BACKGROUND: Activation of leucocyte and endothelial cell in ischemic area of brain and the expression of adhesive molecule on the surface can cause aggregation and infiltration of leucocyte which deteriorated cerebral injury due to cytotoxicity. Ligustrazine can inhibit thrombosis and improve microcirculation.OBJECTIVE: To observe the effect of ligustrazine on adhesion of leucocyte and endothelial cell in focal area after cerebral ischemia-reperfusion injury.DESIGN: Randomized controlled animal study.SETTING: Second Division of Brain, Department of Neurology, Daping Hospital of the Third Military Medical University of Chinese PLA; Department of Psychiatry, the Second People's Hospital of Yuxi, Yunnan Province.MATERIALS: The experiment was carried out at the Second Cerebral Laboratory of Neurological Department of Daping Hospital Affiliated to the Third Military Medical University of Chinese PLA. A total of 32 male Wistar rats weighing 250-300 g were randomly divided into normal control group (n=8), cerebral ischemia-reperfusion group (n=12) and cerebral ischemia-reperfusion + ligustrazine group (n=12).METHODS: Rats in ligustrazine group were venously injected with 15 g/kg ligustrazine phosphoric acid, and rats in normal control group and cerebral ischemia-reperfusion group were venously injected with the same volume of saline. Cerebral ischemia-reperfusion injury and adhesive changes of leucocyte in focal area after administration of ligustrazine were observed with immunofluorescent labeling technique and micro-ultra-speed imaging system.MAIN OUTCOME MEASURES: ① Adhesive density index of leucocyte of arteriole in focal area after cerebral ischemia-reperfusion injury; ② Adhesive changes of leucocyte in focal area after administration of ligustrazine.RESULTS: All experimental animals were involved in the finalanalysis.① As compared with those in control group, adhesive density index of leucocyte of arteriole in focal area in cerebral ischemia-reperfusion group was increased, broken stress between leucocyte and endothelial cell was decreased remarkably, adhesion was increased obviously, and there was significant difference (P ＜ 0.01). ② As compared with those in cerebral ischemia-reperfusion group, adhesive density index and adhesion of leucocyte in ligustrazine group were decreased and reached the lowest values after 24 hours. Broken stress was increased and maintained at a higher level. There was no significant difference from that in normal control group till 24 hours.CONCLUSION: Ligustrazine can relieve adhesion between endothelial cell and leucocyte after cerebral ischemia-reperfusion injury.

Objective To investigate the effect of α7nAchR gene 713T>C mutation on the cognitive function and Aβ expression in Alzheimer′s disease(AD)mice.Methods Twenty APPSwe transgenic APPa7KO mice(6 months old,α7nAchR gene knockout)were divided into the mutation type group and wild type group according to the random number table method,10 cases in each group.The mutation type and wild type of AVV-α7nAchR cDNA were respectively injected by lateral ventricle,once per month,for 6 times.The change of cognitive function in mice was examined by Morris water maze.The ELISA method was used to detect Aβ 40 and Aβ 42 expression levels.The Aβ plaque deposit situation was detected by the immunochemical method.Results Compared with the mice in the wild type group,the escape latency and the time of first time to find the platform of the mice in the mutation type group were significantly extended,while Hippocampal Aβ40 and Aβ42 expression levels were significantly increased,the difference was statistically significant(P＜0.05).Conclusion α7nAchR gene 713T>C mutation aggravates the cognitive function impairments in AD mice and hippocampal neuron Aβ expression level.

