Clinical and imaging analysis of neurological complications in critically ill children infected with SARS-CoV-2 Omicron / 中华危重病急救医学

OBJECTIVE@#To summarize clinical predictors and imaging characteristics of critically ill children infected with SARS-CoV-2 Omicron with neurological complications in Shenzhen during the peak of the first round of infections.@*METHODS@#The clinical data of 11 critically ill children with neurological complications infected with SARS-CoV-2 Omicron in Shenzhen Children's Hospital from December 12 to 31, 2022, were retrospectively collected and analyzed. Laboratory test results related to liver parenchymal injury, histiocytic injury, inflammation, and coagulation function were collected, and imaging characteristics including CT and/or magnetic resonance imaging (MRI) were analyzed. The differences in CT/MRI score, acute necrotizing encephalopathy severity scale (ANE-SS) score and total score (CT/MRI score + ANE-SS score) were compared between the two groups with different prognosis during hospitation.@*RESULTS@#Among 11 children, 7 were male and 4 were female. The age ranged from 10 months to 16 years. There were 5 cases of acute necrotizing encephalopathy (ANE) and 6 cases of acute fulminant cerebral edema (AFCE). During hospitalization, 3 patients survived and 8 patients died of multiple organ dysfunction syndrome (MODS), including 2 cases of ANE and 6 cases of AFCE. All cases had fever (> 38.5 centigrade), and 3 cases had ultra-high fever (> 41 centigrade). Within 48 hours of onset, all cases had disorders of consciousness and 9 cases had seizures. The 8 dead children had complications with multisystem involvement, including shock, respiratory failure, disseminated intravascular coagulation (DIC), liver failure, renal failure or myocardial damage, and the laboratory predictors related to hepatocellular injury [alanine aminotransferase (ALT), aspartate aminotransferase (AST)], histocyte injury [creatine kinase (CK), lactate dehydrogenase (LDH)], inflammation [procalcitonin (PCT), interleukin-6 (IL-6), serum ferritin (SF)], coagulation function (D-dimer) and blood glucose (Glu) increased in different quantities, of which PCT was specifically increased in 6 cases with AFCE, PLT was specifically decreased in 3 cases with AFCE, and ALT and LDH were significantly increased in 2 cases with ANE. Imaging analysis showed subarachnoid hemorrhage, basal ganglia and thalamus lesions in all 6 cases with AFCE, while thalamus lesions in all 5 cases with ANE. The ANE-SS score of 8 deceased children ranged from 2 to 7 (of which 6 cases were ≥ 5), and the ANE-SS score of 3 surviving children ranged from 0 to 2. Eight dead children had a CT/MRI score of 1-4 (of which 6 cases were 4), and 3 surviving children had a CT/MRI score of 1-2 (of which 2 cases were 1). The total score of 8 deceased children was 6-10 (of which 6 cases ≥ 8), and 3 surviving children was 1-4.@*CONCLUSIONS@#The neurological complications of critically ill children infected with SARS-CoV-2 Omicron in Shenzhen progressed rapidly to ANE and AFCE, with high mortality. High fever (> 40 centigrade), convulsion/disturbance of consciousness, and multiple organ failure were the most common symptoms in ANE and AFCE cases. PCT increased and PLT decreased specifically in AFCE cases. Poor prognosis (death) was more common in age < 4 years old, predictors of ALT, AST, CK, LDH, PCT, D-dimer, Glu, IL-6 increased significantly, PLT decreased significantly. The common imaging feature of ANE and AFCE is the involvement of dorsal thalamus, a new imaging sign of AFCE (subarachnoid hemorrhage) was found. The higher the ANE-SS score, CT/MRI score and total score, the greater the risk of death.

Pediatric pulmonary actinomycosis: A misdiagnosed case report.

