GLP-1 modulated the firing activity of nigral dopaminergic neurons in both normal and parkinsonian mice.

The spontaneous firing activity of nigral dopaminergic neurons is associated with some important roles including modulation of dopamine release, expression of tyrosine hydroxylase (TH), as well as neuronal survival. The decreased neuroactivity of nigral dopaminergic neurons has been revealed in Parkinson's disease. Central glucagon-like peptide-1 (GLP-1) functions as a neurotransmitter or neuromodulator to exert multiple brain functions. Although morphological studies revealed the expression of GLP-1 receptors (GLP-1Rs) in the substantia nigra pars compacta, the possible modulation of GLP-1 on spontaneous firing activity of nigral dopaminergic neurons is unknown. The present extracellular in vivo single unit recordings revealed that GLP-1R agonist exendin-4 significantly increased the spontaneous firing rate and decreased the firing regularity of partial nigral dopaminergic neurons of adult male C57BL/6 mice. Blockade of GLP-1Rs by exendin (9-39) decreased the firing rate of nigral dopaminergic neurons suggesting the involvement of endogenous GLP-1 in the modulation of firing activity. Furthermore, the PKA and the transient receptor potential canonical (TRPC) 4/5 channels are involved in activation of GLP-1Rs-induced excitatory effects of nigral dopaminergic neurons. Under parkinsonian state, both the exogenous and endogenous GLP-1 could still induce excitatory effects on the surviving nigral dopaminergic neurons. As the mild excitatory stimuli exert neuroprotective effects on nigral dopaminergic neurons, the present GLP-1-induced excitatory effects may partially contribute to its antiparkinsonian effects.

Monitoring and management of abandoned, lost and discarded fishing gear (ALDFG) in Penghu Islands, Taiwan.

This study investigated the conditions of abandoned, lost, discarded fishing gear (ALDFG) in natural and artificial reef zones and removed it afterward in Penghu Islands. Various feasible suggestions for improving ALDFG management were proposed for the county government to manage and reduce the generation of ALDFG in the future and maintain the marine ecosystem. This study divided the ocean areas of Penghu into five sub-areas for carrying out research and surveys. 165 boat trips of ALDFG investigation and removal were conducted from July 2018 to October 2019. The results show the ALDFG in natural reef areas is mostly large-mesh gillnets (26 %). The rest are single-layer bottom gillnets (21 %) and multi-layer bottom gillnets (20 %). In line with the recent efforts of the Penghu County Government to address ALDFG, it is recommended that the participation of citizen scientists and the promotion of ocean education can be utilized for fishery co-management in Penghu.

Prevalence of post-traumatic stress disorder after earthquakes among the elderly in China: A meta-analysis.

BACKGROUND: The study aims to investigate the occurrence of post-traumatic stress disorder (PTSD) after earthquakes among the elderly. METHODS: Data from cross-sectional studies focusing on the prevalence of PTSD after earthquakes among the elderly were collected from PubMed, EMBASE, Cochrane Library, and China National Knowledge Infrastructure in December 2019. The search terms included post-traumatic stress disorder, earthquake, and elderly. This study used Review Manager 5.0 to evaluate the impact of the results. In addition, forest plots, sensitivity analysis, and bias analysis were carried out on the included articles. The combined estimate of the risk ratio and the standard deviation of the 95% confidence interval (95% CI) were measurements of the size of the effect. RESULTS: There were 4,834 patients included from 10 eligible studies. The sample sizes of PTSD group and non-PTSD group were 1,277 and 3,557, respectively. The meta-analysis showed that the overall occurrence of PTSD after earthquakes among the elderly was 0.25; the occurrence in females was higher than that in males, and the occurrence in the same province indicated little difference (Wenchuan city 0.25 and Ya'an city 0.24). CONCLUSIONS: After earthquakes, the occurrence of PTSD is higher among the elderly than among other age groups, and higher among the females than among the males, while there is little difference among different areas within the same province. This indicated that prioritized specific psychological interventions should be provided to the aged and the females.

In silico prediction and validation of potential therapeutic genes in pancreatic ß-cells associated with type 2 diabetes.

