Objective: To identify Aconitum pendulum Busch. and Aconitum kongboense Lauener. Methods: Aconitum pendulum Busch. and Aconitum kongboense Lauener were identified by microscopical identification and TLC. And the contents of aconitine in the two herbs were determined by HPLC. Results:Microscopical identification showed they were different from each other, and aconitine was used as the reference component. Using the solution consisting of hexane ∶ethyl acetate ∶diethylamine (10 ∶6 ∶0. 8) as the developing solvent, the compositions in the two herbs were different in TLC. The content of aconitine in Aconitum pendulum Busch was 0. 71 mg· g-1 , while that in Aconitum kongboense Lauener was only 0. 03 mg·g-1 . Conclusion:Aconitum pendulum Busch. and Aconitum kong-boense Lauener Identified by microscopical identification, TLC and HPLC,SHOW NOTABLE differences between them, and Aconitum kongboense Lauener should not be used as Aconitum pendulum Busch.

Objective To determine the occurrence and baseline predictive factors of early neurological deterioration ( END) among mild ischemic stroke patients.Methods Mild ischemic stroke patients admitted in the hospital were prospectively enrolled.Univariate and multivariate Logistic recession analyses were used to analyze the demographic data, risk factors of ischemic stroke, clinical, brain imaging and laboratory data.Risk factors of END were identified.Results From June 2012 to August 2013, a total of 319 patients with mild ischemic stroke were enrolled, 45 patients (14.1%) of them experienced END.Univariate analysis showed that baseline NIHSS ( U=3522.000,P=0.000), baseline systolic blood pressure (t=2.871,P=0.004), proportion of symptomatic large artery severe stenosis or occlusion (χ2 =52.564,P=0.000) and proportion of large artery atherosclerosis among TOAST subtypes (χ2 =47.287,P=0.000) in END group were significantly higher than those in non-END group. Multivariate logistic regression analysis showed that baseline systolic blood pressure>142 mmHg (1 mmHg=0.133 kPa) (OR=3.954, 95%CI:1.693-9.236, P=0.001), symptomatic large artery severe stenosis or occlusion (OR=3.170, 95%CI:1.170-8.583, P=0.023) and baseline NIHSS (OR=2.038, 95%CI:1.359-3.057, P=0.001) were associated with END.Conclusions About 14.1% of the mild ischemic stroke patients can occur END.Baseline systolic blood pressure>142 mmHg, symptomatic large artery severe stenosis or occlusion and higher baseline NIHSS were the independent risk factors of END.

Objective To investigate the functional outcome in patients with mild ischemic stroke and to identify its risk factors for poor outcome.Methods The patients with mild ischemic stroke treated within 72 hours after onset were enrolled prospectively.According to modified Rankin Scale (mRS) scores at day 90 after onset,the patients were randomly divided into either a poor outcome group (mRS score ＞2) or a good outcome group (mRS scores 0-2).Univariate analysis and multivariate logistic regression analysis were used to compare and analyze the demographic data,vascular risk factors,clinical data,laboratory data,imaging data,and follow-up data.The risk factors for poor outcome in patients with mild ischemic stroke were identified.Results A total of 253 patients with mild ischemic stroke were enrolled,and 71 of them (28.1％) had poor outcome.Univariate regression analysis showed that the patients' proportions of age (t =2.037,P =0.043),baseline National Institutes of Health Stroke Scale (NIHSS) score (U =4 610.000,P =0.000),baseline mRS score (U =5 723.000,P =0.000),as well as previous history of ischemic stroke (x2 =4.950,P =0.026),severe symptomatic artery stenosis or occlusion (x2 =49.037,P =0.000),large artery atherosclerotic stroke (x2 =34.359,P =0.000),early neurologic deterioration (x2 =45.804,P =0.000),complicated by pneumonia (x2 =12.121,P =0.000) and recurrent ischemic stroke (x2 =14.305,P =0.000) of the poor outcome group were significantly higher than those of the good outcome group.Multivariate logistic regression analysis showed that advanced age (odds ratio [OR] 1.049,95％ confidence interval [CI] 1.012-1.086; P =0.008),higher baseline mRS score (OR,2.130,95％ CI 1.212-3.743;P=0.009),higher baseline NIHSS score (OR 1.532,95％ CI 1.064-2.206; P=0.022),severe symptomatic large artery stenosis or occlusion (OR 7.569,95％ CI 3.497-16.380; P=0.000),early neurological deterioration (OR 7.369,95％ CI 2.648-20.510; P =0.000) and recurrent ischemic stroke (OR 10.450,95％ CI 3.071-35.564; P =0.000) were the independent risk factors for poor outcome.Conclusions More than one fourth of the patients with mild ischemic stroke had poor outcome.Advanced age,higher baseline mRS score,higher baseline NIHSS score,severe symptomatic large artery stenosis or occlusion,early neurological deterioration,and recurrent ischemic stroke were the independent risk factors for poor outcome.

