Acute cerebral ischemia and reperfusion injury of rabbits was produced by permanently occluding the vertebral arteries and temporarily clamping the common carotid arteries for 30 min. Beta-endorphin immunoreactive substance ( ir beta-endorphin ) content were measured in cerebrospinal fluid at pre-ischemia and after ischemia and reperfusion stages. In control group, the content of ir beta-endorphin significantly increased (1.01?0.52 mg/L, P

The experimental study of cerebral ischemia plays an important role for understanding the pathogenesis of ischemic brain injury, but its correlation with the clinical therapeutic strategies has certain limitations. One of its main reasons is that the experimental models and methods can not or only partially repeat the pathophysiological processes of natural cerebral ischemia. In order to promote the understanding and interpretation of the experimental data, we review the commonly used experimental animal models and modeling methods and mainly elaborate the methods of current different in vivo and in vitro clinical evaluation. Based on these studies, we believe that the standardized clinical evaluations are hugely important for assessing the experimental results and clinical transformation.

BACKGROUND: With development of modern medical sciences, the out comes after meningioma surgery cannot be fully assessed using morbidity,livability and mortality merely. Quality of life (QOL) is a health-related multivariable index, which provides integrated inf ormation associated with physiological,sychological and social adaptation status of the patients to doctors. Assessment of the QOL in meningioma patients may be one of a relatively good method for guiding surgery and reducing reoccurrence of tuOBJECTIVE: To evaluate the QOL in meningioma patients and then to provide relevant data for assessing the outcomes of meningioma surgery comprehensively.DESIGN: It was a single-sample investigation. SETTING: Neurosurgery Department, Second People's Hospital of Wuxi City of Nanjing Medical University.PARTICIPANTS: Totally 147 patients underwent meningioma surgery in the Neurosurgery Department of the Second Affiliated Hospital of Wuxi City affiliated to Nanjing Medical University between January 1995 to January 2001 were selected, 61 males and 86 females, with a male/female ratio of 2:3 and an age ranging from 5-77 years old, in average of 43 years old, and the median was 43 years old.METHODS: Based on World Health Organization Quality of Life 100item questionnaire (WHOQOL-100) and Karnofsky Performance Scale (KPS), we designed a questionnaire on QOL in patients with meningioma.Outcomes of the transverse investigation on 147 meningioma patients were compared with healthy controls. Surgery-related QOL curve was used for identifying the threshold satisfactory point of QOL. In addition, with selfcontrol, influence of surgery on QOL was assessed.MAIN OUTCOME MEASURES: Relationship between QOL and clinical histories, radiological analysis, operation grading, histological properties and reoccurrence were investigated.RESULTS: All of the 147 patients entered the statistical analysis. ①In patient with meningioma, Cronbach's coefficient was 0.9521 and the correlated coefficient was 0.8685, which suggested that QOL questionnaire for patients with meningioma had a good reliability and validity. ②QOL ≥70 represented that the patient was satisfied with the QOL. ③In patients underwent surgical treatment, their physiological functions, self-help and self-care except for psychological functions were significantly improved (P ＜ 0.001 ).CONCLUSION: Surgical treatment enables patients to get a satisfied QOL. QOL questionnaire for patients with meningioma is helpful to provide relevant data for meningioma operation.

