BACKGROUND: The observation of vascular endothelial growth factor gene expression of cerebrovascular diseases and ultrastructure of cells may be helpful to understand angiogenesis and its relative cellular factors involved in the pathogenesis at cellular and molecular levels. OBJECTIVE: To investigate the method of culture of human cerebral cap illary endothelial cell by separation of capillary fragment in vitro, and to ob serve vascular endothelial growth factor gene expression and ultrastructure of cells. DESIGN: A randomized controlled research on technique and method. SETTING: The neurosurgery department of a general hospital of a military area command of Chinese PLA and the neurosurgery department of a college hospital. PARTICIPANTS: Eighteen patients with arteriovenous malformation of brain(Spetzler Ⅱ-Ⅲ grade), as confirmed by aortocranial angiography before operation, in the Department of Neurosurgery, General Hospital of Shenyang Military Area Command of Chinese PLA were included. The material was obtained from fresh integrated specimen of arteriovenous malfor mation of brain with surrounding fresh brain tissues during the opera tion. Capillary endothelial cell was separated by homogenate, filtration and enzymatic digestion techniques. Cells grew well in culture flask and were divided into 4 groups(hypoxia state for 2, 4, 8 hours groups and control group). Each group contained four flasks.METHODS: Simulation of anoxia condition: volume faction 0.95 N2 and volume fraction 0.05 CO2. Expression of factor Ⅷ related antigen in cells was detected by immunohistochemistry. mRNA expression of vascular endothelial growth factor on endothelial in every group was observed by RT-PCR, protein content of vascular endothelial growth factor in supernatant detected by enzyme-linked immunoadsordent assay, and cellular ultrastructural change observed by transmission electron microscopy.MAIN OUTCOME MEASURES: mRNA expression of vascular endothelial growth factor on endothelial cell and protein content of vascular endothelial growth factor in supernatant in control group and every hypoxia groups; cellular ultrastructural changes.RESULTS: Under phase contrast microscope, cultured living cells had mono-layer pebble-like typical character. More than 90% of were factor Ⅷrelated antigen(FⅧ-RA) staining positive. mRNA and protein expression of vascular endothelial growth factor in hypoxia 4 hours group was 0.98 ±0. 19,( 180. 77 ± 20. 15) ng/L, which was significantly higher than in control group [0, (26. 20 ± 6.33) ng/L, P ＜ 0.01 ]. Eight hours later, expression decreased [(0. 35 ±0.07), (31.68 ±8.34) ng/L]; swollen mitochondrion, dilated endoplasmic reticulum, and lysosome vesiculation were found.CONCLUSION: Humane cerebral capillary endothelial cell can be cultured by separation of capillary fragment, which is easy to operate and the cellular purity is reliable. In the early stage of ischemia and hypoxia, expression of vascular endothelial growth factor is not enough to maintain cellular ultrastructure integrity. Cells may be injured along with the prolong of hypoxia.Zhao MG, Tang T, Gao YZ, Pu PY, Wei XZ. Culture of human cerebral capillary endothelial by separation of capillary fragment and the observation of vascular endothelial growth factor gene expression and cell ultrastructure. Zhongguo Linchuang Kangfu 2005; 9(21):211-3 (China) [www. zglckf. com]

Objective To investigate the gene expression of vascular endothelial growth factor(VEGF) and ultrastructural changes in cultured endothelial cells from human cerebral microvessels under hypoxic conditions.Methods Human cerebral microvessels were isolated from freshly obtained specimens of normal brain adherent to resected cerebral arteriovenous malformations.The expression of factor Ⅷ-relative antigen(FⅧ-RA) in cultured cells was observed with immunocytochemistry.The level of VEGFmRNA in cells and released VEGF protein in cell supernatant were determined by RT-PCR analysis and ELISA respectively when they were exposed to hypoxic conditions(95% N_2,5% CO_2;two hours,four hours,eight hours) or maintained in basal condition.Ultrastructural changes in cells were also observed by electron microscopy.Results In inverted microscope the cultured cells showed contact inhibition and a rounded cobblestone appearance.More than 90% of them were stained strongly with antibodies against FⅧ-RA.Significant VEGF mRNA and protein accumulated when these cells were exposed to hypoxia for 4 hours.However,their VEGF expression was down-regulated after hypoxia for 8 hours and a number of vesicles and swollen mitochondria were present in the cytoplasm.Conclusion The level of VEGF expression may havesignificant relationship with ultrastructural changes in human cerebral endothelial cells under hypoxic conditions.

