Objective To study the relationship between the expression of aquaporin-4 (AQP4) and cerebral edema formation during the pathologic course of hemorrhagic cerebral edema. Methods The intracerebral hemorrhage (ICH) was established by infusing collagenase into rat caudate nucleus. In situ hybridization and immunohistochemistry were respectively used to evaluate AQP4 mRNA and protein expression, and electronic microscopy and microangium perfusion were respectively used to observe the changes of the ultrastructural and local capillaries in perihematomal brain edema. Results As compared with the control group, there appeared a significant increase in AQP4 mRNA and protein expression on the edematous tissue at 6 hours in rats following ICH. AQP4 mRNA expression (optical density, A) was increased from 0.29 to 0.57 (P0.82, P s

Objective To observe the distribution of aquaporin-4(AQP*!4) in brain tissue of intracerebral hemorrhagic rats, and its role in hemorrhagic brain edema.Methods The model of intracerebral hemorrhage(ICH) was made by infusing collagenase into rat caudate nucleuses, the immunohistochemical method was used to observe the expression of AQP*!4 in brain tissue during different time after ICH in rats.Results The expression of AQP*!4 immunoreactive positive cell bodies were observed mainly in the perihematomal brain edema zone and astrocytes of cerebral cortex, periventricular zone, supraoptic nucleus and paraventricular nucleus of ICH rats. AQP*!4 expression level elevated at 6 h and peaked at 72 h after ICH, and it was yet higher than control lever at 1 week after ICH.Conclusion AQP*!4 express increases strongly in the areas of a relevant relationship with the water metabolism. It can be concluded that AQP*!4 plays an important role in the development of brain edema after hemorrhage.

Objective To study the effect of Nimotop on the permeability of blood-brain barrier (BBB) and cerebral infarction size after cerebral ischemic reperfusion (CIR) in rats.Methods CIR models were established by occluding unilateral middle cerebral arteries(MCA) of rats for 2 hours and then reperfused. The models were divided into 2 groups:Nimotop group and the saline control group,each group had CIR 6、12、24、48 and 72 h sub-groups. As soon as reperfusion,Nimotop or saline was abdominal abministrated(2 mg/kg weight) respectively per 12 h. Fluorophotometry and transmission electron microscopy were used to detect the permeability of BBB,the rate of infarction size was calculated by 2,3,5-triphenyl tetrazolium chloride(TTC) dyeing.Results Following reperfusion,the permeability of BBB and the rate of cerebral infarction size were increased. The permeability of BBB had two peaks. The first peak took place at 12h after CIR. The second peak was at 48 h after CIR. These changes were more severe in Nimotop group than in saline group( P

Objective To introduce a new method that abdominal puncture is used in ventriculoperitoneal shunt. Methods A retrospective review of the clinical materials of 49 patients who underwent improving ventriculoperitoneal shunt.Results After operations, all the patients had fellow-up survey that the rates of infection and obstruction are both 4.08%. They are lower than that of the lectures. Conclusion It has many advantages that abdominal puncture taken the place of incision of abdominal cavity. They are less wounded, less infection, less abdominal complication , not easy to be packed by the omentum and so on.

Objective To investigate the pathogenesis in hemifacial spasm by establishing animal models of hemifacial spasm and combining with electrophysiological technique. Methods 28 New Zealand white rabbits were randomized into four groups: 13 rabbits underwent both artificial demylination and arterial compression (model group). 5 rabbits underwent only arterial compression, 5 rabbits underwent only artificial demyelination and 5 rabbits underwent sham operation control. Abnormal muscle response (AMR) and F wave changes in all groups were tested and compared at the third or sixth week after operation respectively.Results No AMR was recorded in all four groups at the third week after operation, while a clear AMR was elicited in ten animals in model group rather than in the other groups at the sixth week of postoperation. F/M amplitude ratio, the F wave duration and frequency of F wave appearance in model animals significantly increased as compared with those of the other groups ( P 0 05). Conclusion The hyperactivity of the facial motonucleus may be the pathophysiological basis of hemifacial spasm.

