Moyamoya disease is a tare intracranial angiopathy resulting in symptoms and prognosis similar with the stroke,if not diagnosed and treated early.The article reviews the characteristics,pathogenesis,treatment and prognosis of Moyamoya disease.Clinicians should be aware of this disease in routine work,so that the patients with Moyamoya disease can be early diagnosed and treated to avoid disability or death.

Objective To determine the effect of ghrelin on protecting the human umbilical vein endothelial cells (HUVEC) from injury by angiotesin Ⅱ(AngⅡ) in vitro. Methods (1)HUVEC was incubated for 24 h with AngⅡ whose final concentration in the medium varied from 10-9 to 10-6mol/L or pretreated with 10-9to 10-6mol/L ghrelin for 2 h before incubation for 24 h with AngⅡwhose final concentration in the medium was 10-6mol/L. HUVECs were harvested to measure the cell vitality and cell apoptosis. The cell vitality was determined by MTT and cell apoptosis rates were measured by Annexin V-FITC apoptosis detection kit. (2)HUVECs were incubated for 3,6,12,or 24 h with 10-9,10-8,10-7,or 10-6mol/L AngⅡ, respectively. Before HUVECs were incubated with 10-6 mol/L AngⅡfor 24 h, ghrelin (10-9,10-8,10-7, and 10-6 mol/L) was used to pretreat the cells for 2 h. Growth hormone secregogue receptor 1a blocker [D-Lys3]GHRP-6 was added to the cells which were incubated for 24 h with 10-6mol/L AngⅡ and pretreated with 10-6 mol/L ghrelin for 2 h. Cell reactive oxygen species were measured by dichlorofluorescin (DCF) fluorescence probe method. (3)HUVECs were incubated for 24 h with 10-9,10-8,10-7, or 10-6mol/L AngⅡ and ghrelin, respectively,and then were incubated with 10-6mol/L of AngⅡ for 3,6,12,or 24 h. Furthermore,HUVECs were pretreated with 10-9,10-8,10-7, or 10-6mol/L ghrelin for 30 min,1 h,or 2 h, and then were incubated with the inhibitor of mitogen-activated protein kinase /extracellular regulated kinase (MAPK/ERK1/2),PD98059, the inhibitor of phosphoinositide-3-kinase/serine threonine kinase( PI3K/Akt)wortmannin, and [D-Lys3]GHRP-6 for 24 h. NO production was compared among groups. HUVECs were pretreated with ghrelin,PD98059, wortmannin, and [D-Lys3]GHRP-6 for 2 h and co-cultured with 10-6mol/L AngⅡfor 24 h,or pretreated with ghrelin plus PD98059, wortmannin, and [D-Lys3]GHRP-6 before incubation with AngⅡfor 24 h. NO was measured in the endothelial cell supernatants by Griess method. (4)HUVECs were cultivated with blank or AngⅡwith or without pretreatment with ghrelin or both ghrelin and wortmannin. The protein expression of eNOS and phospho-protein expression of Akt were measured by Western blot analysis. Results AngⅡinjuried the endothelial cell vitality,increased the cell apoptosis rates in HUVECs, and decreased NO production in HUVEC supernatants,whereas ghrelin protected HUVECs from AngⅡ injury. Ghrelin decreased the reactive oxygen species in HUVECs induced by AngⅡ. The effect could be attenuated by [D-Lys3]GHRP-6 pretreatment; PD98059 alleviated AngⅡ inhibition of NO production in HUVEC supernatants. Wortmannin and [D-Lys3]GHRP-6 could abolish protection of ghrelin from reducing NO production in HUVEC supernatants. AngⅡreduced the expression of eNOS,but ghrelin increased eNOS expression. Wortmannin could cancel this effect of ghrelin. Ghrelin increased p-Akt expression and reached the peak in 10 and 20 min. Conclusion Ghrelin may protect HUVECs from AngⅡinduced injury, which is related to decreasing oxidative stress, increasing the protein expression of eNOS, and activating PI3K/Akt signal pathway through GHSR1a receptor.

