With the efforts of several generations, modern medicine has been from experience medicine and evidence-based medicine to the precise medicine. The precision medicine has also become a common goal for global clinical workers. However, traumatic brain injury involves a wide range and various types of injuries. The extent of the brain damage caused by trauma is complex. There is still a big gap between current medicine and precise medicine in the treatment of traumatic brain injury. Therefore, to achieve accurate, punctual, sharing and individualized precision medicine of traumatic brain injury, we must follow the objective routines of traumatic brain injury, and constantly improve the monitoring and treatment means of traumatic brain injury, and constantly improve the clinical research with globalization, multi-center, large data and prospection.

0. 05); but plasma levels of NPY in patients with hepatic cirrhosis and ascites or those with HRS had significant difference (P

Objective To explore the effect and experience of problem-based (PBL) teaching in neurosurgical clinical training and improve the quality of the neurosurgical clinical training. Methods 600 clinical medical students of Grade 2011 in their probation in our department of neurosurgery were chosen as the subjects of study and were randomly divided into the experimental (PBL, 15 groups, 20 people/group, over 300 people) and control groups (CBL+ LBL, 15 groups, 20 people/group, over 300 people). In experimental group, PBL which is a problem-based, student-centered and teacher-directed pedagogy was adopted. In control group, CBL (case-based learning) + LBL (lecture-based learning) were adopted. After probation, two groups of students had the unified test and assessed their teaching methods by questionnaire survey and at the same time, the questionnaire survey about PBL' impact on the various aspects was done only to experimental group students. SPSS 15.0 software was used to do statistical analysis and data were processed by description analysis, t test, Mann-Whitney U test and correlation analysis. Results The scores of theoretical knowledge and general ability in PBL group [(40.57 ±3.24), (41.23 ±4.56) individually] were higher than these in control group [(37.21 ±4.05), (36.51±4.11) individually]. The differences demonstrated statistically meanings. Through the surveys, the students in experimental group showed the high satisfaction (97.0%, n=291) in PBL teaching. Most of the students considered that their abilities of team cooperation (96.7%, n=290), and self-directed learning (92.7%, n=278) were improved by PBL teaching. The students in experimental group illustrated their attitudes in satisfaction of teaching; interests of clinical training, participation of teaching and understanding of knowledge were superior to the control group. The differences demonstrated statisti-cally meanings. Conclusion PBL teaching got a good effect in neurosurgical clinical training. This method, which improved students' participation and motivation of study and contributed to the training of medical students' comprehensive abilities, is suitable for modern neurosurgical clinical training.

Objective To explore a surgical procedure of reduction mammary plasty to assure the viability and sensory of the nipple-areolar complex (NAC) after transposition and to keep the lactiferous function partly. Methods Reduction was accomplished by using perforating vascular branches from the pectoralis major muscle and its fascia supplying the nipple and breast parenchyma instead of the subdermal plexus. The central vascular pedicle supplying the nipple-areola complex was preserved. And the sensory nerve of the NAC was not injured. The erection of the nipple could be observed in operation. Lactation was possible because of preservation of the lactiferous ducts. The technique had been used in 17 patients since 1996. Results The nipple-areola complex was safely transposed with great freedom, and the amount of resection was accurately adjusted for symmetry. No cases of nipple-areola complex sensory change occurred postoperatively in all 17 patients. Breast-feeding was possible at least in one patient after operation. Conclusion This method is ideal for the patients, which keeps the viability and sensory of the nipple-areolar complex and the function of lactation. In another case, the amount of resection is easily adjusted for symmetry.

Objective To evaluate the relative quantities of flt-1, KDR, endostatin mRNA in tissue specimens of human hemangioma and great saphfenous vein with the modified reverse transcriptase-polymerase chain reaction (RT-PCR). Methods Total RNA from human specimens by Trizol was reverse-transcribed and amplified by PCR in 4 deffirent tubes containing one of the primer pairs such as flt-1, KDR, endostatin or ?-actin. The target genes and beta-actin PCR products were about 200 bp in length. The ratio of the yield of the target gene PCR product to the beta-actin PCR product could be calculated after 35 cycles of amplification.Results These ratios were correlated positively ( P=0.014,P=0.019) in two groups, but no relationship in endostatine level was observed (P=0.436).Conclusions VEGFR may play a very important role in the pathogenesis of the congenital hemangioma in children. But the endostatin may take little effect on it.

