Chronic cerebral hypoperfusion is a common pathological state. Cognitive impairment is its main manifestation in early stage, and it will eventually result in persistent or progressive cognitive impairment and neurological deficits. Chronic cerebral hypoperfusion caused neuronal damage, synapse abnormity, energy impairment and the function defects of central cholinergic system and monoaminergic system are its pathophysiological mechanisms resulting in cognitive impairment.

Objective To explore the effect of red lip defect repair using orbicularis oris muscles pedicle island flap disc.Methods 100 cases of unilateral pure red lip defect 1/3-2/3,lip lines full of patients were selected as the research subjects.They were randomly divided into two groups,50 cases in each group.Group A treated with debridement surgery to repair.Group B received red lip flap to promote repair treatment.The treatment effect of the two groups, satisfaction, lip survival rate and the degree of obvious scars were compared.Results he operation effect of the two groups was good.The satisfaction rates of group A and group B were 94.00% and 96.00%,respectively.For the lip shape treatment satisfaction, the difference was no statistically significant (P>0.05).The patients of the two groups with lip all alive, and 1 patient in group A with obvious scar, the scar was not obvious in group B.Conclusion For patients with red lip defect, take orbicularis oris muscles pedicle island flap of the oral mucosa or red lip flap to promote repair treatment has relatively significant clinical efficacy, with easy operation, less influence on the patients with facial form, it is worthy of popularizing.

Objective By using a newly developed animal model of limited macular translocation (LMT) in rabbit eyes, to explore the complications,indications and predictability of LMT. Methods LMT models were performed in 15 rabbit eyes, and were divided into 4.5 mm group and 3.5 mm group by the length of scleral shortening.The effect of retinal translocation (distance and direction) and its complications were analyzed. In a separated group, postoperative corneal astigmatism was studied after release of scleral shortening suture 1 month after LMT. In order to study the impact of neuroretina retinal pigment epithelium (RPE) adhesion on LMT, retinas and choroids in 4 pigmented rabbit eyes were pretreated with photocoagulation. Results Success rate of LMT was 86 7%. In these cases, retinal translocations were achieved [(distance of 610 to 2 690 ?m, [AKx-]?s =(1 395?636) ?m; translocation angle ? of 10 38?, ?s =(22.7?8.3) ?]. The difference in scleral shortening between 4.5 mm and 3.5 mm groups did not significantly influence the final translocation. Major complications of LMT included intraocular bleeding, retinal break, and corneal astigmatism. Release of scleral shortening suture reduced corneal astigmatism and made it more regular, meanwhile, retinal translocation did not regress. The neuroretina RPE adhesion induced by retinal photocoagulation made neuroretinal hydrodissection difficult, and led to retinal break readily. . The difference in scleral shortening between 4.5 mm and 3.5 mm groups did not significantly influence the final translocation. Major complications of LMT included intraocular bleeding, retinal break, and corneal astigmatism. Release of scleral shortening suture reduced corneal astigmatism and made it more regular, meanwhile, retinal translocation did not regress. The neuroretina RPE adhesion induced by retinal photocoagulation made neuroretinal hydrodissection difficult, and led to retinal break readily. Conclusion Sufficient LMT models in rabbit eye were obtained with few postoperative complications. Direction of retinal translocation is an important factor influencing the effect of LMT, except for distance. Release of scleral shortening suture can effectively reduce corneal astigmatism without causing regression of retinal translocation. For the patients with a history of macular or para macular photocoagulation, LMT should be performed carefully.

BACKGROUND: Precise clinical treatment of talar ischemic necrosis remains controversial at present.OBJECTIVE: To observe the changes in the stress and its distribution on talar trochlear articular surface in case of talar necrosis at different levels.METHODS: The present study adopted eight ankle specimens to establish the three-dimensional finite element model of ankle. Through changes in the talar necrosis volume of these models, this study analyzed the change law of talar trochlear articular surface stress and its distribution and calculated the critical necrosis volume of traumatic foot and ankle arthritis or talar collapse that may be induced by talar ischemic necrosis.RESULTS AND CONCLUSION: The experiment successfully established the three-dimensional finite element model of ankle. This study found that talar trochlear articular surface stress distribution showed little change in case of talar medial and lateral necrosis at a lower level; when medial talar necrosis volume reached (26.6±1.5)%, and lateral talar necrosis volume reached (35.0±2.5)%. Stress concentration phenomenon occurred in the boundary area between talar necrosis tissue and normal osseous tissue, and the stress area took the shape of irregular pattern. It is suggested that surgical treatment should be considered due to the high-risk induction of ankle-foot traumatic arthritis or talar collapse.

