Objective To Study the characteristics of the high site visual field injury and the LED-VEP after the head trauma for the purpose of the medico-legal appraisals. Methods 11 cases with cortical blindness resulted from the head injury were studied and then compared with 20 cases suffered from optical nerve injuries with respect to the clinical manifestations and characteristics of the visual field injury and LED-VEP. Results As compared with the characteristics of the optical nerve injuries, besides the subjective complain of lowering the visual field, there were not any positive findings in pupil reflex of light and retina examination in case of the high site visual field injuries. The electrical visual field test revealed the homony-mous hemianopia while the internal segment optical nerve injury manifested unilateral visual field defect. 8 out of 11 cases with cortical blindness, occipital cortex were injured and the flash VEP demonstrated the slight prolongation of the latent period of the PI wave of both eyes, while the PI amplitudes were normal. 3 out of 11 cases were suffered from the subcortical injuries and were manifested with the prolongation of the latent period of the PI wave and the amplitude of the PI wave were significantly reduced. Conclusion Bilateral homonymous hemianopia were the characteristics of the high site visual field injury while the abnormal rate of the flash VEP of the high site visual field was quite low. So that, homonymous hemianopia may be helpful for the diagnosis of cortical blindness. At the same time CT scanning and the electroen-cephalography (EEG) also must be considered comprehensively in the medico-legal appraisals.

Impedance cardiography,being developed recently,is a noninvasive cardiovascular monitoring technique.In this study,fifty-eight patients undergoing open-heart operations were monitored pre-and posto-peratively by impedance cardiography.It was shown that the results were comparable with the results of other authors using indicator-dilution curves.EVI greater than 1.0?/s indicated normal cardiac fun-ction while EVI less than 0.8?/s indicated markedly subnormal cardiac function.The results indicated that EVI was a sensitive and reliable parameter to estimate myocardial function.TEI less than 1.9? was usually associated with abnormal arterial blood gas analysis,so TFI was useful to assess postoper- ative respiration insufficiency.It was concluded that impedance cardiography was helpful and dependable-in early postoperative patient care in cardiac surgery and it had the advantage of continuous,noniuva-sive,real-time monitoring.

Eight murine monoclonal antibodies against surface determinants of Schistosoma japoni-cum (Chinese mainland strain) schistosomula were generated,of which only one monoclonal IgM antibody (N15D9) gave protection at level ranging from 14 to 39% in experiments of passive transfer or inhibition of infectivity while the others did not exhibit significant levels of passive protection.Further characterization of N15D9 antigen specificity showed that 96 and 14 kDa antigen molecules in cercaria,and 132 and 10 kDa in schistosomula could be recognized by N15D9 in Western blot assay.Furthermore,the 96 and 132 kDa molecules could also be recognized by pooled infected human sera while 14 kDa and 10 kDa only by sera from mice vaccinated with 3-hour schistosomula.The molecules recognizable by N15D9 were surface epitopes repeatedly expressed on cercaria,in vitro 3-hour mechanically transformed schistosomula and 5 day lung-stage schistosomula,as demonstrated by indirect immuno-fluorecence surface binding assay.

Taking feasible precautions is an important step in effectively reducing medical disputes and improving medical quality. Guarding against medical disputes is a complex systematic project, which shares similarities with disease prevention. In view of the causes, evolution and various manifestations of medical disputes, it is imperative to take measures from the following three aspects and guard against them on three levels: ①taking first level(primary) precautions so as to boost overall development and tackle medical disputes at the source; ②taking second level(key) precautions so as to conduct timely imterventions and nip medical disputes in the bud; ③taking third level(emergency) precautions so as to dissolve prominent conflicts and prevent the worsening of medical disputes.

