Volume 88  ·   Issue 19  ·  2008

In recent years, the level of diagnosis and treatment of cerebrovascular surgery in China has improved significantly, which is in synchronization with the international development level. In order to report the current level of diagnosis and treatment of cerebrovascular surgery in China in time, this journal published four research papers on cerebrovascular surgery in this issue.

Objective To investigate the effects of microoperation combined with embolization in treatment of spinal cord hemangioblastoma. Methods Thirty-six patients with spinal cord hemangioblastoma,21 males and 15 females, aged 24. 2 ( 12 -48), underwent MRI and digital abstraction angiography. Twelve of them underwent pure microsurgical treatment and 24 of them underwent operation combined with remobilization. Results MRI showed clear boundary mass, and DSA showed round or oval high density images with clear boundary and definite supplying artery. 30 cases had their tumors totally removed; and 6 cases had their tumors subtotaUy removed.Complete functional recovery was seen in 27 of the 36 patients (67%).Four patients resumed their self-care ability,and 4 still needed someone's help. Conclusion Embolization lowers the blood supply of the spinal cord hemangioblastoma, elevates the cure rate, and enlarges the indication of spinal cord hemangioblastoma operation.

Objective The clinical diagnosis and surgical management of intramedullary spinal cord cavernous angioma were discussed. Method Total 19 patients with intramedullary cavernous angioma were analyzed retrospectively on the clinical manifestation, radiographic feature, diagnosis and differentiation,surgical technique and caution. Of all the 19 patients, averaging 38.7 years old, 14 were male and 5 were female. Nine patients were followed. Result All the 19 patients pathologically diagnosed with spinal cord cavernous angioma got good surgical results, besides one patient showed loss of proprioception. Nine patients were followed up and all demonstrated improvement on neurological function. Conclusion The clinical symptom of most of the patients with spinal cord cavernous angioma presented mildly at onset, but deteriorated gradually because of repeated rehemorrhage. Since the lesion showed some characteristic in MRI, MRI examination was regarded as an important diagnostic tool. Dissection should be done between the tumor and the gliosis during the surgical procedure, special attention should be paid to avoiding tumor residual. It was not necessary to aggressively evacuate the hemotoma derived from tumor hemorrhage, which extended along the central canal up and down, except obvious occupied syndrome exited.

Objective To evaluate the factors of recurrence of intracrauial aneurysm after endovascular embolization. Methods Seventy patients with 74 intracranial aneurysms, 37 males and 33 females, aged 47 (37 - 63 ), underwent endovascular embolization. Cerebral angiography was conducted 3 months to 1 year after the endovascular embolization on 37 patients. The geometric forms of aneurysm,method and material of endovascular embolization, and digital subtraction angiography (DSA) images beforeand after the recurrence were analyzed, geometry form, method and material of endovascular embolization and image. Results Nine recurrent aneurysms were discovered in 8 patients of which 5 were located in the posterior communicating artery; 2 in the anterior communicating artery;and 2 in the first crotch of the right middle cerebral artery. Four of the recurrent aneurysms were wide-necked aneurysms ; and 5 were of irregular forms. Before recurrence, complete aneurysm occlusion was achieved in 3 aneurysms and incomplete occlusion was achieved in 6. Conclusion The percentage of complete aneurysm occlusion is related to the location, size, geometric form, method and material of endovascular embolization and density of coil packing. Intracranial aneurysms located in crotch of artery, with wide-neck, large, with irregular forms, and embolized incompletely are liable to recur.

