Adrenomedullin (ADM) has wide distribution in the body and has many biological effects,which participates in many physiological and pathological processes.What's more,it is closely related to the degree of malignancy,prognosis and metastasis of tumors.ADM has different effects on different types of cells via one or more signal pathways,so that can product various effects.It also provides a new treatment strategy for preventing or slowing the progress of the cancer.

Objective To observe the curative effect of cervicogenic headache(CEH)treatment through the combination of pulse radio frequency(PRF)on the C2 dorsal rootganglion and continuous epidural space block.Methods Sixty patients with CEH in our hospital were randomly divided into groups A and B,30 cases in each group.The group A was treated with combination of PRF on cervical dorsal root ganglion and continuous epidural space block.The group B was treated with PRF on cervical dorsal root ganglion method.The pain VAS scores before treatment and at 1 week,3,6 months after treatment were compared between the two groups.Results Compared with pretreatment,the VSA scores at 1 week,3,6 wonths after treatment in the two groups had statistical difference(P＜0.05),moreover,the VAS score decrease in the group A was better than the group B.All the patients had no nerve and artery injury or infection complications.Conclusion It is safe and effective to treat cervical CEH through the combination of ganglion PRF on the cervical 2 dorsal root and continuous epidural space block.

BACKGROUND: Peri-implant crestal bone resorption is considered as a normal reaction according to traditional butt-joint prosthesis around two-piece implants. OBJECTIVE: To evaluate bone loss around two-piece implants restored according to the platform switching concept in the posterior area of the mandible. METHODS: Eighty-eight implants were consecutively placed in 50 patients following submerged surgical protocol. In the test group, 40 Ankylos implants were placed using platform switching technique, while 48 3i implants using traditional butt-joint in the control group. All the implants were positioned at the crestal level. Definitive prosthesis was delivered after 3 months. RESULTS AND CONCLUSION: All implants were judged to be successfully osseointegrated. The success rate was 100%. Twelve months after restoration, radiographic analysis showed an average bone reduction level of (0.31±0.39) mm in the test group that was statistically significantly different (P < 0.01) from the average reduction in the control group [(0.94±0.43) mm]. In the follow-up time, no implants were loose or lost and healthy gingival was seen. These findings show that the platform switching technique can reduce peri-implant crestal bone resorption and preserve alveolar bone level around dental implants 12 months after restoration.Oral Implantology Center, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, Shandong Province, China

Objective To investigate the operative techniques of microsurgery treatment of M1 segment of middle cerebral artery (MCA) aneurysms via pterional approach in 132 cases.Methods Retrospectively analyzed the clinical manifestation,angiograms,and surgical operation data of 132 patients with M1 segment of MCA aneurysms who underwent microsurgery through pterional approach.Results Preoperative digital subtraction angiography (DSA) was conducted in 121 cases to identify the size,shape,orientation and relationship with blood vessels around the MCA aneurysms.The other 11 cases underwent emergency operation.Among the 132 cases,72 patients were discharged in good condition according to Glasgow Outcome Scale; 41 patients were in poor condition; 19 cases were dead or in predying state.Postoperative CT showed that49 cases occurred new infarction and 7 cases developed hydrocephalus or enlargement of ventricles.Ventriculoperitoneal shunt was conducted in 2 cases.Intraoperation rupture and bleeding of aneurysms occurred in 17 cases.Conclusion The aneurysms in M1 segment of the middle cerebral artery are mostly located in the bifurcation of M1 segment.Most branches and perforating arteries stem from middle cerebral artery trunk.Patients with Hunt-hess grade Ⅰ-Ⅲ MCA aneurysms or with Hunt-hess grade Ⅳ,Ⅴ should be treated with microsurgery as soon as possible.Inside Sylvian fissure approach is the most frequently adopted in microsurgery via pterional approach.It is key for the success of the operation to preoperatively understand the anatomy surrounding the aneurysms,have good microsurgical skills and employ correct methods of preventing and managing of rupture of aneurysm.It can relieve the secondary cerebral vasospasm to clear up hematocele in the cisterns or to wash the cisterns or use adhesive wound dressing on blood vessels during operation using papaverine.

Objective To comparatively study the advantage and disadvantage of different polysaccharide extraction methods of enzymatic extraction,ultrasonic extraction and a combination of these two processes.Methods The enzymatic extraction and ultrasonic extraction were first optimized by orthogonal design and then compared with the effect of combination.Results From the results of three extraction techniques,enzymatic extraction of Talinum crassifolium polysaccharide's average extraction rate was 17.45％,ultrasonic extraction was 20.01％,enzyme-ultrasonic extraction was 20.74％.Conclusion The combined optimum preparative procedure of Talinum crassifolium is simple,quickly and high efficient.