Background: Pulmonary actinomycosis is an uncommon kind of bacterial illness caused by actinomycetes, involving the chest wall in extraordinarily rare cases. Due to non-specific clinical signs and perplexing radiological characteristics, this kind of pulmonary actinomycosis is frequently misinterpreted as a malignant tumor or lung abscess. Case presentation: An 11-year-old child presented with a palpable lump on his left chest and periodic chest discomfort. An irregular soft-tissue mass in the left upper zone with bony destruction was first identified as a malignant small round cell tumor (MSRCT) known as an Askin tumor on post-contrast CT. However, pathological biopsy of the pulmonary lesion through the chest wall revealed actinomycosis. Conclusion: Pulmonary actinomycosis is an uncommon bacterial illness that has a variety of clinical manifestations, particularly in young patients. A chest lump with nearby "lace-like" rib bone destruction was the distinguishing characteristic of our case. For appropriate treatment and diagnosis, infection with actinomycosis should be considered when observing a similar chest lump. Pathological biopsy, as a valuable diagnostic tool, can help to distinguish between infectious diseases and thoracic tumors. The pathological manifestations of actinomycosis are characterized by inflammatory lesions that range from purulent to granuloma-like inflammatory processes, and second-generation sequencing of alveolar lavage fluid can help to confirm pathogens.

The favorable prognosis of cystic biliary atresia may be related to early surgery and mild liver pathological changes.

OBJECTIVE: The objectives of this study is to compare the prognostic differences between cystic biliary atresia (CBA) and non-CBA, analyze the clinical and liver pathological differences between the two groups, and explore the possible factors that affect the native liver survival of infants with CBA after Kasai portoenterostomy (KPE). METHODS: From 2013 to 2020, 131 infants with BA were admitted to Tianjin Children's Hospital. A total of 108 infants with BA were included after excluding those who did not undergo surgery after diagnosis (n = 23), including 12 cases of CBA and 96 cases of non-CBA. The clinical data, native liver survival and liver pathology, including liver fibrosis, bile ductular proliferation (BDP), bile plug, and portal area inflammation infiltration of the two study groups were compared. RESULTS: CBA accounts for 9.16% (12/131) and type I CBA accounts for 6.87% (9/131) of all types of BA. 16.7% (2/12) of CBA were detected prenatally with diagnosis of choledochal cyst (CC). The age at KPE, total bilirubin, direct bilirubin, and total bile acid levels of CBA were significantly lower than those of non-CBA (P = 0.047, P = 0.013, P = 0.009, P = 0.010, respectively). The long and wide diameters of the gallbladder were significantly larger than those of non-CBA (both P < 0.001). The 1-, 3-, and 5-year survival rates of CBA were 83.3%, 71.4%, and 71.4%, respectively, and 56.5%, 32.5%, and 29.8%, respectively, in non-CBA. The difference between the two groups was statistically significant (P = 0.031). The degree of liver fibrosis and bile plug in non-CBA was higher than that of CBA (P = 0.004, P < 0.001, respectively). There was no difference of BDP and inflammation infiltration between the two groups (P = 0.285, P = 0.243, respectively). CONCLUSION: CBA is a distinct type different from non-CBA, with different pathological processes, pathological manifestations, and clinical prognosis. The favorable prognosis of CBA may be derived from the early diagnosis, early operation, and mild pathological changes.

Practice and thinking of pre-hospital emergency support for the 2022 Beijing Winter Olympic Games / 中华医院管理杂志

Under the leadership of the Beijing Winter Olympic Organizing Committee and the Beijing Municipal Health Commission, the Beijing Emergency Center, as the designated medical institution for the 2022 Beijing Winter Olympic Games, has completed the first aid support task of this Winter Olympic Games with other medical institutions. The author systematically analyzed the development of each link in the pre-hospital emergency support for the 2022 Beijing Winter Olympic Games, summarizes the key links of the entire Winter Olympics cycle, such as the construction of the organizational system, the formulation of support plans, and the training of support personnel, and analyzed the results of related work, so as to provide reference for the pre-hospital emergency support for China to host large-scale international events in the future.

Multimodal magnetic resonance imaging for assessment of motor function after hemispherectomy in children with refractory epilepsy / 中华实用儿科临床杂志

Hemispherectomy (HS) is an effective surgical therapy to treat refractory epilepsy caused by diffuse hemispheric disorders.After HS surgery, the seizures are often well controlled in patients, and the bilateral limb motor function improves even recovers in some children.This result reveals the strong neuronal plasticity of the brain.The brain, especially of young children, can achieve functional reorganization and cortical remodeling after extensive damage.Multimodal magnetic resonance imaging techniques can jointly analyze the structure and function of the brain and associated neuroimaging features to reveal the neurophysiological mechanisms underlying improved motor function.In this paper, the progress of multimodal magnetic resonance imaging research on motor function alterations in children after hemispherectomy was reviewed.

