Objective To observe the ultrastructure of blood-brain barrier (BBB) around hematoma in patients with hypertensive intracerebral hemorrhage (ICH).Methods Brain tissue around hematoma in 10 patients with hypertensive ICH was obtained using stereotaxic apparatus targeted by CT scan. Ultrastructure of BBB was observed under electron microscope. Results Astrocytic end feet swelled and pinocytotic vesicles increased 12 h after ICH. Mitochondrion of endothelial cells swelled and ridges disrupted 24 h after ICH. Astrocytic end feet and endothelial cells showed apparent edema, cell nuclei tumefied 48 h after ICH. Cytoplasm loosened and fundus membranes ruptured 72 h after ICH. Endothelial cell membranes and nuclei dissolved and capillary vessels dented 5 d after ICH. Conclusion Prevention of BBB from damage is important in treating ICH at early stage.

Objective To observe the therapeutic role on monoclonal antibody of alkaline phosphatase(AAP) to vasogenic cerebral edema in rats(VCE).Methods 60 Wistar rats were randomly divided into 3 groups:normal group,VCE group and AAP group.VCE animal model was made by injecting AAP.Brain water content of gray and white matter were measured by Moistrue Analyzer respectively.The permeability of the blood brain barrier (BBB) was determined by Evan's blue(EB) extravasation.Results The brain water content of gray and white matter in AAP group was reduced markedly,so the permeability of BBB was reduced(P0.05). Conclusion AAP can treat VCE well. Morbidity mechanism of VCE is related to the activity of alkaline phosphatase.

Objective: To study the effect of cognitive therapy in combination with electromyographic feedback therapy on diabetes patients with depression after cerebral infarction. Methods: 60 patients were randomly divided into study group (n=30) and control group (n=30) , The former received cognitive therapy and electromyographic feedback trainings in addition to regular medication. All patients were evaluated with Hamilton Depression Rating Scales (HAMD),Neurological Function Deficit scale(NFD)?Barthel Index(BI) and FPG (free plasma glucose), 2HPG (plasma glucose after 2 hours of a meal). Results: The improvement of study group was greater than the control group(P

Objective To compare the characteristics of MRI, CT, single photon emission computed tomography(SPECT) and transcranial Doppler sonography(TCD) in patients with spongiform leukoencephalopathy after inhaling heroin vapor. Methods Seventeen patients were investigated. MRI or CT was scanned in 17 patients, SPECT in 9 patients′ and TCD in 11 patients. Results MRI or CT: Brain MRI and CT revealed extensive symmetric white matter involvement of bilateral cerebral and cerebellar hemispheres and the brainstem.The lesions, which showed no contrast enhancement, were hypodense on CT and hypointense on T 1 weighted and hyperintense on T 2 weighted MRI. SPECT: The regional cerebral blood flows(rCBF) of white matter involvement on bilateral cerebral and cerebellar hemispheres was reduced obviously. The rCBF of temporal lobes, parietal lobes, occipital lobes, cerebellar hemispheres, and basal ganglion was reduced in varying degrees. TCD: The systolic peak became sharpened, and end diastolic flow velocity and mean flow velocity were reduced obviously and pulsatility index was increased markedly in patients with spongiform leukoencephalopathy after inhaling heroin vapor. Conclusion The characteristic manifestations of MRI and CT imaging may be regarded as the main foundation of diagnosing spongiform leukoencephalopathy after inhaling heroin vapor; SPECT and TCD can help comprehend the changes of hemodynamics of cerebral vessels and the degree of cerebral ischemia in patients with spongiform leukoencephalopathy after inhaling heroin vapor.

Objective To observe the pathological changes of cerebral arterioles around hematom in patients with acute period of intracerebral hemorrhage. Methods Brain tissue fragments were collected from the drainage effluents of 43 patients who received mini-invasive puncture drainage treatment of acute intracereal hemorrhage. Pathological changes of arterioles were analyzed under light microscope by routine HE and Congo red staining, respectively. Results The primary pathological changes of cerebral arteriole around hematom was arteriosclerosis and hyaline degeneration, which accounted for 28 cases (65.12%). Other pathological etiological factors included atherosclerosis in 3 cases (6.98%) and thrombosis in 5 cases (11.63%). Light microscopy also showed neutrophilic granulocytes sticking on the endothelial cells and exuding around vessels in 10 cases (23.26%) from 6h to 4d, and mini-focal hemorrhage in 8 cases (18.6%) from 24 to 48h.Conclusions Arteriosclerosis is the principal pathological etiology for spontaneous intracerebral hemorrhage. Neutrophilic granulocytes infiltrating was one of the most important pathological changes in acute stage of intracerebral hemorrhage.

Objective To explore the CT, MRI?PET features of Heroin Spongiform Leukoencephalopathy (HSLE).Methods CT and MRI of 29 patients, and PET of 4 patients were analysed.Results 1.CT and MRI showed extensive and symmetric lesions in white matters of bilateral cerebellum,posterior crus of internal capsule and parieto occipital region;2.Cerebral CT showed hypodense areas, MRI showed corresponding areas with decreased signal intensity on T1 weighted images and increased signal intensity on T2 weighted images, no edema, FLAIR and enhancing scan showed no destruction of brain blood barrier, PET imaging showed hypometabolism or non metabolism changes in corresponding areas; 3. PET imaging showed non metabolism areas in untreated patients' posterior limb of internal capsule, parietooccipital lobes and cerebellum, and the metabolism in corresponding areas of improved patients was low obviously; 4.PET imaging showed hypometabolism in grey matter of untreated and improved patients, and the metabolism in the grey matter remarkable improved patient was normal.Conclusion CT and MRI changes of HSLE sufferers almost limited in brain white matters, PET imaging showed hypometabolism or non metabolism changes in corresponding areas, the metabolism improvement in grey and white matters was very important to the improvement of HSLE sufferers, PET was more appropriate than MRI to the prognoses of HSLE sufferers.

