Tangdu hospital of the fourth military medical university explored the aim,method,critical points and effect for organizing a neurosurgical continuous education Journal club and summarized the key factors important for its successful organization and the improvement of its short-term and long-term educational effects in order to discover a Journal club education pattern which could satisfy the demand of for neurosurgical refresher doctors.Paying attention to these factors could better satisfy the demand of for neurosurgical refresher doctors,achieve their participating aims,promote their understanding of the advancing front of the discipline and improve their literature analyzing competence and problem solving ability.The wide application of continuous education Journal club is helpful to improve the level of neurosurgical continuing education in our country.

Objective To analyze the surgical treatment and pathological manifestations in patients with hyperparathyroidism. Methods The clinical data of 368 patients undergoing parathyroidectomy with hyperparathyroidism in Peking Union Medical College Hospital between Oct 1974 and Jan 2009 were retrospectively analyzed. Results 368 cases underwent parathyroidectomy. There were 249 women (67.7%) and 119 men (32. 3% ). Parathyroid lesions were located in normal positions in 318 cases (86. 4% ), and in ectopic positions in 50 cases (13.6%). The pathology of 264 cases (71.7%) was adenoma, 91cases (24.7%) was hyperplasia, 11 cases (3.0%) was carcinoma, and two cases was parathyroid cyst. Postoperatively 257 cases (68.0%) presented with hypocalcaemia, and 159 cases (66. 0% ) recovered within 7 days. Conclusions The main pathological diagnosis was adenoma. It is common for a ectopic parathyroid gland in which a parathyroid lesion is located.

Objective To discuss the appearances of focal nodular hyperplasia(FNH) of the liver on the muhiphase helical CT scanning, and to improve its diagnostic accuracy with CT. Methods Helical CT scanning of pre- and post- contrast arterial phase,portal venous phase and delayed phase was performed in 10 cases with surgically and pathologically proved FNH. Results On pre- contrast scans,9 of 11 FNH lesions were hypodense(either homo-geneous or non-homogeneous), the other two lesions were isodense. On the arterial phase scans, all lesions were markedly and homogeneously enhanced,except for the central scar area. Tortuous and dilated arteries were seen at the center or peripheral area in 3 out of 11 lesions. On the portal phase and delayed phase scans ,4 of 11 lesions turned to isedanse of slightly hypodense,7 lesions remained slightly hyperdense. Central scar was found in 8 FNH lesions ,2 of them showed no enhancement while the other six demonstrated late enhancement. Conclusion Mulfiphase helical CT scanning can fully reflect the blood supplying and pathologic features of FNH, and it is of great value in diagnosing and differentiating FNH.

Journal Club education method is widely used in resident training in foreign countries.Its function in neurosurgery clinical training is gradually focused on.This method will promote the mastery of new concept,new method and new technique by the residents,help them to form good reading habit and improve their ability to solve actual clinical problems.The application of Journal Club education method in neurosurgery clinical training in our country may have positive influence on the standardized training of clinicians and the spreading of evidenced-based medicine.

Objective To investigate the effect of hypoxia on vascular endothelial growth factor (VEGF) expression and secretion in human renal fibroblasts. Methods Human renal fibroblasts were primary cultured from donor kidney, and cells in passage 3 were used in this experiment. Hypoxia was induced by incubation in a gas-tight box gassed with 10% CO2/10% H2/80% N2 for 24 hours. VEGF mRNA levels were measured by semi-quantitative RT-PCR method. VEGF proteins expressed on cell surface were measured by flow cytometry. VEGF proteins secreted into supernatants were measured by ELISA method. Results Hypoxia caused a 2. 5-fold increase of VEGF mRNA level in human renal fibroblasts. Hypoxia also induced significant increases of VEGF proteins on cell surfaces (mean fluorescence intensities: 1. 053?0. 055 vs 0.763?0.057, n=4,P

Intracytoplasmic sperm injection,which combined with in vitro fertilization and micromanipulation techniques,has been applied to research the molecular mechanisms of fertilization,and produce the sexing livestock and transgenic animals.The research advances in porcine intracytoplasmic sperm injection,including in vitro maturation and pretreatment of oocytes,selection and treatment of spermatozoon,artificial activation of injected oocytes after injection,and improvement of the operation technique were reviewed.