Diabetes mellitus is becoming a major health burden worldwide. Pancreatic ß-cell death is a characteristic of type 2 diabetes (T2D), but the underlying mechanisms of pancreatic ß-cell death remain unknown. Therefore, the aim of the present study was to identify potential targets in the pancreatic islet of T2D. The GSE20966 dataset was obtained from the Gene Expression Omnibus (GEO) database, and differentially expressed genes (DEGs) were identified by using the GEO2R tool. The Gene Ontology terms and Kyoto Encyclopedia of Genes and Genomes Pathway enrichment analysis of DEGs were further assessed using the Database for Annotation, Visualization and Integrated Discovery. Furthermore, protein-protein interaction (PPI) networks were constructed for the up- and downregulated genes using STRING databases and were then visualized with Cytoscape. The body weight, fasting blood glucose (FBG), pancreatic index and biochemistry parameters were measured in db/db mice. Moreover, the morphology of the pancreas was detected by hematoxylin and eosin staining, and hub genes were assessed using reverse transcription-quantitative PCR (RT-qPCR) and western blot analysis. In total, 570 DEGs were screened, including 376 upregulated and 194 downregulated genes, which were associated with 'complement activation, classical pathway', 'proteolysis', 'complement activation' and 'pancreatic secretion pathway'. It was found that the body weight, FBG, alanine aminotransferase, aspartate aminotransferase, total cholesterol, triglycerides, blood urea nitrogen, creatinine, fasting serum insulin, glucagon and low-density lipoprotein cholesterol levels were significantly higher in db/db mice, while high-density lipoprotein cholesterol levels and the pancreatic index were significantly decreased. Furthermore, albumin, interleukin-8, CD44, C-C motif chemokine ligand 2, hepatocyte growth factor, cystic fibrosis transmembrane conductance regulator, histone cluster 1 H2B family member n, mitogen-activated protein kinase 11 and neurotrophic receptor tyrosine kinase 2 were identified as hub genes in PPI network. RT-qPCR and western blotting results demonstrated the same expression trend in hub genes as found by the bioinformatics analysis. Therefore, the present study identified a series of hub genes involved in the progression of pancreatic ß-cell, which may help to develop effective therapeutic strategy for T2D.

A bioinformatics and network pharmacology approach to the mechanisms of action of Shenxiao decoction for the treatment of diabetic nephropathy.

BACKGROUND: The epithelial-to-mesenchymal transition (EMT) of renal tubular epithelial cells is the main pathological alteration in diabetic nephropathy (DN). Traditional Chinese medicine (TCM) has been used for the treatment of DN in clinical practice and has been proven to be effective. PURPOSE: This aim of this study was to shed light on the efficacy of Shenxiao decoction (SXD) on the EMT of renal tubular epithelial cells and the molecular mechanisms of SXD in mice with DN, as well as on the high glucose (HG)- and TGF-ß1-induced EMT of NRK-52E and HK-2 cells. STUDY DESIGN AND METHODS: A bioinformatics and network pharmacology method were utilized to construct the active ingredient-target networks of SXD that were responsible for the beneficial effects against DN. The effects of RUNX3 were validated in HG- and TGF-ß1-induced EMT processes in NRK-52E and HK-2 cells. RESULTS: Bioinformatics analysis revealed that 122 matching targets were closely associated with the regulation of cell migration and the AGE-RAGE signaling pathway in diabetic complications. The results also revealed that, relative to the mice with DN, the mice in the treatment group had an improved general state and reduced blood glucose levels. The degradation of renal function was ameliorated by SXD. Moreover, the protective effects of SXD were also observed on renal structural changes. Furthermore, SXD suppressed the activation of the transforming growth factor (TGF)-ß1/Smad pathway and upregulated the RUNX3 and E-cadherin levels and downregulated the extracellular matrix (ECM) protein levels in mice with DN. SXD was further found to prevent the HG- and TGF-ß1-induced EMT processes in NRK-52E and HK-2 cells. Additionally, the overexpression of RUNX3 markedly inhibited the EMT and TGF-ß1/Smad pathway induced by HG and TGF-ß1 in NRK-52E and HK-2 cells. CONCLUSION: Taken together, these results suggest that SXD maybe alleviate EMT in DN via the inhibition of the TGF-ß1/Smad/RUNX3 signaling pathway under hyperglycemic conditions.

Biochemical and genetic characterization of a novel metallo-ß-lactamase from marine bacterium Erythrobacter litoralis HTCC 2594.

