Amyotrophic lateral sclerosis (ALS) is a rapid progressive neurodegenerative disease, characterized by the degeneration of both upper and lower motor neurons. The progressive motor unit loss due to lower motor neuron damage is one of the most important pathological process in ALS. However, there are lack of specific biomarkers for early diagnosis and progression monitoring of ALS. The relevant electrophysiologic techniques which quantify the number of motor unit have been developed rapidly in recent years. Among them, the motor unit number estimation (MUNE) and the motor unit number index (MUNIX) have been widely applied to quantify motor unit number loss in ALS. The most recent advances of MUNE and MUNIX in ALS were reviewed.

BACKGROUND: Patients with acute stroke mostly receive treatment in the integrative hospital, but quite a large part of them were treated only with medication during the earlier stage.OBJECTIVE: To probe the influence of earlier integrative rehabilitations on emotions and daily life capability of patients with acute stroke with the outcomes compared with those unexposed to rehabilitative treatment.DESIGN: Randomized controlled study.SETTING: Neurological Department of a municipal Hospital.PARTICIPANTS: Eighty patients who received treatment due to the first onset of acute stroke of internal carotid system were selected from the Neurological Department of the First People's Hospital of Lianyungang City, Jiangshu Province between January 2002 and August 2003. Totally 51 males and 29 females aged (63.42±7.47) years were randomly divided into rehabilitation control group with 40 cases each.METHODS: Patients of the two groups received routine neurological medication in the hospital. When stroke was controlled, patients in the rehabilitative group (including patients with cerebral infarction who were hospitalized for less than 1 week and patients with cerebral hemorrhage who were hospitalized for less than 2 weeks) were subjected to rehabilitative treatment, including rehabilitative training of insulted limbs (physical treatment and/or exercise therapy), physical therapy, acupuncture and psychological consultation. Rehabilitative treatment was given 1-2 times a day and 45 minutes for each time. Physical therapy and acupuncture were given once a day and 20 minutes for each time. In contrast, patients in the control group were only asked in the doctor's round to do exercise themselves or with the assistance of others. Psychological states of all the patients were assessed with Symptom Self Rating Scale before treatment and discharge and daily life capability was also assessed with Barthel index (totally 10 items with scores of 0-15, full mark was 100, and patients who scored for ＜ 60were considered of self-incapability).MAIN OUTCOME MEASURES: Scores for symptom checklist (SCL)and Barthel index of the two groups before treatment and when patients were discharged.Scores for each symptom factors in SCL were significantly improved in the rehabilitation group when patients were discharged from the hospital (P ＜ 0.05-0.01), and somatization, obsessive-compulsive, depression, anxiety and psychoticism, etc. were also obviously improved in the control group (P ＜ 0.05); moreover scores for somatization, obsessive-compulsive,depression, anxiety phobic anxiety and psychoticism in the rehabilitation group after treatment were significantly lower than those in the control group [(1.55±0.43), (1.80±0.35); (1.48±0.39), (1.68±0.55); (1.54±0.43),(1.83±0.37); (1.32±0.39), (1.56±0.36); (1.46±0.43), (1.66±0.52); (1.12±0.38),creased aftertreatment (P ＜ 0.05-0.01), but those of the rehabilitation group were significantly higher than those of the control group [(73.24±4.64),(52.44±2.86), P ＜ 0.05].CONCLUSION:Scores for symptomatic factors in SCL and Barthel indexes were improved after treatment, especially in patients who received rehabilitative treatment, suggesting that earlier integrative rehabilitative treatment may play active influence on the emotions and daily life capability of patients following acute stroke.

