Objective To explore the causes and risk factors of cerebral stroke in young adults.Method The clinical data of 392 young patients (≤45 years old) of cerebral stroke were analyzed retrospectively,and analyzed its causes and risk factors. Results The most common etiology in youth ischemic cerebral stroke was atherosclerosis (48.70%, 112/230), followed by cardiogenic cerebral embolism (13.04% ,30/230). The main cause in youth hemorrhagic cerebral stroke was hypertension (39.51% ,64/162), followed by intracranial aneurysm(14.81%,24/162) and cerebral vascular malformation(10.49%,17/162). The main risk factors for young patients with cerebral stroke were hypertension (40.31% ,158/392),smoking (36.22%, 142/392),drinking (33.93%, 133/392),prior stroke (13.78% ,54/392),hyperlipidemia (11.99% ,47/392), others were heart disease (9.69% ,38/392), family history of strokehistories (8.16%,32/392) and diabetes (5.36%,21/392) and so on. As far as 160 young patients and 110 young patients were detected separately homocysteine and anticardiolipin antibody, positive rates were 39.38%(63/160) and 3.64%(4/110) respectively. Conclusions The main etiological factor of ischemic cerebral stroke in young adults is atherosclerosis, cardiogenic cerebral embolism is followed. The main etiological factor of hemorrhagic cerebral stroke in young adults is hypertension, intracranial aneurysm and cerebral vascular malformation are followed. The order of risk factors for the young patients with cerebralstroke were hypertension, smoking,drinking, prior stroke, hyperlipidemia,heart disease, family history of stroke-histories, diabetes and hyperhomocysteinemia.

Information of metabolic enzymes and transporters, physiological parameters of animals and demography of Chinese people were integrated to establish a digital liver model (DLM) based on metabolism and transporter and coded with VBA. Clearance and drug-drug interaction (DDI) of candidate drugs in animal and human could be predicted based on the pharmacokinetic data obtained from in vitro and in vivo experiments. Pravastatin and pitavastatin were selected as the samples to examine this model, where their clearance and their DDI with cyclosporine were predicted. The results showed that the predicted values of median parameters in same species were within twofold of observed values for 83.3% (5/6). The program's successful prediction in DDI tendency might indicate its application in optimizing the dosage regimen and reducing the risk of clinical trial.

OBJECTIVE: To construct a plant effective expression vector driven by a fruit specific promoter for the expression of hepatitis B virus surface antigen (HBsAg), to further improve the expression of exogenous gene in plant, and to prepare for the development of an effective anti-hepatitis vaccine. METHODS: Tomato fruit-specific promoters' gene 2A12 and E8 were respectively introduced to pBPFOmega7 to form pB2A12 and pBE8. The DNA fragment containing HBsAg-s gene from plasmid YEP-HBs was inserted respectively into pB2A12 and pBE8 to form pB2A12-HBs and pBE8-HBs. The fragment containing "p35S+2A12+Omega+HBsAg-s+Tnos" of the pB2A12-HBs was sub-cloned into plasmid pCAMBIA1301 to yield the reconstructed plant binary expression plasmid pCAM2A12-HBs, and the fragment containing "p35S+E8+Omega+HBsAg-s+Tnos" of the pBE8-HBs was sub-cloned into plasmid pCAMBIA1301 to yield the plasmid pCAME8-HBs. The inserted gene HBsAg and fruit-specific promoters in the reconstructed plant binary expression vectors were confirmed by sequencing. Then, pCAM2A12-HBs and pCAME8-HBs were directly introduced into Agrobacterium tumefaciens strain EHA105. RESULTS: Digestion with restriction enzymes proved that all recombinant vectors had the inserts with expected length of the target fragments, and the sequencing results were confirmed correct. CONCLUSION: In this study, plant expression vector containing HBsAg gene driven by fruit specific promoter and CaMV35s promoter was successfully constructed.