Metallo-ß-lactamases (MBLs) are a group of enzymes that can inactivate most commonly used ß-lactam-based antibiotics. Among MBLs, New Delhi metallo-ß-lactamase-1 (NDM-1) constitutes an urgent threat to public health as evidenced by its success in rapidly disseminating worldwide since its first discovery. Here we report the biochemical and genetic characteristics of a novel MBL, ElBla2, from the marine bacterium Erythrobacter litoralis HTCC 2594. This enzyme has a higher amino acid sequence similarity to NDM-1 (56%) than any previously reported MBL. Enzymatic assays and secondary structure alignment also confirmed the high similarity between these two enzymes. Whole genome comparison of four Erythrobacter species showed that genes located upstream and downstream of elbla2 were highly conserved, which may indicate that elbla2 was lost during evolution. Furthermore, we predicted two prophages, 13 genomic islands and 25 open reading frames related to insertion sequences in the genome of E. litoralis HTCC 2594. However, unlike NDM-1, the chromosome encoded ElBla2 did not locate in or near these mobile genetic elements, indicating that it cannot transfer between strains. Finally, following our phylogenetic analysis, we suggest a reclassification of E. litoralis HTCC 2594 as a novel species: Erythrobacter sp. HTCC 2594.

Shift work, night work, and the risk of prostate cancer: A meta-analysis based on 9 cohort studies.

BACKGROUND: Epidemiology studies suggested that shift work or night work may be linked to prostate cancer (PCa); the relationship, however, remains controversy. METHODS: PubMed, ScienceDirect, and Embase (Ovid) databases were searched before (started from the building of the databases) February 4, 2017 for eligible cohort studies. We pooled the evidence included by a random- or fixed-effect model, according to the heterogeneity. A predefined subgroup analysis was conducted to see the potential discrepancy between groups. Sensitivity analysis was used to test whether our results were stale. RESULTS: Nine cohort studies were eligible for meta-analysis with 2,570,790 male subjects. Our meta-analysis showed that, under the fixed-effect model, the pooled relevant risk (RR) of PCa was 1.05 (95% confidence interval [CI]: 1.00, 1.11; P = .06; I = 24.00%) for men who had ever engaged in night shift work; and under the random-effect model, the pooled RR was 1.08 (0.99, 1.17; P = .08; I = 24.00%). Subgroup analysis showed the RR of PCa among males in western countries was 1.05 (95% CI: 0.99, 1.11; P = .09; I = 0.00%), while among Asian countries it was 2.45 (95% CI: 1.19, 5.04; P = .02; I = 0.00%); and the RR was 1.04 (95% CI: 0.95, 1.14; P = .40; I = 29.20%) for the high-quality group compared with 1.21 (95% CI: 1.03, 1.41; P = .02; I = 0.00%) for the moderate/low-quality group. Sensitivity analysis showed robust results. CONCLUSIONS: Based on the current evidence of cohort studies, we found no obvious association between night shift work and PCa. However, our subgroup analysis suggests that night shift work may increase the risk of PCa in Asian men. Some evidence of a small study effect was observed in this meta-analysis.

Serum TGF-ß1 as a Biomarker for Type 2 Diabetic Nephropathy: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Abnormal expression of serum TGF-ß1 was found in patients with diabetic nephropathy. However, the association of TGF-ß1 with the risk of diabetic nephropathy remains unknown. The present study was undertaken to investigate whether such an association exists. METHODS: We searched the Chinese VIP, Wangfang, China National Knowledge Infrastructure, PubMed, Embase, and Google Scholar databases for relevant studies and extracted all eligible data. Stata12 software was used for statistical analysis. RESULTS: Nine reports met our criteria and were used for data extraction. There were 264 patients and 227 healthy controls from qualified reports in this meta-analysis. The results suggested that serum TGF-ß1 levels were significantly up-regulated in patients with diabetic nephropathy; the instrumental variable was 3.94 (95% confidence interval 3.20-4.68, p<0.01). CONCLUSIONS: Meta-analysis suggested that elevated serum TGF-ß level in patients with diabetes is associated with a high risk of nephropathy. Further studies are required to validate these observations.

Apparent diffusion coefficient measurements and Gd-DTPA enhanced-imaging in staging hepatic fibrosis in rats.

