By different numbers of arteries occlusion among bilateral carotid (bCA) and bilateral vertebral arteries (bVA) of cats, effects of cerebral ischemia on the electrocardiogram, (ECG) was studied After bCA plus unilateral vertebral artery (uVA) and bCA+ bVA occlusion the duration of Q-T was prolonged from its control value of 0.21?0.04s to 0.23?0.08s and 0.25?0.1ls, and heart rate was also reduced from its contrl value of 179?33 beat/min to 173?27 beat/min and 151?39 beat/min (P

AIM: To study the endothelial progenitor cell markers and biological characteristics of human umbilical cord blood CD133+ cells isolated by immunomagnetic bead (IMB) method. METHODS: The experiment was carried out in the Laboratory of Burn Surgery, Xijing Hospital of the Fourth Military Medical University of Chinese PLA from November 2002 to August 2003.①CD133+ cells were enriched from human umbilical cord blood of placenta through spontaneous delivery or cesarean delivery (offered by Department of Gynecology and Obstetrics, Xijing Hospital of the Fourth Military Medical University of Chinese PLA), with the informed consents of parturients.②Human umbilical cord blood was anticoagulated by ACD-B and then diluted, 7 mL of cord blood combined with 3 mL lymphocyte isolation liquid were centrifuged for 30 minutes at 2 100 r/min. Low-density mononuclear cells coloring buffy were selected to wash off platelet and inoculated for 30 minutes by the IMB and FITC-CD133 antigen at room temperature to wash excessive antigens. The FITC-CD 133-coated IMB was added into mononuclear cells which were cultured for 30 minutes at room temperature and placed in magnetic field for 1 minute to remove the cell suspension. IMB-cell isolation liquid was supplemented to release CD133+ endothelial progenitor cells, which were cultured with EGM-2MV media in dishes coated with collagen I. And 24 hours later those unadherent cells were detached, culture liquid was removed half after 3 hours, and total culture duration was 3-4 weeks.③The morphologic change of CD133+ cells isolated with IMB were observed; The percentage of CD133+ cells in cord blood monocytes and sorting efficiency of IMB were analyzed by fluorescence activated cell sorting (FACS). The cells cultured in vitro were identified by fluorescence immunoassay and enzymo-histochemistry while transmission electron microscope (TEM) was used to observe the W-P body of mature vascular endothelial cells. RESULTS: ①Morphologic observation of CD133+ cells culture in vitro: The adherent cells expanded pseudopods on days 4 and 5, and grew rapidly in clonal manner 7 days later. The cells showed a typical spindle-shaped morphology during 2-3 weeks and cluster areas of cobblestone-like cells after 2-week culture and confluence.②Isolation rate of CD133+ cells: The percentage of CD133+ cells in cord blood monocytes was 0.91%. And after IMB sorting, the percentage of CD133+ cells was 85.52%.③On the fifth day, few cells were positive for CD133 while most cells were positive for CD 34 and vWF; On the tenth day, all cells were negative for CD133 and most cells were still positive for CD 34 and vWF.④The cells after 10-day culture had typical W-P body in TEM. CONCLUSION: Immunomagnetic sorting can efficiently select enriched CD133+ endothelial progenitor cells from human umbilical cord blood. Our data of CD133, CD34, vWF antibodies and TEM support the hypothesis that endothelial progenitor cells may contribute to mature vascular endothelial cells.

Objective To explore a new surgical method for hypertensive cerebral hemorrhage and its efficacy.Methods A total of 12 patients with hypertensive cerebral hemorrhage in the fundus node at a super early stage(≤6 h)were enrolled in this study.Microsurgery trough the lateral fissure and insula via pterional keyhole approach was employed to treat the patients.Results All but one of the patients survived after the operation.One patient received a second operation because of hemorrhage for twice,one patient developed intracerebral infection.The survivors were followed up for 3 to 6 months.According to GOS scoring system,7 of them achieved excellent outcomes,3 were good,and 1 was moderate.Conclusion Microsurgery trough the lateral fissure and insula via pterional keyhole approach is effective for hypertensive cerebral hemorrhage.

