Objective Investigation of the clearance rate of RBC in cerebral spinal fluid(CSF)after lumber subarachnoid space continuous drainage following subarachnoid hemorrhage(SAH)and the relationship with cerebral vasospasm(CVS) were carried out. Methods An experimental SAH was achieved in dogs by twice injecting fresh autologous arterial blood into cisterna magna of each animal.RBC counts in CSF were measured in the drainage group, puncture group and control group respectively.The degrees of CVS were analyzed through cerebral angiography(%reduction of basilar artery diameter,%RBAD). Results Comparing with puncture group and control group, the drainage group showed a significantly higher clearance rate of RBC with lesser occurrance and degree of CVS. Conclusions RBC and its degeneratives in CSF may be involed in the process of CVS following experimental SAH. Continuous lumber subarachnoid space drainage may prevent CVS.

Genes, Reporter ; Genetic Vectors ; Luciferases ; genetics ; Transcription, Genetic ; bcl-2-Associated X Protein ; genetics

Objective: To investigate the hyponatremia incidence in patients with ruptured intracranial aneurysms and the correlation with Fisher grading and cerebral vasospasm. Methods: Totally 150 patients with ruptured intracranial aneurysms from March 1998 to May 2001 were divided into anterior communicating artery (ACoA) group,posterior communicating artery (PCoA) group and middle carotid artery(MCA) group according to the sites of aneurysms.The patients were treated with GDCs interventionally and the incidences of hyponatremia were analyzed. Results: The incidences of hyponatremia in 3 groups were 48%(32/67),15%(8/52) and 16%(5/31),respectively; The incidences of severe hyponatremia of 3 groups were 30%(20/67),6%(3/52) and 6%(2/31), respectively. In ACoA group, the incidences of hyponatremia in Fisher grade Ⅲ-Ⅳ and Ⅰ-Ⅱ were 67%(20/30) and 32%(12/37) and the incidences with and without vasospasm were 71%(24/34) and 24%(8/33), respectively. Conclusion: The ACoA group has a significantly higher incidence of common and severe hyponatremia than the other groups. In ACoA group,hyponatremia is significantly more often in Fisher grade Ⅲ-Ⅳ cases and those with vasospasm.

OBJECTIVE:To discuss the correlation between Interntion Normalized Ratio(INR)with concentration of warfarin enantiomer and dose density after cardiac valve replacement. METHODS:The plasma concentration of R-warfarin or S-warfarin, dose of unit weight and INR of 176 patients with anticoagulation after cardiac valve replacement in each time point were moni-tored,and the correlation of INR and warfarin plasma concentration or dose was observed. RESULTS:Doses of all patients in 24-288 h were significantly higher than 0 h,the differences were statistically significant(P<0.001),the dose was fluctuated within a certain range after 96 h,and compared with 96 h,there were no significant differences(P>0.05). Average plasma concentration of R-warfarin or S-warfarin had consistent trend,plasma concentration of enantiomers was fluctuated within a certain range after 108 h,there were no significant differences(P>0.05). Compared with 0 h,there was no significant difference when INR was 12 h (P>0.05),it increased significantly in 36 h and had been increasing,then fluctuated within a certain range after 108 h,compared with 108 h,there were no significant differences(P>0.05). The correlation coefficient between INR and unit weight dose of warfa-rin in 60 h>36 h>12 h,it showed correlation(P<0.001). There was certain correlation between plasma concentration of warfarin and dose density in 12,36 and 60 h. CONCLUSIONS:The correlation between plasma concentration of warfarin and unit weight dose is stronger than the correlation between INR and unit weight dose. When combined with other coagulation,it may help to man-age warfarin dose.

Objective To evaluate the clinical outcome of one-level posterior lumbar interbody fusion (PLIF) performed with microendoscopic approach.Methods A consecutive series of 56 patients who under went one-level PLIF procedure(24 cases performed with microendoseopic approach and 32 cases with tradition- al open approach)were studied from January 2005 to May 2006.The following data were compared between 2 groups with 12 to 27 months follow-up:estimated blood loss,postoperative drainage,transfusion needs,surgi- cal time,length of hospital stay,postoperative back pain by visual analogue scale,complications,and the clinical and radiographic results.Results The microendoscopic approach was found to have a significantly less blood loss,less postoperative drainage,less needs of transfusion,less postoperative back pain,shorter re- covery time and shorter length of hospital stay.However,the microendoscopic approach needed significantly longer surgical time.There was no significant difference between 2 groups in the aspects of the complications and the clinical and radiographic results.Conclusion The one-level PLIF performed with microendoscopic approach minimize estimated blood loss,length of hospital stay,postoperative back pain.It also shows the ex- cellent surgical efficacy of the microendoscopic approach for suitable patients.

