OBJECTIVE:To investigate the molecular mechanism of cerebral vasospasm (CVS) from the perspectives of the basic molecular biology of cerebrovascular regulation, vascular cell proliferation, inflammatory reactions of vascular cells, and gene activation.DATA SOURCE: By using the key words "subarachnoid hemorrhage","cerebral ischemia", "temporal", and "molecular biology", we retrieved the related articles between January 1998 and December 2004 in Medline,and the language was limited to English.STUDY SELECTION: All articles related to our study purpose were setal subjects. Exclusion criteria: Duplicated experiments. The rest of articles were searched for the full text.DATA EXTRACTION: Totally 20 articles related to the molecular mechanism of CVS induced by subarachnoid hemorrhage (SAH) with or without randomized studies were selected, and 14 of them accorded with the inclusion criteria. The other 6 papers of duplicated study were excluded.oxygen radicals damage both cerebral endothelial and smooth muscle cells through the following possible mechanism: increasing endothelial permeability, increasing intracellular calcium and inositol 1,4,5-triphosphate levlarize and show impaired relaxation after SAH. This may be due to a depletion of the energy metabolism causing a dysfunction of ion pumps or inhibition of potassium channels, which leads to membrane depolarization gene activation can relieve CVS.CONCLUSION: The patbogenesis of SAH-induced CVS may be related to a number of pathological processes, including endothelial damage, smooth muscle cell contraction resulting from dysfunction of ion pumps or PKC activation, vascular cell proliferation, inflammatory reaction of the vascular wall, and gene activation.

Objective To explore the application of utrasonic technology-assited microsurgery resection of ventral or ventrolateral spinal schwannomas.Methods Forty patients with ventral or ventrolateral spinal schwannomas were treated by CUSA-assited microsurgery.Results The tumors were totally resected suc-cessfully acompanied by minimal blood loss and adjacent structures could avoid damaged.Preoperative and postoperative magnetic resonance imaging demonstrated complete resection in all cases.Neurological func-tions had good recovery.With follow-up of 3 months to 3 years,there was no instability of the spine or any recurrence.Conclusion utrasonic technology-assited microsurgery resection of ventral or ventrolateral spi-nal schwannomas by posterior approach appears a safe,efficient mini-invasive surgical approach,without mechanical or heat injury.

Objects To assess the effect of BMP(bone morphogenetic protein) in orthotopit grafting with an autogenous cranial bone flap in cranioplasty.Methods 45 cases (48 locations ) have been reconstructed by orthotopic repair with autogenous bone flap, it has been divided into two group;26 locations of them using porous autogenous bone flap plus BMP (group Ⅰ), 22 locations of them only using porous autogenous bone flap(group Ⅱ), All cases have been closely followed up for 1～2 years with X-ray and CT , including postoperative complications, absorption or regeneration of the bone flap. Results No flexible with the porous autogenous bone flap was seen , and the appearance was perfectly. The bone graft survival and besetting apposition were all right. The gap disappears gradually. It is obvious that the osteotylus come into being. The density of bone flap was normal in group Ⅰ. 5 cases in group Ⅱ have shown that bone partial absorption occurred and the density reducing in the center of the flaps,and with the significant difference. Conclusions The local application of BMP can avoid bone flap absorption and stimulate osteotylus morphofogenesis.

Objective To investigate the diagnosis value of mucin 7 in plasma and urine in the detection of bladder cancer.Methods Expression of mucin 7 was detected quantitatively in plasma and urine from 23 patients with bladder cancer and 23 patients as control group by enzyme-linked immunosorbent assay(ELISA) from November 2012 to September 2013.There were 15 were male and 8 were female in the 23 bladder cancer patients,aged from 41 to 95 years,with an average of 64 years.Of the 23 bladder cancer pathology,12 with high grade,11 with low grade,11 with invasive disease and 12 with noninvasive disease.There were 19 males and 4 females in the 23 patients in control group,aged from 28 to 85 years,with an average of 61 years.Results The amount of mucin 7 in plasma was significantly higher in bladder cancer group than that in control group [(7.43±4.54) ng/ml versus (4.55±.1.98) ng/ml,P=0.017].While there was no significant difference in urine between the two groups [(12.44±7.1 1) ng/ml versus (11.96±8.41)ng/ml,P=0.840].There was no significant differences in the amount of mucin 7 had in different grades and stages of bladder cancer (P＞0.05).Conclusions Expression of mucin 7 in plasma of patients with bladder cancer is significantly higher than that in control group.Mucin 7 expression has no significant correlation with the grading and staging of bladder cancer.Detecting mucin 7 expression quantitatively with ELISA for diagnosis of bladder cancer is a method with certain value.

