BACKGROUND:Cerebrovascular drag, occlusion and other mechanical stimulations inevitably occur during some craniocerebral operations, which cause acute mechanical cerebrovascular vasospasm. At present, the mechanism underlying the patho-physiology as well as the pathological prognosis of this acute mechanical vasospasm remains unclear.OBJECTIVE: To observe changes in the vascular diameter of the middle cerebral artery, cerebral blood flow (CBF), and ultrastructure of vascular wall and vascular endothelial cells, during the early stage (2 hours) of mechanical cerebral vasospasm in cats.DESIGN: Open experiment.SETTING: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University; Beijing Institute of Neurosurgery.MATERIALS: Six healthy adult hybrid cats, of either gender, weighing from 2.5 to 3.5 kg, were provided by the China Medical Science Institute of Experimental Animals. Laser Doppler flowmetry (Periflux 5010, Sweden Perimed Company)was used.METHODS: This study was carried out in the Beijing Institute of Neurosurgery between August 2005 and March 2006. For all experimental surgical procedures, the cats were anesthetized by intraperitoneal injection of 200 g/L chloral hydrate, at 2 mL/kg, and then placed in a prone position. A median incision was made in the scalp and a square bone window, 8×10 mm, was opened at 1.5 cm posterior and 1.5 lateral to the anterior fontanel, after which the dura mater was pricked out. The fine detecting head of the Laser Doppler flowmetry was fixed to a region of the cerebral surfacewith no vessels or with only a few vessels. Subsequently, the cats were placed in lateral position. Under the surgical microscope, the right middle cerebral artery was exposed through a suborbital approach. Blunt apparatus was used to stimulate middle the middle cerebral artery repeatedly, at a frequency of 100 time/min within 30 minutes.The diameter of the middle cerebral artery was measured and a perfusion index of cortical brain tissue was monitored, separately, before and then at 0, 0.5, 1.0, 1.5, 2.0 hours after stimulation. Ultrastructural changes in the vascular wall and the vascular endothelial cells were observed during the early stage (2 hours) of mechanical cerebral vasospasm in cats.MAIN OUTCOME MEASURES: Diameter of the middle cerebral artery and the perfusion index of cortical brain tissue before and then at 0, 0.5, 1.0, 1.5, 2.0 hours after stimulation, as well as any ultrastructural changes in the vascular wall and endothelial cells 2 hours after stimulation.RESULTS: The results from six cats were were analyzed. ①The diameter of the middle cerebral artery was (0.617±0.129), (0.723±0.082), (0.840±0.084) mm 0, 0.5 and 1.0 hours after stimulation, respectively, which was significantly smaller than that before stimulation [(0.897±0.066) mm,t =4.74, 4.017, 1.299,P ＜ 0.01]. ② The perfusion index of cortical brain tissue was 67.8±18.5, 82.5±17.5, 89.8±24.0, 94.0±22.2 and 98.5±21.0 at 0, 0.5, 1.0,1.5 and 2.0 hours after stimulation, which was significantly lower than that before stimulation (159.2±23.5, t =4.716-7.469, P ＜ 0.01 ). ③ At the early stage of acute mechanical stimulation (2 hours) to middle cerebral artery, endothelial cell chromatin aggregated at the edge of the cells and achromocyte formed, but mitochondrial crista was unclear.CONCLUSION: Mechanical stimulation to the middle cerebral artery in cats can lead to cerebral vasospasm. Apoptosis of endothelial cells appears at the early stage of stimulation (2 hours). These results indicate that, in order to prevent against cerebral vasospasm, cerebrovascular mechanical stimulation should be as minimal as possible and that as few as possible craniocerebral operations should be performed.

Objective To discuss the influence of coronary computed tomography angiography(CCTA)on correctness of assessing revascularization in patients with coronary artery disease. Methods A retrospective study method was conducted,605 cases underwent CCTA before coronary angiography(CAG)from 2008 to 2009 in Chinese PLA General Hospital were selected as CCTA before CAG group,and meanwhile 616 cases examined by CAG directly were selected as direct CAG group. Patients with multiple procedures of CAG were excluded. The proportions of various treatment strategies were compared,including per-cutaneous coronary intervention(PCI),coronary artery bypass grafting(CABG),medical therapy(MT),normal rate of CAG and the correctness of assessing revascularization between the two groups. Results The comparison between the baseline of the two groups showed that in the CCTA before CAG group,there were more severe lesions than those in the direct CAG group,such as Syntax score(11.31±8.90 vs. 10.23±9.73,P<0.05). Compared with direct CAG group,the triage of PCI and CABG in the CCTA before CAG group was significantly increased〔PCI:65.3%(395/605)vs. 57.1%(352/616),CABG:16.5%(100/605)vs. 3.4%(21/616)〕,while the percentages of medical treatment and normal CAG were obviously reduced〔medical treatment:11.7%(71/605)vs. 19.3%(119/616),normal rate of CAG:6.4%(39/605)vs. 20.1%(124/616),all P<0.01〕. With the guidance of CCTA,the correctness of assessing revascularization was increased〔81.8%(495/605)vs. 60.6%(373/616),P<0.01〕. Conclusion Compared with the direct induction by CAG,the CCTA examination carried out before CAG is capable of increasing the rate of correctness in the determination of revascularization in coronary heart diseases.

