Objective To clarify the clinical and imaging features of the small centrum ovale infarcts by comparing with the small basal ganglia infarcts. Methods Forty-six consecutive patients with small centrum ovale infarct showed on the axial MR diffusion weighted imaging admitted to hospital within one week after onset were enrolled retrospectively. One hundred fifty-seven patients with small basal ganglia infarct were used as a control group. The differences of demography,vascular risk factors,clinical features, and imaging data in patients with small centrum ovale infarct and small basal ganglia infarct were compared and analyzed. Results The mean age of small centrum ovale infarct was 69 ± 12 years,among them, 27 patients were male. The mean age of small basal ganglia infarct was 66 ± 11 years,among them,98 were male. The vascular risk factors,clinical features and imaging data of the small centrum ovale infarct and the small basal ganglia infarct were compared. There were significant differences in hypertension (63. 0% [n =29]vs. 43. 3% [n = 68],P = 0. 018),coronary heart disease (4. 3% [n = 2]vs. 17. 8% [n = 28],P =0. 042),atrial fibrillation (15. 2% [n = 7]vs. 5. 7% [n = 9],P = 0. 036),single limb weakness (17. 4% [n = 8]vs. 6. 4% [n = 10],P = 0. 021),National Institutes of Health Stroke Scale score (2 [1,3]vs. 3 [2,5],P = 0. 002),infarct diameter (6 ± 3 mm vs. 10 ± 3 mm,P < 0. 01),ipsilateral middle cerebral artery(MCA)stenosis (4. 3% [n =2]vs. 24. 2% [n =38],P = 0. 006),and accompanied with contralateral intracranial artery stenosis (ICAS)(4. 3% [n = 2]vs. 17. 8% [n = 28 ],P = 0. 042). Conclusions Compared with the small basal ganglia infarcts,the prevalence of atrial fibrillation of the small centrum ovale infarcts was higher. The degree of neurological deficits on admission was milder,the diameter of the infarct was smaller,and the incidences of ipsilateral MCA stenosis and contralateral ICAS were lower.

Fufang Ganning(FGN)is an oral liquid,consisting of 8 kinds of chinese herbs including Radix Astragali,Radix Salviae Multiorrhizae,Radix Curcumae,Rhizoma Polygonati,etc.It was found to be effective in protecting against experimental acute hepatic damage caused by CC14,TAA and D-Glan in mice,FGN could reduce ALT and retention of BSP,and histopathological chan- ges revealed that the hepatic injury induced by CC14 in animals received FGN was much less severe than those of the control ones.It could also lower ALT and serum bilirubin in mouse and rat models with hepatic injury caused by ?- isothioeyanate.On the other hand,in the animal models with cirrhosis induced by CC14,FGN could not only cut down ALT but also lessen the degeneration and necrosis of hepatic cells and cirrhotic changes.Meanwhile,FGN could significantly increase the clearance index of carbon particles(phagocytic func- tion)and serum hemolysin in normal mice.It is concluded that FGN has the effects of protecting liver from damage and enhancing the immune function.

Objective To investigate the clinical significance of BiPAP mechanical ventilation in the treatment of chronic obstructive pulmonary disease(COPD)with type Ⅱ respiratory failure.Methods A total 56 patients suffering from respiratory failure due to exacerbation of COPD were randomly divided into treatment group (BiPAP plus routine therapy)and control group(routine comprehensive therapy).Blood gases,respiratory rates,heart rates,scores of the activity of accessory respiratory muscles,incubation rate,fatality rate were observed.Results In the treatment group,PO2 greatly increased,PCO2 greatly decreased,pH improved significantly,and respiratory rate,heart rate and scores of the activity of accessory respiratory muscles greatly decreased.The incubation rate and the fatality rate were significantly lower in the treatment group than those in the control group(P＜0.05).Conclusion BiPAP mechanical ventilation plus routine therapy on COPD with type Ⅱ respiratory failure can improve the curative effects,lessen respiratory muscle fatigue,and decrease the need for incubation and fatality rate.

