Objective To probe the occurrence of neuroal apoptosis in rats after status epilepticus(SE) and the relationship between neuron apoptosis and caspase-3 expression.Methods Rat model of SE was induced by intraperitoneal injection of 300 mg/kg pilocarpine in 20 male Wistar rats.Another 5 rats served as control.The apoptotic neuron was detected by TdT-mediated dUTP Nick End Labeling(TUNEL),and caspase-3 expression was observed by immunocytochemistry at 6~(th),48~(th),72~(th) h and 7~(th) d after SE induction.Results In control rats,TUNEL-positive neuron could not be found in hippocampus.The number of TUNEL-positive neuron began to increase at 6~(th) h after SE induction and peaked at 72~(th) h,began to decrease at 7~(th) d after SE induction.In control rats,there were few caspase-3 expression in hippocampus.The caspase-3 immunoreactivity began to increase at 6~(th) h after SE and peaked at 48~(th) h,especially in CA1 and CA3 region of hippocampus,began to decrease at 72~(th) h and dropped to normal level at 7~(th) d.The results indicated that the distribution of caspase-3 expression was consistent with the distribution of TUNEL-positive neuron.The peak of caspase-3 expression was earlier than that of TUNEL-positive neuron.Conclusion Neuron apoptosis participated in the process of delayed neuronal death in hippocampus after SE and was correlated with caspase-3 activation.

Neurology is an important clinical course. Because of old teaching contents,laggard teaching mode and single teaching goal,the students can not apply after learning neurology course. The curriculum reform of neurology should be carried out under the teaching thoughts of ‘student-centered and competency-based’,to make creation and development in teaching content,teaching style and teaching mode and so on,so as to complete teaching mission better.

Objective To compare the BIS values in patients under anesthesia with minimum alveolar concentration (MAC) of sevoflurane and median effective concentration (EC50) of propofol at loss of consciousness.Methods Sixty ASA Ⅰ or Ⅱ patients,aged 18-60 yr,undergoing elective surgery under general anesthesia,were equally and randomly divided into 2 groups:inhalational anesthesia with sevoflurane group (group Sev) and intravenous anesthesia with propofol ( group Pro).The end-tidal concentration of sevoflurane was monitored using Aestiva anesthesia machine (Datex Ohmeda) in group Sev.Anesthesia was induced with intravenous injection of etomidate 0.3 mg/kg,rocuronium 1 mg/kg,and remifentanil 0.2 μg/kg.The patients were mechanically ventilated after tracheal intubafion.Sevoflurane inhalation was started 12.5 min after intubation in group Sev.Propofol was given by target-controlled infusion with the target plasma concentration set at 3.8 μg/ml 12.5 min after intubation in group Pro.When the effect-site concentrations of propofol reached EC50 of propofol at loss of consciousness (2.2 μg/ml),1.3 EC50(2.86 μg/ml) and 1.5 EC50 (3.3μg/ml) and when the end-tidal concentrations of sevoflurane reached 1.0,1.3 and 1.5 MAC,BIS value,MAP and HR were recorded.Results HR was significantly higher at 1.3 MAC or 1.3 EC50,and at 1.5 MAC or 1.5 EC50 in group Pro than in group Sev ( P ＜0.05).BIS value was significantly decreased at 1.3 MAC or 1.3 EC50,and at 1.5 MAC or 1.5 EC50 compared with that at 1.0 MAC or EC50(P ＜0.05).There was no significant difference in MAP and BIS value at each time point between the two groups ( P ＞ 0.05).Conclusion No significant change in BIS values is found in patients under anesthesia with 1.0,1.3 and 1.5 MAC of sevoflurane and with 1.0,1.3 and 1.5 EC50 of propofol.

Objective To observe the effects of Melatonin on hippocampal neuron apoptosis and caspase-3 expression in epileptic rats. Methods Using model of status epilepticus (SE) induced by Pilocarpine, the rats were administered with melatonin (melatonin group) or saline (Pilocarpine group) before Pilocarpine injection. The apoptotic neuron was detected by TdT-mediated dUTP Nick End Labeling (TUNEL) and caspase-3 expression was observed by immunocytochemistry method, respectively.Results In Pilocarpine group, the number of TUNEL positive neurons began to increase at 6 h post-SE, peaked at 72 h post-SE, and decreased at 7 d post-SE. Caspase-3 immunoreactivity began to increase at 6 h post-SE, peaked at 48 h post-SE, especially in CA1 and CA3 region of hippocampus, began to decrease at 72 h post-SE and dropped to normal level at 7 d post-SE. The numbers of TUNEL positive neurons and caspase-3 expression in Melatonin group were significantly decreased compared to Pilocarpine group at different time points (all P

