OBJECTIVE: Aneurysmal subarachnoid hemorrhage is mainly due to intracranial aneurysm rupture. Modern techniques enable most survivors to make a good functional recovery Nevertheless,it has been suggested that such patients suffer from a persistent disturbance of cognitive function,which affects their life quality. Therefore,cognitive assessment following aneurysmal subarachnoid hemorrhage has been gradually drawing increasing attention in recent years.DATA SOURCES: Related literature was searched through the computer in PUBMED with key terms of "aneurysmal subarachnoid hemorrhage" and"cognitive deficit" and the language was limited to English. Meanwhile literature between 2001 an.d 2004 was also searched with key terms of"subarachnoid hemorrhage" and "cognitive function" in the Chinese or English language,respectively.STUDY SELECTION: Literature with cognitive assessment as its main index determined by standardized measurement was enrolled in this study.DATA EXTRACTION: A total of 101 related articles were collected,including 15 ones closely related to the present study,while those with cognitive assessment as part of their content and cognitive function determined with new methods were excluded.DATA SYNTHESIS: Cognitive assessment was analyzed in respect of its content,measurement,results and risk factors. Effect of aneurysmal subarachnoid hemorrhage itself and its complications,as well as therapeutic methods on the onset and development of cognitive disturbance were also explored.CONCLUSION: Patients with aneurysmal subarachnoid hemorrhage suffer from cognitive impairment,which also results from operation,anesthesia and drugs.

Objective: To determine the frepuency and severity of cognitive impairments associated with aneurysmal subarachnoid hemorrhage. Methods: A series of 37 patients with aneurysmal subarachnoid hemorrhage were examined by means of a battery of cognitive tests before surgical treatment. Results: In 70.3% of the patients, one or more cognitive functions were impaired. Compared with normative data, 2.7% of patients showed impairment on arithmetic, digit symbal and picture complement respectively, 5.4% on digit span, 48.6% on Visual Reproduction , 27%(food) and 18.9% (ordinary tools) on verbal fluency test, 18.9%(part A) and 21.6% (part B) on trail-making test,?18.9% on MMSE (mini mental state examination). Conclusion: The patients have impressive cognitive deficits after aneurysmal subarachnoid hemorrhage. SAH patients were especially impaired in functions that are related to short-term memory, concentration capacity, and frontocortical functions.

Objective To probe the effects of the size and location of cranial defect on the neurological symptoms of patients with skull bone defect.Methods The patients were classified into the following groups according to the influence to symptoms by changes in body position and changes of symptoms before and after craniectomy: True syndrome of the trephined(ST,Ⅰ), partial ST patients(Ⅱ), other patients or symptom-free patients (Ⅲ).Results The group I consisted of 33 cases, their defects were located in the parieto-occipital region in 23 cases, frontoparietal in 10 cases. All these patients had flaccid skin flaps that became concave while in the upright position. The group Ⅱ was composed of seven cases, their defects were located in frontoparietal and parieto-occipital region in three respectively. All these patients had flaccied skinflap in defects pars.Group Ⅲ included twelve patients, flat and rigid skin flaps were usually demonstrated , predominantly in the tempora and parietal regions.Conclusions The size and location of the cranial could play an important role in the development of the neurological symptoms.

Objective To investigate the effect of metformin on the osteogenic differentiation of human mesenchymal stem cells exposed to PMMA particles. Methods Human placental mesenchymal stem cells were iso-lated and cultured in vitro. The effect of metformin with different concentrations on cell viability was determined by CCK8 assay. The effect of metformin on the mRNA expression of osteogenic genes was detected by using real-time RT-PCR. Calcified nodules were stained by alizarin S. The effect of metformin on the expression of eNOS was also detected by using real-time RT-PCR. Results PMMA particles could inhibit the viability of mesenchymal stem cells. Metformin(0.05 mmol/L)could promote the viability of mesenchymal stem cells exposed to PMMA particles. Metformin(0.05 mmol/L)could increase the expression of osteogenic genes,including OCN,RNUX2,and ALP, in human mesenchymal stem cells exposed to PMMA particles. The calcium deposit was also increased after metfor-min treatment. Results of real-time RT-PCR showed that metformin could increase the expression of eNOS in human mesenchymal stem cells exposed to PMMA particles. Conclusions Metformin can increase the osteogenic differentiation of human mesenchymal stem cells exposed to PMMA particles,partially by inducing eNOS expression.

