Diagnostic Value of Structural MRI in Spinocerebellar Ataxia Type 3 / 中山大学学报(医学科学版)

ObjectiveTo explore the role of structural MRI in the diagnosis of spinocerebellar ataxia type 3 （SCA3） and further evaluate its correlation with disease severity and disease duration. MethodsWe prospectively enrolled 81 genetically diagnosed SCA3 patients ［59 symptomatic （sym-SCA3） and 22 pre-symptomatic （pre-SCA3）］ and 35 age- and sex-matched healthy controls （HCs）. MRI structural images （3D T1 MPRAGE） and clinical data of all subjects were collected. Three observers with different radiological experience measured the width of the superior， middle and inferior cerebellar peduncle （SCP， MCP and ICP）， the anterior-posterior diameters of the pons and spinal cord at the levels of the foramen magnum and upper edge of the 3rd-5th cervical vertebra. One observer performed the measurements again 2 months later to assess for the intra- and inter-observer reliability， respectively. One-way ANOVA， rank-sum test， ROC curve and Random Forest were used to evaluate the diagnostic value of the above metrics for SCA3， and the correlation between the metrics and clinical variables was analyzed. ResultsNot depending on the radiological experience， the metrics based on morphological MRI showed high intra- and inter-observer reliability， among which bilateral superior and middle cerebellar peduncles performed best. The diameters of bilateral SCP， MCP， ICP， pons and spinal cord （except spinal cord at the level of the upper edge of the 5th cervical vertebra） decreased successively in HCs， pre-SCA3 and sym-SCA3 with a statistical difference （P<0.017）. ROC analysis revealed that the left MCP had the highest diagnostic value for pre-SCA3 （AUC=0.911）， with sensitivity， specificity and a cut-off value of 85.7%， 95.5% and 10.15 mm， respectively. In contrast， the right SCP had the highest diagnostic value for sym-SCA3 （AUC=0.999）， with sensitivity， specificity and a cut-off value of 100%， 98.3% and 2.62 mm， respectively. The Random Forest model based on the above metrics also had high diagnostic efficiency （AUC= 0.970， specificity=93.1%）， and the left MCP contributed the most. Correlation analysis showed that the above metrics had a significantly or moderately negative correlation with the Scale for the Assessment and Rating of Ataxia （SARA） and disease duration （P<0.05）. ConclusionNot depending on radiological experience， measurements of brain structure based on morphological MRI are reliable， which can help diagnose SCA3 and predict disease severity and duration. The left MCP and the right SCP perform best for predicting pre-SCA3 and sym-SCA3， respectively. Therefore， the structural MRI is recommended for assisting the clinical diagnosis of SCA3.

Research progress of therapeutic exosomes / 药学学报

Exosomes are a kind of endosomal vesicles that are secreted by most if not all living cells. Due to their capability of delivering a variety of cargos, such as tissue- or cell-specific proteins, lipids, and genetic materials, and their broad biological activities, exosomes have gained substantial attention as emerging therapeutics. Exosomes derived from mesenchymal stem cells (MSCs) and dendritic cells (DCs) are two types of exosomes that are widely studied. Many preclinical and clinical studies have shown that they have a satisfactory treatment effect in lung diseases, liver diseases, nervous system diseases, tumors, and other diseases. In addition, exosomes from macrophages, tumor cells, plant cells, and many other cells are getting more attention due to their therapeutic potential. Besides natural exosomes, research on engineered exosomes has also made plenty of progress. There have been several engineering methods of exosomes, such as targeting modification and loading of active ingredients. In this review, we summarize the research progress of therapeutic exosomes from different sources, and further discusses the application prospects of exosomes and possible challenges in the future.

