This article reviewed the effects of acupuncture on structure and function of central nervous system (CNS). Acupuncture is effective on motor function and ability of learning and memory. The mechanism is complex, including cerebral blood flow, pathomorphism, energy metabolism, free radicals metabolism, cell apoptosis, synaptic connections, and expression of neurotrophic factor, etc.

Objective To study the neuroprotective effect of sevoflurane on controlled hypotension in patients with coronary heart disease undergoing craniocerebral surgery. Methods Twenty-six patients with coronary heart disease undergoing craniocerebral surgery were randomly divided into two groups,receiving either inhaled 2%-5%sevoflurane plus intravenous sodium nitroprusside (treatment group,n=13) or intravenous sodium nitroprusside 3-8 μg·kg-1 alone (contorl group,n=13) for blood pressure control. The hemodynamic changes were recorded during the operation. Patient satisfaction with surgeons and the duration hospital stay after surgery were recorded. The levels of cardiac troponin I (TNI),creatine kinase-MB (CK-MBM),neuron specific enolase ( NSE) and S100 calcium binding proteinβ( S-100βprotein) in serum were detected at one day pre-operation,the end of the operation,and one day post-operation. Results The duration of hospital stay after surgery was significantly shortened in treatment group [(20. 3±3. 8) versus (23. 9±4. 6) d,P<0. 05) compared with control group. The average heart rate significantly decreased, patient satisfaction significantly increased, and serum levels of NSE and S-100β protein one day post-operation significantly decreased as compared to control group (all P<0. 05). Compared with the day before operation,serum levels of NSE and S-100βprotein in the two groups increased significantly at the end of surgery (P<0. 05),and the levels of TNI,CK-MBM,NSE and S-100βsignificantly elevated one day post-operation (P<0. 05). Compared with the end of operation,serum levels of NSE and S-100βin contorl group incarcerated remarkably (P<0. 05) Conclusion Sevoflurane plays an important neuroprotective role,as evidenced by improving patients' satisfaction,reducing hospital stay after surgery,and maintaining the balance of myocardial oxygen delivery and consumption in craniocerebral surgery patients with coronary heart disease during controlled hypotension. However,it can not prevent postoperative myocardial injury in these patients.

Objective To investigate the relationship of apolipoprotein E ?4 allele to early cognitive dysfunction after cardiac surgery and to identify the predictors of cognitive decline after cardiac operation. Methods Two hundred and thirty patients aged over 18 yr undergoing coronary artery bypass grafting (CABG) were studied. They were capable of completing the preoperative cognitive function tests in terms of the education they had received. Patients with neurological or mental disease and those with serious hepato-renal or cardiac dysfunction were excluded. Cognitive function was evaluated using a battery of nine neuro-psychologieal tests before operation, at one week and 3 months after operation. Cognitive decline was defined as ≥20% decrement in 20% or more of the completed tests. The changes in the Z-based scores were used to evaluate the severity of cognitive decline. Logistic regression and multiple linear regression were used to determine the relationship of ApoE genotype to cognitive decline and identify the predictors of postoperative cognitive decline ( POCD) after cardiac operation. Results The incidence of cognitive decline was as high as 51.9 % and 21.0% at 1 week and 3 months after operation respectively. The ?4 allele was present in 7.4 % , ?3 allele in 86.1 % and ?2 allele in 6.5 % of the 230 patients. The cognitive decline was not significantly associated with the presence or absence of the ?4 allele. The ?4 allele was associated with poor baseline performance. Age, the use of cardiopulmonary bypass (CPB), duration of endotracheal intubation were predictors of cognitive impairment after cardiac operation. There was positive correlation between the neuro-psychological test scores at 1 week and 3 months after operation. Conclusion The results suggest that age, the use of CPB and duration of endotracheal intubation are the predictors of POCD. The ?4 allele is not associated with POCD after cardiac operation. The cognitive dysfunction at 3 months after operation is positively correlated with the level of cognitive decline at 1 week after operation.

Objective To study expression of matrix metalloproteinase‐9(MMP‐9) protein and its mRNA in breast cancer and e‐valuate its significance in the occurrence ,development and metastasis of breast cancer .Methods The protein expression of MMP‐9 breast cancer were detected by using immunohistochemistry and the expression of mRNA were detected by reverse transcription polymerase chain reaction(RT‐PCR)Results The positive rate of MMP‐9 protein expression in 56 cases of breast cancer was 69 .6% (39/56) ,while in benign breast diseases was 20% (6/30) ,which were significantly different(P<0 .05) .The levels of MMP‐9 mRNA were significantly higher in the patients with breast cancer than those in benign breast diseases(P<0 .05) ,which were 0 .914 2 ± 0 .108 1 and 0 .379 4 ± 0 .0428 respectively .Conclusion The MMP‐9 protein and mRNA expression in human breast cancers are positively correlated with the stage and lymph node metastasis .Expression of MMP‐9 could be used as an indicator for the ability of invasion and metastasis of breast cancer .

