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.

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.

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.

BACKGROUND: Loss of sacral slope has been shown to be an important anatomic basis for low back pain. The effect of sacral slope changes after lumbar fusion on pain relief remains unclear.OBJECTIVE: To analyze the variations of sacral slope and clinical significance at the early stage after posterior lumbar interbody fusion at L4-5.METHODS: Sixty patients with herniation at disc levels L4-5 and spinal stenosis (n=38) or lumbar spondylolisthesis at L4 (n=22) undergoing posterior lumbar interbody fusion were enrolled. All patients were followed up for 12-24 months to compare the sacral slop at baseline and postoperatively. The clinical outcomes were evaluated by MacNab criteria, and its correlation with age, sex and sacral slop variations was analyzed.RESULTS AND CONCLUSION: At 12-24 months postoperatively, the sacral slope in the two groups was significantly improved than that at baseline (P < 0.05), but there was no significant difference in sacral slop between two groups (P > 0.05). The age, sex and sacral slop variations showed no significant effects on the early clinical outcomes (P > 0.05).These results suggest that posterior lumbar interbody fusion can markedly improve the sacral slope in patients with spinal stenosis and lumbar spondylolisthesis at early period. Furthermore, age, sex, and sacral slope variations all show no obvious effect on postoperative early functional recovery.

OBJECTIVE:To establish the Microbial limit test(MLT) for Danggui funing drop pills.METHODS:The recovery rates of 5 tested strains treated by Danggui funing drop pills were detected and the MLT method for the control bacteria was validated.RESULTS: Danggui funing drop pills exhibited strong inhibitory effect on staphylococcus aureus and bacillus subtilis,but showed no effect on escherichia coli,candida albicans and aspergillus niger.CONCLUSION: By membrane-filter procedure,the antibacterial effect of Danggui funing drop pills can be eliminated and the bacterial count can be conducted;however,by routine method,the test of control bacteria is feasible.