Objective To explore the value of sympathetic skin response (SSR) detection for evaluating the autonomic nervous damage in patients with cerebral infarction.Methods 56 cases with cerebral infarction within 2 weeks and 50 cases of healthy controls were detected SSR by EMG,and the results were compared.Results 18 patients with cerebral infarction did not elicit SSR and 18 patients were abnormal with the latency and amplitude of SSR,and the abnormality rate of SSR was accounting for 64.29％,which was significantly different compared with control group( t =10.66,3.83,all P ＜0.01 ).Conclusion The patients with cerebral infarction had severe autonomic dysfunction and SSR,and SSR detection was a simple,safe and noninvasive method,and could quantitatively evaluate the svmpathetic function in patients with cerebral infarction.

BACKGROUND:Bone marrow mesenchymal stem cells have potential to self-renewal and multi-lineage differentiation. But after a long period of culture in vitro, the proliferation and differentiation capacities of bone marrow mesenchymal stem cells gradual y loss, the mechanism underlying which is not clear now.
OBJECTIVE:To observe the expression of autophagy-related gene Beclin-1 in differentiation from human bone marrow mesenchymal stem cells into neuron-like cells in vitro.
METHODS:The changes of morphological characteristics of neuron-like cells differentiated from human bone marrow mesenchymal stem cells induced by epidermal growth factor were observed. The expression of neuron-specific enolase and glial fibril ary acidic protein in treated and untreated human bone marrow mesenchymal stem cells were detected using immunocytochemistry. The Beclin-1 protein expressions were detected by western blot before and after induction.
RESULTS AND CONCLUSION:After being induced, human bone marrow mesenchymal stem cells presented classical neuron-like morphology;the expressions of neuron-specific enolase and glial fibril ary acidic protein were 78.7%and 8.1%, respectively. The expression of Beclin-1 protein was changed correspondingly during the induction, which increased after 30 minutes of induction and decreased gradual y after 1 hour of induction. Human bone marrow mesenchymal stem cells could be induced into neuron-like cells in vitro by epidermal growth factor. Autophagy-related gene was highly expressed in the induction of early differentiation and the expression gradual y reduced until it remained at a low level during the differentiation.

Objective To investigate the mechanism of brain injury caused by thrombin and the intervention effect of hirudin and nimodipine.Methods Different doses of thrombin or/and hirudin were injected into nucleus caudatus of SD rats,nimodipine was given intraperitoneally.Dry-wet-weighing technique,immunohistochemical method and TUNEL were used to examine brain edema,the changes of cytoskeleton,neuron apoptosis and histological changes.Results(1) High dose of thrombin resulted in severe cerebral edema as early as 4 h after injection and the maximum edema occurred at 24~48 h.The edema gradually decreased and got close to normal within 3~7 d.Cytoskeleton changes were observed at early stage(4h),reversible or irreversible injuries presented at 24~48 h,and neuron necrosis occurred within 3~7 d.Neuron apoptosis started at 4h and peaked at 24~48 h.In contrast,low dose of thrombin and normal saline did not show these effects.(2) The effects of thrombin could be inhibited by hirudin and nimodipine(a calcium-ion antagonist) could relieve or delay cell injury.Conclusions High dose of thrombin may result in severe brain edema,neuron irreversible injury and apoptosis,which all peak at 24~48 h.Early treatments could greatly reduce brain damage and improve prognosis of intracerebral hemorrhage.

Objective To determine the perioperative risks of partial hepatectomy by determining the preoperative liver functional reserve in patients with hepatocellular carcinoma (HCC),and to compare the model for end-stage liver disease (MELD) score with the Child-Pugh classification in predicting prognosis.Methods We reviewed the clinical data of 202 patients with HCC who underwent partial hepatectomy.The MELD score and the Child-Pugh classification were determined preoperatively.Results The incidence of postoperative liver dysfunction happened in 44.0％ of Child A patients,50％ in Child B patients,41.6％in patients with a MELD score below 14,and 91.7％ in patients with a MELD score of ＞ 14.The difference between the rates of postoperative liver dysfunction in patients with a preoperative MELD score above 14 and below 14 was significant (P ＜ 0.05),while that between patients with Child-Pugh A and B was insignificant (P ＞ 0.05).The incidences of postoperative liver dysfunction in patient with a MELD ＜ 8,8 ≤ MELD ≤ 14,MELD ＞ 14 were 38.2％,57.6％ and 91.7％,respectively,indicating that there was a positive co-relationship between the MELD score and the incidences of liver dysfunction.The Spearman rank correlation test showed the MELD score was significant correlated with the Child-Pugh score (r =0.404 ; P ＜ 0.05).The areas under the ROC curves of the MELD score and the Child-Pugh score were 0.703 and 0.587 (P ＜ 0.05).Conclusions The MELD score predicted postoperative liver dysfunction more accurately than the Child-Pugh classification.HCC patients undergoing partial hepatectomy with a preoperative MELD score ＞ 14 had a high perioperative risk.To ensure the safety of partial hepatectomy,HCC patients with a preoperative MELD score ＞ 14 requires active preoperative preparation,bringing the score near to or less than 14.

