Objective To observe the effect of monosialoteterahexosyl ganglioside (GM1) combined with Shuxuening injection on nerve function in patients with acute cerebral infarction (ACI) and its mechanism.Methods A total of 94 patients with ACI admitted to the Department of Neurology in Xiangyang First Peoples' Hospital Affiliated to Hubei Medical College from January 2013 to June 2016 were enrolled,and they were divided into two groups by random number table,each group 47 cases.The patients in two groups were all given conventional western medicine treatment;The patients in one group (single group) were treated by intravenous (Ⅳ) drip of GM1,100 mg once a day;and the patients in another group (combined group),by above GM1 Ⅳ drip combined with Shuxuening intramuscular injection,once 2 mL,twice a day;the therapeutic course in two groups was 14 days.Before and after treatment,the changes of China stroke clinical neurological impairment score (CSS score),glasgow coma score (GCS),nerve factor,oxidative stress index and hemodynamics index of two groups were observed.Results Compared with those before treatment,after treatment the CSS score,the levels of neuron specific enolase (NSE),and malondialdehyde (MDA) were significantly lower,while the GCS score,the levels of nerve growth factor (NGF),neurotrophic factor (NTF),maximum blood flow velocity (Vmax),minimum blood flow velocity (Vmin),mean blood flow velocity (Vmean),mean blood flow quantity (Qmean),glutathione peroxidase (GSH-Px),catalase (CAT) and superoxide dismutase (SOD) were all significantly higher in the combined group (all P ＜ 0.05).After treatment,the CSS score,levels of NSE and MDA in the combined group were significantly lower than those of the single group [CSS:11.20 ± 1.78 vs.16.24 ± 1.95,NSE (μg/L):13.17± 1.00 vs.17.68 ± 1.84,MDA (μmol/L):4.14±0.49 vs.5.61 ±0.50,all P ＜ 0.05],GCS score,NGF,NTF,GSH-Px,CAT,SOD,Vmax,Vmin,Vmean and Qmean of the combined group were all significantly higher than those of the single group [GCS:13.68± 1.85 vs.12.01±1.76,NGF (ng/L):88.10±8.83 vs.68.13±7.16,NTF (pg/L):5.13±0.38 vs.3.71±0.30,GSH-Px (U/L):128.13±8.07 vs.103.90±6.58,CAT (U/L):25.74±2.15 vs.19.43± 1.84,SOD (μU/L):94.36±8.00 vs.77.29±7.34,Vmax (cm/min):48.23±3.36 vs.43.17±2.88,Vmin (cm/'min):8.11±0.76 vs.6.85 ± 0.64,Vmean (cm/min):18.69 ± 1.37 vs.15.60 ± 1.24,Qmean (mL/min):9.10 ± 0.74 vs.7.79 ± 0.66,all P ＜ 0.05].Conclusions GM1 combined with Shuxuening injection can improve nerve function in patients with ACI by improving brain blood flow,secreting neurotrophic related factors and inhibiting oxidative stress reaction,thus it has important clinical significance for repairing the damaged nerve function.

Objective To evaluate the effects of different blood-saving strategies on postoperative cellular immune function in patients undergoing resection for liver cancers.Methods Sixty-six ASA physical status Ⅰ or Ⅱ patients,aged 25-64 yr,with hepatocellular carcinoma classification G1-G3 and clinicopathological staging Ⅰ-Ⅳ,undergoing elective resection for liver cancers,were randomly divided into 3 groups (n =22 each) using a random number table:low central venous pressure group (L group),acutenormovolemic hemodilution group (A group),and acute normovolemic hemodilution combined with low central venous pressure group (AL group).Acute normovolemic hemodilution was performed after endotracheal intubation.Right jugular vein was cannulated for central venous pressure monitoring.Blood withdrawn from the radial artery at a rate of 25-40 ml/min was simultaneously replaced by iv infusion of the equal volume of 130/0.4 hydroxyethyl starch at the same rate until the target Hct (30％) was achieved.In A and AL groups,central venous pressure was maintained at 3-5 cm H2O during the procedure of liver parenchyma transection.Peripheral venous blood samples were taken before operation (T1,baseline) and on postoperative days 1,3 and 5 (T2-4) to determine the percentage of regulatory T-lymphocytes (CD4 + CD25 +,CD25 + Foxp3+),effective T-lymphocytes (CD8 +,CD4 + CD25-) and natural killer (NK) cells by flow cytometry.Results Compared with the baseline value at T1,the percentage of CD4 + CD25 +and CD25 + Foxp3+ was significantly decreased,and the percentage of CD8 + and CD4 + CD25-was increased at T3,4,and the percentage of NK cells was decreased at T2 in A and AL groups,and the percentage of CD4 + CD25 +and CD25 + Foxp3+ was decreased,and the percentage of CD8 + and CD4 + CD25-was increased at T4,and the percentage of NK cells was decreased at T2,3 in group L (P ＜ 0.05).Compared with L group,the percentage of CD4 + CD25 + and CD25 + Foxp3+ was significantly decreased at T3,the percentage of CD8 + was increased at T3,4,and the percentage of NK cells was increased at T3 in AL group (P ＜ 0.05).Conclusion Acute normovolemic hemodilution combined with low central venous pressure provides slighter inhibitory effect on the immune function of T-lymphocytes and NK cells in patients undergoing resection for liver cancers than either alone.

