BACKGROUND: Diffusion tensor imaging, as a relatively new method based on MRI, has become an important means of examination and diagnosis in the field of neuroimaging. OBJECTIVE: To investigate the role of using diffusion tensor tensor imaging data to predict 3D-bioprinted collagen/silk fibroin scaffolds in the locomotor function recovery after spinal cord injury. METHODS: Ordinary and 3D-bioprinted collagen/silk fibroin scaffold were prepared. Forty adult female SD rats provided by the Laboratory Animal Center of the Academy of Military Medical Sciences of the People’s Liberation Army were randomly divided into four groups with 10 rats in each group. In the sham operation group, only T10 vertebral plate was removed. In the model group, spinal cord injury was induced by total transection of spinal cord at T10 segment. In the ordinary collagen scaffold and 3D-printed scaffold groups, after induction of T10 spinal cord injury, ordinary collagen scaffold and 3D-printed scaffold were implanted, respectively. At 1, 2, 3, 4, 6 and 8 weeks after surgery, Basso, Beattie and Bresnahan (BBB) locomotor function scoring and oblique plate test of the hind limbs were carried out. At 8 weeks after surgery, electrophysiological test of the hind limbs was performed to evaluate locomotor function. At 8 weeks after surgery, diffusion tensor imaging of the lumbar spine was performed and the correlation between diffusion tensor imaging parameter and rat locomotor function was analyzed. Animal experiments were approved by the Animal Ethics Committee of Characteristic Medical Center of the Chinese people’s Armed Police Force (approval No. 27653/58). RESULTS AND CONCLUSION: (1) From 3 weeks after surgery, BBB score in the 3D-printed group was significantly higher than that in the model and ordinary collagen scaffold groups (P < 0.05 or P < 0.01). From 2 weeks after surgery, the slope angle in the 3D-printed scaffold group was significantly higher than that in the model and ordinary scaffold groups (P < 0.05 or P < 0.01). (2) The amplitude of motor evoked potential in the 3D-printed scaffold group was significantly greater than that in the model and ordinary collagen scaffold groups (P < 0.05 or P < 0.01). The latency of motor evoked potential in the 3D-printed scaffold group was significantly shorter than that in the model and ordinary collagen scaffold groups (P < 0.05 or P < 0.01). (3) Diffusion tensor imaging showed that the nerve fiber trajectories in the three groups were irregular and lacked the continuity of nerve fibers, but the number of regenerated nerve fiber bundles in the 3D-printed collagen scaffold group was greater than that in the model and ordinary collagen scaffold groups (P < 0.01). The fractional anisotropy at 9, 7.5, 4.5, -3, -6, -7.5, -9 mm from the center of spinal cord injury in 3D-printed collagen scaffold group was significantly higher than that in model and ordinary collagen scaffold groups (P < 0.05 or P < 0.01). (4) The BBB score, slope angle, amplitude of motor evoked potential, latency of motor evoked potential were positively correlated with the fractional anisotropy value of diffusion tensor imaging from head to tail of rats. (5) These results suggest that diffusion tensor imaging can be used as an effective predictor to evaluate the recovery of neurological function after spinal cord injury in experimental animals and clinical cases.

Objective To construct shRNA against optineurin ( OPTN ) clone and transfect the construction into HEK293FT cells for inhibiting the expression of OPTN, which is laid the foundation for further research of molecu-lar mechanism OPTN protein. Methods The insert of this clone was a double-strained DNA sequence against OPTN which would be transcripted into shRNA and it was synthesized according to the sequence in Origene. Ex-pression vector pRFP-C-RS was employed to fuse the insert to get the construction and finally confirmed by sequen-cing. HEK293FT cells were transfected with the very clone pRFP-C-RS-shOPTN and RFP signals could be detected using fluorescence microscope. Western blot was further employed to check the protein level of OPTN. HEK293FT cells were transfected with the very clone pRFP-C-RS-shOPTN was then obtained to investigate the functional study of OPTN which was measured by Salmonella infection experiment. Results shRNA eukaryotic expression vector targeting OPTN gene was successfully constructed. HEK293FT cells were transfected with pRFP-C-RS-shOPTN and 72 hours later we observed strong RFP signals showing that shOPTN expressed. Western blot was further employed to check the protein level of OPTN which showed that OPTN expression was indeed interfered. Salmonella infection assays was then performed and showed that OPTN could inhibit the proliferation of Salmonella that has invaded HEK293FT cells. Conclusion HEK293FT cell line which expresses shRNA against OPTN show a sharp inhibition of OPTN protein expression by 80%. So this cell line can be further used to investigate how OPTN regulates auto-phagy as an autophagy receptor. Meanwhile we find that OPTN can be as a autophagy regulator and strongly sup-press the proliferation of invasive Salmonella in vivo.