Objective To investigate the changes of airway resistance before and after Bronchial Diulation Test in patients with senile asthma and the effect of age on the degree of airway resistance. Methods A total of 29 (> 60 years)senile asthma patients and 21 younger(< 60 y)patients were enrolled in the study. The status of their pulmonary function was determined by MEFV(Maximum expiratory flow?volume curve)and an IOS(impulse oscillometry) system before and after Bronchial Diulation Test,The spirometric indexes such as forced vital capacity,total respiratory impedance,respiratory resistance and respiratory system reactance were collected and analyzed. Results Significant decreases of indexs were found after Bronchial Diulation Test compared with those before Bronchial Diulation Test in the study group(P<0.05,respectively). No significant difference in improvement of indexs was found between the group of patients with senile asthma(age > 60 years)and the group of healthy control(age < 60 years ). Each index of the airway resistance has a very good correlation with FEV1%,with the highest degree of relation is X5%. Conclusion The airway resistance of senile asthmatic patients was significantly improved after diuslation test and these indexes IOS would be valuable in evaluating the changes of airway resistance of senile asthma.

Objective To explore the means of haemostasis in gallbladder preserving cholecystolithotomy. Methods The clinical data of 31 cases were retrospectively analyzed, summarizes the successful experiences. Results There appeared 31 cases the gallbladder internal bleeding in 512 cases gallbladder preserving cholecystolithotomy. In all the cases, 31 operations were stopped bleeding satisfactorily and performed successfully without conversion to conventional laparoscopic surgery, without perforation of gallbladder. pressure and lavage hemostasis had common effect, the control coagulation hemostasis had satisfaction rate 96.6%. Except one patient used gallbladder whole layers suture method. Conclusion The control coagulation hemostasis with the high-frequency electric knife is the optimal way, pressure and lavage hemostasis is basal, and gallbladder whole layers suture method is supplement.

AIM: To assess the impact of weaver gene on neuronal development,protein expression and vitality. METHODS: DNA encoding the wild-type and mutant ion channel was introduced into immortalized tyrosine hydroxylase-positive CNS-derived neurons named CAD(Cath.a-differentiated,a variant of Cath.a. Cath.a was established by targeted oncogenesis in transgenic mice) cells. DNA clone, immunostaining and Western blotting were used. Three different concentrations (0 25 mg/L, 0 5 mg/L, or 1 0 mg/L) of Girk2 and wv Girk2 expression plasmids were transfected into the CAD cells. The number of transfected cycling cells, protein synthesis and neurites growth were observed between two groups. RESULTS: The number of transfected cycling CAD cells with high concentration of wv Girk2 reduced to about 60%, compared to Girk2-transfected cells. Low concentration of wv Girk2 did not cause cell death but reduced the protein production of transfected genes. Neurite growth was also affected by wv Girk2. MK-801 and Kir2.3 altered the effect of wv Girk2. CONCLUSION: The results indicate that wv Girk2 functions as a blocker in weaver animals, which blockes the wv Girk2 channel to rescue the cells from death. Our data also suggest that the presence of channels and the level of wv Girk2 may have a significant impact on the fate of cells containing wv Girk2.

Objective To explore the changes of rabbit adipose stem cells(ASCs)and bone mesenchymal stem cells(BMSCs)cultured in vitro and the anabolism under basic fibroblast growth factor(bFGF).Methods BMSCs and ASCs were cultured with DMEM,DMEM/F12(2∶1)or α-MEM respectively.The 3rd generation ASCs and BMSCs were divided into 2 groups respectively:group A:ASCs cultured in chondrogenic medium(CM),group B:ASCs cultured in CM supplemented with bFGF 5 ng/ml,group C:BMSCs cultured in CM,group D:BMSCs cultured in CM supplemented with bFGF 5 ng/ml.Morphological changes were observed under inverted microscope.The 35SO42-incorporation and total hydroxyproline were measured.Results BMSCs and ASCs showed much higher growth rate when cultured in α-MEM medium comparison with that in DMEM or in DMEM/F12(2:1).Both stem cells attachment cultured in monolayer greatly increased and cell clones were abundant,while the cells attachment became rather difficult and cell clones were less after cutured in CM.All stem cells possessed a round-like morphology,and the cells in group B and D were more than that in the other 2 groups.The 35SO42-incorporation and total hydroxyproline synthesis of group B or D increased compared with that of group A or C,but there was no diference between group D and B.Conclusion The rabbit ASCs and BMSCs cultured in CM suppling with bFGF grow well and their metabolism increased.

Objective To compare the effect of high volume continuous blood purification (CBP) with routine CBP on multiple organ dysfunction syndrome(MODS).Methods 38 patients with MODS were randomly divided into high volume CBP group( treatment group,18 cases) and routine CBP group (control group,20 cases).And they were respectively detected on mean arterial pressure(MAP),dosage of Dopamine,PaO2/FiO2,APACHE [ score,lactic acid,length of stay and mortality in ICU post-treatment 24h and 48h.Results Compared with control group,MAP and PaO2/FiO2 on treatment group were more higher( P ＜ 0.05 ),while dosage of Dopamine,APACHE Ⅱ score,lactic acid were significantly shorter than these of treatment group( P ＜ 0.05 ),and length of stay and mortality in ICU were significantly lower than those of treatmen group [ ( 8.54 ± 4.15 ) d vs ( 11.82 ± 5.76) d,P ＜ 0.05:22.2％ vs 35.0％,P ＜0.05 ].Conclusion High volume CBP could reduce the mortality in ICU compared with control group routine CBP.

