Head MRI and CT scans Can frequently find ischemic cerebral white matter lesions in healthy elderly and in patients with atherosclerosis.Ischemic cerebral white matter lesions are regarded as a manifestation of cerebral small vessel lesions.which Can result in symptoms such as cognitive impairment,and predict extraeranial or intracranial ischemic events.This article reviews the recent progress in research on cerebral white matter lesions.their pathogenesis and clirilcal significance.

Objective To evaluate the role of protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway in ulinastatin-induced reduction of oxidative stress injury to cardiomyocytes of rats.Methods H9c2 cells were inoculated in 96-well plates at a density of 104 cells/well.The cells were divided into 5 groups using a random nomber table:control group (group C,n =12),H2O2 group (n=12),H2O2 plus ulinastatin group (group HU,n=12),H2O2 plus ulinastatin plus LY294002 group (group HUL,n=9) and H2O2 plus LY294002 group (group HL,n=9).In group H2O2,H2O2 (final concentration 200 μ mol/L) was added,and the cells were incubated for 12 h in the incubator.In HU,HL and HUL groups,ulinastatin (final concentration 50 U/ml),LY294002 (final concentration 10 μmol/L),and ulinastatin (final concentration 50 U/ml) plus LY294002 (final concentration 10 μmol/L)were added,respectively,the cells were incubated for 2 h,H2O2 (final concentration 200 μmol/L) was then added,and the cells were incubated for 12 h in the incubator.The cell survival rate was measured by methyl thiazolyl tetrazolium assay.The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) were determined by using water soluble tetrazolium-1 and thiobarbituric acid colorimetric assays.Cell apoptosis was measured by flow cytometry,and apoptosis rate (AR) was calculated.The expression of Akt,phosphorylated Akt (p-Akt),mTOR,phosphorylated mTOR (p-mTOR),activated caspase-3 and activated poty-ADP-ribose polymerase (PARP) was detected by Western blot.The p-Akt/AKT and pmTOR/mTOR ratios were calculated.Results Compared with group C,the cell survival rate was significantly decreased,AR was increased,the SOD activity was decreased,the MDA content was increased,the expression of activated caspase-3 and PARP was up-regulated (P＜0.05),and no significant change was found in p-Akt/AKT ratio or p-mTOR/mTOR ratio in group H2O2 (P＞0.05).Compared with group H2O2,the cell survival rate was significantly increased,AR was decreased,the SOD activity was increased,the MDA content was decreased,the p-Akt/AKT and p-mTOR/oTOR ratios were increased,and the expression of activated caspase-3 and PARP was down-regulated in group HU (P＜0.05).Compared with group HU,the cell survival rate was significantly decreased,AR was increased,and the expression of activated caspase-3 and PARP was up-regulated in group HUL (P＜0.05).Conclusion The mechanism by which ulinastatin reduces oxidative stress injury to cardiomyocytes is related to activation of Akt/mTOR signaling pathway in rats.

0.05),but the markedly effective rate in the treatment group was superior to that in the control group(P

Objective To compare effect and security between duloxetine combined with small-dose of mirtazapine and duloxetine alone in treatment of refractory depression in elder patients.Methods A total of 100 cases elder refractory depression patients were randamly divided into study group (duloxetine+mirtazapine, 50 cases) and control group(duloxetine, 50 cases).Compared HAMD,HAMA and CGI-SI between two groups, as well as the side reactions and TESS.Regression analysed mirtazapine blood concentration and HAMD subtraction rate.Results The effective rate of study group was 92.00%, while in control group was 76.00%, the difference was statistically significant(P<0.05).After treatment, the HAMD, HAMA and CGI-SI of each group significantly increased, and the difference of HAMD, HAMA and CGI-SI at 2w, 4w and 8w between two groups were statistically significant(P<0.05).The TESS and side reaction of two groups had no statistical difference.Conclusion Effect of duloxetine combined with small-dose of mirtazapine in treatment of refractory depression is better than duloxetine alone use, without significant side reaction.

Objective To ob serve the clinical effect of blood-activating and stasis-dissolving drugs combined with western medicine ( WM) for the treatment of recurrent spontaneous abortion ( RSA) induced by prethrombotic state ( PTS). Methods A total of 120 patients with RSA at PTS were randomly assigned to treatment group (68 cases) and control group (52 cases). Patients in both groups were treated with aspirin and low molecular weight heparin, while those in the treatment group additionally received Chinese medicine for activating blood and dissolving stasis. Before and after treatment, indexes of coagulation-fibrinolysis and the development of embryos were compared between the two groups. Results The therapeutic effective rate was 88.24% in the treatment group, higher than that of the control group ( 69.23%, P<0.05). The levels of plasma thrombin time ( TT) , D-dimer, fibrinogen and antithrombin Ⅲ ( AT-Ⅲ) were all improved ( P<0.05) in the two groups after treatment. Besides, the treatment group had better effect on improving levels of plasma D-dimer, fibrinogen and AT-Ⅲ ( P<0.05). During the treatment, no drug-induced adverse reaction was found. Neither neonatal deformity nor maldevelopment occurred. Ninety-seven cases achieved successful pregnancy, and 45 cases had given term girth ( 29 cases from the treatment group and 16 from the control group). Fifty-two cases were in stable middle- and late-stage of pregnancy. Conclusion Therapy of activating blood and dissolving stasis is an effective method for RSA at PTS. It has obvious effects on improving high coagulation state during pregnancy. Chinese medicine combined with WM shows better therapeutic efficacy than WM alone.

