With the changes of life style, diabetes and its complications have become a major cause of morbidity and mortality. It is reasonable to anticipate a continued rise in the incidence of diabetes and its complications a...With the changes of life style, diabetes and its complications have become a major cause of morbidity and mortality. It is reasonable to anticipate a continued rise in the incidence of diabetes and its complications along with the aging of the population, increase in adult obesity rate, and other risk factors. Diabetic en- cephalopathy is one of the severe microvascular complications of diabetes, characterized by impaired cogni- tive functions, and electrophysiological, neurochemical, and structural abnormalities. It may involve direct neuronal damage caused by intracellular glucose. However, the pathogenesis of this disease is complex and its diagnosis is not very clear. Previous researches have suggested that chronic metabolic alterations, vascular changes, and neuronal apoptosis may play important roles in neuronai loss and damaged cognitive functions. Multiple factors are responsible for neuronal apoptosis, such as disturbed insulin growth factor （IGF） system, hyperglycemia, and the aging process. Recent data suggest that insulin/C-peptide deficiency may exert a primary and key effect in diabetic encephalopathy. Administration of C-peptide partially improves the condition of the IGF system in the brain and prevents neuronal apoptosis in the hippocampus of diabetic patients. Those findings provide a basis for application of C-peptide as a potentially effective therapy for diabetes and diabetic encephalopathy.展开更多
The dynamic failure mode and energybased identification method for a counter-bedding rock slope with weak intercalated layers are discussed in this paper using large scale shaking table test and the Hilbert-Huang Tran...The dynamic failure mode and energybased identification method for a counter-bedding rock slope with weak intercalated layers are discussed in this paper using large scale shaking table test and the Hilbert-Huang Transform(HHT) marginal spectrum.The results show that variations in the peak values of marginal spectra can clearly indicate the process of dynamic damage development inside the model slope.The identification results of marginal spectra closely coincide with the monitoring results of slope face displacement in the test.When subjected to the earthquake excitation with 0.1 g and 0.2 g amplitudes,no seismic damage is observed in the model slope,while the peak values of marginal spectra increase linearly with increasing slope height.In the case of 0.3 g seismic excitation,dynamic damage occurs near the slope crest and some rock blocks fall off the slope crest.When the seismic excitation reaches 0.4 g,the dynamic damage inside the model slope extends to the part with relative height of 0.295-0.6,and minor horizontal cracks occur in the middle part of the model slope.When the seismic excitation reaches 0.6 g,the damage further extends to the slope toe,and the damage inside the model slope extends to the part with relative height below 0.295,and the upper part(near the relative height of 0.8) slides outwards.Longitudinal fissures appear in the slope face,which connect with horizontal cracks,the weak intercalated layers at middle slope height are extruded out and the slope crest breaks up.The marginal spectrum identification results demonstrate that the dynamic damage near the slope face is minor as compared with that inside the model slope.The dynamic failure mode of counter-bedding rock slope with weak intercalated layers is extrusion and sliding at the middle rock strata.The research results of this paper are meaningful for the further understanding of the dynamic failure mode of counter-bedding rock slope with weak intercalated layers.展开更多
Objective： Paraplegia due to traumatic spinal cord injuries is one of the devastating effects of dorsolumbar vertebral fractures. Treatment modalities for such fractures, such as stabilization, have no effect on the ...Objective： Paraplegia due to traumatic spinal cord injuries is one of the devastating effects of dorsolumbar vertebral fractures. Treatment modalities for such fractures, such as stabilization, have no effect on the neurological recovery. Thus, various pharmacological and biological treatment modalities have been used. The more recent trend of using autologous stem cells from the iliac crest has been used in some clinical trials with varying success. Thus, more clinical studies are required to study the effect of this novel approach Methods： This