Effect of Functional Electrical Stimulation Rehabilitation Cycling on Lower Limb Motor Function in Children with Spastic Cerebral Palsy / 中国康复理论与实践

Objective To explore the effect of functional electrical stimulation (FES) rehabilitation cycling on lower limb motor function in children with spastic cerebral palsy. Methods From November, 2017 to December, 2020, 36 children with spastic hemiplegia in Beijing Bo'ai Hospital were randomly divided into control group (n = 18) and observation group (n = 18). The control group received routine rehabilitation training twice a day, and the observation group received FES rehabilitation cycling in addition, for eight weeks. Before and after treatment, the muscle tension of gastrocnemius and hamstring muscles on hemiplegic side was evaluated by modified Ashworth Scale (MAS), the change of walking speed was evaluated by 10-meter walking speed, the change of walking endurance was evaluated by 6-minute Walking Test, the walking function was evaluated by areas D and E of Gross Motor Function Measure (GMFM), and the energy consumption was evaluated by physiological cost index (PCI) . Results Two cases dropped out in the observation group. After training, there was no significant difference in MAS score of gastrocnemius muscle in both groups (t < 1.145, P > 0.05), the MAS score of hamstring muscle significantly decreased in the observation group (t = 4.869, P < 0.001), and no significant change was found in the control group (t = 1.458, P > 0.05). After training, the 10-meter walking speed, 6-minute walking distance, the score of GMFM and PCI significantly improved in both groups (|t| > 6.241, P < 0.001), and were better in the observation group than in the control group (|t| > 2.097, P < 0.05). Conclusion FES rehabilitation cycling training can improve the lower limb motor function of children with spastic hemiplegia.

Effect of Functional Electrical Stimulation Rehabilitation Cycling on Lower Limb Motor Function in Children with Spastic Cerebral Palsy / 中国康复理论与实践

Objective To explore the effect of functional electrical stimulation (FES) rehabilitation cycling on lower limb motor function in children with spastic cerebral palsy. Methods From November, 2017 to December, 2020, 36 children with spastic hemiplegia in Beijing Bo'ai Hospital were randomly divided into control group (n = 18) and observation group (n = 18). The control group received routine rehabilitation training twice a day, and the observation group received FES rehabilitation cycling in addition, for eight weeks. Before and after treatment, the muscle tension of gastrocnemius and hamstring muscles on hemiplegic side was evaluated by modified Ashworth Scale (MAS), the change of walking speed was evaluated by 10-meter walking speed, the change of walking endurance was evaluated by 6-minute Walking Test, the walking function was evaluated by areas D and E of Gross Motor Function Measure (GMFM), and the energy consumption was evaluated by physiological cost index (PCI) . Results Two cases dropped out in the observation group. After training, there was no significant difference in MAS score of gastrocnemius muscle in both groups (t < 1.145, P > 0.05), the MAS score of hamstring muscle significantly decreased in the observation group (t = 4.869, P < 0.001), and no significant change was found in the control group (t = 1.458, P > 0.05). After training, the 10-meter walking speed, 6-minute walking distance, the score of GMFM and PCI significantly improved in both groups (|t| > 6.241, P < 0.001), and were better in the observation group than in the control group (|t| > 2.097, P < 0.05). Conclusion FES rehabilitation cycling training can improve the lower limb motor function of children with spastic hemiplegia.

Debridement effectiveness of infected bone tissue of chronic hematogenous osteomyelitis in the lower extremities under the guidance of 99mTc-MDP SPECT/CT fused images / 中华创伤杂志

