BACKGROUND: Alzheimer disease (AD) and vascular dementia (VD),the two major types of dementia in old age, differ from each other in pathological mechanism, treatment and prognosis. Up to now, no effective therapeutic method for AD is available, but VD can be treated effectively so that patients' quality of life can be improved.OBJECTIVE: To investigate the clinical features of brain electrical activity mapping (BEAM) and brain evoked potentials (BEP) between AD and VD patients.DESIGN: Retrospective analysis based on AD and VD patients.SETTING: Neurological Department, the First Clinical Medical College of Harbin Medical University.PARTICIPANTS: All inpatients and discharged patients were selected filiated to Harbin Medical University from December 1996 to December 2000. The history was provided by the patients themselves or their relatives who lived together with them. Nine cases of AD and fourteen cases of VD were diagnosed according to the diagnostic standard for AD and VD set by the National Institute of Neurological and Communicative Disorder and Stroke-the Alzheimer disease and Related Disorder Association, and Chinese Classification and Diagnostic Criteria of Mental Disease (4th edition). According to the clinical rating standard, the patients had mild or moderate degree of dementia.METHODS: AD and VD patients were analyzed with retrospective analynitive functions, including long-term and short-term memory, calculation,comprehension, abstract thinking, dyschronism and disorientation; c. emotional reaction, including depression, anxiety, fear, euphoria, compulsive laughing and crying; d personality alteration, including indifference,optimally were collected from the abnormal segment signals. After calculation, 4 frequency band powers of θ,δ, α and β of the total power of 1-30 N1, P2, N2 and P3 and the waves of P2 and P3 were measured. Comparison between the two groups and rate comparison were made with t-test and χ2 test, respectively.ease, cognitive functions and noncognitive functions between AD patients RESULTS: Data of 9 AD and 14 VD patients as well as 15 normal old cognitive functions and noncognitive functions between AD patients and VD patients: The onset of AD was slow, but that of VD was abrupt. Cognitive functions of AD patients were decreased, including memory decline,calculation decrement, abstract thinking disorder, dyschronism and disorientation. The cognitive functions of VD group were characterized by partial decrement and intermittent ladderlike aggravation. Memory decline and calculation ability decrease were the main characteristics, but other cognitive dysfunctions could not be observed as much as in AD. The patients of AD group often had depression as the most common emotional disorder.Personality alteration took initiative decrement as the most common one,whereas emotional disorder in the patients of VD group was presented by compulsive crying and laughing. One patient seldom had more than two and VD patients: BEAM of 7 AD patients was characterized by the power of θ frequency band of the whole head increased. The level of increase was consistent with the level of dementia (score of MMSE). At the same time,the power of α and β frequency bands declined, and the power of δ increased later, the left side (F3) was significantly higher than the right side AD and VD patients: The changes of BEP in the two group patients had poorly differentiated waves, with lower P300 wave and obviously delayed latent period. The abnormality degree of patients in AD group was more obvious than that in VD group.with memory decline and calculation ability decrease as the main characteristics in VD patients. The noncognitive functions of AD patients were more aftients were presented as the increased power of the whole head in the former ones and the increased power of θ frequency band in the latter ones. The changes were coincident with the severity of dementia in AD, but not in VD.effect of the former one was greater than that of the latter one.

Objective To investigate the effects of local mild hypothermia on the expression of EMAP-Ⅱ and proEMAP-Ⅱ after cerebral ischemia and reperfusion in rats and to explore the possible neuroprotection mechanism of mild hypothermia.Methods Forty-four male Wistar rats were divided randomly into a sham-operation group (Sham),a normothermia group (NT) and a hypothermia group (HT).Middle cerebral artery occlusion was performed using Longa's method,and reperfusion was allowed after 2 hours of occlusion.Mild hypothermia (33.0 ± 0.5)℃ for 6 hours was initiated at the start of reperfusion,followed by rewarming.Brains were harvested after 6,12,24,48 and 72 hours of reperfusion and used for HE staining to evaluate cellular apzoptosis and immunohistochemical staining for detecting the expression EMAP-Ⅱ and proEMAP-Ⅱ.Results The expression of EMAP-Ⅱ and proEMAP-Ⅱ in the ischemic penumbra was significant at 6 hours in the normothermia and hypothermia groups.It peaked at 12 hours in the normothermia group and 24 hours in the hypothermia group,and then decreased gradually.At 72 hours the expression of EMAP-Ⅱ and proEMAP-Ⅱ in the ischemic penumbras was very close to that in the sham group.EMAP-Ⅱ-positive cells were significantly fewer in the hypothermia group than in the normothermia group at all time points.ProEMAP-Ⅱ-positive cells were significantly more numerous in the normothermia group than in the hypothermia group at 6,12 and 24 hours.Conclusions Mild hypothermia (33.0 ± 0.5) ℃ has a valid neuroprotective effect which involves reducing EMAP-Ⅱ and proEMAP-Ⅱ expression in the ischemic penumbra and inhibiting apoptosis and inflammatory reactions after cerebral ischemia and reperfusion,at least in rats.

