Introduction Despite the implementation of mechanical thrombectomy, acute ischaemic stroke with large vessel occlusion (AIS-LVO) remains a significant health concern, characterised by substantial morbidity and mortality. Our trial aims to evaluate the efficacy and safety of minocycline in reducing infarct volume and improving functional outcomes in patients undergoing mechanical thrombectomy for anterior circulation AIS-LVO.Methods and analysis The MIST-A trial is a prospective, randomised, open-label, blinded-endpoint trial to be conducted across 12 medical centres. The study will enrol 180 adult patients who have experienced an anterior circulation AIS-LVO and have undergone mechanical thrombectomy. These patients will be randomly divided into two groups: one receiving minocycline in addition to standard care and the other receiving only standard care. The primary efficacy outcome is the change in infarct volume as measured by MRI, from baseline to day 5. The secondary efficacy outcomes include the incidence of intracerebral haemorrhage occurring within 24 hours and the clinical scores between the baseline and follow-up assessments. The primary outcome will be assessed using a mixed-effects model to determine the association between treatment and outcomes.Ethics and dissemination The study is approved by the Ethics Committee of Xijing Hospital (XJLL-KY20222186) and is registered at ClinicalTrials.gov (NCT05487417). This trial is estimated to end in the first quarter of 2025 and study findings are expected to be published in scientific journals that undergo peer review and also to be showcased at scientific conferences.Trial registration number NCT05487417.

Eye disease patients often suffer from liver disease, liver Qi stagnation, poor circulation of Qi and blood, and blockage of eye orifices, which leads to the onset of the disease.The depression and anxiety caused by eye disease have a great impact on the patients. Some patients with macular edema are worried about blindness and often accompanied by depression,tension, and anxiety, which worsens the condition and creates a vicious cycle. In clinical practice,the patients with decreased vision may experience emotional discomfort, stagnation of Qi, and a series of organ dysfunction, which belong to the category of "Yu syndrome" in Traditional Chinese Medicine. Depending on the patient’s condition, the treatment strategy of Traditional Chinese Medicine based on the differentiation of symptoms and signs of internal organs can be adopted,and the advantages of treating different diseases with the same method can be fully utilized. This approach can effectively alleviate depression and treat macular edema, thus relieving the bidirectional vicious cycle caused by depression due to decreased vision, and achieving good therapeutic effects.

中心性浆液性脉络膜视网膜病变(简称"中浆")常因精神紧张和过度疲劳,情志不舒,气机失畅,郁而发病.中浆的发生与肝失疏泄,情绪郁结,脾失运化,痰湿阻滞,郁而化火等密切相关,患者多有抑郁和焦虑的表现,属于中医"郁证".朱丹溪首次提出"气、血、痰、火、湿、食"六郁致病之说,诸多目病,多生于郁,情志变化会导致脏腑气血平衡失调,引发多种病变."六郁"又可相继而生,气不行则血行不畅病血瘀,同样气郁可致水液代谢失常、产生湿郁、痰郁、食郁,其他郁证就会相继而生,并且"六郁"相互影响.本文从"六郁"探讨中浆病因病机及治疗,指出从"六郁"论治中浆,临床之中,往往病情复杂,又可诸郁并见,治疗需从本出发,兼顾诸症,可以起到较好疗效.

视网膜色素上皮(RPE)撕裂是湿性年龄相关性黄斑变性(wAMD)的一种常见并发症,也属于中医眼科学的"视瞻昏渺""暴盲"等范畴,从病因病机方面认为其可能与脏腑气机的升降失调、肝失疏泄、脾失健运以至气血运行不畅,不能濡养清窍,目失所养等有关.临床表现为视力骤降、视物遮挡等,黄斑区出现水肿、渗出、出血等病变.周婉瑜教授根据此中医诊疗思路运用半夏泻心汤加减治疗RPE撕裂肝郁脾虚证临床疗效显著,体现了治病求本,病证结合,标本兼治的思想,兹将其经验总结于此,供大家临床参考.

