Recent advance in neuroprotectants combined with reperfusion in acute ischemic stroke / 中华神经医学杂志

Acute ischemic stroke (AIS) is a kind of central nervous system disease that seriously threatens human health and life. Current treatment for AIS is mainly reperfusion. However, the time-sensitive of reperfusion limits its clinical application, and a considerable part of patients within the time window cannot achieve the expected effect after reperfusion; related complications of reperfusion have not been completely solved. So far, some clinical trials have confirmed that neuroprotectants are useful supplements and adjuncts to reperfusion. This paper reviews the recent advance in neuroprotectants combined with reperfusion in AIS to provide references for AIS treatment.

Advances in the study of ischemic cerebrovascular disease and restless legs syndrome / 中国医师杂志

Restless legs syndrome (RLS) and ischemic cerebrovascular disease (ICVD) are two common disorders in neurology departments that place a significant economic burden on patients′ families and society. In recent years, increasing attention has been paid to the relationship between the two, but there is no clear-cut conclusion that RLS may be both a consequence of ICVD and associated with an increased risk of developing ICVD and poor functional outcome. This article summarizes the latest research findings on ICVD and RLS in China and abroad, with a view to providing a better understanding of their interaction and pathophysiological mechanisms, as well as providing some references for the early prevention and treatment of ischemic cerebrovascular events and rehabilitation.

Efficacy and safety of thrombolytic therapy with intravenous alteplase in elderly patients with acute cerebral infarction on maintenance dialysis / 中华老年医学杂志

Objective:To investigate the efficacy and safety of thrombolytic therapy with intravenous alteplase(rt-PA)for elderly acute ischemic stroke patients on maintenance hemodialysis.Methods:In this retrospective study, data of 165 elderly patients with acute cerebral infarction on maintenance dialysis, aged 65-85, treated at the Stroke Center of the Fourth Central Hospital Affiliated to Nankai University between May 2018 and March 2021, were collected.Based on whether intravenous thrombolysis with alteplase(rt-PA)was used and differences in thrombolytic schemes, patients were divided into a conservative treatment group( n=58, receiving only standardized secondary stroke prevention), a low-dose rt-PA group( n=57, receiving rt-PA intravenous thrombolysis, 0.6 mg/kg)and a standard-dose rt-PA group( n=50, receiving rt-PA intravenous thrombolysis, 0.9 mg/kg). The safety and efficacy of rt-PA treatment were assessed. Results:The rate of effectiveness at 24 h and the rate of good prognosis at 7 d were 64.9%(37/57)and 70.2%(40/57)for the low-dose rt-PA group and 68.0%(34/50)and 74.0%(37/50)for the standard dose group, respectively.There was no significant difference between the two groups( χ2=0.417, P=0.518; χ2=0.636, P=0.425), but these rates were better than 29.3%(17/58)and 41.4%(24/58)for the conservative treatment group( χ2=10.583、16.714, P<0.001). The good prognosis rate at 90 days were 73.7%(42/57), 78.0%(39/50)and 69.0%(40/58)for the three groups, respectively, with no significant difference( χ2=1.126, P=0.569), but the fatality rate for the low-dose rt-PA group was 7.0%(4/57), lower than 18.0%(9/50)( χ2=5.420, P=0.020)for the standard dose rt-PA group and 20.0%(8/58)for the conservative treatment group( χ2=5.048, P=0.025). The incidence of intracranial hemorrhage was 8.8%(5/57)for the low-dose rt-PA group, lower than 24.0%(12/50)for the standard-dose rt-PA group( P=0.032). The incidence of extracranial complications was 15.8%(9/57)for the low-dose rt-PA group, lower than 36.0%(18/50)for the standard-dose group( P=0.017). Conclusions:For elderly patients with acute cerebral infarction on maintenance hemodialysis, intravenous thrombolytic therapy with low dose rt-PA should be considered with caution.

A qualitative study of the difficulties faced by adolescents with depression in the treatment and rehabilitation / 中国学校卫生

Objective@#Based on a qualitative research method, the present study aims to explore the negative experiences and real dilemmas of adolescent with depression in the treatment and rehabilitation process, so as to provide references to promote the improvement of the treatment system for adolescent depression in China.@*Methods@#From August 2022 to November 2022, 30 adolescents with depression were selected for in-depth interviews in the inpatient department of child and adolescent psychiatry at Beijing An Ding Hospital affiliated with Capital Medical University by using the purposive sampling method, and the interview data were analyzed by using the Colaizzi method to summarize the themes.@*Results@#The real dilemmas faced by depressed adolescent during treatment and recovery included three aspects:inappropriate family coping (caregivers lacking of correct disease cognition; caregivers lacking of effective coping methods), difficulties in disease diagnosis and treatment (low rate of identification and adverse effect of treatment; medical service failing to satisfy the demands), and barriers to continued schooling (barriers to academic progress and interpersonal communication).@*Conclusion@#Adolescents with depression face real dilemmas in the process of disease treatment and rehabilitation at home, school and medical care. Caregivers disease literacy and caregiving skills should be improved. A collaborative disease management system among family, school, community and medical institutions should be established to promote adolescent depression treatment and social function recovery.

