AIM: To investigate the role of NF-κB in diabetic neuropathy.METHODS: The diabetic rats were induced by intraperitoneal injection of streptozocin ( STZ) .The pain behavior test was used to detect the mechanical and thermal withdraw threshold of the rats’ bilateral hind paws.The protein levels of p-NF-κB and t-NF-κB in the rats’ L4 and L5 dorsal root ganglions ( DRG) were determined by Western blotting.The expression of Nav1.7 in DRG of diabetic neuropathy rats with or without NF-κB inhibitor PDTC was detected by the method of immunohistochemistry.RESULTS:The mechanical and thermal withdraw threshold of bilateral hind paws in the diabetic rats was decreased from 4 weeks to 12 weeks after injection of STZ.The protein levels of p-NF-κB in L4 and L5 DRG were significantly increased in the rats with diabetic neuropathy.Intrathecal administration of NF-κB inhibitor PDTC attenuated the increase in p-NF-κB and Nav1.7 in L4 and L5 DRG.Pain behaviors were also alleviated by PDTC.CONCLUSION:The increase in p-NF-κB is closely rela-ted to the generation of diabetic neuropathy.Inhibition of NF-κB blocks pain behaviors and the over-expression of Nav1.7 in DRG.

Objective To study the prognostic predictive value of quantitative dectroencephalography (qEEG)for patients with large middle cerebral artery infarction (LMCAI).Methods The scores of routine electroencephalography (EEG),qEEG and the Glasgow Coma Scale (GCS) of the patients within 72 hours after symptom onset were recorded.The short-term prognosis (death or survival) was evaluated at 1 month after the onset.The long-term prognosis (good or poor) was evaluated at 3 months after the onset.All the observed data in each prognostic group were compared.Results A total of 105 patients were included in the study.There were significant differences in the margin of amplitude integrated electroencephalogram (aEEG) (upper margin:19.11 ± 7.80 μV vs.11.87 ±6.41 μV;t =2.392,P =0.019; lower margin:11.90 ± 4.78 μV vs.7.58 ± 4.15 μV; t =3.327,P =0.022),Synek-classification (x2 =48.114,P =0.000) between the short-term survival group and the death group; in patients with left LMCAI,there were significant differences in the absolute energy of the β-activity (13.16 ±12.66 μV2 vs.19.20 ±17.96 μV2;t =-2.781,P =0.039),spectral edge frequency 95％ (SEF95％) (9.17 ± 3.24 Hz vs.10.36 ± 3.76 Hz; t =-5.614,P =0.002) between the short-term survival group and the death group.There were significant differences in the age (59.33 ±13.67 years vs.68.87± 10.473 years; t =-3.215,P =0.002),GCS scores (10.86±2.80 vs.9.21 ±2.51;t =2.511,P =0.015),SEF95％ (13.80 ±5.40 Hz vs.10.93 ±4.68 Hz; t ＝2.311,P =0.024) and sides of infarction (x2 =4.737,P =0.030) between the long-term good prognosis group and the poor prognosis group.Conclusion qEEG can be used as an effective means of monitoring for evaluating the prognosis of patients with LMCAI.

Objective To explore the predictive value of early electroenphalography (EEG) for a malignant course in patients with large middle cerebral artery infarction (LMCAI).Methods Thirty-seven patients (20 patients with a malignant and 17 with a benign course) with stroke of >50% of the middle cerebral artery territory in early CT/MRI scan were included;Glasgow-Pittsberg Coma Scale (24 ±1 vs. 30 ±4, P =0. 003) and National Institutes of Health Stroke Scale (23 ±3 vs. 16 ±4, P =0.000) in the group with a malign course were higher than those in the group with a benign course. Early EEG was recorded within 24 h after ischemic stroke. The correlation between the change characteristics of EEG and a malignant course in patients with LMCAI was analyzed. Results The contralateral occipital background frequencies < 8 Hz (17/20 vs. 3/20, P =0.000), β frequency within the focus ≤20 Hz (19/26 vs. 7/26, P= 0-001), EEG non-reaction to stimuli (11/12 vs. 1/12, P= 0.002),slowing affecting the whole hemisphere in the lesion (17/24 vs. 7/24, P = 0. 008) and focal slowing contralateral to the lesion (16/19 vs. 3/19, P =0. 000) were significantly related with a malignant course. Whereas the contralateral occipital background frequencies ≥8 Hz (14/17 vs. 3/17, P =0. 000),β frequency >20 Hz within the focus (10/11 vs. 1/11, P =0. 001) were related with a benign course. Conclusions Early EEG has a certain predictive value for a malignant course in patients with LMCAI, and it may be used as one of the bedside monitoring approaches of LMCAI.