Deep learning-based model for detecting 2019 novel coronavirus pneumonia on high-resolution computed tomography: a prospective study in 27 patients

BackgroundComputed tomography (CT) is the preferred imaging method for diagnosing 2019 novel coronavirus (COVID19) pneumonia. Our research aimed to construct a system based on deep learning for detecting COVID-19 pneumonia on high resolution CT, relieve working pressure of radiologists and contribute to the control of the epidemic. MethodsFor model development and validation, 46,096 anonymous images from 106 admitted patients, including 51 patients of laboratory confirmed COVID-19 pneumonia and 55 control patients of other diseases in Renmin Hospital of Wuhan University (Wuhan, Hubei province, China) were retrospectively collected and processed. Twenty-seven consecutive patients undergoing CT scans in Feb, 5, 2020 in Renmin Hospital of Wuhan University were prospectively collected to evaluate and compare the efficiency of radiologists against 2019-CoV pneumonia with that of the model. FindingsThe model achieved a per-patient sensitivity of 100%, specificity of 93.55%, accuracy of 95.24%, PPV of 84.62%, and NPV of 100%; a per-image sensitivity of 94.34%, specificity of 99.16%, accuracy of 98.85%, PPV of 88.37%, and NPV of 99.61% in retrospective dataset. For 27 prospective patients, the model achieved a comparable performance to that of expert radiologist. With the assistance of the model, the reading time of radiologists was greatly decreased by 65%. ConclusionThe deep learning model showed a comparable performance with expert radiologist, and greatly improve the efficiency of radiologists in clinical practice. It holds great potential to relieve the pressure of frontline radiologists, improve early diagnosis, isolation and treatment, and thus contribute to the control of the epidemic.

Study on the development of the standardized system of pre-hospital rescue and transfer / 中华医院管理杂志

Pre-hospital rescue is key to the emergency medical system. Based on the current pre-hospital emergency standardized system construction in China, the authors explored the standardization of pre-hospital emergency system construction, command dispatch and emergency service quality control standardization, pre-hospital classification standardization, pre-hospital emergency service capacity standardization, pre-hospital emergency and intra-hospital emergency connection standardization, standardized training for pre-hospital emergency doctors and nurses. These efforts aim to achieve such rescue and transfer criteria for patients, as " vicinity, urgency, professional needs, and intension of both patients and their families" . Such criteria if met can further reduce emergency response time and shorten the emergency radius, hence improving emergency medical services.

Brain dynamic functional connectivity between default mode network and executive control network by resting state functional MRI in patients with alcohol use disorder / 中华放射学杂志

Objective:To investigate the changes of dynamic functional connectivity between the default mode network (DMN) and executive control network (ECN) in the resting state in patients with alcohol use disorder (AUD).Methods:From September 2018 to June 2019, 23 cases of AUD group and 24 cases of healthy control (HC) group matched with age, gender, education level and handedness were collected at Renmin Hospital of Wuhan University. Mini-mental state examination (MMSE) and Michigan alcoholism screening test (MAST) were performed in all subjects for cognition and alcohol dependence score. All the subjects underwent T 1WI-3D structural imaging and resting state functional MRI (rs-fMRI) examination. Group spatial independent component analysis (ICA) was used to select the independent components of DMN and ECN. Then dynamic changes in the functional connectivity between the DMN and the DMN were obtained by sliding window approach and clustering method. Finally, the independent sample t test was used to compare the difference of general clinical data between the two groups, the linear correlation analysis was conducted in the parameter value and MMSE and MAST scores. Results:Compared with the HC group, the static functional connectivity analysis showed that the precuneus and posterior cingulate gyrus of the DMN were enhanced in the AUD group ( P=0.016, t=2.496). The DMN and ECN functional connectivity showed four different brain activity states, the proportion of state1 increased by 6.81% and state2 decreased by 6.83% in the AUD group, state3 and state4 were relatively stable. In state1, the internal functional connectivity of the DMN in the AUD group was enhanced, while the functional connectivity between DMN and ECN was mainly enhanced. In state2, the internal functional connectivity of the ECN was enhanced, and the connectivity between the DMN and ECN was mainly weakened. The mean dwell of state2 in the AUD group was negatively correlated with the MAST score ( r=-0.433, P=0.039). Conclusions:Dynamic functional connectivity patterns between DMN and ECN have been changed in patients with AUD. Dynamic functional connectivity can reveal transient changes in brain activity, which can provide certain imaging evidence for finding changes in AUD deep brain activity.

