Fibroblast grow factors are important regulators of the embryonic and adult central nervous system during developmental processes and adult physiology.FGF control cell migration and establishment of the anterior-posterior body axis of the neural plate during gastrulation.At later shaping stage of the brain,FGF function in those organs and tissues control the morphogenesis and differentiation.During adult and injured in the adult brain,FGF contain the active hyperplasia of the adult stem cells and promote regeneration and repair in the central nervous system.This article mainly reviews the function of FGF family members in the central nervous system.

Objective To investigate the clinical characteristics and therapy methods of dorsolateral medullary syndrome.Methods The clinical data of 36 cases of dorsolateral medullary syndrome were analyzed retrospectively.Results The palients presented with acute or sub-acute oneset.Vertigo(83.3%),dysarthria(61.1%),dysphagia(52.8%),Horner's syndrome(80.6%),ataxia(72.2%) and crossed sensory disturbance(50%) were the most common symptoms and signs.MRI examination demonstrated dorsolateral medullary infarction in 32 of 36 patients.13 patients received DSA examination and the results showed 6 patients with different degree disease of vertebral arery,2 patients with isolated posterior inferior cerebellar artery occlusion,1 patient with vertebral occlusion and ipsilateral posterior inferior cerebellar artery stenosis.In 33 patients who received anticoagulation,antiplatelet and activating blood circulation to dissipate blood stasis therapies,26 patients improved 7~10 days after treatments and the symptoms almost disappeared during 1～2 months.6 cases remained different degree sensory disturbance and ataxia 1 case died.3 patients were treated with percutaneous transluminal angioplasty and stenting.The symptoms relieved at the day of operation and recovered completely 1 week after operation.Conclusions Dorsolateral medullary syndrome is a clinical syndrome because of insufficient blood-supply in local blood vessel.MRI is sensitive for the diagnosis of dorsolateral medullary syndrome.The location and degree of the disease can be identified by DSA.Intervention treatment is an effective method in the therapy of dorsolateral medullary syndrome.

Approximately one-quarter of ischemic stroke occurred in vertebrobasilar artery system. Atherosclerotic vertebrobasilar artery stenosis is one of the major causes of posterior circulation stroke. In addition to the conventional medical and surgical treatment, endovascular intervention has received more and more attention, and it has become the most promising therapeutic approach.

Endovascular treatment is becoming a novel technique in the treatment of carotid stenosis. Since this technique is in its infancy, there are many controversies on this technique and theory now. This paper briefly reviews the most recent advances in endovascular treatment of carotid stenosis.

Objective To explore an UPLC method for simultaneous content determination of the five nucleosides (cytidine, uridine, adenine, thymidine and adenosine) in Hedyotis diffusa and its adulterants; To compare the content differences.Methods The analysis was performed on a BEH C18 column (2.1 mm×50 mm, 1.7 μm) by UPLC eluted with acetonitrile and water in gradient mode. The flow rate was 0.5 mL/min; the detection wavelength was set at 254 nm; the column temperature was set at 30℃.Results Five nucleosides have good linear relationship, precision, stability, and repeatability according to the requirements of the methodology determination. The recoveries were among 98.7%–101.5%. Five nucleosides in Hedyotis diffusa and its adulterants from different areas were determined by the UPLC method.Conclusion The method is certified to be simple, rapid, accurate and reliable, which can be used for the determination of nucleosides in Hedyotis diffusa and its adulterants.

ObjectiveTo study the quality of life of patients with hepatolenticular degeneration (HLD)and analyze the influencing factors.Methods287 patients with HLD and 51 health people were investigated by World Health Organization quality of life assessment instrument brief version (WHOQOL-BREF),Symptom Checklist 90 (SCL-90),Life Satisfaction Index A (LSIA) and variance analysis,t-test and multiple linear regression analysis were analyzed the influencing factors.Results①Scores of WHOQOL-BREF:physical domain(54.64 ± 17.11 ),psychological domain ( 52.09 ± 15.83 ) in patients with HLD were lower than those in the health people (67.30 ± 12.66,58.90 ± 12.75 ) with statistically significant difference (P ＜ 0.01 ) ; social domain ( 51.35± 17.18),the domain of environment(53.54 ± 16.67) in patients with HLD were lower than those in the health people (57.53 ± 14.99,58.42 ± 10.55 ) with statistically significant difference (P ＜ 0.05 ).②The quality of life of the patients with HLD was influenced by LSIA,total score of SCL-90,the attitude toward the doctors,economic status,the attitude toward the disease,residence with statistically significant difference (P ＜ 0.0l ).ConclusionThe quality of life in patients with HLD is lower than that in health people and much factors influence it,so it is necessary to take multi-facet interventions to improve their quality of life.

