Head MRI and CT scans Can frequently find ischemic cerebral white matter lesions in healthy elderly and in patients with atherosclerosis.Ischemic cerebral white matter lesions are regarded as a manifestation of cerebral small vessel lesions.which Can result in symptoms such as cognitive impairment,and predict extraeranial or intracranial ischemic events.This article reviews the recent progress in research on cerebral white matter lesions.their pathogenesis and clirilcal significance.

Objective To screen the amyloid protein-β(Aβ)degradation-associated genes through peripheral blood monocytes(PBMC)-extracted gene microarray analysis in patients with Alzheimer's disease(AD).Methods PBMC were isolated from blood of elderly AD patients versus age-matched healthy individuals(control).The cDNA(mRNAs)were analyzed using gene microarray.And real-time quantitative polymerase chain reaction detection and enzyme activity analysis were used to verify the primary outcome of gene chip.Results The expression of cathepsin D mRNA in peripheral blood monocytes was 104.70±15.96 in AD patients as compared with the control group 49.86±5.19,and the activity of cathepsin D was (22 620 ± 1 389) RFU in AD versus (32 210 ± 2 284) RFU in control (both P＜0.05).Conclusions The results suggest that the decreased levels of cathepsin D could be the stage markers related to the pathophysiology of AD process.Based on the microarray data,we select cathepsin D genes for further study.

Cerebral small vessel disease refers to a series of clinical, imaging and pathological syndromes caused by various diseases affecting small arteries, arterioles, capillaries, venules, and venules in the brain, thereby causing ischemia or hemorrhage in brain tissue. At present, intravenous thrombolytic therapy is the first choice for the treatment of acute ischemic stroke, however a large number of studies have shown that the presence of cerebral small vessel disease before acute ischemic stroke increases the risk of intravenous thrombolysis. In this article, the recent research progresses about the relationship between cerebral small vessel disease and hemorrhagic transformation after venous thrombolysis in acute ischemic stroke are reviewed, aiming to provide a new reference for clinical intravenous thrombolytic therapy.

Stroke has increasingly become one of the three major diseases threatening human beings,among which acute ischemic stroke is the most common.Intravenous thrombolysis has become the first choice for acute ischemic stroke,but a large number of studies have shown that intravenous thrombolysis increases the risk of hemorrhagic transformation.The latest advances in clinical types,incidence,mechanism and risk factors of hemorrhagic transformation after thrombolysis with recombinant human tissue plasminogen activator are reviewed in this article,and the possible predictors of hemorrhagic transformation are discussed,aiming to provide new reference for clinical thrombolytic therapy.

Objective:To investigate the situation of nursing handover among psychiatric nurses, and explore the association between perceived organizational support, self-efficacy and quality of nursing handover.Methods:A total of 186 clinical nurses in Shandong Mental Health Center were enrolled by convenience sampling method. They were assessed with handover evaluation scale, perceived organizational support scale and general self-efficacy scale for the evaluation of nursing handover, perceived organizational support and self-efficacy.Results:The average score of quality of nursing handover was 5.85±1.14, and bi-variate correlations were found between perceived organizational support, self-efficacy and quality of nursing handover. Self-efficacy could mediate the relationship between organizational support and nursing handover, and the value of mediating effect was 13.4%.Conclusions:Self-efficacy might mediate the relationship between perceived organizational support and nursing handover among psychiatric nurses.

Sweet's syndrome (SS) is a rare disease characterized by fever, elevated neutrophil count and skin erythema. When the central nervous system is involved, it is called neuro-Sweet disease (NSD). The clinical manifestations of NSD are highly heterogeneous. Encephalitis or meningitis are the most common neurological manifestations. There can be no specific changes or abnormal signal changes in the focus in brain magnetic resonance imaging (MRI). Circular enhancement of the focus can be seen on enhanced scanning. The disease is sensitive to hormone therapy, but it is easy to relapse in the process of hormone reduction. In order to improve clinicians' understanding of this rare disease, our study systematically reviews the clinical manifestations, diagnosis, treatments and prognoses of NSD.

Cerebral small vessel disease refers to a series of clinical, imaging and pathological syndromes caused by various diseases affecting small arteries, arterioles, capillaries, venules, and venules in the brain, thereby causing ischemia or hemorrhage in brain tissue. At present, intravenous thrombolytic therapy is the first choice for the treatment of acute ischemic stroke, however a large number of studies have shown that the presence of cerebral small vessel disease before acute ischemic stroke increases the risk of intravenous thrombolysis. In this article, the recent research progresses about the relationship between cerebral small vessel disease and hemorrhagic transformation after venous thrombolysis in acute ischemic stroke are reviewed, aiming to provide a new reference for clinical intravenous thrombolytic therapy.

Objective: To examine the potential mediating effect of perceived social support on job insecurity and psychological distress among clinical nurses. Methods: A total of 462 clinical nurses in Shandong Province were selected by convenience sampling method. They were assessed with job insecurity scale, perceived social support and 10-item Kessler Psychological Distress Scale (K10) for the evaluation of job insecurity, self-esteem and psychological distress. Results: The mean score of K10 was (23.72±7.22) points among clinical nurses, and 85.9% (397/462) of them had psychological distress problems. The K10 scores were positively correlated with the scores of job insecurity (r=-0.282, P<0.01), and the K10 scores were negatively correlated with perceived social support scores (r = -0.282, P<0.01). Job insecurity was negatively correlated with perceived social support (r = -0.365, P<0.01). The confidence interval from Bootstrap method indicated perceived social support played a partial mediating role between job insecurity and psychological distress, and the value of mediating effect was 13.7%. Conclusion The relation of perceived social support to job insecurity and psychological distress among clinical nurses are intimate. Perceived social support might mediate the relationship between job insecurity and psychological distress.