ObjectiveTo study the efficacy and safety of intravenous recombinant tissue-type plasminogen activator (rt-PA) on hyperacute cerebral infarction. Methods41 patients with the supra-early acute cerebral infarction were divided into two groups: thrombolytic group (n=21) and control group (n=20). They were evaluated with European Stroke Scale (ESS) and Barthel Index before and 24 h, 21 d, 90 d after treatment. ResultsThe scores of the thrombolytic group showed more efficacious than that of the control groups (P<0.05). One patient suffered from cerebral hemorrhage in thrombolytic group, however his prognosis was good. There was no death in both groups. ConclusionThrombolytic therapy with rt-PA in the hyperacute cerebral infarction shows positive effect and safety.

Objective:To establish the model of pancreaticoduodenal transplantation in rats. Methods:The enteric drained whole pancreas duodenal transplantation model was investisated. The donor aortic segment including the celiac, superior mesenteric divergence were anastomosed with recipient abdominal aorta with end to side. The donor portal was cuff-anastomosed with left renal vein. The graft duodenum were anastomosed with the host jejunum with end to side. Results:Eighty-nine operations were performed and 51 rats were successful, of which all graft of successful case had endocrinium function. Conclusion:This model for pancreas transplantation is reliable.

Objective To investigate apoptosis in acinar cells during posttransplant reperfusion, and the expression of Bcl 2, Bax, Fas Methods Pancreas transplantation was performed between male SD rats after 2 hours of cold ischemia Rats ( n =65) were divided at random into 7 groups: sham group, cold ischemia group (as controls), reperfused 1 h, 3 h, 6 h, 9 h, 12 h group The pathologic pancreatic tissue was observed by electron microscope; Apoptotic cells were stained by TUNEL technique; Expression of Bax、Bcl 2 and Fas protein in pancreatic tissue were detected by SABC immunohistochemical method Results Apoptotic cells were observed in early phase after pancreas transplantation The peak of apoptotic pancreas cells occurred 3 hours after reperfusion [AI ( 9 5? 2 9)%, P

The application of Toric intraocular lens (IOL) provides an opportunity for patients who want to remove cataract and correct astigmatism at the same time.In order to optimize the postoperative result and minimize the residual astigmatism, the accurate preoperative measurement and calculation of Toric IOL are crucial.To improve the accuracy, different astigmatism measurement devices with various advantages have been introduced into clinical practice one after another.Knowing the principle, advantages and disadvantages of the devices contributes to personalized selection of devices according to the patient's condition.Manual keratometer is still the gold standard tool for measuring curvature, and corneal topography is used to assess whether the corneal astigmatism is regular.Most devices can provide reliable corneal data for Toric IOL calculation, and it is recommended that at least three different devices should be used to enhance the prediction accuracy preoperatively.The posterior corneal astigmatism, which has an effect on the measurement and calculation of Toric IOL, has been attracting more attention of ophthalmologists.With high accuracy and strong applicability, Barrett Toric Calculator is preferred in Toric IOL calculation.Moreover, various Toric calculators and formulas can give stable and accurate results after modification and optimization.In this article, the effects of various corneal curvature measurement devices, posterior corneal astigmatism and Toric calculator on Toric IOL measurement and calculation were reviewed.

[Objective]To explore the curative effect of lumbar discogenic low back pain treated with posterior lumbar interbody fusion(PLIF)and transpadicular instrumentation.[Method]Thirty-six patients with lumbar discogenic low back pain were treated with disc excision,lumbar interbody fusion and transpedicular instrumentation.The clinical results were evaluated by pre-and post-operative VAS(visual analogue scale),and the fusion rates were evaluated by X-ray of the lumbosacral spine.[Result]The average period of follow-up was 16 months,ranging from 8 to 28 months.Low back pain basically disappeared in 33 patients treated with PLIF,mild back pain occurred in 3 patients;the VAS after operation decreased significantly in comparison with that of preoparation(P

