Depression is a common complication after stroke.It is often associated with disability and increased mortality.This article reviews the pathophysiology mechanisms of poststroke depression.

ObjectiveTo investigate the effect of endoscopic retrograde cholangiopancreatography(ERCP)combined with laparoscopic resection (LC) in the treatment of patients with cholecystic stone.Methods100 patients with cholecystic stone were randomly divided into observation group and control group.The patients in the control group (50 cases) received traditional open surgery,and the patients in observation group(50 cases) were given ERCP combined with LC.The effects of two groups were observed.ResultsThe operative time was (49.2 ± 8.5 ) min and intraoperative blood loss was(54.0 ± 12.2 )ml in the observation group.The operative time was (80.2 ± 15.7 )min and intraoperative blood loss was ( 114.5 ± 27.5 ) ml in control group.There were statistically significant differences between two groups(P ＜0.05 ).The hospital stay time and postoperative infection rate of the observation group was significantly lower than that of the control group ( all P ＜ 0.05 ).ConclusionIt was a safe and effective method to treat patients with cholecystic stone by ERCP combined with LC,which had the advantages of less trauma,faster recovery,less hospitalization time and could reduce the financial burden on patients,thereby it was worthy of clinical application.

Cervical artery dissection (CeAD) is an important cause of ischemic stroke in young adults w ith ischemic stroke. The clinical manifestations are often local facial pain, Horner syndrome, and ischemic stroke. With the development of noninvasive imaging, many patients w ith CeAD have got early diagnosis. Thromboembolism is an important mechanism of its pathogenesis. Timely giving anticoagulation therapy is reasonable. How ever, anticoagulants may lead to intramural hematoma expansion; therefore, there are also people w ho support antiplatelet therapy. How ever, the effectiveness of the 2 regimens needs to be confirmed by randomized trials. The recently completed Cervical Artery Dissection in Stroke Study (CADISS) in patients w ith stroke is the first prospective study aiming at the problem. The results have show ed that there w as no significant difference in efficacy betw een the anticoagulants and the antiplatelet drugs. Thrombolysis in patients w ith acute CeAD can not increase the risks of hemorrhage, and the rate of good functional outcome is similar to that of the control group. Therefore, it can be used as a treatment method in acute phase. For patients w hose antithrombotic treatment is invalid or having contraindications and repeated recurrent stroke can conduct endovascular intervention or surgical treatment. Usualy, the prognosis of patients w ith CeAD is better. The stroke recurrence rate is low . The abnormal arterial w als in more than half of the patients w il disappear at 3 to 6 months.

This study examined the effect of artesunate (Art) on the proliferation, DNA replication, cell cycles and apoptosis of vascular smooth muscle cells (VSMCs). Primary cultures of VSMCs were established from aortas of mice and artesunate of different concentrations was added into the medium. The number of VSMCs was counted and the curve of cell growth was recorded. The activity of VSMCs was assessed by using MTT method and inhibitory rate was calculated. DNA replication was evaluated by [3H]-TdR method and apoptosis by DNA laddering and HE staining. Flowmetry was used for simultaneous analysis of cell apoptosis and cell cycles. Compared with the control group, VSMCs proliferation in Art interfering groups were inhibited and [3H]-TdR incorprating rate were decreased as well as cell apoptosis was induced. The progress of cell cycle was blocked in G0/G1 by Art in a dose-dependent manner. It is concluded that Art inhibits VSMCs proliferation by disturbing DNA replication, inducing cell apoptosis and blocking cell cycle in G0/G1 phase.
Aorta/cytology ; Apoptosis/*drug effects ; Artemisinins/*pharmacology ; Cell Cycle/drug effects ; Cells, Cultured ; DNA Replication/*drug effects ; Muscle, Smooth, Vascular/*cytology ; Sesquiterpenes/*pharmacology

Branch atheromatous disease (BAD) is a deep cerebral infarction at the entrance or the origin of perforating artery because of atherosclerosis causing lumen stenosis or occlusion. It is common in clinical practice and there is often a clinical feature of progression or fluctuation in the acute phase. Its prognosis is poor and it will bring a heavy burden to the family and society. Therefore, the early intervention for patients with BAD is very important. This article reviews the treatment of BAD.

