Objective To observe dynamic changes of Nestin and Erythropoietin(EPO)expression after cerebral ischemia and investigate possible mechanism of intrinsic neurogenesis. Methods A total of 36 SpragueDawley rats were divided into a control group(n=4)and an experimental group(n=32)randomly.The experimental group were further divided into 8 subgroups corresponding to the observation time points of 3,6,12,24 hours and 3,7,14,and 21 days after reperfusion.The model of experimental ischemia was made by 4-VO.The specimens were made into paraffin section.The expression of Nestin and EPO were detected by immunohistochemistry method. Results (1)Nestin detection:No Nestin positive cells were observed in hippocampal zone,subventricular zone (SVZ)and contex in the control group.The expression of Nestin started at 3 h in SVZ but not in hippocampal zone and it started to increase at 6 h after cerebral ischemia and reach a peak at 14d after cerebral isehemia in the hippocampal zone,then decreased at 21 d.The difference of Nestin expression among different time points is statistically significant(P<0.05).(2)EPO detection:A few EPO positive cells were observed in hippocampal zone in the control group.The expression of EPO started to increase at 3 h after cerebral ischemia and reach a peak at 24 h after cerebral ischemia,then decreased with time.The difference of EPO expression among the different time points is statistically significant(P<0.05). Conclusion (1)The increased expression of EPO and Nestin after cerebral ischemia might be a beneficial protective response of cells to the ischemic injury.(2)The sequence of expression of EPO and Nestin after cerebral ischemia is relevant.EPO may promote proliferation of NSC.

Objective To investigate the effects of Bushen-Huoxue decoction on the plasma level of brain natriuretic peptide (BNP) and heart function in patients with chronic heart failure (CHF) due to kidney deficiency and blood stasis. Methods A total of 96 patients with CHF due to kidney deficiency and blood stasis were randomized into a treatment group (50 cases) and a control group (46 cases). In the control group, the normal treatment of western medicine was given. In the treatment group, on the basis of the control group, Bushen-Huoxue decoction was added. Both groups were treated for 4 weeks. The plasma BNP level was detected with enzyme-linked immunosorbent assay. The left ventricular ejecting function, New York Heart Association functional classes and score of traditional Chinese medicine syndromes were evaluated before and after the treatment. Results After the treatment, the plasma BNP level in the treatment group was significantly lower than that in the control group (897.3 ± 286.7 pg/ml vs. 1 423.5 ± 458.7 pg/ml;P<0.05);the left ventricular end systolic diameter (4.8 ± 0.8 cm vs. 5.4 ± 0.9 cm) and the left ventricular end systolic volume (57.23 ± 5.30 ml vs. 69.78 ± 5.86 ml) in the treatment group were significantly lower than those in the control group (all P<0.05);the stroke volume (72.56 ± 7.23 ml vs. 62.56 ± 5.86 ml) and the left ventricular ejection fraction (59.75%± 6.47%vs. 49.87%± 6.91%) in the treatment group were significantly higher than those in the control group (all P<0.05). The heart function (90.0%vs. 80.4%;χ2=4.369, P<0.05) and the traditional Chinese medicine syndromes (94.0%vs.82.6%;χ2=3.988, P<0.05) had shown significant improvement in the treatment than those in the control group. Conclusions Bushen-Huoxue decoction can reduced the plasma BNP level, improve the heart function in patients with CHF due to kidney deficiency and blood stasis.

Bone and Bones ; pathology ; Humans ; Immunologic Deficiency Syndromes ; diagnosis ; Osteochondrodysplasias ; diagnosis

Acupuncture Therapy ; methods ; Adult ; Female ; Humans ; Jaw ; physiopathology ; Male ; Middle Aged ; Temporomandibular Joint Disorders ; physiopathology ; therapy ; Young Adult

