Cerebrovascular remodeling is the most important pathologic change during hypertension. Stroke induced by hypertension is threatening thousands of people's lives. The ion channels in cerebrovascular smooth muscle cells may be altered during hypertension and thus the abnormality of cytosolic ion concentration can accelerate cerebrovascular remodeling. These channels, including potassium channels, calcium channels and chloride channels, may play an important role in the cerebrovascular remodeling during hypertension.

Objective To study the ulnar nerve and its adjacent structures in the forearm and understand the anatomic basis for endoscopic harvesting of the ulnar nerve for the treatment of brachial plexus avulsion injury. Methods Ulnar nerves and their adjacent structures in 6 formaldehyde solution fixed upper limb specimen and 26 fresh upper limb specimens were carefully dissected and observed and measured. The entry path and implementation were designed according to the observations. Simulated operation was performed in 6 fresh autopsy specimens Results In the forearm, ulnar nerve passes through the flexor carpi ulnaris under the medial epicondyle of the humerus and the dorsal branch of the hand passes between the ulnar bone and flexor carpi ulnaris. Also the ulnar nerve descends through intermuscular space, accompaning the ulnar artery in the distant part of the forearm and the artery lies laterally along the nerve. The simulated operations were successfully done in all the 6 specimens. Conclusions The anatomy of the ulnar nerve in the forearm is fairly fixed with no crossing with important structures in its path, incisions of 1～2cm are made above the pisiform bone and under the medial epicondyle of the humerus 3～5cm respecitvely, After isolation of the ulnar nerve's two crosses from the muscle, the remaining part of the ulnar nerve and its adjacent structures are easily dissected. It is concluded that it is safe and reliable to harvest the ulnar nerve in the forearm with endoscopy.

Objective To investigate the feasibility of endoscopy in diagnosis and treatment of compressed peripheral nerves. Methods An 1.5 cm transverse incision posterior to the margin of pectoralis major along the second rib was made in 2 old and 9 fresh cadaver specimens. The distance from the incision to the insertions of anterior and middle scalene muscle on the first rib was measured at various angles. The structures surrounding the approach was observed and measured to find a safer approach for endoscopic treatment of brachial plexus compression syndrome. Results With the upper limb hyperabducted at 120 degrees, anteriorly tilting at 30 degrees, through an 1.5 cm transverse incision made posteriorly to the margin of pectoralis major and along the second rib, the apparatus was inserted toward the point 6.5 cm laterally apart from the sternoclavicular articulation and 7.8 cm in depth, reaching the insertions of the anterior and middle scalene muscle on the first rib without injury to the nerves and vessels. Conclusion The approach is safe for endoscopic apparatus reaching the insertions of the anterior and middle scalene muscles on the first rib. It also provides a basis for further investigation of cutting anterior and middle scalene muscles through endoscope.

[Objective]To investigate the outcomes of cementless metasul metal-on-metal total hip arthroplasty.[Method]Metasul metal-on-metal total hip arthroplasty of 30 hips in 25 patients was performed from August 2003 to December 2005.There were 11 males and 14 females with an average age of 47 years(28-72 years).Harris hip scores were determined before surgery and at the last follow-up examination.Standardized radiographs were obtained to evaluate component conditions.Blood samples were taken to determine serum chromium levels with use of atomic absorption spectrometry.[Result]Twenty-three patients(28 hips)were followed up with a mean period of 3.6 years(2.5-4.8 years).The mean Harris hip score improved from 49.5(17-78)points preoperatively to 93.4(55-99)points at the time of final follow-up.Twenty-two hips(85%)had an excellent result.Radiolucent lines were found in 3 hips.Focal femoral osteolysis was seen only in one patient.Sciatic nerve was injured in one case,which showed rehabilitation after 2.5 years.One hip had periprothetic infection because of diabetes 4 years after operation.There was no measurable wear by X-rays.No dislocation or fracture was found.The median serum chromium concentration was 0.082 ?g/mL(0.020～0.140 ?g/mL).No patient was diagnosed with renal insufficiency or hematologic malignancy during the study period.[Conclusion]The outcomes of Metasul metal-on-metal total hip arthroplasty are satisfactory.However,additional follow-up is necessary to determine any possible long-term deleterious effects.