AIM:To detect the activation of macrophage autophagy caused by lipopolysaccharide ( LPS) and the possible related signaling pathways .METHODS:The macrophage cell line RAW264.7 cultured in vitro was divided into 5 groups according to the culture environment , including normal culture group , starvation-activated sautophagy group , LPS group, LPS+PI3K inhibitor (hVps34) group and LPS+mTOR inhibitor (rapamycin) group.Fluorescent expression vector pcDNA3.1-GFP-LC3 constructed in previous work was transfected into the macrophages .The fluorescence microscopy was used to detect the formation of autophagosome .The mRNA expression of autophagy-associated genes Atg5, Atg7, LC3-II and Bnip3 in the macrophages was detected by qRT-PCR.The protein levels of LC3-II, p-Akt and p-mTOR were deter-mined by Western blotting , so as to evaluate the molecular pathways of autophagy in LPS-activated macrophages .RE-SULTS:The macrophages stably expressing GFP-LC3 were successfully established , which were used to observe the auto-phagy under fluorescence microscope .Compared with normal culture group , the autophagy in starvation group , LPS +hVps34 group and LPS+rapamycin group was significantly increased .The mRNA expression levels of Atg5, LC3-II and Bnip3 were significantly increased in starvation group , LPS+hVps34 group and LPS +rapamycin group , while in LPS group, those decreased slightly .The protein level of p-Akt in starvation group , LPS group and LPS+rapamycin group was significantly increased , while p-mTOR in starvation group , LPS+hVps34 group and LPS+rapamycin group significantly declined .LC3-II expression level in starvation group , LPS+hVps34 group and LPS+rapamycin group was higher than that in control group and LPS group .CONCLUSION: LPS regulates macrophage autophagy , and its possible pathway is the PI3K/Akt/mTOR pathway, but there are some other effective regulatory pathways .

Objective To determine the effect of nanochemotherapy drug on Survivin and p53 ex-pressed by human biliary traet carcinoma cell line QBC939.Methods Culturing the human biliary tract carcinoma cell line QBC939 in vitro and it was divided into five groups including saline,nanochemotherapy drug,nanopartiele withoul nanochemotherapy drug,5-FU and gemcitabine.Using the methods of MTT and flow cytometry to observe the growth of QBC939 which was dealt with different drugs.In addition,RT-PCR and Western blot were used to delect the expression of mRNA and protein by Survivin or p53.Results The expression of mRNA and protein by Survivin decreased in the following set:saline,nanoparlicle withoul nanochemotherapy drug,5-FU,gemcitabine and nanochemotherapy drug,respeclively.However,the ex-pression of mRNA and protein by p53 were in reverse order.The inhibiting action to QBC939 was obvious in nanochenmtherapy drng and the apoplotic rate was higher than others except for gemcitabine(P＜0.05). Conclusion Nanochemotherapy drug has significant effect on treatment cholangiocarcinoma in vilro,which may attribute to the down regulation of Survivin and up regulation of p53.

Objective To investigate the relationship between HbA1c in blood and IL-6 in tear fluid of the elderly patients with diabetic retinopathy ( DR ) in Shijiazhuang urban communities , and the relationship between IL-6 in tear fluid and the severity of DR. Methods The elderly people who lived more than 5 years , older than ≥45 year old. in nine urban communities of Shijiazhuang were stratified randomly sampled and received cross-sectional epidemiology questionnaire survey and OGTT. A total of 1 447 subjects (509 males and 938 females) were included. Each participant underwent epidemiological surveys and oral glucose tolerance test (OGTT), according to the 1999 WHO diabetes mellitus (DM) diagnostic criteria established. For patients who were newly or previously diagnosed as DM. HbA1c level, tear fluid IL-6 and serum IL-6 tested.The severity of DR was evaluated by fundus examination, the people were divided into normal group(NGT), non-diabetic retinopathy ( NDR ) , non-proliferative diabetic retinopathy ( NPDR ) , and proliferative diabetic retinopathy ( PDR ) . The correlation of serum IL-6 and tear fluid IL-6,blood HbA1c and tear fluid IL-6 were assessed by SPSS 19.0 statistical software. Results Concentrations of tear fluid IL-6 were (3.10 ± 1.25)pg/mL in the NGT group, (10.25 ± 3.22)pg/mL in the NDR group,(16.80 ± 5.76)pg/mL in the NPDR group,(25.11 ± 5.20)pg/mL in the PDR group(P < 0.01). SNK-q test revealed significant differences between every two groups (P < 0.01,P <0.05,P < 0.05) Concentrations of serum IL-6 were (88.04 ± 17.06)pg/mL in the NGT group,(126.38 ± 20.73) pg/mL in the NDR group, (239.83 ± 40.33)pg/mL in the NPDR group, (268.36 ± 27.72)pg/mL in the PDR group(P < 0.01). SNK-q test revealed significant differences between every two groups (P < 0.01). Tear fluid IL-6 level was positively correlated with serum IL-6 level(R = 0.756,P < 0.01). Tear fluid IL-6 level was positively correlated with blood IL-6 level (R = 0.338, P < 0.01). Conclusion The tear fluid IL-6 levels of the elderly patients with DM in Shijiazhuang urban communities , increased; with the increased severity of DR , the levels of tear fluid IL-6 gradually increase. The level of tear fluid IL-6, serum IL-6, HbA1c closely correlates with the severity of DR.

· Basal ceil carcinoma (BCC) is one of the most common human cancers. The giant ulcerated BCC invading the eyeball and orbit has been rarely reported. We present a case of giant BCC with cutaneous ulcer on the left head,invading the eyeball, orbit and skull.

Objective To study the changes of somatostatin(SOM) in plasma and cerebrospinal fluid (CSF) of children with convulsive diseases.Methods Sixty-seven children with convulsive diseases were studied as following:obtaining the samples of plasma in the 1st and 7th day after being in hospital,and the samples of CSF in the 1st after being in hospital.We investigated the changes of SOM in plasma and CSF with radioimmunoassay(RIA).Results 1.Convulsive group:the concentration of SOM in plasma in the 7th day(29.47?9.40 ng/L) was significant lower than that in the 1st day(39.23?11.00 ng/L)(t=21.530 P0.05).The concentration of SOM in plasma in the 1st day in control group was(19.58?6.04) ng/L.There were significant differences in convulsive group and encephalitis group without convulsion, control group(t= 6.847,7.921 P