BACKGROUND: The presence of cognitive impairment following stroke onset strongly indicates poor prognosis of the patients surviving the crisis.Understanding of the incidence of cognitive impairment after ischemic stroke and its confidence interval has practical significance in preventing is occurrence in stroke patients and its differentiation from age-related cognitive impairment.OBJECTIVE: To study the incidence of cognitive impairment in patients with the first onset of ischemic stroke.DESIGN: Single-factor analyses of the cases followed up for 3 months SETTING: Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA.PARTICTPANTS: Totally 434 inpatients with acute cerebral infarction [218 male and 216 female, aged 55 to 85 with a mean of (70.3±9.5) years]admitted within 48 hours after the onset in Department of Neurology, Daping Hospital of Third Military Medical University from May 8, 1999 to December 31, 2000. All patients participated in this study voluntarily.METHODS: The general background and clinical data of the patients were collected at the time of admission. A simplified intelligence test was performed both 7 to 10 days of the onset and 3 months after discharge. The scale employed for the test included 20 questions with a total of 30 items divided to test 5 aspects of the patients' cognition, namely orientation ability, memory, calculation ability, memory recall and linguistic ability (1 point was given for a correct answer, and 0 for an wrong one or an answer of "I don't know", with the total score of 30 for all items). A score of the simplified intelligence test less than the score of demarcation (specifically,below 17 for illiterate patients, below 20 for those receiving an education no more than 6 years, and below 24 for those having an education for no less than 7 years) for 3 months after cerebral stroke was regarded as the diagnostic criteria for cognitive impairment.MAIN OUTCOME MEASURES: The incidence of cognitive impairment was recorded 3 months after hospital discharge and single-factor analysis of the scores of simple intelligence test.RESULTS: All the 434 patients were included in result analysis. Totally 161 (37.1%) patients were diagnosed as having cognitive impairment, and 273 (62.9%) had normal cognitive function 3 months after hospital discharge. The mean age of the patients with cognitive impairment was significantly higher than that of the patients with normal cognitive function [(73.0±7.0) years vs (64.5±6.6) years, t=2.626, P ＜ 0.01]. The proportion of patients with cognitive impairment receiving education for no more than 6 years was significantly higher than that among patients with normal cognition (45.3% vs 22.7%, OR=2.823, with 95% confidence interval of 1.855 -4.297), and the score of simple intelligence test was significantly lower in the former patient group (16.3±8.7 vs 23.4±4.2, t=3.352, P ＜ 0.001).CONCLUSION: The incidence of cognitive impairment in this cohort is relatively high. The patients with cognitive impairment following cerebral infarction have obviously older age and poorer education, suggesting significant synergetic effect of age and education with cognitive impairment following cerebral infarction.

BACKGROUND: Pro-inflammatory cytokines can promote the expression nof intercellular adhesion molecule-1 (ICAM-1), and the adhesion of white cells to intravascular endothelium, thereby involving in the developing ischemic stroke.OBJECTIVE: To investigate the prognostic value of soluble intercellular adhesion molecule-1 (sICAM-1) and its relative factors in the developing ischemic stroke.DESIGN: Randomized controlled study based on patients.SETTING: Department of neurology, the field surgery research institute in a military hospital of Chinese PLA.PARTICIPANTS: Between January 1st and December 31st 2000, total 238patients with ischemic stroke received treatment at the Neurological Department of the Third Affiliated Hospital, the Third Military Medical University of Chinese PLA, including 117 males and 121 females, amongst which 186cases were confirmed of none-developing ischemic stroke and 52 cases developing ischemic stroke.INTERVENTIONS: After hospitalization, patients were subject to daily neurological examination, Canada stroke score(CSS), temperature and white blood cell(WBC) counting, sICAM was examined at 1, 3 and 7 days after hospitalization.correlative factors between developing ischemic stroke and non-developing ischemic stroke at 24 hours 3 days and 7 days after the onset of stroke.RESULTS: Within 24 hours from the onset of stroke, the number of WBC was[(8.4 ± 1.2) × 109 L-1] in developing ischemic stroke group, with blood glucose of[ (45.8 ± 5.1) g/L], fibrinogen of[ (64. 6 ± 5. 1) g/L] and sICAM-1 of[ (261.4 ± 9. 7) μg/L], which were obviously higher than the corresponding[(6.7±1.3) ×109 L-1, (36.2±5.5) g/L, (44.0±6.2) g/L,(223. 1 ± 8.4) μg/L] in non-developing ischemic stroke group, the difference was of statistical significance( t = 2. 368 - 2. 387, P ＜ 0. 01 ) . The results of multiple factor analysis on developing ischemic stroke indicated that serum sICAM-1 was a risk factor independent of higher blood glucose,fibrinogen and CSS, and was obviously correlated with developing ischemic stroke( OR =2.9, 95% CI= 1.4 -6. 3) . There was significant change in sICAM-1, the number of WBC, blood glucose and fibrinogen at 24 hours, 3days and 7 days, as well as the scores for CSS at hospitalization in developing ischemic stroke group, which were significantly different from non-developing ischemic group( t = 2. 345 - 2. 878, P ＜ 0.01 ).CONCLUSION: sICAM-1 was proved obviously correlated with developing ischemic stroke, and can be used as a prognostic factor.

