Objective To study the clinical, imaging and pathological features of primary angiitis of central nervous system (PACNS). Methods The clinical data of 8 patients with PACNS (4 suspected and 4 definite) were retrospectively analysed.Results There were 5 males and 3 females in 8 patients with PACNS. Average age was 32 years old and average disease course was 11 months. The initial symptoms were headache in 5, extremital weakness in 2, and speech disorder in 1 patients. The major clinical manifestations were headache in all patients, extremital weakness and numbness in 5, speech disorder in 1, and seizure disorder in 2 patients. 7 patients were with slow-progressive disease courses, and 1 patients with a relapsing-remitting one. MRI showed abnormality in all patients. 6 cases had unilateral lesions and 2 had bilateral lesions. MRI showed ill-defined, irregular or atypical wedge-shaped foci in cortical and subcortical areas in 7 patients and strip-shaped foci with surrounding finger-like cerebral edema in the left frontal and parietal lobe and gyrus cinguli in 1 patient. All lesions enhanced with different degree on contrast-enhanced scan. Enhanced lesions along sulcus and gyrus were seen in 7 patients and mass-like irregular linear enhancement lesion in 1 patient. Diffusion-weighted imaging(DWI) showed hyper-signal and apparent diffusion coefficient(ADC) showed hypo-signal in 5 patients. MRA showed stiffness and lack of smooth in one or more cerebral arteries with multiple segmental narrowing and expanding, and rarity of arterial distal branches in 8 patients. Digital subtraction angiography (DSA) also showed multiple segmental narrowing and expanding in cerebral arteries, and rarity of arterial distal branches in 4 patients. Brain biopsy in 4 cases revealed angiitis with lymphocytic infiltration. 5 patients received treatment with single corticoid, and 3 with cyclophosphamide. All cases had good outcome. Conclusions The clinical manifestations of PACNS are various. The changes of imaging are obvious, MRI, MRA and DSA are helpful in the diagnosis of PACNS. The definite diagnosis relies on brain biopsy.

AIM: To explore clinical significance of the serum changes of neuron-specific enolase (NSE)and S-100 ? protein (S-100 ?) during acute cerebral infarction. METHODS: 59 acute cerebral infarction patients were classified as total anterior circulation infarcts (TACI), partial anterior circulation infarcts (PACI), lacunar infarcts (LACI) and posterior circulation infarcts (POCI). Their serum NSE and S-100 ? concentrations were determinated by enzyme linked immunosorbent assay (ELISA) during stroke onset 6 d, and compared with 32 controls. RESULTS: The every time point serum NSE concentration of TACI was higher than controls (P

BACKGROUND: The involvement of genetic factors in migraine has been under close investigation, and geneiic epidemiological study and segregation analysis have confirmed genetic disposition as an important risk factor for migraine.OBJECTIVE: To analyze the connection between mutations in CACNA1A gene and familial hemiplegic migraine (FHM) in southern Chinese Han patients by examining the three most frequently mutated sites in CACN1A gene.DESIGN: Sampled survey.SETTING: First Affiliated Hospital of Zhongshan University and Baoan Xixiang People's Hospital of Shenzhen City.PARTICIPANTS: All the participants were selected from patients in the above two hospitals and their relatives, including 10 patients with FHM, 12 relatives of the patients in 2 pedigrees, 53 migraine patients with aura without family history, and 10 healthy control subjects.METHODS: The exons 13, 16 and 17 of CACNL1A4 gene were amplified by PCR. Single-strand conformation polymorphism technique was employed to detect the most frequent mutations in the 3 exons (T666M, R583Q and D715E) in these subjects.MAIN OUTCOME MEASURES: ① Results of PCR amplification of the 3 exons of CACNL1A4 gene; ② Results of SSCP for mutation analysis of the 3 exons.RESULTS: Participants completed the study. The target fragment length of exons 13, 16 and 17 were 247 bp, 268 bp and 204 bp, respectively.None of mutations of T666M, R583Q and D715E were detected in the subjects, including FHM patients and their relatives, migraine patients without family history and the healthy control subjects.CONCLUSION: None of the 3 most frequent mutations (T666M, R583Q and D715E) can be detected in southern Chinese FHM pedigrees or migraine patients without family history.