Objective To investigate the clinical features of pediatric cerebrovascular disorders. Methods The clinical data of 204 cases of pediatric cerebrovascular disease, 134 male and 70 female ( 1.91 : 1 ), aged 12. 7 ( 32 d - 17. 9 years ), hospitalized in the past 13 years were analyzed retrospectively.The diagnosis of intracranial hemorrhage was mainly based on CT,Digital substraction angiography was conducted on 130 cases and pathological examination was conducted on 78 cases. Results Intracranial hemorrhage was seen in 195 cases. The onset of symptoms was acute or subacute in 73.5% of the patients (150/204). The main manifestations included headache (70. 6% ), vomiting (50%), loss of consciousness (22. 5% ) , convulsion (21.6%), and focal neurological deficits ( 13.2% ). The causes included arterio-venous malformation (42. 2%, 86/204 ), cavernoma ( 16. 2%, 33/204 ), aneurysm (8. 8%, 18/204 ),and moyamoya disease(5.9%, 12/204) , and the cause remained unknown in 43 of the patients (21%).Conclusion The epidemiology of pediatric cerebrovascular diseases has its own specificity. Therefore, it is crucial to deal timely with it according to the characteristics of the cerebrovascular diseases in children's.

Objective To analyze the clinical characteristics of recurrence of vulvar squamous cell cancer and to explore the treatment thereof. Methods The clinical data of 18 patients vulvar squamous cell cancer, confirmed at the age 28 - 76, who developed recurrence were retrospectively analyzed. Results The overall recurrence rate was 21.3%. The time range between the primary operation and the discovery of primary recurrence was 2 months - 16 years. Local recurrence occurred in 11 of the 18 patients (61.1%).Recurrence in groin alone occurred in 4 of the 10 patients (22.2%) and recurrence in both the vulva and groin occurred in 3 of the 18 patients ( 16. 7% ). Local recurrence occurred more than 1 year after the primary treatment and inguinal recurrence occurred mostly within 1 year after the primary treatment. The survival time of the patients with vulvar recurrence was (63.2 ± 8. 1 ) months, significantly longer than that of the patients with groin recurrence [ ( 10. 7 ± 1.6 ) months, P ＜ 0. 01 ] . Conclusion The clinical characteristics and the prognosis of recurrent vulvar squamous cell cancer depend on the site of recurrence.The best treatment option for recurrence is surgery.

Objective To investigate the feasibility of detecting Helieobaeter pylori (Hp) directly from gastric mucosa and the relationship of HP genotypes to gastric diseases. Methods Specimens of gastric mucosa were collected by biopsy from 217 patients, 90 with superficial gastritis (GS), 70 with atrophicgastritis (GA) , 28 with gastroesophageal erosions and ulcers (GEU) , and 29 with gastric cancer (GC) , to undergo pathological examination, culture of Hp, and DNA isolation from the gastric mucosa respectively.Routine phenol/chloroform method was used to isolate the DNA in the cultured Hp. PCR was conducted to detect the ureB, cagA, vaeAsl, vacAml, vacArn2, iceA1, iceA2, and baba2 genotypes in both the gastric mueosa-originated Hp-DNA and cultured Hp-DNA. Results The concordance rates of ureB, cagA, vacAsl,vacAml, vacAm2, iceA1, iceA2, and baba2 genotypes between the gastric mueosa-originated Hp-DNA and cultured Hp-DNA were 74. 23% , 73.39% , 93.69%, 62. 16% , 78. 16%, 89. 13%, 88.37% , and 75%respectively ( all P ＞ 0. 05 ). There were no significant differences in the distribution rates of ureB, eagA,vacAsl, vacAmlb, iceA1, iceA2, and baba2 genotypes among different gastric diseases (all P ＞0. 05).However, the distribution frequency of vacAslml strain in the GA patients was 22. 22%, significantly higher than that in the GA patients (5.71% , x2 = 8.416, P = 0. 004), and the distribution frequency of vaeAsl m2 strains in the GA patients was 47. 14%, significantly higher than that in GS patients ( 18.89% , x2 =13. 336, P =0. 000). Conclusion Rapid detection of Hp can be achieved by using DNA isolated directly from infected gastric mucosa. VacAs] ml is associated with GA and vacAs1m2 is associated with GA.