Objective To compare the clinical efficacy and safety of Qingyi Decoction (a preparation of Chinese herbal medicine) between two different routes of the administration by using nasogastric tube or nasojejunal tube for treatmnent of severe acute pancreatitis (SAP).Methods A total of 79 SAP patients enrolled were randomly divided into nasogastric tube group (n =41) and nasojejunal tube group (n =38) according to the random number table method.In addition to the conventional therapy,they were treated with Qingyi Decoction administered by using nasogastric tube or nasojejunal tube.Results After treatment for 14 days,the levels of C-reactive protein (CRP),procalcitonin (PCT) and white blood cell count (WBC),urinary bladder pressure,and APACHE Ⅱ score in nasojejunal tube group were significantly lower than those in nasogastric tube group (P ＜ 0.05).The time required for the recovery of bowel sounds,length of abnormal serum amylase persistence,the duration of abdominal pain,the time necessary for mechanical respiratory support in nasojejunal tube group was significantly shorter than those in nasogastric tube group.The blood fungus infection rate and pulmonary fungus infection rate in nasojejunal tube group were significantly lower than those in nasogastric tube group,and 28-day survival rate in nasojejunal tube group was significantly higher than that in nasogastric tube group (P ＜ 0.05).Conclusion The nasojejunal tube route for the administration of Qingyi Decoction for the treatment of SAP can effectively alleviate the severity of patient's condition,shorten the time required for improving clinical symptoms,reduce the incidence of morbidity and mortality,and it is worthy of further popularization in clinical practice.

Neuromuscular diseases is one of the difficulties in neurology teaching and clinical practice. We chose the typical cases of Guillain-Barre syndrome and progressive muscular dystrophy as case based study, and evaluated the effect of teaching. The result shows that application of case base study can help medical students to enhance their learning interests and cultivate their good clinical thinking and then to meet the requirements of the teaching syllabus. So it is worth improving and promoting in clinical practice teaching.

Objective To evaluate the relationship between amniotic fluid (AF) epidermalgrowth factor (EGF) concentration and fetal pulmonary maturation. Methods Lecithin － sphin-gomyelin ratio (L/S) and EGF were measured in amniotic fluid from women(n = 138,21～42 weeks'gestation) undergoing amniocentesis by TLC and RIA. ResultsThe AF L/S ratio and EGF concen-tration increased linearly with Gestational age(GA) ( r = 0.8t3 and 0.87, respectively, P < 0.01 ).There was a strong correlation between the AF L/S ratio and EGF( r = 0.76, P < 0. 001 ). Conclu-sionThere are a confirmed relationship between AF EGF levels and fetal pulmonary maturation.

Objective To study characteristics of hospital infection and bacterial drug-resistance in our new Intensive Care Unit (ICU) to provide evidence to clinical rational use of drugs. Methods The data of 142 patients in our ICU last year were analyzed retrospectively, and compared to other inpatients treated in general ward during the same time period. Results Among the 142 ICU inpatients,31 times of hospital infection occurred in 22 patients,gave rise to a infection rate of 15.49% and case time infection rate of 21.83% in ICU; but among the 15 978patients treated simultaneously in general ward,413 times of hospital infection occurred in 324 inpatients, gave rise to a infection rate of 2. 03% and case time infection rate of 2. 58% outside of ICU. The hospital infection rate and case time infection rate were significantly different between the ICU and general ward (P ＜ 0. 01 ). Among the ICU infections, the lower respiratory tract infection accounted for 70. 96% ;the main pathogens were Gram-negative bacilli (65. 12% ) and Gram-positive bacilli (23.26%), follwed by fungus (11.63%). The most common bacteria were Escherichia ( 32. 65% ) and Staphylococcus ( 11.63% ). Gram-negative microorganisms were highly sensitive to cefoperazone/sulbactam,imipenem, meropenem and piperacillin/tazobactam; all Gram-positive microorganisms were sensitive to vancomycin,linezolid and teicoplanin. Conclusions The constitution,distribution and drug-resistance of pathogens in new ICU are similar to previous domestic reports. Gram-negative organisms are the main photogenic bacteria of hospital infection in ICU, and Escherichia is the most popular type in nosocomial infection.