To evaluate the utility of ADC values and Gd-DTPA equilibrium phase MR imaging in staging hepatic fibrosis in rats. 48 rats were allocated into experimental and control groups. Experimental rats were subcutaneously injected with a mixture of CCl4. From 4th-12th weeks, MR images were obtained, which include pre-enhanced phase imaging, DWI and equilibrium phase imaging. Then the rat groups were subdivided according to the stages of fibrosis (S0, S1, S2, S3 and S4) after histopathological analysis. The original MRI data were forwarded to the workstation to obtain apparent diffusion coefficient (ADC) maps at b value of 500 s/mm(2). Pre-enhanced phase and equilibrium phase signal intensities and relative contrast enhancement index (RCEI) were measured as well. Lastly, the ADC values and RCEI of the experimental group were compared with each other and with the control group. All statistical analyses were carried out with SPSS, where P < 0.05 is considered to represent a significant difference. Hepatic ADC values are significantly different between the experimental and control groups (P = 0). There is a statistically significant difference between the experimental and control groups on RCEI (P = 0). Comparing the S1, S2, S3 and S4 groups, there is a statistically significant difference between the mild group (S1 and S2) and the severe group (S4) in terms of ADC values and RCEI (all P < 0.05). A statistically significant difference is also found between the moderate group (S3) and the severe group in ADC values. As the degree of fibrosis increases, there are a reduction in ADC values and an increase in RCEI. Comparing the groups with ADC values and enhancement index, there are statistically significant differences in sensitivity and specificity on diagnosis of hepatic fibrosis. The ADC values have the best sensitivity (93.1%) and specificity (83.3%). Quantitative ADC values and RCEI may be helpful to the staging of rat fibrosis, but their application in human is controversial.

Design and application of specific 16S rDNA-targeted primers for assessing endophytic diversity in Dendrobium officinale using nested PCR-DGGE.

Novel specific 16S rDNA-targeted primers were successfully designed and applied to the characterization of endophytic diversity in Dendrobium officinale. Using the popular universal bacterial primers 27f/1492r, the fragments of chloroplast and mitochondrion 16S/18S rDNA were amplified from D. officinale. They shared high nucleotide identity with the chloroplast 16S rDNAs (99-100 %) and with the mitochondrion 18S rDNAs (93-100 %) from various plants, respectively, and both shared 73-86 % identities with the bacterial 16S rDNA sequences in GenBank. The current bacterial universal primers, including 27f/1492r, match well with the chloroplast and mitochondrion 16S/18S rDNAs, which accordingly renders these primers not useful for endophytic diversity analysis. Novel 16S rDNA-targeted primers fM1 (5'-CCGCGTGNRBGAHGAAGGYYYT-3') and rC5 (5'-TAATCCTGTTTGCTCC CCAC-3') were designed, which show good specificity compared to the 16S/18S rDNAs of D. officinale, and perfect universality within bacteria except for Cyanobacteria. The primers fM1/rC5, together with 515f-GC/rC5, which overlaps the whole V4 region of 16S rDNA, were subjected to nested polymerase chain reaction denaturing gradient gel electrophoresis (PCR-DGGE) to analyze the diversity of endophytic bacteria in D. officinale from three different sources in China. The results showed diversities in roots and stems of the plants from all three locations. Altogether, 29 bands were identified as bacteria, with the dominant group being Proteobacteria and the dominant genus being Burkholderia, some of which commonly has the function of nitrogen fixation and thus may play potentially important roles in D. officinale. Therefore, the nested PCR-DGGE method based on the novel primers provides a good alternative for investigating the communities and roles of endophytes in D. officinale.

Study on the relationship between Chinese medicine constitutive susceptibility and diversity of syndrome in diabetic nephropathy.

OBJECTIVE: To explore the relationship between Chinese medicine (CM) constitutive susceptibility and syndrome diversity in diabetic nephropathy (DN). METHODS: Epidemiologic investigation on constitution adopting the "Constitution in Chinese Medicine Questionnaire" (CCMQ), and survey on syndrome type by CM syndrome scale (preliminary) were carried out in 180 DN patients. Cluster analysis on symptom items was used to determine the syndrome type, and canonical correlation analysis was used to analyze the relationship between patients' constitution and syndrome. RESULTS: Baseline levels in all enrolled patients were not different statistically. Cluster analysis showed 8 syndromes existed in DN patients, namely: I, qi-yin deficiency with qi-stagnancy type; II, yin-yang deficiency with heat-water-blood stasis type; III, qi-yin deficiency with dampness-heat type; IV, yin-yang deficiency with blood-stasis and heat type; V, qi-yin deficiency with stagnant heat type; VI, yin-yang deficiency with inner dampness-heat stagnancy type; VII, yin deficiency with heat stagnancy type; and VIII, Kidney (Shen)-Spleen (Pi) deficiency with stagnant heat type. Correlation analysis on the 8 syndromes and the 9 constitutions showed statistical significant correlations between syndrome III and dampness-heat constitution (P=0.0001); syndrome IV and blood-stasis constitution (P=0.0001); and syndrome VII and yin-deficiency constitution (P=0.0180). CONCLUSION: Certain relationship revealed between CM constitutions and syndrome types; constitution decides the disease genesis, its syndrome type and prognosis, as well as the change of syndromes.