is a prospective hospital-based cohort study （level IV）. The study was conducted in the Dept. of Orthopaedics, University College of Medical Sciences and GTB Hospital, Delhi from November 2010 to March 2012. Ten patients who had sustained traumatic dorsolumbar vertebral fractures with complete paraplegia were recruited for this study. Under suitable anaesthesia, at the beginning of surgery, 100 ml of bone marrow was aspirated. This was centrifuged and buffy coat isolated and then transferred into a sterile tube and sent to the operating room on ice packs. After surgical decompression and stabilization, the buffy coat isolate was injected into the dural sleeve at the site of the injury using a 21G needle. All the patients were evaluated for neurological improvement using the American Spinal Injury Association （ASIA） score and Frankel grade at 6 weeks and 3 months postoperatively. Results： The evaluation at 6 weeks showed some improvement in terms of the ASIA scores in 2 patients but no improvements in their Frankel Grade. The other 8 patients showed no improvements in their ASIA scores or their Frankel Grades. The current pilot study has shown that there has been no improvement in most of the recipients of the transplant （n=8）. Some patients （n=2） who did show some improvement in their sensory scores proved to be of no significant functional value as depicted by no change in their Frankel Grades. Conclusion： The outcome of current study shows that although this modality of treatment is safe for the patients, it provides no additional benefits on improvement of quality of life among these patients.展开更多
Objective: To compare the therapeutic effect and indication between standard large trauma craniotomy and routine craniotomy. Methods: There were 97 patients in the standard large trauma craniotomy group and 110 patien...Objective: To compare the therapeutic effect and indication between standard large trauma craniotomy and routine craniotomy. Methods: There were 97 patients in the standard large trauma craniotomy group and 110 patients in the routine craniotomy group. The mortality, postoperative ICP (intracranial pressure), ratio of pupil rebound, complication and results of six month follow up after operation were compared between the two groups. Results: Fifteen patients ( 15.6 %) died in the standard large trauma craniotomy group and 30 ( 27.7 %) in the routine craniotomy group. The postoperative mean ICP was 3.75 kPa±1.89 kPa in the standard large trauma craniotomy group and 5.11 kPa±1.57 kPa in the routine craniotomy group. The pupil rebound was found in 47 patients ( 61.0 %) in the standard large trauma craniotomy group and in 41 patients ( 46.1 %) in the routine craniotomy group (P< 0.01 ). The rate of complication was lower in the standard large trauma craniotomy group, but no obvious difference in long term therapeutic effect was found between the two groups. Conclusions: Standard large trauma craniotomy can attenuate brain hernia and the mortality of the patients with acute subdural hematoma . The incidence of complication can also be decreased. But the long term life quality of the patients can not be improved.展开更多
文摘With the changes of life style, diabetes and its complications have become a major cause of morbidity and mortality. It is reasonable to anticipate a continued rise in the incidence of diabetes and its complications along with the aging of the population, increase in adult obesity rate, and other risk factors. Diabetic en- cephalopathy is one of the severe microvascular complications of diabetes, characterized by impaired cogni- tive functions, and electrophysiological, neurochemical, and structural abnormalities. It may involve direct neuronal damage caused by intracellular glucose. However, the pathogenesis of this disease is complex and its diagnosis is not very clear. Previous researches have suggested that chronic metabolic alterations, vascular changes, and neuronal apoptosis may play important roles in neuronai loss and damaged cognitive functions. Multiple factors are responsible for neuronal apoptosis, such as disturbed insulin growth factor （IGF） system, hyperglycemia, and the aging process. Recent data suggest that insulin/C-peptide deficiency may exert a primary and key effect in diabetic encephalopathy. Administration of C-peptide partially improves the condition of the IGF system in the brain and prevents neuronal apoptosis in the hippocampus of diabetic patients. Those findings provide a basis for application of C-peptide as a potentially effective therapy for diabetes and diabetic encephalopathy.