Objective To investigate the natural history of mild adolescent idiopathic scoliosis in a period of 15 years and search for the risk factors of progress as well as to recommend the modification program of school screening for scoliosis. Methods From a group of 204 patients with adolescent idiopathic scoliosis who were detected from school screening for scoliosis among 20 418 school children in Beijing from May 1985 to January 1986, 90 of the patients were reevaluated 15 years later. The follow-up items of the therapeutic history, physical examination and standing spinal X-ray films were carried out. The late data were compared statistically with the original data at the time of school screening. The final results were divided into four groups: 1)Resolved group with a current curve less than 10 degrees; 2)Reduced group with a current curve more than 10 degrees but reducing less than 5 degrees regarding to the original status; 3)Unchanged group with a current curve more than 10 degrees while progressing less than 5 degrees compared to the original data; 4)Progressed group with a current curve was more than 10 degrees and aggravating more than 5 degrees than the original curve. Results Of 204 patients, 111 patients were followed up, and X-ray films were taken in 90. The follow-up results suggested that 29 cases showed resolved(32.2%), 21 cases reduced (23.3%), 30 cases unchanged (33.3%) and 10 cases progressed (11.1%). In 10 cases of progressed group, there were 8 females and 2 males, furthermore, 6 patients were found with the cobbs angle of curve between 10 and 19 degrees and 4 patient with the cobbs angle of curve more than 20 degrees when school screening. The curve pattern of the 10 progressed patients consisted of double thoracic curves in 2, double thoracic and lumbar curves in 2, right thoracic curve in 3, thoraco-lumbar curve in 2 and lumbar curve in 1. Conclusion Most of cases with less than 20 degrees curve are of no progress. The high risks of progress are as followed: curve more than 20 degrees, female, double thoracic curve, double thoracolumbar curve, right thoracic scoliosis and top vertebral rotation more than grade Ⅱ. The school screening for scoliosis should be carried out by school medical team who were trained by orthopaedists. The specialists should reexamine the suspected children and monitor the patients with high risk of progress.

Objective To explore the effects of 4-phenylbutyric acid(PBA) on cognitive dysfunction after chronic cerebral hypoperfusion and underlying mechanisms.Methods 62 male Sprague Dawley rats in clean degree were divided into sham group(n=14),chronic cerebral ischemia group(bilateral carotid arteries occlusion,2VO group,n=24),and chronic cerebral ischemia with PBA treatment(2VO+PBA group,n=24).The chronic cerebral ischemia models were produced by the occlusion of bilateral common caroid artery for 1 month.During the hypoperfusion,the rats were injected intraperitoneally with 11.25 mg · ml-1 PBA(90 mg · kg-1 · d-1) or equal volume of saline once a day for 3 days followed by every other day for 27 days.Learning and memory abilities were tested by Morris water maze and novel object recognition test.The expression and distribution of NR2A in hippocampus were examined by Western blot and immunohistochemistry.Results Morris water maze test showed that the 2VO group had significantly longer latent time than sham group in searching platform (P＜0.01) (from 2nd day to 7th day latency time),and the 2VO+PBA group had dramatically shorter latent time than 2VO group (2nd,5th,6th,7th (P＜0.01),3rd(P＜0.05)).Then the rats' memory test showed that 2VO group spent markedly longer time than sham group to reach the location of the former platform(P＜0.01),but the 2VO+PBA group spent dramatically shorter latent time than 2VO group (P＜0.01).The novel object recognition test showed the exploration ratio and discrimination index of novel object in 2VO group were noticeably smaller than that in sham group (P＜0.01),but the exploration ratio and discrimination index of novel object in 2VO+PBA group were noticeably higher than that in 2VO group (P＜0.01).The Western blot data showed that the level of NR2A in 2VO group was significantly lower than that in sham group (P＜0.01),but the level of NR2A in 2VO+PBA group was significantly higher than that in 2VO group (P＜0.05).The level of NR2B in hippocampus of 2VO group had no significant difference with sham group and 2VO+PBA group (P＞0.05).Immunohistochemistry data was consistent with the data of Western blot for NR2A level and distribution.The ratio of p-CREB/total CREB in 2VO group(0.62±0.04) was remarkably lower than that in sham group(1.00±0.07),but the ratio of p-CREB/total CREB in 2VO+PBA group(0.97±0.07) was remarkably higher than that in 2VO group(P＜0.01).Conclusion NR2A reduction is associated with chronic cerebral hypoperfusion-induced cognitive impairment,which is rescued by the PBA treatment.It suggests that PBA may have a therapeutic effect on preventing chronic cerebral hypoperfusion-induced cognitive impairment.