Objective:To explore the feasibilitv of stereotactic minimally invasive aspiration of small thalamic bemorrhage.Methods:Twenty-two patients with small thalamic hemowhage(5 to 10 mL)were divided into two groups:a stereotactic group(n=10)and a control group(n= 12).The patients in the stereotactic group received stereomctic minimally invasive puncture and drainage of hematomas.According to the condition,repeated infusion of urokinase(10-20 kU) into the hematoma cavities were administered 12 hours after the procedure,and the hematomas were irrigated and drained so as to removal of them completely after retaining for 2-4 hours, The appropriate symptomatic treatment was administered in the patients in both groups.National Institutes of Health Stroke Scale(NIHSS)scores were determined 14 and 30 days before and after the treatment in all the patients.The reductiom of the NIJSS scores (as compared with those before treatment)were calculated at day 14 and 30 respectively after the treatment. Results:The reductiom of the NIHSS scores in the stereotactic group at day 14 and 30 were significantly higher than those in the control group.It was suggested that the neurological functional recovery of the patients was faster after stereotmtic minimally invasive puncture and drainage of intracranial hematorna in the stereotactic group.Concision:The stereotactic minimally invasive puncture and drainage of intracranial hematoma may significantly improve the outcome in patients with small thalamic hemorrhage.

Objective To Explored the relative factors which caused the extubation failure in neurological intensive care unit (NICU).Methods It was a retrospective study.40 cases of patients who met the criteria,were brought into statistical analysis.They were admitted in NICU in Nan Fang Hospital from December 2008 to February 2011.The name,sex,age,diagnosis,respiratory parameters,24 hours discrepancy quantity,sputum,and Glasgow Coma Scale,Full Outline of UnResponsiveness Scale were recorded.SPSS 13.0 was used as statistic software.P ＜ 0.05 was considered statistically significant.Results Both in extubation successful and failure groups,GCS and Four were significantly different (all P ＜ 0.05).Howerer,there were no statistically significant in the other factors.There were significantly differences between GCS and Four in predicting extubation results (P =0.012).Logistic multiple regression showed that Four and GCS grade were predictive factor of extubation failure (P =0.041).Conclusions The result suggests that it is statistically significant to use GCS and Four as factors to predict extubation results.It can be widely used to help medical personnels monitoring the changes of patients'clinical conditions,judging prognosis,and making treatment plan in NICU.Wether other factors would effect the extubation results,more prospective,randomized controlled studies were needed.

