Objective To investgate the role of aquaporin-4(AQP4) in secondary cerebral edema after ischemia/reperfusion injury in rats.Methods When the models of reversible middle cerebral artery occlusion were established, the alterations of cerebral edema and BBB were evaluated by measuring water and Eval's Blue (EB) contents of cerebral tissue, and the expression of AQP4 in brain was observed by Western Blot at different time point after reperfusion. At last, the correlation between expression of AQP4 and water and EB contents of cerebral tissue were analysed.Results There were found that water and EB contents of cerebral tissue in rat models significantly higher than those of control group at different time point after ischemia/reperfusion ( P

Objective To evaluate the application value of Microendoscopic Discectomy (MED) in the treatment of lumbar disc herniation and lumbar spinal stenosis. Methods 188 cases of lumbar disc herniation and lumbar spinal stenosis were treated by MED, 38 cases of them performed lateral recess decompression. Results The mean follow-up period was 6.9 months. excellent and good therapeutic result rate was 97.4% (Macnab's standard). Conclusions MED in the treatment of lumbar disc herniation and lumbar spinal stenosis has short-term satisfactory therapeutic efficacy.

Objective To evaluate the method and curative effect of reconstruction with vascularized or nonvascularized autogenous fibular transplantation of radiocarpal joint after en bloc excision of giant cell tumor of distal radius.Methods Seventeen cases with giant cell tumor of distal radius bone were treated by en bloc resection and reconstruction of wrist joint with vascularized or non-vascularized autogenous fibular transplantation.Postoperative wrist joint function and radiographic outcomes were evaluated.Results Seventeen cases were followed up from 2.0 to 5.5 years (average 3.6 years).Three cases were treated by peroneal artery anastomosis and other 3 cases by inferior lateral genicular artery anastomosis.All cases achieved primary healing of incision and the radial average length that was en bloc excised was 7.6 cm.All of the transplanted fibulas were healed well.The bone healing average time of the vascularized fibular graft was 3.7 months,while that of the non-vascularized fibular graft was 7.9 months.No tumor recurrence or lung metastases was observed during the follow-up,but 1 wrist joint was narrowed and another had degeneration of the wrist.After 2 years of surgery,the average range of motion of the wrist joint was as follows:dorsiflexion 47°,flexion 30°,ulnar deviation 23°,radial deviation 14°,pronation 55°,supination 62°.The grip force was from 40％ to 80％ of the contralateral upper limb.The MSTS score averaged 87.6 ％ with 6 excellent,eight good and 3 satisfactory results.Disabilities of the Arm,Shoulder,and Hand (DASH) questionnaire score averaged 3.48.Conclusion The method of autogenous fibular transplantation and reconstruction of radiocarpal joint after en bloc excision of giant cell tumor of distal radius can save the wrist joint function in a certain extent.It is an effective method of the wrist joint function reconstruction and beneficial to bone healing with vascularized transplantation which has less complications.

Objective To investigate the effect of lateral ventricle transplantation of neurotrophic factor-transfected cells derived from Glia cell line on vascular dementia in rats and gene expression of Drebrin in hippocampal region.Methods By using gene clone technique,the GDNF gene was transfected into SH-SY5Y cell lines.104 adult male Sprague-Dawley rats weighing (200± 20) gram were divided into groups:transplanted group,injected group,control group,all of which accepted operation by permanent ligation of left common carotid artery and clipping right common carotid artery repeatedly to build up model of vascular dementia,and sham operation group which accepted no ligation or clipping.6 rats from each group were decapitated on the third day,seventh day and tenth day after transplanting treatment were for fluorescence detection.The rest 20 rats in each group were used to detect learning and memory functions by Morris water maze on the third day and decapitated on the fourth day after transplanting treatment.Then GDNF level in temporal lobe were detected by enzyme-linked immunosorbent assay (ELISA),while Drebrin mRNA and protein levels in hippocampal region were detected by real time-PCR and Westernblot respectively.Results There was strong fluorescent light detected around lateral ventricle of rats in transplanted group on the third day after transplantation,which faded on the seventh day and disappeared on the tenth day.The learning and memory functions of rats in transplanted group were improved significantly.The escape latency was shorter in transplanted group than in injected group and control group [(34.89±4.15) s vs.(43.86±6.95) s,(50.89±3.66) s,both P＜0.05],while shuttle times through the third quadrant were more often in transplanted group than in injected group and control group [(11.00±1.49) vs.(9.26 ±1.38),(8.04 ± 1.12),both P＜0.05].GDNF level and Drebrin mRNA and protein levels were higher in transplanted group than in injected group and control group [GDNF:(315.71±27.43) vs.(256.26±19.90),(141.95±21.33),Drebrin mRNA:(5.54±0.35) vs.(3.10±0.33),(1.32±0.23),Drebrinprotein:(0.55±0.05) vs.(0.43±0.06),(0.26±0.06),all P＜0.05].Conclusions GDNF-transfected cells could survive in the lateral cerebral ventricle of rats for about seven days.The method for treating vascular dementia through the technique of transplanting GDNF-transfected cells is certain feasible,which has a better therapeutic effect than GDNF-injection directly into lateral cerebral ventricle.The therapeutic effect of GDNF on vascular dementia may be related to its action of regulating neural plasticity.