Objective 　To search the relative factors of cerebral damage, rebleeding, delayed cerebral ischaemia(DCI) and hydrocephalus after subarachnoid haemorrhage (SAH) by CT scans and clinical findings in acute phase. Methods　To analyse the relationship between cerebral damage after SAH and clinical findings: CT scans resulte, age, sex, blood pressure, hyponatraemia, therapeutic methods. Results　Cerebral damage were related to the pattern of distritution of SAH on brain CT and hyponatraemia. The high attack rate of rebleeding and DCI is related to presence of blood in the surface of brain, collection of blood in the ventricle, saccula aneurysms or cerebral arteriovenous malformation (AVM) (P＜0.01). Conclusions　To forecast of cerebral damage after SAH by study of CT scans showing and clinical findings have clincal significance. According to these findings, we may take some therapeutics to prevent the cerebral damage after SAH.

AIM: To observe the activity and distribution of astrocytes and glial fibrillary acid protein(GFAP) after middle cerebral artery occlusion (MCAO). METHODS: The rat MCAO model was made by two-kidney, tow clip renovascular hypertensive rat stroke prone(RHRSP). Rats were killed and brain samples were collected at the end of 1,3,6 and 9 weeks after MCAO, respectively. The ultrastructure of astrocytes was determined at broder of infarct (A area); distant of infarct (B area) and opposite of hemisphere (C area) by electron microscope. The number and optical density of GFAP-positive cells were also observed. RESULTS: The astrocyte proliferation distributed in the whole brain after MCAO. The highest numbers of GFAP-positive cells were observed at A area, then B area. The lowest numbers of GFAP positive cells were found in C area. The time course of GFAP-positive cell change was that the highest number was observed at 1 week after MCAO, then decreased by time from 3, 6 weeks to 9 weeks. The optical density of GFAP-positive cells showed the same patterns. CONCLUSION: The correlation between astrocyte proliferation and tissue damage after MCAO can be estimated by GFAP expression. The astrocyte proliferation plays an important role in healing process after MCAO.

BACKGROUND: At present, there is few reports about using middl ecerebral artery obstraction (MCAO) model to determine the repair course of cerebral infarction during functional training.OBJECTIVE: To determine the effect of electro-stimulating therapy on promoting the rehabilitation of cerebral infarction and its mechanism.DESIGN: Randomized controlled study.SETTING: Animal Center and Electron Microscope Laboratory of Zhongshan University.MATERIALS: The experiment was carried out in the Animal Center of Zhongshan Medical College and Neurological Laboratory of the First Affiliated Hospital of Zhongshang University from January 2002 to December2004. A total of 200 healthy males SD rats, aged 3 months and weighing 90-110 g, were selected. According to the following criteria: SBP＞180mmHg (1 mmHg=0.133 kPa), BWT score of MCAO models which were reproduced by RHRSP was 1, totally 180 RHRSP were admitted to the research and divided into electro-stimulating therapy group (n=90) and control group (n=90).METHODS: Electro-stimulating was given to four accupuncture points of the paralyzed limbs of rats. The electro-stimulating treatment was given about 30 minutes once a day. And a therapy course was 6 days, and between two therapy courses there was one-day break. At the end of 1st, 3rd,6th and 9th therapy courses, the brain of motor function and tissue in marginal zone of cerebral infarction were assayed as follow: [1] The beam walking test (BWT, 1 as severe disorder and 7 as normal). [2] Electron microscope. [3] Astrpcyte glial fibriliary acidic protein, neurofilament protein and microtubule-associated protein-2 were assayed with immunohistochemistry. Five fields of each slice in the two groups were randomly selected to add up the positive cell number. Totally 30 positive cells of glial fibriliary acidic protein was selected to assay average absorbency (A) of positive cellular plasm. [4] Apoptosis of neurons were observed with in situ end-labeling (ISEL). [5] Brain-micro vasodilatatio was observed according to the criteria of one complete microvessel account under the field.MAIN OUTCOME MEASURES: [1] Scores of motor function; [2] Ultramicrostructure of cranial neurons and astrocyte; [3] Cranial glial fibriliary acidic protein, neurofilament protein and microtubule-associated protein-2;[4] Apoptosis of neurons; [5] Diastole of cerebral microvessel.RESULTS: Totally 180 rats were eligible while 20 rats were excluded because of their BWT score＞1 after MCAO operation. [1] Results of beam walking test (BWT): Functional recovery of paralysis limbs in electric stimulation group was better than that in control group from the third to the ninth course. In the ninth course, 6 points of rats in electric stimulation group was more than that in control group (42, 46, χ2=15.4, P ＜ 0.01). [2]Positive absorbency of cerebral glial fibriliary acidic protein: That in electric stimulation group was higher than that in control group in the 3rd, 6th,and 9th [(52.97±0.59)% vs (46.40±0.56)%; (49.44±0.80)% vs (46.40±0.56)%;(43.25±0.48)% vs (34.20±0.50)%, P ＜ 0.05]. [3] Assay of neurofilament protein: That in electric stimulation group was higher than that in control group in the 6th and 9th course [(22.9±2.7)% vs (11.9±2.3)%; (26.5±1.7)%vs (11.7±1.5)%, P ＜ 0.05]. [4] Assay of microtubule-associated protein-2:That in electric stimulation group was higher than that in control group in the 6th and 9th course [(21.7±1.3)% vs (11.3±1.1)%; (24.4±2.1)% vs(11.9±2.3)%, P ＜ 0.05]. [5] Apoptosis of neurons: There was not significantly different between the two groups. [6] Results of open number of cerebral microvessel: That in electric stimulation group was higher than that in control group in the 1st, 3rd, 6th and 9th course (33 vs 19; 48 vs 31;45 vs 25; 46 vs 23, Z=-2.309, P ＜ 0.05).CONCLUSION: Electro-stimulating treatment can promote motor function of paralyzed limbs, which was due to that electro-stimulating treatment may promote extinction of the swollen feet of astrocytes, reinforce neurons activity and arouse the dilatation of cerebral capillary which promote the microvascular dilatation in order to improve cerebral blood circulation.

