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Table of Content

    20 December 2014, Volume 9 Issue 12
    Entanglement on Ideal and Action
    WANG Yong-Jun
    2014, 9(12):  987-998. 
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    Research Progress of Ischemic Brain Injury after Intracerebral Hemorrhage
    WU Jie-Hong,HU Bo
    2014, 9(12):  989-992. 
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    Calpain Induces Secondary Neuronal Injury after Intracerebral Hemorrhage via
    Degradation of SynapsinⅠ
    ZHANG Zhen-Tao*, ZHANG Guo-Xin, WANG Hong-Cai,XIONG Jing, HU Dan, ZHANG Zhao-Hui.
    2014, 9(12):  993-998. 
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    Objective To investigate the role of calpain in secondary neuronal injury after intracerebral hemorrhage. Methods Experimental intracerebral hemorrhage (ICH) was induced in mice by intraparenchymal injection of autologous blood. The animals were randomly separated into 4 groups:0 h group (control group), 2 h group, 4 h group, and 24 h group. Each group contains 10 mice. The activity of calpain in the brain tissues were evaluated at different time points. The degradation of synapsin Ⅰ was analyzed by Western blot. The cleavage of recombinant synapsin Ⅰ was analyzed after incubation with active calpain. The effects of exogenous calpain and calpain inhibitors ALLN and MDL28170 on PC12 cells were analyzed by MTT assay. The expression of synapsin Ⅰ was determined by Western blot. Results The activity of calpain increased in a time-dependent manner, with peak activation at 24 h. 0 h, 2 h, 12 h, and 24 h after surgery, the calpain activity reading was 234.32, 343.87, 425.29, and 597.36, respectively. The calpain activity of 12 h group and 24 h group was significantly higher than the 0 h group (P <0.05). The expression of synapse-associated protein synapsin Ⅰ decreased as the activity of calpain increased, indicating synapsin Ⅰ might be cleaved by calpain. The protein level of synapsin Ⅰ decreased to 67% of the control group (P <0.01). To verify the cleavage of synapsin Ⅰ by calpain, purified recombinant synapsin Ⅰ was incubated with active calpain in vitro. Calpain induced the degradation of synapsin Ⅰ. Synapsin Ⅰ level decreased to 57.75% (P =0.001) of the control group after 30 min incubation. The in vitro cleavage of synapsin Ⅰ by calpain was inhibited by calpain inhibitors. The level of synuclein Ⅰ was 87.00% and 84.75% in the present of ALLN and MDL28170, respectively (P <0.05 compared to the calpain group). Exogenous calpain induced cell toxicity in neuronal differentiated PC12 cells. The cell viability decreased to 58.25% of the control group after 12 h incubation, In the presence of calpain inhibitors ALLN and MDL28107, the cell viability increased to 83.00% and 80.25%, respectively (P <0.01 compared to calpain group). Conclusion Calpain plays importan roles in the secondary neuronal injury after intracerebral hemorrhage by degradation synapsin Ⅰ. It is a potential therapeutic target for the treatment of intracerebral hemorrhage.

