The effects of minimally invasive surgery on the blood-brain barrier (BBB) of 30 patients with cerebral hemorrhage were investigated. Difference of the BBB index and serum MBP concentration were assessed in 15 cases of conservative treatment group and 15 cases of minimally invasive surgery group. The BBB index in minimally invasive surgery group was significantly lower than in conservative treatment group (P<0.05), and the BBB index in the two treatment groups was significantly higher than in control group (P<0.01). Serum MBP concentration in minimally invasive surgery group was significantly lower than in conservative treatment group (P<0.05), and that in the two treatment groups was significantly higher than in control group (P<0.01). It was suggested the permeability of BBB in patients with cerebral hemorrhage was increased, and BBB index and serum MBP concentration in patients with cerebral hemorrhage were increased. Minimally invasive surgery can reduce the lesion of cytotoxicity to BBB and cerebral edema.

BACKGROUND:Inflammatory factor plays an important role in restenosis after bal oon injury. Sphingosine1-phosphate receptor 1 can enhance the expression of inflammatory factor and promote development and progression of this pathological process.
OBJECTIVE:To observe the expression of the inflammatory factors and sphingosine1-phosphate receptor 1 after bal oon injury of the rat carotid artery and effects of fingolimod hydrochloride on reducing inflammatory reaction.
METHODS:Sixty Sprague-Dawley rats were equal y and randomly divided into four groups. In the blank control group and negative control group, left common carotid artery was only isolated, and left external carotid artery was ligated. In the bal oon injury group and drug intervention group, rat models of carotid artery injury were
established by bal oon injury on the left common carotid artery. In the negative control and drug intervention groups, the rats were intraperitoneal y injected with fingolimod hydrochloride 1 mg/kg. In the blank control and bal oon injury groups, the rats were intraperitoneal y injected with an equal volume of saline. Samples were col ected at 3, 7 and 21 days.
RESULTS AND CONCLUSION: Hematoxylin-eosin staining showed that the proliferation of blood vessel was remarkable in the bal oon injury group, but attenuated in the drug intervention group. The appearance of blood vessels was normal in the blank control group and negative control group. Real-time fluorescent quantitative PCR revealed that cyclooxygenase 2 and prostaglandin E2 mRNA expression levels were significantly lower in the drug intervention group than those in the bal oon injury group at 7 days (P<0.05). Cyclooxygenase 2 and prostaglandin E2 mRNA expression levels were significantly higher in the bal oon injury group and drug intervention group than those in the blank control group and negative control group at the same time point (P<0.05). Western blot assay results revealed that sphingosine1-phosphate receptor 1 expression was high in early stage of injury, and then reduced in late stage of injury. In particular, protein expression further decreased after drug intervention. Results indicated that fingolimod hydrochloride suppressed inflammatory reaction of injured blood vessels and lessened the stenosis of injured blood vessels by regulating cyclooxygenase 2 and prostaglandin E2 mRNA expression using sphingosine1-phosphate receptor 1.

Objective To evaluate the implementation feasibility of the nurse performance appraisal and allocation plan based on the holistic nursing mode, and the clinical effect in mobilizing nursing staff's work enthusiasm and ensuring the quality of nursing service. Methods The nurse performance appraisal and allocation plan were further improved based on the previous research of this index system construction. The model were implemented in 32 clinical departments of Yidu Center Hospital of Weifang City. Four aspects data were collected for analysis six months later to evaluate the effect. They were nurses on merit pay distribution satisfaction, patients′satisfaction, doctors′satisfaction with nursing job, different clinical departments′nursing quality scores. Results Six months later, four factor scores of nurses to the satisfaction of merit pay distribution were significantly improved. The scores of fairness and impartiality evaluation of the merit pay distribution, incentive effect evaluation, pay and return on equity evaluation and performance pay gap rationality evaluation were higher than before [(3.39 ±0.64) points vs. (1.88 ±0.33) points, (3.28 ±0.74) points vs. (1.84 ±0.49) points , (3.28 ±0.71) points vs. (1.88 ±0.42) points and (3.38 ±0.67) points vs. (2.01±0.53) points, t=19.28, 16.22, 18.08, 16.79, all P<0.05]. Patients′satisfaction, doctors′satisfaction with nursing job and different clinical department' nursing quality scores were significantly increased as well [(99.14±0.82) points vs. (96.78±0.84) points, (96.59±0.91) points vs. (93.59±1.27) points and(97.67±0.41) points vs. (95.70±1.13) points]. Difference had statistical significance (t=11.79, 11.63, 9.60, P<0.05). Conclusions The performance salary allocation plan can effectively improve the hospital nurses on performance salary allocation satisfaction, patients′satisfaction, doctor′s satisfaction with nursing work and the quality of nursing department, and has good incentive in arousing the work enthusiasm of nursing staff and in ensuring the quality of nursing service.

