Astrocytes are the most abundant neuronal cells in the central nervous system.It plays an important physiological role.In the process of cerebral ischemia,astrocyte activation is one of the major changes in the central nervous system.The activated astrocytes can play a neuroprotective role through the mechanisms such as maintaining ionic balance,regulating energy metabolism,removing excitatory amino acids,against oxidative stress,and secreting neuroprotective substances.However,astrocyte activation after cerebral ischemia also has its disadvantage.This article reviews the neuroprotective and damage roles of astrocyte activation during cerebral ischemia.It also investigates its regulatory mechanisms in order to provide new ideas for the treatment of ischemic stroke.

Background Researches determined that ELOVL4 gene is a disease-causing gene of Stargard tmacular dystrophy and is a elongation enzyme of very long chain fatty acids.Stargardt type Ⅲ(STGD3) may be associated with the metabolism of extensive enzyme of very long chain fatty acids.To explore the effect of ELOVL4 in STGD3 and its relationship with the metabolism of extensive enzyme of very long chain fatty acids is of important clinical significance.Objective This study was to determine the role of ELOVL4 gene for the pathogenesis of STGD3.Methods Recombinant adenovirus type 5 carrying mouse ELOVL4 gene and green fluorescent protein (GFP) was transfected into pheochromocytoma cells (PC12 cells),and then the cells were divided into PC12 group,PC12+Ad5-GFP group and PC12+AdS-ELOVL4 group.Ad-GFP or Ad-ELOVL4 was added into the culture medium for 24 hours with the virus plasmid 1 × 104-2× 104 pfu/ml.Expression of ELOVL4 mRNA in the PC12 was quantified by quantitative real time PCR(qRT-PCR) and was described as relative value to the expression of RPL19.ELOVL4 protein was assayed by Western blot.The transfected cells were treated with arachidonic acid (AA,20:4n6),eicosapentaenoic acid (EPA,20:5n3) and docosahexaenoic acid (DHA,22:6n3) individually for 48 hours.The cells were collected,and total lipids were extracted,and fatty acid methyl esters were prepared and analyzed by gas chromatography-mass spectrometry (GC-MS).Results The relative expression levels of ELOVL4 mRNA in PC12 cells in the PC12+Ad5-ELOVL4 group,PC12+Ad5-GFP group and PC12 group were 0.833± O.138,0.027t±0.002 and 0.024 ±0.002,with a significant difference among the 3 groups (F =102.700,P =0.000),and relative expression levels of PC12+Ad-ELOVL4 were 30-40 folds more than those in the PC12 group and the PC12+Ad-GFP group.Western blot assay showed a stronger response band for ELOVL4 protein in the PC12+Ad-ELOVL4 group.GC-MS found that abundant polyunsaturated fatty acids (C28-C38) were synthesized by PC12 cells in the PC12+Ad-ELOVL4 group,with the more levels in C34 and C36.Conclusions ELOVL4 can promote the synthesis of C28-C38 polyunsatured fatty acid in PC12 cells,which offers a novel clue for the treatment of STGD3.

Objective To investigate the correlation of microperimetric parameters,best-corrected visual acuity (BCVA) and central retinal thickness (CRT) in diabetic macular edema (DME) eyes.Methods It is a prospective,no controlled,open study.Twenty-four consecutive patients (40 eyes) with DME were included.There were 10 males (18 eyes),14 females (22 eyes);aged from 41 to 79 years,with the mean age of (56.84±8.96) years.All the patients were type 2 diabetes,the average duration of diabetes was 8 years.BCVA was evaluated using the international Snellen E vision test chart,and then recorded as logarithm of the minimum angle of resolution (logMAR).CRT was measured by Cirrus HD-OCT4000.MAIA microperimetric parameters were evaluated,including average threshold (AT) of retinal sensitivity,macular integrity index (MI),fixating points within a circle of 1° (P1) and 2° of radius (P2),bivariate contour ellipse area (BCEA) considering 63％ and 95％ of fixating points (A63,A95),and horizontal and vertical axes of that ellipse (H63,H95,V63,V95).Pearson correlation analysis was performed to evaluate the association between these variables.The independent factor influenced the type of fixation was analyzed by multiple linear regression analysis.Results Strong correlations of logMAR BCVA with CRT (r=0.58,P=0.000),V63 (r=0.44,P=0.004),V95 (r=0.41,P=0.008),MI (r=0.36,P=0.024),AT (r=-0.61,P=0.000),P1 (r=-0.41,P=0.009),P2 (r=-0.38,P=0.015) were found.AT was correlations with P1 (r=0.53,P=0.000),P2 (r=0.51,P=0.001),A63 (r=-0.39,P=0.012),A95 (r=-0.40,P=0.012),V63 (r=-0.53,P=0.000),V95 (r=-0.46,P=0.003),MI (r=-0.50,P=0.001).There was no correlation between AT and CRT (r=-0.21,P=0.190).Forty eyes were included in this study,8 eyes (20％) had stable fixation,14 eyes (35％) had relatively unstable fixation,18 eyes (45％)had unstable fixation.Multiple linear regression analysis showed that fixation classification was independently affected by P 1.Conclusions In DME eyes,logMAR BCVA was positively correlated with CRT,negatively correlated with AT,P1 and P2.There is no correlation between AT and CRT.The fixation classification was independently affected by P 1.