    Minocycline Improves the Depressive Behaviors of Vascular Depression Mice
    and Influences the Neurotransmitters Content in Hippocampus via Restraining
    Neuroinflammation
    LI Hai-Long*, LIU Min, ZHANG Hai, ZHENG Hui-Wen, ZHOU Kai-Ge, WANG Yun-Xia, BI Xiao-Ying.
    2014, 9(12):  999-1006. 
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    Objective To investigate the effects of minocycline, a neuroinflammation inhibitor, on the depressive behaviors and neurotransmitters in the vascular depression mice model. Methods Male CD1 mice were subject to repeated common carotid artery occlusion and reperfusion to establish the vascular depression model, then randomly divided into experimental group (n =10), control group (n =10) and sham group (n =10). Minocycline (30 mg/kg, i.p.) and same dose of saline were administrated immediately after the surgery and subsequently the consecutive 6 days in experimental group and control group respectively. Mice in sham group were conducted the same surgery expect occluding carotid artery, then administered the same dose of saline as the control group. After the administration, tail suspension test and open-field test were used to assess depression behaviors of mice on the post operation day (POD) 8 and 9 respectively, and Morris water maze was used to assess cognitive function on the POD 10. On POD 11, mice were deeply anesthetized and euthanized and transcardially perfused with phosphate buffered saline (PBS). Expressions of tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) in hippocampus were measured by enzyme-linked immunosorbent assay (ELISA) kit. Contents of 5-hydroxytryptamine (5-HT), norepinephrine (NE) and dopamine (DA) were measured by high performance liquid chromatography (HPLC). Results Among the three groups, the immobility time was significantly different ([174.75±11.37]s vs [194.32±14.32]s vs [169.62±19.27]s, F =6.59, P =0.005), and the immobility time of experimental group and sham group was shorter than control group significantly. The times of exploring holes, prolonged time and distance of movement were significantly different (F =6.17, P =0.008; F =11.55, P <0.001; F =13.47, P <0.001), the times of exploring holes of experimental group and sham group was more than control group significantly, and so did both prolonged time and distance of movement of those two groups. But there was significant difference in escape latency ([87.38±13.36]s vs [88.50±19.88]s vs [44.38±19.76]s, F =16.09, P <0.001) among the three groups, the escape latency of experimental group and control group was significantly longer than sham group. The expression of TNF-α, IL-1β and IL-6 in hippocampus were down-regulated in experimental group and sham group compared with control group (TNF-α:[141.10±24.36]pg/100 mg vs [167.6±15.91]pg/100 mg vs [123.8±15.53]pg/100 mg, F =13.42, P <0.001; IL-6:[20.01±3.62]pg/mg vs [24.39±5.04]pg/mg vs [18.40±3.78]pg/mg, F =5.49, P =0.010; IL-1β ([5.32±1.89]pg/mg vs [10.31±2.83]pg/mg vs [4.50±2.07] pg/mg, F =18.69, P <0.001). There were no significant difference in the level of NE among the three groups ([3.97±1.35]ng/ml vs [3.16±1.55]ng/ml vs [4.68±1.99]ng/ml, F =2.13, P =0.139), but there is a increased level of DA in experimental group and sham group compared with control group ([10.72±2.65] ng/ml, [11.76±3.10] ng/ml vs [7.99±2.31] ng/ml). Conclusion Minocycline can restrain the expression of inflammatory cytokines in vascular depression mice, and inhibited inflammation may improve their depression behaviors, but no improvement found in the cognitive impairment. Among those relevant neurotransmitters, the content of DA changes most significantly.

    Study on the Treatment Effectiveness of Per Rectum Olanzapine for Patients with Delirium Post-Stroke
    FU Xiao-Ling, SHI Yu-Zhi, GAO Chang, CHU Qing-Ying, LI Jian-Hua, SHU Gang-Ming.
    2014, 9(12):  1007-1012. 
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    Objective To investigate the effectivity and safety about olanzapine administered rectally for ischemic stroke old patients. Methods Sixty patients (aged ≥65 years) admitted to the Department of Cardre Ward-2 of the First Affiliated Hospital of the General Hospital of People's Liberation Army (PLA) from March 2013 with delirium after a recent stroke was accepted. All these 60 patients were randomly divided into two groups to accept with olanzapine orally or rectally, respectively. All the patients fulfilled the National Institutes of Health Stroke Scale (NIHSS) and the Confusion Assessment Method (CAM) scale before and one week after they used the drug of olanzapine. Compare the baseline data, severity of the stroke and the delirium. One week after the patients used the drug, compare the mean dose of olanzapine, the treatment effect and the side effect of the two groups. We followed up all the 60 patients with modified Rankin Scale (mRS) after 3 months to evaluate the prognosis of the two methods of administration. Results ①There is no significant difference between the oral group and the rectal group on the age, gender and the score of NIHSS and CAM: Media of NIHSS (8.5 vs 10; P =0.79)、CAM ([25.8±3.1] vs [26.1±5.3]; P =0.79). Also the comorbidity of hypertension (6.7% vs 2.0%; P =0.18), diabetes (10.0% vs 23.3%; P =0.17) and coronary heart disease (CHD) (50.0% vs 60.0%; P =0.43) have no significant differences between the two groups. ②Both two groups' olanzapine orally and rectally are both well tolerated among these patients, and there is no significant side effect on those 60 patients in the first week ([5.33±2.12] vs [4.25±2.06]; P =0.03). ③The follow-up data after 3 months showed that there was no significant difference between the two groups in the score of mRS (P =0.15). Conclusion Olanzapine administered rectally may be an effective and safe method for delirium patients, especially for those patients who are difficulty in taking oral medicine. And the dose of rectal use should be less than that of oral use.

