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At present,the standardized training of neurosurgery resident is in the primary stage in our country,and the master's degree postgraduates of Neurosurgery major are the main part of the students of neurosurgery planning training in our department.At present,a systematic and sound training system and teaching mechanism hasn't been formed in the standardized training of postgraduates in Neurosurgery.It is imperative to explore the training mode of postgraduates majoring in neurosurgery to keep pace with the times and meet the needs of the society.Based on the problems in the current training mode of neurosurgery in the First Affiliated Hospital of Heavy Medicine and combined with the existing problems,this paper focuses on the cultivation of professional basic theoretical knowledge,clinical practice ability,clinical thinking and innovative ability and aims to establish professional assessment team,so as to boost the education development of postgraduates with neurosurgery degree and improve the quality of standardized training.
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[Objective]To forecast the sponge mechanism mediated by LOC389023 in patients with intractable temporal lobe epilepsy(TLE),through investigating the expression of microRNA interacted with dipeptidyl peptidase 10(DPP10)and LOC389023.[Methods]The expression of DPP10 and Kv4.3 were detected in 15 temporal neocortex from patients with brain trauma (control group)and in 26 temporal neocortex from patients with intractable TLE(epilepsy group)by western blot(WB)and immunohisto?chemical(IHC)staining. The location of DPP10 and voltage dependent potassium channel 4.3(Kv4.3)was detected by immunofluo?rescent(IF)staining. The interaction between DPP10 and Kv4.3 was testified by co-immunoprecipitation(Co-IP). The expression of microRNA obtained by softwares(miRanda,Pita,TargetScan and miRDB)was detected by qPCR.[Results]IHC and WB showed an increased expression of DPP10(P0.05). But decreased expression of LOC389023 and miR-140-5p and increased expression of miR-25-3p and miR-367-3p were found in epilepsygroup compared to control group (P < 0.05).[Conclusion]miR-25-3p and miR-367-3p may be regulated by LOC389023 through the sponge mechanism followed by altered expression of DPP10 in intractable temporal lobe epilepsy.
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Clinical medicine professional degree education focuses on cultivating students' ability to engage in clinical practice, but the aim of medical postgraduate education program is to cultivate high-leveled clinical and research personnel. In the light of the problems that professional degree postgraduates majoring in obstetrics and gynecology are faced with such as unreasonable energy distribution in scientific research, the weak foundation of scientific research, the emergence of new trend of obstetrical and gynecological dis-eases, we have explored how to improve obstetrics and gynecology professional students' scientific research ability from several aspects such as the guidance of mentors, transferring learning and thinking and strength-ening the communication between various disciplines, to adapt to the requirements of the scientific develop-ment of modern obstetrics and gynecology.
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Objective To assess whether it have difference between mannitol combined with glycerin fructose and only use mannitol for the treatment of cerebral hemorrhage ,which provides relevant evidence‐based basis for guiding clinical treatment of cerebral hemorrhage .Methods We used literature retrieval through to the China national knowledge internet (CNKI) ,China biolo‐gy medicine disc ,VIP Chinese periodical database ,Wanfang data knowledge service platform and manual retrieval ,and formulate the inclusion and exclusion to screening literature ;and using the Jadad quality evaluation method to evaluate literature which had been included ,heterogeneity inspection at the same time .If the effect of multiple resulted ,we used fixed effect model ;on the other hand , used a random effects model .Results Mannitol combined glycerol fructose significantly improved symptoms and nervous function in patients with cerebral hemorrhage ,and the difference was statistically significant (RR=1 .12 ,95% CI:1 .03 -1 .22 ,P<0 .01);mannitol combined glycerol fructose significantly decreasd impaired renal function and complications (RR=0 .34 ,95% CI:0 .25-0 . 47 ,P<0 .01);mannitol combined glycerol fructose significantly decreasd severe unbalance of electrolyte after taking the medicine (RR=0 .31 ,95% CI:0 .19-0 .49 ,P<0 .01) .Conclusion Compared to use mannitol only ,combination with mannitol and glycerin fructose could effectively improve the prognosis of patients with cerebral hemorrhage ,and reduce the side effects .
