Objective To study the metabolic characteristics of neuronal injury in the temporal lobes during the radiotherapy in the elderly patients with nasopharyngeal carcinoma by 1H-MR spectroscopy.Methods Conventional MRI and 1H-MRS were performed in 21 elderly (age ≥60 years) and 33 young (age ≤ 45 years) patients who were historically confirmed with nasopharyngeal carcinoma and received radiotherapy for the first time.MR data were collected before and during the therapy at the radiation dosages of 20,40 and 60 Gy,respectively.Student t test was used to compare the NAA/Cr,Cho/Cr and NAA/Cho ratios of 1H-MRS in the temporal lobes between the two groups.Results The ratios of NAA/Cr,Cho/Cr before radiotherapy were 1.94 ± 0.15,1.86 + 0.20 in the elderly group,and 2.12 + 0.25,1.82 ± 0.24 in the young group respectively,but the difference was not statistically significant ( t =1.417,1.070,P ＞ 0.05 ).At the radiation with dosages of 20,40,and 60 Gy,the ratios of NAA/Cr were 1.81 ± 0.14,1.53 + 0.16,1.06 ±0.08 in the elderly group respectively,and were 2.03 ±0.16,1.92 ±0.21,1.77 ±0.18 in the young group respectively.There were statistical differences between two groups ( t =8.386,9.113,13.729,respectively,P＜0.05,＜0.05,＜0.01).The ratios of Cho/Cr were 1.82 +0.16,1.61 +0.29,1.37 +0.13 in the elderly group respectively,and were 1.77 + 0.19,1.48 + 0.17,1.06 + 0.14 in the young group respectively.There were statistical differences between the two groups at dosages of 40 and 60 Gy ( t =5.230,9.322 respectively,P ＜ 0.05 ).The ratios of NAA/Cho were 1.17 + 0.15,1.10 ± 0.08,0.83 ±0.05 in the elderly group respectively,and were 1.52 ±0.13,1.36 +0.15,1.10 +0.17 in the young group respectively.There were statistical differences between two groups ( t =5.862,2.560,9.754 respectively,P ＜0.05,＜0.05,＜0.01 ).At the dosages of 20,40 and 60 Gy,the decreases of NAA/Cr in the elderly group (6.70％,14.43％,24.23％ respectively) were more significantly higher than those in the young group(4.25％,5.19％,7.08％ respectively).The decrease of Cho/Cr in the elderly group (2.15％,11.29％,12.90％ respectively) were lower than those in the young group ( 3.30％,15.93％,17.58％ respectively).And the decrease of NAA/Cho in the elderly group (8.59％,5.47％,21.09％ respectively) were higher than those in the young group (2.56％,10.26％,16.67％ respectively).Conclusion Under the same radiotherapy pattern and radiation dosage,the injury to the neurons in the temporal lobes is significantly greater in the elderly patients than in young patients.Since the injury is smallest at the dose of 20 Gy among the doses evaluated,the intervention conducted in the elderly patients at this dose may help to minimize the injury to the neurons.

Adult ; Female ; Hearing Loss, Sensorineural ; complications ; Humans ; Mitochondrial Encephalomyopathies ; complications

Objective To explore the influence of 300 g/kg high protein diet on myelination of the intrauterine grow retardation (IUGR) in the rat brain and their learning and memory ability.Methods The pregnant rats were fed with 60 g/kg low protein diet.After birth,the offspring of IUGR group were fed separately by 300 g/kg high-protein diet (SH group) and 210 g/kg normal-protein diet(SC group).Forty newborn female pups,born from pregnant rats fed by normal-protein diet,were used as the control group(CC group).On the first,the 7th,the 15th and the 218t day,the body weight,brain weight of the offspring and their dynamics expressions of myelin basic protein(MBP) in corpus callosum,internal capsule and external capsule were observed with immunohistochemistry method.Morris water maze test was performed to assess learning and memory ability during the 26th-32ed,then the expression of MBP in the brain was observed.Results On the 21st day,the SH group gained catch-up growth weight,while the brain weight of them was still lower than that of the CC group (P ＜ 0.05),but higher than that of the SC group.At each time point,the MBP expression in corpus callosum,internal capsule and external capsule of SH group and SC group was lower than that of the CC group(all P ＜0.05),whereas the expression of myelin basic protein in the SH group was higher than that in SC group.The average latencies in all rats were reduced to some degree from the first to the 5th day.On the 5th day,there was no significantly difference between the SH group and CC group (P ＞ 0.05),while the escape latency was significantly shorter in rats of SH group than those of SC group (P ＜ 0.05).As far as search strategy was concerned,there was no difference in SH group and SC group of rats(P ＞ 0.05),but they performed better than those in the SC group on the 5th day(P ＜0.05).The frequency of passing through the platform quadrant was not significantly difference in rats among the 3 groups (P ＞ 0.05).Conclusions 300 g/kg high-protein diet on IUGR rats can increase brain weight and the expression of MBP,and improve the ability of learning to some extend.