Objective To summarize PET?MRI and pathologic characteristics of heroin spongiform leukoencephalopathy(HSLE). Methods Clinically, 28 cases underwent CT and MRI analysis,in which 2 cases had brain autopsies and 8 cases had brain biopsies. HE, GFAP, Loyez and Congo Red staining were made and observation done through electronic microscope. 4 cases underwent PET analysis. Results The PET, MRI and pathologic characteristics of HSLE showed (1) Spongiform vacuoles degeneration of white matter was pathologically the main morphological change. (2) All the 28 cases had a history of inhalation of heated heroin vapor and abstained from durg. (3) Most cases were described with acute onset characterized by cerebellar signs. (4) PET shows the cortex of the parietal lobe, occipital lobe and cerebellum became thin in 4 cases, while the cerebral white matter had enlarged. (5) Brain CT and MRI revealed extensive symmetric white matter lesions in cerebra and cerebellum. Conclusions Brain CT and MRI revealed extensive symmetric white matter lesions in cerebra and cerebellum. PET has more advantage in judging progress of patient's condition and therapeutic effecacy than MRI. Spongiform vacuoles degeneration of white matter was the main pathological change.

Objective To research the relationship between flash visual evoked potentials (fVEP)and intracranial pressure (ICP),to evaluate the usefulness of baseline fVEP testing in the diagnosis of increased ICP Methods 22 normal individuals,44 increased intracranial pressure patients and other 35 patients which were measured by lumbar puncture were recorded with fVEP The latency of their waves were compared Results A positive correlationship between elevated intracranial pressure and a latency shift of the P 2,N 2,P 3,N 3 wave of the flash evoked potential is demonstrated( P

Objective To investigate the effects of cognitive therapy combined with picture recognition training on depression after stroke (PSD).Methods Sixty patients with PSD after cerebral infarction were randomized into study and control groups.All accepted routine rehabilitation therapy.In addition,the study group accepted cognitive therapy combined with picture recognition training.The effects were assessed in terms of average reaction time and accuracy in picture recognition,and using the Hamilton depression rating scales (HAMDs) and the Barthel index (BI) before and after 4 weeks of treatment.Results The average reaction time and accuracy in picture recognition and the HAMD and BI scores improved significantly in both groups.The effects in the study group were significantly better than those of the control group.Conclusion Cognitive therapy combined with picture recognition training can alleviate depression symptoms and improve ability in the activities of daily living after stroke.

Objective To investigate the correlation between urinary 8-iso-prostaglandin F2α (8-iso-PGF2α) level and carotid atherosclerotic plaque stability in patients with acute ischemic stroke.Methods The patients with acute ischemic stroke were enrolled consecutively.According to the findings of carotid artery ultrasound,they were divided into either a non-plaque group or a plaque group,and then the plaque group was redivided into a stable plaque subgroup and an unstable plaque subgroup.Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of urinary 8-iso-PGF2α.Multivariate logistic regression analysis and Spearman correlation analysis were used to investigate the relationship between 8-iso-PGF2α and carotid artery plaques.Results A total of 150 patients with acute ischemic stroke were enrolled,including 104 had carotid artery plaque (30 were stable plaques and 74 were unstable plaques) and 46 had no carotid artery plaque.The urinary 8-iso-PGF2α level (86.45 ± 6.20 ng/mmol creatinine vs.45.70 ±6.19 ng/mmol creatinine; t =37.136,P=0.001) and intima-media thickness (IMT) (2.89 ± 1.03 mm vs.0.86 ±0.53 mm; t =3.518,P =0.002) in the plaque group were significantly higher than those in the nonplaque group.Multivariate logistic regression analysis showed that urinary 8-iso-PGF2α level (odds ratio [OR] 1.183,95％ confidence interval [CI] 1.087-1.276; P=0.001) and IMT (OR 28.642,95％ CI 8.276-137.231; P =0.001) were the independent risk factors for carotid artery plaque.Pearson correlation analysis showed that there was no significant correlation between urinary 8-iso-PGF2α level and carotid artery IMT (r =0.075,P =0.264).The urinary 8-iso-PGF2α level of the unstable plaque subgroup was significantly higher than that of the stable plaque subgroup (97.30 ± 7.20 ng/mmol creatinine vs.69.17 ±9.25 ng/mmol creatinine; t =16.506,P =0.001).Multivariate logistic regression analysis showed that urinary 8-iso-PGF2α level (OR 4.652,95％ CI 1.732-12.643; P =0.001) was an independent risk factor for unstable plaque.Conelusions The urinary 8-iso-PGF2α level is associated with the existence of carotid atherosclerotie plaque and instability,its increased level is an independent risk factor for carotid plaque instability in patients with ischemic stroke.