Objective To study the motor evoked potential (MEP) evoked by transcranial electric stimulation in the masseter muscles of patients with amyotrophic lateral sclerosis (ALS), and to compare the results obtained from a control population, so as to establishe a method to evaluating the impairment of corticobulbar projections in ALS.Method Transcranial electrical stimulation was used in 20 patients with ALS and 30 matched normal control.Central motor conduction time (CMCT) was calculated.Results Responses to direct activation of the trigeminal motor root (R-MEP) were able to be recorded in all ALS.The latency and amplitude of R-MEP was (3.44?0.53) ms and (2.79?2.19) mV respectively.They had nonsignificant differences as compared to the controls.Responses to activation of corticobulbar descending fibers (C-MEP) were absent or delayed in 12 ALS patients, and CMCT was significantly prolonged ( P

Objective To build the linear models for exploring relations between behavior data and functional magnetic resonance image(fMRI) signals of brain during cognitive task and to validate whether it is reasonable.Methods The linear models of behavior data and fMRI signals were built,and the functional regions of brain were detected by tests of corresponding parameters.Experimental data of Stroop tasks were used to study the effects of the models by comparing with the results of SPM.Results The results of Stroop data showed that dorsal lateral prefrontal cortex(Brodmann 9/46),and superior frontal median cortex(Brodmann 8/9) were associated with response time of Stroop tasks,and accorded with SPM results and other reports.Conclusion The models can quantitatively analyze the relations of response time and fMRI signals,providing a new way to explore functional images of cognition.

Objective: To explore therapeutic effects of calcium channel blocker combined statins on aged patients with hypertension, and their influence on inflammatory factor levels.Methods: A total of 124 aged patients with hypertension, who were treated in our hospital from Oct 2014 to Oct 2015 , were randomly and equally divided into amlodipine group (received amlodipine therapy based on routine treatment) and combined treatment group (received atorvastatin calcium based on amlodipine group) according to random number table.Levels of blood pressure, C reactive protein (CRP), interleukin (IL)-6, endothelin (ET) and blood lipids before and after treatment, and therapeutic effect and incidence of adverse reactions were compared between two groups.Results: Compared with amlodipine group after treatment, there were significant reductions in levels of systolic blood pressure [(143.57±3.14) mmHg vs.(131.73±3.42) mmHg], diastolic blood pressure [(82.17±3.26) mmHg vs.(76.51±3.27) mmHg], CRP [(7.32±0.71) mg/L vs.(5.57±0.76) mg/L], IL-6 [(133.42±27.31) ng/L vs.(123.73±22.81) ng/L], ET [(50.74±4.96) pg/L vs.(45.71±5.78) pg/L], total cholesterol [(5.32±0.66) mmol/L vs.(4.12±0.52) mmol/L], triglyceride [(1.56±0.42)mmol/L vs.(1.21±0.37) mmol/L] and low density lipoprotein cholesterol [(3.12±0.48) mmol/L vs.(2.43±0.43) mmol/L], and significant rise in high density lipoprotein cholesterol level [(1.41±0.12) mmol/L vs.(1.55±0.17) mmol/L] in combined treatment group, P<0.05 or <0.01.Compared with amlodipine group, there was significant rise in total effective rate (77.4% vs.91.9%) in combined treatment group, P=0.025.There was no significant difference in incidence rate of adverse reactions between two groups (P>0.05).Conclusion: Calcium channel blocker combined statins possesses definite therapeutic effects on aged patients with hypertension.It can reduce levels of blood pressure and blood lipids and inflammations and improve vascular endothelial cell function, which is worth extending.

Objective To analyze the clinical features of 27 Chinese patients with Kennedy's disease(KD), a sex-linked inheritance disorder. Methods We collected the clinical data of 27 KD patients whose diagnosis were confirmed by gene examination to analyze their clinical features, as well as their serum levels of sex hormones and biochemical indicators. Results Patients with spinal and bulhar muscular atrophy tend to have an adult onset, exhibiting a slow progression of lower motor neuronal weakness and atrophy involving limbs and bulbar zones. Part of the invalids presented signs of androgen insensitivity such as gynecomastia or reduced sexual function, even though their degrees of sex hormones were normal. There was mild motor functional lesion which correlated with the course of the disease ( r = 0. 77, P = 0. 000). The degrees of creatine kinase ( ( 920. 10 ± 495.54 ) U/L ) and triglyceride ( ( 3.27 ± 2. 78) mmool/L) increased mildly and was significantly different from the levels of healthy ones (107.20 U/L,t =7.517,P =0.000;1.40 mmol/L, t =2.687,P =0.017). Conclusions Basically, Chinese KD patients present the same clinical features as the literature reports, however they have distinctive aspects such as elevated degree of triglyceride. The present research can help us to understand the features of Chinese KD more particularly.