Acid-sensing ion channels (ASICs) are widely expressed in the nervous system. The intracellular C terminus of ASIC1a has many sites involved in regulating its expression and the opening mechanism, but the role of the intracellular N-terminal domain is poorly understood. Here, we explored the correlation of ASIC1a intracellular N terminus with membrane expression and gate opening. We modified the N-terminal structure of ASICs by deletion/truncation/mutation strategies and transfected the recombinant plasmids into CHO cells. Protein expression was analyzed with immunofluorescence, Western blots, and patch-clamp experiments. Deleting the entire N terminus decreased the membrane expression of channel proteins, and ion channel opening was lost. Deleting sections of the N terminus also decreased membrane expression and suggested that all areas were significant, with no single or group of amino acid residues playing a decisive role in regulating ASIC1a membrane expression. In terms of gate opening, five amino acid (AA) residues from AA 16 to AA 20 participated in gate opening, and isoleucine at AA 18 was the most important. The whole N terminus of ASICs participates in the membrane expression of ASIC1a, and five amino acid residues (AA 16-20) are involved in the gate opening mechanism. SIGNIFICANCE STATEMENT: The whole N terminus of ASICs participates in the membrane expression of ASIC1a, and five amino acid resi-dues (amino acid 16-20) are involved in the gate opening mechanism.

Graphene plays an essential role in the energy conversion field because of its particular geometrical structures. With its development, the study of its by-products (e.g., graphene residual carbon) is urgent. Herein, the novel synthesis of nickel sulfide and carbon-based material composite (NiS/GR) by one-step hydrothermal method via utilization of graphene residual carbon prepared by Hummer method as carbon-based material. The influence of graphene residual carbon content (5%, 10%, and 15%) on the electrochemical performance of NiS/GR in investigated. It is that when the content of graphene residual carbon is 5%, exhibiting the highest specific capacitance (774 F/g at 1 A/g), good rate capability (78.1% retention after current density increases to 10 A/g) and good cycling performance (77.2% capacitance retention after 1000 cycles at 5 A/g).

本文通过对治疗热毒炽盛之脱疽专方四妙勇安汤溯源、方解、现代药理及抗炎机制研究,充分论证了四妙勇安汤具有解毒活血通络的功效;葡萄膜炎是一种血管炎,相当于中医的络病,其病因是先天阳性体质与后天热邪相搏,形成热毒,腐络伤血,在病理上谓络病瘀滞,气血失运,形成血瘀、出血、水肿、渗出.周婉瑜主任以四妙勇安汤加味诊治葡萄膜炎的临床验案,在临床疗效、缩短病程、减少复发等方面效果显著,论证了从络病治疗葡萄膜炎的经验,体现中医学异病同治的治疗法则,可以将其作为治疗葡萄膜炎基本方的思路加以推广.

Valsalva 视网膜病变(valsalva retinopathy)是Duane在1972年首次提出的[1].该病多因Valsalva动作导致眼内的静脉压突然增高,引起黄斑区表层毛细血管破裂[2],黄斑区内界膜下出血,可单眼或双眼发病.

病证结合是当前中医眼科的主要临证模式,气、血、水三者在病理和生理上密切相关,其病理状态是眼睛局部证候的反应,是辨证治疗眼底病不可或缺的证候要素.非动脉炎性前部缺血性视神经病变(NAION)好发于老年人群中,是临床常见的急性致盲性视神经病变.基于病证结合的气血水理论,其主要病机可概括为气、血、水运行和代谢障碍、络脉阻塞,病变的根本在目系络脉.在治疗上,采用中药联合针刺进行治疗,中药治疗以益气活血、利水通络法为基本法则,以补阳还五汤为基本方,根据气滞、血瘀、水停的偏重加减用药;针刺选穴以局部穴位为主、远端穴位为辅的原则,以达益气化瘀、通络明目之功.

新型冠状病毒肺炎(corona virus disease 2019,COVID-19)自2019年12月爆发以来,由于具有高传染性,迅速在世界各地蔓延,国内外疫情防治形势空前严峻.COVID-19不仅造成肺部、肠道、肾脏等多脏器损害,且部分患者以眼表损害为首发或伴发症状出现,临床上很容易被忽视.COVID-19的眼表损害归属于祖国医学"天行赤眼"范畴,本文结合国内外最新的文献报道,探讨新型冠状病毒(2019 novel corona virus,2019-nCoV)对眼表的损害,阐明其可能机制,并从中西医角度提出可行的治疗措施.

Objective: This meta-analysis aims to systematically measure the immediate efficacy of the Gufoni maneuver for horizontal canal benign paroxysmal positional vertigo (HC-BPPV). Methods: A extensive search electronic databases, including PubMed, Embase, Web of Science and Cochrane library, were searched until to September 1, 2018 for relevant articles. We selected only randomized clinical trials studying with treatment of HC-BPPV employ by the Gufoni maneuver. Results: Five randomized clinical trials were included in the current meta-analysis with a total of 714 HC-BPPV patients. The meta-analysis revealed that Gufoni maneuver had a higher immediate recovery rate than sham maneuver in treatment of HC-BPPV (risk ratio = 2.68, 95% CI, 1.54-4.65, p < 0.01). No difference was observed in immediate recovery rate between Gufoni maneuver and other maneuvers (risk ratio = 1.18, 95% CI, 0.99-1.41, p = 0.06). And Gufoni maneuver had a similar otolith switch rate with other maneuvers (risk ratio = 2.13, 95% CI, 0.56-8.07, p = 0.27). Conclusion: Gufoni maneuver has a satisfactory immediate efficacy for HC-BPPV and does not increase otolith switch rate. (C) 2019 Elsevier B.V. All rights reserved.