Objective To compare the clinical outcome of unipedicular versus bipedicular vertebroplasty treating for osteoporotic vertebral compression fracture.Methods Sixty-four patients(68 vertebra)were divided into two groups by treated methods:unipedicular kyphoplasty group(33 cases)and bipedicular vertebroplasty group(31 cases).The Cobb angle and vasual analogue pain scale(VAS)were measured preoperatively and postoperatively.The operation time was recorded.Compared the Cobb angle,VAS and the operation time between two groups.Results Of unipedicular kyphoplasty group preoperative,24 hours and 3 months after operation,VAS were(8.42 ± 1.33),(2.21 ± 1.67),(2.09 ± 1.58)scores,the Cobb angle were(31.24 ±9.12)°,(14.21 ±9.21)°,(14.43 ±9.36)° ;while those of bipedicular vertebroplasty group were(8.36 ± 1.52),(2.13 ± 1.80),(2.00 ± 1.71)scores and(30.84 ±8.77)°,(13.94 ± 8.87)°,(14.07 ± 9.87)°.VAS and the Cobb angle of both groups at 24 hours and 3 months after operation were lower than those preoperative(P＜ 0.01).VAS and the Cobb angle of both groups were similar at the same time preoperatively and postoperatively(P ＞ 0.05).The operation time of unipedicular kyphoplasty group and bipedicular vertebroplasty was(45.00 ± 8.76),(72.00 ± 9.32)min,respectively,there was statistically significant difference between two groups(P ＜ 0.01).Conclusions Compared with the bipedicular vertebroplasty,the advantages of unipedicular kyphoplasty are as follows:less trauma,less operation time and less X-rays rediation accepted of the patient and the operator.And it has the similar clinical outcome with the bipedicular vertebroplasty.

Objective To investigate the dynamic changes of hippocampal insulin like growth factor-1(IGF-1)/IGF-1 receptor (1GF-1 R) signaling pathway and learning and memory function and to investigate the possible mechanisms of vascular dementia (VaD).Methods A rat chronic cerebral hypoperfusion model was induced by using permanent bilateral common carotid artery ligation.At day 3,1 and 2 weeks,1,2 and 4months after modeling,Morris water maze test was used to evaluate the changes of learning and memory function in rats.HE staining was used to observe the morphological changes of hippocampal neurons.Enzymelinked immunosorbent assay was used to detect the dynamic changes of IGF-1,IGF-1R,Akt and p-Akt in hippocampal tissue.Results One month after modeling,the rats of a model group began to appear significant learning and memory dysfunction.The numbers of crossing the platform were significant lower than those in a sham operation group (1.91 ±0.45 times vs.3.95 ± 1.64 times; t =17.251,P =0.000).With the extension of ischemia time,the degree of injury of pyramidal cells in hippocampal CA1 region aggravated gradually in the model group.The levels of IGF-1 and p-Akt in hippocampal tissue increased early after modeling in the model group,and then they declined gradually to the normal levels.The levels of IGF-1 (0.09 ± 0.05 ng/mg vs.0.20 ±0.03 ng/mg; t =-5.263,P =0.003) and p-Akt (12.50± 1.40 pg/mg vs.17.13 ± 0.87 pg/mg; t =- 5.651,P =0.000) at 1 month were significantly lower than those in the sham operation group and continued to 4 months.There were no significant changes in the levels of IGF-1R and Akt.Conclusions The down-regulation of IGF-1/IGF-1R signaling pathway may be one of the pathogeneses of VaD.