Objective To analyze the characteristics of cardiovascular two-dimensional (2-D) and Color Doppler echocardiography for patients with Marfan's syndrome. Method 23 cases of Marfan's syndrome were examined by transthoracic 2-D and Color Doppler echocardiography.Results Aneurysms of the ascending aorta and aortic sinusal were found in all of these cases. Aortic regurgitation and left ventricular enlargement coexisted with all of these cases. Fourteen cases complicated with type A and three with type B aortic dissection. Conclusions 2-D and Color Doppler echocardiography is a rapid non-invasive,reproducible, comprehensive medical imaging technique and can be regarded as an initial imaging model to screen and diagnosis of Marfan's syndrome.

Objective To discuss the causes of misdiagnosis and therapeutic errors of tracheobronchial foreign bodies.Methods 139 cases of tracheobronchial foreign bodies hospitalized in our department during 5 years were reviewed. Retrospective analysis was performed, on statistics of case history, clinical manifestation, location of foreign bodies, the time of initial diagnosis and the time for definite diagnosis.Results 89 cases (64 03%) were misdiagnosed, and were given inappropriate treatments. The main causes include ignored or vague history of foreign body inhalation, the atypical or complex clinical manifestations, and underestimation of the importance of bronchoscopy.Conclusion We should pay more attention to history of foreign body ,bronchoscopy examination action in diagnosis and treatment and more aware of the various manifestations of tracheobronchial foreign bodies,these could contribute to decrease the misdiagnosis and therapeutic errors.

12 months postoperatively,and excellent results were obtained in 16.0% of the patients((4/25)),good in 40.0%(10/25),and poor in 44.0%(11/25). Conclusions For patients with locally advanced breast cancer previously treated with downstaging neoadjuvant chemotherapy,breast-conserving therapy offers satisfactory results.Strict adherence to technique and use of postoperative irradiation and systemic therapy are crucial to breast-conserving therapy.

Objective To investigate the therapeutic procedures,indications and efficacy of breast-conserving therapy (BCT). Methods BCT was carried out in 148 patients with breast carcinoma in this hospital from January 1996 to October 2003.There were 5 patients in stage 0,85 patients in stage Ⅰ,55 patients in stage Ⅱ,and 3 patients in stage Ⅲ.The surgical treatment was quadrantectomy or local wide excision of tumor,combined with axillary lymph node dissection.Routine adjuvant irradiation,chemotherapy and hormone therapy were given postoperatively. Results Pathological examinations of breast specimens found no positive margins.Follow-up observations for a median of 54 months (range,2 ～ 84 months) revealed a local recurrence rate of 2 7% ( 4/148 ;3 patients in breast and 1 patient in axillary fossa).Distant metastasis occurred in 5 patients (3 4%) and 3 of them died.Sites of metastasis included lung,liver,meninges and bone.The duration from surgery to distant metastasis was 6 ～ 43 months.Evaluation of cosmetic results in 108 patients who had received BCT for at least 12 months showed that good outcomes were achieved in 32 4% of the patients (35/108),fair outcomes,in 49 1% of the patients (53/108),and poor,in 18 5% (20/108). Conclusions For patients with early stage breast carcinoma,and part of those with local advanced breast cancer who have received neoadjuvant chemotherapy and gotten downstaging effects,the effects of BCT is satisfactory.Standard excision,postoperative irradiation and systemic combination treatment are crucial to BCT.Most patients receiving BCT have good cosmetic results.

Objective To recombine the tissue plasminogen activator (TPA) gene and establish the expressing model in vitro to provide both theoretical basic and technical guidance for gene therapy of ischemic heart disease and prevention of postoperative vessel re-stenosis. Methods Expression vector pcDNA3.1 TPA was constructed, and transfected into Chinese hamster ovary(CHO) cells. Then the exogenous TPA expression was observed. Results The expression quantity of TPA in transfected CHO cells was higher than that in non-transfected cells. The exogenous TPA activity was 12 296 IU/10 6cell/24hr in the transfected cells, when measured by chromogenic substrate assay, while that of non-transfected cells was 3 176IU/10 6cell/24hr. The TPA quantity of non-transfected cells was 9 608 ng/10 6cell/24hr, when measured by enzyme-linked immunosorbent assay (ELISA), while that of transfected cells was 586 172 ng/10 6 cell/24hr, and the latter was the 60 times of the former. Conclusions When pcDNA3 1(+)TPA was transfected into CHO cells, exogenous TPA can efficiently be expressed, which provides theoretical basic for TPA clinical gene therapy.

Objective To summarize some problems about the management of acute pancreatic pseuclocyst(PPC) by CT guided percutaneous drainage(PCD).Methods The recent domestic and foreign literatures were reviewed in order to explore the research advancement,such as indication,applied time,technique skill,complication and curative effect by CT guided PCD.Results This operation could be early performed in patients with acute PPC,preventing and decreasing the incidence of possible complications resulted from the traditional long-term observation and waiting.The technique skill of operation was easy with low incidence of complications and the effect was good.Combined use of somatostatin might shorten the treatment time.Some patients could be postoperatively managed in out-patient,thus the expense could be cut down.Conclusions CT guided PCD is a minimally invasive operation and is easy to perform with high effective rate and low incidence of complications and low cost.Reasonable selection of the indications and improvement of equipments and operation techniques may be helpful to improve the curative effect.The extended application of this operation is advised.