Objective To analyze the clinical characteristics of narcolepsy in children with obesity,and to e-valuate the impact of obesity on narcoleptic children clinically. Methods Forty cases first diagnosed as narcolepsy were recruited in the study who to see doctors at the Department of Neurology,Children's Hospital of Capital Institute of Pediatrics,from July 2012 to January 2015. According to diagnostic criteria for obesity by the body mass index(BMI) growth curve for the Chinese children and adolescents,they were divided into the obese group and the nonobese group. The general clinical data of 2 groups were analyzed,and the related metabolic indexes and the whole night polysomnog-raphy(PSG)of 2 groups were studied. Results In this group,male versus female 3: 1,obesity was found in 21 cases (52. 5% )and nonobesity was found in 19 cases(47. 5% )from the samples. The mean BMI of all patients was (21. 55 ± 3. 11)kg/ m2 . The average BMI of the obese group was(23. 09 ± 2. 46)kg/ m2 ,and BMI of the non - obese group was(19. 85 ± 2. 89)kg/ m2 . Obese children were younger at the onset of disease and by the time of diagnosis age [(7. 94 ± 2. 22)years old,(8. 76 ± 2. 36)years old]than nonobese children[(10. 75 ± 3. 10)years old,(12. 51 ± 2. 88)years old]. The fasting blood glucose and blood lipid in all patients were normal,and there was no significant difference between 2 groups. The total sleep time,sleep efficiency and the ratio of rapid eye movement(REM)phase of the obese group[(397. 45 ± 53. 76)min,(68. 70 ± 8. 90)% ,(18. 37 ± 4. 39)% ]were significantly lower than those of the non - obese group[(449. 95 ± 86. 49)min,(76. 58 ± 13. 60)% ,(22. 19 ± 6. 34)% ]. According to the sleep structure,the percentage of stageⅠnon rapid eye movement(NREM)sleep in the obese group[(20. 90 ± 6. 38)% ] was more than that in non - obese group[(16. 26 ± 4. 22)% ]. There was no difference between the percentage of stageⅡNREM sleep in the obese group[(42. 59 ± 5. 52)% ]and the non - obese group[(38. 54 ± 8. 74)% ]. Stage Ⅲ + Ⅳ(slow wave sleep)NREM sleep ratio in the obese group[(18. 14 ± 6. 97)% ]was significantly lower than that in the non - obese group[(22. 60 ± 5. 69)% ]. Conclusions Obesity is one of the most common comorbids in narcolepsy, which affects more than 50% of narcoleptic children,mostly younger at disease onset. The narcolepsy children with obe-sity has total sleep time decreased,sleep efficiency reduced and sleep structure disorder is more obvious. To improve the realization of obesity in narcolepsy children and early treatment is the key to the success of the therapy.

ObjectiveTo assess the diagnostic value of ultrasonography in the diagnosis and pathological classifi cation of appendicitis with pathological results.MethodsThe study included 111 cases who confi rmed by surgery and pathology in the Six Affi liated Hospital of Sun Yat-sen University from June2012 to December 2013. The image characteristics of ultrasonic images performed before surgery were analyzed retrospectively. The cases were divided into five groups based on the pathology: 6 acute simple appendicitis, 45 acute suppurative appendicitis, 15 acute gangrenous appendicitis, 33 chronic appendicitis, and 12 acute attack of chronic appendicitis. The length, width and wall thickness of the appendicitis measured by preoperative ultrasound between various pathological type were compared with Kruskal-Wallis statistical methord, and also used the same method to compared the one which had statistically signifi cance between the fi ve groups. As in the above case, Fisher Exact Test was used to compare the characters′ of ultrasonography included gradations of the appendix, the tube cavity expansion, stercorolith, the appendiceal abscess, mergering lymph node enlargement and the appendix around effusion, if there was statistically signifi cance, the same methord was used to the further comparison between thefi ve groups.ResultsTotally 90 of 111 cases of were reminded appendicitis by preoperative ultrasound, the diagnostic accuracy rate was 81.08%, including acute suppurative appendicitis 91.11% (41/45), acute gangrenous appendicitis 93.33% (14/15), acute simple appendicitis 83.33% (5/6), chronic appendicitis 60.61% (20/33), chronic appendicitis onset acute 83.33% (10/12). There were no statistical differences of preoperative ultrasound measured between various pathological type of appendicitis in length, while the appendix width measured by preoperative ultrasound of acute gangrenous appendicitis was wider than the acute simple group and chronic group, and there were statistically signifi cance between them (P<0.05), in the aspect of wall thickness, the acute suppurative appendicitis and the acute gangrenous appendicitis groups were thicker than the chronic group, and these differences had statistically signifi cance (P<0.05). The stercorolith, lymph node enlargement and the appendiceal abscess in different types of appendicitis had no statistical difference. There were statistically differences (P<0.05) between the acute suppurative goup, acute gangrenous group and the chronic group respectively, both in gradations of the appendix and the tube cavity expansion. Also there were statistically difference (P<0.05) between the acute gangrenous appendicitis group and the chronic group in the aspect of the appendix around effusion.ConclusionsUltrasound is valuable in the diagnosis of appendicitis, especially for acute gangrenous appendicitis and acute purulent appendicitis. The measurement of appendix with wide diameter, wall thickness by ultrasond preoperatively, and the characteristics of the wall layers, lumen expansion degree and the appendix around effusion are valuable in identifying chronic appendicitis, acute suppurative appendicitis, and acute gangrene appendicitis; The ultrasonic measurement of appendix wide diameter could identify acute gangrenous appendicitis and acute simple appendicitis. Ultrasound had limited value in identifying acute suppurative, acute gangrenous appendicitis, acute simple appendicitis, chronic appendicitis, and chronic appendicitis onset acute.