Objective To investigate the effect of fire needling on tumor marker CA-125 levels and endometrial antibody (EMAb) in endometriosis patients.Methods Eighty endometriosis patients were randomly allocated to a treatment group of 43 cases and a control group of 37 cases. The treatment group received fire needling and the control group took gestrinone capsules. CA-125 levels and EMAb were measured in the two groups before and after treatment.Results CA-125 levels and EMAb positive rate decreased significantly in the two groups after treatment compared with before (P<0.05) but there were no statistically significant post-treatment differences between the two groups (P>0.05).Conclusion Fire needling has a good interference effect on CA-125 levels and EMAb in endometriosis patients.

Objective To investigate the neuroprotective effect and mechanism of astragalus injection in cerebral ischemia reperfusion injury in rats .Methods A total of 70 healthy adult male Wistar rats were subjected to establish middle cerebral artery occlusion reperfusion models by inserting a monofilament thread from the external -internal carotid artery and treated by injecting 1g/L intraperitoneally astragalus injection (3ml/kg).The neurobehavioral function of rats was evaluated by Longa ’ s test and the cerebral infarction volume was calculated by tetrazolium chloride staining .The shape and ultrastructure of neurons in parietal cortex were observed by HE stain TEM .The early apoptotic ratio of neurons was detected by flow cytometry .The expressions of c-Jun N-terminal kinase 3 ( JNK3) mRNA and protein were determined by RT-PCR and Western blotting , respectively.Results After treatment with astragalus injection , the expressions of JNK3 mRNA and protein reduced significantly , the number of neuronal apoptosis in parietal cortexminus , the cerebral infarction volume shrink, the neuronal shape and ultrastructure and animal neurobehavioral function were improved significantly than those in model group rats .Conclusion The results suggest that astragalus injection may inhibit neuronal apoptosis , reduce the infarction volume and improve the animal neurobehavioral function by down -regulated the expression of JNK 3 gene following cerebral ischemia in rats .

Objective To study the relationship between spinal shifting and C5 palsy after posterior approach cervical decompression surgery (PACDS).Methods Twenty-four patients underwent PACDS were examined with MRI before and one month after operation.The spinal shifting were measured.Clinical and imaging characteristics of patients with post-operative C5 palsy were observed.Analyzed the correlation between C5 palsy and spinal shifting after operation.Results The average spinal shifting was (2.41 ± 0.46) mm.Three cases developed C5 palsy,whose spinal shifting at C5 level was significantly greatert han those without C5 palsy.Conclusion Excessive posterior spinal shifting after PACDS can drag C5 nerve root leading to C5 palsy.

AIM:This study was concerned with the effect of Alexipharmie Capsule(Flos Lonicerae Japonicae,Fructus Forsythiae,Radix Scutellariae,Radix Isatidis,Herba Ephedrae,Radix et Rhizoma Glycyrrhizae) on fever,inflammation,pain and cough. METHODS: We adopted ear swelling mouse model induced by xylene and foot swelling mouse model induced by carrageenan to observe the anti-inflammatory effects;took 15% beer yeast and bacterial endotoxin as pyrogen to study the antipyretic effects on rats and rabbits;used acetic acid stretching method to observe the analgesic effects;adopted strong aqua ammoniae spraying and sulfur dioxide stimulus method to study the antitussive effects. RESULTS: Alexipharmic Capsule could obviously inhibit ear and foot swelling of mouse model(P

Objective To describe the clinical characters and risk factors of feeding intolerance in neonates. Methods The data of all neonates hospitalized in the newborn ward from January 2003 to March 2007 were ana- lyzed.Results The incidence of feeding intolerance was 6.99 % in the term infants and 27.63 % in the premature infants,and this increased in low birth weight and small gestational age infants.The symptoms of feeding intoler- ance.such as vomiting,gastric residual,abdominal distension and defecation difficulty presented usually in the first week of enteral feeding.The neonates with smaller gestational age and lower birth weight often presented with gas- tric residual,abdominal distension and defecation difficulty,but the larger ones with vomiting.The incidence of feed- ing intolerance increased in asphyxia aegrotus.Conclusion The birth weight and gestational age are protection fac- tors of feeding intolerance in neonates,the asphyxia are risk factors.More attention should be paid to vomiting,gas- tric residual,abdominal distension and defecation difficulty of neonates,especially,in the first week of enteral feeding.