The post-stroke depression (PSD) is one of the common complications of stroke.It can not only delay the recovery of the neurological function in patients, seriously affect the quality of life of patients, but also increase the mortality and morbidity.More and more attention has been paid to the pathogenesis of PSD.Recent studies have confirmed that brain small vessel disease is closely related to the occurrence of PSD.This article reviews relationship between brain small vessel diseases and PSD.

Objective To investigate the effects of peroxisome proliferators-activated receptorγ(PPARγ)agonist pioglitazone on the expressions of glial fibrillary acidic protein (GFAP) and cyclin D1 in the hippocampal CA1 region after cerebral ischemia in rats.Methods Fifty-four Sprague-Dawley rats were randomly divided into 3 groups:sham operation group,ischemia/reperfusion group,and pioglitazone intervention group (18 in each group).A rat middle cerebral artery occlusion and reperfusion model was induced by the modified suture method.Continuous pioglitazone rosiglitazone gavage (0.65 mg/kg once a day) was conducted for 5 days before modeling in the pioglitazone intervention group.At day 1,3,and 7 after modeling the rats (6 at each time point) were sacrificed and their brains were removed.HE staining was used to detecte the pathological changes of neurons in the hippocampal CA1 region.Immunohistochemical staining was use to detect the expressions of GFAP and cyclin D1 in the hippocampal CA1 region.Results Compared to the sham operation group,at day 3 and 7 after ischemia/reperfusion,the number of neuronal survival in the hippocarmpal CA1 region in the ischemia/reperfusion group was significantly reduced (all P ＜ 0.01).The expressions of GFAP and Cyclin D1 at all time points were significantly upregulated (all P ＜ 0.01).At day 3 and 7 after ischemia/reperfusion,the numbers of neuronal survival in the hippocampal CA1 region in the pioglitazone intervention group were significantly increased (all P ＜0.01).Compared to the ischemia/reperfusion group,the expressions of GFAP and Cyclin D1 at all time points were significantly down-regulated (all P ＜ 0.01).Conclusions PPARγagonist pioglitazone has a significant protective effect on neuron in the hippocampal CA1 region after cerebral ischemia/reperfusion in rats.Its mechanism may be associated with inhibiting GFAP and cyclin D1 expressions.

ObjectiveTo study the effect of topiramate on the expression of Heat Shock Protein 70 (HSP70) after brain ischemia and reperfusion injury.MethodsWistar rats were performed operation of double renal artery stenosis to make hypertension. 2 months after, the rats were separated into 3 groups randomly: topiramate group,ischemic reperfusion group and fake operation control group. The rats were performed operation of middle cerebral artery occlusion (MCAO) and made them in ischemia for 2 h. One day later, their brains were obtained, and the number of positive and negtive cells were counted by computerized pathological image analyzer.ResultsThe HSP70 expression of topiramate group was higher than that of ischemic reperfusion group(P<0.05).No positive cell had been found in the samples of the control group.ConclusionTopiramate can enhance the expression of HSP70 and may therefore protect the ischemic brain tissue from reperfusion injury.

Objective To evaluate the clinical effect of hepatocellular carcinoma treatment with a combination therapy of transcather arterial super liquefied lipiodol embolization and cytokine-induced killer cell(CIK) infusion.Methods There were 3 groups in this study,group 1:38 cases of HCC patients treated with a combination therapy of transcather arterial super liquified lipiodol embolization and CIK infusion;group 2:80 cases of HCC patients treated with a combination therapy of transcather arterial super liquefied lipiodol embolization and percutaneous intratumoral ethanol injection;group 3:134 cases of HCC patient treated with transcather arterial super liquefied embolization.Finally,the outcomes of the 3 groups were compared.Results The short term effective rates of group 1,2 and 3 were 76.1%,41.3% and 14.9% respectively,simultaneously with significant difference of changes concerning AFP value among the three groups especially in group 1 the AFP decrease to normal level while those of the other two groups still remain in higher levels.Conclusions The living quality and survival rate of HCC patients could be improved by a combination therapy of transcather arterial super liquefied lipiodal embolization and CIK infusion.(J Intervent Radiol,2007,16:235-239)

Objective To investigate the significance and mechanism of intracerebroventricular injection viper venom nerve growth factor (Vngf) in rat neural plasticity after cerebral ischemia reperfusion injury.Methods Ninety Wistar male rats were randomly assigned into Vngf-25 U group (n = 18), Vngf-50 U group (n = 18), Vngf-100 U group (n = 18), ischemia reperfusion group (n = 18) and sham operated group.The expression of candidate plasticity-related gene 15(cpg-15) Mrna and nuclear factor of kappa B ( NF-Κb ) Mrna in rat brain tissues which were collection at 2,7,14 days after surgery were evaluated by the real time PCR.Results The expression of cpg-15 Mrna and NF-Κb Mrna began to increase after surgery( the F value of cpg-15:70.43, 34.11, 31.89, the F value of NF-Κb: 27.47, 34.56, 31.89,P＜0.01).At the same time, expression of cpg-15 Mrna and NF-Κb Mrna in the Vngf groups was significantly different from the I/R group and the sham operated group (the F value of cpg-15:48.18, 55.93, 78.43, the F value of NF-Κb: 45.92, 55.72, 50.49, P ＜0.01).The more Vngf were injected, the more cpg-15 Mrna and NF-Κb Mrna were expressed in Vngf groups.Conclusions The Vngf could accelerate neural plasticity and restore neurofunctional defect through up-regulated the expression of cpg-15 and NF-Κb.