BACKGROUND: Multiple sclerosis(MS) is a chronic autoimmune disease induced by the interaction between genetic and environmental factors. Its pathogen and the mechanism of the relapse and remission m the course of the disease are still unknown. Most of the MS research centers are looking for the pathogenic polypeptide epitope in proteolipid protein(PLP), myelin sheath basic protein (MBP) and oligodendrocyte glycoprotein (MOG) OBJECTIVE: To compare the proliferation of T cell lines(TCL) in MS induced by myelin sheath and delipidated myelin sheath towards 11 components of myelin sheath to mainly search the possible pathogenic polypeptide epitope in PLP, and investigate the possible effects of abnormal dcgrease in myelin sheath.DESIGN: A case-controlled trial.SETTING: Department of neurology in a hospital of a university.PARTICIPANTS: Mononuclear cells(MNC) of 16 MS cases(clinical relapsing-remitting type, patients did not receive any immunosuppresant for at least 3 months when their peripheral blood samples were taken) and 12 HLA-DR15 healthy volunteers were furnished by Dr. Trotter JL of MS Research Center of Washington University from the cell database.INTERVENTIONS: MS-TCL and normal TCL were induced twice by stimulation with myelin sheath and delipidated myelin sheath in vitro by cell culture in vitro. TCL proliferation was tested by 11 antigens including PLP,MBP, M87-106, P30-49, P40-60, P89-106, P95-117, P117-137,P139-151, P178-191, and P185-206.MAIN OUTCOME MEASURES: Difference of scintillation counting in every minute of every well, and the stimulative index of each well were calculated, and the mean wells with positive proliferation of TCL towards each antigen were confirmed as well.RESULTS: The general specific proliferation towards myelin sheath antigens was bigger in MS group than control group 5.49 ±5.31 to 3.10 ± 3. 17, and delipidated myelin sheath-induced TCL was bigger than myelin sheath-induced one 5. 49 ± 5.31 to 3.41 ± 4. 83 . Delipidated myelin sheath significantly changed the immune responses of MS group,especially the changes of responses towards P30-49, P40-60, P89-106,P117-137, P139-161, and P185-206 were significant compared with that the control group only responded to two polypeptides, which indicated that the antigen epitope of MBP, PLP, M87-106, P95-117, P40-60, and P185-206 might have significance in the triggering of MS autoimmune responses.CONCLUSION: TCL induced by MS myelin sheath has different proliferation towards antigen components of myelin sheath from control group. Delipidated myelin sheath significantly increases TCL proliferation in MS group, which suggests that if MS patients developed abnormal degrease in myelin sheath, TCL would produce autoimmune response towards self-myelin sheath, MBP, PLP and its polypeptide segments all can trigger MS or aggravate the state of the illness. Our finding supports the hypothesis of MS autoimmune pathogenic mechanism.

OBJECTIVE:To investigate the effects of TanshinoneⅡA sodium sulfonate injection on levels of P-selectin,glial fi-brillary acidic protein (GFAP),vascular endothelial growth factor (VEGF) and neurological function in patients with acute cere-bral infarction. METHODS:A total of 114 patients with acute cerebral infarction selected from Lianyungang First People's Hospi-tal during Apr. 2013-Apr. 2016 were divided into control group and observation group according to random number table,with 57 cases in each group. Control group was given routine treatment. Observation group was additionally given Tanshinone ⅡA sodium sulfonate injection 40 mg 0.9％ sodium chlonride injection 250 mL,ivgtt,qd. A treatment course lasted for 7 d,and both received 2 courses of treatment. NIHSS scores,the levels of serum P-selectin,GFAP and VEGF were compared between 2 groups before treatment and after 7,14 d of treatment. The occurrence of ADR was also compared. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). Compared to before treatment,NIHSS score,the levels of se-rum P-selectin and GFAP in 2 groups were decreased significantly after 7,14 d of treatment,while the serum level of VEGF was increased significantly. These indexes of 2 groups after 14 d of treatment were significantly better than 7 d of treatment,except for NIHSS score. Above indexes of observation group was significantly better than those of control group during corresponding period, with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:For acute cerebral infarction, Tanshinone ⅡA sodium sulfonate injection can significantly reduce the levels of serum P-selectin and GFAP,improve VEGF level and promote the recovery of neurological damage with good safety.