Objective To investigate the current status,diagnostic difficulties,and the necessity of formulating a consensus on several issues of cerebrovascular ultrasound examination in China.Methods A network questionnaire survey was conducted to investigate several problems of cerebrovascular ultrasound and the needs of expert consensus among practitioners of transcranial Doppler(TCD)ultrasound and transcranial color coded Doppler(TCCD)ultrasound in medical institutions.The questionnaire covered the basic information of the respondent group,including the region where the medical institution was located(Q1),the level of the medical institution(Q2),the scope of practice of TCD or TCCD practitioners(Q3),title(Q4);the assessment mode of cerebrovascular and cervical vascular(Q5);the general demand for expert consensus(Q6)and TCD diagnosis-related issues(Q7-Q17).There were three dimensions of TCD diagnosis-related issues(diagnostic criteria,multi-dimensional comprehensive assessment,and dynamic monitoring during the perioperative period of angioplasty),with a total of 11 items(Q7-Q17:intracranial artery stenosis or occlusion,vascular development anomalies,side branch circulation judgment,ultrasound dynamic monitoring after angioplasty,cerebral vasospasm,contrast-enhanced TCD examination,etc.).At the same time,open-ended questions were also set up:the most important content to be improved in cerebrovascular ultrasound(Q18).The reliability analysis of the questionnaire was used to assess the reliability,with Cronbach's α coefficient ≥0.7 considered as good reliability.The validity evaluation was conducted by factor analysis.The comparison of the demand for each item under different conditions was conducted by x2 test,and the Kruskal-Wallis H test was used to compare ranked data among different groups.Results A total of 1 395 complete and valid questionnaires were collected,involving TCD or TCCD practitioners from 31 provinces,autonomous regions,and municipalities(there was no response from the Xizang Autonomous Region),which had a certain representativeness.Survey reliability evaluation:Cronbach's α coefficient=0.917(F=132.702,P＜0.01).Factor analysis,KOM=0.930(x2=8 478.844,P＜0.01),the cumulative contribution rate was 70.600％when taking into account three factors.Among the respondents,the proportion of those from tertiary-level grade A hospitals was the highest(64.2％[896/1 395]);the distribution of titles was dominated by those of attending physicians(48.5％[676/1 395]),followed by senior titles(37.2％[519/1 395]);among the respondents,66.6％(929/1 395)said they urgently needed expert consensus,while 32.7％(456/1 395)said they needed to improve existing standards.There were significant differences in the needs for expert consensus and each item across different regions,professional titles and evaluation models(all P＜0.05).Conclusions The questionnaire have high reliability and validity.There is an urgent need for expert consensus on several issues related to cerebrovascular ultrasound among the respondents.The establishment of expert consensus would contribute to standardized and precise evaluation system,thereby promoting quality control management and standardization of cerebrovascular ultrasound practices.

AIM: To probe into the anti-epilepsy action of artificial Calculus Bovis,by observing its effect on the behavioral of the experimental epileptic rats,neuron loss in the hippocampus and hilus,and GAD positive cell alteration in the hippocampus.METHODS: SD rats were divided into three groups: group A(artificial Calculus Bovis treatment group);group B(acute epilepsy group) and group C(control group).A model of acute epilepsy rats was established by PTZ.The rat's behavioral alteration was observed by the Racine' scale.The neurons in the hippocampus and hilus were calculated by Nissl staining.The GAD positive cells were observed by immunohistochemical staining.RESULTS: The latency of the first seizure in group A was longer than that in group B,while the seizure times in group A was less than that in group B.Besides,in group A,both the neuron loss amount in the hippocampus and hilus and the GAD positive cell loss amount in the hippocampus were less than those in group B.CONCLUSION: The artificial Calculus Bovis prolonged the latency of the first seizure time,decreased the frequency of seizure,and prevented the neuron loss and protected the GAD positive cells.

Cerebrovascular ultrasound includes transcranial color coded Doppler(TCCD)and transcranial Doppler(TCD).The clinical application of TCCD and TCD has gone through a clinical application process over 30,40 years,respectively.Cerebrovascular ultrasound is increasingly receiving clinical attention for early screening,diagnosis,treatment,and follow-up of intracranial and extracranial artery(especially intracranial artery)lesions,especially for the evaluation of neurological function,ischemic stroke,subarachnoid hemorrhage,right-to-left shunting,cerebral blood flow autoregulation,sickle cell anemia,and other diseases.This review focused on reviewing the progress of clinical applications of cerebrovascular ultrasound both domestically and internationally.

