From 1979 to 1989, 170 cases of firearm wounds in spinal column and spinal cord were treated. Of them 9 cases were recovered, 34 cases regained satisfactory function, 40 cases improved, 79 cases had no effects and 8 cases died. This article presented clinic materials and discussed the characteristic of such wounds. It was emphasized the early treatment and antishock should be taken, the decompression with laminectomy be done timely and any complication be actively prevented.

Objective To analyses the efficacy of treatment of blood vessels wounded with firearm in limbs by microsurgical technique Methods From March 1979 to October 2000,560 cases whose blood vessels were wounded with firearm in limbs were repaired by microsurgical technique Results Five hundred and twenty cases were good,17 cases were disable,15 cases were amputated limds,and 8 cases died Conclusions The majority of blood vessels wounded with firearm in limbs can be obtained good results being repaired by microsurgical technique

Objective To explore the effect of hyperphosphorylated tau protein on the formation of brain amyloid.Methods Okadaic acid was injected into lateral ventricle of rats, once a day for eight weeks. The place navigation and spatial probe ability of rats were assessed by Morris water maze. Immunohistochemistry techniques were used to detect the expressions of neurofibrillary tangles and amyloid.Results In the Okadaic acid group, the spatial learning and memory abilities of rats were significantly impaired. The mean incubation period of Morris water maze was longer than control group. The accumulation of neurofibrillary tangles and plenty of ?-amyloid positive cells were detected in hippocampus CA1, CA3 and CA4 regions, dentate gyrus and cortex. Deposition of ?-amyloid was observed in hippocampus CA1 and CA3 regions, dentate gyrus and cortex.Conclusion The hyperphosphorylated tau protein may significantly increase deposition of amyloid in brain.

Objective To observe the effects of repetitive transcranial magnetic stimulation (rTMS) on the expression of glial fibrillary acidic protein (GFAP) and OX-42 in hippocampus and dentate gyrus in rats.Methods The rats were treated with 1 Hz, 100 mT TMS 10 min once a day for 14 days, and then the expression of GFAP and OX-42 in hippocampus and dentate gyrus were investigated by ABC technique of immunohistochemistry.Results Compared with the control group, there were no significant difference in the expression of GFAP and OX-42 between the two groups.Conclusion rTMS using our parameters does not cause brain injury in rats.

Objective To evaluate the clinical manifestations and magnetic resonance imaging(MRI) features of the clinically isolated syndrome(CIS) of the spinal cord.Methods MRI features and expanded disability status scale(EDSS) score in 63 patients with multiple sclerosis(MS) showed early clinical manifestations of spinal CIS were retrospectively analysed.Results 52.9% of MS patients in the early performance was the spinal CIS,88.9% was acute or subacute onset,42.9% of the initial symptoms was isolated sensory dysfunction,and 54.9% had cervical spinal cord involvement.The first MRI positive rate was 91.1% and 35.3% presented with "multifocal" plagues.81.7% of the MRI lesions were not more than two vertebral segments,and 89.0% in the axial diameter of the spinal cord did not exceed 1/2.The number,volume and area of MRI lesions at baseline confirmed the positive correlation with EDSS at diagnosis of MS.Corticosteroid therapy before and after the EDSS score was of a significant difference(P= 0.003).Conclusion Spinal CIS often occurs in cervical spinal cord with acute or subacute onset,and incomplete spinal cord injury.MRI may detect "multifocal" plagues.Quantitative MRI is valuable for the assessment of prognosis.Early intravenous corticosteroid therapy can be an effective way to ease symptoms.

Objective　To review the recent progress in the treatment of wrist disorder by limited intercarpal arthrodesis and the related experimental study. Methods　Recent original articles related to limited intercarpal arthrodesis, including clinical practice and experimental study, were extensively retrieved and carefully analyzed. Results　Limited intercarpal arthrodesis could relieve pain and stabilize the wrist joint with partial motion. Conclusion　 With suitable indication and well selected operation approach, the limited intercarpal arthrodesis should be the optimal surgical intervention than total carpal athrodesis in the treatment of wrist disorder.

