The clinical diagnosis of cerebral small vessel disease (CSVD) is largely dependent on neuroimaging. Features seen on neuroimaging of CSVD include white matter hyperintensities, lacunes and lacunar stroke, microbleeds, and perivascular spaces, suggesting brain tissue injury secondary to microvascular changes. Additionally, with the rapid development of neuroimaging method, several new methods from magnetic resonance imaging (MRI), functional MRI and positron emission computed tomography are applied in the clinical diagnosis of CSVD. Therefore, unified understanding of terminology and de?nitions for imaging features of CSVD, and of protocols for image acquisition and assessment, makes a significant meaning in clinical diagnosis and research of CSVD.

Objective To compare the predictive values of the classification of clinical symptoms(OCSP classification), brain images and artery abnormalities on prognosis of cerebral infarction. Methods Totally 116 acute ischemic stroke patients were divided into 4 subtypes based on the OCSP clinical classification. Lesion distributions were classified into cortical infarction, basal ganglion infarction, centrum ovale infarction and posterior infarction according to brain MRI image. Artery abnormalities were grouped into large artery disease and small artery disease according to the results of transcranial doppler, brain MRA, carotid duplex sonography or cerebral angiograph. The neurological function of patients 1 year after onset was evaluated by Barthel index and Rankin scale. Kaplan-Meier survival curves were graphed, and log-rank testing was performed to investigate the differences among stroke subtypes. Results OCSP clinical classification and brain image classification predicted the neurological function recovery 1 year after stroke onset, but it might be based on the size of the lesion whether it caused a dominant factor or not. Patients with small artery disease were found having a lower recurrence and mortality rate, as compared those with large artery diseases(0 vs 17.9%, Log-rank test, P=0.03). Conclusions There might be differences in predictive value among these 3 classification methods upon the prognosis of cerebral infarction.

The cerebral ischemia was produced by Pulsinellis method in Sparaque-Dawley rats. The brain edema and survival rate of rats with bilateral carotid and vertebral arteries occlusion for 60 min were observed in ip tetradrine at doses of 1 ~ 4 mg/kg groups and control rats.Superoxide dismutase and malondialdehyde in brain tissue were also measured by pyrogallol method and fluorescence spec-trometry. The results suggested that tetradrine have protective effect on cerebral ischemia, which was related to the inhibition of lipoxide and scavenging of oxygen free radical.

Objective To study the relationship between MRI and histopathological findings of cerebral schistosomiasis,and the value of MRI on this disease. Methods 18 patients with cerebral schistosomiasis proved by pathological examination and laboratory test were enrolled in the study. Plain and Gd DTPA enhanced MRI were performed in all patients with GE 1.5 T MRI scanner. Results The lesions were located in infratentorial region in 7 cases and in supratentorial region in 11. There were three types of pathological pattern in the disease including focal encephalitis and meningiomas (5), granuloma (12), and encephalatrophy (1). Most of the lesions were iso or hypointensity on T 1WI, hyperintensity on T 2WI, with nodules, spot or ring like enhancement, and periphery edema. Conclusion MRI manifestations of cerebral schistosomiasis have specific features,which is a very important tool in early diagnosis and follows up for this disease.

Objective: To investigate the alterations of bcl-2 gene family in the rat brain and the molecular mechanism of neuronal apoptosis follow ing traumatic brain injury (TBI). Methods: Male Sprague-Dawley rats were subjected to lateral fluid percussion brain injury(FPBI) of moderate severity. bax and bcl-xL mRNA and protein expression was detected by RT-PCR an d immunohistochemistry. In addition to morphological evidence of apoptosis, TUNE L histochemistry was used to identify DNA fragmentation in situ under both l ight and electron microscope, whereas characteristic internucleosomal DN A fragm entation of apoptosis was demonstrated by DNA gel electrophoresis. Resul ts: bcl-xL mRNA and protein decreased in the ipsilateral hemisphere t o the impact site as early as 6 h post-injury［(67.42±7.54)% and (85.85±5.72)% r espectively］. The decrease in bcl-xL mRNA and protein preceded apoptosis was observed 12 h post-injury. And this was the main cause of up-regulation of the ratio of bax to bcl-xL in the acute period(minutes-hours) followin g FPBI. bax mRNA and protein were observed to rise slowly, doubled 3 d post- injury, returned to sham level slowly. The delayed cell death (days-weeks) migh t associated with the up-regulation of pro-apoptotic gene bax. Conclusio n: The expression of bcl-xL and bax coincide with apoptosis following TBI. The reg ulation of bax and bcl-xL by TBI occur before transcription. The balance of bax/bcl-xL ratio determines the neurocytes to survive or die following FPBI.

