Cocaine-and amphetamine-regulated transcript (CART), an endogenous neuropeptide, is widely distributed in human organs and tissues, such as brain, gastrointestinal tract and pancreas. It has a variety of important physiological functions, including eating and obesity, stress, mental anxiety, drug addition, and endocrine regulation. Previous studies have suggested that CART is widely distributed in the central nervous system, and it involves in the regulation of a variety of physiological processes and has some central protective effects. It is a potential neuroprotective agent. This article reviews the recent progress in research on the neuroprotective effect of CART on stroke and neurodegenerative disease and its mechanisms, as well as its therapeutic effect in central nervous system diseases.

Objective To explore the application and management of deep hypothermic extracorporeal circulation (DHECC) in surgical procedures. Methods From Dec. 1997 to Dec. 2007, DHECC was applied in 54 patients suffered from great vessel diseases (34/54), complex congenital heart disease (10/54), giant basilar artery aneurysm (5/54), and abdominal tumor with tumor embolus intruding into right atrium or inferior vena cava (5/54) in the General Hospital of PLA. Extracorporeal circulation was performed with arterial perfusion by ascending aorta (n=25), axillary artery (n=18) and femoral artery (n=11), and venous drainage by superior vena cava and inferior vena cava (n=21), right atrium (n=25), and femoral vein (n=8). Clinical data were analyzed retrospectively including extracorporeal circulation (ECC) time, aortic clamping time, deep hypothermic circulation time, the lowest temperature, and the use of ultrafiltration. Results The ECC time was 63-414 (178.55?74.42)min. Aortic clamping time was 16-259 (123.39?52.21) min in 46 patients. Deep hypothermic circulatory arrest (DHCA) was performed in 43 patients, and the duration was 2-109 (30.00?22.37)min. The lowest nasopharyngeal temperature was 13.6-25.7 (19.61?3.40)℃, and the lowest rectal temperature was 15.2-30.5 (21.58?3.63)℃. Ultrafiltration technique was used in 49 cases. 36 of 54 cases (66.7%) self-awakened. Four cases (7.41%) died in the early post-operation period. Conclusion The DHECC can offer a clear and exsanguinated operating field, and is helpful to execute complicated or major operations which are hard to complete with common techniques.

To summarize the experience of application of the cardiopulmonary bypass (CPB) technique in non cardiac surgery in 28 patients, including 22 cases of Budd Chiari syndrome, 2 cases of renal cell carcinoma with cancer cell emboli in the inferior vena cava, 2 cases of tracheal carcinoma, 1 case of intracranial basilar artery aneurysm, and 1 case of leiomyolipoma of the liver with excision and replantation of remaining liver. Different types of CPB were adopted as follows: 10 cases were supplemented by hypothermia and low flow perfusion, 15 cases by deep hypothermia and circulation arrest (DHCA) and 3 cases with vena vena bypass in normothermia, respectively. 2 patients died in early post operative period. It is our opinion that CPB can be used in non cardiac surgery, when it is difficult or almost impossible to carry out with routine surgical technique. The technique can make operations more convenient and safer to perform, even though there are some disadvantages, such as more trauma and higher cost.

Objective To study the protective effect of pyrrolidine dithiocarbamate (PDTC) on acute irradiated mice.Methods The 6-8 weeks old male ICR mice were randomly divided into five groups:irradiation alone group (IR),positive control group (amifostine WR-2721 250 mg/kg) and PDTC of 30,60 and 90 mg/kg dose groups.Each group had 10 mice and the drug was given at 0.5 h before whole body irradiation.At 30 d post-irradiation of 7.5 Gy 137 Cs γrays,the mice survival were observed.At 8 d post-irradiation of 5.0 Gy 137 Cs γ-rays,the peripheral blood,hematopoietic system and organ indexes were observed to evaluate the radiation protective effect of PDTC.Results PDTC increased the 30-day survival rates and 60 mg/kg dose had the most obvious effect by increase the survival to 60％ (6/10).The survivals of irradiation alone group and the amifostine positive control group was 10％ (1/10) and 70％ (7/10),respectively.Compared with the irradiation alone group,60 mg/kg PDTC group had the significant difference in spleen index,WBC,HGB,PLT,bone marrow nucleated cells and colony forming unit of spleen (t =2.354,4.793,2.342,6.542,2.649,3.982,P ＜ 0.05).Conclusions PDTC is effective in radiation protection with an optimum dose of 60 mg/kg.