Objective To investigate the relationship between serum levels of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) and Suzuki' s grading system in adult moyamoya disease (MMD).Methods Fifty-two adult patients with MMD,who were diagnosed in Jinling hospital between April 2009 and January 2010,were retrieved from the Nanjing Stroke Registry Program (NSRP).Sixteen sex- and age-matched healthy individuals with MMD patients consisted of the control group.Using enzyme-linked immunosorbent assay,serum concentrations of VEGF and MMP-9 were compared between adult MMD patients and healthy individuals.By Suzuki' s six-grading system,patients were divided into different subgroups,and the correlation of serum levels of VEGF and MMP-9 corresponding to different subgroup and Suzuki's grading was respectively analyzed.In addition,the correlation of serum levels of VEGF and MMP-9 was also evaluated.Results Serum VEGF concentrations in ischemic and hemorrhagic MMD patients was respectively ( 289.4 + 69.2 ) pg/ml and ( 324.3 ± 95.6 ) pg/ml and were significantly higher compared to those in healthy controls ( ( 63.5 ± 7.6 ) pg/ml; F =69.43,P ＜ 0.01 ).Similar findings were observed for MMP-9 ( ( 499.4 ± 76.2 ) ng/ml and ( 531.2 + 100.2 ) ng/ml versus (257.1 ±30.7) ng/ml; F =66.023,P ＜0.01 ).With the increase of Suzuki' s grading,serum levels of VEGF and MMP-9 respectively showed a high trend ( r =0.879,P ＜ 0.01:r =0.838,P ＜ 0.01 ).In addition,a positive correlation between serum levels of VEGF and MMP-9 was found in the MMD group( r =0.590,P ＜0.01 ).Conclusion The results show that serum levels of VEGF and MMP-9 in adult MMD are higher than those in healthy controls,which may play a role in neovascularization in MMD,and moreover,serum levels of VEGF and MMP-9 show a high trend with the progression of MMD,which suggest that serum levels of VEGF and MMP-9 can reflect the severity of MMD.

Objective To establish and validate a modified rat thromboembolic stroke model.Methods After taking femoral arterial blood and mixing it with thrombin,they were injected into PE-50 catheter for preparing in vitro thrombosis in 60 Sprague-Dawley rats.A thromboembolic cerebral ischemia model induced by catheterization of the right external carotid artery and the small blood clot emboli were injected into the internal carotid arteries.Thirty rats were randomly divided into a large number of emboli group (n =10 with 12 emboli),a median number of emboli group (n =10 with 10 emboli) and a small number of emboli group (n =10 with 8 emboli).Two hours after embolus injection,the neurological deficit score was performed and the success rate of the model was compared in all groups.Twenty-four hours after embolus injection,the rats were sacrificed and the brains were removed for 2,3,5-triphenyltetrazolium chloride staining.The hemorrhage,infarct volume,bleeding incidence and mortality after cerebral infarction were evaluated.The high success rates of the modeling in the emboli groups were selected and they were randomly divided into either a normal saline group (n =12) or a recombinant tissue-type plasminogen activator (rtPA) group (n =12).The rats were given normal saline and rtPA at 3 hours after embolus injection.Before embolus injection and 2,6,12 and 24 hours after embolus injection,the neurological scores were performed respectively; 24 hours after embolus injection,the rats were sacrificed and the brains were removed for 2,3,5-triphenyltetrazolium chloride staining.The hemorrhage rate,infarction size,degree of cerebral edema,and blood-brain barrier permeability were evaluated.Results Only 40％ of rats had neurological deficits in the small number of emboli group,and the infarct volume was only 10.54 ± 2.82％.The success rates in the median and large number of emboli groups were 80％ and 100％ respectively.They were all significantly higher than those in the small number of emboli group (P =0.011 ).The infarct volume was also significantly greater than that in the small number of emboli group (F =40.897,P =0.000).After administration of rtPA,the mean survival time of the rats in the large number of emboli group was less than 24 hours,so the median number of emboli group was selected to study the thrombolytic effect of rtPA.The infarct volume and neurological function score in the rtPA group were improved significantly compared to the normal saline group (t =7.728,P =0.000),while there were no significant differences in the hemorrhage rate,degree of brain edema and blood-brain barrier permeability between the 2 groups.Conclusions The stability and reproducibility were good in the modified thromboembolic cerebral ischemia model injected with 10 emboli,the neurological function was improved significantly after thrombolysis,and it was applicable to the experimental study of pathophysiology of cerebral ischemia and thrombolytic therapy.