Neurovascular unit is a new paradigm to explore pathophysiology of central nerve system. Its components constitute complex networks for maintaining the steady-state microenvironment of neurons. This article reviews the steady-state changes, related diseases, and neurovascular unit protection among all the components of neurovascular unit, mainly focuses on the neurovascular coupling, ion signal of neurovascular unit, channel regulation, neurovascular regeneration and nutritional factors, as well as the pathological changes of neurovascular unit of ischemic stroke and related control methods.

The vascular depression is a subtype of depression.It has its specificity in clinical features,imaging,and treatment outcome etc.This article reviews the advances in research on the aspects of risk factors,pathogenesis,diagnosis,clinical features,and outcomes of vascular depression,particularly the vascular risk factors,steady-state changes in the neurovascular unit,immune cytokine activation,imaging characteristics of white matter damage and treatment of repetitive transcranial magnetic stimulation as well as its correlation with dementia and cardiocerebrovascular diseases.

Objective This clinical research will compare the constitution of patients with positive and negative family history in order to study on the relation between TCM constitution and the familial hereditary in type 2 diabetes patients.Methods The data of family history,general conditions,Chinese medical constitutional types of 231 type 2 DM patients in Dongzhimen Hospital were collected and analyzed.Results Among patients with family history,the number of patients' mothers with diabetes was significantly more than that of fathers'(x2=22.319,P＜0.05).There was a positive correlation between phlegm-dampness constitution r=0.215,blood stagnant constitution r=0.268 and female patients' family history(P＜0.01).And there was a positive correlation between the familial hereditary of DM and the familial hereditary of hypertension r=0.328,hyperlipidemia r=0.223,obesity r=0.151 and coronary artery diseases r=0.215.Conclusion Among type 2 DM,female had stronger familial hereditary.It indicated that diabetic mothers had a stronger influence on following generations than diabetic fathers,especially those female patients of phlegm-dampness constitution or blood stagnant constitution.There was inner correlation between the familial hereditary of DM and the familial hereditary of hypertension,hyperlipidemia,obesity and coronary artery disease.

The psychological adjustment of disabled athletes generally experienced five times,psychosocial rehabilitation of disabled athletes should be targeted for education and other cognitive therapy.To find out the psychological features of disabled athletes,take health education such as the psycho-social rehabilitation is of far-reaching significance to help disabled athletes restoring good mental state,raising the level of mental health,reconstructing social behavior,and re-entrying society as soon as.

ObjectiveTo investigate the clinical significance of posterior spinal cord shifting after two different types of laminoplasty for multilevel cervical myelopathy.Methods From June 2004 to September 2007,65 patients with cervical spondylotic myelopathy were reviewed in this study,including 41 males and 24 females with an average age was 56.3 years(range,39-75).Among them,33 patients underwent selective laminoplasty and 32 patients underwent open-door laminoplasty.There were no significant differences of preoperative JOA scores and cervical curvature index between two groups.After one year follow -up,the posterior shifting of spinal cord,Japanese Orthopaedics Association (JOA) recovery rate,loss of curvature index and axial symptom for each patient were calculated.ResultsAll cases were followed up for average 34 months(range,26-47).There was significant difference of the postoperative posterior shifting between the two groups,which was(1.4±0.6) mm in selective laminoplasty group and(3.3±1.2) mm in opendoor laminoplasty group,respectively.The average JOA recovery rate was 60.5％±21.3％ and 61.1％±17.9％ in selective laminoplasty and open-door laminoplasty group,respectively.There was no significant difference of JOA recovery rate between the two groups.Loss of cervical curvature indices was 3.3％±1.7％ and 3.1％± 2.4％ in selective laminoplasty and open-door laminoplasty group,respectively,with no significant difference between the two groups.The rate of patients with evident axial symptoms was 18.2％ and 33.3％ in selective laminoplasty group and open-door laminoplasty group,and the difference of the scores of cervical axial symptom was statistically significant.ConclusionThe degree of the postoperative posterior shifting of the spinal cord in open-door laminoplasty group was greater than that in selective laminoplasty group.The posterior shifting of the spinal is correlated with cord,axial symptom but not the recovery rate and curvature index.