BACKGROUND:Low concentration of nicotine promotes the angiogenesis and facilitates the healing of skin wounds. However, the role of low concentration of nicotine on the repair of maxil ofacial soft tissue trauma especial y oral mucosa stil remains unclear
OBJECTIVE:To evaluate the effect of low concentration of nicotine on mucosa defect repair of rat hard palate.
METHODS:A circular soft tissue defect at 3 mm diameter was produced in the centre of hard palate of 65 Wistar rats. After the operation, animals were randomly divided into low concentration of nicotine with gel group, gel group and control group. Rats were sacrificed at 3, 7, 10 and 14 days post-surgery. The wound healing was detected with hematoxylin-eosin staining and the difference of wound healing in different groups was compared with gross observation and image measurement.
RESULTS AND CONCLUSION:There was no significant difference in the wound healing in different groups on day 3 post-surgery. On days 7 and 10, the group of low concentrations of nicotine with gel was faster than gel group and control group (P<0.05);the wounds were completely healed on day 14, with no significant difference among the groups. Low concentrations of nicotine may promote the mucosa defects repair of rat hard palate.

Objective To investigate the value of neuronavigation system in resection of pituitary adenoma through the endonasal transsphenoidal approach. Methods Twenty-one patients with pituitary adenomas underwent magnetic resonance imaging (MRI) or CT scans studies. The image datasets were transported into the neuronavigation system. The anatomic information of approach was reconstructed for three-dimensional visualization and the best approach was designed. The midline structure and internal carotid artery were displayed in real-time intraoperatively, the anterior-wall of sphenoidal sinus and the floor of sella were accurately opened and the tumor was resected guiding by neuronavigation system. Results All the operations were smoothly and accurately performed under the neuronavigation by transsphenoidal approach. No injury occurred in the internal carotid artery and cavernous sinus. After surgery, 13 patients got better vision and visual field. Postoperative transient diabetes insipidus was found in 11 cases, and CSF leak in 1 and serious hyponatremia in 2 cases. Total tumor removal was achieved in 17 patients and subtotal removal in 2 cases during operations, which were confirmed by postoperative MRI. Three-month follow-up data showed only one recurrence case (subtotal tumor removal), the recurrence rate was 4.8%. Conclusion Neuronavigation system provided real-time localization with three-dimensional anatomic information of the endonasal transsphenoidal approach during pituitary adenomas surgery. As a result, the approach proceeds more smoothly and accurately, the tumor can be resected more completely, the surgical injury and complications can also be reduced.

Objective: To study the effect of enalapril on inducible atrial fibrillation(AF) in old rats. Methods: Old male Wistar rats were randomly divided into control group(n = 12) and experimental group(n = 13). Rats in control group were fed routinely. Rats were fed with enalapril besides normal diet in experimental group for three months. Rats were then anesthetized, thoracotomy was performed and pericardium was opened to expose heart. Right atrium effective refractory period(ERP) was measured. Sinus conduction time (SCT) and sinus recovery time (SRT) were measured for evaluating sinus function. Interatrial conduction time(IACT) and atrium response to burst pacing were evaluated in vivo. Plasma angiotensinⅡ level and atrial tissue angiotensinⅡ level were determined by radioimmunoassay. Sections were cut from the tissue of atrium and stained with Masson trichrome. The ratio of the area occupied by interstitial to the total area was measured. Results: Contrast to control group,IACT and SRT were shorter in experimental group(P ＜ 0.01 and P ＜ 0.05 respectively). AF were induced in 9 rats in control group and 4 rats in experimental group(P ＜ 0.05). AngiotensinⅡconcentration was significantly decreased in right and left atrium tissues of experimental group compared with that in control group(P ＜ 0.01). A significant decrease in interstitial atrial fibrosis was presented in experimental group compared with that of control group(P ＜ 0.01). Conclusion: Inducible atrial fibrillation rate was decreased in old rats after treatment with enalapril. This effect maybe resulted from the inhibited local atrium renin-angiotensin system and improved sinus node function by enalapril.

