BACKGROUND: Interleukin-1 receptor antagonist can relieve damage of neuron and protect nerve. Aminoglutaric acid can induce exitotoxicity through activating some kinds of aminoglutaric acid receptor, at the same time, can protect nerve through some receptors. But the relationship between them was unclear during the process of cerebral ischemia reperfusion.OBJECTIVE: To investigate the effect of neuroprotective actions of interleukin-1 receptor antagonist on hippocampal neurons, and the relationship between interleukin-1 receptor antagonist and metabotropic glutamate receptor 5 within the process of cerebral ischemic reperfusion injury.DESIGN: Completed randomized controlled study.SETTING: State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences; School of Medicine & Life, Jianghan University.MATERIALS: The experiment was performed at State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Chinese Academy of Science from May 2004 to January 2005. Totally 32 well-being pure breed male Wistar rats were selected.METHODS: Totally 32 rats were divided into four groups by method of the simple random sampling: normal group (n=8) received no surgical treatment, sham operated group (n=8) subjected to only dorsal and ventral neck midline incisions and gently dissection of the bilateral common carotid arteries free of surrounding nerve fibers without occlusion of the both vertebral arteries and common carotid arteries, saline group (n=8) suffered from the permanently occlusion of the both vertebral arteries by electrocauterization and transient (20 minutes) occlusion of bilateral common carotid arteries respectively, and received the treatment of a 2 μL normal saline injection into right lateral ventricle at the rate of 0.4 μL/minute following a needle withdrawal within 5 minutes, and experiment group (n=8) offered the same procedure of the saline group but for that the equivalent amount of rhIL-1ra took the place of normal saline into the lateral ventricle. Hematein-eosin staining was applied to observe pathological changes and immunohistochemistry (ABC) was used to survey the IR of mGluR5 varieties of the hippocampal neurons.MAIN OUTCOME MEASURES: ① Basic pathological changes of hip pocampus and cerebral cortex; ② mGluR5 immunoreactivity (IR) of hippocampus, the sensitive area to cerebral ischemia.RESULTS: Two rats were excluded from the experiment on account of their convulsion during reperfusion (one of the experiment group, another of the saline group), data of 30 rats was entered final analysis. ①Basic pathological changes of hippocampus and cerebral cortex: The Hemateineosin (H.E) staining showed that there is little pathological discrepancy between the normal group and the sham operated group, apparent neuronal degeneration such as peripheral edema around neurons, pyknosis, karyorrhexis and so onin the hippocampus and cortex of the rats of the saline group compared with those of the previous groups, and also the pronounced lower degree of neuronal degenerationin the rats of the experiment group.② mGluR5 immunoreactivity (IR) of hippocampus, the sensitive area to cerebral ischemia (absorbency): The immunohistochemistry presented that the mGluR5 immunoreactivity (IR) of CA1, CA3 areas of the normal group and sham group rats was strong positive (CA1: 0.54±0.12, 0.54±0.05; CA3:0.57±0.02, 0.58±0.08;P ＞ 0.05) Compared with of the normal group and sham group, the mGluR5 IR of the saline and the experiment groups reduced apparently (CA1: 0.30±0.03, 0.40±0.04; CA3: 0.30±0.04, 0.42±0.06;P ＜ 0.01), but the mGluR5 IR of the experiment group was quite stronger than that of the saline one (P ＜ 0.05).CONCLUSION: IL-1ra, one member of the Interleukin-1 family (system)of the cytokines, and mGluR5, one subtype of the metabotropic glutamate receptors were both involved in the pathophysiological process of the global cerebral ischemia reperfusion injury of the rat. Also, as the antagonist of the proimflammatory medium intetleukin-1 receptor, IL-1ra may show neuroprotection by affecting the mGluR5 expression of the CA1 and CA3 areas of the rat hippocampus within the process of cerebral ischemic reperfusion injury. Furthermore, here it demonstrated that besides IL-1ra, other factors might regulate the expression of mGluR5.

Objective To compile an applicable inventory of academic diligence for middle school students. Method By means of literature analysis and in-deep interview with teachers, an academic diligence inventory was constructed and used for 393 high school students. Such methods as correlation analysis, exploratory factor analysis and reliability analysis were analyzed by SPSS11. 0 for windows XP. Results ① Five principal components of academic diligence were selected, which could be called target monitoring, time investment, task commitment, persistence and concentration. ②Internal consistency reliability and split-half reliability of total scale are 0. 9126 and 0. 9003. Reliability of each subscale are above 0. 7615. Correlation coefficient between subscales and total scale ranged from 0. 672 to 0. 820. That of among subscales ranged from 0. 248 to 0. 521. Conclusion Reliability and validity of the inventory of academic diligence for middle school students are both satisfactory enough to meet psychometric indexes.

Objective To accomplish the requirement analysis and design of database for electronic medical tag information system. Methods According to the principle and requirement of information engineering methodology, the operation requirement and data requirement were analyzed, and the database was designed including its concept, logic and physics models. Results The thought and method of electronic medical tag information database were proposed. Conclusion A basic data platform is established for casualties' information collection, storage, transmission, exchange and utilization in wartime.

