Objective To investigate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) of right hemisphere on the rehabilitation of aphasia in patients with acute cerebral infarction. Methods Forty right-handed patients with acute cerebral infarction on the left hemisphere complicated with aphasia were randomly allocated into either a treatment group (n=20) or a control group (n=20). There was no significant difference in the ages between the patients in both groups. They all received routine drug treatment and appropriate language training. The patients in the treatment group also received a course of low frequency rTMS at language area of right hemisphere 7 days after the symptom onset, once a day for 10 days. Their language function was evaluated by the Aphasia Battery in Chinese (ABC) before and after the treatment, and at day 90 after the onset. The National Institutes of Health Stroke Scale (NIHSS) and Barthel Index (BI) were used to evaluate their overall neurological function and activities of daily living. Results There were no significant differences in the ABC, NIHSS and BI scores between the control group and the treatment group before and after rTMS; at day 90 after the onset, the ABC scores were improved significantly in the treatment group (P＜ 0.05), however, there was still no significant difference between the NIHSS and BI scores.There were significant differences between the ABC scores before and after the rTMS in the treatment group (P＜0.01), and there was no significant difference between the NIHSS and ABC scores, however, the 3 scores were improved more significantly than those before and after the treatment at day 90 after the onset (P ＜0.01). There were no significant difference in the 3 scores before and after the treatment in the control group, and at day 90 after the onset the 3 scores were improved more significantly than those before and after rTMS (P＜0.01).Conclusions The early low-frequency rTMS of the right hemisphere contributes to the rehabilitation of language function in patients with acute cerebral infarction complicated with aphasia.

Objective To study the relationship of levels of acetylcholine receptor antibody (AChRAb) and thyroid antibodies in patients with myasthenia gravis (MG) and thyroidism. Methods Thyroid function of FT3, FT4 and TSH, and thyroid antibodies including TSH receptor antibody ( TRAb), thyroid globulin antibody (TGAb) and thyroid microsome antibody (TMAb) were detected in 100 patients with MG and 100 healthy controls. Among them, 32 patients were further tested for AChRAb. The relationship between AChRAb and each of TRAb, TGAb and TMAb was analyzed along with their relevant clinical characteristics. Results Of 100 patients with MG, 12 cases ( 12% ) were hyperthyroidism and 4 cases (4%) were hypothyroidism, and 71 cases (71%) were thyroid antibodies positive. The percent of thyroid antibodies positive cases was significantly higher than that of thyroidism cases (χ2=4. 788, P < 0. 05 ). Analysis on AChRAb and TRAb in 32 AChRAb tested cases demonstrated a linear correlation (r= 0. 609, P = 0. 0002). Conclusions The incidence of thyroid antibody positive in MG cases is significantly higher than incidence of hyperthyroidism and hypothyroidism in MG. AChRAb and TRAb has a linear correlation.

OBJECTIVETo study the sequential changes of HIF-1alpha (hypoxia-inducible factor 1 alpha) in experimental spinal cord injury in rats and to analyze its potential effects in SCI.

METHODSA static compression model of SCI was employed in this study. Expressions of HIF-1alpha were measured with immunohistochemical staining, while flow cytometry was used to determine the apoptotic ratio and bcl-2 expressions.

RESULTSHIF-1alpha began to increase 1 day after injury, and reached the peak at 3-7 days. Two weeks later, it declined significantly. The sequential changes of HIF-1alpha coincided well with the alterations of apoptotic ratio and contents of bcl-2.

CONCLUSIONSHIF-1alpha possibly participates in the secondary ischemic and hypoxic procedures after spinal cord injury, and may mediate the traumatic apoptosis. Further understanding of HIF-1alpha may provide new therapeutic regimens for SCI.

Animals ; Apoptosis ; Biomarkers ; analysis ; DNA-Binding Proteins ; analysis ; metabolism ; Disease Models, Animal ; Female ; Flow Cytometry ; Hypoxia-Inducible Factor 1 ; Hypoxia-Inducible Factor 1, alpha Subunit ; Injury Severity Score ; Ischemia ; pathology ; Nuclear Proteins ; analysis ; metabolism ; Probability ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; metabolism ; pathology ; Transcription Factors

OBJECTIVE: To explore the relationship between neuronal apoptosis and hypoxia or traumatic injury. METHODS: Rat neurons primarily cultured in vitro were treated w ith hypoxia (the hypoxia group) or traumatic injury (the trauma group). The neur onal apoptosis was evaluated with microscope, TUNEL (terminal deoxynucleotidyl t ransferase mediated X-dUTPnick end labeling) staining, flow cytometry, agarose gel electrophoresis and immunohistochemistry RESULTS: Morphological changes of apoptosis appeared in the t reated neurons and the DNA fragmentation showed "ladder" break. The apoptotic index was 10.8% in the hypoxia group and 4.8% in the trauma group, while it was only 1.6% in the control group. The expression of apoptosis-associated genes (c-myc, fas and fasL) increased. CONCLUSIONS: Hypoxia or traumatic injury can induce neuronal ap optosis, and its molecular mechanism is probably related to the expressions of a poptosis-associated genes.

Objective To study the clinical characteristic and correlation factors of fungal infection in severe acute pancreatitis(SAP). Methods Clinical data of SAP patients with fungal infection (fungus infection group-F1 group) and with bacterial infection (bacteria infection group, B1 group) in January,1994-December,2001 were retrospective analysed and compared. Results There were 40 cases in F1 group, 84 cases in B1 group. There were no significant difference in age, sexual, causes, APACHE II score between the two groups, Hospitalization in F1 was significantly longer than that in B1 group (57.7d∶42.7d, P= 0.044 ).Diabetes-mellitus, SAP grade II, multi-operation, intestinal and/or bile duct fistulas were related to fungal infection in SAP; mortality in F1 group was significantly higher than that in B1 group (P= 0.02 ). Conclusions Diabetes-mellitus, SAP grade II, multi-operation, intestine and/or bile duct fistulas are the risk factors of patients with severe acute pancreatitis developing fungal infection; fungus infection can increase the mortalily of SAP patients.Extra-pancreas fungal infection is commonly seen in digestive tract, respiratory tract and urinary system. unknown consciousness change and massive bleeding may indicate that the patient is complicated with fungal infection.

ObjectiveTo study the early diagnosis and prevention of fungal infection in severe acute pancreatitis(SAP). Method 1.SAP patients from July 1998 to June 2002 were prospectively randomized into 3 groups: garlicin prevention group, fluconazole (low dosage) prevention group and control group, the incidence of fungal infection in SAP was compared between the groups. For fungal infection patients, the fungal clearance and mortality rate were observed. 2.Clinical data of SAP patients with fungal infection and with simple bacterial infection was compared by multivariate logistic regression, and clinical characters and risk factors of fungal infection were evaluated. Results 1.There were lower incidences of fungal infection in garlicin group (16% vs. 30%,P

Objective To determine the prevention and therapy of fungal infection in patients with severe acute pancreatitis (SAP). Methods Seventy patients with SAP admitted from July,1998 to June,2002 were randomly divided into 3 groups: garlicin prevention group, fluconazole (low dosage) prevention group and control group.The incidence of fungal infection, the fungal clearance and mortality after the treatment were compared. Results The incidence of fungal infection in garlicin group and fluconazole group was lower than that in control group. (16%∶30%,P

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.