Objective To establish a standardized middle cerebral artery occlusion (MCAO) model with suture method in rabbits and to investigate the value of the assessment for cerebral ischemia with amplitudeintegrated electroencephalogram (aEEG).Methods A total of 34 male New Zealand white rabbits were randomly assigned to either an MCAO group (n =29) or a sham operation goup (n =5).A model of MCAO was induced with intraluminal suture method and the cerebral function monitor was performed.According to 2,3,5-triphenyltetrazolium chloride staining,the MCAO group was further divided into cortex + basal ganglia infarction,basal ganglia infarction,subarachnoid hemorrhage,and non-lesion subgroups.The differences among the physiological indicators,weight,thread end diameter,and insertion length were compared before and after modeling in all subgroups.Results The success rate of MCAO modeling with suture method in rabbits was 62.07％ (18/29),in which 37.93％ (11/29) involved in the cortex and basal ganglia,24.38％ (7/29) only involved in the basal ganglia,17.24％ (5/29) complicated by subarachnoid hemorrhage,and 20.69％ (6/29) had no infarction.There were no significant differences in the body temperature,heart rate,mean arterial pressure and arterial blood pH,oxygen partial pressure,and CO2 partial pressure among all the subgroups before and after modeling.The weight in the non-lesion subgroup was 2.36 ± 0.10 kg,it was significantly lower than 2.55 ± 0.09 kg in the cortex + basal ganglia infarction subgroup (P =0.001) and 2.50 ± 0.12 kg in the basal ganglia infarction subgroup (P =0.017).The length of suture placement in the cortex+basal ganglia infarction subgroup was 5.59 ± 0.24 cm,and it was significantly less than 6.00 ± 0.50 cm in the subarachnoid hemorrhage subgroup (P =0.036).However,it was significantly longer than 5.20 ± 0.50 cm in the non-lesion subgroup (P =0.033).After modeling there were significant differences in aEEG among all subgroups (F =14.059,P =0.000).Compared to before modeling,aEEG decreased 50.02％ (t =9.573,P ＜ 0.001) and 14.20％ respectively after modeling in the cortex + basal ganglia infarction subgroup and the ganglia infarction subgroup (t =2.908,P =0.027).Conclusions A standardized MCAO model in rabbits may be successfully established with suture method.The significantly decreased aEEG indicates that the MCAO model is successful and the lesions involve in the cortex.

OBJECTIVE:To analyze the utilization of drug included in the army of rational medicine directory in a military sanatorium in 2009.METHODS:To extrac convalescent medication data from a military sanatorium "military sanatorium information system",and analyze the drug use situation.RESULTS:The first 6-bit key role of drug consumption was the circulatory system drugs,anti-microbial drugs,a major role in the central nervous system drugs,clinical subjects medication,a major role in the respiratory system drugs,a major role in the digestive system drugs.CONCLUSION:The drug use of the military sanatorium for the convalecents basically matches the spectrum of convalecent disease.

Objective To investigate the neuroprotective effect of sophocarpine against transient focal cerebral ischemia via down-regulation of the acid-sensing ion channel 1(ASICl) in rats.Methods Twenty-five SD rats were randomly allocated into sham operation,cerebral ischemia/reperfusion,and 5,10,and 20 mg/kg sophocarpine pretreatment groups (n=5 in each group).A rat focal ischemia model was induced by the intraluminal suture method.Five,10 and 20 mg/kg sophocarpine were injected intraperitoneally for pretreatrnent.2,3,5-triphenyltetrazolium chloride staining was used to detect cerebral infarct volume.TUNEL staining was used to detect apoptosis.Immunohistochemistry and Western blot were used to detect the expression of ASIC1 and ASIC2.Results The infarct volume after ischemia-reperfusion was(181.21±9.21)mm3,while the 5,10,and 20 mg/kg sophocarpine pretreatment groups were(150.12±6.19),(52.31±4.20),and(32.18±3.82)mm3,respectively;the neurological function scores in the cerebral ischemia/reperfusion group was(3.62±0.36),while the 5,10,and 20 mg/kg sophocarpine pretreatment grows were(3.15±0.36),(1.92±0.18),and(1.85±0.21),respectively;The surviving neurons only accounted for(31.2±2.8)% of the total cell number in the cerebral ischemia-reperfusion group,while they accounted for(51.2±3.7)%,(76.5±2.1)%,and(77.1±4.1)% in the 5,10,and 20 mg/kg sophocarpine pretreatnmat groups.Compared with the cerebral ischemia/reperfusion group,the cerebral infarct volume was decreased significantly in the sophocarpine pretreatrnent groups(all P<0.01),the neurological function scores were decreased significantly(all P<0.01),and the number of apoptotic cells was decreased significantly (all P<0.01).Immunohistochemistry showed that the number of ASIC-1 positive cells in the sham operation,cerebral ischemia-reperfusion,and 5,10,and 20 mg/kg sophocarpine pretreatment groups were(162.5±8.3),(165.1±5.3),(138.3±7.2),(82.1±6.3),and(69.2±5.5)/mm respectively;Western blot showed that the ASIC1 protein expression was decreased sigaificantly in the 10 and 20 mg/ky sophocarpine pretreatment groups (P<0.01),while there WaS no significant difference in the ASIC2 protein expression.Condusions Sophocarpine may play a neuroprotective role for cerebral ischemia-reperfusion injury in rats via down-regulating the expression of ASIC1 protein.

