Stroke is a type of neurological disease with high morbidity,disability,and mortality.It has become a global public health problem.At present,the stroke burden in countries around the world has shown an upward trend.This article reviews the extent of population health hazards caused by stroke,as well as the evaluation of economic burden of the disease.

Delayed cerebral vasospasm (DCVS) is an important incapacitating or lethal cause after subarachnoid hemorrhage (SAH),but the patho-physiological process was vague. The effective drugs of treating DCVS are particularly important including ion channel blockers or openers,endothelin synthetic inhibitor or receptor antagonist,anti-inflammatory agents,antioxidants,fibrinolytic agents,traditional Chinese herbs,etc. The article reviews the research progress in the preclinical and clinical pharmacotherapy on DCVS after SAH,and explores the applications and effects and debates about these therapeutic drugs at present.

AIM:Neural stem cells(NSCs)and their supporting factors are related to nerve regeneration after central nerve injury, but there are few evidences for the changes of NSCs and their derived supporting factors.This study explores the change of NSCs and gene expression of stem cell-derived neural stem/progenitor cell supporting factor(SDNSF)in the injured spinal cord tissues of rats,and investigates the relation between the NSCs and expressions of SDNSF. METHODS:The experiment was carried out in the laboratory of Nantong University Neuroscience Institute between September 2005 and March 2006.①A total of 27 SD rats,cleaning grade,were offered by the Animal Experimental Center of Nantong University.Twelve rats used for immunohistochemistry assay were divided into sham operation group and spinal cord injury group,while other 15 rats used for RT-PCR detection were assigned into sham operation group and spinal cord injury group.All the disposals were in agreement with the ethical standard for animals.②The spinal cord contusion model of rats was established according to Allen's falling strike method.Laminectomy was conducted without strike in the sham operation group.The quantity and morphology of NSCs,gila cells and SDNSF-positive cells were observed by immunochemistry to detect expressions of nestin,glial fibrillary acidic protein(GFAP)and SDNSF in the injured spinal cord on days 8 and 16 after injury.The expression of SDNSF mRNA in the injured spinal cord was studied by semi-quantitative RT-PCR on days 4,8,12,16 after injury. RESULTS:①There were nestin-positive cells about central canal of spinal cord in the sham operation group.The nestin-positive cells showed erupted roots,migrated peripherally and proliferation,some GFAP-positive cells emerged and the SDNSF-positive cells were observed,which were similar to neuron on morphology on day 8 after injury.The quantity of nestin-positive cells decreased obviously,there were a number of GFAP-pesitive cells and few SDNSF-positive cells were showed on day 16 after injury.②RT-PCR revealed that SDNSF mRNA expressed in normal rate,and the expression was up-regulated on day 4 after injury,peaked on day 8,and decreased to the normal level on day 16. CONCLUSION:①There are some NSCs about the central canal of spinal cord,which proliferate and soon may differentiate to gila cell after injury in normal rats.②SDNSF is expressed in the normal spinal cord.The expression of SDNSF mRNA in the spinal cord varies with injured time,accompanying the proliferation and differentiation of NSCs. There are intimate relations between NSCs and expression of SDNSF in the repair of spinal cord injury.

Objective: To study the effect of dexamethasone in differentiating human glioma cell line .Methods: The human glioma cell line was incubated with l mg/L dexamethasone in 1640 culture medium with 10% vitulary serum for 48 hours. The cell form was observed by contrapositive microscope,and PHA was used to induce the agglutination of these cells.Mitotic index and AgNOR amount was counted. The expression of GFAP was detected by immunocytochemisty.Rusults: SHG 44 cells incubated with dexamethasone adhered to plate firmly and its shape became astroid .The agglutination degree and mitotic index decreased significantly .The Ag NOR was atrophied and its amount decreased.The Immunocytochemistry showed the content of GFAP increased sign ficantly.Conclusion: Dexamethasone plays a role in differentiating human glioma cell.

Objective To investigate the effect of normal saline(NS)of different temperature on morphological changes and nitric oxide synthase(NOS)expression of spinal cord.Methods The spinal canal of 96 SD adult rats was opened at T9.which of 24 rats was flushed with 37 ℃ NS,24 with 20 ℃ NS,24 with 4 ℃ NS respectively,and which of 24 rats in control group received no flushing.The spinal canal was closed one hour later,and the spinal cord was taken out 24 hours later.Then the water content in spinal cord was determined by dry-wet method.The morphological changes of spinal cord were observed under light microscope and the electronic microscope.The amount of NOS-positive neuron was measured by ?-NADPH histochemical methods.Results The water content in spinal cord was(66.53?0.61)% in control group,(66.75?1.00)% in 37 ℃ group,(70.55?0.77)% in 20 ℃ group,(71.92?2.50)% in 4 ℃ group.The spinal cord of control group and 37 ℃ group contained less water than that of 20 ℃ group and 4 ℃ group.There were no obvious morphological changes in the control group and 37 ℃ group.In 20 ℃ and 4 ℃ groups,the demyelination of axon,swelling of cell body and the disappearance of tigroid body were observed under light microscope,the partial disaggregation of medullary sheath,swelling of mitochondria and disappearance of mitochondria crista could be observed under electron microscope.The amount of NOS-positive neuron in spinal cord was(18.75?2.12),(18.63?1.41),(14.75?1.67),(8.13?1.25)in control,37 ℃,20 ℃ and 4 ℃ groups,respectively.The control group and 37 ℃ group showed more NOS-positive neuron than those of 20 ℃ group and 4 ℃ group.Conclusion NS below 20 ℃ can injury spinal cord.It is suitable to choose 37 ℃ NS to flush brain and spinal card during operation.