Objective:To explore the debridement effectiveness of infected bone tissue of chronic hematogenous osteomyelitis in the lower extremities under the guidance of 99mTc-MDP SPECT/CT fused images. Methods:A retrospective case series analysis was conducted on 21 patients with chronic hematogenous osteomyelitis in the lower extremities treated at Southwest Hospital of Army Medical University from May 2017 to June 2020. There were 8 males and 13 females, with the age range of 10-62 years [23(18, 37)years]. The tibial infections were found in 16 patients, and femoral infections in 5 patients. The duration of bone infection was 4-480 months [120(42, 228)months]. According to the Cierny-Mader anatomico-physiological system, 4 patients were classified as type I, 14 as type III, 3 as type IV; 18 patients were classified as type A and 3 as type B. Intraoperative debridement of infected bone tissue was operated at stage I on the region of interest (ROI) where the isocontour(ISO) value was between 30%-40%, using the preoperative 99mTc-MDP SPECT/CT fused images as the reference. The stage II bone defect reconstruction was based on autologous and / or allogeneic bone. To observe the frequency of operations regarding bone infection control in stage I. The preoperative white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), intraoperative bacterial culture and pathological examination were compared at stages I and II. The skin redness and swellings, pain, sinus tract in the infected limbs, and ossification of grafted bones in the original bone defect part were observed at stage II. The accuracy rate between ISO value in the region of interest (ROI) and set ISO figure was checked. The difference of longitudinal length of the bone debridement area in ROI area with the actual bone debridement area was observed under the coronal position. Results:All patients were followed up for 6-36 months [11(9, 29)months] after stage II operation. All of the 21 patients had undergone operations of infection control with an average number of 1.04 times in stage I. 1 patient's intraoperative frozen section indicated that neutrophils were>5/HP. The bone graft at stage II had been completed after another debridement. Comparison of preoperative inflammatory markers at stages I and II: the WBC was decreased from (5.9±1.6)×10 9/L to (5.4±1.5)×10 9/L ( P>0.05), the ESR decreased from 9(5, 26)mm/h to 4(2, 10)mm/h ( P<0.05), and the CRP decreased from 2.8(2.3, 7.7)mg/L to 2.3(1.4, 3.0)mg/L ( P>0.05). The results of bacterial culture of tissue at stage I were positive in 12 patients and negative in 9 patients. The pathological examination indicated neutrophils and lymphocyte infiltration. The results of bacterial culture of tissue at stage II were all negative. A modicum of plasmacyte and lymphocyte infiltration and the neutrophils (<5 per/Hp) had been found in the intraoperative frozen section and pathological examination. No redness, swelling or sinus tract was found in the skin after stage II surgery and ossification of grafted bone was good. The accuracy rate between ISO value in the ROI and set ISO figure was 90.5%. The comparison between longitudinal debridement scope of ROI [(86.8±31.1)mm] and actual bone tissue debridement scope [(86.0±31.3)mm] at stage I showed no significant difference ( P>0.05). Conclusions:99mTc-MDP SPECT/CT fused images can be used as an effective means to define the debridement scope of infected bone tissue preoperatively. The method can not only avoid excessive debridement, but also improve the cure rate of hematogenous osteomyelitis in the lower extremities.

Design, synthesis, and neuroprotective and anti-platelet aggregation research of 3-n-butylphthalide derivatives / 药学学报

Butylphthalide and ferulic acid exhibit excellent therapeutic effects in ischemic stroke. In this research, twelve 3-n-butylphthalide derivatives were designed by molecular hybridization strategy. The target compounds were obtained by nucleophilic substitution, reduction reaction, esterification reaction and elimination reaction, and the structure was confirmed by 1H NMR, 13C NMR and ESI-MS. All compounds were evaluated for neuroprotective activity against OGD/R-induced neurotoxicity in rat cortical neurons by MTT assay. The compounds with the best neuroprotective activity were biologically evaluated for their ability to inhibit platelet aggregation induced by arachidonic acid (AA) and adenosine diphosphate (ADP) via the Bron method．The results indicate that 7b exhibited potent neurocyte protective activity as well as prominent anti-platelet aggregation activity. Compound 7b has potential to be developed as a drug for ischemic stroke.

