Objective:To study changes in blood glucose and insulin in rats after traumatic brain injury.Methods:Based upon the Feeney's model, the blood glucose and insulin concentration of each animal group were measured 1/2 hour before the injury and 6?12?24?48?72?120 hours after the injury.Results:The blood glucose concentration increased markedly in each injured group after the injury.The severer the trauma was, the faster the blood glucose increased and the higher the concentration peak reached.The blood insulin concentration increased markedly in moderately and severely injured group,but not in lightly injured one.The severer the trauma was, the faster the blood insulin increased and the higher the concentration peak reached.Conclusion:The post-traumatic hyperglycemia is probably associated with insulin resistance or the changes of the hormones which can raise or drop the insulin level.

Objective:To study the insulin resistance after traumatic brain injury in rats.Methods:Based upon the Feeney's model,the blood glucose and insulin concentration of each animal group were measured 1/2 hour before injury and 6,12,24,48,72,120 hours after injury;the three indices BG_(60-120),GIR_(60-120),ISI reflecting the insulin sensitivity were measured 24 hours after severe traumatic brain injury by euglycemic-hyperinsulinemic clamp technique.Results:Both the blood glucose and insulin concentration increased markedly in medium and severely injured group after injury.BG_(60-120) increased markedly and GIR_(60-120),ISI decreased significantly 24 hours after severe trauma in injured animal compared with sham group.Conclusion:Both the blood glucose and insulin concentration increase markedly in severe injured group after injury.The fact that higher-level insulin cannot reduce the increased blood glucose is due to acute insulin resistance developing after traumatic brain injury.

Objective:To investigate the clinical features of the intracranial primary malignant lymphma(IPML).Methods:23 cases comfirmed by pathological examination in our department was reviewed.Results:The median survival time for the patients received complete surgical resection or partial resection combined with postoperative radiotherapy and chemotherapy was 10 months which was much longer than that in the patients who received operation only.Conclusion:The intracranial primary malignant lymphma is rare.There is no typical manifestation and image feature for the IPML and it is difficult to distinguish IPML from other central nervous system tumors before operation.The diagnosis relies on the pathological examinations.The combination of operation with radiotherpy and chemotherapy is the best therapeutic method.

Objective:To summrize the clinical features of brain herniation in patients with moderate craniocerebral injury during subacute phase after truma and to study the etiology.Methods:The data of 33 cases of brain herniation in patients with moderate craniocerebral injury during subacute phase after truma in the department where the authers worked from 1997 to 2005 were studied retrospectively.Results:Hematoma formation after cerebral contusion,cerebral edema after cerebral contusion,delayed intracerebral hematomas formation were main causes of brain herniation in patients with moderate craniocerebral injury during subacute phase after truma.There were 28 patients had been treated surgically after exacerbation.22 cases had a good prognosis and 5 cases died of cerebellar tonsillar herniation.Conclusion:The conditon of most patients with moderate craniocerebral injury during subacute phase after truma is stable,while some cases worsen and even develop into brain herniation,and the incidence of disablity and mortality rise significantly.

Objective: To summarize the experience in the use of medical aural and encephalic glue in neurosurgical operation.Methods: The effects of medical aural and encephalic glue used in 1024 neurosurgical operation were retrospected and analyzed and discussed in relationed to the pertinent literature.Results: The effect of medical aural and encephalic glue in all kinds of neurosurgical intervention we operated in our department was reliable and there was no side effect.Conclusions: The effect of medical aural and encephalic glue in neurosurgical operation is notable,especially in preventing and treating the cerebrospinal fluid fistulae and stopping bleeding during the operation.The glue is safe and trustworthy.

Objective To evaluate the value of lung ultrasound score (LUS) on assessing the severity and extubation opportunity in postoperative patients of general surgery, and to investigate the correlation between LUS and oxygenation index (PaO2/FiO2), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure assessment (SOFA), stay length in ICU and stay length in hospital. Methods A prospective double- blind cohort study was conducted. Eighty- nine postoperative patients of general surgery with successful extubation were selected, and the patients were divided into 2 groups:group A ( admission ICU to extubation time less than 48 h, 52 cases) and group B(admission ICU to extubation time more than 48 h, 37 cases). Before extubation, the PaO2/FiO2 was recorded according the blood gas analysis, and APACHE Ⅱ, SOFA and LUS were examined, and the staying time in ICU and staying time in hospital were recorded. The correlation was analyzed. Results The LUS, APACHE Ⅱ, SOFA, staying time in ICU and staying time in hospital in group A were significantly lower than those in group B: (3.98 ± 2.31) scores vs. (13.41 ± 2.82) scores, (7.52 ± 1.96) scores vs. (14.92 ± 3.07) scores, (4.50 ± 2.24) scores vs. (9.70 ± 3.64) scores, (1.77 ± 1.41) d vs. (8.49 ± 4.35) d and (8.49 ± 2.28) d vs. (15.63 ± 6.10) d, and the PaO2/FiO2 was significantly higher than that in group B:(441.57 ± 45.31) mmHg (1 mmHg=0.133 kPa) vs. (305.78 ± 90.72) mmHg, and there were statistical differences (P<0.01). The LUS had negative correlation with the PaO2/FiO2 (r=-0.882, P<0.01), and it had positive correlation with APACHEⅡ, SOFA, staying time in ICU and staying time in hospital (r=0.711, 0.590, 0.930 and 0.709;P<0.01). Conclusions The LUS is simple and easily available. It can evaluate the changes of pulmonary ventilation, and also evaluate its degree of severity and prognosis. It is helpful in the prediction of the extubation time, staying time in ICU and staying time in hospital in patients with general surgery.