Amplified in breast cancer 3 (AIB3) is a newly discovered pleiotropic nuclear receptor co-activator.AIB3 regulates cell proliferation,growth,migration and apoptosis by interacting with many nuclear receptors.At the mean time,some reports show that AIB3 interacts with variety of transcription factors,which indicates AIB3 may play an important role in cancer occurrence and progression.

Data of 55 patients with duodenal mass lesions treated by endoscopic submucosal dissection (ESD) were retrospectively analyzed. Risk factors of delayed bleeding after ESD were explored by univariate analysis and multivariate unconditional logistic regression analysis. Duodenal delayed bleeding occurred in 5 patients (9.09%). No closure treatment under endoscopy( P=0.035) was significantly different between the delayed bleeding group and the non-delayed bleeding group. Multivariate non-conditional logistic regression showed no closure treatment under endoscopy was an independent risk factor for delayed bleeding after ESD in duodenal mass lesions ( P=0.029, OR=0.079, 95% CI: 0.008-0.776). Patients older than 60 years and who did not take endoscopic closure treatment have higher incidences of delayed bleeding after ESD. No closure treatment under endoscopy is directly related to postoperative delayed bleeding.

AIM:To investigate the pathologic role of aldosterone and protective effect of aldosterone receptor antagonist on peritoneal fibrosis in peritoneal dialysis rats .METHODS:A peritoneal fibrosis rat model was established by intraperitoneal injection of lipopolysaccharide ( at 1 d, 3 d, 5 d and 7 d, 0.6 mg/kg) and dialysate ( daily intraperitoneal injection of 4.25%dialysate, 100 mL/kg).At the same time, spironolactone (an aldosterone receptor antagonist , 100 mg? kg -1? d-1 ) was given to the model rats .After 4 weeks, the expression of aldosterone synthase CYP 11B2, 11β-hydrox-ysteroid dehydrogenase type 2 (11β-HSD2), mineralocorticoid receptor (MCR), and inflammatory factors were detected by immunohistochemistry , real-time PCR and Western blotting .RESULTS:The rat model of peritoneal fibrosis was suc-cessfully established .At the same time, the injury of mesothelial cells , deposition of collagen fibers and thickness of perito-neal were increased .Moreover , the infiltration of macrophages in the peritoneum/dialysate was increased .The level of al-dosterone and the expression of MCR , 11β-HSD2 and CYP11B2 in fibrotic peritoneum were obviously up-regulated as com-pared with normal rats .The expression of NF-κB/MCP-1 was also increased .However , treatment with spironolactone alle-viated peritoneal fibrosis and reduced the expression of NF-κB/MCP-1.CONCLUSION:Local aldosterone is involved in the process of peritoneal fibrosis via NF-κB/MCP-1 pathway.Spironolactone alleviates peritoneal fibrosis of peritoneal dial-ysis.

Objective To explore whether dexmedetomidine(Dex)could mitigate acute lung in-jury induced by hind limb ischemia reperfusion(I/R).Methods One hundred and twenty SD rat weigh-ting 250-300 g were allocated to receive hind limb I/R,I/R plus Dex (25 μg/kg Dex was intraperitoneal in-jection 30 min before ischemia)and norm control group,and each group was further divided into five sub-groups:before operation and 4 h ischemia followed by 0,1,3 and 6 h reperfusion.After euthanization,lung W/D weight ratio,PaO2 ,SOD,MDA and TNF-α were determined.Results Compared with group C, hind limb I/R injury significantly increased serum TNF-α concentration and W/D ratio,with significantly decreasing PaO2 level at any time of reperfusion in the group I/R,the concentration of MDA increased and the SOD activity decresed at 1,3,6 h of reperfusion.Conversely,W/D ratio as well as the concentration of TNF-αin the serum of the I/R plus group Dex were significantly lower than those of the I/R at 6 h of reperfusion,PaO2 level increased respectively;the concentration of MDA decresed at 1,3,6 h of reperfusion and the SOD activity increased at 3,6 h of reperfusion in I/R plus group Dex.Conclusion Dex mitigates a-cute lung injury induced by unilateral hind limb I/R in rats.The mechanisms may involve attenuating oxida-tive stress and inhibiting inflammatory response.