Chemical constituents from stems and leaves of Clausena emarginata / 中国中药杂志

The chemical constituents from the stems and leaves of Clausena emarginata were separated and purified by column chromatographies on silica gel,ODS,Sephadex LH-20,and PR-HPLC. The structures of the isolated compounds were identified on the basis of physicochemical properties and spectroscopic analysis,as well as comparisons with the data reported in the literature. Sixteen compounds were isolated from the 90% ethanol extract of the stems and leaves of C. emarginata,which were identified as siamenol( 1),murrastanine A( 2),3-formyl-1,6-dimethoxycarbazole( 3),3-methoxymethylcarbazole( 4),3-methylcarbazole( 5),murrayafoline A( 6),3-formylcarbazole( 7),3-formyl-1-hydroxycarbazole( 8),3-formyl-6-methoxycarbazole( 9),murrayanine( 10),murrayacine( 11),girinimbine( 12),nordentatin( 13),chalepin( 14),8-hydroxy-6-methoxy-3-pentylisocoumarin( 15) and ethyl orsellinate( 16). Compounds 1-4,14-16 were isolated from C. emarginata for the first time. Among them,compounds 1,2,15 and 16 were isolated from the genus Clausena for the first time. All isolated compounds were evaluated for their cytotoxic activities against five human cancer cell lines: HL-60,SMMC-7721,A-549,MCF-7 and SW480 in vitro. Compounds 12 and 14 showed significant inhibitory effects against various human cancer cell lines with IC_(50) values comparable to those of doxorubicin.

Treatment of calcaneal fracture by closed reduction and minimally invasive plate fixation assisted with bidirectional distractor distraction / 中国骨伤

<p><b>OBJECTIVE</b>To investigate clinical effects of calcaneal fracture with closed reduction and minimally invasive plate fixation assisted with bidirectional distractor distraction.</p><p><b>METHODS</b>From September 2015 to October 2016, 11 male patients(13 feet) with calcaneal fractures treated with bidirectional distractor distraction assisted with minimally invasive plate fixation were retrospectively studied. They were aged from 24 to 57 years old with an average of 36.4 years old;8 feet were type IIand 5 feet were type III according to Sanders classification. Postoperative incision, fracture healing, Böhler angle, Gissane angle were observed and Maryland scoring system was used to evaluate clinical effects.</p><p><b>RESULTS</b>All fractures healed well without incision inflammation and incision disunion. All patients were followed up from 12 to 15 months with an average of 13.5 months. Böhler angle were improved from (9.6±7.3)° before operation to (20.2±4.6) ° at 1 year after operation, and had statistical meaning; Gissane angle increased from (92.7 ±8.5)° before operation to (121.7 ±7.6) ° at 1 year after operation. Maryland score at 1 year after operation was 88.79±8.25, and 11 feet got excellent results and 2 feet moderate.</p><p><b>CONCLUSIONS</b>Bidirectional distractor distraction assisted with minimally invasive plate fixation could effectively fix calcaneal fractures, reduce postoperative complications, and get satisfied results of postoperative images and functional recovery. It is one of effective methods for treating Sanders II and III calcaneal fractures.</p>

Screening, preparation and biological activity of human monoclonal antibodies against postsynaptic short-chain neurotoxins fromLapemis curtus / 解放军医学杂志

Objective To prepare human anti-postsynaptic neurotoxin monoclonal antibody from phage antibody library using recombined postsynaptic short-chain neurotoxins ofLapemis curtus.Methods The three postsynaptic neurotoxins were expressed inEscherichia coli and phage antibodies against neurotoxins were screened. The obtained scFvs were further constructed to full antibodies. The antigen binding ability, biochemical and pharmacokinetic characteristics of the depurated antibodies were evaluated, and the anti-toxin effects of the antibody drugs were verifiedin vivo.Results Two positive scFvs with specific binding ability to all the three neurotoxins were obtained after 4 rounds of panning, and then the full antibodies were generated, expressed and purified. Antibody binding specificity was further confirmed. Pharmacokinetics of these two antibodies, SM-SD-911 and SM-SD-861 were similar to a conventional IgG molecule. SM-SD-911 and SM-SD-861 also showed strong antitoxin effectin vivo. Conclusionfull human anti-postsynaptic neurotoxin antibody has been successfully obtained by using recombinant neurotoxin technology and a large phage antibody library which may achieve clinical efficacy in navy medical applications.