Design and construction of an intelligent pre-hospital emergency synergy system / 中华医院管理杂志

As a key part of the emergency medical system,pre-hospital emergency service proves critical for critical care,higher pre-hospital care success rate,improvement of patient outcome,and promotion of health recovery.This paper analyzed the status quo of pre-hospital emergency services information,discussed the application of information technology in pre-hospital industries including command and dispatch system,ambulance real-time positioning and tracking system,pre-hospital emergency video surveillance system,medical record system,electronic patient health file system,electronic payment system,and data mining and analysis system.Furthermore,it also discussed the prospect of sizably upgrading prehospital emergency service and building intelligent pre-hospital emergency coordination system.

Design and construction of an intelligent pre-hospital emergency synergy system / 中华医院管理杂志

As a key part of the emergency medical system, pre-hospital emergency service proves critical for critical care, higher pre-hospital care success rate, improvement of patient outcome, and promotion of health recovery. This paper analyzed the status quo of pre-hospital emergency services information, discussed the application of information technology in pre-hospital industries including command and dispatch system, ambulance real-time positioning and tracking system, pre-hospital emergency video surveillance system, medical record system, electronic patient health file system, electronic payment system, and data mining and analysis system.Furthermore, it also discussed the prospect of sizably upgrading pre-hospital emergency service and building intelligent pre-hospital emergency coordination system.

Celastrol inhibits colorectal cancer cell proliferation and migration through suppression of MMP3 and MMP7 by the PI3K/AKT signaling pathway.

Colorectal cancer (CRC) is one of the most frequent malignant tumors. Signaling by the PI3K/AKT pathway is crucial for CRC development and progression, including proliferation and migration. Celastrol has an anticancer effect, but its mechanism needs to be determined. Here, we showed that celastrol suppressed CRC cell proliferation and migration. Celastrol treatment also decreased the PI3K/AKT pathway components, and MMP3 and MMP7 expression levels. In addition, knockdown of AKT, not mTOR, inhibited MMP3 and MMP7 expression levels and AKT silencing promoted the celastrol-induced effects on CRC cell proliferation and migration. Taken together, these findings indicated that the celastrol-induced antitumor effects were mediated through MMP3 and MMP7 by the PI3K/AKT signaling pathway.

Effects of Simvastatin on myocardial apoptosis and oxidative stress mechanism in immature rabbits with chronic heart failure / 中华实用儿科临床杂志

