Humans ; Liver, Artificial

Objective To review the complications of initial phacoemulsification in a grass-roots hospital and to investigate preventive measures from complications. Design Retrospective cases series. Participants 184 cataract patients of initial phacoemulsification in the Fangshan First Hospital. Methods 184 patients (188 eyes) were performed phacoemulsification and intraocular lens (IOL) implantation. The complications were observed and recorded. All patients were followed up 3-6 months. Main Outcome Measures The rate of main complications. Results Major complications during and after phacoemulsification cataract surgery included posterior capsule rupture in 8 eyes (4.3%), iris injury in 2 eyes (1.1%), corneal edema in 23 eyes (12.2%), uveitis in 16 eyes (8.5%), ocular hypertension in 4 eyes (2.1%), detachment of retina in 2 eyes (1.1%), after-cataract in 21 eyes (11.2%). At the last visit, the post-surgery visiual acuities were 0.5 or better in 149 eyes (79.3%). Conclusion There may be more complications happened in the initial phacoemulsification in a grass-roots hospital. It should be gradually developed under the direction of skilled surgeons.

The anatomy of the trunks and branches of anterior inferior cerebellar artery(AICA) was studied and its surgical importance especially in the operation for acoustic neuroma(AN), was discussed.15 fresh adult cadavers were perfused with ABS via internal carotid artery and vertebral artery and then dissected under operation microscope in detail. AICA was constantly present in all specimens. The incidence of labyrinthine artery(LA), recurrent perforating artery(RPA), subarcuate artery(SA),and cerebellar subarcuate artery (Cer.SA) was 100%,86.7%,80% and 16.7%, respectively. 97.1% of LA entering the internal auditory meatus (IAM) were located under the facial vestibulocochlear nerve complex, 56.7% of RPA passed between it ,and 75% of SA was located posteroinferiorly to it .60.7% of the loop of AICA was situated close to the IAM, and 53.6% of them lay between the Ⅶ and Ⅷ cranial nerves. These data may be helpful in microneurosurgical operation and radiography.

BACKGROUND: The observation of vascular endothelial growth factor gene expression of cerebrovascular diseases and ultrastructure of cells may be helpful to understand angiogenesis and its relative cellular factors involved in the pathogenesis at cellular and molecular levels. OBJECTIVE: To investigate the method of culture of human cerebral cap illary endothelial cell by separation of capillary fragment in vitro, and to ob serve vascular endothelial growth factor gene expression and ultrastructure of cells. DESIGN: A randomized controlled research on technique and method. SETTING: The neurosurgery department of a general hospital of a military area command of Chinese PLA and the neurosurgery department of a college hospital. PARTICIPANTS: Eighteen patients with arteriovenous malformation of brain(Spetzler Ⅱ-Ⅲ grade), as confirmed by aortocranial angiography before operation, in the Department of Neurosurgery, General Hospital of Shenyang Military Area Command of Chinese PLA were included. The material was obtained from fresh integrated specimen of arteriovenous malfor mation of brain with surrounding fresh brain tissues during the opera tion. Capillary endothelial cell was separated by homogenate, filtration and enzymatic digestion techniques. Cells grew well in culture flask and were divided into 4 groups(hypoxia state for 2, 4, 8 hours groups and control group). Each group contained four flasks.METHODS: Simulation of anoxia condition: volume faction 0.95 N2 and volume fraction 0.05 CO2. Expression of factor Ⅷ related antigen in cells was detected by immunohistochemistry. mRNA expression of vascular endothelial growth factor on endothelial in every group was observed by RT-PCR, protein content of vascular endothelial growth factor in supernatant detected by enzyme-linked immunoadsordent assay, and cellular ultrastructural change observed by transmission electron microscopy.MAIN OUTCOME MEASURES: mRNA expression of vascular endothelial growth factor on endothelial cell and protein content of vascular endothelial growth factor in supernatant in control group and every hypoxia groups; cellular ultrastructural changes.RESULTS: Under phase contrast microscope, cultured living cells had mono-layer pebble-like typical character. More than 90% of were factor Ⅷrelated antigen(FⅧ-RA) staining positive. mRNA and protein expression of vascular endothelial growth factor in hypoxia 4 hours group was 0.98 ±0. 19,( 180. 77 ± 20. 15) ng/L, which was significantly higher than in control group [0, (26. 20 ± 6.33) ng/L, P ＜ 0.01 ]. Eight hours later, expression decreased [(0. 35 ±0.07), (31.68 ±8.34) ng/L]; swollen mitochondrion, dilated endoplasmic reticulum, and lysosome vesiculation were found.CONCLUSION: Humane cerebral capillary endothelial cell can be cultured by separation of capillary fragment, which is easy to operate and the cellular purity is reliable. In the early stage of ischemia and hypoxia, expression of vascular endothelial growth factor is not enough to maintain cellular ultrastructure integrity. Cells may be injured along with the prolong of hypoxia.Zhao MG, Tang T, Gao YZ, Pu PY, Wei XZ. Culture of human cerebral capillary endothelial by separation of capillary fragment and the observation of vascular endothelial growth factor gene expression and cell ultrastructure. Zhongguo Linchuang Kangfu 2005; 9(21):211-3 (China) [www. zglckf. com]