The inhibitory effect of Withaferin A on the growth of orthotopic xenograft tumor of hepatocellular carcinoma in nude mice and the mechanism / 中国医师杂志

Objective To investigate the inhibitory effect of Withaferin A ( WFA) on the growth of orthotopic xenograft tumor of hepatocellular carcinoma in nude mice and the mechanism of its antitumoral effect. Methods For in vivo model, anti-tumor efficacy of Withaferin A was evaluated in nude mice mod-els of human liver cancer orthotopic xenograft. The nude mice were randomly divided into model group, Sunitinib group,and Withaferin A groups [6, 3 mg/(kg·d)]. All mice were given intraperitoneal injec-tion for 14 days. Tumor volume and tumor weight were observed. Antiangiogenic effects were assessed in vi-vo by the tumor inhibition rate and microvessel density. Quantitative polymerase chain reaction ( QPCR) as-say was used to detect the mRNA expression of vascular endothelial growth factor ( VEGF) , basic fibroblast growth factor (bFGF), angiopoietin-2 (Ang-2), vascular endothelial growth factor receptor 2 (VEGFR2) from tumor tissues. For in vitro experiments, the cell count kit 8 ( CCK8 ) assay was used to detect the effect of Withaferin A on HepG2 cells proliferation. QPCR assay and enzyme-linked immunosorbent assay ( ELISA) were used to detect the mRNA expression of VEGF. Results Compared to the model group, the high-dose Withaferin A group and the Sunitinib group had a significantly lower tumor weight (P<0. 05). The tumor inhibition rate was 42. 69％ in the high-dose Withaferin A group, 20. 22％ in the low-dose With-aferin A group, and 49. 43％ in the Sunitinib group. The growth of HepG2 cells was significantly inhibited by different concentrations of Withaferin A,and the 50％ concentration of inhibition ( IC50 ) of Withaferin A were (2. 64 ± 0. 18)μmol/L at 24 h. Withaferin A (6,3 μmol/L) could inhibit the protein and mRNA ex-pression of VEGF ( P<0. 05 ) . Conclusions Withaferin A significantly reduces the growth of orthotopic xenograft tumor of hepatocellular carcinoma in nude mice via antiangiogenic effect. Downregulation of the protein and mRNA expression of VEGF by WFA may be one mechanism of its anti-liver cancer effect.

Protective effect of MCC950 against lung injury induced by mitochondrial damage-associated molecular patterns / 医学研究生学报

Objective There is still no specific immuno-therapy to acute respiratory distress syndrome induced by severe trau-ma.The article aimed to investigate the effect of MCC 950 on lung in-jury induced by mitochondrial damage-associated molecular patterns ( MTDs) and preliminarily evaluate its molecular mechanism . Methods 40 SD rats were randomly devided into control group , MTDs group, MCC950 group, MTDs+MCC950 group.The rats were were taken MCC950 (20mg/kg) by peritoneal injection pretreatment for 1 hour, followed by tail vein injection of MTDs (5%liver vol-ume) and were killed 12 hours later.ELISA were applied to detect tumor necrosis factor (TNF-α), interleukin-1β( IL-1β) and IL-18 in broncho-alveolar lavage fluid ( BALF) , and BCA method to assess the content of total protein .Lung tissues were weighed to calculate lung wet weight/body weight( LWW/BW) ratio, and stained by HE staining to observe the pathological changes through light micro -scope.Smith lung injury score was used to assess histological lung injury .Western blot was employed to evaluate the protein expression of Pro-Caspase-1 and Caspase-1. Results ①Compared with control group , TNF-α, IL-1βand IL-18 in BALF of MTDs group were significantly increased( all P<0.05), but not in MCC950 group(P>0.05), TNF-αin BALF of MTDs +MCC950 group were signifi-cantly increased( all P<0.05), IL-1βand IL-18 were not(all P>0.05).Compared with MTDs group, IL-1βand IL-18 in BALF of MTDs +MCC950 group were in serious decline (all P<0.05).Compared with control group, the LWW/BW ratio [(4.19±0.36)mg/g vs (6.32±0.54)mg/g, P<0.05] and the content of total protein [(0.12±0.03)g/L vs (0.79±0.07)g/L, P<0.05] were dramatically increased.Compared with MTDs group, the LWW/BW ratio [(4.35±0.29)mg/g, (4.47±0.0.46)mg/g, P<0.05] and the content of total protein [(0.12±0.06)g/L, (0.15±0.06)g/L, P<0.05] were in serious decline.Smith lung injury score revealed that compared with control group the score of MTDs group was elevated (1.00±0.00 vs 8.33±0.58, P<0.05), and the score of MTDs+MCC950 group was significantly decreased than MTDs group ( 8.33±0.58 vs 3.67±0.58, P<0.05) .Compared with control group , the protein expres-sion of Pro-caspase-1 and caspase-1 were markedly improved (all P<0.05).However, the expression of caspase-1 was significantly milder than that in MTDs group ( P<0.05), the protein expression of Pro-caspase-1 was comparable ( P>0.05). Conclusion MCC950 exerts protective effect against lung injury induced by MTDs probably via the inhibition of NLRP 3 inflammasome activation .

