Thunderclap headache is a sudden severe headache. It is an uncommon type of headache. Identifying it in time and accurate diagnosis are very important because this type of headache is often complicating serious cerebral diseases. This article reviews its causes and diagnostic assessments.

0.05).(3)The levels of CRH and DHEA-S in umbilical cord blood of PL(7.8?3.3)ng/L,and(514?295)?g/L,respectively and of TL (7.7?4.1)ng/L,and(483?207)?g/L,were higher than that in term not in labor(4.8?2.4)ng/L, and(360?80)?g/L,respectively(P 0.05).In PL,the level of CRH in umbilical cord blood and the expression of CRH mRNA in placentas and fetal membranes were correlated with each other(r=0.935 and 0.853,P

Diagnostic Errors ; Epilepsy ; diagnosis ; Ethylene Dichlorides ; poisoning ; Humans ; Male ; Young Adult

OBJECTIVETo observe the improvements of synchronous treatment of bilateral scalp acupuncture and rehabilitation training on activities of daily life in patients with cerebral infarction at acute phase, so as to compare the efficacy differences between scalp acupuncture at bilateral and affected side as well as differences between synchronous and non-synchronous treatment.

METHODSNinety patients of acute-phase cerebral infarction with motor dysfunction were randomly divided into three groups. The observation group was treated with synchronous treatment of scalp acupuncture at the Dingzhongxian (middle line of vertex), bilateral Dingnieqianxiexian (anterior oblique line of vertex-temporal) and bilateral Dingniehouxiexian (posterior oblique line of vertex-temporal) and rehabilitation training; the control group A was treated with synchronous treatment of affected scalp acupuncture at the Dingzhongxian, affected Dingnieqianxiexian and affected Dingniehouxiexian and rehabilitation training; the control group B was treated with bilateral scalp acupuncture for 4 h, followed by rehabilitation training. All the patients took the treatment once a day, and 6 days for a course of treatment for total of 4 courses. The modified Barthel index (MBI), activities of daily living (ADL) and Fugl-Meyer motor assessment (FMA) were used to perform efficacy assessment before treatment, in the 14th days of treatment and in the 28th days of treatment in three groups.

RESULTSAfter treatment, three indices at each time point were superior to those before the treatment in three groups (all P<0.01) ; the improvements of ADL and FMA in the observation group after 28 days of treatment were superior to those in the control group A and control group B (all P<0.05), and the improvement of MBI was superior to that in the control group B (P<0.05).

CONCLUSIONThe synchronous treatment of bilateral scalp acupuncture and rehabilitation training could significantly improve the activities of daily life and motor function in patients with cerebral infarction at acute phase, which is superior to scalp acupuncture at affected side and non-synchronous treatment.

Activities of Daily Living ; Acupuncture Points ; Acupuncture Therapy ; Aged ; Cerebral Infarction ; rehabilitation ; therapy ; Female ; Humans ; Male ; Middle Aged ; Scalp ; Treatment Outcome

BackgroundDry eye is a multi-factorial-induced tear film and ocular surface disorder.Immunoinflammation plays a key role in the pathogenesis of dry eye.As inhibitor of the cyclo-oxygenase pathway,nonsteroidal anti-inflammatory drugs play an anti-inflammatory and anti-hypersensitivity role,and it can be a potential treatment for dry eyes.ObjectiveThis study was to investigate the effectiveness of nonsteroidal anti-inflammatory drugs (0.1％topical pranoprofen) on moderate to severe dry eyes and its mechanism.MethodsThis was a small sample of randomized controlled clinical trial.Thirty right eyes of 30 patients with moderate to severe dry eyes were included in the study according to the diagnosis criteria and randomized into two groups.The patients of the trial group received topical administration of 0.1％ pranoprofen plus 0.1％ sodium hyaluronate,and those of the control group received the topical 0.1％ sodium hyaluronate only.Ocular surface inflammation index scores (OSDI) and ocular surface fluorescine staining (OSS) scores were measured under the slit lamp,and tear film break-up time (BUT),Schirmer Ⅰ test values were evaluated.The expression of human leucocyte antigen-DR (HLA-DR) and CD11b in conjunctiva epithelial cells were detected by impression cytology and flow cytometry (FCM).All the indexes were compared between the two groups before and after treatment.Informed consent was obtained from all patients.ResultsThere were no significant differences in terms of age and gender and their baseline values between the trial group and control group (t=0.412,P=0.684;x2=0.240,P=0.624),and so were all the indexes (P＞0.05).Compared with the control group,the OSDI,OSS scores and cells positive for HLA-DR were lowered but the BUT was delayed in the trial group on day 15 ( t=2.43,P=0.03;t=2.83,P=0.01;t=3.29,P=0.00;t=3.23,P=0.00 ).No significant differences were found in the Schirmer Ⅰ test value and CD11b expression between these two groups (t=0.17,P=0.87;t=0.28,P=0.79).The OSDI,OSS scores and BUT were significantly improved,and the number of cells positive for HLA-DR were reduced 15 days after administration of drugs in comparison with before treatment in the trial group ( t =12.30,10.70,6.10,7.92,P =0.00 ).However,there were no comparable alteration seen in these indexes before and after the usage of drugs in the control group ( P＞0.05).Positive correlations were found in HLADR expression with OSDI and OSS ( r =0.601,P =0.018 ; r =0.586,P =0.022 ) and a negative correlation in HLADR expression with BUT (r=-0.697,P=0.004) on day 15 in the trial group.ConclusionsTopical usage of 0.1％ pranoprofen is beneficial for remitting the ocular signs and symptoms in moderate to severe dry eyes.This study illustrates that topical usage of 0.1％ pranoprofen can down-regulate the expression of inflammatory markers in conjunctival epithelial cells.