normal pregnancy and RSA (P=0.0250).Compared with women with normal pregnancy, those with RSA showed significantly decreased levels of Arg-1 ( P=0.0474) and suppressed activities of MDSCs against CD8+T cell proliferation (P=0.0230).Conclusion The MDSCs might play an important role in the main-tenance of maternal immune tolerance.Decreased number and inhibited function of MDSCs in the peripheral blood of women with RSA might be responsible for the development of RSA.

Objective To investigate the effects of ch1D1, an anti-CD86 chimeric antibody, on autoreactive B lymphocytes isolated from patients with systemic lupus erythematosus ( SLE) . Methods Flow cytometry analysis was performed to measure the expression of CD86 on the surface of B cells isolated from patients with SLE and to analyze the effects of ch1D1 on the activation of CD4+T cells. The method of magnetic bead sorting was used to separate B cells, NK cells and CD4+T cells from PBMC collected from healthy subjects and patients with SLE for subsequent experiments. Antibody-dependent cell-mediated cyto-toxicity (ADCC) and complement-dependent cytotoxicity (CDC) that were mediated by ch1D1 were meas-ured with LDH release assay. Effects of ch1D1 on the secretion of auto-antibodies and the proliferation of CD 4+ T were detected by ELISA and 3 H -thymidine ( 3 H-TdR) incorporation assay, respectively. Results The levels of CD80 (68. 08±14. 28 vs 46. 10±12. 14, n=24, P<0. 000 1) and CD86 (44. 72±14. 90 vs 13. 99±10. 74, n=24, P<0. 000 1) expressed on the surface of B cells isolated from patients with SLE were significantly higher than those from the healthy subjects, suggesting the abnormal activation of B cells. Com-pared with the negative control group and the murine monoclonal antibody 1D1, ch1D1 was more effective in mediating the ADCC and CDC responses (P=0. 017 2, P=0. 038 8). Activated T cells significantly en-hanced the secretion of auto-antibodies by B cells isolated from patients with SLE. Compared with the nega-tive control group, the enhanced secretion of auto-antibodies was significantly inhibited by treatment with ch1D1 (P=0. 001 9). Moreover, ch1D1 significantly inhibited the proliferation and activation of CD4+T cells induced in patients with SLE (P=0. 002 4, P=0. 049 5). Conclusion ch1D1, the anti-CD86 chim-eric antibody, could effectively mediate the ADCC and CDC responses against autoreactive B cells isolated from patients with SLE, inhibit the secretion of auto-antibodies and suppress the proliferation and activation of auto-reactive CD4+T cells. It might be a potential immunotherapy agent for the treatment of SLE.

[Objective]To evaluate the role of mature cumulus cells from oocyte-cumulus complex(OCC)in in-vitro maturation(IVM)and establish a new culture technique which is convenient to carry out.[Methods]The cumulus cells of OCC were cut off and dispersed by 1 mL syringe.The cumulus cells were co-cultured with the immature oocytes retrieved from the COH cycles after they adherent to the bottom of the dish.The immature oocytes were experienced IVM procedures in different culture media.They were divided into 3 groups(the oocytes at germinal vesicle stage from one woman were allotted to the same group randomly).Group 1(solution A):basic culture medium+human follicular fluid(hFF);Group 2(solution B):solution A+ cumulus cells(OCC);Group 3(solution C):solution A+ OCC+ follicle stimulating hormone(FSH)+ epidermal growth factor (EGF).Then,the maturation rate,fertilization rate and formation rate of available embryo were observed.[Results]In 113 treatment cycles,298 immature oocytes were performed IVM with solution A,B,and C.The difference for 24 hour maturation rates among 3 groups wag statistically significant(A:45.2%,B:61.7%,C:78.2%,P＜0.05).There was no statistical difference for 25～48 hour maturation rates and normal fertilization rates of mature oocytes.The differences of cleavage rates and rescued embryo rates between group 1 and 2,group 1 and 3 were statistically significant(P＜0.05).The formation rates of available embryo showed an increasing trend from group 1,2,to 3.[Conclusion]After being dispersed by simply beat upon with syringe and adherent culture,the mature cumulus eells from mature OCCs in COH cycles,together with growth factors in the follicular fluid or extraneously supplemented,could promote the IVM of immature oocyte.

