OBJECTIVE: Controversy over the presence of neuronal apoptosis in acute brain injuries has not been resolved due to the lack of direct evidence. In this article, the authors briefly review the current research progress of apoptosis and discuss the relationship between acute brain injuries and neuronal apoptosis.DATA SOURCES: A computer-based retrieval for relevant papers with abstracts indexed in Medline database published in English full text between January 1995 and February 2005 was conducted using the key words of "acute brain injuries" and "Neuronal apoptosis". Related articles in Chinese full text published between January 2000 and December 2004 were also searched in Chinese periodical full text database, Wanfang databases with key words of "acute traumatic brain injury, neuronal apoptosis".STUDY SELECTION: The retrieved articles were first examined to exclude review articles and repetitions, and only randomized and non-randomized controlled experiments or clinical trials on acute traumatic brain injury and neuronal apoptosis were included.DATA EXTRACTION: Altogether 136 articles directly related to acute traumatic brain injury and neuronal apoptosis were collected, among which 19 met the inclusion criteria with the other 117 removed for repetition or irrelevancy.DATA SYNTHESIS: The valid articles were reviewed to identify the factors related to neuronal apoptosis, apoptotic network theory, detection methods of apoptosis, and the relationship between acute traumatic brain injury and neuronal apoptosis as well as the possible mechanisms.CONCLUSION: Neuronal apoptosis occurs after acute traumatic brain injury, which induces intrinsic and extrinsic neuronal environment changes including increased extracellular excitatory amino acid content, massive free radical production and abnormal gene expression. These factors interact with each other and modulate neuronal apoptosis through multiple pathways.

OBJECTIVE: To probe into the progression of biochemical study on caspase-3 and its functions in disorders of center nerve system.DATA SOURCES:The relevant papers were looked up on Medline database from January 1995 to February 2005 with the retrieved words as"caspase-3", "apoptosis", "center nerve system" and "emergency diseases" in combination, limited in English version.STUDY SELECTION: By initial checking,the papers on caspase-3 in molecular biology and randomized control experiments on caspase-3 and the disorders in center nerve system were collected.DATA EXTRACTION: Totally 156 papers were collected directly related to caspase-3 and center nerve system, of which, 25 papers were in conformity with the criteria and 131 papers were exuded because of repeated contents and indirect relation with this paper.DATA SYNTHESIS: To synthesize the relevant information from the retrieved papers and sum up that the activity of caspase-3 is increased after acute cerebral injury, acute spinal injury, cerebral ischemia and cerebral hemorrhage and broadspectrum caspase-3 inhibitor, Z-VAD-fmk can reduce significantly the activity of caspase-3.CONCLUSION: Caspase-3 is the most important protease in cell apoptosis, it is the component in downstream effect of coordination of various apoptotic approaches and is the only way in protease cascade of cell apoptosis. The activated caspase-3 can split the essential and protective enzymes in cell and result in the alternations of apeptosis in morphology and biochemistry. DNA segmentation is the important biochemical property of nerve cell apoptosis at early stage in acute cerebral injury and the formation of it is necessary.

Objective To observe the relationship between high-mobility group box-1 protein HMGB-1 andthe prognosis of systemic inflammatory response syndrome (SIRS) patients after multiple trauma. Method Sixtypatients with SIRS after multiple trauma in the emergency trauma center were divided into multiple organ dysfunc-tion syndrome (MODS) group and non-MODS group according to the MODS diagnostic criteria, and were followedup for 28 days and then assigned to survival group and fatal group, respectively. Another 20 healthy people wereera-oiled in the conrtol group. The levels of HMGB-1 were measured by ELISA at 24 hours, 3 days, 5 days and 7days after admission. APACHE Ⅱ scores were calculated. Results The concentrations of HMGB- 1 in the patientswith SIRS after trauma at every time point were higher than those in control group (P<0.01). The concentrationsof HMGB-1 and APACHEⅡ scores in the MODS group and the fatal group were higher than those in non-MODSgroup and the survival group (P<0.05 and P<0.01 separately). There was positive correlation between theconcentrations of HMGB-1 and APACHE Ⅱ scores (r=0.7938, P<0.05). Conclusions As an importantpro-inflammatory cytokine in sepsis, HMGB-1 may play a role in the development of SIRS after multiple trauma andcan be used to assess the severity of illness and prognosis.

