Vascular vertigo is a common vertigo.Vertebral artery dominance is a vascular phenomenon,and its mechanism remains unclear.It causes basilar artery changes and hemodynamic changes in posterior circulation.Vertebral artery dominance may trigger vascular vertigo through a variety of mechanisms.

With the development of neuroimaging the detection rate of basilar artery tortuosity is significantly high.The occurrence and development processes of basilar artery tortuosity are affected by age,basilar artery length,vertebral artery dominance,and other factors.Basilar artery tortuosity may influence the blood supply of posterior circulation and cause brainstem and cranial nerve pressure leading to clinical symptoms.

Basilar artery hypoplasia (BAH) has been paid less attention to in the past.However,the increased detection rate makes the clinical significance of BAH to be gradually recognized.BAH have interaction with vascular risk factors,and this may promote the occurrence of ischemic events in posterior circulation.Brain evoked potential can be used as an important means for early detection of this pathophysiological events.The depth study of pathological significance of BAH helps to deepen the understanding of the mechanisms of posterior circulation ischemic events.

Objective To enhance engraftment by infusing two partially matched cord blood (CB) units from unrelated donors simultaneously. Methods Two patients with high-risk leukemia(1 case of ALL and 1 case of CML-BC) received total body irradiation with antithymocyte globulin (ATG) and then were transplanted with two HLA-mismatched CB units from unrelated donors. A combination of cyclosporine A, methylprednisonelone and mycophenolate mofetil (MMF) was administered for graft-versus-host disease (GVHD) prophylaxis. Results Two patients were all engrafted and the time to neutrophil≥ 0.5 ?10 9/L and platelet≥20?10 9/L were 21, 22 days and 51, 28 days post-transplant respectively, and DNA analysis showed only one donor DNA was detectable after engraftment. There was no serious GVHD. And these 2 patients are still alive and disease free for more than 34 and 30 months repectively. Conclusion Double units cord blood from unrelated donors can restore hematopoiesis and is suitable in adults without bone marrow donors.

Objective To investigate the risk factors of death in patients with acute stroke in the neurological intensive care unit(NICU). Methods The clinical data of 137 patients with acute stroke in the NICU were induced. The risk factors were analysed by univariate and multi-variate Logistic regression analysis.Results There were 13 risk factors including age, coma, hyperpyrexia, pulmonary disease, atrial fibrilation/cardiac dilatation, stroke history, mechanical ventilation, brain midline shift, initial serum glucose, APACHEⅡscores, feeding tube, urethral catheter and concurrent pulmonary infection which had statistical significance between the death group and survive group,by univariate analysis(P

Objective To investigate the clinical risk factors of vertebral artery origin tortuosity and its impact on vascular vertigo. Methods Totally 206 inpatients in Department of Neurology were divided into tortuous group (n=137) and non-tortuous group (n=69).Clinical risk factors of cerebral vascular disease,vertigo scales and days of treatment relieve were recorded.Total cholesterol (CH),low density lipoprotein cholesterol (LDL-C),homocysteic acid (Hcy) and high sensitivity Creactive protein (hsCRP) were detected.Cervical computer tomography angiography (CTA) and contrast enhancement magnetic resonance angiography (CEMRA) were completed.The risk factors of vertebral artery origin tortuosity were analyzed with multiple logistic regression analysis. Results Vertebral artery dominance was much more in tortuous group than non-tortuous group(x2 =2.496,P＜0.01).Vertigo scales from 1 to 5 appeared in 17 cases,36 cases,79 cases,4 cases,1 case,respectively,and days of treatment relieve were 1-10 d in tortuous group,hut the corresponding data was 18 cases,35 cases,10 cases,3 cases,1 case and 1-6 d in non-tortuous group with statistical significance between the two groups(t=2.014,2.849,P＜0.01).The distinctions were found in age more than 65 years,hypertensive disease,high LDL-C,diabetes mellitus,smoking,stroke history,vertebral artery dominance and cervical spondylosis between tortuous group and non-tortuous group(x2=7.498,5.182,3.724,10.46,6.883,2.748,4.496,8.265,all P＜0.05).Age more than 65 years (95％CI:5.36-18.23,OR=4.84),hypertensive disease(95 ％ CI:2.79-16.45,OR=3.21),vertebral artery dominance(95％ CI:3.25-13.49,OR =5.48) and cervical spondylosis (95％ CI:4.38-21.28,OR=3.57) were high clinical risk factors. Conclusions Patients with vertebral artery origin tortuosity present with higher vertigo scales and longer days of treatment relieve.Age more than 65 years,hypertensive disease,vertebral artery dominance and cervical spondylosis are clinical risk factors for vertebral artery origin tortuosity.

