Objective To investigate errors and the mechanism of acalculia in patients with left or right hemisphere cerebral infarction.Methods Fifty-six patients with single hemisphere cerebral infarction and 56 normal adults who were matched in age,sex and years of education were tested with EC301-CR.The patients were divided into a left hemisphere cerebral infarction group(n =34)and a right hemisphere cerebral infarction group(n =22).Results The scores on 30 out of 32 EC301-CR items were significantly lower among the patients than in the normal control group.Scores on 14 EC301-CR items were significantly lower in the left hemisphere group than in the right hemisphere group.In the left hemisphere group the item scores of aphasia patients were significantly lower than those of no-aphasia patients except on digit identity.Conclusion Mathematical processing and calculation were impaired in patients with single hemisphere cerebral infarction.Calculation was significantly worse among left hemisphere patients compared with right hemisphere cerebral infarction.There was a highly significant correlation between acalculia and aphasia.

BACKGROUND: The injury of blood-brain barrier following cerebral ischemia reperfusion is a considerate pathological basis for injury caused by cerebral ischemia and reperfusion.OBJECTIVE: To investigate the effects of four most basic Chinese medicinal herbs, or safflower, peach seed, ligusticum and red peony with actions of activating blood and resolving the stasis on the contents of nitric oxide, immunoglobulins, C-reactive protein (CRP) and complements (immunological indices) of serum and cerebral homogenate, as well as the morphological and structural changes of cerebral tissue cells in rats with ischemia and reperfusion to vertify relationship between time effectiveness and quantitative effectiveness.DESIGN: A randomized controlled study, and evaluation by single blind.MATERIALS: The experiment was completed in the Laboratory of Traumatology Institute of Guangzhou Red Cross Hospital from January 2001 to De cember 2002. Safflower, peach seed, szechwan lovge rhizome and red peony are concentrated granules of single decocting pieces, the blood activating and stasis resolving decoction was prepared at 2.5 g/L according to 1:1:1:2 ratio.Totally 138 adult female SD rats were selected for the experiment,weighing 280-300 g, provided by Animal Center of Guangzhou University of TCM.INTERVENTIONS:The models rats with middle cerebral artery occlusion were set up by thread ligation(24 hours reperfusion after 2 hours middle cerebral artery occlusion).All 138 rats were randomly divided into 6 groups with 23 in each group.Sham operation group:The vessels were ligated but the middle cerebral artery was not occluded.No.1 medicated group: The BASR was by gavage given in a dose of 2 g/kg 30 minutes before operation. No. 2 medicated group: The BASR was by garage given in a dose of 2.5 g/kg 30 minutes before operation. No. 3 medicated group: The BASR was by garage given in a dose of 2 g/kg for consecutive 7 days be fore operation. No. 4 medicated group: The BASR was by gavage given in a dose of 2.5 g/kg for consecutive 7 days before operation.Control group:the same volume of saline was by gavage given for consecutive 7 days before operation. ① Scoring of dysneuria (5-score system: 0-1 score meant mild dysneuria, 2-4 scores meant severe dysneuria) for all rats were performed after consciousness following 2 hours ischemia and 24 hours reperfusion.② After 24 hours reperfusion,10 rats in each group were at random selected for assay of levels of CRP, complement 3 (C3) and complement 4 (C4) (rate nephelometry), and concentration of nitric oxide (nitrate reductase method)in both cerebral homogenate and serum.③ After 24hours reperfusion, 10 rats in each group were at random selected, and after anesthesia was completed, the brain was quickly collected through decapitation, put into a 110 ℃ drying oven till its constant weight, then the water content in brain was calculated.④ The cerebral cytomorphology in every group was observed under light microscope. ⑤ After reperfusion, 3 rats in each group were randomly selected for preparation of coronal section of cerebral tissue,the cerebral ultrastructure in each group was observed under transmission electronic microscope.MAIN OUTCOME MEASURES: ① The results of dysneuria scoring in each group. ② The levels of CRP, C3 and C4, and concentration of nitric oxide in both cerebral homogenate and serum.