Objective To study the variables of behavioral function and TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling) figure in Bcl-2 transgenic (TG) mice and control mice after spinal cord injury (SCI), thus to find new ideas and ways for diagnosing and treating SCI. Method The genesis of Bcl-2 overexpression transgenic (TG) mice were produced by injection of Bcl-2 plasmid into the fertilized ova of mice.Nine Bcl-2 TG mice and nine control mice were subjected to SCI of moderate severity at T10, with the use of weight dropping (WD) method (impact force 2.5～3.0 g·cm). Up to 1 day , 7 days, and 14 days after SCI,functional deficits were evaluated with BBB scales, and the apoptosis of neurons was investigated by using TUNEL method. Another three mice of control group were only treated with laminectomy without SCI for comparison. Results The mean functional scores in the control mice were lower than those in the Bcl-2 TG mice, although the unpaired T -test revealed no significant differences. On the other hand, the number of TUNEL positive neurons and IOD(Integrated Optical Density)score in the Bcl-2 TG mice were both significantly lower than those in the control mice. Conclusions This experiment suggests that overexpression of Bcl-2 may suppress neuronal apoptosis after SCI. The Bcl-2 may be an important factor in relieving the damage within CNS after trauma.

Generic drug products (test products: drug A, B...) are bioequivalent to an innovator product (reference product) when their bioavailabilities in the same molar dose are similar. Bioavailability is usually expressed by following pharmacokinetic parameters: the area under plasma concentration-time curve (AUC), the maximum plasma concentration (Cmax) and the time of maximum plasma concentration (tmax). This paper used a two period crossover bioequivalence study to develop convenient, friendly user interface software, BA&BE Analysis to statistically process data in clinical pharmacology studies and other areas. The method involves user input of data for analysis into a grid format, setting variables and parameters, followed by one-way analysis of variance (ANOVA), bioavailability and bioequivalence analysis of the data. The software developed in the present study should help scientists to carry out data analysis of bioavailability and bioequivalence testing quickly and easily.

Objective To investigate the protective effect and associated mechanism of PNS in spinal cord hemisection injury.Methods fifty-five adult SD rats were randomly divided into three groups,sham group(n =5),spinal cord injury group(n =25),PNS group(n =25).The rats were evaluated in behavioral test with BBB score,pathology and immunohistochemistry at 1 d,3d,7d,14d,21d after the procedures.Results Motor recovery was significantly better in PNS group than the spinal cord injury group at 3d,7d,14d and 21d.Nissl staining showed less neuron necrosis and more integrated neural cells in morphology.cPLA2 expression was inhabited in PNS group,and less number of positive cells were found in the group.Conclusion PNS can inhibit the expression of cPLA2 after spinal cord injury,which may be one of the mechanisms of its effect on promoting motor recovery.

Objective To investigate the protective effect and cytosolic phospholipase A2 (cPLA2) associated mechanism of panax notoginseng saponins (PNS) in spinal cord hemisection injured rats. Methods 55 adult Sprague-Dawley rats were randomly divided into three groups: sham group (n=5), spinal cord injury group (n=25) and PNS group (n=25). The rats were evaluated with BBB score, pathology and immunohistochemistry 1 d, 3 d, 7 d, 14 d and 21 d after intervention. Results Compared to the spinal cord injury group, motor recovery was significantly better in PNS group 3 d, 7 d, 14 d and 21 d after intervention (P<0.05). Nissl staining showed less neuron necrosis and more integrated neural cells in morphology in PNS group 7 d, 14 d and 21 d after intervention. Cytosolic phospholipase A2 (cPLA2) expression was inhabited, and less number of positive cells were found in PNS group 7 d, 14 d and 21 d after intervention. Conclusion PNS can inhibit the expression of cPLA2 after spinal cord injury, which may be one of the mechanisms of its effect on promoting motor recovery.