This article investigates the effect of regulating wei qi and tonifying brain on insomnia from two aspects. It provides theoretical basis for clinical application of regulating wei qi and tonifying brain. First of all, this method regulates the sleep function to keep the body’s yin-yang balance by regulating wei qi. Wei qi is the defense qi in the body and has close relationship with sleep. Wei qi can regulate sleep by the excitement and depression of Yin and Yang Heel Meridians. Then, this method also can improve the brain function for insomnia treatment by dredging Governor Channel and tonifyjng marrow, tonifyjng brain and calming the nerves. On basis of inheriting traditional theory, this article expounds the theory of treating insomnia by regulating wei qi and tonifying brain and verifi es its stable therapeutic effect and safty by clinic study.

The connotation and extension of the acupuncture changes along with the development of science and technology. Working out the principle on the connotation and extension of acupuncture at present will contribute to better inherit and development of acupuncture. In this paper, through literature analysis, the study on the process of formation and development of acupuncture, we believe connotation of acupuncture and moxibustion mainly include the basic theory of TCM, meridians theory, diagnosis, techniques, clinics, and literatures of acupuncture and moxibustion;and its extension include basic integrated medicine of acupuncture and moxibustion, physiology, pathology, and theories, techniques and clinics derived from modern science.

Objective To evaluate physiologic ability and surgical stress (E-PASS) for predicting postoperative complications in patients undergoing elective colonic surgery. Methods The clinical data of 158 patients with colonic cancer who were admitted to the West China Hospital from August to October, 2009 were retrospectively analyzed. E-PASS was applied to evaluate the surgical risk. Three indexes of the E-PASS system,including preoperative risk score (PRS), surgical stress score (SSS) and comprehensive risk score (CRS) were compared with actual postoperative outcomes. Correlation between PRS, SSS, CRS and postoperative risks was analyzed using multiple linear regression analysis. Results Of the 158 patients, 27( 17.1% ) had postoperative complications, and the predictive value was 19.4% ± 2.0% according to the E-PASS. Dukes stages, physical performance indexes, severe heart disease, severe pneumonia disease, length of operation time were correlated with the incidence of complications (r = 0. 193, 0. 410, 0. 183, 0. 174, 0. 198, P ＜ 0.05). PRS, CRS and SSS had good predictive effect on postoperative risks (r = 0. 299, 0. 349, 0. 183, P ＜ 0. 05 ). Conclusions E-PASS system is a relatively simple, fast and user friendly tool for predicting the risk of short-term postoperative complications.