Sick neonates often require periodic small volume transfusion (10mg/kg) to replace blood draw for laboratory monitoring during their hospital stay. The effect of packed red cel transfudion on the hematocrit, potassium, ionized calcium, acid base status, glucose and indirect bilirubin was investigated in 25 transfusions. Analysis of transfused blood by the age of the red cells, older red cells (more than 5 days old, 13+/-7 days) showed increased potassium (27.2+/-14.1mEq/L vs 11.3+/-4.9mEq/L), decreased bicarbonate (14.4+/-2.6mEq/L) and glucose (130+/-28mg/dl vs 203+/-93mg/dl) compared with newer red cells (less than 5 days)(p<0.05). No significant changes occured in hematocrit and pH. Inspite of these results, the transfusion of the older red cells did not affect the older red cells did not affect the serum potassium, ionized calcium, pH, bicarbonate, glucose and indirect bilirubin level in neonates. The hematocrit of infants increated significantly after transfusion from 29.6%+/-4.3% to 38.3%+/-6.1%(mean+/-SD)(P<0.05). Transfusion of older red cells seemed to be as equally effective as newer ones. The valus of hematocrit obtained immediately after transfusion does not show any differences compared to those obtained 30 min, 1, 2, 4, 6 and 24 hours after transfusion. The result in the study indicate that there was no adverse effect after transfusion with packed red cell more than 5 days old and no significant difference in hematocrit observed between 0 to 24 hours following transfusion. Therfore old red cell more than 5 days can be used safely for sick neonatal transfusion and the stored donor blood can be optimzed for repeated blood transfusion.
Bilirubin ; Blood Transfusion ; Calcium ; Glucose ; Hematocrit* ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn* ; Length of Stay ; Potassium ; Tissue Donors

Adolescent ; Adult ; Chi-Square Distribution ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Occupational Diseases ; prevention & control ; Occupational Health ; Sampling Studies ; Young Adult

Objective To study the characteristics of pharmacokinetics and pharmacodynamics of insulin dry powder inhalation and its relative bioavailability as compared with subcutaneous injection of regular insulin. Methods In this open,single-center,randomized,two-period,cross-over,euglycemic glucose clamp study,18 healthy volunteers(14 men and 4 women),aged(24.9?1.7)years,with body mass index(20.6?1.2)kg/m~2, received the insulin dry powder inhalatin(80 U)or regular insulin(15 U)subcutaneous administration.The blood samples of this study at 0,20,30,40,50,60,70,80,90,100,110,120,135,150,165,180,195, 210,225,240,270,300,330,360,390,420,450 and 480 rain were taken for serum insulin measurement, meanwhile,glucose infusion rates(GIR)were determined per 5 minutes over a period of 8 hours.Results The C_(max)were(57.9?17.8 vs 114.5?29.7)mU/L(tested vs reference preparation),T_(max)were(46.7?45.6 vs 107.8?33.7)min,GIR_(max)were(3.35?0.98 vs 5.17?1.75)mg?kg~(-1)?min~(-1)and T_(GIRmax)were(88.3?17.0 vs 151.9?34.6)min.The relative bioavailability was(10.26?2.25)%,and the relative bioefficacy was(14.33?7.26)%.Conclusion The study shows that insulin dry powder inhalation is absorbed via lungs and its action sets in earlier than that of the regular insulin injected subcutaneously.These pharmacokinetie and pharmacodynamic data may provide a reliabe guide for further clinical trial.

Objective To study the effect of cadmium on the spatiotemporal sequence of Zic_2 expression in the development of the nervous system.Methods Wistar rats were used in the initial portion of the study.Male and female animals were housed together overnight;the presence of sperms by vaginal smearing methods the following morning indicated that copulation had occurred,and that day was designated embryonic day 0.5(E0.5).Forty dams were divided randomly into the control group and the cadmium exposure group.The dams in the cadmium exposure group were treated with cadmium at a dose of 4 mg/kg by intraperitoneal injection.The dams of control and cadmium exposure groups were divided 4 subgroups respectively,sacrificed at various times on embryonic days 9.0,9.5,10.5,and 11.5,laparotomized and the one half pregnant uterus were taken out.The embryos were taken out under stereomicroscope and the morphological score of the nervous system were calculated.The other pregnant uterus were fixed fixed with 4% paraformaldehyde routinely embedded in paraffin and coronally sliced into slice 5 ?m of thickness for immunohistochemical staining.Results Cadmium could lead to dysplasia of nervous system in embryos of rats.The main manifestations were growth retardation,delay closure or unclosures pre- and post- neuropores,and so on.Developmental scores of the forebrain,midbrain and hindbrain of rat embryos in the cadmium exposure groups were lower than the corresponding control groups,and in cadmium exposure groups had significant difference compared with those in control group(P0.05).According to developmental overall scores of nervous system,the scores of the cadmium exposure groups were lower than that of the control groups with significant difference on E9.5,E10.0,E10.5 and E11.5(t=2.71,4.72,3.78,and 5.61 respectively,all P