Objective To explore the treatment gap and influencing factors of convulsive epilepsy in rural areas of Jiangsu Province.Methods The clinical data of 7836 rural convulsive epilepsy patients screened from 2005 to 2020 were statistically analyzed,and the treatment status,treatment gap and related influencing factors of epilepsy patients were analyzed.Results A total of 7836 patients with convulsive epilepsy were enrolled in this study.The treatment gap for convulsive epilepsy in rural areas of Jiangsu Province was 69.05%.There was no significant difference in the treatment gap between different genders(P＞0.05).There were statistically significant differences in the treatment gap between age(χ2 = 12.196,P =0.007),age of onset(χ2 =58.658,P＜0.001),disease duration(χ2 =65.430,P＜0.001),seizure frequency(χ2 =171.276,P＜0.001),and hospitalization level(χ2 = 122.076,P＜0.001).Multivariate Logistic regression analysis showed that the older the age of onset was,the shorter the course of the disease was,the more frequent the seizures was,and the greater the treatment gap in patients with epilepsy was(all P＜0.05).Patients aged 45-59 years(P =0.012)and treated in municipal and county hospitals(P＜0.001)were more likely to receive regular anti-epileptic treatment.Conclusions There is a significant treatment gap for convulsive epilepsy patients in rural areas of Jiangsu Province.This may be due to insufficient awareness of epilepsy and the underdevelopment of primary healthcare institutions.

Cardiovascular disease is a health hazard to humans and systolic heart failure due to myocardial infarction is a major cause of death.It was previously thought that myocardial cells of the adult mammalian heart possess a limited ability to proliferate and self-renew.However,it has been widely reported that mammals have the ability to regenerate the myocardium,which is restricted to early postnatal life,and that it is strong enough to repair damaged heart tissue.The discovery of myocardial regeneration in neonatal hearts has provided an ideal animal model to investigate the mechanisms that affect myocardial regeneration,and many mechanisms that reverse myocardial cell cycle arrest and promote myocardial regeneration have been revealed.In this article,we review the factors affecting gene expression for myocardial regeneration(e.g.,ncRNAs and transcription factors),myocardial regeneration-related signaling pathways,and the regulation of myocardial regeneration by non-myocardial cells(e.g.,extracellular matrix,immune response,and epicardium)to provide directions for achieving myocardial regeneration after myocardial injury in adult mammals.

Objective To investigate the efficacy of valproic acid monotherapy in patients with convulsive epilepsy in several rural areas of Jiangsu Province,China,in 2005-2020.Methods The patients with convulsive epilepsy were given valproic acid monotherapy and follow-up management,and they were analyzed in terms of clinical features,medica-tion dose,drug efficacy,and adverse reactions.Results A total of 195 patients with convulsive epilepsy were enrolled in this study,among whom there were 117 male patients.Among these patients,48.72%were treated with valproate acid at a maximum dose of≤600 mg/d.In this study,193 patients were followed up for 1 year,with a response rate of 74.09%,and 79 patients were followed up for 5 years,with a cumulative response rate increasing to 87.34%.The incidence rate of adverse reactions gradually decreased with the increase in the course of treatment,and there was an increase in the propor-tion of patients with a subjective feeling of improvement in their conditions.Conclusion Valproic acid monotherapy has a marked clinical effect with slight adverse reactions,and thus it can be widely used in the treatment of patients with con-vulsive epilepsy in rural areas.