OBJECTIVE:To investigate the inhibitory effects mechanism of scallop skirt glycosaminoglycan(SS-GAG)on inju-ry in human umbilical vein endothelium cells (HUVEC). METHODS:In the test,there was a negative control group,a model group and the groups of SS-GAG at high,middle and low concentrations(mass concentrations of 200,100 and 50 mg/L respective-ly). The cells in latter 3 groups were cultured in SS-GAG at different mass concentrations for 12 h,and then in 50 μmol/L oxidized low-density lipoprotein(OX-LDL)for 24 h. MTT method was used to detect cell viability and the activity of lactic dehydrogenase (LDH),the flow cytometer to determine the level of reactive oxygen species (ROS),real-time fluorescence quantitative poly-merase chain reaction (RT-PCR) to detect mRNA expression of lectin-like oxidized low-density lipoprotein receptor 1 (LOX-1), and Western blot to detect NOX4 protein expression. RESULTS:Compared to the cells in the negative control group,those in the model group demonstrated lower viability,higher activity of LDH,higher level of ROS,and stronger expressions of LOX-1 mRNA and NOX4 protein. There was statistical significance (P<0.01). Compared to the cells in the model group,those in the groups of SS-GAG at high,middle and low concentrations showed higher viability,lower activity of LDH,lower level of ROS and weaker expressions of LOX-1 mRNA and NOX4 protein. There was statistical significance (P<0.01). CONCLUSIONS:SS-GAG can protect HUVEC to some degree by a mechanism which may be related to inhibiting ROS production via LOX-1/NOX4 pathway and relieving oxidative stress injury.

Objective To investigate the imaging features of the nigrosomes-1 region in the substantia nigra at 3.0 T with enhanced gradient echo T2 star weighted angiography(ESWAN), and to explore its clinical value in the evaluation of Parkinson disease (PD). Methods Fifty-four patients diagnosed with PD (PD group), and 51 non-PD volunteers (N-PD group) were scanned with 3.0 T ESWAN, who had selected randomly. The widths of the typical high signal correspondence with the nigrosomes-1 region (a), the width at the middle of the substantia nigra (b) and the width of the banded high signal of which the oval structure were not displayed (c) were measured and collected. The result of reclassification performed by 2 physicians were compared with clinical gold standard. Specificity and sensitivity were calculated; Eleven outpatients with clinically suspected PD but undiagnosed (UD group) were continusouly selected. They received the same scanning and were performed with imaging diagnosis according to the conclusions of previous studies, then compared the imaging diagnosis with the final clinical diagnosis. Results In non PD group, hyperintensity of nigrosomes-1 were shown in 49 cases (96.1%) in bilateral or unilateral of the SN, the hyperintensity were shaped as“drop”, wedge or oval and the average size (a/b) was (0.31 ± 0.07)mm approximately; PD group, all 54 cases (100.0%) of the oval rear the“drop”were completely disappeared. The sensitivity of the loss of the hyperintensity of nigrosomes-1 for the diagnosis of PD was about 100.0%(54/54)and the specificity of it was about 96.08%(49/51). In UD group, 7 cases with the“drop”completely missed and 1 case with smaller“c”were clinically proven to PD, 2 cases with the typical hyperintensity and 2 case with larger“c”were proven to Parkinson plus syndrome. Conclusions The nigrosomes-1 typical hyperintensity in PD patients' substantia nigra on the 3.0 T ESWAN are disappeared. There may be an effective method for PD and Parkinson's plus syndrome identification that by analyzing of the presence or absence of the typical hyperintensity and its size in the patients with symptoms of PD.

