Objective:To compare the awakening effects of enriched environmental quantitative stimulation and conventional rehabilitation on patients with consciousness disorder after traumatic brain injury (TBI).Methods:A retrospective cohort study was conducted to analyze the clinical data of 60 patients with consciousness disorder after TBI admitted to Hospital of Zhejiang Provincial Armed Police Corps from October 2021 to October 2022, including 38 males and 22 females, aged 26-72 years [(41.6±13.2)years]. The injury was located at the frontal and temporal lobe in 37 patients, at the brain stem in 9, and at the thalamus in 14. The types of injury included cerebral contusion and laceration in 36 patients and intracerebral hematomas in 24 patients. The Glasgow Coma Scale (GCS) score on admission was 5-8 points in 11 patients, 9-12 in 34, and 13-15 in 15. Disease course was (19.2±5.4)days. A total of 30 patients received conventional rehabilitation treatment (conventional rehabilitation group) and 30 patients received enriched environmental quantitative stimulation on the basis of conventional rehabilitation treatment, which lasted 4 cycles in 28 days (quantitative stimulation group). The Coma Recovery Scale-Revised (CRS-R) score, Activities of Daily Living (ADL) score, and brainwave α/δ ratio (ADR) before treatment and at the second and fourth treatment cycles were compared between the two groups. The incidence of complications at the end of the fourth treatment cycle and the rate of favorable outcome of Glasgow Outcome Scale (GOS) at the last follow-up were compared between the two groups.Results:All the patients were followed up for 6-12 months [(8.3±2.5)months]. There were no significant differences in CRS-R score, ADL score, or brainwave ADR between the two groups before treatment ( P>0.05). At the second treatment cycle, they were (13.03±0.73)points, (14.83±0.95)points and 0.35±0.11 respectively in the quantitative stimulation group, which were all higher than those in the conventional rehabilitation group [(11.18±0.14)points, (8.74±0.43)points and 0.29±0.09 respectively] ( P<0.05). At the fourth treatment cycle, they were (17.83±0.23)points, (52.93±10.75)points and 0.44±0.11 respectively in the quantitative stimulation group, which were all higher than those in the conventional rehabilitation group [(13.67±0.35)points, (40.56±7.15)points and 0.37±0.07 respectively] ( P<0.05). The CRS-R score, ADL score, and brainwave ADR at the second treatment cycle were significantly higher than those before treatment, and they were even higher at the fourth treatment cycle than those at the second treatment cycle ( P<0.05). At the end of the fourth treatment cycle, the incidence of complications in the quantitative stimulation group was 13.3% (4/30), which was lower than that of the conventional rehabilitation group [36.7% (11/30)] ( P<0.05). At the last follow-up, the favorable outcome rate of GOS was 80.0% (24/30) in the quantitative stimulation group, which was superior to 66.7% (20/30) in the conventional rehabilitation group ( P<0.05). Conclusion:Compared with the conventional rehabilitation treatment, enriched environmental quantitative stimulation for patients with consciousness disorder after TBI achieves enhanced consciousness level, activity of daily life and electroencephal reactivity, together with decreased incidence of complications and improved prognosis.

This paper reports a case of reparing the tissue defect after resection of a malignant tumor in the glabellar nasion with bilateral modified horizontal advancement flaps. The patient, a 20-year-old female, was admitted to the hospital because of a mass on the nasion between the eyebrows for more than 5 years, with enlargement and ulceration for 5 months. Surgical resection of the tumor was performed. Intraoperative rapid frozen sections showed that the tumor was basal cell carcinoma, and there were no cancer cells at the margins. Bilateral modified horizontal advancement flap repair was performed. At three months after the operation, the incision area healed well, the appearance and eyelid function were normal, and there was no sign of recurrence of basal cell carcinoma. Bilateral modified horizontal advancement flap was effective in repairing the tissue defect after resection of glabellar nasal root basal cell carcinoma.