Objective To observe the effects of Simvastatin on myocardial apoptosis and oxidative stress mechanism in immature rabbits with chronic heart failure.Methods Thirty-six male New Zealand big-eared immature rabbits were randomly divided into 3 groups:Adriamycin(ADR) ± Simvastatin group(ADR-s group,n =12),in which ADR(1.5 mg/kg) received injection via the auricular vein of rabbits weekly,and the rabbits received oral Simvastatin [1.5 mg/(kg · d)] simultaneously for 12 weeks;ADR group (n =12),in which the rabbits received ADR like ADR-S group,and 9 g/L saline instead of Simvastatin;control group (CON group,n =12),which received the same amount of 9 g/L saline.Echocardiography examination was performed in 13th week.Myocardial fibrosis degree was detected by using MASSON staining,and the myocardial apoptosis was detected by using terminal deoxynucleotidyl transferase dUTP nick end labeling.Colorimetric method was used to detect the myocardial concentration superoxide dismutase (SOD) and malondialdehyde (MDA).Enzyme-linked immunosorbent assay was used to detect serum B-type brain natriuretic peptide (BNP) level.Results (1) In CON group,the immature rabbits were all alive.Four rabbits died in ADR group,and the survival rate was 66.7％,while 2 rabbits died in ADR-s group,and the survival rate was 83.3％.(2)Compared with CON group,the left ventricular end diastolic diameter (LVEDd) and left ventricular end systolic diameter (LVESd) in ADR-s group and ADR group increased [(11.90 ±1.09) mm,(ll.34 ±0.92) mm vs.(10.73 ±0.48) mm;(9.80 ±0.88) mm,(8.47 ± 1.23) mm vs.(7.31 ±0.36) mm];left ventricular fractional shortening(LVFS) and left ventricular ejection fraction(LVEF) decreased [(17.65 ± 1.70)％,(22.58 ± 2.19)％ vs.(31.79 ± 2.58) ％;(41.35 ± 3.19) ％,(49.17 ± 3.53) ％ vs.(64.34 ± 3.97) ％],and all the differences were significant(all P ＜ 0.05);LVEDd and LVESd in ADR-s group were lower than those of ADR group,while LVEF and LVFS in ADR-s group were higher than those of ADR group,and the differences were significant(all P ＜ 0.05).(3)MASSON staining:compared with ADR group,there was less myocardial cell hyperplasia of fibrous tissue in ADR-s group.(4) Compared with CON group,the apoptosis index was higher in ADR and ADR-s group [(34.25 ±11.13) ％,(24.00 ±6.85)％ vs.(16.58 ± 5.34)％],but ADR-s group had less than ADR group,and the differences were significant (all P ＜ 0.05).(5) Compared with ADR group,SOD activity of ADR-s group was higher [(13.40 ± 2.68) kU/L vs.(10.66 ± 2.99) kU/L],but MDA content was lower [(5.67 ± 1.36) μmol/mg vs.(7.08 ±0.98) μmol/mg],and the differences were significant (all P ＜0.05).(6) Serum BNP level in ADR group and ADR-s group was higher than that of the CON group[(33.28 ±9.58) μg/L,(26.71 ±6.72) μg/L vs.(13.56 ±2.82) μg/L],while was higher in ADR group than that of ADR-s group,and the differences were significant (all P ＜ 0.05).Conclusions Simvastatin can protect cardiac function of immature rabbits with chronic heart failure.The possible mechanism may be the up-regulation of myocardial SOD activity,reduction of cell lipid peroxidation and inhibition of myocardial apoptosis.

Effect of Simvastatin on expressions of myocardial chromogranin A and apoptosis signal-regulating kinase 1 of immature rabbits with chronic heart failure / 中华实用儿科临床杂志

Objective To observe the influence of Simvastatin on immature rabbit model of chronic heart failure(CHF),and to explore the possible protective mechanism of Simvastatin for the rabbits with CHF.Methods Thirty immature male rabbits were divided into 3 groups randomly:control group,heart failure group (HF group)and Simvastatin group(SIM group),10 rabbits in each group.The models of CHF were established by injecting Adrinmycin via the auricular vein of rabbits (1.5 mg/kg,once 1 week,for 12 weeks).The control group were injected the same amount of 9 g/L saline.SIM group were given both injection of Adrinmycin and Simvastatin [1.5 mg/(kg · d)for 12 weeks].The immature rabbit's cardiac function and myocardial morphology changes were evaluated.The expressions of chromogranin A (CgA) and apoptosis signal-regulating kinase 1 (ASK1) were evaluated.Results (1) In control group,the immature rabbits were all alive;in the other 2 groups,most immature rabbits were depressed and sluggish.The survival rate of HF group was 60％,while in SIM group the survival rate was 80％.(2)Compared with the control group,the left ventricular ejection fraction in HF group and SIM group decreased significantly [(40.05 ± 6.74)％,(50.18 ± 5.73) ％ vs.(65.93 ± 5.65) ％,all P ＜ 0.01],while in SIM group was higher than that of HF group,and the difference was significant (P ＜ 0.05);compared with HF group,the left ventricular end diastolic diameter and left ventricular end systolic diameter decreased in SIM group [(13.48 ± 1.24) mm vs.(16.23 ± 2.82) mm;(9.87 ± 0.85) mm vs.(11.13 ± 1.21) mm],and the differences were significant (all P ＜ 0.05).(3) Compared with the control group,the expression of CgA (mean optical density 142.24 ± 17.14,127.93 ± 12.12 vs.78.65 ± 6.78,P ＜ 0.05;integrated optical density 1 422.41 ± 167.34,1 279.37 ± 118.15 vs.786.54 ± 75.84,P ＜ 0.05) and ASK1 (mean optical density 140.32 ± 18.65,115.48 ± 12.30 vs.69.85 ± 6.54,P ＜ 0.05;integrated optical density 1 403.23 ± 165.67,1 158.79 ± 137.81 vs.698.58 ± 64.51,P ＜ 0.05) increased in the HF group and SIM group.While the expression in the SIM group decreased significantly compared with that of the HF group,and the difference was significant (P ＜ 0.05).Conclusions Simvastatin can improve cardiac function of immature rabbits with CHF.The mechanism of SIM may depress the expressions of CgA and ASK1.

