ObjectiveTo review the surgical technique and outcome of intracranial angiographically occult vascular malformations (AOVM) hemorrhage. Methods40 patients with spontaneous intracranial hemorrhage episodes and accepted microsurgery were analyzed retrospectively. ResultsAll AOVMs were successfully resected. No operative death occurred.36 patients were followed up for mean 28 months. CT and/or MRI revealed no residual lesions. Most neurological complications improved postoperatively. 1 case demonstrated rebleeding in surgical site 48 months after operation. Another case, a follow-up MRI scan revealed a contralateral denovo lesion 44 months after operation.ConclusionA current neurosurgical procedure is a satisfactory method to prevents AOVMs rebleeding. Long-term follow-up evaluation is necessary despite the lesion has been totally resected.

Objective To observe the effects of recombinant staphylokinase (r-SAK) on platelet activation parameters in patients with acute myocardial infarction(AMI) by intravenous thrombolysis in order to investigate the clinical thrombolytic efficacy of r-SAK therapy in AMI comparing with recombinant tissue-type plasminogen activator(rt-PA) therapy.Methods Thirty-three patients with AMI within 12 h after the onset were selected and divided randomly into the r-SAK therapy group(n=17) and rt-PA therapy group(n=16).Coronary artery angiography(CAG) was performed 90 min after thrombolytic therapy in patients.Thrombin-antithrombin complex(TAT) and alpha granule membrane protein(GMP-140) were measured by similar commercial enzyme-linked immunosorbent assay(ELISA).Results In r-SAK group and rt-PA group,the plasma contents of GMP-140 2 h after thrombolytic therapy were significantly higher than before therapy(P0.05).In rt-PA group,the plasma content of TAT 2 h after thrombolytic therapy increased significantly(P0.05).) Conclusion r-SAK has similar effect with rt-PA and it will become available for highly fibrin-selective thrombolytic therapy of AMI.Thrombolytic treatment with r-SAK can improve the injury of myocardial microperfusion.

Viral myocarditis (VMC) is a clinical frequent cardiovascular disease with extremely high mortality and disability rate ,which seriously impairs the health of children and young adults ,and its pathogenesis has not been fully elucidated .It is generally believed that VMC pathogenesis is mainly related to direct damage on myocardial cells ,immune damage ,cell apoptosis and cytokines .The present article made a summary about the research progress of its pathogenesis .

BACKGROUND: This study aimed to determine the potential protective effect of inducing hypertransfusion to the gastrointestinal tract following a porcine model of cardiac arrest and cardiopulmonary resuscitation (CPR) by evaluating the influence of gastrointestinal ultrastructure, ATPase and serum diamine oxidase. METHODS: Ventricular fibrillation was induced by programmed electrical stimulation in 16 male domestic pigs (n=8/group). Four minutes after ventricular fibril ation, CPR was performed. The pigs that successfully restored spontaneous circulation received intravenous infusion of either norepinephrine to maintain the mean arterial pressure at 130％ of the baseline before ventricular fibril ation or normal saline. Serum diamine oxidase and gastrointestinal ATPase activity were determined, and histopathological examination of the gastrointestinal tract was performed by light and electron microscopy. RESULTS: CPR caused significant injury to the gastrointestinal tract, elevating serum diamine oxidase and causing destruction of intestinal microvillus in control animals. Na+-K+ ATPase and Ca2+ATPase activity in gastric tissue were significantly elevated in animals receiving hypertransfusion treatment compared with the control animals. Hypertransfusion also significantly reduced serum diamine oxidase to below control levels after CPR. Moreover, severe injury sustained by the gastrointestinal tissue was markedly ameliorated under hypertransfusion conditions compared with the control animals. CONCLUSIONS: Gastrointestinal injury and abnormal energy metabolism were strikingly evident following CPR. Hypertransfusion inducing hypertension can improve energy metabolism and ameliorate gastrointestinal mucosal injury, indicating that hypothermia significantly ameliorates gastrointestinal injury sustained following cardiac arrest.

Objective: To investigate the association between frailty and type 2 diabetes mellitus (T2DM) using a bidirectional two-sample Mendelian randomization (MR) analysis, so as to provide the evidence for the prevention and control of frailty and T2DM. Methods: Frailty status was assessed using the Fried Frailty Score (FFS), with aggregated data sourced from 386 565 European samples in the UK Biobank. The T2DM data were obtained from the summary results of genome-wide analysis published by the Diabetes Genetics Replication and Meta-analysis Consortium, excluding the UK Biobank data, including 455 313 European samples. Eligible single nucleotide polymorphism site were selected from the FFS and T2DM summary data as instrumental variables. The bidirectional MR analysis was performed using the inverse-variance weighted method. The heterogeneity was assessed using the modified Cochran Q test. The horizontal pleiotropy of instrumental variables was examined using MR-Egger regression. The robustness of the results was evaluated using the leave-one-out method. The bias was tested using funnel plot. Results: The forward MR analysis revealed a statistically significant association between increased FFS and an increased risk of T2DM (OR=2.280, 95%CI: 1.169-4.447). The reverse MR analysis showed a statistically significant association between T2DM and increased FFS (β=0.026, 95%CI: 0.012-0.041). Both bidirectional MR results were robust, with no horizontal pleiotropy of the instrumental variables was found (all P>0.5); and the funnel plots did not show significant basis. Conclusion The study found a bidirectional causal association between frailty and T2DM.