Objective To explore the repair mechanism of olfactory ensheathing cells (OECs)-neurotrophin-3 (NT-3) gene engineering cell on neuron myeline and axon of experimental allergic encephalomyelitis (EAE).Methods OECs-NT-3 gene engineering cell, constructed by ueurotrophin-3 transinfecting OECs inducted by retrovirus, was transplanted into lateral ventricle.The migration and distribution were observed and compared with control group and OECs transplantation group.Then myeline repair and axon regeneration were evaluated in the aspects of function score, morphological structure, SYN grey level Results (1) OECs-NT-3 could survive, diffuse, migrate with axons, spread in the focus diffusely on the 28th day after transplantation.(2) OECs-NT-3 survived and migrated to the transcription level of NT-3 mRNA in transgene group, being (212.3±16.1)×10-2, significantly higher than OECs group ((1.98±0.19)×10-2) and the contrast group ((1.23±0.13)×10-2, t = - 31.161, -31.928, P < 0.01).(3) The myeline of transgene group was kept complete and the number of inflamatory focus was lower than those of other groups (t = 11.388-22.728, P <0.01).(4) The SYN grey level of transgene group was obviously higher (P < 0.01).Conclusion OECs-NT-3 cell expresses NT-3 in EAE stably and effectively, which contributes to the repair of myeline and the regeneration of axon.

BACKGROUND: Being a kind of regenerative and auto-transplanting cell, olfactory ensheathing cell (OEC) has been extensively concerned on transplantation treatment for spinal disease. Concerning to the transplantation in treatment of cerebral hemorrhage, it is expected a further accumulation of experimental results at present.OBJECTIVE: To observe the proliferation of neural progenitor cells in cerebral hemorrhagic rats after OEC transplantation and to evaluate the therapeutic effects of OEC transplantation on cerebral hemorrhage.DESIGN: Completely randomized controlled experiment.SETTING: Department of Neurology of Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology.MATERIALS: The experiment was performed in Research Center for Clinical Neurology , Tongji Medical College of Huazhong University of Science and Technology from March 2002 to March 2003. Thirty-two healthy male Wistar rats were employed and randomized into 2 groups, 16 rats in each. In OEC transplantation group, on the 3rd day of modeling hemorrhage of caudate nucleus, OEC suspension 10 μL was injected evenly in the brain of rat (1 μL/min). In the control group, physiological saline 10 μL was injected.METHODES: Neural function evaluation was done before transplantation,on the 3rd, 7th, 14th and 30th days after transplantation successively. On the first day after modeling, 1 rat was collected from each of two groups to prepare brain tissue section. Myelin sheath blue staining was used for observation of neuronal axonal myelin sheath. Never fiber argentophil staining was used for observation of never fiber. One rat was collected from each of two groups on the 3rd, 7th, 14th and 30th days after transplantation successively to prepare paraffin section. The survival and migration after OEC transplantation as well as proliferation of neural progenitor cell were observed.The count of neural progenitor cell was recorded.myelin sheath and nerve fiber after cerebral hemorrhage in rats of two function deficits on the 3rd, 7th, 14th and 30th days after cerebral hemorrhage in rats of two groups.around and in hematoma on the 30th day after cerebral hemorrhage: In transplantation group, myelinated amount and nerve fiber amount were cell after cerebral hemorrhage in rats of two groups: on the 7th, 14th and 30th days after cerebral hemorrhage, the amount of neural progenitor cell in OEC transplantation group was more remarkably than that in the control group [(41.1 ±2.4)pcs/vision field, (34.5 ±1.2)pcs/vision field; (43.6±1.2)pcs/vision rield, (37.2±2.0)pcs/vision field; (19.3±1.0)pcs/vision rield, ( 14.2±0.4)pcs/videficits after cerebral hemorrhage in rats of two groups: In OEC transplantation group, on the 14th and 30th days, the evaluation was lower remarkably than the 3rd day [(2.21 ±0.20)scores, (1.50±0.21)scores, (2.74±0.21)scores, (t=2.06, 3.27, P ＜ 0.05)]. In the control group, that on the 30th day after cerebral hemorrhage was lower than that on the 3rd day [(1.96±0.12)scores ,(2.76±0.20) scores, (t=2.47, P ＜ 0.05 )].tion of intracerebral nerve cell, re-myelination and building-up synaptic system so as to recover the motor function and accelerate repair of injured tissue.

