Cerebral ischemia reperfusion injury （CIRI） is a secondary brain injury that may occur in patients with ischemic stroke during the process of blood flow recovery. NOD-like receptor protein 3 （NLRP3） inflammasome plays an important role in the occurrence and development of CIRI. Regulating the activity of NLRP3 inflammasome can induce cell pyroptosis， induce neuroinflammatory response， promote macrophage/microglial polarization， destroy the blood-brain barrier， affect angiogenesis and neurogenesis， thereby affecting CIRI. Traditional Chinese medicine has obvious advantages in the treatment of CIRI. In this paper， with NLRP3 inflammasome as the core， we systematically elucidated the mechanism of action of traditional Chinese medicines on CIRI， and found that traditional Chinese medicines monomers （such as baicalin， polygalasaponin F） and traditional Chinese medicines compound formulas （such as Huangqi guizhi wuwu decoction， Yiqi shengqing formulation） can inhibit NLRP3 inflammasome activity， reduce inflammatory response and oxidative stress， and improve neuronal injury， thereby reducing CIRI.

Cerebral ischemia reperfusion injury （CIRI） is a secondary brain injury that may occur in patients with ischemic stroke during the process of blood flow recovery. NOD-like receptor protein 3 （NLRP3） inflammasome plays an important role in the occurrence and development of CIRI. Regulating the activity of NLRP3 inflammasome can induce cell pyroptosis， induce neuroinflammatory response， promote macrophage/microglial polarization， destroy the blood-brain barrier， affect angiogenesis and neurogenesis， thereby affecting CIRI. Traditional Chinese medicine has obvious advantages in the treatment of CIRI. In this paper， with NLRP3 inflammasome as the core， we systematically elucidated the mechanism of action of traditional Chinese medicines on CIRI， and found that traditional Chinese medicines monomers （such as baicalin， polygalasaponin F） and traditional Chinese medicines compound formulas （such as Huangqi guizhi wuwu decoction， Yiqi shengqing formulation） can inhibit NLRP3 inflammasome activity， reduce inflammatory response and oxidative stress， and improve neuronal injury， thereby reducing CIRI.

Cerebral ischemia-reperfusion injury(CIR1)refers to the recovery of blood supply after cerebral ischemia,which leads to further damage and the dysfunction of brain tissue.Modern medicine has made some progress in the prevention and treatment of CIRI,but it still faces some challenges and limitations.Therefore,it is of great clinical value to find effective interventions to prevent and treat CIRI.AMP-activated protein kinase(AMPK)and its downstream proteins are important targets for the treatment of CIRI and play key roles in the regulation of cellular energy homeostasis.Traditional Chinese medicine for CIRI has multi-target and multi-pathway activities and multiple effects.It can activate a cascade of reactions in the AMPK signaling pathway and can be used to treat CIRI by regulating autophagy,oxidative stress,inflammatory response,and apoptosis,and has achieved certain result.Therefore,this paper summarizes the structure and mechanisms of the AMPK-related signaling pathway,elaborates on its relationship with CIRI,and systematically summarizes the research status of traditional Chinese medicine's ability to regulate the AMPK signaling pathway in the prevention and treatment of CIRI.This paper aims to provide new ideas for the prevention and treatment of CIRI using traditional Chinese medicine and the development of new drugs.

Ischemic stroke is the leading cause of disability in China,and treatment options are still very limited.The method of dredging Fu-organs has been proved to have a significant effect in the treatment of ischemic stroke,but its mechanism is not clear.With the progress of brain-gut communication research,more and more evidence shows that brain-gut communication plays an important role during ischemic stroke.Based on the theory of"brain-gut interaction",this paper discusses the mechanism of Tongfu method in the treatment of ischemic stroke,and discusses the intestinal flora,brain-gut peptide,intestinal metabolites,intestinal mucosal barrier and other aspects.It is concluded that Tongfu method can treat ischemic stroke by regulating intestinal flora,brain-gut peptide content,intestinal metabolite content and repairing intestinal mucosal barrier.In order to provide more ideas for elucidating the mechanism of Tongfu method in the treatment of ischemic stroke,it has very important theoretical and clinical value.

Animals ; Antigens, Surface/genetics* ; Cell Communication/genetics* ; Copulation/physiology* ; Fallopian Tubes/metabolism* ; Female ; Fertilization/genetics* ; GPI-Linked Proteins/genetics* ; Gene Expression Regulation ; Genes, Reporter ; Green Fluorescent Proteins/metabolism* ; Litter Size ; Luminescent Proteins/metabolism* ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Mitochondria/metabolism* ; Reproduction/genetics* ; Signal Transduction ; Sperm Count ; Sperm Motility/genetics* ; Spermatozoa/metabolism* ; Uterus/metabolism*

Objective To report the clinical features,microsurgical techniques and outcomes of 5 patients admitted in our hospital,who had solid hemangioblastoma in medulla oblongata in the last 5 years.Methods 5 consecutive cases of solid hemangioblastoma in medulla oblongata operated from March,2011 to May,2016 were reviewed and fl lowed up.Results All patients suffered headache,dizziness and cerico-occipital pain from the beginning plus one was found because of obstructive hydrocephalus.The mean duration before operation was 6.7 months.The mean maximum diameter of tumor was (33.7±3.4)mm.The suboccipital posterior midline approach was performed and gross total resection was achieved in all 5 cases.After operation,endotracheal tube was removed in all 5 patients,but 3 received tracheotomy,and all patients can take food freely now through rehabilitation exercise.Followed up until September 2016,all patients lived a normal life.Conclusion The operation of solid hemangioblastoma in medulla oblongata is full of huge risk,but microsurgical resection is the only cure means for the tumor.

