Objective To investigate the electrophysiological characteristics of the ventralis intermedius nucleus (Vim) in order to find an easy and safe way to confirm the target in Vim-thalamotomy. Method In microelectrode-guided selective Vim-thalamotomy for 23 Parkinson's disease patients, the background activity, amplitude and discharge frequencies of Vim were compared with its surrounding structures. The response of kinesthetic neuron and tremor cell to microstimulation was also compared. Result There were differences in backgroud activity and discharge amplitude for Vim, ventralis lateralis nucleus (VL), ventralis caudalis nucleus (VC), and internal capsule. Based on the response to active or passive movement of contralateral limb tremor cells were divided into two subgroups, which were different in localization. Contralateral tremor showed different response when the two subgroups of tremor cells were mircrostimulated. Conclusion The anterior border of Vim was easily found by microrecording. Only by combining microstimulation with microrecording could the posterior border of Vim and its interior and lateral ordination of target were identified exactly and safely. Kinesthetic neurons and tremor cells which responded to the movement of contralateral limbs should be destroyed.

Objective To explore the possibility of early definitive operation for enteric fistulas. Methods In 37 selected enterocutaneous fistula patients, early definitive operation was performed during laparotomy for treating peritonitis within 10 days of fistula formation. Thorough irrigation of peritoneal cavity, effective sump drainage, fibrin glue sealant to reinforce anastomosis, appropriate nutritional support, and administration of growth hormone were key elements of perioperative management. Results Among 37 patients, 35 of them recovered uneventfully. Fistula recurred in 2 cases postoperatively; one fistula closed after conservative management, and another patient died of advanced gastric cancer 3 months postoperatively. The fistula operative closure rate was 94.5%. No operative death. Conclusion Advances in perioperative management can promote the success rate of early definitive operation for enteric fistulas. It may become a challenge to the present strategy of enteric fistula management.

Objective To analys the clinicopathological features and pathological diagnosis and differential diagnosis of the nasal neuroendocrine carcinomas (NEC). Methods 12 cases of nasal neuroendo crine carcinomas were studied with clinical datas and light microscopic examination and electron microscopic and immunohistchemical staining. Results The majority of the patients were middleaged. The patient population was composed of 10 meles and 2 females(sex ratio,5:1) with average age 39 6 years. On pathological examination,8 of them were small cell type neuroendocrine carcinoma,3 large cell type neuroendocrine carcinoma and 1 atypical ueuroendocrine carcinoma. Electron microscopy of 8 cases showed abundant neuroendocrine granules in the tumors. Immunohistochemical analysis showed that cells expressed EMA,CK,CgA,NSE and Syn Conclusions The key point for clinicopathological features of the NEC were discussed. Its differentila diagnosis includes malignant lymphoma, undifferentiatel carcinoma, malignant melanoma and olfactory neuroblastoma. Histological type of the tumor is important for clinical treatment plan and prognostic evaluation

Objective To Observe the adjusting effect of bone morphogenetic protein 4 (BMP4) on cholinergic-expression in embryo rats' neurons. Method Neurons isolated from hippocampus and cerebral cortex of 15-20 days gestational age SD rat's brain were cultivated in a DMEM/F12 medium containing Ara-C and identified with morphological characters and microtubulin associated protein 2 (MAP2 ) immunocytochemical test. The medium was replaced with BMP4 96 hours after Ara-C adding, and cultivated another 10 days. The expression of choline acetyltransferase (ChAT) of the adjusted cells was observed by immunocytochemical staining and FITC-labeled cholinergic nerve cells Flow Cytometry. Results It has been showed that cultured neurons accorded with the typical morphological characters and the immunologic markers of neurons; the percentage of ChAT-positive cells in BMP4 group was prominently higher than that in control group(13.3?1.37% vs 6.44?0.81%, P