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Objective To explore the guidance significance of the functional MRI and DTI (fMRI ,DTI) ,intraoperative ultra-sound(IOUS) ,neuronavigation ,electrocorticography(EcoG) monitoring used in surgical treatment of low-grade gliomas with epi-lepsy as main symptom located near the eloquent brain regions .Methods 23 neurosurgical patients in the First Affiliated Hospital of Chongqing Medical University during 2009-2010 were performed the retrospective analysis .The preoperative fMRI ,DTI deter-mined the positional relation between the lesions with the conduction bundle and the eloquent brain regions ,the electrophysiological and imageological examinations positioned the epileptogenic focus and lesions ,the MRI-mediated neuronavigation system was adopt-ed to formulate the surgical plan and choose the best surgical approach ,IOUS was used to perform the realtime monitoring for pre-cisely positioning the lesion range and determining the extent of resection ,and the intraoperative EcoG was adopted to determine the epileptogenic focus localization ,the lesions and the epileptogenic focus was dealed by the operating microscope for avoiding the func-tional region ,and the patient′s prognosis was evaluated and recored in detail after operation .Results By the precisely positioning the lesions and epileptogenic focus by fMRI ,DTI ,neuronavigation and ultrasound ,the lesion resection degrees by the operative mi-croscope and intraopertaive pathological guidance were 17 cases of Ⅰ-Ⅱ grade ,4 cases of Ⅲ grade and 2 case of Ⅳ-Ⅴ grade .1 case of motor aphasia ,4 cases of hemiplegia and monoplegia and 1 case of disturbance of consciousness after operation were improved by the treatment of neurotrophy ,dehydration and hyperbaric oxygen and discharged from hospital with rehabilitation .No death case occurred .The evaluation of the life quality :20 cases ofⅠ-Ⅱ grade ,3 cases of Ⅲ grade and no vegetable survival case of Ⅳ grade . The evaluation of resection clinical effect :20 cases of cure ,3 cases of improvement ,no case of as before and exacerbation .After fol-lowed up for 6-24 months ,according to Engel classification of seizure efficacy assessment :Ⅰ-Ⅱ grade in 21 cases ,Ⅲ grade in 2 case ,no case of Ⅳgrade .Conclusion fMRI ,DTI ,neuronavigation ,IOUS and EcoG for guiding the operation of low grade gliomas located near the eloquent brain regions can resect the lesion to the largest extent and simultaneously deal with epileptogenic focus , effectively protect the neurological function of the functional region ,greatly reduce the side-injury of the normal brain tissues in the functional region ,at the same time increase the curative effect of symptomatic epilepsy .
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Objective To analyze the performance of the glioma in proton magnetic resonance spectroscopy (1H-MRS) and diffu-sion tensor imaging(DTI) ,and to explore the relationship between the characteristics and pathological grade .Methods The 41 ca-ses of glioma patients were divided into two groups according to the World Health Organization (WHO) classification method :the low-level group and the high-level group .The patients underwent conventional magnetic resonance imaging ,DTI and 1H-MRS ex-amination ,and the ipsilateral placeholder district and contralateral reference zones ADC ,FA ,Cho ,NAA and Cr values were meas-ured .Results The difference of ADC and FA values in solid area between the two groups was significant compared with the contra-lateral ones (P< 0 .05) .The difference of ADC and FA value of the gliomas between the two groups was also significant (P<0 .05) .The NAA/Cr and Cho/Cr values in the two groups of glioma tumor was significantly different compared with the contralat-eral ones (P<0 .05) .The NAA/Cr and NAA/Cho values of the gliomas between the two groups were also significantly different (P<0 .05) .Conclusion The performance of glioma in 1H-MRS and DTI between the two groups showed significantly different .
