Adiponectin (APN) is an insulin sensitizing protein with protective effect secreted by adipose tissue.It has the effects of regulating glucose and lipid metabolism,protecting vascular endothelial function,promoting angiogenesis,and anti-inflammation,etc.It plays an important protective effect in cerebrovascular diseases.This article reviews APN and its effect in ischemic stroke.

gress. A growing body of research has committed to exploring more thrombolytic regimens. This article reviews the main methods, drugs and recent progress in thrombolytic therapy.

Endothelial progenitor cells have self-replication and multi-differentiation potentials. They participate in the maintenance of vascular dynamics and physiological reconstruction. Though the research of endothelial progenitor cells has become a current hot spot, there are a series of unknown factors from the fields of the basic research to the clinical application. This article reviews the advances in research on endothelial progenitor cells,particularly the roles in ischemic cerebrovascular disease.

Objective To detect the alteration of circulating CD34 + cell level in patients with the In'st-ever nonlacunar stroke and to investigate the prognostic value of CD34 +cell level. Methods 1he level of the circulating CD34+ cells were examined using flow eytometry in 119 patients with nonlacunar infarction. 1he patients were divided into group A (higher than average) and group B (lower than average) according to the detected values, The National Institutes of Health Stroke Scale (NIHSS) scores on admission and the modified Rankin Scale (mRS) scores at 3 months after the onset in the two groups wre compared. Results The level of CD34 + cells in group A was significantly higher than that in group B (0. 048 ± 0. 001 versus 0. 032 ± 0. 002, P < 0. 05 ), however, there was no significantly difference in NIHSS sores between the two groups. One week after admission, the increased level of CD34 + cells in group A was significantly higher than that in group B (0. 001 ±0. 003 versus - 0. 005 ± 0. 000, P < 0. 05 ). Three months after the onset of symptoms, the average mRS score in group A was significantly superior to that in group B (2. 98 ± 1.14 versus 3.25 ± 1.39, P <0. 05). 1he level of circulating CD34 + cells at the initial onset of symptom was negatively correlated with the mRS score at 3 months after stroke (r = -0. 48, P <0. 05). Conclusions The higher level of circulating CD34+ cells had better prognosis in patients with cerebral infarction. The level of circulating CD34+ ceils may be used as a prognostic indicator in patients with cerebral infarction.

Objective To detect the distribution of cerebral microbleeds (CMBs) in patients with lacunar infarction (LI) and/or leukoaraiosis (LA) and to analyze the correlation between the CMB related risk factors and cognitive impairment.Methods Thirty-eight patients with LI and/or LA were divided into either a CMB group or a non-CMB group according to the findings of susceptibility weighted imaging.The number of CMB lesions was recorded.Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were used to conduct cognitive function tests,and the patients were also divided into a cognitive impairment group and a non-cognitive impairment group according to the MoCA scores.The demographic and clinical data in each group were compared.The independent risk factors for CMBs and cognitive impairment were identified.Results Thirteen patients had 58 CMBs in the CMB group.Their distributions were as follows:36 CMBs in basal ganglia and thalamus,14 in cortical and subcortical regions,3 in brain stem,and 5 in cerebellum.There were 25 patients in the non-CBM group,26 in the cognitive impairment group,and 12 in the non-cognitive impairment group.There were significant differences in age and the proportions of hypertension,taking antithrombotic drugs and the patients with LA between the CMB group and the non-CMB group (all P ＜ 0.05).Multivariable logistic regression analysis showed that only age was an independent risk factor for CMBs (odds ratio 1.103,95％ confidence interval 1.034-1.454; P =0.045).MMSE (26.92±2.87vs.29.00± 1.44; t=2.452,P=0.027) and MoCA (21.62±3.36vs.25.04 ± 2.59; t =-3.493,P =0.001) scores in the CMB group were significantly lower than those in the non-CMB group.There was only significant difference in the number of CMBs between the cognitive impairment group and the non-cognitive impairment group (2.08-± 3.64 vs.0.33 ±0.78; t =-1.629,P =0.010).Multivariate logistic regression analysis showed that only the number of CMBs was an independent risk factor for cognitive impairment (odds ratio,1.534,95％ confidence interval 1.100-2.576; P=0.046).Spearman rank correlation analysis showed that the number of CMBs was significantly negatively correlated with the MoCA language (r =-0.229,P=0.003) and the delayed recall (r =-0.332,P=0.042) scores.Conclusions In patients with LI and/or LA,CMBs were correlated with age.Their existence and number were associated with cognitive impairment.