Objective To explore the influence of plasma matrix metalloproteinase-7 ( MMP-7 ) levels and genetic polymorphism of MMP-7 - 181 A/G on the stability of carotid plaque.Method According to carotid ultrasound examination, 503 patients with carotid atherosclerotic lesions were consecutively recruited and divided into vulnerable plaque group (n = 118) and stable plaque group (n = 385).Plasma MMP-7 levels were measured by enzyme-linked immunosorbent assay (ELISA), and MMP-7 -181 A/G genotypes were determined by polymerase chain reaction-restiction fragment length polymorphism (PCR-RFLP).Results Plasma MMP-7 levels in carotid vulnerable plaque group were significantly enhanced as compared to stable plaque group (t =5.49, P =0.00).The frequency of MMP-7 -181G allele in vulnerable plaque group was significantly higher than that in stable plaque group (11.4% vs 7.0% ,χ2 = 4.78, P= 0.029).Compared to AA genotype, the genotypes with - 181G allele (AG + GG) significantly increased susceptibility to carotid vulnerable plaque ( χ2 = 5.01, OR = 1.81, P = 0.025 ) .When further analyzing the relationship between genotype and plasma MMP-7 levels, no significant differences of plasma MMP-7 levels were observed between AA genotype and AG + GG genotype in stable plaque group.However, in vulnerable plaque group, plasma MMP-7 levels of AG + GG genotype were significantly higher than that of AA genotype( t = 2.62, P = 0.01).Conclusion The present findings suggest that plasma MMP-7 level may be a biomarker for carotid vulnerable plaque.Genetic polymorphism of - 181 A/G in MMP-7 promoter may affect the expression of MMP-7, and seems to be implicated in susceptibility to carotid vulnerable plaque.

Studies have shown that the clinical manifestation of patients with neuropsychiatric disorders might be related to the abnormal connectivity of brain functions. Psychogenic non-epileptic seizures (PNES) are different from the conventional epileptic seizures due to the lack of the expected electroencephalographically epileptic changes in central nervous system, but are related to the presence of significant psychological factors. Diagnosis of PNES remains challenging. We found in the present work that the connectivity between the frontal and parieto-occipital in PNES was weaker than that of the controls by using network analysis based on electroencephalogram (EEG) signals. In addition, PNES were recognized by using the network properties as linear discriminant nalysis (LDA) input and classification accuracy was 85%. This study may provide a feasible tool for clinical diagnosis of PNES.
Brain ; physiopathology ; Electroencephalography ; Epilepsy ; Humans ; Seizures ; diagnosis

OBJECTIVETo observe the differences in onset time and the overall efficacy of the acupuncture therapy of dredging Governor Vessel and regulating mentality combined with fluoxetine and the fluoxetine for post-stroke depression(PSD).

METHODSSixty-three patients were randomly divided into an acupuncture intervention of dredging Governor Vessel and regulating mentality group(acupuncture and medication group, 33 cases) and a control group (medication group, 30 cases). In the medication group, 20 mg fluoxetine was used by oral administration, once a day at 7:00 in the morning, continuously for 4 weeks. In the acupuncture and medication group, based on the oral administration of fluoxetine, the acupuncture intervention of dredging Governor Vessel and regulating mentality was applied mainly at Baihui(GV 20), Fengfu(GV 16), Shenting(GV 24), Shuigou(GV 26), Dazhui(GV 14) and Shendao(GV 11), once a day, 6 times a week, continuously for 4 weeks. Twenty-four items in Hamilton Depression Scale(HAMD), modified Edinburgh Scandinavia Stroke Scale(MESSS) and activity of daily life scale(ADL, Barthel index, BI) were used before and after 2-week and 4-week treatment. The efficacy was compared between the two groups.

RESULTSAfter 2-week treatment, the HAMD score and the MESSS score in the acupuncture and medication group were obviously decreased and the BI score was apparently increased(all P<0. 01). In the medication group, however, the score of every scale was not statistically different from that before treatment(P'>0. 05). After 4-week treatment, HAMD scores and MESSS scores in the two groups were obviously decreased and the BI scores I were apparently increased(all P<0. 01). After 2-week and 4-week treatment, the HAMD scores and the MESSS scores in the acupuncture and medication group were lower than those in the medication group and the BI scores were higher than those in the medication group(P<0. 01, P<0. 05). The total effective rate of anti-depression (97. 0%, 32/33) the total effective rate of nerve function impairment(90. 9%, 30/33) and the total effective rate of daily life activity(97. 0% 32/33) in the acupuncture and medication group were better than 80. 0% (24/30), 80. 0%(24/30), 83. 3%(25/30) in the medication group(all P<0. 05).