Objective To investigate the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in Chinese patients with ischemic stroke . Methods In this multi‐center study ,2 310 continuously inpatients with ischemic stroke diagnosed in 20 stroke screening and prevention project base hospitals from June 2015 to M ay 2016 were enrolled . Carotid ultrasonography and transcranial color‐coded sonography or transcranial Doppler were performed in all patients to confirm the presence of cerebral artery stenosis or occlusion . According to the distribution of lesions ,the subjects were divided into 2 groups :the simple intracranial artery stenosis group and the simple extracranial artery stenosis group . T he difference of risk factors between the two groups was compared . Results Of the 2 310 patients with ischemic stroke ,1 516 ( 65 .6% ) had simple intracranial artery stenosis and 794 ( 34 .4% ) had simple extracranial artery stenosis . T he incidence of anterior circulation artery stenosis was higher in the group of intracranial artery stenosis than that in the extracranial artery stenosis group ( 68 .1% vs 48 .7% , P ＜0 .001) . Posterior circulation artery stenosis and combined anterior with posterior circulation artery stenosis were more common in patients with extracranial artery stenosis group than those in intracranial artery stenosis group ( 36 .4% vs 22 .1% ,14 .9% vs 9 .8% ;all P ＜0 .001) . Univariate analysis of risk factors for stroke showed that patients with intracranial arterial stenosis had a higher prevelence of hypertension , diabetes ,obesity ,and family history of stroke ,and their systolic blood pressure ,diastolic blood pressure , body mass index ( BM I) ,fasting blood‐glucose ,glycosylated hemoglobin ,triacylglycerol ,total cholesterol , and low‐density lipoprotein cholesterol were significantly higher than those in the extracranial arterial stenosis group ( all P ＜ 0 .05 ) . T he proportion of elderly ( ≥ 65 years old ) ,male and smokers in the extracranial arterial stenosis group was significantly higher than that in the intracranial arterial stenosis group ( all P ＜0 .05) . Multivariate logistic regression analysis showed that elderly ( ≥65 years old) ,male , and smoking history were independent risk factors for extracranial arterial stenosis ( OR＝ 2 .012 ,1 .637 , 1 .325 ,respectively ;all P ＜0 .05) . While hypertension ,diabetes ,less physical activity ,and high BM I levels were independent risk factors for simple intracranial arterial disease ( OR ＝ 1 .301 ,1 .252 ,1 .248 ,1 .030 , respectively ;all P ＜0 .05) . Conclusions There are significant differences in the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in patients with ischemic stroke in China .

Objective To analyze the correlation between smoking and occurrence of intracranial artery stenosis.Methods From June 2015 to May 2016,a total of 10 711 inpatients with transient ischemic attack (TIA) or ischemic stroke from 20 basel hospitals of nationwide were enrolled using a cross-sectional study,76 patients with unknown smoking and smoking cessation years were excluded.Finally,a total of 10 635 patients were enrolled.Transcranial color coded sonography and/or transcranial Doppler were used evaluate the intracranial artery stenosis lesions.The basic risk factors for cerebrovascular disease (age,sex,smoking and smoking years,whether smoking cessation and years,hypertension,diabetes,hyperlipidemia,atrial fibrillation,and family history of stroke) were recorded.According to the different smoking years,the smoking years were divided into five groups:non-smoking,smoking time ≤10-year,11 to 20-year,21 to 30-year,and >30-year groups for trend chi square test.According to the different smoking cessation years in the smokers,the smoking cessation years were divided into four groups:non-cessation,cessation time 1 to 10-year,11 to 20-year,and >20-year groups for trend chi square test.The effects of different smoking years and different smoking cessation years on the occurrence of intracranial arterial stenosis were analyzed.Results The incidence of intracranial artery stenosis in the smokers (40.4%[1 433/3 547]) was significantly higher than that in the non-smoking patients (29.4%[2 085/7 088]).There was significant difference (χ2=128.850,P<0.01),and the incidence of cerebral infarction in the smokers (91.6%[3 250/3 547]) was significantly higher than the non-smokers (85.0%[6 027/7 088]).There was significant difference (χ2=92.328,P<0.01).Smoking was an independent risk factor for intracranial artery stenosis (OR,1.603;95%CI 1.456-1.765;P<0.01).With the increase of smoking years,the detection rate of intracranial arterial stenosis increased gradually (trend χ2=115.437,P<0.01).Whether giving up smoking had no significant effect on the incidence of intracranial artery stenosis in patients with ≥20 years of smoking (trend χ2=1.043,P=0.307).Conclusions Smoking is an independent risk factor for affecting intracranial artery stenosis;the risk of disease increases with the number of smoking years.Long-term smokers (≥20 years) cannot reduce the effect on intracranial artery stenosis,even if they give up smoking.