Carotid atheroscleorotic stenosis is one of the most common causes of cerebral ischemic stroke. In China, unfortunately, Its importance has not been fully stressed,and carotid endarterectomy hasn't been used widely so far. Therefore, noninvasive studies on carotid atheroscleorotic stenosis are introduced. The surgical and intravascular interventional therapies are emphasized again.

Objective to study the effect of blood pressure on the enlargement of saccular aneurysm and its mechanism. Methods Forty-eight SD rats were divided into 3 groups randomly(A, B and C; n=16 in each group). Saccular aneurysms of the carotid artery were induced by corrosion of the initial segment of the external carotid artery (1mm long) with elastase. In group A, the posterior branches of both renal arteries were ligated in order to produce a marlced blood pressure elevation. In group B, only unilateral renal artery was ligated, and a moderate hypertension was produced. In group C high blood pressure was not produced to serve as the control group. After 2 and 8 weeks, the blood pressure and the size of the aneurysms were measured. Then the aneurysms were fixed by intraarterial perfusion of formalin and were harvested for examinations. The expression of basic fibroblast growth factor (bFGF) in aneurismal wall was determined by immunohistochemical analysis. Results Two weeks after the beginning of the experiment, there was no difference in size of aneurysm among the 3 groups. But after 8 weeks, significant difference in aneurysmal size was found between group A and the other two groups. The expression of bFGF in group A was stronger than that in group B and C. Conclusion The elevation of blood pressure and enhancement of bFGF expression in aneurismal wall play an important role in enlargement of the aneurysm.

Objective To observe the dynamic changes in neuroglobin (NGB) expression in cerebral cortex and hippocampus after cerebral ischemia-reperfusion injury in gerbils. Methods The global cerebral ischemia of gerbils was induced by clamping bilateral carotid arteries for 20 minutes, then they were released to allow reperfusion for 2h, 8h, 16h, 24h, 48h and 72h. The NGB expression in cerebral cortex and hippocampus was measured with immunohistochemical methods coupled with computer-assisted image analysis. Results The changes in NGB expression were different in cerebral cortex and in the hippocampus. NGB protein was up-regulated from 16h to 48h after ischemia-reperfusion insult to cerebral cortex, whereas it was down-regulated hippocampus. Conclusion The different expressions of NGB in cerebral cortex and hippocampus are suggestive of compensatory and repair mechanisms in ischemia-damaged neurons after transient global cerebral ischemia. The increased expression of endogenous NGB in the brain after ischemia-reperfusion may be associated with the protective response to ischemic damage.

The aim was to look for the method for getting highly purified population and large amount of Schwann cells from the newborn rats. Sciatic nerves from 1～3 days old SD rats were taken out . The Schwann cells were cultured and purified by modified repeated explanation, and fibroblastic cells were removed by rapid trysinization , differential adhesion and anti mitosis methods. The Schwann cells were identified by indirect immunocytochemistry with mouse anti S 100 protein McAb. The result showed that the purity of Schwann cells was more than 95%, and the cells were in a good state. It is considered that the methods are simple and convenient , and a great number of highly purified Schwann cells can be acquired by them.

To correlate the ultrasound and MR imaging of carotid atherosclerotic plaque with its histologic compositions,20 patients(22 lesions) scheduled for carotid endarterectomy were examined by B mode ultrasound and MRI preoperatively. The specimens were also examined postoperatively and the images of carotid plaque were recorded. The transverse pathological sections of plaques were made and matched with images of ultrasound and MRI. 256 gray scale ultrasound densitometric analysis of carotid plaque compositions was performed. Ultrasonic density of calcium, fibrous tissue, hemorrage/thrombus and lipid deposits was (89?12), (53?8), (37?6) and (39?3) respectively in vivo , and was (168?11), (136?12), (85?12) and (89?10) respectively in vitro . In vivo relative signal intensities of calcium, fibrous tissue, old hemorrhage/thrombus and lipid deposits were low, equal, equal and very high respectively on T 1 W MR image, and very low, equal, high and high respectively on PDW MR image, and low, equal or slightly high, high and high respectively on T 2 W MR image. Signal intensities of plaque contents ex vivo were correlated to signal intensities in vivo. Densitometric analysis of ultrasound images of carotid plaques can quantify possible components of plaque, and MRI has the feasibility to identify the components of plaque.