Quantitative analysis on diffusion tensor imaging is prerequisite. The arithmetic of statistical analysis was reviewed in this article via analyzing the arithmetic of quantitative parameters and fiber track on diffusion tensor imaging.

ObjectiveTo observe the changes of artery diameters, cerebral blood flow and glutamate level in the early stage (2 h after the stimulus finished) of acute mechanical middle cerebral artery (MCA) vasospasm in cats. MethodsThe right MCA was persistently mechanically stimulated using a small smooth stainless steel nail in the field across the olfactory tract for 30 min. The diameter of MCA was recorded with metrical ocular of microscope. The changes of the perfusion index of brain tissue were observed through the Laser Doppler flowmetry monitor fixed on the skull. The level of glutamate were investigated through high performance liquid chromatography. ResultsThe diameter of MCA decreased to 68.8% of normal. 2 h later, the diameter of MCA recovered. The perfusion index of the cortex surface decreased to 42.6% of normal and up to 63.8% 2 h later. The level of glutamate raised about 40 times of normal and maintained a high level 2 h after the mechanical stimulus. ConclusionThe persistent mechanical stimulus can cause acute cerebral vasospasm. Reduce of cerebral blood flow and raise of excitatory amino acids were observed in the early stage of acute mechanical vasospasm.

Objective To assess the influence of community intervention on blood pressure and quality of life in aged patients with hypertension.Methods A total of 378 elderly hypertensive patients received community intervention with anti-high blood pressure agents for one year.Before and after intervention,blood pressure was recorded and genetic quality of life inventory(GQOLI-74),symptom checklist(SCL-90),self-rating anxiety scale(SAS),and self-rating depression scale(SDS)were carried out on the basis of giving unite guiding words.Results In addition to blood pressure degraded,the blood pressure control rate was improved after intervention(67.7% vs.40.1% before intervention,x2=57.59, P<0.05).Observation items of body health dimension,psychological health dimension,social function dimension were better than those recorded before intervention(P<0.05).But difference of the material life dimension was not statistically significant(P>0.05).With 41 scores as a SDS rude mark to judge the depression incidence.the incidence was decreased from 22.7% before intervention to 12.5%after intervention(x2=12.565,P<0.05).Conclusions Community intervention is a practical and valuable strategy for controlling high blood pressure and improving quality of life in aged patients.

Objective To research the method of Chronic hepatic injury modeling in mice induced by D -galactosamine and lipopolysaccharide combination . Methods Injected D-galactosamine ( 30 mg/mL ) and lipopolysaccharide ( 2μg/mL ) combination by intraperitoneal injection , two days at a time for 8 weeks .Monitored variation of diet and weight; detected serum level of alanine aminotransferase ( ALT ) and aspartate aminotransferase (AST), been put to death in mice and removed the liver tissue .strained hepatic tissue by the HE and Masoon dye to observe Liver tissue structure and cellular morphology and the degree of fibrosis .Results Lipopolysaccharide and D-galactosamine combination resulted in ALT rise , hepatocyte degeneration and necrosis ,collagen fiber hyperplasia obviously . Conclusion D-galactosamine and Lipopolysaccharide combination could induce mice chronic hepatic injury modeling .