BACKGROUND: Aquaporin-4 may be one of the candidates for inducing the brain edema in ischemic stroke, however, it still has not been reported whether aquaporin-4 is involved in the formation of brain edema after intracerebral hemorrhage (ICH).OBJECTIVE: To observe the expression of aquaporin-4 of cerebral tissue in the pathologic course of hemorrhagic cerebral edema in rats, and investigate itsrelationship with the formation of brain edema following ICH.DESIGN: A randomized controlled experimental study.SETTING: Department of Neurology, People's Hospital of Guangxi Zhuang Autonomous Region; Research Room of Neurobiology, Chongqing University of Medical Sciences.MATERIALS: This experiment was carried out in the Research Room of Neurobiology, Chongqing University of Medical Sciences between April and October 2003. Totally 120 adult healthy male Wistar rats, weighing 250-300 g, were provided by the Experimental Animal Center of Chongqing University of Medical Sciences.METHODS: The experiment had four parts, each part (n=30) was divided into the control group (n=5) and operation group (n=25), and then the latter was subdivided into 6-hour, 1, 3, 5 and 7-day following ICH groups with 5rats in each group. In the operation group, ICH models were established by infusing collagenase into left caudate nucleus of rats unilaterally. The operative process in the control group was the same as that in the operation group except for infusing collagenase. Standards for successful model establishment: the paralytic forelimb flexed under abdomen after withdrawal,and the normal forelimb extended to the ground. ① The expression of aquaporin-4 was detected with immunohistochemistry. ② The expression of aquaporin-4 mRNA was assessed with in situ hybridizution. ③ The expression of aquaporin-4 mRNA was assessed with reverse transcription polymerase chain reaction (RT-PCR). ④ The pathological changes of hemorrhagic edema were observed under transmission electron microscope.MAIN OUTCOME MEASURES: ① expression of aquaporin-4 mRNAand protein; ② pathological changes of hemorrhagic edema.RESULTS: The model establishments were all successful in the operation group, and all the rats were involved in the analysis of results without deletion. ① Comparison of the expression of aquaporin-4 mRNA and protein among the groups. There was no significant change in the control group. As compared with the control group, there was a significant increase of the expressions of aquaporin-4 mRNA and protein in the edematous tissue at 6 hours following ICH, and then reached the peaks at 3 days, and the expression of aquaporin-4 was still significantly higher than that in the control group at one week following ICH (t=12.65, P ＜ 0.01). ② The corresponding sequential pathological changes in the edematous tissue of rats in the operation group: There was a gradual increase of intracellular edema within 1-3 days following ICH, and then the brain edema became aggravated at 3 days, an emergence of vasogenic edema and local edema tissue degeneration and necrosis were observed.CONCLUSION: The increased expression of aquaporin-4 was obviously enhanced following ICH, suggesting that aquaporin-4 may play an important role in the pathological course of hemorrhagic brain edema, and inhibition of aquaporin-4 expression may be an effective pathway to prevent and treat brain edema.

Objective To investigate the expression changes of Ire1α and caspase-12 in rats with spinal cord ischemia-reperfusion injury.Methods Fifty-five adult SD rats(250-300 g)were randomly divided into control group(re=5)and operation group(n=50).The spinal cord ischemia-reperfusion models were established and the neuronal apoptosis was detected by terminal deoxynucleotidyl transferasemediated dUTP nick end labeling(TUNEL).The expressions of Ire1α and caspase-12 in spinal cord tissue were detected by immunohistochemistry,immunofluorescence and Western blot analysis at 1,4,8,16and 24 hours after ischemia-reperfusion.Results TUNEL staining showed that the number of apoptotic cells was gradually elevated with time.The expressions of Ire 1α and caspase-12 were increased at 1 hour after reperfusion,and peaked at 16 hours,but began to decline at 24 hours after reperfusion.The number of neurons with positive expressions of Irelaand caspase-12 was significantly higher than that of control group(P＜0.05).Conclusion Ire 1α and caspase-12 synergistically participate in the neuronal apoptosis induced by the endoplasmic reticulum stress.

Objective To evaluate the changes of GRP78 expression in the Spinal Cord of Ischemia/Reperfusion Injuried Rat.Methods Fifty five adult Wistar rats(250～300 g)were randomly divided into 2 groups as control group(n=5)and operation group(n=50).The spinal cord SCII model was established.The expression of GRP78 was detected in spinal cord tissue through immunohistochemistry(IHC)and Western blot analysis,and the neuronal apoptosis was detected through terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL)methods.Results The GRP78 expression was increased at 30 min of reperfusion,and peaked at 7 h,but began to decline at 11 h post-reperfusion,and reduced significantly at 23 h.The number of GRP78 positive neurons at 0.5,3,7,11 and 23 h groups was(19.4?1.34),(42.6?2.30),(82.4?2.07),(40.0?1.58)and(18.8?0.83),respectively and significantly higher than that of control group(P

Stakeholder theory and game theory were applied to analyze the stakeholders,role definition,participation,interest,power,position and the shift of positions under different conditions in the negotiation.Use SPSS 17.0 to analyze the database of NCMS in 2009～2010 in three counties of Hubei province,and then employ Linear programming method to do a case study of price negotiation.It is difficult to meet all stakeholders' expectations under the current condition of catastrophic disease insurance pooled at municipal-level.Medical cost differences in tertiary hospitals at provincial level are small for different regions,which constitute a basis for price negotiation at provincial level.Besides,the negotiation at province level can effectively address the conflicts of interest,and promote the negotiations.Negotiation at provincial level for such diseases,and formulating unified pricing standards for multi-wins.

Purpose:Taking tuberculosis as an example, this paper aims at to analyzing the level of reimburse-ment for infectious diseases care, and clarifying the government responsibility. Methods:In order to achieve the ob-jective of this research, UHC framework was used to analyze the security level. Result:The findings of this research reveal that TB in-patients' Compensation Ratio of the New Cooperative Medical Scheme ( NCMS) was lower than aver-age level of all the NCMS patients, the out-patients' was even lower. The categories of anti-tuberculotic for free was limited, the utilization was not as expected. Medical assistance covered few people in spite of its high level of reim-bursement. Conclusion:Based on the findings of this review, it has been revealed that the medical insurance didn't make a big difference in financial protection for patients with infectious diseases. As the treatment for of infectious diseases is a quasi-public good, the government has to shoulder the responsibility of improving the compensation ratio of the patients.