Objective To observe the effects of low dose of veratrine on the discharges of rat hippocampus pyramidal neurons,and to elucidate its possible cytological mechanism.Methods The discharge features of hippocampus CA1 pyramidal neurons of 14-day-aged healthy Sprague-Dawley rats induced by low dose(0.3～0.8?mol/L)of veratrine were observed by slice patch-clamp technique.Presynap- tic stimulation was given to Schaffer collaterals.Presynaptic receptor inhibitors such as 6-cyano-7-nitroquinoxaline-2,3-dione(CNQX, 5?mol/L),DL-2-amino-5-phosphonopentanoic acid(AP-5,12.5?mol/L),bicuculline(Bic,10?mol/L)and tetrodotoxin(TTX,40～80nmol/L)were used to investigate the influence on veratrine-induced epilepsy andⅠ-Ⅴcurves were plotted under these conditions.Elec- trophysiological mechanism of veratrine-induced epilepsy was elucidated on the basis of these experiments,Results After a perfusion with low dose of veratrine,the pyramidal neurons were found to discharge relatively fixed-mode slow wave epileptoid bursts accompanied with hyperpolarization of membrane potential.These epileptoid bursts were not blocked by a mixture of CNQX,AP-5 and Bic,but by low dose of TTX.After a perfusion with veratrine,Ⅰ-Ⅴrelationship tended to be nonlinear and the depolarization rectification was enhanced,which were reversed by administration of low dose of TTX.The subthreshold TTX-sensitive persistent sodium current of CA1 pyramidal cells was enhanced by veratrine in a voltage-dependent manner.Conclusion Inducing slow wave epileptoid bursts,the low dose of veratrine can remarkably change the discharge features of CA1 pyramidal neurons.Such epileptoid activities were not influenced by the synaptic receptor inhibitors,and were obviously related to the persistent sodium current.

Objective To observe the effects of phenytoin and gabapentin in therapeutic dosage on low-dose veratridine-induced epileptiform discharge in rats' hippocampal CA1 neurons,and explore the involved mechanisms.Methods By means of whole-cell patch clamp technique,the epileptiform discharge model of rats' hippocampal CA1 neurons was constructed with extracellular perfusion of 0.5?mol/L veratridine,and the model should be regarded as successfully estabilshed if bursting discharge emerged within 30min perfusion.The effects of phenytoin(2.5,5,10 and 15?mol/L) and gabapentin(2.5,5 and 10?mol/L) on the epileptiform activity were observed under the voltage-clamp configuration,and the current changes for 1 hour in CA1 neurons was also observed.Results Nine-sixteen minutes after veratridine perfusion,the huge,rhythmic slow oscillation emerged,with 100～200Hz high-frequency discharge,in the hippocampal CA1 neurons,which was similar to the paroxysmal depolarization shifts(PDS),implying that the epileptiform activity was reproduced.Therapeutic dose of phenytoin blocked the veratridine-induced epileptiform activity.The bursting interval of the epileptiform activity was prolonged along with the increased phenytoin concentration,and the duration of bursting was not shortened.1h current decreased gradually in the generation of veratridine-induced epileptiform activity.Therapeutic dose of gabapentin did not block the epileptiform activity in this model.Conclusions In the epileptiform discharge model of rats' hippocampal CA1 neurons,phenytoin can block the epileptic activity in a dose-dependent manner,and the effect may be related to the inhibition of 1h currents.Gabapentin shows no influence on the epileptiform activity,and the possible mechanism may be its ineffectiveness to the persistent sodium currents,and vertridine-induced epileptiform activity does not enhance the 1h currents.

Objective To summarize the experience of microsurgical repair of soft tissue defects in 136 cases with firearm wound,to probe into repairing defect methods in different parts and to improve repairing results Methods According to the location,area of soft tissue defects or special needs,dorsalis pedis flap,latissimus dorsi flap,thoracoumbilical flap,forearm flap,lateral leg flap,tensor fascia lata flap or compound tissue flap were used to repair 136 cases with soft tissue defects in the firearm wound Results All 136 cases with soft tissue defects were repaired successfully Conclusions Microsurgical technique is a good method to repair soft tissue defects and reconstruct function in the firearm wound

Objective Peripheral nerve injuries are common in firearm injuries The outcomes of peripheral nerves injuries by firearm treated with microsurgical techniques were discussed Methods All 314 cases of firearm injuries of peripheral nerves were treated with five types of microsurgical techniques Results The outcome was good in a 2 year follow up The recovery rate for nerve function was 79 4% in upper extremity,and 62 6% in lower extremity Conclusions Microsurgical techniques are effective methods for treatment of firearm injuries of peripheral nerve