Objective To analysis the medium and long term effects of the quadratus femoris muscle pedicle bone graft with screw internal fixation for the treatment of femoral neck fractures in adults.Methods From March 2003 to December 2008,sixty-two patients with femoral neck fractures were operated.There were 50 males and 12 females,with an average age of 39 years (ranged from 16 to 62 years).Fifteen cases suffered from traffic accidents and 47 from falling injury.There were 8 cases which fracture site was infer-head in Garden type Ⅱ,twenty-nine cases in type Ⅲ and 25 cases in type Ⅳ.The average time were 12 hours (2-96 hours) from injured to hospital admission and 4 days (2-8 days) from injured to operation.Partial weight bearing started on 3 months postoperatively and full weight bearing on 6 months.The postoperative duration of follow up was 3 to 5 years in 39 cases.Healing of fractures and avascular necrosis of the femoral head were evaluated based on the X-ray results or MRI if necessary.The pain,function,deformity,range of motion were evaluated based on Harris joint function scores.Results Nonunion of fracture was noted in 2 cases during the follow-up period.The fracture healing rate was 96.8％.The avascular necrosis of the femoral head was noted in 6 cases (15.4％).There were statistical significant differences between 3 months of postoperation and 3 years of postoperation in the pain,function,deformity,range of motion.After 3 years of postoperation,there were excellent in 29 cases,good in 6 cases,general in 1 case,poor in 3 cases according to Harris joint function scores.Conclusion This technique is relatively simple and has high rate of fracture healing.The avascular necrosis of the femoral head rate is low.The medium-and long-term results are satisfactory.

Objective To investigate the effect of U0126 on brain edema and the expression of aquaporin 4 (AQP4) in rat brains after cerebral ischemic injury.Methods Totally 48 healthy male SD rats were divided randomly into ischemia group, treatment group and normal group.Rats in ischemia group and treatment group underwent middle cerebral artery occlusion by using an intraluminal thread method.Thirty minutes before operation, the rats in treatment group were injected into lateral cerebral ventricle with U0126, while rats in ischemia group accepted normal saline.24 hours after operation, the water content and Evans Blue in rat brains were determined as to exploring the degree of brain edema.Immunohistochemistry,Western blot and RT-PCR technique were applied to detect AQP4, p-ERK1/2 and p-ELK1.Results Compared with normal group, the water content and AQP4 expression in ischemia group were increased obviously.The water content and AQP4 expression in treatment group (protein:149.0?1.1,mRNA:0.328?0.010) were lower than those in ischemia group (protein:153.6?0.8,mRNA:0.400?0.015,P

ObjectiveTo study the mechanism of nimodipine combined with electroacupuncture therapeutics protecting rats from cerebral ischemia and reperfusion injury.Methods60 rats were divided randomly into 3 groups, 24 rats in treatment group that accepted nimodipine combined with electroacupuncture therapy after middle cerebral artery occlusion (MCAO) for one hour, and 24 in control group,which acceptd normal saline after ischemia and reperfusion injury, and 12 rats in normal group. One or three days later, all rats were decapitated and their brains were extracted for superoxide dismutase(SOD) activity and malonaldehyde(MDA) concentration assay. And immunohistochemistry was used to detect the expression of growth associated protein 43(GAP-43),microtubule associated protein 2(MAP-2) and cyclin D1 protein.ResultsAfter ischemia and reperfusion injury,SOD activity markedly decreased in both treatment and control group while MDA concentration increased, compared with normal group(P<0.01).Level of MAP-2 expression in treatment and control group was markedly lower than normal group(P<0.01), while levels of GAP-43 and cyclin D1 expression were higher (P<0.01). Contrasted to control group, SOD activity was higher and MDA concentration was lower in treatment group. Level of GAP-43 and MAP-2 expression in treatment group were higher than those in control group, while level of cyclin D1 lower. Differences between treatment group and control group were significent(P<0.01).ConclusionsNimodipine combined with electroacupuncture therapeutics can prevent brains from ischemia and reperfusion injury. It's actions of wiping free radicals out, inhibiting apoptosis and protein hydrolysis and promoting nerve regeneration are involved in the mechanism.

