Objective: In this study, the neuroprotective effects of a water-soluble extract from culture medium of Ganoderma lucidum mycelia (WER) on oxidative stress-induced injury were examined using H₂O₂-treated PC12 cells. Additionally, we investigated both the acute and chronic effects of WER on brain necrosis and apoptosis induced by hypoxia/ischemia (H/I) followed by reoxygenation in mice.
Methods: Viability and apoptosis index of H₂O₂-treated PC12 cells were determined by 3,4,5-dimethylthiazol-2-yl (MTT) assay and TUNEL staining, respectively. H/I in mice was induced by unilateral ligation of carotid artery and exposure of 8%O₂ for 30 min. Twenty-four hours after H/I, neurological deficits, cerebral infarction volume, and apoptosis level were evaluated.
Results: WER–pretreated PC12 cells showed an increased viability evaluated by MTT assay compared to untreated cells. TUNEL staining indicated that WER induced a concentration-dependent decrease of the number of apoptotic cells. In the mouse model of H/I, acute (pre-H/I) treatment of WER (1 g/kg, p.o.) did not affect neurological deficits, total plasma oxidative stress, cerebral lipid peroxidation, and infarction volume assessed 24-h after reoxygenation. However, chronic treatment of WER (1 g/kg, p.o., for 7 days) significantly improved these parameters compared with distilled water-treated mice. Moreover, chronic treatment of WER decreased the levels of apoptosis in two brain areas, the sensori-motor cortex and the CA1 of the hippocampus, analyzed by TUNEL and cleaved caspase-3 immunostaining.
Conclusion: These results show that daily intake of WER relieves the cerebral ischemic injury, which may be attributed to decrease of oxidative stress.

1) In problem-based learning (PBL) tutorials during the2nd year, general symptoms (fatigue, weight change, bleeding, fever, pain, and edema) were chosen as subjects.Changes in the students'way of thinking about how to learn were evaluated before and after PBL tutorials.
2) After tutorials students were significantly more likely to believe that their participation in tutorials was a more effective way of learning. The students'views after tutorials on listening to lectures differed between2006and2007.
3) We conclude that PBL tutorials affect medical students'views about learning.

　The education program in all medical schools in Japan has been studied and analyzed every 2 years since 1974 by the curriculum committee of the Association of Japan Medical Colleges. Based on the most recent analysis in 2015, the marked innovation of medical education, such as an integrated curriculum, active learning, and clinical clerkship, was recognized.

Coronavirus disease 2019 (COVID-19) has been spreading globally since 2019；however, comprehensive rehabilitation of elderly patients with COVID-19 pneumonia remains a challenge. A 76-year-old American woman with COVID-19 pneumonia was admitted to our hospital. Because her disease was complicated by acute respiratory distress syndrome (ARDS), she was treated with intensive care, including invasive ventilation and extracorporeal membrane oxygenation (ECMO). During and after intensive care, she exhibited physical symptoms such as weakness, pain, shortness of breath, and difficulty in movement and exercise. Furthermore, during approximately 3.5 months of hospitalization, she received swallowing and speech therapies along with physical therapy. These rehabilitation therapies enabled her to get home in the United States. Her rehabilitation schedule had to be carefully planned according to her symptoms and infectiousness of COVID-19. This paper highlights few important points regarding the difficulty in rehabilitation including that of physical function, mental health, and cognitive function of patients with COVID-19. Furthermore, this report provides a problem-solving approach for long-term rehabilitation in elderly patients with COVID-19 pneumonia.