BACKGROUND: Cervical intumescence is the earliest and easy attacking part of motor neuron disease (MND). With the development of patients'condition, cervical part and medulla oblongata region were involved early,and the trigemino-cervical reflex (TCR) was involved earliest.OBJECTIVE: To establish electromyography of TCR and analyze the value in the diagnosis of MND of the TCR.DESIGN: Case-control study.SETTING: Room of Electrophysiologic Study, Department of Neurology,Third Hospital, Peking University.PARTICIPANTS: Thirty MND patients,mainly amyotrophic lateral sclerosis (ALS) patients and 70 healthy volunteers who were examined at Third Hospital, Peking University from 2002 to 2005. MND patients accorded with the diagnostic standard of Spain El Escorial conference.METHODS: The subjects held the heads slightly raised when lying supine to make the sternocleidomastoid muscles contracted slightly. Electrical stimulation was applied to the infraorbital nerves and latency and amplitude of wave were recorded from the bilateral sternocleidomastoid muscles. The detecting instrument was Keypoint electromyography (EMG).The surface EMG activity was recorded via Ag/AgCl.MAIN OUTCOME MEASURES: Latency of positive wave/ negative wave (P20/N30); square root of the ratio of the amplitudes, that is, value A.RESULTS: Stimulation of the infraorbital nerve on one side of controlled people produced bilateral positive and negative waves. In the MND group,7 patients showed normal (23.3%), 8 patients showed absence of wave (26.7%), 11 patients were delayed in latency (36.7%), and extreme asymmetry of reflection of the two sides was found in 4 patients (13.3%).In the MND group, the latency of positive and negative waves of TCR (P20/N30) was markedly longer than that in the normal control group,and the difference was significant. Square root of the ratio between the amplitudes after and before stimulation (square root of the ratio between peak to peak value and amplitude of wave before stimulation, that was,value A) was lower remarkably than that in the normal control group, and the difference was significant.CONCLUSION: The TCR can be reliably measured. It may help examine the cervical-bulbar lesion and diagnosing motor neuron disease in an early period.

Objective To study the features of pain evoked potentials in patients with amyotrophic lateral sclemsis(ALS)and evaluate the pain pathway in these patients.Methods Sixty patients with ALS and 60 controls were set on supine position.The contact heat evoked potential stimulator with a diameter of 27 mm and an area of 573 mm2was used to elicit pain and contact heat evoked potentials(CHEP)in an accelerating speed of 70 ℃/s.Thermal stimuli were given at 54.5 ℃ to three body sites:the dorsum of hand,proximal volar for aml and C7. CHEP was recorded at spots of Cz and Pz.The features of CHEP was observed At the same time,somatosensory evoked potential(SEP)was assesed.Results The figure and latency of CHEP in ALS patients were normal.The latency was:the dorsum of hand:(561.2±28.6)ms; proximal volar forarm:(540.1±39.2)ms;C7:(512.7±31.4)ms.There were no significant differences of latency and SEP between tlle ALS patients and the controls((558.7±30.2),(536.6±23.5), (501.8±26.0)ms,t=4.23,4.51,3.74,P＞0.05).Conclusion Patients with ALS have a normal CHEP,suggesting that the pain pathway in patient with ALS is intact.

Objective To assess the value of electromyography (EMG) of rectus abdominis muscle in the diagnosis of polyneuropathy. Methods 109 patients with polyneuropathy were studied. The routine nerve conduction study was done and standard EMG was recorded from rectus abdominis muscle, first dorsal interosseous muscle and tibialis anterior muscle. The parameters studied included spontaneous activity fibrillation potentials (fib) and positive sharp waves (psw); duration, amplitude and percentage of polyphasic wave of motor unit action potential (MUAP) and pattern of recruitment. A group of controls and patients with amyotrophic lateral sclerosis (ALS) were studied at the same time. EMG parameters of rectus abdominis muscles were compared among patients with polyneuropathy, patients with ALS and the controls.Results EMG of rectus abdominis muscle in the patients with polyneuropathy showed neurogenic change.The amplitude of motor unit potential in patients with polyneuropathy(451.67±75.01)μV was higher than that of the controls (373.78±56.46)μV (t=2. 01, P < 0. 04) and lower than that of patients with ALS (537.19±159. 04)μV (t=2. 32, P<0.03). Conclusion EMG of rectus abdominis muscle might be used to find the lesion of intercostal nerve in polyneuropathy.