Objective To explore the formation mechanism of peritumoral brain edema(PTBE)by vascular endothelial growth factor(VEGF).Methods 40 biopsies were obtained from 37 patients.Inmunohistochemical staining and Western blot were performed to detect the expression of VEGF protein.Reverse-transcriptase polymerase chain reaction(RT-PCR)was used to analyze the presence and quantity of VEGF mRNA.The extent of PTBE was estimated as an edema index(EI)based on preoperative magnetic resonance imaging.Results In VEGF-positive cases,a decreasing gradient of VEGF protein expression was observed with increasing distance from tumors(0.38±0.08,0.20±0.03,0.04±0.02).In meningiomas,the protein level and the mRNA level were congruent and the expression of both protein and mRNA had a significant correlation with EI(protein: r =0.892,RNA: r =0.875,P ＜ 0.05).However,in peritumoral areas,protein level were not consistent with the mRNA level.Protein results showed high correlation with EI(r =0.912,P ＜ 0.05),but mRNA almost was almost undetectable(0.06±0.02).Conclusion VEGF is impartant on PTBE.It is concluded that VEGF macromolecules are secreted by tumor tissue and enter peritumoral normal brain tissue to induce edemagenesis in meningiomas.

Objective To study changes of trigemino-cervical reflex (TCR) in patients with Kennedy's disease (KD). Methods The parameters of TCR were analyzed among patients with KD, amyotrophic lateral sclerosis and healthy controls. Results The parameters of ipsilateral P19, N31, A and contralateral P19, N31, A among patients with KD were (23.91±4.84), (35.45±4.76) ms, 1.24± 0.33 and (24.34±4.82), (36.20±4.91) ms, 1.19±0.25, respectively. Compared with the healthy controls((18.37±2.16), (28.50±1.56) ms, 1.90±0.43; (18. 72±2. 18), (29. 19±1.43) ms, 1.84 ± 0. 40), the difference in each parameter was significant (ipsilateral : t = 5.77, 8. 19, -6. 64; contralateral:5.05, 7.62, -7.77, all P<0.01). Conclusion The parameters of TCR were abnormal in KD patients, indicating that the trigeminal nerves and the bulbar may be involved in the disease.

The clinical and fundamental research for intrahepatic and extrahepatic biliary stones were still inadequate currently.It was difficult for treat and has the following clinical features:extensive he-patic lesion,complex conditions,more complications,higher recurrence rate,etc.Satisfactory results were hard to gained if just depend on conventional surgery recently.As the methods of diagnosis and treatment are continuously increasing:Ultrasound,CT,MRCP,Choledochoscope,Cholangiography and 3D imaging of hepa-tobiliary system.From the traditional open operation to a variety of minimally invasive treatment.Different examination and treatment methods has its advantages and disadvantages.How to choose the effective,less trauma,appropriate pathway method is the main direction for the current research.

Objective A new breed of licorice seeds(Wuxin No.1) was selected from wild licorice,Glycyrrhiza uralensis.Methods Its germination rate,content of soluble protein,and peroxidase(POD) activities were investigated and compared with the wild licorice seeds(control group).The leaves of Wuxin No.1 were collected and its genetic polymorphism was analyzed by inter-simple sequence repeat technique(ISSR).Results The results suggested that the seed vitality in Wuxin No.1 was higher than that in the control group.The change of soluble protein and POD activity also demonstrated that the seeds in Wuxin No.1 have the higher vigor.ISSR Analysis showed that among 22 random primers used in this experiment,six primers generated different DNA band types,which meant that there was genetic polymorphism in Wuxin No.1.Conclusion All these changes indicate that Wuxin No.1 is a prospective domestication species of licorice and may be cultivated widely in the future.

Interin-linked kinase (ILK)is a kind of effector of intra-and extracellular biological signal transduction,partici-pating in the formation of multiple signal pathways,it plays an important role for occurrence and development of heart dis-eases such as cardiac hypertrophy,coronary heart disease,viral myocarditis,dilated cardiomyopathy etc..