Homocystine (Hcy) is an important intermediate product of amino acid metabolism.It is dual-regulated by both gene and environmental factors.The key enzyme of metabolic reaction is dependent on vitamin B class.The studies of in vitro experiment and animal models have demonstrated that Hcy may aggravate atherosclerosis by reducing the nitric oxide activity,enhancing intracellular oxidative stress,and promoting thrombosis,etc.Epidemiological studies have also demonstrated that hyperhomocystinemia (HHcy) is an independent risk factor for atherosclerosis.However,large randomized controlled trials have failed to confirm the close correlation between HHcy and ischemic stroke.By supplementing vitamin B class to decrease the Hcy level is still controversial in the primary and secondary prevention.The therapeutic dose of vitamin B class may be unable to obtain additional benefits in patients with ischemic stroke.

The occurrence of cerebral vasospasm (CVS) following aneurysmal subarachnoid hemorrhage is a multi-factor participatory process.Its pathogenic mechanism is complex.The clinical presentation and imaging findings are not consistent.Theoretically,by the measures of blocking calcium channels,inhibiting Rho kinase,removing oxygen free radicals and antagonizing endothelin receptors and other measures can prevent and treat CVS,but the actual clinical effects of various drugs are not satisfactory,especially in the aspects of improving clinical outcomes.The clinical application of the 3H therapy has been limited because of having many potential complications,and the intra-arterial interventional treatment is limited by the technology,equipment,indications,and other factors.Therefore,the prevention and treatment of CVS is still facing many challenges.

Objective To investigate the risk factors for carotid artery atherosclerosis in young and middle-aged patients with ischemic stroke and the effect of serum lipoprotcin(a) [(Lp (a)] level on young and middle-aged patients with ischemic stroke.Methods Patients with ischemic stroke between the ages of 18 to 55 were enrolled.Carotid artery ultrasonography was used to evaluate the degree of carotid artery atherosclerosis,and the concentrations of serum total cholesterol,triglycerides,high density lipoprotein cholesterol,low density lipoprotein cholesterol,very low density lipoprotein cholesterol,apolipoprotein A1,apolipoprotein B and Lp(a) were detected.According to the results of carotid ultrasound,the patients were divided into groups of without atherosclerosis,plaque without stenosis,and carotid artery stenosis.The demographic and clinical features were compared among the 3 groups.Multivariate logistic regression analysis was used to identify the independent risk factors for carotid artery atherosclerosis in young and middle-aged patients with ischemic stroke.Results A total of 106 patients with ischemic stroke (n =50 in the without atherosclerosis group,n =44 in the plaque without stenosis group,n =12 in the carotid artery stenosis group) were enrolled in the study.The constituent ratios of age (45.98 ±7.12,50.07 ±4.79,and 50.92 ± 1.83 years,respectively; F =7.169,P =0.001),hypertension (26.0％,47.7％ and 58.3％,respectively; x2 =6.862,P =0.032),diabetes mellitus (22.0％,45.5％ and 66.7％,respectively; x2 =10.729,P =0.005),hyperlipidemia (24.0％,40.1％ and 75.0％,respectively; x2=11.372,P=0.003) and smoking (34.0％,61.4％ and 75.0％,respectively;x2 =10.93,P=0.006),as well as the serum high-density lipoprotein cholesterol (1.03 ± 0.26,0.95 ± 0.26 and 0.76 ± 0.08 mmol/L,respectively; F=5.882,P =0.004) and Lp (a) (0.108 ± 0.044,0.155 ± 0.028 and 0.200 ± 0.011 g/L,respectively; F =41.556,P =0.000) levels had significant differences in the 3 groups.Multivariate logistic regression analysis showed that age ＞ 48 years (plaques without stenosis:odds ratio [OR] 2.89,95％ confidenee interval [CI] 1.20-6.96,P =0.018; carotid artery stenosis:OR 4.43,95％ CI 1.19-16.57,P =0.027),hypertension (plaque without stenosis:OR 2.60,95 ％ CI 1.09-6.18,P =0.031; carotid artery stenosis:OR 3.99,95％ CI 1.08-14.77,P =0.039),diabetes (plaque without stenosis:OR 2.96,95％ CI 1.21-7.23,P=0.018; carotid artery stenosis:OR 7.09,95％ CI 1.79-28.02,P =0.005),hyperlipidemia (plaque without stenosis:OR 2.19,95％ CI 0.91-5.31,P =0.082; carotid artery stenosis:OR 9.50,95％ CI 2.21-40.86,P =0.002),smoking (plaque without stenosis:OR 3.08,95％ CI 1.33-7.16,P =0.009; carotid artery stenosis:OR 5.82,95％ CI 1.39-24.38,P =0.016),and Lp (a) (plaque without stenosis:OR 4.38,95％ CI 1.76-10.90,P=0.001; carotid artery stenosis:OR 12.80,95％ CI 2.73-52.67,P =0.001) were the independent risk factors for carotid artery atherosclerosis in young and middle-aged patients with ischemic stroke.Conclusions Age,smoking hypertension,diabetes and Lp(a) were the independent risk factors for carotid artery atherosclerosis in young and middle-aged patients with ischemic stroke.