BACKGROUND:Short-segment pedicle screw technology has been extensively used in the treatment and repair of thoracolumbar burst fractures in the clinic. However, it requires further investigations whether bone graft through unilateral pedicle channel has superiority. ＜br> OBJECTIVE:To observe the perioperative effects on thoracolumbar burst fractures posterior by bone graft through unilateral pedicle channel with short pedicle screw segment fixation. ＜br> METHODS:Clinical data of 57 cases of thoracolumbar burst fractures without neurological symptoms treated by short segment pedicle screw internal fixation therapeutic method at the Department of Orthopedics, The First People’s Hospital of Yinchuan City from January 2009 to December 2013 were retrospectively analyzed. According to therapeutic methods, they were divided into three groups:pedicle screw fixation through injured vertebrae (n=21), unilateral pedicle screw fixation with vertebrae pedicle screw (n=19), and the short segment pedicle screw fixation with unilateral pedicle screw fixation and bone graft through pedicle channel (n=17). We observed the changes in operation time, the blood loss volume in operation, postoperative drainage blood (at the period of removing the drainage tube), injured vertebrae height’s ratio, the Cobb’s angel of injured vertebrae sagittal plane, vertebral canal encroachment rate and visual analog scale. ＜br> RESULTS AND CONCLUSION:(1) The unilateral pedicle screw fixation and bone graft by pedicle channel could prolong operation time and increase postoperative drainage blood volume (P＜0.05). (2) Three operation methods improved vertebral body height. (3)There were no significant differences in Cobb’s angle postoperation among the three groups (P>0.05). These data suggested that the bone graft through pedicle channel was not the factors to improve the spine kyphosis. (4) Bone graft by pedical channel improved vertebrae channel value. (5) Bone graft through pedicle channel combined with screw implantation could improve pain after treatment. These findings indicated that the therapeutic technology of short pedicle screw fixation on thoracolumbar vertebral burst fracture with unilateral pedicle fixation and bone graft through pedicle channel is a safe reliable operation method.

Objective To investigate the effects of bone marrow mesenchymal stromal cells (BMSCs) transplantation after mannitol pretreatment on behavioral performance and synaptophysin expression in the CA3 region in hippocampus of vascular dementia (VD) rats.Methods The BMSCs of rats were isolated and purified by the whole bone marrow adherence method.The rats were subjected for permanent ligation of bilateral common carotid arteries at an interval of 3 days for each carotid artery.At the same time,Sham group was set in parallel.Four weeks after modeling,the VD rats were divided randomly into five groups:(1) VD control group; (2) culture media group; (3) mannitol group; (4) BMSCs group;(5) mannitol with BMSCs group.Morris water maze performance and synaptophysin expression in the CA3 region in hippocampus were observed at 4 weeks after transplantation.Results The morris water maze performance significantly improved in mannitol with BMSCs group when compared with BMSCs group,VD control group,culture media group,mannitol group.Moreover,the escape latency of fifth day decreased significantly ((9.3 ±2.9),(14.1 ±3.5),(23.5 ±4.4),(22.8 ±4.4),(23.2 ±2.8) s,F =43.900,P =0.000)),and the platform quadrant residence time increased significantly ((40.8 ± 6.3),(34.9 ±5.8),(26.4±4.8),(27.4 ±7.0),(28.5 ±6.2) s,F=13.000,P=0.000)).The synaptophysin expressions of the hippocampal CA3 region were significantly increased in the mannitol with BMSCs group (39 624 ± 7798) when compared with BMSCs group,VD control group,culture media group,mannitol group (27060 ±4668,18 294 ±6446,19 956 ±4244,18 946 ±4953,F =39.206,P =0.000).Conclusions Intravenous BMSCs transplantation after mannitol pretreatment improves the behavioral performance of VD rats and facilitates the synaptophysin expression of hippocampal CA3 region in VD rats than BMSCs transplantation alone.Mannitol pretreatment can amplify the therapeutic effect of intravenous BMSCs transplantation in VD rats.