Objective To observe the effect of electro-acupuncture therapy (ET) on the expression of sodium channel Na(v) 1.1 in rats after acute cerebral ischemia and the mechanism of any protective function of ET.Methods A model of focal acute cerebral ischemia was established by occluding the right middle cerebral artery.One hundred and eighty healthy SD rats were randomly divided into a sham operation control (SC) group, an ischemia control (IC) group, a real ET group and a false ET group, with 45 in each group. Immunohistochemistry and real-time polymerase chain reaction (PGR) methods were used to detect Na(v)1. 1 expression. 2,3,5-triphenyl tetrazolium chloride (TTC) staining was used to detect infarct volume. Neurological examination and grading was carried out at 6 hours and then 1, 2, 3 and 7 days after inducing ischemia. Results The gradings and infarction volume ratios of the rats in the IC group were the most serious, while in the real ET group the severity was much less at each time point. Compared with the SC group, the expression of Na(v) 1.1 was significantly up-regulated in the IC group. The expression of Na(v) 1.1 was increased at the 6th hour, then down-regulated to the lowest level at day 1,then from the 2nd to the 7th day was up-regulated again. The expression of Na(v) 1.1 in the real ET group was significantly lower than in the IC group. Although the expression of Na(v)1.1 in the false ET group was low compared with the IC group, the difference was not significant. The difference between the real ET group and the false ET group was significant, however. Conclusions ET can reduce damage from cerebral ischemia and benefit the recovery of neural function. ET can also could regulate the expression of Na(v)1.1 after acute cerebral ischemia, which may be an important mechanism for neural function recovery.

The present study aimed to explore the neuroprotective effect and possible mechanisms of rhGLP-1 (7–36) against transient ischemia/reperfusion injuries induced by middle cerebral artery occlusion (MCAO) in type 2 diabetic rats. First, diabetic rats were established by a combination of a high-fat diet and low-dose streptozotocin (STZ) (30 mg/kg, intraperitoneally). Second, they were subjected to MCAO for 2 h, then treated with rhGLP-1 (7–36) (10, 20, 40 µg/kg i.p.) at the same time of reperfusion. In the following 3 days, they were injected with rhGLP-1 (7–36) at the same dose and route for three times each day. After 72 h, hypoglycemic effects were assessed by blood glucose changes, and neuroprotective effects were evaluated by neurological deficits, infarct volume and histomorphology. Mechanisms were investigated by detecting the distribution and expression of the nuclear factor erythroid-derived factor 2 related factor 2 (Nrf2) in ischemic brain tissue, the levels of phospho-PI3 kinase (PI3K)/PI3K ratio and heme-oxygenase-1 (HO-l), as well as the activities of superoxide dismutase (SOD) and the contents of malondialdehyde (MDA). Our results showed that rhGLP-1 (7–36) significantly reduced blood glucose and infarction volume, alleviated neurological deficits, enhanced the density of surviving neurons and vascular proliferation. The nuclear positive cells ratio and expression of Nrf2, the levels of P-PI3K/PI3K ratio and HO-l increased, the activities of SOD increased and the contents of MDA decreased. The current results indicated the protective effect of rhGLP-1 (7–36) in diabetic rats following MCAO/R that may be concerned with reducing blood glucose, up-regulating expression of Nrf2/HO-1 and increasing the activities of SOD.
Animals ; Blood Glucose ; Brain ; Diet, High-Fat ; Hypoglycemic Agents ; Infarction ; Infarction, Middle Cerebral Artery ; Malondialdehyde ; Neurons ; Neuroprotective Agents ; Phosphotransferases ; Rats* ; Reperfusion ; Reperfusion Injury* ; Streptozocin ; Superoxide Dismutase