基金financially supported by the National Basic Research Program (973 Program) of the Ministry of Science and Technology of the People's Republic of China (Grant No.2011CB013605)the Research Program of Ministry of Transport of the People's Republic of China (Grant No.2013318800020)
文摘The dynamic failure mode and energybased identification method for a counter-bedding rock slope with weak intercalated layers are discussed in this paper using large scale shaking table test and the Hilbert-Huang Transform(HHT) marginal spectrum.The results show that variations in the peak values of marginal spectra can clearly indicate the process of dynamic damage development inside the model slope.The identification results of marginal spectra closely coincide with the monitoring results of slope face displacement in the test.When subjected to the earthquake excitation with 0.1 g and 0.2 g amplitudes,no seismic damage is observed in the model slope,while the peak values of marginal spectra increase linearly with increasing slope height.In the case of 0.3 g seismic excitation,dynamic damage occurs near the slope crest and some rock blocks fall off the slope crest.When the seismic excitation reaches 0.4 g,the dynamic damage inside the model slope extends to the part with relative height of 0.295-0.6,and minor horizontal cracks occur in the middle part of the model slope.When the seismic excitation reaches 0.6 g,the damage further extends to the slope toe,and the damage inside the model slope extends to the part with relative height below 0.295,and the upper part(near the relative height of 0.8) slides outwards.Longitudinal fissures appear in the slope face,which connect with horizontal cracks,the weak intercalated layers at middle slope height are extruded out and the slope crest breaks up.The marginal spectrum identification results demonstrate that the dynamic damage near the slope face is minor as compared with that inside the model slope.The dynamic failure mode of counter-bedding rock slope with weak intercalated layers is extrusion and sliding at the middle rock strata.The research results of this paper are meaningful for the further understanding of the dynamic failure mode of counter-bedding rock slope with weak intercalated layers.
文摘Objective： Paraplegia due to traumatic spinal cord injuries is one of the devastating effects of dorsolumbar vertebral fractures. Treatment modalities for such fractures, such as stabilization, have no effect on the neurological recovery. Thus, various pharmacological and biological treatment modalities have been used. The more recent trend of using autologous stem cells from the iliac crest has been used in some clinical trials with varying success. Thus, more clinical studies are required to study the effect of this novel approach Methods： This is a prospective hospital-based cohort study （level IV）. The study was conducted in the Dept. of Orthopaedics, University College of Medical Sciences and GTB Hospital, Delhi from November 2010 to March 2012. Ten patients who had sustained traumatic dorsolumbar vertebral fractures with complete paraplegia were recruited for this study. Under suitable anaesthesia, at the beginning of surgery, 100 ml of bone marrow was aspirated. This was centrifuged and buffy coat isolated and then transferred into a sterile tube and sent to the operating room on ice packs. After surgical decompression and stabilization, the buffy coat isolate was injected into the dural sleeve at the site of the injury using a 21G needle. All the patients were evaluated for neurological improvement using the American Spinal Injury Association （ASIA） score and Frankel grade at 6 weeks and 3 months postoperatively. Results： The evaluation at 6 weeks showed some improvement in terms of the ASIA scores in 2 patients but no improvements in their Frankel Grade. The other 8 patients showed no improvements in their ASIA scores or their Frankel Grades. The current pilot study has shown that there has been no improvement in most of the recipients of the transplant （n=8）. Some patients （n=2） who did show some improvement in their sensory scores proved to be of no significant functional value as depicted by no change in their Frankel Grades. Conclusion： The outcome of current study shows that although this modality of treatment is safe for the patients, it provides no additional benefits on improvement of quality of life among these patients.
文摘Objective: To compare the therapeutic effect and indication between standard large trauma craniotomy and routine craniotomy. Methods: There were 97 patients in the standard large trauma craniotomy group and 110 patients in the routine craniotomy group. The mortality, postoperative ICP (intracranial pressure), ratio of pupil rebound, complication and results of six month follow up after operation were compared between the two groups. Results: Fifteen patients ( 15.6 %) died in the standard large trauma craniotomy group and 30 ( 27.7 %) in the routine craniotomy group. The postoperative mean ICP was 3.75 kPa±1.89 kPa in the standard large trauma craniotomy group and 5.11 kPa±1.57 kPa in the routine craniotomy group. The pupil rebound was found in 47 patients ( 61.0 %) in the standard large trauma craniotomy group and in 41 patients ( 46.1 %) in the routine craniotomy group (P< 0.01 ). The rate of complication was lower in the standard large trauma craniotomy group, but no obvious difference in long term therapeutic effect was found between the two groups. Conclusions: Standard large trauma craniotomy can attenuate brain hernia and the mortality of the patients with acute subdural hematoma . The incidence of complication can also be decreased. But the long term life quality of the patients can not be improved.