[Objective]To evaluate the outcome of thoracolumbar fracture with spinal cord injury treated with short-segment pedicle instrumentation.[Method]47 cases of thoracolumbar fracture with spinal cord injury from 1999 to 2004 in our department were collected,all of them were treated with short-segment pedicle instrumentation.The radiologic,neurologic,and functional outcome were assessed.[Result]All of the 47 cases were followed up,the mean follow-up were 51.9 months(18~ 86 months),the average of vertebral anterior and posterior height were corrected from 43.6%,71.4% to 92.2%,96.4%;and 88.3%,93.1% at the last follow-up separately.The Cobb's angle were corrected from 23.5?to 4.3?,and 8.8? at the last follow-up.62.8% of the vertebral canal was occupied pre-operation,and 11.4% post-operation,6.2% at last follow-up.There was significant deference in targets between pre-operation and post-operation(P0.05).Neurologic status improved at least 1 Frankel grade in the patients who had preoperative incomplete paraplegia.61.7% of patients returned to work.[Conclusion]Short-segment pedicle instrumentation can provide good reduction,strong fixation,complete decompression and fusion.The treatment outcome is good.Moreover,it is a less traumatic,simple and safe technique.

BACKGROUND: Neuroprotective role of hypothermia on cerebral ischemic-reperfusional impairment has been long acknowledged. Since general hypothermia is complicated and unfit for observing postoperative consciousness and neurological function, it is of important significance to explore novel methods of focal cerebral hypothermia.OBJECTIVE: To study the neuroprotective effect of lateral ventricle infusion of low-temperature fluid on ischemic neurons of middle cerebral artery (MAC) occlusion models established on New Zealand rabbits.DESIGN: A randomized case-control study based on experimental animal models.SETTING: Neurosurgical department and pathological department of a general military hospital of Chinese PLA.MATERIALS: This study was carried out at Neurosurgical Laboratory of Nanjing General Hospital, Nanjing Military Area Command of Chinese PLA. Altogether 18 healthy New Zealand male rabbits, weighing from 2. 8 to 3.2 kg, were selected 4 - 6 months after birth, and randomly divided into occlusion group, hypothermia group and control group.INTERVENTIONS: Cerebral focal ischemic-reperfusional model was established on the New Zealand rabbits through MCA occlusion for 2 hours followed by reperfusion for 24 hours.MAIN OUTCOME MEASURES: Scores for neurological function, water content in the left and right brain, pathological changes of nerve cells in the left MCA supplying region.pothermia group, significantly higher than that in occlusion group(7.58 ± 0.58 )( P ＜ 0.01 ), but no significant difference could be observed in contrast with brain was(81.64 ± 0.82)% and (79.26 ± 1.30)% in occlusion and hypothermia groups with significant difference between them( P ＜ 0.05), and it was significantly different between the left side [ (81.64 ± 0. 82 )% ] and opyknosis and deep staining could be observed in nerve ganglion cells in occlusion group under optical microscope, but no obvious pathological changes were observed in MCA supplying brain regions in hypothermia group.CONCLUSION: Permanent infusion of low-temperature fluid into the lateral ventricle plays an important neuroprotective role by attenuating cerebral ischemic-reperfusional impairment and improving post-ischemic neurological functions.

