Objective To investigate the relationship between the changes of peripheral cellular immune function and the spleen weight index and the spleen histopathological changes following cerebral ischemiareperfusion in rats.Methods A model of middle cerebral artery occlusion (MCAO) of adult male rats was induced.The peripheral blood cytokine levels,spleen weight index and the spleen histopathological changes were evaluated.Results The serum proinflammatory cytokine interleukin (IL) -1β and interferon (INF) -γ levels in rats increased at 6 and 12 hours respectively after modeling.They began to decrease at 24 hours and decreased to the lowest at 72 hours.Compared to the sham operation group,there were significant differences (P ＜ 0.01 );on the contrary,the anti-inflammatory cytokine IL-10 level decreased at 6 hours after modeling It began to increase at 12 hours and reached the peak at 72 hours.Compared to the sham operation group,there were significant differences (P＜0.01).The spleen weight index in a MCAO group decreased significantly at 6 hours after modeling(P＜0.01) and it began to increase at 12 hours,but it was still lower than that in the sham operation group (P＜0.01),and then it decreased gradually and decreased to the lowest at 72 hours (P＜0.01).HE staining showed that the spleen germinal centers of rats reduced significantly at 72 hours after MCAO and the contours did not show very clear.The correlation analysis showed that the proinflammatory cytokine IL-1 β(r =0.304,P =0.002) and INF-γ (r =0.644,P =0.000) levels were positive correlated with the spleen weight index,and the anti-inflammatory cytokine IL-10 level was negatively correlated with the spleen weight index (r =0.492,P =0.000).Conclusions The rat peripheral cellular immune function after MCAO was in an inhibitory state.The changes of spleen may play an important role in the process of immunosuppression after stroke.

Objective To investigate the learning and memory functions,expression changes of disintegrin and metalloprotease 10 (ADAM10) mRNA in hippocampus in the aged rats with chronic cerebral hypoperfusion as well as the effect of atorvastatin on them.Methods A total of 72 rats were randomly divided into sham operation,cerebral hypoperfusion and atorvastatin treatment groups.A permanent bilateral common carotid artery occlusion (2VO)model was induced.Atorvastatin 10 mg/(kg · d) was administered orally after procedure in the atorvastatin treatment group.Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression of ADAM10 mRNA in bilateral hippoocampus at 1,2,4,and 16 weeks after modeling,Results Two weeks after modeling,the learning and memory functions were decreased significantly in the cerebral hypoperfusion group compared to the sham operation group (P ＜ 0.05).At 4 and 16 weeks after modeling,they were further decreased (P ＜0.01); there were no significant differences in the learning and memory functions at 1,2,and 3 weeks after modeling between the atorvastatin treatment group and the cerebral hypoperfusion group,however,they were improved significantly at 16 weeks compared to the cerebral hypoperfusion group (P＜0.01).The expression of ADAM10 mRNA in hippocampus at different time points after modeling in the cerebral hypoperfusion group was down-regulated by 22％,43％,35％,and 50％,respectively compared to the sham operation group (all P ＜0.05).The expression of ADAM 10 mRNA in hippocampus at 2 weeks in the atorvastatin treatment group was higher than 22％ in the cerebral hypoperfusion group (P＜0.05).There were not significant differences at other time points.Conelusions Chronic cerebral hypoperfusion results in the down-regulation of the expression of ADAM10 mRNA in hippocampus in the aged rats,and atorvastatin may inhibit down-regulation of the expression of ADAM10 mRNA at early stage.

