Objective]With discussion of stroke machine with depression syndrome and law,we broaden the clinical thinking and improve clinical therapeutic effect.[Methods]Ancient medical books discussion of stroke and depression syndrome were collected,referring to the definition of post-stroke depression in modern medicine,traditional Chinese medicine continued to collect relevant papers in modern treatises,and combined with the experience of the author's departments in the diagnosis and treatment of post-stroke depression.[Outcome]Post-stroke depression in the pathogenesis of disorders with blood and viscera of yin and yang,phlegm and qi stagnation as the standard.Treatment should be given on multi-organs,especially focusing on regulating liver;emphasis interconversion between pathological factors in clinic,adjusting for the first Qi; taking care treatments with acupuncture combined emotions inter-resistance. Through organizing the relevant literature depression after stroke,come to the disease and its treatment of its laws,as well as the clinical treatment of attention points,which can improve clinical outcomes.[Conclusion] The pathogenesis of post-stroke depression is varied, we must analyse the syndrome and law carefully to promote better recovery, and then improve clinical therapeutic effect.

Objective Depression is a mood disorder that causes a persistent feeling of sadness,with high morbidity rates and great social impairment.Increasingly studies show the abnormalities of brain networks.We summarized the results of resting state functional magnetic resonance imaging study of depression,and demonstrated the neural loops mechanism from neuroimaing perspective.Methods The key words depression, resting state and network were searched in PubMed,CNKI and Wan Fang databases from January 2000 to December 2014.The nodes of depression related network and the alterations of cortex resting-state networks were summarized.Results 24 studies focusing on resting state network of depression were identified.40 studies based on ROI (region of interest) analysis,which included amygdala,frontal lobe,pregenual anterior cingulate cortex and cerebellum.The functional connectivity of ROIs were calculated and compared between groups.8 studies based on ICA (independent component analysis),the resting state networks were extracted and compared between groups.Two based on graph theory,the functional connectivity of whole brain were analyzed and compared.Conclusion There are abnormalities of functional connectivity among limbic system-thalamus-frontal cortex,and the changes of functional connectivity were associated with clinical symptom and drug efficacy of depression.

Objective To explore the nursing method during bedside fibrobronehoseope to patients with inhalation injury and ensure the safety of the procedures. Methods 58 patients with inhalation injury with bed-side flbrobronehoseope treatment from 2005 to 2008 were retrospectively analyzed. Results 3 eases showed a-cute respiratory distress syndrome, 3 cases died of respiratory failure, 2 patients died of multiple organ failure,dyspnea, cough symptoms improved in others after sputum aspiration. Conclusions To master the preoperative,intraoperative, postoperative nursing methods during fibmbronehoscope can improve clinical efficacy.

The effects of SB203580 (SB) with different concentrations at different time points on renal function, apoptosis, P38MAPK activity and the expression, as well as the P38MAPK substrates in renal ischemia/reperfusion injury were investigated. Forty-nine rats were divided into 7 groups at random (n = 7 in each group) according to the durations of ischemia/reperfusion injury and the time of medication. Based on the orthogonal Latin side, the rats were injected, by caudal vein, with the same volume but different dosages of SB. BUN and Scr were determined. The apoptosis was detected with TUNEL kit. The protein was assayed qualitatively and semi-quantitatively by Western blot. The results showed that SB could significantly reduce the increased Scr and BUN, the apoptosis of renal tubular epithelia and the activation of P38MAPK all caused by renal ischemia/ reperfusion injury in a dose-dependent manner (P < 0.05). And the effect was most predominant when SB was given 3 h before renal ischemia. This suggested that SB could significantly alleviate renal ischemia/reperfusion injury. Administration of SB 3 h before ischemia at the concentration of 5 micromol/L could obtain an optimal effect.
Apoptosis/*drug effects ; Enzyme Inhibitors/pharmacology ; Imidazoles/*pharmacology ; Kidney/*blood supply ; Kidney/pathology ; Pyridines/*pharmacology ; Random Allocation ; Rats, Sprague-Dawley ; Reperfusion Injury/enzymology ; Reperfusion Injury/*pathology ; p38 Mitogen-Activated Protein Kinases/*metabolism

Objective To investigate the effect of emergency nursing pathway in emergency treatment of patients with questionable sources. Methods A clinical nursing pathway for the treatment for patients with questionable sources was formulated. From February to December 2014, 78 patients with questionable sources treated by clinical nursing pathway were selected as the observation group. From January to November 2013, 75 patients with questionable sources treated by routine nursing care methods were selected as the control group. Differences were compared in duration of staying in the emergency department, nursing complication and fees paid rate between the two groups. Results For the average duration of staying in the emergency department, the observation group was lower than that in the control group [19.35%(9.08) vs. 19.90%(25.20), P< 0.05)]. For the nursing complication rate, the observation group was significantly lower than that of the control group [1.28%(1/78) vs.10.67%(8/75), P<0.05]. For the fees paid rate, the observation group was significantly higher than that in the control group [64.10%(50/78) vs. 33.33%(25/75), P<0.01]. Conclusions By the emergency nursing pathway, emergent patients with questionable sources will be treated with satisfactory result in the shortest time.

