The most rigorous and valid spinal cord injury(SCI)clinical trials would be a prospective,double-blind,randomly,control one.The design and conduct of SCI clinical trials should meet appropriate standards to make it of efficacy and safety,trustworthy,and in the best interests of subjects.

Objective To investigate the influence of deoxyschizandrin (Deo) on P-glycoprotein (P-gp).Methods The effect of P-gp on Deo (20,40,80 μg·mL-1) was studied in the Caco-2 cell model in vitro,and the apparent permeability coefficient (Papp) of Deo (20-160 μg·mL-1) on a P-gp substrate,rhodamine123 or cyclosporine A,was calculated.Healthy male Sprague-Dawley rats were randomly divided into five groups:blank control group,verapamil group,low-,medium-and high-dose Deo group (8 rats in each group).Rats in the low-,medium-and high-dose Deo group were intragastrically administered once daily with Deo at 8,16 and 32 mg·kg-1 for 3 consecutive days,while rats similarly received gavagewith verapamil (4 mg·kg-1) in the verapamil group and equal volume of purified water in the blank control group.Thirty minutes after the rats were treated with their respective drugs,rhodamine123 (5 mg· kg-1) was orally administrated.Then the pharmacokinetic profiles of rhodamine 123 were analyzed to evaluate the inhibitory ability of Deo on P-gp in vivo.Results The bidirectional transport rates of Deo (20,40,80 μg·mL-1) were similar,with non-selectivity.Deo (20-160 pg·mL-1)significantly inhibited the basolateral→apical(BL→AP) directional transports of rhodamine 123 and cyclosporine A in Caco-2 cell model (P ＜ 0.05) in a concentration-dependent manner.And Deo (8-32 mg· kg-1) also dose-dependently decreased the peak concentrations (Cm.) and the area under the plasma concentration-time curve (AUC0-t) of Rho123.Conclusion Deo can inhibit P-gp in vitro and in vivo,but it is not a P-gp substrate.

Objective:To investigate the effects of schizandrin B on P- glycoprotein by a classical in vitro cell model. Methods:Caco-2 cell model was used as the carrier,and rhodamine 123 and cyclosporin A were employed as the P-gp substrates, the transmembrane transportation of schizandrin B,rodamine 123 and cyclosporin A were detected by HPLC and a liquid scintillation counting assay,and the apparent permeability coefficient and permeability directional ratio were calculated. Results:The bidirectional transportation rates of schizandrin B(20 μg·ml -1 ,40 μg·ml -1 and 80μg·ml-1 )were similar,and showed non-selective difference. Schizandrin B(20-160 μg ·ml -1 )significantly inhibited the BL → AP directional transportation of rhodamine 123 and cyclosporine A in Caco-2 cell model(P < 0. 05) in a concentration-dependent manner. Conclusion:Schizandrin B is a P-gp inhibitor,while it isn’t a P-gp substrate.

Objective To study the changes of the expression of adhesion molecules on peripheral blood CD34+ cells during recombinant human granulocyte colony stimulating factor(rhG-CSF) mobilization,and to study the influence of rhG-CSF on donors.Methods Fifteen healthy blood donors were subcutaneously injected with rhG-CSF(10?g?kg-1?d-1)for 4 to 6 days.The expressions of very late antigen 5(VLA-5,CD49e) and L-selectin(CD62L) on CD34+ cells were examined by flow cytometry before mobilization,the fourth day during mobilization and the seventh day after mobilization.Results The percentage of CD34+ cells,especially CD34+CD49e+ cells,increased significantly during mobilization,reaching the peak on the forth day,but declined to normal level when the mobilization stopped.The percentage of CD34+CD62L+ cells didn't show any significant change during the mobilization.Conclusion rhG-CSF could increase the percentage of CD34+CD49e+ cells in peripheral blood,but the percentage was reduced one week after the mobilization.rhG-CSF doesn't affect the percentage of CD34+CD62L+ cells.

Objective To investigate the value of the acupuncture with Medicinal herbs in the treatment of the intractable hiccup after severe craniocerebral injury. Methods Sixty patients diagnosed of intractable hiccup after severe craniocerebral injury were randomly recruited into a therapeutic group and a control group. The therapeutic group was treated with acupuncture and medicinal herbs, while the control group was treated with western medicine. The therapeutic course for both groups was one week. The efficacy was evaluated by observing the cure rate, improvement rate and non effective rate respectively. Results In the therapeutic group :23 patients were cured and the total effective rate was 96.67%;While in the control group: 12 patients were cured and the total effective rate was 70.00%. The effective rate of therapeutic group was obviously better than the control group. Conclusion Acupuncture with medicinal herbs in the treatment of the intractable hiccup after severe craniocerebral injury has good efficacy.

Objective To evaluate the efficacy of living donor liver transplantation in the treatment of infants with end-stage liver diseases. Methods The clinical data of 33 infants who received living donor liver transplantation at the Renji Hospital of Shanghai Jiaotong University from October 2006 to September 2009 were retrospectively analyzed. The median age of the infants was 10.9 months, and the mean body weight was 8.2 kg.All of the grafts were left lateral lobes. Tacrolimus (or cyclosporine A) + steroid or tacrolimus (or cyclosporine A)+ steroid + mycophenolate mofeti] were applied to the infants to suppress the immune reaction. Operative techniques, perioperative management and results of follow-up were analyzed. Results The mean operation time,blood loss and blood transfusion of the donors were (384±108)minutes, (183±35) ml and O, and the three indexes of the recipients were (500± 103) minutes, (296±163) ml and (292 ± 159) ml , respectively. The cold preservation time of the grafts was (64 ±23)minutes, the mean weight of the grafts was (249 ±52)g, and the mean graft to recipient weight ratio was 2.1% ± 0.4%. All donors recovered smoothly and no complication occurred. Of the recipients, three were complicated with hepatic artery thrombosis, two with portal vein thrombosis,nine with biliary complications, 11 with infection, two with acute rejection and five infants died perioperatively.The one-year cumulative survival rate of the infants was 85% (28/33). Conclusions Infants with end-stage liver diseases could be treated by living donor liver transplantation. The development of surgical techniques and perioperative managements improves the success rate of operation and the long-term survival rate.

