BACKGROUND: Abnormal curvature of the cervical spine reflects in large measure the degenerative changes of the cervical vertebrae. OBJECTIVE: The effect of manipulative therapy has been recognized in restoring normal cervical curvature, and aimed to further probe into the effect of this therapy on blood flow velocity in the vertebrobasilar arteries of patients with cervical spondylosis. DESIGN: A non-randomized and controlled concomitant study. SETTING: Departments of Spinal Orthopaedics and General Sugery of a University hospital, and the Outpatient Department of Orthopaedic Institute of a college of Traditional Chinese Medicine. PARTICI PANTS: From January 1999 to December 2001, 60 patients with cervical spondylosis were treated in the Department of Spinal Orthopaedics in Ruikang Hospital, Third Department of Surgery, First Affiliated Hospital of Guangxi College of Traditional Chinese Medicine, and Outpatient Clinic of Institute of Orthopaedics, Guangxi College of Traditional Chinese Medicine. The patients were divided into spondylosis group with abnormal curvature(30 cases) and spondylosis group without normal curvature(30 cases) . Thirty healthy subjects were also included to serve as the control group.METHODS: Manipulation was applied in these patients and the cervical curvature and blood flow velocity in the left vertebral artery (LVA) and right vertebral artery(RVA) as well as in the basilar artery(BA) were measured before and after the treatment for comparison. The correlation coefficients between them were also calculated.MAIN OUTCOME MEASURES: ① The cervical curvature before and after manipulation in spondylosis group and control group; ② The blood flow velocity in maximal systolic phase and end-diastolic phase in the specified arteries.RESULTS: The blood flow velocity in maximal systolic phase and end-diastolic phase decreased in LVA, RVA and BA in patients with abnormal cervical curvature, whose blood velocities in maximal systolic phase in these arteries was less than those in control subjects and patients with normal curvature ( P ＜ 0.05). After manipulation, the velocity in these arteries in creased apparently in patients with abnormal curvature. The changes in systolic velocity in LVA and systolic in BA were correlated to the curvature before manipulation, and after that, the maximal systolic velocity in LVA,maximal systolic velocity in RVA and BA were all related to the changes of the cervical curvature. CONCLUSION: Abnormal cervical curvature is the anatomical basis for abnormalities of the vertebrobasilar arteries. Manipulative therapy can restore the cervical curve and blood flow velocity in these arteries.

One hundred and sixty non-diabetic patients with cerebral ischemia of primary onset were enrolled in the study. The patients were divided into impaired glucose tolerance (IGT) group and normal glucose tolerance (NGT) group according to the oral glucose tolerance test (OGTT). Carotid atherosclerosis and carotid artery stenosis were examined with vascular Doppler ultrasonic detection. The incidence rates of carotid atherosclerosis in IGT group and NGT group were 87. 5% (70/80)and 63.8% (51/80)respectively (χ2= 12.240,P <0.001);the incidence rates of carotid stenosis in IGT group and NGT group were 63.8% (51/80) and 47. 5 % (38/80), respectively(χ2 =4. 279, P =0. 039);the degree of carotid artery stenosis in IGT group was higher than that in NGT group(χ2= 21.95, P < 0. 01). The results indicate that IGT may be related to atherosclerosis and stenosis of carotid artery in cerebral ischemic patients.

