Objective:To observe the changes of TLR4 and IL-6 expression in rats hippocampus CA1 region in remote ischemic postconditioning(RIP) and explore its significance.Methods: All the 72 male SD rats were divided into Sham group,Contrast group and RIP group randomly.Each group was divided into 4 time points:12h,24 h,48 h and 72 h group.There were 6 rats in each group.Use the cerebral ischemia-reperfusion model which was established with modified Longa method as the contrast group.The method of RIP was to Fasten rats Posterior limbs by a tourniquet for 30 min immediately,then relax them for 30 min, repeat 3 times.To observe the pathological variation of hippocampus CA1 region by HE dyeing;to test the expression of TLR4 and IL-6 by immunohistochemical staining.Results: Compared to contrast group, neuronal loss and swelling reduced significantly in RIP group.Compared to sham group, the TLR4 and IL-6 expression in contrast group and RIP group increased significantly ( P<0.05 ) .Compared to contrast group,the TLR4 and IL-6 expression in RIP group reduced significantly(P<0.05).Conclusion:RIP dose have protective effect on cerebral ischemia.The effect may be associated with the inhibition of TLR4 and IL-6 expression.

Objective Therapeutic hypothermia has become a standard neuroprotective treatment in term newborn infants following perinatal asphyxia,but active cooling with whole body surface or head cooling is both complex and expensive.The clinical feasibility of passive cooling in treatment of full term infants with severe asphyxia was investigated.Methods Thirty-two severe asphyxiated term newborns treated with hypothermia were analyzed,who were randomly divided into 2 groups:passive cooling group(n =17) and active cooling group(n =15).Active cooling group adopted MTRE ALLONTM-thermo regulatory systems,passive cooling group using natural cooling method.Hypothermia treatment time was 72 hours.At the end of treatment,the clinical manifestations,biochemical parameters and clinical efficacy of infants between the 2 groups were compared.Results During treatment all infants had no cardiac arrhythmia,hypoglycemia,sustained metabolic acidosis,blood-borne infections,local cold injury or bleeding.Infants in passive cooling group had a relatively wide range of rectal temperature fluctuations[average (33.47-0.71) ℃] and infants in active cooling group had a relatively narrow range of rectal temperature fluctuations[average (33.66 ± 0.29) ℃],but there was no statistically significant difference in their mean rectal temperature(t =1.941,P =0.055).One patient died in active cooling group,but there were no significant differences in suckling age,length of hospital stay,neonatal behavioral neurological assessment score,abnormal cranial ultrasound and MRI between the survivors of the two groups(all P ＞0.05).Conclusions In NICU,environmental temperature is relatively stable,passive cooling for asphyxiated newborns appears to be feasible for maintenance of hypothermia with a lower risk of adverse reactions.

Objective To study the risk factors and outcome of symptomatic BAAS.Methods Eighty symptomatic BAAS patients served as a BAAS group and 80 symptomatic anterior circulation stroke (ACS) patients served as a ACS group in this study.The risk factors for symptomatic BAAS were compared.The symptomatic BAAS patients were further divided into mild-moderate stenosis group (n =43) and severe stenosis group (n=37),progressive stenosis group (n =34) and non-gressive group (n=46),survival group (n=42) and death group (n=38) respectively.The relationship between risk factors and outcome of symptomatic BAAS was analyzed.Results The rate of male patients and the incidence of hypertention were significantly higher in BAAS group than in ACS group (75.0％ vs 57.5％,80.0％ vs 66.3％,P＜0.01).The history of ischemic stroke and smoking was related with the severity of BAAS (P＜0.05).Premonitory symptoms were re lated with the progression of BAAS (P＜0.01).Pulmonary infection and tracheal intubation or tracheotomy were related with the outcome of BAAS (P＜0.01).Conclusion Male gender,hypertension,and history of ischemic stroke and smoking are the independent risk factors for symptomatic BAAS which is less likely to progress in patients with premonitory symptoms.Pulmonary infection and tracheal intubation or tracheotomy are the independent risk factors.