Objective To report the clinical,electrophysiological and genetic features in a family with Charcot-Marie-Tooth disease type 1D (CMT1 D).Methods The proband,a 53-year-old man who was found with pes cavus when he was 15 years old,presented with weakness in both lower limbs at the age of 37,aggravated and numbness in legs at the age of 50.His daughter was confirmed pes cavus in her teens and weakness in both lower limbs at the age of 18.Electrophysiology and next generation sequencing were performed in the proband.Results Electrophysiological results of the proband showed demyelinating change in motor and sensory nerves.Latency prolongation was found in bilateral waves Ⅲ,V and abnormal differentiation in bilateral waves Ⅰ of brainstem auditory evoked potential,while both interpeak latencics of Ⅲ-Ⅴ were normal.DNA analysis revealed a heterozygous 1141C ＞ T mutation in exon 1 of early growth response 2 (EGR2) gene in both of the proband and his daughter.Conclusions The onset age of Arg381Cys mutation in EGR2 gene could be at juvenile with weakness in both lower limbs.The phenotype of CMT1D is mild and progressive slowly.

Objective To assess the different protein expressions of epithelial mesenchymal transition (EM T ) markers Vimentin and E‐cadherin in craniopharyngioma ,especially at the tumour invasive front ,and correlate the findings with clinicopathological fea‐tures and patient outcomes .Methods Forty‐two craniopharyngiomas were subjected to the detection of Vimentin and E‐cadherin by immunohistochemistry and double immunofluorescence staining .The relationships between expression of these markers and various clinico pathological indicators and clinical outcomes of these tumors were analyzed .Results There was statistically significant difference in the expression of Vimentin and E‐cadherin between adamantinomatous and papillary variants in whole tumor and at the tumor invasive front .The expression of Vimentin and E‐cadherin in whole tumor sections were associated with tumor recurrence , postoperative weight and hypothalamic disturbances ,and the expression of vimentin and E‐cadherin at the tumor invasive front were colligated with tumor recurrence ,postoperative weight and hypothalamic disturbances .Conclusion Our study exemplifies the po‐tential prognostic implications of Vimentin and E‐cadherin expression in craniopharyngioma .EM T may represent a crucial mecha‐nism in the progression of adamantinomatous craniopharyngioma .

Objective To evaluate the sensitivity of arterial ketone body ratio as an indicator for multiple organ failure.Materials and methods The experimental model of multiple organ failure was made in adult and old rats by hypoperfusion-induced hemorrhagic shock. After blood sampling, the arterial acetoacetate, β-hydroxybutyrate, total ketone body, ALT, AST, BUN, creatinine at 2, 4, 8 hr in hypoperfusion were examined to compare the differences of ketone body ratio and organ failure between adult and old rats. Hepatic and mitochondrial metabolism were assessed by comparing ketone body ratios (AcAc/β-OHB) and free NAD+/NADH ratios. Results Ketone body ratio in old rats at 2, 4, 8 hr after the induction of hemorrhagic shock decreased from 0.68 to 0.31, 0.27 and 0.22, respectively. In adult rats, it decreased from 1.12 to 0.17, 0.12 and 0.09, respectively. Changes of ketone body ratio in the adult group were larger than in the elderly group ( P ＜ 0.001). The development of multiple organ failure is associated with the time of hemorrhagic shock development. Conclusions There was a different ketone body ratio between multiple organ failure in the elderly (MOFE) and multiple organ failure (MOF) in general adults. Ketone body ratio is a better indicator than ALT and AST in reflecting hepatic function in the early status of MOF. (J Geriatr Cardiol 2004;1(2) :125-128. )