According to the actual situation that neurosurgery professional postgraduate is un-even and the ability of operation is low and combined with new requirements of medical development, the author discusses concretely the neurosurgery master graduate students' clinical ability cultivation from the necessity and teaching measures of adding neurosurgery microscopy techniques course, neural micro dissection course, neuroimaging curriculum course. The specific course orienta-tion andproject drive-independent inquiry teaching mode are the characteristics of cultivation measures. The key point for the implementation of measures lies in the teachers' effective guidance of students' intrinsic motivation according to the discipline direction, on the basis of grasping curriculum positioning.

Objective To observe cerebral apoplexy patients complicated with carotid atherosclerosis plaque given aggressive lipid lowering treatment on the prognosis of stroke and reduce the recurrence rate through the large sample study on neurological department of internal medicine.Methods 300 cases of cerebral infarction complicated with different degree of neck lesions were selected and randomly divided into 3 groups,each group had 100 cases.Intensive lipid-lowering group received fluvastatin,80mg/d + 100mg aspirin,conventional dose group received fluvastatin,40mg/d + 100mg aspirin,aspirin group was given aspirin 100mg.After 4 weeks,8 weeks,12 weeks,16 weeks,20 weeks,24 weeks,blood lipid level,changes in internal carotid artery plaque (CIMT),plaque area,and the incidence rate of cerebral vascular events after 24 weeks were observed.Results The results of intensive lipid-lowering treatment group IMT (1.06 ± 0.36) mm,plaque area (8.09 ± 0.47) mm3,the incidence rate of cerebral vascular events after 24 weeks (12％),serum lipid levels and regular dose group after treatment with IMT (1.19 ±0.39) mm,plaque area (9.91 ± 0.78) mm3,the incidence rate of cerebral vascular events after 24 weeks (18 ％),serum lipid levels after aspirin group were significantly reduced(P ＜ 0.05).Aspirin group before and after treatment,IMF,plaque area and lipid levels had no significant differences(P ＞ 0.05).Intensive lipid-lowering treatment group compared with the conventional dose group,IMT,plaque area and lipid levels improved obviously(P ＜ 0.05),the recurrence rate of ischemic cerebral vascular disease had significant difference compared with the other two groups (P ＜ 0.05).Conclusion Intensive lipid-lowering treatment on blood lipid levels,delay and reverse the carotid atherosclerosis is superior to conventional dose using fluvastatin group and simply antiplatelet group,and can prevent the recurrence of ischemic cerebrovascular disease.

Objective To investigate the principle and its clinical initial application of the dual-energy imaging with the dual-source CT and increase the realization of it. Methods According to the research results of the dual-energy imaging with the dual-source CT and the course of development of the dual-energy imaging to analyze and summarize the basis radiological physics, the principles, the correlation parameters and the clinical initial application of the dual -energy imaging with the dual -source CT. Results The dual -energy imaging with the dual -source CT is different from other common dual-energy imaging, it has its own special feature. Conclusion According to the analysis of the dual-energy imaging with the dual-source CT, greatly increase the realization of the dual-energy imaging with the dual-source CT.

Objective To observe the effect of intravenous low intensity laser radiation (ILLLI) combined with traditional Chinese medicine on TXB2, 6-Keto-PGF1? and Ang II of the rabbits of experimental diabetic stroke. Method 35 successfully modeled rabbits, after alloxian injection for diabetes and photochemical radiation for stroke, were randomized into four treatment group-control group (B), ILIB group (C), a group with compound treatment of ILIB and TCH (D), TCM treatment group (E), and 7 unmodeled rabbits were made as the normal group (A). TXB2, 6-Keto-PGF1? and Ang II level were observed and compared. Result Compared with group B, group C and E can significantly rectify the disorderly TXB2, 6-Keto-PGF1? and Ang II, Group D was better than C and E. Conclusion ILLLI combined with TCM can effectively rectify the TXB2, 6-Keto-PGF1? and Ang II level, reduce nervous injury, cure diabetes cerebral infarction.

Objective To investigate the influence of Tanyu-Tongzhi (TYTZ)recipe on Rho/Rho kinase signal transduction pathway of myocardial ischemia-reperfusion injury in high fat-fed rats.Methods 60 SD rats were divided into 5 groups randomly,a sham-operated group,a model group,a western medicine control group,a high-dose group and a low-dose group of TYTZ recipe.The model of ischemia reperfusion of the myocardium was reproduced by ligation of left descending artery for 30 min followed by releasing the ligation for 2 hours in rats.The downstream substrates of ROCK myosin light chain (MLC) phosphorylation expression of myocardial tissues in rats were detected by Western blotting method.The levels of RhoA,ROCK Ⅱ mRNA were determined with RT-PCR.Results Compared with the model group,the expression of p-MLC and RhoA,ROCK Ⅱ mRNA were lower in low-dose group of TYTZ,there were significant differences between the two groups(P=0.004、0.003、0.018、0.004,P＜0.01).Conclusion The TYTZ Recipe can protect myocardium from MI/RI.The mechanism of action was related to its inhibiting the protein expression of RhoA,ROCK Ⅱ and p-MLC,restraining the activation of Rho/Rho kinase signal transduction pathway.

The methyl group plays an important role in the rational drug design. Introducing methyl into small molecules has become an important strategy of lead compound optimization. The application of methyl in drug design is reviewed in this paper. Methyl can modulate the physicochemical, pharmacodynamic, and pharmacokinetic properties by ortho effect, inductive effect, and conformational effect. It also improves the metabolic stability as a soft metabolic point. In addition, introducing methyl into drug molecules can also be applied as a strategy in new uses of old drugs and generate me-too drugs.