Objective To investigate the effect of different parts leukoencephalopathy on cognitive function in patients with acute cerebral infarction,and analyze the relationship between injury site of cholinergic pathways and cognitive function.Methods Ninety-seven patients with acute cerebral infarction were divided into leukoencephalopathy group (59 cases) and non-leukoencephalopathy group (38 cases)according to the cranial MRI T2 scanning.The all patients of 2 groups were evaluated by cholinergic pathways hyperintensities scale (CHIPS) and reforming Scheltens scale.The cognitive function of all patients were evaluated by Montreal cognitive assessment (MoCA).The difference of the cognitive function between 2 groups was observed,and the relationship between CHIPS score,reforming Scheltens scale score and MoCA score was investigated.Results There were statistical differences in MoCA total score and visuospatial/execution,memory,attention score between leukoencephalopathy group and non-leukoencephalopathy group [(20.86 ± 4.52) scores vs.(23.47 ± 4.49) scores,(3.80 ± 1.68) scores vs.(3.11 ± 1.47) scores,(2.78 ±1.57) scores vs.(1.95 ± 1.80) scores,(4.00 ± 2.08) scores vs.(3.87 ± 2.04) scores] (P ＜ 0.01 or ＜ 0.05).There were statistical differences in CHIPS score and reforming Scheltens scale score between cognitive dysfunction group (35 cases)and non-cognitive dysfunction group (24 cases)[(47.77 ± 12.36) scores vs.(39.83 ±7.98) scores,(5.14 ± 1.73) scores vs.(2.58 ±2.10) scores] (P ＜0.01).There was negative correlation between MoCA total score and frontal periventricular score,occipital periventricular score,parietal lobe score,periventricular total score,deep alba total score and reforming Scheltens scale total score (P ＜0.01).There was negative correlation between visuospatial/execution score,attention score,fixing score,MoCA total score and CHIPS score (P ＜ 0.01).There was negative correlation between attention score,fixing score,MoCA total score and reforming Scheltens scale score (P ＜ 0.01).Conclusions In acute cerebral infarction patients leukoencephalopathy is probably related to cognitive function,and the severity of leukoencephalopathy correlates with the degree of cognitive function impairment.Different parts leukoencephalopathy can induce different influence on cognitive function.The cognitive function impairment caused by leukoencephalopathy correlates with the impairment of cholinergic pathways,with main effects of visuospatial/execution function,and the severity correlates with the impairment of cholinergic pathways.

BACKGROUND:Recent studies have found that stem cels can directly differentiate into mature myocardial cels or promote their regeneration, providing a new therapeutic strategy for the treatment of myocardial infarction. However, the low cel transplantation rate reduces the myocardial differentiation ability and myocardial repair.
OBJECTIVE: To study the role of heat shock treatment in Sca-1+ cel transplantation for treatment of myocardial infarction in mice.
METHODS:Sca-1+ cels were isolated from the bone marrow of mice using magnetic bead sorting method, and were subjected to heat shock treatment. Animal models of myocardial infarction were made in mice, and then randomized into two groups: heat shock group and non-heat shock group, which were given 1 mL heat shock-treated Sca-1+ cels and 1 mL non-heat shock-treated Sca-1+ celsvia the tail vein, respectively. After transplantation, cel survival, heart function, myocardial cel apoptosis and myocardial fibrosis were detected. Meanwhile, the expressions of heat shock factor (HSP), HSP70 and miR-34a in the left ventricle were measured.
RESULTS AND CONCLUSION:(1) The expression of sry gene in the heat shock group was significantly higher than that in the non-heat shock group. (2) The left ventricular ejection fraction and fractional shortening in the heat shock group were significantly higher than those in the non-heat shock group. The left ventricular end-diastolic diameter and systolic diameter in the heat shock group were significantly lower than those in the non-heat shock group. (3) The cardiac fibrosis and myocardial cel apoptosis in the heat shock group were significantly lower than those in the non-heat shock group. (4) The HSF and HSP70 expression in the left ventricle was significantly higher in the heat shock group than the non-heat shock group, and the miR-34a expression in the left ventricle was significantly lower in the heat shock group than the non-heat shock group. These findings indicate that heat shock-treated Sca-1+ cel transplantation can reduce myocardial apoptosis and infarct size, and improve heart function of mice with myocardial infarction.

Objective To investigate the species of Acaroid mites breeding in the stored traditional Chinese animal medici?nal materials and the relationship between its community and habitats. Methods A total of 30 samples of traditional Chinese animal medicinal herbs were collected from Wuhu City,Anhui Province,China. The mites were isolated by the directly micro?scopic and floatation microscopic examinations,and then identified and counted under a light microscope. Results Acaroid mites was represented in 28 of the 30 samples,and the breeding rate accounted for as high as 93.3%(28/30). Totally,13 spe?cies of Acaroid mites were identified,which belonged to 4 families and 9 genera. The densities of Acaroid mites were top in 6 Chinese herbal medicines,such as corium erinacei,aspongopus,hirudo,pheretima aspergillum,Apostichopus and huechys. The diversity parameters of these six traditional Chinese animal medicinal herbs were calculated. The highest richness indexes were in aspongopus and hirudo,the highest diversity index was in hirudo,and the highest evenness index was in Apostichopus. Conclusions There are Acaroid mites breeding in parts of the traditional Chinese animal medicinal herbs stored in Wuhu. In the storage and processing of Chinese herbal medicines,we should pay attention to the prevention and control of mites.

