Objective To investigate the prognostic value of optic nerve sheath diameter(ONSD)measured by critical care ultrasound combined with serum biomarkers[S100 calcium-binding protein β(S100β)and neuron-specific enolase(NSE)]in patients with severe traumatic brain injury.Methods A total of 103 adult severe traumatic brain injury patients admitted to the intensive care unit of this hospital from A-pril 1,2023,to April 1,2024 were enrolled.All patients underwent invasive intracranial pressure monitoring after admission,alongside bedside critical care ultrasound measurement of ONSD at 3 mm behind the globe and serum biomarker testing.Baseline data and Glasgow outcome scale(GOS)scores at 90 days after dis-charge were recorded.Patients were divided into the survival and the non-survival groups based on GOS scores.Receiver operating characteristic(ROC)curve analysis and area under the curve(AUC)were used to evaluate the predictive performance of ONSD and serum biomarkers for poor prognosis in severe traumatic brain injury patients.Results Ninety-six patients were ultimately included,with 52(54.1％)in the survival group and 44(45.9％)in the non-survival group.Significant differences were observed in blood glucose,Glas-gow coma scale(GCS)score,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,ONSD,NSE,and S100β levels(P＜0.05)between the two groups.Multivariate analysis identified ONSD(OR=4.962,95％CI:3.473-6.254),NSE(OR=2.704,95％CI:1.987-3.033),S100β(OR=2.983,95％CI:1.843-4.571),and APACHE Ⅱ score(OR=3.726,95％CI:2.837-4.592)as independent predictors of mortality in severe traumatic brain injury patients(P＜0.05).The combination of ONSD,NSE,and S100β yielded an AUC of 0.840 for predicting poor prognosis,with a specificity of 88.3％and sensitivity of 98.6％.Conclusion ONSD and serum brain injury biomarkers(NSE,S100β)are associated with in-hospital prognosis in severe traumatic brain injury patients.Their combined detection can effectively predict a poor outcome.

Stroke imposes a tremendous burden on patients'families and society due to its high rates of mortality,disability,and recurrence.Advances in neuroimaging technologies have provided critical theoretical foundations for investigating the pathophysiological mechanisms of stroke,as well as enabling early clinical intervention and personalized rehabilitation.This article reviewed the application of five commonly used magnetic resonance imaging(MRI)techniques in acupuncture therapy for stroke,including functional MRI(fMRI)for cerebral blood oxygen metabolism,magnetic resonance spectroscopy(MRS),diffusion MRI(dMRI),perfusion MRI(pMRI),and structural MRI(sMRI).By examining functional,metabolic,structural,and hemodynamic aspects,these imaging modalities offer evidence to validate the multi-target effect and efficacy of acupuncture in stroke treatment.

Stroke imposes a tremendous burden on patients'families and society due to its high rates of mortality,disability,and recurrence.Advances in neuroimaging technologies have provided critical theoretical foundations for investigating the pathophysiological mechanisms of stroke,as well as enabling early clinical intervention and personalized rehabilitation.This article reviewed the application of five commonly used magnetic resonance imaging(MRI)techniques in acupuncture therapy for stroke,including functional MRI(fMRI)for cerebral blood oxygen metabolism,magnetic resonance spectroscopy(MRS),diffusion MRI(dMRI),perfusion MRI(pMRI),and structural MRI(sMRI).By examining functional,metabolic,structural,and hemodynamic aspects,these imaging modalities offer evidence to validate the multi-target effect and efficacy of acupuncture in stroke treatment.

