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 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.

Objective: To explore the effects of continuous trickle of low temperature liquids through the lateral ventricle on neural cell apoptosis after rabbit local cerebral ischemia/reperfusion. Methods:The middle cerebral artery (MCA) of New Zealand rabbit was clipped by 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(22℃) to decrease the brain temperature to mild hypothermia (33℃-35℃)and maintained for 2 hours. After reperfusion for 24 hours , we assessed TUNEL method to determine the apoptotic cell rate in the sham-operated group, the control group and the mild hypothermia group respectively. Results:The apoptotic cell rate of the cortex tissues accommodated by MCA in the mild hypothermia group was obviously lower than that in the control group(P0.05). Conclusion:Trickling ventricle with low temperature liquids could decrease the apoptotic cell rate and alleviate cerebral ischemia/reperfusion injury.

OBJECTIVE To strengthen the hospital infection management in community health service centers,in order to reduce the onset of hospital infection.METHODS According to Hospital infection administration regnltions and Shenzhen medical service hospital infection control quality evaluation management demands we had investigated and evaluated the hospital infection management in 9 community health service centers.RESULTS The monitoring,surveillance and management of hospital infection in community health service centers as a quality evaluation index of hospital medical service still had many problems,it should further enhance the quality in the field of administration management,sterilization and disinfection,surveillance and sevage treatment.CONCLUSIONS The hospital infection management in community health service centers is a part of whole hospital medical service,but their quality at present is weak.To strengthen the hospital infection management is important to guarantee the medical service quality and medical care safety.

OBJECTIVE To evaluate the role of qulity control in hospital infection management.METHODS The data were collected in 2005-2007.The mean,standard deviation s,95% confidence interval(? 1.96 s) and 99% confidence intervals(? 2.58 s) were calculated to determine the forewarning threshold value.RESULTS The burn department was under the threshold value(85.95) lower than the respiratory department(87.85) and neurosurgery department(86.90).After intervention,the management improved.CONCLUSIONS With the help of quality control to forewarning and regulation of hospital infection management the problems can be found out in time.It is valuable for preventing hospital infection outbreac.

0.05). In the anatomic plate group,2 cases developed loose of internal fixation,1 case of nail withdraw,without breakage,1 case of knee joint stiffness,1 case of traumatic arthritis in the knee joint. In the limited invasive stabilization system group,1 case affected traumatic arthritis in the knee joint. CONCLUSION:The therapeutic effects of anatomic plate and limited invasive stabilization system were similar in the treatment of complex tibial plateau fractures. Fixation materials should be selected according to the state of injury,bone conditions and economic status.

Objective To observe the MVD and integrin αvβ3 mRNA expression changes in tumor -bearing rats by using endostar combined with radiotherapy ,and to explore the potential synergy mechanism .Meth-ods We randomly divided the tumor -bearing rats into four groups:control group(NC),endostar group(ES), radiation treatment group ( RT) and endostar combined radiotherapy group ( ES +RT) .Tumor inhibition rate was calculated every other day .Microvessel density and αvβ3mRNA were texted by immunohistochemical or real time PCR in each group.Results (1)ES+RT group showed the most obvious inhibition rate;(2)Compared with NC group,microvessel density of RT was increased ,but decreased in ES group and ES +RT group significantly ( P<0.05);(3)Compared with NC group,αvβ3 mRNA expression of RT group was increased,while decreased in ES group and ES+RT group,and ES +RT group displayed a greater decrease when compared to ES group ( P<0.05).Conclusion Endostar combined radiotherapy can inhibit the growth of cancer and the expression ofαvβ3mRNA,improve the disorders of tumor vascular network .It may be one of the mechanisms of increasing radi-osensitization.

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 evaluate the effectiveness and safety of recombinant human endostatin combined with concurrent chemoradiotherapy versus concurrent chemoradiotherapy for advanced non small cell lung cancer ( NSCLC) . Methods Electronic databases including the Cochrane library, PubMed, the Chinese biomedical literature database, China national knowledge internet(,EMbase,VIP and Wanfang database system were searched,until August,2013. The inclusion criteria was efficacy and safety studies of randomized controlled clinical studies in which recombinant human endostatin combined with concurrent chemoradiotherapy was compared with concurrent chemoradiotherapy alone for patients with advanced NSCLC. Cochrane handbook 5. 1. 0 was applied in evaluating the quality of included trials and RevMan 5. 1. 0 software was used for data analysis.Results Five studies including 217 cases of advanced NSCLC were included. The results of the meta-analysis exhibited that compared with concurrent chemoradiotherapy alone, recombinant human endostatin combined with concurrent chemoradiotherapy could increase effective rate [OR=2. 62,95%CI(1. 41,4. 86),P=0. 002]. But there were no significant differences in clinical benefit rate [OR=2. 08,95%CI(0. 92,4. 73),P=0. 08],one year survival rate [OR=1. 18,95%CI(0. 53,2. 66),P=0. 68], improvement in quality of life [OR=1. 57,95%CI(0. 40,6. 07),P=0. 52],rate of leucopenia [OR=1. 25,95%CI(0. 72,2. 17), P=0.43],radioactive esophagitis [OR=1. 16,95%CI(0. 42,3. 21),P=0. 77] and radiation pneumonitis [OR=2. 47,95%CI (0. 34,17. 68),P=0. 37]. Conclusion Compared with concurrent chemoradiotherapy alone,recombinant human endostatin combined with concurrent chemoradiotherapy may be more effective for advanced NSCLC,whereas improvement of life quality and toxicities are similar. For the quality restriction and possible publication bias of the included studies,more high quality randomized controlled trials are required to further verify this conclusion.

OBJECTIVE:To compare the therapeutic effect of surgical approach that should be used for posterior interbody fusion,posterolateral fusion with or without lumbar interbody fusion for adult spondylolisthesis.METHODS:From January 2004 to May 2008,75 patients with adult spondylolisthesis were retrospectively analyzed,comprising 22 males and 33 females,aged 53.3 years (ranging 49-70 years).There were 47 cases in L4,28 in L5;5 cases of degree Ⅰ,24 of degree Ⅱ,37 cases of degree Ⅲ,and 9 of degree Ⅳ.A total of 21 patients were treated with pedicle screw fixation and posterolateral lumbar fusion (group A),26 with pedicle screw fixation and posterior lumbar interbody fusion using cage (group B),and 28 with pedicle screw fixation and posterolateral lumbar fusion with posterior lumbar interbody fusion using cage.The satisfaction rate and fusion rate were compared among the three groups.RESULTS:All 75 patients were followed up for 6 months 3 years.The fusion rate of group A was 57%,and the satisfaction rate was 62%;the fusion rate of group B was 85%,and the satisfaction rate was 89%;the fusion rate of group C was 89%,and the satisfaction rate was 93%.There were no significant differences in the satisfaction rate and fusion rate between groups B and C (P>0.05),but the satisfaction rate and fusion rate of groups B and C were superior over group A (P<0.05).CONCLUSION:Posterior interbody fusion and posterolateral fusion with lumbar interbody fusion display similar treatment effects,which are better than posterolateral fusion.