Objective:To explore the intervention effects of repetitive transcranial magnetic stimulation on cognitive function of schizophrenia patients with methods using meta-analysis.Methods:CNKI,Wanfang Data,VIP,PubMed,Web of Science,the Cochrane Library and Embase were searched for randomized controlled trials of repetitive transcranial magnetic stimulation on cognitive function in schizophrenia.Quality assessment was per-formed with the Cochrane Handbook for Systematic Reviews.Effect sizes and heterogeneity were assessed using RevMan 5.3.Results:A total of 31 randomized controlled trials(2 421 patients)were included in this study.Meta-analysis showed that rTMS improved cognitive function in schizophrenia patients(SMD=0.73).Subgroup analyses showed that intervention intensity was less than or equal to 100％RMT,the intervention frequency was 1 Hz,the intervention time was lasted at least 20 min/time,and the intervention period was four weeks,the effect of rTMS was better.Subgroup analyses showed that rTMS was more effective in improving for patients with durations of 5 to 10 years.Conclusion:rTMS has more significant improvement effects on cognitive function in schizophrenia pa-tients.It is recommended to set the intervention intensity 100％RMT,the intervention frequency of 1 Hz,the in-tervention time ≥20 min,and the intervention period of 4 weeks in the clinic.

Objective To explore the clinical effect of precise radiotherapy in the treatment of cancer in elderly patients. Methods We selected 88 elderly patients with advanced cancer at our hospital from January 2012 to December 2015.The patients were assigned into a control group(n＝44) treated with conventional radiation therapy and an intervention group (n＝44)receiving precise radiation therapy.Clinical effects and treatment reactions and adverse events were compared between the two groups. Results The total effective rate was higher in the intervention group than in the control group ,but the difference was not significant [40.9%(18/44)vs 56.8%(25/44) ,χ2＝ 2.228 ,P ＝0.135] .The control rate of clinical diseases was higher in the intervention group [77.3%(34/44)]than in control group[56.8%(25/44)](χ2＝ 4.166 ,P＝ 0.041).The incidence of adverse reactions was significantly lower in the intervention group [43.2%(19/44 )] than in the control group [68.2%(30/44)] ,(χ2＝ 5.572 ,P ＝ 0.018 ). Conclusions Precise radiotherapy has a precisely clinical efficacy and a lower incidence of adverse events. It is worth recommending and generalizing.

BACKGROUNDThe risk of clinical deterioration still exists in the acute phase despite the fact that patients with minor stroke may display less severe symptoms. The impact of this clinical deterioration on long-term outcomes is unknown. We characterized the clinical features of neurological deterioration (ND) in the acute phase of minor ischemic stroke (MIS) and investigated its impact on mid- and long-term outcomes.

METHODSThis was a multi-centered, prospective clinical study involving patients with MIS (the National Institutes of Health Stroke Scale, NIHSS ≤3) recruited from the China National Stroke Registry. Patients were included who had been hospitalized within 24 hours of stroke onset. Baseline characteristics, complication rates during hospitalization, etiology of stroke, as well as 3-, 6-, and 12-month post-stroke outcomes were compared between patients with and without ND during the acute phase.

RESULTSA number of 368 (15.2%) out of 2424 patients included in the study exhibited ND in the acute phase. Compared to patients without ND, patients with ND had longer hospital stay, increased rate of baseline diabetes, and multiple complications. Multivariate Logistic regression indicated that ND in acute phase was an independent factor predictive of increased dependence (adjusted odds ratio = 5.20, 95% CI, 3.51-7.70, P < 0.001) at 12-month post-stroke.

CONCLUSIONSThe risk of ND in the acute phase is high in patients with MIS. ND in the acute phase is an independent predictor for poor outcomes at 12 months post-stroke onset.