Objective To investigate the relationship between the changes of the sympathetic nervous system activity and the peripheral cellular immunodepression after cerebral infarction.Methods An adult male Sprague-Dawley rat model of middle cerebral artery occlusion (MCAO)was induced.A double-antibody sandwich enzyme-linked immunosorbent assay was used to detect the levels of serum proinflammatory cytokines interleukin(IL)-1β,interferon-γ (INF-γ)and anti-inflamatory cytokines IL-10.A competitive enzyme-linked immunosorbent assay was used to detect the levels of serum metanephrine(MN)and normetanephrine(NMN).After blocking sympathetic activity by injecting β -blocker propranolol intraperitoneally,the sympathetic activity and the levels of pro/anti-inflammatory cytokines were detected.Results The levels of serum MN and NMN at 6 hours after MCAO began to increase in the cerebral infarction group compared with the sham operation group.They reached the peak at 72 hours,and then decreased slowly.However,they were still higher than those in the sham operation group 2 weeks after MCAO(P ＜ 0.01 ).At 72 hours after MCAO,the levels of MN and NMN in the propranolol intervention group were decreased significantly(P ＜0.01 ),the levels of proinflammatory cytokines IL-1β and INF-γwere increased significantly(P ＜0.01 ),and the levels of anti-inflammatory cytokine IL-10 were decreased significantly(P ＜0.01).Conclusions When sympathetic nervous system is overactivated after cerebral infarction in rats,the peripheral cellular immunity is in a state of depression;the peripheral immunodepression will be fundamentally reversed after blocking the sympathetic function,and this suggests that the overactivation of sympathetic nervous system may play a important role in the process of immunodepression after cerebral infarction.

Objective To investigate the early risk factors for stroke-associated pneumonia (SAP) in acute stroke patients with dysphagia.Methods The modified Mann assessment of swallowing ability (MMASA) was used to screen dysphagia in patients with acute stroke admitted to hospital within 24 hours after symptom onset.The patients with dysphagia were used as research subjects.They were divided into either a SAP group or a non-SAP group according to whether they had SAP or not within one week of symptom onset.Univariate and multivariate logistic recession analyses were used to analyze the data of demography,past history,clinical practice,and laboratory.The early risk factors for the occurrence of SAP in patients with dysphagia were identified.The independent risk factors were analyzed with receiver operating characteristic (ROC) curves in order to assess their predictive value for SAP.Results Of the 113 patients with acute stroke,55 had dysphagia,and 30 of them (54.54％ ) had SAP.Univariate analysis showed that the National Institutes of Health Stroke Scale (NIHSS) score (median,[ interquartile range] 16,[ 13 - 21 ] vs.3,[ 1 - 7 ] ; P =0.000),neut rophil counts ([ 8.22 ± 3.75 ] × 109/L vs.[ 5.39 ± 2.56 ] × 109/L; t =3.198; P =0.002),proportion of hemorrhagic stroke (96.00％ vs.4.00％ ;x2 =7.333; P =0.007),and proportion of mechanical ventilation (20.00％ vs. 0.00％;x2=5.612; P=0.018) in the SAP group (n=30) were significantly higher than those in the non-SAP group (n =25),while the MMASA score (median,[ interquartile range ] 53,[ 27 - 84 ] vs.88,[ 66 - 92 ] ; P =0.002),Glasgow Coma sCale (GCS) score (median,[ interquartile range] 10,[7-13] vs.15,[11-15];P=0.001),lymphocytecounts([1.17±0.54] ×109/L vs.[1.75±0.81 ] × 109/L; t =-3.563,P =0.001),CD3+ T lymphocyte counts ([0.73 ± 0.42] × 109/L vs.[ 1.14 ±0.85] × 109/L; t=-2.307; P=0.025),and CD4+ T lymphocyte counts ([0.38± 0.22] × 109/L vs.[ 0.69 ±0.57] × 109/L; t =-2.761; P =0.008) were significantly lower than those in the non-SAP group.Multivariate logistic regression analysis showed that the NIHSS score was higher at admission (odds ratio [ OR ],1.206,95％ confidence interval [ CI ] 1.076- 1.351; P=0.001) and the CD4+ T lymphocyte counts decreased ( OR,0.974,95％ CI 0.952 - 0.997; P =0.025) were the independent risk factors for SAP in stroke patients with dysphagia.The NIHSS score ≥ 10.5 had good predictive value for SAP,and its sensitivity and specificity were 86.7％ and 72.0％ respectively (P =0.000).Conclusions More than half of the acute stroke patients with dysphagia occurred SAP.The NIHSS score at admission,neutrophil counts,stroke types,mechanical ventilation,MMASA score,GCS score,lymphocyte counts,CD3+ T lymphocyte counts,CD4+ Tlymphocyte counts,and other factors were associated with occurrenee of SAP in patients with dysphagia,in which a higher NIHSS score and a decreased CD4+ T lymphocyte counts were independent risk factors for the occurrence of SAP in stroke patients with dysphagia.The NIHSS score ≥ 10.5 at admission had higher predictive value.