Background and purpose:Neoadjuvant chemotherapy is an excellent model for evaluation of predictive parameters.The goal of predictive parameters is to select patients who would most likely benefit from neoadjuvant chemotherapy.The objective of this study was to investigate the predictive value of biological markers for the patients' response to neoadjuvant anthracycline combined with taxanes chemotherapy.Methods:We investigated 160 patients with breast cancer who underwent 4 cycles of neoadjuvant anthracycline combined with taxanes chemotherapy,retrospectively.The expression of estrogen receptors(ER),progesterone receptors(PgR),Her2,Topo-Ⅱ and Ki-67 proteins were detected by immunohistochemical assay in core-needle biopsy specimens.The associations between biological markers as well as clinical and pathologic responses were analyzed.Results:The overall clinical response was 85%,including 28.8%(46/160) with clinical complete response(cCR) and 56.3%(90/160) with clinical partial response.The pathological complete response(pCR) was 14.4%.In the univariate analysis,absence of ER,PgR expression and over-expression of Her-2 were predictive of the cCR and pCR(P

Objective To explore the diagnostic significance of CT and MRI in dermatofibrosarcoma protuberans.Methods Analyze the CT and MRI images of 16 cases which were confirmed as dermatofibrosarcoma protuberans by pathology.The medical imaging features of dermatofibrosarcoma protuberans were summarized.In the total 16 cases(including 6 male cases,10 female cases),15 cases had suffered from dermatofibrosarcoma protuberans for more than 1 year, 11 cases for more than 5 years, and 9 cases had history of recurrence.Results On MRI, the mass was slightly hypointense on T 1 WI, inhomogeneously hyperintense on T 2 WI with inhomogenous enhancement.The diameters of mass were less than 5 cm in 3 cases,and were more than 5cm in 13 cases.Fifteen cases had clear demarcation between the masses and their adjacent muscles , 7 cases had “suspension sign” in shapes, 10 cases had “sub-nodules outward” features at the edge of the tumors , 12 cases had “multinodular” features inside the tumor , and 8 tumors grew into the surrounding fat layer like roots.Conclusion Dermatofibrosarcoma protuberans can be diagnosed accurately based on the features displayed on CT and MRI.

Objective:The study aimed to validate the Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram and Stan-ford Online Calculator (SOC) prediction of non-sentinel lymph node (NSLN) metastasis in Chinese patients with sentinel lymph node (SLN)-positive breast cancers. Methods:The MSKCC nomogram and SOC were used to calculate the probability of NSLN metastasis in 120 breast cancer patients who were positive for SLNs. The area under the receiver operating characteristic curves (AUC) for each model was evaluated. Patients with 10%and 90%probabilities of NSLN metastasis were separately examined. Results:The MSKCC and SOC predicted the likelihood of NSLN metastasis in a consecutive group of 120 patients with AUCs of 0.688 and 0.734, respective-ly. At the lowest probability cutoff value of 10%, the false-negative rates of MSKCC and SOC were both 4.4%, and the negative predic-tive values were 75.0%and 90.0%, respectively. When the highest probability cutoff value of 90%was used, the false-positive rates were 0.0%and 6.7%, and the positive predictive values were 100.0%and 68.8%, respectively. Conclusion:Results of the MSKCC no-mogram and SOC were inferior to those of previous studies on predicting NSLN metastasis in Chinese patients with breast cancers. The prediction ability of SOC was slightly superior to that of the MSKCC nomogram.