In the teaching course of the clinic neurology,how to explore and foster the capability of the students and how to take the co-acting teaching in neurological clinica1 education is a key point for our probing.

Objective　The poststroke depression(PSD) is a common complication in the cerebrovascular diseases.Methods　Having used the monoamine oxidase inhibitor,procaine hydrochloride composite film-coating tablets,we observed the Hamilton rating scale for depression(HAMD) and selfrating depression(SDS) of the patients with poststroke depression.Results　Two weeks late after the procaine hydrochloride composite film-coating tablets administrated,the scales of HAMD and SDS have been improved obviously.Conclusion　This investigation has suggested that the monoamine oxidase inhibitor can improve the depression of the patients with poststroke and be beneficial to the brain stroke.

The aim of our study wasto investigated the changesof NO concentration in the ischemic and reperfutional brain tissues and the relationship between the NO and brain damage.The animal models of middle cerebral artery occlusion were established by suture method.The changesof NO concentration were researched with method of Hb O2 -NO during the permanent ischemia and ischemia/ reperfusion.The results showed that the NO level in the injured brain tissue after3hours of ischemia was increased.After reperfusion,the NO level increased progressively,but NO level showed decreased and then increased during the permanent ischemia.Although there wasa decrease of NO level at7days after ischemia and reperfusion,but the NO level was higher than that of preischemia.It indicated that the changes of NO concentration during the different process of cerebral ischemia and reperfu- sion are related to the differentisoform of NOS,which have respective characteristic forsyn- thesizing NO in biochemistry,and deal with the cerebral ischemic and reperfusional injury.

EZH2 is the catalytic subunit of polycomb repressive complex 2 (PRC2),which represses gene expression by catalyzing lysine 27 of histone H3.It is overexpressed in prostate cancer,breast cancer,bladder cancer,gastric cancer and several other cancers.There is a close correlation between overexpression of EZH2 and progression of malignancy,invasion and migration of cancer cells.With a thorough understanding of the function,up and down stream regulatory mechanism and clinicopathological features,EZH2 will be expected to as a target and provide a new way for the treatment of cancers.

Background Oxidative damage is a major cause of age-related cataracts,and the ubiquitinproteasome system is involved in lens differentiation and development.Ubiquitin carboxy-terminal hydrolase L1 (UCHL1),one of key enzymes of ubiquitin-proteasome system,was discovered to participate in the age related diseases and oxidative stress damage. Objective This study was to investigate the effects of UCHL1 on the formation and development of age-related cataract. Methods Lens capsule were collected from 24 patients with age-related cataract(including 12 cases of cortical cataract and 12 cases of nuclear cataract) during the surgery.Five normal lens capsule membranes were obtained from eye bank of Tongji University.Human lens epithelial cells (LECs) line (SRA01/04) was also collected in this study.Expression of UCHL1 in the lens epithelial layer of different samples was assayed using immunofluorescence technology.UCHL1 eukaryotic expressing vector was constructed and transfected into cultured SRA01/04 by liposome,and green fluorescent protein (GFP) eukaryotic expressing vector was transfected at the same method as the control group.UCHL1 over-expressing cells were then exposed to different concentrations (0.2,0.3,0.4 and 0.5 mol/L) of tert-butyl hydroperoxide (TBHP) for 24 hours and subsequently monitored for cell viability evaluation by MTT assay. Results Immunofluorescence showed that UCHL1 was expressed in human lens epithelial layer,but significantly different expressing levels were seen among normal lens capsular membrane,cortical cataract and nuclear cataract ( F =13.411,P =0.000),and UCHL1 expressing levels were lower in cortical cataract and nuclear cataract than the normal lens (P =0.000,P =0.000).No significant difference was found in UCHL1 expressing level between cortical cataract and nuclear cataract ( P =0.164).Western blot analysis verified that UCHL1 exhibited a stranger expression in the UCHL1 transfected group compared with the GFP transfected group,illuminating a successful transfection of UCHL1 in SRA01/04 cells.MMT assay revealed that the A570/630 value in UCHL1 transfected cells was significantly elevated in comparison with GFP transfected cells following the treatment of 0.3 mol/L TBHP. Conclusions UCHL1 has an antioxidative ability,and it might plays an important role in the progress of age-related cataract.

