ObjectiveTo evaluate the safety and efficacy o f microvascular deco mpression in the management of primary trigeminal neuralgia.Methods We review ed 13 patients with unilateral primary trigeminal neuralgia treated by microvasc ular decompression. Conventional spin-echo (SE) sequence and 3-D fast inflow wit h steady-state precession (3-D-FISP) sequence MRI scans were used preoperatively to find evidence of neurovascular compression. The operation was accessed by re trosigmoidal approach and the nerve root was separated away from pressure vessel s by artificial vascular patch.ResultsDuring operations it w as found that tr igeminal nerves were pressed on by blood vessels in all the cases (by the superi or cerebellar artery in 11 cases; by the basilar artery and the superior cerebel lar artery in 1 case; and by the vein in 1 case). Complete pain relief was achie ved in all the patients without mortality or permanent complications. Eleven pat ients were clinically followed for 6～24 months with a mean of 13 months, and no recurrence was seen. ConclusionsMicrovascular decompression is a safe and effective procedure in the treatment of primary trigeminal neuralgia.

ObjectiveTo evaluate the significance of pirif orm aperture enlarge ment in transsphnoid approach microsurgery for pituitary macroadenomas.MethodsTranssphnoidal approach microsurgery through enlarged pyrifor m aperture was ca rried out in 96 patients with pituitary macroadenoma from March 1997 to October 2000.ResultsAmong the 96 patients, 65 (67 7%) underwent tot al removal of the tumor, 25 (26 0%) underwent subtotal removal (80%～90%), and 6 (6 3%) partial removal (

Scientific and rigorous management system is the prerequisite for specialists to standardize training.In order to cultivate and promote the actual clinical ability,the First Clinical College of Harbin Medical University establish a scientific,reasonable,standard and strict evaluation system in specialist training - the Mini-CEX.This system was employed to test on completion of a course and meet the current medical development of specialist training and evaluation mode.

Objective To investigate the role of local aldosterone system in oncofetal fibronectin ( oncofetal FN) mRNA expression and reactive oxygen species (ROS) production in human mesangial cells (HMCs) exposed to short-term intermittent high glucose and the effect of Fenofibrate.Methods The HMCs were divided into 8 groups:normal glucose(NG) ;osmotic fluctuation(OF) ;mean glucose load (MGL) ;stable high glucose (SHG),short-term intermittent high glucose (IHG) ; intermittent high glucose plus eplerenone (IHGE) ; intermittent high glucose plus fenofibrate(IHGF) ; and normal glucose plus fenofibrate (NGF) groups.The mRNA expression levels of Aldosterone synthase ( CYP11 B2 ),11 β-hydroxysteroid dehydrogenase type 2 ( 11βHSD2 ) and oncofetal FN were determined by RT-PCR.The expression of CYP11B2 protein was determined by western-blot.Aldosterone level in cell culture supernatant was detected by radioimmunoassay.The expression and translocation of mineralocorticoid receptor (MR)protein were assayed with confocal laser scanning microscopy. ROS levels were determined by Fluorescence microscopy and fluorescence microplate reader.Results ( 1 ) MGL,SHG,and IHG groups showed a 2.41,3.63,and 4.45 times increase in CYP11B2 mRNA expression,and a 1.83,2.15,and 2.78 times increase in CYP11B2 protein expression,respectively,compared with NG group (P ＜ 0.05 ).The aldosterone levels of HMCs culture supernatant in MGL,SHG,and IHG groups were also increased,being 1.49,2.04,and 2.54 times of that in NG group ( P＜0.05 ),and the degree of elevation in IHG group was more marked than that in SHG group( P＜0.05 ).MR was activated and translocated from cytosol to nucleus in MGL,SHG,and IHG groups.Quantitative analysis showed the ratioes of cytosol/nucleus fluorescence intensity in MGL,SHG,and IHG groups were 15％,38％,and 53％ decreased as compared with that in NG group,and the decrease was more marked in IHG group ( P＜0.05 ).(2) Oncofetal FN mRNA expression and ROS levels in MGL,SHG,and IHG groups were increased,being 1.54,2.31,3.65 and 1.26,1.91,2.48 times of those in NG group,respectively ( P＜0.05 ),and this increase was more marked in group IHG ( P＜O.05 ).Compared with IHG group,oncofetal FN mRNA expression and ROS levels in group IHGE were significantly decreased by 54％ and 53％,and in group IHGF by 45％ and 39％. ( 3 ) CYP11B2 mRNA,protein,and aldosterone levels in IHGF group were decreased by 74％,59％,and 50％,and the activation of MR in group IHGF was inhibited when the ratio of cytosol/nuclear fluorescence intensity was increased 1.88 fold as compared with that in group IHG ( P＜0.05 ).Conclusions Increased expressions of oncofetal FN and ROS by HMCs induced by short-term intermittent high glucose were nore marked than those induced by stable high glucose.The mechanism was associated with activation of local aldosterone system.Fenofibrate may inhibit the activation of local aldosterone system and alleviate the injury to HMCs induced by intermittent high glucose.

Objective To identify the nanobaeteria in prostate fluid of patients with CPPS.Methods Expressed prostatic secretion(EPS)and urine specimens were collected by Meares-Stamey way from CPPS patients(n=100)and normal controls(n=100).The specimens were cultured and nanobacteria was identified by indirect immunofluoreseenee staining with rnonoelonal antibody.The morphological features were observed by using transmission electron microscopy(TEM). Results The positive rate of nanobaeteria in the EPS cdture of CPPS patients and controls were 43% and 5% respectively,with significant statistical difference(X2=39.58,P＜0.01).By TEM,the sizes of NB ranged from 100 to 500 nm and appeared eoccoid-ccccobacillary shape. Conclusion Nanobaeteria infection may exist in EPS of CPPS patients.