BACKGROUND: Researches on the hand allograft have been transited from laboratory aspects to clinical application.OBJECTIVE: To evaluate the clinical significance of serial monitoring of co-stimulating signals in double hand transplantation.DESIGN: Case controlled observation.SETTING: Department of Traumatic Orthopaedics, Nanfang Hospital,Southern Medical University.PARTICIPANTS: From September 2001 to December 2001, a patient who was proposed to have double hand transplantation in the Department of Traumatic Orthopaedics, Nanfang Hospital Affiliated to Southern Medical University was taken as the subject of the experiment, meanwhile 15healthy adult man were enrolled as controls.METHODS: Before operation, blood sample was collected from the patient once before given immunodepressant and twice after given immunodepressant; blood sample was also collected before arteriovenous connection during operation, as well as once a day during the first week after operation, once every other day on the second week, twice a week on the third and fourth week, followed by once a week for total two month. The first week after operation was taken as inducing period with the remainder as maintaining period. 2 mL peripheral venous blood was collected from healthy adult and anti-coagulated by EDTA of mass scores of 20 g/L.Flowcytometry was used to carry out a serial monitoring of T cell surface co-stimulating moleculars (CD28, CD54, CD11a).MAIN OUTCOME MEASURES: The change of co-stimulatingmolecules on the surface of T lymphocyte before and after transplantation.RESULTS:The changes of the three co-stimulating molecules were consistent with each other after double hand transplantation (CD28,CD54,CD11a),displaying decrement during inducing period comparing to pre-operation [(9.84±5.28)%, (55.50±3.62)%; (71.03±5.33)%, (95.10±1.26)%;(9.40±9.17)%, (29.70±3.23)%] and keeping at lower level at maintaining period [ (22.54±6.56) %, (91.28±8.12 ) %, ( 11.22±4.08 ) %].CONCLUSION:The serial monitoring of the co-stimulating signals in the peripheral blood of patients with linb allograft is beneficial to the observation of the posopertaive immunologic reaction, providing important guidance for the application of immunosuppression medicine, as well as the prediction and diagnosis of postoperative immune rejection. Meanwhile, costimulating signal induced immunological tolerance is proved promising for the application of hand transplantation.

Objective To provide vascular feature of neurocutaneous vascular flap and anatomical details about how to design the flap.Methods Ten fresh human body sample with twenty limb were perfused.The clinical anatomy of lateral antebrachial cutaneous nerve,medial antebrachial cutaneous nerve,sural nerve,superficial peroneal nerve,saphenous nerve and their nutrient vessels were studied.The distribution of their nutrient perforators were observed.Results Neurocutaneous nutrient vessels or nutrition artery with large diameter were accompanying nervus cutaneus by a long distance; Or longitudinal vascular chains were formed by ramus communicans with the ascending branches and descending branches from multiple segmental vessels.Medial antebrachial cutaneous nerve,lateral antebrachial cutaneous nerve,sural nerve,superficial peroneal nerve,saphenous nerve has the ulnar artery perforating branches,radial artery perforating branches,anteriolateral supra malleolar perforating branches,posterolateral supra malleolar perforating branches,medial supra malleolar perforating branches,accompanied separately,and the occurrence rate were 100％,95％,80％,90％,100％ respectively.Conclusion Cutaneous branch from the main deep artery is the anatomical basis of neurocutaneous nutrient vessel.Its distribution also accord to pressure balance rule.Mostly nervus cutaneus had constant perforator attending to suply its nutrition.Actually neurocutaneous nutrient vessel is a predictable and reliable vascular chain.

Objective:To explore the mechanism of the embolism and sclerotherapy of fibrin glue combined with bleomycin (FG/BLM) for the treatment of cervicofacial vascular malformations by color doppler ultrasound.Methods:10 patients with venous malformation(VM) and 10 patients with arterio-venous malformation(AVM) were included.All patients underwent embolism and sclerotherapy of FG/BLM guided by ultrasound.Color doppler ultrasound was used to record the real-time two-dimensional ultrasonography and color doppler image.The flow and distribution of FG/BLM after injection into the lesions were observed.Results:Two-dimensional ultrasonography showed clumps or flake strong echo after immediate injection of FG/BLM into the cavity of VMs,then floated in the abnormal venous lumen and diffused throughout the cavity.At the later stage the lesions were filled by a large number of flocculent and netted low echo,and patchy strong echo.The volume of VMs cavity expanded dramaticlly,and the blood flow signal was significantly decreased.After injection of FG/BLM into the lumen of AVMs,clumps or flake strong echo were observed,then most of the snowflake strong echo rapidly filled or scattered along with blood stream to the distal part of the vessels.The color doppler showed significantly decrease of blood flow signal.Conclusion:FG/BLM injection can embolize and block the draining vein of VM,and play a role on the storage of sclerozing agent.FG/BLM injection can embolize both the dilated blood vessels and capillary network of AVM.