Objective:The study retrospectively identified the correlative factors of low back pain after single-level oblique lateral interbody fusion (OLIF).Methods:Records of 93 patients (55 males and 38 females) who underwent OLIF (oblique lateral interbody fusion) surgery for lumbar degenerative diseases from May 2016 to September 2019 were analyzed retrospectively and patients' age was 55.73±9.48 years (range 32-78 years). There were 18 patients underwent L 3, 4 segment (19.35%), 73 patients underwent L 4, 5 segment (78.50%), and 2 patients underwent L 5S 1 segment (2.15%). There were 43 patients underwent OLIF stand alone and 50 patients underwent OLIF combined with lateral or posterior internal fixation. The follow-up time was 22.86±5.90 months (range 12-32 months). According to whether the visual analog scale (VAS)≥3 at the last follow-up visit, the patients were divided into low back pain group and no low back pain group. The demographic characteristics (age, gender, body mass index and comorbidities), basic surgical data (surgical segments, surgical methods, surgical time, intraoperative bleeding, endplate injury or not during operation), imaging data (lumbar lordosis, segmental lordosis, intervertebral height and cage subside) and lumbar function were recorded. The potential related factors were analyzed by univariate analysis, and the factors with P<0.05 were selected in the multivariate logistic regression model. Then the risk factors of low back pain after OLIF were determined by multivariate logistic regression analysis. Results:Nineteen patients with VAS score equal or greater than 3 were included in low back pain group, and the remaining 74 patients were included in no low back pain group. There was no significant difference in baseline data such as age, gender, BMI, follow-up time and comorbidities between two groups. There was no significant difference in VAS score between the two groups before operation ( t=0.818, P=0.414), but there was significant difference in VAS score at last follow-up visit ( t=6.958, P<0.001). The incidence rate of osteoporosis in low back pain group (63.16%) was significantly higher than that in no low back pain group (25.68%) ( t=9.558, P=0.002). There was no significant difference in vertebral height between the two groups ( t=1.008, P=0.316), however, the vertebral height was higher in no low back pain group ( t=2.537, P=0.316) at the last follow-up. The incidence of cage subsidencewas 8.11% in no low back pain group and 36.84% in low back pain group and there was significant difference between the two groups ( t=10.381, P=0.001). Multivariate logistic regression analysis showed that osteoporosis ( P=0.009), intraoperative bone endplate injury ( P=0.031), decreased intervertebral space height ( P=0.029) and cage subsidence ( P=0.016) were associated with low back pain after single-level OLIF. Conclusion:Low back pain is one of the common complications after OLIF. Osteoporosis, intraoperative bony endplate injury, decreased intervertebral space height and cage subsidence were closely related to postoperative low back pain. In order to reduce the incidence of postoperative low back pain and improve the clinical outcomes, attention should be paid to the protection of the bony endplate, rational use of internal fixation and active anti-osteoporosis treatment after operation.

Objective:To study the risk factors of complications after bowel resection for acute mesenteric ischemic disease.Methods:Retrospective case-control study was used to analyze the case data of 68 patients diagnosed with acute mesenteric ischemic disease (AMI) with bowel resection at the First Medical Center of the PLA General Hospital from January 2010 to January 2020, including 43 males and 25 females. The patients were divided into complication group ( n=21) and the non-complication group ( n=47) according to whether they had complications after surgery. The risk factors associated with the development of postoperative complications were analyzed by multivariate Logistic stepwise regression method to determine the risk factors with clinical significance. Measurement data with normal distribution were expressed as mean ± standard deviation ( ± s), and t-test was used for comparison between groups. Chi-square test was used for comparison between count data groups. Results:Univariate analysis showed that age >60 years, Marshall score≥2, type of resected bowel, pathology suggestive of irreversible transmural necrosis, length of ICU stay >6 d, length of mechanical ventilation >2 d, American Society of Anesthesiologists (ASA) classification, and preoperative procalcitonin≥2 ng/mL were the risk factors affecting the development of complications after bowel resection for acute mesenteric ischemic disease risk factors ( P<0.05). Multivariate Logistic regression analysis showed that age>60 years ( HR=12.364, 95% CI: 1.135-134.662, P=0.039) and preoperative procalcitonin ≥2 ng/mL ( HR=14.144, 95% CI: 1.280-156.303, P=0.031) were independent risk factors for the development of postoperative complications after AMI parallel bowel resection. Conclusion:The rate of complications after combined bowel resection for AMI is high. When patients are combined with age>60 years and preoperative procalcitonin≥2 ng/mL, preoperative prevention of postoperative complications should be emphasized to improve the prognosis of patients.