    Cerebral Hemorrhage and Cerebral Microhemorrhage
    Hu Bo
    2014, 9(12):  1014-1014. 
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    Advances of Cerebral Microbleeds and Cognition Impairment
    DAI Ruo-Lian, LI Yan-Sheng.
    2014, 9(12):  1015-1019. 
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    Cerebral microbleed (CMB), as an imaging sign of small vascular disease, has gradually gained people's attention because of the correlation with cognitive impairment. Current clinical research found that CMB widely existed in healthy people and cerebrovascular or neurodegenerative patients with cognitive impairment. The further studies indicated that CMB might be an independent risk factor for cognitive impairment, and especially impaired executive function. The numbers of CMB were positively correlated with cognitive impairment. We reviewed the previous studies, and briefly introduced the inner pathological mechanisms, which may help treat or delay cognitive decline in high-risk patients.

    A Case of Congenital Adrenal Hyperplasia with Cerebral Infarction Related to Hypertension in Child
    AN Ze-Xin, SHAO Ru-Sheng, DONG Qiao-Yun, et al.
    2014, 9(12):  1020-1023. 
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    Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack
    (Part 5)
    XIE Hong-Rong, YU Fei, GAO Wei-Ming, et al.
    2014, 9(12):  1024-1041. 
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    Review of Prognosis in Acute Stroke Patients Treated with Thrombolysis
    ZHANG Xin-Miao, WANG Chun-Juan, LIAO Xiao-Ling, WANG Yi-Long, LIU Li-Ping, WANG Chun-Xue,ZHAO Xing-Quan, WANG Yong-Jun.
    2014, 9(12):  1041-1047. 
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    Intravenous thrombolysis was the most effective treatment of acute ischemic stroke, however, the accompanied risks of hemorrhage transformation and poor prognosis increased at the same time. In this paper, the risk factors of the miserable prognosis of intravenous thrombolysis for acute ischemic stroke were summarized and related prediction models were described. We aimed to analyze the different characteristics and predicting abilities of different prediction models to help clinical neurologists make their decision quickly and effectively when they accepted the patients with acute ischemic stroke for whether to give them intravenous thrombolysis.

    Blood Pressure Variability Correlates with Target Organ Damage and its Prognosis
    LI Qun, XU Xiu-Ying.
    2014, 9(12):  1048-1053. 
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    Blood pressure variability (BPV) becomes more and more important because of its relationship between target organ damage and clinical significance. The related researches reported in the papers increased. Related researches on blood pressure variability and hypertensive target organ damage are also often found in reports. More and more evidence suggests that the greater of the blood pressure variability, the more severe hypertensive target organ damage. Blood pressure variability had a great value in predicting the level of left ventricular hypertrophy (LVH) and target organ damage and clinical cardiovascular events. This review summarized a lot of studies in recent years about blood pressure variability, including quantitative analysis, the regulation mechanism, target organ damage and the mechanism of target organ damage, and clinical significance.

    Teaching Experiences of Foreign Students on Neurology
    WANG Zhan, CHEN Sheng-Yun,WANG Chun-Xue, ZHANG Zai-Qiang, ZHANG Ning.
    2014, 9(12):  1054-1056. 
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    Objective To explore the questions about the foreign students’ educations on neurology. Methods From 2011 to 2012, fifty foreign students from the Southeast Asia and Arabia area participated in our neurological practice class. Some experiences of clinic neurology education were summarized. Results There were many questions about the clinic neurology education, including the language communication, cultural differences, unsuitable textbook and the specialty of neurology. Conclusion Improving the teachers' English level and trying various forms of teaching may play a key role in improving foreign teaching quality.

    Developing Self-directed Learning of Medical Graduates
    ZHOU Yong.
    2014, 9(12):  1057-1059. 
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    Objective To explore how to cultivate medical graduate students' self-directed learning ability, combining the modern educational notion. Methods Three graduate students were selected from Capital Medical University and Hebei Medical University, respectively. Using group discussion and literature retrieval method to discuss the interview outline and obtain the method of cultivating medical students to self-directed learn. Results After the end of the study, the baseline scores of subjects was significantly increased compared with the scores before the study began, and the scientific research level improved significantly. Conclusion Medical colleges should focus on cultivating medical students' self-directed learning ability.