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Objective To monitor the itrracranial pressure in patients with hypertensive intracerebral hemorrhage after minimally invasive surgery and to explore its correlation with nerve injury,inflammatory stress response.Methods From December 2014 to October 2017,60 patients of hypertensive intracerebral hemorrhage underwent minimally invasive surgery in Taizhou Municipal Hospital were chosen in the research.According to the prognosis,the patients were divided into hematoma clearance group (n =45) and rebleeding group(n =15).The levels of intracranial pressure 24h after surgery,serum contents of nerve injury related indicators,inflammatory mediators and oxidative stress indicators were compared between the two groups.Pearson test was used to evaluate the correlation between intracranial pressure 24h after surgery and nerve injury,inflammatory stress response.Results 24 h after surgery,the intracranial pressure in the hematoma clearance group was (349.27 ± 45.81)mmH2O,which was lower than (511.09 ± 57.64) mmH2O in the rebleeding group (t =-11.093,P ＜ 0.05).The serum contents of nerve injury markers such as NSE,h-FABP,GFAP,S 100B in the hematoma clearance group were (9.37 ± 1.05)ng/L,(7.04 ±0.85) μg/L,(7.19 ± 0.85) μg/L,(20.47 ± 3.19) ng/L,respectively,which were significantly lower than those in the rebleeding group [(14.58 ± 1.62) ng/L,(11.36 ± 1.62) μg/L,(16.23 ± 1.72) μg/L,(45.87 ± 5.62) ng/L](t =-14.414,-13.330,-26.989,-21.749,all P ＜ 0.05),the BNP level of the hematoma clearance group [(22.61 ± 2.85) μg/L] was significantly higher than (15.28 ± 1.79) μg/L ih the rebleeding group (t =11.732,P ＜ 0.05).The levels of inflammatory mediators such as IL-6,IL-1β,TNF-α in the hematoma clearance group were (5.28 ± 0.59) ng/L,(9.73 ± 1.54) ng/L,(15.28 ± i.76) ng/L,respectively,which were lower than those in the rebleeding group [(11.07 ± 1.63) ng/L,(20.46 ± 2.95) ng/L,(23.51 ± 3.79) ng/L] (t =-20.410,-18.225,-11.445,all P ＜ 0.05).The levels of antioxidant factors such as SOD,CAT in the hematoma clearance group were (49.58 ± 6.21) U/L,(68.11 ± 7.59) U/L,repectively,which were significantly higher than those in the rebleeding group [(32.16 ±4.05) U/L,(45.23 ±5.61)U/L] (t=10.138,10.715,all P ＜0.05).The contents of ROS,AOPP in the hematoma clearance group were (15.28 ± 1.73) μg/L,(10.94 ± 1.62) μg/L,respectively,which were lower than those in the rebleeding group [(34.19 ± 4.25) μg/L,(22.53 ± 2.18) μg/L] (t =-24.632,-21.945,all P ＜0.05).Pearson test showed that the level in 24h intracranial pressure in patients with hypertensive intracerebral hemorrhage was positively correlated with the degree of nerve injury,inflammation stress(r =0.371,0.483,0.427,0.519,0.537,all P ＜ 0.05).Conclusion Monitoring of intracranial pressure after minimally invasive surgery for hypertensive intracerebral hemorrhage,can effectively judge the severity of nerve injury and inflammatory stress reaction,and can predict the risk of recurrent intracerebral hemorrhage.
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AIM:To investigate matrine-induced apoptosis of human medulloblastoma D 341 cells and the ex-pression of Bax , Bcl-2, serine/threonine kinase Akt and phosphorylated Akt ( p-Akt) in vitro.METHODS: D341 cells were divided into experimental groups ( added with matrine at different concentrations ) and control group ( under the same conditions without matrine).The proliferation of D341 cells was analyzed by CCK-8 assay.Apoptosis was detected by An-nexin V-FITC/PI double staining and the expression of Bax , Bcl-2, Akt and p-Akt was detected by Western blotting .RE-SULTS:Matrine significantly inhibited the proliferation of D 341 cells and increased the apoptosis in a dose-and time-de-pendent manner .The cell apoptosis was characterized by chromatin condensation with margination of chromatin to the nu -clear membrane , increased when and larger cytoplasmic vacuoles , and formation of apoptotic body after treatment with ma-trine.The expression of Bax increased , while the expression of Bcl-2 and p-Akt decreased when the drug concentration gradually increased .CONCLUSION:Matrine induces the apoptosis of human medulloblastoma D 341 cells in vitro by acti-vation of Bax, down-regulation of Bcl-2 and reduction of p-Akt expression level in the PI3K/Akt signaling pathway.
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Objective To report the surgical treatment results of cardiac and esophageal cancer of remnant stomach.Methods From 1980 to 2005,11 patients with cardiac and esophageal cancer of remnant stomach were treated surgically.Results Primary cardiac and esophageal carcinoma of remnant stomach developed in male patients more than females.Of 11 patients,7 underwent subtotal gastrectomy with Billroth Ⅱ reconstruction at first time.The mean interval between two operations was 13 years.Clinical symptoms frequently included abdominal distension,pain and hemorrhage.Thirty patients received radical resection.Conclusion Cancer in remnant stomach should be suspected in patients undergoing subtotal gastrectomy 5 years and over have clinical symptoms of upper gastrointestinal tract.Early diagnosis and early curative resection should be done.For esophageal cancer of remnant stomachmcolon reconstruction after the resection of esophageal cancer is recommmended.