Objective To observe the efficacy of pars plana vitrectomy (PPV) combined with endoscopic cyclophotocoagulation (ECP) for refractory glaucoma.Methods Twenty-eight patients (30 eyes) diagnosed with refractory glaucoma were enrolled in this study.The intraocular pressure was ranged from 28 to 55 mmHg (1 mmHg=0.133 kPa),with the mean of (46.3±10.3) mmHg.There were 24 eyes with initial visual acuity ＜0.05,1 eye with 0.05-0.08 initial visual acuity and 5 eyes with ≥0.1 initial visual acuity.The mean number of intraocular pressure-decreased drugs was 4.All the eyes underwent PPV combined with ECP.The cyclophotocoagulation ranged from 90°-360°,with the mean of (232.5 ±77.6)°.The cyclophotocoagulation was ＜180° in 4 eyes,180°-270° in 6 eyes,＞270° in 20 eyes.The follow-up ranged from 12 to 20 months,with the mean of 15.2 months.The intraocular pressure,vision and the mean number of intraocular pressure decreased drugs before and after surgery were comparatively observed.The relationship between cyclophotocoagulation area and postoperative intraocular pressure was analyzed.Results At the final follow up,the intraocular pressure ranged from 12 to 36 mmHg,with the mean of (18.5± 4.4) mmHg,which decreased 49.4％ compared with preoperative intraocular pressure (t=15.537,P＜ 0.01).Among 30 eyes,the intraocular pressure was ≤ 21 mmHg without any intraocular pressuredecreased drugs in 24 eyes (80.0％),1 eye (3.3％) with ≤21 mmHg who treatment by local intraocular pressure decreased drugs,lose control of intraocular pressure in 5 eyes (16.7％).The vision was ＜0.05 in 15 eyes,0.05-0.08 in 3 eyes and ≥0.1 in 12 eyes.The difference of vision distribution before and after surgery was not significant (x2=6.197,P＞0.05).Compared with preoperative vision,the postoperative vision was improved in 8 eyes (26.7％),stabled in 15 eyes (50.0％),decreased in 7 eyes (23.3％).The mean number of intraocular pressure-decreased drugs was reduced from 4 to 1 (t=8.402,P＜0.01).The cyclophotocoagulation area was positive related to postoperative intraocular pressure (r=4.160,P＜0.05).There were no ocular and systemic complications during and after surgery except slight inflammation.Conclusion PPV combined with ECP for refractory glaucoma can reduce intraocular pressure,stabilize or improve the visual acuity.

BACKGROUND:A number of studies have been conducted on the prevention of enamel demineralization in orthodontic treatment, but no work has been carried out on the comparative studies addressing manual toothbrush, orthodontic fur V brush and interdental brush. OBJECTIVE:To compare the efficacy of manual toothbrush, orthodontic fur V brush and interdental brush on enamel decalcification during orthodontic treatment. METHODS:Adolescents, aged 12 to 17 years old, were randomly and averagely divided into three groups: manual toothbrush, orthodontic fur V brush, and interdental brush groups. Enamel decalcification index and augmenter of enamel decalcification index were examined and calculated by the same orthodontist before treatment and 1 year later. RESULTS AND CONCLUSION: There was no statistical difference in the enamel decalcification index among the three groups at the beginning (P > 0.05). After 1 year of treatment, the enamel decalcification index of each group was higher than that at the beginning (P < 0.05); the enamel decalcification index and augmenter of enamel decalcification index in the three groups were ranked as folows: orthodontic Fur V toothbrush group < manual toothbrush < interdental toothbrush group , and there was a statistical significant difference among the three groups (P < 0.05). Orthodontic fur V brush is proved to have advantages over manual toothbrush and interdental brush in the respect of controling enamel decalcification, and interdental brush has no good effect on preventing enamel demineralization while it is used alone.

