Objective To investigate the effect of mild hypothermia therapy on plasma tissue-type plasminogen activator (tPA)/plasminogen activator inhibitor-1 (PAI-1) in patients with massive cerebral infarction (MCI).Methods The patients with MCI were randomly divided into the conventional therapy group and the mild hypothermia therapy group.On the basis of conventional therapy,the latter received local mild hypothermia therapy for 48 hours immediately after admission.Enzyme-linked immunosorbent assay was used to detect plasma tPA and PAI-1 at admission and at 48 hours after mild hypothermia,respectively.The general information and the tPA and PAI-1 levels before and after treatment in both groups were compared.Results A total of 46 patients with MCI were included.There were 26 and 20 patients in the conventional therapy group and the mild hypothermia therapy group,respectively.There were no significant differences in the general information,the tPA and PAI-1 levels before and after treatment in both groups,and the levels of plasma tPA (80.98 ± 34.64 pg/mL vs.110.1 ± 32.7 pg/mL; t =3.462,P =0.013) and PAI-1 (145.40 ± 45.29 pg/mL vs.174.2 ± 38.0 pg/mL; t =4.854,P =0.034) at 48 hours of mild hypothermia therapy in the mild hypothermia therapy group were significantly lower than those in the conventional therapy group.Conclusions Mild hypothermia therapy may decrease the plasma tPA and PAI-1 levels in patients with MCI,and it may be associated with the neuroprotective effect of hypothermia therapy.

The imbalance in the fibrinolytic system participates in the pathophysic-logical processes of ischemic stroke. Most researchers consider that the fibrinolytic activity decreases in patients with ischemic stroke, while others believe that it increases. Mild hypothermia is a therapeutic approach with great potential and plays the neuroprotective effect through a variety of mechanisms. Animal experiments have demonstrated that the treatment with mild hypothermia may increase the plasma fibrinolytic activity and decrease the expression of local plasminogen activator in ischemic area. Howere, the related clinical research studies are few, and most of them are limited in the safty and collaborative research of mild hypothermia combined with other treatment therapies.

Objective To investigate the correlation between cerebral microbleed (CMB) and hemorrhage transformation (HT) after urokinase intra-arterial thrombolysis in patients with acute ischemic stroke.Methods The patients with acute cerebral infarction treated with intra-arterial urokinase were enrolled.They were divided into either an HT group or a non-HT goup according to whether they had HT or not.Conventional MRI sequences,susceptibility-weighted imaging (SWI),and CT scan were performed before procedure.CT or MRI was reexamined within 48 hours after procedure.The patients' demographic data,vascular risk factors,and the SWI sequences showed the numbers of CMB were documented in detail and they were compared and analyzed.Results A total of 62 patients were included,22 in HT group and 40 in non-HT group.Univariate analysis showed that the proportions of hypertension (81.8％ vs.57.5％ ; x2 =3.125,P =0.048),diabetes (63.6％ vs.40.0％ ; x2 =4.019,P =0.042),smoking (72.7％ vs.37.5％ ; x2 =4.971,P =0.030),and presence of CMB (x2 =5.297,P =0.018) of patients in the HT group were significantly higher than those in the non-HT group.Multivariate logistic regression analysis showed that hypertension (odds ratio [OR]1.51,95％ confidence interval [CI]1.102-2.954; P =0.028),diabetes (OR 1.48,95％ CI 1.09-2.825; P =0.039),and CMB (OR 1.867,95％ CI 1.103-3.158; P =0.020) were the independent risk factors for HT after urokinase intra-arterial thrombolysis in patients with acute ischemic stroke.Conclusions CMB was one of the independent risk factors for occurring HT after urokinase intra-arterial thrombolysis in patients with acute ischemic stroke.

Objective:To explore whether cigarette smoking extract (CSE) has influence on fluorescence protein ex-pression of thrombomodulin (TM) on surface of African green monkey kidney fibroblast cells (COS-7) or not . Methods:When TM-green fluorescent protein (GFP) plasmid was successfully constructed ,COS-7 cells were trans-fected by it ,then incubated by prepared 5% CSE (5% CSE group) ,PBS of certain volume was added to serum-free minimal essential medium (MEM ,simple medium) ,which was cultured at the same time and treated as control group .Flow cytometry counting method was used to detect change of TM-GFP expression amount on COS-7 surface at different time point .Results:Compare with control group ,there were no significant difference in the expression of TM-GFP on COS-7 surface at 1h and 6h in 5% CSE group [1h :(134.99 ± 18.41) vs .(146.61 ± 12.06) ,6h :(116.89 ± 27.28) vs .(123.89 ± 39.24) ,P>0.05 both] .Conclusion:The 5% cigarette smoking extract has no influ-ence on fluorescence expression of thrombomodulin on surface of African green monkey kidney fibroblast cells .