Objective To study the effect of elemene on transcription factor ELK1 and its target gene in human cervix cancer Hela cell. Methods The cell proliferation was assessed by MTT assay. The luciferase activity of transcription factor ELK1 was determined by the Dual-Luciferase Reporter Assay System. The protein expression of phosphorated ELK1 and its target gene c-fos were determined by Western Blot. Results Elemene can remarkably inhibited the growth of Hela cell and its IC50 was 80.6 ?g/mL. The luciferase activity of transcription factor ELK1 in Hela cells treated with elemene was inhibited. The protein expression of phosphorated ELK1 and its target gene c-fos in Hela cells treated with elemene were down-regulated. Conclusion Elemene can inhibit human cervix cancer Hela cell proliferation,which may be related with suppression of c-fos gene through inhibiting expression of phosphorated ELK1.

Objective To study the effect of 3,4-oxo-isopropylidene-shikimic acid (ISA) on transcription factor STAT1, STAT3 and NF-?B in human cervix cancer Hela cell. Methods The cell proliferation was assessed by MTT assay. The luciferase activity of transcription factor STAT1, STAT3 and NF-?B was determined by the Dual-Luciferase Reporter Assay System. Results ISA can not inhibited the growth of Hela cell. The luciferase activity of transcription factor NF-?B in Hela cells treated with ISA was inhibited, while the luciferase activities of transcription factor STAT1 and STAT3 were not inhibited. Conclusion ISA can inhibit inflammation, which may be related with suppression of NF-?B transcriptional activity.

To observe the effect of intaspinal implantation of Schwann cells (SC) genetically modified with microgene pSVPoMcat on spinal cord injury (SCI) repair.120 SD rats were used to establish the hemisected spinal cord injury model at T 8 level,and they were divided randomly into three groups: genetically modified SC implantation group (group A),normal SC implantation group (group B) and control group without cell implantation (group C).One week after the operation ,combined behavioral score(CBS) and the cortical somatasensory evoked potential (GFAP) were measured and the expression of glial fibrillary acidic protein(GFAP) was examined by in situ hybridization and immunocytochemistry.Three months after the operation, all the rats were scanned with MRI and then were sacrificed.Neurofilament (NF) was examined with imunohistocytochemistry staining by using NF monoclonal antibody. Following were the results:(1) In group A,the number of cells expressed GFAP in injured sites was less than that in groups B and C.(2) MRI scanning showed that the SCI region almost recovered in group A but did not recover in group B.There was a malacie focus in SCI region in group C.This was corroborated by the NF staining.(3) The amplitudes of potential in the latent period in group A and B showed a tendency to recover,and it was consistent with CBS.The results suggested that the implantation of genetically modified SC with microgene pSVPoMcat could inhibit GFAP expression and promote the functional recovery of spinal cord injury in rats.

Polypeptide fragment of rabies virus glycoprotein(RVG)has become one of the most popular polypeptides in drug delivery field,because of its advantages of neurotropiam,penetration of blood-brain barrier and biosafety.Polypeptide fragment of RVG can directly deliver proteins and nucleic acids into brain.Additionally,when polypeptide fragment of RVG couples with drug-loading polymers,nanoparticles or liposomes,it can mediate the latters into brain.The application of the RVG polypeptide fragment provides a safe and effective approach for the treatment of brain diseases with biomolecules,such as chemicals,proteins.plasmids,siRNA,miRNA.

Objective To assess the different protein expressions of epithelial mesenchymal transition (EM T ) markers Vimentin and E‐cadherin in craniopharyngioma ,especially at the tumour invasive front ,and correlate the findings with clinicopathological fea‐tures and patient outcomes .Methods Forty‐two craniopharyngiomas were subjected to the detection of Vimentin and E‐cadherin by immunohistochemistry and double immunofluorescence staining .The relationships between expression of these markers and various clinico pathological indicators and clinical outcomes of these tumors were analyzed .Results There was statistically significant difference in the expression of Vimentin and E‐cadherin between adamantinomatous and papillary variants in whole tumor and at the tumor invasive front .The expression of Vimentin and E‐cadherin in whole tumor sections were associated with tumor recurrence , postoperative weight and hypothalamic disturbances ,and the expression of vimentin and E‐cadherin at the tumor invasive front were colligated with tumor recurrence ,postoperative weight and hypothalamic disturbances .Conclusion Our study exemplifies the po‐tential prognostic implications of Vimentin and E‐cadherin expression in craniopharyngioma .EM T may represent a crucial mecha‐nism in the progression of adamantinomatous craniopharyngioma .