Objective To evaluate the radical effect and prognosis of laparoscopic resection for colorectal cancer in China.Methods Articles of non.randomized comparative studies(NRCs)of laparoscopic resection and open Burgery for colorectal cancer which were published before October 2007 were retrieved,and correlated indexeswere extraeted for meta.analysis.Results The mean quality score of the 14 articles selected was 18.92±1.27.The basic characteristics of patients in laparoscopic resection group were similar to those in open surgery group.Compared with open surgery group,the incised length of the intestine in the laparoscopic resection group was shorter by 0.66 cm.and the distance between distal margin of resection and tumor was farther by 0.26 cm.The 2-year survival rate of patients in laparoscopic group Was 1.67 times higher than that of open surgery group.There was no significant difference upon follow-up rate,tumor diameter,number of resected lymph nodes,local recurrence rate and distal metastasis rate between the 2 groups.Conclusions The results of meta-analysis show that laparoscopic resection has the sanle radical effect as open surgery for colorectal cancer.but the 2-year survival rate of patients treated by laparoscopic resection is comparatively higher.

ObjectiveEvidence-based medicine was used to make an individualized treatment plan for rare solitary splenic metastasis of an ovarian carcinoma in a female patient. MethodsAfter clinical problems were discovered, evidence was collected from the Cochrane Library, PubMed, EMBASE, ScienceDirect, CNKI and Wanfang databases according to our predefined search strategy. The search was done until October, 2009. The validity of the evidence was assessed. The evidence, combined with the doctor experience and the patient value, was applied to the patient. ResultsA total of 15 English literature and 11 Chinese literature were identified. A rational treatment plan was made upon a critical evaluation of the data. There were 5 review articles in PubMed, EMBASE and ScienceDirect databases and no RCT in the Cochrane Library. And there was one retrospective cohort study inCNKI and Wanfang databases. The others were all case reports. After 20 month follow-up, the treatment protocol was proven correct. Conclusion The patient has rare disease, and the evidence intension for the evidence-based medicine was low. It can not present the efficacy of the evidence-based medicine treatment sufficiently, though it could provide some suggestion for rare disease which was lack of large RCT for evidence-based Methods .

Objective To investigate the correlation between enlarged perivascular space (EPVS) and post-stroke depression (PSD) in patients with ischemic stroke. Methods Consecutive patients with acute cerebral infarction admitted to hospital from March 2010 to March 2014 were enroled prospectively. The patients completed head MRI examination after admission and performed EPVS grading. At 3 months after symptom onset, they performed PSD assessment according to Hamilton Depression Scale (HAMD) and Classification and Diagnostic Criteria of Mental Disorders in China, 3rd edition (CCMD-3). The relationship between EPVS and PSD was analyzed. Results A total of 249 patients were enroled; including 62 patients (4. 9% ) experienced PSD at 3 months. There were significant differences in the proportions of the EPVS classification patients of the baseline National Institutes of Health Stroke Scale score ( the median [interquartile range]; 4 [3 - 6] vs. 3 [2 - 5]; Z = - 2. 950, P = 0. 003), centrum semiovale (χ2 = 14. 370, P = 0. 001), and periventricular (χ2 = 11. 590, P = 0. 003)between the PSD group and the non-PSD group. Multivariable logistic regression analysis showed that centrum semiovale EPVS grade 2 (odds ratio [OR] 3. 89, 95% confidence interval [ CI] 1. 59 - 9. 56) and grade 3 (OR 3. 28, 95% CI 1. 04 - 10. 33) were significantly correlated with PSD; periventricular EPVS grade 2 (OR 0. 72, 95% CI 0. 27 - 1. 91) and grade 3 (OR 2. 24, 95% CI 0. 68 - 7. 37) were not correlated with PSD. Conclusions Centrum semiovale EPVS is independently associated with PSD, and periventricular EPVS is not.