Timing of intravenous thrombolysis with rt-PA combined with edaravone dexborneol in super elderly patients with moderate to severe acute ischemic stroke / 中华神经医学杂志

Objective:To investigate the efficacy and safety of recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis combined with edaravone dexborneol at different timing in super elderly patients (aged≥85 years) with moderate to severe acute ischemic stroke (AIS).Methods:A prospective study was performed. Seventy-one super elderly patients with moderate to severe AIS treated with rt-PA intravenous thrombolysis combined with edaravone dexborneol from December 2020 to March 2023 in Department of Neurology, Affiliated Fourth Central Hospital of Nankai University were selected and randomly divided into early group ( n=35) and advanced group ( n=36); patients in the early group were given edaravone dexborneol immediately after rt-PA intravenous thrombolysis, and patients in the advanced group were given edaravone dexborneol 24 h after rt-PA intravenous thrombolysis. In addition, 31 patients with moderate to severe AIS received rt-PA intravenous thrombolysis only in Department of Neurology of the hospital from August 2018 to December 2020 were selected as control group. Differences in efficacy and safety indexes among the 3 groups were compared. Results:After 7 d of treatment, the improvement rate of neurological function in early group was significantly higher than that in control group and advanced group ( P<0.05). After 90 d of treatment, modified Rankin scale (mRS) scores in early group were statistically lower than those in control group and advanced group ( P<0.05); good prognosis rate in early group was statistically higher than that in control group and advanced group ( P<0.05). The incidences of intracranial hemorrhage and symptomatic intracranial hemorrhage in early group were significantly lower than those in control group and advanced group ( P<0.05). After 30 and 90 d of treatment, the advanced group had significantly lower mortality than the control group, but significantly higher mortality than the early group ( P<0.05). Conclusion:Edaravone dexborneol immediately after rt-PA intravenous thrombolysis is the optimal timing for super elderly patients with moderate to severe AIS, which can improve the efficacy and safety.

Immunotherapy for Guillain-Barré syndrome / 中华神经医学杂志

The first line of clinical treatment for Guillain-Barré Syndrome (GBS) is intravenous immunoglobulin (IVIg) and plasma exchange (PE). However, the prognoses of patients vary greatly, with high disability and mortality rates. Immunotherapy has become a research hotspot in recent years. This paper reviews the research progress of GBS immunotherapy in recent years from the prospect of monoclonal antibody, immunomodulator and cytokines, in order to provide basis for treatment of GBS.

Intravenous thrombolysis with recombinant tissue plasminogen activator in patients with acute ischemic stroke and maintenance hemodialysis / 中华神经医学杂志

Objective:To investigate the efficacy and safety of intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) in patients with maintenance hemodialysis (MHD) and acute ischemic stroke.Methods:The clinical data of 235 patients with acute ischemic stroke receiving MHD were collected in our hospital from March 2018 to October 2021. According to the treatment methods chosen by themselves, these patients were divided into control group ( n=70, only receiving standardized secondary stroke prevention), rt-PA low-dose group ( n=85, receiving rt-PA intravenous thrombolysis, 0.6 mg/kg) and rt-PA standard-dose group ( n=80, receiving rt-PA intravenous thrombolysis, 0.9 mg/kg). The effective rate 24 h after treatment, good efficacy rate 7 d after treatment, and good prognosis rate and mortality 90 d after treatment were used to evaluate the effectiveness. The incidences of intracranial hemorrhage, symptomatic intracranial hemorrhage, and severe extracranial hemorrhage 90 d after treatment were used to evaluate the safety. Results:There was no statistical difference in the good prognosis rate 90 d after treatment among the rt-PA low-dose group, the rt-PA standard-dose group and the control group (71.8%, 68.8%, and 64.3%; P>0.05), but the effective rate 24 h after treatment and good efficacy rate 7 d after treatment in the rt-PA low-dose group and rt-PA standard-dose group (44.7%, 57.7%; 46.3%, 62.5%) were both significantly higher than those in the control group (27.1%, 38.6%; P<0.05). The mortality 90 d after treatment in the rt-PA low-dose group (7.1%) was significantly lower than that in the rt-PA standard-dose group (22.5%) and control group (21.4%, P<0.05). The incidences of intracranial hemorrhage and symptomatic intracranial hemorrhage in the rt-PA low-dose group (8.2%, 3.5%) were significantly lower than those in the rt-PA standard-dose group (22.5%, 16.3%; P<0.05), and the incidences of extracranial complications and gastrointestinal bleeding (5.9%, 1.2%) were significantly lower than those in the rt-PA standard-dose group (18.8%, 10.0%; P<0.05). Conclusion:Intravenous thrombolytic therapy with 0.6 mg/kg rt-PA is recommended for acute ischemic stroke patients receiving MHD.