Neural loops are formed by interconnections between neurons through synaptic structures,which are the basic units of information transmission and processing in the brain and play an important role in the regulation of neural functions.After stroke,neural connections between the infarct and peri-infarct regions and the remote area are damaged,resulting in patients being at risk of neurological dysfunction or even disability.However,with advances in detection technology,an increasing number of studies are demonstrating that patients with stroke can undergo some functional recovery during the chronic phase,possibly via a mechanism related to the re-establishment of synaptic connections and neural circuits.Therefore,the development of specific technology to identify and manipulate neuronal activity patterns,as well as the use of high-resolution temporal and spatial imaging strategies to decipher these neurological processes,will allow us to understand the whole-brain network dynamics of stroke recovery and the mechanisms by which neural loop reestablishment occurs.Furthermore,we may be able to neurobiologically comprehend the closed-loop mechanisms that underlie the development of stroke pathology and their relationship to behavioral outcomes.Current technologies used for studying neural circuits include optogenetics,chemical genetics,in vivo calcium imaging,and functional magnetic resonance imaging.This article introduces the working principles of these four major technologies and focuses on summarizing the result of their respective application in resolving neural remodeling after stroke.We briefly analyze the application scenarios,advantages and disadvantages,and future development trends of each technique.This paper will help clinical and basic researchers to use these technologies to discover new therapeutic strategies and evaluate the effectiveness of rehabilitation strategies.

Objective:To evaluate the cerebral infarct volume and the nerve fiber connectivity between cortical and neurogenesis-related regions in the mouse model of reperfusion after middle cerebral artery occlusion (MCAO) by 11.7 Tesla(11.7 T) magnetic resonance imaging (MRI).Methods:MCAO models were established in SPF grade adult male C57BL/6 mice using the suture-occluded method.MRI scans were performed at 3 days before and 1 day after modeling.Infarct volumes were calculated, and nerve fiber tracking was performed on specific brain regions to analyze the nerve fiber number and the parameters of fractional anisotropy(FA), mean diffusivity(MD), axial diffusivity (AD)and radial diffusivity(RD). SPSS 26.0 was used for statistical analysis, and paired t test was used to compare the data before and after modeling. Results:(1) After MCAO-induced ischemia, the infarct volume was up to (35.11±17.57)mm 3, and the FA value of the infarct area was significantly reduced compared with that of before modeling( t=4.73, P<0.01). (2) At the anterior-posterior(AP): + 1.2 mm section, the results of fiber tracking showed that compared with before modeling, the number of fiber bundles originating from the dorsal horn of the lateral sub-ventricle zone(SVZ)to the cortex reduced ((92 584.20±14 751.00) vs (59 815.60±6 752.46), t=4.87, P<0.01), and the number of fiber bundles projected to the infarcted area reduced ((107 671.40±10 497.57) vs (61 658.60±10 178.21), t=6.43, P<0.01). FA, AD, MD, and RD values were all decreased in different degrees( t=3.38-6.43, all P<0.05). (3) At the AP: -3.8 mm section, the number of fiber bundles originating from the dorsal horn of the SVZ to the cortex decreased (after modeling(96 944.00±18 331.09), before modeling(58 767.80±16 445.25), t=2.99, P<0.05), and the values of FA, AD, MD and RD decreased after ischemia ( t=7.30, 5.05, 6.74, 4.13, all P<0.05). Conclusion:The ultra-high field strength of 11.7 T MRI can accurately detect the following results that the number of nerve fiber bundles from the SVZ to the cortex or infarct area are both significantly reduced, and diffusion tensor parameters are consistently changed in mice after 1 day of ischemia-reperfusion.

Objective: To construct a scientific behavioral research of pasta matrix reaching task (PMRT) and comprehensively evaluate sensory-motor dysfunction caused by brain injury. Methods: Twenty-one SD rats were subjected to 14-days pasta matrix grasping training and then were randomly divided into model group (11 rats) and sham group (6 rats). Motor cortex ischemia was induced by injection of endothelin-1 in SD rats. The number of pasta grabed by the injured forelimb and the location in matrix were evaluated daily 7 days after surgery. The infarct volume was measured by Nissl staining at the 7 days, 14 days, and 28 days after stroke. Results: The number of pasta obtained by rats was reduced from (33.43±1.02) to (20.57±0.57) at 7 days post stroke in model group, and then increased to (26.85±0.98) at 28 days post stroke, although there was a significant difference between sham group(32.33±1.45) and ischemic group (t=3.198, P<0.05). The frequency of retrieval from each slot of the pasta matrix represented that sham group demonstrated a significant gain in performance in the antero quadrant of the matrix compared to ischemic rats by the fourth week after stroke.The stroke volume was decreased from (37.82±1.17)mm³ at 7 days post-stroke to (24.35±0.38)mm³ at 28 days post-stroke, indicating brain recovery from ischemic injury. Conclusion The pasta matrix reaching task can function as a versatile and sensitive behavioral assay that permits experimenters to collect accurate outcome data and manipulate limb use to mimic human clinical phenomena including compensatory strategies and focused rehabilitative training after stroke.

