Microglia is the principal immune effector cell in brain. It plays some important roles in support, nutrition, protection, and repair in the physiological activities of neuron. Microglia can be quickly activated, which may proliferate after cerebral ischemia, and promote phagocytosis of macrophage. It exerts dual effects by producing neurotoxic molecules and neurotrophic factors. Therefore, to study the relationship between microglia and cerebral ischemia, give full play to its protective functions and reduce its damage will help to improve the therapeutic effects of cerebral ischemic injury.

Objective To study the significance on dynamic changes of serum vascular endothelial growth factor( VECF) and matrix metalloproteinase 9( MMP-9) in patients with acute cerebral infarction. Methods 123 patients with acute cerebral infarction were selected as research object, and they were the observation group, and 80 healthy peoples at the same time were selected as control group. Then the serum VEGF and MMP-9 in patients with acute cerebral infarction after pathogenesis at first,third,fifth,seventh and fourteenth day were detected,and the correction between the levels and infarct size,prognosis were studied. Results The serum VECF and MMP-9 of observation group compared with those of control group,the change showed increased first and decreased afterwards,but the levels were all higher than those of control group (P ＜ 0.01). There were correction between the levels and infarct size, prognosis.The serum VEGF[(369.3 ± 108.7,476.2 ± 118.4,551.5 ± 144.5,661.7 ± 164.6,437.6 ± 123.9)ng/L]and MMP-9[(333.8±101.4,459.7±119.9,370.3 ±119.5,320.5 ± 129.1,255.4 ± 101.6)ng/L] in poor prognosis patients after pathogenesis at first,third,fifth,seventh and fourteenth day were all higher than those of good prognosis patients ( P ＜0.01). Conclusion The serum VEGF and MMP-9 in patients with acute cerebral infarction showed dynamic change,and there was close relationship between the levels and infarct size.

Objective To study the effects of bone marrow stromal cells derived neural stem cells on apoptosis and the expression of Bcl-2 and Bax after focal cerebral ischemia and reperfusion.Methods The model of middle cerebral artery occlusion (MCAO) and reperfusion was set up by Longa. Thirty-two Sprague-Dawley rats were divided into 4 groups: sham-operated group (A), ischemia control group (B), bone marrow stromal cells transplanted group (C) and bone marrow stromal cells derived neural stem cells transplanted group (D). The rats were killed on the day 7 and 14 after transplantation. The brain sections were used for terminal deoxynucleotidyl transferase dUTP mickend labeling (TUNEL) staining and Bcl-2, Bax immunohistochemical staining.Results The number of apoptotic cells in groups C and D was decreased as compared with that in group B on the day 7 and 14 after transplantation (P

Objective To examine the influence of 3R intensive nursing on working memory dysfunction of patients with early Parkinson's disease. Methods 30 patients with early Parkinson's disease were assessed by Working Memory Test Battery,and acceped 3R- nursing. The condition of working memory dysfunction was compared before and after nursing intervention. Results The patients with early Parkinson's disease had evident difference than the normal controls, especially the visualspatial working memory. After 3R- nursing, the subtest scores and dimensions were improved apparently. Conclusions The clinical effect of 3R- nursing method in patients with early Parkinson's disease has significant predominance ,so it is worth popularizing.

OBJECTIVE:To study the analgesic and anti-inflammatory action of Lamiphlomis from different growing areas.METHODS:The analgesic action was observed with hot plate test and writhing test and the anti-inflammatory action with xylolinduced ear swelling test and acetic acid-induced peritoneal capillary permeability test in mice.RESULTS:Lamiphl_ omis could obviously inhibit the pain induced by hot plate and acetic acid as well as the ear swelling induced by xylol and the capillary permeability resulting from peritoneal injection of acetic acid.CONCLUSION:Lamiphlomis possesses analgesic and anti-inflammatory action and on this point,the actions of Lamiphlomis from three growing areas are more or less alike.

