Objective To study the changes of apoptosis in brain after traumatic injury(TBI)treated with exogenous vascular endothelial growth factor(VEGF)gene therapy in oder to find out the role of exogenous VEGF gene in protectiog brain tissue.Method The injurea cerebral cortex from the rat models of brain with traumatic injury was injected with adenovirus(adenovirus,Ad)as the carrier of VEGF-165 gene(Ad-VEGF-165 Gene).RT-PCR and Western blot were used to detect the expression of VEGF mRNA and VEGF protein in the brain 6 h,24 h,3 d,7 d and 14 d after injury,and apoptosis in the injured location of brain was also detected by TUNEL successively after Ad-VECF-165 gene therapy.Results With exogenous Ad-VEGF-165 applied to the locally injured brain tissue after injury,VEGF mRNA and VEGF protein showed consistent expression and their expressions were significantly higher than those in trauma group and vehicle control group.Compared with the trauma group.the apoptosis in the gene therapy group 24 h,3 d and 7 d after injury presented a.significant reduction,and had close relationship with VEGF.(Control group:4.17±0.73;TBI group,24 h:47.18±6.01,3 d:79.44±11.23;TBI+VEGF group.24 h:28.72±5.31,3 d:54.18±7.66;P＜0.05).Conclusions The exogenous VEGF gene therapy administered to have protective effects on the local brain tissue in rats with traumatic injury in a certain time.

Objective To investigate the changes of region cerebral homodynamic and cerebral vascular autoregulation in traumatic brain injury(TBI) by dynamic CT perfusion(CTP) imaging in rat.Methods Forty-five SD rats underwent CTP,including 10 control rats and 35 TBI rats,on 1,6,24 h,and day 3,7,14,21 after TBI.The region of interest(ROI) was located near traumatic area within 2 mm and mirror area of relative brain hemisphere.False color pictures and dynamic rCBF,rCBV,MTT and PS were obtained in different time.Pathological examination was also done.Results The rCBF,rCBV on 1 h after TBI was lower than that of control group,and significantly higher on 6-24 h after TBI.They reached the peak on day 3.PS had a similar change compared with rCBF,rCBV,but a longer duration.MTT showed to moderate changes except an isolated tide on 3 days after TBI.The rCBF on mirror area of relative brain hemisphere was almost stable except 3 days after TBI,which was lower than that of control group.Meanwhile,the rCBV on mirror area of relative brain hemisphere was normal.Conclusion CTP is an advanced technique to investigate the changes of region cerebral homodynamic and cerebral vascular autoregulation in TBI.The early hypoperfusion and next hyperperfusion around traumatic areas after TBI suggest that the dysfunction of cerebral vascular autoregulation should be committed to the change of homodynamic in TBI.

With the rapid development of neurosurgery,requirement for neuroanatomy is increasing in clinical practice.The authors made a primary exploration on how to teach focal neuroanatomy for neurosurgical postgraduate students.The idea of asking the students to draw focal anatomy was suggested by the author with the purpose of making them learn it positively.Software workstation and clinical neuroradiological work-ups such as MRI and DSA were also applied and evaluated.The authors proposed all these procedures be helpful for comprehending neuroanatomy.

Objective To investigate the indication, preoperative evaluation, technical tip, prevention and treatment of complications, effect, and clinical use of the embolization of intracranial aneurysms by using GDCs. Methods From July 1998 to February 2000,93 patients with 118 intracranial aneurysms were embolized using GDCs, including 84 ruptured aneurysms (Hunt-Hess grade, Ⅰ 18 cases, Ⅱ 29 cases, Ⅲ 25 cases, Ⅳ 10 cases, Ⅴ 2 cases). 72 patients were treated at emergency, and 48 patients had CTA examination preoperatively. The operations were completed under the DSA monitoring. Continuous lumbar subarachnoid drainage was instituted and standard 3H treatment was given postoperatively. Results Total occlusion was achieved in 104 aneurysms(88 14%), over 90% in 11aneurysms(9.32%), less than 90% in 3 aneurysms(2 54%), with 3 patients (3/93, 3 23%) died in the cohort. One case rebleeded after 1.5 months and was cured by surgical clipping, 2 patients experienced enlargement of the aneurysmal neck and were reembolized. Following-up was performed from 2 to 22 months, 1 had severe disability, 7 had mild neurological deficit symptoms. Conclusion The results of short-term follow-up suggested that embolization of intracranial aneurysms with GDCs be microtraumatic, safe, effective, and reliable. Partial packing may result in continuous enlargement, rupture, and bleeding, while tight coil packing in aneurysms was reliable. The ruptured aneurysms need emergency embolization, and postoperative continuous lumbar subarachnoid drainage can enhance curative effect significantly.