OBJECTIVE: To compare the effectiveness of unilateral biportal endoscopy (UBE) technique assisted spinal canal decompression combined with percutaneous pedicle screw internal fixation versus traditional open decompression and internal fixation for treatment of lumbar burst fractures. METHODS: A retrospective study was conducted on the clinical data of 61 patients with single-segment lumbar burst fractures who met the selection criteria and were admitted between October 2022 and December 2023. Of them, 25 patients received UBE technique assisted decompression combined with percutaneous pedicle screw fixation (UBE group), while 36 patients were treated with traditional posterior unilateral hemilaminectomy decompression and internal fixation (open group). There was no significant difference in baseline data between the two groups ( P>0.05), including gender, age, body mass index, fracture segment, cause of injury, AO classification of lumbar fractures, and preoperative height ratio of the anterior margin of injured vertebra, segmental kyphosis angle, rate of spinal canal invasion, the classification of American Spinal Injury Association (ASIA) grading, visual analogue scale (VAS) score, and Oswestry disability index (ODI). The operation time, intraoperative blood loss, and postoperative complications were recorded and compared between the two groups. VAS score, ODI, and ASIA grading were used to evaluate the effectiveness before operation, at 1 week after operation, and at last follow-up. Lumbar anteroposterior and lateral X-ray films and CT were performed to measure the segmental kyphosis angle, height ratio of the anterior margin of injured vertebra, and the rate of spinal canal invasion. RESULTS: Surgery was successfully completed in both groups. No complication such as dural sac, nerve root, or vascular injury was found during operation, and all incisions healed by first intention. There was no significant difference in operation time between the two groups ( P>0.05), the UBE group revealed significant less intraoperative blood loss when compared with open group ( P<0.05). Patients in both groups were followed up 6-20 months, with an average of 13 months. There was no loosening, breakage, or failure of internal fixation in all patients. The ASIA grading, VAS score, ODI of the two groups significantly improved at 1 week after operation and further improved at last follow-up ( P<0.05). There was no significant difference in ASIA grading at 1 week after operation and last follow-up between the two groups ( P>0.05), but the VAS score and ODI in the UBE group were significantly superior to the open group ( P<0.05). At 1 week after operation, the height ratio of the anterior margin of injured vertebra, segmental kyphosis angle, rate of spinal canal invasion significantly improved when compared to preoperative ones ( P<0.05), the height ratio of the anterior margin of injured vertebra and segmental kyphosis angle significantly decreased at last follow-up when compared to the values at 1 week after operation ( P<0.05), but the rate of spinal canal invasion was further significantly improved, and there was no significant difference between the two groups at different time point postoperatively. CONCLUSION UBE technique assisted spinal canal decompression combined with percutaneous pedicle screw fixation is a safe and effective treatment for lumbar burst fractures, which with little trauma and faster recovery when compared with traditional open decompression and internal fixation.
Humans ; Lumbar Vertebrae/injuries* ; Spinal Fractures/surgery* ; Fracture Fixation, Internal/instrumentation* ; Endoscopy/methods* ; Decompression, Surgical/methods* ; Pedicle Screws ; Treatment Outcome ; Retrospective Studies ; Male ; Female ; Middle Aged ; Adult

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.

OBJECTIVE： To provide reference for the improvement of drug information traceability system in China. METHODS： Using “drug information traceability”“drug traceability”“electronic drug supervision” as keywords， related literatures，relevant laws and regulations about drug information traceability were retrieved from PubMed， CNKI， Wanfang database， VIP， Drug Supervision Department or Health Administration websites of USA， EU and China from Jan. 2014 to Apr. 2019. Compared with USA and EU， the problems of drug information traceability system in China were analyzed to put forward the countermeasures and suggestions. RESULTS & CONCLUSIONS：A total of 31 literatures were included. The drug information traceability system was established in USA， EU and China. USA and EU have the advantages of coding to be in line with international standards， making full use of third-party platforms to avoid forming monopoly， etc. Drug information traceability system was still in a crucial stage of improvement in China. There were still many problems， such as more specific operating standards and guidelines are needed， too many supply chain participants， uneven information level， drug information traceability system independent of the transaction， reimbursement and other information systems， and insufficient coordination. It is suggested to improve the relevant laws and regulations on drug information traceability system by drug supervision department as soon as possible， and give full play to the role of third-party platform， and establish drug information traceability platform based on drug trading platform so as to ensure the system to play an important role in deepening the reform of medical and health system， ensuring the supply of shortage drugs， promoting rational drug use and comprehensive supervision.