Objective To investigate the cerebral ischemia/reperfusion protection mechanism of viper venom nerve growth factor(vNGF) by the change of expression of growth associated protein-43 (GAP-43) and neurological function.Methods 45 adult male Wistar rats (weight 220～280 g) were divided randomly into 3 groups: sham group(S, n=9), balanced salt solution group (BSS, n=9) and venom nerve growth factor group (vNGF, n=27). Each group was observed for 7 days. vNGF group was divided into 25 U, 50 U and 100 U subgroups respectively. The following indexes in 3 groups were observed respectively: neurologic deficits and the expression of GAP-43 (immunohistochemistry method).Results Neurological function: The scores of neurological function was 0 in S group. The neurological deficits score was lower at the same time in vNGF group than that in BSS group (P<0.05). Immunohistochemistry: GAP-43 expressed in both BSS group and vNGF group. The expression of GAP-43 in vNGF group increased in 25 U, and to maximum in 100 U. The expression of GAP-43 in BSS group was significantly lower than in vNGF group (P<0.05). Conclusion vNGF can effectively enhance and prolong the expression of GAP-43, increase the survival rats of nerve cells, and has the protection effect on nerve cells after cerebral ischemia injured.

ObjectiveTo explore the Apolipoprotein-E （ApoE） gene polymorphism in patients with Alzheimer's disease （AD）, vascular dementia (VD) or mild cognitive impairment (MCI). MethodsPeripheral blood was taken from patient with AD, VD or MCI to determine the ApoE genotypes. ResultsThe most of the patients were ε3/ε3 genotype, while the ε2/ε2 and ε4/ε4 could not be detected. ε3/ε4 genotype （P=0.001） and ApoE ε4 allele （P=0.013） was more frequent in AD than in MCI. ApoE ε4 was more frequent in VD than in MCI （P=0.044）. ConclusionApoE ε4 allele is a risk factor in AD, and may be associated with VD and MCI.

Objective To evaluate the efficacy and safety of endoscopic anterior fundoplication by the MUSETM endoscopic stapling device in gastroesophageal reflux disease (GERD).Methods From March to November 2017,in the Department of Gastroenterology of Chinese PLA General Hospital in Beijing,The First People's Hospital Affiliated to Shanghai Jiao Tong University and Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,thirteen GERD patients who underwent the endoscopic anterior fundoplication by the MUSETM system were enrolled.The GERD health related quality of life questionnaire (GERD-HRQL) score,satisfaction of symptomatic control,questionnaire for gastroesophageal reflux disease (GERD-Q) score,the degree of esophagitis,condition of gastroesophageal flap valve,medicine administration and side effects were compared before and after the operation.Paired t test and Wilcoxon rank sum test were performed for statistical analysis.Results The total GERD-HRQL score decreased from 23 points (14 to 36 points) before operation when proton pump inhibitor (PPI) was stopped for seven days to 3 points (0 to 21 points) at three months after operation and 1 point (0 to 18 points) at six months after operation;and the differences were statistically significant (Z=-3.111 and -3.183,both P＜0.01).Among 13 patients,the GERD-HRQL score of 11 patients decreased over 50 ％ after operation.The heartburn score decreased from 21 points (13 to 29 points) before operation when PPI was stopped for seven days to 0 point (0 to 17 points) at three months after operation and 0 point (0 to 16 points) at six months after operation;and the differences were statistically significant (Z=-3.113 and -3.182,both P＜0.01).Among 13 patients,assessment of symptom control at three months after operation of seven patients were satisfactory,four patients were mostly satisfactory and two patients were unsatisfactory;assessment of symptom control at six months after operation of nine patients were satisfactory,four patients were mostly satisfactory;and the satisfaction rate were both higher than that before operation,and the differences were statistically significant (x2=16.235 and 25.159,both P＜0.01).The total GERD-Q score reduced from 13 points (8 to 17 points) before operation to 6 points (3 to 11 points) at three months after operation and 6 points (6 to 13 points) at six months after operation (Z=-3.192 and-3.066,both P＜0.01).DeMeester score decreased from 38.40 points (20.20 to 255.30 points) to 11.10 points (1.10 to 46.20 points) at six months after operation;and the percent of total time of esophageal pH＜4 reduced from 10％ (5％ to 75％) to 3％ (0 to 13％) at six months after operation;the difference was statistically significant (Z=-3.181 and-3.180,both P=0.001).There was no significant difference in esophageal motility changes before and after treatment (all P ＞ 0.05).The number of patients without esophagitis increased from three before treatment to eight after treatment.Additionally,the number of patients whose gastroesophageal flap valve was less than grade Ⅱ increased from three before operation to 11 at six months after operation.The patients were followed up for six months,among 13 patients,10 patients were completely deprived of PPI,one patient was reduced over 50％,and two patients were treated with less than 50％ reduction.All 13 patients had mild tolerable abdominal pain and sore throat within 48 hours after operation.No other adverse reactions were observed.Conclusion The endoscopic anterior fundoplication by the MUSETM is a safe and effective treatment for GERD.