Animal experiments and clinical studies have shown that intracerebral hemorrhage may damage the white matter.The pathophysiology mechanisms of cerebral white matter injury and repair after intracerebral hemorrhage is very complicated.This article reviews the related clinical and experimental evidence,pathophysiological mechanisms,and possible intervention strategies of cerebral white matter injury after intracerebral hemorrhage.

Animals ; Cattle ; Cell Line ; Electrophoresis, Polyacrylamide Gel ; Fluorescent Dyes ; chemistry ; Malondialdehyde ; chemistry ; Mice ; Microscopy, Confocal ; Serum Albumin, Bovine ; analysis ; chemistry ; metabolism ; Ultraviolet Rays

Objective To investigate the ATP binding cassette transporter A1 (ABCA1) expression in perihematomal tissue of mouse cerebral hemorrhage model induced by collagenase. Methods Stereotactic injection of type Ⅳ collagenase was used to induce a model of caudate putamen intracerebral hemorrhage in mice. The behavioral scores were use to assess neurological deficits at 24 h, 48 h and 72 h after model making. Neisserian staining was used to detect the morphology of neurons around hematomas.Immunohistochemical staining and Western blot analysis were used to detect the expression of ABCA1 around hematomas. Results Nissl bodies reduction, atrophy, necrosis of perihematomal neurons were observed and aggravated over time. Immunohistochemical staining and Western blot analysis showed that the expression level of ABCA1 in the perihematomal tissue was significantly higher than that in the sham operation group (all P < 0. 05), and the expression level increased significantly with time (all P < 0. 05 ).Conclusion ABCA1 was up-regulated after cerebral hemorrhage, suggesting that it might be involved in the pathological process of cerebral hemorrhage.

Objective To observe the therapeutic effect of endovascular embolization for perimedullary arteriovenous fistula(PMAVF).Methods Data of 8 PMAVF patients who underwent endovascular embolization were retrospectively analyzed.Findings of digital subtraction angiography(DSA)immediately and 6 months after treatment were reviewed,and the modified Aminoff-Logue score(mALS)was compared before and 6 months after treatment.Results Among 8 cases of PMAVF,there were 2 cases of type Ⅰ,5 cases of type Ⅱand 1 case of type Ⅲ,among them 3 were treated with Onyx glue while 5 with Glubrane glue.The immediate DSA results after treatment showed complete embolization of the fistula in all 8 cases,while those 6 months after treatment showed no recurrence.One case recovered and the other 7 cases improved,and mALS(2.25±2.12)6 months after treatment was lower than that(5.50±2.39)before treatment(P＜0.05).Conclusion Endovascular embolization could safely and effectively treat PMAVF.

Background: Anal fissure is one of the most common anal-rectum diseases, and approximately 10 percent patients with chronic anal fissure ultimately receive surgery. Relieving postoperative pain and protecting functions of the sphincter are central issues for coloproctologists. Objective: To evaluate the efficacy and safety of anoplasty in the treatment of chronic anal fissures. Design, setting, participants and interventions: In this prospective, multicenter, randomized controlled trial, 120 adult patients with chronic anal fissure were referred from Department of Coloproctology of Yueyang Hospital of Integrated Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Shanghai Municipal Hospital of Traditional Chinese Medicine. The patients were enrolled from January 2009 to April 2010 and randomly divided into study (mucosa advancement flap anoplasty, abbreviated as anoplasty) group and control (fissurectomy) group. The two groups were assessed separately, and the main outcome measures were observed for 2 weeks, with a short-term follow-up for 6 weeks. Main outcome measures: Degree of pain, haemorrhage and anal canal pressure were observed and recorded preoperatively, and on the third day, the fourteenth day and the sixth week postoperatively. The wound healing time was also recorded. Surgical complications of the two groups were recorded and compared on the third day and the sixth week postoperatively. The curative effects associated with the surgery were analyzed on the fourteenth day and the sixth week after surgery and the therapeutic results were evaluated. Results: Three patients were dropped out due to the early discharge from hospital and losing connection (1 in study group and 2 in control group). Overall the surgery showed that the anoplasty group had better results than the fissurectomy group in the curative effect on the sixth week after operation (P<0.05). Time of wound healing in the anoplasty group was (17.22±4.41) d and was better than (21.24±7.44) d of the fissurectomy group (P<0.05). Concerning the relief of wound pain, the anoplasty group achieved better results than the fissurectomy group at the third day, the fourteenth day and the sixth week after operation (P<0.05). Anoplasty reduced bleeding and had better efficacy than the fissurectomy at the third day and the fourteenth day after operation (P<0.05), however, there was no statistical difference at the sixth week after operation (P>0.05). There were no significant differences in relieving the anal canal pressure (P>0.05) and the surgical complications (dysuria, edema of anal margin, fever, infection, anal incontinence and anal deformation) between the two groups (P>0.05). None of the patients suffered postoperative complications by the sixth week after operation. Furthermore, there was no recurrence in either of the two groups at six weeks after operation. Conclusion: The results indicate that anoplasty for chronic anal fissures has advantages such as better therapeutic effects, less postoperative pain, a shorter healing time and no incidence of anal incontinence.

Objective To investigate the correlation between serum miR-320b and carotid atherosclerosis in patients with acute ischemic stroke.Methods From January 2017 to December 2017,patients with acute ischemic stroke visited the Department of Neurology,the Affiliated Hospital of Yangzhou University were enrolled.According to the findings of carotid artery ultrasonography,they were divided into plaque group and plaque-free group.The baseline clinical data such as demographic data,vascular risk factors,and blood biochemical indicators were collected.Reverse transcription quantitative polymerase chain reaction was used to detect the expression level of serum miR-320b.Multivariatelogistic regression analysis was used to determine the independent risk factors for carotid atherosclerosis.Results A total of 135 patients with acute ischemic stroke were enrolled in this study,including 58 females and 77 males,aged 58.4 ± 10.6 years.There were 85 patients in the plaque group and 50 in the plaque-free group.The total cholesterol (t =5.523,P =0.023) and low-density lipoprotein cholesterol (t =4.415,P =0.044) in the plaque group were significantly higher than those in the plaque-free group,while high-density lipoprotein cholesterol (t =5.849,P=0.017) and serum miR-320b (t =4.331,P=0.039) were significantly lower than those in the plaque-free group.Multivariate logistic regression analysis showed that referring to the highest quartile group,the low serum miR-320b level might be an independent risk factor for carotid atherosclerosis (the first quartile group:odds ratio 2.701,95％ confidence interval 1.154-6.321,P =0.022;the second quartile group:odds ratio 2.521,95％ confidence interval 1.249-5.091,P =0.010;and the third quartile group:odds ratio 1.849,95％ confidence interval 1.041-3.283,P=0.036).Conclusion The low serum miR-320b level might be an independent risk factor for carotid atherosclerosis in patients with acute ischemic stroke.