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Great difficulties and challenges are existed in the training of clinical type postgraduate of neurosurgery because of the acute onset,server illness and difficult diagnosis of neurosurgical diseases.This paper proposed countermeasures of combing theory with clinical practice and strengthening comprehensive ability after analyzing problems of inadequate professional knowledge,lack of doctor-patient communication and insufficient clinical thinking and innovating ability.The aim was to cultivate the overall quality of postgraduates,making them more qualified for the difficult task of being neurosurgery clinicians.
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Because of the specificity and complexity,of obstetrics and gynecology,interns often meet doctor-patient communication problems during the internship.This study explores these problems to enhance interns' doctor-patient communication and to cultivate interns' technical proficiency.We have also made them grasp the methods and skills of doctor-patient communication,and enable them to successfully communicate with patients on internship.
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<p><b>OBJECTIVE</b>To explore the role of p38 signal pathway in regulating matrix metalloproteinase-9 (MMP-9) expression and brain edema formation in a rat model of traumatic brain injury (TBI).</p><p><b>METHODS</b>A total of 130 adult male Sprague Dawley rats were randomly divided into 4 groups, namely the normal group (n=10), sham-operated group (n=40), TBI (induced by Feeney free falling methods) group (n=40), and SB group with intraperitoneal SB203580 treatment (10 µmol/L) 15 min before TBI (n=40). The rats were sacrificed 2 h and 2 days after TBI. The expressions of p38, p-p38, and MMP-9 mRNA and protein were detected by RT-PCR and Western blotting. The blood brain barrier permeability was detected by Evans Blue (EB) test, and the brain water content (BWC) was determined using a gravimetric technique.</p><p><b>RESULTS</b>The expression of p-p38 protein increased markedly 2 h after TBI (P<0.05), and was suppressed by SB203580 treatment (P<0.05). MMP-9 mRNA and protein showed no obvious increase at 2 h after TBI, but significantly increased at 2 days as compared with those in the sham-operated group (P<0.05). MMP-9 mRNA and protein were much lower in SB group than in TBI group 2 days after TBI (P<0.05). The blood brain barrier permeability significantly increased 2 h after TBI (P<0.05) and kept increasing until 2 days (P<0.05), but was reduced significantly by SB203580 (P<0.05). BWC increased obviously 2 days after TBI (P<0.05) and was lessened by SB203580 (P<0.05).</p><p><b>CONCLUSION</b>Blocking p38 signal pathway can attenuate MMP-9 upregulation and brain edema after TBI, suggesting the important role of p38 in regulating MMP-9 expression to affect traumatic brain edema.</p>
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Animals , Male , Rats , Brain Edema , Pathology , Brain Injuries , Metabolism , Enzyme Inhibitors , Pharmacology , Imidazoles , Pharmacology , MAP Kinase Signaling System , Matrix Metalloproteinase 9 , Metabolism , Pyridines , Pharmacology , Rats, Sprague-DawleyABSTRACT
<p><b>OBJECTIVE</b>To explore the role of P38 signaling pathway in neonatal rat astrocyte swelling and the expression of aquaporin-4 (AQP4) after oxygen-glucose deprivation (OGD) and recovery (OGD/R).</p><p><b>METHODS</b>Primarily cultured neonatal rat astrocytes were subject to OGD for 5 h followed by oxygen-glucose recovery in the presence or absence of the P38 inhibitor SB203580 (10 µmol/L). The astrocytes were investigated at 0.5, 2, 8 and 24 h after oxygen-glucose recovery for morphological changes and cell injuries using lactate dehydrogenase (LDH) assay. The expressions of P38, P-P38, and AQP4 mRNAs and proteins in the astrocytes were detected using RT-PCR and Western blotting.</p><p><b>RESULTS</b>OGD/R caused significantly enhanced expression of P-P38 protein, and this effect was blocked by SB203580. AQP4 mRNA and protein expression declined transiently at 0.5 h after OGD and increased gradually to reach the peak level at 8 h (P<0.05). Application of the SB203580 significantly lowered OGD-induced AQP4 mRNA and protein up-regulation (P<0.05). Astrocyte swelling occurred after OGD/R but was obviously lessened by SB203580. LDH release increased markedly after OGD/R, and was attenuated by treatment with SB203580 (P<0.01).</p><p><b>CONCLUSION</b>P38 signaling pathway participates in astrocyte swelling after OGD/R, and blocking this pathway can attenuate AQP4 up-regulation and ameliorate the cell swelling.</p>
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Animals , Rats , Animals, Newborn , Aquaporin 4 , Metabolism , Astrocytes , Metabolism , Pathology , Brain Edema , Metabolism , Pathology , Cell Hypoxia , Glucose , Pharmacology , MAP Kinase Signaling System , Physiology , Oxygen , Pharmacology , Rats, Sprague-Dawley , Reperfusion Injury , MetabolismABSTRACT
On the basis of experiences in guiding five-year system undergraduates in their clinic practice,we realized that it was important to accomplish the following tasks:both teachers and students should have good preparation for it;teachers should instruct students in interrogation and physical examination;teachers should cultivate students' clinic thoughts;teachers should help students to summarize their practice.