Epidemiology of eight common rheumatic diseases in China: a large-scale cross-sectional survey in Beijing.

OBJECTIVE: To investigate the prevalence of eight common rheumatic diseases in a large Chinese population. METHODS: A population-based epidemiological investigation of the prevalence of eight common rheumatic diseases in a suburb of Beijing was conducted in 14 642 individuals. A community-based survey was carried out using a screening questionnaire. Positive responders were included in a clinical and laboratory examination. Diagnosis was based on the criteria of ACR or those used widely in literature. RESULTS: A total of 10 556 inhabitants were interviewed. Forty-three cases of RA were identified with an age-adjusted prevalence of 0.28% (95% CI 0.19%, 0.41%). Gout was diagnosed with a crude prevalence of 0.09% (95% CI 0.05%, 0.17%). Psoriasis was reported in 28 individuals with a prevalence of 0.27% (95% CI 0.18%, 0.38%). This included two cases diagnosed with PsA, resulting in a prevalence of 7.14% (95% CI 0.88%, 23.5%) in psoriasis patients and 0.02% (95% CI 0%, 0.07%) in the general population. Three individuals were identified with SLE, with a prevalence of 0.03% (95% CI 0%, 0.06%). One individual was identified with SSc and the calculated prevalence was 0.01% (95% CI 0%, 0.05%). One case of Behçet's disease was identified, giving a prevalence of 0.01% (95% CI 0%, 0.05%). CONCLUSION: This large-scale epidemiological survey provides an estimate of the burden of rheumatic diseases in China.

(E)-4-Chloro-N-(2,4,6-trimethyl-benzyl-idene)aniline.

In the title compound, C(16)H(16)ClN, the dihedral angle between the benzene rings is 24.61 (13)°. In the crystal, only van der Waals inter-actions occur between neighbouring mol-ecules.

Association of Chinese medicine constitution susceptibility to diabetic nephropathy and transforming growth factor-ß1 (T869C) gene polymorphism.

OBJECTIVE: To explore the association of Chinese medicine constitution susceptibility to diabetic nephropathy (DN) and transforming growth factor (TGF)-ß1 (T869C) gene polymorphism. METHODS: TGF-ß1 gene polymorphism detected with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was screened for 180 DN cases and 180 type 2 diabetic mellitus (T2DM) cases without combined DN. Patients with DN were surveyed epidemiologically with constitution in the Chinese medicine questionnaire (CCMQ). Binary logistic regression analysis was utilized to study the correlation between nine types of Chinese medicine constitution and TGF-ß1 (T869C) gene polymorphisms. RESULTS: The DN group has a higher frequency of TGF-ß1 (T869C) gene polymorphism than the T2DM group, and CC/CT genotypes than the T2DM group [CC, CT, TT (DN group): 88, 87, 5 (cases) versus (T2DM group) 71, 73, 36 (cases), P<0.05]. The phlegm-dampness constitution, damp-heat constitution, and blood stasis constitution have correlations with TGF-ß1 (T869C) gene polymorphism. CONCLUSION: Chinese medicine constitutions were associated with TGF-ß1 (T869C) gene polymorphism, a potential predictor of susceptibility to DN in T2DM patients.

2-Meth-oxy-naphthalene-1,4-dione.

The title compound, C(11)H(8)O(3), was isolated from Impatiens balsamina plants (balsam, LIB) grown in our laboratory. The two six-membered rings of the naphthalene-1,4-dione unit are coplanar [maximum deviation = 0.009 (1) Å]. The O and C atoms of the meth-oxy substituent also lie close to the naphthalene plane, with deviations of 0.0090 (2) and 0.047 (2) Å, respectively.

9a-Hy-droxy-3,8a-dimethyl-5-methyl-ene-4,4a,5,6,9,9a-hexa-hydro-naphtho-[2,3-b]furan-2(8aH)-one.