Five hundred and twelve patients with psudohypertrophic muscular dystrophy underwent rapidly minimally invasive muscle biopsy with TZ semi-automatic biopsy needle under intravenous anesthesia. Three hundred and seventy nine samples were taken from quadriceps femoris muscle, while other 133 samples were taken from the deltoid muscle. The pathological diagnosis was obtained in all patients and there were no complications after biopsy. The results indicated that this method was simple, safe, effective, indolent, and minimally invasive. The obtained muscle samples can meet the request of histopathological and immunohistochemical examination and the method should be recommended for clinical applicatioa.

Objective: To evaluate recent prognosis of patients with acute ST elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI), and explore related risk factors.Methods: Clinical data of 168 STEMI patients undergoing primary PCI were retrospectively analyzed.According to occurrence of major adverse cardiovascular events (MACE) within 30d or not, they were divided into poor prognosis group (n=40) and good prognosis group (n=128).Clinical data were compared between two groups.Logistic regression analysis was used to analyze independent risk factors for MACE.Results: Incidence rate of MACE was 23.81% among the 168 STEMI patients.Logistic regression analysis indicated that age (OR=1.326, 95%CI 1.168~1.505), family history of coronary heart disease (OR=1.852, 95%CI 1.369~2.505), number of diseased vessels ≥2 (OR=1.682, 95%CI 1.382~2.047), Killip′s class Ⅲ~Ⅳ (OR=1.693, 95%CI 1.428~2.007) and onset-to-PCI time (OR=1.785, 95%CI 1.425~2.236) were the independent risk factors, P<0.01 all;TIMI grade 3 (OR=0.623, 95%CI 0.518~0.749) and tirofiban application (OR=0.452, 95%CI 0.367~0.557) were independent protective factors for MACE, P<0.01 both.Conclusion: Advanced aged, family history of coronary heart disease, number of diseased vessels ≥2, poor cardiac function and long onset-to-PCI time are independent risk factors, while TIMI grade 3 and tirofiban application are independent protective factors for MACE.

Objective To study the value of CT perfusion imaging(CTPI)on brain hemodynamic of the aged with cerebral infarction. Methods The 48 patients who were doubted with cerebral infarction underwent 16-slice CT plain scanning and CTPI within 24 hours of onset. The cerebral blood flow(CBF), mean transit time(MTT)and time to peak(TTP)of contrast-medium in region of interest(FOV)were used as brain hemodynamic parameters in comparation with contralateral regions. All cases were followed up with MRI after 3-10 days. Results Ischemia lesion was found on CT plain scanning in 40.9% of patients, while 93.2% of patients showed abnormal perfusion on CTPI. The sensibility of CTPI in identifying ischemia area was 93.2%, and the specificity was 100%. CBF in research area was significantly reduced, MTT and TTP were remarkably increased in contrast to counterparts(P＜0.01). Conclusions CT perfusion imaging can sensitively reveal the hemodynamic condition of cerebral ischemia, which could provide the important information for early diagnosis and treatment of the elderly with brain infarction.

Objective To investigate the clinical characteristics, operation time and methods for patients with central brain herniation caused by bifrontal contusions. Methods A retrospective study was performed on the medical records of patients with central brain herniation caused by bifrontal contusions admitted from January 2000 to December 2006. There were 45 males and 18 females, at age range of 20-72 years (average 43 years). The majority of the patients were victims of falls and traffic accidents. There were 29 patients treated with immediate operation and 34 with emergency operation. All the operations involved simultaneous bilateral craniectomy for decompression, including 17 patients treated with bilateral decompressive craniectomy and 46 with unilateral decompressive craniectomy. Results The prognosis was favorable in 19 patients with GOS score of 5 or 4 points, severely disabled in seven with GOS score of 3 points, vegetative in four with GOS score of 4 points and the worst in seven with GOS score of 1 point. Of all, 19 patients suffered severe mental disorders especially personality change and disturbance of intelligence. Seven patients were complicated by epilepsy and three by hydrocephalus. Conclusions Based on early clinical manifestations of central brain herniation combined with imaging manifestations, bilateral balance decompression craniectomy can reduce the mortality and morbidity and improve the cure rate of patients with central herniation caused by bifrontal brain contusions.