[Objective]To discuss the cementless revision for postoperative infection after hip arthroplasty.[Methods]From November 1997 to December 2006,7 patients(7 hips) with infection after hip arthroplasty were treated,including 3 males and 4 females,with a mean age of 58 years(36～73 years).In the 7 hips,4 hips underwent a revision of total hip arthroplasty,2 hips only received new acetabular components and 1 hip underwent stem revision.One-stage revision was performed in 4 cases,two-stage revision was performed in 3 cases.Consecutive radiographs were compared to evaluate component conditions.Harris hip scores were determined before surgery and at the final follow-up examination.The erythrocyte sedimentation rate and C-reactive protein were detected.[Results]All patients were followed up with a mean period of 3.6 years(1.5～10.6 years).The mean Harris hip score improved from 35(18-63) points preoperatively to 89(60～99) points at the time of final follow-up.No re-infection was found.Femoral component exsertion was found in 1 patient but without any symptom.Pain of hip joint disappeared in 5 cases,and 2 patients had mild pain when walking long distance.At the time of final follow-up,5 patients still had slight limp.Heterotopic ossification developed in 1 hip.The mean polyethylene liner wear was 0.08 mm per year at final follow-up.Deep vein phlebothrombosis and nerve injury were not found.[Conclusion]It is possible to have satisfactory clinical outcome by one-stage or two-stage revision using cementless prothesis for postoperative infection after total hip arthroplasty.Whether the original prothesis can be saved when fixed tightly with femur or acetabular bone needs more experiences to confirm.

[Objective]To evaluate the clinical and radiographic results of revision hip arthroplasty with cementless prothesis.[Method]Revision hip arthroplasty of 41 hips in 36 patients was performed from November 1997 to August 2007 using cementless prothesis.In the 41 hips,29 hips underwent a revision total hip arthroplasty,8 hips underwent new acetabular components,and 4 hips underwent stem revision.Consecutive radiographs were compared to evaluate component conditions.The value of AAOS and Paprosky classification was used.Harris hip scores(HHSs)were determined before surgery and at the most recent follow-up examination.The Kaplan-Meier survivorship analysis was used to estimate the probability of survival of the prothesis.[Result]Twenty-two patients(26 hips)were available for complete clinical and radiographic analysis.The mean follow-up period was 4.6 years(range,1-11 years).The mean preoperative Harris hip score of 38(range,11-76)points improved to 88(range,60-99)points at the time of final follow-up.The pain and function socre improved from 16.9 and 17.3 points to 40.4 and 39.9 points,respectively.All patients had moderate to severe limp before revision.At the time of final follow-up,8 patients still had slight limp and 4 patients had moderate limp.Twenty-one hips(75%)had an excellent result.A 1mm width radiolucent line was found in 1 femoral component without any symptom.Osteolysis and migration were seen in 4 hips(3 in acetabular and 1 in femoral component),which needed re-revision(12.5% failure).Heterotopic ossification developed in 8 hips(31%).The mean polyethylene liner wear was 0.27 mm(range,0.02-0.87 mm)in all and 0.08 mm(range,0-0.25 mm)per year.The wear rate was only correlated with changes of abduction angle of the acetabulum.The coincidence of bone defect classification in AAOS is better than Paprosky.Kaplan-Meier survivorship at 4.6 years was 89% with repeat revision for any reason as the end point and 81% with repeat revision or radiographic loosening as the end point.[Conclusion]Cementless prothesis appears to be a good alternative to other revision systems in revision total hip arthroplasty.Careful intraoperative evaluation of bone deficiency are needed to choose an appropriate prothesis in order to obtain a good outcome.

[Objective]To evaluate the midterm clinical and radiographic results of revision hip arthroplasty by acetabular reinforcement ring (ARR) with impaction bone grafting. [Methods]Revision hip arthroplasty by ARR with impaction bone grafting of 8 hips was performed from May 2001 to December 2006. There were 5 males and 3 females with an average age of 53 years (range, 36~70 years).The mean BMI was 20 (range, 15~28). The mean interval between the primary arthroplasty and revision was 5 to 20 years (mean 6.7 years). The causes for revision were infective loosing in 2 and aseptic loosening in 6. In the 8 hips, 6 hips underwent a revision total hip arthroplasty, 2 hips received replacement of the acetabular component. Consecutive radiographs were compared to evaluate component conditions and the influence of bone deficiency to fix the prothesis was analyzed. Harris hip scores (HHSs) were determined before surgery and at the most recent follow-up examination. The Kaplan-Meier survivorship analysis was used to estimate the probability of survival of the prothesis.[Results]Seven hips were available for complete clinical and radiographic analysis. One patient died for myocardial infarction. The mean follow-up period was 4.5 years (range, 1.5~7.1 years).The mean preoperative Harris hip score of 30(range, 20~64) points improved to 88 (range, 74~94) points at the time of final follow-up, the pain and function socre improved from 13.8 and 11.5 to 40.3 and 39.9 respectively. All patients had severe limp before revision. At the time of final follow-up, 5 patients still had slight limp and 1 patients had moderate limp.Five hips had an excellent result. Infective osteolysis and migration were seen in 2 hips, which need re-revision. Heterotopic ossification developed in 2 hips . Kaplan-Meier survivorship at 4.5 years was 63% with repeat revision or radiographic loosening.[Conclusion]ARR with impaction bone grafting is an effective approach to treat massive acetabular bone defect in revision hip arthroplasty, the midterm result is acceptable, but any possible reason for infection must be monitored.

