Two children with late-onset congenital central hypoventilation syndrome / 临床耳鼻咽喉头颈外科杂志

Two children with late-onset congenital central hypoventilation syndrome were reported, one of whom was male and had no abnormal manifestations after birth, respiratory failure occurs at the age of 1 year and 6 months. After being hospitalized, he was treated with oxygen inhalation and non-invasive ventilation, but carbon dioxide retention could not be corrected. After one month of tracheal intubation, he was failure to wean from ventilator, so tracheostomy was performed. He needs a ventilator to help breath while sleeping, and can breath autonomously during the day without ventilator. The other case was a female, with no abnormalities after birth. At the age of 11 months, she developed respiratory failure. During sleep, the child needs non-invasive assisted ventilation through a nasal mask, and during the day, she breathed autonomously.Two patients were followed up forever 2 years and their growth and development were normal.

Lipopolysaccharide preconditioning protects rats against cerebral ischemia reperfusion injury by reducing the damage of blood-brain barrier / 国际脑血管病杂志

Objective:To investigate the protective effect of lipopolysaccharide (LPS) preconditioning on cerebral ischemia reperfusion in rats.Methods:One hundred and twenty adult male SD rats were randomly divided into sham operation group, model group, low-dose LPS group (0.05 mg/kg), medium-dose LPS group (0.15 mg/kg), and high-dose LPS group (0.45 mg/kg). LPS was injected intraperitoneally for preconditioning, once a day for 7 consecutive days. Twenty-four hours after the last injection, the left middle cerebral artery occlusion model was induced by suture-occluded method. The model was reperfused 1.5 h after ischemia. At 24 h after reperfusion, the neurological deficit was evaluated by neurobehavioral score. The volume of cerebral infarction was measured by triphenyltetrazolium chloride staining. The serum levels of proinflammatory cytokines interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF)-α were detected by enzyme-linked immunosorbent assay. The expression of Toll-like receptor 4 (TLR4), matrix metalloproteinase (MMP) -2 and MMP-9 in ischemic brain tissue was detected by Western blot analysis.Results:Compared with the sham operation group, blood-brain barrier permeability was increased in the model group, serum IL-1β, IL-6 and TNF-α were up-regulated, and the expression of TLR4, MMP-2 and MMP-9 proteins in ischemic brain tissue was up-regulated. Compared with the model group, the neurological impairment of each LPS intervention group was significantly reduced, the volume of cerebral infarction was significantly reduced, the permeability of blood-brain barrier was significantly reduced, the serum IL-1β, IL-6 and TNF-α were down-regulated, and the expression of TLR4, MMP-2 and MMP-9 protein in ischemic brain tissue was down-regulated, especially in the medium-dose group and the high-dose group.Conclusions:LPS preconditioning can induce the formation of ischemic tolerance, inhibit the activation of TLR4-MMP-2/MMP-9 signal pathway, reduce the damage and inflammation of blood-brain barrier structure, and thus play a neuroprotective role in rats with cerebral ischemia reperfusion.

Breviscapine confers a neuroprotective efficacy against transient focal cerebral ischemia by attenuating neuronal and astrocytic autophagy in the penumbra.

Breviscapine is a flavonoid derived from a traditional Chinese herb Erigerin breviscapus (Vant.) Hand-Mazz, and has been extensively used in clinical treatment for cerebral stroke in China, but the underlying pharmacological mechanisms are still unclear. In present study, we investigated whether breviscapine could confer a neuroprotection against cerebral ischemia injury by targeting autophagy mechanisms. A cerebral stroke model in Sprague-Dawley rats was prepared by middle cerebral artery occlusion (MCAO), rats were then randomly divided into 5 groups: MCAO+Bre group, rats were treated with breviscapine; MCAO+Tat-Beclin-1 group, animals were administrated with specific autophagy inducer Tat-Beclin-1; MCAO+Bre+Tat-Beclin-1 group, rats were treated with both breviscapine and Tat-Beclin-1, MCAO+saline group, rats received the same volume of physiological saline, and Sham surgery group. The autophagy levels in infarct penumbra were evaluated by western blotting, real-time PCR and immunofluorescence 7days after the insult. Meanwhile, infarct volume, brain water content and neurological deficit score were assessed. The results illustrated that the infarct volume, brain water content and neurofunctional deficiency were significantly reduced by 7days of breviscapine treatment in MCAO+Bre group, compared with those in MCAO+saline group. Meanwhile, the western blotting, quantitative PCR and immunofluorescence showed that the autophagy in both neurons and astrocytes at the penumbra were markedly attenuated by breviscapine admininstration. Moreover, these pharmacological effects of breviscapine could be counteracted by autophagy inducer Tat-Beclin-1. Our study suggests that breviscapine can provide a neuroprotection against transient focal cerebral ischemia, and this biological function is associated with attenuating autophagy in both neurons and astrocytes.