Objective To investigate micro-inflammatory state and protein-energy wasting (PEW) states in maintenance peritoneal dialysis(MPD) patients,then analysis of the correlation between them.Methods Ninty-six cases of MPD patients in this Hospital were selected from March 2012 to September 2015.The status of nutrition were assessed by Quantitative Subjective and global Assessment(SGA),malnutrition-inflammation score(MIS) and albumin(Alb),micro-inflammatory state was assessed by enzyme-linked immunoassay(ELISA) method serum hypersensitive c-reactive protein (hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6).At the same time,various serological markers like serum Alb,serum total protein(TP),serum prealbumin(PA),hemoglobin(Hb),transferrin(TF),serum creatinine(Scr),urea nitrogen(BUN),cholesterol(Teh) were measured.Results The incidence of PEW in MPD patients was 36.50％,among which 62.86 ％ of them were over 65 years old,57.10％ were over 2 years of dialysis time and 40.00％ with diabetic nephropathy.MPD patients with hs-CRP＞5 mg/L accounted for 58.33％,of which over 65 year old accounted for 42.86％,MPD age longer than 2 years accounted for 60.71％,32.14％ of them with diabetic nephropathy.The proportion of diabetic nephropathy,average age,dialysis duration time,hs-CRP,TNF-α and IL-6 in PEW group were higher than non-PEW group(P＜0.05);BM,TP,Alb,PA,Hb,TCh,MAC and MAMC were lower ban non-PEW group(P＜0.05).Compared with the hs-CRP≤5 mg/L group,average age,the time of dialysis duration,TNF-α,IL-6 were higher and TP,Alb,PA,TF,Hb,the proportion of Kt/V≥1.72 were lower in the hs-CRP＞5 mg/L group.After the correction of age,sex,dialysis ages,it was found that the level of hs-CRP in MPD patients was negatively correlated with the level of Alb,PA,TF,Tch,Scr,TG;The level of IL-6 was negatively correlated with the levels of Alb,PA,TF,Tch,TG.The level of TNF-α in MPD patients showed different degrees of negative correlation with the leves of Alb,PA,TF,TG,Tch(all P＜0.05).Multivariate analysis showed that elderly,the time of dialysis duration,the microinflammatory state,and hypoalbuminemia were the independent risk factors of PEW.Conclusion PEW and micro-inflammatory state are very common in PHD patients.Patients with longer duration of dialysis,elderly or associated with diabetic nephropathy are more likely to suffer PEW and micro-inflammatory.Elderly,the time of dialysis duration,microinflammatory state,hypoalbuminemia are the independent risk factors of PEW.

Objective To discuss the effects of acupuncture therapy on resting state functional magnetic resonance imaging (fMRI) in patients with ischemic stroke; To explore the central mechanism of acupuncture therapy.Methods Ten is chemic stroke patients with hemiplegia limbs and ten matched control subjects were included. Treatment group was given anti-platelet aggregation, anticoagulation, and nutrition brain cell therapy. At the same time, acupuncture therapy was given, taking Jianyu, Quchi, Shousanli, Waiguan, Hegu, Zusanli, Fenglong, Yanglingquan, Sanyinjiao, and Taichong, with even reinforcing-reducing method, and retaining the needle 30 min, manipulating needle every 10 min, once a day, 5 times a week, needle stopping for 2 d, for continuous 30 d. The health group did not undergo any treatment. BOLD-fMRI imaging technique was used, and based on RSET1.8 software, the parameters of brain activity before and after treatment were observed by amplitude of low frequency fluctuation (ALFF) method. The Results were compared with healthy group. Results Before treatment, the ALFF value of left caudate nucleus, putamen and globus pallidus in the treatment group was lower than that in the health group, and the ALFF value of bilateral precentral and postcentral gyrus, left grus frontalis superior, gyrus frontalis medius, gyrus temporalis medius and precuneus was higher than the health group (P<0.05). After treatment, the ALFF value in left caudate nucleus, putamen and globus pallidus in the treatment group was higher than that before treatment, and the ALFF value in left gyrus frontalis superior, gyrus frontalis medius and precuneus decreased than before group (P<0.05).Conclusion In the resting state of the ischemic stroke patients with hemiplegia limbs, the principal injured brain regions are caudate nucleus, putamen and globus pallidus. Acupuncture has a regulatory role for these brain areas, presumably may be the central mechanism of efficacy.

