The seat of human intelligence is the human cerebral cortex, which is responsible for our exceptional cognitive abilities. Identifying principles that lead to the development of the large-sized human cerebral cortex will shed light on what makes the human brain and species so special. The remarkable increase in the number of human cortical pyramidal neurons and the size of the human cerebral cortex is mainly because human cortical radial glial cells, primary neural stem cells in the cortex, generate cortical pyramidal neurons for more than 130 days, whereas the same process takes only about 7 days in mice. The molecular mechanisms underlying this difference are largely unknown. Here, we found that bone morphogenic protein 7 (BMP7) is expressed by increasing the number of cortical radial glial cells during mammalian evolution (mouse, ferret, monkey, and human). BMP7 expression in cortical radial glial cells promotes neurogenesis, inhibits gliogenesis, and thereby increases the length of the neurogenic period, whereas Sonic Hedgehog (SHH) signaling promotes cortical gliogenesis. We demonstrate that BMP7 signaling and SHH signaling mutually inhibit each other through regulation of GLI3 repressor formation. We propose that BMP7 drives the evolutionary expansion of the mammalian cortex by increasing the length of the neurogenic period.
Animals ; Mice ; Humans ; Ependymoglial Cells/metabolism* ; Hedgehog Proteins/metabolism* ; Ferrets/metabolism* ; Cerebral Cortex ; Neurogenesis ; Mammals/metabolism* ; Neuroglia/metabolism* ; Bone Morphogenetic Protein 7/metabolism*

ObjectiveTo explore the syndrome elements and evolving patterns of patients with hepatitis B virus-related acute on chronic liver failure （HBV-ACLF） at different stages. MethodsClinical information of 1,058 hospitalized HBV-ACLF patients， including 618 in the early stage， 355 in the middle stage， and 85 in the late stage， were collected from 18 clinical centers across 12 regions nationwide from January 1， 2012 to February 28， 2015. The “Hepatitis B-related Chronic and Acute Liver Failure Chinese Medicine Clinical Questionnaire” were designed to investigate the basic information of the patients， like the four diagnostic information （including symptoms， tongue， pulse） of traditional Chinese medicine （TCM）， and to count the frequency of the appearance of the four diagnostic information. Factor analysis and cluster analysis were employed to determine and statistically analyze the syndrome elements and patterns of HBV-ACLF patients at different stages. ResultsThere were 76 four diagnostic information from 1058 HBV-ACLF patients， and 53 four diagnostic information with a frequency of occurrence ≥ 5% were used as factor analysis entries， including 36 symptom information， 12 tongue information， and 5 pulse information. Four types of TCM patterns were identified in HBV-ACLF， which were liver-gallbladder damp-heat pattern， qi deficiency and blood stasis pattern， liver-kidney yin deficiency pattern， and spleen-kidney yang-deficiency pattern. In the early stage， heat （39.4%， 359/912） and dampness （27.5%， 251/912） were most common， and the pattern of the disease was dominated by liver-gallbladder damp-heat pattern （74.6%， 461/618）； in the middle stage， dampness （30.2%， 187/619） and blood stasis （20.7%， 128/619） were most common， and the patterns of the disease were dominated by liver-gallbladder damp-heat pattern （53.2%， 189/355）， and qi deficiency and blood stasis pattern （27.6%， 98/355）； and in the late stage， the pattern of the disease was dominated by qi deficiency （26.3%， 40/152） and yin deficiency （20.4%， 31/152）， and the patterns were dominated by qi deficiency and blood stasis pattern （36.5%， 31/85）， and liver-gallbladder damp-heat pattern （25.9%， 22/85）. ConclusionThere are significant differences in the distribution of syndrome elements and patterns at different stages of HBV-ACLF， presenting an overall trend of evolving patterns as "from excess to deficiency， transforming from excess to deficiency"， which is damp-heat → blood stasis → qi-blood yin-yang deficiency.

Objective To investigate the effects of fasudil hydrochloride on learning and memory, and the autophagy in hippocampal CA1 neurons in subarachnoid hemorrhage (SAH) rats. Methods Fifty-four male Sprague-Dawley rats were randomly divided into sham group (n=18), SAH group (n=18) and drug group (n=18). Subarachnoid hemorrhage model was established with internal carotid artery punc-ture. The drug group was injected fasudil hydrochloride 10 mg/kg intraperitoneally after modeling per 24 hours, while the sham group and SAH group were injected the same volume of saline. They were tested with shuttle box test 6, 24 and 72 hours after intervention, then the hippocampal CA1 area was stained with HE and immunohistochemistry to observe the morphology of cells and the expression of Beclin-1 and microtubule-associated protein 1 light chain 3 II (LC3-II). Results Compared with the sham group, the frequence of avoidance de-creased in SAH group at each time point (P<0.05), while the avoidance reaction time increased (P<0.05);the survival of neurons in hippo-campal CA1 area decreased (P<0.05), and the expression of Beclin-1 and LC3-II increased (P<0.05). Compared with SAH group, the fre-quence of avoidance increased in the drug group at each time point (P<0.05), while the avoidance reaction time decreased (P<0.05);the sur-vival of neurons in hippocampal CA1 area increased (P<0.05) and the expression of Beclin-1 and LC3-II increased further (P<0.05). Con-clusion Fasudil hydrochloride can improve learning and memory ability and protect neurons from damage, which may associate with the ex-cess of autophagy activation in hippocampal CA1 areas in SAH rats.

