Objective:To explore the relationship between coronary heart disease (CHD)and silent brain infarction (SBI).Methods:A total of 430 patients who had received coronary angiography were enrolled,including 330 CHD patients and 100 non-CHD patients.According to complicated with SBI or not scanned by cranial MRI,CHD pa-tients were divided into CHD+SBI group (n=208)and CHD without SBI group (pure CHD group,n=122).Levels of high sensitive C reactive protein (hsCRP)and homocysteine (Hcy)were measured,and coronary artery score (CAS)and Gensini score (GS)were calculated in all patients.Results:Incidence rate of complicated SBI in CHD patients was significantly higher than that of non-CHD patients (63% vs.31%,P <0.01);compared with pure CHD group,there were significant rise in age [(60.79±9.65)years vs.(67.14±9.77)years],percentages of hy-pertension (41.0% vs.66.8%),hyperlipidemia (37.7% vs.55.8%)and levels of hsCRP [(3.92±2.17)g/L vs. (5.85±6.27)g/L],Hcy [(9.20±3.20)μmol/L vs.(10.54±4.25)μmol/L],CAS [(0.88±0.88)scores vs. (1.94±0.94)scores]and GS [(18.62±16.23)scores vs.(53.04±39.61)scores],and percentage of left anterior descending artery stenosis (25.4% vs.69.2%)in CHD+SBI group,P <0.01;Logistic regression analysis indicated that risk factors of SBI were age (OR=1.07,95%CI:1.032~1.108),hypertension history (OR=2.195,95%CI:1.104~4.366),Hcy (OR=1.088,95%CI:1.001~1.182),CAS (OR=1.776,95%CI:1.049~3.007)and GS (OR =1.039,95%CI:1.013~ 1.066),P <0.05 or <0.01. Conclusion:Incidence rate of SBI in CHD pa-tients is significantly higher than that of non-CHD patients;the more severe coronary artery disease is,the higher percentage of complicated SBI is.CAS and Gensini score abnormities suggest there may be SBI existence simultaneously.

Objective To observe the effects of treadmill training on the recovery of neurological function and the expression of HSP70 and C-MYC in the brains of rats with focal cerebral ischemia. Methods Forty-two male adult Sprague-Dawley rats were randomly divided into a sham group ( n =6), a model group (n =18) and a treadmill exercise group (n=18). Focal cerebral ischemia was induced by right middle cerebral artery occlusion (MCAO) in the model group and exercise group using a modified version of Longa's method. The rats in the treadmill exercise group were given treadmill training 6 d per week for 2 weeks after 24 h of MCAO. By contrast, the rats in the sham group and the model group were reared in standard cages. Before the rats were sacrificed at the 3rd, 7th and 14th d after MCAO, their neurological functions were tested using modified neurological severity scores ( mNSS) , and the mRNA and protein levels of HSP70 and C-MYC were detected using a reverse transcriptase-polymerase chain reaction (RT-PCR) , immunohistochemistry and Western blotting. Results Neurological function in the exercise group at the 7th and 14th days after MCAO had improved significantly compared with the control and model groups.The mRNA and protein levels of HSP70 and C-MYC were significantly upregulated at the 7th and 14th days. Conclusions Treadmill training can improve neurological function by upregulating the expression of HSP70 and C-MYC in the ischemic brain after MCAO.

Objective To study the effects of treadmill training on the recovery of neurological function and the expression of IGF-1/IGF-1Rin the brain poat focal cerebral ischemia.Metheods Forty-two male,adult Sprague-Dawley rats were randomly divided into a sham group(n=6),a model group(n=18)and a treadmill exercises group(n=18).Focal cerebral ischemia was induced in the latter two groups by right middle cerebral artery occlusion(MCAO)using a modified Longa's metheod.The rats in the treadmill exercises group were given treadmill training 6 days a week for 4weeks beginning 24 h after the MCAO. Rats in the sham group and model groups were reared in standard cages and could move frddly. Before being sacrificed at the 7th 14th and 28th day after the MCAO,the rats' neurological function were tested giving modified neurological weverity scores (mNSS). The expression of IGF-1/IGF-1R was detected using the reverse transcriptsae polymersae chain reaction and immunohistochemical methods.Results Neurological runction in the exercises group at the 14th and 28th day was better than in the control group,and IGF-1 and IGF-1Rexpression were significcantly upregulated on the 7th,14th and 28th day after the MCAO.Conclusion Treadmill training can improve neurological function by upregulating the expression of IGF-1 and IGF-1R in the ischemic brain, at least in rats.

