Journal Club education method is widely used in resident training in foreign countries.Its function in neurosurgery clinical training is gradually focused on.This method will promote the mastery of new concept,new method and new technique by the residents,help them to form good reading habit and improve their ability to solve actual clinical problems.The application of Journal Club education method in neurosurgery clinical training in our country may have positive influence on the standardized training of clinicians and the spreading of evidenced-based medicine.

Objective To explore the related factors for improving the effect of the staged bilateral multi-targets pallidotomy and thalamotomy on Parkinson's disease.Methods 387 patients were divided into different groups according to various factors,including the age of patient,operation method,interval of radiofrequency and the diameter of electrode. The relationship between the above mentioned factors and the effect or complication was analyzed.Results All the symptoms of PD were significantly improved after second operation in the near future. Staged bilateral pallidotomy was the most popular operation way in clinical practicing. The incidence of complication of staged bilateral thalamotomy was high (100%). The rate of complication in the patients over 55 years old (29.70%) was higher than that in the patients not more than 55 years old (12.66%)( P

BACKGROUND: The copper-superoxide dismutase (Cu-SOD) can not play an effective role in free radical-scavenging in the process of hypoxia or reaeration because of blood-brain barrier, whether the treating effect can be enhanced by chitosan nanoparticles is uncertain. OBJECTIVE: To observe the ability of chitosan nanoparticles loaded the Cu-SOD plasmid on free radical-scavenging in ischemia-reperfusion brain tissue. DESIGN: An observation experiment. MATERIALS: The Cu-SOD plasmid was provided by the Center Laboratory of Tangdu Hospital, Forth Military Medical University of Chinese PLA. A total of 36 rats were prepared ischemia-reperfusion models, and randomly divided into the control, physiological saline (PS) plus Cu-SOD plasmid and chitosan nanoparticles loaded the Cu-SOD plasmid groups. METHODS: The chitosan nanoparticles were prepared by cross-linking method. The Cu-SOD plasmid was absorbed to chitosan nanoparticles by electrostaficforces, mixed the 50.0 ?L nanoparticles with 10.0, 25.0, 50.0, 75.0, 100.0 ?L SOD plasmid respectively. The electrophoretic analysis was used to examine the combination condition of the chitosan nanoparticles with superoxide dismutase plasmid, and the embedding rate was calculated with ultraviolet spectrophotometer. Chitosan nanoparticles, SOD and Cu-SOD plasmid were infused into the rat after brain ischemia-reperfusion. Further more, to detect the content of malondialdehyde and superoxide dismutase in brain tissues. MAIN OUTCOME MEASURES: The combination condition of the chitosan nanoparticles with superoxide dismutase plasmid, and the activity of malondialdehyde (MDA) and SOD were measured. RESULTS: Chitosan nanoparticles and superoxide dismutase in volume ratio of 50: 75 could harvest the largest embedding rate with 100%, which had good protective effect on DNA. The contents of MDA in brain tissues of the Chitosan nanoparticles loaded the Cu-SOD plasmid group were obvious lower than that of the control (P

Objective To evaluation the efficacy and safety of endovascular stenting for intracranial artery stenosis.Methods By the checking of DSA,39 patients with intracranial artery stenosis were divided into the anterior circulation group [26 cases,including 11 cases of transient ischemic attack(TIA),15 cases of cerebral infarction(CI)] and posterior circulation group(13 cases,including 3 cases of TIA,10 cases of CI).All the patients were treated with endovascular stents.The rates of the stenting success,improvement rate of stenosis post-stenting and incidence of complications were compared between the two groups.In 6～12 months follow-up,DSA reexamination was performed,and the scores of mRS and BI in patients with CI between pre and post-stenting were compared.Results The rate of stenting success in anterior circulation group was 92.3%,and 100% in posterior circulation group.The improvement rates of stenosis compared pre-stenting in the two groups were all above 70%.The incidence of complications was 19.2% in anterior circulation group and 7.7% in posterior circulation group.There was no statistical difference between the two groups.There were 10 cases in anterior circulation group and 5 cases in posterior circulation group received DSA reexamination,and 50% restenosis was found in the 2 cases(1 case in each group).In the period of the follow-up,the score of mRS and BI at the 6 months and 12 months post-stenting of patients with CI were significant improved than pre-stenting(all P

To investigate the effects of preoperative intravascular embolization on treatment of intracranial giant arteriovenous malformations (AVMs), 27 patients with intracranial giant AVMs were successfully treated from August, 1997 to April 1998 every patient was treated with preoperative intravascular embolization. Compared with single surgical resection, it was found that surgical resection after intravenous embolization can greatly reduce the intraoperative hemorrhage, diminish postoperative mortality and morbidity, and prevent normal perfusion pressure breakthrough (NPPB) significantly. The present study suggested that combination of surgical resection and intravascular embolization was an effect way in the treatment of giant cerebral AVMs.