Objective To investigate the effectiveness of radio gu ided surgery (RGS) in lung carcinoma by using ~18F-FDG. Methods Forty mice bearing lung adenocarcinoma were divided randomly into two gro ups according to presence or absence of the lung metastasis. A dose of 200?l (1 00?Ci) of ~18F-FDG was injected via the tail vein. The external radioimmu nography was performed after injection. All viscerae and tumor were detected i n vivo by means of a hand-held gammaray-detecting probe (GDP), and the radio active distribution was analyzed with the well-gammaray detector. Resul ts The tumor images in mice were clear, and the images were best at two hours after injection. The values of %ID/g of tumor and heart obtained by well -gammaray detector were higher than those of other organs. Ratios of tumor/norm al tissue (T/NT) except cardiac muscle being detected by GDP ranged from 3.71 t o 13.57. There was a significant difference between the radioactivity of lung t issues in lung metastasis group and that of control group (P

Objective To study the relationship between vascular endothelial growth factor (VEGF) expression and proliferation of hepatic blood vessel and fibrosis in hepatitis B (HB) patients. Methods The total RNA of VEGF was extracted from human liver tissues, and VEGF mRNA probe was acquired by RT-PCR. It was then labeled on hepatic tissues of 160 patients with HB and 10 healthy individuals (control group). Immunohistochemistry of VEGF was performed at the same time. Results The results of hybridization in situ showed that VEGF mRNA was negative in the control group. While in the HB groups, VEGF mRNA was located in the hepatic sinusoids, Disse′s space and hepatocyte cytoplast around the dilated sinusoids. Immunohistochemistry showed that VEGF was expressed in three patterns: the cytoplasm, sinusoid membrane, and sinusoidal endothelium. The expression strength and distribution range of VEGF were closely related with the grading and staging of HB, hepatic vascular inflammation, destruction, obstruction, proliferation and fibrosis. There was remarkable difference between different liver pathological changes (P

Objective To analyze the status and trend of the development of percutaneous coronary intervention (PCI) in Chinese military hospitals from 2003 to 2004. Methods In April 2005, a registry form was dispatched to all army hospitals, and items in regard of PCI during 2003 to 2004 were asked to be filled for analysis. Results From 2003 to 2004, a total of 16842 cases of PCI performed in 61 PLA hospitals (7052 in 2003, 9790 in 2004) were registered and reported. The intervention procedures were performed in a total of 23706 target lesions, of which only 1632 target lesions (6.9%) were dilated by balloon, and 22074 target lesions (93.1%) were implanted with coronary stents, and 8086 stents among all were drug eluted (36.6% of all stents), including 4270 eluted with rapamycin (Cypher and Firebird, 52.8%), 2072 Paclitaxel eluted (25.6%) and 1744 eluted with other kinds of drug (21.6%). Total success rate of PCI was 97.7% (16449/16842), and success rate was 99.8% in patients with stented procedure. The incidence of major complications and major adverse cardiovascular events was 4.2% (708/16842), including acute occlusion of coronary artery (0.3%), subacute occlusion (0.4%), pericardial tamponade (0.1%), falling of stent (0.1%), emergency coronary artery bypass grafting (0.1%), an inhospital mortality of 1.2% (including death resulted in acute myocardial infarction), and slow-flow or no-flow (1.6%). During follow-up period, target vessel revascularization was done in 5.1% of the patients. Emergency PCI for acute myocardial infarction was performed in 2467 cases, PCI for left main coronary artery and grafted vessel was performed in 576 cases and 137 cases, respectively. Trans-radial PCI was done in 3051 cases. 2124 PCI were done for chronic total occlusion lesions, and the number increased tremendously compared with the last registry. In 57.3% of the hospitals enrolled in the registry, the annual PCI number was less than 100 cases, while in 13.2% of the hospitals the annual number of PCI was over 200 cases, and in only 2 hospitals the annual PCI number was over 1000 cases. Conclusions The annual case numbers of PCI in PLA hospitals within the recent two years increased by around 40% every year. The success rates for complicated lesions, the use of new technique, and the complication rate of PCI were comparable with that reported in domestic and foreign literature published in recent years. It is noted that, the development has been quite different among different hospitals, so that technical training and cooperation should be emphasized in the future.