ObjectiveTo investigate changes of the cellular immune function in the elderly patients with nonsmall-cell lung cancer (NSCLC) after chemotherapy.Methods T-lymphocyte subsets and natural killer cell were detected in 29 elderly patients with NSCLC,20 adults with NSCLC and 22 healthy elderly,and their levels were compared between pre-chemotherapy and at the end of 2 cycles of chemotherapy in the elderly patients with NSCLC.ResultsThe levels of CD3,CD4,CD8,CD4/CD8andNK cell were (58.9±15.8),(32.3±12.7),(22.0±9.8),(1.3±0.7),(21.6± 7.7),respectively in the elderly patients with NSCLC,(65.9 ± 7.2),(38.5 ± 7.6),(23.1 ± 9.2),(1.5±0.7),(16.8±6.2),respectively in adults with NSCLC and (67.3±9.0),(39.0±7.8),(23.9±9.3),(2.0±1.6),(22.5±5.8),respectively in healthy elderly.The levels of CD3 and CD4 were decreased (t=2.109,2.159,P＜0.05) and NK cell was increased (t=2.273,P＜0.05) while CD8 and CD4/CD8 had no difference(t = 0.406,0.736,P＞ 0.05 ) in the elderly patients with NSCLC as compared with adults with NSCLC.The levels of CD3,CD4,and CD4/CD8 were lower (t = 2.234,2.200,2.016,all P＜ 0.05) in elderly patients with NSCLC than in healthy elderly,with no significant change in the levels of CD8 and NK cell(t= 0.700,0.474,P＞0.05) between the two groups.The levels of CD3 (51.6 ±10.3)was reduced(t=2.067,P＜0.05) and CD4 (31.7 ± 11.7),CD8(21.6 ± 6.5),CD4/CD8 (1.3 ± 0.7),NK cell (26.0 ±12.7)had no remarkable difference (t =0.186,0.180,0.289,1.570,all P＞ 0.05)after chemotherapy in elderly patients with NSCLC.ConclusionsThe cellular immune function in the elderly patients with NSCLC is lower than in adults with NSCLC and healthy elderly,and further decreases after chemotherapy.

Objective Toinvestigatetherelationshipbetweendifferenttypesofinternalwatershed infarctionandtandemstenosesofinternalcarotidartery(ICA).Methods Atotalof55patientswith internal watershed infarction confirmed by head MRI and diffusion-weighted imaging (DWI )examination were enrolled. They all underwent the extracranial internal carotid artery (ICA ) ultrasonography and intracranial cerebral artery MR angiography (MRA)examinations. According to the findings of imaging,the 55 patients with internal watershed infarction were divided into a simple internal watershed infarction (IWSI)group and an internal watershed infarction accompanied with ipsilateral cortical watershed infarction (C-IWSI)group. The relationship between the two types of internal watershed infarction and tandem stenoses of ICA was analyzed. Results (1 ) Of the 55 patients with internal watershed infarction,24 cases (43. 6%)were in the internal watershed infarction group and 31 cases (56. 4%)were in the C-IWSI group. The ipsilateral vascular stenosis were ICA 20 cases (36. 4%,including extracranial segment 11 cases and intracranial segment 17 cases),middle cerebral artery (MCA)44 cases (80. 0%), and tandem stenoses of ICA 15 cases (27. 3%). (2)Ipsilateral tandem stenoses of ICA:2 cases were in the IWSI group (intracranial ICA+MCA 2 cases);13 cases were in the C-IWSI group (extracranial ICA+intracranial ICA +MCA 4 cases,extracranial ICA + intracranial ICA 1 case,extracranial ICA + MCA 2 cases,and intracranial ICA+MCA 6 cases). (3)Compared with the IWSI group,the incidences of ipsilateral ICA stenosis and tandem stenoses of ICA in patients of the C-IWSI group were higher (54. 8%[n=17]vs. 12. 5%[n=3],41. 9%[n=13]vs. 8. 3%[n =2]),and there were significant differences(P =0. 001, 0.006]). The incidences of extracranial and intercranial ICA stenosis were higher than those of the IWSI group (35. 5%[n=11]vs. 0,45. 2%[n=14]vs. 12. 5%[n=3]),and there were significant differences (P=0.003,0.009).Conclusion Inthedifferenttypesofinternalwatershedinfarction,theincidenceof tandem stenoses of ICA is different. The IWSI patients with ipsilateral cortical watershed infarction often accompany by tandem stenoses of ICA.