Background It has been clarified that topical administration of cholinomimetic drug or prostaglandin analogus can effectively low intraoeular pressure (IOP) in primary angle-closure glaueoma and angleopen glaucoma,respectively.The two eyedrops are often combined clinically to treat glaueomatous eye.But their effect mechanism on ciliary muscle is different.It is neeessarv to prove the clinical efficacy of combination of these two drugs.Objective This study attempted to compare hypotensive effect of individual and combinative use of 2％piloearpine and 0.004％ travoprost in normal rabbit eyes.Methods Thirty normal albino rabbits were randomly divided into three parallel groups.Lateral eye of each rabbit was appointed as the experimental eye and the fellow eye was used as control eye.2％ Pilocarpine eyedrop was instilled three times daily and 0.004％ travoprost eyedrops was used once per night in the pilocarpine and travoprost group.These two drugs were combined in the combination group.The normal saline solution was used in the control eyes IOP was measured bilaterally with Perkins application tonometer at 8:00 am on the day before and 1,2,4,8,14,24 days after the administration of eyedrops.The use of the animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The IOP was significantly lower on 1 day after use of eyedrops than baseline IOP in the experimental eyes in the pilocarpine group,travoprost group and combination group,but no obvious change in IOP before and after use of eyedrops in the control eyes.There was no significant difference in the baseline IOP in both experimental eyes and control eyes,however,signifieant differences were seen in various time points after administration of eyedrops between experimental eyes and control eyes(P＜0.05).Compared with baseline IOP,IOP declined by 17.5％-22.0％ in pilocarpine group,23.8％-26.4％ travoprost group,27.6％-32.0％ in the combination group.For normal eye,piloearpine+travoprost showed a more power lowing IOP effect.Conclusions Hypotensive effect of combinative use of 2％ pilcoarpine and 0.004％ travoprost is strongest in comparison with individual use of pilocarpine or travoprost,but less than the statistical sum of individual use of these two drugs in a 24-day duration in normal eye of albino rabbit.

AIM: To evaluate the effect of binocular visual function training in pediatric ocular trauma. METHODS: There were 76 patients (76 eyes) that were hospitalized with a primary diagnosis of ocular injury at the Affiliated Hospital of Medical College, Qingdao University between January 2006 and December 2009. Binocular visual function training was given after primary wound repair. Far stereopsis function were checked using AIT-1000 synoptophore fusion, and near stereopsis function was checked using Titmus stereogram.Binocular visual function was compared before and after training. RESULTS: Before binocular visual function training,26 eyes（34%）had no binocular vision, after training there were only 16 eyes（21%） without binocular vision. Before undertaking binocular visual function training with fusion, only 27 eyes (36%) had binocular vision, after the training there were 48 eyes (63%) with binocular vision. Before undertaking binocular visual function training with far stereopsis ,there were 23 eyes (30%) with binocular vision, after the training there were 29 eyes (38%). Before binocular visual function training with near stereopsis, there were 14 eyes (18%) with binocular vision, after the training there were 33 eyes (43%) with binocular vision. There was a significant difference in the number of patients with binocular vision before and after binocular visual function training. CONCLUSION:The training is useful for the reconstruction of binocular visual function in pediatric ocular trauma.