Objective To study the effect of atorvastatin on serum levels of CRP,IL-6 and TNF-in patients with acute cerebral infarction.Methods 90 patients with acute cerebral infarction from March 2014 to March 2015 in the third people′s hospital of Huizhou were enrolled in the study.The control group received routine symptomatic treatment,and the observation group was treated with rosuvastatin on the basis of routine symptomatic treatment.The levels of serum CRP,IL-6 and TNF-α were observed before and after treatment in the two groups.After treatment,the neurological impairment was evaluated by the National Institutes of Health Stroke Scale (NIHSS),and the therapeutic effects of the two groups were compared.Results After treatment,CRP,TNF-α,IL-6 levels in observation group were (2.66±0.68)mg/L,(11.20±1.21)mg/L,(4.90±0.92)ng/L respectively,while (6.35±1.50)mg/L,(24.93±5.98)mg/L,(9.38±2.01)ng/L in control group.The three indicators of observation group were lower than those in control group,the difference was statistically significant(P<0.05).The NIHSS score of observation group was (2.83±0.51)%,which was lower than that of control group[(6.91±1.21)%],the difference was statistically significant (P<0.05);the total efficiency of observation group was 95.55% (43/45),better than 71.11% in the control group (32/45),the difference was statistically significant (P<0.05).Conclusion Rosuvastatin can effectively reduce the levels of serum inflammatory factors CRP,IL-6 and TNF-α in patients with acute cerebral infarction,and effectively improve the therapeutic effect.

OBJECTIVE: To study the effect and mechanism of Tongma Qining prescription(TQP) on improving sciatic nerve injury (SNI) in rats. METHODS: The SNI model rats were replicated by using hemostatic forceps. The model rats were randomly divided into the model group, the mecobalamine group (mecobalamine 6×10-4 g•kg-1), the high-dose group (30 g •kg-1), the medium-dose group (15 g•kg-1) and the low-dose group (7.5 g•kg-1), and the sham operation group was set(10 mice per group). After continuous intragastric administration for 6 weeks, sciatic nerve index (SFI), sensory conduction velocity (SNCV) and hemodynamic indexes were detected in each group. HE staining were employed to detect the pathological alterations of sciatic nerve tissues. Then the expression of BDNF, NGF and VEGF in sciatic nerve were detected by IHC-P, the protein expression of NGF and VEGF were detected by Western blot. RESULTS: Tongma Qining prescription was able to alleviate sciatic nerve tissue injury in SNI rats, significantly improved SFI and SNCV (P<0.01), observably reduced the hematocrit, plasma viscosity and value of whole blood viscosity (high shearing and low sheating)(P<0.05), and markedly upregulated the expression level of BDNF, NGF, VEGF and the protein expression level of NGF, VEGF (P<0.01). CONCLUSION: The Tongma Qining prescription can significantly improve SNI in rats. Its action mechanism may be related to improving blood rheology, promoting angiogenesis and protecting nerve cells.

OBJECTIVE: To investigate the differences of MMP-9 and TIMP-1 mRNA expression between eutopic and ectopic endometrium tissues in endometriosis (EMS) rats, and to observe the effects of Dan'e Fukang decocted extract (DFD) on the expression levels of MMP-9 and TIMP-1 mRNA. METHODS: The EMS rat model was made by autotransplantation and verified by ELISA method. Then the rats were randomly divided into 5 groups, sham operation group, EMS model group, Gestrinone group, high dose DFD group, and low dose DFD group. After continuous intragastric administration for 30 d, the expression levels of MMP-9 and TIMP-1 mRNA were detected by RT-PCR. RESULTS: DFD could significantly down-regulate the expression levels of MMP-9 mRNA in EMS rats (P < 0.01), and significantly up-regulate the expression level of TIMP-1 mRNA (P < 0.01). CONCLUSION: DFD can treat EMS through adjusting the balance of MMP-9 and TIMP-1. Copyright 2012 by the Chinese Pharmaceutical Association.

Endothelial glycocalyx is a hairy-like structure covered the endothelial cell surface,which consists of multiple functional elements.It has been proved that glycocalyx can regulate vascular permeability,mediate shear-induced release of NO by endothelial cells,and exert wide array of vasculoprotective effects via inhibition of coagulation and leucocyte adhesion.Degradation of glycocalyx may be associated with many cardiovascular diseases.In this review,the relationship between the endothelial glycocalyx and cardiovascular disease will be discussed.