Objective:to investigate the clinical feature and dynamic changes of the cervical dural sac and spinal cord during neck flexion in Hirayama disease(juvenile muscular atrophy of distal upper extremity).Methods:Clinical data were taken and MRI in neutral neck position and a fully flexed neck position were performed on 27 cases of Hirayama disease.Results:(1)All patients were consistent with the diagnostic criteria of Hirayama disease who had asymmetric muscular atrophy and weakness of the hand and forearm.All patients were young males and right handed of whom 77.8% had initial symptoms before they were 19 years old.More patients(20 cases,74%)had muscular atrophy in the right hand than in the left at onset.The duration after disease onset was from 2-72 months[(26.48?15.57)months].(2)In neutral neck position by MIR examination,16 patients showed abnormal cervical curvature,14 showed atrophy of the lower cervical cord and 2 patients had intramedullary abnormal high signal.(3)In a fully flexed position of the neck,all patients showed forward displacement and flattening of the lower cervical cord,and a crescent-shaped high signal area behind the cord.(4)The crescent-shaped area was enhanced on T1-weighed imaging and disappeared after the patient returned to a neural position in one case.Conclusion:Hirayama disease occurs mainly in young males.There are obviously dynamic changes of the cervical cord during neck flexion in Hirayama disease by MRI examination,which can help the doctor make diagnosis in the early stage.

Objective To investigate the mechanism underlying the WNK4 kinasemediated inhibitory effect on BK channel. Methods Cos-7 cells were cotransfected with BK in combination with either CD4 (control group) or wild type WNK4 (WNK4-WT).Immunostaining and confocal microscopy,chemiluminescence,Western blotting analysis were then employed to determine the BK localization in cells,BK surface expression and total protein level,respectively.To further investigate whether the reduction of BK protein expression is due to an increase in degradation through a lysosomal pathway,BK protein level was determined after treated with bafilomycin A1(Baf A1),a proton pump inhibitor affecting lysosomal degradation. Results Immunostaining and confocal microscopic study showed that BK was localized both in plasma membrane and cytosol in the control group.After cells transfected with WNK4-WT,BK expression was markedly reduced.Chemiluminescent assay found that BK surface expression level was 299.9±18.6 in the control group,whereas it was significantly reduced (148.4±13.7,P＜0.01) in the WNK4-WT group.Western blotting analysis showed that total BK protein level was markedly reduced in the presence of WNK4-WT compared to the control group.WNK4-WT was shown to significantly reduce the BK total protein level (42.3％±15.2％) compared to the control group (100％) (P＜0.01).When the cells was treated with Bafilomycin A1 (Baf A1,0.5 μmol/L),WNK4-mediated reduction in BK protein was reversed (82.2％±12.1％,P＜0.05). Conclusions WNK4 inhibits total and surface protein expression of BK in Cos-7 cells whick is likely due to an increase in BK degradation through a lysosomal pathway.

BACKGROUND:Shengji Yuhong col agen showed good curative effect of promoting angiogenesis and tissue healing compared with Shengji Yuhong Gao and col agen alone or gelatin alone.
OBJECTIVE:To explore the curative effect and mechanism of subcutaneous implantation of Shengji Yuhong col agen in rabbits in promoting angiogenesis and repair.
METHODS:Shengji Yuhong col agen as the experimental group and collagen as the control group was implanted inside the rabbit subcutaneous pockets of the back of New Zealand rabbits. The implanted samples and
surrounding tissues were obtained at 3, 7, 14, 28 and 56 days fol owing surgery. Pathological sections were made and the repair of surrounding tissue was observed. Hemoglobin levels in col agen were measured.
Immunofluorescence and CD34 dyeing marking method were utilized to observe capil ary angiogenesis. Western blot assay was employed to examine vascular endothelial growth factor and angiogenin-1 expression.
Immunohistochemistry was used to observe the secretion of typeⅠ and Ⅲ col agen on the surrounding tissues.
RESULTS AND CONCLUSION:The experimental group showed increased subcutaneous vascularization. There were reduced inflammatory exudation, granulation tissue hyperplasia, and mature fiber connective tissue at 28 days.
Angiogenesis and hemoglobin contents were greater in the experimental group than in the control group (P<0.05 or P<0.01). At 3 and 7 days fol owing surgery, vascular endothelial growth factor and angiogenin-1 expression was greater in the experimental group than that in the control group (P<0.05 or P<0.01). The secretion of type Ⅰ col agen was
identical between the experimental and control groups. However, the secretion of type Ⅲ col agen was higher in the experimental group than in the control group at 28 and 56 days (P<0.05), and the proportion of type Ⅰ and Ⅲ
col agen was lower in the experimental group than in the control group at 28 and 56 days (P<0.01). These suggested that Shengji Yuhong col agen can significantly promote angiogenesis in the surrounding tissues with the possible
mechanisms of adjusting the protein expression of vascular endothelial growth factor and angiogenin-1. At the same time, it has the function of regulating col agen formation with better ratio of typeⅠ and type Ⅲ col agen to acquire higher
quality of wound healing with reduced scar formation.