Objective To dynamically observe the effect of mild hypothermia on concentration of plasma S-100B protein in patients with acute severe brain injuries so as to further explore its role in treat-ment of acute severe brain injury. Methods A total of 120 patients with acute severe brain injuries were randomly divided into mild hypothermia group and general group. The patients in mild hypothermia group were treated with mild hypothermia besides conventional therapy, with maintenance of rectal tem-perature at 33℃-35℃ for 3-5 days. Serial concentration of S-IOOB protein in serum was measured in all patients from 6 hours to 6 days after hospitalization. GOS evaluation was done three months after treat-ment. Results The concentration of S-100B protein in serum of mild hypothermia group and general group was significantly higher than of normal group (P <0.05), with significant lower level in mild hypo-thermia group than general group(P <0.05). Mild hypothermia could improve prognosis of patients with acute severe brain injury. Conclusions Early use of mild hypothermia can decrease concentration of S-100B protein in serum, protect neurofunction and improve prognosis, as may be related to its function in alleviating damnification brain cell inflammation reaction mediated by S-100B protein.

BACKGROUND:It is confirmed that astrocytes can differentiate into neurons by Neurogenin2 gene regulation, suggesting that Schwann cells may also differentiate into neurons by gene regulation.
OBJECTIVE:To evaluate the feasibility of Schwann cells differentiating into neurons by Neurogenin2 gene regulation.
METHODS:Rats Schwann cells were isolated, purified and identified. Then the Schwann cells were transfected with Neurogenin2 via green fluorescent protein gene-plentivirus. To induce neuronal differentiation, the Schwann cells were cultured in serum-free Dulbecco’s modified Eagle’s medium containing epidermal growth factor, basic fibroblast growth factor and brain-derived neurotrophic factor for 2 weeks. The morphology of induced cells was observed by microscope, and myelin basic protein and neuron-specific enolase were detected by immunocytochemistry.
RESULTS AND CONCLUSION:After transfection with Neurogenin2 via green fluorescent protein gene-plentivirus and induced differentiation, immunofluorescence assay demonstrated that 12.56%of the induced cellexpressed neuron-specific enolase, but the control group did not express neuron-specific enolase. Neurogenin2 gene-transfected Schwann cells can express neuron-specific enolase, suggesting Neurogenin2 gene may regulate transdifferentiation of Schwann cells into neurons.

Objective To determine sexual function in 612 male addicts with methadone maintenance therapy (MMT),analyze its cause and explore the treatment strategies.Methods Self-made questionnaire and International Index of Erectile Function-5 ( IIEF-5 ) were used in 612male addicts receiving MMT.ResultsThe number of addicts who felt worse sexual function was significantly more than those who felt better sexual function (P ＜0.01 ).About 88.6％ addicts were dissatisfied with their current sexual function,90.7％ of whom were willing to continuously receive MMT.The number of addicts suffering from hyposexuality and erectile dysfunction (ED) was significantly increased at post-MMT than at pre-MMT ( P ＜ 0.01 ),while the number of addicts with normal sexuality and inhibitive ejaculation decreased significantly (P ＜0.01 ).Both the dose of methadone and the age of subjects were negatively correlated with IIEF-5 scores.Correlation between the duration of MMT and IIEF-5 scores was not found.ConclusionMMT might deteriorate sexual function in male addicts.To improve the compliance of MMT and sexual function in male addicts,the dose of methadone should be adjusted to minimally effective one.