Objective To investigate the value of MR diffusion tensor imaging (DTI) quantitative parameters in evaluating the injury of the tibial nerve and the common peroneal nerve in patients with Guillain-Barre syndrome(GBS). Methods Sixteen healthy volunteers and sixteen patients with GBS underwent DTI examination of the tibial nerve and the common peroneal nerve. The denervation of skeletal muscles controlled by the tibial nerve and the common peroneal nerve was observed. The apparent diffusion coefficient (ADC) value, fractional anisotropy (FA) value, axial diffusivity (AD) value and radial diffusivity (RD) value were measured respectively,and diffusion tensor tractography (DTT) of the tibial nerve and the common peroneal nerve was performed. Between-groups comparison was made with the independent sample t test and receiver-operating characteristic (ROC) analysis was used to evaluate the diagnostic efficacy of the parameters. Results (1)The MR features of denervated skeletal muscles comprehend hyperintensity on T2WI SPAIR sequence and the instinct boundary, muscle atrophy occationally. (2)Compared with the healthy volunteer group, the ADC value of the tibial nerve and the common peroneal nerve of GBS group was increased and the FA value, AD value, RD value were decreased, and there was significant difference between the ADC value, FA value, AD value and RD value of GBS and volunteer groups respectively(P<0.05). The area under the curve (AUC) of FA value was higher than that of the corresponding ADC value in the tibial nerve and the common peroneal nerve. (3)DTT showed that the number of fibers decreased in patients with GBS compared to the normal volunteers. Conclusion MR can clearly show the denervated skeletal muscles controlled by the tibial nerve and the common peroneal nerve. The ADC value, FA value, AD value and RD value, the quantitative parameters of DTI, can evaluate the injury of the tibial nerve and the common peroneal nerve in patients with GBS.

OBJECTIVETo determine the influence of maximal androgen blockade (MAB) on bone mineral density (BMD) in men with prostate cancer.

METHODSWe enrolled 40 men with prostate cancer treated by MAB for 7 to 12 months. We obtained the laboratory results of PSA, testosterone, serum calcium and phosphorus, 24-h urine calcium and phosphorus, alkaline phosphatase, and parathyroid hormone, measured the BMD of the lumbar spine and femoral neck by dual energy X-ray absorptiometry, recorded pain scores, and compared the results before and after the treatment.

RESULTSBefore MAB treatment, 5 (12.5%) of the patients met the BMD criteria of lumbar spine (L2-4) osteopenia, 8 (20%) lumbar spine (L2-4) osteoporosis, 13 (32.5%) left femoral neck osteopenia, and 15 (37.5%) left femoral neck osteoporosis. The PSA and testosterone levels were decreased from (52.9 +/- 69.9) microg/L and (18.9 +/- 6.5) nmol/L before MAB to (1.5 +/- 1.6) microg/L and (1.9 +/- 1.3) nmol/L after it (P<0.05). There were no statistically significant differences before and after MAB in the levels of serum calcium and phosphorus, 24-h urine calcium and phosphorus, alkaline phosphatase, and parathyroid hormone (P>0.05), nor in the BMD levels of the lumbar spine ([1.1 +/- 0.1] vs [1.1 +/- 0.2] g/cm2) and femoral neck ([0.8 +/- 0.2] vs [0.8 +/- 0.1] g/cm2), nor in the pain score ([0.6 +/- 0.2] vs [0.7 +/- 0.1], P>0.05).

CONCLUSIONMAB treatment (range from 7 to 12 months) has no significant influence on BMD in men with prostate cancer, but BMD should be measured before MAB.