Objective To determine the effectiveness and safety of antiplatelet and anticoagulant agents in the treatment of extracranial internal carotid artery dissection (eICAD). Methods Antiplatelet and anticoagulant agents were adopted to treat two cases of eICAD in our hospital. The clinical data were retrospectively analyzed and the medical literatures concerning eICAD, which were obtained from Pubmed database, were reviewed. Results Most researches advocated the empirical use of antiplatelet and anticoagulant agents in eICAD. About 30% of occluded eICAD could be reopened in 8 days and about 60% - 80% in 3 months after the onset of the disease. During the period of treatment, the rate of ischemic stroke recurrence, disability or death was 8.3%-14.3% in anticoagulant group, while it was 7% - 23.7% in antiplatelet group. Conclusion Antiplatelet agents can be used in patients with eICAD who are contraindicated to anticoagulants. Anticoagulants should be used as early as possible in patients who are not contraindicated to anticoagulants.

Objective To summarize experiences in diagnosis and interventional management for intracranial vertebral arterial dissection. Methods Clinical symptoms and imaging results were analysed in 23 cases of intracranial vertebral dissection, and corresponding interventional managements were reviewed. Results Clinical symptoms consisted of spontaneous SAH and vertebrobasilar insufficiency. DSA usually showed "pearl and string" sign. Interventional management included stent assisted coiling of the dissection, embolization of the affected artery with GDC and to learn the details of the stenotic ICA and draw up and appropriate operation plan.Conclusions Direct energetic intervention should be undertaken promptly for intracranial dissection.

Due to the minimum free energy model, it is very important to predict the RNA secondary structure accurately and efficiently from the suboptimal foldings. Using clustering techniques in analyzing the suboptimal structures could effectively improve the prediction accuracy. An improved k-medoids cluster method is proposed to make this a better accuracy with the RBP score and the incremental candidate set of medoids matrix in this paper. The algorithm optimizes initial medoids through an expanding medoids candidate sets gradually. The predicted results indicated this algorithm could get a higher value of CH and significantly shorten the time for calculating clustering RNA folding structures.
Algorithms ; Cluster Analysis ; Nucleic Acid Conformation ; RNA ; chemistry

BACKGROUND:Baloon kyphoplasty is effective in the treatment of osteoporotic vertebral compression fractures, but it is unclear that which one is proper, unilateral or bilateral approach, with better efficacy and fewer
complications.
OBJECTIVE:To assess the efficacy and safety of unilateralversus bilateral baloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures.
METHODS: We searched the electronic bibliographic databases including Cochrane Library, PubMed, EMBASE, ISI Web of Knowledge, CBMdisc and other databases to colect clinical trials concerning unilateral versus bilateral baloon kyphoplasty. Two estimators independently evaluated the quality of these included studies and analyzed data by Cochrane Colaboration’s RevMan 5.2 software.
RESULTS AND CONCLUSION:Fourteen trials involving 876 patients were included. There were 442 cases of unilateral approach and 434 of bilateral approach. The meta-analysis showed that there were no significant
differences in pain score by visual analog scale, vertebral height, and kyphotic angle; while the unilateral approach had less operating time, lower amount of cement injected and lower risk of cement leakage
than the bilateral approach [mean difference (MD)=-19.33, 95% confidence interval (CI) (-24.42,-14.24);
MD=-2.07, 95%CI (-2.42,-1.71); odds ratio=0.47, 95% CI (-24.42,-14.240)]. These findings indicate that the unilateral baloon kyphoplasty can reduce the leakage rate of bone cement.