The title compound, C(15)H(18)O(3), was isolated from Lacta-rius piperatus (Fr.) S. F. Gary collected from the Kunming area in Yunnan province, China. The central cyclo-hexyl ring adopts a chair conformation, while the furan-one ring is close to planar (r.m.s. deviation = 0.0174 Å). The remaining methyl-ene cyclo-hexene ring has a flattened chair conformation. In the crystal, mol-ecules are linked via inter-molecular O-H⋯O and C-H⋯O hydrogen bonds into zigzag chains along the a axis.

(2R,4R)-3-(tert-But-oxy-carbon-yl)-2-(3-chloro-phen-yl)-1,3-thia-zolidine-4-carb-oxy-lic acid monohydrate.

In the title compound, C(15)H(18)ClNO(4)S·H(2)O, the thia-zolidine ring displays a half-chair conformation. In the crystal, the water mol-ecules are linked to the organic acid mol-ecules via inter-molecular O-H⋯O hydrogen bonds.

[Relationship between hepatitis B virus YMDD mutation and serum viral DNA loadings].

OBJECTIVE: To investigate the relationship between lamivudine-resistant mutants of hepatitis B virus (HBV) and serum HBV DNA loading before antiviral therapy. METHODS: This study involved 106 patients with hepatitis B receiving lamivudine treatment for an average of 32 months (rang 12-48 months). Serum HBV DNA loadings were measured with PCR before and every 4 to 6 months during lamivudine therapy. HBV YMDD mutants were detected using mismatched PCR-restriction fragment length polymorphism (PCR-RFLP) during lamivudine treatment. RESULTS: HBV DNA loading was significantly higher in patients infected with HBV YMDD mutants during lamivudine therapy than those infected with HBV without YMDD mutation. CONCLUSION: High viral loading in hepatitis B patients before treatment is associated with high likeliness of HBV YMDD mutation during lamivudine treatment. HBV DNA loading may be indicative for the occurrence of YMDD mutation during lamivudine therapy.

[Collateral supply in patients with severe carotid stenosis].

OBJECTIVE: To determine the collateral supply is sufficiency or not in patients with carotid stenosis. METHODS: Fifteen consecutive patients with carotid stenosis underwent carotid endarterectomy (CEA). We evaluated the patent collateral pathways through the anterior and posterior communicating arteries or the ophthalmic artery (ACoA; PCoA; OA) with TCD before CEA. A total of 15 subjects were monitored the mean velocity of the ipsilateral middle cerebral artery (mvMCA) by TCD and simultaneously detected stump pressure (SP) after cross clamping carotid artery during the operation. RESULTS: Three subjects patent anterior communicating artery; 5 cases patent posterior communicating artery; 6 of 15 patent OA. SP > or = 50 mm Hg in 8 cases and SP < 50 mm Hg in 7 patients were detected after cross clamping. The decrease of the ipsilateral mvMCA is less than 30% of baseline in 11 cases. Both TCD preoperatively and SP during CEA indicated collateral blood adequately or not in 9 cases. Results of 12 patients evaluated collateral supply by means of SP and mvMCA changes were common. CONCLUSION: TCD is a useful tool for the evaluation of the sufficiency of collateral circulation in patients with carotid artery severe stenosis, especially monitoring the ipsilateral mvMCA changes during carotid endarterectomy.

[Application of cerebral protection to carotid endarterectomy at perioperation, intraoperation, and postoperation].

OBJECTIVE: To evaluate the significance of cerebral protection applied at carotid endarterectomy (CEA) at perioperation, intraoperation, and postoperation. METHODS: Thirty patients underwent CEA with application of cerebral protection at perioperation, intraoperation, and postoperation in our hospital from January 2002 to August 2005. Perioperative carotid Doppler ultrasound and computed tomography angiography (CTA) were applied in 29 patients and carotid angiography applied in only one patient. The key methods of intraoperative cerebral protection included general anaesthesia, selective shunting, monitoring of transcranial Doppler, and careful manipulation. The methods of postoperative cerebral protection included leaving tracheal cannula and brain ice-bag, maintaining normal blood pressure, and applying dehydrant under guidance by monitoring of transcranial Doppler. RESULTS: Among all the 30 patients, shunts were used in 10 patients (33%), and angioplasty by patch was applied in 17 patients (57%). No cranial nerve-associated complications or death was documented. CONCLUSION: Application of cerebral protection at CEA at perioperation, intraoperation, and postoperation can effectively prevent the occurance of cranial nerve-associated complications.