Objective To assess the alterations of the systolic peak radial strain (RS) and the time to systolic peak radial strain(TRS) in ischemic myocardial segments with different extent of coronary artery stenosis using three-dimensional ultrasound speckle tracking imaging(3D-STI).Methods RS and TRS of 16 left ventricular segments were analyzed by 3D-STI in 87 patients,every left ventricular segment of all patients were divided into 5 groups according to coronary stenosis based on the results of selected coronary angiography:normal,≤25 ％,＞25 ％ - ≤50 ％,＞50 ％ - ≤ 75 ％,＞ 75 ％.All times were corrected by heart rate.Results In the coronary normal group,coronary stenosis extent ≤25％ group and coronary stenosis extent ＞25％ - ≤50％ group,the variance of RS was non-significant( P ＞0.05).Compared with the coronary normal group,coronary stenosis extent ≤25％ group and coronary stenosis extent ＞ 25％ -≤ 50％ group,RS was decreased in groups of coronary stenosis ＞50％ - ≤75％ and ＞75％.Between the coronary normal group and coronary stenosis extent ≤25 ％ group,the variance of TRS was non-significant( P ＞0.05).Compared with coronary normal and coronary stenosis extent ≤25 ％ group,TRS was increased in groups of coronary stenosis ＞25％ - ≤50％,＞50％ - ≤75％,＞75％.Compared with group of coronary stenosis ＞ 50％ -≤ 75％,TRS was shorter in group of coronary stenosis ＞ 75％,some variance was significant( P ＜0.05).Conclusions The RS was decreased along with the coronary stenosis increase,but TRS was increased along with the coronary stenosis increase.There is a tendency that TRS was decreased when the coronary stenosis is more than 75 ％ compared with the coronary stenosis ＞50％ - ≤75 ％ group.3D-STI can access the regional radial systolic function of the ischemic myocardial segment.

Objective Analyse the influencing factors of early enteral nutrition support in patients of severe acute pancreatitis( SAP). Methods From April 2006 to August 2008, a total of 57 patients with SAP were analyzed in two aspects:the APACHE II scores, Ranson scores, Balthazar CT scores, and some frequent complications (shock, MODS, ACS, severe sepsis, paralytic ileus, etc.) were compared in two groups of A(≤5 d) and B( >5 d) according to the initial time of enteral nutrition:Hie initial timing of entend nutrition,the above scores and complications were also compared in two groups of nasojejunal feedingtube and jejunostomy feeding tube. Results The APACHE H scores, Ranson scores, Balthazar CT scores and the incidence of shock, MODS and ACS in group A were significant higher than those in group B; The APACHE II scores, Ranson scores and Balthazar CT scores in group of nasojejunal feeding tube were significant lower than those in group of jejunostomy feeding tube, and the initial time of enteral nutritionin nasojejunal feeding tube was significantly earlier. Conclusions Early enteral nutrition support in SAP is influenced by multiple factors, especially of pathogenetic severity, severe complications and feeding pathways.Homeostasis and intestines functions recover are the sign of enteral nutrition initiation, and to carry out enteral nutrition in ≤5 d after admission is feasible.The APACHE II scores may be helpful to guide the time of EN start.

