Objective To investigate the possible presence of radiation brain injury (RBI) in vascular injury and blood-brain barrier (BBB) damage.Methods Seventy 8 weeks old male BALB/C mice were randomly divided into irradiation group and control group;mice in the two groups received whole-brain exposure with a single dose of 10 Gy irradiation or sham irradiation.Tissue samples were taken 1,7,30,90 and 180 days after irradiation (7 mice in each time point per group);HE staining was used to observe the microvascular morphology and density changes;immune-fluorescence staining was used to visualize the differential expressions of factor Ⅷ related antigen (vWF) and zonulaoccludens-1 (ZO-1).Results Micro-vascular disorders began to appear from the first day of irradiation,deteriorating with time extension gradually.After the X-ray irradiation exposure,the protein expressions of vWF and ZO-1 in the irradiation group were significantly decreased as compared with those in the control group 1,7,30,90 and 180 days after irradiation (vWF:23.17±2.93 vs 15.80±2.39,21.25±2.33 vs 11.60±2.3,19.78±2.16 vs 8.20±1.64,17.21±3.31 vs 6.00±2.12 and 16.98±1.92 vs 3.80±2.59;ZO1:26.17±3.31 vs 15.40±1.82,23.20±2.93 vs 12.00±1.58,20.88±2.20 vs 9.10±2.55,18.32±1.87 vs 6.20±1.92 and 17.50±1.91 vs 2.40±1.52,P＜0.05);besides,the decreased expression ofvWF and ZO-1 in the irradiation group showed a time-depended manner,with significant differences between each two time points (P＜0.05).Conclusion X-rays may induce persistent micro-vascular injury and destroyed BBB tight junctions,which may be closely related to the occurrence and development of RBI.

Objective To investigate the effect of Dan-Hong injection on peripheral neuropathy in experimental rats with type Ⅰ diabetes.Methods Forty Wistar male rats were chose in our study and divided into Dan-Hong injection group,mecobalamin treatment group,model group and normal control group (n=10);rat models of type Ⅰ diabetes in the first three groups were induced by intraperitoneal injection of streptozotocin.Different drugs were given to these rats,and 12 weeks after model making,the blood glucose level and the body weight were measured;footprints gaits were analyzed;nerve conduction velocity was observed;immumohistochemical staining and HE staining were employed to detect the pathological alterations of intraepidermal nerve fiber and peripheral nerve tissues.Results As compared with model group,rats in Dan-Hong injection group had increased nerve conduction velocity and footprint parameters with statistical differences ([62.05±5.45] m/s vs [37.72±4.06] m/s;[22.00±0.34] mm vs [22.74±0.19] mm;[10.79±0.22] mm vs [11.49±0.14] mm;[17.50±0.16] mm vs [17.67±0.17] mm) (P＜0.05).The number of intraepidermal nerve fiber was increased and the pathological damage of peripheral nerves was obvious improved in the Dan-Hong injection group as compared with those in the model group;the nervous tissues showed edema with myelin fuzzy and swelling of the axon,which had been much improved as compared with those in the model group.Conclusions Dan-Hong injection can prevent and improve peripheral neuropathy of rats with type Ⅰ diabetes.

Objective To observe the effect ofintraperitoneal injection of sodium benzoate on learning and memory abilities and morphology of hippocampal neurons in rats.Methods Thirty-six male SD rats were randomly divided into three groups:control group,sodium benzoate low-dose group and sodium benzoate high-dose group (n=12);intraperitoneal injection of 1 mL normal saline,60 mg/kg sodium benzoate or 120 mg/kg sodium benzoate was performed on the rats of three groups,respectively,for 20 d.Morris water maze test (place navigation,space exploration and visible platform searching) was used to assess the spatial learning and memory of rats,and HE staining was used to observe morphological changes in hippocampal neurons.Results The escape latency of rats in the sodium benzoate high-dose group was statistically significant in the navigation test as compared with that in the control group and the sodium benzoate low-dose group (P＜0.05);no significant difference was noted between sodium benzoate low-dose group and control group (P＞0.05).In probe test,no significant differences in the number crossing target quadrant were found after withdrawal of platform between groups (P＞0.05).HE staining showed that hippocampal CA1 neurons were sparse,showing a disordered arrangement in sodium benzoate low-dose group;the hippocampal neurons of CA1 region and fascia dentata region in sodium benzoate high dose group showed messed arrangement,nuclear pyknosis and cytoplasmic concentration as compared with that in the control group.Conclusion The high-dose sodium benzoate can decrease the learning ability of rats and impair hippocampal neurons.

