Vascular cognitive impairment (VCI) is a cognitive impairment caused by cerebrovascular disease and its risk factors,its mechanism is very complex Recent studies have shown that cerebral microbleed (CMB) is correlated with VCI.This article reviews the relationship between CMB and VCI.

Thirty New Zealand albino rabbits of both sexes were used for the experi-ments which was (1) To observe the febrile response induced by microinjection of TNFinto the lateral ventricle; (2) To measure the PGE_2 & cAMP contents of the plasma andcerebrospinal fluid. The results showed that injection of TNF (50ng/each) into the lateralventricle did induce a definite raise of body temperature (T=0.79?0.14℃). The PGE_2concentration increased markedly in c. s. f. while that in plasma remain unchanged ascompared with the control. However cAMP lever in both, plasma and c. s. f. had nochange. These results suggested that (1) The injection of TNF into the lateral ventriclecaused a raise in PGE_2 synthesis in the brain while there was no alterations of PGE_2found in peripheral blood (2) The increase in PGE_2 didn't followed by an increase incAMP which indicated that the fever induced by TNF must have a different mechanismfrom that induced by leucocyte pyrogent (LP or In-1). PGE_2 might be involved in thefever inducing mechanism but these results don't support the hypothersis that the raiseof PGE_2 level may increase the cAMP content which in turn reduced the fever.

Autophagy generally exists in organisms as a protective mechanism against external pressure, and myocardial autophagy plays a vital role to maintain myocardial function. Early exercise-based rehabilitation improves health-related quality of life and functional capacity after acute myocardial infarction. This paper summarized the role of autophagy in sport rehabilitation for myocardial infarction and possible mechanisms.

Objective: The aim of this study was to develop and assess the computer-assisted fabricated individual titanium mesh technique applied for reconstruction of fractured orbital walls to correct post-traumatic enophthalmus and diplopia. Methods: Twenty patients (12 males and 8 females) were inclu-ded in this study. All of patients suffered from unilateral impure orbital fractures. Group A included 8 patients who were reconstructed for the fractured orbit with computer-assisted fabricated titanium mesh technique. Group B had 12 patients treated with traditional methods (titanium meshes in 2, autogenous bone grafts in 7 and Medpor implantation in 3). CT data of group A was input into a image software to rebuild a 3-D orbit and then mirror the unaffected side onto the affected side to replace the demolished orbit. A resin model of the reshaped orbit was then produced and was used to develop custom-fabricated titanium mesh for repair of the fractured orbital wall. The fabricated mesh was used in operation to reconstruct the orbital wall. Treatment was assessed in comparison with traditional way by means of clinical examinations and CT measurements. Results: The difference between pre-operative and post-operative enophthalmos: the mean value of group A was 2.6 mm, group B was 2.0 mm;the difference between the pre-operative and post-operative enlargement volume of traumatic orbit: the mean value of group A was 4.3 mL, group B was 3.7 mL; Index of Medial orbital wall of both groups was 100% and Index of inferior wall reconstruction of group A was 84.7%, group B was 53.3%; The mean depth of implants of group A was 31.2 mm, of group B was 28.3 mm; Improvement of diplopia of group A was 1.5 quadrants, that of group B was 1 quadrant. There were no infection, gaze restriction, or graft extrusion in all patients after operation. Conclusion: Computer-assisted fabricated titanium mesh technique could provide more accurate orbital reconstruction and improve the correction of enophthalmus and diplopia.