BACKGROUND:With the trend of population aging,the morbidity of cognitive dysfunction has been gradually increased.People start to pay attention to the impact of smoking to cognitive dysfunction. OBJECTIVE:To investigate the effects of smoking on cognitive dysfunction in elder people,and explore the possibility of intervention. DESIGN:Randomized cluster sampling. SETTING:Neurology Department of a hospital. PARTICIPANTS:A total of 3 012 old people aged above 60 year were selected from two resident committees by drawing from Gaoxin district,Yubei district and Yuzhong district of Chongqing in which there were 1 668 males and 1 344 females. METHODS:Mini mental state examinate(MMSE) was used to assess cognitive function.t test and Logisitc regression were used to analyze the information. RESULTS:MMSE assessment was conducted to 3 012 people,the total smoking rate was 35% .The abnormality rate of cognitive function in aged people of Chongqing was 11.95% .Among smoking population,11.8% of the currently smoking people and 4.5% of previously smoking people suffered from the cognitive dysfunction while 5.3% of the non smoking people got cognitive dysfunction. CONCLUSION:Smoking is closely correlated with cognitive dysfunction(χ 2=6.59,P=0.047) and education background, age, occupation and sex are the influencing factors of cognitive dysfunction.Current smoking people get higher risk to suffer cognitive dysfunction(RR=2.33,95% CI=1.37- 5.82).Smoking is an important risk factor for cognitive dysfunction in aged people so that it will be an effective strategy for aged people to reduce the incidence of cognitive dysfunction by quitting smoking.

Objective To investigate the association between aortic calcification and risk of vertebral fracture in Chinese postmenopausal women.Methods This study recruited 561 postmenopausal women aged 60 or older who were prospectively followed for 3 years.Based on the ACS,the patients were divided into aortic calcification group (n =236) and non-aortic calcification group (n =325).Extent of aortic calcification and incidence of vertebral fracture were quantified on the baseline lateral radiographs of lumbar spine.Dual energy x-ray absorptiometry was utilized to evaluate the bone mineral density (BMD).Cox proportional hazards models were used to assess the associations between aortic calcification and risk of vertebral fracture.Results In aortic calcification group incidence of vertebral fracture was significantly higher than that in non-aortic calcification group (P ＜ 0.01).Moreover vertebral fracture presented an increased incidence while the ACS was higher.After the adjustment of age,body mass index,BMD,current smoking,current drinking,hypertension,diabetes,total cholesterol,myocardial infarction,stroke and 25-hydroxy vitamin D,aortic calcification with ACS ＞ 6(HR =3.03,95％CI 1.42-6.24),BMD (HR =2.82,95％ CI 1.75-5.68),age (HR =1.96,95％ CI 1.38-4.52),history of two or more falls (HR =1.45,95％ CI 1.24-2.79) and adiponectin (HR =1.07,95％ CI 1.22-2.31) were associated with increased risk of vertebral fracture.Conclusion Severe aortic calcification is closely associated with vertebral fracture for postmenopausal women.

Objective To explore the relationship of serum levels of β-amyloid precursor protein (β-APP) with degree of traumatic brain injury (TBI) and the traumatic time.Methods Sprague-Dawley (SD) rats were randomly divided into normal control and injury group.The rats in injury groups suffered from TBI after free-falling percussion with different pressure (wild-injury,moderate-injury and severe-injury group).Then serum was collected at 0.5 h,2 h,6 h,and 24 h and subject to β-APP detection by ELISA.All data were analyzed statistically with completely randomized design multiple factor repeated measure of variance analysis and least significant difference (LSD) test.Results The serum levels of β-APP were higher after injury.The serum levels of β-APP were significantly higher in moderate-injury or severe-injury group than those in normal group or slight-injury group (P＜0.05).The serum levels of β-APP were higher in severe-injury group than that in moderate-injury group with no statistical difference (P＞0.05).There was no statistical difference in serum β-APP levels between normal control and slight-injury group (P＞0.05).Conclusion The serum level of P-APP is increasingly higher with traumatic brain injury more serious and could be employed as an indicator of TBI degree.It implies that β-APP has the potential as an early diagnosis marker for TBI.