By means of ATPase histochemistry and OKT-6 immunogold-silver staining, it was demonstrated that Langerhans ceils (LC) were present in the epithelia of human skin, palatine tonsil, ectocervix and esophagus. In the skin LC were located mainly in the stratum spinosum of the epidermis. There were some LC in the hair follicle and duct of sebaceous gland, and a few in the dermis and around sebaceous gland acinus. In the tonsil, ectocervix and esophagus, LC were located mainly in the middle layer of epithelia. No LC were found in the lymphoid follicle and thymus-dependent zone of the tonsil, and no LC in the lamina propria of ectocervix and esophagus. ATPase histochemistry was also used to examine the distribution of epidermal LC in normal human skin of various ages and various anatomic regions. This study showed that the density and morphology of epidermal LC varied with age and different anatomic regions of human body. Statistical analysis indicated that LC density in various age groups was as follows: fetus

Objective To analyse the imaging characteristics of pulmonary tuberculosis(TB) in elder in order to improve its diagnostic accuracy.Methods Radiological and CT fndings of pulmonary tuberculosis in 200 old patients were analysed retrospectively.Results The types of TB in 200 patients were:type Ⅱin 13 cases(6.5%),type Ⅲ in 163 cases (81.5%),accompanied with the pleuritis in 44 cases(22%) and type Ⅳ in 24 cases (12%).The mainly imaging findings included:old lesions in 85 cases(42.5%),exudative and/or multiplicative lesions in 81 cases (40.5%),caseous pneumonia in 47 cases(23.5%),cavitive lesions in 127 cases(63.5%),tuberculoma in 12 cases(6%),miliary nodules in 13 cases(6.5%),TB pleuritis in 68 cases(34%) and enlargement of lymph nodes in 57 cases (28.5%).Conclusion TB in elder is of characteristics of atypical location and unstable morphology.

Erythropoietin (EPO) belongs to cytokines.It mainly promotes erythropoiesis in the peripheral blood circulation.Fundamental research shows that EPO can reduce cerebral ischemic injury through a variety of mechanisms,but at the same time,there are many unsolved problems.In addition,the two clinical trial outcomes are also very inconsistent.This article reviews the problems in EPO research.

Objective To investigate the neuroprotective effect of adiponectin on rats with cerebral ischemic-reperfusion injury and explore its possible mechanism.Methods Sixty-four SD rats were divided into normal group (C) and diabetic group (D) randomly.Type 2 diabetic rats model were made by high-fat diet before the middle cerebral artery occulation model (MCAO) surgery.Each group was divided into two subgroups.CAPNand DAPN groups were given exogenous recombinant globular adiponectin via jugular vein one hour after ischemic-reperfusion injury,C0 and D0 groups were given the same amount of normal saline at the same time.Body weight and blood glucose of the rats were measured before ischemia.We also evaluated the neurological function of rats 24 h after treatment according to Longa criteria and observed the morphological changes of cells in brain area via HE staining.The vascular density in ischemic-reperfusion injury area was detected through 3D confocal image system 2 weeks after the treatment.Results The body weight of diabetic rats was significantly lower than normal rats((284.06 ± 19.85)vs (220.31 ±21.87) g,t =8.634,P =0.000).Blood glucose of diabetic rats before ischemia was significantly higher than normal rats ((4.36±0.13)vs(22.92 ± 1.58) mmol/L,t =11.74,P =0.000).Compared with C0 group,the neurological function score of CAPN group was lower(2.29 ± 0.69 vs 17.0 ± 0.69,t =2.186,P =0.038).Compared with D0 group,the neurological function score of DAPN group was lower(2.89 ± 0.33 vs 2.40 ±0.51,t =2.567,P =0.018),too.HE staining showed that the neuronal injury were milder in CAPN,DAPN group,compared with C0,D0 group,respectively.Adiponectin increased the vascular density of ischemic cortex inC group ((2014.58±61.18)/0.002 mm2 vs(3211.95 ±71.64)/0.002 mm2,t =12.16,P=0.023) and D group ((502.86 ± 30.43)/0.002 mm2 vs (1426.69 ± 97.24)/0.002 mm2,t =25.64,P =0.001).Adiponectin increased the vascular density of ischemic striatum in C group (472.59 ± 4.78)/0.002mm2 vs (736.60 ±104.90) /0.002 mm2,t=7.11,P=0.007) and D group (432.04 ±4.65)/0.002 mm2 vs (1780.75 ± 74.54)/0.002 mm2,t =51.08,P =0.000).Conclusions Adiponectin exerts the neuroprotective effect on cerebral ischemic-reperfusion injury in normal and diabetic rats.And it may protect the brain through promoting angiogenesis.

Objective To assess the efficacy of Danggui Yinzi versus western medicine for treating chronic urticaria.Methods CNKI,VIP,Wanfang data,EMbase,the citation databases of PubMed,web of science updated to August 2012 were electronically searched.Randomized controlled trials (RCTs) and Clinical controlled trial (CCTs) on Danggui Yinzi and western medicine for chronic urticaria were identified.The quality of included RCTs and CCTs was assessed,and the meta-analysis was conducted with Revman5.1 software.Funnel-plot was used to identify the publication bias and performed sensitivity analyses.Results 13 trails involving 1042 patients were included.The qualities of all these trails were relatively low.There was no trail set double blinding and allocation concealment.Meta-analysis indicated that compared with western medicine,the effective rate of Danggui Yinzi was superior to that of western medicine[OR=2.53,95％CI(1.92,3.34)].The funnel-plot demonstrated that there was publication bias.Conclusion The current evidence showed that Danggui Yinzi was superior to western medicine in efficacy,but we need more multicenter,randomized,double-blind trails to support it.