Efficacy and Side Effect of Paracetamol and Tramadol Hydrochloride Tablet and Paracetamol and Dihydroco-deine Tartrate Tablet on Chronic Pain / 中国康复理论与实践

Objective To compare the efficacy and side effect between Paracetamol and Tramadol Hydrochloride Tablet and Paracetamol and Dihydrocodeine Tartrate Tablet on chronic pain. Methods From October, 2013 to October, 2015, 84 patients with chronic pain were divided into group A (n=42) and group B (n=42), who took two Tramadol tablets or Dihydrocodeine Tartrate tablets, three times a day orally for five days. They were assessed with Numerical Rating Scale (NRS), and the incidence of satisfaction and side effect were in-vestigated. Results The score of NRS decreased in both groups after treatment (t>9.402, P0.061). Conclusion The analgesic efficacy is similar of both drugs, but different in side effects of gastrointestine.

The role of microRNAs in bone remodeling / 国际口腔科学杂志·英文版

Bone remodeling is balanced by bone formation and bone resorption as well as by alterations in the quantities and functions of seed cells, leading to either the maintenance or deterioration of bone status. The existing evidence indicates that microRNAs (miRNAs), known as a family of short non-coding RNAs, are the key post-transcriptional repressors of gene expression, and growing numbers of novel miRNAs have been verified to play vital roles in the regulation of osteogenesis, osteoclastogenesis, and adipogenesis, revealing how they interact with signaling molecules to control these processes. This review summarizes the current knowledge of the roles of miRNAs in regulating bone remodeling as well as novel applications for miRNAs in biomaterials for therapeutic purposes.

Liposuction in facial contour rejuvenation / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of vacuum suction on facial shaping and cervicofacial rejuvenating.</p><p><b>METHODS</b>Based on injection of swelling solution, vacuum suction was used in totally 327 cases, including local fat deposit in face or neck.</p><p><b>RESULTS</b>Since 1993, we have carried out 327 case, satisfactory rate was up to 98%.</p><p><b>CONCLUSIONS</b>This is an adaptable method for facial shaping and cervicofacial Rejuvenating, very good results can be achieved.</p>

Clinical observation on treatment of depression by electro-acupuncture combined with Paroxetine / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the clinical efficacy and adverse reactions of Paroxetine combined with electro-acupuncture (EA) in treating depression.</p><p><b>METHODS</b>Forty-two patients with depression were randomly assigned to the observation group (22 patients) treated with EA combined with Paroxetine, and the control group (20 patients) treated with Paroxetine alone, and the therapeutic course for both groups was 6 weeks. The therapeutic efficacy and adverse reactions were evaluated with scores by Hamilton depression scale (HAMD) and treatment emergent symptoms scale (TESS), respectively.</p><p><b>RESULTS</b>HAMD scores determined at the end of the 1st, 2nd, 4th, and 6th week of the treatment course were significantly lower in the observation group than those in the control group (P<0.05). The significant improvement rate evaluated at the end of the 6-week treatment was remarkably higher in the observation group than that in the control group (72.7% vs 40.0%). No significant difference of TESS scores was found between the two groups.</p><p><b>CONCLUSION</b>EA combined with Paroxetine has better clinical efficacy than that of Paroxetine alone, with milder adverse reaction and quicker initiation of effect.</p>