Objective There are differences in the diagnosis and treatment of primary melanocytoma in central nervous sys -tem.The article was to investigate the experience of its diagnosis and treatment . Methods Retrospective analysis were made on the clinical data of 14 cases with primary melanocytoma in central nervous system ( CNS) from January 1999 to December 2012, among which were 5 males and 9 females.The incidence ages were 14-52, average 32.7.The course of disease ranged from half a month to 19 years, geometric average 7.9 months.5 cases recurred and 9 cases occurred first.10 cases were intracranial and 4 were intraspinal. Results 14 patients underwent surgery and had pathologic diagnosis of melanocytoma .Total resection was performed in 7 patients, subtotal resection in 3, and partial resection in 1.Immunohistochemical study showed , in all cases, S-100 and HMB-45 were positive, GFAP and EMA were negative .Vimentin was positive in 8 cases and MelanA positive in 5 cases.12 cases recovered well and dis-charged except for paraplegia and facial paralysis in 1 case each. Conclusion Primary melanocytoma in CNS is very rare .Diagnosis is based on intraoperative findings , surgical pathology and immunohistochemistry results .Surgery is the primary therapy and early total resection is advocated .Adjuvant radiotherapy can reduce the recurrence rate .

Objective To study the lesion patterns of hemorrhagic type of moyamoya disease (MMD) in adults. Methods Seventy-two consecutive cases of hemorrhagic type of MMD, confirmed by digital cerebral angiography in Jinling hospital between January 2004 and February 2010, were retrieved from the Nanjing Stroke Registry Program. MMD patients were classified according to the hemorrhagic sites into 4 types: non-thalamic parenchymal, thalamic, primary ventricular and subarachnoid. The ipsilateral anterior choroidal artery and posterior communicating artery (AChA-PComA) were evaluated by the modified Morioka's 3-points grading system: normal or mild to moderate dilation, severe dilation with abnormal extension and non-visualization. The relationship between lesion patterns and the angiographic findings was analyzed. Results In the stage of normal or mild to moderate dilation of AChA-PComA, non-thalamic parenchymal hemorrhage was the more frequent type (51.6%, 16/31 ;Z = -3.266,P =0.001 ), and there was a high incidence of intrastriatal hemorrhage occurred (22.6%, 7/31 ). In the stage of severe dilation with abnormal extension, intraventricular hemorrhage was most common ( 58.8%, 20/34 ;Z = -2.696 ,P =0.008). In addition, posterior circulation subarachnoid hemorrhage (SAH) was associated with a higher grade of AChA-PComA than anterior circulation SAH (Z = -4.655 ,P ＜ 0.01 ). Furthermore, posterior circulation SAH was the only type of SAH in the stage of non-visualization(9.7% ,7/72; x2 =42.999,P ＜0.01 ). Conclusion In adult patients with MMD, different subtypes of hemorrhagic stroke were associated with angiographic changes of AChA-PComA, and the angiographic characteristics may predict the location of hemorrhage.

Objective To develop a simple and effective method for monitoring cortical ischemia after temporary occlusion of the parent arteries during anterior circulation intracranial aneurysm surgery. Methods Fifty-two patients with anterior circulation aneurysm (58 aneurysms) received craniotomy from April to November 2008, and at the same time,cortical electroencephalograpby (EEG) and scalp EEG were monitored during the surgery.According to the international 10/20 electrode placement system, scalp electrodes were placed on O1, O2, P3, P4, T5, and T6 for monitoring the changes in the depth of anesthesia. A cortical strip electrode was placed on the cortical surface supplied by the artery that was possibly blocked during the operation, which was used to monitor the possible cortical ischemia. For patients who had cortical EEG suppression after the temporary occlusion of the parent arteries Were compared with the changes of scalp EEG. Whether there were ischemic events in the corresponding supply territory after vascular occlusion were observed after surgery. Results Of the 58 aneurysms, 40 aneurysms and 41 major arteries were occluded temporarily. After being occluded temporarily in 19 arteries of 18 patients, cortical EEG changed significantly,while scalp EEG did not change significantly. Only 9 patients had ischemic events in the corresponding supply territories after the occlusion in the cortical EEG significant change group. The changes in the depth of anesthesia had the consistent impact on cortical and scalp EEG. Conelusions Simultaneous monitoring of cortical and scalp EEG is a simple and effective method for monitoring cortical ischemia during anterior circulation intracranial aneurysm surgery, and may effectively identify the effect of anesthesia on EEG.

Objectives:The screening examination of bladder cancer by detecting urinary survivin and the survivin expression in bladder cancer were evaluated. Methods:Urinary survivin was detected by ELISA and survivn expression of tumor tissue was observed by immunohistochemistry.(Results):There was significant difference in urinary survivin between the groups of treatment and control((P