Objective To discusses the clinical features of early inflammatory bowel obstruction (EPIS-BO) after abdominal surgery,and analyze diagnosis and treatment. Methods The clinical data of 48 patients with early inflammatory bowel obstruction after abdominal surgery were analyzed retrospectively from July 2005 to July 2015. Results 45 patients were recovered after non-operative treatment including gastrointestinal decompression , total parenteral nutrition (TPN),antibiotics,glucocorticoid and somatostatin. The average time of treatment was 17.45 days. The other 3 patients underwent laparotomy respectively on 16,19 and 20 days after conservative treat-ment.Two cases were turned to intestinal fistula after operation ,and one of them died after reoperation because of severe abdominal infection 9 days later. Conclusion Conservative treatment should be regarded as the first choice for EPISBO in clinical practice due to less complications and better effect than operative treatment.

Objective To study autocrine characteristics of substance P(SP)in epidermal stem cells(ESCs). Methods In vitro cultured ESCs was stimulated by exogenous SP.Then,the expressions of SP gene,protein and exogenous SP protein in ESCs and the supernatant fluid were detected by immunofluorescence,ELISA,Western blot and real-time PCR. Results After stimulation by exogenous SP,the expression of SP protein in ESCs and supernatant fluid was up-regulated and reached peak at 24th hour,with higher concentration than the added SP.The gene expression of SP was up-regulated to the peak 6 hours after stimulation by SP.Both expression of gene and protein remained unchanged after the natural killer cell receptor Was blocked even by stimulation with exogenous SP. Conclusion Anticrine of SP of ESCs can be induced by exogenous SP.

High altitude polycythemia (HAPC) had become one of the main common chronic diseases, which had seriously threatened the health of Plateau people. In the Tibetan medicine classic bookSi-Bu Yi-Dian, there were recordings on HAPC treatment methods and medications, which had the unique advantages of identified therapeutic effect with little side effect. This article analyzed Tibetan medicine in the prevention and treatment of HAPC from aspects such as etiology and pathogenesis, clinical treatment advantages and modern innovation study. Questions were also raised on lacking of standardization on HAPC clinical effectiveness, as well as Tibetan medicine compound material basis and action mechanisms were unclear. It was proposed that based on the inheritance of Tibetan medicine theoretical basis and clinical therapeutic effect, the Tibetan medicine original thinking should be combined with modern science and technology, in order to strengthen the analysis of ancient literature collection in HAPC treatment and data mining in medication experiences. The clinical treatment standards and medication plan should be standardized. Methods of systems biology, such as metabolomics, can be used in the further study of the scientific connotation of HAPC treatment by Tibetan medicine.

OBJECTIVE:To optimize the preparation technology of substance P multivesicular liposomes(Depo-SP)and investigate its property.METHODS:Depo-SP was prepared by multiple emulsion method,with encapsulation efficiency taken as index,molar ratio of phospholipid to cholesterol(A),ultrasound emulsification time(B),volume ratio of colostrum to two-phase water(C)and coemulsifier concentration(D)as factors to design the orthogonal experiment for optimizing the preparation technology.The encapsulation efficiency,distribution of particle size,in vitro drug release profiles,phase transition temperature and melting point of the optimized preparation were determined.RESULTS:The optimized preparation conditions of Depo-SP were as follows:A-2:1,B=30 s,C=1:2 and D=2%.The encapsulation efficiency of the preparation reached 85%;the particle size stood at 0.75～27.75?m;the SP release in normal sodium was t_(1/2)=11 h and the sustained release maintained for 72 hours;the phase transition temperature was 34℃and the melting point was 110℃. CONCLUSION:The prepared Depo-SP had high encapsulation efficiency and stable in physical property,and it is an ideal sustained release preparation.