Intravenous thrombolysis with recombinant tissue plasminogen activator in acute ischemic stroke with high stress hyperglycemia / 中华神经科杂志

Objective:To investigate the efficacy and safety of intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) for acute ischemic stroke with stress hyperglycemia under the guidance of glycosylated hemoglobin A1c (GHbA1c).Methods:The clinical data of 195 patients of acute cerebral infarction with admission blood glucose over 22.2 mmol/L and GHbA1c less than 15.59% were collected in Nankai University Affiliated Tianjin Fourth Central Hospital from January 2018 to June 2021 and analyzed retrospectively. Patients were divided into control group (60 cases), rt-PA low-dose group (0.6 mg/kg, 70 cases) and rt-PA standard-dose group (0.9 mg/kg, 65 cases) to evaluate the guiding effect of GHbA1c and the efficacy and safety of rt-PA.Results:The effective rate at 24 hours and good rate at 7 days were 61.4% (43/70) and 72.9% (51/70) in the rt-PA low-dose group, 64.6% (42/65) and 69.2% (45/65) in the rt-PA standard-dose group, respectively, both better than the control group [30.0% (18/60); χ2=18.25, P<0.001 and 46.7% (28/60); χ2=13.65, P=0.001]. The good outcome rate at 90 days was 82.8% (58/70) in the rt-PA low-dose group, which was better than 63.3% (38/60) in the control group (χ2=6.38, P=0.016), but without statistically significant difference compared with the rt-PA standard-dose group [72.3% (47/65); χ2=2.17, P=0.153]. The case fatality rate at 90 days of the rt-PA low-dose group was 7.1% (5/70), which was lower than 20.0% (13/65) in the rt-PA standard-dose group (χ2=4.82, P=0.041) and 18.3% (11/60) in the control group (χ2=5.04, P=0.030). The incidence of intracranial hemorrhage and symptomatic intracranial hemorrhage was 8.5% (6/70) and 2.9% (2/70) in the rt-PA low-dose group, lower than 20.0% (13/65; P=0.048) and 13.8% (9/65; P=0.020) in the rt-PA standard-dose group. The incidence of extracranial hemorrhage was 7.1% (5/70) in the rt-PA low-dose group, lower than 18.9% (12/65) in the rt-PA standard-dose group ( P=0.042). Conclusion:Acute cerebral infarction patients with admission blood glucose over 22.2 mmol/L can receive rt-PA treatment when GHbA1c is less than 15.59%, and 0.6 mg/kg dosage is recommended.

The correlation between serum microRNA-124 and microRNA-181c expression and the treatment outcome of Solitaire stent thrombectomy in patients with acute cerebral infarction and analysis of influencing factors / 中国医师进修杂志

Objective:To explore the correlation between serum microRNA(miR)-124 and miR-181c expression and the treatment outcome of Solitaire stent thrombectomy in patients with acute cerebral infarction and its influencing factors.Methods:Eighty-one patients with acute cerebral infarction performed Solitaire stent thrombectomyfrom June 2018 to October 2020 in the Affiliated Hospital of Jining Medical College were selected. The predictive value of miR-124, miR-181c expression in patients with acute cerebral infarction were analyzed.Results:In 81 patients, 21 patients with poor outcome(poor outcome group) and 60 patients with favorable outcome (favorable outcome group). The ratio of age ≥ 60 years in poor outcome group was higher than that in the favorable outcome group: 76.19% (16/21) vs. 46.67% (28/60), there was statistical difference ( χ2 = 5.46, P<0.05). The levels of miR-124, miR-181c before surgery and postoperative 1-day, 7-day in the favorable outcome group were higher than those in poor outcome group: 2.81 ± 0.82 vs. 2.24 ± 0.74, 3.01 ± 1.52 vs. 2.07 ± 1.04, 3.25 ± 1.67 vs. 1.86 ± 0.92; and the levels of miR-181c before surgery and postoperative 1-day, 7-day in the favorable outcome group were lower than those in the poor outcome group: 1.43 ± 0.59 vs. 1.79 ± 0.65, 1.35 ± 0.62 vs. 1.94 ± 0.79, 1.24 ± 0.60 vs. 2.16 ± 1.08, there were statistical differences ( P<0.05). The results of Logistic multivariate analysis showed that the age, the levels of miR-124, miR-181c before operation and postoperative 1-day, 7-day were influencing factors for the treatment outcome of Solitaire stent thrombectomy. The receiver operating characteristic (ROC) curve analysis showed that the area under the curve of miR-124, miR-181c on the postoperative 7-day were 0.806, 0.861, and were higher than those before operation and the postoperative 1-day, the diagnostic sensitivity were 71.43%, 76.19%, the specificity were 88.33%, 85.00%. Conclusions:The expression of miR-124 and miR-181c in the serum of acute cerebral infarction is related to the outcome of Solitaire stent thrombectomy, especially the expression level on the postoperative 7-day has better application value. It can be used to predict the outcome of surgery.