Objective To investigate the effect of internal fixation with proximal femoral nail antirotation (PFNA) and bone cement on peritrochanteric tumors due to metastatic carcinoma.Methods Clinical data of 19 patients with peritrochanteric tumors due to metastatic carcinoma during June 2007 and July 2013 treated with PFNA and bone cement were retrospectively analyzed.Results Visual analogue scale(VAS) was (8.37 ± 1.12) scores before surgery,and (2.58 ± 1.26) scores after 3 d surgery.There was significant difference (t =22.45,P ＜ 0.05).Conclusion For patients with peritrochanteric tumors due to metastatic carcinoma,internal fixation with PFNA and bone cement is an effective way to relieve pain,restore and improve hmb function and enhance quality of life.

Objective To investigate the value of high-resolution magnetic resonance imaging (HR-MRI) of arterial walls in the diagnosis of cerebral artery dissection (CAD).Methods The patients diagnosed as CAD and completed computed tomography angiography (CTA),magnetic resonance angiography (MRA),digital subtraction angiography (DSA),and HR-MRI were enrolled retrospectively.The detection rate and diagnostic value of the 4 imaging techniques were compared and analyzed.Results A total of 15 patients were enrolled,5 had internal carotid artery dissection,7 had vertebral artery dissection,2 had middle cerebral artery dissection,and 1 had basilar artery dissection.HR-MRI revealed 11 intramural hematoma,9 intimal flap,3 double lumen sign,and 2 pseudoaneurysm.A total of 18 CADs were detected in 15 patients,17 (94.44％),14 (77.78％),5 (27.78％) and 6 (33.33％) were detected with HR-MRI,DSA,CTA and MRA,respectively.There were significant difference in CAD detection rates of HR-MRI,DSA,CTA and MRA (x2 =24.939,P ＜ 0.001).The CAD detection rate of HR-MRI and DSA were significantly higher than those of CTA and MRA (all P ＜ 0.01 for HR-MRI,all P ＜ 0.05 for DSA),but there was no significant difference in CAD detection rate between HR-MRI and DSA.Conclusion HR-MRI is a diagnostic method for CAD with higher sensitivity.

Objective To study the mechanism of anti-inflammation and bacteriostasis effect of Qinlian Liyan Heji. Methods To assess the anti-inflammatory effect, blood capillary permeability in mice was increased by acetic acid, the swelling of toe in rats was induced by albumen, and granuloma was induced by cotton ball in mice.The agar dilution method was used to check the minimal inhibitory concentration of Qinlian Liyan Heji on Staphylococcus aureus, Staphylococcus epidermidis, Moraxella catarrhalis, Klebsiella pneumoniae.The microdilution method was used to detect the minimal inhibitory concentration of Qinlian Liyan Heji on group A streptococci, Streptococcal pneumonia and Haemophilus influenzae. Results Contrast to the negative control group, Qinlian Liyan Heji significantly inhibited the increase of blood capillary permeability caused by acetic acid in the middle dose and the high dose groups.In the low dose and middle dose groups, Qinlian Liyan Heji obviously reduced the swelling of plantar in 2, 3, 4, 5 h.In the high dose group, Qinlian Liyan Heji markedly lowered the swelling of plantar in 1, 2, 3, 4, 5 h. Qinlian Liyan Heji significantly reduced the granuloma caused by cotton ball. On the other hand, Qinlian Liyan Heji exerted bacteriostatic effect on the above 7 types of bacteria. Conclusion Qinlian Liyan Heji has effects of anti-inflammation and bacteriostasis.

