BACKGROUND: There are obvious neuropsychological changes after stroke besides the damage of cognitive function, and the symptoms of depression and anxiety which are also very conspicuous.OBJECTIVE: To investigate the related characteristics of neuropsychological changes after stroke by means of neuropsychological methods.DESIGN: A case-control study.SETTING: Department of Psychology, the Third Hospital of Daqing; Department of Neurology, the Second Affiliated Hospital of Harbin Medical University.PARTICIPANTS: Sixty stroke inpatients (33 males and 27 female)aged from 42 to 75 years old with an average of (59.3±8.8) years old were selected from the Department of Neurology, the Second Affiliated Hospital of Harbin Medical University between October 2001 and June 2002. Totally 49 cases had cerebral infarction and 11 cases had cerebral hemorrhage; 31 cases had single focus and 29 cases had multiple focuses (including 2 focuses or more); 20 cases had lesion in left hemisphere,21 cases had lesion in right hemisphere and 19 cases had bilateral lesions. The lesion was at temporal lobe in 6 cases, at occipital lobe in 2 cases, at frontoparietal temporal lobe in 15 cases, at internal capsule in 4 cases, at basal nuclei in 19 cases, at lateral ventricle in 4 cases, at thalam us in 4 cases, at cerebellum in 1 case and at multiple sites in 5 cases. The focal size was ＜ 15 mm in 33 cases and ≥ 15 mm in 27 cases. Sixty residents (33 males and 27 females) aged 42to 75 years with an average of (58.7±7.9) years old were selected simultaneously from the communities and suburbs of Harbin city as the controls and they all had no cerebral and organic lesion, mental disorder, severe somatic diseases and family history of mental disease.INTERVENTIONS: The poststroke mental status of the patients at stable recovery period was assessed with symptom checklist-90 (SCL-90, consisted of 90 items and 9 symptoms, scored by 5 grades of 0 to 4, including 0 as never, 1 as mild, 2 as moderate, 3 as a little severe and 4 as severe;Hamilton depression scale (HAMD, consisted of 24 items, including 11 somatic symptoms scored by 0 to 2 grades and 13 mental symptoms scored by 0 to 4 grades; the total score ＞ 24 points was taken as severe depression, 17 to 24 as moderate depression, 7 to 16 as mild depression, ＜ 7 as no depression), self-rating depressive scale (SDS, consists of 20 items, evaluated according to the occurrence frequency of the symptom, and classified into 4 grades; the score was 1, 2, 3 and 4 points for the forward scored questions, but 4, 3, 2 and 1 point for the backward scored questions; the highest total score was 80 points; the depressive severity=accumulative scores of each item/80×100, the depressive index ranged 25 to 100, the index ＜ 0.5 was taken as no depression, 0.5 to 0.59 as mild depression,0.6 to 0.69 as moderate depression, ＞ 0.7 as severe depression) and selfrating anxiety scale (SAS, consisted of 20 items, scored by 4 grades, mainly evaluated according to the occurrencefrequency of the symptoms. The forward scores were 1, 2, 3 and 4 points, and the backward scores were 4,3, 2 and 1 point; the total score multiplied by 1.25, and then the integer was taken as the standard score, the lower the better, and the delimitative value was 50. The total score of anxiety ＜ 50 points was taken as normal,50 to 60 as mild anxiety, 61 to 70 as moderate anxiety, ＞ 70 as severe anxiety). According to the different characters of disease, the patients with moderate depression and above were given suitable psychotherapy and psychiatric drugs for 4 weeks as a course.of the 4 scales between stroke patients with different lesion natures, foin the patients accompanied by depression. RESULTS: All the 60 stroke patients and 60 eases in the control group were involved in the analysis and SAS between the stroke group and control group: All the total scores were higher in the stroke group than in the control group [(131.45 ±18.89), (94.25 ±9.08) points; (18.73 ±6.54), (8.60 ±2.39)points; (56.49±11.85), (41.63±9.91) points: (40.08±6.55), (28.72±1.84)the 4 scales between stroke patients with different lesion natures, focal sites and focal sizes: In the stroke group, the total scores were higher in the patients with lesion in left hemisphere, cortical lesion, multiple focuses and large focal size (≥ 15 mm) than in those with lesion in right hemisphere, subcortical lesion, single focus and small focal size (＜ 15 mm)(t=1.92 to 4.31, P ＜ 0.05), but the scores were almost the same between the patients with cerebral infarction and those with cerebral hemorrhage accompanied by depression before and after treatment: 21 patients had moderate depressive symptoms and above, and their total scores of SCL90, HAMD, SDS and SAS were obviously higher than those in the control group (t=7.45 to 13.75, 9.83 to 21.20, P ＜ 0.01).CONCLUSION: The poststroke neuropsychological changes are more obvious, and the changes are associated with the lesion location, focal size and focal site, but have no close correlation with the lesion nature.After psychological interventions, the depressive emotion is markedly ameliorated in the patients with obvious depressive symptoms and it is then indicated that poststroke patients should be given psychological interventions.

