Objective To explore the effect of mild hypothermia on tumor necrosis factor alpha (TNF-?),interleukin-1?(IL-1?),interleukin-6 (IL-6) and interleukin-8 (IL-8) in serum of patients with severe traumatic brain injury and its clinical significance. Methods Mild hypothermia was used within 24 hours after injury to keep the rectal temperature at 33℃-35℃ for five days in 23 patients, who suffered from severe brain injury with GCS score of 3-8 (mild hypothermia group). And 21 patients who suffered from severe brain injury with GCS score of 3-8 were taken as control group. The dynamic changes of serum TNF-?, IL-1?, IL-6 and IL-8 at days 1, 2, 3 and 4 respectively after trauma were monitored using ELISA. Results Levels of serum TNF-?, IL-1?, IL-6 and IL-8 were decreased more significantly in the mild hypothermia group than those in the control group(P

objective To investigate the changes in angiotensin-Ⅱ (AT-Ⅱ), endothelin (ET) andcalcitonin gene-related peptide (CGRP) during clipping of intracranial aneurysm performed under desfiuraneanesthesia. Methods Forty-five ASAⅠ -Ⅱ patients (20 male, 25 female) aged 14-66yr undergoing electiveclipping of intracranial aneurysm two weeks after acute subarachnoid bleeding. Anesthesia was induced withmidazolam 0 .05 mg?kg~(-1), fentanyl 2?g?kg~(-1), propofol 2 mg?kg~(-1) and vecuronium 0.1 mg?kg~(-1). The patientswere mechanically ventilated after tracheal intubation and P_(ET)CO_2 was maintained at 30-35 mm Hg. Anesthesia wasmaintained with desflurane at 1 .0-1 .5 MAC with low flow (0.3-0.5 L?min~(-1) ) supplemented with intermittentintravenous boluses of vecuronium. Radial artery was cannulated for direct continuous BP monitoring. ECG, HR,SPO_2 and P_(ET) CO_2 were continuous monitored during operation. Blood samples were taken before induction ofanesthesia (T_1, baseline), when dura was opened (T_2 ), while aneurysm was being clipped (T_3 ) and 30 min afterclipping for determination of plasma concentrations of AT-Ⅱ, ET and CGRP. Results Plasma concentration ofAT-Ⅱ did not change significandy throughout the surgery. Plasma ET concentration decreased significantly at T_2and T_3 compared with the baseline (P

Moyamoya disease is a tare intracranial angiopathy resulting in symptoms and prognosis similar with the stroke,if not diagnosed and treated early.The article reviews the characteristics,pathogenesis,treatment and prognosis of Moyamoya disease.Clinicians should be aware of this disease in routine work,so that the patients with Moyamoya disease can be early diagnosed and treated to avoid disability or death.

ObjectiveTo investigate the effect of adaptive support ventilation (ASV) plus lung recruitment maneuvers (LRM) and intermittent positive pressure ventilation (IPPV) on respiratory mechanics, hemodynamics and oxygen delivery in trauma patients combined with acute respiratory distress syndrome (ARDS).MethodsTwenty-eight trauma patients combined with ARDS including 18 males and 10 females at age range of 19-48 years were mechanically ventilated by two modes, ie, IPPV and ASV + LPS.The patient was initially ventilated with IPPV for eight hours, with tidal volume (VT) of 10 ml/kg, PEEP = 0, oxygen delivery speed for 32 L/min and oxygen inhalation concentration of 60％.Then, one of ASV + LRM and IPPV was randomly selected for continual ventilation.There were three levels of positive end-expiratory pressure (PEEP,0,5 and 10 cmH2O).Each level of PEEP was maintained for 60 minutes.During the use of ASV + LRM, continuous positive airway pressure (CPAP) was at 45cmH2O and breath holding continued for 30 seconds.Then, the mode was turned to ASV and respiratory mechanics, hemodynamics and oxygen delivery were measured by using Swan-Ganz catheter, electrocardioscanner and ventilator when each level of PEEP was ventilated for 50 minutes.Results Compared with IPPV mode in the same level of PEEP, ASV + LRM mode had lower peak inflating pressure (PIP),airway plate pressure (Pplat) and intrapulmonary shunt (Qs/Qt) (P ＜ 0.05) but higher oxygenation index (PaO2/FiO2) and oxygen delivery (DO2) (P ＜ 0.05).There was no statistical difference in aspects of MAP, CI and SVRI during ventilation with IPPV and ASV (P ＞ 0.05).ConclusionASV + LPS model is better than IPPV in ventilation for trauma patients combined with ARDS.

Recent studies have demonstrated that hyperhomocysteinemia is an independent risk factor for stroke,which may cause vascular endothelial injury by multiple mechanisms,destroy blood coagulation and fibrinolytic systems,and influence on lipid metabolism.Methylenetetra hydrofolate reductase(MTHFR)is a key enzyme of homocysteine metabolic pathway in the human body.If it is insufficient or its activity decreases,it will directly result in the accumula tion of homocysteine in the human body,and callse hyperhomocysteinemia.Although a number of studies have found that MTHFR gene mutation is the main cause of MTHFR insufficient and its activity decrease,the correlation between MTHFR gene mutation and ischemic cerebral vascular disease is quite controversial now.This article reviews the relationship between MTHFR gene polymorphisms and ischemic stroke.