CONCLUSIONThe acupuncture therapy of dredging Governor Vessel and regulating mentality could reduce the onset time of anti-depression medicine treatment of PSD and enhance the overall efficacy. Therefore, it enhances the clinical compliance.

Acupuncture Therapy ; Adult ; Aged ; Antidepressive Agents ; administration & dosage ; Combined Modality Therapy ; Depression ; drug therapy ; etiology ; therapy ; Female ; Humans ; Male ; Meridians ; Middle Aged ; Stroke ; complications ; psychology

Objective To explore the relationship between the levels of Cu, Fe, Mn, Zn in serum and Parkinson disease (PD). Methods A total of 40 patients with PD (PD group) and 40 control subjects (control group)were enrolled in this study. Serum levels of Mn were measured by graphite atomic absorption, and Cu ,Fe, Zn were measured by inductively coupled plasma(ICP)mass spectrometry. Resudts There were significantly increase in the levels of Mn and Fe in PD group than those in control group [(0.269±0.326) μ mol/L vs (0.125±0.054) μmol/L, P< 0.05, (1.512±0.949) μmol/L vs (0.676±0.111) μmol/L, P< 0.01)]. There were no significant difference in the levels of Cu and Zn between two groups (P> 0.05). Condusion Micreelements may play important roles in pathogenesis and development of PD, especially Fe and Mn.

Objective To investigate the clinical characteristics of posterior communicating artery (PcomA) aneurysm-induced oculomotor nerve paresis (ONP) before and after endovascular coiling,and provide a reference for diagnosis,treatment and prognosis of PcomA aneurysm-induced ONP.Methods A total of 55 patients with ONP attributable to PcomA,admitted to our hospital from July 2007 to January 2013,were chosen in our study;their clinical data and postoperative recovery were retrospectively analyzed to investigate clinical characteristics of ONP attributable to PcomA.Results The average preoperative paralysis time was 12.24±5.33 days in patients with complete preoperative paralysis and 8.90±3.51 days in patients with incomplete preoperative paralysis with significant difference (P=0.014).Of the 55 patients,31 (56.36％) had complete recovery ofoculomotor nerve function,19 incomplete recovery (34.55％),and 5 (9.09％) remained unchanged after endovascular treatment.Most patients (41/50) began to improve in 3 months after endovascular treatment.The complete recovery ratio between patients encountered improvement of ONP within 30 days and over 30 days had statistical differences (P=0.032).Of 31 patients received complete resolution of ONP at the end of the follow-up,25 (80.65％) fully recovered 6 months after endovascular treatment.Thirty patients (96.77％) fully recovered within one year of endovascular treatment.One (3.23％) received complete resolution of ONP over one year of operation.Within 31 patients encountered complete resolution of ONP,there were 24 patients (77.42％) whose duration of recovery was less than 3 months and 7 patients (22.58％) more than 3 months.Functional recovery was noted firstly in the levator palpebrae muscle,followed by the medial rectus muscle,superior rectus muscle,constrictor muscles of the iris,and ciliary muscle.Patients with incomplete recovery often had residual diplopia in upward gaze and pupillary dysfunction.Conclusions The degrees of oculomotor nerve palsy before endovascular coiling are significantly associated with the paralysis time.Endovascular treatment can promote the recovery of PcomA-induced ONP.The earlier the ONP starting improvement,the better the ONP recoverary after endovascular treatment.The muscles which functional damage occurs early will encounter improvement lately.

Objective To describe the evolution of oculomotor nerve paresis (ONP) after endovascular packing of posterior communicating artery aneurysms (PcomA) to prospectively evaluate the effect of mecobalamine treatment on ONP prospective recovery.Methods A total of 56 patients with ONP attributable to PcomA,treated with coils in our hospital from July 2007 to January 2013,were enrolled in a randomized,controlled open study,and 55 of them got follow up;embolization+mecobalamine treatment was performed in 28 and embolization treatment was in 27.The degrees of ONP were recorded one year after treatment.Results All patients succeeded in one year follow-up; 31 patients (56.4％) achieved complete resolution of ONP,19 (34.5％) partial improvement and 5 (9.1％) no changes.The complete recovery rate in the embolization+mecobalamine treatment group was 71.4％ (20/28) and that in the embolization treatment group was 40.7％ (11/27),with statistically significant differences (P＜0.05).Conclusion Endovascular treatment is highly efficacious in treating ONP-inducing PcomA and mecobalamine treatment can promote the recovery of oculomotor nerve palsy after embolism.