Objective To explore the correlation between the elder brain atrophy and calcification score at siphon segment of internal carotid artery.Methods The brain CT examination was detected in 327 elders.The brain atrophy occurrence were observed, and the calcification score at siphon segment of internal carotid artery were determined and calculated.Accroding to the calcification score, all the cases were divided into calcification 0 score group, calcification 1-199 score group, calcification 200-399 score group, calcification 400-599 score group and calcification ≥600 score group.The situation of brain atrophy were compared among these groups.And the correlation between the brain atrophy and calcification score were analyzed.Results Accroding to the calcification score, there were 63 cases in calcification 0 score group, 133 cases in calcification 1-199 score group, 72 cases in calcification 200-399 score group, 28 cases in calcification 400-599 score group and 31 cases in calcification ≥600 score group.There were 13 cases ( 20.63%) of brain atrophy in calcification 0 score group, 64 cases (48.12%) in calcification 1 -199 score group, 51 cases (70.83%) in calcification 200 -399 score group, 23 cases (82.14%) in calcification 400-599 score group and 28 cases (90.32%) in calcification≥600 score group;the differences of the brain atrophy rate among these groups were statistical significant ( all P<0.05 ) .The brain atrophy was mainly mild-moderate in calcification 0 score group and calcification 1 -199 score group;which was mainly severe in calcification 200 -399 score group;and mainly moderate-severe in calcification 400 -599 score group and calcification≥600 score group (all P<0.05).Spearman rank correlation analysis showed that the degree of brain atrophy were positive correlated with calcification score at siphon segment of internal carotid artery ( r=0.717, P<0.05) .Conclusions The elder brain atrophy is significantly correlated with calcification score at siphon segment of internal carotid artery.The calcification score higher, the brain atrophy rate higher and the degree more severe.Calcification score can be used as an important indicator of the elder brain atrophy.

Objective To investigate the effects of mouse nerve growth factor on amikacin (AK)-induced ototoxicity in guinea pigs .Methods 45 guinea pigs were randomly divided into three groups with 15 guinea pigs in each group .The control group received no drug treatment ,the poisoning group received an intraperitoneal injection of AK (400 mg · kg -1 · d-1 ) for 10 days ,and the treatment group received an intraperitoneal injection of AK (400 mg · kg -1 · d-1 ) for 10 days and an intramuscular injection of NGF (1 500 AU · kg -1 · d-1 ) for 14 consecutive days .Auditory brainstem responses were tested on the day before administration ,the 10th day and 20th day after administration .All the guinea pigs were sacrificed when the last ABR test was finished on the 20th day whose Corti organs were observed as well .Results The ABR thresholds of each group showed no significant difference before administration .The ABR threshold of the treatment group was lower than that of the poisoning group .With light microscopy ,the hair cells with normal morphology were observed in the control group .However ,there was an ex-tensive loss of outer hair cell in the poisoning group .For the treatment group ,the miss rate of hair cell was lower compared with the poisoning group .Conclusion Our data shows that NGF has played a protective role on amikacin-induced ototoxicity .

Objective To study the histopathological characteristics and the correlations between the cortical tissues from ictal discharge (ID) area and interictal epileptiform discharge (IED) area in epilepsy patients due to focal cortical dysplasia (FCD), in order to further discuss the mechanism of epileptogenicity. Methods Twenty-two subjects who underwent epilepsy surgeries consecutively in our institute since April 2005 to August 2006. All patients underwent intracranial electrode implantations and long-term video-EEG monitoring before the resective surgeries and the postoperative pathologies proved to be FCD. According the long-term EEG monitoring results, the cortex with intense IED and the cortex with ID onset were resected separatively in the operation for further histopathologic studies. Twenty cases were collected. Based on the Palimini' s pathologic subtype classification for FCD as well as quantificational scoring for immunocytochemistry for the calcium-binding protein parvalbumin (PV) which we designed by ourself, the specimens of IED and ID were studied and compared. Results The resected specimens from 20 cases were examed. ID specimens showed more severe abnormalities in the laminar cortical architecture, alterations in the morphology of neurons and in the appearance of abnormal balloon cells. With the PV quantificational scoring, we found significant difference between IED (6.4±2.1) and ID (4.4±1.8) from FCD Ⅱ specimens (P=0.042). No difference was found between ID subtypes (F=2.734, P=0.093 ). Conclusions ID cortical area showed more severe abnormalities in histopathologic changes than lED area. Our results suggested that the ID area of FCD had more severe damage in inhibitory synaptic circuits and neural networks, which meant it was more epileptogenic than IED. No difference was identified between each ID subtype in term of epileptogenicity, which meant all of them should be resected during the surgery.