Aged ; Aged, 80 and over ; Alkaline Phosphatase ; analysis ; Androgen Antagonists ; administration & dosage ; adverse effects ; therapeutic use ; Bone Density ; drug effects ; Bone Diseases, Metabolic ; etiology ; Calcium ; blood ; urine ; Humans ; Male ; Middle Aged ; Osteoporosis ; etiology ; Parathyroid Hormone ; analysis ; Phosphorus ; urine ; Prostatic Neoplasms ; drug therapy ; metabolism ; Testosterone ; blood

The effects of minimally invasive surgery on the blood-brain barrier (BBB) of 30 patients with cerebral hemorrhage were investigated. Difference of the BBB index and serum MBP concentration were assessed in 15 cases of conservative treatment group and 15 cases of minimally invasive surgery group. The BBB index in minimally invasive surgery group was significantly lower than in conservative treatment group (P＜0.05), and the BBB index in the two treatment groups was significantly higher than in control group (P＜0.01). Serum MBP concentration in minimally invasive surgery group was significantly lower than in conservative treatment group (P＜0.05), and that in the two treatment groups was significantly higher than in control group (P＜0.01). It was suggested the permeability of BBB in patients with cerebral hemorrhage was increased, and BBB index and serum MBP concentration in patients with cerebral hemorrhage were increased. Minimally invasive surgery can reduce the lesion of cytotoxicity to BBB and cerebral edema.

The expression of hypoxia inducible factor-1 alpha (HIF-1alpha) and its relationship to apoptosis in tissues around cerebral bleeding loci was studied. The expression of HIF-1alpha and apoptosis in 37 samples of tissues around cerebral bleeding loci and 9 samples of normal cerebral tissues was assessed by immunohistochemical straining and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling methods. In 37 tissue samples around cerebral bleeding loci, the positive rate of the HIF-1alpha expression was 40.6%. Especially in the patients with amount of bleeding >60 ml, the positive rate (88.9%) of the HIF-1alpha expression was significantly higher than those with the amount of bleeding ranging from 30-45 ml or 45-60 ml (P<0.05). The expression of HIF-1alpha was increased as the amount of bleeding and operative time increased (P<0.05). There existed a positive correlation between HIF-1alpha labeling index and apoptosis index (n=12, r=0.56, P<0.01). These results suggested that the expression of HIF-1alpha was closely related with the time of hemorrhage and the amount of bleeding, and could induce the apoptosis of neurons.
Adult ; Aged ; Apoptosis ; physiology ; Brain ; metabolism ; pathology ; Cerebral Hemorrhage ; metabolism ; pathology ; DNA-Binding Proteins ; biosynthesis ; genetics ; Female ; Humans ; Hypoxia-Inducible Factor 1 ; Hypoxia-Inducible Factor 1, alpha Subunit ; Immunohistochemistry ; Male ; Middle Aged ; Neurons ; pathology ; Nuclear Proteins ; biosynthesis ; genetics ; Time Factors ; Transcription Factors ; biosynthesis ; genetics

OBJECTIVETo investigate the value of laparoscopic virtual reality simulator in laparoscopic suture ability training of catechumen.

METHODSAfter finishing the virtual reality training of basic laparoscopic skills, 26 catechumen were divided randomly into 2 groups, one group undertook advanced laparoscopic skill (suture technique) training with laparoscopic virtual reality simulator (virtual group), another used laparoscopic box trainer (box group). Using our homemade simulations, before grouping and after training, every trainee performed nephropyeloureterostomy under laparoscopy, the running time, anastomosis quality and proficiency were recorded and assessed.

RESULTSFor virtual group, the running time, anastomosis quality and proficiency scores before grouping were (98 ± 11) minutes, 3.20 ± 0.41, 3.47 ± 0.64, respectively, after training were (53 ± 8) minutes, 6.87 ± 0.74, 6.33 ± 0.82, respectively, all the differences were statistically significant (all P < 0.01). In box group, before grouping were (98 ± 10) minutes, 3.17 ± 0.39, 3.42 ± 0.67, respectively, after training were (52 ± 9) minutes, 6.08 ± 0.90, 6.33 ± 0.78, respectively, all the differences also were statistically significant (all P < 0.01). After training, the running time and proficiency scores of virtual group were similar to box group (all P > 0.05), however, anstomosis quality scores in virtual group were higher than in box group (P = 0.02).

CONCLUSIONThe laparoscopic virtual reality simulator is better than traditional box trainer in advanced laparoscopic suture ability training of catechumen.

Adult ; Computer Simulation ; Humans ; Inservice Training ; Laparoscopy ; education ; Male ; Suture Techniques ; education