Amyotrophic lateral sclerosis (ALS) is a rapid progressive neurodegenerative disease, characterized by the degeneration of both upper and lower motor neurons. The progressive motor unit loss due to lower motor neuron damage is one of the most important pathological process in ALS. However, there are lack of specific biomarkers for early diagnosis and progression monitoring of ALS. The relevant electrophysiologic techniques which quantify the number of motor unit have been developed rapidly in recent years. Among them, the motor unit number estimation (MUNE) and the motor unit number index (MUNIX) have been widely applied to quantify motor unit number loss in ALS. The most recent advances of MUNE and MUNIX in ALS were reviewed.

BACKGROUND: Patients with acute stroke mostly receive treatment in the integrative hospital, but quite a large part of them were treated only with medication during the earlier stage.OBJECTIVE: To probe the influence of earlier integrative rehabilitations on emotions and daily life capability of patients with acute stroke with the outcomes compared with those unexposed to rehabilitative treatment.DESIGN: Randomized controlled study.SETTING: Neurological Department of a municipal Hospital.PARTICIPANTS: Eighty patients who received treatment due to the first onset of acute stroke of internal carotid system were selected from the Neurological Department of the First People's Hospital of Lianyungang City, Jiangshu Province between January 2002 and August 2003. Totally 51 males and 29 females aged (63.42±7.47) years were randomly divided into rehabilitation control group with 40 cases each.METHODS: Patients of the two groups received routine neurological medication in the hospital. When stroke was controlled, patients in the rehabilitative group (including patients with cerebral infarction who were hospitalized for less than 1 week and patients with cerebral hemorrhage who were hospitalized for less than 2 weeks) were subjected to rehabilitative treatment, including rehabilitative training of insulted limbs (physical treatment and/or exercise therapy), physical therapy, acupuncture and psychological consultation. Rehabilitative treatment was given 1-2 times a day and 45 minutes for each time. Physical therapy and acupuncture were given once a day and 20 minutes for each time. In contrast, patients in the control group were only asked in the doctor's round to do exercise themselves or with the assistance of others. Psychological states of all the patients were assessed with Symptom Self Rating Scale before treatment and discharge and daily life capability was also assessed with Barthel index (totally 10 items with scores of 0-15, full mark was 100, and patients who scored for ＜ 60were considered of self-incapability).MAIN OUTCOME MEASURES: Scores for symptom checklist (SCL)and Barthel index of the two groups before treatment and when patients were discharged.Scores for each symptom factors in SCL were significantly improved in the rehabilitation group when patients were discharged from the hospital (P ＜ 0.05-0.01), and somatization, obsessive-compulsive, depression, anxiety and psychoticism, etc. were also obviously improved in the control group (P ＜ 0.05); moreover scores for somatization, obsessive-compulsive,depression, anxiety phobic anxiety and psychoticism in the rehabilitation group after treatment were significantly lower than those in the control group [(1.55±0.43), (1.80±0.35); (1.48±0.39), (1.68±0.55); (1.54±0.43),(1.83±0.37); (1.32±0.39), (1.56±0.36); (1.46±0.43), (1.66±0.52); (1.12±0.38),creased aftertreatment (P ＜ 0.05-0.01), but those of the rehabilitation group were significantly higher than those of the control group [(73.24±4.64),(52.44±2.86), P ＜ 0.05].CONCLUSION:Scores for symptomatic factors in SCL and Barthel indexes were improved after treatment, especially in patients who received rehabilitative treatment, suggesting that earlier integrative rehabilitative treatment may play active influence on the emotions and daily life capability of patients following acute stroke.

This study researched the results transformation problem in medical universities,sorted the current situation in this filed,analyzed the causes of the low transformational rate.Then by referring to the domestic and overseas experience,the author designed the classified transforma tional path of medical research results according to their respective features,finally put forward policy suggestions for institutional guarantee policy to promote the transformation of medical universities.