ObjectiveTo study the rehabilitative effects and pathological changes in rats after acute cerebral infarction. Methods 30 male Wister rats were randomly divided into 3 groups :Group A(sham group),Group B(model group) and Group C(rehabilitation group). Animal model was made by the middle cerebral artery occlusion(MCAO).For each group, Bederson Neural Function was scored and balancing wood,rotating bar,and net screen were tested at 24 hours,3 days and 7 days after operation respectively. On the 7th day after operation, pathological change of brain tissue was observed. ResultsCompared with Group A, Bederson Neural Function scores of Group B,C indicated significant differences at each time (P<0.01).The abilities of grasping, walking and coordinating of all the groups after 24 hours by operation handicapped, however with time continuing,every function of Group A restored and that of Group B or C improved partly,but showed significant difference compared with Group A(P<0.01).After 3 days by operation,balancing wood test of Group C was better than that of group B(P<0.05),after 7 days,except Bederson Neural Function score,there were difference between Group C and B(P<0.05 or P<0.01).After 7 days by operation,compared with Group A,brain tissue of infarction area in Group B indicated significantly edema, neural cells decreased. Compared with Group B, the edema in Group C decreased and neural cells increased.ConclusionsRehabilitation therapy can improve the MCAO rats' ability of equilibrating, grasping and walking, and decrease edema, increase neural cells in infarction areas.

ObjectiveTo observe effects of rehabilitation training on behavior and sensory evoked potential of rats with acute cerebral infarction.Methods30 male Wistar rats were randomly divided into sham operation groups (group A), model group (group B), and rehabilitation group (group C). Animal model was made by blocking the middle cerebral artery (MCA). For each group, the Bederson Neural Function was scored and balancing wood, rotating bar, and net screen were tested at the 24 hours, 3rd day and 7th day after operation respectively. The sensory evoked potential (SEP) latency of each group was also tested right after operation and on the 7th day after operation.ResultsComparing with group A, Bederson Neural Function scores of groups B and C indicated significant differences at each time (P<0.01). The ability of grasping, walking and coordinating of all groups handicapped 24 hours after operation, however, with time continuing, every function of group A restored and that of group B or C improved partly, but showed significant difference compared with group A (P<0.01). On the 3rd day after operation, balancing wood test of group C was better than that of group B (P<0.05), on the 7th day after operation, except Bederson Neural Function scores, there were significant difference between groups C and B (P<0.01 or P<0.05). Right after operation, compared with group A, the SEP latency of group B and C showed significant difference (P<0.01), on the 7th day after operation, the SEP latency of group C improved significantly compared with itself right after operation (P<0.01).ConclusionThe rehabilitation training can improve the MCAO rats' ability of equilibrating,grasping and walking and adjust the abnormal latency of SEP after MCAO, and prevent the nerve cells from damage caused by ischemic trauma.

Objective To study the effects of rehabilitation training on the expression of Nogo-A around the area of cerebral infraction using rats. Methods A total of 60 Wistar rats were randomly divided into a reha- bilitation group and a control group after an experimental cerebral infarction had been established in them. The ani- mals in the rehabilitation group were given exercise with a rotating bar, a balance beam and a rolling cage for one hour daily, while those in the control group were caged without any abnormal exercise. Nogo-A expression in the ar- ea surrounding the infarcts was detected by imunohistochemical techniques at the 3rd, 7th, 14th, 21st and 28th day after infarction. Meanwhile, neurobehavioral evaluations were also conducted. Results The animals in the rehabilitation group scored much lower than the controls in the behavioral evaluations at the 14th, 21st and 28th day. The expression of Nogo-A in tissues around the infracted area increased by the 7th day and peaked at the 21st day in both groups, but the expression of Nogo-A was significantly stronger in the rehabilitation group at the 14th, 21st and 28th days. Conclusion Rehabilitation training decreased the expression of Nogo-A in the brain of rats after infarction. This may have important implications for the functional recovery of the central nervous system.