Objective To evaluate the effects of dexmedetomidine (DEX) on cell apoptosis induced by endoplasmic reticulum stress and c-Jun N-terminal kinase (JNK) pathway during one-lung ventilation (OLV) in rats.Methods Sixty male Sprague-Dawley rats were randomly allocated into 6 groups (n =10 each):sham operation group (Sham group),OLV group,OLV + atipamezole (α2 receptor antagonist) group (AD group),OLV + atipamezole + DEX group (DEX+AD group),OLV + low-dose DEX group (DEX-L group) and OLV + high-dose DEX group (DEX-H group).The animals were anesthetized with 10％ chloral hydrate 4.5 ml/kg,tracheostomized and mechanically ventilated.Bilateral lungs were ventilated for 2.5 h in Sham group.The right lung was ventilated for 2.0 h followed by 0.5 h two-lung ventilation in OLV group.In DEX-L and DEX-H groups,DEX was infused intravenously for 1 h at a rate of 2.5 μg · kg-1 · h-1 and 5.0 μg · kg-1 · h-1,respectively,starting from 1 h prior to OLV.Atipamezole 250 μg/kg was injected intravenously at 1 h prior to OLV in AD group.Atipamezole 250 μg/kg was injected intravenously at the onset of DEX infusion (5.0 μg · kg-1 · h-1) in DEX+AD group.The rats were sacrificed and left lungs were removed for determination of weight to dry lung weight ratio (W/D),cell apoptosis in lung tissues (by TUNEL),and expression of glucose-regulated protein 78 (GRP78) mRNA and protein,JNK mRNA and phosphorylated JNK (p-JNK) protein (by RT-PCR and Western blot).Pathological changes of lungs were examined and the injured alveolus rate (IAR) was counted under light microscope.The changes in ultrastructure of lung tissues were observed under transmission electron microscope.Apoptosis index (AI) was calculated.Results W/D,AI and IAR were significantly higher in OLV,AD and DEX+AD group than in Sham group,while lower in DEX-L and DEX-H groups than in OLV,AD and DEX+AD groups.The pathological changes of the structure of lung tissues were observed in OLV,AD and DEX+AD groups,while the pathological changes were significantly alleviated in DEX-L and DEX-H groups.In OLV,AD and DEX + AD groups,there was apoptosis in lots of pulmonary vascular endothelial cells and alveolar epithelial cells,while cell apoptosis was significantly reduced after administration of DEX.The expression of GRP78 mRNA and protein,JNK mRNA and p-JNK protein was significantly higher in OLV,AD and DEX+AD groups than in Sham group,and lower in DEX-L and DEX-H groups than in OLV,AD and DEX +AD groups.Conclusion DEX pretreatment can protect lungs during OLV,and inhibited JNK signaling pathway and reduced cell apoptosis induced by endoplasmic reticulum stress may be involved in the mechanism.

Objective To evaluate the efficacy and safety of itraconazole injection in treatment of invasive fungal infection in the patients with multiple organ dysfunction syndrome.Methods Invasive fungal infection in 15 patients with multiple organ dysfunction syndrome was treated with 200 mg itraconazole injection,twice a day on the first two days,then once a day,for 8 to 14 days.During the treatment,the symptoms and signs,the results of chemical detection were recorded.Everyday fungus,sputum,stool smear or culture were performed.Results The recovery rate,effective rate,and fungal clearance in this trial with itraconazole injection were 80%(12/15),86.7%(13/15),and 86.7%(13/15) respectively.The side effect was not found.Conclusion Itraconazole injection is an effective and safe drug against invasive fungal infection in patients with multiple organ dysfunction syndrome.

Objective To evaluate the effects of propofol on the expression of hippocampal γ-aminobutyric acid (GABAA) and NMDA receptor in a rat model of inflammatory pain (IP).Methods A total of 32 female Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 4 groups (n =8 each):control group (group C),group IP,and different doses of propofol groups (P1,2 groups).IP was induced by injection of formalin.In group C,normal saline and dimethyl sulfoxide (DMSO) 0.1 ml/kg were injected intraperitoneally.In group IP,normal saline and DMSO 0.1 ml/kg were injected intraperitoneally,and 5 min later formalin was injected.In P1,2 groups,propofol 30 and 100 mg/kg were intraperitoneally injected,respectively,and 5 min later formalin was injected.The pain behavior of rats was observed within 1 h after injection of formalin and pain intensity scoring (PIS) value was calculated.The animals were sacrificed at 1 h after injection of formalin and the hippocampi were isolated for determination of GABAA and NMDA receptor expression by immunohistochemisty.Results Compared with group C,PIS value was significantly increased,GABAA and NMDA receptor expression was up-regulated in IP and P1.2 groups.Compared with group IP,PIS value was significantly decreased,GABAA receptor expression was up-regulated,and NMDA receptor expression was down-regulated in P1,2 groups.PIS value was significantly lower,GABAA receptor expression was higher,and NMDA receptor expression was lower in group P2 than in group P1.Conclusion Intraperitoneal propofol can down-regulate NMDA receptor expression in hippocampi of rats with IP,thus inhibiting responses to pain sensitivity; intraperitoneal propofol can up-regulate hippocampal GABAA receptor expression,thus enhancing endogenous mechanism of analgesia.