Objective To report a newly developed method and procedure to establish a rat model of subarachnoid hemorrhage in detail, and to provide a better model simulating the clinical subarachnoid hemorrhage caused by a ruptured aneurysm for related research.Methods One hundred and twenty healthy SPF 2-3-month old male Sprague-Dawley rats were divided into 4 groups, 30 rats in each group.The three experimental groups were sacrificed at 6, 24 and 72 hours after modeling.Rat models of subarachnoid hemorrhage were established by inserting a fiber core in the internal carotid artery and piercing this artery.Successful establishment of the subarachnoid hemorrhage model was confirmed by observation of breathing, pupil, defecation, urination and inspection at autopsy dissection.The controllability and reproducibility of this model were verified by observation of clinical manifestation and explored by mortality analysis.Results Subarachnoid hemorrhage was successfully induced by fiber core piercing the internal carotid artery at the needed location.Conclusions This method of model preparation is stable and understandable.The operation is nimble, with a good reproducibility.This model can be successfully performed after a short time learning, well simulate the sudden hemorrhage caused by a ruptured aneurysm, and suitable for research on early brain injury and vasospasm after subarachnoid hemorrhage.

Objective To determine the median effective target effect-site concentration (EC50) of sufentanil inhibiting cardiovascular response to tracheal intubation when combined with propofol in patients of Uygur nationality.Methods Thirty-one ASA Ⅰ or Ⅱ Uighurs of both sexes,aged 21-59 yr,with body mass index 18-28 kg/m2,undergoing elective surgery,were enrolled in this study.Anesthesia was induced and maintained with propofol and sufentanil target-controlled infusion and iv injection of cisatracurium 0.2 mg/kg.The target effect-site concentration (Ce) of propofol was set at 3.0 μg/ml.Tracheal intubation was performed after the target Ce and plasma concentrations were balanced.The target Ce was set at 0.8 ng/ml in the first patient.Each time Ce increased/decreased by 10％ in the next patient depending on whether or not the cardiovascular response to tracheal intubation occurred.The positive cardiovascular response was defined as increase in systolic blood pressure by 15％ and/or HR＞ 90 bpm lasting for ＞ 15 s.The EC50(95％ confidence interval) of sufentanil blunting cardiovascular responses to trancheal intubation was calculated by Probit analysis.Results EC50 (95 ％ confidence interval) of sufentanil inhibiting cardiovascular response to tracheal intubation when combined with 3.0 μg/ml propofol was 0.46 (0.43-0.49) ng/ml.Conclusion EC50 of sufentanil inhibiting cardiovascular response to tracheal intubation is 0.46 ng/ml in patients of Uygur nationality when combined with propofol.

Objective To assess the risk factors of the in-hospital mortality of acute type A aortic dissection after operation. Method From January 2003 to June 2008,185 patients, 144 males and 41 females, with acute type A aortic dissection operated on were enrolled. The average age of patients was (49.46 ± 11.04 ) years old.The patients' demographics, history, clinical features, and some laboratory examinations were reviewed. Univariate and multivariate analysis followed by logistic regression analysis were carried out to identify the predictors of inhospital mortality. Results The in-hospital mortality rate was 9.1%. The results of univariate and multivariate analyses as follows: pre-operation positive neurological symptom (Univariate OR = 5.084,95%CI:1.792 -14.426, P = 0.002; Multivariate OR = 5.538,95%CI: 1.834 - 16.721, P = 0.002, respectively), hypotension (Univariate OR = 6.986,95%CI:1.510- 32.323,P =0.013; multivariate OR = 1.998,95%CI:0.315-12.679,P = 0.463, respectively) and renal failure (Univariate OR = 3.594,95%CI:1.237 - 10.438,P =0.019; Multivariate OR = 3.254,95%CI:1.034- 10.242, P= 0.044, respectively). Conclusions There are two predictors, pre-operation positive neurological symptom and renal failure, of pre-hospital mortality found in current analyses. Our results may improve the regimen made by cardiac surgeons and emergency doctors so as to help patients and their relatives to make correct decision.