Improvement Effect of Minocycline on Cognitive Dysfunction Induced by Old RBCs Transfusion in Rats / 中国药师

Objective:To observe the effect of old RBCs transfusion on cognitive function in rats and the improvement effect of mi -nocycline.Methods: Male SD rats at the age of 6 months were randomly divided into 4 groups.The RBCs were obtained from male rats by centrifuging the total blood and stored at 4℃.The rats of fresh RBCs group (group F) were transfused with the RBCs stored for 1 day.The rats of old RBCs group (group O) were transfused with the RBCs stored for 7 days.The rats of treatment group (group T) received 40 mg· kg-1 minocycline with intraperitoneal injection before the transfusion .The rats of the control group ( group C) were transfused with the normal saline .The brain levels of IL-1βand IL-6 were determined with Quantikine ELISA kits in 24 hours after the blood transfusion (n=6).The rats were subjected to Barnes maze tests after 1 week of the blood transfusion (n=10).Results:The brain levels of IL-1βand IL-6 in group O were higher than those in group C and F (P<0.05), which were lower in group T than those in group O(P<0.05).The rats of group O spent longer time finding the target box than those of group C and F in the Barnes maze (P<0.05), and the time was shorter in group T than that in group O (P<0.05).Conclusion: Old RBCs transfusion plays a role in neuro-inflammation and induces cognitive dysfunction in rats , which may be improved by minocycline .

Role of angiotensin-converting enzyme (ACE) and ACE2 in a rat model of smoke inhalation induced acute respiratory distress syndrome.

Smoke inhalation induced acute respiratory distress syndrome (ARDS) has become more and more common throughout the world and it is hard to improve the outcome. The present research was to investigate possible roles of angiotensin-converting enzyme (ACE) and ACE2 in lung injury resulted from smoke exposure. Rats were exposed to dense smoke to induce ARDS. Histological changes, blood gases, bronchoalveolar lavage fluids (BALF) and wet-to-dry weight were analyzed to evaluate lung injury after smoke inhalation; beside, we also measured the expression of ACE and ACE2 at different time points to explore the possible mechanism of those changes. The results showed that pH of arterial blood, partial blood oxygen (PaO2) and blood oxygen saturation (SO2) decreased after smoke inhalation at different time points (P<0.01); while, partial blood carbon dioxide (PaCO2), wet-to-dry weight ratio, leukocytes count, protein concentration and inflammatory cytokines in BALF increased after smoke exposure (P<0.01). More importantly, both immunohistochemical staining and Western blot results showed that ACE and ACE2 expression in lungs from the experimental groups significantly increased compared with that of the control group (P<0.05). This study indicated that inflammation pulmonary edema and histological changes resulted from smoke inhalation induced lung injury were possibly attributed to abnormal expression of ACE and ACE2 related pathway.

Protective Effects of Memantine on Isofluane￣induced Decrease of Proliferation in Neural Stem Cells / 医药导报

Objective To investigate the protective effects of memantine on isofluane￣induced decrease of proliferation in neural stem cells ( NSCs) and the potential mechanisms in vitro. Methods Neural stem cells were isolated from rat hippocampi (postnatal day 1) and grew in culture. Cultured NSCs were randomly divided into the control ( Group Control), Vehicle (Group Vehicle), Isoflurane ( Group Iso), Isoflurane +Memantine ( Group Iso +Mem) and Isoflurane + Memantine +LY294002 groups (Group Iso+Mem+LY).Proliferation was assessed by cell counting and BrdU incorporation.Western blot was conducted to detect protein expression of phospho￣Akt. Results Compared with the control group,BrdU incorporation and phospho￣Akt expressions in neural stem cells significantly declined after 2.4% isoflurane exposure for 6 h (P<0.01).However, isofluane￣induced decrease of BrdU incorporation and phospho￣Akt expressions was attenuated by the treatments of memantine (P<0.01)). It was showed that Akt inhibitors LY294002 reversed the protective effects on neural stem cells proliferation by memantine(P<0.01). Conclusion The results suggest that memantine treatment might attenuate isofluane￣induced decrease of proliferation in neural stem cells via Akt signaling pathway.

