Intracranial atherosclerosis is one of the important causes of ischemic stroke. Because extra- and intracranial arteries have differences in the structure and hemodynamics, the effects of traditional vascular risk factors, including sex, age, hypertension, and diabetes mellitus, on extra-and intracranial atherosclerosis are also different. The early identification of the risk factors for intracranial atherosclerosis has important significance for aggressively preventing and treating intracranial atherosclerosis and reducing the incidence of ischemic stroke. However, many research conclusions aiming at the risk factors and intracranial ng andatherosclerotic correlation are not consistent. This article reviews the research status quo of the risk factors for intracranial atherosclerosis.

Objective To investigate the curative effect and care measures using subhypothermia treatment in patients with severe brain injury.Methods 70 cases of severe brain injury were randomly divided into treatment group(n=35) and control group (n=35),the treatment with subhypothermia and correlation care,control group treated with conventional treatment care.Compared rate of cure,mortality and complications in two groups.Results In treatment group cured 30 cases ( 85.7% ),5 patients died (14.3% ),the control group cured 23 cases (65.7%),death 12 cases(34.3%).Two groups had significant difference (x2 = 4.15,x2 = 3.99,P ＜ 0.05 ).The GOS score (3.23 ±2.15) points in treatment group were lower than the control group(5.03 ±0.96) points after treatment(t =3.52,P ＜0.05).The incidence of complications in the treatment group was 17.0% (6/35) lower than the control group,37.1% (13/35 ) (x2= 3.95,P＜0.05).Conclusion Subhypothermia care may reduce complications in patients with severe brain injury.

Objective To summarize experience of the combined treatment of ependymoma in fourth ventricle of the brain of child and to study improvement of effect of the operation plus radiotherapy.Methods 35 cases with ependymoma in fourth cerebral ventricle were treated with microneuro-surgical resection.Among the 35 cases,25 were treated with total brain and spinal cord plus local focus radiotherapy within 2 to 3 weeks after operation;8 only with local focus radiotherapy,2 cases were not done with radiotherapy.Results Total removal of tumors was done in 20 cases,subtotal removal in 15 cases,and no patient died from operation.After operation,20 patients had a good recovery,10 had a light disability,and 5 needed assistance.The 5-year survival rate were 90.0%(18/20),6.6%(1/15),88.0(22/25),62.5%(5/8) and 0%,in different group respectively.Conclusion Surgical treatment is obviously effective to ependymoma in fourth ventricle of the brain and total removal of tumors combined with radiotherapy is aid to extend the patient's survival time.

Objective To discuss the diagnosis and treatment of microneuro-surgery for meningiomas of the lateral ventricle.Methods A retrospe CT analysis was performed on 20 patients with meningomas of the lateral ventricle during a 7-year period.Results 20 cases had total tumor removal.among them 6 cases were completed removal,14 cases were cent piece removal.There were no postoperative deaths.The follow-up period ranged from 0.5 to 7 years.All followed patients went well.Conclusion Lateral ventricular meningiomas can be diagnosed by CT or MRI and fedding vascular of tom or revealed by cerebral vascular angiography.By using the ideal approach,the tumors could be totally removed under microscope.

Objective To study the techniques for treating the intracranial tumor.Methods Through a keyhole approach with endoscope-assisted micro-neurosurgery,30 patients with intracranial tumor were treated.With microneurosurgery,larger part of tumor was resected,then under neuroendo-scope remains of tumors were found out and removed.Results Tumors were totally removed in 22 patients,subtotally removed in 5.In three patients cerebral aneurysm was clipped successfully.Two patients with pituitary adenoma had temporay diuresis and one patient non-bacteria meningitis,and after two weeks treatment all recovered.There was no-mortality in 41 patients,no cerebral hemorrhage,optic nerve injury,internal carotid injury,and other complications occurred.Conclusion Endoscope-assisted microneurosurgery through a keyhole approach can increase the total-resection rate for tumors,reduce the trauma of operation and postoperative reaction.