Objective To investigate the proliferative inhibition of lens epithelial cell (LEC) by arsenic trioxide (ATO) and rhizoma curcumae (RC), in order to provide scientific basis for pursuing safe and effective natural drugs to prevent and cure after cataract. Design Experimental study. Participants Cultured Bovine LEC in vitro. Methods Changes of cellular form were observed with microscope. Different concentration of ATO (2.5, 5, 10?mol/L) and RC(5, 10, 20mg/ml) were added to the proliferative LEC separately. The effects of proliferative inhibition by ATO and RC on the LEC were measured with methyl thia-zolyl tetrazolium (MTT) assay method after 72 hours incubation. Main Outcome Measures Cellular form, Absorbance. Results Under the microscope, good growth and quantity increase were found in proliferative control group. Slowing proliferation,poor growth, and few disintegration were observed in ATO group and RC group. MTT assay: Different concentration of ATO (2.5, 5, 10?mol/L)and RC(5, 10, 20mg/ml) can significantly inhibit the proliferation of LEC and these effects were dose dependent(P

OBJECTIVE: To investigate the signal transduction mechanism of curcumin in inhibiting the proliferation of bovine lens epithelial cell (LEC) induced by recombinant human epidermal growth factor (rhEGF). METHODS: There were three groups in this experiment, which were normal control group, untreated group and curcumin-treated group. Proliferation of LEC was induced by rhEGF (50 microg/L). The concentration of intracellular Ca(2+) ([Ca(2+)](i)) in LEC was measured with Fura-2/AM by spectrofluorimetry. The contents of intracellular cAMP and cGMP were assayed by radioimmunoassay. RESULTS: The [Ca(2+)]i in LEC was obviously increased in the untrated group as compared with that in the normal control group (P<0.01), and the [Ca(2+)](i) in LEC in the curcumin-treated group was highest among three groups (P<0.01). The content of intracellular cAMP in LEC was decreased while the content of intracellular cGMP was obviously increased in the untreated group as compared with those in the normal control group (P<0.01). The content of intracellular cAMP in LEC was higher in the curcumin-treated group than that in the untreated group, while the content of intracellular cGMP was lower than that in the untreated group (P<0.01). CONCLUSION: The antiproliferation effects of curcumin on LEC may relate to the regulations of multiple processes of signal transduction.

[Objective]Taking the theory of"sinew meridan-channel-viscera"as the context,to explain the pathogenesis of visual fatigue from a new perspective,and to provide a new diagnosis and treatment idea for the clinical treatment of visual fatigue.[Methods]By summarizing with teachers,sorting out medical cases,reading relevant ancient books and documents,the application of the theory of"sinew meridian-channel-viscera"in the occurrence,development and treatment of visual fatigue is deeply discussed.[Results]The basic pathogenesis of visual fatigue is in the formation of nodules,so the treatment should take"adjusting the meridians and regulating viscera,dispersing and reinforcing"as the general guidelines,emphasize the overall concept in the process of treatment,pay attention to dredge the nodules,get through the meridian system,adjust the body system,according to the degree of the progress of different,using flexible adjustment of"dredge the nodules""get through the meridian system""adjust the body function"three aspects of related drugs.In the attached medical records,using the experience of the team,embodying the core principles of"adjusting the meridians and regulating viscera,dispersing and reinforcing",and it achieved good clinical curative effect.[Conclusion]Based on this theory,firmly grasping the overall concept,connecting with all parties,and using drugs flexibly provide a new idea for the treatment of visual fatigue,which is worth promoting.