③ The water content in brain. ④ The cerebral cytomorphology and the cerebral ultrastructure. RESULTS: All 138 rats entered into the result analysis. ① Comparison of the extents of dysneuria of rats in each group: The ratio of severe dysneuria after 24 hours ischemic reperfusion in all medicated groups was obviously lower than that in control group(P ＜ 0.01),and the ratio in No.4 medicated group was lower than that in No.2 medicated group(P ＜ 0.05).② Comparison of water contents in brain of rats in each group:The water contents in sham operation group and all medicated groups were obviously lower than that in control group (P ＜ 0.05). ③ Comparison of the nitric oxide concentration in cerebral homogenate of rats in each group: The concentration in sham operation group and all medicated groups were obviously lower than that in control group (P ＜ 0.01). The concentration in No. 3medicated group was obviously lower than that in No. 1 medicated group (P ＜ 0.05).The concentration in No.4 medicated group was obviously lower than that in No. 2 medicated group (P ＜ 0.01). ④ Comparison of the nitric oxide concentration in serum of rats in each group:The concentrations in sham operation group and all medicated groups were obviously lower than that in control group(P ＜ 0.01).The concentration in No.3 medicated group was higher than that in No. 1 medicated group (P ＜ 0.05). The concentration in No. 4 medicated group was higher than those in No. 2 and in No. 3 medicated groups (P ＜ 0.05). ⑤ Comparison of the levels of CRP in cerebral homogenate and serum of rats in each group: The levels in sham operation group and all medicated groups were lower than that in control group(P ＜ 0.05-0.01).The level in No.3 medicated group was lower than that in No. 1 medicated group (P ＜ 0.01). The level in No. 4 medicated group was lower than those in No. 2 and in No. 3 medicated groups (P ＜0.05-0.01).⑥ Comparison of the levels of C3 in cerebral homogenate and serum of rats in each group:The levels in sham operation group and all medicated groups were lower than that in control group (P ＜ 0.05-0.01). The level in No.3 medicated group was lower than that in No.1 medicated group (P ＜ 0.05). The level in No. 4 medicated group was lower than those in No. 2 and in No. 3 medicated groups (P ＜ 0.01). ⑦ Comparison of the levels of C 4 in cerebral homogenate and serum of rats in each group:The levels in sham operation group and all medicated groups were lower than that in control group (P ＜ 0.05-0.01). The level in No. 3 medicated group was lower than that in No. 1 medicated group (P ＜ 0.05). The level in No.4 medicated group was lower than those in No. 2 and in No. 3 medicated groups (P ＜ 0.01). ⑧ Comparison of the condition of cerebral edema of rats in each group:In control group there was obvious cerebral congestive edema,indicating an obvious infection;while in medicated groups the extent of cerebral edema was milder than that in control group.⑨ Changes of cerebral ultrastructure of rats in each group:The ultrastructure in sham group was normal. In control group, there obvious edema of cells, capillaries and sheaths in the marginal zone of cortex necrosis,and reduction of organelles of neuron. As well. In No. 3 and No. 4 medicated groups, the limits of cell membranes were clear, the structure was integral, the chondriosomes were rich and even in size,the medullated fibers were morphologically normal.And in No.1 and No.2 medicated groups the changes were between the twoCONCLUSION:① The scoring of dysneuria in rats was decreased after the blood-activating and stasis-resolving medicine was given,and it was lower in rats that were given a longer period of medication,indicating that the improved extent for dysneuria is related to prolonged medication.②The nitric oxide concentration of cerebral tissue in rats that recevied the blood-activating and stasis-resolving medicine was decreased, and the nitric oxide concentration of serum in the rats was increased,indicating that the blood-activating and stasis-resolving medicine can reverse the anomalies of nitric concentration in different tissues after ischemic reperfusion so as to reduce cerebralinjury.③ The levels of C3 and C4 of cerebral tissue and serum in rats that received the blood-activating andstasis-resolving medicine were obviously decreased,indicating that the medicine may reduce the cerebral injury through triggering complement system;and the CRP was also get decreased,further suggesting that the medicine can inhibiting infective reaction.④ The longer the period of medication,the milder the cerebral injury, and the dose of 2.5 g/L was better in effect.