OBJECTIVE: To observe the influence of the change of cervical curvature on the nerve root and the vertebral artery of the patients with cervical spondylosis and the curative effect of therapeutic manipulations. METHODS: Sixty cases of cervical spondylosis with the change of cervical curvature, 60 cases of cervical spondylosis without the change of cervical curvature and 60 normal people were chosen. They were clinically observed and the cervical spondylosis was treated by manipulations and the data was processed according to the principle of statistics. RESULTS: The change of cervical curvature affected the nerve root and the vertebral artery and therapeutic manipulations produced a satisfactory curative effect. CONCLUSION: Cervical spondylosis with change of cervical curvature has special characteristics in the etiology, course and state of the disease. The change of cervical curvature produces an effect on the nerve root and the vertebral artery. Selected therapeutic manipulations produce a better curative effect.

Objective To explore the consistency of the clinical serum creatinine results in Shanghai district and investigate the population distribution of apparently healthy people, modified MDRD formula adapted to Chinese population was used to estimate glomerular filtration rate and its distribution for further assessment of the clinical applicability of the eGFR.Methods A fresh pooled human serum sample with given IFCC's creatinine level from c.f.a.s.(calibration for automatic system) ,was used to calibrate the creatinine detecting systems of each participating hospital laboratory before every examination. Fourteen hospital laboratories successively conducted 6 experiments, and the test results were almost identical.They tested and studied the creatinine values of 6 837 ( male 3 289, female 2 132, children and teenagers 1 416)apparently healthy individuals, age from 0 to 99 years old, and estimated eGFR value of these apparently healthy individuals according to the documented eGFR formula [ eGFR = 175 × (Scr) -1.154 × (age) -0.203 ×0.742 (female) × 0.827 ] which was applied especially to Shanghai people.Results Before calibration,the inter-laboratory CVs of creatinine results varied from 3.1％ -9.1％, and after calibration, CVs decreased to less than 5％.A good consistency of the creatinine results was established among all these hospitals.The result of population distribution study of creatinine for men was 63.0-102.8 μmol/L,for women was 45.0-76.0 μmol/L, and for children and teenagers was 0-1 year old 11.0-77.0 μmol/L, 2 years old 15.5-33.3 μmol/L,3-5 years old 19.0-42.0 μmol/L, 6-19 years old 41.4-62.0 μmol/L.The Cr value were different between the male and femal [ male: ( 82.1 ± 10.9 ) μmol/L, femal: ( 59.4 ± 8.4 ) μmol/L, t =94.3 ,P <0.01 ＝ ;The eGFR value could decrease the sexual difference[ male: (79.1 ± 13.5) ml · ( min ·1.73 m2 ) -1, femal: (79.2 ± 13.6) ml · ( min · 1.73 m2 ) - 1, t = 0.266, P > 0.05 ].The difference of Cr and eGFR could not be eliminated between the groups divided by every 10 years(x2Cr =2 601 ,P <0.01 ;x2eGFR2= 1 105 ,P <0.01 ＝.Conclusions The pooled patients' sera could be used as calibrator for harmonizing of creatinine results among the laboratories. The reference rang of Cr should be differentiated by age and sex.Although eGFR can decrease the difference of sex, it cannot eliminate the difference of age.

Objective To establish the reference intervals of serum osteocalcin (OCN), C-terminal cross-linking telopeptide of type Ⅰ collagen (β-CTx) and total type Ⅰ procollagen N-terminal peptide (P1NP) by electrochemiluminescence assay. Methods According to the Clinical and Laboratory Standards Institute (CLSI) "CA8-A" document the appropriately healthy people, who were divided into three groups (men, premenopausal women, and postmenopausal women) by sex and pre- or postmenopausal status were screened. The levels of fasting serum of OCN,β-CTx, tPINP were detected by Roche Modular E170 electrochemical immunoassay. Results 393 appropriately healthy people consists of 112 men between the ages of 29 and 69 years, 148 premenopausal women between the ages of 29 and 69 years, 133 postmenopausal women between the ages of 29 and 69 years. The levels of serum OCN, β-CTx, tP1NP in men group were (15.33±4.76) μg/L, (413±189) ng/L, (42.15±17.14) μg/L, respectively. The levels of serum OCN, β-CTx, tP1NP in premenopausal women group were (12.99±4.53) μg/L, 265(30-820) ng/L, (36.43±14.23) μg/L, respectively. The levels of serum OCN, β-CTx, tP1NP in postmenopausal women group were (18.96±5.15) μg/L, (513±195) ng/L, 51.40 (8.98 -118.6)μg/L, respectively. Logarithmic transformation produced normal distributions for all markers but serum β-CTx of premenopausal women group and serum tPINP of postmenopausal women group. The 95% of the distribution intervals for serum OCN, β-CTx, tP1NP in men group was 6.00-24.66 μg/L, 43-783 ng/L, 9.06-76.24 μg/L, respectively. The 95% of the distribution intervals for serum OCN, β-CTx, tP1NP in premenopausal women group was 4.11-21.87 μg/L, 68-680 ng/L, 8.53-64.32 μg/L respectively. The 95% of the distribution intervals for serum OCN, β-CTx, tPl NP in postmenopausal women group were 8.87-29.05 βg/L, 131-900 ng/L, 21.32-112. 80 μg/L, respectively. Conclusions Compared with the reference intervals provided by manufacture, the reference intervals of three serum bone turnover markers established by our laboratory have great difference. Laboratory should pay attention to the reference intervals was cited.