Objective To compare the efficacy and safety of thrombolysis and anticoagulant therapy for post-traumatic acute submassive pulmonary embolism (PE) in middle-aged and elderly patients.Methods Totally 45 patients with post-traumatic acute submassive pulmonary embolism in our hospital were selected.Patients were divided into thrombolysis group (n =22) and anticoagulation group (n=23) according to their conditions.Symptoms and signs,blood gas analysis,D-dimer,echocardiography,CT pulmonary angiography (CTPA) were performed before and after thrombolysis or anticoagulant therapy.Results There were no significant differences in clinical curative rate between thrombolysis group and anticoagulation group [95.5％ (21/22) vs.91.3％ (21/23),x2 =0.32,P＞0.05],and no case was found dead in both two groups.There was a significant difference in hemorrhage rate between thrombolysis group and anticoagulation group [27.3％ vs.4.3％,x2 =4.53,P ＜ 0.05].At 24 hours after thrombolysis or anticoagulant therapy,the improvement rate of dyspnea,PaO2 level was significantly higher and the pulmonary arterial pressure was significantly lower in thrombolysis group than in anticoagulation group [45.5％ (10/22) vs.17.4％ (4/23),(80.4±8.1) mm Hg vs.(73.6±9.3) mm Hg,(51.2±6.2) mm Hgvs.(60.3±5.7) mm Hg,respectively,all P＜0.05],and there were no statistical significances at other time points between the two groups.Conclusions The clinical curative rate and fatality rate are similar in thrombolysis group versus anticoagulation group.Hemorrhage rate is higher in thrombolysis group than in anticoagulation group.Thrombolysis can relieve dyspnea rapidly,reduce pulmonary artery pressure and make the embolized blood vessels recanalized.Patients with low bleeding risk in a critical condition are suggested to take thrombolysis therapy,while patients with high bleeding risk in a light condition are suggested to take anticoagulant therapy.

Diffusion tensor imaging(DTI) is an efficient and noninvasive tool to investigate the characteristics and functions of white matter fiber tracts,and it can be used to study the relationship between the structure and function in the nervous system,the plasticity and damage repair of visual development,abnormalities of the white matters that relate to the visual pathways.Recently,the quantification of white matter fiber tracts from the lateral geniculate bodies to the occipital lobe visual cortex using DTI offers morphological information for the function and structure of the white matters during visual development.Some studies attempt to compare the DTI outcomes and tractography between amblyopic children and normal children so as to better display the variations of optic radiation in children with amblyopia,and to evaluate the relationship between structure and function of the white matters.DTI becomes an important supplementary research approach in these fields.This paper reviews the application of DTI in visual development and amblyopic eyes.

Objective:To examine the effect of compound ketotifen eye drops(CKF,containing 0.1% ketotifen and 0.000 5% dexamethasone) on experimental acute allergic conjunctivitis in rats.Methods:27 male Wistar rats were immunized by intraperitoneal injection of egg albumin and were randomized into three groups: CKF,0.1% ketotifen (KF) and 0.000 5% dexamethasone (DM) Rats in each group received the respective eye drops in one eye and vehicle in the other eye 60,45,30,15 min before and 15,30 min after challenge.Immediately before challenge,the rats were injected intravenously with Evans Blue(EB).The challenge was performed by topical instillation of egg albumin,and 60 min later,the animals were killed and the dye was extracted from the eyes.The intensity of EB extravasation was determined by spectrophotometry at 620nm and inhibitory rates were calculated.Results:CKF,KF and DM suppressed EB extravasation significantly.The inhibitory rate was 53.98%±15.57% for CKF,27.91%±28.36% for KF and 11.90%±34.16% for DM.CKF was more effective than both KF and DM on inhibiting dye vascular leakage in the eyes (P＝0.028,0.004,respectively).Conclusion:These data clearly indicate that the compound of ketotifen eye drops has potential as a topical ocular formulation for anti-allergic disease.

Objective　To develop a rapid，sensitive and reliable high-performance gas chromatography to evaluate the fluconazole (FCZ) bioavailability after topically applied FCZ in-situ gelling ophthalmic delivery system to the rabbit eyes.Methods　A megabore capillary column（30m long and inner diameter of 0.530 mm） with a 0.88-μm-thick bonded liquid phase was used.Detector was nitrogen-selective type.Tears adsorbed to the filter paper was directly by methanol with no evaporation stage prior to analysis.Aqueous humors was extracted by ethyl acetate.Results　The duration of each analysis was less 10 min and the minimum detectable concentration was 0.01μg/ml.The assay was linear from 0.1 to 20 μg/ml.The average recoveries from tears and aqueous humors were 99.0% and 94.8%，respectively.Conclusion　This method can be used to determine rabbit tears and aqueous humors levels of fluconazole and was practicable approach for evaluating intraocular pharmacokinetics after topically applied to rabbit eyes.