BACKGROUND: It has been known that re-recovery of blood flow after cerebral ischema may aggravate brain injury. It has been verified in some researches that the components for activating blood circulation and removing stasis in Chinese herbs can resist cerebral ischemic reperfusion injury.OBJECTIVE: To observe 4 most basic Chinese herbs for activating blood circulation and resolving stasis [honghua (Flos Carthami), taoren (Semen Persicase), chuanxiong (Rhizoma ligustici Chuanxiong) and chishao (Radix Paeoniae Rubra)] as the exertive factors on their influences on immune index changes in IgG, C-reactive protein (CRP) and complements of serum and homogenate in brain tissue so as to verify their graded and time effects.DESIGN: Randomized control experiment and single blind method.SETTING: Guangzhou Red Cross Hospital and Department of Neurology of the Fourth Hospital Affiliated to Jina University.MATERIALS: The experiment was performed from January 2001 to Decemb er 2002 in Experimental Room of Traumatic Institute of Guangzhou Red Cross Hospital. Totally 138 SD female adult rats were employed, mass weighted varied from 280 to 300 g, provided from Experimental Animal Center of Guangzhou University of Chinese Medicine. Honghua (Flos Carthami), taoren (Semen Persicase), chuanxiong (Rhizoma ligustici Chuanxiong)and chishao (Radix Paeoniae Rubra)] were the concentrated granules individually. At the ratio of 1:1:1:2, they were prepared into 2.5 g/mL raw herbal decoction (huoxue huayu tang).INTERVENTIONS: Thread embolic method was used to prepare cerebral medium sized artery obstruction model in rats (reperfusion for 24 hours after cerebral medium sized artery obstruction for 2 hours). Totally 138 rats were randomized into 6 groups, 23 rats in each. Sham operation group: ligature was done in each vessel without blocking medium sized artery of cerebrum.First perfusion group: 30 minutes before operation, gastric peffusion was done with 2 g/kg huoxue huayu tang. Second peffusion group: 30 minutes before operation, gastric perfusion was done with 2.5 g/kg huoxue huayu tang. Third perfusion group: before operation, gastric perfusion was done with 2 g/kg huoxue huayu tang continuously for 7 days. Fourth perfusion group: before operation, gastric perfusion was done with 2.5 g/kg huoxue huayu tang continuously for 7 days. In the control, physiological saline of all of the groups, when rats woke up, after 24 hours reperfusion and 2 hours ischemia, neural functional deficits were evaluated (5-score system, 0-1:After 24 hours reperfusion, 10 rats were randomized from each group for determination of the contents of CRP in homogenate and serum, complehours reperfusion, 10 rats were randomized from each group. After anesthetized, they were sacrificed rapidly to collect brains. Dried over heat in oven at 110℃ till constant weight, the water content of brain tissue was domized from each group to observe ultrastructure of brain tissue under transmission electron microscope (TEM) of rats in each group.and homogenate, complement C3 and C4 as well as serum IgG in rats of of severe neural functional deficits after 24 hours ischemic reperfusion in rats of each peffusion group was lower remarkably than the control (P ＜ 0.01),in which, that in fourth peffusion group was lower than second group (13%,group and each perfusion group was lower than the control (P ＜ 0.05), in which, that in third peffusion group was lower than first group (P ＜ 0.01).ment C3: That in sham operation group and each perfusion group was lower sham operation group and each perfusion group was lower than the control ( P ＜ 0.01), in which, that in third perfusion group was lower than first group (P ＜ 0.01); That in fourth perfusion group was lower than second and group and each perfusion group was lower than the control (P ＜ 0.01), in which, that in fourth perfusion group was lower than second group(P ＜ 0.05).each perfusion group was lower than the control (t=5.626-17.929, P ＜ 0.01),in which, that in third perfusion group was lower than first group (P ＜ 0.01),complement C3 in brain homogenate: That in sham operation group and each perfusion group was lower than the control (P ＜ 0.05-0.01), in which, third perfusion group was lower than first group (P ＜ 0.01), that in fourth group brain homogenate: That in sham operation group and each perfusion group was lower than the control ( P＜ 0.05-0.01), in which, that in third perfusion group was lower than first group (P ＜ 0.01), that in fourth group was lower tissue: The inflammatory reaction in the control was obvious. Brain edema and pathological damage in perfusion groups were milder than the control.Ulztrastructure was normal in sham operation group. The edema was obvious in cells, capillaries and myelin sheath in cortical necrosis margin area and neuronal cell organs were decreased in the control. In third and fourth peffusion groups, cellular membrane was clear in boundary line,integrative in structure, rich in mitochondria and even in size and the morphology of medullated fibers was normal. The situation of first and second perfusion was between two of them.deficits in the evaluation of rats and the score with long medication was lower, suggesting that long medication can even better improve neural funcplement C3 and C4 in brain bomogenate and serum and decreases serum IgG content, explaining that the medicine alleviates brain tissue injury by startup complement system. The remarkable decrease of C-reactive protein further suggests the inhibition of such medicine on inflammatory reaction.jury is, and the better result is achieved at dosage of 2.5 g/L.