Objective To examine the relationship between quetiapine serum concentration,dose,therapeu-tic efficacy and side effects in male patients with schizophrenia.Methods Sixty-three male patients with schizo-phrenia were collected.They were treated openly for 8 weeks with quetiapine,the dose was adjusted according to clini-cal improvement and tolerance.The plasma quetiapine concentrations,therapeutic efficacy and adverse drug reactions were observed after the 4 -week treatment period,and at the end of the 8 weeks of the treatment.Results After 4 weeks,the serum concentration had significant correlation with age,the disease duration and education level.After 8 weeks,there was significant correlation between serum concentration and age.We found a correlation between dose and serum concentration of quetiapine,and no relationship between serum concentration and PANSS scores.Side effects were correlated with 4 weeks′serum concentrations.Conclusion Quetiapine is effective for male patients with schizophrenia.Age,quetiapine dose and side effects have significant correlations with the serum concentration.It appears that plasma quetiapine concentration has no effects on therapeutic efficacy.

Objective To evaluate the feasibility and its clinical application of 3.0 T MRI in the assessment of the late gadolinium enhancement in patients with cardiac arrhythmias with phase-sensitive inversion recovery (PSIR) single-shot true fast imaging with steady-state precession (True FISP) sequence.Methods Fifty-six patients with arrhythmia confirmed by electrocardiogram underwent MRI in this prospective study.Late gadolinium enhancement were performed with both PSIR single-shot True FISP (sequence 1) and conventional segmented PSIR Turbo FLASH sequences (sequence 2).The overall image quality (4 scales) was assessed and recorded independently by two experienced radiologists.Statistical analysis was performed with Chi-square test and weighted Kappa test.Results Late gadolinium enhancement of all the 56 patients were successfully examined with the sequence 1 and 2.All the image qualities of sequence 1 reached 3 scales or more and met the requirements of clinical diagnosis,and late gadolinium enhancement lesions were detection in 19 patients.All the sequence 2 images were improperly used for clinical diagnosis of the different degrees of artifacts,especially in patients with severe arrhythmia and those who breath-hold with difficulty.Sequence 1 images were classified as scale 4 in 50 cases and scale 3 in 6 cases by Doctor 1,while scale 4 in 48 cases and scale 3 in 8 cases by Doctor 2,respectively.However,sequence 2 images were classified as scale 2 in 15 cases and scale 1 in 41 cases by Doctor 1,as well as scale 2 in 13 cases and scale 1 in 43 cases by Doctor 2,respectively.Sequence 1 image qualities were significantly higher than those of the segmented sequence 2 (x2 values were 141.329 and 141.177,P＜0.01).Excellent agreements between two observers of the 2 sequences (Kappa values were 0.837 and 0.905,P＜ 0.01) were found.Conclusion PSIR single-shot True FISP sequence provides higher reliability for image quality of late gadolinium enhancement in patients with cardiac arrhythmia,which may be useful for clinical application.

BACKGROUND:Valgus-varus constrained polyethylene insert is selected in strict accordance with the principle of“to obtain reliable stability using minimum restriction”. The stability of the prosthesis is elevated, but the restriction is not increased.
OBJECTIVE:To retrospectively analyze the application experience of constrained polyethylene insert in valgus and varus instability of primary total knee arthroplasty for older patients and to summarize the indications and clinical effects of this kind of implements.
METHODS:From March 2010 to March 2012, a total of 70 patients combined valgus and varus malfomation who accepted primary total knee arthroplasty were enrol ed in this study, including 56 varus patients (averagely 15°-30°) and 14 valgus patients (averagely 10°-20°). Constrained polyethylene insert was performed in 23 patients (25 knees) who stil had remaining unilateral valgus or varus<6 mm (18 patients were varus instability and 7 patients were valgus instability) when finished operation of standard osteotomy and soft tissue balancing. The bone cement knee prostheses in 23 cases were purchased from Smith&Nephew. The stem implant was not used in al cases. Cement or autografts were used in 11 valgus knees to fil the bone defects.
RESULTS AND CONCLUSION:Patients were fol owed up for 2 years on average (18-42 mouths). The knee pain symptoms of al cases disappeared. The joint stability was obviously improved. The lower limb power lines were correct. The Knee Society Score scores were improved from an average of 39.4 points preoperation to an average of 88.5 points postoperation. Al cases did not need the protection of knee braces. The maximum degree of flexion was 110°(96°-130°). The satisfaction degree of 36-Item Short Form Health Survey was 98%. No dislocation or infection happened. Results indicated that constrained polyethylene insert could be applied in the cases of less than 6 mm valgus and varus instability when finished operation of standard osteotomy and soft tissue balancing in total knee arthroplasty for older patients. This kind of implements can preserve bone mass, simplify operational process and have good clinical outcome in a short period.