Objective To observe the effect of depressive disorder on ventricular remodeling and its mechanism in acute myocardial infarction (AMI) rats. Methods Forty-six AMI Wistar rats were randomly divided into sham-operation (n=10), AMI (n=12), depression (n=12), neurostan by open field test, and the detection of angiotensin Ⅱ (Ag Ⅱ ), aldosterone (ALD), malondialdehyde (MDA), superoxide dismutase (SOD) were performed, the pathological sections were observed under light and electron microscopes. Results Compared with sham-operation group, depression group had decreased values of squares crossing times, rearing times and grooming time, increased time of staying in the central square and defecation. Compared with depression group, AMI and neurostan treatment groups had increased values of squares crossing times, rearing times and grooming time,decreased time of staying in the central square and defecation (F=16. 9, 44.56, 71.79, 34.86,29. 18, P＜0.01). At the 4 week of test, the left and right ventricular relative weights (LVRW,RVRW) and thickness of interventricular septum were (1.63±0.15) mg/g, (0. 48±0. 10) mg/g and (1.75 ± 0. 38) mm in sham-operation group, the corresponding data were (2.06±0.21) mg/g,(0.62±0.10) mg/g and (2.25±0.30) mm in AMI group, (2.90±0.47) mg/g, (1.00±0.28) mg/gand (2.58±0.34) mm in depression group, (2.20±0.34) mg/g, (0.67±0.15) mg/g and (2. 25±0.23) mm in neurostan treatment group. Compared with sham-operation group, AMI, depression and neurostan groups had obviously increased values of LVRW, RVRW and thickness of interventricular septum. Compared with depression group, AMI and neurostan groups had decreased LVRW, RVRW and thickness of interventricular septum (F=6.31, 21.9, 115.7, 9.91, P＜0.05). And the depression also could aggravate edema and injury of ultrastructure in myocardial tissue. The values of AgⅡ , ALD, MDA and SOD were (1957.5±662.6) ng/L, (0.453±0.111) ng/L, (16. 00±3.03)nmol/L and (80.57 ± 7.00) U/ml in depression group, the corresponding data were (1143.8± 98.0)ng/L, (0.198±0.087) ng/L, (8.03 ± 0.44 ) nmol/L and (95.20 ± 4.87) U/ml in sham-operated group, (1407.5±255.8) ng/L, (0.295±0.027) ng/L, (11.18±4.30) nmol/L and (87.33±3.51)U/ml in AMI group, (1400.0±239.0) ng/L, (0.326±0.073) ng/L, (11.88±3.36) nmol/L and (89.13 ±0.17) U/ml in neurostan group. After 4 weeks, the values of Ag Ⅱ , ALD and MDA increased in depression group while the level of SOD reduced (F=6.58, 11.9, 11.39, 8. 82, P＜0.05). Conclusions Depressive disorder after AMI in rats can aggravate ventricular remodeling and lower the ability of antioxygen.

Objective To study the mechanism of glycerol in treatment of trigeminal neuralgia. Methods After chronic constriction injury was produced to the infraorbital nerve and the model of trigeminal neuralgia in rats was successfully established, the trigeminal ganglion and preganglionic rootlets were exposed through infratemporal fossa approach. In the experimental group, pure glycerol was instilled into the preganglionic rootlets, while in the control group physiologic saline instead. The electrophysiologic response and the results of the electron microscopy were observed at different time points after glycerol injection. Results The latency of sensory evoked potential in the experimental group was longer than that in control group. Under the electron microscope, demyelination and degeneration were very similar in two groups, but disruption of neuraxon was only observed in the experimental group. Neuraxon regeneration occurred 10 weeks later. Conclusion Retrogasserian glycerol rhizotomy in treatment of trigeminal neuralgia was through disruption of myelinated nerve fiber that is reversible.