Objective To investigate the oxidative stress and cytoskeleton protein carbonylation in rat brains after different severities of traumatic brain injury (TBI).Methods Fluid percussion percussion device was used to establish the mild,severe and sham-operated Sprague-Dawley rat models (n=15);24 h after that,enzyme linked immunosorbent assay was used to detect the levels of malondialdehyde (MDA) and glutathione (GSH),and Western blotting was employed to detect the cytoskeletal proteins (β-actin,β-tublin and glial fibrillary acidic [GFAP]) carbonylation levels;phosphorylated tau (p-tau) protein expressions were examined by Western blotting.Results The expression levels of MDA in mild TBI group and severe TBI group were (389.62±29.95) μmol/g and (642.50±37.56) μmol/g,respectively,which was significantly increased as compared with the MDA level ([233.94±25.08] μmol/g) in sham-operated group (P＜0.05).The expression level of GSH in mild TBI group and severe TBI group was (352.10±37.75) μmol/g and (153.27 ±43.49) μmol/g,respectively,which was significantly decreased as compared with the GSH level ([492.48 ±41.43] μmol/g) in sham-operated group (P＜0.05).The β-actin,β-tublin and GFAP proteincarbonylation levels (0.099± 0.104,0.194±0.114 and 0.643±0.037;0.142±0.017,0.290±0.029 and 0.902±0.021) and p-tau level (0.289±0.014 and 0.373±0.012) in mild TBI group and severe TBI group were significantly higher than those in sham-operated group (0.068±0.017,0.108±0.016 and 0.673±0.032;0.185±0.009;P＜0.05).Conclusions The oxidative stress and carbonylation of cytoskeleton proteins are significantly increased after TBI,and the expression levels are correlated with the severity of TBI.The carbonylation of cytoskeleton protein aggravates the axonal injury after TBI.

Objective To discuss the microanatomy features of jugular foramen region in transpetrosal-presigmoidal minimally invasive approach based on virtual reality image models.Methods CT and MRI scans were performed to fifteen adult cadaver heads,and then,imaging data were inputted into Vitrea virtual reality system to establish three-dimensional anatomy models of jugular foramen region.Different minimally invasive transpetrosal-presigrnoidal approaches exposing superior edge of internal acoustic meatus (route A),anterior edge of jugular foramen (route B),and posterior edge of jugular foramen (route C) were simulated by selecting osseous landmark points.Anatomic exposures in surgical trajectory following alternation of minimally invasive approach were observed,measured and compared.Results Spacial sequence of nerves and vessels in the route simulating transpetrosal-presigmoidal approach for exposure of jugular foramen region was displayed clearly;route A had the highest location and route C was the lowest.Volumes of route and petrosal osseous structure involved in route A was the largest,and then,volumes of route and osseous structure involved in route B was larger than those in route C,with significant differences (P＜0.05).Volumes of involved venous sinus were as follow:route B＞route A＞route C,with significant differences (P＜0.05).Volumes of facial-acoustic nerve complex and anterior inferior cerebellar artery involved in route A were (53.32± 5.54) mm3 and (30.55±3.51) mm3,respectively.Volumes of lower cranial nerves involved in route B were (84.59±9.23) mm3.Conclusion There are different impacts on the osseous structures and venous sinus for the minimally invasive routes of transpetrosal-presigmoidal approach exposing different targets,of which combinations are helpful to utilize respective advantages.