Intravenous thrombolysis in acute cerebral infarction combined with hyperglycemia under guidance of glycosylated hemoglobin A 1c in the elderly / 中华神经医学杂志

Objective:To investigate the safety and efficacy of intravenous thrombolysis with recombinant human tissue-type plasminogen activator (rt-PA) in acute cerebral infarction combined with hyperglycemia under the guidance of glycosylated hemoglobin A 1c (HbA1c) level in the elderly. Methods:A retrospective study was performed. Two hundred and sixty-two elderly patients with acute cerebral infarction, admitted to our hospital from January 2018 to June 2021, were chosen in this study. Patients with admission blood glucose of 2.8-22.2 mmol/L and accepted intravenous thrombolysis with standard dose of rt-PA were enrolled into control group; patients with admission blood glucose over 22.2 mmol/L and HbA1c less than 15.59% were enrolled into experimental group. The patients in the experimental group were subdivided into conservative treatment group ( n=63), rt-PA low-dose group (0.6 mg/kg, maximum dose 60 mg, n=67) and rt-PA standard dose group (0.9 mg/kg, maximum dose 90 mg, n=60) according to whether these patients received rt-PA intravenous thrombolysis or not and dosage of rt-PA. The response rate 24 h after treatment and short-term prognosis 7 d after treatment were evaluated by referring to the treatment effectiveness evaluation criteria developed by NINDS clinical trials. The long-term prognosis was evaluated by modified Rankin Scale (mRS) 90 d after treatment. The safety evaluation indexes mainly included incidences of intracranial hemorrhage and complications within 90 d of treatment. Results:(1) The response rate 24 h after treatment showed significant differences among the 4 groups ( P<0.05): that in the control group, rt-PA low-dose group, and rt-PA standard dose group was significantly higher than that in the conservative treatment group ( P<0.05); the good prognosis rate 7 d after treatment showed significant differences among the 4 groups: that in the control group, rt-PA low-dose group, and rt-PA standard dose group was significantly higher than that in the conservative treatment group ( P<0.05). (2) Ninety d after treatment, 59 patients (81.9%), 46 (73.0%), 53 (79.1%), and 46 (76.7%) in the control group, conservative treatment group, rt-PA low-dose group, and rt-PA standard dose group had good prognosis, without significant differences among each group ( P>0.05). (3) There was significant difference in the incidence of cerebral hemorrhage within 90 d of treatment among the 4 groups ( P<0.05): that in the rt-PA standard dose group and rt-PA low-dose group was significantly higher than that in the control group and conservative treatment group, and that in the rt-PA standard dose group was significantly higher than that in the rt-PA low-dose group ( P<0.05). Seven patients (9.7%), 8(12.7%), 5(7.5%), and 13(21.7%) in the control group, conservative treatment group, rt-PA low-dose group, and rt-PA standard dose group had extracranial complications: the incidence of extracranial complications in the rt-PA low-dose group was significantly lower than that in the rt-PA standard-dose group ( P<0.05). There were 7 kinds of residual neurological dysfunction in 4 groups within 90 d of treatment, among which, numbness, weakness and speech impairment were the most common. Conclusion:Elderly acute cerebral infarction patients with admission blood glucose over 22.2 mmol/L can receive rt-PA treatment when HbA1c is less than 15.59%, and 0.6 mg/kg dosage is recommended.

Retrospective analysis of clinical diagnosis and treatment and genetic characteristics of patients with TRE(TSC-related epilepsy) / 中风与神经疾病杂志