Objective: To investigate the spectrum of gene mutations in adult patients with B-acute lymphoblastic leukemia (B-ALL), and to analyze the influences of different gene mutations on prognosis. Methods: DNA samples from 113 adult B-ALL patients who administered from June 2009 to September 2015 were collected. Target-specific next generation sequencing (NGS) approach was used to analyze the mutations of 112 genes (focused on the specific mutational hotspots) and all putative mutations were compared against multiple databases to calculate the frequency spectrum. The impact of gene mutation on the patients’ overall survival (OS) and recurrence free survival (RFS) was analyzed by the putative mutations through Kaplan-Meier, and Cox regression methods. Results: Of the 113 patients, 103 (92.0%) harbored at least one mutation and 29 (25.6%) harbored more than 3 genes mutation. The five most frequently mutated genes in B-ALL are SF1, FAT1, MPL, PTPN11 and NRAS. Gene mutations are different between Ph⁺ B-ALL and Ph^- B-ALL patients. Ph^- B-ALL patients with JAK-STAT signal pathway related gene mutation, such as JAK1/JAK2 mutation showed a poor prognosis compared to the patients without mutation (OS: P=0.011, 0.001; RFS: P=0.014,<0.001). Patients with PTPN11 mutation showed better survival than those without mutation, but the difference was not statistically significant (P value > 0.05). Besides, in Ph⁺ B-ALL patients whose epigenetic modifications related signaling pathway genes were affected, they had a worse prognosis (OS: P=0.038; RFS: P=0.047). Conclusion Gene mutations are common in adult ALL patients, a variety of signaling pathways are involved. The frequency and spectrum are varied in different types of B-ALL. JAK family gene mutation usually indicates poor prognosis. The co-occurrence of somatic mutations in adult B-ALL patients indicate the genetic complex and instability of adult B-ALL patients.

Objective: To analyze the incidence trends and to describe the characteristics of soft tissue sarcoma (STS) among residents in Beijing from 1999 to 2013. Methods: Medical information of the cases diagnosed as STS(ICD10: C47&C49) from 1999 to 2013 in Beijing was extracted from the population-based database of Beijing Cancer Registry.Crude incidence rate, age-standardized incidence rates to Chinese population (ASRC)and the world population(ASRW) were calculated. The characteristics of the STS cases in different gender and age groups from urban and rural areas were respectively analyzed.The incidence trends and annual percentage changes (APC) during last 15 years were analyzed by using JoinPoint 3.4.3 software. Results: A total of 2 048 cases were diagnosed as STS during the study period and the incidence rate of STS was 1.15 per 100 000 person-years. The ASRC was 0.74 per 100 000 person-years and ASRW was 0.86 per 100 000 person-years, respectively. Except for the impact of changes in the age composition, the APC of ASRW from 1999 to 2013 was 3.95%. For males, the incidence rate was increased from 0.65 per 100 000 in 1999 to 1.51 per 100 000 in 2013, and the APC was 4.27% (P<0.05); For females, the incidence rate was increased from 0.61 per 100 000 in 1999 to 0.91 per 100 000 in 2013, and the APC was 3.38% (P<0.05). In urban area, the incidence rate increased from 1.14 per 100 000 in 2000 to 1.35 per 100 000 in 2013, and the APC was 2.70% (P=0.05); In rural area, the incidence rate increased from 0.57 per 100 000 in 2000 to 0.98 per 100 000 in 2013, and the APC was 4.66% (P=0.04). 85.89%cases were pathologically diagnosed.Among them, undifferentiated pleomorphic sarcoma was the most common subtype, which accounting for 19.22%, followed by liposarcoma (19.04%), malignantnerve sheath tumor (10.18%), fibrosarcoma (10.06%)and sarcoma without definite type(7.22%). Conclusions The incidence rate of STS is still increasing, especially in the rural area of Beijing. The most common subtypes of STS in different age-groups were different. Further study is needed to explore the high risks of STS in the population with specific characteristics.