BACKGROUND:Breast cancer stem cel s have a greater impact on the occurrence and metastasis of breast cancer. Under simulated tumor microenvironment, we can better analyze the proliferation and differentiation of breast cancer stem cel s. OBJECTIVE:To explore the tumor microenvironment effect on the differentiation of breast cancer stem cel s. METHODS:Breast cancer cel s and MCF-7 cel s were primarily cultured in fibroblast supernatant and serum-free PCM-2 medium, and formation of breast cancer cel s microspheres was observed. Proliferative ability of breast cancer cel s was detected using MTT colorimetry, and the surface markers of breast cancer stem cel s and epithelial-mesenchymal transition markers were measured using immunocytochemistry and RT-PCR methods. RESULTS AND CONCLUSION:The diameter of primary cel microspheres was larger in the serum-free PCM-2 medium than in the fibroblast supernatant, but the culture speed was faster in the fibroblast supernatant than the serum-free PCM-2 medium. At 3 days of primary culture, the expression of ALDH1 in primary cel s was greatly higher in the serum-free PCM-2 medium than in the fibroblast supernatant. However, the expressions of E-cadherin and vimentin were up-regulated in the fibroblast supernatant than in the serum-free PCM-2 medium. In addition, the expressions of E-cadherin and vimentin in MCF-7 cel s cultured in the fibroblast supernatant were up-regulated, while the expressions of ALDH1 and Oct-4 were downregulated. These findings indicate that the tumor environment has some certain effects on the growth and differentiation of breast cancer stem cel s, and some cytokines secreted from fibroblast supernatant can promote the proliferation and differentiation of breast cancer stem cel microspheres to some extent.

Rat models of diabetes were established by injecting streptozocin intraperitoneally.According to random number table,three groups were divided:normal group,diabetic group,and fisetin-treated group.After 24 weeks,all rats were sacrificed.Biochemical parameters of blood and urine samples were tested.The pathological changes were observed by paraffin sections staining with HE.The expression of extracellular matrix proteins was analyzed via PAS and Masson staining.Location of p300 protein expression was analyzed by immunohistochemistry.The protein expressions of p300 and MMP-2 were determined by Western blotting.The mRNA expressions of MMP-2 were analyzed via real-time PCR.The biochemical parameters and kidney pathological images in fisetin-treated group were better than those in diabetic group.The expression of extraeellular matrix proteins was lower than that in diabetic group.Immunohistochemistry analysis showed that among three groups the expression of p300 was mainly in glomeruli,and was also expressed in cell nucleus and cytoplasm and the coloration of fisetin-treated group was weakened as compared with diabetic group.Western blotting analysis showed that the expression of p300 protein in fisetin-treated group was lower than that in diabetic group(P＜O.05).The expressions of MMP-2 mRNA and MMP-2 protein were higher than those in diabetic group (P ＜ 0.05).It is suggested that fisetin may attenuate diabetes associated abnormalities in the kidney of rats,owing probably to inhibiting the expressions of p300 and enhancing the expressions of MMP-2.

Objective To compare the application of two different radial artery puncture and cannulation methods in septic shock patients. Meth-ods A total of 80 septic shock patients who need emergency operation were enrolled in this study. The shock index was>1.0. The patients were randomly divided into two groups:ultrasound group(group U)and palpation group(group A),with 40 cases in each group. For the patients in group U,Sonosite S-Nerve ultrasound in the wrist was used to determine the location of the radial artery puncture. For the patients in group A ,pal-pation method was used to determine the location of the radial artery puncture. The heart rate,blood pressure,first puncture success rate,total suc-cess rate,number of punctures,puncture time and complication rate of the two groups were monitored. Results The success rate of first puncture and total success rate of group U were higher than those of group A ,the number of puncture was less than that of group A ,the puncture time was shorter than that of group A,and the incidence of complications was lower than that of group A(P<0.05). Conclusion The application of ultra-sound for radial artery puncture and catheterization in septic shock patients is accurate ,and with higher first success puncture rate and total success rate,less number of puncture,shorter puncture time,and lower incidence of complications compared with palpation method.

Objective To investigate the relationship between the expression of β-glucuronidase mRNA in hepatocellular carcinoma(HCC)tissue and the clinicopathologic factors.Methods The expressions of β-glucuronidase mRNA in 25 samples of HCC tissue and 10 samples of normal hepatic tissue were detected by RT-PCR,and the relationship between β-glucurenidase mRNA in HCC tissue and clinicopathologic factors was analyzed.Results The expression of β-glucuronidase mRNA in HCC tissue was not influenced by the age of patient,tumor size and alpha-fetoprotein level.The expression of β-glueuronidase mRNA in patients with portal vein tumor thrombus or lymph node metastasis Was significantly higher than those without(t=7.857,9.341,P＜0.05).Conclusions The expression of β-glucuronidase mRNA is closely related to the existence of portal vein tumor thrombus and lymph node metastasis.β-glucuronidase may play a role in the invasion and metastasis of HCC.

0.05).However,the expression content of ?-G mRNA in hepatocellular carcinoma tissues was 3.88?0.86,which was significantly higher(P