The efferent projections of the rostral ventrolateral medulla(RVL) to the hypothalamic paraventricular nucleus(Pa) and the thoracic cord were studied in the adult cat by using WGA-HRP or fluorescent retrograde tract-tracing method. After injection of WGA-HRP or fluorescent tracer Fast blue(FB) into one side of the Pa, retrogradely labelled cells were found in bilateral RVL, with an ipsilateral predominance. The labelled cells decreased in number from the caudal to the rostral level. After injection of FB into one side of the thoracic cord at T_2-T_3 segments, retrogradely labelled cells in the RVL were observed which increased in number from the caudal to the rostral level and reached the peak at 1.0-1.5mm caudal to the trapezoid body. Most of these cells were distributed in the ipsilateral RVL, and clustered in the region 0.0-1.0mm from the ventral surface of the medulla. After Diamino yellow 2HC1 and FB were injected into the Pa and the thoracic cord respectively, only single labelled cells were detected in the RVL, no double labelled cells were found. The above results suggest that the Pa and the thoracic cord receive separate fiber projections from different cells of the RVL.

Objective To investigate the treatment of pronation external rotation ankle injuries and to evaluate its outcomes. Methods 58 cases of severe ankle injuries of pronation external rotation type who had been hospitalized between October, 2001 and October, 2003 were retrospectively analyzed. They were 42 males and 16 females, with an average age of 32.4 years old (16 to 61 years old). According to Lauge Hansen classification, 39 cases were grouped as grade Ⅲ, while other 19 cases as grade Ⅳ. Most cases were surgically managed, and routine examinations were done. Results The average follow up period was 16.4 months (from 10 to 36 months). The satisfactory outcome was 89.7%. 2 cases of osteoarthritis were observed. Conclusions In treatment of pronation external rotation ankle injuries, the key points are to correct the fibular shortening and external rotation and to take great care of technical details.

[Objective]To use urodynamic method to evaluate "free sacro-capsule"pre-operation and post-operation effect,also evaluate bladder and urethral function.[Method]Twenty children were included in this study.[Result]All children had none damage after operation.The PVR and DLPP of post-operative group are significantly decreased.The BC and MCC of post-operation group was significantly higher than pre-operation group(P

The distribution of serotonin(5-HT), phenylethanolamine-N-methyltransferase (PNMT), substance P(SP) and leu-enkephalin(L-ENK) immunoreactive neurons in the rostral ventrolateral medulla (RVL) of the cat was studied with the immunohistochemical ABC technique, and the projection of 5-HT, SP and L-ENK positive neurons of the RVL into the thoracic cord was preliminarily investigated by a combined fluorescent retrograde transport and immunofluorescence method. The results indicate that 5-HT, PNMT, SP and L-ENK immunoreactive neurons mentioned above were localized primarily in the caudal part of nucleus paragigantocellularis lateralis and the rostral part of nucleus lateralis reticularis. SP positive cell bodies in the reticular formation close ventrolateral to nucleus ambiguus were also found. Some 5-HT, SP and L-ENK positive cells were situated in the area near the pia mater. In the most area of the RVL, 5-HT, PNMT, SP and L-ENK immunoreactive cell bodies had an overlapping distribution. 5-HT or PNMT or L-ENK positive neurons crowded, intertwined each other with their processes in the region at the levels 1.0-3.5mm caudal to trapezoid body, about 3.3mm lateral to the midline and about 0.8mm from the ventral surface of the medulla, and formed a longer or shorter continuous cell column which ran in the rostrocaudal direction. These three columns nearly coincided with each other at the level 1.5-2.5mm caudal to trapezoid body. Part of 5-HT, SP and L-ENK positive neurons in the RVL projected into the thoracic cord. The functional significance of these substances in the RVL was also discussed.

Objective To assess the significance of urethral sphincter electromyography (US-EMG) and external anal sphincter electromyography (EAS-EMG) for the diagnosis of multiple system atrophy (MSA).Methods US-EMG and EAS-EMG were performed in 9 patients who were diagnosed as MSA.Duration,motor unit action potentials amplitude,polyphasicity,as well as recruited pattern and amplitude during powerful contraction were recorded and analyzed.Results Among 9 patients who were diagnosed as MSA,7 cases showed neural injury by both US-EMG and EAS-EMG.There was significant difference of electromyographic findings between US-EMG group and EAS-EMG group (average volatility (μV):1063.44 ±499.92 vs 634.89 ±265.07; polyphasic wave:0(0,20％ ) vs 57％ (28％,63％ ) ; t =2.567,P=0.033;t =2.833,P=0.012).Conclusions Although US-EMG may be difficult to perform,US-EMG may have the same specificity as EAS-EMG for the diagnosis of MSA,especially for the diagnosis of MSA patients only with urination disorders,who are involved in Onuf neclear according to some of the abnormal indexes.