Objective To evaluate the value of the fusion of 99m Tc-MIBI imaging technology apply in the diagnosis of malignant lung tumor. Methods Thirty - four cases with lung nodules proved by X-ray and/or CT scanning, a total of 48 lung nodular lesions. And the imaging with-99m Tc-MIBI of chest performed at 10 minutes and 2 hours delayed after injection by GE Infinia Hawkeye 4 SPECT-CT. then the regions of interesting ( ROI) were drawn in the tumor and contra lateral position to calculate the radioactivity ratios of tumor to normal ( T/NT) , and fused with the spiral CT scanning image in the same machine, and reading the early and delayed image respectively. Judged the result of the image develops, and statistical analysis of the ratio (T/NT) according to the final pathologic consequence. Results All cases with total of 48 nodular lesions, 21 nodules were positive in early imaging, 16 nodules were positive in delayed imaging (the ratio T/NT over 3. 33). defined the delayed image positive as the final criterion, The(T/NT)ratios of Malignant lung lesions were significantly higher than the benign lesions ( P ＜0. 05). Negative nodes 27, 13 cases of lung cancer lesions were malignant, confirmed by postoperative pathologic examination. The falsepositive nodules 3, false-negative nodules 2. The sensitivity was: 88.88%, the specificity was: 90.9% positive predictive value ( +PV) was: 84. 21% , negative predictive value (-PV) is: 93.75%. Conclusion 99mTc-MIBI as a tumor positive imaging agent is highly sensitivity to lung lesions, but specificity is not so high.

Objective To evaluate the effect of mild hypothermia on the recovery from cisatracurium blockade during the recovery from anesthesia in patients .Methods Thirty ASA physical status Ⅰ or Ⅱ patients , aged 18-64 yr , with body mass index 18-25 kg/m2 , scheduled for elective abdominal surgery under general anesthesia ,were enrolled in the study .The patients were divided into 2 groups according to the body temperature recorded when cisatracurium infusion was stopped at the end of surgery .The body temperature 36.0-36.9 ℃served as normothermia group (group N , n=14 ) and 34.0-35.9 ℃ served as mild hypothermia group (group H , n= 16 ) . The body temperature was measured by a thermocouple placed in the nasopharynx . Neuromuscular function was monitored by measuring the evoked mechanical response of the adductor pollicis muscle to supramaximal train-of-four (TOF) stimulation (frequency 2 Hz ,wave length 0.2 ms ,intensity 50 mA ,interval 15 s) of the ulnar nerve at the wrist using TOF-Watch SX? .Cisatracurium was intravenously infused at 1-3μg·kg-1 ·min-1 during surgery to maintain neuromuscular block with 1%