Objective To investigate the effect of exogenous stromal cell-derived factor-1 α (SDF-1 α) on angiogenesis peri-infarct region in cerebral cortex in adult rats and its possible mechanisms.Methods Twenty-four adult male Sprague-Dawley rats were randomly divided into four groups:sham operation,solvent control,SDF-1α treatment,and SDF-1α + CXCR4 antagonist (n =6 in each group).A model of focal infarct in the cerebral cortex was induced by permanent ligation of the cortical branch of the right middle cerebral artery with temporary clip occlusion of both common carotid arteries.At 1 h after cortical branch occlusion of the right middle cerebral artery,SDF-1 α (1 μg/d) or equal volume of normal saline were injected via the lateral ventricle in the SDF-1α treatment group and solvent control group,and continued for 6 days.CXCR4 antagonist AMD3100 (1 mg/d) was injected subcutaneously before injecting SDF-1 α in the SDF-1 α + CXCR4 antagonists group,and continued for 6 days.Before all the rats were sacrificed,5-bromo-2-deoxyuridine (BrdU) was injected intraperitoneally and their newly proliferated cells were labeled.At day 7 after modeling,the rats were sacrificed after neurological scores.Immunofluorescence staining was used to detect the vascular density,the numbers of neovasculature endothelial cells and the CXCR4 + cells in the peri-infarct regions or sham operation regions.Results At 7 d after modeling,the neurological function of the SDF-1α treatment group was improved significantly compared with those of the solvent control group and the SDF-1α + CXCR4 antagonist group (all P＜ 0.01).The vascular densities in the peri-infarct or sham operation regions in the groups of sham operation,solvent control,SDF-1α treatment,and SDF-1α+ CXCR4 antagonist were 2.1±0.3％,7.0±0.3％,10.0 ±0.9％ and 7.1 ±0.3％,respectively (F=232.469,P＜0.001),and that in the sham operation was significantly lower than that in the SDF-1α group (P ＜0.001),SDF-1 α group significantly higher than both groups of solvent control (P =0.002) and SDF-1oα + CXCR4 antagonist (P =0.001).The numbers of BrdU+/laminin+ cells in the peri-infarct regions in the groups of sham operation,solvent control,SDF-1α treatment,and SDF-1α + CXCR4 antagonist were 21.7 ± 3.1,79.7 ± 6.0,176.0 ± 12.5 and 90.3 ± 6.9,respectively (F=391.550,P＜0.001),and that in the sham operation was significantly less than that in the SDF-1 α group (P ＜ 0.001),SDF-1 α group was significantly more than both groups of solvent control and SDF-1 oα + CXCR4 antagonist (all P ＜0.001).The numbers of CXCR4 + cells in the peri-infarct regions in the groups of solvent control,SDF-1α treatment,and SDF-1α+ CXCR4 antagonist were 59.3± 4.5,120.3 ± 13.9 and 62.9 ± 5.9,respectively (F =85.052,P ＜ 0.001),and that in SDF-1α group was significantly more than those in the both groups of solvent control and SDF-1 α + CXCR4 antagonist (all P ＜ 0.001).Conclusions SDF-1α treatment may improve the neurological function after focal infarction in the cerebral cortex in adult rats and promote angiogenesis in peri-infarct region.The SDF-1/CXCR4 signal pathway may play an important regulatory role in the process of angiogenesis after cerebral infarction.

Objective To investigate the clinical value of large platelets (P-LCR) and mean platelet volume (MPV) in acute cerebral infarction patients with type 2 diabetes. Methods 627 patients with acute cerebral infarction from January 2012 to May 2015 were enrolled and divided into type 2 diabetes and non-type 2 diabetes groups. The hemocytometer was used to detect the changes of P-LCR and MPV. Results The levels of P-LCR and MPV in the type 2 diabetes group were significantly higher than those of non-type 2 group (P <0.05). Logistic regression analysis showed that there was a statistically significant association between P-LCR, hypertension and hyperlipemia and the cute cerebral infarction patients with type 2 diabetes. Conclusion The levels of P-LCR and MPV could be used as important indexes for prognosis and early diagnosis of acute cerebral infarction patients with type 2 diabetes.