Objective To study on the relationship between plasminogen and brain-derived neurotrophic factor(BDNF),and explain the molecular mechanism of depression ,then provide new clew for diagnosis and treatment of depression .Methods The chronic unpredictable mild depression rat mode was established ,then depression symptoms including absence of delight ,the decline of actions and activities ,and weight reduction of rat were tested .The levels of individual plasminogen and BDNF in hippocampus were determined by Western blot .Results The expression of BDNF and plasminogen in depression rat mode and control group was significantly different(P<0 .01) ,and there was a positive correlation between BDNF and plasminogen(r=0 .65 ,P<0 .01) .Accord-ing to the linear-regression analysis ,there was a dependence relationship between them(r2 =0 .423) .The equation of regression was YBDNF=0 .750XPlasminogen +0 .201 .Conclusion Stress could affect the growth and survival of nerve cell ,which lead to the depression behavior of rats ,meanwhile ,the decline of plasminogen and BDNF levels ,the positive correlation between them illustrate that plas-minogen and BDNF take part in the mechanism of depression .

Objective To investigate the effects of comprehensive geriatric assessment (CGA) and health intervention on outcome in discharged patients.Methods Discharged patients in geriatric ward from May to July 2012 were randomly assigned to control (n=36) and intervention (n=36) groups.Patients in the two groups were given comprehensive geriatric assessment (CGA) before discharging from hospital.Both groups were followed up for 3 months.Patients in intervention group received health intervention when leaving hospital,at 1 week,3 weeks and 3 months after discharge from hospital,while patients in control group were not given any intervention.The comprehensive illness condition (MCIRS-G),ability of daily life (ADL and IADL),rehospitalization and survival rate were compared between the two groups 3 months after the intervention.Results After 3 months,the scores of MCIRS-G,ADL and IADL were significantly better in intervention group than in control group[(29.06±4.51) vs.(33.09±4.34),(75.69±16.57)vs.(63.86±19.37),(11.72±3.20) vs.(9.77±2.52),respectively,t=3.84,2.77,2.85,all P=0.01].The total times ofreadmission and readmission length were less in intervention group than in control group [3 vs.17,x2 =8.79,P=0.02; (1.94±6.68) days vs.(8.81±14.09) days,t=2.64,P=0.01].There was no difference in survival rate between the two groups [100％ (36/36) vs.97.2％ (35/36),x2=1.01,P=0.30].Conclusions Comprehensive geriatric assessment and health intervention can alleviate symptoms and improve the ability of daily life.

Objective To investigate the regulatory networks of DNA methylation profiles in STEMI by methylation microarrays.Methods A total often male patients with STEMI and ten male healthy controls were recruited.Methyl-DNA immunoprecipitation and Nimblegen HG18 Meth 385K promoter plus CpG island microarrays were used to identify differentially methylated regions.And several bioinformatics analysis tools which included chromosomal assignment, gene ontology analysis and pathway analysis with SignalMap and The Database for Annotation, Visualization and Integrated Discovery were used to high-throughput analysis.Results Compared with healthy controls, DMRs of STEMI is 1 634, There are 1 480 (90.57％), 131 (8.02％) and23 (1.41％) methylated sites were separately located on High CpG-containing promoter, Intermediate CpG-containing promoter and Low CpG-containing promoter;Gene Ontology and Pathway analysis expressed DNA methylated genes of signaling pathway in MI identified glycerophespholipid metabolism, cysteine and methionine metabolism, Dilated cardiomyopathy, Arrhythmogenic right ventricular cardiomyopathy, regulation of actin cyteskeleton, calcium signaling pathway.However, the signal pathway about lipid metabolism is shown no significant difference.Conclusions Bioinformatics tools could provide the quick and high-throughput analysis of data from methylation microarray and enable the function classification of differentially expressed genes of STEMI.

Objective To examine the difference in the effectiveness between proximal femoral nail anti-rotation (PFNA) and femoral head replacement (FHR) of intertrochanteric fracture in elderly patients.Methods This study collected 69 patients that underwent PFNA or FHR after intertrochanteric fractures between June 2012 and September 2014.PFNA group was composed of 41 subjects (17 males and 24 females) aged 80-101 years (mean,86.7 years),and time from injury to operation was (3.12 ± 0.95)days.FHR group was composed of 28 subjects (13 males and 15 females) aged 80-99 years (mean,87.2 years),and time from injury to operation was (3.2 ± 1.0) days.Comparison of operation time,intraoperative blood loss,postoperative blood transfusion,off-bed time,complication incidence,hemoglobin concentration and hip function was made between groups.Results Duration of follow-up was 1-3 years (mean,1.8 years).Operation time and intraoperative blood loss in PFNA group were (46.8 ± 4.4) minutes and (77.0 ± 24.2) ml respectively,differed from (57.4 ± 5.9) minutes and (150.7 ± 46.5) ml in FHR group (P ＜ 0.05).Three days after operation,a similar decrease in hemoglobin concentration was seen in PFNA group [(21.3 ±6.1)g/L] and FHR group [(23.2 ±5.8)g/L] (P ＞ 0.05).Off-bed time in FHR group was (3.2 ± 1.2) days,shorter than (7.1-± 2.5) days in PFNA group (P ＜ 0.05).Incidence of postoperative complications in FHR group was 14％,lower than 37％ in PFNA group (P ＜ 0.05).Hip function of the two groups presented no significant difference six months after operation,but the proportion of excellent results in FHR group was higher than that in PFNA group (82％ vs.73％) (P ＞ 0.05).Conclusion FHR provides better results over PFNA regarding off-bed time,complication incidence and hip function,and hence is preferred for the treatment of elderly patients with intertrochanteric fractures,especially in those with severe osteoporosis.