Objective: To explore the recovery pattern of the high-frequency acceleration vestibulo-ocular reflex (VOR) function in unilateral vestibular neuritis (UVN).Methods: Forty-seven consecutive patients with UVN were recruited within 10 days of symptom onset for this study. The high-frequency acceleration horizontal VOR function was assessed using the video head impulse test (vHIT). Patients returned for follow-up evaluation at ~6 months after the onset of symptoms. According to the dizziness handicap inventory questionnaire (DHI), the patients were classified into the normal to mild dizziness group (DHI score ≤30) and moderate to severe dizziness group (DHI score >30) at the follow-up. All the obtained horizontal vHIT gains and corrective saccades parameters were analyzed.Results: vHIT results showed a significantly horizontal VOR gain recovery in UVN patients at the follow-up on the lesion side (p < 0.01). A significantly reduction in the occurrence of corrective saccades (overt and covert) and velocity of corrective saccades (overt and covert) were observed at the follow-up (p < 0.05). At the follow-up, the normal to mild dizziness group (DHI score ≤30) had a significantly higher normal rate of VOR gain, the mean vHIT gains and occurrence of isolated covert saccades (P < 0.05). Furthermore, the occurrence of mixed saccades and the mean velocity of covert saccades were significantly lower in normal to mild dizziness group (P < 0.05).Conclusion: Apart from the recovery of the VOR gain, recovery pattern of corrective saccades can play a key role in vestibular compensate.

Epilepsy-associated cognitive impairment is common, and negatively impacts patients’ quality of life. However, most antiepileptic drugs focus on the suppression of seizures, and fewer emphasize treatment of cognitive dysfunction. Melatonin, an indolamine synthesized primarily in the pineal grand, is reported to be neuroprotective against several central nervous system disorders. In this study, we investigated whether melatonin could reverse cognitive dysfunction in lithium-pilocarpine treated rats. Chronic treatment with melatonin (8 mg/kg daily for 15 days) after induction of status epilepticus significantly alleviated seizure severity, reduced neuronal death in the CA1 region of the hippocampus, improved spatial learning (as measured by the Morris water maze test), and reversed LTP impairments, compared to vehicle treatment. Furthermore, we found that melatonin rescued the decreased surface levels of GluR2 in the CA1 region observed in epilepsy, which might be the underlying mechanism of the neuroprotective and synapse-modulating function of melatonin. Our study provides experimental evidence for the possible clinical utility of melatonin as an adjunctive therapy to prevent epilepsy-associated cognitive impairments.

AIMS:Mounting evidence showed that GABAergic interneurons play an important role in the generation of seizures by regulating excitatory/inhibitory balance in the hippocampus; however, there is a continuous debate regarding the alteration in the number of hippocampal GABAergic interneurons during epileptogenesis. Here, we investigated the degeneration and regeneration of GABAergic interneurons in the dentate gyrus during epileptogenesis using glutamic acid decarboxylase-green fluorescence protein (GAD67-GFP) knock-in mice.METHODS AND RESULTS:Pentylenetetrazol (PTZ)-induced chronic kindling model and lithium-pilocarpine-induced status epilepticus (SE) model were used in this study. We found a progressive loss of GABAergic interneurons in the dentate gyrus during post-SE epileptogenesis rather than PTZ kindling. Both types of epileptogenic insults significantly promoted the proliferation of neural progenitor cells in the dentate gyrus; however, compared to 80% neuronal differentiation ratio in the control group, there was a remarkable decrease in PTZ kindling and pilocarpine models, that is 58% and 29%, respectively. Double/triple immunofluorescence labeling revealed no newborn neurons colabeled with GFP in both intact and epileptic dentate gyrus. In addition, valproate (a first-line antiepileptic drug) treatment prevented the loss of GABAergic interneurons but still failed to induce the regeneration of GAD67-positive interneurons in the dentate gyrus during post-SE epileptogenesis.CONCLUSIONS:These results indicate that degeneration of GABAergic interneurons may depend on the type of epileptogenic insult and that no newborn GABAergic interneurons occur in the adult dentate gyrus during epileptogenesis.