Objective To investigate the relationship of chondroeyte apoptosis to cartilage destruction in osteoarthritis (OA). Methods Specimens of cartilage were collected from 20 OA patients and 8 patients with femoral neck fracture during operation. TUNEL method was performed to semi-quantitatively detect the distribution of apoptotic chondrocytes. Immunohistochemistry was used to detect the expression of the apoptosis-associated proteins : surviving ( SVV ), caspase-3, and apoptosis regulating protein Bc]-2.Results Apoptotic chondrocytes were identified in a relatively early phase of cartilage destruction, and correlated positively and significantly with the degree of cartilage degeneration. In contrast, the specimens of normal subjects contained few cells with apoptotic changes ( P = 0. 000 ＜ 0. 05 ). The TUNRL positive cell rate of the OA group was significantly higher than that of the control group ( P = 0. 000). Protein expression of SVV was observed in the chondrocytes within the degraded lesions and in the chondrocytes of the superficial layers, and showed a kind of positive correlation with the number of TUNEL-stained cells. The distribution area of easpase-3 was greater than that of SVV, and could be detected in relatively normal cartilage areas. Protein expression of Bcl-xl was not definitely detected in cartilage tissue. Conclusion The degree of chondrocyte apoptosis is closely related to cartilage destruction. The protein expression of SVV and easpase-3 may reflect the involvement of these proteins in the apoptotic process in the articular chondrocytes in OA.

Objective To explore the clinical value of CT guided 125I seeds implantation in the treatment of local recurrent rectal cancer after surgery resection. Methods Twenty-one patients with local recurrent rectal cancer after surgery, 12 males and 9 females, aged 47 (35 -69), with the longest diameter of 4. 2 cm (3.4 -6.4 cm), were treated by CT guided 125I radioactive seeds implantation according to treatment planning system (TPS) or Halarism's experienced function: mCi = Da × 5. Totally, 506 seeds,24. 1 for one patient on average, were implanted. All the patients received PET-CT scan 3 months after the treatment and were followed up for 12. 5 months (7 - 22 months). Results Complete remission, partial remission, and no change were seen in 16, 3, and 2 patients respectively. All patients survived. Conclusion CT guided 125I seeds implantation is an effective methods in the treatment of local recurrent rectal cancer after surgery resection.

Objective To explore the situation of residual lesions in excision margin after loop electrosurgical excision procedure (LEEP) and cold knife conization (CKC) and the risk factors of recurrence in the cases featuring with positive margin. Methods The medical records of 1213 women undergoing LEEP or CKC, aged (35 ± 5 ) (22 -40), were retrospectively reviewed. 148 of the 1213 patients (12.2%) who were identified as with positive margin were re-underwent pathological re-examination. 118 of the 148 patients were diagnosed as with cervical intraepithelial neoplasia Ⅲ (CIN Ⅲ )and 30 as with stage I a invasive cervical carcinoma. These patients were followed up for 12 -99 months,The pathologic diagnoses, position of positive margin, and residual lesion in subsequent specimens were analyzed. Results Endocervical positive margins were identified in 30 of the 118 (25.4%) CIN Ⅲ patients and 26 of the 30 (86.6%) stage Ⅰ a patients. Residual lesions were found in 15 of the 28 (53.6%) stage Ⅰ a cases and 4 pf the 19 ( 19% ) CIN Ⅲ cases. The rates of endocervical positive margin and residual lesion were higher in stage Ⅰ a patients. The risk of residual lesion was 53.1% (17/32) in the patients with endocervical positive margins, significantly higher than that of the patients with extracervical positive margin ( 16. 7% ). Recurrence was found in 90 patients during follow-up. Conclusion Residual lesions often occur in some patients with positive margin. Choice between additional surgery and closely follow-up in the young patients with positive margins who want to preserve their fertility depends on the lesion seriousness and positive position. Residual lesions more frequently exist in the patients with microinvasion and endocervical positivity. Additional surgery should be considered in these cases.