Objective To verify the evaluation index system of clinical science and technology achievements, taking the evaluation of science and technology achievements in Guangdong province as a demonstration. Methods We specified the criteria for grading each index included in the evaluation index system that we proposed before. 5 experts in clinical medicine were invited to evaluate 20 achievements applying for the Award of Guangdong Science and Technology Achievements in 2010. The weighted sum of scores for each achievement was calculated and used for further analysis. The reliability and validation of the system were assessed. Results The Cronbach's ? coefficient of the index system was 0. 91, indicating good reliability. There were high correlation of each measure with the total score and their affiliated grade one index. The scores that the experts graded were correlated with the original results of evaluation (rs= 0. 71, P ＜0. 000 1), but there remained some inconsistence. Conclusion The demonstration based on investigation data indicates that the evaluation system is easy to handle and has satisfactory reliability and validation. It can be applied to the evaluation of science and technology achievements in clinical medicine.

Objective To set up a scientific, objective, reasonable, qualitative and quantitative,operational evaluation index system of clinical science and technology achievements, which provides the reference to evaluating clinieal science and technology achievements scientifieally. Methods The Delphi method was used to investigate 30 experts for weight of the index via questionnaire. Results The response rate was 100%. The Kendall's concordance coefficient was up to 0. 963. The final index system includes three first-class indicators, eight second-class indicators and 18 third-class indicators. The weight coefficeient of each class was identified. Conclusion The experts showed enthusiasm for this investigation. The agreement of respondents was high after two rounds of investigation. The index system can be used in comprehensive evaluation for science and technology achievements in clinical medicine. The index system takes a guiding effect for science and technology achievements to solve clinical services and problems.

Objective To observe the effects of Yushen Heji on expressions of Heme Oxygenase (HO-1) and HO-2 in kidney of diabetic rats;To explore its mechanism in diabetic nephropathy. Methods SD rats were randomly divided into normal group, model group, control group and treatment group. Models were duplicated by subcutaneous injection STZ. Control group and treatment group were given gavage with related medicine, while normal group and model group were given gavage with the same amount of distilled water. Eight weeks later, the urine of rats was collected to detect the 24 h Upro and Ucr;the rats were sacrificed to detect the levels of CO, BUN and Scr;the kidneys were harvested for observing the expressions of HO-1 and HO-2 by immunohistochemistry.Results Compared with normal group, the contents of BUN, 24 h Upro and Scr all increased in model group;Ccr and plasma CO decreased;the expressions of HO-1 and HO-2 in kidney tissues were obviously reduced (P<0.01). Compared with model group, the contents of BUN, 24 h Upro and Scr all obviously decreased in treatment group and control group;Ccr and plasma CO increased;the expressions of HO-1 and HO-2 in kidney tissues obviously increased (P<0.05,P<0.01). Compared with control group, the contents of 24 h Upro decreased in treatment group;plasma CO increased;the expressions of HO-1 and HO-2 in kidney tissues obviously increased (P<0.05,P<0.01).Conclusion Yushen Heji has therapeutic effect on diabetic nephropathy rats, which may related with HO/CO system.

This study researched the results transformation problem in medical universities,sorted the current situation in this filed,analyzed the causes of the low transformational rate.Then by referring to the domestic and overseas experience,the author designed the classified transforma tional path of medical research results according to their respective features,finally put forward policy suggestions for institutional guarantee policy to promote the transformation of medical universities.

Objective To explore the mechanism of vessel endothelial dysfunction in rats under intermittent hypoxia (IH). Methods The respiratory simulation system was used to simulate IH. Sixty C57BL/6J rats (male) were randomized into control group and IH group. The rats of IH group were exposed to IH 8 hours per day for 6 weeks. The serum levels of hypoxia inducible factor (HIF)-1a and stromal cell derived factor (SDF)-1a were assessed by ELISA. The serum levels of reactive oxygen species (ROS) were detected in two groups. The serum expression of miR-199a-5p was detected by real-time fluorescent quantitative PCR in two groups. The dual luciferase report system and point mutation test were used to verify target gene for HIF-1a. Results The serum levels of HIF-1a and SDF-1a were significantly higher in IH group than those of control group (μg/L:1.60±0.02 vs. 1.19±0.02, 1 823.00±8.97 vs. 1 444.00±17.90, P<0.01). The serum level of ROS was significantly higher in IH group than that of control group (U/mL:487.66±35.73 vs. 211.57±23.82, P<0.01). The serum level of miR-199a-5p expression was significantly lower in IH group compared to that of control group (1.31±0.07 vs. 3.47± 0.17, P<0.01). The result of dual luciferase reporter gene detection confirmed that target gene of miR-199a-5p was HIF-1a. Conclusion The serum level of miR-199a-5p is decreased first due to IH, and then its target gene (HIF-1a) is increased. HIF-1a can induce the increased level of SDF-1a, and its receptor (CXCR-4 ) is also increased. Finally, HIF-1a can increase the serum level of ROS, resulting in the endothelial dysfunction.