Objective This experiment was carried out to study the effect of fibronectin on the infection of primary human fetal hepatocytes with hepatitis B virus (HBV) in vitro. Method Human fetal hepatocytes were inoculated with HBV positive serum in culture dish coated with fibronectin (Fn) in vitro. HBsAg and HBeAg in supernatant were assayed with ELISA, HBcAg in nuclei by immunohistochemistry, HBV DNA in cells by fluorescence quantitative PCR, and cccDNA in cultured cells by nest PCR. The results were compared with the cells cultured in dishes without fibronectin coating. Results HBsAg and HBeAg in supernatants were positive on the fifth day in dishes without Fn coating, and on the first day in dishes with Fn coating. HBcAg in nuclei was positive on the second and the first day in dishes without and with Fn coating, respectively, and the positive rates were about 10%～15% and 90%, respectively. HBV DNA was detected in cells on the fourth day and first day in dishes without and with Fn coating, respectively. CccDNA in cells was positive on the eighth day and the first day in dishes without and with Fn coating, respectively. Conclusion Fibronectin coating could facilitate HBV infection in primary fetal hepatocytes in vitro. The infection time of HBV was shortened, and the number of infected cells was increased.

Objective:To approach the actions of survivin and COX-2 during the genesis and development in brain astrocytoma and whether they have dependablity each other.Methods:The expression of survivin and COX-2 was examined by immunohistochemistry SP and their interrelationship was analyzed.Results:The positive expressive rates of survivin in astrocytoma gradeⅠ,Ⅱ,Ⅲ and Ⅳsubgroups were shown in an increased tendency.The expression was weak positive in higher differentiation group,and the positive expressive rate of survivin was increased in the lower differentiation group.There was an significant difference between these two groups(?2=11.20,P

Objective To investigate the proliferation and collagen secretion of transplanted human fibroblasts.Methods The solution containing human fibroblasts(2?1010L-1)was prepared and 1 mL was injected into the dermis of BALB/CNU nude mice.Animals were killed by the end of the 1st,2nd and 3rd month after injection.The dermis in the injected area was taken out and stained with HE.Immunohistochemical staining for type I and type Ⅲ collagen was performed at the same time.Results Mitosis was observed by the end of the 1st,2nd and 3rd month.The concentration of type I and type Ⅲ collagen in the extra cellular matrix increased with the passing of time.Conclusion Transplanted human fibroblasts can proliferate automatically in the dermis of nude mice and manufacture the type I and type Ⅲ collagen in situ.Long period of survival and secretion will make it possible for fibroblasts to become promising option to correct minimal tissue defects.

Transient ischemic attack (TIA) is a common acute ischemic cerebrovascular disease.It is a risk warning sign and needs to be evaluated and treated urgently.This article reviews the development history of the definition of TIA and its evolution,and TIA prognostic rating scale in order to conduct a comprehensive evaluation,risk stratification and appropriate treatment in patients with TIA,thereby reducing the risk of stroke after TIA.

Objective To study the effect of atorvastatin on serum cystatin C and urinary microprotein in patients with early diabetic nephropathy (DN).Methods Sixty-eight cases of early DN were divided into control group and observation group with 34 cases each by random digits table,the control group was treated with the conventional treatment,the observation group was treated with atorvastatin on the basis of conventional treatment,then blood lipids,serum cystatin C,urinary albumin excretion rate (UAER),microalbuminuria( MAU ),α1-microglobulin(MG),β 2-MG between the two groups were compared.Results After intervention,the levels of total cholesterol (TC),triacylglycerol (TG),serum cystatin C,UAER,MAU,αt 1-MG,β 2-MG were significantly decreased compared with those before treatment in the observation group [ (4.32 ± 1.26) mmol/L vs.(5.65 ± 1.38 ) mmol/L,( 1.67 ± 0.64) mmol/L vs.(2.53 ± 0.96 ) mmol/L,( 1.29 ± 0.38 ) mg/L vs.( 1.74 ± 0.51 ) mg/L,(61.09 ± 18.45 ) μ g/min vs.( 86.42 ± 21.34) μ g/min,( 5.73 ±4.81) mg/L vs.(23.16 ±9.73) mg/L,(1.41 ± 1.21) mg/L vs.(4.76 ± 1.24) mg/L,(1.21 ±0.13) mg/L vs.(2.58 ± 0.26) mg/L ] (P ＜ 0.01 or ＜ 0.05 ).In the control group,the levels of TC,TG,serum cystatin C were lower than those before treatment,but there were no significant differences (P＞0.05),but the levels of UAER,MAU,α 1-MG,β 2-MG had significant differences compared with those before treatment (P ＜ 0.01or ＜ 0.05 ) and the same time of the observation group (P ＜ 0.05 or ＜ 0.01 ).Conclusion Atorvastatin can significantly reduce serum cystatin C and urinary micro-protein levels in patients with early DN,which plays an important role in kidney protection.