The relationship between carotid artery stenosis and cognitive function are receiving increasing attention.Most studies have shown that carotid artery stenosis has a direct impact on cognitive impairment.Carotid endarterectomy or stenting can improve the cognitive function to varying degrees in patients with carotid artery stenosis.The mechanism of cognitive impairment in patients with carotid artery disease may be associated with hypoperfusion,white matter lesions,multiple lacunar infarction and spontaneous emboli.

Elevated blood pressure in acute cerebral hemorrhage is very common and is associated with the poor clinical outcomes.Due to the acute elevated blood pressure has impact on hematoma volume,cerebral perfusion pressure and perihematomal edema,etc.,whether aggressively control blood pressure in acute phase still remains controversial.This article reviews the theoretical basis of acute blood pressure management,the relevant clinical trials,and the current problems in spontaneous intracerebral hemorrhage.

BACKGROUND:Radiotherapy alone is not suitable for tumor-caused vertebral fractures and neurological dysfunction. In recent years, 125I radiation particles have been widely used in a variety of primary or secondary tumors and achieved good results. Percutaneous kyphoplasty can restore vertebral height efficiently, remodel spinal stability, and relieve pain.
OBJECTIVE:To evaluate safety and effectiveness of percutaneous kyphoplasty combined with 125I in patients with metastatic spinal tumors.
METHODS:A retrospective study was conducted to review 30 cases of metastatic spinal tumors undergoing percutaneous kyphoplasty combined with 125I from March 2011 to July 2012. Symptoms, signs, and imaging findings were col ected and analyzed. Al the patients had a refractoriness back pain. CT scan showed osteolytic changes in the vertebrae. The visual analogue scales, WHO standards for pain relief and Owestry disability index were recorded to analyze the clinical symptoms outcome and recovery of neurological function, and the change of height in abnormal vertebrae was measured. The fol ow-up time was 1 day, 1 month and 6 months postoperatively. RESULTS AND CONCLUSION:Operations in al the 30 patients were done successful y. Al patients got a conspicuous pain relief in 24 hours after operation, and nospinal injury or compression was found. There were significant differences in scores of visual analogue scales, pain levels, Owestry disability index, and the height of vertebral bodies before and after operation (P<0.05). During postoperative fol ow-up of 1 and 6 months, scores of visual analogue scales, pain levels, Owestry disability index, and the height of vertebral bodies showed no difference from those at 24 hours postoperatively (P>0.05). Bone cement leakage occurred in the anterior longitudinal ligament (n=2) and intervertebral space (n=2), and no serious complications occurred. Percutaneous kyphoplasty combined with 125I is a safe and effective way to treat metastatic spinal tumors, which can quickly ease the pain caused by spinal tumor, recover the abnormal vertebral height, reduce complications and improve life quality of patients.

Objective To investigate the chemical constituents of Polygala tenuifolia. Methods Silica gel column and Sephadex LH-20 column chromatography were used to separate and purify the chemical constituents. The structures were elucidated by spectral data. Results Six compounds were isolated and identified as: 2-hydroxy-4, 6-dimethoxybenzophone (hydrocotoin, Ⅰ), 1, 7-dihydroxy-3-methoxyxanthone (Ⅱ), 1, 7-dihydroxy-2, 3-dimethoxyxanthone (Ⅲ), ?-spinasterol (Ⅳ), 1, 5-anhydro-D-sorbitol (polygitol Ⅴ) and benzoic acid (Ⅵ). Conclusion Compound Ⅳ is isolated from the plant and compound Ⅰ is isolated from the plants of Polygala L. both for the first time.

Objective To investigate the influence of c-myc on the growth, proliferation, apoptosis,invasion and cell cycle of the gastric line HFE145. Methods The cDNA of c-myc was subcloned into a constitutive vector pcDNA3.1 followed by transfection in HFE145 by using liposome. Then stable expression clones (HFE-myc) were selected. The apoptosis and cell cycles were detected using flow cytometry. The growth and proliferation were analyzed by making cell growth curves and colony formation assay respectively. The ability of invasion were tested using cell migration assay. Results HFE-myc group grew faster than HFE145and HFE-pc. The cell counts of HFE-myc in five of seven days were more than those of others significantly (P＜0.05). There was no difference between the two control group. Cell cycle analysis showed that HFE-myc group proliferated faster, mean proportion of cells in G2-M was about 25 % and higher significantly (P ＜0.05)than those of the two control groups. Results of colony formation assay showed that the mean colony formation rate of HFE-myc was 0.27 and higher than those of the control groups(P ＜0.05). The results of cell migration assay suggested that the cell migration rate of HFE-myc was not higher significantly than those of the control groups (P ＞0.05). Conclusion c-myc can promote the growth, proliferation. It can increase the proportion of cells in division stage, so promote the division. But it have little influence on the invasion of cells.

