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.

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

To study the changes in levels of tumor necrosis factor ? (TNF ?), interleukin 6 (IL 6) and interleukin 1? (IL 1?) produced by the peripheral blood mononuclear cells (PBMC) of patients with congestive heart failure (CHF), and to investigate the effects of captopril, one of angiotensin converting enzyme inhibitors in active form, on production of these cytokines. PBMC from 35 CHF patients and 12 healthy controls were isolated by density centrifugation with Ficoll Hypaque, and were cultured with captopril at 10 -4 ～10 -2 mol/L in the presence of lipopolysaccharide (LPS). After incubation for 24 hours, TNF ? and IL 6 contents in the culture supernatants were measured by an enzyme linked immunosorbent assay (ELISA), and IL 1? by radioimmunoassay (RIA). The results showed that PBMC from CHF patients released significantly more TNF ?, IL 6 and IL 1? compared with cells from controls ( P

Objective To observe the pharmacological characteristics of a novel antihypertensive drug iptakalim hydrochloride (Ipt) by dilating large and small arteries. Methods The vasodilating action of Ipt was studied using isolated rat tail artery helical strips and aortic rings. Results The vasodilating action of Ipt at 10 7-10 3mol/L was observed in rat tail artery strips precontracted with potassium chloride (KCl) in a concentration and endothelium dependent manner, but no significant vasodilating effect was seen on rat aortic rings. Ipt-induced relaxation in tail artery was significantly greater in spontaneous hypertensive rats than that in normotensive rats. The vasodilating actions of Ipt in small arteries could be markedly antagonized by glibenclamide, an inhibitor of ATP-sensitive potassium channels. Conclusion The results suggest that iptakalim hydrochloride has a selective vasodilating action in small arteries, and the action is related to activation of ATP-sensitive potassium channels.

Objective To detect mitochondrial gene 3243 A to 1507 Chinese and analyze their clinical characteristics.Methods Classical PCR－ RFLP was used to detect the mutation and statistical analysis was performed on the data after stratification in accordance with presence or absence of diabetes.Results (1)In this study,prevalence of mitochondrial gene 3243 A to G mutation was 1.16～ 1.20％ .(2)Compared with MDM(mitochondrial diabetes),M－ NGT(normal glucose to lerance with mutation)showed no significant difference in body fat parameters,blood lipid and C－ peptide except for early onset and hearing loss(P=0.0028).(3)Compared with type 2 DM,MDM presented characteristics of early onset,weight loss,hearing loss,islet cell function decrease and maternal hereditary.Conclusion Follow－ up should be given to the carrying the mitochondrial gene 3243 A to G mutation but presenting generally normal clinical manifestation in order to give the patient in－ time diagnosis and treatment.

Background and purpose:Lung cancer is currently the greatest threat to human life and health of the malignant tumor, clinical examination revealed a solitary pulmonary nodules (SPN), including a signiifcant portion of early stage lung cancer. The research aimed to discuss the diagnosis value of CT guidance Hookwire positioning thoracoscopic surgery for solitary pulmonary nodule. Methods:From Jul. 2011 to Jun. 2013, 310 SPN patients in the Department of Thoracic Surgery of Fudan University Shanghai Cancer Center were collected. Hookwire positioning pins were retained guided by CT scan into the patients’ body. Video assisted thoracic surgery (VATS) pulmonary wedge resection was adopted. According to the result of intraoperative frozen pathology, further treatment method was decided. Positioning accuracy, complications, VATS lung wedge resection surgery successful rate, transfer rate in the chest and SPN pathological classiifcation and other indicators were calculated with statistical methods. Results:Hookwire positioning successful rate was 100%, meanwhile, 2 patients with hemoptysis received symptomatic treatment.Intraoperative Hookwire fell off in 12 patients (3.87%), VATS wedge resection surgery successful rate was 99%, transit thoracotomy was carried out in 3 patients. SPN postoperative histological pathology results:237 cases with primary lung cancer, 73 cases with benign lesions. Conclusion:The method of CT guided Hookwire thoracoscopic surgery after positioning in treatment of SPN has higher diagnostic accuracy rate, reliable curative effect, fewer complications and great value in clinical promotion.

Tangdu hospital of the fourth military medical university explored the aim,method,critical points and effect for organizing a neurosurgical continuous education Journal club and summarized the key factors important for its successful organization and the improvement of its short-term and long-term educational effects in order to discover a Journal club education pattern which could satisfy the demand of for neurosurgical refresher doctors.Paying attention to these factors could better satisfy the demand of for neurosurgical refresher doctors,achieve their participating aims,promote their understanding of the advancing front of the discipline and improve their literature analyzing competence and problem solving ability.The wide application of continuous education Journal club is helpful to improve the level of neurosurgical continuing education in our country.

