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.

Objective:To investigate the influence of propofol on the binding function of GABA A receptor. Methods: By using radioligand receptor binding assay, effects of propofol on the specific binding of 3H GABA and saturation curves of GABA A receptor were observed in cortical membrane preparations from mouse cerebral cortex. Results: Specific binding experiments showed that propofol at the concentrations of 10 300 ?mol/L markedly enhanced the specific binding of 3H GABA( P 0.05). Conclusion: Clinical concentrations of propofol can enhance the binding function of GABA A receptor through increasing the affinity of the low affinity binding site of GABA.

Objective To verify the evaluation index system of clinical science and technology achievements, taking the evaluation of science and technology achievements in Guangdong province as a demonstration. Methods We specified the criteria for grading each index included in the evaluation index system that we proposed before. 5 experts in clinical medicine were invited to evaluate 20 achievements applying for the Award of Guangdong Science and Technology Achievements in 2010. The weighted sum of scores for each achievement was calculated and used for further analysis. The reliability and validation of the system were assessed. Results The Cronbach's ? coefficient of the index system was 0. 91, indicating good reliability. There were high correlation of each measure with the total score and their affiliated grade one index. The scores that the experts graded were correlated with the original results of evaluation (rs= 0. 71, P ＜0. 000 1), but there remained some inconsistence. Conclusion The demonstration based on investigation data indicates that the evaluation system is easy to handle and has satisfactory reliability and validation. It can be applied to the evaluation of science and technology achievements in clinical medicine.

Objective To set up a scientific, objective, reasonable, qualitative and quantitative,operational evaluation index system of clinical science and technology achievements, which provides the reference to evaluating clinieal science and technology achievements scientifieally. Methods The Delphi method was used to investigate 30 experts for weight of the index via questionnaire. Results The response rate was 100%. The Kendall's concordance coefficient was up to 0. 963. The final index system includes three first-class indicators, eight second-class indicators and 18 third-class indicators. The weight coefficeient of each class was identified. Conclusion The experts showed enthusiasm for this investigation. The agreement of respondents was high after two rounds of investigation. The index system can be used in comprehensive evaluation for science and technology achievements in clinical medicine. The index system takes a guiding effect for science and technology achievements to solve clinical services and problems.

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.

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.

Recurrent pancreatitis ( RP) can be further divided into two items , including recurrent acute pancreatitis ( RAP ) and recurrent chronic pancreatitis ( RCP ) .In recent years, with the rising incidence of pancreatitis , the incidence of RP has also been increased .During the development of pancre-atic diseases, RP may serve as a transitional disease .Thus, this article reviewed the latest research progress on RP in order to discuss its role in the development of the related pancreatic di-seases and the effects on clinical prognosis , and provide a refe-rence for preventing and treating RP and even cancer .

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 prospectively assess the nutritional status in the patients with alimentary tract malignancy,and to elucidate the factors related to malnutrition.Methods The nutritional status of 328 patients with newly diagnosed alimentary tract malignancy was assessed using subjective global assessment(SGA)and serum levels of prealbumin and albumin.And the factors influencing the nutritional status of the patients with alimentary tract malignancy in different locations were analyzed.Results The prevalence of malnutrition was 64.43% in all,75.81% in colon cancer,63.24% in esophageal cancer,62.40% in gastric cancer and 60.27% in rectal cancer.The changes of nutritional status mainly manifested weight loss with the incidence of 67.39%,serum prealbumin level under 200 g/L with the incidence of 24.1% and serum albumin level less than 35 g/L with the incidence of 31.70%.And there was significant difference in weight loss and serum levels of prealbumin and albumin among the patients with different nutritional status(P=0.000).The factors that influence the nutritional status of the patients with alimentary tract malignancy include the location and TNM staging of tumors,and the age,appetite and digestive symptoms of the patients.Conclusion The patients with alimentary tract malignancy are susceptible to malnutrition due to the multiple factors such as the tumor location and metabolic impacts of tumor on host.Nutritional screening,assessment and early intervention should be emphasized in the inpatients with alimentary tract malignancy.