OBJECTIVE: To study preparation technology and properties of a new kind of iron-supplement of alginate-iron (III) complex. METHODS: The preparation parameters of polysaccharide iron (III) complex with sodium alginate and ferric trichloride were optimized by means of the single factor and response surface design. Alginate-iron (III) complex was characterized by IR and DSC. Its reducibility and drug release percentage were determined in simulated gastrointestinal liquid. RESULTS: Optimum condition follows; alginate sodium to ferric trichloride with mass ratio of 1:3.2 and alginate sodium to sodium citrate with mass ratio of 1:1.4, which were reacted in pH 6.95 of reaction liquid and at 80℃ of water bath lasting for 3. 29 h and generated alginate-iron (III) complex with the 19.57% of iron content. The IR and DSC indicated that the hydroxyl groups of alginate was combined with Fe(III). The alginate-iron (III) complex could be dissolved and reduced easily by vitamin C in physiological pH conditions. And the cumulative release percentage was more than 80% within 60 min in stimulated gastrointestinal liquid. CONCLUSION: The preparation technology of alginate-iron (III) complex was feasible. The product is high iron content and the solubility. And it can meet with the fundamental functions as a new kind of is supplement source.

Objective To investigate the value of ABCD3-I score in predicting the outcome of acute minor ischemic stroke. Methods Totally 255 patients were valued by ABCD, ABCD2, ABCD3, ABCD3-I and ESSEN score then the clinical characters, outcome and early progression of these patients were investigated. Results Forty-eight patients had poor outcome after 90 days. Univariate logistic regression indicated that the differences of hypertension, diabetes, cardiovascular disease, stenosis of criminal artery, abnormal signal in diffusion weighted imaging (DWI) and other clinical symptoms between poor outcome group and good outcome group were statistically significant (P<0.05). The AUC of ABCD, ABCD2, ABCD3, ABCD3-I and ESSEN score in predicting outcome of acute minor stroke was 0.791 0, 0.798 3, 0.827 9, 0.930 0 and 0.735 9 respectively. There was difference among patients with different ABCD3-I scores both in outcome and early progression. Conclusion ABCD3-I score can predict the outcome of acute minor stroke and supply a new method for personalized treatment.

Objective To analyze the clinicopathological characteristics and the prognostic survival factors of young patients who have undergone hepatectomy for primary hepatic carcinoma.Methods Clinicopathological da-ta and treatment outcomes in 79 young (≤40 years old)and 67 elderly (≥65 years old)patients who underwent hep-atectomy for primary hepatic carcinoma between 2008 and 2012 were retrospectively collected and compared using various parameters.Then the survival rate and prognostic factors of the younger patients were analyzed using Kap-lan-Meier and COX multivariate proportional hazards model.Results The positive rate of HBs-antigen and alpha-fetoprotein level were significantly higher in the younger patients than in the elderly patients (P<0.05).However, the positive rate of Anti-HCV-Ab was markedly lower in the younger patients (P<0 .0 5 ).The two groups did not significantly differ in gender,clinical symptoms,intraoperative parameters or pathological features (P>0.05).The overall survival rate was similar between the two groups.COX multivariate proportional hazards model analysis showed that the independent prognostic factors of overall survival were pre-operative albumin level <3 5 g/L and maximum tumor diameter ≥5 cm.Conclusion Hepatectomy is a safe and feasible treatment for young and elderly patients with primary hepatic carcinoma.The independent prognostic factors of survival for young patients are pre-operative albumin level <3 5 g/L and the maximum tumor diameter ≥5 cm.

Objective To measure middle cerebral artery (MCA) hemodynamic parameters of chronic cerebral ischemia in middle aged and elderly people with phase contrast magnetic resonance imaging (PCMRI),and to explore cerebral blood flow dynamic pattern in different degrees of chronic cerebral ischemia patients.Methods Middle aged and elderly people underwent conventional MRI scan,and were divided into 12 cases of the normal group,16 cases of mild cerebral ischemia group and 13 cases of obvious cerebral ischemia group.All groups underwent bilateral MCA PCMRI.Bilateral MCA hemodynamic parameters and phase-velocity curve in a heartbeat cycle were obtained by QFLOW analysis software on the workstation for post-processing.Bilateral MCA vascular area,peak velocity (PV),mean velocity (MV) and mean flow (MF) were recorded.The differences of bilateral MCA hemodynamic parameters among the three groups were compared by SPSS17.0 software.Results Bilateral MCA vascular area,MV,MF and right MCA PV among three groups were statistically significant by one-Way ANOVA (P＜0.05).Compared with normal group,systolic peak of bilateral MCA phase-velocity curve was low,dull,widen,and the connection between the diastolic peak and systolic peak became flattened in chronic cerebral ischemia patients.Conclusion PCMRI can reflect the differences of the cerebral blood flow dynamic change pattern between different degrees of chronic cerebral ischemia.