Objective:To investigate the correlation between serum procalcitonin (PCT) level and intracranial atherosclerotic burden (ICASB) in patients with ischemic stroke.Methods:From January 2019 to December 2020, consecutive patients with acute ischemic stroke admitted to the Department of Neurology, Jiangsu Provincial Second Chinese Medicine Hospital were enrolled. Chemiluminescence immunoassay was used to detect serum PCT levels, and ICASB was evaluated based on the results of cranial magnetic resonance angiography. Univariate analysis was used to determine the baseline data among the different ICASB score groups. Then the independent correlation between serum PCT level and ICASB was determined by the ordinal logistic regression analysis. At the same time, the correlation between serum PCT level and ICASB was determined by the linear regression analysis. Results:A total of 291 patients with acute ischemic stroke were enrolled, including 161 male (55.3%), aged 64.5±8.4 years; median serum PCT level was 0.053 μg/L. According to the ICASB score, the patients were divided into 0 group ( n=155, 53.3%), 1-3 group ( n=95, 32.6%) and >3 group ( n=41, 14.1%). Univariate analysis showed that the age, serum homocysteine and PCT level, as well as the proportion of diabetes were significantly higher in the higher ICASB score group, while the proportion of the patients with atrial fibrillation was significantly lower (all P<0.05). Ordinal multivariable logistic regression analysis showed that higher serum PCT level was an independent factor for higher ICASB score (the 4 th quartile vs. the 1 st quartile: odds ratio, 2.015, 95% confidence interval 1.052-3.927; P=0.043). Multiple linear regression analysis showed that the serum PCT level was positively correlated with the ICASB score ( r=0.253, P=0.001). Conclusion:The serum PCT level is correlated with ICASB.

Objective:To evaluate the effect of oxiracetam on sevoflurane-induced cognitive dysfunction in mice and the role of phosphatidylinositol 3-kinase/serine/threonine protein kinase (PI3K/Akt) signaling pathway.Methods:Eighty adult Kunming mice, half male and half female, weighing 35-55 g, were divided into 4 groups ( n=20 each) using a random number table method: control group (group C), sevoflurane group (group S), oxiracetam plus sevoflurane group (group OS), and LY294002 plus oxiracetam plus sevoflurane group (group LOS). Group S inhaled 2% sevoflurane for 6 h. A 2 h before sevoflurane anesthesia, oxiracetam 105 mg/kg was injected via the tail vein in group OS, oxiracetam 105 mg/kg and LY294002 0.3 mg/kg were injected via the tail vein in group LOS, and the equal volume of normal saline was injected in group S. The apoptosis rate of hippocampal neurons was detected using TUNEL.The expression of PI3K, phosphorylated PI3K (p-PI3K), Akt and phosphorylated Akt (p-Akt) was determined by Western blot.Cognitive function was assessed using Y-maze at 14 days after the end of anesthesia. Results:Compared with group C, the apoptosis rate of hippocampal neurons was significantly increased, the total number of times and the number of errors required for 10 times of correct responses in Y-maze test were increased, and the expression of PI3K, Akt p-PI3K and p-Akt in hippocampal tissues was down-regulated in group S ( P<0.05). Compared with group S, the apoptosis rate of hippocampal neurons was significantly decreased, the total number of times and the number of errors required for 10 times of correct responses in Y-maze test were decreased, the expression of PI3K, Akt, p-PI3K and p-Akt in hippocampal tissues was up-regulated in group OS ( P<0.05), and no significant changes were found in the parameters mentioned above in group LOS ( P>0.05). Compared with group OS, the apoptosis rate of hippocampal neurons was significantly increased, the total number of times and the number of errors required for 10 times of correct responses in Y-maze test were increased, and the expression of PI3K, Akt, p-PI3K and p-Akt in hippocampal tissues was down-regulated in group LOS ( P<0.05). Conclusion:Oxiracetam can alleviate sevoflurane-induced cognitive dysfunction in mice, and the mechanism may be related to activating PI3K/Akt signaling pathway and inhibiting apoptosis in neurons.

Objective The abnormal ankle-brachial index ( ABI) is associated with the incidence of cardiocerebral vascular diseases, but little is known about its relationship with cerebral microbleeds (CMB).This study aimed to investigate the correlation be-tween ABI≤0.9 and different distribution patterns of CMB . Methods We enrolled 187 patients with acute lacunar infarction , inclu-ding 115 non-CMB cases and 72 CMB cases (20 strictly lobar, 24 strictly deep, and 28 lobar and deep).We analyzed the differences between the two groups and the association of abnormal ABI with the occurrence and distribution of CMB by logistic regression analysis . Results ABI≤0.9 was found in 57 (30.5%) of the patients, with a significantly higher incidence rate in the CMB group than in the non-CMB group (43.1%vs 22.6%, P=0.003).The level of ABI was negatively correlated with the number of CMBs (r=-0.211, P=0.006).Multivariate logistic regression analysis after adjusted for confounders indicated that ABI ≤0.9 was significantly associated with the presence of CMB (OR=2.363;95%CI:1.181-4.729), deep CMB (OR=3.434;95%CI:1.283-9.187), and lobar and deep CMB ( OR=2.837;95%CI:1.098-7.333) in patients with ischemic cerebrovascular disease . Conclusion Decreased ABI is a risk factor of CMB, particularly deep CMB, in patients with ischemic stroke.