Objective To investigate the effect of restraint stress on liver injury in mice induced by D-galactosamine and lipopolysaccharide (D+L).Methods Normal BALB/c (B/c) mice were randomly divided into normal control, stress control, D+L group, and D+L+stress group.The mice of normal control group were bred routinely.The stress group was giv-en stress regularly and quantitatively.Mice in the D+L group were injected intraperitoneally with mixed solution of D-galac-tosamine and lipopolysaccharide at final concentration of 30 mg/mL and 2μg/mL, respectively, once every two days.The D+L+stress group was given equal stress as stress group after injection of D-galactosamine and lipopolysaccharide mixed solution. Eight weeks later, blood samples were collected to test serum aminotransferase (ALT) and aspartate aminotransferase (AST), liver tissue samples from all animals were collected to evaluate the degree of liver fibrosis by HE and Masson staining.Results At the 8th week, the ALT and AST values in the D+L+stress group were significantly reduced( P＜0.01) and AST/ALT value was significantly increased(P＜0.01)compared with that in the D+L group.For HE and Masson staining, disordered structure of hepatic lobules, nodular hyperplasia, and necrosis of epithelial cells were present in animals of the D+L group.However, no obvious pathological changes were observewd in the D+L+stress group.For fibrosis scores, the fibrosis grade in the D+L+stress group was significantly decreased than that of the D+L group (P＜0.05).Conclusions Constraint stress presents pro-tective effect on D-galactosamine and lipopolysaccharide induced liver injury in mice.

Objective The aim of this study was to establish a mouse model of chronic hepatic injury induced by low dose carbon tetrachloride ( CCl4 ) .Methods Twenty SPF male B/C mice ( body weight 18-20 g) were randomly di-vided into three groups including the CCl 4-treated group , oil-treated group and non-treated control group ( n=5/group ) . Mice in the CCl4-treated group were intraperitoneally injected with 0.5% CCl4 prepared in oil.Mice in the oil group re-ceived intraperitoneal injection of oil .Mice in the non-treated control group were left untreated .After 6 weeks, the serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured, as well structure, cellular morphology and degree of fibrosis of the hepatic tissues were examined by histology with HE and Masson staining .Results After low dose CCL4 treatment, the serum ALT and AST were significantly increased (P =0.00).Histology with HE stai-ning showed extensive vacuolar degeneration of hepatic epithelial cells and large number of necrotic foci .Histology with Masson staining revealed fibrous hyperplasia mainly located around hepatic lobules .Quantitative analysis of the fibrosis showed that the degree of fibrosis and the integrated optical density of fibrosis were significantly increased after CCl 4 induc-tion( P=0.00) .Conclusion Low dose carbon tetrachloride can induce hepatic injury in B /C mouse models presenting pathological changes of hepatic injury and fibrosis .

Objective To investigate the effect of BPI-1095 on caspase-3 protein expression in middle artery occlusion(MCAO) rats.Methods Cerebral ischemia was induced with MCAO in adult male SD rats.Rats were randomly subjected into 6 groups with 15 rats in each group.Each rat has been given tested medication of different dosage and was sacrificed 24 h after treatment.The area of infarction was measured on each slice by image analysis system.Meanwhile,immunohistochemistry staining was used to identify caspase-3 expression in ischemic brain tissue.Results The infarcted area were significantly decreased in big and moderate dose treated rats(P<0.05,vs the placebo group).The expression of caspase-3 protein decreased in contralateral and ipsilateral hemisphere areas.The caspase-3 positive cell was significantly decreased in rats treated with big doses compared with placebo-or ASA-treated rats.Conclusion BPI-1095 shows neuroprotection in MCAO rats,which may related with the inhibition of caspase-3 expression resulting in apoptosis in penumbra.

OBJECTIVETo investigate the triaging pathways of patients after coronary computed tomography angiography (CCTA).

METHODSThe patients undergoing CCTA were enrolled consecutively during the period from March 3, 2008 to June 23, 2009. The rate of coronary angiography (CAG) examinations after CCTA was calculated. The rates of normal CAG, medication, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) were compared between CCTA and direct CAG cohorts.

RESULTSA total of 8030 cases receiving CCTA and 3260 receiving direct CAG were included in the study. The CCTA patients had significantly fewer risk factors than those having direct CAG. Of the 8030 patients undergoing CCTA, 953 (12.03%) received further CAG and 6977 (87.97%) did not. Of the patients who received CAG after CCTA, 35 (3.7%) had normal CAG findings, 604 (63.4%) underwent PCI, 108 (11.3%) received conservative treatment with medications, and 206 (21.6%) underwent CABG. In the 3260 patients directly undergoing CAG, 706 (52.3%) underwent subsequent PCI, 142(4.4%) underwent CABG, 815(25.1%) received medications, and 579 (17.9%) had normal CAG findings. Comparison between the cases receiving direct CAG and CAG after CCTA showed that CCTA resulted in a significant increase in the revascularization rate (P<0.0001).

CONCLUSIONCCTA can help prevent unnecessary CAG and allows more accurate patient triage.

Coronary Angiography ; methods ; Coronary Artery Disease ; diagnostic imaging ; therapy ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed