Perioperative stroke refers to acute ischemic or hemorrhagic stroke that occurs before operation,during operation and within 30 days after operation.Although the levels of anesthesia and surgical treatment have improved in recent years,there is no significant decrease in the incidence of perioperative stroke.The traditional vascular risk factors,such as advanced age,hypertension,and diabetes,are also the risk factors for stroke onset.In addition,perioperative stroke is closely associated with the operation site,operation mode,anesthesia,and other perioperative events.The treatment and prevention of perioperative stroke is attracting more and more attention,including surgery,anesthesia,neurology and other clinicians.This article reviews the risk assessment,prevention,and treatment of perioperative stroke.

[Objective]To discuss axonal regeneration and functional recovery after rat's spinal cord injury with transplantation of human cord blood mononuclear cells(HCMNCs).[Method]Thirty injured spinal cord models of Wistar rat were made with Impactor ModelⅡat T10 and then divided into 3 groups randomly and evenly(DMEM control,HCMNCs grafted 3 days post injury and HCMNCs grafted 14 days post injury).Hindlimb functional recovery of rats in each group was evaluated by BBB locomotor functional scale.HE,immunohistochemistry staining,and BDA anterograde tracing were used to observe the axonal regeneration in the lesion site.[Result]Compared with control group,grafted HCMNCs exerted larger effect on promoting nerve regeneration and functional recovery.Rats in the group of HCMNCs grafted 14 days post-injury had better functional recovery than those in HCMNCs grafted 3 days post-injury group.Statistic difference existed among three groups(P

Objective To investigate the phototoxicity effects of the nanocompound of upconversion nanoparticles (UCNPs) on rat astrocytes in vitro.Methods The spinal astrocytes cells were cultured successfully in vitro and then incubated with the UCNPs-MC540 of various concentrations and exposured 980 nm infrared laser irradiation of different energy densities.The cell survival rates of each group were detected by MTT assay.The cellular morphology was observed via transmission electron microscope after photodynamic therapy.Results UCNPs-MC540 of different concentrations without laser irradiation or laser of different energy had no significant effects on cell survival rates.when cells incubated with 100 μg/ml UCNPs-MC540 for 12 h underwent laser irradiation of different energy,the cellular survival rates significantly decreased with the increased energy densities.when the cells incubated with UCNPs-MC540 of various concentrations for 12 h underwent laser irradiation of 2 000 J/cm2,the cellular survival rates significantly decreased with the increased concentrations.Compared with controls,the TEM show the apoptosis sign in the cells incubated with 200 μg/ml UCNPs-MC540 after laser irradiation of 2 000 J/cm2.Conclusion The UCNPs-MC540 mediated photodynamic therapy have effective killing effect on astrocytes by the mechanism of induction the apoptosis.

Objective To develop a new-type animal dental stent for the experiment of canine pulp regeneration.Methods The stent was composed of an upper support frame,an oral limit bracket and a lower support frame,which were aligned from top to bottom.A sleeve joint was made for the connection structure of the bracket,and the height and the width both could be adjusted to adapt to different animals' mouths.The rubber dam could be spread into tension and concave form by rotating the upper and lower support frames' ends.Results By resizing the animal dental stent based on the structure of animal facies maxillaris,medical staffs could proceed the examination and treatment to animals effectively,including the throat examination,oral examination,oral care,dental treatment (such as root canal therapy and dental filling) and other medical behaviors.Conclusion The experimental result shows the feasibility of utilizing the stent in the process of animal experiment or diagnosis and treatment.Moreover,the stent proves the capacity in protecting the soft tissue,widening the vision of operation field,getting rid of the saliva contamination,which is worthy popularizing in animal experiments and animal medical care.

ObjectiveTo investigate the clinical promoting effect of crossing nape electroacupuncture on the recovery of swallowing function and recovery from pulmonary infection in post-cerebral infarction patients with tracheotomy.MethodSixty post-cerebral infarction patients with cough reflex disorder and swallowing dysfunction associated with pulmonary infection receiving tracheotomy and tracheal intubation were subjects. They were allocated, using a random number table, to three groups, 20 cases each. In each group, the patients were enrolled in order of visits. The three groups were given the same basic treatment for fighting inflammation, resolving phlegm and improving blood supply. The crossing nape electroacupuncture group received bilateral points Fengchi (GB20), Yifeng (TE17), Dicang (ST4)-to-Jiache (ST6) and Lianquan (CV23) acupuncture with electrodes connected by left-right crossing. The acupuncture group received bilateral points Fengchi, Yifeng, Dicang-to-Jiache and Lianquan acupuncture without electrodes connected. The control group received basic treatment with Western drugs without acupuncture therapy. Observations were carried out using the Kubota’s water drinking test, the Toshima Ichiro Swallowing Assessment and the Clinical Pulmonary Infection Score. The clinical therapeutic effects were evaluated in the three groups.ResultThe therapeutic effects evaluated using the Kubota’s water drinking test and the Toshima Ichiro Swallowing Assessment were better in the crossing nape electroacupuncture group than in the acupuncture group and better in the acupuncture group than in the control group (P<0.05). The score of the Clinical Pulmonary Infection Score decreased in all the three groups. The promoting effect on recovery from pulmonary infection was marked in the crossing nape electroacupuncture group (P<0.01).ConclusionCrossing nape electroacupuncture has a marked improving effect on dysphagia in post-cerebral infarction patients with tracheotomy and tracheal intubation. It can promote recovery from pulmonary infection in post-cerebral infarction patients with cough reflex disorder receiving tracheotomy and tracheal intubation.

Objective To investigate the characteristics of hospitalized elderly schizophrenia patients combined with somatic diseases.Methods A cross-sectional study was conducted on hospitalized elderly schizophrenia patients using a questionnaire developed by ourselves at three mental health centers in Shanghai.Gender,age,length of education,course of disease,somatic diseases (hypertension,diabetes,hyperlipidemia,organic cerebral disease,and heart disease),antipsychotic medication as well as other relevant information were collected.Meanwhile,body mass index,body height and other relevant indexes were measured.Results Among 304 subjects,176 (57.9 ％) were complicated with somatic diseases,including 120 (39.5％) with hyperlipidemia,113 (37.2％) with hypertension and 78 (25.7％) with diabetes mellitus as the top three somatic diseases.Patients who were overweight or took atypical antipsychotics were more susceptible to somatic diseases (both P＜0.05);female patients were more susceptible to heart disease and diabetes than male patients (P ＜0.05);patients aged 70 years and over were susceptible to hypertension and hyperlipidemia than those under 70 years old (P＜0.05).Somatic diseases were related to age (over 70 years old),overweight and use of atypical antipsychotics in hospitalized elderly schizophrenia patients (P＜0.05).Conclusions The incidence of somatic diseases in hospitalized elderly schizophrenia patients is relatively high,and the most common somatic diseases are hyperlipidemia,hypertension and diabetes mellitus.Age,overweight and use of atypical antipsychotics are the influence factors for somatic diseases in these patients.

OBJECTIVETo study the effect of dimethoate on the expression of heat shock protein 70 (HSP70) in peripheral blood lymphocytes of human beings and to explore the feasibility of HSP70 in biomonitoring among workers exposed to organophosphorous pesticides.

METHODSPeripheral blood lymphocytes were isolated from subjects, comprising 11 people of the control group and 35 workers of the exposure group exposed to dimethoate. Flow cytometry was used for detecting both the basic level and the level of the dimethoate-induced expression of HSP70. The activity of whole blood acetylcholinesterase (AChE) was examined at the same time. Then the potential influential factors to HSP70 expression and AChE activity were analyzed.

RESULTSThe basic level of HSP70 expression in the exposure group and the control group was 41.24% +/- 10.45% and 23.97% +/- 4.29% respectively. The activity of AChE in these two groups were (125.23 +/- 7.97) and (145.36 +/- 8.78) U/ml respectively. Both differences were statistically significant (P < 0.01). Among the exposure group, the basic level of HSP70 expression of the two categories comprising operators and packers, were 47.34% +/- 11.87% and 38.05% +/- 8.20% respectively (P < 0.05), while there was no significant difference (P > 0.05) in AChE activity between these two categories. The factors that had significant influence on the HSP70 basic level of the exposure group were the health condition, the environmental concentration of dimethoate and the exposure time in order, according to their significance of influence. At least 88% variance of HSP70 could be explained by these factors. The only factor that could influence AChE activity significantly was the exposure time, and it could only explain about 12% variance of AChE activity. After the treatment of dimethoate in vitro, the level of the induced expression of HSP70 in the control group was significantly higher than that of the exposure group (P < 0.01). The increasing order was the control group, the group of packers and the group of operators according to the increasing extent and there were significant difference among them (P < 0.01). The factors that could significantly influence the change ratio of HSP70 expression were the environmental concentration and the exposure time.

CONCLUSIONHSP70 is a potential index that can reflect the individual and environmental conditions of workers exposed to dimethoate comprehensively.

Acetylcholinesterase ; blood ; Adult ; Cells, Cultured ; Dimethoate ; toxicity ; Female ; HSP70 Heat-Shock Proteins ; biosynthesis ; Humans ; Insecticides ; toxicity ; Lymphocytes ; drug effects ; metabolism ; Male ; Middle Aged ; Occupational Exposure

OBJECTIVETo investigate the influence of pyrrolidine dithiocarbamate (PDTC) on the expression of transforming growth factor beta(1) (TGF-beta(1)), matrix metalloproteinase-2 (MMP-2) and tissue inhibitor-1 of metalloproteinase (TIMP-1) in rats with pulmonary damage induced by paraquat (PQ).

METHODSFifty-four healthy male SD rats were randomly assigned into the control group (normal saline), the PQ-treatment groups (4 groups) and the PDTC treatment groups (4 groups). Except the rats in the control group, the rats in the PQ group were gavaged only with 40 mg/kg PQ, and PDTC group with 40 mg/kg PQ plus immediate injection 120 mg/kg PDTC (i.p). On the 3rd, the 7th, the 14th and 28th day after treatments, one group rats of each treatments were sacrificed and lung and blood samples were collected. The level of TGF-beta(1) protein in the plasma, the mRNA expression of TGF-beta(1), MMP-2 and TIMP-1 were evaluated using RT-PCR and real-time quantitative PCR, while pathological changes of lung were examined under optical microscope and electrical microscope.

RESULTSThe TGF-beta(1) protein, TGF-beta(1) and MMP-2 mRNA expression were increased significantly in the earlier stage and then decreased after PQ administration (P < 0.05 or P < 0.01), while the mRNA level of TIMP-1 was augmented continuously (P < 0.01) throughout the study compared to the control group. In comparison with the PQ group, in the PDTC treatment group, the TGF-beta(1) mRNA expression on the 3rd and the 14th day, 0.54 +/- 0.08 and 0.72 +/- 0.04 respectively, the MMP-2 mRNA expression on the 7th and 14th day, 1.62 +/- 0.50 and 1.97 +/- 0.34 respective-ly, and the TIMP-1 mRNA on the 7th and 21st day, 1.79 +/- 0.21 and 2.00 +/- 0.34 respectively, were significantly decreased (P < 0.05 or P < 0.01).

CONCLUSIONPDTC could attenuate paraquat-induced up-regulation of TGF-beta(1) and its mRNA expression, MMP-2 and TIMP-1 mRNA levels, which indicates that PDTC may exert its protective effects on paraquat-induced pulmonary damage by alleviating the earlier inflammation damage and adjust-ing the balance between MMPs and TIMPs. However, further studies are still warranted to investigate and clarify the underlying mechanisms involved in this complicated process.