Objective To investigate the effect of acupuncture decompression operation on the quality of life of patients with mild to moderate essential hypertension. Methods 74 cases of mild to moderate essential hypertension were divided into experimental group and control group by random number table, 4 cases were lost. Finally, a total of 70 patients were included in the data analysis. In the control group, 35 cases were given routine drug taking and health guidance, the experimental group of 35 patients increase the treatment of acupuncture decompression operation points on this basis. The two groups of patients were measured with blood pressure before and after intervention, and World Health Organization Quality of Life (WHOQOL-BREF) was used to evaluate the quality of life, and the data were analyzed. Results The scores of physiological and psychological fields in the experimental group were (15.23 ± 2.66) points and (16.68 ± 2.23) points while the control group were (13.98 ± 2.18) points, (15.25 ± 2.52) points, the difference was statistically significant (t=2.305, 2.522, P<0.05). The experimental group of social relations, environmental score were respectively (1.37 ± 2.24) points, (14.16 ± 1.24) points, while the control group were (13.29 ± 2.30) points, (13.56 ± 1.36) points, 2 groups were not statistically significant (t=0.770, 3.063, P > 0.05). The experimental group systolic blood pressure, diastolic blood pressure were (121.43 ± 6.43) mmHg (1 mmHg=0.133 kPa), (71.74 ± 3.88) mmHg, compared with the control group were (128.34±5.72) mmHg, (76.06±4.43) mmHg. The difference was statistically significant (t=-4.753,-4.210, P<0.05). Conclusions acupuncture decompression operation can improve blood pressure in young and middle-aged patients with hypertension, improve the quality of life.

Pancreatic acinar cell death modality is a significant factor which determines the course and prognosis of acute pancreatitis (AP).The severity of AP is positively correlated with acinar necrosis,while negatively correlated with acinar apoptosis.Adenosine triphosphate (ATP) level is the key to control the manner of death,and acts as a switch during the conversion of necrosis and apoptosis in a variety of pathophysiological settings:low levels of ATP can accelerate cell necrosis and high levels of ATP might promote apoptosis.Hypoxia inducible factor 1 (HIF-1) is a highly expressed transcription factor in anoxic conditions which can effectively regulate cell energy metabolism and play an important role in regulating cell death and inflammatory injury.Therefore,this review aimed to provide a reference about better understanding of the pathogenesis and new therapeutic targets of HIF-1 in AP.

Objective To analyze the adverse reactions of hysterosalpingography and prevention measures. Methods Totally 6 352 patients who underwent hysterosalpingography in our hospital between January 2006 and December 2013 were analyzed. Results Totally 836 cases had adverse reactions of different degrees including 312 cases of drug reactions and 626 cases of non?drug reactions. The adverse drug reactions were mainly hy?pogastralgia,laryngopharyngeal malaise,irritating cough,nausea,vomiting,shortness of breath,flush of the face,and pruritus. The non?drug reac?tions were mainly hypogastralgia,nausea,vomiting,pallor,speeding up of heart?beat,decreased blood pressure,dizziness,and blur version. Con?clusion Among patients who were negative for iodine anaphylactic test,there were still some who had adverse reactions of different degrees during HSG. Targeting at different conditions of reactions,corresponding prevention measures should be adopted to ensure the smooth progress of hysterosal?pingography.