Objective To investigate the influences of polyethylene glycol on the solubility and in vitro dissolution of m-nisoldipine,which could provide guidance for chosing formulations of m-nisoldipine. Methods Solid dispersions of m-nisoldipine were prepared by solvent-melting method with polyethylene glycol6000 matrix. DSC and XRD spectroscopy were applied to identify the solid dispersions. The solubility and in vitro dissolution were detected by UV spectroscopy. Results The DSC and XRD map were different from the crude drug and their physical mixtures. The dissolution rates(13,15,17) were faster(35. 31%,38. 71%,41. 48%) than that of the crude drug(26. 80%),and the dissolution rates of the solid dispersions in the same ratio were higher than the physical mixtures. Conclusion DSC analysis indicated that eutectic compounds were produced by the m-nisoldipine and polyethylene glycol,in which polyethylene glycol6000 acts as a carrier. The solubility and in vitro dissolution of m-nisoldipine can be increased.

Objective To explore the bioeffect of different parameters on 4 cell lines by ultrasoundmediated microbubble destruction.Methods The orthogonal experimental design was used to investigate the effect of three factors on the bioeffects of four cell lines under three levels.Three factors included microbubble concentration,sound intensity,irradiation time.Human breast tumor (MCF-7) cells,ovarian tumor (A2780) cells,liver tumor (Bel7402) cells and thyroid tumor (ARO) cells were exposed to ultrasound in the presence of SonoVue.The cell survival rate was determined by MTT methods and the cell luminosity factor was detected by flow cytometry.Results The optimum parameters for Bel7402 and ARO cell were the same (A2B3C2),and they were different from those from MCF-7 (A3B1C1) and A2780 (A1B3C3) cell.The cell survival rates for 4 cell lines were above 75％,and the cell luminosity factors were different among 4 cell lines.Conclusions The optimum parameters by ultrasound-mediated microbubble destruction for different cell lines are different,and under the optimum parameters the bioeffects of different cell lines are different.

Objective To evaluate the changes of diffusion kurtosis imaging (DKI) parameters with time in cerebral in farction patients,and contrast with diffusion tensor imaging (DWI).Methods DWI and DKI scans were performed in 95 patients of cerebral infarction.The patients were divided into five groups according to the time of cerebral infarction:Hyperacute phase (n=10),acute phase (n=12),early subacute phase (n =33),late subacute phase (n =20) and chronic phase (n =20).Parameters of DKI were obtained,and the parameters and percentage change of diffusion metrics from normal to ischemic tissue were compared.The evolution rule of parameter with time was analyzed.Results Mean kurtosis (MK),axial kurtosis (K//),radial kurtosis (K⊥) of DKI parameters increased after infarction,and reached the peak at acute phase,and decreased gradually with the prolonging of time.Mean diffusion (MD),axial diffusion (D//),radial diffusion (D⊥) of DTI parameters decreased after infarction,and reached the lowest at the acute phase,and increased gradually with the prolonging of time.The percentage change of MK,K//,K⊥ were higher than those of MD,D//,D⊥,and percent change along the axial direction were significantly larger than that along the radial direction.Conclusion DKI is superior to DTI in evaluating cerebral infarction,and can analyze the changes of microstructure of cerebral infarction comprehensively.

Objective To evaluate the effect of online teaching platform in clinical neurology prac-tice. Methods The participants were medical undergraduate students in the process of clinical practice in Department of Neurology of XiJing hospital, who were divided into the traditional practice teaching group (n=77) and online platform auxiliary practice teaching group (n=90), respectively carry-ing out the corre-sponding rotation practice teaching . Unified objective structured clinical examination was given to two groups of students to implement departmental rotation examination , and investigation was made among teachers and students on the evaluation of the effect of practice. SPSS 19.0 was used to do t test to the two sets of corresponding evaluation data. Results Total score of departmental rotation examination in online platform auxiliary practice teaching group (69.33 ±2.74) was significantly higher than traditional teaching group (67.23±2.50) (P=0.000). Scores of basic theories, skill and operation, clinical case analysis in online platform auxiliary practice teaching group were significantly higher than traditional teaching group (P<0.05). However, medical record writing scores in online platform auxiliary practice teaching group (7.39± 1.09) were significantly lower than the traditional teaching group (8.03±1.03) (P=0.000). Teachers' eval-uation of practice effect was obviously higher in online platform auxiliary practice teaching group (12.33± 0.52) than that in traditional teaching group (10.67 ±1.03) (P=0.005). Students' evaluation of interest in learning, content arrangement, teachers' sense of responsibility, evaluation of teaching ability, practice effect were obviously higher than that of traditional teaching group (P<0.05). Conclusion This study preliminary has achieved good practical effect by using online auxiliary teaching platform, and got high evaluation by both teachers and students. Inter-active communication and sharing of resources is easy in the online plat-form of practice teaching . On-line platform will help students develop with clinical neurology diagnosis thinking.