Objective: To investigate the alteration of bcl- 2 gene family in the rat brain and the molecular mechanism of neuronal apoptosis following traumatic brain injury. Methods: Male Sprague -Dawley rats were subjected to lateral fluid percussion brain injury(FPI) of mo derate severity. Bcl-2, Bcl-x and Bax protein expression was detected by immun ohistochemistry. Results: (1) The immunoreactivity of Bcl-2 and Bcl-x protein decreased in the hippocampus ipsilateral impact site as early as 6 h post-injury, and this was the main cause of down-regulation of the ratio of Bcl-2+Bcl-x to Bax. (2) During 1-3 d after injury, the Bax protein express i on increased significantly, while the Bcl-2 and Bcl-x protein expression decre ased relatively slow. The decreased ratio of Bcl-2+Bcl-x to Bax was mainly due to the Bax up-regulation. Conclusion: The bcl-2 gene family is involved in neuronal apoptosis after FBI, and the protein expression alteration of the family members leads the neuronal cell to apoptosis.

Objective To investigate the association between the number of periphery artery atherosclerotic stenosis and cardio-cerebrovascular events in elderly people.Methods Totally 163 subjects aged 60 years and over (median age 83 years) in special outpatient service of PUMC Hospital were retrospectively reviewed and underwent Doppler ultrasound of carotid,lower extremity,and renal artery.General conditions,cardio-cerebrovascular events,risk factors and results of periphery artery ultrasound were assessed.Results Age (F =13.413,P ＜ 0.001 ),hypertension,hyperlipidemia and the statin users(x2 =24.961、13.592、16.207,all P＜0.001) significantly enhanced along with increasing number of peripheral artery stenosis (P＜0.001).The more the peripheral arteries stenosis,the more cardio-cerebrovascular events occurred (x2 =15.258,P ＜ 0.001).Symptomatic peripheral artery obstructive disease increased the prevalence of cardio-cerebrovascular events.Conclusions Multiple periphery artery atherosclerotic stenosis is associated with cardiocerebrouascular events and Doppler ultrasound is effective to detect high-risk patients.

Objective: To investigate the alteration of bcl 2 gene family in the rat brain and the molecular mechanism of neuronal apoptosis following traumatic brain injury. Methods: Male Sprague Dawley rats were subjected to lateral fluid percussion brain injury(FPI) of moderate severity. Bcl 2, Bcl x and Bax protein expression was detected by immunohistochemistry. Results: (1) The immunoreactivity of Bcl 2 and Bcl x protein decreased in the hippocampus ipsilateral impact site as early as 6 h post injury, and this was the main cause of down regulation of the ratio of Bcl 2+Bcl x to Bax. (2) During 1 3 d after injury, the Bax protein expression increased significantly, while the Bcl 2 and Bcl x protein expression decreased relatively slow. The decreased ratio of Bcl 2+Bcl x to Bax was mainly due to the Bax up regulation. Conclusion: The bcl 2 gene family is involved in neuronal apoptosis after FBI, and the protein expression alteration of the family members leads the neuronal cell to apoptosis.

Objective: To investigate the effects of adenosine A 1 receptor agonist N 6 cyclohexyladenosine(CHA) on neurofunction after fluid percussion injury in rats. Methods: The effects of CHA intra cerebroventricular injection 10 min before brain trauma on rats neurofunction and neuropathological changes were evaluated. Results: Compared with the control group, CHA could ameliorate the behavior deficits and improve pathological change. Conclusion: Adenosine A 1 receptor plays an important neuroprotective role in rat secondary injuries following brain trauma.

Objective Plasma levels of matrix metalloproteinase-9 ( MMP-9 ) and serum level of high-sensitivity C reactive protein (hs-CRP) were detected to investigate their distributions between patients with stable stroke and those with asymptomatic intracranial artery stenosis and to explore their clinical significance. Methods The mean level of the serum hs-CRP of the group with recurrent stroke (2.34 mg/L)was the highest, followed by that of the group with the stable stroke( 1.45 mg/L),asymptomatic intracranial artery stenosis ( 1.31 mg/L) and control group (0.96 mg/L) ( P = 0.001 ). The level of the MMP-9 was in sequence of recurrent stroke group ( 121.82 ± 72.99 ) μg/L ＞ asymptomaticintracranial artery stenosis group ( 119.18 ± 80.01 ) μg/L ＞ stable stroke group( 112.76 ± 59.66) μg/L,while no statistical significance was found among groups( P = 0.947 ). However, the level of MMP-9 of three patient groups( 118.08 ± 71.06 ) μg/L was significant higher than control group( 57.55 ± 10.44 )μg/L (P ＜0.001 ). The spearman analysis for the relationship showed that the concentration of MMP-9 was positively associated with that of hs-CRP ( r = 0.337, P ＜ 0.001 ). Conclusions The hs-CRP maintained a high level in stable stage of stroke. The MMP-9 level in the patients group was significant higher than control group and the level of MMP-9 was positively associated with that of hs-CRP which suggested MMP-9 might be correlated with atherosclerosis other than stroke occurrence.