Objective To explore the effect of PGE1 on the cognitive impairment and the expression of VEGF and BDNF in the hippocampus after bilateral common carotid artery occlusion in adult rats. Methods Forty-eight rats were randomly divided into PGE1 group (10μg·kg-1·d-1, iv), PGE1+VEGFR antagonist group (PGE1, 10μg·kg-1·d-1, iv;SU5416, 25 mg·kg-1·d-1, ip), saline group and sham group (n=12 each). Morris Water Maze test (MWM) was used to examine cognitive function in rats. Drugs and saline were given to VD rats at 24 d for 7 consecutive days following opera?tion. Half of the rats in each group were sacrificed for Western Blot at 6 days after MWM test. Western Blot was conduct?ed to examine the relative expression levels of VEGF and BDNF in the hippocampus. Results Compared to saline and PGE1+VEGFR antagonist groups, the escape latency in PGE1 group was shorter (P<0.05), and the times that rats swam across the platform location and time percentage in previous platform quadrant in PGE1 group was longer (5.77±0.83 vs.2.88 ± 0.47 vs. 2.63 ± 0.44, P<0.01;32.28%± 4.56%vs. 20.42%± 5.50%, 23.08%± 5.06%, P<0.05). Compared with saline group and sham group, PGE1 group had higher levels of VEGF (0.057±0.005 vs. 0.038±0.002 vs. 0.027±0.002, P<0.05) and BDNF (0.481±0.049 vs. 0.339±0.021 vs. 0.224±0.04, P<0.05). but the increase in VEGF expression in PGE1 group was no significant (0.057±0.005 vs. 0.053±0.003, P>0.05) compared with PGE1+VEGFR antagonist group, while the aug?ment of BDNF in PGE1 group was remarkable (0.481±0.049 vs. 0.373±0.034, P<0.05). Conclusions PGE1 can upregu?late VEGF and BDNF expression and modify cognitive impairment in VD rats, while the effects of PGE1 on cognitive function and BDNF expression can be partially blocked by VEGFR antagonist SU5416.

Objective To investigate the risk factors,severity and infarct site features and clinical characteristics of the elderly patients over 80 years with cute cerebral infarction.Methods One hundred and sixty-two patients with acute cerebral infarction in Red Cross Hospital of Guangzhou,The Forth Affiliated Hospital of Medical College of Jinan University from January 2012 to May 2015 were enrolled and randomly divided into the elderly patients (≥ 80 years old) and the middle aged patients (＜ 60 years old).The risk factors,national institutes of health stroke scale (NIHSS) scores and Oxfordshire community stroke project (OCSP) criteria were compared between the two groups.Results Coronary artery disease,atrial fibrillation and NIHSS in the elderly patients (25％ (22/88),13.6％ (12/88),7.74 ± 4.986) were significantly higher than those of the middle aged group (12.2％ (9/47),4.1％ (3/74),5.04± 4.305),and the differences were significant (x2 =4.281,4.393,t =-3.649;P＜ 0.05 or P＜ 0.001).The logistic regression analysis finally showed that smoking,hyperlipemia,NIHSS scores and gender(male) were the independent risk factors(OR=3.851,3.609,1.100 and 2.670;P＜0.05).There were more LACI patients in the elderly group than he middle aged group ((40.9％,36/88) vs.(60.8％,45/74),x2 =6.369,P ＜ 0.05).Conclusion Compare to the middle aged patients,occurrence of the elderly patients with acute cerebral infarction is more severe,and the clinical features and risk factors have its particularity.Secondary prevention strategy should be emphasized on the control of different risk factors based on the patients' age.

Objective To summarize the experience of diagnosis and treatment strategy of pancreatic injury.Methods The data of 36 cases of pancreatic injurics admitted to Fujian Medical University Provincial Clinical College from 1990 to 2011 were analyzed retrospectively.Results 14 cases(39％)were diagnosed preoperatively,and the other cases were diagnosed during the laparotomy.2 cases underwent non-surgical treatment.34 cases underwent surgical treatment,among whom 23 cases underwent pancreatic debridement and drainage,6 cases underwent distal pancreatectomy(4 cases undergoing distal pancreatectomy plus splenectomy included),4 cases underwent distal Roux-Y pancreajejunostomy plus proximal pancreas closure,and 1 case underwent pancreatoduodenectomy.31 cases (86％) were cured,and 5 cases died (14％).Conclusions Most of the pancreatic injury is diagnosed through laparotomy.Surgical opcration is the main approach to treat pancreatic injury.Nonsurgical treatment is primarily limited to grade Ⅰ and Ⅱ pancreatic injury without obvious peritonitis,major pancreatic duct injury,and associated injuries.Surgical procedure should be selected based on the grading scale of pancreatic injury,associated injuries and overall conditions of the patient.