[摘 要] 目的：基于生物信息学方法探究几丁质酶-3样蛋白2（CHI3L2）在脑胶质瘤中的表达和生物学过程及其对患者临床预后的影响。方法：以中国脑胶质瘤基因组图谱（CGGA）为训练集（n = 325）、癌症基因组图谱（TCGA）为验证集（n = 702），对CHI3L2与脑胶质瘤患者临床病理特征的关系、预后价值和生物学过程进行交叉验证分析。用Kaplan-Meier法进行生存分析，采用Cox回归模型分析CHI3L2表达及相关临床病理特征与脑胶质瘤患者预后的关系，利用受试者工作特征（ROC）曲线分析CHI3L2在脑胶质瘤诊断中的价值，用GO、KEGG及GSVA途径分析CHI3L2在脑胶质瘤中的潜在生物学过程，构建CHI3L2的列线图以校准曲线及C-Index值来评估预测的准确性。WB法和qPCR 法检测CHI3L2在正常星形胶质细胞HA1800、胶质瘤U215和U87细胞中蛋白质与mRNA水平表达的影响。选取长沙市中心医院病理科保存的7例正常脑组织、5例低级别胶质瘤（LGG, WHOⅠ~Ⅱ级）和6例胶质母细胞瘤（GBM，WHO Ⅳ级）标本进行免疫组化染色分析，验证CHI3L2在正常脑组织和不同级别脑胶质瘤组织中的表达情况。结果：CHI3L2在GBM（P < 0.000 1）、非1p/19q编码（P < 0.000 1）、IDH-野生型（P < 0.000 1）、非MGMT甲基化（P<0.01）患者中显著表达，对GBM具有一定的预测价值，并且是脑胶质瘤患者总生存期（OS）的独立预后因素（P < 0.001）。构建的列线图对脑胶质瘤患者的生存预后预测性良好。CHI3L2与LGG和GBM的免疫细胞浸润水平、肿瘤免疫微环境和免疫细胞均有显著关系。脑胶质瘤中CHI3L2蛋白（P < 0.05）和mRNA（P < 0.000 1）的表达水平与更高的恶性程度相关，免疫组化的结果进一步验证了这个发现。结论：CHI3L2的表达与脑胶质瘤的恶性程度、临床病理特征及预后关系密切，并且参与脑胶质瘤的肿瘤微环境和免疫浸润，有望成为脑胶质瘤治疗策略中的一个新靶点。

Humans ; Leg/pathology* ; Skin Neoplasms/pathology* ; Lymphoma, Large B-Cell, Diffuse/pathology*

Cross-Sectional Studies ; Urodynamics ; China

ObjectiveThe antitumor activity of sesquiterpenoid M36 isolated from Myrrha against human hepatoma HepG2 cells was investigated in this study. MethodHepG2 cells were treated with M36 at different concentrations （0， 2， 4， 6， 8， 10 μmol·L^-1）. Firstly， the effects of M36 on the proliferation of human hepatoma HepG2 cells were detected by methyl thiazolyl tetrazolium （MTT）， colony formation assay， and EdU proliferation assay. Hoechst staining， flow cytometry analysis， and Western blot were used to explore the effect of M36 on the apoptosis of human hepatoma HepG2 cells. Acridine orange staining and western blotting were used to examine the effect of M36 on autophagy in HepG2 cells. Finally， Western blot was used to detect protein expression of cancer-related signaling pathways. ResultCompared with the blank group， M36 treatment significantly inhibited the proliferation of human hepatoma HepG2 cells （P<0.01）， and the half inhibitory concentration （IC₅₀） value of M36 for 48 h was 5.03 μmol·L^-1， in a dose- and time-dependent manner. M36 was also able to induce apoptosis and autophagy in human hepatoma HepG2 cells. After treatment with 8 μmol·L^-1 M36 for 48 hours， the apoptosis rate of HepG2 cells was （42.03±9.65）% （P<0.01）. Compared with the blank group， HepG2 cells treated with 4 and 8 μmol·L^-1 M36 for 48 h had a significant increase in cleaved poly ADP-ribose polymerase （cleaved-PARP） protein levels （P<0.01）. Acridine orange staining showed that autophagy was significantly activated in HepG2 cells treated with 4 and 8 μmol·L^-1 M36 for 48 h compared with the blank group （P<0.01）， which was further verified by the up-regulation of microtubule-associated protein 1 light chain 3 Ⅱ （LC3 Ⅱ）. Western blot results showed that compared with the blank group， the levels of phosphorylated extracellular regulated protein kinase （p-ERK）， phosphorylated p38 mitogen-activated protein kinase （p-p38 MAPK）， phosphorylated c-Jun N-terminal kinase （p-JNK）， and its downstream nuclear transcription factors c-Jun and p-c-Jun protein were significantly increased in M36 group （P<0.05， P<0.01）. The mechanism may be related to the up-regulation of MAPK signaling pathway. ConclusionThe sesquiterpenoid M36 isolated from Myrrha inhibits the proliferation of human hepatoma HepG2 cells and promotes apoptosis and autophagy， which may be related to the activation of the MAPK signaling pathway.