AIM: To explore the effects of adipose-derived stem cell (ADSC) transplantation on the expression of IL-10 amd TNF-α after cerebral ischaemia in Middle cerebral artery occlusion (MCAO) rats. METHODS: 72 male adult Sprague-Dawley rats were randomly divided into 4 groups: sham group, MCAO group, Vehicle group and ADSC group (n=18). Rat's cerebral ischemia model was established by MCAO with Longa' s method. ADSC were labeled by DAPI before transplantation. One day after MCAO, 30 μL of cell suspension containing 1×10~6 ADSCs were injected into the lateral ventricle of ADSC group and the same dose of PBS was given to the Vehicle group. At day 4, day 7 and day 14 after MCAO, the rats were decapitated to detect the expression of IL-10 and TNF-α in ischaemic rat' s brain by ELISA, immunohistochemistry and RT-PCR. RESULTS: Compared with sham group, the expression of IL-10 and TNF-α significantly up-regulated at 4 d, 7 d of MCAO group(P<0.05). There was no statistical difference of IL-10 and TNF-α expression between MCAO and vehicle group ant any time point(P>0.05). Compared with Vehicle group, the expression of IL-10 significantly up-regulated while TNF-α expression significantly decreased of ADSC-treated group at any timepoint post MCAO(P<0.05). CONCLUSION: The transplantation of ADSC could up-regulate the expression of IL-10 and down-regulate the expression of TNF-α in MCAO rat' s brain, which might contribute to its protective role upon cerebral ischaemia.

Objective To observe the effects on and the possible mechanism of early exercise training underlying the mobilization of circulating endothelial progenitor cells in patients with acute ischemic stroke.Methods One hundred and twenty patients with acute ischemic stroke were randomized into two groups:an early exercise group (treated with exercise training,n =60) and a control group(no exercise training,n =60).Meanwhile,each group was divided into two different age groups (50-68 years group of 32 cases,＞ 68 years group of 28 cases in exercise group;50-68 years group of 29 cases,＞ 68 years of 31 cases in control group).The amount of circulating endothelial progenitor cells in peripheral blood was accounted by flow cytometry (FCM),while the level of vascular endothelial cell growth factor (VEGF) in blood serum was examined by enzyme-linked immunoassay (ELISA).National Institutes of Health Stroke Scale (NIHSS),Fugl-Meyer Assessment (FMA) and modified Barthel index (MBI) were used to evaluate the patients at 1st day and 14th day after exercise.Results The amount of circulating progenitor cells after 14 days of exercise training in exercise group (from 27.93 ± 6.08/ml to 457.49 ± 73.02/ml)is higher than in control group(from 28.29 ± 5.93/ml to 81.87 ± 9.92/ml) (P ＜ 0.01).Compared with the control group,the level of VEGF at 14th day of exercise group is significantly higher (P ＜ 0.01).The score of NIHSS,FMA,MBI were not significantly different between exercise group and control group (P ＜ 0.01).However,the score of NIHSS was decrease in both exercise group and control group after treatment.Furthermore,the amount of circulating progenitor cells was not significantly different between the age groups either in exercise group or control group (P ＞ 0.05).Conclusion Early Exercise training may promote the mobilization of the circulating progenitor cells,which might be related to the increase of VEGF.The mobilization of the EPCs has no effect on the early neurological function after acute ischemic stroke.Age is not associated with the amount of circulating endothelial progenitor cells.

BACKGROUNDTo study the specific expression of tumor-related genes (p53, bcl-2 and c-myc) in non small cell lung cancer with neuroendocrine differentiation (NSCLC-NE).

METHODSThe expression of neuron-specific enolase (NSE), chromogranin A (CgA), synaptophysin(Syn), c-myc, bcl-2 and p53 was detected in 60 surgically resected and paraffin-embedded non-small cell lung cancer (NSCLC) specimens by immunohistochemistry (S-P method).