AIM:To observe the Toll-like receptor 9 (TLR9) activation in microglia BV-2 cells after oxygen-glucose deprivation and reoxygenation ( OGDR) , and its effects on neuronal apoptosis.METHODS:The BV-2 cell super-natants were collected after the corresponding treatment and added to mouse primary cortical neurons after OGDR for 4 h, followed by normal culture for 24 h.The cells were divided into normal BV-2 group, NC-siRNA group, TLR9-siRNA group, OGDR group, OGDR+NC-siRNA group, OGDR+TLR9-siRNA group and control group (without adding BV-2 cell supernatant) .The changes of the neuronal morphology were observed under an inverted phase-contrast microscope, and the neuronal apoptosis was detected by TUNEL.The protein expression of cleaved caspase-3 was detected by Western blot-ting.RESULTS:After OGDR, the axon turned thin, twisted and broken, and neuronal swelling, decrease in refraction and vacuolar degeneration were observed.The green-stained apoptotic bodies in the neurons in all groups were positive. Compared with control group, the caspase-3 protein levels in other groups were increased.Compared with the normal BV-2 group, the caspase-3 protein in OGDR group and TLR9-siRNA group was increased.Compared with OGDR+TLR9-siRNA group, the caspase-3 protein in TLR9-siRNA group and OGDR group was decreased.CONCLUSION: After OGDR, TLR9 activation in BV-2 cells induces neuronal apoptosis with the increase in caspase-3 protein level.Inhibition of TLR9 expression reduces neuronal damage.

Objective To investigate the role of PPAR-γ in the gene expression of T-bet/GATA-3 in Jurkat T cells,and to explore the mechanisms underling this sensitizing effect of the change of TH cell subpopulation group.Methods Jurkat T cells were stimulated with PPAR-γ agonist pioglitazone.TH cell related cytokine IFN-γ and IL-10 was detected by ELISA,and the expression of transcription factors(T-bet and GATA-3)mRNA was detected by RT-PCR.To prove the PPAR-γ-dependent effect.the PPAR-γ-specific antagonist GW9662 was used.Results Stimulated with agonist PPAR-γpioglitazone.the concentration of IFN-γ and IL-10 and the expression of transcription factor T-bet and GATA-3 mRNA were both significantlY decreased in Jurkat T cells obviously,and these actions were dependent on the time and the concentrations of pioglitazone.Added with antagonist GW9662 at the same time,such inhibitory actions of IFN-γ and T-bet expression were recovered.but not IL-10 and GATA-3.Conclusion Pioglitazone can inhibite T cells proliferation and their secretion of cytokines.Pioglitazone can inhibit TH1 cells from secreting cytokines,and it is a PPAR-γ-dependent effect related to T-bet.The inhibition on TH2 is not a PPAR-γ-dependent effect and it is GATA-3 related.

Objective To investigate the cellular immune function changes and the effect of thymosin alpha-1 on the changes in elderly patients with severe pneumonia. Methods T cell subset and natural killer (NK) cell were detected in 66 elderly patients with severe pneumonia and 34 elderly patients with common pneumonia. The severe pneumonia patients were randomly divided into 2 groups: the treatment groups (34 cases) and the control group (32 cases). All patients received conventional therapy of pneumonia. The treatment group received 1.6 mg of thymosin alpha-1 through subcutaneous injection once a day for a week and twice a week later. Results The levels of CD3, CD4, CD8 and NK cell were lower in elderly patients with severe pneumonia than in patients with common pneumonia [(43.54%±18.97%) vs. (45.46%±10.43%), (25.43%±12.72%) vs. (38.47%±8.20%), (16.68%±9.30%) vs. (22.36%±8.06%), (13.52%±4.66%) vs. (17.87%±7.11%), t=-6.779、-5.85、-3.161、-3.285 respectively all P＜0.05]. The levels of CD3, CD4, CD4/CD8 and NK cell increased significantly after treatment in treatment group [(64.22%±5.53%) vs. (61.53%±13.41%), (31.70%±4.38%) vs. (26.07%±4.31%), (1.27%±0.91%) vs. (0.97%±0.22%), (17.67%±4.56%) vs. (15.44%±3.82%), F=5.591,11.526,8.934,4.564 respectively, all P＜0.05]. The duration of antibiotic injection and length of stay were lower in treatment group than in control group [(14.17±2.51) d vs. (14.42±2.79) d, (12.69±2.80) d vs. (15.04±3.58) d, t=-3.152、-2.690 respectively, all P＜0.05]. Conclusions The immune function of the elderly patients with severe pneumonia is lower. Thymosin alpha-1 can improve the immune function of the elder patients with severe pneumonia and is helpful for controlling an infection.