Mitochondria is an important organelle in mammalian cells with multiple functions,such as ener-gy production and cell homeostasis maintaining. It is known that hundreds of diseases are associated with mi-tochondrial defects. The studies show that the exoge-nous mitochondria can directly enter mammalian cells in vitro, and they also can quickly transform into ani-mal tissues by local or intravenous injection. Current-ly, it has raised a new therapeutic strategy for mito-chondrial diseases, called mitotherapy, which trans-plants exogenous functional mitochondria into mito-chondria-defective cells. The mitochondria in recipient cells play their own roles, including energy produc-tion,maintaining free radical balance,and cell viabili-ty recovery. Since there is no effective method for mito-chondria-related diseases up to now, the mitotherapy will provide a new approach for the prevention and treatment of these diseases.

The effect of magnetic Fe3O4 particles on cellulase in the enzymatic hydrolysis of sunflower seed hull was studied in different adding ways and additive amount. In the process of enzymatic hydrolysis of sunflower seed hull, the variations of cellulase activity, reducing sugar concentration and cellulose conversion were evaluated. After the reaction, the analysis of pH and surface tension of hydrolysate were also used to determine the mechanisms of cellulase by the magnetic effect. The results indicated that after adding magnetic Fe3O4, the cellulase activity, reducing sugar concentration and conversion of cellulose had an increased between the 0.5 g/L and 2.0 g/L cases after 48 h. When the additive amount of magnetic Fe3O4 was 2 g/L, the cellulase activity at 60 h was improved significantly by 25.9%. It was found that the concentration of reducing sugar was increased from 6.950 mg/mL to 8.775 mg/mL with magnetic Fe3O4 1.5 g/L. Simultaneously, compared with the blank, which the conversion of cellulose was 47.932%, the maximum celluloseconversion of samples with adding magnetic Fe3O4 was 60.531%. Besides, the stability of cellulase activity adding in times was better than in one time. After the reaction, the final surface tension of hydrolysate with 1.5 g/L magnetic Fe3O4 was the lowest in comparison with the blank. However, no significant differences were observed in the final pH of the hydrolysate.

Background The domestic and international researches discovered that many proteins and enzymes of the extracellular matrix (ECM) participate in the sclera remodeling by affecting the collagen typeⅠand fibronectin.Objective This study was to investigate the effect of matrixmetalloproteinase-2 (TIMP-2) on expression of collagen typeⅠand fibronectin of ECM in the posterior sclera by injecting liposomes containing tissue inhibitor of TIMP-2 gene into suprachoroidal space of the form-deprivation myopia in guinea pig.Methods Form-deprivation myopia was induced by translucent goggles in 36 clean guinea pig for 2 weeks.Then the animals were randomly assigned to TIMP-2 group,empty plasmid group,saline group and 12 for each group.Liposomes of 5μl containing TIMP-2 gene,empty plasmid and saline were suprachoroidally injected in the right eye respectively,and the left eyes without any treatment were used as self-control group.Other 12 matched guinea pigs only covered the right eyes through out the experimental duration as model control group.The guinea pigs were sacrificed and the posterior sclera tissue of the eyeballs were collected at 2,7 and 14 days after injection of drug.The expressions of collagen typeⅠmRNA and fibronectin mRNA were detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR).This study followed the Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The expression level of collagen type Ⅰ mRNA in the posterior sclera of guinea pig was lower but that of fibronectin mRNA was higher in TIMP-2 group than self-control group,showing significant differences between them (P＜0.05).The expression level of collagen type Ⅰ mRNA in the posterior scleral tissue began to increase from the 2nd day after drug injection and was obviously elevated at the 7th day and then gradually decreased at the 14th day.However,the expression level of fibronectin mRNA in the posterior scleral tissue showed the opposite pattern.The expression levels of collagen typeⅠmRNA and fibronectin mRNA at the 7th after drug injection were significantly lower than that at the 2nd day or 14th day (P＜0.01).Conclusion Suprachoroidal injection of TIMP-2 in form-deprivation myopia could up-regulate the expression of collagen typeⅠmRNA and down-regulate the expression of fibronectin mRNA in the posterior scleral tissue.It may slow down the sclera remodeling of form-deprivation myopia in guinea pig in the early stage.