Host genes involved in lipid metabolism are differentially affected during the early stages of hepatitis C virus (HCV) infection.Here we demonstrate that artificial up-regulation of fatty acid biosynthesis has a positive effect on the replication of the HCV full-length replicon when cells were treated with nystatin.Conversely,the HCV RNA replication was decreased when fatty acid biosynthesis was inhibited with 25-hydroxycholesterol and PDMP(D-threo-1-phenyl-2-decanoylamino-3- morpholino-1-propanol).In agreement with these results,the expression level of GlcT-1(ceramide glucosyltransferase),a host glucosyltransferase in the first step of GSL (glycosphingolipid) biosynthesis,was found to be closely associated with the expression and replication of HCV RNA.On the other hand,the viral RNA can also activate GlcT-1 in the early stage of viral RNA transfection in vitro.To identify viral factors that are responsible for GlcT-1 activation,we constructed ten stable Vero cell lines that express individual HCV proteins.Based on the analyses of these cell lines and transient transfection assay of the GlcT-1 promoter regions,we conclude that HCV proteins,especially NS5A and NS5B,have positive effects on the expression of GlcT-1.It is possible that NS5A and NS5B stimulate transcription factor(s) to activate the expression of GlcT-1 by increasing its transcription level.

Objective To evaluate the efficacy and safety of small endoscopic sphincterotomy (EST) plus large balloon dilataion (EPLBD) for removal of common bile duct (CBD) stones larger than 12mm.Methods From June 2009 to December 2011,a total of 198 patients with CBD stones were randomly divided into two groups to receive EPLBD (n =100) or EST only (n =98).The rate of complete stone removal after the first session,the overall success rate of stone removal,the rate of using mechanical lithotripsy (ML),the rate of post procedure complication,procedure time and fluoroscopy time were compared between the two groups.Results The rate of complete stone removal after the first session in EPLBD group (89.0％) was significantly higher than that in EST group (71.4％,P ＜ 0.05).ML was required significantly more often in EST group (35.7％) compared to EPLBD group (12.0％,P ＜0.05).Total procedure time and total fluoroscopy time in EPLBD group (39.3 ± 15.8 min and 14.2 ±5.2 min) were significantly shorter than those of EST group (48.4 ± 19.3 min and 24.2 ±9.4 min,P ＜0.05).There was no significant difference between two groups in overall success rate of stone removal (97.0％ in EPLBD vs.93.9％in EST group,P ＞ 0.05) and the complications rate (8.0％ in EPLBD vs.13.3％ in ESTgroup,P ＞0.05).Conclusion EPLBD is as safe and effective as EST for common bile duct stones,larger than 12mm,and is more efficient in terms of procedure time,use of ML and success rate of stone removal.

Objective To compare the effect of difierent combinatio of mannitol, furesemide and albumin in reducing intracranial pressure in 451 patients with severe traumatic brain injury (sTBI). Methods A total of 451 patients with an admissiou Glasgow Coma Scale of or less from 5 medical centers were randomly divided into 5 groups, ie, Group A(250 ml 20% mannitol each time as control), Group B(125 ml 20% mannitol each time), Group C(alternate use of 250 ml 20% mannitol each time or 40 mg furosemide), Group D(alternate use of 125 ml 20% mannitol each time and 20 mg furosemide)and Group E(alternate use of 125 ml 20% mannitol and moderate or large dose of albumin). We monitored intracraniai pressure continuously and observed the changes of intracranial pressure, electrolytes, hemato-crit and renal function after use of 5 combinations of mannitol. Furosemide and albumin. Results Man-nitol and furosemide could independently reduce intracranial pressure after 1-3 hours (P<0. 05). Semis mannitol plus furosemide or albumin could more signifieantly reduce intracranial pressure, with statistical difference compared with full dose of mannitol. Semis mannitol and alternate use of mannitol and furose-mide in aspect of intracranial pressure reduction and persistence time(P<0. 05). Alternate use of man-nitol and furosemide begot higher incidence rate of electrolyte abnormality, compared with the other com-binations (P<0. 05). Rebound rate of intracranial pressure was higher in full dose of mannitol than other combinations (P<0. 05). Incidence of renal function abnormality was higher in combination involved al-bumin than alternative use of mannitol and furosemide as well as combination of semis mannitol and furo-semide (P<0. 05). Abnormality of electrolyte and renal function wag reversible. Conclusion The use of 125 ml 20% mannitol each time plus 20 mg furesemide is more reasonable than other combina-tions. Meanwhile, semis mannitol combined with moderate or large dose of albumin has certain advantages too.