Cerebral ischemia-induced inflammatory cascade reaction may aggravate nerve tissue damage and destroy blood-braln barrier, and angiogenesis after ischemia can improve nerve function. Inhibiting inflammatory response after stroke, promoting angiogenesis and protecting blood-braln may reduce nerve tissue damage and promote recovery of neurological function. Monocyte chemotactic protein 1-induced protein inhibits inflammatory signaling pathways through degradating proinflammatory cytokine mRNA. Its unique biological characteristics also suggest that it has the potential protective effect in cerebral ischemia. This article focuses on the roles of monocyte chemotactic protein 1-induced protein in cerebral ischemia.

ObjectiveTo evaluate the effect of the comprehensive surgical management of primary venous reflux disease in lower extremity. MethodsComprehensive surgical management was performed on 108 patients( 126 limbs) with primary venous reflux disease between February, 1996 and Sept, 2000. All limbs were performed with superficial venous operation. External valvuloplasty of femoral vein valve was given to 83 cases(97 limbs) simultaneously, and to 22 cases (26 limbs) with concomitant subfascial endoscopic perforator surgery(SEPS). 3 cases (3 limbs) were operated with concomitant SEPS only. ResultsVenous claudication,swelling, and aching disappeared in 80.2% of limbs( 101/126) and apparent improvement in 19.8 % of limbs(25/126). All varicose veins were gone. Ulcer healing pre sented in 80 % of the limbs(8/10) with ulcers and ulcer decreasing in 20% of the limbs(2/10) in 3～6 months after superficial and deep venous operations. Ulcer healing presented in 23 cases(26 limbs) with ulcers and ulcer decreasing in remaining 2 limbs in 14 to 32 days after additional SEPS besides superficial and or deep venous operations. Deep venous valve sufficiency was demonstrated in 89.7% (113/126) of the limbs by Color Duplex. ConclusionIn the patients with severe primary venous reflux disease,comprehensive surgical management with concomitant superficial, deep and perforating veins might greatly improve the clinical effect.

Objective:To study the bactericidal effect of ultrasonic technique combined with saline(SL),sodium hypochlorite(SH) or Koutai(KT) irrigation in root canal preparation. Methods:120 single-rooted teeth in 120 patients with chronic periapical periodontitis were divided into six groups randomly with 20 in each group.The tooth canal in group A, B and C were prepared with ultrasonic technique. SL, SH and KT were used to irrigate in the root canals group A,B and C respectively.Routine hand instruments were used in group A1, B1 and C1.SL, SH and KT were used as irrigations in group A1, B1 and C1 respectively.30 ?l of liquid sample was obtained from each root canal and examined for anaerobic bacteria colony counting before and after root canal preparation. Result:After root canal preparation the number of anaerobic bacteria colony was significantly reduced in all the 6 groups(P

Objective To explore the importance of the separation and reconstruction of the shared venous sinuses of a craniopagus twins Methods The shared superior sagittal sinus, confluence of sinuses, transverse sinus and straight sinus were separated using microsurgical techniques Meantime, one bypass was established from the superior sagittal sinus and the straight sinus to the internal jugular vein with help of the bypass shunt in twin B (right) The above mentioned sinuses were reconstructed with the artificial vessels The normal superior sagittal sinus and confluence of sinuses were preserved in the twin A (left) Results Twin A recovered with no nervous deficits Unfortunately, twin B died of renal failure and hyperkalemia 22 hours after the operation Conclusion The shunt and reconstruction of the venous sinus are the key techniques for the success of separation of craniopagus twins using the microsurgical techniques

Objective To evaluate the risk factors for interventional treatment of neurological complications in elderly patients with rupture intracranial aneurysms.Methods Form December 2004 to December 2014,520 consecutive old patients (≥ 60 years) with ruptured intracranial aneurysm treated at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were enrolled retrospectively.The imaging and clinical follow-up results at day 30 after procedure were documented.According to whether the occurrence of interventional therapy-related neurological complications (including intraoperative aneurysm rupture,interventional therapy-related thromboembolic events,early postoperative aneurysm rebleeding,new postoperative subdural hemorrhage or intraparenchymal hemorrhage),they were divided into a complication group (n =68) and a non-complication group (n =452).Univariate statistical analysis and multivariate Logistic regression analysis were used to screen the independent risk factors for the occurrence of neurologic complications after interventional therapy.Results The incidence of neurological complications in 520 patients with aneurysm was 13.1％ (n =68).Multivariate Logistic regression analysis showed that the history of hypertension (OR,2.207,95 ％ CI 1.149-4.240,P ＜ 0.05),Hunt-Hess grade Ⅳ-Ⅴ (OR,4.287,95％ CI 2.048-8.971,P ＜ 0.01),Fisher grade Ⅲ-Ⅳ (OR,2.686,95％ CI 1.483-4.865,P ＜ 0.01),wide-neeked aneurysm (OR,2.884,95 ％ CI 1.511-5.505,P ＜ 0.01),aneurysm bleb (OR,4.560,95 ％ CI 2.500-8.321,P ＜ 0.01),and aneurysm ＜ 3 mm (OR,5.748,95 ％ CI 2.122-15.570,P ＜ 0.01) were the independent risk factors for treatment-related neurological complications in the interventional treatment of intracranial ruptured aneurysms in the elderly.Conclusion The history of hypertension,high Hunt-Hess grade,high Fisher grade,wide-neck aneurysm,aneurysm bleb,and micro-aneurysm are the independent risk factors for treatment-related neurological complications in interventional treatment of intracranial ruptured aneurysms in the elderly.