@#Objective　To improve the understanding and provide a reasonable plan for clinical diagnosis and treatment of TRE(TSC-related epilepsy,TRE),by analyzing the clinical and genetic characteristics of TRE as well as the treatment effect about medication and surgery.Methods　We analyzed the video EEG,imaging,pathology,genetic characteristics,and treatment effect of 10 patients retrospectively.These patients with refractory epilepsy were diagnosed and treated by our epilepsy center from November 2014 to November 2019.The clinical and genetic characteristics of TRE were summarized.Results　There were 3 females,7 males,4 patients with seizures before 3 years old,5 patients with seizures from 3 to 6 years old and 1 at 19 years old.There were 5 cases of spastic seizures and 5 cases of focal seizures.The Video EEG showed that 7 patients have epileptiform discharge site located on one side brain hemisphere and 3 patients about both side.Imaging results showed 4 cases of unilateral subventricular or subcortical nodules,5 cases of bilateral abnormalities,and 1 case of Dandy-Walker deformity.Pathology showed brain tissue section of 4 patients with six-story structure disappearance and immature neurons appearance.Genetic testing revealed 5 cases of TSC1 mutations,5 cases of TSC2 mutations,7 cases of family mutations,and 4 cases of surgical patients were nonsense mutations.The treatment effect about 3 patients of Rapamycin improved than before significantly.Conclusion　TRE patients usually fall ill in early age,more males than females,mainly spastic and focal seizures.The Video EEG showed epileptiform discharge site located on one side brain hemisphere.Gene testing is useful for treatment.The type of mutation may be related to the degree and location of brain lesions and the origin of the discharge,but there is no significant correlation between the discharge site recorded on the EEG and the abnormal imaging site.Therefore,genetic testing should be considered when clinical treatment is not improvement.

Correlation between serum β-amyloid 42 level and cognitive impairment in patients with cerebral small vessel disease / 国际脑血管病杂志

Objective:To investigate the correlation between serum β-amyloid (Aβ) 42 level and cognitive impairment in patients with cerebral small vascular disease (CSVD).Methods:Consecutive patients with CSVD admitted to the Affiliated Hospital of Jining Medical University from September 2016 to September 2019 were enrolled retrospectively. Montreal Cognitive Assessment (Chinese edition), Clinical Dementia Rating and Center for Epidemiologic Studies-Depression scale were used for neuropsychological evaluations. According to the diagnostic criteria of mild cognitive impairment, they were divided into cognitive impairment group and normal cognitive function group. Multivariate logistic regression analysis was used to identify the independent risk factors for cognitive impairment in patients with CSVD. Receiver operator characteristic (ROC) curve was used to evaluate the predictive value of serum Aβ42 level for cognitive impairment. Results:A total of 171 patients with CSVD were enrolled. The serum Aβ42 was 2.14±0.56 μg/L. Eight-one patients (47.4%) had cognitive impairment, and 90 (52.6%) had normal cognitive function. Univariate analysis showed that there were significant differences in age, smoking, hypertension, diabetes, history of previous stroke or transient ischemic attack, blood pressure, fasting blood glucose and serum Aβ42 between the cognitive impairment group and the normal cognitive function group (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for age, smoking, diabetes, blood pressure and history of previous stroke or transient ischemic attack, serum Aβ42 (odd ratio [ OR] 2.974, 95% confidence interval [ CI] 1.632-6.348; P=0.009), hypertension ( OR 2.063, 95% CI 1.340-5.438; P=0.021) and fasting blood glucose ( OR, 1.598, 95% CI 1.167-4.156; P=0.030) were the independent risk factors for cognitive impairment in patients with CSVD. ROC curve analysis showed that the area under the curve of serum Aβ42 was 0.700 (95% CI 0.619-0.782; P<0.001). The optimal cut-off value was 2.39 μg/L, and the sensitivity and specificity were 56.8% and 80.0%, respectively. Conclusions:Aβ42 is independently correlated with cognitive impairment in patients with CSVD, and can be used to predict cognitive impairment in patients with CSVD.

Effect of Wenyang Jiedu Huayu Granule on TLR4 mRNA, TNF-α and Hepatocyte Apoptosis in IETM Rats with Hepatic Failure / 中国实验方剂学杂志