Safety and efficacy of intracoronary transplantation of G-CSF mobilized autologous peripheral blood stem cells in patients with acute myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the safety and efficacy of intracoronary transplantation of G-CSF mobilized autologous peripheral blood stem cells in patients with acute myocardial infarction (AMI).</p><p><b>METHODS</b>Patients with AMI were randomly assigned to receive intracoronary PBSCs transplantation following bone marrow cells mobilization by granulocyte colony-stimulating factor (300-600 microg/day subcutaneously for 5 days) in addition to standard therapy (standard drug therapy and PCI, PBSCs transplantation group, n = 35) or standard therapy (standard drug therapy and PCI, n = 35). One day after G-CSF treatment was finished the patient's mononuclear cells were harvested by Baxter CS 3000 blood cell separator in a volume of 57 ml and then transferred into the infarct related artery by occluding the over the wire balloon and infusing artery through balloon center lumen. Complications during intervention and left ventricular function at baseline and 6 months thereafter were monitored.</p><p><b>RESULTS</b>No severe side effects of G-CSF treatment could be observed. Malignant arrhythmias were not observed either. Left ventricular function was significantly improved 6 months after G-CSF mobilized autologous peripheral blood stem cell transplantation compared to baseline (global left ventricular function ejection fraction: 57.1 +/- 7.8 vs. 50.0 +/- 8.2%, P < 0.0001; WMSI: 1.101 +/- 0.118 vs. 1.219 +/- 0.190, P < 0.0001; left end-systolic volume: 52.6 +/- 20.3 vs. 63.8 +/- 23.9 ml, P = 0.01 and left end-diastolic volume: 119.2 +/- 30.3 vs. 134.2 +/- 36.7 ml, P = 0.07) while these parameters remained unchanged in the control group.</p><p><b>CONCLUSION</b>The present study demonstrates that G-CSF mobilized autologous intracoronary PBSCs transplantation is a safe and feasible treatment for patients with AMI and global left ventricular function is improved and left ventricular remodeling attenuated at six-month follow-up.</p>

Target-controlled infusion of remifentanil and propofol during operation with suspension laryngoscopy / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate target-controlled infusion (TCI) of remifentail-propofol and the balanced anesthesia of fentanyl-isoflurane during the operation with suspension laryngscope.</p><p><b>METHODS</b>Sixty ASA I-II patients scheduled for the surgery through suspension laryngoscopy were randomly divided into two groups: TCI group and control group. In TCI group, anesthesia was maintained with TCI remifentanil-propofol which was stopped at the end of operation. The target plasma concentration of remifentanil was set at 6 microg/L and propofol at 3 mg/L. In control group, anesthesia was induced with intravenous fentanl 2.5 microg/kg and propofol 1-2 mg/kg, maintained with fentanl 0.03 microg.kg(-1). min(-1) and 1% isoflurane which was stopped at the end of surgery. Intubation was facilitated with succinylcholine 1-1.5 mg/kg.MAP, HR, ECG, S(p)O(2) and P(ET)CO(2) were monitored during anesthesia. The following parameters were recorded and compared between two groups: (1) the changes in blood pressure (BP), heart rate(HR) and S(p)O(2) at different time point; (2) recovery profile including the time of response to verbal commands, autonomous breathing, tracheal extubation, orientation recovery, discharging from PACU after operation; (3) OAAS scores after operation; (4) postoperative complications; (5) unexpected events and awareness during operation.</p><p><b>RESULT</b>(1) The hemodynamics were stable while the target plasma concentration of remifentanil was set at 6 microg/L and propofol at 3 mg/L. (2) During tracheal intubation, suspension laryngoscope was inserted, and extubation MAP was significantly lower in TCI group than that in control group; (3) There were no significant differences in hemodynamic values and S(p)O(2) of different time points between two groups. Study group was faster than control group on recovery profile including the time of response to verbal commands, autonomous breathing, tracheal extubation, orientation recovery and discharging from PACU. There was respectively one unexpected event in both groups.</p><p><b>CONCLUSION</b>Remifentanil supplemented with isoflurane anesthesia can achieve the optimal hemodynamic stability during the operation with suspension laryngoscopy and better recovery profile from anesthesia than fentanyl.</p>