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On the basis of my experiences in advanced neurosurgeons teaching,I realized that it was important to accomplish the following tasks:to make reasonable plan in advanced teaching,to constitute strict rules,to attach importance to clinical neuroanato- my teaching,to cultivate clinical ability,and to strengthen medical morality construction.Only by doing these can we improve the advanced education quality.
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Objective:To investigate the level of excitatory amino acids in the cerebrospinal fluid and the effect of magnesium sulfate on the excitatory amino acids following traumatic brain injury. Methods:The Feeney′s model of the excitatory amino acids in the cerebrospinal fluid (glutamate and aspartate) were measured by amino acid analysis from rats in different time. Results:1. The glutamate and aspartate in the cerebrospinal fluid increased largely 2 hours after traumatic brain injury(P0.05).2.Magnesium inhibited strongly the releasing of the excitatory amino acids at 2h and 8h after the traumatic brain injury(P0.05).Conclusion:Plenty releasing of excitatory amino acid may play an important role at the phase of posttraumatic neuronal injury.Magnesium sulfate can inhibit early releasing of excitatory amino acids.Administering magnesium sulfate may be the optimal choice for treating traumatic brain injury.
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0.05).Conclusion The variety of ECoG on patients with intracranial tumors undergone surgery is helpful to prognosticate postoperative early epilepsy.
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Objective:To investigate apoptosis of neurone in rats following traumatic brain injury and the effects of magnesium sulfate on apoptosis of neurone after brain injury.Methods:Based upon the Feeney′s model the cellular apoptosis was observed in injuried cortex and hippocampus at the 2nd hour to the 5th day after medium traumatic brain injury by TUNEL technique.Results:1.The cellular apoptosis was observed in the injuried cerebral hemisphere at the 2nd hour after traumatic brain injury.The number of apoptotic cells reached its peak at the 2nd to the 3rd day after traumatic brain injury, then gradually reduced at the 5th day after traumatic brain injury.2.At the 8th hour to the 3rd day after treatment with magnesium sulfate,the number of the cellular apoptosis in the injuried cortex and hippocampus reduced significantly compared with the controls (P
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Objective: To study the expression and significance of apoptosis related gene survivin in meningiomas.Methods: The expression of survivin protein was detected by immunohistochemical method(SP) in 60 cases of meningiomas,and its relationship with pathological parameters was analyzed.Results: The expression rate of survivin protein in meningioma of Ⅰ,Ⅱand Ⅲ grade were 32.0%,60.0% and 86.7% respectively,and there were great differences among the three groups(P
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Objective:To study the expression of apoptosis related gene survivin and its relationship with the expression of bcl-2,bax protein in glioma.Methods:Expression of survivin,bcl-2 and bax protein was detected by immunohistochemical method(SP) in 40 cases of glioma,and compared with those in 10 cases of normal brain tissue.The correlation between them was analyzed.Results:The expression rate(42.5%) of survivin protein in glioma was much higher than that(0%) in normal brain tissue(P