Objective To investigate the estimated values of sequential organ failure assessment (SOFA) and quick SOFA (qSOFA) for diagnosis and prognosis in patients with sepsis according to the new diagnostic criteria in Sepsis 3.0.Methods A retrospective study was conducted.All the clinical data were collected from patients with definite diagnosis of infection and they were admitted into the Intensive Care Unit (ICU) of Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical University from July 2014 to June 2016.The patients' gender,age,infectious location,respiratory rate (RR),oxygenation index (PaO2/FiO2),Glasgow coma scale (GCS),total bilirubin (TBil),platelet count (PLT),serum creatinine (SCr),serum lactate level,etc.general data on admission were collected to carry out SOFA and qSOFA scorings.And then the septic patients in accord with the diagnostic criteria of Sepsis 3.0 were screened out.According to outcome after admission,the septic patients were divided into survival group and death group,and the differences in diagnosis and in estimation value of prognosis between SOFA scoring and qSOFA scoring were assessed as SOFA group and qSOFA group.Results From 545 septic patients enrolled,189 septic patients consistent with the diagnostic criteria of Sepsis 3.0 were selected.In SOFA scoring group,the morbidity of septic patients was 34.68％,while in qSOFA scoring group,it was 15.96％,the difference between the two groups being statistically significant (P ＜0.01).The mortality was significantly lower in SOFA scoring group than that in qSOFA scoring group [28.04％ (53/189)vs.42.53％ (38/87),P ＜ 0.05].The mortality of qSOFA scoring group was about 1.52 times that of SOFA scoring group.On the aspect of scoring,in patients with SOFA scoring the score of death group was significantly higher than that in survival group (8.74 ± 0.417 vs.7.10 ± 0.235,P ＜ 0.01);in the patients with qSOFA scoring,the score in death group compared with that in survival group showed uo statistical significant difference (2.32 ± 0.48 vs.2.16 ± 0.37,P ＞ 0.05).On the aspect of laboratory indexes,the levels of GCS score in death group was significantly lower than that in the survival group (8.15 ± 0.67 vs.12.48 ± 0.36),blood lactate level in death group was significantly higher than that in the survival group (mmol/L:8.55 ± 4.66 vs.2.31 ± 0.16,P ＜ 0.01);the PaO2/FiO2,TBil,PLT and SCr showed no significant differences between the two groups (all P ＞ 0.05).Conclusions The new diagnostic criteria (Sepsis 3.0) can be used for diagnosis of sepsis in ICU.Compared with qSOFA scoring,the SOFA scoring is more suitable to be used for diagnosis and predicting prognosis of septic patients in ICU;SOFA scoring,GCS scoring and serum lactate level can be applied to estimate outcome of septic patients.

Objective To investigate the efficiency and safety of allogeneic hematopoietic cell transplantation for malignant hematological diseases in patients older than 50 yeas of age. Methods From May 2002 to January 2010, 35 patients (＞ 50 years) with malignant hematological diseases received allogeneic hematopoietic cell transplantation. In 35 patients, 18 patients were conditioned with non-myeloablative regimen and 17 patients with myeloablative regimen. The outcome,engraftment and prognosis of allogeneic hematopoietic cell transplantation were analyzed. Results The hematopoetic reconstitution was achieved in 32 of 35 patients. The median time of granulocyte count exceeding 0. 5 × 109/L was 12 days and the that of platelet count exceeding 20 × 109/L was 17days. The cumulative incidence of aGVHD was 48. 6 %, and 37. 9 % patients developed cGVHD.The estimate probability of cumulative survival at 5 years was 48. 5 %, The estimate probability of cumulative mortality rate was 51.5 %, and the estimated transplant-related mortality was 22. 9 %.The relapse rate was 11.4 %. There was significant difference except for the incidence of cGVHD.Conclusion Allogeneic hematopoietic cell transplantation may be appropriate for older patients with malignant hematological diseases.

Objective To explore the influence of the killer cell immunoglobulin like receptor (KIR) gene polymorphism on cytomegalovirus (CMV) infection and pathogenesis after hematopoietic stem cell transplantation (HSCT).Methods The KIR genotype was determined by sequence-specific primer polymerase chain reaction (PCR-SSP) in 138 pairs of donors and recipients before HSCT during October,2005 and May,2011.Posttransplant monitoring for CMVpp65 antigen was performed by indirect immune histochemically assays since week 2 after transplantation.The differences between CMV positive group and negative group,inhibitive and active KIR of donors and recipients,and KIR haplotype frequency of donors and recipients were analyzed.Results There were no significant differences in frequency of KIR gene and haplotype AA,AB,BB between the donors and recipients.The frequencies of 2DS2 and 2DS4 * 003-007 of donors in CMV positive group were obviously lower than those in CMV negative group with significant differences(8％ vs 16％,P =0.0420;3％ vs 13％,P =0.0050).There was no significant difference in KIR gene between CMV positive group and CMV negative group.The CMV infection rates of haplotype AA,BB,AB donors were 64.38％,36.84％ and 50.00％,while CMV infection rates of haplotype AA,BB,AB recipients were 53.73％,46.15％ and 51.72％,respectively.The CMV infection rate was higher in the patients received KIR haplotype AA donor than in those received KIR haplotype BB donor (36.84％ vs 64.38％,P =0.0299).2DS4 * 003-007 and haplotype BB of donor were found associated with CMV infection in multifactor analysis.Conclusion KIR genotypes of donors are associated with CMV infection after HSCT.