The effects of acupuncture combined with speech therapy on aphasia caused by stroke: clinical and fMRI study / 中华物理医学与康复杂志

Objective To observe and compare the effects of acupuncture and acupuncture plus speech therapy on activation of the brain areas in aphasic patients by use of oxygenation level dependent-functional magnetic resonance imaging (BOLD-fMRI).Methods Twenty patients with aphasia caused by stroke were randomized into two groups by use of random number table (10 cases in each group):an experimental group subject to acupuncture treatment combined with speech therapy,and a control group subject to speech therapy only.All the cases were dextromanuality.On admission and after 1 month of treatment,BOLD-fMRI was used to test signals of the activated brain areas of both group,and Aphasia Battery of the Chinese (ABC) was employed to evaluate the changes of speech ability of the patients.Results During the study,1 case from control group was unable to do the post-intervention evaluation due to onset of the second stroke.The effective rates of the control and experimental group were 55.56％ and 100.00％,respectively,and recovery of verbal ability in experimental group was significantly better than in control group (P ＜ 0.05).The active volume and extent in brain were significantly increased in both groups (P ＜0.05),and a comparison between the two groups showed that the changes in activation volume and extent of the brain were significantly greater extensive in experimental group than in the control group,especially in bilateral frontal lobe,cuneus,posterior cingulate gyrus,lingual gyrus,occipital lobe,splenium of corpus callosum,cerebellar hemisphere,and the left precentral gyrus,post-central gyrus,paracentral lobule,temporal lobes,angular gyrus,precuneus,and the right hippocampus,parahippocampus gyrus.Conclusion Acupuncture combined with speech therapy could cause changes in activation patterns of the brain areas,which may contribute to the improvement of verbal ability of the aphasic patients.

Effect of lithium chloride pretreatment on isoflurane-induced cognitive dysfunction and inflammatory response in hippocampus in aged rats / 中华麻醉学杂志

Objective To evaluate the effect of lithium chloride (LiCl) pretreatment on isoflurane-induced cognitive dysfunction and inflammatory response in hippocampus in aged rats.Methods Eighty 20-month-old male Sprague-Dawley rats,weighing 350-400 g,were randomly assigned into 4 groups (n =20 each):control group (group C),1.4％ isoflurane group (group I),100 mg/kg LiCI + 1.4％ isoflurane group (group L+ I),and 100 mg/kg LiC1 group (group L).Group I was exposed to 1.4％ isoflurane in 30％ O2-70％ N2 for 6 h,while group C was exposed to 30％ O2-70％ N2 only.LiCl 100 mg/kg was injected intraperitoneally once a day for 3 consecutive days and isoflurane anesthesia was performed on 4th day in group L + I.LiCl 100 mg/kg was injected intraperitoneally once a day for 3 consecutive days and then the rats inhaled 30％ O2-70％ N2 for 6 h on 4th day in group L.Blood samples were taken immediately after the end of anesthesia for blood gas analysis.Hippocampi were isolated 24 h after the end of anesthesia for determination of the expression of glycogen synthase kinase-3β (GSK-3β) and acetyl-NF-κB (Lys310) (by Western blot) and TNF-α,IL-1β and IL-6 mRNA (by RT-PCR).The levels of TNF-α,IL-1β and IL-6 were determined by ELISA and the contents of TNF-α,IL-1β and IL-6 were calculated.The cognitive function was assessed on 2nd day after the end of anesthesia.Results Compared with group C,the expression of GSK-3β and acetyl-NF-κB (Lys310) was significantly up-regulated,the expression of TNF-α,IL-1β and IL-6 mRNA and contents of TNF-α,IL-1β and IL-6 were increased,the escape latency was prolonged,and the time of staying at the original platform quadrant was shortened in group I (P ＜ 0.05).Compared with group I,the expression of GSK-3β and acetyl-NF-κB (Lys310) was significantly down-regulated,the expression of TNF-α,IL-1β and IL-6 mRNA and contents of TNF-α,IL-1β and IL-6 were decreased,the escape latency was shortened,and the time of staying at the original platform quadrant was prolonged in group L + I (P ＜ 0.05).Conclusion LiC1 pretreatment can improve isoflurane-induced cognitive dysfunction and inhibition of inflammatory response in hippocampus is involved in the mechanism in aged rats.