Puerarin provides a neuroprotection against transient cerebral ischemia by attenuating autophagy at the ischemic penumbra in neurons but not in astrocytes.

Puerarin is an isoflavone derived from the Chinese medical herb of Radix puerariae (kudzu root), and has been widely used in the treatment for ischemic stroke in China. However, its underlying pharmacological mechanisms are still not understood. This study was to investigate the efficacy of puerarin on autophagy in the ischemic penumbra after cerebral stroke. A model of cerebral stroke in Sprague-Dawley rats was prepared by middle cerebral artery occlusion (MCAO); rats were then randomly divided into 5 groups: MCAO+Pue group (rats were treated with puerarin), MCAO+Pue+Tat-Beclin-1 group (rats were administrated with both puerarin and autophagy inducer Tat-Beclin-1), MCAO+Tat-Beclin-1 group (rats were treated with Tat-Beclin-1), MCAO+saline group (rats were administrated with the same volume of physiological saline), and sham surgery group. The autophagy levels in infarct penumbra were evaluated by western blotting, real-time PCR and immunofluorescence 14days after the insult. Meanwhile, the neurological deficit score, brain water content and infarct volume were assessed. The results illustrated that the cerebral infarct volume, cerebral edema and neurological deficiency were significantly alleviated by puerarin treatment. Western blotting and the quantitative PCR revealed that the autophagy level in the penumbra was markedly reduced by puerarin administration. However, these effects of puerarin could be counteracted by Tat-Beclin-1. Additionally, double immunofluorescence showed that neuronal autophagy was markedly attenuated by puerarin treatment, whereas astrocytic autophagy was only mildly reduced. Our study suggests that puerarin could confer a neuroprotection against cerebral ischemia, and this biological function is associated with attenuating autophagy in neurons but not in astrocytes.

Observation on curative effect of pulse-radiofrequency combined with epiduralspace block in cervicogenic headache / 重庆医学

Objective To observe the curative effect of cervicogenic headache(CEH)treatment through the combination of pulse radio frequency(PRF)on the C2 dorsal rootganglion and continuous epidural space block.Methods Sixty patients with CEH in our hospital were randomly divided into groups A and B,30 cases in each group.The group A was treated with combination of PRF on cervical dorsal root ganglion and continuous epidural space block.The group B was treated with PRF on cervical dorsal root ganglion method.The pain VAS scores before treatment and at 1 week,3,6 months after treatment were compared between the two groups.Results Compared with pretreatment,the VSA scores at 1 week,3,6 wonths after treatment in the two groups had statistical difference(P＜0.05),moreover,the VAS score decrease in the group A was better than the group B.All the patients had no nerve and artery injury or infection complications.Conclusion It is safe and effective to treat cervical CEH through the combination of ganglion PRF on the cervical 2 dorsal root and continuous epidural space block.

Neuroprotective roles of early exercise training after stroke / 国际脑血管病杂志

Early exercise training after stroke is a therapeutic strategy that has been paid w idespread attention. A series of studies found that early exercise training after stroke can increase expression of neurotrophic factors and maintain the integrity of the blood-brain barrier by inhibiting acute neuroinflammation and apoptosis, and reduce brain damage. This artice reviews the neuroprotective roles of early exercise training after stroke and their possible molecular mechanisms.