Objective To investigate the anti-inflammatory mechanism by which curcumin affects TNF-αand IL-8 production in Propionibactierium acnes-induced THP-1 cells. Methods THP-1 cell viability was determined by CCK8 assay. The productions of TNF-α and IL-8 were detected by ELISA assay. Total RNA and proteins were collected for real-time PCR and Western blot analysis, respectively. Results Curcumin didn′t significantly affect the cell viability at 12 h. It decreased Propionibactierium acnes-induced productions of TNF-αand IL-8 in THP-1 cells. Moreover, it decreased TLR2, NF-κB p65, and P-NF-κB p65 expressions in THP-1 cells. Conclusions Curcumin may reduce TNF-α and IL-8 expressions in Propionibactierium acnes-induced THP-1 cells by inhibiting TLR2/NF-κB signaling pathway.

Objectives:To explore the protective effects of continuous trickle of low temperature liquids through the lateral ventricle on neurons after rabbit local cerebral ischemia reperfusion. Methods: The middle cerebral artery (MCA) of New Zealand rabbit was clipped with micro aneurysm clip for 2 hours and reperfused for 24 hours. Immediately after clipping the MCA, we trickled the left lateral ventricle continuously with low temperature liquids to decrease the brain temperature to mild hypothermia(32-35℃) and maintained for 2 hours. After reperfusion for 24 hours, we assessed the animal's neural deficits, observe the pathology of the ischemic brain tissues dyed by HE and determined the dry wet ratio for brain edema in the sham operated group, the control group and the mild hypothermia group respectively.Results:①The grades of neural deficits in mild hypothermia group were obviously lower than that in the clipping group( P 0.05 );②The dry wet ratios were obviously different in the mild hypothermia group and clipping group;③ Pyknosis and dense dying by HE were observed in the neural nuclei of ischemic cortex tissues of the clipping group, but no obvious changes were observed in the mild hypothermia group. Conclusions:Trickling ventricle with low temperature liquids could alleviate cerebral ischemia reperfusion injury, ameliorated neural deficit after ischemia reperfusion and were protective on the brain.

Objective:To study the relationship between the recurrence of benign meningiomas and cell proliferation, and to find some parameters that can predict the recurrence of benign meningiomas. Methods:49 samples from 15 recurrent benign meningiomas and 22 non recurrent benign meningimas were immunohistochemically stained with PCNA antibody and Ki 67 antibody.The ratios of positive tumor cells were calculated,then PCNA LI and Ki 67 LI of different groups were compared. Results:PCNA LI or Ki 67 LI in recurrent benign meningiomas was significantly higher than non recurent benign meningiomas individually( P 0.05). Conclusion:The proliferative potential of recurrent benign meningiomas was higher than that of non recurrent benign meningiomas.When the PCNA LI was greater than 2.0%,the recurrent risk was high.The proliferative potential did not increase when benign meningiomas recurred.

Objective:To explore a simple and effective method of local hypothermia, and to testify its neuroprotective effects . Methods:This experiment adopts twelve adult and healthy New Zealand rabbits as experimental animals. These rabbits were randomly assigned to two groups : ① MCAO (n=6),② MCAO and hypothermia (n=6). The middle cerebral artery (MCA) was exposed through the left orbital approach, and was clipped 2 hours by a 3 mm straight aneurysm clip to establish the MCAO model. We assign 2 cavities ventricle tube to puncture the frontal angle of the lateral ventricle, then 22℃ physiological brine was dropped into the lateral ventricle to reduce the brain temperature in MCAO and hypothermia group. Temperature thermister probes were inserted for measuring the brain and rectal temperatures. The neurological deficits and histological changes of brain tissue were evaluated in all experimental animals.Results: Brain temperature below cortex was descend to 35℃within 20 minutes after hypothermia in MCAO and hypothermia group while rectal temperature has maintained normal. The neurological deficits and histological changes of brain tissue of MCAO and hypothermia group were better than those in MCAO group. Conclusion: The local intra-ventricle hypothermia model is a reliable, cooling rapidly and useful method for selective brain cooling.