Objective To introduce the clinical experience and investigate the significance and safety of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy.Methods A retrospective analysis was performed on 275 patients who underwent thyroidectomy among which 135 patients were treated by capsular dissection technique and harmonic scalpel (harmonic scalpel group),the other 140 patients were treated by electric knife and traditional ligation (traditional group).The thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications were compared between two groups.Results In harmonic scalpel group,the thyroidectomy operative time of total thyroidectomy and subtotal thyroidectomy was significantly shorter than that in traditional group [(50.0±6.9) min vs.(82.0± 14.4) min,(39.9±6.6) min vs.(73.1 ± 14.5) min](P＜0.01).The intraoperative bleeding volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(18.7 ± 10.9) ml vs.(41.9 ± 15.6) ml,(17.7 ± 9.3) ml vs.(42.2 ± 14.6) ml] (P ＜ 0.01).The postoperative drainage volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(40.7 ± 11.7) ml vs.(53.9 ± 17.5) ml,(42.7 ± 14.5) ml vs.(61.8 ±22.9) ml](P＜0.01).The rate of temporary hypoparathyroidism and temporary recurrent laryngeal nerve palsy had no significant difference between two groups (P ＞ 0.05).Conclusions Application of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy can significantly reduce thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications.Harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy should be widely used.

Objective To improve the diagnosis and treatment of liver trauma. Methods We retrospectively analyzed different therapeutic means on liver trauma including 79 cases with operative treatment and 27 cases with nonoperative treatment. Results In nonoperative treatment group, 25 cases were cured, 2 cases died. In operative treatment group, 73 cases were cured, 6 cases died. Cure rate was 92.5%(98/106), mortality was 7.5%(8/106). 5 cases died of major blood vessels rupture, 3 cases died on multiple organ function failure. Postoperative complications included 3 cases of subphrenic infection, 10 cases of hepatic abscess, 8 cases of pleural hydrops, 7 cases of incisional infection. Conclutions Type I of liver trauma can be treated by nonoperation, type Ⅱ～Ⅳ of blunt liver trauma can be treated by nonoperation on the condition of intensive monitoring. Type Ⅱ～ Ⅵ of liver trauma should be operated on emergently in case of massive intraabdominal bleeding and combined organ injury.

Objective To observe the effects of baicalin on forms of hepatic tissue, liver apoptosis, mRNA expressions of iNOS, NF-κB and protein expression of Caspase-3 in rats with ischemia reperfusion injury; To discuss its mechanism of action.Methods The rat models of liver ischemia reperfusion were performed according to the Pringle's method. Rats were randomly divided into sham-operation group, model group and baicalin group. Sham-operation group and model group were given normal saline for gavage, while baicalin group was given baicalin for gavage. Morphological characteristic was observed by HE staining. Hepatocyte apoptosis was determined by TUNEL. The mRNA expressions of iNOS and NF-κB were determined by RT-PCR. The protein expression of Caspase-3 was determined by Western blot.Results Compared with the sham-operation group, mRNA expressions of iNOS and NF-κB and the protein expression of Caspase-3 in the model group increased, as well as liver apoptosis rate (P<0.05,P<0.01); compared with the model group, mRNA expressions of iNOS and NF-κB and the protein expression of Caspase-3 in the baicalin group decreased, as well as liver apoptosis rate (P<0.05), and the hepatic lesion significantly improved in the baicalin group.Conclusion Baicalin can restrain Caspase-3 induced apoptosis by reducing the expressions of iNOS and NF-κB, with a purpose to realize the hepatoprotective effect for liver of rats with ischemia reperfusion injury.

BACKGROUND: As a kind of unwounded biomagnetism technique, magnetoencephalography (MEG) relfects immediate information of cerebral function by using magnetic source imaging through recording changes of magnetic field of neurocytes under different functional status.OBJECTIVE: To investigate the practicability of magnetoencephalography (MEG) imaging in localizing sensory-motor cortex for brain tumour surgery in 36 patients.DESIGN: Observational study.SETTING: Department of Neurosurgery, Guangdong Provincial Hospital of Traditional Chinese Medicine.PARTICTPANTS: From Janury 2003 to April 2006, 36 patients (17 male and 19 female) with brain tumors selected from Deparment of Neurosurgery, Guangdong 999 Brain Hospital underwent surgery with MEG-guided neuronavigation in the region of the sensory and motor cortex. Ages of the patients ranged from 13 to 70 years. Among the 36 patients, 14 with gliomas (including 5 highly malignant gliomas), 19 with meningomas, 1 with spongy angioma and 2 with adenocarcinoma (due to the metastasis of brain tumor). All patients and relatives provided the confirmed consent and the experiment provided by the local ethics committee.METHODS: A 148-channel biomagnetometer (4-D Neuroimaging, USA) was used to determine motor and/or senory cortex with sampling rate 678.17 Hz, high-pass filter 1.0 Hz and bandwith 200 Hz. MRI images were acquired using a Philips Gyroscan Intera 1.5T MR tomography. And then, the functional maps were transfered to the neuronavigation system for the treatment of brain tumor. All patietns followed up by further consultation and telephone call in 2-26 months after operation.MAIN OUTCOME MEASURES : Operative outcome and prognosis.RESULTS: MEG demonstrated that the tumor lesion changed the sensory-motor cortex in various degrees for the 36 patients. Brain tumors were resected completely in 34 cases. At 2-26 months after surgery, neurological deficits fully recovered in 19 cases, unchanged in 15 cases and deteriorated in 2 cases.CONCLUSION: MEG was found to be practical and useful in localizing sensory-motor cortex and brain tumor. It is a valuable non-invasive method for presurgical planning in the treatment of brain tumors.