Objective To investigate the effects of naloxone hydrechloride on neuronal cell apoptosis and cerebral edema induced by experimental brain injury.Method Animal model of brain injury was established by free-falling method of Fecney.Totally 100 SD rats were randomly divided into sham operated group(n=20),op-erated comparison group(n=40),and naloxone hydrochloride treatment group(n=40).The naloxone hy-drochloride treatment group were subdivided into four sub-groups,and naloxone hydrochloride was injected at 30 min,6 h,24 h and 48 h after brain injury respectively,while the comparison groups were injected with physiologi-cal saline at the same time point.The rats were sacrificed 7 deys after the injury.Neuronal cell apoptosis were de-tected by terminal-deoxynucleotidyl transferase mediated nick end labeling(TUNEL),and water content of brain tis-sue was examined with dry-wet methods.Data were analyzed by using spss 10.0 saftware package statistical analysis was carried out by using variance analysis.Results Gompared to the sham operated group,neuronal cell apopto-sis and water content of brain tissue were increased significantly in operated comparison group(P＜0.05).Com-pared to the operated comparison group,neuronal cell apoptosis and water content of brain tissue were decreased significantly in every naloxone hydirochloride treatment group(P＜0.05).Every sub-groups compared in naloxone hydrochloride treatment group,neuronal cell apoptosis of early injection group(30 min and 6 h after injury)were decreased significantly than late injection group(24 h and 48 h after injury,P＜0.05),but the water content of brain tissue had no difference between the early injection group and the late injection group(P＞0.05).Conclu-sions Naloxone can carry out its protective function to injuried neurecyte through alleviating neuronal cell apopto-sis and hydrecepahalus.and the effect was better as early as it used.

Objective To investigate the value of subdural intracranial pressure (ICP) monito-ring in post-operative patients with severe brain injury. Methods A total of 100 patients with severe brain injury treated with craniotomy were randomly divided into ICP monitoring group (n=50) and rou-tine treatment group (n = 50). In ICP monitoring group, the treatment methods were adjusted according to the changes of ICP, whereas the patients in routine treatment group underwent general treatment ac-cording to standard neurosurgical protocol. Results Patients in ICP monitoring group received mannitol for eight days, with the average dosage of 950 g. Marmitol was administered to patients in routine treat-ment group for 12 days, with average dosage of 1 450 g. There was statistical difference in aspects of time duration and mannitol dosage between two groups (P <0.01). Of all patients in ICP monitoring group, four were found with electrolyte disturbance (8%), seven with acute renal failure (14%), four with stress ulcer (8%) and eight with pulmonary infection (16%). The corresponding numbers of patients in routine treatment group were nine (18%), 14 (28%), five (10%) and nine (18%), respectively. The occurrence of electrolyte disturbance and acute renal failure between two groups showed significant statistical difference (P < 0.05), while the occurrence of stress ulcer and pulmonary infection were be-yond of statistical difference between two groups (P > 0.05). The post-operative initial ICP level was positively correlated with mortality rate (P <0.01). All patients were followed up for three months post-operatively. In ICP monitoring group, 27 patients (26%) obtained good prognosis without any disability (54%), 13 were under mild disability, two (4%) under severe disability, three (6%) under vegeta-tive state and five (10%) died . In the routine treatment group, 17 patients (34%) were with good prognosis without any disability , six (12%) with mild disability , six (12%) with severe disability, eight (16%) under vegetative state and 13 (26%) died. The ICP monitoring group had better prognosis than the routine treatment group(P < 0.05). Conclusion Continuous ICP monitoring postoperatively in severe brain injury patients is valuable in reducing mortality, complication and improving the prognosis.

ObjectiveTo explore the optimal acupuncture-moxibustion treatment protocol in treating diabetic gastroparesis. MethodA hundred patients were randomized into a body-acupuncture group, an electroacupuncture group, a hydroacupuncture group, and an acupuncture-moxibustion group, allto receive 3 treatment courses. The clinical symptoms and sign scores were observed before and after the intervention in the four groups.ResultThe markedly-effective rate of the acupuncture-moxibustion group was significantly higher than that of the other three groups (P<0.05). Regarding the symptom score for bloating, poor appetite, belching, upper abdominal pain, and nausea, the improvements in the acupuncture-moxibustion group were more significant than that in the other three groups (P<0.05,P<0.01).ConclusionCombination of acupuncture and moxibustion is the optimal treatment protocol for diabetic gastroparesis.