Objective To evaluate the efficacy and safety of domestic human recombinant FSH (rhFSH) in women with anovulation of WHO groupⅡ. Methods A randomized, blind, parallel-controlled, non-inferiority and multicenter study was performed. A total of 534 admitted to 13 hospitals from May 2008 to August 2009. There were 531 women with ovulatory disorder was included in the statistical analysis, were randomly divided into test group (domestic rhFSH, n=352) and control group (imported rhFSH, n=179). Percentage of cycle with mature follicle, ovulation rate, clinical pregnancy rate, multiple pregnancy rate, ovarian hyperstimulation syndrome (OHSS) and adverse events were observed. Results No statistical significant differences (P>0.05) were observed between the two groups in terms of the efficiency on mature follicle [91.8%(323/352) versus 88.8%(159/179)], ovulation rate [91.3%(295/323) verus 90.6%(144/159)], clinical pregnancy rate [19.2%(62/323) verus 18.2%(29/159)], the number of the follicles<14 mm, the level of serum LH and progesterone, the thickness of endometrium on the day of hCG administration. The number of follicle≥18 mm and 14 mm≤follicle<18 mm and the level of serum estradiol on the day of hCG in the test group were significantly higher than those in the control group (P<0.05). The number of days of rhFSH administration in the test group was significantly less than that in the control group [(9.8±2.2) versus (11.4± 0.6) days, P<0.05], the dosage of rhFSH was significantly lower than that in the control group [(879 ± 419) versus (1 043 ± 663) U, P<0.05]. The multiple pregnancy rate in the test group was significantly higher than that in the control group [21% (13/62) versu 10% (3/29), P<0.05]. The incidence of OHSS and adverse events were similar between the two groups (P>0.05), and no other adverse events were observed in test group during treatment. Conclusion Ovarian stimulation with domestic rhFSH is effective, safe and economical in women with anovulation of WHO groupⅡ.

Objective:To investigate the effect of salvianolic acid C (SalC) on fibroblast-like synoviocytes and through the role of nuclear factor-erythroid 2-related factor 2 (Nrf2) pathway.Methods:Rheumatoid arthritis-fibroblast-like synoviocytes (RA-FLSs) were exposed to different concentrations of SalC (0.1 μmol/L, 1 μmol/L, 5 μmol/L, 10 μmol/L, 20 μmol/L) for 24-72 h and measured for viability, proliferation, migration and invasion by Cell counting kit 8 (CCK-8) assay, wound-healing and transwell assay. The levels of Tumor Necrosis Factor-α (TNF-α), Interleukin-1 beta (IL-1β) and IL-6 were measured by enzyme linked immunosorbent assay (ELISA). Western blot was used to detect the expression of matrix metallopeptidase (MMP)-9, MMP-13, apoptosis-related proteins and Nrf2 mediated gene. Then we used ML385 to inhibit Nrf2 signaling pathway. RA-FLSs were measured for migration and invasion, and the expression of proteins related to apoptosis, inflammation and Nrf2 pathway.Results:Compared with the control group, SalC inhibited the cell migration significantly (0.1 μmol/L, 0.75±0.05, t=7.65, P<0.001; 5 μmol/L, 0.50±0.05, t=14.25, P<0.001; 10 μmol/L, 0.26±0.05, t=20.67, P<0.001) and invasion (0.1 μmol/L, 0.75±0.11, t=4.93, P<0.001; 5 μmol/L, 0.49±0.06, t=10.32, P<0.001; 10 μmol/L, 0.26±0.07 , t=14.96, P<0.001) of RA-FLs, reduced the levels of MMP-9 (0.1 μmol/L, 0.72±0.10, t=5.60, P<0.001; 5 μmol/L, 0.48±0.08, t=11.03, P<0.001; 10 μmol/L, 0.27±0.06, t=15.94, P<0.001) and MMP-13 (0.1 μmol/L, 0.77±0.06, t=8.66, P<0.001; 5 μmol/L, 0.58±0.06, t=11.03, P<0.001; 10 μmol/L, 0.32±0.13, t=14.22, P<0.001), and promoted apoptosis. SalC reduced the level of pro-inflammatory cytokines significantly ( P<0.001) and activated the expression of Nrf2 signaling pathway proteins Nrf2, CAT, NQO1, SOD1 and GSS ( P<0.001). After ML385 was used to interfere Nrf2, the levels of SalC on Nrf2 pathway proteins, such as Nrf2 (0.68±0.06, t=5.08, P<0.001), CAT (1.44±0.12, t=4.77, P<0.001), NQO1 (0.65±0.12, t=5.04, P<0.001), SOD1 (1.43±0.10, t=6.36, P<0.001) and GSS (1.42±0.10, t=7.60, P<0.001), as well as the levels of TNF-α [(260±22) pg/ml, t=13.75, P<0.001], IL-1β [(701±30) pg/ml, t=12.98, P<0.001], IL-6 [(180±10) pg/ml, t=16.38, P<0.001) were significantly reduced. In addition, ML385 inhibited the inhibition of SalC on cell migration and invasion (0.70±0.09, t=11.24, P<0.001; 0.64±0.04, t=8.03, P<0.001) and induction of apoptosis (24.4±1.8, t=23.02, P<0.001). Conclusion:SalC may inhibit cell activity and inflammatory response, promote apoptosis via the upregulation of Nrf2 signaling pathway. SalC may have therapeutic potential in RA. However, further investigation are needed in animal models and human.