ObjectiveTo study the efficacy of fluoxetine on improving depressive symptoms and activities of daily living(ADL) in early poststroke depressive patients.Methods42 early poststroke depressive patients (within 14 days after first stroke) were randomly divited into fluoxetine treatment group and control group (without antidepressive drugs).Evaluation was conducted before the treatment and at 4 and 6 weeks after treatment,using the Hamilton Depression scale(HAMD)and Barthel Index(BI).ResultsThere was no significant difference in HAMD and BI scores between the two groups before the treatment(P>0.05).At 4 and 6 weeks after the treatment, compared with the control group, the fluoxetine treated group demonstrated significant reduced in HAMD scores (P<0.001) and significant improvement in BI scores (P<0.01).ConclusionsFluoxetine is an effictive drug in improving depressive symptoms and ADL in early postsroke depressive patients.

Objective To study neuroprotective machanisms of Mannitol combined with Nimodipine in treatment of ischemic reperfusion injury in rats. Methods Seventy-two SD rats were randomly divided into six groups (Group A:sham-operated group;Group B:model group;Group C:low-dose Mannitol group;Group D:high-dose Mannitol group;Group E:Nimotop group;Group F:Mannitol combined with Nimotop group). Both nitrate reductase and TUNEL methods were respectively used to measure NO content and apoptotic neurons in the brains.Results NO content and apoptotic neurons were higher in group B than those in group A (P0.05). NO content and apoptotic neurons were lower in group F than in group C,D and E (all P

Objective: To investigate the Ventral Pallidrm′s function of cardiovascular adjustment by observing the changes of the rats′blood pressure. Methods:Ten SD rats′blood pressure were respectively observed through a catheter in one of the common carotid arteries after unilateral Ventral Pallidum stimulation by certain concertration,certain volume glutamate solution under stereotaxic guidance. Results:Glutamate stimulation on Ventral Pallidum caused elevation of the rats′blood pressure,thechanges were significant. Conclusion:Ventral Pallidum has a role in regulating blood pressure. It belongs to behavior related pattern and sympathetic regulated.

A cerebral arteriovenous malformation is a congenital disorder characterised by an abnormal connection between the arteries and the veins in the brain. It causes intracranial bleeding, seizures, severe headache, and progressive neurological deficits. The therapeutic strategies were usually established on the basis of clinical experiences due to lack of ideal models of arteriovenous malformation in the past .In order to further increase the success rate of surgery and decrease complications, this article reviews the advances in establishment and application of animal models of cerebral arteriovenous malformation in recent years.

BACKGROUND: Although improvement could be achieved after the first operation, limb symptoms of patients would aggravate with the progress or reoccurrence of Parkinson disease (PD), thereby second operation would become necessary if symptom could not be controllel by medication.OBJECTIVE: To investigate the improving rate of symptoms and complications of patients with PD after the second operation.DESIGN: Case analysisSETTING: Neurosurgery Department of 153th Military Central Hospital and Neurosurgery Department of Tangdu Hospital Affiliated to the Fourth Military Medical University of Chinese PLA.PARTICIPANTS: Totally 387 primary PD patients were collected from Neurosurgery Department of 153th Military Central Hospital and Neurosurgery Department of Tangdu Hospital Affiliated to the Fourth Military Medical College of Chinese PLA from October 1997 to December 2002.Totally 350 patients received two operations in the same hospital, and other 37 patients received the first operation at other hospital and the second operation in our hospital. The intervals of two operations were within half a year in 36 cases, 0.5-0.9 year in 72 cases, 1.0-1.9 years in 108 cases and 2.0-5.0 years in 171 cases respectively.METHODS: Under the stereotactic microelectrode-guidance, the targets of all patients were subjected to iconographical orientation, microelectrode record, microelectrode stimulation and exploration and radio frequency microelectrode verification before just stage bilateral posteroventral pallidotomy (PVP) or thalamus ventral intermediate nucleus damage(TVIND),unified Parkinson's disease rating scale (UPDRS) was used at preoperative and postoperative "on" state (at the beginning of medication, patients move freely and stays in "on" state) as well as "off" state (when medication loss function, patients displays moving disability and stays in "off" state).complication between two operation .RESULTS: Data of 387 patients were remained in the results analysis.operation was lower than that of first operation (tremor 95.4%, 96.9%;rigidity 94.6%, 95.1%; bradykinesia 88.9%, 92.3%; gait 62.3%, 67.1%;balance 65.1%, 69.4%, akinesia and cramp 95.8%, 98.0%), but no diffor UPDRS were lower than that of preoperative scores (P ＜ 0.01). The mean total UPDRS scores improved by 46.8% in the "on" state and 53.5% in the "off" state after second operation, lower than that of first tive complications: The occurrenceof complications that was specific for the second operation including fatigue, salivation, reduced voice, fake bulbar paralysis, lethargy, hiccough, urinary incontinence, urinary retention were found higher than that of after the first operation (P ＜ 0.05).The occurrence of cerebral hemorrhage was also lower than that of after first operation.UPDRS were lower in the second operation, which may be due to that PD of postoperative complications which was specific for the second operation was obviously increased, which possibly associated with age, state of illness, constitution, operation type and interval between operations. But occurrence of non-specific postoperative complications was basically the same in two operations (cerebral hemorrhage and inflammation), suggesting that hemorrhage risk did not increased due to the second operation.