Objective To investigate the expression of inducible nitric oxide synthase(iNOS) in the cochlear stria vascularis(SV) of guinea pigs after streptomycin(SM).Methods Auditory brainstem response(ABR) was used as measurement index,and combining with transmission electron microscope(TEM),immunohistochemical staining and image quantitative analysis technique, to detect iNOS expression in the cochlea stria vascularis of guinea pigs and the change of morphology after SM.Results 10 days after adminitration, ABR threshold of SM group increased more significantly than that of the control group(P

BACKGROUND: Direct observation of infarcted microvaseular perfusion after cerebral infarction is the most immediate evidence in evaluation of therapeutic effects.OBJECTIVE: To observe dynamic changes in flowing quality and field in cerebral ischemic area in rats so as to qualitatively and quantitatively analyze the microvascular state in pia matral encephali ischemic area and the changes of associated leukocytic flowing velocity and flowing morphology.DESIGN: Randomized controlled experiment was designed.SETTING: Department of Acupuncture and Moxibustion of General Hospital Chinese PLA.MATERIALS: The experiment was performed in Research Room of Microcirculation of General Hospital Chinese PLA, in which, 120 female Wis tar rats of 2-month old were employed and randomized into acupuncture group (36 rats), model group (36 rats), sham-operation group (36 rats) and normal group (12 rats). The first 3 groups were subdivided in 3 hours, 6hours and 24 hours groups according to the prescriptive time divisions, 12rats in each group.METHODS: In acupuncture and model groups, after abdominal anesthesia with pentobarbital sodium, the cranium was opened and the occlusion of meddle cerebral artery was performed in cerebrum with heat-coagulation method. In sham-operation group, anesthesia and cranium opening were performed, but the meddle cerebral artery was not occluded. In normal group, no any management was performed. In acupuncture group, 60 minutes after occlusion of meddle cerebral artery in cerebrum, needling was given on Renzhong (GV 26) and Neiguan (PC 6) with electric stimulation of disperse-dense wave, 4-10 Hz frequency and 0.4 V of intensity, lasting for 5 minutes. Afterwards, pecking-acupuncture technique was done on Renzhong (GV 26) to achieve strong stimulation for 10 seconds. In shamoperation and model groups, the rats were in process of grasping and fixation, but acupuncture was not applied. Vascular endotheliocyte fluorescence staining and leukocyte fluorescence tracing method were applied, in combination with microscopic video system and computer imaging analyzing system, to observe in dynamic and quantitatively the influences of acupuncture on pia matral encephali microvascular morphology, density and blood flowing velocity at 3 hours, 6 hours and 24 hours after cerebral occlusion of meddle cerebral artery.morphology, density and blood flowing state at various time divisions observed directly microscopically and vascular endotheliocyte morphology and the state of brain tissue which near the microvascular after infusion with velocity in infarcted area at various time divisions measured in quantity in each group.microvascular endotheliocytes were colored worse and more fluorescent exudation appeared. Those were better remarkably in acupuncture group ty: That in model group was lower than normal group. That at 3 hours, 6hours and 24 hours in acupuncture group was higher remarkably than model group [(6.92±0.42), (3.25±0.52) pces/visual field; (7.61 ±0.51),(3.68±0.32) pces/visual field; (8.24±0.72), (5.49±1.2) pces/visual leukocyte velocity: That in model group was lower remarkably in normal group. That at 3 hours, 6 hours and 24 hours in acupuncture group was higher remarkably than model group [(1 193±358), (600±261) μm/s;(1 112±267), (517±115) μm/s, (1 766±293), (611±291) μm/s, q=4.608.28, P ＜ 0.01].CONCLUSION: At early stage of cerebral infarction, broken blood flow is severe in artery, vein and capillary in ischemic area; the numbers of opened vessels are few, flow rate is slow down and cerebral perfusion is unsatisfactory. Acupuncture amaliorate the microcirculation perfusion state in ischemic area, increases the numbers of opened vessels and improves flowing morphology of blood cell.

Neural and brain imaging has become one of the most challenging subjects and attracted more attentions. Neural and brain imaging can quantify morphological pattern, structure and function of brain and nerve system, which offers us not only a deeper understanding of brain and nerve system, but also improved effectiveness of clinical diagnosis and treatment of diseases. Optical Coherence Tomography (OCT) is a new imaging technique and has been widely used in areas of biology and medicine. Study on OCT technique applying to neural and brain imaging has drawn special attention and rapid developments have been achieved. The technique provides new ideas and methods to solve problems in neural and brain imaging and its potential needs to be discovered. This article re-views the latest techniques and development in OCT for neural and brain imaging. Advantages and disadvantages of the technique and foreground of the development are discussed.