Objective To study the influence of early intensive blood pressure (BP) lowering treatment on peri-he?matomal secondary neuronal injury and prognosis after acute intracerebral hemorrhage. Methods A randomised con?trolled trial consisting of 36 consecutive patients within 6 h of intracerebral hemorrhage onset were randomly assigned to intensive BP lowering group and guideline BP lowering group. All patients underwent MR spectroscopy at 72 h and were followed up 90 days. N Acetyl Aspartate/Creatine (NAA/Cr) and lactic acid wave around peri-hematomal at 72 h, neuro?logic function at early stage, and death and/or disability at 90d were compared between these two group. Results Spec?trum lines were obtained from thirty-one patients:14 from intensive BP lowing group and 17 from guideline BP lowering group. There was no significant difference in the percentage declines of NAA/Cr at 72 h between the two groups (13.3%± 4.2% vs. 11.9%± 2.8%, P = 0.308). There was no statistical differences either in neurologic function at 7 d or in death and/or disability at 90 d (P>0.05). Conclusions Early intensive BP-lowering treatment had no role on peri-hematomal secondary neuronal injury and prognosis after acute intracerebral hemorrhage. Further high-quality and large-scale ran?domised controlled trial are necessary to verify this result.

Objective To investigate the risk factors of cerebral microbleeds (CMBs) in patients with acute isch?emic stroke of large-artery atherosclerosis. Methods One hundred twelve patients with acute ischemic stroke of large-ar?tery atherosclerosis admitted from July 2013 to January 2014 in Nanjing First Hospital affiliated to Nanjing Medical Uni?versity were enrolled. According to the results of MRI magnetic sensitive weighted imaging, the patients were divided into CMBs group or non-CMBs group. The history, general clinical data, serum biochemical results and MRI in both groups were enrolled. All the data were analyzed by the univariate and multivariate analysis. Results The results of univariate analysis showed that there were significant differences in age (61.620±11.479 vs. 70.620±11.185), serum uric acid (UA) level (278.920±69.512 vs. 353.460±111.206), serum creatinine (Cr) level (71.360±19.797 vs. 90.450±44.989), serum ho?mocysteine (Hcy) level (12.587±2.664 vs. 21.715±10.437) between the two groups (P<0.05). There were significant differ?ences in constituent ratio of Fazekas' s grade of periventricular hyperintensities and deep white matter hyperintensities between the two groups (P<0.05). The results of multivariate analysis showed that age (OR=0.963, 95%CI:0.905~1.025, P<0.05) and serum Hcy level (OR=1.487, 95%CI:1.219~1.813, P<0.05) were the independent risk factors for CMBs in patients with acute ischemic stroke of large-artery atherosclerosis. Conclusions Age and serum Hcy level are the inde?pendent risk factors for CMBs in patients with acute ischemic stroke of large-artery atherosclerosis.

