Objective To study the changes of apoptosis in brain after traumatic injury(TBI)treated with exogenous vascular endothelial growth factor(VEGF)gene therapy in oder to find out the role of exogenous VEGF gene in protectiog brain tissue.Method The injurea cerebral cortex from the rat models of brain with traumatic injury was injected with adenovirus(adenovirus,Ad)as the carrier of VEGF-165 gene(Ad-VEGF-165 Gene).RT-PCR and Western blot were used to detect the expression of VEGF mRNA and VEGF protein in the brain 6 h,24 h,3 d,7 d and 14 d after injury,and apoptosis in the injured location of brain was also detected by TUNEL successively after Ad-VECF-165 gene therapy.Results With exogenous Ad-VEGF-165 applied to the locally injured brain tissue after injury,VEGF mRNA and VEGF protein showed consistent expression and their expressions were significantly higher than those in trauma group and vehicle control group.Compared with the trauma group.the apoptosis in the gene therapy group 24 h,3 d and 7 d after injury presented a.significant reduction,and had close relationship with VEGF.(Control group:4.17±0.73;TBI group,24 h:47.18±6.01,3 d:79.44±11.23;TBI+VEGF group.24 h:28.72±5.31,3 d:54.18±7.66;P＜0.05).Conclusions The exogenous VEGF gene therapy administered to have protective effects on the local brain tissue in rats with traumatic injury in a certain time.

Objective To explore the surgical indexes, therapeutic efficacy and prevention of complications in treatment of some blood diseases by splenectomy (including laparoscopic splenecto- my). Methods The clinical data of 27 patients with blood diseases receiving splenectomy in our hospi-tal were retrospectively analyzed. Results The effective rate of splenectomy was 100% in 4 cases of hereditary spherocytosis, 76.47% in 17 cases of ITP and low in 6 cases of Non-Hodgkin's lymphoma.The postoperative incidence of complications was 7.41% (2/27). Conclusion Splenectomy is of the first choice for treatment of hereditary spherocytosis. Meanwhile, it is effective for most of the patients with ITP. It is an important approach for comprehensive of malignant lymphoma. Proper choice of indications and perioperative management are helpful for decreasing incidence of postoperative complications.

Brain Diseases ; etiology ; Brain Neoplasms ; surgery ; Glioma ; surgery ; Humans ; Infection ; etiology ; Postoperative Complications ; etiology ; Recurrence ; Risk Factors

Objective To investigate the changes of region cerebral homodynamic and cerebral vascular autoregulation in traumatic brain injury(TBI) by dynamic CT perfusion(CTP) imaging in rat.Methods Forty-five SD rats underwent CTP,including 10 control rats and 35 TBI rats,on 1,6,24 h,and day 3,7,14,21 after TBI.The region of interest(ROI) was located near traumatic area within 2 mm and mirror area of relative brain hemisphere.False color pictures and dynamic rCBF,rCBV,MTT and PS were obtained in different time.Pathological examination was also done.Results The rCBF,rCBV on 1 h after TBI was lower than that of control group,and significantly higher on 6-24 h after TBI.They reached the peak on day 3.PS had a similar change compared with rCBF,rCBV,but a longer duration.MTT showed to moderate changes except an isolated tide on 3 days after TBI.The rCBF on mirror area of relative brain hemisphere was almost stable except 3 days after TBI,which was lower than that of control group.Meanwhile,the rCBV on mirror area of relative brain hemisphere was normal.Conclusion CTP is an advanced technique to investigate the changes of region cerebral homodynamic and cerebral vascular autoregulation in TBI.The early hypoperfusion and next hyperperfusion around traumatic areas after TBI suggest that the dysfunction of cerebral vascular autoregulation should be committed to the change of homodynamic in TBI.

Objective To explore the diagnostic value of HR -HPV combined with TCT in the diagnosis of cervical cancer and precancerous lesion.Methods 1 198 cervical specimens were selected for the study.The results of HR -HPV detection and TCT detection were analyzed,with the pathological results as the gold standard,the diag-nostic value of HR -HPV and TCT in the diagnosis of cervical cancer and precancerous lesion were discussed. Results With increasing pathological grade,TCT positive rate increased gradually,there was a correlation between them(r =0.629,P <0.05).With increasing pathological grade,HR -HPV positive rate increased gradually,there was a correlation between them(r =0.684,P <0.05).The sensitivity of HR -HPV combined with TCT in the differ-ential diagnosis of cervical cancer,precancerous lesions was 100.00%,specificity was 79.64%,missed diagnosis rate was 0.00%,the misdiagnosis rate was 20.36%.Conclusion HR -HPV combined with TCT examination has high clinical value in the diagnosis of cervical cancer and precancerous lesions.