Objective To relatively prolong the length of C7 nerve through microanatomical study and carry out direct anastomosis between the end of avulsed nerve and contralateral C7. Methods Fifteen cadaveric specimens and 30 sides of the adult brachial plexus was dissected. The C7 nerve was confirmed and measured by using electric vernier caliper. Parameters as follow: the length of C7 nerve from root to trunk; the length of C7 nerve from root to division(anterior and posterior division); transverse and longitudinal diameter of C7 nerve in root site, combination site between trunk and division, end site of anterior and posterior division. After dissected the nerve adventitia of binding site between division and cord and cut the distal end of anterior and posterior division, the length of C7 nerve from root to division (anterior and posterior division)was measured again. Results The measured result of the length C7 nerve: the length of C7 from root to trunk: (45.87 ± 10.43)mm; Before micro-dissected, the length of C7 from root to anterior division: (61.14 ±13.44)mm; the length of C7 from root to posterior division: (54.63 ± 11.35)mm after micro-dissected, the length of C7 from root to anterior division: (74.67±12.86)mm; the length of C7 from root to posterior division:(68.73± 11.86)mm; the prolonged length of anterior division: (13.15± 4.26)mm; the prolonged length of posterior division: (14.21 ± 6.98)mm. Conclusion Through dessecting the adventitia of binding site of division (anterior and posterior division) and cord of C7 nerve. The length of C7 nerve can be relatively prolonged.

BACKGROUND:J2 takes functional domain (MHC CD4-D1/) of complex conjugate of CD4 molecule and MHC class II molecule as a target, and is a smal molecule compound obtained by computer screening from a chemical data containing hundreds of thousands of organic compounds. In the previous study, J2 was used in mouse models of skin transplantation and keratoplasty by oral and intraperitoneal injection. Results verified that J2 could prolong the survival time of grafts, and suppress occurrence of rejection. To better play the role of a drug targeting and to reduce systemic toxicity, J2 wil be further utilized in local treatment of keratoplasty rejection. OBJECTIVE:To investigate the inhibitory effect of new immunosuppressive agent J2 on CD4+ and CD8+T cel immune functions in rat models receiving alogenic penetrating keratoplasty. METHODS:Alogeneic penetrating keratoplasty model was established using the adult female Wistar rats as donors and Sprague-Dawley rats as recipients. Group A: normal Sprague-Dawley rats were injected with 0.05 mL placebo subconjunctivaly. Surgery rats were randomly divided into three groups. Group B: alograft rats were injected with 0.05 mL placebo subconjunctivaly after autologous keratoplasty. Group C: alograft rats were injected with 0.05 mL placebo subconjunctivaly. Group D: alograft rats were injected with 1% J2-nanosuspension 0.05 mL subconjunctivaly. The distribution of T cel subsets in peripheral blood was detected using flow cytometry at 3 days, 1, 2 and 3 weeks after transplantation and compared among groups. RESULTS AND CONCLUSION: There was no significant difference in total CD3+ T cels, CD4+ T cels, CD8+ T cels and CD4+/CD8+ in peripheral blood lymphocytes in group B at various time points. At 3 days and 1 week after surgery in group C, no significant difference in total CD3+ T cels, CD4+ T cels and CD8+ T cels was detected. At 1 and 2 weeks, the number of total CD3+ T cels, CD4+ T cels and CD8+ T cels increased, showing significant differences (P < 0.05). In group D, no significant hyperplasy was found in CD4+ T cels and CD8+ T cels at 1 and 2 weeks. The horizontal comparison of the same time point: the total CD3+ T lymphocytes of group D was significantly less than group C at 3 days, 1 and 2 weeks after operation (P < 0.05), whereas there was no significant difference at 3 weeks between the group D and group C. The number of CD4+ T lymphocytes in group D was less than in group C at 3 days and 1 week, but with no significant difference. The ratio of CD4+/CD8+ had no significant difference in group D compared with group C at 3 days, 1 and 3 weeks. J2 inhibits T lymphocyte proliferation and then inhibits T cel-mediated corneal alograft rejection.