To improve the quality control of private hospital is urgent in China. Through the visiting to International Neuroscience Institute, Hannover, Germany, the author analyzed the advantages of Germany Medical System, and provided several beneficial aspirations for Chinese Medical System Reformation, including sound Medical Insurance System, efficient quality control based on information platform, powerful government and civilian regulator, elastic Salary Administration, and high self-discipline of medical staff.

Objective To explore the role of apoptosis signal regulating kinase 1(ASK1) in inflammatory mediated secondary injury after spinal cord injury(SCI) in rats.Methods The rat contusion SCI model was used.Forty-eight rats were randomly divided into the sham operation group(Sham),normal saline(Saline group) and inflammatory factors group (Cytokine group) respectively.The expressions of ASK1 and phosphorylated ASK1(pASK1) were detected by using Western blot.The Basso Beattie Bresnahan (BBB) scores and Grid Walking method were performed to assess the behavior changes of injured rat hindlimbs.Somatosensory evoked potential(SEP) and motor evoked potential(MEP) were used to examine the electrophysiological change.Results The expression levels of ASK1 mRNA and protein had no obvious change at 1 week after SCI;the pASK1 expression level in the Cytokine group was significantly up-regulated compared with the Saline group(P=0.002);the BBB scores at 3 or 4 weeks after SCI in the Cytokine group was significantly decreased compared with the Saline group (P =0.000,P =0.000);the hindlimbs missed step rate at 4 weeks following SCI in the Cytokine group was increased compared with the Saline group (P =0.032);the latent period of SEP and MEP in the Cytokine group was prolonged(P =0.043,P =0.045),while the wave peak value had no obvious changed (P =0.889,P=0.434).Conclusion Inflammatory cytokines may lead the hindlimbs movement dysfunction to be aggravated after SCI in rat,its mechanism may be related with the phosphorylation elevation of ASK1.

Objective To investigate the effect of lumboperitoneal (L-P) shunt and ventriculoperitoneal(V-P) shunt for trea-ting the patients with communicating hydrocephalus .Methods The databases of PubMed ,Web of Science ,Scopuss ,Karge , EBSCO+MEDLINE ,OVID ,EMBASE ,CNKI ,CBM disc databases ,Wanfang databases ,Weipu databases were retrieved by com-puter .The relevant literatures about L-P shunt and V-P shunt for treating communicating hydrocephalus included in these databases during 1990-2016 were collected and performed the meta analysis by using the STATA 12 .0 software .Results The success rate of L-P shunt in treating communicating hydrocephalus was apparently higher than that of V-P shunt(P<0 .05) .Moreover ,postopera-tive infection rate ,obstruction rate of shunt system and total postoperative complications rate in L-P shunt were apparently lower than those of V-P shunt(P<0 .05) ,However ,there was no statistical difference in shunt poor rate between L-P shunt and V-P shunt(P>0 .05) .Conclusion L-P shunt is worth recommending .But due to lower quality of the evidences ,it is needed more high quality primary studies to remedy the insufficiency of the study .

Objective To explore the value of applying personalized medicine in the clinical teach-ing of glioma surgery. Methods Totally 80 7-year program undergraduates were divided into experimental class and control class randomly, with 40 cases in each group. The experimental class received personalized medical teaching through introducing idea and method of personalized medicine. The control class received conventional teaching. The effect of teaching was evaluated by questionnaire and examination. The data were analyzed through Chi-square and t-test test. Result Questionnaire survey of satisfaction showed that 37 students of experimental class (92.5%) were interested in the new course. Questionnaire survey of teaching effect showed that in experimental class 36 students (90%) felt it could increase learning interest, 37 students (92%) believed it improved glioma diagnosis and treatment, 34 students (85%) felt their medical view ex-panded, 38 students had consolidated clinical thinking, and 32 students (80%) improved negotiation with patients. All issues were significantly better than control class (P<0.05). Meanwhile, statistical difference was found in average score between experiment class and control class [(88.71 ±6.54) vs. (76.49 ±7.32)] (P=0.000). Conclusion The introduction of personalized medicine concept helps medical students to make personalized diagnosis and treatment plan for glioma patients, and is conducive to the cultivation of their clinical thinking ability and evidence based medicine concept, which is worthy of promotion.

Objective To evaluate the value of electrospun polymethyl methacrylate (PMMA) nanofibers with different topological structures as scaffolds for growth of Schwann cells (SCs).Methods Electrospun PMMA nanofibers with random or aligned topological structures were fabricated and measured with biocompatibility.Lentivirus-transfected green fluorescent protein was used as the reporting gene to monitor form and growth manner of SCs on different substrates and dependency of cell body and process with fiber structure,with PMMA thin films served as the control.Results Electrospun PMMA nanofibers revealed good biocompatibility and could exert contact guidance to the growth of SCs.Topological structures of the electrospun nanofibers influenced cell morphology.SCs were aligned with the orientation of substrate fibers and form longer cell process when growing on aligned nanofibers (P ＜0.01).Primary SCs preferred to follow the cue of aligned nanofibers compared to random fibers.Conclusion Aligned electrospun PMMA nanofibers have the potentiality as transplantable scaffolds for loading SCs after neural injury.

