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.

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 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.

As a result of the increasing use of radiologic contrast medium in patients, especially the elderly in severe or clinical condition with attendant comorbidities, such as diabetes mellitus, renal failure, cardiac failure, and volume depletion. Contrast induced nephropathy(CIN)is now the third most common cause of hospital-aquired renal failure and accounts for approximately 11% of the cases. This article mainly introduces the evaluation of laboratory investigations providing insights into the pathophysiology of this disorder and the examination of the important clinical data of CIN including risk factors and diagnosis. The last section deals with renal protection and preventive strategies.