RESULTSThe positive rates of NSE, CgA, Syn expressed in 60 cases of NSCLC were 45.00%(27/60), 13.33%(8/60), 31.67% (19/60) respectively. According to the results of these three markers, 41.67%(25/60) of 60 specimens was proved to be as NE differentiation cancer. The NE differentiation in NSCLC was remarkably related to differentiation of tumor cells (P < 0.05). NSCLC-NE had a higher metastatic rate (P < 0.05) and a higher clinical staging (P < 0.05) than NSCLC without NE differentiation. The positive rates of bcl-2, p53 and c-myc expression in NSCLC-NE were 68.00% (17/25), 80.00% (20/25), 68.00% (17/25) respectively, and the expression of bcl-2 and p53 was closely related to NE differentiation (P < 0.05).

CONCLUSIONSA certain part of NSCLC have NE differentiation, which has different biological features from NSCLC without NE differentiation. High expression of bcl-2 and mutant p53 can be observed in NSCLC-NE, and bcl-2/Bax unbalance associated with p53 mutation may play an important role in oncogenesis and development of NSCLC-NE.

Objective To evaluate the clinical outcome of fetus diagnosed as mild and moderate isolated ventriculomegaly(IVM)and its correlation with imaging follow-up. Methods Totally,161 cases of single pregnancy whose fetus was diagnosed as mild or moderate IVM by ultrasound were administrated. Data of prenatal ultrasound examination, pregnancy outcomes, and the postnatal MRI results were collected. New borns' growth and development, language expression, movement coordination, auditory and visual function were followed up to evaluate the neurodevelopment. Results (1)Before birth:80.1%(129/161) of IVM disappeared before the delivery, 16.1%(26/161)remained stable, and 3.7%(6/161)continued to deteriorate.(2)Postnatal MRI: 8 cases(9.6%, 8/83)were diagnosed IVM, of which 3 cases were found additional abnormalities(1 case was the corpus callosum dysplasia and 2 cases were leukodystrophy). The additional abnormal detection rate was 3/8.(3)Postnatal assessments: There were 7 cases(8.9%, 7/79) neunatal behavioral neurological assessment (NBNA), 6 cases (7.6%, 6/79) Bayley scales of infant development (BSID)-psychomotor developmental index(PDI) and 3 cases (3.8%, 3/79) BSID-mental development index(MDI) whose scores were low. There was no significant difference of the NBNA and BSID scores between mild and moderate IVM (NBNA: x2=2.042,P=0.210; BSID-PDI: x2=-1.359,P=0.174; BSID-MDI: x2=-1.205,P=0.228). Follow-up of 9 cases(11.4%, 9/79)with low BSID score, 6 of them were found to be stable in the medial ventricle of the uterus, and the size of the lateral ventricle was normal after birth by ultrasound and MRI. Conclusions The majority of IVM fetuses have good prognosis, but there is also a risk of neurodevelopmental dysplasia. The postnatal follow-up should be paid attention to, and MRI should be performed as the postnatal imaging evaluation.

Objective To analysis the common abnormalities in fetus with ventriculomegaly and clinical significance. Methods Collected from March 2010 to December 2016,298 cases of pregnant women whose fetus with ventriculomegaly and accepted the prenatal diagnosis of pregnancy,including 109 cases of isolated cerebral ventriculomegaly(IVM),and 189 cases of non-isolated cerebral ventriculomegaly(NIVM).They were divided into mild groups(10.0-11.9 mm),moderate group(12.0-14.9 mm)and severe group(≥15.0 mm)according to the width of the lateral ventricle. Results(1)The most common abnormality of the NIVM were neurodevelopmental system(37.30%,94/252);The second was ultrasonic soft index(27.78%,70/252).(2)The most frequent combi-nation in mild group was ultrasonographic soft mark anomalies(44.76%,47/105),followed by other ultrasonic indi-cators(18.10%,19/105).The abnormal incidence of central nervous system was higher in middle group(45.16%, 42/93),followed by ultrasonic soft index abnormality(21.51%,20/93).The abnormality of the central nervous sys-tem was 62.96%(34/54)in severe group,followed by an abnormal(14.81%,8/54).(3)There was a difference in the nervous system and the ultrasonic-soft indicator between the non-isolated lateral ventricle dilation with different lateral ventricle widths(P<0.001).There was no difference in cardiovascular abnormalities. Conclusion Prena-tal ultrasound revealed that fetus with cerebral ventriculomegaly should carefully examine whether other abnormali-ties existed to determine the prognosis of the fetus and whether intervention should be taken.There was a difference between the different types of lateral ventricle and the prognosis.