Objective To investigate the characteristics of the mental health and the change of serum copeptin,cortisol and aldosterone levels of the soldiers in field army under military exercises stress.Methods A total of 294 soldiers were evaluated with the psychological stress self evaluation test (PSET) before the exercises and the soldiers whose PSET score were T ＜ 70 had to accept the survey with the general information questionnaire before the exercises, and another two questionnaires including PSET and Symptom Checklist 90 (SCL-90) after the exercises, the higher stress group and lower stress group were defined according to the PSET score, T≥70 and T ＜ 70 respectively.Meanwhile, we draw the venous blood of them in order to detect the serum concentration of copeptin,cortisol and aldosterone before and after the military exercise.Results ( 1 ) After the survey of PSET before the exercises,263 soldiers were determined to be the final research objects.According to the score of PSET after the exercises, 104 soldiers(39.5% ) were considered as the higher stress group,and the symptoms mainly included anxiety,hostility and poor sleep and appetite.(2) Compared with the lower stress group,the higher stress group were younger(21.51 ± 3.13 vs 24.09 ± 4.16, P ＜ 0.01 ), higher at the proportion of soldiers ( 68.27% vs 54.09%, P＜0.01 ) and lower at the proportion of soldiers who have experiences of military exercises(37.50% vs 57.23%, P＜0.01 ).(3) Compared with the lower stress group,the higher stress group had higher score in EPQN ( 10.43 ± 1.78 vs 8.77 ± 1.67, P ＜ 0.01 ).(4) The serum levels of copeptin ( P ＜ 0.01 ), cortisol ( P ＜ 0.01 )and aldosterone( P＜0.01 ) have increased after the military exercise.Compared with the lower stress group, the higher stress group have higher serum copeptin level ( 11.36 ± 2.21 vs 9.43 ± 2.34, P ＜ 0.01 ) after the exercises.( 5 ) The relationship between PSET score and the copeptin level after exercise can be expressed as a formula: PSET score = 27.909 + 3.669X ( X: copeptin level after exercise), and 11.472 pmol/L was considered as the threshold value.Conclusion As a strong stress agent, military exercises may cause obvious physiological changes and has notable effect on related hormones.The change of serum copeptin level can be used as a sensitive indicator to determine the degree of stress.

Objective To provide scientific basis for developing mental interventions for the wounded in major disasters by assessing the mental health status and the mental intervention effect among the Wenchuan earthquake survivors transferred to Chongqing.Methods A total of 389 transferred wounded survivors were examined by using questionnaires including general information questionnaire,Psychological Health Self-rating Questionnaire (PHSQ),Symptom Checklist 90 (SCL-90),Perceived Social Support Scale (PSSS) and Coping Styles Questionnaire (CSQ).According to PHSQ,the wounded were divided into control group and stress group.Then,the stress group was given mental intervention and taken the second mental evaluation one month later.Results Acute stress disorder (ASD) rate (30.08％) was remarkably observed in these transferred wounded,who were subsequently administered a set of mental intervention.The wounded whose PHSQ mark ≥8 were defined as the stress group (Group A) and the others as the control group ( Group B).Compared with Group B,Group A had higher scores in depression ( P ＜ 0.01 ),anxiety ( P ＜ 0.01 ) and consternation ( P ＜ 0.01 ),and lower scores in PSSS (P ＜0.01 ).Group A inclined to negative coping styles mainly including shrink back (P ＜ 0.01 ) and fantasy (P ＜0.01 ),while Group B inclined to coping styles mainly including rationalization and help.The PSSS score in Group A was significant lower than that in Group B (P ＜ 0.01 ).The scores in PHSQ,SCL-90 (anxiety and consternation),CSQ and PSSS were significantly improved after the mental intervention in Group A.Conclusions The incidence of ASD is high in the transferred wounded survivors and is mainly related with mental stress,such as emotional symptoms,negative coping styles and low perception of social support.Early mental interventions will help improve the psychological status of the transferred wounded.

ObjectiveTo explore the effects of hyperbaric oxygen (HBO) on severe brain injury. Methods60 patients with severe brain injury were divided into control group and treatment group. They were treated with neurosurgical conventional therapy, and HBO for treatment group in addition. They were assessed with Glasgow Coma Scale (GCS) before and after treatment, and Glasgow Outcome Scale (GOS) 3 and 6 months after treatment. ResultsCompared with control group, there is significant improvement in GCS (P<0.05) and GOS (P<0.05) in treatment group. ConclusionHBO has immediate and long-term efficiency on severe brain injury.