Objective To assess the analytical performance of three sensitive cardiac troponin Ⅰ assays and compare the clinical application to provide help in choosing the detection method for clinical laboratory. Methods A total of 474 serum samples were collected from apparently healthy subjects and a total of 112 serum samples were collected from patients presenting with symptoms suggestive of acute myocardial infarction. The functional sensitivities of three assays from Abbott, Beckman-Coulter and Ortho were determined ( CV = 10% ). The reference ranges have been established. The analytic performance was compared according to the assessment mode described by Apple. The relationship was compared among the different assays. The preliminary clinical application value for different detection methods has been evaluated and validated with self-established reference ranges. Results The functional sensitivities ( CV = 10% ) of the cTnI assays for Abbott, Beckman-Coulter and Ortho were 0. 030, 0. 04 and 0. 013 μg/L, respectively.The 99th percentiles of cTnI in healthy volunteers were 0. 021, 0. 02 and 0. 026 μg/L respectively. The analytical data of ROC curve showed that the area under curve (AUC) of the cTnI assays for Abbott,Beckman-Coulter and Ortho for diagnosis of AMI was 0. 852,0. 909 and 0. 910,respectively. There was no statistical difference between any two methods(Z1 = 1.18 ,Z2 = 1.21 ,Z3 =0. 026,all P ＞0. 05). There were good consistency between the 99th percentile obtained from our laboratory and suggested by manufacturers (Kappa value were 1. 000, 0. 730 and 0. 893 respectively, all P ＜ 0. 01 ). Conclusions The analytical performance of two cTnl assays is "clinical accepted" ,the other one is accepted according to guideline. All of them could detect cTnI in apparently healthy subjects. There exist differences among three assays, but their diagnostic characteristics for AMI are not significantly different.

Objective To assess the analytical performance of hs-cTnT and biological variations in healthy population as well as establish hs-cTnT reference intervals. Methods The serum samples from 100 acute myocardial infraction patients and 474 apparently healthy subjects were collected. The functional sensitivity,within- and between-run imprecision were determined. The hs-cTnT assay and con-cTnT assay were evaluated. The serum hs-cTnT levels were detected in apparently healthy subjects to establish reference intervals. Moreover,the long-term and short-term biological variations for hs-cTnT in healthy volunteers were assessed. Results The functional sensitivity of hs-cTnT was 0. 005 μg/L. The within- and between-run precision for lower level control(0. 014 μg/L) and higher level control(2. 500 μg/L) was 2. 97% vs 3. 64%and 0. 66% vs 1.01% ,respectively. The correlation between hs-cTnT assay and con-cTnT assay was good ( R2 =0. 972 ,P ＜0. 01 ). The 99th percentile in apparently healthy subjects was 0. 003 μg/L for women less than60 years, 0.008 μg/L for men less than 60 years, 0.015 μg/L for women above 60 years and 0. 021 μg/L for men above 60 years. The CVa, CVi, CVg and CVt of short-term biological variations in detecting hs-cTnT from 22 apparently healthy subjects were 3.8%, 4. 8%, 49.9% and 58.5%,respectively. The CVa,CVi ,CVg and CVt of long-term biological variations were 5. 3% ,6. 4% ,56. 6% and 68. 3% respectively. Conclusions The analytical performance of the hs-cTnT is better than con-cTnT assay,achieving acceptable level according to guideline. Our experimental result could provide the basis for the new high sensitivity cTnT assay in the diagnosis of acute myocardial infarction.