Objective To assess the role of superficial vein and calf perforating vein in chronic venous insufficiency of lower limbs. Methods Consecutive seventy-five cases (78 limbs) of slight PDVI ( I? -Ⅱ?) were evaluated. Venous hemodynamics were detected by color duplex, color Doppler velocity profile technology and APG preoperatively, in the first month, the third month and the first year postoperatively. Data were statistically analyzed. Results Symptoms and signs disappeared in 88. 5% (69/78) limbs. The ulcer-healing rate was 92. 8% ( 13/14). The postoperative VFI at each check-point significantly decreased than that before operation (P0.01). Conclusions Superficial venous reflux can be effectively broken up by the operations. Venous stasis on calf effectively decreased by subfascial endoscopic perforator surgery (SEPS). But neither of the two procedures greatly improve the hemodynamic status of deep vein.

Objective To compare the early result of endovascular repair and conventional open repair for abdominal aortic aneurysm. Methods We analyzed the clinical data of 34 patients with infrarenal AAA. Among them, 15 patients were treated with endovascular repair ( EVR group), 19 with conventional open repair ( COR group). Pre-operative status, intra-operative variables, post-operative outcomes and laboratory findings of the two groups were compared. Results Blood loss and blood transfusion in EVR group were significantly less than COR group (P =0.005, P =0.015). The median fasting period and post-operative hospital stay were shorter in EVR group (P

Objective To investigate the surgical treatment of infected femoral pseudoaneurysm caused by injection of heroin. Method Retrospective analysis was made on the clinical data of 14 cases of infected ruptured femoral pseudoaneurysm caused by injection of heroin. Results All 14 cases underwent operation. The ruptured sizes of arteries were 0.5 cm-2.0 cm . All cases were treated by resection of the aneurysm and replacement of iliac-femoral artery with artificial graft. Blood supply and function were good in all limbs after operations. Aneurysm cavities and incision wounds were treated with debridement, drainage and anti-infective treatment. All wounds were healed. 2 weeks and 3 months after operation, the grafts were patency demonstrated by Color Doppler examination. None of them was complicated with anastomosis leakage or thrombosis. Conclusion Thorough debridement of aneurysms and reconstruction of the artery are the effective approach in treating the infected ruptured femoral pseudoaneurysm caused by injecting heroin. Sufficient drainage, anti-infective and anti-coagulation therapy should be considered after the operation.

Objective To assess the results of surgical intervention on patients with medullary thyroid carcinoma(MTC), and determine the value of measuring plasma calcitonin concentration postoperatively. Methods The diagnosis and treatment of 14 patients with MTC from January 1992 to December 1998 were analysed retrospectively. Results The diagnosis of MTC in the 14 patients was confirmed by pathology. Of them, 64.3% of patients had lymph node metastases. According to AJCC staging system, 1 patient was in stage Ⅰ, 7 in stage Ⅱ, 5 in stage Ⅲ and 1 in stage Ⅳ. Of nine patients measured plasma calcitoinin after initial operation, 4 had persisted hypercalcitoninemia. In the 4 patients, MTC in residual thyroid and enarged lymph node were comfirmed by B mode ultrasounography. After re operation, the calcitonin level returned to normal in 3 cases, but one remained in higher level. Postoperative follow up ranged from 2 to 8 years, 2 patients died of the disease. Twelve patients still lived, 6 of them survived more than 5 years. Conclusions The clinical stage of MTC at the time of diagnosis is an important prognostic factor. An aggressive surgical approach at the initial operation is essential to achieve a curative effect in patient with MTC. Measuring plasma calcitonin postoperatively helps to detect residuled MTC or recurrent MTC.

Objective: To evaluate the role of the MAPK subtypes (p38MAPK, ERK and JNK) in ANG Ⅱ induced apoptosis of cultured human podocytes. Methods: The cultured podocytes were incubated in media containing either vehicle, SB202190(5 ?mol/L, an inhibitor of p38MAPK), PD98059 (1 ?mol/L, an inhibitor of ERK), SP600125 (5 ?mol/L, an inhibitor of JNK), ANG Ⅱ (10 -8 mol/L) with or without SB202190、PD98059 and SP600125 for 18 hours; the cells were assayed for apoptosis by morphologic staining with H 33342 and propidium iodide and DNA fragmentation assays; the cell proteins were probed for phosphorylated MAPKs to determine the activation of specific MAPK subtypes. Results: ANG Ⅱ promoted podocyte apoptosis in a time and dose dependent manner; ANG Ⅱ stimulated p38MAPK, but inhibited JNK; SB202190 inhibited both ANG Ⅱ induced podocyte apoptosis and p38MAPK phosphorylation; Inhibition of ERK by PD98059 had no effect on ANG Ⅱ induced cell apoptosis. Conclusion: ANG Ⅱ induced apoptosis through stimulation of p38MAPK and inhibition of JNK in human podocytes.