Objective: To observe the clinical characteristics and current treatment status in patients with chronic heart failure (CHF) at different grade hospitals in Xinjiang Area.
Methods: A total of 5357 patients with CHF diagnosis discharged from 20 different grade hospitals in Xinjiang area from 2011-01 to 2012-02 were enrolled. The age, gender, nationality, etiology of CHF, cardiac function, complications and current medication status in all patients were systemically studied.
Results:①There were 2295/5357 (42.8%) patients with Han nationality, 2255 (42.1%) with Uyghur nationality and 8.07 (15.1%) with other nationalities. The average age of patients was at (64.60 ± 12.77) years.②The etiology of CHF were, in turn, as: coronary artery disease (CAD) 50.8%, hypertension (31.8%), dilated cardiomyopathy (7.2%).③ The ratios of patients with NYHA III-IV in county hospital 440/682 (64.5%), in regional hospital 1180/1557 (75.8%) were higher than that that in grade A class 3 hospital 967/3118 (31.0%), ( =1390.362,P=0.000).④The patients in county hospital, regional hospital showed increased left atrial diameter (44.7 ± 8.8) mm, (39.5 ± 8.1) mm and left ventricular end-diastolic diameter (60.6 ± 11.1) mm, (56.9 ± 11.1) mm than those in grade A class 3 hospital (37.3 ± 7.1) mm and (53.8 ± 9.7) mm; while decreased LVEF (41.9 ± 10.5) %, (42.3 ± 13.0) % than that in grade A class 3 hospital (46.5 ± 12.8), allP<0.001.⑤The medication status in different grade hospitals as ACEI/ARB, β-blocker, aldosterone antagonist, diuretics, digitalis were at 72.8%, 66.8%, 46.6% , 45.5% and 26.8% respectively. The application of ACEI/ARB and β-blocker in county hospital (61.4% and 51.5%) and in regional hospital (72.3% and 58.3%) were lower than those in grade A class 3 hospital (75.6% and 74.3%); while the application of aldosterone antagonist in county hospitals (57.9%) and in regional hospital (73.8%) were higher than that in grade A class 3 hospital (30.6%), allP<0.001.
Conclusion: The etiology of CHF were mainly as CAD and hypertension in Xinjiang area, the patients in county and regional hospitals had more severe conditions than that in grade A class 3 hospital, which implying the distance between the guideline standard and real practice especially in basic level hospitals.

The aimed of this study was to prepare stabilized thiomers to overcome the poor stability character of traditional thiomers. Poly(acrylic acid)-cysteine (PAA-Cys) was synthesized by conjugating cysteine with poly(acrylic acid) and poly(acrylic acid)-cysteine-6-mercaptonicotinic acid (PAA-Cys-6MNA, stabilized thiomers) was synthesized by grafting a protecting group 6-mercaptonicotinic acid (6MNA) with PAA-Cys. The free thiol of PAA-Cys was determined by Ellmann's reagent method and the ratio of 6MNA coupled was determined by glutathione reduction method. The study of permeation enhancement and stabilized function was conducted by using Franz diffusion cell method, with fluorescein isothiocyanate dextran (FD4) used as model drug. The influence of polymers on tight junctions of Caco-2 cell monolayer was detected with laser scanning confocal fluorescence microscope. The results indicated that both PAA-Cys and PAA-Cys-6MNA could promote the permeation of FD4 across excised rat intestine, and the permeation function of PAA-Cys-6MNA was not influence by the pH of the storage environment and the oxidation of air after the protecting group 6MNA was grafted. The distribution of tight junction protein of Caco-2 cell monolayer F-actin was influenced after incubation with PAA-Cys and PAA-Cys-6MNA. In conclusion, stabilized thiomers (PAA-Cys-6MNA) maintained the permeation function compared with the traditional thiomers (PAA-Cys) and its stability was improved. The mechanism of the permeation enhancement function of the polymers might be related to their influence on tight junction relating proteins of cells.