BACKGROUND: Both animal experiments and clinical practice have confirmed that mild or moderate hypothermia is effective in reducing secondary brain injury, but its effect on homeostasis is not very clear.OBJECTIVE: To investigate the effect of a combined therapy of mild hypothermia and hibernation on the homeostasis of patients with severe brain injury.DESIGN: A randomized controlled study.SETTING: Neurosurgical Institute of Beijing; Neurosurgical Department of the First Clinical Medical College Affiliated to Harbin Medical University;and Neurological Department of the Second Clinical Medical College Affiliated to Harbin Medical University.PARTICIPANTS: The study was conducted at the Department of Neurosurgery, the First Affiliated Hospital of Harbin Medical University, from June to December 2002. Totally 24 patients (aged 35-60 years) with severe cerebral hemorrhage or brain injury were randomly divided into combined therapy group and normothermia group. Their Glasgow Coma Scale scores ranged from 3 to 8. The subjects signed the informed consent.METHODS: Within 10 hours of their injury, patients in hypothermia and hibernation combination group were given half dosage of No. 1 hibernation cocktail (chlorpromazine 25 mg, pethidine hydrochloride 50 mg, and promethazine 25 mg), and were cooled by cooling blankets to make their body temperature dropped to 32-34 ℃ (rectal temperature). Their temperature was kept within this range for 5 days, at 35 ℃ for 24 hours, and then was slowly increased to their normal level. The body temperature of patients in normothermia group was maintained at 37-38 ℃. The mean arterial pressure and heart rate of all patients were measured continuously by HP monitor. On the 3"d and 7th days of hospitalization, intracranial pressure and creatine phosphate kinase were measured via lumbar puncture.Femoral artery puncture was performed to check the partial pressure of arterial O2 and CO2. Platelets count and blood electrolytes K+ and Na+ concentration of each patient were measured, too. On the 7th day Glasgow Outcome Scale scores of each patient and mortality of each group were recorded.activity of creatine phosphokinase, platelets count, blood K+ and Na+ conand CO2 of patients in combined therapy group on the 3rd and 7th days of hospitalization.intracranial pressure, creatine phosphokinase and platelets count: The decreased values of intracranial pressure, creatine phosphokinase and platelet number in combined therapy group were all significantly higher than those in normothermia group [(104.09±54.90), (58.75±25.33) mm H2O; (26.95±19.22), (10.17±7.18) μkat/L; (89.82±46.36)×109/L, (48.83±44.59)×109/L,the mean arterial pressure, blood electrolytes, and partial pressure of artewas significantly lower than that of normothermia group (25.0%, 66.6%,P ＜0.05).CONCLUSION: This combined therapy of hypothermia and hibernation can effectively decrease intracranial pressure and creatine phosphokinase,but has no significant effects on the mean arterial pressure, blood electrolytes concentration, and partial pressure of arterial O2 and CO2. It has the risk of disturbing the patients' hematopoiesis.

Objective To investigate an accurate and applicable localizing method of puncture point for neuroendoscopic third ventriculostomy in neurosurgery so as to ensure that the neuroendoscope is led to the anterior membrane of mammillary body on the base of third ventricle directly. Methods Based on the MR characteristics including multiple directions and angles and high soft tissue resolution, the coordinate of puncture point was measured and calculated for neuroendoscopic third ventriculostomy in MRI. Results~The position of puncture point for neuroendoscopic third ventriculostomy was (127.2?9.9)mm to nasal root, or (17.1?5.6)mm in front of coronal suture and (20.3?4.7)mm to sagittal suture. The angle between the puncturing line and the cerebral falx was (12.3?1.9)?, and the depth from scalp to anterior membrane of mammillary body was (89.3?10.4)mm. Conclusion MRI-guided localization for neuroendoscopic third ventriculostomy is an accurate, simple, safe, painless, and applicable method.

ObjectiveTo explore environmental conditions under which bone marrow stromal cells could be induced into osteogenic phenotype.MethodsRat bone marrow stromal cells were isolated and proliferated in vitro, and the 3rd passage was divided into the group A (control group), group B (cells cultured in the medium containing dexamethasone, β-glycerol disodium phosphate salt hydrate, vitamin C and active form of vitamin D3), and group C (on the bases of group B, the cells were cultured additionally with fracture hematoma extract). On the post-induction day 5, 8, and 11, the morphological changes were observed and the osteogenic markers such as alkaline phosphotase (ALP), collagen type Ⅰ (Col Ⅰ) and osteocalcin (OCN) were assayed with immunohistochemical staining, the calcification was manifested with von Kossa staining.ResultsIn the group A, no evident osteogenic effects had been observed. In the group B, on 5th day post-induction, some bone marrow stromal cells underwent a morphological change, and mild expression of ALP and Col Ⅰ was observed but with no calcification effect. On 8th day post-induction, the ratio of morphologically changed cells increased, and the expression of ALP and Col Ⅰ increased still with no evident calcification. On 11th day post-induction, anti-OCN staining was positive and the calcium nodes were showed by von Kossa staining. The phenotype changes in the group C were similar to group B, but were more evident.ConclusionBone marrow stromal cells can be induced into osteogenic phenotype in vitro with small molecular inducers. Fracture hematoma extract can enhance this effect thus might be used as an addictive in osteogeneration.