Objective To analyze the impact of negative lymph node number on the prognosis of advanced cancer of the cardia and stomach fundus. Methods 236 patients with advanced cancer of the cardia and stomach fundus underwent D2 radical resection. 5-year survival rate and recurrence rate were followed up and the relationships of lymph node (LN) number to 5-year survival rate and recurrence rate were analyzed respectively, according to LN count subgroups. Results The 5-year survival rate of the entire cohort was 37.5%. The number of metastasis negative LNs was positively correlated with the LNs examined ( P ＜ 0. 05 ). For the cancer at the same stage, the higher the number of metastasis negative LNs the higher the 5-year survival rate ( P ＜ 0. 05 ). Linear correlation analysis showed that along with the increase of the number of negative LNs the post-operative survival rate increased. In the cancers at the stages Ⅲ and Ⅳ, the 5-year survival rate increased by 6.09% and 7.65% respectively compared to the predicted values ( P =0. 013 and P =0. 035). The overall recurrence rate was 61.0% within 5 years after surgery. For the cancers at the stages Ⅲ and Ⅳ, the more the number of negative LNs the higher the 5-year survival rates ( P ＜0. 05 ). In the cancers at the stages Ⅲ and Ⅳ there were significant differences in the recurrence rates among the subgroups with different numbers of negative LNs ( all P ＜ 0. 002 ). Conclusion Number of negative LNs has a close relation with stage-based survival prediction. Dissection of sufficient lymph nodes in the procedure of Dz dissection should be recommended so as to improve the long-term therapeutic effects and reduce the recurrence rate.

Objective To explore the possible relationship between vocal fold leukoplakia and gastropharyngeal reflux. Methods Fifteen patients with vocal fold leukoplakia confirmed by pathology, all males, aged ( 53 ± 14 ) ( 20 - 88 ) , underwent esophageal and laryngopharyngeal 24-hour pH monitoring before operation. The rate and characteristics of reflux were recorded. Semi-open-ended questionnaire was used to assess the symptoms. Results Nine of the 15 patients (60%) showed pathologic intra-esophageal reflux. The time of total acid reflux of the positive re intra-esophageal reflux group was 104. 6 min ± 42. 1 min, significantly longer than that of the negative group [ ( 10. 9 min ± 11.5 min ) , P = 0. 001 ] . The frequencies of intra-esophageal acid reflux of the positive group was ( 30. 1 ± 16. 2 ) times, significantly higher than that of the negative group [ ( 4. 8 ± 3.4 ) times, P = 0. 0061. The intra-esophageal acid reflux percentage of the positive group was 7.9% ± 2. 9% , significantly higher than that of the negative group ( 1.0% ± 0. 6% ), P = 0. 01 ]. and the rate in esophageal pH ＜ 4 of total fraction time between reflux positive and negative patients( P ＜ 0. 01 ). The scores of heartburn and acid regurgitaion of the positive group were significantly higher than those of the negative group (both P ＜ 0. 05). Two of 15 patients ( 13.3% )had pathologic laryngopahryngeal reflux. One patient also had obstructive sleep apnea hypopnea syndrome. Conclusion The patients with vocal fold leukoplakia had more pathologic iutra-esophageal reflux compared to the normal individuals. Reflux may be a risk factor of mucosa leukoplakia.