Objective To screen the fragilex mental retardation 1 (FMR1) gene mutations and explore the frequency of FMR1 gene mutation in the population with mental retardation in South China.Methods Seventy-two patients (65 males and 7 females) with suspected fragile X syndrome (FXS) in South China were enrolled in our hospitals from October 2009 to April 2014.The CGG trinucleotide repeats in 5'UTR of FMR1 gene and CCG trinucleotide repeats in FMR2 gene were screened respectively by PCR.Southern blotting and capillary electrophoresis sequencing were performed in male patients without normal target bands and suspected female patients;patients with normal CGG alleles were,then,performed exons and 3'-UTR ofFMR1 gene amplification and sequencing.The frequency of FMR1 gene mutation in patients with mental retardation in different countries and regions was compared with statistical analysis.Results Six pedigrees with full mutation (one female and five males being the probands),one pedigree (mother and son) with FMR1 gene deletion and one pedigree (mother and son) with mutation in the transition region were identified in 72 patients with mental retardation.The prevalence of total mutation was 9.7％ (7/72) and that in male patients was 9.2％ (6/65).These results showed significant differences in prevalence as compared with the results from different countries and areas (P＜0.05);there were no variations in 3'UTR ofFMR1 gene and FMR2 gene mutation in the patients with FXS-like phenotype.Conclusions FMR1 mutation frequency may be higher in mental retardation population in southem China as compared with that in developed countries or areas.Targeted screening on the unexplained mental retardation pedigrees (family history) can improve the diagnosis of FXS.Importantly,deletion mutations screening should also be performed in suspected FXS subjects with normal CGG repeats.

Objective To investigate the relationships of plasma alpha2-macroglobulin (α2-MG) level with occurrence of small-artery occlusion (SAO) and cognitive function in SAO patients.Methods Subjects were collected in our hospital from December 2012 to September 2013;58 patients with SAO stroke,56 with large artery atherosclerosis (LAA) classified by Trial of Org 10172 in Acute Stroke Treatment (TOAST),as well as 58 healthy controls,were enrolled.The serum α2-MG levels were measured by enzyme-linked immunosorbent assay (ELISA) and compared among the three groups.The receiver operating characteristic (ROC) curve was drawn to evaluate the value of α2-MG as a biomarker for SAO.White matter lesions (WMLs) were assessed by MRI using Fazekas classification,and mini-mental state examination (MMSE) was used to evaluate the cognitive function.The correlations of plasma α2-MG level with both Fazekas scores and MMSE scores were analyzed.Results The serum α2-MG levels in SAO patients ([6.70±3.17] μg/mL) were significantly higher than those in LAA patients ([5.04±1.93] μg/mL) and controls ([4.86±1.68] μg/mL) (P＜0.05).Binary Logistic regression analysis showed that the plasma α2-MG level was an independent risk factor for occurrence of SAO (OR=1.409,P=0.001;OR=1.443,P=0.004).The ROC curves obtained that α2-MG=4.23 μg/mL was the cutoff values for SAO,enjoying sensitivity up to 86.2％.SAO patients with different severities of WMLs had significantly different serum α2-MG levels (F=26.509,P=0.000);the serum α2-MG levels were positively correlated with Fazekas scores (r=0.733,P=0.000) and negatively correlated with MMSE scores (r=-0.679,P=0.000).Conclusions Serum α2-MG level is an independent risk factor for SAO and might be a biomarker for SAO.Furthermore,serum α2-MG level,being associated with high-grade WMLs,might contribute to evaluating the cognitive impairment in SAO patients.