Objective To investigate the effect of progesterone pretreatment of focal cerebral ischemic and reperfusion injury (fCIRI) and underlying molecular mechanisms.Methods A single intraperitoneal injection of progesterone (8 mg/kg) given 1 h,48 h and 96 h before fCIRI was established in male Sprague-Dawley rats.The number of survival of neurons in hippocampal CA1 region of the ischemiaside,as well as spatial memory function,was detected on days 3-8 after fCIRI.Extracellular-signalregulated kinase 1/2 phosphorylation (p-ERK1/2) and nuclear translocation of p-ERK1/2 in hippocampal CA1 region were examined using western blot.Results The number of survival of neuronal cells was significantly increased in ischemic groups treated with progesterone at 1 h and 48 h pre-fCIRI (164.3 ± 11.0,218.5 ± 9.1 and 142.7 ± 12.1,F =29.4,P ＜ 0.01) compared with fCIRI group treated with vehicle.Likewise,the escape-latency to reach the hidden-platform recorded in day 5 of Morris water maze test was reduced markedly in fCIRI-treatment groups compared with the vehicle group(10.3 ± 11.1,19.2 ±9.6 and 32.4 ± 14.3 ;F =35.8,P ＜0.01).The level of p-ERK1/2 was elevated notably during 24 h to 48 h postprogesterone by western blot,while restored to the baseline at 96 h post-progesterone.Improved nuclear translocation of p-ERK1/2 was observed from 2 h to 48 h post-progesterone.The progesterone receptor antagonist RU486 blocked the exaltation of either intracellular level or nuclear translocation of p-ERK1/2,which was induced by progesterone.Conclusions The pretreatment with progesterone exerts a neuroprotective effect against the ischemia-induced neuronal death and ameliorates the deficits in spatial memory through enhancing the activation of ERK1/2.The neuroprotection derived from pretreatment with progesterone achieves a time window of not less than 48 h,which is progesterone receptor-mediated ERK1/2 signaling pathway-dependent.

Objective To explore an effective treatment for hypertensive intracerebral hemorrhage.Methods By the method of random and control,patients with hypertensive intracerebral hemorrhage were randomly divided into two groups:the treatment group(32 patients)was treated with integrated traditional Chinese and western medicine therapy,including super-early operation,conventional western medicine and Chuanxiongqin injection treatment.The control group(40 patients)was treated with operation and conventional western medicine treatment.The effect was evaluated on 28 th day after treatment.Results The effect of the treatment group was superior to that of the control group(χ~2=4.15,3.26,P＜0.05).The treatment group had lower mortality rate(χ~2=8.04,P＜0.05)and lower morbidity of complications(pulmonary infection:6/16 cases,χ~2=11.37,P=0.01;upper-congestive hemorrhage:8/16 cases,χ~2=4.10,P=0.04)statistical data indicated that there was significant difference between treatment group and control group.Conclusion Super-early operation with traditional Chinese medicine in treatment of hypertensive intracerebral henorrhage has a better effect than the treatment without traditional Chinese medicine.

To screen and identify the possible pathogen of the firstly confirmed human case of avian influenza A in Beijing, the throat swabs and tracheal aspirates of this case were collected and the H5N1 viral nucleotide was tested with real time RT-PCR. The certification of result, screening of other pathogens in respiratory tract and sub-typing of influenza viruses were made by using re-sequencing microarray. It was found that the H5N1 viral nucleic acid was positive in the tracheal aspirate of this case by means of detection with real time RT-PCR and the specific sequence of the non-structural protein (NS) gene of H5N1 virus was obtained through the detection with re-sequencing clip. Through the comparative study with the sequence in Genbank, it was proved to be the H5N1 nucleic acid of avian influenza viruses and excluded the possibility of infections with 30 subtypes of influenza viruses and 33 other respiratory tract pathogens. It is apparent that the pathogen detection with re-sequencing clip shows the high sensitivity and specificity and it plays an important role in the pathogen screening and identification for the firstly confirmed human case of avian influenza A in Beijing.

Objective To investigate the effects of recombinant tissue plasminogen activator (rt-PA)intravenous thrombolysis on blood-brain barrier (BBB) permeability,the expressions and the activities of MMP-2 and MMP-9 after cerebral ischemia in rats.Methods A total of 40 adult male Sprague-Dawley rats were allocated into 3 groups:Sham operation group (n =10),middle cerebral artery occlusion (MCAO) group (n =18),and rt-PA thrombolysis group (n =18).A MCAO model was established by using autologous thromboembolism.The sham operation group did not inject any thromboembolus,the MCAO group only made MCAO,and the rt-PA thrombolysis group received intravenous thrombolysis with rt-PA at 3 hours after MCAO.Brain infarct volume was determined by 2,3,5-triphenyl tetrazolium chloride staining BBB permeability was measured by Evans blue dye leakage.The activities and the expressions of MMP-2 and MMP-9 in brain tissue were detected by Gelatin zymography and Western blot,respectively.Results Compared to the MCAO group,the neurological function was improved significantly in the rt-PA thrombolysis group,and the infarct volume was also reduced significantly (t =7.365,P =0.005).However,the hemorrhage score (t =-3.286,P =0.017) and BBB permeability (t =-3.947,P =0.029) were increased significantly.The activities and the expressions of MMP-2 and MMP-9 in the sham operation group were lower.The activities and the expressions of MMP-2 (t =-45.121,P =0.000; t =-11.624,P=0.000) and MMP-9 (t=-71.849,P=0.000; t=-8.992,P=0.000) in the MCAO group were increased and upregulated significantly.Compared to the MCAO group,the activities and the expressions of MMP-2 (t =-28.792,P =0.000; t =-3.809,P =0.013) and MMP-9 (t =-53.506,P =0.000; t =-2.640,P =0.046) in the rt-PA thrombolysis group were increased and upregulated significantly.Conclusions After rt-PA intravenous thrombolytic therapy,the BBB permeability was increased.The activities and the expressions of MMP-2 and MMP-9 were increased and upregulated.MMP-2 and MMP-9 might participate in the increased BBB permeability,and thus inducing hemorrhagic transformation after rt-PA intravenous thrombolytic therapy in rats with cerebral ischemia.