Objective: To explore the effect of simvastatin, an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase (the rate-limiting enzyme of cholesterol synthesis) on the proliferation and apoptosis of chronic myelogenous leukemia (CML) cells. Methods: Both normal and CML bone marrow progenitor cells were assayed in semisolid methylcellulose culture after incubation for 24 hours in suspension culture with 10 mg*L－1 simvastatin. Also, sub-G1 cells and DNA end-labeling positive cells as apoptotic cells were identified by flow cytometry after being exposed to simvastatin for 72 hours. Results: Simvastatin selectively inhibited proliferation and induced apoptosis of CML cells, but had no much influence on normal bone marrow cells. Conclusion: CML cells are more sensitive to a short-term exposure to simvastatin than normal bone marrow cells. It will be a promisingly effective chemotherapeutic agent or in vitro purging agent in autologous stem cell transplantation for the treatment of CML.

Purpose To analyze the hemodynamic characteristics of brain stem in patients with basilar artery hypoplasia (BAH) by magnetic resonance perfusion-weighted imaging (PWI).Materials and Methods According to the inclusion and exclusion criteria,51 patients with BAH were selected as the BAH group,and 79 patients without BAH were selected as the non BAH group.All patients were examined by MRI,3D-TOF and PWI,and magnetic resonance angiography was acquired after the three examinations.The regional cerebral blood flow (rCBF),regional cerebral blood volume (rCBV),regional mean transit time (rMTT) and time to peak (TTP) values of pontine area were measured.Results The rCBF value of the BAH group [(17.10±6.52) ml/(100 g · min)] was significantly lower than that of the non BAH group [(29.06± 13.32) ml/(100 g · min)] (P＜0.05);the rCBV value of the BAH group [(1.41 ±0.26) ml] was significantly lower than that of the non BAH group [(2.62± 0.82) ml] (P＜0.05);the TTP value of the BAH group [(6.14± 1.31) s] was significantly higher than that of the non BAH group [(5.39 ± 1.08) s] (P＜0.05);the rMTT value of the BAH group [(20.78±3.48) s] was significantly higher than that of the non BAH group [(19.01 ±2.39) s] (P＜0.05).TTP was the most sensitive index of cerebral perfusion injury,and the incidence of TTP extension was 41.18％ in the BAH group.Conclusion PWI can detect the abnormal cerebral hemodynamics in patients with BAH,which provides the basis for the timely treatment and prevention of irreversible injury in the ischemic area of the brain.

OBJECTIVETo observe the conditioning regimen, efficacy and side effects of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for hemophagocytic lymphohistiocytosis (HLH).

METHODFrom 2010 to 2012, a total of 11 cases after allo-HSCT were evaluated including 8 cases with familial hemophagocytic lymphohistiocytosis (FHL) and 3 cases with Epstein-Barr virus (EBV) related HLH. Allo-HSCT from HLA haploidentical HSCT was performed for 3 cases and unrelated allo-HSCT for 8 cases; 7 cases underwent allo-HSCT with conditioning regimen of etoposide (VP16), busulphan (Bu), fludarabine (Flu) and antilymphocyte globulin (ATG) and 4 cases with Flu, melphalan (Mel) and ATG. Cyclosporine (CsA) or tacrolimus, mycophenolate (MMF) and methorexate (MTX) were used for prevention of graft versus host disease (GVHD). Four cases received anti-CD25 MoAbs, 7 cases received cord blood and 1 of them received haploidentical bone marrow to prevent GVHD.

RESULTThree cases died after allo-HSCT. The median overall survival time of the 8 cases evaluated was 585 days (154-1 115 d). All the patients were successfully engrafted. Acute GVHD (aGVHD) occurred in 8 cases, including 3 cases of gradeI/II and 5 cases of grade III/IV. Chronic GVHD (cGVHD) occurred in 4 cases. Seven cases had cytomegalovirus (CMV) reactivation.

CONCLUSIONThe allo-HSCT was successful in treating primary and refractory hemophagocytic syndrome.

Adolescent ; Child ; Child, Preschool ; Cyclosporine ; administration & dosage ; Cytomegalovirus Infections ; epidemiology ; prevention & control ; Female ; Graft vs Host Disease ; epidemiology ; prevention & control ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Immunosuppressive Agents ; administration & dosage ; Lymphohistiocytosis, Hemophagocytic ; mortality ; therapy ; Male ; Survival Rate ; Tissue Donors ; Transplantation Conditioning ; methods ; Treatment Outcome

Vestibular migraine(VM)is a common vestibular disorder in which vertigo and migraine coexist,and visually induced vertigo is one of the typical vestibular symptoms of VM.The clinical manifestations of VM re-lated visual vertigo are various,which are affected by anxiety,motion sickness,age and other factors.Multiple mechanisms such as anatomical and physiological connections,gaze instability,visual vestibular integration defects,impaired sensory remodeling,sensitization of the central vestibular pathway,5-hydroxytryptamine and glutamate-glutamine cycle and other neurotransmitters may lead to VM-related visual vertigo.