OBJECTIVE To investigate the effect mechanism of andrographolide （Andro） on neuropathic pain （NP） in rats. METHODS Rats were randomly separated into sham operation group， model group， Andro low-dose （1 mg/kg）， Andro medium-dose （5 mg/kg） and Andro high-dose （10 mg/kg） groups， and sodium ferulic acid （150 mg/kg） group， with 12 rats in each group. Except for sham operation group， other groups used the chronic sciatic nerve compression injury method to induce NP model. After modeling， each group was given relevant dose of Andro intrathecally or sodium ferulate intragastrically. The sham operation group and model group were given a constant volume of normal saline once a day for 14 consecutive days. The mechanical withdrawal threshold （MWT） and thermal withdrawal latency （TWL） of rats were detected in each group after 7 and 14 days of administration. After the last medication， the serum levels of interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， prostaglandin E2 （PGE2）， and substance P （SP） in rats were detected in each group， and the pathological morphology of spinal cord tissue was observed. mRNA and protein expressions of ionized calcium binding adaptor molecule-1 （Iba-1）， growth arrest specific protein 6 （Gas6）， and Axl in spinal cord tissue were determined. RESULTS Compared with model group， MWT and TWL after 7 and 14 days of the administration， the mRNA and protein expressions of Gas6 and Axl after the last medication were all increased significantly in administration groups （P＜0.05）， while the levels of IL-6， TNF-α， PGE2 and SP， mRNA and protein expressions of Iba-1 were all decreased significantly （P＜0.05）； pathological injuries such as the disordered arrangement of spinal cord neurons and dilation and congestion of capillaries had been alleviated to varying degrees. Compared with sodium ferulic acid group， there was no statistically significant difference in the above indicators in the Andro high-dose group （P＞0.05）. CONCLUSIONS Andro may inhibit inflammatory response by activating the Gas6/Axl signaling axis， thereby alleviating NP.

This paper reports a case of reparing the tissue defect after resection of a malignant tumor in the glabellar nasion with bilateral modified horizontal advancement flaps. The patient, a 20-year-old female, was admitted to the hospital because of a mass on the nasion between the eyebrows for more than 5 years, with enlargement and ulceration for 5 months. Surgical resection of the tumor was performed. Intraoperative rapid frozen sections showed that the tumor was basal cell carcinoma, and there were no cancer cells at the margins. Bilateral modified horizontal advancement flap repair was performed. At three months after the operation, the incision area healed well, the appearance and eyelid function were normal, and there was no sign of recurrence of basal cell carcinoma. Bilateral modified horizontal advancement flap was effective in repairing the tissue defect after resection of glabellar nasal root basal cell carcinoma.

OBJECTIVES: Cardiac hypertrophy and fibrosis are major pathological manifestations observed in left ventricular remodeling induced by angiotensin II (AngII). Low-intensity pulsed ultrasound (LIPUS) has been reported to ameliorate cardiac dysfunction and myocardial fibrosis in myocardial infarction (MI) through mechano-transduction and its downstream pathways. In this study, we aimed to investigate whether LIPUS could exert a protective effect by ameliorating AngII-induced cardiac hypertrophy and fibrosis and if so, to further elucidate the underlying molecular mechanisms. METHODS: We used AngII to mimic animal and cell culture models of cardiac hypertrophy and fibrosis. LIPUS irradiation was applied in vivo for 20 min every 2 d from one week before mini-pump implantation to four weeks after mini-pump implantation, and in vitro for 20 min on each of two occasions 6 h apart. Cardiac hypertrophy and fibrosis levels were then evaluated by echocardiographic, histopathological, and molecular biological methods. RESULTS: Our results showed that LIPUS could ameliorate left ventricular remodeling in vivo and cardiac fibrosis in vitro by reducing AngII-induced release of inflammatory cytokines, but the protective effects on cardiac hypertrophy were limited in vitro. Given that LIPUS increased the expression of caveolin-1 in response to mechanical stimulation, we inhibited caveolin-1 activity with pyrazolopyrimidine 2 (pp2) in vivo and in vitro. LIPUS-induced downregulation of inflammation was reversed and the anti-fibrotic effects of LIPUS were absent. CONCLUSIONS These results indicated that LIPUS could ameliorate AngII-induced cardiac fibrosis by alleviating inflammation via a caveolin-1-dependent pathway, providing new insights for the development of novel therapeutic apparatus in clinical practice.