Diffuse lower-grade glioma is a diversified group of infiltrative brain tumors comprising WHO grades II and III astrocytomas, oligodendrogliomas, and mixed oligoastrocytomas. These tumors exhibit a wide range of clinical heterogeneity;thus, histopathological classification does not adequately predict clinical outcomes. In recent years, a number of molecular markers closely related to the clini-cal features and prognosis of gliomas have been discovered. These molecular markers include isocitrate dehydrogenase (IDH) muta-tion, chromosome 1p/19q codeletion, ATRX mutation, TERT promoter mutation, and MGMT promoter methylation. Furthermore, nu-merous studies focusing on the integrated molecular classification of diffuse lower-grade gliomas combined with these molecular markers have been conducted. Results indicate that integrated molecular pathological classification can improve the diagnostic and prognostic accuracy and facilitate therapeutic formulation. This paper reviews the research progress on integrated molecular classifica-tion of diffuse lower-grade gliomas.

Objective To explore the roles and related mechanisms of Protein Phosphatase 2A(PP2A) in cognitive dysfunction after the chronic cerebral ischemia.Methods 70 male Sprague Dawley rats in clean degree were divided into sham group,chronic cerebral ischemia group (Bilateral carotid arteries occlusion,2VO),and chronic cerebral ischemia group with PP2A activation group(2VO+aPP2A).The rats were injected intraperitoneally with 1.88 μmol/ml sodium selenate(15 μmol · kg-1 · d-1) or equal volume of saline for 4 weeks.After one month,the chronic cerebral ischemia models were reproduced by the occlusion of bilateral common caroid artery.Then the abilities of learning and memory were tested by Morris water maze,electrophysiological indices were recorded to analyze the LTP changes,and destribution of synaptic vesicles was observed by electron microscope.Results Morris water maze test showed that the 2VO group had significantly longer latent time than sham group in searching platform(P＜0.05),and the 2VO+aPP2A group had dramatically shorter latent time (P＜0.01) than that of 2VO group.Then removing platform to test the rats memory,the data showed that 2VO group spent markedly longer time than sham group to reach the location of the former platform (sham group:(14.50±1.98)s ; 2VO group:(17.30±2.11) s) (P＜0.01),and the 2VO+aPP2A group((15.09± 1.45) s) spent dramatically shorter latent time(P＜0.05) than that of 2VO group.The electrophysiological data showed that 2VO group had the noticeably smaller field excitable postsynaptic potential slope (fEPSP) slope ratio between pre and post of the high frequency stimulations (Long-term potential,LTP) than sham group(sham group:1.69±0.27; 2VO group:2.02±0.137) (P＜0.01),and the 2VO+aPP2A group(1.86±0.19) had strikingly higher ratio than that of 2VO group(P＜0.01).The electromicroscope observation showed that presynaptic vesicles density of 2VO was remarkably lower than that of sham group (sham group:(4.51±0.29) /μm2 ; 2VO group:(2.02±0.14) /μm2) (P＜0.01),and presynaptic vesicles density of 2VO+aPP2A group((3.58±0.50) /μm2) was noticeably higher than that of 2VO group(P＜0.01).Conclusion Activating PP2A can prevent the cognitive dysfunction after chronic cerebral ischemia through regulating LTP and synaptic vesicle density.And PP2A is probably a potential target for preventing and treating the cognitive dysfunction after chronic cerebral ischemia.