Objective To explore the mechanism of vessel endothelial dysfunction in rats under intermittent hypoxia (IH). Methods The respiratory simulation system was used to simulate IH. Sixty C57BL/6J rats (male) were randomized into control group and IH group. The rats of IH group were exposed to IH 8 hours per day for 6 weeks. The serum levels of hypoxia inducible factor (HIF)-1a and stromal cell derived factor (SDF)-1a were assessed by ELISA. The serum levels of reactive oxygen species (ROS) were detected in two groups. The serum expression of miR-199a-5p was detected by real-time fluorescent quantitative PCR in two groups. The dual luciferase report system and point mutation test were used to verify target gene for HIF-1a. Results The serum levels of HIF-1a and SDF-1a were significantly higher in IH group than those of control group (μg/L:1.60±0.02 vs. 1.19±0.02, 1 823.00±8.97 vs. 1 444.00±17.90, P<0.01). The serum level of ROS was significantly higher in IH group than that of control group (U/mL:487.66±35.73 vs. 211.57±23.82, P<0.01). The serum level of miR-199a-5p expression was significantly lower in IH group compared to that of control group (1.31±0.07 vs. 3.47± 0.17, P<0.01). The result of dual luciferase reporter gene detection confirmed that target gene of miR-199a-5p was HIF-1a. Conclusion The serum level of miR-199a-5p is decreased first due to IH, and then its target gene (HIF-1a) is increased. HIF-1a can induce the increased level of SDF-1a, and its receptor (CXCR-4 ) is also increased. Finally, HIF-1a can increase the serum level of ROS, resulting in the endothelial dysfunction.

Objective To investigate the effect of acupuncture decompression operation on the quality of life of patients with mild to moderate essential hypertension. Methods 74 cases of mild to moderate essential hypertension were divided into experimental group and control group by random number table, 4 cases were lost. Finally, a total of 70 patients were included in the data analysis. In the control group, 35 cases were given routine drug taking and health guidance, the experimental group of 35 patients increase the treatment of acupuncture decompression operation points on this basis. The two groups of patients were measured with blood pressure before and after intervention, and World Health Organization Quality of Life (WHOQOL-BREF) was used to evaluate the quality of life, and the data were analyzed. Results The scores of physiological and psychological fields in the experimental group were (15.23 ± 2.66) points and (16.68 ± 2.23) points while the control group were (13.98 ± 2.18) points, (15.25 ± 2.52) points, the difference was statistically significant (t=2.305, 2.522, P<0.05). The experimental group of social relations, environmental score were respectively (1.37 ± 2.24) points, (14.16 ± 1.24) points, while the control group were (13.29 ± 2.30) points, (13.56 ± 1.36) points, 2 groups were not statistically significant (t=0.770, 3.063, P > 0.05). The experimental group systolic blood pressure, diastolic blood pressure were (121.43 ± 6.43) mmHg (1 mmHg=0.133 kPa), (71.74 ± 3.88) mmHg, compared with the control group were (128.34±5.72) mmHg, (76.06±4.43) mmHg. The difference was statistically significant (t=-4.753,-4.210, P<0.05). Conclusions acupuncture decompression operation can improve blood pressure in young and middle-aged patients with hypertension, improve the quality of life.

Objective To analyze the adverse reactions of hysterosalpingography and prevention measures. Methods Totally 6 352 patients who underwent hysterosalpingography in our hospital between January 2006 and December 2013 were analyzed. Results Totally 836 cases had adverse reactions of different degrees including 312 cases of drug reactions and 626 cases of non?drug reactions. The adverse drug reactions were mainly hy?pogastralgia,laryngopharyngeal malaise,irritating cough,nausea,vomiting,shortness of breath,flush of the face,and pruritus. The non?drug reac?tions were mainly hypogastralgia,nausea,vomiting,pallor,speeding up of heart?beat,decreased blood pressure,dizziness,and blur version. Con?clusion Among patients who were negative for iodine anaphylactic test,there were still some who had adverse reactions of different degrees during HSG. Targeting at different conditions of reactions,corresponding prevention measures should be adopted to ensure the smooth progress of hysterosal?pingography.

Objective To observe the effects of Yushen Heji on expressions of Heme Oxygenase (HO-1) and HO-2 in kidney of diabetic rats;To explore its mechanism in diabetic nephropathy. Methods SD rats were randomly divided into normal group, model group, control group and treatment group. Models were duplicated by subcutaneous injection STZ. Control group and treatment group were given gavage with related medicine, while normal group and model group were given gavage with the same amount of distilled water. Eight weeks later, the urine of rats was collected to detect the 24 h Upro and Ucr;the rats were sacrificed to detect the levels of CO, BUN and Scr;the kidneys were harvested for observing the expressions of HO-1 and HO-2 by immunohistochemistry.Results Compared with normal group, the contents of BUN, 24 h Upro and Scr all increased in model group;Ccr and plasma CO decreased;the expressions of HO-1 and HO-2 in kidney tissues were obviously reduced (P<0.01). Compared with model group, the contents of BUN, 24 h Upro and Scr all obviously decreased in treatment group and control group;Ccr and plasma CO increased;the expressions of HO-1 and HO-2 in kidney tissues obviously increased (P<0.05,P<0.01). Compared with control group, the contents of 24 h Upro decreased in treatment group;plasma CO increased;the expressions of HO-1 and HO-2 in kidney tissues obviously increased (P<0.05,P<0.01).Conclusion Yushen Heji has therapeutic effect on diabetic nephropathy rats, which may related with HO/CO system.

