Clinical Study on CT-guided Modified Akupotomye in the Treatment of Lumbar Nerve Posterior Branch Compression

Objective: To observe the clinical effect of modified akupotomye closed lysis under CT guidance on compression of posterior lumbar nerve branch.Methods: Patients were diagnosed by HRCT 3-D reconstruction combined with clinical symptoms and signs.After HRCT three-dimensional reconstruction combined with clinical symptoms and signs, the patients were confirmed as posterior lumbar nerve compression.After CT accurate surface positioning, CT-guided modified akupotomye was used for closed lysis of the posterior lumbar nerve branch.Oswestry Dysfunction Index Questionnaire(ODI) was used for quantitative scoring, 7 days before and after treatment and 6 months after treatment.Results: In 62 cases, 20 cases were cured, with 25 cases markedly effective, 11 cases effective, and 36 cases ineffective.The total effective rate was 90.3%.ODI score: Self-paired t test 7 days before after treatment, P < 0.01;Before treatment and 6 months after treatment, self-paired t test(P < 0.01);Self-paired t-test was performed 7 days after treatment and 6 months after treatment(P > 0.05).Conclusion: With CT precise positioning, the modified akupotomye can be used to do closed lysis, to relieve the adhesion and compression, so that the low back pain can be relieved, with good clinical.The akupotomye closed lysis, combined with modern imaging technology has not only achieved good clinical effect, but also can improve the accuracy, safety and scientificity of akupotomye treatment.     

微型针刀松解疗法治疗颈源性头痛的临床研究

目的:观察微型针刀松解疗法及针灸治疗颈源性头痛的疗效差异。方法:选取2015年7月~2018年6月在我院门诊确诊为颈源性头痛的71例患者,并随机分为针刀组(34例)和针灸组(37例),针刀组采用微型针刀松解治疗,针灸组给予单纯针灸治疗,分别于治疗前后采用视觉模拟评分法(VAS)进行疗效评定。结果:针刀组总有效率为97.05%,显著高于针灸组的81.08%(P<0.05);针刀组静息、活动VAS评分改善程度均显著优于针灸组(P<0.05)。结论:微型针刀松解疗法治疗颈源性头痛疗效显著,值得临床推广应用。     

Frequency of Automatic Stimulations in Responsive Vagal Nerve Stimulation in Patients With Refractory Epilepsy

BackgroundIn vagal nerve stimulation (VNS) therapy, the release of VNS model 106 (AspireSR) allowed for responsive VNS (rVNS). rVNS utilizes a cardiac-based seizure detection algorithm to detect seizure-induced tachycardia to trigger additional stimulation. There are some studies suggesting clinical benefits of rVNS over traditional VNS, but the performance and significance of autostimulation mode in clinical practice are poorly understood.ObjectivesTo assess the effect of initiation of rVNS therapy and altered stimulation settings on the number of daily stimulations and energy consumption in VNS therapy and to compare autostimulation performance in different epilepsy types.Materials and MethodsRetrospective follow-up of 30 patients with drug-resistant epilepsy treated with rVNS including 17 new implantations and 13 battery replaces at a single center in Finland. Our data consist of 208 different stimulation periods, that is, episodes with defined stimulation settings and both autostimulation and total stimulation performance-related data along with clinical follow-up.ResultsThe variation in autostimulation frequency was highly dependent on the duration of the OFF-time and autostimulation threshold (p < 0.05). There was a large additional effect of autostimulation mode on therapy time and energy consumption with longer OFF-times, but a minor effect with shorter OFF-times. Significantly more autostimulations were triggered in the temporal lobe and multifocal epilepsies than in extratemporal lobe epilepsies.ConclusionsThe initiation of autostimulation mode in VNS therapy increased the total number of stimulations. Shortening the OFF-time leads to a decreased number and share of automatic activations. Epilepsy type may affect autostimulation activity.     

低位直肠癌保功能手术的相关问题

外科手术是治疗直肠癌的基础,尤其是对于低位直肠癌,在追求远期肿瘤学疗效的同时,如何更好地兼顾患者术后生命质量,保留正常生理功能,一直是业界关注的重要问题。近年来,随着对直肠癌病理学与分子病理学理解的深入、多学科综合诊断与治疗策略的优化与发展、全直肠系膜切除术和保留盆腔自主神经等手术技术和治疗理念的引入,以及技术设备与外科手术方式的持续创新,低位直肠癌保功能手术得到不断完善与持续发展。直肠癌外科领域未来的发展方向无疑将更多地体现在功能的保留与保护等方面。对于低位直肠癌患者,在保证肿瘤根治前提下如何最大限度地保留功能,有赖于精准选择以循证医学证据为基础的治疗策略和精细地施行个体化的保肛手术。     

Exendin-4 attenuates pain-induced cognitive impairment by alleviating hippocampal neuroinflammation in a rat model of spinal nerve ligation