Objective To explore the change in anatomical volume during intensity?modulated radiotherapy (IMRT) for different stages of nasopharyngeal carcinoma (NPC) and its influence on dose distribution, and to assess the necessity to modify the IMRT plan. Methods Twenty?four patients with newly diagnosed NPC who received IMRT and chemotherapy were enrolled in the study, and were divided into early?intermediate group ( 12 cases ) and locally advanced group ( 12 cases ) according to the 2008 staging system for NPC. Each patient had a repeated CT scan at week 5 of radiotherapy, and target volume and organs at risk ( OAR) were contoured. The dose distribution of the original plan shown on CT was calculated. Changes in target volume, OAR anatomical volume, and dose distribution were analyzed, and paired t?test and Spearman correlation analysis were performed. Results In the early?intermediate group, gross target volume of neck positive lymph nodes (GTVnd) was reduced during radiotherapy (P=0. 059), and gross target volume of nasopharynx ( GTVnx ) , high?risk clinical target volume ( CTV1 ) , and parotid volume were reduced significantly during radiotherapy ( P= 0. 001, 0. 012, 0. 002, and 0. 000, respectively) . In locally advanced group, GTVnx , GTVnd , CTV1 , and parotid volume were significantly reduced during IMRT (P=0. 000, 0. 000, 0. 003, 0. 003, and 0. 000, respectively). Compared with the values before radiotherapy, the parotid dose increased significantly in the two groups during IMRT ( P=0. 044, 0. 026, 0. 033, and 0. 026, respectively;P=0. 024, 0. 016, 0. 030, and 0. 015, respectively) , and the increase in GTVnd dose was observed in the locally advanced group ( P= 0. 029 and 0. 049 ) . Conclusions It is recommended to perform another CT scan for patients with locally advanced NPC at week 5 of radiotherapy and formulate a new IMRT plan to maintain target volume dose and guarantee a safe parotid dose.

OBJECTIVETo explore the method for improving the aging resistance of seeds and seedlings of Perilla frutescens through study on seed germination and physiological characteristics of P. frutescens seedlings.

METHODSeveral physiological indexes of P. frutescens seeds treated by different concentrations of ZnSO4 and PEG were measured. And other indexes like the activities of malondialdehyde (MDA), superoxide (SOD), peroxidase (POD) and catalase (CAT) were also determined.

RESULTThe germination indexes of P. frutescens aging seeds treated by different concentrations of ZnSO4 and PEG were all increased. And the seeds that treated by ZnSO4 (600 mg x L(-1)) and PEG (20%) showed the most significantly increase in every index. The germination vigor were 64.7% and 66.8%, the germination rate were 78.7% and 79.4%, the germination index were 11.8 and 12.2, the vigor index were 0.091 1 and 0.0939 respectively. The content of MDA was decreased under different treatment. The activities of three enzymes include SOD, POD and CAT were increased by different treatment of ZnSO4 (0.28, 4.71, 3.82 U x mg(-1) respectively) and PEG (0.29, 4.93, 4.18 U x mg(-1) respectively).

CONCLUSIONZnSO4 with concentration of 600 mg x L(-1) and PEG with concentration of 20% could significantly alleviate the damages to the seeds and seedlings of P. frutescens by aging and promote the aging resistance of the seeds and seedlings.

Catalase ; metabolism ; Germination ; drug effects ; Malondialdehyde ; metabolism ; Perilla frutescens ; drug effects ; enzymology ; physiology ; Peroxidase ; metabolism ; Peroxidases ; metabolism ; Plant Proteins ; metabolism ; Polyethylene Glycols ; pharmacology ; Seedlings ; enzymology ; Seeds ; enzymology ; physiology ; Zinc Sulfate ; pharmacology

AIM: To explore a simple, reliable method for tissue processing and section staining by extracting DNA from the manually microdissectioned specimen, and to identify whether the extracted DNA is useful in the following study at molecule level. METHODS: The experiment was performed at the pathological laboratory of Guangdong Medical College from July 2004 to July 2007. The paraffin imbedding tissue sections of cervical cancer were thoroughly deparaffinized after mounted on slides for a long period of time. The nucleus was slightly stained with hematoxylin and microdissectioned under inverted microscope. The microdissectioned samples were put into EP tubes filled with digestion buffer to split the cells and then the DNA was extracted. During the whole course, PE tubes did not change, and the complicated phenol/chloroform extraction did not perform. The DNA extraction was rapid and simple. RESULTS: The DNA was measured by the spectrophotometer with concentrations from 0.14 to 5.25 g/L and absorbance values of A260/A280 were 1.6-1.8. All samples were amplified with PCR to produce expected length specific target fragment (231 bp). CONCLUSION: Rapid DNA extraction after manual tissue microdissection can produce adequate amount of DNA and maintain good quality of DNA template for PCR. The DNA meets the need of the following molecular experiments.