Objective::To investigate the relationship between Toll-like receptor 4 (TLR4) mRNA and its downstream inflammatory factor-tumor necrosis factor-α (TNF-α) and hepatocyte apoptosis in mice with intestinal endotoxemia (IETM) of hepatic failure, and explore the regulatory mechanism of Wenyang Jiedu Huayu granule on endotoxin-induced hepatocyte apoptosis. Method::The 85 SPF male SD rats were randomly divided into normal group, model group, TLR4 monoclonal antibody group and Wenyang Jiedu Huayu granule group. D-galactosamine (D-Gal) intraperitoneal injection was performed to establish the IETM model of hepatic failure. The TLR4 monoclonal antibody group and the Wenyang Jiedu Huayu granule group were given Wenyang Jiedu Huayu granule solution by gavage 5 days before the modeling. The normal group and the model group were given isovolumetric distilled water. Each group was given by gavage until sacrifice. Rats in each group were randomly sacrificed at 24, 48, 72 h, respectively, and samples were collected. The levels of serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected at 24, 48, 72 h. The pathological changes of liver tissue were observed by hematoxylin and eosin(HE) staining. The expression of TLR4 in liver tissue was detected by real-time fluorescence quantitative PCR (Real-time PCR). The expression of TNF-α in liver tissue was detected by enzyme-linked immunosorbent assay (ELISA). The apoptotic rate of hepatocytes was detected by flow cytometry. Result::Compared with the normal group, ALT and AST were increased in model group, while the pathological injury degree of liver tissue was significantly increased. The expressions of TLR4 mRNA and TNF-α were increased (P<0.05, P<0.01), whereas the apoptosis rate of liver cells was significantly increased (P<0.05, P<0.01). Compared with the model group, ALT and AST were decreased in Wenyang Jiedu Huayu granule group (P<0.01), and the degree of pathological injury of liver tissue was significantly reduced (P<0.05). The expressions of TLR4 mRNA and TNF-α were significantly decreased (P<0.01), and the apoptosis rate of liver cells was also reduced (P<0.01). Conclusion::TLR4 mRNA and TNF-α are positively correlated with hepatocyte apoptosis in liver failure. Wenyang Jiedu Huayu granule can improve liver function, alleviate liver cell injury and reduce liver cell apoptosis in IETM mice with hepatic failure. The mechanism may be related to its ability to down-regulate the expression of liver TLR4 mRNA, inhibit the release of TNF-α, and reduce the rate of hepatocyte apoptosis.

Altered expressions of SphK1 and S1PR2 in hippocampus of epileptic rats / 中国应用生理学杂志

OBJECTIVE@#To observe the expressions of sphingosine kinase 1 (SphK1) and sphingosine-1-phosphate receptor 2 (S1PR2) in hippocampus of epileptic rats and to investigate the pathogenesis of SphK1 and S1PR2 in epilepsy.@*METHODS@#One hundred and eight male Sprague-Dawley (SD) rats were randomly divided into control group (n=48) and pilocarpine (PILO) group (n=60). A robust convulsive status epilepticus (SE) was induced in PILO group rats by the application of pilocarpine. Control group rats were injected with respective of physiological saline. Pilocarpine group was randomly divided into 6 subgroups (n=8): acute group (E6 h, E1 d, E3 d), latent group (E7 d) and chronic group (E30 d, E56 d). Each subgroup has 8 control rats and 8 epileptic rats. Hippocampal tissue and brain slices were obtained from control rats and rats subjected to the Li-PILO model of epilepsy at 6 h, 1 d, 3 d,7 d,30 d and 56 d after status epilepticus (SE). Western blot technique was used to determine the expressions of SphK1 and S1PR2 in hippocampus at different point of time after pilocarpine treatment. Immunofluorescence was applied to detect the activation and proliferation of hippocampal astrocytes and the localization of SphK1 and S1PR2 in rat hippocampal astrocytes.@*RESULTS@#Compared with control group, the levels of SphK1 in acute phase (E3 d), latent phase (E7 d) and chronic phase (E30 d, E56 d) were significantly increased while the expressions of S1PR2 were decreased in acute phase (E3 d), latent phase (E7 d) and chronic phase (E30 d, E56 d)(P＜0.05 or P＜0.01). Immunofluorescence results showed astrocyte activation and proliferation in hippocampus of epileptic (E7 d) rats (P＜0.05). Confocal microscopy confirmed the preferential expressions of SphK1 and S1PR2 in epileptic rat(E7 d)hippocampal astrocytes.@*CONCLUSION@#The results indicate that SphK1 and S1PR2 may play an important role in the pathogenesis of epilepsy by regulating the activation and proliferation of hippocampal astrocytes and altering neuronal excitability.

Effect of intracerebroventricular injection of miRNA-22 on expression of P2X7 receptor and inflam-matory factors in hippocampus of rats with epilepsy / 中华行为医学与脑科学杂志