BACKGROUND: Conservative treatment of osseous gonarthritis (OG) is mainly to reduce the loading of knee joint and maintain muscle exercise,and non-steroidal anti-inflammatory drugs serve as supplements in case of acute occurrence.OBJECTIVE: To investigate the effect of combination of intraarticular in jection of hyaluronate and pain-point injection of betamethasone in improving the pain symptom in patients with OG.DESIGN: Open experiment.SETTING: Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences.PARTICIPANTS: We selected 45 OG patients, who were aged 40 to 85years and received treatment in the clinic of Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences between January 2004 and October 2004.METHODS: OG parenteral solution was intraarticularly injected into the knee joint, 2.5 mL once a week, 5 weeks set as a disease course. Pain points around knee joint were searched for following thorough physical examination. Anti-inflammatory analgesic solution of 2.0-3.0 mL was injected at each pain point. Physical examination was repeated before treatment in each week. Injection at pain points was maintained if they were still present. Intraarticular injection of hyaluronate was performed only when the pain points disappeared after treatment.MAIN OUTCOME MEASURES: ① Pain score at rest and at exercise.② Time when pain disappeared and times of betamethasone administration.RESULTS: Totally 45 patients entered the result analysis. ① Pain at rest and at exercise 1 week after combination treatment of intraarticular injection of hyaluronate and pain-point injection of betamethasone was ignificantly lessened compared to that before treatment (P ＜ 0.01). Pain relief was more significant at rest than at exercise (P ＜ 0.01). ② Pain disappeared at (17.07±6.00)days after treatment on average. The average times of betamethasone administration was (2.42±0.78) times. ③ No local joint pain and other adverse reactions occurred after administration in any case.CONCLUSION: Combination of intraarticular injection of hyaluronate and pain-point injection of betamethasone can effectively relieve the pain symptom of osseous gonarthritis, with no obvious adverse reactions.

Objective To assess the feasibility of ~(18)F-FDG PET/CT for differentiation of malignancy from benign in pericardial Lesions. Methods ~(18)F-FDG PET/CT data of 16 patients with pericardial lesions (9 malignancy, 7 benign) were analyzed using maximum standard uptake values (SUV_(max)) and the density of lesions, the relationship with surrounding tissues were also evaluated. The results of malignancy or benign were proved by needle biopsy.Results SUV_(max) of malignancy (10.1±6.0) and benign (3.0±2.1) was significant different (P<0.01). Taking the optimal cut-off value as SUV_(max) 3.5-4.5, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of differentiation of malignant from benign in pericardial lesions was 100%, 85.71%, 93.75%, 90.00% and 100%, respectively. Conclusion ~(18)F-FDG PET/CT can predict benign or malignance of pericardial lesions with moderate accuracy.

Background and purpose:Many patients may suffer from acute pain after radical mastectomy un-der general anesthesia. This article aimed to investigate the effect of intercostal nerve block coupled with general anes-thesia on analgesia after radical mastectomy for breast cancer.Methods:Ninety-six patients underwent modiifed radical mastectomy for breast cancer were randomized with random number into group C (intercostal nerve block coupled with general anesthesia) and group G (general anesthesia), with 48 patients in each group. Group C received intercostal nerve block by ultrasound before general anesthesia. Group G received only general anesthesia. The induction of general an-esthesia was the same between the two groups. During the surgery, 10 μg sufentanil was given to the patient if heart rate or blood pressure were 20% higher than baseline. After surgery, sufentanil was given if VAS score exceeded 0 point. The perioperative amount of sufentanil was recorded. VAS scores were recorded respectively on 2 (T1), 12 (T2) and 24 h (T3) after surgery. The incidence of postoperative nausea and vomiting was also observed.Results:Sufentanil amount used intra- and post- operation were signiifcantly lower in group C [(25.2±3.5) and (3.3±1.2) μg] than that in group G [(40.5±4.3) and (8.4±2.2) μg] (P<0.01). The VAS scores on 2, 12 and 24 h after surgery in group C(0.45±0.15,1.75±0.08 and 2.05±0.12), were signiifcantly lower than those in group G (4.32±0.21, 4.88±0.13 and 4.78±0.16) (P<0.01). The incidences of nausea and vomiting on 2 and 24 h after surgery in group C (6.25% and 16.66%) were signiifcantly lower than those in group G (20.8% and 41.66%). There was no adverse complication related with intercostal nerve block in group C.Conclusion:Intercostal nerve block coupled with general anesthesia plays an important role in preemptive analgesia for patients undergoing modiifed radical mastectomy for breast cancer, which may improve postoperative pain control and reduce the usage of opioids and incidence of nausea and vomiting. Intercostal nerve block under ultrasound is quite safe and effective for patients.