Objective To test the hypothesis that Neutiophil gelatinase -associated lipocalin (NGAL) is an early biomarker for acute kidney injury (AKI) in patients after cardiac surgery. Methods 33cases undergoing cardiac surgery were divided into AKI group and Non-AKI group according to the AKI cases (27%) developed postoperative AKI, but diagnosis with serum creatinine was only 12-48 hours after develope AKI were significantly higher compared with those of preoperative ( P ＜ 0. 001 ) . Urinary concentrations of NGAL at 2 h and 4 h after cardiac surgery in patients who developed AKI were significantlypatients who developed AKI were significantly higher after surgery compared with patients who did notdevelop AKI (P ＜ 0.01 ). @Urinary concentrations of NGAL/Ucr at 2 h and 4 h after cardiac surgery in patients who did not develope AKI were significantly higher compared with those of preoperative ( P ＜ 0. 05 ).Urinary concentrations of NGAL/Ucr at 2 h and 4 h after cardiac surgery in patients who developed AKI wereNGAL/Ucr in patients who developed AKI were significantly higher after surgery compared with patients who creatinine 12 h postoperative ( R = 0. 638,P ＜ 0. 05 ). Conclusions The incidence of AKI in patients after cardiac surgery is high, which accounted for 27%. The amount of NGAL and NGAL/Ucr in urine at 2 h after cardiac surgery were the powerful independent predictor of acute renal injury and urine concentrations of NGAL/Ucr is more sensitive.

Objective To clarify the clinical and pathological features and prognosis of Chinese patients with distal myopathy with rimmed vacuoles (DMRV). Methods The clinical data of 17 Chinese DMRV patients with the courses of disease of 1-21 years, 5 males and 12 females, aged 28.9 (19-41) ,were collected. Biopsy of muscle specimens of 17 Chinese DMRV patients were summarized retrospectively. Muscle specimens were collected from the biceps brachii, tibialis anterior, gastrocnemius, or quadriceps femoris and underwent light microscopy. Eight muscle specimens underwent electron microscopy. 11 patients were followed up for 4 months to 15 years. Results The age of onset ranged from 5to 40 years ( averaging 23 years). Distal muscle weakness and atrophy of the lower extremities, especiallyanterior tibial muscle, was predominant in the early stage. Proximal and trunk muscles were involved in the advanced stage. Quadriceps femoris were slightly involved. The striking and characteristic pathological finding was the presence of rimmed vacuoles in atrophic muscle fibers with little evidence of necrotic or regenerative processes. Electron microscopy showed accumulation of myeloid structure and cytoplasmic or intranuclear tubofilamentous inclusion bodies. Although atrophy and weakness of the leg muscle appeared as initial symptoms, severe generalized skeletal muscle involvement with sparing of the facial, extraocular,bulbar, intercostals, and diaphragm muscles was recognized in the advanced stage. The patients became non-ambulant about 7 - 10 years after the onset of the disease. They lost the self-care ability and the quality of their life was rather low. Conclusion The clinical and pathological features of the Chinese DMRV patients are basically similar to those of the Japanese patients. With the disease progressing slowly, the patients become wheelchair-bound and lose the self-care ability. As to daily life, the prognosis of DMRV is extremely poor.