Aged ; China ; Female ; Humans ; Male ; Middle Aged ; Nervous System Diseases ; etiology ; physiopathology ; Prognosis ; Prospective Studies ; Risk Factors ; Stroke ; complications ; pathology

Humans ; Hypertensive Encephalopathy ; etiology ; Purpura, Schoenlein-Henoch ; complications ; diagnosis

OBJECTIVETo study the protective effect of Shenxiong injection on the cerebral ischemia-reperfusion injury of senile rats.

METHODTotally 108 Sprague-Dawley (SD) rats were randomly divided into the sham operation group, the model group, the Ni-modipine group and Shenxiong injection groups (low, middle, and high doses). The rat brain ischemia-reperfusion model was established by the middle cerebral artery occlusion (MCAO) method in rats, in order to observe the effect of Shenxiong injection on neurological score and brain infarct volume of rats with cerebral ischemia-reperfusion injury, and determine the contents of NOS, NO, SOD, MDA and LDH in brain tissues. The contents of TNF-alpha and IL-1beta levels in brain tissues were measured by enzyme-linked immunosorbent assay (ELISA) method.

RESULTShenxiong injection could significantly decrease neurological score, injury degree of brain tissues and brain infarct volume of rats with cerebral ischemia-reperfusion injury, increase the vigor of SOD, decrease the levels of MDA, NO, NOS and LDH, and inhibit IL-1beta and TNF-alpha expressions.

CONCLUSIONShenxiong injection has the obvious protective effect on the brain ischemia-reperfusion injury in rats. Its mechanism may be related to the improvement of neurological function, the reduction of free radical injury, and the inhibition of inflammation factor expression.

Animals ; Brain ; blood supply ; drug effects ; metabolism ; Brain Ischemia ; complications ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Injections ; L-Lactate Dehydrogenase ; metabolism ; Male ; Malondialdehyde ; metabolism ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; complications ; drug therapy ; enzymology ; metabolism ; Superoxide Dismutase ; metabolism

OBJECTIVETo evaluate clinical therapeutic effect of Guan-moxibustion on herpes simplex virus facial neuritis.

METHODSOne hundred and sixty cases were enrolled in 3 centers and 157 cases were completed the study. All he patients were randomly divided into 2 groups, a Guan-moxibustion group and a suspended moxibustion plus acupuncture group. All of them were treated with basic acupuncture, and the Guan-moxibustion group were added with Guan-moxibustion and the suspended moxibustion group with suspended moxibustion. They were treated for 8 weeks, and facial disability index (FDI) and House-Brackmann facial nerve grading system were used to assess therapeutic effects.

RESULTSThe effective rate was 91.0% in the Guan-moxibustion group and 72.2% in the suspended moxibustion group with a significant difference between the two groups (P < 0.05), the Guan-moxibustion being better than the suspended moxibustion group.

CONCLUSIONThe therapeutic effect of Guan-moxibustion plus acupuncture on herpes simplex virus facial neuritis is better than that of suspended moxibustion plus acupuncture.

Acupuncture Therapy ; Facial Nerve ; Facial Nerve Diseases ; Humans ; Moxibustion ; Simplexvirus

Objective To investigate the expression and clinical value of immunohistochemistry in endometrial stromal tumors.Methods Immunohistochemical technique(Envision method)was applied to de- tect the expression of CD_(10),SM-MHC,h-caldesmon,AE1/3,CD_(99),Ki-67,CD_(34),c-kit,ER and PR in 15 cases of endomertrial stromal sarcoma and 3 metastases.The clinical pathological data,including the histological characteristics,histochemical and immunohistochemical staining features,complication,differential diagnosis and prognosis of endometrial stromal tumours were analyzed.Results Among the 18 cases of endometrial stromal tumor,17 cases had shown positive for CD_(10),including 13 cases diffuse positive and 4 muitifocal,7 cases with smooth muscle differentiation,3 cases with epithelial differentiation,7 cases with sex-cord differ- entiation.13 cases of ER and 16 cases of PR were positive expression in endometrial stromal sarcoma.Ki-67 in range 36 %～78 %.Conclusion Endometrial stromal tumour can display multi-differentiation.They show various pathomorphological features,Smooth muscle and sex-coed differentiation,the most common types. CD_(10) can be expressed consistently in endometrial stromal tumors.CD_(10) with h-caldesmon and SM-MHC can be used to make differential diagnosis between the endometrial stromal tumors and cellular leiomy0ma.ER and PR should be routinely estimated and be a prognostic predictor for endometrial stromal sarcoma.