Objective:To compare the head magnetic resonance imaging (MRI) changes and the distribution of pathogens of purulent meningitis in premature and full term infants.Methods:This retrospective study assessed clinical data in 43 cases of neonatal purulent meningitis with positive blood or cerebrospinal fluid bacterial culture admitted to the Neonatal Ward of Shengjing Hospital of China Medical University from January 2012 to November 2019.According to the gestational age, those patients were divided into the premature infant group and the full term infant group.The general situation, head MRI and pathogen characteristics of both groups were compared.Results:The incidence of premature rupture of fetal membranes in the premature infant group was higher than that in the full term infant group [50.00%(13/26 cases) vs.5.88%(1/17 cases)], the rate of cesarean section in the premature infant group was higher than that in the term infant group [61.54%(16/26 cases) vs.23.53%(4/17 cases)], and there were significant difference between the 2 groups ( χ2=9.011 and 5.969, respectively, all P<0.05). There was no significant difference between 2 groups in age of onset [(9.8±7.0) d vs.(8.9±5.5) d], diagnosis[(13.0±7.1) d vs.(10.2±6.1) d] and examination [(16.1±7.9) d vs.(13.1±6.5) d] (all P>0.05). The top 3 pathogens were Klebsiella pneumonia ( K. pneumoniae) in 14 cases, Escherichia coli ( E. coli) in 11 cases and Streptococcus agalactiae (GBS) in 7 cases. K. pneumoniae was the most common pathogen in premature infants, and GBS was the most common pathogen in term infants.In the first MRI, white matter injury (WMI) was the most common disease (19 cases), the abnormal rate of MRI in the premature infant group was 65.38% (17/26 cases), the incidence of intracranial hemorrhage in the premature infant group was higher than that in the term infant group, the abnormal rate of MRI in the term infant group was 52.94% (9/17 cases), and the incidence of cerebral infarction in the term infant group was higher than that in the premature infant group.The MRI positive rates of meningitis caused by K. pneumoniae, E. coli and GBS were 57.14% (8/14 cases), 72.73% (8/11 cases) and 71.43% (5/7 cases), respectively.Infants with K. pneumoniae infections suffered from the main complications of WMI and intracranial hemorrhage.Infants infected with E. coli were prone to WMI in the early stage and hydrocephalus in the late stage.Infants with GBS were prone to WMI and cerebral infarction in the early stage and cerebromalacia in the late stage. Conclusions:There were some differences in the distribution of pathogenic bacteria and head MRI changes between premature infants and term infants, and head MRI of purulent meningitis caused by different pathogenic bacteria.A thorough understanding of the distribution of pathogens and the characteristics of head MRI in premature and full term infants contributed to the early diagnosis, treatment and prognosis of this disease.

Cancer immunotherapy refers to the therapeutic effect of controlling or eliminating tumor cells by interfering with the immune system to restore the anti-tumor immune response. Immune checkpoint inhibitor therapy that blocks programmed death -1/programmed cell death ligand-1/cytotoxic T lymphocyte-associated antigen 4 is one of the most commonly used tumor immunotherapies, with good efficacy and wide application. These drugs cause immune-related ocular complications such as uveitis, autoimmune retinopathy, and scleritis, which represent a new etiology of ocular inflammation. The ophthalmologist's grasp of the clinical characteristics of these diseases is helpful for timely diagnosis. At the same time, the ophthalmologist will work closely with the oncologist to make a comprehensive judgment based on the patient's primary tumor, survival prognosis, severity of adverse reactions related to ocular immunotherapy, and visual prognosis, and develop suitable therapeutic strategie, thereby saving the patients' vision and improving the quality of life.