BACKGROUND: Collagen type Ⅰ possesses low antigenicity and provides special functions of scaffold structure for cell migration, proliferation and secretion.OBJECTIVE: To observe the morphological change after combination of transformed human embryonic tendon cells and artificial materials with collagen type Ⅰ, so as to provide the experimental basis for constructing tissue-engineered muscle tendon in vitro.DESIGN: Randomized and controlled observation.SETTING: Department of Orthopaedics, West China Hospital, Sichuan University.MATERIALS: This experiment was carried out at the Department of Transplantation Immunology, West China University of Medical Sciences from July to September 1998. Human hair, carbon fiber and polyglycolic acid were combined with collagen and then set corresponding groups respectively. Simply hair, carbon fiber and polyglycolic acid control groups were set respectively. Artificial materials: Healthy adult hair (30 cm in length, 80 g in weight), carbon fiber knitted strip (Lanzhou carbon factory )and polyglyolic acid fasciculi (Johnson , American) were used in this experiment.METHODS: ①In the group of human hair combined with collagen,nine healthy adult hairs were chosen . Three hairs as one bundle were knitted into tendon with 0.8 cm in length and 0.4 cm in diameter and a knot was tied respectively at the two ends. ②In the carbon fiber combined with collagen group, the purchased carbon fiber knitted strip was separated and made into artificial materials with the same diameter and length as those of human hair tendon. Two ends of the artificial materials were packed with 5/0 silk thread. ③In the polyglycolic acid combined with collagen group, three polyglycolic acid fasciculi were weaved into bundle with the same diameter and length as those of human tendon,and two ends were packed with 5/0 silk thread. ④The process of knitting scaffold materials was the same in control groups as in the corresponding experimental groups. ⑤ Five pieces were prepared in each scaffold material. After sterilized by 60Co, the scaffold materials were put in collagen type Ⅰ solution for 0.5 hour, then taken out and dried at roomtemperature for use in the experimental groups. ⑥transformed human embryonic tendon cell, density for 3×106/mm3, was used for combined culture in each group, and cell number and morphology were observed at different time points after culture under an inverted microscope and scanning electron microscope.MAIN OUTCOME MEASURES: ① Observation of cell growth and adherence under an inverted microscope ② Observation of cell morphology and material adherence under scanning electron microscope RESULTS: ① Observation of cell growth and adherenceunder an inverted microscope :In each experimental group, at two hours after culture, cells gathered around the materials, and some cells adhered to materials presented round; At three days after culture, the number of cells adhered to materials began to increase, morphology changed from round to oval, and the co-existence of round and oval cells was seen;While in each control group, at two and three hours after culture, few cells adhered to the three materials. On day five after culture, in each experimental group, cell morphology turned into fusiform, the number of cells increased further and a great many fusiform cells grew among carbon fiber materials; while in the control group, most cells presented round and ellipse, and the number of cells was less as compared with the corresponding experimental group. ② Cell morphology and material adherence under scanning electron microscope: On day 5 after in vitro culture, most tendon cells on the surface of materials presented spindle-shape in each experimental group. Apophysis stretched out from the tendon cells, grew along longitudinal axon of the materials. Silk and piece-like substance appeared among the apophysis and weaved each other. While there were fewer cells adhered in control group than in corresponding experimental group, cells also presented fusiform or round, but no silk or piece-like substance was found, also no apophysis appeared.CONCLUSION: Human hair, carbon fiber and polyglycolic acid combined with collagen type Ⅰ will facilitate cell adherence. Cells increase around the materials and co-existence of round and oval cells could be seen, and cells turned into fusiform, suggesting that exogenous collagen facilitate the cells to adhere onto the materials and proliferate.

Most patients with ischemic cerebrovascular diseases,after treated in hospitals during the acute stage,can return home or back to the community.Therefore,secondary prevention of the disease in the community is very important.

Objective To investigate the development of ICUs and critical care medicine at secondary and above hospitals in Inner Mongolia.Methods Questionnaire survey of ICUs at secondary and tertiary hospitals in Inner Mongolia Autonomous Region from October 2010 to June 2011.Results There are 76 ICUs at 26 hospitals,including 24 general ICUs and 52 special ICUs; tertiary hospitals average 2.47±0.63 special ICUs,while secondary hospital average 2.23±1.12 special ICUs; 35％ of the ICUs are subject to close-off management; general ICUs at tertiary hospitals account for 1.21％ ± 0.35 ％ of total beds of the hospital,and for 1.98％ ± 0.63％ of secondary hospitals.Regarding the ratio of physicians to ICUs beds,it is 0.75±0.15 at tertiary hospitals,and 0.62± 0.231 at secondary hospitals.As to the ratio of nurses to beds,it is 1.58 ± 0.72 at tertiary hospitals,and 1.36 ± 0.27 at secondary hospitals.Conclusion This survey showed that ICUs in Inner Mongolia Autonomous Region are acceptable in numbers,but are found with problems in insufficient beds,poor staff deployment,obsolete medical equipments and weak technical forces.Therefore,critical care medicine and ICU development should be enhanced during the second round of hospital accreditation in China.

Objective To explore the relationship between serum leptin levels and insulin levels in type 2 diabetes.Methods Serum leptin concentrations were measeured by radioimmunoassay,body mass index(MBI),mean arterial blood pressure(MBP),waist to hip ratio(WHR),fasting plasma glucose(FPG),fasting serum insulin(FINS),total cholesterol(Tch),triglycerides(TG),LDL-C,HDL-C,HbA1c levels were determined in 20 obese diabetic patients(BMI≥25kg/m 2) and 20 non-obese diabetic patients with BMI0 05).⑵No matter what,in diabetic groups or in non-diabetic groups the serum leptin levels were higher in obese subjects than in non-obese individuals(P

Moyamoya disease is an uncommon cerebral disease, but its morbidity is relatively high in East Asian populations. Ivy sign refers to the dot or linear high signal phenomenon in MRI T1 enhanced sequence in patients with moyamoya disease. It mainly distributes in the pial surface of cerebral cortex or within subarachnoid space. It has important significance for diagnosing moyamoya disease and assessing the staging and prognosis of moyamoya disease. This article briefly reviews this imaging finding and its significance.