Objective To establish and validate a modified rat thromboembolic stroke model.Methods After taking femoral arterial blood and mixing it with thrombin,they were injected into PE-50 catheter for preparing in vitro thrombosis in 60 Sprague-Dawley rats.A thromboembolic cerebral ischemia model induced by catheterization of the right external carotid artery and the small blood clot emboli were injected into the internal carotid arteries.Thirty rats were randomly divided into a large number of emboli group (n =10 with 12 emboli),a median number of emboli group (n =10 with 10 emboli) and a small number of emboli group (n =10 with 8 emboli).Two hours after embolus injection,the neurological deficit score was performed and the success rate of the model was compared in all groups.Twenty-four hours after embolus injection,the rats were sacrificed and the brains were removed for 2,3,5-triphenyltetrazolium chloride staining.The hemorrhage,infarct volume,bleeding incidence and mortality after cerebral infarction were evaluated.The high success rates of the modeling in the emboli groups were selected and they were randomly divided into either a normal saline group (n =12) or a recombinant tissue-type plasminogen activator (rtPA) group (n =12).The rats were given normal saline and rtPA at 3 hours after embolus injection.Before embolus injection and 2,6,12 and 24 hours after embolus injection,the neurological scores were performed respectively; 24 hours after embolus injection,the rats were sacrificed and the brains were removed for 2,3,5-triphenyltetrazolium chloride staining.The hemorrhage rate,infarction size,degree of cerebral edema,and blood-brain barrier permeability were evaluated.Results Only 40％ of rats had neurological deficits in the small number of emboli group,and the infarct volume was only 10.54 ± 2.82％.The success rates in the median and large number of emboli groups were 80％ and 100％ respectively.They were all significantly higher than those in the small number of emboli group (P =0.011 ).The infarct volume was also significantly greater than that in the small number of emboli group (F =40.897,P =0.000).After administration of rtPA,the mean survival time of the rats in the large number of emboli group was less than 24 hours,so the median number of emboli group was selected to study the thrombolytic effect of rtPA.The infarct volume and neurological function score in the rtPA group were improved significantly compared to the normal saline group (t =7.728,P =0.000),while there were no significant differences in the hemorrhage rate,degree of brain edema and blood-brain barrier permeability between the 2 groups.Conclusions The stability and reproducibility were good in the modified thromboembolic cerebral ischemia model injected with 10 emboli,the neurological function was improved significantly after thrombolysis,and it was applicable to the experimental study of pathophysiology of cerebral ischemia and thrombolytic therapy.

Objective To detect the expression of BRIT1 in cervical cancer tissues and cervical noncancer tissues ,and to analyze the differences between the two tissues .Methods The expression of BRIT1 mRNA and protein in cervical cancer tissues and the paired cervical noncancer tissues was evaluated by RT‐PCR and immmunohistochemistry .Its correlation with the clinicopathological parameters including age ,tumor types ,size ,tumor pathological grade and clinical stage was analyzed .Results RT‐PCR results showed that the BRIT1 mRNA level in cervical cancer tissues was significantly lower than that in the paired cervical noncancer tis‐sues ,the difference was statistically significant (P<0 .05) .The immmunohistochemistry results showed that the BRIT 1 protein ex‐pression level in 44 cases of 63 (69 .8% ) samples wa slower than that in the paired cervical noncancer tissues ,the difference was statistically significant(P<0 .05);In high pathological grades and high clinical stages ,the decrease of BRIT1 protein expression was more significant .Conclusion The difference of the BRIT1 expression between the cervical cancer tissues and cervical noncancer tis‐sues suggests that BRIT1 may play a certain role in the occurrence and development of cervical cancer .