The prevalence of stroke is increasing in China and the world,and cognitive impairment,as one of the most common complications of stroke,has attracted much attention of many researchers.Post-stroke cognitive impairment (PSCI) has severely affected patients' daily living ability,which has brought heavy burden to family and society.In addition,with the increasing of age,PSCI may even develop into dementia,so we need to give early diagnosis,early treatment and prevention to patients with PSCI.In this paper,the concept of PSCI,neuropsychological characteristics,screening scale and treatment are described to improve the staff awareness and management of PSCI.

This paper expounds that the construction of a clinical teacher's teaching ability model is an urgent problem to be solved in medical colleges and universities, and analyzes that the current clinical teaching concepts and methods are constantly improving, and the clinical teaching environment is more informatized and intelligent. This paper summarizes the clinical teachers' teaching ability models at home and abroad, such as the ability and quality iceberg model, teacher growth model, inquiry-based teaching model, Molenaar three-dimensional teaching ability model, etc., and discusses the practice research progress of current clinical teacher teaching ability models such as student-centered guided teaching, bedside teaching, micro-teaching and BOPPPS (bridge-in, objective, pre-assessment, participatory-learning, post-assessment, and summary) method, medical simulation teaching, etc., hoping to provide guidance for further constructing models of teacher's teaching ability suitable for Chinese medical colleges and universities.

Compatibility chemistry of acid-alkaline pair medicines in formulas of traditional Chinese medicine (TCM) is an important research field which should merit to pay attention. The ideas and methods in prescription compatibility research on formulas containing alkaline-acid pair medicines were summarized from the aspect of chemical groups of alkaline and acid ingredients; the research results were introduced and analyzed; the research meaning was elaborated; and the expectation of the field was viewed.
Animals ; Chemistry, Pharmaceutical ; methods ; Drug Incompatibility ; Drugs, Chinese Herbal ; chemistry ; Humans ; Medicine, Chinese Traditional ; Research

Objective:To observe the expression of adenosine kinase (ADK) in the hippocampus of patients with refractory epilepsy, and to explore the role of ADK in the pathogenesis of refractory epilepsy.Methods:Thirteen patients with intractable epilepsy who underwent surgical resection of hippocampal tissue at the First Affiliated Hospital of Harbin Medical University were collected as the epilepsy group; At the same time, 4 cases of relatively normal temporal lobe brain tissue from patients with traumatic brain injury undergoing debridement surgery (without previous history of epileptic seizures) were collected, and these 4 patients served as the control group. The expression of ADK in two groups of specimens was detected at the tissue, gene, and protein levels using methods such as dual fluorescence immunohistochemistry, real-time quantitative polymerase chain reaction (RT Real time PCR), and Western blotting.Results:In the human brain, ADK was mainly expressed in the nucleus of astrocytes. Through histological observation, ADK was weakly expressed in normal brain tissue, while there is significant proliferation of glial cells and excessive expression of ADK in the brain tissue of patients with refractory epilepsy. The percentage of ADK positive glial cells in the epilepsy group was (53.90±17.59)%, and the control group was (23.82±4.18)%, with a statistically significant difference ( P<0.01). At the genetic level, using RT Real time PCR, it was found that the expression level of ADK mRNA in the epilepsy group was higher than that in the control group, with a 2 -△△Cp of 13.36, which was 13.36 times higher than that in the control group. At the protein level, the expression of ADK protein in the epilepsy group was found to be higher than that in the control group using protein immunoblotting ( P<0.01). Conclusions:ADK is weakly expressed in the nucleus of astrocytes in normal human brain tissue. In the brain tissue of patients with refractory epilepsy, astrocytes significantly proliferate and there is excessive expression of ADK. ADK may play an important role in the occurrence and development of refractory epilepsy in humans.