AIM:To investigate the neuroprotective effect of pioglitazone (Pio),a potent agonist of peroxi-some proliferator-activated receptor gamma (PPAR?),on the traumatic brain injury (TBI) in rats. METHODS:SD rats were randomly divided into 4 groups:sham group,vehicle + TBI group,Pio + TBI group and Pio + T0070907 + TBI group. TBI was induced by the method of controlled cortical impact (CCI) injury. Neutral red staining technique was used to determine the cortical lesion volume. NeuN,GFAP and OX -42 were measured by immunohistochemical technique to evaluate the morphology of neurons,activation and infiltration of astrocytes and microglia at the edge of cortical lesion. RE-SULTS:CCI injury in rat elicited activation and proliferation of the astrocytes and microglia. The glial scar wall formation at the edge of cortical lesion,which was accompanied by the loss of neurons,was observed. Pio significantly reduced the cortical lesion volume,the activation and infiltration of the astrocytes and microglia,and the loss of pyramidal neurons at the edge of cortical lesion. T0070907,an antagonist of PPAR?,reversed the effects of Pio. CONCLUSION:Pioglitazone exerts a neuroprotective efficacy,attenuates the loss of neurons and cortical lesion volume following CCI injury by inhibiting the activation and infiltration of astrocytes and microglia,especially glial scar formation.

Objective To compare the efficacy of heparin and bivalirudin in patients with acute coronary syndrome undergoing emergency percutaneous coronary intervention ( PCI ) .Methods A total of 90 patients with acute coronary syndrome were included in this study .They were divided into the study group and control group according to the requirements of random envelope method ,45 cases in each group .The study group received bivalirudin during PCI,the control group was given heparin .The Fbg,APTT,TT and PT were detected in the two groups ,and the inci-dence of adverse reactions ( heart failure , cardiac death , platelet reduction , hemorrhage of digestive tract ) was analyzed.Results After treatment,there were no statistically significant differences between the two groups in various blood coagulation indicators (all P>0.05).The incidence rate of adverse events of the study group was 4.44％, which was significantly lower than 24.44％of the control group ,and the difference was statistically significant (χ2 =7.28,P<0.05).Conclusion Application of heparin and bivalirudin in PCI has similar efficacy ,but the safety of bivalirudin is higher ,which is worthy of clinical promotion .

Objective: Undiagnosed critical congenital heart disease (CCHD) was assessed before discharge from maternity hospital.Basic information was provided for screening CCHD in the early neonatal stage.Chi-squared test was used for comparison of categorical variables(detection rate of different types of CCHD). Method: A retrospective cohort study was conducted in neonates with CCHD who were admitted to Children′s Hospital of Fudan University between 1 January 2012 and 31 December 2015. For comparing with the previously reported undiagnosed rate of CCHD at discharge, CCHD was defined as all duct dependent congenital heart disease (DDCHD) and any cyanotic CHD that required early surgery. Result: A total of 1 036 infants with CCHD were included. The prenatal detection rate of CCHD was 14.04%(122/869). As a whole, 52.51% (544/1 036) of CCHD cases were undiagnosed at discharge, and 14.09%(146/1 036)were still missed after 6-week examination. The diagnoses most likely to be unrecognized at discharge included critical coarctation of the aorta (COA) (75.00%), total anomalous pulmonary venous connection (61.54%), pulmonary atresia (PA) with ventricle septal defect (VSD) (61.45%), single ventricle (SV) (60.10%) and critical aortic stenosis (52.94%). Among newborns diagnosed prior to discharge, 54.88% (270/492) due to symptom or prenatal ultrasonographic diagnosis, 45.12% (222/492) due to abnormal findings in routine examination. Among asymptomatic CCHD cases without prenatal diagnosis, 71.02% (544/766) were undiagnosed and the most common delayed diagnosis was SV (82.78%), interrupted aortic arch (81.82%), transposition of the great arteries with intact ventricular septum (79.63%), PA/VSD (79.07%), and critical COA (78.57%). Newborns with DDC were more likely to develop symptoms within the first few days after birth, in comparison with non-DDC cases. However, their detection rates were close to each other. Conclusion The rate of misdiagnosis of CCHD before discharge from maternity hospitals is high in China, indicates the importance of implementation of CCHD screening in Chinese maternity hospitals, so as to give timely diagnosis and proper treatment.