Objective To compare and analyze the epidemiological features of adult talus fractures between East China and West China from 2010 to 2011.Methods The data of adult talus fractures from January 2010 to December 2011 in 63 hospitals in East China and West China were collected through the PACS system and medical records systems.The data of 35 hospitals in East China were assigned into group A while the data of 28 hospitals in West China into group B.The analytic items included gender,age,and type of AO classification.Results A total of 1,014 cases were collected.In group A of 825 cases,there were 624 (75.64％) males and 201 (24.36％) females;in group B of 189 cases,there were 130 (68.78％)males and 59 (31.22％) females.There was no significant difference between groups A and B in male to female ratio (x2 =3.788,P=0.052).The mean age was 36 years old (26,47) in group A and 35 (24,48) years old in group B,showing no significant difference between the 2 groups (Z =-8.244,P ＜ 0.001).There was a significant difference between the 2 groups in the constituent ratio of age ranges (P ＜ 0.05).The peak age range was from 21 to 30 years old in group A (27.76％,229/825),and from 31 to 40 years old in group B (24.34％,46/189).The high-risk type of fracture was AO type 81-A in both groups.Conclusions There were more male talus fractures than female ones in both East China and West China.Most talus fractures happened in patients aged from 21 to 30 years in East China and in patients aged from 31 to 40 years in West China.AO Type 81-A was the most common in both West and East China.

Objective To analyze and compare the epidemiological features of Monteggia fractures between the east and west areas in China from 2010 to 2011.Methods The data of Monteggia fractures treated from January 2010 through December 2011 in 63 hospitals in the east and west China were collected through the PACS system and case reports checking system.The data from the 35 east hospitals were classified as group A while those from the 28 west hospitals as group B.The analytic items included general situation,gender,age,and Bado classification.Results A total of 593 Monteggia fractures were included,including 428 males and 165 females,with a male to female ratio of 2.59:1.The constituent ratios of Bado classification,from high to low,were type Ⅰ (42.50％),type Ⅲ (33.22％),type Ⅱ (14.00％) and type ⅣV (10.29％).There were 376 patients in group A including 263 (69.95％) males and 113 (30.05％)females while 217 patients in group B including 165 (76.04％) males and 52 (23.96％) females.The median age in group B was 31 yearn (from 2 to 75 years),significantly older than that in group A [18 years (from 1 to 83 years)] (Z =2.877,P =0.000).The differences in constituent ratios of age and Bado classification were statistically significant between the 2 groups (P ＜ 0.05).The Monteggia fractures predominated in the age range of 0 to 10 years in group A while in the age range of 31 to 40 years in group B.The high risk fracture type was Bado type Ⅰ in group A and Bado type Ⅲ in group B.The Monteggia fractures accounted for 1.15％ of the forearm fractures and 0.19％ of the systemic fractures.Conclusions More males suffered from Monteggia fracture than females.In the east China,the high risk age range was from 0 to 10 years and the high risk type Bado type Ⅰ;in the west China,the high risk age range was from 31 to 40 years and the high risk type Bado type Ⅲ.The proportion of Bado type Ⅳ in the west China was significantly higher than in the east China.

