Objective To set up an animal model with severe head injury that is similar to clinical condition and treated with mild hypothermia. Methods A total of 120 SD rats were randomly divided into eight groups (n=15 in each group), ie, before cooling, cooling 6, 12, 24, 48, 72, 96 and 120 hours groups. The model was induced by dropping a object of 60 g from a height of 50 cm onto the epidura and treated with mild hypothermia (32-34℃). Blood pressure and ECG were observed and serum K+, Na+ and Mg 2+levels measured. The change of neuron microstructure in rat cerebral traumatic tissue of every group was observed by transmission electron microscope (TEM). Results Animal mortality increased but serum K+ and Mg 2+levels gradually decreased with the treating time lasting. Serum Na+ showed insignificant change. Bradytachycardia occurred in one rat of 72 hours group, two of 96 hours group and two of 120 hours group. TEM showed that the rat’s encephaledema presented gradual relief trend during mild hypothermia treatment. There was one rat in 96 hours group and one in 120 hours group with diffuse tubuli renales necrosis. Conclusion The established model is in conformity with the characteristics of vital sign, serum electrolyte and cerebral microstructure of clinical severe head injury treated with mild hypothermia.

Objective To explore specific risk factors in the early seizures after acute moderate and severe head injuries and understand incidence of nonconvulsive status epilepticus (NCSE) under coma. Methods Eighty-six patients with acute moderate and severe head injuries were monitored with video-electroencephalogram (video-EEG) for one week. Results (1) Of all, 7 cases (8.14%) had clinical seizures and 6 (6.98%) NCSE. (2) In patients with severe head injuries especially intracranial hemorrhage, post-traumatic seizures especially NCSE were more likely to occur, with no significant difference in sex and age. Conclusions Severe and critical head injuries and intracranial hemorrhage are specific risk factors for early post-traumatic seizures, especially NCSE. After brain injury, EEG should be used to evaluate traumatic coma even if clinical seizure does not appear.

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 study the difference of the peripheral blood lymphocyte gene expression in the glioblastoma patients and the normal subjects by the gene chip engineering technique. Methods The human gene expression spectrum chip containing 13 824 cDNA was used to detect the gene expression in the peripheral blood lymphocytes of 23 glioblastoma patients and 40 normal persons. The lymphocyte mRNA in the glioblastoma patients and healthy subjects was withdrawn. The cDNA probe with the different fluorescein was made by reverse transcription. The probe and the chip were hybridized. The fluorescence intensity was scanned and digitized,and gene expression was compared between the two groups. Results The peripheral blood lymphocytes in the glioblastoma patients had 96 genes to present the difference expression with that of normal subjects,including 25 upregulated genes and 71 downregulated genes. Conclusion The gene expression in the peripheral blood lymphocytes of glioblastoma patients and normal subjects exists difference. The lymphocyte DNA union,the abnormal function of transcription and signal conduction are the possible reasons for the different immune function between the glioblastoma patients and the healthy subjects.

Objective To clone rat neuroglobulin (NGB) gene and construct its eukaryotic expression vector. Methods The total RNA was extracted from Wistar rat brain and the full length cDNA encoding NGB was obtained by RT-PCR. After the sequence was confirmed by sequencing and BLAST, it was inserted in the eukaryotic expression vector pCDNA3.1 (+), then the sequence and reading frame were confirmed by two restriction endonucleases and sequencing. Results The NGB gene was cloned with four bases mutated and its eukaryotic expression vector was constructed. Conclusion NGB expressed in Wistar rat brain. NGB gene was successfully cloned and inserted in eukaryotic expression vector.

Objective To observe the protective effect of recombinant plasmid pCDNA3.1(+)/Ngb during focal cerebral ischemia in rat brain.Methods Fifty-four male Wistar rats were randomly divided into three groups:normal saline(NS)control group,plasmid control group,and recombinant neuroglobulin group.NS,plasmid pCDNA3.1(+)and recombinant plasmid pCDNA3.1(+)/Ngb were respectively injected into two sites of the rat cerebra1 cortex 24 hours before induction of neocortical focal ischemia by occlusion of the right middle cerebral artery for 24 hours.The condition of local ischemic damage,expression of bcl-2 and the apoptosis in neural cells were confirmed by staining with 2% 2.3.5-triphenyltetrazolium chloride,in-site cell apoptosis detection,indirect immunofluorescent staining and Western blotting,respectively.Results The extent of cerebral infarction tissue and the apoptosis cells in the pCDNA3.1(+)/Ngb group were significantly reduced than those in other control groups(P

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 investigate the role of neuroendoscope in treatment of cystic craniopharyngiomas in the third ventricle.Methods Neuroendoscope was applied to minimize the volume of the tumors,relieve obstructive hydrocephalus,canalize the intervals of the cysts,and fistulate into the third ventricle or the lateral ventricle and the cysts in 11 patients of cystic craniopharyngiomas in third ventricle accompanied with obstructive hydrocephalus,then radiotherapy followed.Results The symptoms of the intracranial hypertension disappeared and the other symptoms improved postoperatively in all 11 patients.CT imaging and MRI showed that the tumors shrunk and hydrocephalus faded.No severe complications occurred in all patients except 1 patient affected with transitory lethargy.Conclusion Neuroendoscopic technique is effective in improving curative effect and decreasing severe complications in the patients with cystic craniopharyngiomas in the third ventricle accompanied with hydrocephalus.

Objective To investigate the clinical characteristics,diagnosis and treatment of invasive pituitary adenoma.Methods The clinical presentations,imaging studies and surgical outcomes in 62 patients with invasive pituitary adenomas and 78 patients with noninvasive pituitary adenomas were analyzed retrospectively.Results Invasive pituitary adenomas were more common in patients with macroadenomas than those with microadenomas(P

The neurosurgery clinical practice is difficult and important for most undergraduate. The reasons come not only from the development of neurosurgical science,but from shortage of contents in basic peviod,so in clinical education the re-teaching of basic neurosurgical knowledge is important. Teachers should make full use of clinical resources to fulfill this teaching aim and the emphasis should be neuroanatomy and neurophysiology.