Based on the references of relevant statistical data, the implementation of the overall situation of the basic medical insurance system in Henan were compared. The sample cities and counties of basic medical insurance data were analyzed through the field survey. Using empirical analysis methods to discuss the necessity and feasibility of integration between new rural cooperative medical system and urban residents medical insurance, put forward the integration path and propose related suggestions.

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

The incidence of dysphagia after stroke is high.It may affect the rehabilitation of patients and increase mortality.The assessment is of great significance for early objective examination of dysphagia,in which the bedside screening tests are the most common assessment methods in the routine clinical work.This article reviews the advances in research on the commonly used bedside screening tests of dysphagia.

AIM: To investigate the effects of salidroside on intracellular free calcium concentration (([Ca~(2+)]i)), apoptosis, mitochondrial membrane potential (MMP) and activity during injury induced by hypoxia/hypoglycemia in cultured SH-SY5Y cells. METHODS: Mitochondrial activity was measured by methylthiazolyl tetrazolium test. MMP, [Ca~(2+)]i and apoptosis were measured by flow cytometry. RESULTS: SH-SY5Y cells were cultured in a hypoxia/hypoglycemia condition for 2, 4, 6 and 12 h, [Ca~(2+)]i and apoptosis rate significantly increased compared with control group (P

Objective To make the chromosome karyotype analysis of 130 patients with leukemia by using the improved chromosome short-term culture method.Methods We optimized the main factors with a single factor gradient experiment in short-term culture of bone marrow chromosome, including colchicines concentration, duration of action of colchicines,and hypotonic time.On this basis,we conducted the three-factors and three-level orthogonal experiment to achieve improved bone marrow chromosome preparation system,which was later applied in 130 patients with leukemia in our hospital.Results The orthogonal experiment results showed that the optimum conditions were colchicines concentration of 0.07 μg/mL,colchicines action time of 80 min,and hypotonic time of 35 min during the preparation of the bone marrow chromosome.Using this method,the chromosome preparation success rate reached 97.69% and the detection rate of abnormal karyotype reached 82.3% in the chromosome karyotype analysis.Conclusion Bone marrow chromosome preparation system with colchicines concentration of 0.07 μg/mL and colchicines action time of 80 min,and hypotonic time of 35 min is worthy of clinical promotion.

Objective To investigate the correlation between dyslipidemia and important organ damage in patients with active systemic lupus erythematosus (SLE) without treatment. Methods Serum sam-ples from 71 active SLE patients and 30 healthy controls were obtained to measure lipid profiles including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), apolipoproteinA1 (apoA1), apolipoproteinB100 (apoB) and lipoprotein a (LPa). Clinical parameters were recorded. Results The levels of serum TC, TG, LDL, apoB in active SLE patients were higher than those in healthy controls, in contrast,the levels of HDL,apoA1 were much lower (P<0.05 or P<0.01). Patients with important organ damages had longer disease course and elevated levels of serum TC, TG, LDL and apoB concentrations than those without organ damage (P<0.05 or P<0.01), especially in patients with cadiovascular diseases (CVD) (P<0.01). Moreover, these changes in lipid metabolism were positively correl-ated with disease course and negatively with C3 level (P<0.05 or P<0.01). The elevated serum TC and LDL concentrations were negatively correlated with C4 level (P<0.05). Conclusion Severe dyslipidemia is present in active SLE patients.It is correlated with disease course and disease activity. Increased serum TC, TG, LDL and apoB concentrations play key roles in patients with important organ damages.