Objective To compare and analyze the epidemiological features of adult tibial plateau fractures from 2010 to 2011 between West China and East China.Methods The data of adult patients with tibial plateau fracture treated from January 2010 to December 2011 in 63 hospitals from West China and East China were collected through the PACS system and case reports checking system.The data of 28 hospitals from West China were classified as West group while the data of 35 hospitals from East China as East group.The analytic items included gender,age,age distribution and type of Schaztker classification.Results A total of 4,603 adult tibial plateau fractures were collected.The largest age proportion was from 41 to 50 years,with 41 to 50 years in males and 51 to 60 years in females.The highest age proportion in group A was from 51 to 60 years,and that in group B was from 41 to 50 years,showing significant differences between the 2 groups in age distribution (P ＜ 0.05).There were 3,346 cases in group A,including 2,438 males and 998 females with a male to female ratio of 2.35:1;there were 1,257 cases in group A,including 821 males and 436 females with a male to female ratio of 1.88:1.There were significant differences between the 2 groups in gender distribution (P ＜ 0.05).The high-risk fracture type was Schaztker type Ⅵ in both groups,with 898 cases in group A and 411 ones in group B;the lowest fracture type was Schaztker type Ⅴ in both groups,with 214 cases in group A and 149 ones in group B.There were significant differences between the 2 groups in fracture type ratios (P ＜ 0.05).Conclusions Adult tibial plateau fractures predominated in males in both East and West China.The average age of the patients from East China was higher than that from West China.The high-risk type was Schaztker type Ⅵ in both areas.

OBJECTIVETo analyze the clinical feature and constituent ratio of adult hip fractures in Southwest China.

METHODSThe data of adult inpatients and outpatients with hip fractures treated between January 2010 and December 2011 in 11 hospitals of the Southwest China were collected and analyzed. The data includes gender, age, age distribution and fracture pattern according to AO classification.

RESULTSThere were a total of 2,833 adult hip fractures, including 1,340 (47.30%) males and 1,493 (52.70%) females, with a male-to-female incidence ratio of 1: 1.11 and a mean age of (66±18) years. The highest frequency of hip fractures was seen in the 71 to 85 years age group (42.18%, 1,195/2,833). There were 844 fractures (29.79%) in the young and middle-aged group (16-<60 years) and 1 898 fractures (70.21%) in the geriatric group (≥60 years). Men had a higher rate than women (men: 577 fractures, 68.4%) in the young and middle-aged group, while women had a higher rate than men (women: 1,226 fractures, 61.64%) in the geriatric group, with a significant difference in the sex distribution between the two groups (χ2=214.001, P<0.01). The proportion of intertrochanteric fracture (type 31-A), femoral neck (type 31-B) and femoral head fracture (type 31-C) was 46.59%, 49.74% and 3.67% respectively. The highest frequency of the sub-type in each fracture type was type 31-A2, type 31-B2 and type 31-C2.

CONCLUSIONSWomen have a higher rate than men in Southwest China. Geriatric patients are more than the young and middle-aged patients. The femoral neck fractures, intertrochanteric fractures and femoral head fractures are in descending orders according to the proportion of the three different hip fractures.

Aged ; Aged, 80 and over ; China ; epidemiology ; Female ; Femoral Fractures ; Femoral Neck Fractures ; Femur ; Femur Head ; Femur Neck ; Hip Fractures ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged

Objective To study the expression of CDK4 andβ-Catenin and their relevance in glioma. Methods We used immunohistochemistry to detect the expression of CDK4 andβ-Catenin in forty-five glio-ma tissues and eight normal tissues.According to the classification standard of WHO in 2000 classify and grade the tissues.Results There were significant differences of CDK4 andβ-Catenin expressions between normal tis-sues and glioma tissues(P<0.01).The expression of CDK4 and β-Catenin had positive correlation with the pathological grades of glioma and histological type and increased(P <0.05).Furthermore,the expression of CDK4 was positively correlated with the expression ofβ-Catenin in glioma(r=0.52,P<0.01).Conclusion The increased expression of CDK4 andβ-Catenin may have correlation with malignant change of glioma and oc-curance of glioblastoma,and their combination is expected to become an important indicator in assessing malignant glioma.