Objective To discuss the experiences in successful treatment of hyperacute traumatic intracranial hematoma with percutaneous puncture and craniotomy.Methods Pereutaneous puncture and craniotomy was performed in 12 patients with hyperacute traumatic intracranial hematomas including seven with subdural hematoma,three with epidural hematoma and two with episubdural hematoma.Before operation,there found enlargement of bilateral pupil in six patients,enlargement of unilateral pupil in six and changed breathing rhythmicity in eight.Glasgow Coma Scale(GCS)was 3 points in four patients,4 points in six and 7 points in two.Results After pereutaneous puncture,enlarged pupil was retracted at different degrees in nine patients and spontaneous breathing conditions improved in seven.After crani otomy,two patients died within 24 hours,four died after 24 hours but six patients survived.The follow-up for 0.5-2 years showed four patients with sound Glasgow Outcome Score,two at vegetative state and six deaths.Conclusion Percutaneous puncture combined with craniotomy is an effective way for hyperacute intracranial hematoma.

Objective To explore the relationship between the apoptosis of esophageal carcinoma tissue and its adjacent tissues with the survival time of patients with esophageal carcinoma by examining the apoptosis in esophageal carcinoma tissue and its adjacent tissues.Methods FCM Wag performed to detect the rates of apoptosis in 68 cases of esophageal carcinoma and their adjacent tissues and 28 cases of normal esophageal mucosae tissue.Sixty-three patients with esophageal carcinoma had been followed up and noted the survival time of every patient from the operated day to the deadline.Results The rate of apoptosis was the highest in the normal esophageal mucosae tissue(12.78±1.32)%,(7.79±1.48)% in adjacent tissue,and(4.16±2.06)% in esophageal carcinoma tissue,respectively.To follow the survival time after operation of 63 cases with esophageal carcinoma showed 60 cases in one year survival time and 35 cases in three years survival time.The rate of apoptosis in the esophageal carcinoma and its adjacent tissues wag(3.45±1.51)% and (3.96±0.94)% in the patients of one year survival time,(3.90±2.53)% and (7.89±2.27)% in the patients of three years survival time,respectively,P<0.05.Conclusions There is the phenomenon of apoptosis-escape in the esophageal carcinogenesis.There is close relationship between the apoptosis of esophageal carcinoma tissue and the survival time after operation.The apoptosis in the adjacent tissue is more important than that in the esophageal carcinoma tissue for evaluating the survival time after operation of patients with esophageal carcinoma.

Objective To study the expression of early growth response gene-1(Egr-1)in esophageal carcinoma tissue,and to explore the relationship between Egr-1 and the survival time of the patients with esophageal carcinoma.Methods RT-PCR was performed to detect the expression of Egr-1 mRNA in68 cases of esophageal carcinoma.The relationship between survival time and prognosis was analyzed.Results The expression of Egr-1 mRNA was the lowest(0.567±0.404),(0.945±0.336)and(1.201±0.347)in esophageal carcinoma tissue,para-cancerous tissue and normal esophageal mucosa tissue,respectively(F=12.709,P＜0.05,P＜0.00).21 cases showed the positive expression of Egr-1 mRNA of both the esophageal carcinoma tissue and the para-cancerous tissue.21 cases showed the positive expression of Egr-1 mRNA in a single esophageal carcinoma tissue or the para-cancerous tissue.26 cases showed the negative expression of Egr-1 mRNA both in the esophageal carcinoma tissue and the paracancerous tissue.The positive rate of Egr-1mRNA expression was 65.71%and 30.00%in the groups of the survival time for three years and the groups of the survival time for one year(P＜0.05).The survival rates in the two groups with positive expression of Egr-1 mRNA were 94.44%and 86.96%,respectively(P＞0.05).Conclusion Decreased level of EGR1 expression may be related to esophageal carcinogenesis.The expression level of Egr-1 mRNA might be associated with the survival time of the patients with esophageal carcinoma.Egr-1 expression in esophageal carcinoma tissue may be of great value for determining prognosis of esophageal carcinoma.