BACKGROUND:Buyang HuanwuDecoction is commonly used in clinical medicine in treatment of intracerebral hemorrhage. Previous studies have been found that it has excelent neuroprotective effect, can efficiently inhibit the apoptosis of nervecels. Autophagic activity is closely related to apoptosis of nerve cels. CXCR4-PI3K autophagy signaling pathway has been verified in clinic. However, the effect of Buyang HuanwuDecoction is poorly understood. There is no study on Beclin-1 in the neuroprotective studies ofBuyang HuanwuDecoction.
OBJECTIVE:To explore the effects ofBuyang HuanwuDecoction on CXCR4-PI3K autophagy signaling pathway and Beclin-1 in rats with cerebral hemorrhage and related mechanisms.
METHODS:According to Rosenberg method, a rat model of cerebral hemorrhage was replicated and intragastricaly administeredBuyang HuanwuDecoction. Western blot assay was used to measure Beclin-1 protein. Immunohistochemical method was utilized to detect the expression of PI3K, AKT, stromal cel derived factor 1 and CXCR-4 protein. TUNEL assay was applied to identify apoptosis.
RESULTS AND CONCLUSION:(1) After administration,Buyang HuanwuDecoction could reduce the number of neuronal apoptosis in rats with intracerebral hemorrhage, up-regulate the expression of Beclin-1, PI3K, AKT, stromal cel derived factor 1, and CXCR-4 protein, and exert neuroprotective effect. (2)Buyang HuanwuDecoction could activate CXCR4-PI3K autophagy signal transduction pathway, both to stimulate autophagy and to regulate autophagy state, can inhibit apoptosis, and exert cerebral protective effect.

Objective To investigate the diagnostic value of twinkling artifact in urinary calcium stones.Methods Calcium oxalate monohydrate,hydroxyapatite and whitlockite stone phantoms were prepared and embedded in porcine kidneys for ultrasound scanning.The length and width of twinkling artifact were measured.The intensity of twinkling artifact and the contrast-to-noise ratio (C/N ratio) of acoustic shadowing were recorded and all the data was analyzed statistically.Results All the stone phantoms generated twinkling artifact and acoustic shadowing.The difference of the intensity,length and width of twinkling artifact and the C/N ratio of acoustic shadowing had statistically significant each composition (P ＜0.01).There was no overlap between 95％ confidence interval of the intensity of twinkling artifact for any two compositions,and any two compositions of stones could be differentiated by the intensity of twinkling artifact (P ＜0.05).The C/N ratio of acoustic shadowing of calcium oxalate monohydrate and whitlockite stone phantoms were higher than those of hydroxyapatite ones (P ＜0.05).The receiver operating characteristic (ROC) curve displayed that the cutoff value of 1 127 of the intensity of twinkling artifact could be used to diagnose hydroxyapatite stones.The sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) and area under the curve (AUC) were 74 ％,68 ％,69.8％,72.3％ and 0.743 respectively.Conclusions Twinkling artifact could be used to differentiate the calcium stones,which will be helpful for clinical treatment.

Objective To quantitatively analyze the value of color Doppler twinkling artifact and CT in distinguishing urinary stone composition of uric acid from that of cystine,and to assess the ability of color Doppler twinkling artifact and CT to diagnose urinary stone composition of uric acid.Methods Artificial stones made of uric acid and cystihe were inserted in porcine kidneys respectively.Color Doppler ultrasound and CT scanning were performed in vitro and twinkling artifact videos were recorded.The CT attenuation value,the width and length of twinkling artifact (TAW,TAL) were measured.The color pixels representing twinkling artifact intensity (TAI) were calculated.The differences between artificial cystine and artificial uric acid stones in TAW,TAL,TAI and CT attenuation value were compared.The receiver operating characteristic (ROC) curve was used to assess the ability of TAW,TAL,TAI and CT attenuation value to diagnose urinary stone composition of uric acid.Results The TAW [(4.16 ± 1.54)mm vs (4.97 ± 1.93)mm],TAL[(3.75 ± 1.05)mm vs (5.12 ± 2.51)mm] and TAI [(3 005.50 ± 812.33) vs (5 433.86±2 505.81)] of artificial cystine stones were less than those of artificial uric acid stones while the CT attenuation value of artificial cystine stones [(573.75 ± 110.10)HU vs (364.09 ± 67.28)HU] were greater (P ＜0.05).The ROC curve was displayed to diagnose urinary stone composition of uric acid,and the area under curve of CT attenuation value was bigger than that of TAI (0.936 vs 0.817,Z =2.308,P =0.021).Combination of color Doppler twinkling artifact and CT value would dramatically increase the diagnostic accuracy to 98％.Conclusions Both color Doppler ultrasound and CT were reliable examinations for distinguishing urinary stone composition of cystine from that of uric acid.Combination of color Doppler ultrasound and CT would be good references to diagnose urinary stone composition of uric acid.