Objective To analyze blood-CSF barrier and cerebrospinal intrathecal IgG synthesis in patients of multiple sclerosis, and explore the Protis software, IgG index and IgG synthesis rate in the and evaluation for cerebrospinal intrathecal IgG synthesis and blood-CSF barrier dysfunction. Methods 134 patients with neurological diseases were divided into threes groups, including multiple sclerosis group (34 cases), disease control group(80 cases) and control group(20 cases). IgG and ALB concentration of CSF and blood was detected by BN-Ⅱ. The oligoclonal IgG was detected by immunofixation electrophoresis. The relationship between Protis software results and IgG index or IgG synthesis rate was calculated and analyzed. Results The function of blood-brain barrier was almost normal in multiple sclerosis group,QALB was 4.5×10-3[(3.1-7.6)×10-3], there was no significance compared with control group (D=5.25, P>0.05). there were 31 patients with oligaclonal bands in cerebrospinal fluids in multiple sclerosis group (34 patients) with the positive rate of 91.2%. In multiple sclerosis group the intrethecal IgGIF, IgG index and IgG synthesis rate of 24 hours were 31.25% (11.65%-71.45 %), 0.93% (0.80%-1.04%), 24.25 mg/24 h(15.25-46.15 mg/24 h) ,the results were all higher than that in control group (D=175.5, 112.5,103.4,P<0.05). And in multiple sclerosis group there was no significant difference among the intrethecal IgGIF, IgG index and IgG synthesis rate of 24 hours, the positive rate of oligaclonal bands (P>0.05). In disease control group(80 patients) QALB Was 35.2×10-3[(18.5-55.5)×10-3] ,the result was significantly higher than control group (D=102.7, P<0.05), the oligaclonal bands were all negative, IgG index and IgG synthesis rate of 24 hours were 0.75(0.69-0.82) ,44.29 mg/24 h(20.35-65.98 mg/24 h) were both higher than control group(D=85.6,98.5,P<0.05). In disease control group the positive rate of intrathecal IgGIF, IgG index and IgG synthesis rate of 24 hours were 0 (0/80), 40.0% (32/80), 72.5% (58/80) respectively, IgG index and its positive rate both increased alone with the lesion degree of blood-brain barrier increasing (P<0.05). And there was similar trend in the IgG synthesis rate of 24 hours. There were significant correlations among intrathecal IgGIF, IgG index and IgG synthesis rate of 24 hours in multiple sclerosis group (r=0.788, 0.695 ,P<0.05). However there was no correlation among intrathecal IgGIF, IgG index and IgG synthesis rate of 24 hours in disease control group (r=0.000,P>0.05). Conclusions The Protis software can be used to analyze the intrathecal IgGIF and reflect the actual status of intrathecal IgG synthesis more accurately. Protis software has great application value for clinical diagnosis for nervous system disease.

Objective To investigate the neuroprotective effect of Dengzhan Shengmai capsule (DZSM) in rat cerebral ischemia-reperfusion injury and to explore the mechanism. Methods Rats were divided into Sham group, MCAO group, DZSM group, carbenoxolone (CBX) group and DZSM + CBX group. Each group was assessed for neurological function , infarct volume and the expression of Caspase-3 48 h after reperfusion. Connexin 43 (Cx43) expression of MCAO group was detected 3, 12, 24, 48 h after reperfusion. Results There were lower neurological deficit scores , infarct volume and the expression of Caspase-3 in DZSM , CBX and DZSM + CBX group 48 h after reperfusion when compared with those in MCAO group (P < 0.05) but Cx43 expression level in each group increased after reperfusion at each time point (P < 0.05). Expression of Cx43 was lower in DZSM, CBX and DZSM + CBX group than that in MCAO group (P < 0.05). Lower expression of Cx43 was also seen in CBX and DZSM + CBX group when compared with that in DZSM group (P < 0.05). Conclusion DZSM capsule can improve neurological function , reduce infarct volume and inhibit the expression of Caspase-3. The mechanism may be related to its inhibition of Cx43 expression.

Objective To reveal the influential factors on scalp electroencephalogram (EEG)recording and provide valuable information for localization of the epileptic focus by analyzing the characteristics of spikes with continuous focal periodic discharges on scalp and cortical EEG. Methods Five patients with refractory epilepsy who had low amplitude spikes with continuous focal periodic discharges on interictal scalp EEG were studied. Intracranial EEG recording was also performed in patients. The amplitudes of spikes and cortical areas of spike-wave foci were measured by DaVinci system. Patterns of continuous periodic activity were determined by autocorrelograms,power spectral density and coherence analysis using Matlab and Spike2 software.T-test was employed to compare the mean amplitudes of spikes on the scalp and cortical EEG.Results The amplitudes of spikes recorded on scalp EEG of the 5 patients were:(22.2±4.8),(30.4±7.1),(20.7±3.2),(58.4±10.1),(23.4±3.9) μV.The amplitudes of spikes recorded on cortical EEG of the 5 patients were:(1253.8 ± 199.3),(806.5 ± 161.4),( 1585.7 ±305.7),(922.5 ± 140.6),(736.8 ±70.9) μV.The amplitudes of spikes on scalp EEG were significantly higher than those on cortical EEG ( t =6.394,P ＜ 0.05 ).The cortical areas of spike-wave foci of the 5 patients were:4.0,6.0,3.5,5.5,6.5 cm2.Power spectral density and autocorrelugrams showed 1-3 Hz oscillations on the cortical of spike-wave foci. Cross-correlation and coherence analysis showed synchronization of electrical activity in two contacts of intracranial electrodes. Conclusion The low amplitude spikes with continuous focal periodic discharges on interictal scalp EEG provide valuable information for localization of the epileptic focus.