3 months) were involved in this study PV electrogram was divided into disorganized and organized patterns Segmental PV isolation was performed during AF guided by the earliest PV potential recorded on the basket catheter determined by the lone pause during disorganized pattern or organized PV electrogram The sites with the most disorganized activity during fast and irregular fibrillatory activity had been regarded as ablative target Elimination of PV potential in all PVs during AF, and confirmed by remapping of PV during sinus rhythm or atrial stimuli after cardioversion had been considered as the ablative end point (segmental PV isolation was performed repeatedly if PV potential still existed during sinus rhythm) Results Of the total 76 PVs in 20 patients who achieved PV isolation, 68 (89 5%) PV isolations were performed during AF Reappearance of PV potential occurred in 23(33 8%) during sinus rhythm after cardioversion, and isolation was achieved during sinus rhythm Procedure duration was 5 3?3 7 hours Fluoroscopy time was 2 7?3 8 minutes Recurrence of AF occurred in 11 (55%) patients during the 8?9 month follow up No operation related complication occurred Conclusion Segmental PV isolation for chronic AF is feasible, safe and effective Ablation guided by electrophysiological mapping can result in the elimination of PV potential Remapping of PV and repeated ablation during sinus rhythm after cardioversion is essential

Objective To probe the changes of nitric oxide (NO) content and caspase-3 mRNA expression in hippocampus and the correlation between NO and caspase-3 mRNA expression post-status epilepticus (SE). Methods The models of SE were induced by pilocarpine. The nitric oxide content was detected by chromatometry and caspase-3 mRNA expression was observed by reverse transcription polymerase chain reaction (RT-PCR) method. Results The level of NO increased rapidly at 6~72 h post-SE,and was still significantly higher than that of the controls (all (P)0.05).Conclusions The peak expression of nitric oxide is earlier than caspase-3 mRNA post-SE, although they have the similar diversity tendency. Nitric oxide pathway is definitely involved in the seizure initiation and correlated with caspase-3 activation.

Objective To probe the mechanism of anticonvulsant by melatonin from the angle of neurotransmitter.Methods Rat status epilepticus(SE) model was induced by pilocarpine(PILO).?-aminobutyric acid(GABA) content and glutamin acid decarboxylase(GAD)67 mRNA expression was detected at 6,48,72 h,and 7 d in the hippocampus of post-SE rats.The effect of melatonin on these changes was observed.Results GABA content was significantly lower in the hippocampus than in control(P

Objective: To explore the effect of initial lower PO_2 controlled reperfusion on cyanotic hypoxic immature myocardium protective during post-ischemia reperfusion. Methods: 24 hypoxic neonatal rabbits were randomized into 3 groups (8 in each group). Group I (initial lower PO_2 controlled reperfusion), group II (normal PO_2 controlled reperfusion), group III (high PO_2 reperfusion group). Using isolate heart Langendorff ischemia-reperfusion model, the myocardial protection results were observed and the mechanism were discussed from molecular biological and ultrastructural view. Results: Compared with high PO_2 reperfusion group and normal PO_2 reperfusion group, the products of oxygen free radical were lowered at the end of reperfusion in initial lower PO_2 controlled reperfusion group. ATP content was increased, myocardial contractility was elevated, coronary sinus flow was raised, the degree of myocardium edema was reduced, and ultrastructure alteration was lessened significantly. Conclusion: Initial lower PO_2 controlled reperfusion reduces oxygen free radical injury, enhances myocardial energy metabolism, lessens myocytic structure destruction and improves postischemic function recovery of cyanotic myocardium.

ObjectiveTo introduce the operative technique of pedicle evolution from isolated perforator to perforator-plus-adipofascial,and investigate its clinical results in venous drainage and safety in distallybased sural flaps.MethodsAfter identifying the proper viable perforators,the whole flap was designed in an eccentric propeller shape,with the perforating vessels corresponding to the pivot point.The proximal larger blade was a fasciocutaneous flap, while the distal smaller blade was a subdermal vascular plexus flap,preserving at least a quarter area of adipofascial tissue around the perforator.From January 2008 to December 2010,we performed distally perforator-adipofascial pedicled sural fasciocutaneous propeller flap in 12 patients,with 180 degrees rotation to cover foot and ankle defects.Postoperatively,flap swelling,survival and functional recovery were evaluated. Results There were 7 posterior tibial artery perforator flaps from the posteromedial and 5 peroneal artery perforator flaps from the posterolateral sural region. The proximal fasciocutaneous flap measured 4 cm × 8 cm-6 cm × 18cm, and the distal cutaneous flaps measured 2 cm × 2cm-4 cm × 4 cm.Flap swelling was noted under grade 2 in 9 cases,grade 3 in 2 cases,and grade 4 in 1case with some distal superficial skin necrosis,which occurred in the largest flap in our series.All flaps survived eventfully.After average 13 months follow up,the wound were cured successfully,and all patients recovered walking and shoe wearing function. ConclusionPedicle evolution by keeping some adipofascial tissue around the pivot perforator, can preserve more venous return routes and relieve flap swelling. This technique should be recommended in perforator pedicled propeller flaps,as it enhances flap safety,and without increasing the difficulty of 180 degrees rotation.

Objective To explore the effect of the 3rd generation Gamma nail in the treatment of intertrochanteric fractures.Methods 32 cases with intertrochanteric fractures were treated with the third generation Gamma nail internal fixation.Results Mter follow-up,the excellent and good rate was 87.6％.Conclusion The third generation Gamma nail treatment is a good internal fixation for intertrochanteric fracture of femur.