Objective To analyse the clinical features,imaging characteristics diversity of deep cerebral veins thrombosis (DCVT).Methods From 2004 to 2013,6 patients diagnosed as DCVT were recorded and a retrospective review of the cases were undertaken for the purpose of this analysis.Results Among the 6 patients with DCVT,4 were male and 2 were female,aged from 28 to 69 years old.The disease duration of 4 cases ranged from 2 to 7 days,remnants were 20 days and 3 months respectively.The first symptoms of 4 cases were headache,1 was feeblemindedness,and the other was hemiplegia.The secondary symptoms were disturbance of consciousness,apathy,diplopia and non-infectious fever.Non-contrast computed tomography showed low signal in the bilateral thalamus in four patients,high signal in the transverse sinus and straight sinus in one patient and high signal in torcular in one patient.Abnormal signal was found in bilateral thalamus on magnetic resonance imaging in all patients and some of them had abnormal signal in the mesencephalon or basal ganglia.The patients were definitely diagnosed as DCVT by magnetic resonance venography (MRV) or digital subtraction angiography (DSA).Among them,2 patients were confirmed by brain biopsy.Four patients were followed up with good outcome and 2 were lost to follow-up.Conclusions The clinical manifestations of DCVT are not specific.For acute-onset DCVT patients,the first symptoms are always headache and vomiting,while the main symptoms are declined cognition and slow reaction for chronic-onset ones.Along with the progress,the main symptoms of DCVT are disturbance of consciousness,psychiatric symptoms and intracranial hypertension.Changes in the bilateral thalamus and basal ganglia are especially main characteristics which are easily misdiagnosed as brain tumor according to the images.DCVT can be definitely diagnosed by no signal of deep cerebral veins on MRV or DSA.

BACKGROUND:Compared with traditional hydrogels, intel igent hydrogels can appear to exhibit different responses to different stimuli such as temperature, pH value, light, and magnetic field, produce two-stage structure and alter chemical structure to generate the ordered supramolecular structure by self-assembling, and ultimately cause the formation of the gel with three-dimensional structure.
OBJECTIVE:To review the research status of intel igent hydrogels and its application in tissue engineering.
METHODS:A computer-based search of CNKI and PubMed databases was performed to retrieve articles addressing intel igent hydrogels in tissue engineering published before 2014. The keywords were“hydrogel, tissue engineering”in Chinese and English.
RESULTS AND CONCLUSION:Intel igent hydrogels are classified into temperature sensitivity, pH sensitivity, photosensitivity, magnetic susceptibility and temperature/pH dual responsive hydrogels. The change of the external environment can be automatical y detected and responded. Intel igent hydrogels exhibit a series of outstanding performances in drug delivery systems, drug delivery, repair and improvement of defected tissues, which are not possessed by traditional materials. In particular, the intel igent hydrogels show considerable superiorities in tissue engineering, including low immunogenicity that reducing inflammation and rejection, biodegradability, realizing the three-dimensional scale simulation of cel microenvironment that is conducive to cel adhesion, growth, migration and differentiation.

Objective To investigate the self-efficacy levels and its influencing factors of community-based patients with chronic obstructive pulmonary diseases (COPD).Methods From October 2008 to March 2009,320 community COPD patients were recruited from a Shanghai community.They undertook questionnaires,scale survey and pulmonary function testing so as to investigate the influencing factors of self-efficacy.Results The total scale of self-efficacy was 74.24 ± 9.50 and the level of selfefficacy in 286 cases( 89.4％ )was intermediate.The knowledge of COPD,social supports,forced expiratory volume at 1 second (FEV1)/forced vital capacity (FVC) and self-management level were entered into regression equation and could explain 57.1％ of the total variance of independent variables.Conclusions The knowledge of COPD,social supports,FEV1/FVC and self-management level are the major influencing factors of self-efficacy in the COPD patients.We should improve the knowledge of disease and strengthen the psychological care and social supports so as to improve their quality of life.

Objective To improve the recognization of long term interval between optic neuropathy and spinal cord injury of neuromyelitis optica. Methods One 51-year old male patient with 37 years'interval between optic neuropathy and spinal cord injury of neuromyelitis optica underwent the examination of plasma and cerebrospinal fluid and head and spinal MRI examinations, who was also followed up. His clinical data were analyzed and related literature was reviewed. Results The myelin basic protein and IgG index in his cerebrospinal fluid was high, his oligoclonal band of cerebrospinal fluid was positive, and abnormal finding in visual evoked potential. Abnormal intramedullary long T2 signals was showed in spinal cord MRI at T1-7 segment. When dignosed as neuromyelitis optica, the clinical symptom and signs was improved with corticosteroid and gamma globulin therapy. The patient was in stable condition at present.Conclusions There could be a long term interval between optic neuritis and myelitis. One should pay attention to clinical features and imaging examination of subclinical lesion in spinal cord and brain and conoide the possibility of developing neuromyelitis optica or multiple sclerosis.

Objective To explore the clinical features, imaging and their diagnosis vaule of Baló's concentric sclerosis (BCS). Methods The clinical manifestation, laboratory examination, neuroimaging characteristics, pathology and follow-up of 12 (2 outpatients and 10 inpatients) cases of BCS were analyzed retrospectively. Results The onset age of 12 patients (male 4, female 8) ranged from 8 to 54 years old (mean 36.8 years). Unconcerned and slowness response were common in the disease onset (7 cases).Other symptoms and signs such as hypophrenia ( 10 cases), limitation of limb or hand movement (8 cases),urinary and fecal incontinence (7 cases), hypo-myodynamia (7 cases), positive pyramidal sign (6 cases)were not rare in course of disease. Eight cases underwent the examination of cerebrospinal fluid myelin basic protein, which increased in 7 cases. Demyelinating change and perivascular inflammatory infiltration were shown in 6 brain biopsies. The involvements of multi-lesions were found in 11 cases. Four patients underwent CT scanning and all the cases showed with hypodense lesions and couldn' t be enhanced. On MRI, all cases appeared round or round-like in shape. Enhanced lesions showed ring-like or half-ting-like shape (8 cases) and concentric ring (3 cases). It's easy to be misdiagnosed as brain tumor (8 cases).Conclusions BCS is a kind of demyelinating disease of subacute or chronic onset accompanied with cognitive disorder being the most common initiating symptoms. It's prone to be misdiagnosed. Diagnosis depends on MRI and corticosteroid treatment is effective. BCS has a good prognosis and presents with benign clinical course.