Effect of melstonin on isofurane snesthesis-induced cognitive dysfunction in sged rsts / 中华麻醉学杂志

Objective To investigate the effect of melatonin on isoflurane anesthesia-induced cognitive dysfunction in aged rats.Methods Seventy-five male SD rats,aged 18-20 months,weighing 350-400 g,were randomly assigned into 5 groups(n =15 each):control group(group C),1.5％ isoflurane group(group Ⅰ),melatonin 5 mg/kg group(group M1),melatonin 10 mg/kg group(group M2)and melatonin 20 mg/kg group(group M3).Group G inhaled a gas mixture of oxygen and air for4 h and group 1 inhsled 1.5％ isoflurane for4 h.Melatonin 5,10 and 20 mg/kg(in normal saline containing 1％ DMSO)were injected intrsperitoneally at 15 min before anesthesia and 3 h after the beginning of anesthesia in groups M1,M2 and M3 respectively,and then the animals inhaled 1.5％ isoflurane for 4 h.At the end of anesthesia,5 rats in each group were chosen and blood samples were taken to perform arterial blood gas analysis and to detect the blood glucose level and expression of phosphorylated Tau(p-Tau)protein in hippocampus.Ten rats in each group were chosen at 14 d after the end of anesthesia and Morris water maze was performed 3 times a day for 5 consecutive days to assess the cognitive function.Then the animals were sacrificed and hippocampi were removed for detection of p-Tau expression by Western blot.Results There were no significant differences in the parameters of arterial blood gas analysis and blood glucose level among the 5 groups(P ＞ 0.05).Compared with group C,the escape latency at 3-5 d was significantly prolonged,the probe time was significantly shortened,and the expression of p-Tau protein was up-regulated in groups I and M1(P ＜0.05),and no significant change was found in the indexes mentioned above in groups M2 and M3 (P ＞0.05).Compared with groups 1 and M1,the escape latency at 2-5 d was significantly shortened,the probe lime was significantly prolonged,and the expression of p-Tau protein was down-regulated in groups M2 and M3 (P ＜ 0.05).There were no significant differences in the indexes mentioned above between groups I and M1,and between groups M2 and M3(P ＞ 0.05).Conclusion Melatonin(10 and 20 mg/kg)can improve isoflurane anesthesia-induced cognitive dysfunclion in aged rats,which nay be related to inhibition of hyperphosphorylation of Tau protein in hippocampus.

Fractional amplitude analysis of low frequency fluctuation in alcohol dependent individuals : a resting state functional MRI study / 中华放射学杂志

Objective To explore brain activity features during the resting state in alcohol dependent individuals,and study the relationship between the brain activity features and alcohol dependent individuals' clinical symptoms.Methods Twenty-four alcohol dependent individuals and 22 healthy control subjects,well matched in gender,age,education and handedness,were enrolled as the alcohol dependent group and control group respectively.AGE 3.0 T MR scanner was used to acquire all the subjects' resting state data. DPARSF software was used to process resting functional MRI data,and then the whole brain fractional amplitudes of low frequency fluctuation (fALFF) data were acquired.Two-sample t test statistical analysis was made to access fALFF difference between the two groups. Results In comparison with the control group,the alcohol dependent group showed reduced fALFF in bilateral medial prefrontal gyrus,right inferior occipital gyrus,left precuneus,left inferior temporal gyrus,and left posterior lobe of cerebellum (0.64-1.69 vs.0.87-1.78,t =- 4.23- - 2.79,P ＜ 0.05 ). fALFF was increased in the alcohol dependent group at the anterior cingulate,bilateral inferior frontal gyrus,right middle frontal gyrus,bilateral insular lobe,bilateral dorsal thalamus ( 0.86-1.82 vs. 0.76-1.58,t =3.56-3.96,P ＜ 0.05 ).Conclusion Alcohol dependent individuals had abnormal activity at the bilateral prefrontal lobe,anterior cingulate,bilateral dorsal thalamus,bilateral insular lobe,left posterior lobe of cerebellum et al,during the resting state,and these abnormal activities might be related with clinical manifestation and pathophysiology.