Objective To explore the value of CT perfusion (CTP) at the interphase in patients with transient ischemic attack (TIA) by applying 16 multi-slice spiral CT.Methods Sixty-nine TIA patients,admitted to our hospital from October 1,2011 to December 30,2012,were performed CTP;cerebral blood flow (CBF),cerebral blood volume (CBV),mean transit time (MTT) and time to peak (TTP) were measured within specific regions of the brains.Staging was performed according to the CTP results;the relationship between abnormal CTP and clinical symptoms of TIA patients was analyzed.Results In 69 patients with TIA,persisting abnormal perfusion changes corresponding to clinical symptoms were found in 52 patients.According to the CTP results,stage Ⅰ TIA included 25 patients and stage Ⅱ included 27 patients;the TTP and MTT in stage Ⅰ patients were significantly different between the affected side and the contralateral side (P＜0.05),while the CBF and CBV showed no significant difference (P＞0.05);the TTP,MTT and CBF in stage Ⅱ patients were significantly different between the affected side and the contralateral side (P＜0.05),while CBV showed no significant difference (P＞0.05).The percentages of stage Ⅱ patients with National Institutes of Health Stroke Scale (NIHSS) scores higher or equal to 4 points (68.2％) and onset duration longer than 60 min during TIA (75.0％) were significantly higher than those of stage Ⅰ patients (31.8％,25％,P＜0.05).NIHSS scores and duration of TIA onset were negatively correlated with the CBF ratio (affected/contralateral side;r=-0.548,P=0.000;r=-0.848,P=0.000),positively correlated with the TTP ratio (affected/contralateral side;r=0.732,P=0.000;r=0.927,P=0.000),and positively correlated with the MTT ratio (affected/contralateral side;r=0.668,P=0.000;r=0.902,P=0.000) in 52 TIA patients.Conclusion CTP provides valuable hemodynamic information,which could be used as the imaging basis of TIA diagnosis and treatment.

Objective To evaluate the changes ofcerebrovascular reserve (CVR) of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) by transcranial cerebral doppler (TCD) and to study its relation with stroke.Methods One hundred and twenty-six patients with OSAHS,admitted to our hospitals from July 2012 to January 2013 and diagnosed as having OSAHS,were chosen in our study;they were divided into mild OSAHS group (n=49),moderate OSAHS group (n=44) and severe OSAHS group (n=33) according to test results of polysomnography (PSG).Another 40 healthy controls were collected.The CVR of all subjects were evaluated by TCD merging with CO2 experiment and compared among different groups.All the subjects were accepted continued two-year follow-up and recorded the accidents of stroke.The morbidities of stroke were compared between different groups.Results As compared with those in the control group and mild OSAHS group,all of the contractile reserve,dilatation reserve and overall reserve descended in moderate OSAHS group and severe OSAHS group with statistically significant differences (P＜0.05).As compared with those in the moderate OSAHS group,all of the contractile reserve,dilatation reserve and overall reserve descended in severe OSAHS group,and the differences were statistically significant (P＜0.05).In the two years of follow-up,the incidence of stroke in the severe OSAHS group (12.12％) was significantly higher than that in the control group (0％),mild OSAHS group (0％) and moderate OSAHS group (4.55％,P＜0.05).Conclusion The heavier the condition of OSAHS,the more obviously descended the CVR;the stroke morbidity of severe OSAHS patients is increased significantly.

Objective To investigate the effect of early comprehensive rehabilitation on clinical efficacy in patients with acute stroke.Methods One hundred and sixteen patients with acute stroke,admitted to our hospital from August 2012 to August 2014,were randomly divided into treatment group and control group (n=58).Both groups were treated with conventional approach;furthermore,patients in the treatment group conducted the early comprehensive rehabilitation,while those in the control group self-exercised without any professional directions.Neurologic impairment was evaluated by National Institutes of Health Stroke Scale (NIHSS),motor function of the paralytic limbs was evaluated by Fugl-Meyer assessment (FMA) and self-care ability of daily living of the patients was evaluated by Barthel index (BI) before treatment and 7,14 and 28 days after treatment;the complications of the patients were observed.Results NIHSS scores,FMA scores,and BI of the treatment group were significantly different as compared with those in the control group 14 and 28 days after treatment (P＜0.05);the treatment effect in the treatment group was obviously improved as compared with that in the control group 28 d after treatment (mean rank:50.23 and 61.87).The incidence of most commonly encountered complications (glenohumeral subluxation,shoulder-hand syndrome,foot drop,amyotrophy,bedsore,thrombus of lower extremity veins and joint contracture) of the treatment group was significantly lower than that in the control group (P＜0.05).Conclusion Early comprehensive rehabilitation during the treatment of acute stroke can greatly promote the neurological recovery and markedly reduce the complications;early comprehensive rehabilitation can significantly improve the life quality of the patients.