Objective To investigate the alterations in structure and function of sternohyoid muscle of metabolic syndrome (MS) rats effects and the effects of taurine thereupon contractile properties. Methods Twenty-one healthy male SD rats were randomly assigned to three groups: control group ( Group A, n = 6 )fed with normal food, MS group ( Group B, n = 8) fed with high-lipid forage for 9 weeks to induce MS and then fed with the same high-lipid forage for 12 weeks in addition, and tanrine group(Group C, n =7), fed week for 12 weeks. Venous blood samples were collected to undergo biochemical examination of plasma total cholesterol (TC), trig]yceride (TG), high-density ]ipoprotein (HDL), low-density ]ipoprotein (LDL),and glucose (G]u). Radioimmunoassay was used to detect the plasma insulin. The sternohyoid muscles were collected. Muscle tissue homogenate was made. The superoxide dismutase (SOD) and malondialdehy (MDA) levels were measured. Myosin-ATPase histochemistry was used to assay the size and capillary density of the isolated sternohyoid muscles. Isometric contractile properties were determined by electrostimulating the strips of isolated sternohyoid muscles at different frequencies (from 10 Hz to 100 Hz)to observe the changes of the sternohyoid contractile properties in different conditions. Results ( 1 ) The levels of TG, LDL, Glu, PGI, and MDA of Group B were significantly higher than those of Groups A and C,while the HDL level of Group B was significantly lower than that of Group A ( P ＜ 0. 01 ). The OD level of Group B was significantly lower than those of Groups A and C. (2) The capillary density, capillary-to-fiber ratio (C/F), and cross-sectional area of type Ⅰ fiber in sternohyoid muscles of Group B were( 140 ± 5)/sternohyoid muscle of Group B at the frequencies from 10 Hz to 60 Hz were (29 ± 6 )g/cm2, (34 ± 7 )g/cm2, (41 ± 6 ) g/cm2, (47 ± 6 ) g/cm2, (53 ± 7 ) g/cm2, and ( 59 ± 20 ) g/cm2 respectively, all significantly lower than those of Group A group[ (40 ± 3) g/cm2, (52 ± 13) g/cm2, (60 ± 17) g/cm2, (74 ± 32) g/cm2,(80 ±29)g/cm2, and (96 ±24)g/cm2 respectively, all P ＜0. 05] and Group C [ (43 ± 26)g/cm2, (48 ±6 ) g/cm2, ( 55 ± 9 ) g/cm2, (67 ± 14) g/cm2, (75 ± 15 ) g/cm2, and ( 80 ± 15 ) g/cm2 respectively, all P ＜0. 05]. (4) In fatigue test, the tension percentages of sternohyoid muscle at the time intervals of 1 min, 2min, 3 min, 4 min, and5 min of Group B were(80.5 ± 8.0)%, (64.1 ±1.2)%, (59.1 ±1.1)%,(56. 4 ± 10. 9 )%, and (53.5 ± 9. 1 )% respectively, all significantly lower than those of Group A [(87.7±3.5)%, (78.5 ± 1.5)%, (76.0 ± 1.2)%, (72.3 ± 15.0)%, and (68.7 ± 17.2)%respectively, all P ＜ 0. 05 ] and Group C group [ ( 87. 4 ± 2.4 ) %, ( 77. 9 ± 5. 5 ) %, ( 73.6 + 1.1 ) %,(71.3 ± 8.7)%, and(68.0 ±6.7) respectively, all P ＜0.05]. Conclusion With the development of MS, the capillary density, C/F, cross-sectional area of type Ⅰ fiber of upper airway muscles decrease, in part via oxidative stress, which leads to reduction of the contractile function of upper airway muscles, thus contributing to the onset of obstructive sleep apnea-hypopnea syndrome.

Objective To investigate the dose-effect relationship and time-effect relationship of astragalus injection on the protein expression of nitric-oxide synthase (NOS) and extracellular signal-regulated kinase (ERK) in cultured cardiac myocytes. Methods ( 1 ) Ventricular myocytes of Sprague-Dawley rats were isolated, cultured, and incubated with astragalus injection of the concentrations of 0, 20, 100, 200, or 400 ml/L for 8 days. Cell growth curve was drawn. Automatic biochemical analyzer was used to detect the level of creatine kinase (CK). (2) Western blotting was used 2 h after incubation to observe the protein expression of ERK and nitric oxide synthase ( NOS ) . ( 3 ) Myocytes were incubated with astragalus injection (200 ml/L) or with astragalus and PD98059, an ERK inhibitor, for 5,15,30,60, and 120 min respectively, and Western blotting was used to detect the protein expression of ERK and NOS. Results Astragalus of different concentrations showed no effect on the cell proliferation. Only the CK level of the astragalus 200 ml/L group was significantly higher than that of the control group ( P ＜ 0.05 ).Astragalus showed no dose-dependent effect on the ERK expression, and dose-dependently reduced the NOS expression level. 15 min after the co-incubation with astragalus 200 ml/L the ERK level of the myocytes decreased transiently, and then began to increase gradually since 15 min after the co-incubation; the NOS level began to increase since 60 min after the co-incubation ( P ＜ 0.05 ). After the addition of PD98059 the ERK expression significantly decreased (P ＜ O. 05). Conclusion Astragalus injection has modulation effect on ERK and NOS expression. This effect is enhanced time-dependently at appropriate Astragalus concentration, but attenuated by high dose Astragalus injection.