ObjectiveTo evaluate the efficacy of hypertonic saline (HS) treatment in cardiopulmonary resuscitation (CPR) in animal models of cardiac arrest (CA).Methods PubMed and EMBASE data were retrieved from January 1st, 1966 to September 30th, 2014, and Wanfang data and CNKI were searched from January 1st, 1990 to September 30th, 2014 for randomized controlled trials (RCTs) regarding CPR intervention of CA animal models with HS. HS was intravenously infused at the initiation of CPR in HS group, without limiting its dosage or concentration. The same volume of normal saline (NS) was given in NS group. Meta-analysis concerning the rate of restoration of spontaneous circulation (ROSC), the serum sodium concentration before CA and during CPR, and related hemodynamic parameters, including mean arterial pressure (MAP) and coronary perfusion pressure (CPP) at the immediate beginning of CPR and 90 minutes after ROSC was conducted by RevMan 5.3 software.Results A total of 8 RCTs were included. Meta-analysis showed that compared with NS group, the rate of ROSC [relative risk (RR) = 1.23, 95% confidence interval (95%CI) = 1.05-1.43,P = 0.010], serum sodium concentration during CPR [weight mean difference (WMD) =17.44, 95%CI = 12.57-22.31,P< 0.01], and the level of MAP at 90 minutes after ROSC (WMD = 4.81, 95%CI =1.58-8.03,P = 0.003) were significantly improved in HS group. There was no significant statistic difference in other hemodynamic parameters, including serum sodium concentration before CA (WMD = 0.78, 95%CI = -0.26-1.82,P =0.14), MAP (WMD = 5.43, 95%CI = -0.74-11.59,P = 0.08) and CPP at the immediate beginning of CPR (WMD =6.82, 95%CI = -5.54-19.19,P = 0.28), and CPP at 90 minutes after ROSC (WMD = -0.77, 95%CI = -10.33-8.80, P = 0.88) between two groups. It was showed by funnel chart that bias was not significant in the published articles. Conclusion This systematic review indicates that HS infusion is followed by an improved ROSC rate, serum sodium concentration during CPR, and MAP at 90 minutes after ROSC in animal models of CA.

To discuss treatment of wide-necked aneurysms.Methods Guglielmi detachable coil(GDC)after stent Pacement treat wide-necked aneurysm.Results Aneurysm was complete embolized,parent artery was intact.Conclusions Endovascular treatment of wide-necked aneurysms using and GDC is technically feasible.

Objective To investigate the value of platelet-to-lymphocyte ratio (PLR) in the prognosis prediction of patients with diabetic ketoacidosis (DKA).Methods Total of 105 patients with DKA who were treated in resuscitation room of Peking Union Medical College Hospital from January 1,2006 to December 31,2015 were reviewed.Among them,there were 8 cases died,and the other 97 cases survived.Another 105 patients with diabetes mellitus who were treated in the ward of Endocrinol ogy Department in the same period were selected as non DKA control group.The clinical characteristics of the patients in each group were compared and Logistic regression analysis was performed on the prognosis of DKA.Results Mechanical ventilation,simultaneous other organ dysfunction,PLR,Glasgow coma score related to prognosis of DKA (P ＜ 0.05).The OR value of platelet-to-lymphocyte ratio was 3.242.The optimal cutoff value of PLR for predicting the prognosis of patients was 256.50.Its sensitivity and specificity were 87.5％ and 88.7％,respectively.Conclusions PLR can be used as a sensitive indicator to predict the prognosis of DKA patients.

Objective To summarize experiences of microsurgical treatment of dumbbell tumors of the high cervical spine. Methods A series of 12 patients with dumbbell tumors of the high cervical spine were treated by using microsurgical techniques through posterior approach or antero-lateral approach. Results Complete resection was achieved in 10 patients. Postoperative neurological symptoms improved greatly in all. Conclusion The key points of treatment in dumbbell tumors of the high cervical spine are to analyze the preoperative image carefully and have knowledge about anatomy of high cervical spine as well as the experience of microsurgical technique.