MicroRNAs ( miRNAs) , which are endogenous small noncoding RNAs , mainly regulate the expression of many target genes at the post-transcriptional and ( or ) translational levels.Aberrant expressions of several miRNAs were found in a large variety of neoplasms , including hepatocellular carcinoma ( HCC).Previous studies have shown the existence of a large amount of stable miRNAs in human serum, which have laid the foundation for studying the role of serum miRNAs in the diagnosis and prognosis of HCC.

Objective To compare the therapeutic effects of minimally invasive percutaneous nephrolithotomy(MPCNL) and retroperitoneal laparoscopic ureterolithotomy(RLUL) in the management of impacted upper ureteral calculi.Methods A total of 72 patients with unilateral impacted upper ureteral calculi were treated with MPCNL(n=45) or RLUL(n=27).The operation time,clearance rate of the stone,and the incidence of postoperative hyperpyrexia were statistically analyzed.Results All the operations were completed.As compared to the RLUL group,the MPCNL group had a significant shorter operation time [(43?9) minutes vs(69?17) minutes,t=-11.564,P=0.000].On the day after the operation,both the groups showed a stone clearance rate of 100%.No significant difference was detected in the rate of postoperative hyperpyrexia between the two groups [13.3%(6/45) vs 11.1%(3/27),?2=0.000,P=1.000).The patients were followed up for 1 to 24 months(mean,8 months),none of them developed ureteral stricture or recurrent stones during the period.Conclusion Both MPCNL and RLUL are safe,effective,and feasible for impacted upper ureteral calculi.

Objective To study the alteration of surfactant protein A and D(sp-A,SP-D)result-ing from pneumcystis carinil pneumonia(PCP)and investigate its implication in the pathogenesis of PCP.Methods SD rat models of PCP were induced by subcutaneous injection of 25 mg cortisone acetate,normal control and negative control as well as bacterial pneumonia group were set up for comparison.During 8～12weeks.broncboalveolar lavage fluid (BALF) of rats was collected.Total nucleate cells of BALF were counted and differentiated as well as the concentrations of surfactant protein A(SP-A)and surfactant pro-tein D(SP-D)were measured by immunoblotting assay.Results The rats were divided into three im-munosuppressive groups,plus a norrflal control group. Group A: normal control(n=6)consisted of healthy SD rats;group B:negative control(n=6)employed rats with cortisone acetate injection over 8weekz without tung infection;group C:bacterial pneumonia(n=11),rats were injected with cortisone ac-etate over 8 weeks and resulted in bacterial pneumonia without other pathogens isolated;group D(n=14):rats were injected with cortisone acetate during 8～12 weeks and resulted in PCP without other pathogens isolated.During PCP infection,the total cell counts and the percentage of polymorphonuclears (PMNs)in BALF were significantly increased(P<0.01),but were lower than those in the bacterial pneumonia group.The concentration of SP-A of BALF in PCP(45.1 μg/ml 4±22.1 μg/m1)was signifi-cantly increased in comparison with that in negative control group(16.2 μg/ml±9.9 gg/ml,P<0.05)and that in bacterial pneumonia group(6.2 μg/ml±5.6 μg/ml,P<0.001).We also found that the rela-tive content of SP-D was significantly higher in PCP(24 249±4 780 grey values)than that in both nega-tive control(13 384±2 887 grey values,P<0.001)and bacterial pneumonia group(11 989±2 750 grey values,P<0.001).SP-A and SP-D were also higher in moderate to severe group of PCP than those seen in mild group(P<0.01,P<0.001).Conclusion There was obvious increase of SP-A and SP-D in PCP rats,and particularly,the change of which was greater than that in bacterial pneumonia.Therefore,the alteration of SP-A and SP-D may be of implication in the prevention and management of PCP.