[Objective]To discuss the clinical results and treatments of the Monteggia's fracture in children.[Method]Total of 66 patients including 61 fresh and 5 old fractures were reviewed.There were 47 males and 19 females.According to the Bado classification system: 46 of type Ⅰ,4 of type Ⅱ,15 of type Ⅲ,1 of type Ⅳ,all patients received conservative or operatire treatment.The conservatively treated patients received manipulation and plaster immobilization.In the operative group,the patients were fixed with single or/and double Kirschner's wires after reduction of the radiohumeral joints or/and fractured ulna.Neither reparation nor reconstruction was needed.[Result]All patients were available at the final follow up with 0.5～5 years.According to the Li Hanmin's scoring system for the motion function in children: excellent and good rate was 95.7% in conservative group and 84.2% in operative group.There was no complication such as myositis ossificans,synostosis of radius and ulna,ulna nonunion,radial head dislocation and profundus radial nerve injury.The cases of nerve injury were complete recovered after operation two or four months later.[Conclusion]The clinical results of the Monteggia's fracture in children was very good with immediate reduction and internal fixation in proper cases,a good overall therapeutic outcome can be expected in children with Monteggia's fracture.It is very important to prevent missed diagnosis.

Adult ; Antithyroid Agents ; therapeutic use ; Autoantibodies ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glycosides ; therapeutic use ; Graves Disease ; drug therapy ; immunology ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Methimazole ; therapeutic use ; Middle Aged ; Phytotherapy ; Tripterygium ; chemistry

Objective: To assess the autonomic nervous impairm ent in chronic renal failure and its related factors. Methods: F orty adults were randomly selected including in-patients in the nephrology ward and healthy subjects for routine medical examination. The subjects were classifi ed into 4 groups: normal subjects(NS)，normal renal function，nitremia， uremic patients. The time domain measurements of heart rate variability(HRV) and ambula tory blood pressure were analyzed simultaneously . Results: (1) There were significant differences as compared with normal subjects in the time domain measurements of HRV in uremic group. It decreased significantly when the patient was defined as end stage chronic renal failure. There were no significan t differences between NS，normal renal function group and nitremic group. (2) Ti me domain measurements of HRV was significantly lower(P<0.05) in uremia with renal hypertension than in uremia with normal blood pressure. Conclusio n: (1) Patients with chronic renal failure(HRV) have their cardiac auton omic nervous system impaired conspicuously in the course of uremia. (2) There is a positive correlation between cardiac autonomic nervous system impairment in p atients with CRF and renal function levels. Uremia itself is an independent fact or for the impairment of cardiac autonomic nervous system. (3) Renal hypertensio n with uremia may intensify the impairment of cardiac autonomic nervous system of the patients.

[Objective] To explore the clinical characteristics and pathogenic mechanism of sensory ataxia form of GBS.[Methods] To Summarize clinica1 data of 19 cases with sensory ataxia form of GBS.[Result] The main clinical manifestations were sensory ataxia.The disease relieved and recurred easily and had long course.The protein in CSF increased significantly.Pathological feature was same with general CIDP.Treatment of glucocortieoid was satisfied.[Conclusions] Sensory ataxia form of GBS was one sub-type of CIDP.Pathogenic mechanism was perhaps that immunoreaction attacked proproioceptive sense fibre of radix dorsalis.

Objective To analyze the factors affecting prognosis of children with non-Hodgkin′s lymphomas(NHL).Methods Thirty patients of childhood NHL histologically proven in Shanghai children′s medical center from Jan.1996 to Dec.2000 were analyzed.The patients were divided into groups according to some clinical factors that may have predictive significance including age,gender,immunologic phenotype,general system symptom,the size of tumor bulk,bone marrow involvement,mediastinal involvement,hepatomegaly or liver involvement,splenomegaly or spleen involvement and early response to chemotherapy,then the difference of survival rate were compared between groups.Survival analysis was performed by the Kaplan-Meier method,and difference between groups were campared using the Log-rank test.Results The 3-year survival rate was better in patients without giant tumor bulk than that with giant tumor bulk(P0.05).Conclusions Bone marrow involvement and the size of tumor bulk have very significant influence on prognosis of childhood NHL,and splenomegaly or spleen involvement have significant influence on disease-free survival.It can′t be proven in childhood NHL in this study.