Objective:To observe the changes of cognitive function, subcortical nuclei volumes, and diffusion kurtosis imaging (DKI) parameters (values of fractional anisotropy [FA], mean diffusivity [MD] and mean kurtosis [MK]) after surgery in patients with aneurysmal subarachnoid hemorrhage (aSAH), and analyze the correlations of cognitive dysfunction with subcortical nuclei volumes and DKI parameters.Methods:A prospective sutdy was conducted;17 patients with aSAH confirmed by surgery in our hospital from September 2019 to June 2020 were selected as patient group, and 16 healthy volunteers whose age, gender, and education level were matched with the patient group were recruited as control group. Neuropsychological tests and MR imaging were performed in the patients 3 months after surgery and the controls right after enrollment. The structural image data of all subjects were post-processed. Bilateral subcortical nuclei volumes and DKI parameters were analyzed. The differences of general clinical data, subcortical nuclei volumes and DKI parameters were compared between the two groups. The correlations of mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) scores with subcortical nuclei volumes and DKI parameters were analyzed.Results:As compared with the control group, the patient group had significantly lower MMSE and MoCA scores, and statistically decreased volumes of ipsilateral hippocampus, ipsilateral thalamus and ipsilateral lentiform nucleus ( P<0.05). The FA values of the contralateral caudate nucleus, bilateral thalamus and bilateral lentiform nucleus and MK values of the ipsilateral hippocampus in the patient group were significantly decreased as compared with those in the control group ( P<0.05); while the MD values of the ipsilateral caudate nucleus in the patient group were significantly increased as compared with those in the control group ( P<0.05). The volume of ipsilateral hippocampus was positively with MoCA scores ( r=0.604, P=0.038); the FA values of contralateral caudate nucleus were negatively correlated with MMSE scores ( r=-0.579, P=0.049). Conclusions:Cognitive dysfunction, atrophy of ipsilateral hippocampus, thalamus and lenticular nucleus, and changes of DKI parameters exist in patients with aSAH after surgery. The changes in ipsilateral hippocampus volume and FA values of caudate nucleus may be related to the postoperative cognitive dysfunction in these patients.

Objective:To investigate molecules involved in the occurrence of pruritus in patients with mycosis fungoides (MF) .Methods:Totally, 522 patients with MF were enrolled from Peking University First Hospital from October 2009 to August 2021, and the incidence of pruritus was calculated. The patients were grouped according to whether they suffered from pruritus or not. RNA sequencing data on biopsied skin lesions of 49 patients were analyzed to identify differentially expressed genes between patients with pruritus and those without; enzyme-linked immunosorbent assay and immunohistochemical techniques were performed to determine the protein expression of CC chemokine ligand 17 (CCL17) in serum samples from 88 MF patients, and in tissue samples from 81 MF patients, respectively; flow cytometry was conducted to detect markers for T lymphocyte activation and differentiation in peripheral blood samples from 46 MF patients to identify peripheral blood lymphocyte subsets associated with pruritus. Statistical analysis was carried out by using chi-square test, Mann-Whitney U test, and Spearman correlation analysis. Results:Among the 522 patients with MF, 305 were males and 217 were females; 347 were diagnosed with early-stage MF, and 175 with advanced MF. The incidence of pruritus was 67.2% (351/522) in the patients with MF, and significantly higher in the patients with advanced MF (81.7%, 143/175) than in those with early-stage MF (59.9%, 208/347; χ2 = 25.03, P < 0.001) . RNA sequencing showed that CCL17 mRNA expression was significantly higher in the MF patients with pruritus than in those without (fold change = 10.09, P < 0.001) . The serum CCL17 concentration was significantly elevated in the patients with pruritus (1 017.05[377.12, 4 831.80] pg/ml) compared with those without (361.66 [180.47, 500.08] pg/ml; Z = -4.57, P < 0.001) , and correlated with pruritus scores ( r = 0.57, P = 0.010) . In both early and advanced stages of MF, the serum CCL17 concentration was significantly higher in the patients with pruritus than in those without ( Z = -3.68, P < 0.001; Z = -2.54, P = 0.011, respectively) . Immunohistochemical staining revealed that there was no significant difference in the relative quantification value of CCL17 between the patients with pruritus and those without ( Z = -1.84, P = 0.066) . The percentage of CD3 +CD4 +CD26 -CCR4 + malignant T cells significantly increased in the MF patients with pruritus than in those without ( Z = -2.03, P = 0.043) , and was positively correlated with serum CCL17 concentrations ( r = 0.49, P < 0.001) . Conclusions:Both CCL17 mRNA expression in lesional tissues and serum CCL17 concentrations increased in MF patients with pruritus, and CCL17 was associated with the occurrence of pruritus. CCL17 may be involved in the occurrence of pruritus through the recruitment of CD3 +CD4 +CD26 -CCR4 + malignant T cells.