Objective To investigate the differences in susceptibility to Lewis lung carcinoma and T lymphocyte subsets in the immune microenvironment between young and elderly mice.Methods Six C57/B6 mice at two months(young)and six mice at twelve months(aged)were injected with Lewis lung carcinoma cells at the dose of 1 × 106 in the left armpit to establish a murine model of lung carcinoma.The weight and tumor growth were monitored.Blood samples for routine blood tests were collected after 24 days.The proportions of CD4+ and CD8+T cells in the spleen were detected by flow cytometry,and the infiltration of CD4+,CD8+ T cells and related effector T cells in the tumor microenvironment were determined in the same way.Results The body weight of tumor bearing mice in the aged group was significantly higher than that in the young group(P ＜0.001);The tumor weight in the aged group(5.084±0.528)g was significantly higher than that in the young group(2.963 ±0.378)g(t =3,349,P =0.012);Routine blood tests showed that the numbers of leukocytes and subsets(except mononuclear)in the aged group were significantly lower than in the young group(P ＜0.05);Flow cytometry found that the effector and memory/effector CD4+T cell ratios in the spleen were significantly higher in the aged group than in the young group(P ＜0.001)and the expression of effector and memory/effector CD8+T cells in the tumor microenvironment was also significantly higher than in the young group(P ＜0.05);Quantitative expression values of IL-6 and IL-10 in the tumor microenvironment were 25090±3820 and 10670± 1793 in the aged group and 6252±864 and 3061±451 in the young group,respectively.Moreover,the expression levels of IL-6 and IL-10(t =3.925,P =0.01;t =3.552,P =0.02)in the tumor microenvironment in the aged group were significantly lower than those in the young group.Conclusions Young mice are more susceptible to Lewis lung carcinoma,probably as a result of differences in inflammation and immunity.

Objective To investigate the distribution of islet autoantibodies (GAD-Ab, IA2-Ab, IAA) in new-onset diabetic patients with unprovoked ketosis and their association with clinical characteristics and pancreatic ? cell function.Methods Islet autoantibodies, including GAD-Ab、IA2-Ab and IAA were detected in 161 new-onset diabetic patients with unprovoked ketosis by radioligand assay. Prevalence of positive islet autoantibodies was compared among groups with different ages, body mass indexes (BMI), severity of ketosis and fasting C peptide (FCP) levels. Clinical characteristics and pancreatic ? cell function were compared between groups with positive and negative islet autoantibodies.Results One or more kinds of islet autoantibodies were detected in 68 from the 161 subjects (42.2%), with higher prevalence of positive islet autoantibodies in the patients aged equal to or less than 20 years, of BMI equal to or less than 18.5 and with FCP equal to or less than 300 pmol/L. Younger age of onset, lower BMI, more severe ketosis and poorer islet endocrine function were found in patients with positive islet autoantibodies, as compared with those with negative ones.Conclusions In diabetic patients with unprovoked ketosis, the younger, the lower C peptide and the lower BMI they are, the higher prevalence of positive islet autoantibodies, the more possibility that they are classified as type 1A diabetes and the less possibility as type 1B diabetes or type 2 diabetes.Pancreatic ? cell function was poorer in patients with positive islet autoantibodies,which should be treated with insulin as earlier as possible.

Objective To explore the correlation between circadian clock gene clock circadian regulator (CLOCK) and attention-deficit/hyperactivity disorder (ADHD) and the role of CLOCK and sleep problems on inhibition in male children with ADHD. Methods Two single nucleotide polymorphisms (SNPs) of CLOCK were genotyped in 854 male ADHD children and 320 male controls. Sleep problems were assessed using parent symptom questionnaire. In ADHD cases, the main effects and interaction of CLOCK SNPs and sleep problems on inhibition assessed by using Stroop Color and Word Test, were analyzed using the analysis of covariance (ANCOVA). Results No significant differences of allele and genotype frequencies were found for rs6832769 and rs11932595 in all case-control groups (P>0.05). In ADHD cas?es, the main effects of rs6832769 and rs11932595 genotypes and sleep problems on inhibition were not significant (P>0.05). However, the interaction of rs6832769 genotype and sleep problems was significant (F=6.71, P=0.01). When ac?companied with sleep problems, ADHD cases carrying the AA&AG genotype showed the longest time of word interfer? ence (F=6.63, P=0.01). Conclusions Inhibition of male ADHD children can be modulated by the interaction of CLOCK rs6832769 and sleep problems.