Background and purpose:Obvious pulmonary dysfunction may exsist preoperatively in part of the patients undergoing pulmonary lobectomy. Volume-controlled ventilation (VC) during one-lung ventilation (OLV) may lead to lung injury in lung cancer patients with preoperative pulmonary dysfunction. However, pressure-regulated volume-controlled (PRVC) ventilation mode is a new type of ventilation mode, and can alleviate ventilation-induced lung injury. This study explored the effect of PRVC on respiratory mechanics, oxygenation index, pulmonary inlfam-matory response, and clinical outcomes in patients undergoing pulmonary lobectomy during OLV compared with VC mode.Methods:Forty ASAⅡ-Ⅲ patients with moderate to severe pulmonary dysfunction undergoing pulmonary lobectomy were randomly divided into group VC and group PRVC (n=20).PRVC ventilation mode was performed for patients in group VC during the ifrst 5 minutes after OLV, and then ventilation mode was switched to VC ventilation mode till the end of surgery. In the other group, ventilation modes were performed in reverse order. Ventilation settings remained unchanged when ventilation mode was switched. Respiratory mechanics, static lung compliance, hemody-namic parameters and arterial blood gas were obtained during the surgery. Blood samples and bronchoalveolar lavage (BALF) in ventilated lung were collected to determine the level of TNF-α, IL-1β, IL-6 and IL-8 at the end of surgery.Results:Both the peak expiratory pressure and static lung compliance in group PRVC were signiifcantly lower than those in group VC (P<0.01). However, there were no statistical difference in hemodynamic parameters (heart rate and blood pressure) and arterial blood gas analysis (pH,paO2andpaCO2) between the two groups during OLV, as well as postoperative pulmonary complications and length of hospital stay. The levels of TNF-α, IL-1β and IL-6 in BALF in group PRVC were signiifcantly lower than those in group VC (P<0.05), while there was no difference in blood sample. Conclusion:PRVC mode during OLV may relieve the extravagant airway pressure and then reduce the release of inlfammatory factors in ventilation lung, which might prevent acute lung injury induced by lung barotraumas, especially for those patients with pulmonary dysfunction preoperatively. Therefore, PRVC mode is a safe and effective ventilation mode for high-risk patients undergoing pulmonary lobectomy.

Objective To review the neuron synaptic plasticity in hioppocampus in the pathogenesis of depression in present studies,and expected to provide reference and basis for study of depression in clinic and model.Methods The wordsdepression, antidepression, chronic unpredictable stimulate, hippocampus, synapse,plasticity were used as index words.Analysis the relationship of depression or antidepression and synaptic plasticity in hippocampus from the results of researches enrolled at home or abroad.Summarize the effect of neuron synaptic plasticity in hioppocampus in the pathogenesis of depression.Result Totally 37 articles enrolled.They show the onset of depression or antidepressant processes always combine with the damage or recover of neuron synaptic plasticity.Conclusion The reduction or damage in synaptic plasticity in hippocampus is likely to be the pathogenesis of depression,like the changes of function or expression of SYN-1,MAP-2,SYT-1,PSD-95 or any other synapse-associated proteins.Meanwhile,studies of using enrich environment to treat depression indicated that depression is likely related to the synaptic plasticity in hippocampus in another way.But who are the synapse-associated proteins related to synaptic plasticity in depression? How to design the enrich environment.? These still need further study.

Objective To observe the clinical effect of treating atlanto-axial subluxation by manipulative reduction therapy. Methods 128 patients with atlanto-axial subluxation confirmed by cervical plain X ray were randomized into two groups: 64 in the treatment group treated by manipulative reduction therapy, and 64 in the control group treated by the routine cervical traction. The clinical effect was evaluated by both clinical and X-ray confirmation. Results The X-ray study showed that after treatment the reconstruction of excursion in odontoid process in the treatment group was better than that in the control group significantly (P<0.01). The improvement of vertebra basal artery blood flow in the treatment group was also better than that in the control group significantly (P<0.05). The total effective rate of the treatment group was 95.3%, while the control group was 78.1%. Conclusion The technique of manipulative reduction on atlanto-axial subluxation acts more directly on the cause of the disease than the routine traction, and exerts better results in restoring proper atlanto-axiai joint position and mechanics stability of cervical vertebra.. Thus it is the effective shortcut way with high safety and low cost.