AIM:To investigate the pathological changes of aquaporin 4 (AQP4) and related proteins in the rats with focal cerebral ischemia injury , and to observe the effect of silent information regulator 1 ( SIRT1) on the AQP4 ex-pression in order to explore the pathological mechanism of cerebral ischemia and brain edema .METHODS: Adult male SD rats were randomly divided into sham group and middle cerebral artery occlusion ( MCAO) model group.The MCAO model group was divided into the 4 time point (6 h, 12 h, 24 h and 48 h) subgroups.The animal model of MCAO was es-tablished by suture method in mature SD rats .The neural symptom score was measured at the corresponding time points . Morris water maze test was used to study the cognitive function .The cerebral infarction volume was evaluated by TTC stai-ning .The changes of brain water content was analyzed by a dry /wet weight method .The morphological changes of the brain tissues were observed under microscope with HE staining .The protein expression of SIRT 1, MMP-9 and AQP4 was deter-mined by Western blot .RESULTS: Compared with sham group , the neural function score of the rats in MCAO model group was significantly elevated .With the increasing reperfusion time , the cerebral infarction volume , brain tissue permea-bility and the brain water content were also increased .The increases in the protein levels of AQP 4 and the related proteins showed apparent changes .The protein expression of SIRT 1 was decreased , while the MMP-9 expression was increased .The most obvious differences of the protein level changes in MCAO-48 h model group were observed (P<0.01).CONCLU-SION:Accompanied with the aggravating cerebral injury after cerebral ischemia , the process of AQP4 expression is activa-ted with the increasing expression levels of MMP-9 and SIRT1.These factors are combined to induce the formation of brain edema.

Objective To investigate the effect of aminophylline and pentoxyverine on serum CRP, monocyte chemotaxis protein 1(MCP-1) and serum immune factors in elderly patients with sleep apnea syndrome .Methods 112 elderly patients with apnea syndrome were divided into the control group and the experiment group by order of medical treatment and 56 cases in each group.The control group were treated by rosiglitazone hydrochloride tablets and bay three ramie snore capsule and the experiment group were treated on the control group with Aminophylline Tablets and Pentoxyverine Citrate Tablets.Follow up 3 months, the CRP, MCP-1,IFN-γ,IL-4,IL-8 and IL-10 were tested and compared.Results Compared with the control group after treatment, the CRP,MCP-1,IFN-γand IL-8 level were lower(P <0.05),the IL-4 and IL-10 level were higher(P <0.05).Conclusion Aminophylline and pentoxyverine can be effective in treatment of elderly patients with apnea syndrome and its complications , suggesting that the mechanism may be related to reduce the patients serum CRP, MCP-1, IL-8 and IFNγ-levels, is related to the increasing of the levels of IL-4, IL-10.

Objective To investigate the efficacy of frontoparietal drill versus parietal drill in the burring hole and drainage for chronic subdural hematoma(CSDH),and provide an evidence for clinical application.Methods A total of 82 patients with CSDH from January 2013 to January 2016 in our hospital were randomly divided into observation group and control group.The observation group chose frontoparietal drill which located at the front 1/4 point at the axial view with the thickest hematoma.Control group chose parietal drill which nearby the parietal tuberodties at the axial view with the thickest hematoma.The postoperative residual hematoma volume,intracranial gas volume,recurrence rate,neurologic function and mental state between two groups were compared.Results The postoperative residual hematoma volume,intracranial gas volume,the recurrence rate and CSS were lower compared with the control group,the differences were significant(P<0.05).The MMSE score of observation group were higher that of the control group,the difference was significant(P<0.05).Conclusion The frontoparietal drill has a better effect to remove the hematoma and promotes neural functional recovery.

Objective To investigate effect of Dahuang Fuzi decoction on alveolaur epithelial barrier in rats with lung injury with severe acute pancreatitis. Method Ninty-six health SD rats were randomly divided into three groups: sham operation group, SAP-ALI group, Dahuang Fuzi decoction group, and then according to the time point of sacrifice after operation, each group was subdivided into 3,6,12,24 hour subsets ( each, n = 8). After the belly of a rat in the sham operation group was cut open, the pancreas was flipped several times,and then a stoma was made in the jejunum to form its fistula. In the SAP-ALl group,1 mL/kg sodium taurocholate was reversely injected into the pancreatobile duct to establish the model of SAP, and then the jejimum fistula was performed. The SAP-ALI model in Dahuang Fuzi decoction group was treated by injection of 10ml of Dahuang Fuzi decoctionon into the fistula respectively. Blood was collected from heart to detect serum amvlase and endotoxin (ET) levels before the rat being executed. The lung histopathologic changes, pulmonary injury scores and wet/dry weight(W/D) ratios were observed after the rats were executed. The alveolar liquid clearance rate(ALCR), total lung water content (TLW), extravascular lung water content(EVLW) and alveolar epithelial permeability (AEP) were examined in 3,6, 12,24 h after injury.Results There was continuous increase of AEP,TLW and EVLW,as well as progressive reduction of ALCR compared with sham operation group at 3,6,12,24 h after operation. Compared with SAP-ALI group, there was continuous decrease of AEP,TLW and EVLW, and elevated of ALCR at 3,6,12,24 h after operation.Conclusions Dahuang Fuzi decoction can significantly reduce alveolaur epithelial barrier and degree of lung tissue of SAP-ALI rats by inhibiting the elevation of LPS and inflammation reaction.