BACKGROUND:The OPG-RANKL-RANK transport system plays a crucial role in bone resorption mechanism of osteoclasts. OBJECTIVE:To observe the expression of OPG-RANKL-RANK signaling system in osteoclasts, osteoporosis, and the targeted therapy of OPG-RANKL-RANK signaling system. METHODS:We retrieved related literatures in the periodicals database with the key words of“osteoprotegerin, RANKL, RANK, osteoclasts, osteoporosis”in English and Chinese. According to the inclusion criteria, the literatures were included in this study after the evaluation of quality. RESULTS AND CONCLUSION:The mature of osteoclasts is mediated via OPG-RANKL-RANK signaling system and its associated signaling pathways. This signal pathway leads to the mechanism of osteoporosis. At the genetic and molecular levels, the targeted therapy of osteoporosis has become the focus. OPG-RANKL-RANK signaling system can provide a research platform for targeted treatment of osteoporosis, and OPG-RANKL-RANK signaling system is an important way to the regulation of osteoclasts and osteoporosis.

ObjectiveTo evaluate the prevalence of occult hepatitis B infection in blood donors and to explain the possible molecular mechanfism of occult hepatitis B infection.Methods Enzyme linked immunosorbent assay (ELISA) method was used for detection of hepatitis B virus (HBV)markers in serum samples of 594 donors which were collected from blood bank with HBsAg negative results.Nested-polymerase chain reaction (PCR) was performed to detect serum HBV DNA.In donors with occult HBV infection,the serum HBV markers were quantitatively detected by Abbott nested-PCR kit.The PCR products of S region were sequenced and sequence alignment was performed to analyze relevant virus mutations.Eleven HBsAg positive patients were randomly recruited as positive controls and S region was amplified and sequenced.The difference of S region sequences was compared between patients with occult HBV infection and HBsAg positive HBV infection.ResultsAmong 594 HBsAg negative donors,15 were diagnosed with occult HBV infection with the incidence of 2.5 ％.No correlation was found between results of serum HBV markers and occult HBV infection.Sequencing results of HBV S region were obtained from 10 cases,which revealed mutations of HBV.The amino acid mutations in the “a” determinant cluster were found in three patients,which were I126T,T140I and T140I,respectively.On the contrast,mutation in the “a” determinant cluster of T131 N was only found in one positive control.ConclusionsThe occult HBV infection exists in blood donors with negative results for HBsAg test.Genetic mutation may play a role in the occult HBV infection.

BACKGROUND:The V-ATPase a3 transport system plays a crucial role on bone resorption mechanism of the osteoclasts.
OBJECTIVE:To observe the expression of V-ATPase a3 transport system in fracture repair and the effect of V-ATPase a3 transport system inhibitor on fracture healing.
METHODS:We retrieved related literatures in the periodicals database with the key words, and screen them according to the inclusion criteria. The literatures were included in this study after the evaluation of quality.
RESULTS AND CONCLUSION:V-ATPase a3 transport system widely exists in the cytoplasm membrane and organel e membrane of eukaryotic cells. V-ATPase a3 has two structural domains:V0 and V1. V0 structural domain is the proton transport channel, V1 structural domain is mainly the hydrolysis of ATP. V-ATPase a3 transport system focuses on the fril ed edge of osteoclasts, H+is transported to form a high concentration, dissolves inorganic minerals and provides the acidic environment for hydrolytic enzymes, thus being involved in bone resorption. So V-ATPase a3 transport system is selected as the research target in the fracture repair and reshape.