Phase I Study of Axitinib in Combination with Cisplatin and Capecitabine in Patients with Previously Untreated Advanced Gastric Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: This phase I trial evaluated the question of whether the standard starting dose of axitinib could be administered in combination with therapeutic doses of cisplatin/capecitabine in patients with previously untreated advanced gastric cancer, and assessed overall safety, pharmacokinetics, and preliminary antitumor activity of this combination. MATERIALS AND METHODS: Patients in dose level (DL) 1 received axitinib 5 mg twice a day (days 1 to 21) with cisplatin 80 mg/m2 (day 1) and capecitabine 1,000 mg/m2 twice a day (days 1 to 14) in 21-day cycles. Maximum tolerated dose (MTD) was the highest dose at which 5 consecutive days of missed axitinib due to thrombocytopenia. DL1 was established as the MTD, since higher DL cohorts were not planned. Common grade 3/4 non-hematologic adverse events in 22 patients treated at DL1 included hypertension (36.4%) and decreased appetite and stomatitis (18.2% each). Cisplatin/capecitabine slightly increased axitinib exposure; axitinib decreased capecitabine and 5-fluorouracil exposure. Eight patients (36.4%) each had partial response or stable disease. Median response duration was 9.1 months; median progression-free survival was 3.8 months. CONCLUSION: In patients with advanced gastric cancer, standard doses of axitinib plus therapeutic doses of cisplatin and capecitabine could be administered in combination. Adverse events were manageable.

Optimization of Glycyrrhiza flavonoid and ferulic acid cream by reflect-line orthogonal simplex method / 中国中药杂志

<p><b>OBJECTIVE</b>To optimize the formula of Glycyrrhiza flavonoid and ferulic acid cream and set up its quality control parameters.</p><p><b>METHOD</b>Reflect-line orthogonal simplex method was used to optimize the main factors such as amount of Myrj52-glyceryl monostearate and dimethicone, based on the appearance, spreadability and stability of the cream.</p><p><b>RESULT</b>9.0% Myrj52-glyceryl monostearate (3:2) and 2.5% dimethicone were chosen in prescription. The prepared cream presented a good stability after being placed 24 h at 5 degrees C, 25 degrees C and 37 degrees C respectively,and its spreadability suited with the property of semi-fluid cream.</p><p><b>CONCLUSION</b>[corrected] The formula of Glycyrrhiza flavonoid and ferulic acid cream is suitable, and its quality is stable. The reflect-line orthogonal simplex method is suitable for the formula optimization of cream.</p>

Percutaneous radiofrequency thermocoagulation for the treatment of different types of trigeminal neuralgia: Evaluation of quality of life and outcomes / 华中科技大学学报（医学）（英德文版）

Radiofrequency thermocoagulation (RFT) of the gasserian ganglion is a routine and effective technique for the treatment of classical trigeminal neuralgia (CTN). In this study we compared its efficacy in patients with CTN and atypically symptomatic or mixed trigeminal neuralgia (MTN). Fifty-seven patients were treated with RFT for trigeminal neuralgia from June 2006 to February 2009. Thirty patients had CTN, and 27 had MTN. Outcomes were measured by using the visual analog pain scale (VAS) and patients' reports of quality of life (QOL), medication usage, and complications over a follow-up period of up to 3 years. Our results showed that the patients with MTN were younger, tended to have bilaterial involvement of the first division, and were unresponsive to treatment. All surgeries were completed smoothly. About 86.7% CTN patients and 48.1% MTN patients responded immediately to RFT. The VAS scores were significantly higher in the CTN group than in MTN group (P<0.05). Kaplan-Meier curves showed that 1-year, 2-year, and 3-year pain relief rates were 76.7%, 73.3%, and 73.3% in the CTN group and 46.6%, 41.4%, and 41.4% in the MTN group, respectively. The rates of pain relief for both groups leveled off at 2 years. Complications included numbness, dysesthesia, and anesthesia dolorosa. RFT did not cause any deaths and complications were low. The treatment was very effective for CTN and, to some degrees, effective for MTN. If numbness, dysesthesia, and anesthesia dolorosa are limited to the trigger area, QOL will be greatly improved.