BACKGROUND: With further understanding of deep venous thrombosis(DVT)following total hip replacement,reduction and prevention of DVT has become hot topic in clinical studies.The reports of DVT formation factors remain controversial due to small samples,little statistical significance,confusion of basic experimental and clinical results and lacks of science.OBJECTIVE: To explore the causes and factors for the early DVT following total hip replacement and summarize measures to prevent and treat early DVT to reduce incidence of complications.METHODS: A total of 1780 cases of primary total hip replacement operation were analyzed retrospectively.The statistical indexes included sex,age,body mass,other system disease,previous hip joint operation,anesthesia,operative time,prosthetic fixation,blood transfusion,postoperative functional exercise,antithrombotics,and complication.Standardized database was built and analyzed by SPSS(version 13).Regression analysis was performed using Binary Logistic Regression.RESULTS AND CONCLUSION: Of 1780 cases,136 had DVT.Age,other system diseases,anesthesia,prosthetic fixation,blood transfusion,postoperative functional exercise and antithrombotics were correlated with early DVT(P < 0.05).Old age,hypertension or diabetes,general anesthesia,fixation of bone cement,whole blood transfusion were the risk factors for early DVT following total hip replacement,while postoperative functional exercise and antithrombotics were the protective factors for DVT.The incidence rate of early complications can be reduced by the methods such as dealing with perioperative treatment carefully,effectively controlling the chronic diseases,efficient evaluation before surgery,precise manipulation,and the postoperative prophylactic treatment and nursing.

Objective To explore clinical characteristics of chronic total occlusion(CTO) in population with routine coronary angiography,and to cumulate therapeutic experience.Methods Retrospective analysis was performed on clinical data of 57 cases with CTO selected from 825 patients undergone coronary angiography.Results Among 57 cases,the percentage of male,myocaridial infarction,diabetes mellitus,hyperlipidermia and left ventricular dysfunction was 73.7%,84.2%,22.8%,73.7% and 22.8%,respectively.The types of lesions included single branch(n=11),double branches(n=29) and three branches(n=17).Of 70 branches lesion vessels,44 were TIMI 0 of blood flow classification and 26 were TIMI1.The position of lesions occurred at left anterior descending branch(n=32),left circumflex branch(n=16),right coronary artery(n=22).The occlusion time was less than three months(n=41) and more than three months(n=29).The lengths of lesion was divided into less than 20 mm(n=43) and more than 20 mm(n=27).The shapes of terminal lesion looked like rat-tail(n=42) and blaze knife-edge(n=28).The coronary stents were performed at 57 lesions among 70 branches and the successful rate of operation was 82.9%.Conclusions Timely coronary angiography and selecting suitable treatment on different kinds of lesions for male patients with myocardial infraction,especially complicated with diabetes mellitus,might play important roles in prevention of CTO and in improvement of the successful rate of percutanous coronary intervention for the complex lesion.

Objective To evaluate the significance of laparoscopy in the diagnosis and treatment of unexplained acute right lower abdominal pain in women. Methods Clinical data of 52 women with unexplained acute right lower abdominal pain from April 1999 to April 2004 were retrospectively analyzed. Results Diagnosis was clarified under laparoscope in all the 52 patients, including 28 cases of acute appendicitis, 18 cases of acute pelvic inflammatory disease, 3 cases of ovarian cyst pediculotorsion, 2 cases of right tubal pregnancy, and 1 case of Crohn’s disease with iliac perforation. With exception of a conversion to open surgery in 3 patients, laparoscopic treatment was successfully completed in the remaining 49 patients. No surgical complications occurred. The patients were discharged from the hospital 2~6 days postoperatively. Conclusions Laparoscopy is a timely, safe and effective alternative for the diagnosis and treatment of unexplained acute lower right abdominal pain in women.

OBJECTIVETo evaluate the effect of shuxuetong (SXT) in preventing restenosis after intracoronary stenting.

METHODSSixty-eight patients, accepted intracoronary stenting, were divided into two groups, the SXT group and the control group, both of them were treated with conventional treatment, and to the SXT group, SXT was given additionally. The condition of treated coronary artery restenosis in the two groups was compared by way of quantitative coronary angiography and a 6-month follow-up study was adopted.

RESULTSFollow-up study was completed in 43 patients (23 cases in the SXT group, and 20 in the control group). The angina recurrence rate in the SXT group (3 cases, 13%) was significantly lower than that in the control group (7 cases, 35%, P < 0.05). Quantitative coronary angiography showed the restenosis degree of operated artery in the SXT group was significantly milder than that in the control group, with the last lumen losing and index in the SXT group (0.46 +/- 0.25 mm, 24.26 +/- 8.64%) less than those in the control group (0.75 +/- 0.33 mm, 31.25 +/- 11.03%). The net gain lumen and the net gain index in the SXT group (1.23 +/- 0.30 mm, 58.96 +/- 24.68%) were greater than those in the control group (0.98 +/- 0.33 mm, 42.68 +/- 29.51%), all P < 0.05. But the restenosis rate in the two groups was insignificantly different (P > 0.05).

CONCLUSIONSXT might has some definite effect in preventing restenosis after intracoronary stenting.

Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; Coronary Disease ; drug therapy ; therapy ; Coronary Restenosis ; prevention & control ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Phytotherapy ; Stents ; adverse effects