Objective To investigate the risk factors for vascular cognitive impairment and the effet of cerebral microbleeds (CMBs) on cognitive function in patients with ischemic stroke.Methods The data of patients with ischemic stroke over the age of 50 were collected.The Montreal cognitive assessment (MoCA) scale and Alzheimer's disease assessment scale-cognitive subscale were used to evaluate cognitive function.Hamilton depression scale (HAMD) was used to evaluate the depression status in order to exclude the patients with depression.The patients with ischemic stroke were divided into either a cognitive impairment group or a non-cognitive impairment group according to the scale evaluation results.The demographic and clinical characteristics in both groups were compared,and the multivariate logistic regression analysis was used to look for the independent risk factors for cognitive impairment in patients with ischemic stroke.The Spearman rank correlation method was used to analyze the degree of CBMs,total score of MoCA,and the correlations of all cognitive domains scores.Results A total of 169 patients with ischemic stroke were enrolled in the study.There were 80 patients in the cognitive impairment group and 89 in the non-cognitive impairment group; 34 patients had CMBs and 135 had no CMBs.The age was older (71.99 ±6.01 years vs.64.47 ±6.15 years; t =8.014,P =0.000),years of education were fewer (4.51 ± 1.534 years vs.6.94 ±2.357 years; t =8.023,P =0.000),systolic blood pressure was higher (156.19± 17.53 mm Hg vs.142.04± 16.03 mmHg,1 mmHg=0.133 kPa; t =5.479,P =0.000),scale of white matter lesion was higher (7.33 ± 2.04 vs.4.39 ± 2.17; t =8.951,P =0.000),cerebral infarction volume was larger (7 123.8 ± 1 587.1 mm3vs.5 628.4 ± 1 017.8 mm3;t =7.201 ; P =0.000),proportion of the patients with history of previous stroke or transient ischemic attack was higher (46.2％ vs.28.1％;x2 =5.982; P=0.014),and number of CBMs was larger (x2 =17.565; P=0.000) in the cognitive impairment group.Multivariate logistic regression analysis showed that the age (odds ratio [OR] 1.115,95％ confidence interval [CI] 1.013-1.227; P =0.026),years of education (OR 0.490,95％ CI0.325-0.793; P=0.001),systolic blood pressure (OR 1.048,95％ CI 1.014-1.083; P =0.005),scale of white matter lesion (OR 2.044,95％ CI 1.466-2.851; P =0.000),and cerebral infarction volume (OR 2.204,95％ CI 1.386-3.503; P =0.001) were all the independent risk factors for cognitive impairment in patients with ischemic stroke.Compared to the non-CBM group,the age was older (72.06 ± 5.59 years vs.67.01 ±7.15 years; t =4.427; P =0.000),years of education were fewer (3.97 ± 1.381 years vs.6.25 ±2.317 years; t =7.367,P =0.000),systolic blood pressure was higher (155.03 ±20.16 mm Hgvs.147.16 ±17.32 mm Hg; t =2.290,P =0.023),scale of white matter lesion was more higher (7.03 ±2.139 vs.5.47 ±2.591; t =3.247,P =0.001),cerebral infarction volume was larger (6 968.5 ± 1 507.4 mm3 vs.6 177.0 ±1 477.1 mm3; t =2.735,P =0.007),and proportions of hypertension (82.4％ vs.41.5％ ;x2 =18.149,P =0.000),hyperlipidemia (88.2％ vs.39.3 ％ ;x2 =26.067,P =0.000),history of previous stroke or transient ischemic attack (70.6％ vs.28.1％ ;x2 =21.061,P =0.000) and coronary heart disease (94.1％ vs.45.2％ ;x2 =26.278,P=0.000) were higher in the CBM group.The MoCA total score (M[Q1 ～ Q3]; 24 [24 ～25]vs.28 [27 ～ 28] ; Z =-7.092,P =0.000) as well as the scores of attention (6 [5 ～ 6] vs.6 [6 ～ 6] ; Z =-2.502,P =0.012),abstraction (2[1 ～2] vs.2[2 ～2] ; Z =-2.382,P =0.017) and visuoexecutive (2[1 ～2] vs.4[4 ～5]; Z=-7.321,P=0.000) in the CMB group were significantly lower than those in the nonCBM group.The Spearman rank correlation analysis showed that the CMB grade was negatively associated with the MoCA total score (rs =-0.879,P =0.000) as well as the scores of visuoexecutive (rs =-0.895,P =0.000),attention (rs =-0.337,P =0.005),and abstraction (rs =-0.333,P=0.006).Conclusions The age,years of education,systolic blood pressure,degree of white matter damage,and cerebral infarction volume are the risk factors for vascular cognitive impairment.The visuospatial executive dysfunction,attention and abstract thinking decline significantly in ischemic stroke patients with CBMs.CMBs and their numbers are closely associated with cognitive impairment.The more the CMB numbers are,the more obvious the cognitive impairment will be.