Objective To investigate the potential and early effect of hypertonic saline resuscitation on Tlymphocyte subpopulations in patients with traumatically hemorrhagic shock.Method Eighty-two patients with acute traumatically hemorrhagic shock admitted from Department of Emergency，Beijing Tongren Hospital，from De cember 2006 to July 2008 were randomly divided into：hypotonic saline(HS)group(n=43)and Lactated Ringer's solution(LR)group(n=39).The criteria of eligible patients were systolic blood pressure＜90mm Hg at admission with definite evidence of blood loss.Patients with immune system diseases and those who died within 24 hours of admission were excluded.Patients in HS group received intravenous administration of 200 mL of 7.5% sodium chloride withhin 15～20 minutes，and LR group received routine therapy with Lactated Ringer's solution.Blood pressure and heart rate were recorded 10，20，and 60 minutes after the start of resuscitation and compared between two groups.Before and 24 hours after treatment，peripheral blood levels of T-lymphocyte subpopulations including CD3+，CD4+，and CD8+ were measured by using direct immunofluorescence test and compared between two groups.The inter-group comparison was carried out by using independent sample t-lest and intragroup comparison using paired t-test.The numabers of operation，complication cases and death cases were conducted by using X2 test.SPAS version 11.0 software was used for statistical analysis.Results The volume of solution infused in HS group was(3820±623)mL and in LR group was(5430±1254)mL(P＜0.05).At 10 and 20 minutes after the sdministration of solution.the mean blood pressures in HS group were both significantly higher than those in LR group(P＜0.01).The levels of CD3+and CD4+lymphocytes in peripheral blood in HS group 24 hours after treatment were sinificantly higher than those in LR group(P＜0.01).Totally，63(76.8%)patients were cured and 19(23.2%)patients died.ARDS occurred in 10 patients and MODS occurred in 14 patiellts.The mortality，and the rates of ARDS and MODS in HS group were sinificantly higher than those in LP group(P＜0.05).Conclusiom In patients with acute traumatically hemorrhagic shock.HS can increase the effective circulating vol. ume，ameliorate the perfusion of tissues and organs，improve the immune fuction of T-lymphocytes，decrease the rats of ABDS and MODS，mad decrease the morality.HS is more effective than routine solution used for resuscitation.

AIM: To investigate the effect of aminoguanidine (AG) on plasma and renal levels of angiogenesis Ⅱ (AngⅡ), and to identify the relationship of AGEs with AngⅡ in STZ-induced diabetic rats. METHODS: Wistar rats were randomly assigned to three groups. Diabetes was induced, rats were then received AG in treatment group. At the end of 12th week, urine albumin excretion rate (UAER) and calculate creatinine clearance (Ccr) were detected. Periodic acid-Schiff reagent was used to evaluate renal pathology. Plasma and renal AngⅡ were analyzed by radioimmunoassay and immunohistochemistry, respectively. RESULTS: AG treatment significantly prevented the increase in UAER (P<0.01), renal pathology (P<0.01), and level of renal AngⅡ (P<0.01). However, plasma concentration of AngⅡ was higher than that in diabetic rats without AG treatment (P<0.01). CONCLUSION: AG down-regulates renal Ang Ⅱ level, probably by reducing the formation of AGEs, which may be one of the renoprotective factors in diabetic nephropathy. More proofs are needed to identify the result that plasma AngⅡ concentration increases in DMA group.

Objective To evaluate the effect of stent implantation using Multimodal CT in patients with MCA and ICA stenosis. Methods Twenty-six patients with ischemic cerebrovascular disease who received MCA or ICA stent implantation in ChongQing xinqiao Hospital were recruited. Multimodal Stroke Assessment Using CT Score (MOSAIC) was used to evaluate the Neuroimaging data before stent implantation and Alberta Stroke Program Early CT Score (ASPECTS) to evaluate the time to peak (TTP) of CTP before and after stent implantation. Results Patients were divided into 4 groups based on scores: 4 scores, 5 scores, 6 scores, and 7 scores groups. the improvement degree was increase by 31.7%±14.17%、38.6%±15.73%、43.3%±10.3%、358.6%±13.45% in 4 scores, 5 scores, 6 scores, and 7 scores groups, respectively. The paired t test demonstrated that there were a statistically significant difference among four groups(H=10.673, P <0.05). Preoperative MOSAIC score was positively correlated with the improvement of ASPECT score for TTP, with a correlation coefficient of 0.579 ( P <0.002). Conclusions Multimodal CT is a sensitive assessment for the evaluation of ischemic cerebrovascular disease and patients with a higher MOSAIC score may benefit more from stent implantation.