Acute Lung Injury ; chemically induced ; metabolism ; pathology ; Animals ; Disease Models, Animal ; Lung ; metabolism ; pathology ; Male ; Matrix Metalloproteinase 2 ; genetics ; metabolism ; Paraquat ; poisoning ; Pyrrolidines ; pharmacology ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley ; Thiocarbamates ; pharmacology ; Tissue Inhibitor of Metalloproteinase-1 ; genetics ; metabolism ; Transforming Growth Factor beta1 ; genetics ; metabolism

OBJECTIVE:To observe clinical efficacy and safety of compound α-ketoacid tablet in the treatment of type 2 dia-letic mellitusc(T2DM)complicated with early diabetic nephropathy. METHODS:A total of 180 T2DM patients with early nephrop-athy during Jan. 2013-Dec. 2015 selected as research objects were divided into group A,B,C according to random number table, with 60 cases in each group. Group C was given basic symptomatic treatment. Group A was additionally given Compound α-ketoac-id tablets 2.52 g orally,tid,on the basis of group C. Group B was additionally given Compound α-ketoacid tablets 5.04 g orally, tid,on the basis of group C. Three groups were treated for consecutive 24 weeks. The renal function indexes (BUN,Cr,GFR, urine ALB),blood glucose indexes (FPG,PPG,HbA1c),blood pressure indexes (SBP,DBP) and nutritional indexes (serum ALB,PA,Hb) were observed in 3 groups before and after treatment. The occurrence of ADR was recorded in 3 groups. RE-SULTS:Before treatment,there was no statistical significance in renal function indexes,blood glucose indexes,blood pressure in-dexes or nutritional indexes among 3 groups(P>0.05). After treatment,urine levels of ALB,HbA1c and SBP were decreased sig-nificantly in 3 groups;the group B was significantly lower than the group A;the group A was significantly lower than the group C. The levels of serum ALB,PA and Hb were decreased significantly in group A and C;the group B was significantly higher than the group A;the group A was significantly higher than group C,with statistical significance (P<0.05). The incidence of ADR in 3 groups were 8.3％,10.0％ and 6.7％ respectively,without statistical significance(P>0.05). CONCLUSIONS:Compound α-keto-acid tablet can significantly improve renal function,control blood glucose and blood pressure levels and complete necessary nutri-ents in T2DM patients with early nephropathy patients with good safety. High dose are more effective.

BACKGROUNDPulmonary hypertension (PH) frequently complicates the course of idiopathic pulmonary fibrosis (IPF) patients and is associated with significantly worse outcomes. The aim of the present study was to investigate the incidence of PH in IPF patients and evaluate the correlation between clinical parameters and systolic pulmonary artery pressure (sPAP).

METHODSHospitalized patients with IPF, who were evaluated for sPAP by Doppler echocardiography from January 2004 to December 2011, were enrolled in our study. Patients were defined as PH by an estimated sPAP > 50 mmHg and graded as PH likely, PH possible and PH unlikely, based on the 2009 European Society of Cardiology/European Respiratory Society PH Guidelines. The correlations between clinical parameters and sPAP were analyzed by multiple linear regression.

RESULTSTotally, 119 IPF patients were enrolled in our study and 28 (23.5%), 20 (16.8%) and 71 (59.7%) patients were PH likely, PH possible and PH unlikely, respectively. Borg dyspnea score was positively correlated with sPAP, r = 0.467, P < 0.001. Oxygen saturation was negatively correlated with sPAP, r = -0.416, P < 0.001. Diffusing capacity of the lung for carbon monoxide percentage predicted was negatively correlated with sPAP, r = -0.424, P = 0.003. N-terminal fragment of pro-brain natriuretic peptide and pulmonary artery width was positively correlated with sPAP, r = 0.452, P = 0.011 and r = 0.513, P < 0.001, respectively.

CONCLUSIONSThe incidence of PH in IPF patients was 23.5% in a single center of China. PH may worsen the dyspnea, right heart dysfunction and decrease the life quality of the patients with IPF.

Aged ; Echocardiography, Doppler ; Female ; Humans ; Hypertension, Pulmonary ; blood ; epidemiology ; physiopathology ; Idiopathic Pulmonary Fibrosis ; blood ; epidemiology ; physiopathology ; Incidence ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Pulmonary Artery ; physiopathology ; Smoking