BACKGROUND: Due to individual characteristics of human body, it is difficult to well match between standard prosthesis and patient skeleton. Computer-assisted design and manufacture of individualized prosthesis can effectively prolong artificial joint lifespan and quality and reduce revision rate. However, related studies are few in China.OBJECTIVE: To explore computer-assisted design for individualized femoral head prosthesis according to three-dimensional (3D)reconstruction of CT images for improving prosthesis and affected skeleton matching.METHODS: The CT scanning image of one healthy male volunteer, with no hip joint disease, was used. His femur was scanned with GE Speed Light CT with 3.0 mm thick cross-section slices. CT 2D images were transmitted to a computer. The medical image format was translated from DICOM into bmp. Inner and external bone contours were drawn automatically or by hand and processed digitally, and then these data were downloaded into 3D Mimics8.1, and Rapidform2004 software. The 3D femoral canal model was rendered. Femur canal contours curve was downloaded into the Solidworks2004 software in the form of dxf. Femoral prosthesis was designed on the base of femoral canal contours curve.RESULTS AND CONCLUSION: The CT image was transmitted in the form of vector by a set of self-made medical image processing software. The accurate 3D femoral internal/external outline model was obtained by CT 2D image and reverse technique. Suitable femoral prosthesis was designed by means of image reverse engineering and norientation CAD. Reverse engineering and CAD provide an effective way to develop individualized prosthesis, improve the matching of prosthesis and affected skeleton, prevent prosthesis loosening and improve long-term stability.

Objective:To explore protective effect of atorvastatin on blood vessels in early stage of atherosclerosis (AS).Methods:A total of 120 patients without AS plaques,who had >2 cardiovascular risk factors and received control cardiovascular risk factors therapy,were randomly divided into four groups:control group (did not receive atorvastatin),atorvastatin 5mg group,10mg group and 20mg group (received corresponding dose of atorvastatin). All patients were followed up for six months,changes of thromboxane B2 (TXB2),6-Keto-prostaglandin F1α (6-Keto-PGF1α),brachial-ankle pulse wave velocity (baPWV),ankle brachial index (ABI)and intima-media thickness (IMT)were observed.Results:There were no significant changes in ABI and IMT between before and after treat-ment among four groups (P >0.05 all).Compared with baseline,TXB2、baPWV levels significantly rose,6-Keto-PGF1αlevel significantly decreased after treatment in control group and 5mg group;in contrast,TXB2、baPWV lev-els significantly decreased,6-Keto-PGF1αlevel significantly rose after treatment in 10mg group and 20mg group(P <0.05~ < 0.01).After treatment six-month,compared with control group and 5mg group,the TXB2 [(148.3 ± 29.2)pg/ml,(142.3±30.6)pg/ml vs.(111.5±22.8)pg/ml,(104.9 ± 17.4)pg/ml]、baPWV[(1621.1 ± 136.1) cm/s,(1597.7±125.3)cm/s vs.(1232.9±132.3)cm/s,(1178.2±155.1)cm/s]levels significantly decreased,6-Keto-PGF1α[(104.7±66.1)pg/ml,(102.2±70.3)pg/ml vs.(132.8±48.3)pg/ml,(139.1±66.3)pg/ml]level significantly rose(P <0.05~<0.01)in 10 mg group and 20 mg group.Conclusion:Atorvastatin has protective effect on blood vessels in early stage of atherosclerosis,and 10mg atorvastatin may be the minimum effective dosage to protect blood vessels.

Objective Former standards for Yishen Pills only identify angelica root , astragalus root and ligustrum lucidum by thin layer chromatography ( TLC) and there is no test for the content of effective components .The study was to improve the quality of Yishen Pills by perfecting the quality standards . Methods We determined the content of specnuezhenide in Yishen Pills by high-per-formance liquid chromatography(HPLC), with a mobile phase of MeOH-Water, a chromatography column of Agilent TC-C18(2) (4.6 × 250 mm, 5μm), a flow rate of 1.0 mL/min, a column temperature of 25℃, a detection wavelength of 224 nm, and a sample loop volume of 10μL. Results The linear relationship of specnuezhenide content was good in the range of 15.375μg/mL~246.000μg/mL.The relative standard deviation of precision experiment , stablity experiment and repeatablity experiment was 0.44%, 0.95%and 2.65%re-spectively.The average recovery was 99.60%.The qualified standard for specnuezhenide in Yishen Pills was ≥0.3 mg/g. Conclusion The method is simple , accurate and reliable , with good reproducibility , and it is applicable for the quality control of Yishen Pills .

2-Amino-5-phosphonovalerate ; pharmacology ; Animals ; Animals, Newborn ; Cells, Cultured ; Cerebral Cortex ; cytology ; physiology ; Hydrogen-Ion Concentration ; Hypothermia, Induced ; Neurons ; drug effects ; Nimodipine ; pharmacology ; Protons ; Random Allocation ; Rats ; Rats, Wistar