Objective To investigate the markers in early diagnosis of acute kidney injury (AKI) in patients undergoing heart surgery.Methods Markers included serum cystatin C (CyC),and urinary neutrophil gelatinase-associated lipocalin(NGAL),interleukin 18(IL-18),retinol binding protein(RBP)and N-acetyl-β-D-glucosaminidase(NAG).Twenty-nine cardiac surgical patients hospitalized were enrolled in the study.Serial blood and urine samples were collected immediately before incision and at various time intervals after surgery.The primary outcome measure was AKI.defined as a 50%increase in Scr from baseline. Results The cohort consisted of 29 patients aged(62.9±13.7)years,and baseline Scr was(73.2±11.9)μmol/L.There were no significant differences in demographics between cases and controls,while the aortic clamp time was predictably longer in AKI cases as compared to controls[(60.63±13.92)vs(43.00±9.20)rain,P<0.05].Each biomarker difiered significantly between cases and controls at least one timepoint.Optimal AUCs were for CyC at 10 houm with sensitivity (ST)0.71,specificity(SP)0.92,AUC=0.83(0.67-1.00),cut-off(CO)1.31 mg/L;NGAL at 0 hour with ST 0.84,SP 0.80,Auc=0.85(0.70-1.00),CO 49.15 μg/g Ucr;IL-18 at 2 hours with ST 0.85,SP 0.73,AUC=0.81(0.64-0.97),CO 285.65 ng/g Ucr;RBP at 0 hour with ST 0.75,SP 0.67,AUC=0.77(0.60-0.95),CO 2934.65μg/g Ucr and NAG at 4 hours with ST 0.86,SP 0.67,AUC=0.72(0.53-O.92),CO 37.05 U/mg Ucr.Using a combination of all the 5 biomarkers analyzed at the optimal time-point as above,an AUC of 0.98(0.93-1.02)(P<0.01)in this limited sample was able to obtain. Conclusions Application of serum and urinary biomarkers for the prediction of AKI in patients undergoing cardiac surgery is highly dependent on the sampling time.Of the evaluated markers,uNGAL has the best predictive profile.uRBP also shows similar predictive power.Combining all the five above biomarkers is able to predict significantly more cases,suggesting that the use of more than one marker may be beneficial clinically.

Objective To compare the RIFLE and AKIN diagnosis criteria for acute kidney injury ( AKI) in patients undergoing cardiac surgery. Methods Patients undergoing cardiac surgery from January 2004 to June 2007 were retrospectively evaluated. RIFLE and AKIN criteria were employed for the diagnosis and staging of AKI which occurred 7 d after cardiac surgery. The diagnosis sensitivity and precision for prediction of hospital mortality were compared between these two criteria. Results One thousand and fifty-six patients were included in this study. There was no significant difference between the prevalence of AKI after cardiac surgery diagnosed by RIFLE criteria and that diagnosed by AKIN criteria (29.55% vs 31.06%, P>0.05). There was no significant difference between the total hospital mortality and the hospital mortality of each stage of AKI diagnosed by RIFLE criteria and those diagnosed by AKIN criteria ( P > 0. 05). Logistic regression analysis suggested that the relative risk of hospital mortality for AKI was similar between patients diagnosed by AKIN criteria and those diagnosed by RIFLE criteria. The area under the ROC curve for hospital mortality was 0. 856 for RIFLE and 0.865 for AKIN in all patients (P<0.001). Conclusion Compared to RIFLE criteria, AKIN criteria do not improve the sensitivity of diagnosis and predictive ability of hospital mortality of AKI after cardiac surgery.