Glucagon-like peptide-1 receptor has anti-apoptotic,anti-inflammatory,and neuroprotective effects.It is now recognized that the occurrence and development of chronic pain are strongly associated with anti-inflammatory responses;however,it is not clear whether glucagon-like peptide-1 receptor regulates chronic pain via anti-inflammatory mechanisms.We explored the effects of glucagon-like peptide-1 receptor on nociception,cognition,and neuroinflammation in chronic pain.A rat model of chronic pain was established using left L5 spinal nerve ligation.The glucagon-like peptide-1 receptor agonist exendin-4 was intrathecally injected into rats from 10 to 21 days after spinal nerve ligation.Electrophysiological examinations showed that,after treatment with exendin-4,paw withdrawal frequency of the left limb was significantly reduced,and pain was relieved.In addition,in the Morris water maze test,escape latency increased and the time to reach the platform decreased following exendin-4 treatment.Immunohistochemical staining and western blot assays revealed an increase in the numbers of activated microglia and astrocytes in the dentate gyrus of rat hippocampus,as well as an increase in the expression of tumor necrosis factor alpha,interleukin 1 beta,and interleukin 6.All of these effects could be reversed by exendin-4 treatment.These findings suggest that exendin-4 can alleviate pain-induced neuroinflammatory responses and promote the recovery of cognitive function via the glucagon-like peptide-1 receptor pathway.All experimental procedures and protocols were approved by the Experimental Animal Ethics Committee of Renmin Hospital of Wuhan University of China(approval No.WDRM 20171214)on September 22,2017.     

The mouse olfactory peduncle 4: Development of synapses,perineuronal nets,and capillaries

Olfaction is critical for survival in neonatal mammals. However, little is known about the neural substrate for this ability as few studies of synaptic development in several olfactory processing regions have been reported. Odor information detected in the nasal cavity is first processed by the olfactory bulb and then sent via the lateral olfactory tract to a series of olfactory cortical areas. The first of these, the anterior olfactory nucleus pars principalis (AONpP), is a simple, two layered cortex with an outer plexiform and inner cell zone (Layers 1 and 2, respectively). Five sets of studies examined age-related changes in the AONpP. First, immunocytochemistry for glutamatergic (VGlut1 and VGlut2) and GABAergic (VGAT) synapses demonstrated that overall synaptic patterns remained uniform with age. The second set quantified synaptic development with electron microscopy and found different developmental patterns between Layers 1 and 2. As many of the interhemispheric connections in the olfactory system arise from AONpP, the third set examined the development of crossed projections using anterograde tracers and electron microscopy to explore the maturation of this pathway. A fourth study examined ontogenetic changes in immunostaining for the proteoglycans aggrecan and brevican, markers of mesh-like extracellular structures known as perineuronal nets whose maturation is associated with the end of early critical periods of synaptogenesis. A final study found no age-related changes in the density of vasculature in the peduncle from P5 to P30. This work is among the first to examine early postnatal changes in this initial cortical region of the olfactory system.     

不同TGF-β表达量的hAMSCs尾静脉移植对异种周围神经移植小鼠坐骨神经功能的影响

目的探讨不同转化生长因子-β(TGF-β)表达量的人羊膜间充质干细胞(hAMSCs)尾静脉移植对异种周围神经移植小鼠坐骨神经功能的恢复作用。方法从健康剖宫产产妇志愿捐献的新鲜羊膜中分离出hAMSCs,并进行纯化及鉴定。构建上调和下调TGF-β表达的慢病毒质粒,并转染纯化的hAMSCs,构建出稳定的上调或下调TGF-β表达的hAMSCs。分离并剪去C57BL/6小鼠的部分坐骨神经,将SD大鼠的坐骨神经分离剪取并移植至小鼠的坐骨神经缺损处,构建出异种周围神经移植小鼠模型。将模型小鼠按随机数字表分为对照组、未修饰的hAMSCs治疗组、高表达TGF-β的hAMSCs治疗组、低表达TGF-β的hAMSCs治疗组,每组10只。各组于造模前1 d分别经尾静脉注射磷酸盐缓冲液或相应的hAMSCs重悬液进行移植治疗。于治疗后第14天时采用DigGait步态分析系统评估各组小鼠的坐骨神经功能恢复情况。结果治疗后第14天时,高表达TGF-β的hAMSCs治疗组小鼠的坐骨神经功能指数(-25.820±0.286)明显高于低表达TGF-β的hAMSCs治疗组(-33.413±0.920)和未修饰的hAMSCs治疗组(-30.755±0.421),差异均有统计学意义(P<0.05)。结论高表达TGF-β的hAMSCs尾静脉移植能够更有效地改善异种周围神经移植小鼠的坐骨神经功能,其可能成为周围神经损伤治疗的新突破口。