Objective To summarize the clinical experience in treatment of the Lisfranc joint injury with open reduction and internal fixation at early stage. Methods Twelve patients ( including ten males and two females at average age of 34 years) with early stage Lisfranc joint injury received open reduction and screw/wire fixation from 2005 to 2010. According to the Myerson classification, there were two patients with type A, eight with type B and two with type C. All the patients received open reduction and internal fixation with screw or Kirschner wire within 17 days after injury. The post-operative function was estimated by mid-foot scoring scale of AOFAS. X-ray and CT scan were used in radiography estimation. Results All the patients were followed up for average 33 months ( range, 6-60 months). The mean score of post-operative mid-foot scoring scale of AOFAS was 74.5 points ( range, 53-96 points), with excellent result in eight patients, good in two and fair in two. The anatomical reduction was observed in eight patients and all the patients obtained bony union according to the results of X-ray and CT scan.There was no any complication found.Conclusions Open reduction and internal fixation is a good choice for the treatment of Lisfranc joint injury at early stage. A preoperative comprehensive analysis combined with clinical X-ray and CT scan is necessary.

This article was aimed to study the correlation among traditional Chinese medicine (TCM) syndrome elements in the first year after ischemic stroke. Data of TCM four examinations were collected among subjects all over China by cross-sectional study, using the same observing rating scale. The results showed that internal-heat, internal-wind and phlegm-damp syndrome were risk factors with obvious positive correlation. On the contrary, blood-stasis, internal-heat and qi-deficiency syndrome were in obvious negative correlation. But syndrome of yin-deficiency had no significant correlation with other syndrome elements. It was concluded that there were remarkable positive correlations on excess syndromes, such as wind, fire and phlegm. The syndromes of excess in the branch are easily to be combined.

Objective To provide reliable technical method by identifying referential anatomic landmarks for retroperitoneal laparoscopic renal surgery,with respect to the renal hilum and renal artery.Methods The regional anatomy of the posterior abdominal wall was studied in 35 cases of retroperitoneal laparoscopic renal surgery from January to August 2010.These included 27 cases of renal cancer,6 cases of renal pelvis cancer and 2 cases of renal tuberculosis.Distended the retroperitoneal space using balloon dilation along with sharp and dull dissection.We recorded the forms and positions of the posterior abdominal cavity's anatomical landmarks and evaluated the relationship between each anatomical landmark with respect to the renal hilum and renal artery.Results The perirenal fascia posterior layer and perinephric fat on the renal side were observed,and several anatomical landmarks gradually appeared on the posterior abdominal wall.The diaphragm extended across the upper retroperitoneal space near the superior pole of the kidney,and the psoas major and the quadratus lumborum muscles were located at the lower retroperitoneal space,near the inferior part of the kidney.The intersection of the upper diaphragm muscle with the lower psoas major and quadratus lumborum muscles were bordered by the lateral and medial arcuate ligaments.The lateral arcuate ligament arched across the upper part of quadratus lumborum,while the medial arcuate ligament arched across the upper part of psoas major.The medial arcuate ligament points extended towards the upper border of the renal hilum.These landmarks enable us to locate the position of the kidney,reach the renal hilum and identify the renal vessels in all 35 cases.Conclusions The relative position of the muscles and ligaments of the posterior abdominal wall are consistent and can be clearly seen under retroperitoneoscopy.Based on the position of the diaphragm and psoas major,the kidney can be located.In addition,based on the position of the medial arcuate ligament,the renal hilum and renal artery can be located.Assistance from these anatomical landmarks will simplify the retroperitoneal laparoscopic renal surgery.

Objective To characterize the clinical features and assess the role of surgery in posterior cortex epilepsy. Methods A retrospective analysis of clinical data was performed in 43 patients with posterior cortex epilepsy. The diagnosis Was established by means of a standard presurgical evaluation, including ictal semiology, MRI, interictal and ictal scalp video-EEG, and additional intracranial EEG monitoring in selected cases. Results The 43 patients included 11 parietal lobe epilepsy, 13 occipital lobe epilepsy, and 19 patients with seizures originating from other part of posterior cortex. Thirty-three patients (76.7%)experienced at least one type of aura, such as visual aura, somatosensory aura, dizziness and so on. The common ictal manifestations included deviation, automatisms, tonic posture and so on. Intracranial EEG monitoring was preformed in 22 selected cases. Transient contralateral hemiparesis occurred in 2 patients, mixed aphasia in 1 patient, and they recovered in 3 weeks after surgery. Visual and visual field deficits were observed in 5 patients, and they did not fully recovered. All patients were followed-up 1 to 5 years, and 27(62.8%)became seizure free (Engel' S I class). Conclusions Some of the specific auras or ictal manifestations may indicate posterior cortex epilepsy. Favorable surgical outcome has been achieved in many of the patients.