With the development of new energy industry,electric vehicle becomes the new development direction of the vehicle industry in the world.So the energy storage technology,as the electric vehicle’s important support and auxiliary technology,also gets more attention.This paper respectively not only analyzed and compared the storage principle,working characteristics of battery,hydraulic and flywheel accumulator used in the electric vehicles but described the advantages and disadvantages of them.It provided useful reference for the selection and further research of energy storage devices.

Status epilepticus (SE) is a life-threatening neurological disorder associated with significant morbidity and mortality. MicroRNAs (miRNAs) are small, non-coding RNAs that act post-transcriptionally modulating messenger RNA (mRNA) translation or stability which may have important roles in the pathogenesis of epilepsy. It has been reported that silencing microRNA-134 in vivo has significant neuroprotective and prolonged seizure-suppressive effects. However, the mechanism by which miR-134 inhibition suppressed seizures and whether miR-134 inhibition works in an in vitro model of SE, is unknown. Compared to a complex in vivo system, in vitro models of SE-like electrographic activity can be powerful tools to study this miRNA. Using a cell culture model of low Mg(2+) treatment of rat hippocampal neurons, we found SE-like electrographic activity increased expression of miR-134. Inhibiting expression of miR-134 using an inhibitor lentivirus with two miR-134 binding sites reduced SE-like electrographic activity in the hippocampal neurons and reduced neuronal death. This study provides direct evidence that inhibition of miR-134 can block status epilepticus-like discharges and is neuroprotective in hippocampal neuronal cultures and implies that inhibiting miR-134 may be a potential candidate for the clinical treatment of SE.

Cannabinoid type 1 receptor (CB1R), which is traditionally located on axon terminals, plays an important role in the pathology of epilepsy and neurodegenerative diseases by modulating synaptic transmission. Using the pilocarpine model of chronic spontaneous recurrent seizures, which mimics the main features of mesial temporal lobe epilepsy (TLE) with hippocampal sclerosis (HS) in humans, we examined the expression of CB1R in hippocampal astrocytes of epileptic rats. Furthermore, we also examined the expression of astrocytic CB1R in the resected hippocampi from patients with medically refractory mesial TLE. Using immunofluorescent double labeling, we found increased expression of astrocytic CB1R in hippocampi of epileptic rats, whereas expression of astrocytic CB1R was not detectable in hippocampi of saline treated animals. Furthermore, CB1R was also found in some astrocytes in sclerotic hippocampi in a subset of patients with intractable mesial TLE. Detection with immune electron microscopy showed that the expression of CB1R was increased in astrocytes of epileptic rats and modest levels of CB1R were also found on the astrocytic membrane of sclerotic hippocampi. These results suggest that increased expression of astrocytic CB1R in sclerotic hippocampi might be involved in the cellular basis of the effects of cannabinoids on epilepsy.

OBJECTIVE To analyse the reasons of misdiagnosis with dry eye and explore how to prevent these factors.METHODS The cases of 213 patients with dry eye were reviewed.The factors including the case history,clinical examination of dry eye and causes of misdiagnosis were studied retrospectively.RESULTS The misdiagnosis rate of dry eye was 36.6%,and the kinds of eye diseases misdiagnosed as dry eye were chronic conjunctivitis;virus keratitis,asthenopia,unwell feeling after cataract surgery and filiform keratitis.CONCLUSIONS Similarities of the clinical features in symptoms and signs of dry eye to the other eye diseases were objective misdiagnosis factors.But doctor inquired about patient's case history with less carefulness,paid no attention to the clinic features of dry eye,lack of understanding and comprehending the causes of dry eye were subjective misdiagnosis factors.This sub jective factors are also important links to reducing misdiagnosis of dry eye.

OBJECTIVE To study the clinical efficacy of combined therapy of acupuncture,acupoint injection and direct irritation on paralytic ocular muscles on the treatment of external ophthalmoplegia.METHODS Forty-five cases of postnatal ophthalmoplegia were treated by the combination of acupuncture,acupoint injection of cobamamide and direct irritation.RESULTS The effective time of combined therapy was 7~13 days,the duration of treatment was 15~63 days and the healing time was 28.6 days on average.Twenty-two cases were cured(48.8%),11 cases showed marked effects and 7 cases were treated effectively(15.5%).The total effective rate was 88.9%.CONCLUSIONS Combined therapy of acupuncture,acupoint injection and direct irritation on paralytic ocular muscles could promote the recovery of paralytic ocular muscle with remarkable clinical efficacy and high recovery rate.