The knowledge absence of neurosurgical regional anatomy is the major shortcoming which makes seven-year program medical students feel difficult in studying neurosurgical special course.The reasons for this phenomenon include the limited teaching time for basic medical course and the continuous progress in the field of neurological anatomy.The teacher should make good use of clinical resources to carry on the additional teaching of neurosurgical regional anatony.The detailed plans include small-class teaching and individual case analysis using the data of neuroimaging and angiography of the brain and spinal cord.All these measures are intend to let the students grasp of the basic knowledge clinical neurosurgery during the internship and make the smooth transition from interns to doctors,providing references for other department.

Objective To investigate the correlation between apolipoprotein E (APOE) polymorphisms and expression of p38MAPK of injured astrocytes in the early stage.Methods Scratch injury to astrocytes of three different alleles of APOE (ε2,ε3,andε4) was induced.RT-PCR and Western-blot were applied to detect dynamic changes of intracellular p38MAPK before injury and at 12,24,48,and 72 hours postinjury.Results Expression of p38MAPK in APOEε2,ε3,andε4 astrocytes increased gradually over time,whereas before and 12-hour after injury,the difference was insignificant in pair comparison (P ＞ 0.05).p38MAPK in APOEε2,ε3,andε4 astrocytes revealed progressive up-regulation at 24,48,and 72 hours postinjury,but the expression in APOEε4 astrocytes was the highest (P ＜ 0.05).Conclusion In the early period of injury,highly expressed p38MAPK in APOEε4 astrocytes indicates a more active p38MAPK-induced inflammatory response in APOEε4 carriers which may contribute to acute exacerbation and poor outcome.

OBJECTIVETo evaluate the impact of the topographic features of electrospun polymethylmethacrylate (PMMA) nanofibers on growth pattern of primary rat astrocytes.

METHODSRat astrocytes were cultured on fabricated random and aligned electrospun nanofibers. Using PMMA film as the control, the cells were transfected with a lentivirus harboring GFP gene to reveal the cell growth pattern on different substrates.

RESULTSoth random and aligned electrospun PMMA nanofibers could support the growth of rat astrocytes, but the topographic features of the fibers significantly affected their growth pattern. On aligned nanofibers, astrocytes extended long cell processes along the direction of the substrate fibers, and on random fibers the astrocytes formed shorter processes. On merged images of GFP expressions and substrate fibers, the cell processes of the astrocytes were shown to adhere to and elongate along the fibers both on random and aligned nanofibers.

CONCLUSIONThe topographic features of PMMA nanofibers can significantly influence the growth pattern of primary rat astrocytes. Aligned electrospun nanofibers has the potential to serve as scaffold material for reducing glia scar formation after spinal cord injury.

Objective To investigate the standard hemicraniectomy and temporal muscleresection therapeutic in the treatment effect of massive cerebral infarction patients .Methods Looking back at my hospital from February 2006 to October 2012 massive cerebral infarction patients ,30 cases were divided into two groups ,namely simple drug treatment(group A) ,the standard hemicrani-ectomy combined temporal muscleresection treatment (group B) .Followed up two groups of patients and deaths neurological deficit situation after treatment ,compared two groups of patients in hospital mortality and one month after treatment ,neurological impair-ment score .Results After treatment ,the patient midline reply ,mortality ,cure rates three aspects ,group B than the group A .Con-clusion Standard hemicraniectomy combined temporal muscle resection in the treatment can reduce the mortality rate of patients w ith active .

Objective To evaluate the impact of the topographic features of electrospun polymethylmethacrylate (PMMA) nanofibers on growth pattern of primary rat astrocytes. Methods Rat astrocytes were cultured on fabricated random and aligned electrospun nanofibers. Using PMMA film as the control, the cells were transfected with a lentivirus harboring GFP gene to reveal the cell growth pattern on different substrates. Results Both random and aligned electrospun PMMA nanofibers could support the growth of rat astrocytes, but the topographic features of the fibers significantly affected their growth pattern. On aligned nanofibers, astrocytes extended long cell processes along the direction of the substrate fibers, and on random fibers the astrocytes formed shorter processes. On merged images of GFP expressions and substrate fibers, the cell processes of the astrocytes were shown to adhere to and elongate along the fibers both on random and aligned nanofibers. Conclusion The topographic features of PMMA nanofibers can significantly influence the growth pattern of primary rat astrocytes. Aligned electrospun nanofibers has the potential to serve as scaffold material for reducing glia scar formation after spinal cord injury.