Objective:To understand the health needs of patients with non-dementia cognitive impairment after stroke, to provide reference for targeted interventions.Methods:Using the convergent mixed research method, convenience sampling was used to select post-stroke patients with non-dementia cognitive impairment in China-Japan Friendship Hospital and Beijing University of Chinese Medicine Third Affiliated Hospital, a cross-sectional survey was conducted on 191 patients with non-dementia cognitive impairment after stroke using the health needs questionnaire in March to August 2023. A descriptive study was used to conduct semi-structured interviews with 16 patients.Results:A total of 191 questionnaires were distributed and 191 valid questionnaires were collected, including 103 male and 88 female patients, aged from 34 to 90 years old. The items of the post-stroke health questionnaire were (3.47 ± 0.54), with the highest need for understanding the rehabilitation program (148/191); multiple linear regression analysis showed that gender and primary caregiver type were factors influencing their health needs ( t = 2.39, 2.73, both P<0.05). A total of 16 patients with non-dementia cognitive impairment after stroke, 10 males and 6 females, aged from 58 to 90 years old, were interviewed. Four themes were extracted, namely, information support and behavioral guidance needs, psychological care needs, social support needs, and pre-established medical care plan needs. Conclusions:The health needs of patients with non-dementia cognitive impairment after stroke are at an above medium level and have diversified characteristics. Medical staff should conduct systematic health management based on patients′specific conditions and actual needs to help patients recover or maintain cognitive function.

Objective To evaluate the effect of perioperative nutritional support on the prognosis of lung transplant.Methods Retrospective analysis was carried out on nutritional support for 6 lung transplant recipients in the Department of Thoracic Surgery in Henan Provincial People's Hospital between September 2015 and September 2016.The recipients were all males,with ages ranging from 28 to 60 (40± 12.1).The recipients' body mass index (BMI),serum albumin and pulmonary function at the first test after admission (t1),the last test before surgery (t2) and the last test after surgery (t3) were compared.The recipients' nutritional status was assessed with subjective global assessment.Results The 6 patients had successful single-lung transplant,without mortality or severe complications.At t3,all of them had increases in BMI by (2.4±1.4) kg/m2,weight by (3.2±1.2) kg,deltoid skin-fold thickness by (3.0±0.35) mm,prealbumin by (30±10.4) g/L,total protein (15.2±6.4) g/L,albumin by (6.4±4.1) g/L,triglyceride by (0.2± 1.4) mmoL/L,and total cholesterol by (1.4± 0.9) mmol/L (P＜0.01).The patients were followed up for 6 to 12 months.SGA results suggested no abnormality in their nutrition,and the patients were well able to function independently.Conclusion Nutritional support is vital for patients with severe malnutrition during the perioperative period of lung transplant,and can significantly improve the patient's quality of life.

Objective: To investigate adolescent haze weather health protection behavior, and to provide scientific basis for behavioral intervention and health guidance for adolescents in haze weather. Methods: From June 2015 to April 2016, 1 025 adolescents were selected from 22 classes in two middle schools of Baoding City, Hebei Province, by stratified cluster sampling method. General information questionnaire and the Brief Haze Weather Health Protection Behavior Assessment Scale Adolescent Version (BHWHPBAS AV) were used. Multiple linear regressions were conducted to explore factors affecting adolescent haze weather health protection behavior. Different models were used to confirm associations between influencing factors and BHWHPBAS AV scores. Results: Adolescents had a low overall score of BHWHPBASAV (45.81±13.16). The score rate of self adjustment after haze weather was the highest (64.54%). The score rate of obtaining relevant knowledge before haze weather was the lowest (50.28%). Compared with adolescents in urban area, rural adolescents had a lower BHWHPBAS AV score ( β=-3.20, P <0.01). Compared with students (living with parents), those living without parents had a lower BHWHPBAS AV score ( β=-4.16, P =0.01). Compared with students never receive physical examination,those had received physical examination during the past years had a higher BHWHPBAS AV score ( β=4.44，5.66，9.04, P <0.01). Compared with students with no knowledge of respiratory system diseases, those with moderate to sufficient knowledge had a higher BHWHPBAS AV score ( β=9.34，12.19，P <0.01). These associations were stable and consistent.Multiple linear regression analysis showed that residence, residence with parents, physical examination and knowledge of respiratory diseases were the relevant factors of BHWHPBAS AV score ( P <0.05). Conclusion Adolescent haze weather health protection behavior level is low and is affected by many factors. Cooperation should be strengthened to conduct behavioral interventions and health guidance on haze health protection for adolescents, so as to promote healthy growth of adolescents.