BACKGROUND: Within the bone marrow stroma there exists a subset of non-hematopoietic stem cells referred to as marrow stromal cells or mesenchymal stem cells. Mesenchymal stem cells (MSCs) are a group of cells with highly capability of self-renew and potential of multilineage differentiation, these properties make them present a promising prospect for clinical practice. Of particular concern is hepatogenic potential that can be used for liver-directed stem cell therapy and transplantation. However, the culture system has not been developed.OBJECTIVE: To explore whether human MSCs are able to differentiate into functional hepatocyte-like cells with hepatocyte growth factor (HGF) and basic fibroblast growth factor (bFGF) in vitro.DESIGN : Open study.SETTING: Department of Infectious Disease and Institute of Urology Surgery, First Affiliated Hospital, Nanchang University.MATERIALS: The study was performed in the Institute of Urolgoy Surgery, the First Affiliated Hospital of Nanchang University from July 2004 to March 2005. Bone marrow was donated by healthy adult with informed consent. DMEM/F12 medium (Gibco); insulin, transferrin, human epidermal growth factor (EGF); human HGF; monoclonal antibodies against human AFP; FITC-conjugated rabbit anti-mouse IgG (Sigma); human bFGF (Invitrogen); monoclonal antibodies against human CK18 and CK19 (Chemicon); fetal bovine serum (Si jiqin, Hangzhou).METHODS: Bone marrow (10 mL) in this study was aspirated from the iliac crest of healthy donors. MSCs were isolated by density gradient centrifugation in combination with plastic adherence. For hepatic differentiation, the 4th- to 8th-passage human MSCs seeded on 24-well tissue culture plates coated with 0.1% gelatin, at 1×104 MSCs/mL, were serum deprived for 2 days, in DMEM/F12 supplemented with 10 μg/L EGF, 10 μg/L bFGF, 5 mg/L insulin and 5 mg/L transferrin. Differentiation was induced by treating MSCs with differentiation medium, consisting of DMEWF12 supplemented with 10 μg/L bFGF, 20 μg/L HGF, 5 mg/L insulin, 5 mg/L transferrin. Medium changes were performed every three days. MSCs without HGF and bFGF in medium served as the control. In the differentiating period, the concentration of AFP in the suernatant was determined dynamically by radioimmunoassay (RIA). The hepatic surface phenotype including AFP, CK18 and CK19 were identified by immunofluorescent staining at day 0, 7, 14, 21 and 28. Glycogen storage was detected by Periodic Acid-Schiff (PAS) staining.MAIN OUTCOME MEASURES: ① the morphological changes of induced MSCs; ② the concentration of AFP in the supernatant; ③ the hepatic surface phenotype; ④ glycogen storage.RESULTS: ① After 14 days ofinduction, the fibroblast-like morphology of human MSCs was lost and cells became broadened and fiattened. After prolonged culture, polygonal cells were seen and further matured hepatocyte-like colonies were seen by day 28. ② The concentration of AFP in the supernatant was first detected on day 14, at a concentration of 0.1 μg/mL, and increased to 0.4 μg/mL by day 17, then decreased to 0.3 μg/mL by day 21. ③ Immunofiuorescent staining showed the expression of AFP and CK18 until day 14. The expression of CK19 was detected by day 28. ④ Glycogen storage could be detected by day 21.CONCLUSION: Human bone marrow MSCs are able to differentiate into functional hepatocyte-like cells and may sere as a new source of cells for cell therapy of hepatic diseases.

We present a case of subarachnoid hemorrhage induced by chronic suppurative otitis media and discuss the possible mechanism here. Chronic suppurative otitis media is a common suppurative inflammation of middle ear, which can cause sorts of extracranial and intracranial complications in the situation of lower resistance or higher virulence. However, the condition of subarachnoid haemorrhage caused by chronic suppurative otitis media is quite rare. According to this case and previously published articles, we consider that meningitis may be the main reason of subarachnoid hemorrhage induced by chronic suppurative otitis media.
Chronic Disease ; Ear, Middle ; Female ; Humans ; Meningitis ; complications ; Middle Aged ; Otitis Media, Suppurative ; complications ; Subarachnoid Hemorrhage ; complications

Objective To investigate the effects of low-concentration lidocaine on the persistent sodium currents enhanced by hypoxia in isolated rat CA1 hippocampal neurons. Methods Brains were harvested from 10-14 day old SD rats of both sexes. Hippocampi were immediately isolated and cut into slices (400-500 ?m) which were incubated in artificial cerebral-spinal fluid (ACSF) at 31 ℃ for 1-1.5 h. CA1 regions were isolated and hippocampal neurons were prepared by enzymatical digestion. The experiment was performed in 7 groups ( n = 10 each): hypoxie control group (C) and lidocaine 1, 3, 6, 10, 20, 30 ?mol groups (L1-6). The isolated neurons were transferred to the recording chamber. The persistent sodium currents were recorded using whole-cell patch clamp technique first under normal condition. The normal perfusion solution was then replaced with hypoxie and glucose free perfusion solution within 20 seconds. The persistent sodium currents were recorded again after being perfused with hypoxie and glucose free solution with and without lidocaine. Results The persistent sodium current was greatly enhanced after 5 min hypoxia as compared to the baseline value before hypoxia. The persistent sodium current in group L1-6 was significantly lower than that in group C after 5 min hypoxia. The inhibitory effect of lidocaine on the persistent sodium current enhanced by hypoxia was dose-dependent. Conclusion Low concentration lidocaine can inhibit the persistent sodium current enhanced by hypoxia.