Objective　To study the similarities and differences on in vitro replication and expression of hepatitis C virus (HCV) between human fetal hepatocytes (HFH) and 7721 cell line. Methods　Human fetal hepatocytes and a hepatoma cell line 7721 were incubated with a serum from hepatitis C patient. After incubation, the presence of HCV RNA, the expression of HCV NS3 antigens in cells and/or supernatant were examined by RT-PCR, in situ hybridization and immunohistochemistry, respectively. Results　It was found that: ①The intracellular HCV RNA was first detected on d 2～3 post-incubation and then could be intermittently detected in cells and/or supernatant subsequently (HCV RNA could be detected in 7721 cells during a period of at least 66 days. In HFH, HCV RNA could be detected up to 25 days after incubation); ②HCV-NS3 antigen could be expressed in infected cells; ③Minus-strand RNA of HCV was mainly located within cytoplasm by in situ hybridization. Conclusion　The results suggest that both the fetal hpatocytes and the hepatoma cell line 7721 are susceptible to HCV, and especially 7721 cell line can stably support HCV replication in vitro and may be used as the target cell for long-term cultures of HCV.

Objective To investigate the effect of escitalopram treatment on cognitive bias to the emotional facial information in patients with panic disorder. Methods 30 patients met CCMD-3 criteria for panic disorder were enrolled as research group and marched sexual and age 30 healthy persons enrolled as control group. Patients were treated with escitalopram for 8 weeks. All participants measured with dot-probe task of emotional facial information at base and after 8 weeks. RTs and attentional bias scores were compared respectively. Results After 8 weeks,HAMA scores (7. 81 ± 2. 52) in research group were lower than that of at base ( 17. 23 ± 3. 12) (P = 0.002). A repeated measure ANOVA revealed a significant probe site main effect (F(1,58) =4. 34, P = 0.031 ) , RTs of antarafacial site were longer than that of homonymy site. It revealed a significant probe site and group interaction(F(1,58) =16.15, P=0.000) ,a significant emotional facial information type and probe site interaction(F(1,58)=9.25, P =0.015) ,and a significant emotional facial information type × probe site× group interaction(F(1,58) =7. 31, P = 0. 002). LSD test showed that RTs of antarafacial site to fear facial information in research group were longer than that of homonymy site(P = 0.0009). RTs and attention bias scores of antarafacial site to fear facial information after 8 weeks in research group were lower than that of at base(P=0.032,0.008). Conclusion Patients with panic disorder have the cognitive bias to the fear facial emotional stimulus, and escitalopram treatment might improve the cognitive bias.

Objective To investigate the potential factors which have impact on the working space for surgeons in gasless laparoscopic cholecystectomy and to probe into the specifications of gasless surgeries.Methods Clinical data of 49 cases of gasless laparoscopic cholecystectomy between March 2007 and July 2010 were summarized.The impacts of body mass index,bowel preparation and means of anesthesia on operation time and conversion to laparotomy were analyzed.Results For patients with body mass index ≤25and ＞ 25,operation times were (43.0 ± 5.4) min,and (52.8 ± 7.4 ) min,respectively,and rates of conversion to laparotomy were 0/34 and 4/15,respectively.Both indices in the first group were higher.For patients with and without bowel preparation,operation times were (44.5 ± 5.4) min and (46.1 ± 8.0)min,respectively,and rates of conversion to laparotomy were 2/26 and 2/23,respectively.For patients with epidural anesthesia and lumbar/epidural anesthesia,operation times were (46.5 ± 7.9) min and (44.1 ±6.8) min,respectively,and rates of conversion to laparotomy were 2/24 and 2/25,respectively.Conclusions The operation time of gasless laparoscopic cholecystectomy could be affected by many factors,such as body mass index.Gasless operations can be improved by evaluating the conditions of patients correctly and by selecting suitable operation methods,anesthesia means and bowel preparation.