Objective To investigate the effect of microRNA-22 (miRNA-22) on the expression of P2X7 receptor and inflammatory factors in hippocampus of rats with epilepsy. Methods Healthy SD male rats were intraperitoneal injected with lithium chloride and pilocarpine to induce epilepsy. Three days later, 45 epileptic rats were randomly divided into three groups: epilepsy group( EP group), miRNA-22 agomir group (EF+agomir group) and miRNA-22 agomir control group ( EF+agomir control group). Another 15 healthy rats were selected as control group(N group). The expression of P2X7 protein was detected by West- ern blot and the levels of miRNA-22, P2X7 mRNA, NF-κB mRNA ,IL-1β mRNA were detected by qRT-PCR. Nissl staining was used to observe the damage of Nissl bodies. Results Western blot result showed that compared with the N group(0. 91±0. 10), the level of P2X7 protein in EP group (1. 17±0. 052) in-creased, and the difference was statistically significant (t=-4. 11,P=0. 02). Compared with the EP+ag-omir control group(0. 94± 0. 14),the expression of P2X7 protein in EP+agomir group (0. 66± 0. 06) de-creased and the difference was significant (t=-3. 10,P=0. 04). And the qRT-PCR results showed that compared with N group, the levels of P2X7mRNA (9. 08±0. 94), NF-κB mRNA (20. 10±2. 15) and IL-1β mRNA (50. 64±5. 42) in EP group increased(t=-14. 96,P<0. 05; t=-15. 38,P<0. 05; t=-15. 87,P<0. 05). The expression of P2X7mRNA (1. 31 ± 0. 64), NF-κB mRNA ( 2. 28 ± 1. 10) and IL-1β mRNA (2. 12±1. 20) in EF+agomir group decreased compared with EP group((9. 08± 0. 94),( 20. 10± 2. 15), (50. 64±5. 42)) and EF+agomir control group((7. 03 ±1. 90),(18. 72±1. 76),(47. 39±6. 16)), and the differences were statistically significant(F=29. 77, P<0. 01;F=98. 99, P<0. 05;F=96. 29, P<0. 01). Nissl staining results showed that a large number of morphologically abnormal and disintegrated Nissl bodies could be observed in the hippocampal CA1 and CA3 regions of EP group,which showed a smaller size,irreg-ular morphology,chromatin pyknosis,boundary blur between nucleus and cytoplasm. Compared with the nor-mal group, the difference was significant (P<0. 05). While in miRNA-22 agomir group, the disintegration of Nissl bodies was improved and the number of Nissl bodies increased. Conclusion Intraventricular injec-tion of miRNA-22 agomir can down-regulate the expression of P2X7 receptor and related inflammatory factors in hippocampus of epileptic rats, thus inhibiting seizures.

Study on the best concentration of miRNA-22 agomir in the treatment of temporal lobe epilepsy by single injection of lateral ventricle / 中国医师杂志

Objective To investigate the optimal initial concentration of microRNA22 agomir in epilepsy model induced by lithium chloride-pilocarpine after single injection of lateral ventricle.Methods 36 rats with acute temporal lobe epilepsy were randomly divided into 6 groups:the control group and the other five groups were the experimental group.All epilepsy rats were selected for right lateral ventricle injection.The control group was given negative control reagent,while the experimental group were given 0.1 mmol/L,2.5 mmol/L,5 mmol/L,10 mmol/L,20 mmol/L different concentrations of miRNA22agomir reagent.6 rats in each group were randomly selected for acute phase experiment after 3 days of administration.The expression of P2X7 in hippocampus of epilepsy rats was determined by Western blot and quantitative real-time polymerase chain reaction (qRT-PCR).Results Compared with control group,the protein and mRNA expression of P2X7 reduced in all of the model group.The protein and mRNA expression level of P2X7 protein in hippocampus of rats injected with 2.5 mmol/L,5 mmol/L and 10 mmol/L in each experimental group were significantly lower than that in the other two groups (P ＜ 0.05).Moreover,the protein and mRNA expression level of P2X7 were the lowest at 2.5 mmol/L injection and 10 mmol/L,and there was no significant difference between the two groups (P ＞ 0.05).Conclusions The optimal onset concentration for unilateral lateral ventricle injection miRNA22 agomir treatment of temporal lobe epilepsy is 2.5 mmol/L.

Timing calibration comparison research of integrated TOF-PET/MR / 生物医学工程学杂志

Integrated TOF-PET/MR is a multimodal imaging system which can acquire high-quality magnetic resonance (MR) and positron emission tomography (PET) images at the same time, and it has time of flight (TOF) function. The TOF-PET system usually features better image quality compared to traditional PET because it is capable of localizing the lesion on the line of response where annihilation takes place. TOF technology measures the time difference between the detectors on which the two 180-degrees-seperated photons generated from positron annihilation are received. Since every individual crystal might be prone to its timing bias, timing calibration is needed for a TOF-PET system to work properly. Three approaches of timing calibration are introduced in this article. The first one named as fan-beam method is an iterative method that measures the bias of the Gaussian distribution of timing offset created from a fan-beam area constructed using geometric techniques. The second one is to find solutions of the overdetermination equations set using L1 norm minimization and is called L1-norm method. The last one called L2-norm method is to build histogram of the TOF and find the peak, and uses L2 norm minimization to get the result. This article focuses on the comparison of the amount of the data and the calculation time needed by each of the three methods. To avoid location error of the cylinder radioactive source during data collection, we developed a location calibration algorithm which could calculate accurate position of the source and reduce image artifacts. The experiment results indicate that the three approaches introduced in this article could enhance the qualities of PET images and standardized uptake values of cancer regions, so the timing calibration of integrated TOF-PET/MR system was realized. The fan-beam method has the best image quality, especially in small lesions. In integrated TOF-PET/MR timing calibration, we recommend using fan-beam method.