Objectives To investigate the effects of different degrees of carotid artery stenosis on cognitive function and neuronal apoptosis of hippocampal CA1 region in rats and to analyze the possible mechanisms of cognitive impairment. Methods According to the random number table,50 male Wistar rats were allocated into a sham operation group,a unilateral mild stenosis group,a unilateral moderate stenosis group,a unilateral severe stenosis group,a bilateral mild stenosis group,a bilateral moderate stenosis group,
a bilateral severe stenosis group,and a sham operation group. Aneedle-controlled suture method was used to induce a carotid stenosis model with different degrees of stenosis in rats. Water maze was to localize navigation and spatial search test was used to evaluate the cognitive function with different degrees of carotid artery stenosis in rats. Immunohistochemical method was used to observe the numbers of positive cells of P75 neurotrophin receptor (p75NTR),Bax,Bcl-2,neurotrophic factor-3 (NT-3 ),nerve growth factor (NGF)in hippocampal CA1 region under the light microscope. The conditions of neuronal apoptosis were observed. Results In 50 rats,6 died,1 rat in poor health failed to complete the Morris water maze test. The degree of bilateral carotid artery stenosis in 1 rat failed to meet 30%-60% at the same time,they were all removed. The remaining 42 rats were 6 in each group. (1)Compared with the sham operation group,the mean escape latency was prolonged (39 ± 6 s,32 ± 5 s,69 ± 7 s,respectively vs. 23 ± 4 s;all P < 0. 01),and the percentage of swimming distance in the platform quadrant was decreased (35 ± 4%,44 ± 4%,22 ± 5%,respectively vs. 53 ± 7%;all P < 0. 01),and the cognitive function was decreased with the degree of stenosis in the unilateral severe stenosis group,bilateral moderate stenosis group,and bilateral severe stenosis group. Compared with the unilateral severe stenosis group,the mean escape latency was prolonged and the percentage of swimming distance in the platform quadrant was decreased in the bilateral severe stenosis group (P < 0. 01). (2)Compared with the numbers of positive cells of Bax,p75NTR and Bcl-2 (8. 8 ± 3. 1,4. 2 ± 2. 3,and 5. 8 ± 1. 8,respectively)in the sham operation group,the numbers of positive cells of Bax,p75NTR,and Bcl-2 were increased (25. 5 ± 3. 5,11. 0 ± 2. 2,12. 3 ± 2. 7;15. 8 ± 3. 7,8. 9 ± 2. 2, 10. 5 ± 2. 9;and 47. 9 ± 6. 3,24. 7 ± 3. 0,12. 8 ± 2. 5,respectively)in the unilateral severe stenosis group, bilateral moderate stenosis group,and bilateral severe stenosis group (all P < 0. 01). The numbers of Bax and p75NTR positive cells were increased with the degree of stenosis. When the stenosis was severe,the numbers of Bax and p75NTR positive cells were increased in the bilateral severe stenosis group compared with those of the unilateral severe stenosis group (P < 0. 01). The numbers of NGF and NT-3 positive cells in each stenosis group had an increased trend compared with sham operation group,but there were no significant differences (F =1. 034,and 1. 358;P = 0. 420 and 0. 259 respectively). Conclusions Carotid stenosis can cause cognitive disorder in rats,and it is correlated with the degree of carotid stenosis. Ischemia caused neuronal apoptosis in hippocampal CA1 region may be one of the mechanisms of cognitive impairment after carotid artery stenosis in rats.

A microfluidic chip with integrated microelectrode for real-time dopamine detection was designed and fabricated. The chip consisted of a polydimethylsiloxane ( PDMS) channel plate and a glass electrode plate. One central channel as the culture chamber of neural stem cells and two lateral channels for transport of the culture medium were integrated on the PDMS channel plate. Microelectrodes for real-time dopamine detection were integrated on the glass electrode plate. To solve the problem in demoulding the PDMS channel plate from the silicon mould, a novel demoulding method was developed. An Au-Au-Au three-electrode system was constructed, and it performed well in electrochemical detection. The performance of the microfluidic chip was primarily studied by detecting dopamine dissolved in the medium for the culture of neural stem cells. The limit of detection was 3. 92 μmol/L, the linear detection range was from 10 μmol/L to 500 μmol/L, and the detection reproducibility from different chips was less than 4%.

Objective: To study the effects of Ruanmailing Oral Liquid, a compound traditional Chinese herbal medicine, on spatial learning and memory ability and expression of apurinic/apyrimidinic endonuclease/redox factor-1 (APE/Ref-1) in hippocampal CA1 region in rats with experimental vascular dementia (VaD). Methods: VaD was induced in rats by permanent occlusion of bilateral common carotid arteries. Forty-five VaD rats were randomly divided into untreated group, nimodipine group, low-dose Ruanmailing group and high-dose Ruanmailing group. Another 15 rats underwent a sham operation consisting of similar skin incision and manipulation but without occlusion of carotid arteries. From the next day after occlusion, the rats were intragastrically administered with normal saline, nimodipine suspension or Ruanmailing Oral Liquid respectively for 30 days. Morris water maze experiment was adopted to test learning and memory of rats in each group. Expression of APE/Ref-1 protein in the hippocampal CA1 region was measured by immunohistochemical method. Results: Escape latency was significantly shortened and number of entries in the target area of rats was significantly increased in the high-dose Ruanmailing group as compared with those in the untreated group (P<0.01). Compared with the untreated group, count of APE/Ref-1 positive cells was significantly increased in the hippocampal CA1 region in the high- and low-dose Ruanmailing groups (P<0.01). Compared with the low-dose group and the nimodipine group, the count of APE/Ref-1 positive cells was remarkably increased in the hippocampal CA1 region in rats of the high-dose Ruanmailing group (P<0.01). There was no statistical difference between the low-dose Ruanmailing group and the nimodipine group. Conclusion: Ruanmailing Oral Liquid can improve the learning and memory ability and enhance the lowered expression level of APE/Ref-1 in the hippocampal CA1 region of rats with VaD.