Objective To investigate the role of P-type Na+ -K+ -ATPase in the mechanism of migraine. Methods nitroglycerin induced migraine Twenty Sprague-Dawley rats, 10 male and 10 female,were randomly divided into 2 groups: model group, undergoing subcutaneous injection of nitroglycerin 10 mg/kg once a week for 4 weeks so as to establish migraine model, and control group, undergoing subcutaneous injection of normal saline. Then the rats were killed with their trigeminal ganglia,trigeminocervical complex, and cortex of frontal lobe taken out. RT-PCR and Western-blotting were used to detect the mRNA and protein expression of P-type Na+ -K+ -ATPase. Immuno-precipitation assay was conducted to observe the Na + -K + -ATPase activity. The concentration of intracellular Ca2 + was investigated by Fluo-3/AM fluorometric method. Results The mRNA and protein expression levels and activity of P-type Na + -K + -ATPase in the trigeminal ganglion and trigeminocervical complex of the model group were 0. 72 ±0. 05,0. 59 ± 0. 05 ,and 5.21 ± 0. 51 respectively, and the mRNA and protein expression levels and activity of P-type Na + -K + -ATPase in the cortex of frontal lobe of the model group were 0. 70 ± 0. 05,0. 60 ± 0. 05,and 3.61 ± 0. 49 respectively, all significantly lower than those of the control group (0. 83 ± 0. 10,0. 67 ±0.06,6.53 ±0.73,0.81 ±0.08,0.71 ± 0.09, and 6.61 ±0.73 respectively, all P ＜0.05). The concentration of intracellular Ca2+ in trigeminal ganglion and trigeminocervical complex and the concentration of Ca2+ in the cortex of frontal lobe of the model group were 211 182 ± 12 973 and 186 511 ± 18 297respectively, both significantly higher than those of the control group ( 135 243 ± 18 105 and 143 289 ±25 175 respectively, both P ＜ O. 01 ). Conclusion P-type Na + -K + -ATPase may infect the pathogenesis of migraine by its expression and activity.

Objective To study the effects of cadmium on the structure and functions of mitochondria in hepatocytes. Methods Mitochondria were isolated from cultured human hepatocytes of the added into the culture medium. Mitochondrial permeability transition pore (MPTP) opening degree was tested by spectrophotometer. Morphologic changes of mitochondria were observed under transmission electron microscope. The activities of Na+-K+ -ATPase, Ca2 + -Mg2 + -ATPase, LDH, superoxide dismutase ( SOD ) ,glutathione peroxidase (GSH-Px), and the contents of malondialdehyde (MDA) were measured.Mitochondria membrane potential (MMP) was monitored by spectrofluorimeter with fluorescence dye Rh-123. Results CdC12 reduced the absorbance of mitochondria, signifying the opening of MPTP,control group (P ＜ 0.05, P ＜ 0.01 ) . The activity levels of ATPase, LDH, SOD, and GSH-Px in mitochondria decreased in the CdCl2 groups ( all P ＜ 0. 05 ) , and the contents of MDA increased in the CdCl2 groups compared with the control group. Conclusion CdCl2 causes destruction of mitochondria structure,opening of MPTP, decrease of MMP, and changes of vitality of mitochondria enzymes that all play important roles in apoptosis of hepatocytes.

A 68-year-old male was admitted to hospital for more than 9 months due to repeated painless macroscopic hematuria. The patient developed macroscopic hematuria without obvious inducement 9 months ago, which was initial hematuria, without blood clots, no low back pain, no frequent urination, urgency, painful urination, no dysuria, no fever or chills. Bladder polyps and prostatic hyperplasia were found in the local hospital, and bladder polyp removal was performed. Five months ago, the patient developed full-course hematuria with dull pain in the right waist.