Objective To investigate the procedures and effects of surgical treatment for double disruption of the superior shoulder suspensory complex (SSSC).Methods Twenty-nine cases of double disruption of SSSC treated from January 2007 to October 2011 were enrolled in the study.There were 19 males and 10 females,at a mean age of 36 years (range,25-49 years).Injury causes included traffic injury in 25 cases and fall from height in 4.An open reduction and internal fixation was performed in 18 cases of scapular neck fracture combined with clavicular fracture,2 cases of scapular neck fracture combined with acromion fracture,2 cases of distal clavicular fracture combined with acromion and glenoid cavity fracture; hook plate fixation and ligament repair were performed in 3 cases of complete dislocation of acromioclavicular joint combined with complete disruption of coracoclavicular ligament ; open reduction and internal fixation and ligament repair were performed in 3 cases of scapular neck fracture combined with acromioclavicular joint dislocation and 1 case of clavicular fracture combined with coracoclavicular ligament disruption.Results All cases were followed up for a mean period of 11.5 months (range,6-30 months).Anatomic reduction of fractures was achieved for all cases and mean healing time was 8.4 weeks (range,7-12 weeks).Mean Constant-Murley score was 91 points (range,72-100 points),which indicated excellent results in 13 cases,good in 11,fair in 5,with excellence rate of 83％.ConclusionBased on the complex anatomic structure of the double disruption of SSSC,surgical management should focus mainly on respective fixation of the double injuries,which leads to good stability and therapeutic outcome.

Objective:To study the early-onset epilepsy of intracerebral hemorrhage and build a prediction model to evaluate its prediction efficiency.Methods:A cross-sectional investigation was conducted to construct a specialized optimized prediction model. The prediction model was converted into a visual optimized scoring scale, so as to quantify the probability of secondary epilepsy after intracerebral hemorrhage. Based on the current prediction model of acute cerebral infraction and post-stroke seizure (AIS-PSS), the evaluation efficacy of optimized score for secondary epilepsy after hemorrhagic stroke was explored.Results:① After sample size calculation and sufficient inclusion and exclusion, 159 patients with cerebral hemorrhage were continuously selected as the model group of this cross-sectional study. A total of 29 patients with early-onset epilepsy and 130 patients without secondary epilepsy were enrolled. The time span was from January 2021 to August 2021. In addition, 77 patients with acute cerebral hemorrhage from August 2021 to February 2022 were selected as the verification group, among which 12 patients had early-onset epilepsy and 65 patients had not any secondary epilepsy. ② There were significant differences in demographic characteristics such as diabetes history, cerebral infarction history, smoking history, National Institutes of Health Stroke Scale (NIHSS) score, intracerebral hemorrhage hematoma volume, serum creatinine (SCr), neuron-specific enolase (NSE), S-100 protein and intracerebral hemorrhage site between the two model groups with different prognosis (all P < 0.05). ③ The above indexes were included in univariate and multivariate Poisson regression analysis, and the results showed that the duration of diabetes [relative risk ( RR) = 1.229, 95% confidence interval (95% CI) was 1.065-1.896, P = 0.036], smoking history ( RR = 1.419, 95% CI was 1.133-2.160, P = 0.030), history of cerebral infarction ( RR = 1.634, 95% CI was 1.128-2.548, P = 0.041), hematoma volume of cerebral hemorrhage ( RR = 1.222, 95% CI was 1.024-2.052, P = 0.041), NES content ( RR = 1.146, 95% CI was 1.041-1.704, P = 0.032), were independent influencing factors to constitute the prediction model. The prediction model was converted into a visual optimized scoring scale in the form of a line diagram to obtain the prediction probability corresponding to the corresponding score. ④ Receiver operator characteristic curve (ROC curve) was used to test the evaluation efficiency of optimized score and AIS-PSS score for early-onset cerebral hemorrhage epilepsy. Relevant data of patients in the verification group were extracted according to the information of two scores, and the final score of each patient in the verification group was obtained. The score and prognosis were put into the ROC curve to evaluate the predictive ability of different prediction models. The results showed that the cut-off value of the optimized score and the AIS-PSS score were 144 points and 7 points, respectively, and the area under the ROC curve (AUC) and the Yoden index of the optimized score were slightly lower than the AIS-PSS score. However, compared with AIS-PSS score, there was no significant difference in the evaluation efficiency of optimized score for early-onset epilepsy ( Z = 1.874, P > 0.05). Conclusion:This study constructed a specific early-onset epilepsy prediction model for patients with hemorrhagic stroke, and transformed it into an optimized score that is easy for clinical use, and its evaluation efficiency is reliable.