Effects of adenovirus mediated vascular endothelial growth factor gene transfer on reconstitution of hematopoiesis in post-bone marrow transplantation mice / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Bone marrow transplantation (BMT) conditioning procedure is considered as the cause of damage to bone marrow microvasculature and the delay of hematopoiesis recovery. However, hematopoiesis regulation post BMT by vascular endothelial growth factor (VEGF) has not yet been studied. In this study, adenovirus were used to investigate the effects of VEGF gene transfer on preventing damages to bone marrow microenvironment and its promotion of hematopoiesis in post-BMT mice.</p><p><b>METHODS</b>Recombinant adenovirus (Ad)-enhanced green fluorescent protein (EGFP)/hVEGF165 was injected via tail vein into BALB/c mice undergoing syngeneic BMT. During the different phases post BMT, the distribution of adenovirus and the plasma levels of hVEGF were measured as well as the numbers of white blood cells (WBC), platelet (PLT) and red blood cells (RBC) in peripheral blood. At the same time, the mice were injected with Chinese ink via tail vein, following which the tibias were separated and were used for analysis of bone marrow microvasculature surface area and cellularity.</p><p><b>RESULTS</b>Significant expression of EGFP and hVEGF was observed in multiple organs at different phases post BMT, and the plasma level of hVEGF was up to (866.67 +/- 97.13) pg/ml. The recovery of WBC, PLT and RBC of the group treated with recombinant adenovirus Ad-EGFP/hVEGF165 were significantly more rapid than those of other BMT groups (P < 0.05, respectively). At the 20th day post BMT, the percentage of bone marrow microvasculature surface area in group treated with VEGF [(61.2 +/- 4.0)%] returned to normal level [(62.0 +/- 5.0)%, P > 0.05]. The restoration of hematopoiesis was retarded more than that of microvasculature. The cellularity of bone marrow in each group was still lower than that of normal control [(62.3 +/- 4.0)%, P < 0.05] at the 30th day post BMT, but the percentage in group treated with VEGF at the 20th and 30th days post BMT [(46.5 +/- 5.0)% and (55.1 +/- 4.5)%] exceeded those of other BMT groups (P < 0.05, respectively).</p><p><b>CONCLUSION</b>VEGF gene transfer mediated by adenovirus may protect the hematopoietic microenvironment to promote the restoration of hematopoiesis in post-BMT mice.</p>

Differentiation of neural stem cells transplanted into ventral horn of spinal cord after brachial plexus avulsion / 中华显微外科杂志

Objective To study the survival,migration and differentiation of the neural stem cells which transplanted into ventral horn of spinal cord after brachial plexus avulsion.Methods Neural stem ceils isolated from spinal cord of neogenetic rats and cultured,expanded,labeled by BrdU before transplanted. Twenty adult healthy SD rats preformed as the model of brochial plexus avulsion(Roots C_(5～7)),then transplan- rod stem ceils into the C_6 ventral horn of spinal cord.On 1,2,4,8,12 weeks postoperatively,immunohisto- chemistry assay were carried out in the spinal cord.Results Transplanted into ventral horn of spinal cord after brachial plexus avulsion.Neural stem cells can survive,migrate for at least one segment of spinal cord and differentiate to neurons and astrocytes.The differentiation of stem cells were time-depends.Conclusion Neural stem cells can survive,migrate and differentiate after transplanted into ventral horn of spinal cord in the rats which suffered from brachial plexus avulsion.