To study the distribution of two different phenotype mast cells in atherosclerotic lesions of human carotid arteries, 32 samples of endarterectomy and 10 autopsies of normal carotid specimens were fixed and embeded in paraffin, sections were stained with hematoxylin-eosin, toluidine blue,monoclonal antibodies against the two major proteases of mast cells(tryptase and chymase) and monoclonal antibodies against CD-3 of T lymphocytes and CD-68 of macrophages. The quantity,distribution and degranule of two different phenotype mast cells in atherosclerotic lesions of human carotid arteries were investigated,and the ratio of mast cells to T lymphocytes and macrophages in atherosclerotic lesions was calculated. The density(cells/mm 2 ) of mast cells in shoulder region of plaque(6 3?4 0) was much higher than that in normal intima,cap and core region(1 3?2 3,2 3?2 6,2 2?3 7) .The proportion of chymase-containing mast cells to tryptase-containing mast cells was 0 36,0 51,0 47 and 0 39 respectively in normal intima,cap,core and shoulder region of plaque.The propotion of degranulated mast cells was the highest in shoulder region of plaque(65%).The ratios of mast cells to T lymphocytes and to macrophages were 0 25 and 0 14 respectively in shoulder region of plaques.Light microscopic studies of mast cells revealed that mast cells were more commonly observed in thrombus and around calcification and blood vessels of plaque.Mast cells play a role in the formation of plaque,and participate in the destabilization of plaque.

To assess the indication, intraoperative monitoring with selective shunting and surgical outcomes of carotid endarterectomy for patients with contralateral carotid occlusion, the clinical manifestations, imaging data, surgical methods and results of 16 patients were analysed retrospectively. It was verified that the surgical risk of these patients was not as high as prediction,satisfactory results coold be achieved with intraoperative monitoring, selective shunting and skilled surgical techniques. It is reasonable to offer the following typical treatment examples: Carotid endarterectomy should be performed for patients with symptomatic carotid stenosis irrespective of the contralateral carotid occlusion, while medical therapy should be maintained for patients with asymptomatic carotid stenosis and contralateral carotid occlusion. maintained. If the asymptomatic stenosis is found to be progressing in noninvasive testing, then a prophylactic endarterectomy should be considered.

Exposure of the distal internal carotid artery is very important and difficult in carotid endarterectomy for patients with high bifurcations or extension of the atherosclerotic plaque into the distal internal carotid artery. Exposure techniques are introduced based on the surgical experiences of 28 cases.

To evaluate clinical effect of transcranial optic nerve decompression on fronto orbito sphenoidal fibrous dysplasia with progressive vision loss, 25 cases were studied retrospectively. All patients had undergone transcranial optic nerve decompression. One week after operation, 21 patients experienced improvement or stability in vision, but 4 patients complained reduction in vision. Before operation, the vision of the affected eye was near blindness in 3 cases among the 4 cases who failed to gain improvement in vision after operation. Effective follow up was achieved in 18 cases, and the follow up period was from two to twenty two years (average six years). Among them, only 3 paticnts showed recurrence of visual disturbance. The results showed that transcranial optic nerve decompression was effective in rescuing vision in fronto orbito sphenoidal fibrous dysplasia with progressive vision loss. Once the patient was near blind before the operation, the surgical result was unsatisfactory.

Objective To study the efficacy and safety of nanometer perfluorocarbon (PFC) in the treatment of hemorrhagic shock, and its role in protecting cerebral cortex nerve cells.Methods Hemorrhagic shock was induced in New Zealand rabbits by arterial bleeding. In the course of the experiment, heart rate, respiratory rate, blood pressure, blood gases, hepatic and renal function, and pathological changes in cerebral cortex were observed. Results The survival rate of animals in the experimental group at 12 hours was higher than that of control group, respiration was deeper and respiratory rate was faster, blood pressure and PaO 2 were significantly higher than that in animals of the control group. There was a tendency of acidosis in the control group. Pupil reflex was more sensitive in the experimental group, and hepatic and renal functions were better in the experimental group than that in control group. Pathological observation showed the cerebral cortex was less damaged in the treatment group than that in control group. Conclusions Nanometer PFC was effective in combating hemorrhagic shock, showing no toxicity to liver and kidney, and it could also be used as an effective neuroprotective agent.