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Objective:To investigate the clinical efficacy of trigeminal neuralgia treatment in elderly patients with percutaneous balloon compression assisted by a robotic surgical navigation and positioning planning system.Methods:Eleven elderly patients with trigeminal neuralgia admitted to the Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University between August 2021 and August 2022 were retrospectively analyzed.Three-dimensional time-of-flight magnetic resonance angiography, a three-dimensional fast spin-echo sequence with variable flip angles and thin-slice CT scans were performed before the procedure, and multimodal image fusion was performed by a robot workstation.The volume of Meckel's cave was calculated.Two paths were set up in the surgical planning: an actual puncture path, targeting the anterior inner quadrant of the internal foramen ovale, and a virtual path, used to plan the insertion depth of the balloon.The actual puncture path was completed under the guidance of the robotic arm adapter, and the virtual path for depth measurement was completed under lateral X-ray views of digital subtraction angiography.The balloon was placed at the predetermined depth and was inflated to form a pear shape to complete the procedure.The visual analogue scale(VAS)score was used to evaluate preoperative pain, and the Barrow Neurological Institute(BNI)facial numbness score was used to evaluate postoperative facial numbness.The patients were followed up for 1-12 months and the results were analyzed.Results:In all of the 11 patients, puncturing the foramen ovale and entry into the Meckel's cave were successfully conducted and the balloon was inflated to form a pear shape.Ten patients(90.9%)achieved complete remission immediately after the procedure, and 1 patient had delayed healing at 5 days after the procedure.There were no serious complications related to the procedure.There was no recurrence of pain during the follow-up, and the BNI numbness grading was between 2-3.The ratio between the inflated balloon volume and the preoperative volume of the Meckel's cave was approximately 1.7.Conclusions:Robot-assisted percutaneous balloon compression is safe and effective for the treatment of trigeminal neuralgia in elderly patients.
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OBJECTIVE:To change traditional working mode of drug storehouse by applying intelligent system,improve drug storage management,improve work efficiency and quality of drug storehouse,and to provide reference for hospital drug storehouse information management. METHODS:The changes of drug storehouse working mode and management in our hospital were compared before and after the application of intelligent drug storehouse management system. The time taken to complete individual work and the times of error occurrence 12 weeks before and after the application of the system were adopted as indexes to evaluate the effects of the system. RESULTS:Through the combination of Internet+Internet of things bar code,radio frequency identification,electronic tags,etc.,intelligent drug storehouse management system,which included temperature and humidity management,drug storehouse management,supply chain management three modules,was established in our hospital. Its application improved the drug storehouse working mode and process,strengthened the drug storehouse management in respect of staff,supplier,cold chain drugs and special drugs. Before application,average weekly time-consuming of drug shelfing,bill warehousing,outgoing and deliverying and inventory were(11.92 ± 0.701)h,(13.96 ± 0.752)h,(14.96 ± 0.542)h,(4.58 ± 0.376)h;the times of errors within 12 weeks were 10,8,9,2,respectively. After application of the system,average weekly time-consuming were(9.83±0.718)h,(11.29±0.753)h,(9.91±0.557)h,(3.00±0.316)h,respectively(vs. before application, all P<0.05). The times of errors within 12 weeks were 1,1,2,0. CONCLUSIONS:The application of intelligent drug storehouse management system optimizes workflow of drug storehouse in our hospital,strengthens the management of drug storehouse,and improves working efficiency and quality of the drug storehouse.
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Objective To evaluate the role of mTOR in spinal cord in the development of diabetic neuropathic pain in rats.Methods Sixty adult male Sprague-Dawley rats,aged 2 months,weighing 180-220 g,were used in the study.Forty-five rats among them were chosen randomly and diabetes mellitus was induced by intraperitoneal streptozotocin (STZ) 60 mg/kg and confirmed by blood glucose ＞ 16.7 mmol/L on day 3 after STZ injection.The left 15 rats received intraperitoneal injection of the equal volume of citric acid-sodium citrate buffer and served as normal control group (group C).Paw withdrawal threshold to von Frey filament stimulation was measured in the right hind paw before STZ injection and on 3,6,9,12,15,18,and 21 days after STZ injection.The diabetic rats with mechanical pain threshold decreasing by more than 50％ of the baseline were allocated to diabetic neuropathic pain group (group DP),and by less than 25 ％ of the baseline were allocated to diabetic non-neuropathic pain group (group NP).The rats were sacrificed at 21 days after STZ injection,and their lumbar enlargements of the spinal cord were removed for determination of the expression of mTOR and phosphorylated mTOR (p-mTOR) by Western blot.Results The expression of mTOR was significantly up-regulated in DP and NP groups when compared with group C (P ＜ 0.05),the expression of p-mTOR was up-regulated in DP group,and no significant change was found in the expression of p-mTOR in group NP (P ＞ 0.05).Compared with group NP,the expression of p-mTOR was significantly up-regulated (P ＜ 0.05),and no significant change was found in the expression of mTOR in group DP (P ＞ 0.05).Conclusion Activation of mTOR in the spinal cord is involved in the development of diabetic neuropathic pain in rats.