OBJECTIVE To investigate the protective effect of velvet antler polypeptides(VAP)on hydrogen peroxide( H2 O2 )-induced injury in vascular endothelial cells and the possible mechanism.METHODS The EVC-304 cells cultured invitrowere incubated with H2 O2 for another 12 h after pretreat-ment with VAP 20,40 and 80 mg·L-1 for 24 h. Cell viability was determined by MTT assay, Hoechst333258 staining was used to observe cell morphology,the activity of superoxide dismutase (SOD)and the level of malondialdehyde( MDA)were detected with kits and the expression of heat shock protein(HSP70)and caspase 3 was detected by Western blotting. RESULTS Compared with the normal control group,the cell survival rate was decreased significantly in H2 O2 injury group( P ﹤0.01),cell shrinkage,chromatin condensation,and nuclear fragmentation were seen,the intracellular SOD activity decreased while MDA content increased(P﹤0.01),and caspase 3 and HSP70 expression increased(P﹤0.01). Compared with H2 O2 group,the cell survival rate in VAP 20,40 and 80 mg·L-1 pre-treatment groups increased significantly(P﹤0.01),the apoptosis ratio declined from(25.3±1.0)% to (15.2±1.2)%,(10.3±0.9)% and(7.9±1.4)%(P﹤0.01),the SOD activity increased to 19.2±0.5,22.3± 1.7 and(24.9±0.6)kU·g-1 protein(P﹤0.01),MDA concentration decreased to 1.51±0.2,1.48±0.3 and (1.02±0.1)μmol·g-1 protein(P﹤0.01),and the expression of caspase 3 and HSP70 declined significant-ly(P﹤0.01). CONCLUSION VAP has exert protective effect on H2 O2-induced injury in vascular endothe-lial cells. The possible mechanism might be related to improvement of intracellular oxidative stress level.

BACKGROUND:Bone marrow mesenchymal stem cel s have a low survival rate after implanted into the ischemic myocardium. However, hypoxia preconditioning (HPC) may enhance bone marrow mesenchymal stem cel proliferation and promote its survival rate. OBJECTIVE:To explore whether Pim-1 is involved in HPC protecting against apoptosis of bone marrow mesenchymal stem cel s and the relevant mechanism. METHODS:Bone marrow mesenchymal stem cel s were respectively subjected to HPC for 0, 6, 12, and 24 hours. The expression of Pim-1 and apoptosis-related genes were detected by RT-qPCR and western blot. Then, the best hypoxic preconditioning time was determined as 12 hours. Then, bone marrow mesenchymal stem cel s were assigned to one of the fol owing groups:control (without HPC), 12-hour HPC, 12-hour HPC+Pim-1 inhibitor groups. Flow cytometry analysis was used to detect the cel apoptosis, Transwel assay to analyze the cel migration ability in each group, and JC-1 kit to detect mitochondrial membrane potential. Animal models of myocardial infarction were established. One week after modeling, bone marrow mesenchymal stem cel s were given via multi-point injection around the infarct zone of rats. Two weeks after modeling, heart tissues of rats were taken and sliced fol owed by DiI staining to calculate the survival rate of bone marrow mesenchymal stem cel s. Additional y, rat cardiac function was assessed by echocardiography prior to and after modeling as wel as at 4 weeks after cel transplantation. RESULTS AND CONCLUSION:At 12 hours after HPC, the expression of Pim-1, p-Akt and Bcl-2 gene in the infarct region was significantly increased, but the expression of caspase-3 and Bax was significantly decreased. Compared with the control group, cel viability in the 12-hour HPC group was increased very significantly at 1 week after cel transplantation (P<0.001), the migration and anti-apoptosis ability were enhanced significantly (P<0.01) and the cardiac function of rats was significantly improved in the 12-hour HPC group (P<0.05). Al of these protective effects were blocked by the Pim-1 inhibitor. These findings indicate that HPC can protect bone marrow mesenchymal stem cel s from apoptosis through activating Akt and up-regulating Pim-1, and thereby improve the therapeutic effect of bone marrow mesenchymal stem cel transplantation on ischemic heart diseases.