Diagnostic value of 18F-FDG PET/CT and tumor markers (CEA, CA19-9, CA24-2) in recurrence and metastasis of postoperative colorectal moderately differentiated adenocarcinoma / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the diagnostic value of 18F-FDG PET/CT and tumor markers (CEA,CA19-9,CA24-2) in detection for recurrence and metastasis of postoperative colorectal moderately differentiated adenocarcinoma.@*METHODS@#Fifty-five patients were enrolled in this study. All of the patients were tested with serum CEA within 2 weeks when they underwent 18F-FDG PET/CT scan, and some patients were tested with serum CA19-9 and CA24-2 simultaneously. According to the pathology and clinical results of their follow-up, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 18F-FDG PET/CT and tumor markers were calculated based on different divided groups, respectively.@*RESULTS@#According to the pathology and the results of their clinical follow-up, the sensitivity of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 95.74%, 68.09%, 28.57%, 40.00% and 74.47%, respectively. The specificity of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 75.00%, 50.00%, 66.67%, 71.43% and 50.00%, respectively. The positive predictive valueof 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 95.74%, 88.89%, 85.71%, 88.89% and 89.74%, respectively. The negative predictive value of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 75.00%, 26.67%, 11.42%, 17.24%, 25.00%, respectively. The accuracy of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 92.73%, 65.47%, 32.65%, 44.68% and 70.91%, respectively. There were 2 cases of false positive and 2 cases of false negative in 18F-FDG PET/CT.@*CONCLUSION@#18F-FDG PET/CT has high value in detecting recurrence and metastasis of postoperative colorectal carcinoma. Tumor markers have the positive value to imply the recurrence and metastasis of postoperative colorectal carcinoma and are useful to indicate when to perform the 18F-FDG PET/CT. The combination of tumor markers could improve the diagnostic efficiency to some extent.

Clinical Observation of Viper Bites Injury Limb Swelling Treated by Fushe Jiedu Decoction Combined with Red Light / 中国中医药信息杂志

Objective To explore the efficacy of Fushe Jiedu Decoction combined with red light on viper bites injury limb swelling and the effects on the inflammatory cytokines. Methods Totally 90 patients were divided into control group and experimental group by using random number table method, with 45 cases in each group. The wounds of the control group were sterilized and given anti-snake venom serum, antibiotics, and tetanus immunoglobulin and supplemented with energy to correct water and electrolyte disturbances. The experimental group was treated with Fushe Jiedu Decoction based on the treatment of control group,150 mL each time,orally,twice a day; Red light was applied at the site of the most obvious swelling of the injured limb, 20 minutes each time, twice a day. The treatment lasted for 6 d. The swelling of injured limbs, serum C-reactive protein (CRP), 5-hydroxytryptamine (5-HT), histamine, tumor necrosis factor-α (TNF-α), interleukin (IL)-6 levels before and after treatment in the two groups were observed. Results Compared with before treatment, the swelling of the limbs disappeared significantly in the experimental group at 3 d and 6 d and in the control group at 6 d, with statistical significance (P<0.01). Compared with the control group at the same time point, the swelling of the limbs in the treatment group was significantly better than that in the control group at 3 d and 6 d, with statistical significance (P<0.01). Compared with before treatment, the levels of CRP, 5-HT, TNF-α, and IL-6 were significantly lower in the two groups, with statistical significance (P<0.05). After treatment, CRP, 5-HT and histamine in the experimental group were significantly better than that in the control group(P<0.05).Conclusion Fushe Jiedu Decoction combined with red light has good efficacy for viper bites injury limb swelling, which can reduce inflammatory cytokines levels of patients.

Effect of sanqi decoction on early diabetic nephropathy and its effect on lipid metabolism and renal function / 中国生化药物杂志

Objective To investigate the clinical efficacy of Sanqi Decoction in the treatment of early diabetic nephropathy (Diabetic, Nephropathy, DN) and its influence on the metabolism of lipid and glucose and renal function. Methods 96 patients with DN in our hospital were randomly divided into two groups. 48 cases in control group were treated with Enalapril, and 48 cases in observation group were treated with Sanqi decoction. Results The total effective rate of the observation group was 95.65%, which was significantly higher than that of the control group (81.25%) (P<0.05). Lipid, glucose metabolism and renal function improvement were better than those in the control group (P<0.05). Conclusion Sanqi Decoction is effective in the treatment of early DN, it can effectively improve the metabolism of lipid and sugar, reduce the excretion rate of urinary albumin, and have the effect of renal protection.