Objective To explore the repair possibilities of endothelial progenitor cells (EPCs)in peripheral blood in patients with different extents of obstructive sleep apnea (OSA) through measuring the levels of pro-angiogenic factors and different subgroups EPCs in peripheral blood in patients with OSA. Methods Ninety adult patients with OSA, 30 healthy controls with matched age and gender were enrolled for this study. The subjects performed Polysomnography, were divided in-to four group based on Apnea Hypopnea Index (AHI). The serum levels of HIF-1α, SDF-1αand VEGF were assessed by ELISA. Mononuclear cells were isolated from peripheral blood with density gradient centrifugation, and flow cytometry was used to detect levels of CD133+KDR+EPC, CD133+CD34+EPC, CD34+KDR+EPC and ALDHloCD34+KDR+EPC based on AL-DH activity, and CD133, CD34, PE-KDR related cell surface markers. Results The levels of CD133+KDR+EPC, CD133+CD34+EPC, CD34+KDR+EPC were higher in OSA groups than those of control group, both of which were higher in severe OSA group than those of in mild and moderate OSA groups. The levels of ALDHloCD34+KDR+EPC were higher in mild and moderate OSA groups than that of the control groups, and the levels of ALDHloCD34+KDR+EPC were significantly lower in se-vere OSA group than those of control, mild and moderate OSA groups. Serum levels of HIF-1α. VEGF were significantly high-er in OSA groups compared to those in control groups, both of which were higher in severe OSA group than those of mild and moderate OSA groups. Serum levels of SDF-1αwere significantly lower in severe OSA groups than those of mild, moderate OSA and control groups (P<0.05). Conclusion The mobilization and recruitment of different subtypes of EPCs are obvious-ly increased in patients with OSA, but ALDHloCD34+KDR+EPC with vascular repair capacity keeps to invariability, even de-creases in patients with severe OSA, which results in endothelial damage, and increases the risk of cardiovascular disease.

Objective How to avoid the rejection of the synthetic patch and human tissue has become an urgent problem to be solved.The article investigated thein vivobiocompatibility of polypropylene mesh scaffold with adipose -derived stem cells(ADSCs) in rabbits. Methods Rabbit ADSC suspension were prepared.ADSCs were seeded onto polypropylene mesh scaffolds after passage and amplification and cultured invitro for 1 week .The polypropylene mesh and ADSC fixed polypropylene mesh were implanted respec-tively into the surface of rectus abdominis in rabbits.4 weeks later, adhesion and erosion of the meshes were evaluated, HE staining was used in histological observation and RT-PCR was applied to detect the dynamic changes of VEGF mRNA level.ADSCs were isola-ted from rabbit subcutaneous adipose tissue after collagenase digesting, filtrating and centrifuging. Results The results of flow cy-tometry showed that the expressions of CD44, CD73, CD90, CD45, CD14 and CD34 were 98.54%, 95.32%, 98.49%, 1.21%, 3.01%, 2.14%, respectively.Polypropylene mesh, ADSC-fixed polypropylene mesh had different degrees of corrosion and adhesion , but polypropylene mesh showed denser adhesion.In comparison with polypropylene,ADSC fixed polypropylene meshes induced a mil -der chronic inflammation response,with lower scores for inflammation (1.1 ±0.2 vs 0.6 ±0.1, P=0.001), higher scores for neovas-cularization (17.0 ±0.0 vs 2.6 ±0.3, P=0.000) and fibroblastic proliferation(0.9 ±0.1 vs 2.2 ±0.2, P=0.001).Relative a-mounts of VEGF mRNA of were significantly lower for ADSC-fixed polypropylene compared with the remaining polypropylene meshes (t=94.6, P<0.05). Conclusi on Polypropylene mesh scaffold with ADSCs exhibits excellent cellular compatibility and have a bright future in clinical practice.

Objective To optimize the synthesis process of iloperidone 1 for industrial production.Methods Piperi-dine-4-carboxylic acid, acetic acid and acetic anhydride were used as starting materials to generate 2 via amidation, Friedel-Crafts acylation, hydration, oximation, intramolecular cyclization and salification.Compound 2 was treated with 4-(3-chloropropoxy)-3-methoxyphenylethanone through condensation to afford iloperidone.The target compound 1 was prepared with an overall yield of 34.9%.Results and Conclusion Such factors as the ratio of the raw materials, the catalyst, reactive time were investigated and optimized to make the reaction conditions mild and easy to control with less side effects.The structure has been confirmed by IR, 1 H-NMR and MS.