ObjectiveTo investigate the status of depression and its relationship with quality of life in Fuzhou city community Methods With stratified random sampling method,3285 elderly people (age≥ 60 years) in 12 communities of Fuzhou city were investigated by SF-36 health survey questionnaire and Geriatric Depression Scale (GDS)Results The number of the elderly with depression was 1981 ( 60.3％).The incidence of depression in the female elderly was statistically higher than male(x2 =7.561,P＜0.01).The incidence of depression increased with age(P＜0.01),and declined with higher education ( P ＜ 0.01 ) and income ( P ＜ 0.05).The higher incidence of depression appeared in the elderly with no spouse,paying for medical expenses themselves,living alone(all P＜0.01).The scores of physiological functions (PF),physiological role (RP),body pain (BP),general health (GH),vigor (VT),social function (SF),emotional role (RE),mental health (MH) and quality of life in the elderly without depression (78.0± 19.2,62.7 ± 39.7,94.1 ± 12.3,57.9± 12.0,74.3 ± 14.9,83.0 ± 20.1,64.3 ± 39.1,73.8 ± 14.8,and 73.5 ± 13.6,respectively) were higher than in the elderly with depression (65.9±22.6,45.3±37.8,89.5±15.2,50.8±11.4,59.8 ± 15.9,70.5± 20.9,44.7 ± 37.8,60.6 ± 15.6 and 60.9 ± 14.0,respectively) (P＜0.01 ).All scores had significant differences among different levels of depression (P＜ 0.01 )and the dimension scores decreasedwithserious depression.Depression was negatively correlated with various dimensions of quality of life and total score(P＜0.01).ConclusionsThe incidence of depression of the elderly in Fuzhou city is high.There are negative correlations of depression with quality of life scores and total score of various dimensions.The community nursing service should emphasize on the elderly who are female,advanced age,no spouse,poor-education,low-income,no medical insurance and live alone,then take appropriate measures to reduce depression and improve quality of life of the elderly.

Objective To observe the expression level change of vascular endothelial growth factor (VEGF) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), and to explore the relationships of VEGF expression with OSAHS, OSAHS related cardiovascular and cerebrovascular diseases. Methods Polysomnography (PSG) was used to conduct sleep apnea monitoring in 24 OSAHS patients from 6OSAHS popular families and 48 healthy controls with normal physical examination results. The expression of VEGF mRNA was examined by reverse transcriptionpolymerase chain reaction (RT-PCR) analysis, meanwhile, the level of VEGF in plasma was measured VEGF mRNA in PBMC were significantly higher in simple OSAHS group [plasma levels: (205.75±2.79) pg/ml; mRNA: 0. 61±0. 02] than in control group [(168.72±4.64) pg/ml; 0. 47±0. 02,cardiovascular and cerebrovascular diseases group [(288.74 ± 2.73) pg/ml, 1.16 ± 0. 03] than in simple OSAHS group [ ( 205.75 ± 2.79 ) pg/ml, 0. 61 ± 0.02, P ＜ 0. 01]. ( 2 ) There was a positive correlation of the levels of VEGF in plasma and mRNA with AHI as well as systolic and diastolic blood pressure in early morning. There was a negative correlation of the level of VEGF in plasma and VEGF mRNA with the lowest saturation of blood oxygen. There was a positive correlation of the level of VEGF mRNA with AHI as well as systolic and diastolic blood pressure in early morning.Conclusions The level of VEGF in OSAHS significantly increases, which may play a role in the pathophysiology of OSAHS and OSAHS related cardiovascular and cerebrovascular diseases.