Dopamine(DA) modulates diverse wake-related behaviors including movement,reward, and cognition.Dopaminergic neurons are located in the substantia nigra pars compacta and ventral tegmental area.There are five distinct DA receptors(R):D_1R,D_2R(D_(2S)R and D_(2L)R), D_3R,D_4R and D_5R in the central nervous system, in which D_1R and D_2R are majorly expressed. The affinity of D_2R for endogenous DA is significantly higher than that of D_1R.Re- cently,studies by pharmacological and gene knock-out animals revealed that dopamine D_2R is essential inmaintaining wakefulness.Here,we review the progress on roles of D_2R in sleep-wake regulation.

Histaminergic neurons solely originate from the tuberomammillary nucleus (TMN) in the posterior hypothalamus and send widespread projections to the whole brain. Experiments in rats show that histamine release in the central nervous system is positively correlated with wakefulness and the histamine released is 4 times higher during wake episodes than during sleep episodes. Endogeneous prostaglandin E2 and orexin activate histaminergic neurons in the TMN to release histamine and promote wakefulness. Conversely, prostaglandin D2 and adenosine inhibit histamine release by increasing GABA release in the TMN to induce sleep. This paper reviews the effects and mechanisms of action of the histaminergic system on sleep-wake regulation, and briefly discusses the possibility of developing novel sedative-hypnotics and wakefulness-promoting drugs related to the histaminergic system.

BACKGROUND: Guided tissues regeneration (GTR) has been successfully used in the treatment of periodontal diseases by using biocompatible membrane to prevent tooth epithelial cell growing towards root and to facilitate the formation of a certain gap which is favorable for periodontal membrane cells to occupy the surface of the root, thereby to rebuild the peridental structure. OBJECTIVE: To verify whether GTR can promote the repair of periodontal bone defect and the formation of new bones and whether combined use of GTR membrane, artificial bone, and growth factors can acquire much more new periodontal tissue. DESIGN, TIME AND SETTING: An animal observation experiment was performed at the laboratory of Medical College of Dalian University between February and July 2006. MATERIALS: Basic fibroblast growth factor (bFGF) freeze-dry powder (50 mg/ampoule) was thoroughly dissolved with ddH2O to prepare 5 g/L bFGF solution, bFGF solution was dropped onto collagen membranes with a size of 10 mm ×10 mm (5 mg bFGFs per piece of collagen membrane). METHODS: Cementum and the alvelor bone 6 mm below the cement-enamel junction were removed to induce periodontal defect in 16 rabbits with big ears. Artificial bone with bFGF and GTR membrane were used to fold around the defect on the right side, followed by reduction and suture, serving as experimental side. The left side underwent identical experimental procedure, with the exception of application of artificial bone with bFGF and GTR membrane, serving as control side. MAIN OUTCOME MEASURES: Carrier material absorption, inflammation of inner connective tissues, and status of junctional epithelium were examined through the use of microscope. RESULTS: The control side exhibited no concrescence, while the expedmental side displayed concrescence of the cementum to various extents. CONCLUSION: Application of GTR membrane, artificial bone, and bFGF can promote the concrescence of damaging bone.

BACKGROUND:Studies have shown that exogenous bone marrow mesenchymal stem cells can settle down in lung tissue, participate in long regeneration, but few studies concerned the repair of aging lung injury. OBJECTIVE:To observe the effect of bone marrow mesenchymal stem cells on lung injury induced by D-galactose. METHODS:A total of 30 Sprague-Dawley rats were equal y divided into three groups at random:control group, aging model group and celltreatment group. To establish the aging rats, 10 rats each in the aging model group and celltreatment group were daily subcutaneously injected with D-galactose for 4 months. 3×106 bone marrow mesenchymal stem cells were transplanted via caudal vein in the celltreatment group, once a week, for 4 weeks. cellmedium of equal dose was added in the control and aging model groups. Bone marrow mesenchymal stem cells were transfected by lentiviral vectors expressing green fluorescent protein to determine the implantation of bone marrow mesenchymal stem cells in rat lung. Superoxide dismutase activity and malondialdehyde content in rat lung were measured in each group. The difference in rat lung structure was observed using hematoxylin-eosin staining in each group. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cells marked by green fluorescent protein were implanted in rats, migrated towards lung tissue and survived. Compared with aging model group, superoxide dismutase activity was apparently increased, but malondialdehyde content was obviously diminished in the celltreatment group. In each group, histopathological sections revealed that normal pulmonary alveolus was damaged in the aging model group, showing enlarged air cavity and emphysema. Lung injury was evidently repaired inthe celltreatment group. Results suggested that bone marrow mesenchymal stem cells could repair lung injury in aging rats, and exert anti-aging effects.

Objective To analyze the clinical features and diagnosis-treatment of pancreatic lymphoma presenting as acute pancreatitis.Methods The clinical records of 7 patients including laboratory findings were retrospectively reviewed.Some related medical literatures were reviewed.Results Seven patients presented acute abdominal pain.Laboratory findings revealed significant increase of serum amylase and lipase levels.CT scan of the abdomen or PET-CT showed a diffuse swelling of the pancreas or masses in the body or tail.Extrapancreatic spread such as bone,bone marrow,spleen infiltrate was found out in 5 patients.Of the 7 patients,6 were diagnosed as the diffuse large B-cell lymphoma,1 as the anaplastic large cell lymphoma.Six patients underwent systematic chemotherapy.Two died and the others received complete or part remission.Conclusion Pancreatic lymphoma is uncommon and represents a rare cause of acute pancreatitis.It needs to be confirmed by histopathologic examination.The standard treatment is not only for acute pancreatitis,but also for NHL including CHOP or CHOP-like chemotherapy.

Objective To investigate the clinical, neuroimaging and serum risk factors of cerebral microbleeds (CMBs) in patients with ischemic stroke and find the associations between these risk factors and the location and num?bers of CMBs were also analyzed. Methods One hundred and fifty-three patients with acute ischemic stroke were re?cruited in this study and their data werewas retrospectively analyzed. All of the patients underwent MRI- susceptibility weighted imaging (SWI). The location and numbers of CMBs were recordedexamined. The severity of WMLs was assessed using the Fazekas scale. Logistic regressions were performed to find the predictors of the presence of CMBs. The relation?ships between these risk factors and the location and numbers of CMBs were also analyzed. Results Fifty-nine(38.6%) cases had at least one CMB. The frequency of cortical-subcortical, deep and infratentorial CMBs were 34.0%, 24.8%and 27.5%, respectively. Multivariate logistic regression showed that male sex, hypertension and moderate-to-severe deep white matter hyperintensities (DWMH) were independent risk factors of the presence of CMBs. Adjusted with age and sex, partial correlation showed that hypertension only correlated with the numbers of deep CMBs significantly (r=0.174, P=0.032). Moderate-to-severe DWMH significantly correlated with the numbers of cortical-subcortical and deep CMBs (r=0.285, P<0.001 and r=0.258, P=0.001, respectively). Conclusion Male sex, hypertension and moderate-to-severe DWMH were are independent risk factors of CMBs in patients with ischemic stroke. Hypertension correlates with Deep deep CMBs, while Moderatemoderate-to-severe DWMH correlates with cortical-subcortical and deep CMBs.

BACKGROUND: If high-intensity resistance training is used as a rehabilitation measure after musculoskeletal injury, it may be aggravated by factors such as pain. The blood flow restriction training can achieve high-intensity resistance training through low-intensity resistance training, which can accelerate the recovery of patients. OBJECTIVE: To elaborate the current situation of blood flow restriction training as a new way to accelerate musculoskeletal rehabilitation at home and abroad. METHODS: The first author searched the related studies on the musculoskeletal rehabilitation of blood flow restriction training included in PubMed, Cochrane Library and CNKI from January 2002 to October 2018. The keywords were "blood flow restriction training; Kaatsu training; low intensity resistance training; safety; musculoskeletal rehabilitation; knee osteoarthritis; patellofemoral pain; knee joint injury; ankle joint injury; quantitative difference" in English and Chinese. RESULTS AND CONCLUSION: Blood flow restriction training, as a new treatment method, can reduce the training load and achieve the effect similar to the high-intensity resistance training by designing an individualized and precise rehabilitation scheme. Additionally, it can make the resistance training happen in advance due to its unique advantage, thus contribute to rapid rehabilitation. However, this method is mostly applied to lower limb injuries, and its feasibility for other parts still needs a further investigation.

Objective To investigate the clinical manifestation,neuroimaging characteristics and follow-up results of chorea associated with non-ketotic hyperglycemia (C-H-BG).Methods Clinical data of six patients with C-H-BG were analyzed retrospectively.Results The average age of the six patients (five female and one male) was 65.8±13.9 years,All patients had acute-subacute course.Patients presented with choreic movements involving facial muscles (n=6) and unilateral (n=5) or bilateral limbs (n=1).The average value of plasma glucose at admission was 9.21 ± 5.15 mmol/L.All patients had significantly elevated HbA1c (14.1 ±3.5％).The brain MRI T1 imaging from all patients showed hyperintensity in the basal ganglia,putamen,lenticular nucleus and caudate nucleus.SWI imaging revealed corresponding hypointensity signal in the basal ganglia in three patients.Two patients had severe stenosis of the MCA.Five patients were followed up for an average of 16.2 ±7.2 months.Three patients died.Conclusion The high T1 hypertense lesions in the basal ganglia are the mainly radiological feature of C-H-BG which may be accompanied by SWI hytointense signals in the basal ganglia.

Six patients with POEMS syndrome who received autologous peripheral blood stem cell transplantation (auto-PBSCT) were retrospectively analyzed.Conditioning regimen was high dose melphalan.Peripheral blood stem cells were collected after mobilization with cyclophosphamide (CTX) and growth factors.One patient presenting hydrothorax and ascites was treated with 3 cycles of lenalidomide and dexamethasone before mobilization.Auto-PBSCT was fairly tolerable.Hematopoietic reconstitution was successful in all patients without transplantation-related mortality.A decrease or normalization of serum vascular epithelial growth factor (VEGF) was observed in all patients at 3 months after transplantation.The neurological remission was seen in 5/6 patients.

Objective:To investigate the incidence of venous thromboembolic disease (VTE) in urological inpatients during perioperation.Methods:The clinical data of 7 988 inpatients admitted to the Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January to December 2019 were analyzed retrospectively. The cohort included 5 657 males and 2 331 females. The average age of the enrolled patients was (56.3±15.8) years old, and the body mass index was (23.8±3.2) kg/m 2. There were 1 628 malignant tumors patients and 6 360 non-malignant tumors patients in the cohort. Of all the patients, 7 725 cases received surgical treatment. All patients were scored with the Caprini Risk Assessment Model (2005) after admission and 1 655 cases were classified as very low risk, 2 940 cases were low risk, 2 922 cases were medium risk, 345 cases were high risk and 126 cases were very high risk. Patients with Caprini score ≥ 2 and/or clinical symptoms were examined by venous color Doppler ultrasound. CT pulmonary angiography was performed for patients with chest pain, chest tightness, decreased blood oxygen saturation and other symptoms suspected of pulmonary embolism according to clinical judgment to screen the incidence of VTE. Results:Among the 7 988 cases, 180 cases (2.25%, 180/7 988) with VTE were found by preoperative examination, including 1 case (0.01%, 1/7 988) with pulmonary embolism. There were 199 new cases with VTE after operation, and the incidence of new VTE after operation was 2.58% (199/7 725). Among them, pulmonary embolism was found in 7 cases, with a incidence of 0.09% (7/7 725). Only 7.92% (30/379) of the VTE patients had VTE-related symptoms. The operations with higher incidence of VTE were radical cystectomy, nephroureterectomy, radical prostatectomy and radical nephrectomy, with the incidence of 11.61% (13/112), 10.87 (10/92), 8.25% (16/194) and 6.16% (22/357) respectively.Conclusions:The incidence of VTE in hospitalized patients with urinary surgery in this study is much higher than previously reported. Most of the patients with VTE are asymptomatic. The operations with high incidence of VTE after operation are radical cystectomy, nephroureterectomy, radical prostatectomy and radical nephrectomy. Therefore, it is necessary to carry out VTE screening for hospitalized patients in urology department, which is helpful to realize early intervention of VTE and reduce the risk of VTE progression and pulmonary embolism.