Objectives To explore ventilation induced cytokine production and the role of oxidant stress in lung stretch. Methods Both in vitro and in vivo models of ventilator-induced lung injury (VILI) were used. Alveolar epithelial cells were stretched in vitro to mimic the lung injury in VILI. Rats were ventilated at large tidal volume to produce ventilator-induced lung injury in vivo. A total of 23 inflammatory cytokines were screened with micro gene array in stretched alveolar epithelial cells. Cytokines found to have up-regulated in cells were measured in serum and lung tissue of rats exposed to large tidal volume ventilation. For investigating the intracellular pathway of cytokine up-regulation in VILI, exogenous TNF-? or H_ 2O_ 2 was added to culture media of alveolar epithelial cells. Cytokines were then measured. To explore the role of oxidant stress in VILI, N-acetylcysteine (NAC), as an anti-oxidant, was used in vitro and in vivo. Results We found that transforming growth factor-?_1 (TGF-?_1 and transforming growth factor-?_2 (TGF-?_2) were up-regulated in stretched alveolar epithelial cells and also in serum of rats with large tidal volume ventilation. Tumor necrosis factor-? (TNF-?) had no effects on TGF-? production in alveolar epithelial cells. Exogenous H_ 2O_ 2, as an oxidant, increased TGF-? production in alveolar epithelial cells. NAC, an anti-oxidant, decreased stretch induced TGF-? production, along with a down-regulation of oxidant injury. NAC also blocked the up-regulation of TGF-? in in vivo model of VILI. Conclusion TGF-?_1 and TGF-?_2 were up-regulated in VILI. Oxidant injury mediated up-regulation of TGF-? in VILI. NAC, which attenuated oxidant injury and blocked TGF-? up-regulation in VILI, could be a future therapeutic strategy in VILI.

Objective To study the changes in activity of phospholipase A_2 (PLA_2) in the course of endotoxin (ET)-induced acute lung injury (ALI) in rabbits and the antagonizing effect of fructose-1,6-diphosphate (FDP), in order to evaluate the therapeutic effect of FDP on ET-induced ALI. Methods Flap-eared white rabbits were randomly assigned to three groups: control group (group A), ET challenge group (group B) and treatment group (ET challenged followed by FDP, group C). Group A animals were injected with saline (2ml/kg) as control. Group B animals were injected with ET (500?g/kg) solution followed by saline. Total amount of liquid was 2ml/kg. Group C animals were given the same amount of ET solution followed by injection of FDP (300mg/kg) solution. Total amount of liquid was also 2 ml/kg. During the experiment, respiratory rate, heart rate, blood pressure, arterial blood gases and the plasma PLA_2 activity were determined at 0h, 0.5h, 2h, 4h and 6h respectively. The rabbits were sacrificed at 6h, pulmonary PLA_2 activity was assessed, and the pathologic changes in pulmonary tissues were examined with light microscope and transmission electron microscope. Results Compared with group A, rabbits of group B manifested the typical characters of ALI after ET injection, and the PLA_2 activity in both serum and pulmonary tissue was much higher than those of group A (P

Objective To summarize the clinical effect of individualized cranioplasty with different materials. Method The clinical data of 75 patients with skull defect were analyzed retrospectively. Ultrathin cranial CT and three-dimension reconstruction were done to delineate the shape and contour of cranial defect. The templet for repair was fabricated with methyl silicone rubber, bone cement or titanium mest according to the condition of the bone defect with laser rapid prototyping technique. With patient's consent, the individualized templet was implanted to repair the cranial defect. Results Methyl silicone rubber or bone cement were used for 40 of 75 patients to fill the defects, and in the other 35 patients titanium mesh was used to cover the defects with overlapping edges. The patches matched cranial defect perfectly without the necessity of revision. The average operation time was 45 minutes. Perfect or excellent cosmetic results was obtained in 63 of the 75 patients (84%). Postoperative complications were as follows: 5 patients complained of headache, which disappeared in there months. Collection of fluid under the scalp was found in 12 patients, among them the fluid was Absorbed 10 days after operation in 8 cases without any treatment, while in 3 patients it disappeared after suction for 1-4 times. In the remaining one patient, the bone cement templet was removed due to infection, and a titanium mesh was implanted one year later. Loosening and displacement of the templet occurred in 2 patients, and silk sufures were used for fixation in both patients. In these two patients, the templet became stable 3 months later, and in the other titanium was used for repair one year later. The incidence of complications was signifieantly different between inlay and onlay methods of repair (P