higher than≤30 years group,significant statistic difference were observed.The incidence of hyperuricemia was more than 15% in≥41 years group,significantly higher than≤30 years group.The population of physical examination was concentrated in the 31~40 years group.The hyperuricemia incidence was 27.9% in 5 214 male residents,and the average serum uric acid level was 368±74μmol/L and higher than the female group (P<0.001).The hyperuricemia incidence was as high as 43.1% in 31~40 years group.But the level of average serum uric acid showed no significant difference with≤30 years group(P>0.05).The level of average serum uric acid level was less in≥61 and 41~50 years group than in ≤30 years group (P<0.05),but the hyperuricemia incidence were higher than ≤30 years group.The incidence of hyperuricemia was 4.6% in 2 096 female residents.The level of average serum uric acid was 257±57μmol/L and lower than the male group in all age groups (P<0.001).The incidence of hyperuricemia was 18.6% in≥60 years old and lower than 10% in the other groups.The incidence of hyperuricemia increased gradually with age.Conclu-sion The hyperuricemia incidence in island residents was higher,and higher in male than in female.The occurrence of hype-ruricemia was significantly younger.Therefore,health education,reasonable diet adj ustment,improvement of lifestyle and eating habits etc.Should be conducted for a long time to prevent the occurrence of hyperuricemia and related diseases.
9.Image anatomy of nasal septal swell body
Hangjun ZHU ; Jiandong ZHANG ; Yuhai WANG
Chinese Archives of Otolaryngology-Head and Neck Surgery 2015;(9):463-464
[ABSTRACT]OBJECTIVETo investigate the clinic significance of nasal septal swell body by observing and measuring it in the normal and deviated nasal septum on CT images.METHODSThe locations of the nasal septal swell bodies on horizontal CT images in 50 normal subjects and 30 patients with deviated nasal septum were studied, and their length, width and the thicknesses of the mucosa of the both sides were measured. The data were analyzed with SPSS.RESULTSSeptal swell bodies were observed in most of CT images. The swell body was fusiform and located anterior to the middle turbinate, with mean(SD) width of (10.30±1.27) mm and length of (31.35±5.18) mm. There no marked difference in thickness of the nasal septal swell body between two sides of the nasal septum in normal nasal septum, but the thickness of the nasal septal swell body in camber side was thicker than that in the other side of the deviate nasal septum.CONCLUSIONThe shape and location of spetal swell body suggests its potential capacity may be to alter the nasal airflow. Additional study is required for its clinical significance.
10.Endoscopic anatomy study of jugular foramen region.
Hangjun ZHU ; Jiandong ZHANG ; Yuhai WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(14):1288-1290
OBJECTIVE:
To observe anatomic structure of jugular foramen region by endoscope, to provide anatomic data for avoiding damnification in the surgery.
METHOD:
We performed the retrolabyrinthine and retrosigmoid endoscopic surgery on 8 fomalin-fixed adult cadaver specimens and observed the structures of jugular foramen by endoscope and compared the different surgeries at the same time. We excised the calvarium and cereburm and exposured and observed the nerves and vessels. Moreover we measured the the distance from internal accoustic pore to glossopharyngeal and analyse the data by SPSS.
RESULT:
All retrolabyrinthine endoscopic surgeries were performed successfully. Only 4 postsigmoid endoscopic surgeries were performed without damage of cerebellum which is the major obstacles. The distance from internal accoustic pore to glossopharyngeal was(8.26 ± 1.05) mm. About half of posterior inferior cerebellar arteries located to inboard of nerves.
CONCLUSION
The jugular foramen region endoscopic surgery can be performed successfully by retrolabyrinthine. The "lockhole" technology by retrosigmoid is more difficult for blocking of cerebella. The internal acoustic porus is a fixed structure of the cerebellopontine angleand a perfect landmark to the surgery.
Adult
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Cadaver
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Endoscopy
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Foramen Magnum
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anatomy & histology
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Humans
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Jugular Veins
;
anatomy & histology
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Temporal Bone
;
anatomy & histology

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