Objective:To study the clinicopathological characteristics, diagnosis and differential diagnosis of bronchiolar adenoma (BA).Methods:Fifteen cases of BA were collected from the First Affiliated Hospital of Nanjing Medical University, from January 2016 to October 2019. The clinical data, imaging examination, morphology, immunostaining and molecular changes were retrospectively analyzed.Results:There were 3 males, 12 females, most of the patients were female, mainly in middle-aged to elderly (51-77 years). Three had smoking history. The patients usually had no clinical symptoms. Imaging findings were ground-glass and/or lobulated nodules. Grossly, the tumors were gray-whitish, taupe solid or focally microcystic nodules with distinct boundary but no capsule. The maximum diameter was 0.4-2.5?cm (mean 1.0?cm). Histologically, there were glandular, papillary, or flat patterns that were composed of basal cells, mucous cells, ciliated cells and type Ⅱ pneumocytes, some of which showed basal cell proliferation and squamous cell metaplasia. However, there were some cases with few or even without mucous and/or ciliated cells. Immunostaining highlighted the continuous basal cell layer (positive for p63, p40 and cytokeratin 5/6), which was the most important diagnostic evidence. Genetic tests did not show mutation in BRAF or EGFR genes. All patients were followed up for 1-41 months, and they were without recurrence or metastasis.Conclusions:BA is a benign neoplasm that develops in the peripheral lung with good prognosis. Definite diagnosis is very crucial for surgical treatment, especially in frozen consultation. Immunohistochemistry will be helpful if necessary.

Optical Coherence Tomography(OCT) system may cause dislocations and distortions of the collected image volumetric?data when proceeding dynamic 3D imaging because of the involuntary movements of eyebal, which wil result in misdiagnoses during clinical diagnosis. The optic disk region of human eye has much more complex structure and further more blood vessels compared with macular region, which means the conventional image correction method aiming at macular region can not apply to optic disk region. In this paper, we propose a X direction artifact correcting method based on pixel row correlation matching algorithm of C-Scan, specifi c to the structural features of human eye optic disk region OCT images. Moreover, using this method, we can estimate whether the image sequences with motion artifacts have part image repetition or missing or not, and we can further confi rm the positions and numbers of repetition and missing with the help of Y direction 2D scan images. Model verifi cation indicates that this method can effectively rebuild the real image sequences and truly refl ect the physiology structure of retina.

Objective To explore the predictive value of combined detection of immunoglobulin binding protein 1(IGBP 1)in serum and urine in lupus nephritis(LN).Methods A total of 60 LN patients were selected as LN group,and 60 SLE erythematosus(SLE)patients in the same period were selected as SLE group,the serum IGBP 1 and urinary IGBP 1 levels between the two groups were compared,and the value of serum IGBP 1,urinary IGBP 1 and their combination in predicting LN was analyzed.Results Serum IGBP 1 and urinary IGBP 1 in the LN group were significantly higher than those in the SLE group(P＜0.05).Binary Logistic regression analysis showed that serum IGBP 1 and urinary IGBP 1 were risk factors for LN(P＜0.05).Receiver Operating Characteristic(ROC)curve revealed that the area under the curve(AUC)for serum IGBP1,urinary IGBP1,and their combined detection for LN was 0.856,0.834,and 0.902,respectively.The Youden index was 0.533,0.533,and 0.666,respectively.The sensitivity and specificity of serum IGBP1 were 85.0％and 68.3％,re-spectively.The sensitivity and specificity of urinary IGBP1 were 53.3％and 100.0％,respectively.The sensitivity and specificity of the combined detection were 78.3％and 88.3％,respectively.Con-clusion Serum IGBP 1 and urinary IGBP 1 are highly expressed in LN patients,and their combina-tion has a high predictive value for LN.