Objective To comparison of clinical efficacy between mini-invasive transforminal lumbar interbody fusion(mis-TLIF) assisted by Quadrant system and open posterior lumbar interbody fusion (PLIF)treatment for lumber spondylolisthesis,to find a better treatment for lumbar spondylolisthesis.Methods A total of 65 cases who were under lumber spondylolisthesis were retrospectively selected from our hospital,26 cases in mini-invasive transforminal lumbar interbody fusion assisted by Quadrant system (mis-TLIF group).39 cases in open posterior lumbar interbody fusion(PLIF group).Record the incision length,intraoperative blood loss,opertive time,bed time,hospital time,pre-and post-operative visual analogue scale(VAS) and Oswestry disability index(ODI) score were recorded respectively.After surgery,the imaging(X-Ray) evalute the vertebral fusion status.Results There were no significant difference between mis-TLIF group and PLIF group in BMI [(22.77 ± 4.38) kg/m2 and (21.28 ± 5.24) kg/m2],preoperative VAS score [(6.46 ± 1.67) and (6.59 ± 1.56)],preoperative ODI score [(58.70 ± 7.19) ％ and (60.10 ± 9.56) ％] (all P ＞ 0.05).There were significant difference between two groups in incision length [(6.10 ± 0.95) cm and (11.12 ± 2.02) cm],intraoperative blood loss [(247.31 ± 36.72) ml and (340.51 ± 64.32) ml],opertive time[(179.96 ± 17.54) min and(151.85 ± 16.06) min],bed time[(3.62 ± 1.44) d and (4.98 ± 1.74) d],hospital time [(9.38 ± 2.60) d and (11.95 ± 3.61) d] (all P ＜ 0.05).Postoperatively VAS score was assesssd at 1 month [(3.15 ± 1.08]),3months [(1.58 ± 0.81)],6months [(1.08 ± 0.74)] and ODI score was(30.77 ± 6.45) ％,(25.54 ± 6.33) ％,(20.23 ± 7.05) ％,respectively in mis-TLIF group were lower than those of PLIF group (P ＜ 0.05).There were no significant difference between two groups in the fusion rate in 3 months,6 months after operation.Conclusion Mis-TLIF had a lot of advantages relative to PLIF in the treatment of lumber spondylolisthesis,be like less trauma,less bleeding,less hospital time,quick rehabilitation and good curative effect,provide a new minimally invasive method for lumber spondylolisthesis patient.

Objective To summarize the complications after cervico-occipital fusion and to explore the methods of the prevention and treatment of complications. Methods Three hungred and eighteen patients were fused in cervico-occipital region from January 1985 to January 2003. Of them, 65 cases with postoperative complications were reviewed. The complications in perioperative period comprised vertebral artery injury during the operation, temporary injury of nerve root, leakage of cerebrospinal fluid, spinal cord injury or deterioration, infection and asphyxiation. The complications in mid- to long-term included bone graft nonunion or delayed fusion, vertebral body shifting, internal fixation implants breaking or loosening, slipping of screws and pseudojoint formation. The complications in bone graft donor region were haematoma, pain and infection. Two physicians were assigned to follow-up the patients. Results Three hungred cases were followed up from 18 months to 18 years with an average of 6 years and 8 months. There were 15 cases with complications after surgery in single fusion group, the incidence was 24.4%. 1 case deteriorated of spinal function after surgery, 2 with bone graft displacement, 1 with bone graft absorption, 1 with bone graft nonunion who recovered after reconstruction. 50 complications presented in internal fixation group, the incidence was 19.1%, Foramen magnum was decompressed in 1 case with vertebral displacement and fixed with Cervifix. Odontoid process was resected in 1 case with atlanto-axis dislocation and deterioration of spinal function through oral approach and cervico-occipital region was fused, the symptom was improved obviously after operation. Spinous process fracture was found in 1 case 3 months later post-fixation with Simmons wire, the atlanto-odontoid vertebra was fused again and fixed with Vetex, the bone graft was fused completely. The temporary injury of nerve root due to wrong directions of the screws, were adjusted during the operation. 4 patients who felt pain caused by screw, which were then extruded out. 2 cases with vertebral artery injury were ligated or bleeding ceased after screw fixation. Conclusion The key points to reduce the complications are familiarity with dissection and operative skills. Appropriate internal fixation also can reduce the complications. Pressure dressing was useful to eliminate the haematoma in bone graft donor region.

[Objective]To summary the methods and results of free hand insertion with the lateral mass screw of atlas and vertebra dentata pedicle screw.[Method]Fifty samples of fresh adult atlas and dentate were used.There were 25 males and 25 females samlpes.Then rongeur forceps was used to bite the bone of entrance.The way of screw was made by Kirschner wire of 1.5mm and 2.5mm in diameter.Guide pin was inserted along the way.The screws were placed in lateral mass of atlas beside the posterior arch of atlas about 18～20mm and the point of intersection above 2mm inferior boarder of posterior arch.Vertical with coronal plane,the tip of the screw was made 5? to side of head in sagittal plane.The site of the screws placed in vertebra dentate was divided equally the inferior articular process of axis,made 15?with sagittal plane and 30?with cross section.There were 26 patients with Atlantoaxial vertebra unsteadiness,15 males and 11 females,with an average age of 39.5 years.Seventeen cases were used with screws and rod system and 9 patients were used screws and plate system.Preoperative JOA scores were from 5.1 to(10.6),with an average of 7.6.[Result]There were no cases with spinal cord and vertebral artery injury after surgery.Follow-up duration was from 10 to 25 months,with an average of 14 months.The postoperative JOA scores were from 12.9 to 16.5,with an average of 14.8.The improve rate was 87.6 percent.The plant bones all fused and there were no internal fixation rupture and mobiled.[Conclusion]The technique of free hand insertion with the lateral mass screw of atlas and vertebra dentata pedicle screw is simple,fixation is reliability and is well worth to spreading.