Objective To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)on the spinal segmental excitability after spinal cord injury in adult rats.MethodsT 10 spinal cord injury models were made with weight-drop method.8 weeks later,rTMS were applied to the experimental group at 0.5 Hz suprathreshold stimulation,500 pulses daily for 4 weeks.Spinal cord injury rats without stimulation and normal rats were used as controls.At different time points,electronic evoked F-wave were measured.The ratio of F-wave amplitude to M-wave amplitude(F/M)were compared among these groups.Immunohistochemistry was used to detect the expression of 5-hydroxytryptamine(5-HT)in the rostral and caudal lesion segments.ResultsThe ratio of F/M increased significantly(P<0.01)8 weeks after spinal cord injury compared with baseline ratio and regressed significantly(P<0.01)after 4 weeks of rTMS.Expression of 5-HT in grey matter around lesion was decreased after spinal cord injury and increased significantly(P<0.01)both in the rostral and caudal lesion segments in rTMS treatment group.ConclusionThe increased spinal segmental excitability after spinal cord injury can be regressed by rTMS,which may be resulted in increased expression of 5-HT.

Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS)on spinal cord injured rats.Methods Weight-drop spinal cord injury model was made at thoracic 10 segments with NYU impactor device.Stimulated group received daily superthreshold rTMS continued for 4 weeks.BBB locomotor scores were recorded weekly.Growth associated protein 43(GAP43)and 5-hydroxytryptamine(5-HT)were detected with immunofluorescence staining in the area of rostral and caudal to the lesion.Results The BBB scores in stimulation group improved compared with that in the control(P<0.01).GAP43 and 5-HT markers increased in the stimulation group(P<0.01),and they increased in the rostral than in the caudal areas(P<0.01).Conclusion rTMS can improve the locomotor function of incomplete spinal cord injury rats,which may result from the increase of expression of GAP43 and 5-HT.

Objective To investigate the effect of integrin-linked kinase (ILK) on inducing mesenchymal stem cells (MSCs) to neuron stem-like cell in vitro. Methods MSCs isolated from umbilical cord were transfected with plasmid DNA encoding green fluorescent protein (GFP) and GFP-fusion ILK, wild and mutant, respectively; and cultured in serum-free media with basic fibroblast growth factor, epidermal growth factor and B27. It was assessed with the proliferative activity and the efficiency of differentiation into neural stem-like cell. Results MSCs transfected with GFP-fusion wild ILK expressed ILK and kinase-dead mutant ILK stably. The activity of proliferation increased and more of them differentiated into neural stem-like cell, which express CD133 and Nestin validated by PCR and Western blotting, and more of wild than of mutant. Conclusion Integrin-linked kinase may play a positive role in MSC differentiation into neural stem-like cell, which may associate with the activity of kinase.

Objective To investigate the short and long term therapeutic effects of prostaglandin E1 (PGEl) on diabetic nephropathy (DN). Methods Patients with DN in stage Ⅲ to Ⅴ according to Mogensen criteria were randomly assigned to four groups of PGE1, angiotensin-converting enzyme inhibitor (ACEI), PGE1 + ACEI and control drug. The levels of proteinuria and albuminuria were measured before and 15 days, 6 months and 18 months after treatment. Patients with DN in stage Ⅳ were subdivided into three groups according to proteinuria: early stage IV (protienuria was less than 1.5 g/d), middle stage Ⅳ (protienuria was between 1.5 g/d and 2.5 g/d) and late stage Ⅳ (protienuria was larger than 2.5 g/d). Results Fifteen days after treatment, the levels of proteinuria and albuminuria were significantly decreased compared with pre-treatment in PGE1 and PGE1 + ACEI groups (P<0. 01), and the therapeutic effect was better in PGE1 + ACE1 group than in ACEI group (P<0. 01). Six months after treatment, there were still significant differences in above parameters in patients with DN in stage Ⅲ and Ⅳ between PGE1 + ACEI and PGE1 groups. And for the patients in stage Ⅴ, statistic significance between pre-and post-treatment existed only in PGE1 + ACEI group (P<0. 05). but not in PGE1 and ACEI groups (both P>0. 05). Eighteen months atter treatment, the levels of proteinuria and albuminuria were significantly decreased in patients in stage HI and early stage IV in all treatment groups (P<0. 01). For patients in middle stage IV and late stage Ⅳ , the significant differences still occurred between pre-and post-treatment in PGE1 + ACEI group (P<0. 01 or P<0. 05), and were significantly better than in ACEI group (P<0. 01 or P<0. 05). However, the proteinuria of patients in late stage IV elevated in PGE1 group in post-treatment versus pre-treatment (P<0. 05). Conclusions The short term therapeutic effect of PGE1 is quick and good in patients with DN. The therapeutic effect is much better in patients in stage Ⅲ compared with stage Ⅴ. The combination of PGE1 and ACEI will get better best therapeutic effect than PGE1 or ACEI alone in long term.