Angiogenesis is a process that new blood vessels generate on the basis of an original vascular plexus via sprouting or other forms during normal growth and development of an organism or under particular conditions such as wound repairing and ischemic hypoxia. In general, angiogenesis includes five stages: degradation of the vascular basement membrane, endothelial cell proliferation, vascular sprouting, lumen formation and vascular network turning stable and mature. Among ischemic heart diseases, acute myocardial infarction seriously threatens human health, its pathological characteristics include myocardial vascular stenosis and blockage,leading to myocardial infarction. Therefore,the promotion of angiogenesis has become one of the therapies for ischemic heart diseases. A variety of pro-angiogenic cytokines are involved in the process of angiogenesis, such as polypeptide growth factors and lipid mediators. In this paper we review the recent progress in research on the expression of pro-angiogenic factors in myocardium after ischemic myocardial infarction.

Objective To explore the effects of morroniside on the expression of CD34 in ipsilateral cortex of rats after focal cerebral isch-emia-reperfusion. Methods 45 male Sprague-Dawley rats were divided into sham group (n=9), ischemia group (n=9), and morroniside groups (low, medium and high dosage groups, n=9). The middle cerebral artery were occluded for 30 minutes, and reperfused. Morroniside was administered intragastrically once a day at dose of 30 mg/kg, 90 mg/kg, 270 mg/kg after operation. The expression of CD34 in the isch-emic ipsilateral cortex were detected with immunohistochemistry (n=6) and Western blotting (n=3) 7 days after operation. Results The ex-pression of CD34 increased in the ischemia group compared with the sham group, and further increased in the morroniside groups of high dos-age compared with the ischemia group (F>14.865, P<0.001). Conclusion Morroniside could increase the expression of CD34 in the ischemic ipsilateral cortex after ischemia-reperfusion in rats, which may promote the angiogenesis and neurogenesis after ischemia.

Objective To investigate the effects of morroniside on the expression of vascular endothelial growth factor (VEGF) and fi-broblast growth factor-2 (FGF-2) in rat cortex after focal cerebral ischemia-reperfusion. Methods 30 male Sprague-Dawley rats were ran-domly divided into sham group, model group, morroniside-low group (30 mg/kg), morroniside-middle group (90 mg/kg) and morroni-side-high group (270 mg/kg). Middle cerebral arteries of rats were occluded for 30 minutes with Longa's method and re-perfused. The ex-pression of VEGF and FGF-2 in the ischemic ipsilateral cortex was detected with Western blotting 7 days after reperfusion. Results The ex-pression of both VEGF and FGF-2 increased in the ischemic ipsilateral cortexin in all the ischemic groups compared with the sham group (P<0.05). The expression of VEGF further increased in a dose-dependent manner in all the morroniside groups compared with that of model group (P<0.05), and the expression of FGF-2 increased in the morroniside-high group (P<0.001). Conclusion Morroniside could increase the expression of VEGF and FGF-2 after ischemia-reperfusion, which might promote angiogenesis.

Tissues and organs generate angiogenesis under the stimulation of angiogenic factors in physiological or pathological conditions.Multiple signal pathways including VEGF, Notch, Wnt/β-catenin, Ang1(2)/tie2 and PIK-Akt etc.have effects on various stages of angiogenesis.VEGF exerts irreplaceable effects on the whole process of angiogenesis through multiple signal pathways.Over the past few years, new progress has been made in the researches of mechanisms regulating angiogenesis through VEGF-related signal pathways both at home and abroad.These findings provide us new theoretical basis for clarification of the pathogenesis of many diseases and clinical drug development.In this article we will summarize the recent research progress in this field, hoping to provide new possibilities for the treatment of angiogenesis-related diseases.