Objective To investigate the effect of the reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase on Toll-like receptor 4 (TLR4)-mediated proinflammatory phenotype of cultured vascular smooth muscle cells (VSMCs) in mice.Methods NADPH oxidase agonist platelet-derived growth factorBB (PDGF-BB) and inhibitor apocynin were used respectively to treat cultured VSMCs from C57BL/6J and TLR4-/-mice.The fluorescent probe 2',7'-dichlorodihydrofluorescein diacetate was used to detect the reactive oxygen species (ROS) level in VSMCs.An enzyme-linked immunosorbent assay was used to detect the expressions of interleukin (IL)-6,IL-1β,and tumor necrosis factor-α (TNF-α) in VSMCs.Tetrazolium blue staining and Boyden chamber assay were used to detect the proliferation and migration of VSMC.Results The ROS levels were increased in VSMCs both from C57BL/6J and TLR4-/-mice after PDGF-BB treatment,and this could be inhibited by apocynin.PDGF-BB pretreatment significantly upregulated the expressions of IL-6 (52.69 ±3.49 ng/ml vs.35.04 ±2.74 ng/ml; P =0.001),IL-1β (79.68 ±2.33 ng/ml vs.62.38 ±0.54 ng/ml;P=0.000),and TNF-α (218.35± 5.42 ng/mlvs.124.74± 4.59 ng/ml; P=0.000) in VSMCs from C57BL/6J mice,and the abilities of proliferation (1.69 ± 0.53 vs.1.04 ± 0.40; P =0.000) and migration (42.11 ±4.05 vs.1.69 ± 0.53; P =0.000) were increased significantly; apocynin pretreatment significantly inhibit the expressions of IL-6 (42.11 ± 4.05 ng/ml vs.52.69 ± 3.49 ng/ml; P =0.010),IL-1β (67.57 ± 1.36 ng/ml vs.79.68 ±2.33 ng/ml; P =0.000) and TNF-α (156.18 ± 6.98 ng/ml vs.218.35 ± 5.42 ng/ml;P =0.000),as well as proliferation (1.23 ±0.42 vs.1.69 ±0.53; P =0.000) and migration (42.11 ±4.05 vs.52.69 ± 3.49; P =0.000).While there were no significant changes in the expressions of IL-6,IL-1β,and TNF-α in VSMCs from TLR4-/-mice after PDGF-BB and apocynin pretreatment.Conclusions NADPH oxidase-derived ROS involved in the TLR4-mediated VSMC inflammatory phenotype as well as proliferation and migration,which may be the important mechanisms of its influencing on the occurrence and development of atherosclerosis.

Objective:To investigate the predictive value of plasma exosomal microRNA (miR)-124-3p in the risk of chronic cerebral hypoperfusion (CCH).Methods:A case-control study. Thirty patients who were diagnosed with CCH (CCH group) based on cranial artery spin labeling (ASL) in the neurology outpatient clinic of Sichuan Provincial People′s Hospital from March 2022 to June 2022 and 30 healthy volunteers (control group) were included. Age, gender, smoking history, alcohol consumption history, diabetes history, hypertension, hyperlipidemia history, uric acid, fasting blood glucose, homocysteine and plasma exosomal miR-124-3p expression level were compared between the two groups. Comparisons of categorical variables were analyzed by either χ2 test or Fisher′s exact test. If the data of continuous variables followed a normal distribution, they were expressed as mean±standard deviation (SD) and compared by t-test for two independent samples; otherwise, the data were expressed as M( Q1, Q3), and analyzed by Mann-Whitney U test for comparison between two groups. The correlation between cerebral blood flow and exosomal miR-124-3p levels was analyzed by Pearson′s correlation. Binary multifactorial logistic regression analysis was used to determine the risk factors associated with CCH, and corresponding odds ratios ( OR) and 95% confidence intervals ( CI) were calculated. P<0.05 was considered significant. Results:There was no significant difference in age (64±8 vs. 60±8 years old), gender (33.3% vs. 30.0%), history of smoking (20.0% vs. 3.3%), alcohol consumption (20.0% vs. 6.7%), diabetes mellitus (13.3% vs. 13.3%), hypertension (53.3% vs. 30.0%), history of hyperlipidemia (46.7% vs. 36.7%), uric acid (288±60 vs.319±67 μmol/L), and fasting glucose [4.99(4.63, 5.91) vs. 5.28(5.09, 6.05) mmol/L] and homocysteine [11.35(10.18, 13.08) vs.11.00(9.78, 13.03) μmol/L] between the CCH and control groups ( P>0.05). Plasma exosomal miR-124-3p expression was significantly higher in the CCH group than in the control group [13.08 (8.59, 21.55) vs. 2.85 (1.44, 5.10), respectively; U=169.50, P<0.001]. Pearson′s correlation test showed that the level of exosomal miR-124-3p was negatively correlated with cerebral blood flow in the hypoperfused region in patients with CCH ( r=-0.932, P<0.001). Multi-factor logistic regression analysis showed that plasma exosomal miR-124-3p was independently associated with the risk of CCH ( OR=1.169,95% CI 1.063-1.286, P=0.001). Conclusions:The expression of plasma exosomal miR-124-3p is negatively correlated with cerebral blood flow in areas of low perfusion and is an independent risk factor for CCH. Plasma exosomal miR-124-3p may thus serve as a valid biomarker for CCH risk prediction.