Objective To explore the clinical characteristics,diagnosis,treatment and outcomes of anti-N-methyl-D-aspartate receptor(anti-NMDAR) encephalitis in children.Methods Six children diagnosed as anti-NMDAR encephalitis were recruited at the Department of Neurology,Capital Institute of Pediatrics,from December 2011 to April 2013.The data of clinical characteristics and laboratory examinations were retrospectively analyzed.All the children had long-term follow-ups and the prognosis was assessed.Results (1) Age and course of the disease at the time of the admission:the mean age of the 6 patients (2 female) was 3 years and 5 months,ranging from 2 years and 2 months to 6 years and 8 months.The course of the disease at the time of the admission ranged from 15 to 80 days,with a mean time of 39 days.(2)Clinical characteristics:5 cases had afebrile convulsion and 1 case had speech impairment at the onset of disease.Convulsion occurred in all the 6 cases,4 cases of whom had persistent convulsion,and 5 cases had impaired consciousness.All the 6 cases exhibited aphasia,and complicated with mental or emotional abnormalities,irritability or shouting.Five cases developed into sleep disorders such as sleep deprivation.Five cases had limb and facial involuntary movement,in which 2 cases had stereotyped action.Prominent autonomic nervous dysfunction including hidrosis was found in 1 case.(3) Laboratory examination:cerebrospinal fluid test was normal in 6 cases,and 1 case had slightly increased white blood cell level.Specific anti-NMDAR antibody was positive in serum and/or cerebrospinal fluid in the 6 cases.Electroencephalograph of the 6 cases showed slow wave background during lucid interval,and 5 cases had interictal epileptiform discharges.The skull MRI showed cerebral atrophy 4 cases,and 2 cases of them were complicated with encephalomalacia.No tumor was found in the patients.(4) Treatment and follow-ups:6 cases received gamma globulin or methylprednisolone or other immunotherapy.Three cases received combined therapy with Rituximab,1 case received plasmapheresis,and 1 case received Cyclophosphamide.Follow-ups lasted for 2 to 31 months.Three patients had clinical recovery,and varying degrees of neurological complications were found in 3 cases.Conclusions (1) Anti-NMDAR encephalitis is common in children.(2) The specificity of its clinical symptoms is not strong.The incidence of convulsion is high,and different degrees of consciousness disorders may occur in some of the severe patients.Degeneration of language function and emotional changes can be observed.Most pediatric patients have abnormal movement,and the symptoms of automatic nervous system are not prominent.(3) The disease can be confirmed by the specific anti-NMDAR antibody in the spinal fluid or plasma.(4) The time of clinical recovery is long,and an early immunotherapy is associated with a better prognosis.

Objective To explore the value of applying flipped classroom in human parasitology. Methods Totally 430 students of 5-year program were divided into experimental group and control group. The experimental class received human parasitology teaching through flipped classroom teaching mode, while the control class received traditional teaching. The effect of teaching was evaluated by questionnaire and examination. The data were analyzed through t-test. Result Meanwhile, statistical difference was found in aver age score of total between experiment group and control group [(68.2 ±8.6) vs. (66.6 ±11.0), P=0.032]. There was also statistical difference in average score of comprehensive analysis [(16.4±3.2) vs. (16.1 ±3.9), P=0.038]. Questionnaire survey of satisfaction showed that 191 students of experimental class (90.95%) felt new teaching mode could improve autonomous learning ability, 199 students (94.76%) in-creased interest in learning;185 students (88.10%) had more interactive with teachers, 178 students (84.76%) enhanced cooperation between st udents, 186 students (88.57%) approved of small group discussion learning and 165 students (78.57%) had no extra burden. Conclusion Flipped classroom teaching mode can improve students' autonomous learning ability and cultivate their abilities of independent thinking, cooperation, criti-cism, innovation, analyzing and solving problems. Thus this new teaching mode is worthy of reference and popularization.

By analyzing the questionnaire survey of consciousness of rights protection and status quo of rights and interests among medical staff in three 3rd degree and A grade hospitals located in northwest Hubei province,this paper concludes that medical staff there have a generally strong consciousness of rights,while their rights and interests are not well protected by society and hospitals,especially certain aspects including personal security,occupational health,working hours,legal vacation,and the rights to be involved in hospital management.It is suggested that legal rights and interests of medical staff should be improved through legislation,social support,and the direction function of public opinions.