OBJECTIVE: To observe the effect of electroacupuncture (EA) combined with transplantation of Schwann cells (SCs) on limb locomotor, myelin sheath repair and expression of CD4 and CD8 in compressed spinal cord injury (CSCI) rats, so as to explore its mechanisms underlying improvement of CSCI. METHODS: A total of 45 female SD rats were randomly divided into normal control, model, EA, Schwann cell (SC) transplantation, and EA＋SC transplantation groups (n＝9 rats in each group). The CSCI model was established by laminectomy at T12-L2 and clip compression. Rats of the SC transplantation group accepted injection of the cultured SC suspension (2×106/6 µL) into the central, upper and lower sites of the injured spinal cord (5 mm in depth) 7-8 days after CSCI modeling. EA (2 Hz) was applied to bilateral "Zusanli" (ST36) and "Sanyinjiao" (SP6) for 10 min, once daily and 6 days a week for 3 weeks. The Basso, Beattie and Bresnahan locomotor rating scale (BBB scale) was used to evaluate the function state of CSCI. Morphological changes of the regional injured tissue were observed under light microscope after H．E. staining. The myelin sheath repair state and survival of SCs were detected by Luxol fast blue (LFB) staining and immunofluorescence histochemistry, and the expression of CD4, CD8 and P0 of the injured spinal cord was detected by Western blot. RESULTS: Compared with the normal control group, the BBB scores at the time-points of 0 d, and 1, 2, and 3 weeks were significantly decreased in the model group (P<0.001), and those of the EA＋SC transplantation group at the 2nd and 3rd week were significantly higher than those of the model group (P<0.05). No significant changes of BBB scores were found after EA and SC transplantation relevant to the model group (P>0.05). LFB staining showed a disordered arrangement of the nerve fibers in the white matter, myelinociasis and obvious decrease of the medullated fibers in the model group, and these situations were relatively milder in both EA and SC transplantation groups and obviously milder in the EA＋SC transplantation group. H．E. staining displayed that the structure of the injured region of the spinal cord was incomplete, accompanied with a large number of defect cavities and neuronal karyopyknosis in the model group, while the structure was relatively clear, with an increase of the normal neurons and fewer neuronal karyopyknosis in the EA＋SC transplantation group. Compared with the normal control group, MBP in the model group was significantly decreased (P<0.001)，and P0 was significantly increased (P<0.001). Compared with the model group, the expressions of MBP and P0 were significantly increased in the EA, SC transplantation, and EA＋SC transplantation groups (P<0.01, P<0.001), and was significantly higher in the EA＋SC transplantation group than in both EA and SC transplantation groups (P<0.001). The average immunofluorescence intensity of Hoechst33342-labeled SCs was significantly higher in the EA＋SC transplantation group than in the SC transplantation group (P<0.05). After CSCI, the expression levels of spinal CD4, CD8 and P0 proteins had no significant changes in comparison with the normal control group (P>0.05), while after the intervention and in comparison with the model group, the expression levels of P0 protein were significantly increased in the EA, SC transplantation and EA＋SC transplantation groups (P<0.05), and was significantly higher in the EA＋SC transplantation group than in both EA and SC transplantation groups (P<0.05). The expression levels of CD4 and CD8 proteins were significantly lower in the EA＋SC transplantation group than in the SC transplantation group (P<0.05)．. CONCLUSION: EA＋SCs transplantation can improve the locomotor function in CSCI rats, which may be related to its effects in increasing the survival of transplanted SCs to promote the remyelination and in reducing the immune rejecting reaction.

Objective To identify pre-operative demographic and urodynamic (UD) parameters related to overactive bladder (OAB) symptoms of pre-operation and persistence of after pelvic organ prolapse (POP) repair.Methods From Jan 1,2010 to Oct 31,2012,this perspective study examined demographic and UD data of 175 patients undergoing POP surgery.Pre-and post-operative urinary distress inventory 6 (UDI-6) scores for frequency and urge urinary incontinence (UUI) were analyzed,and correlations between scores and pre-operative UD data were also analyzed.Results (1)Surgery resulted in a improvement of frequency (71.0％,71/100) and UUI (69.2％,63/91) at 12-24 months follow-up.(2)Pre-operative UD parameters:first desire of bladder ＜100 ml,6.3％ (11/175); detrusor overactivity,14.9％ (26/175); post-void residual ≥50 ml,11.4％ (20/175); maximal flow rate (Qmax),(16±7) ml/s.(3)Comparison of pre-operative UD datas between patients with OAB symptoms and without,with OAB symptoms group had more patients of type Ⅲ stress urinary incontinence [5％ (5/91) versus 0 (0/84),P=0.022].(4)Qmax was higher in improvement in UUI group than that in persistent UUI after POP repair [(17±7) m]/s versus (13±5) ml/s,P＜0.01].Conclusions POP repair significantly reduces OAB symptoms; however,there had not exact predictor for symptoms of persistent frequency,UUI after POP repair.Persistent UUI symptom may be related to Qmax of pre-operative UD.

Objective To investigate the effects of intrathecal transplantation of bone marrow stromal cells (BMSCs) on inter cellular cell adhesion molecule-1 (ICAM-1) expression and blood spinal cord barrier following spinal cord ischemia reperfusion injury.Methods Ninety Sprague Dawley rats were randomly divided into three groups:sham (Sham group),ischemia-reperfusion injury (I/ R group),and BMSCs transplantation (BMSCs group).Spinal I/R injury was induced by clamping the aortic arch between left common carotid artery and left subclavian artery for 14 min in I/R group and BMSCs group.Sham group was subjected to exposure of aortic arch but without occlusion.I/R group and BMSCs group were intrathecally injected with phosphate buffered saline (PBS) or BMSCs (2 × 106) two days before injury.At 1 d,3 d,and 7 d after injury,neurological function was evaluated and damaged lumbosacral seg ment was removed for measurement of blood spinal cord barrier permeability and ICAM-1 protein expression.Results Compared with Sham group,neurological function score was significantly lower:1 d (F =38:59,P =0.001),3 d (F =31.34,P =0.001),and 7 d (F =27.71,P =0.001) ; ICAM-1 expression was increased 1 d (F =34.33,P =0.001),3 d (F =29.76,P =0.001),and 7 d (F =23.65,P =0.001),and blood spinal cord barrier permeability was higher:1 d (F =42.57,P =0.001),3 d (F =32.75,P =0.001),and 7 d (F =26.89,P =0.001) in I/R group.Compared with I/R group,neurological function score was increased:1 d (F =16.62,P =0.001),3 d (F =21.54,P =0.001),and 7 d (F =12.84,P =0.002) ; ICAM-1 expression was decreased:1 d (F =19.84,P =0.018),3 d (F =17.38,P =0.008),and 7 d (F =22.46,P =0.007),and blood spinal cord barrier permeability was lower:1 d (F =22.38,P =0.016),3 d (F =27.59,P =0.009),and 7 d (F =23.25,P =0.001) in BMSCs group.Conclusions Intrathecal transplantation of BMSCs inhibited ICAM-1 expression and decreased blood spinal cord barrier permeability,and then attenuated spinal cord ischemia-reperfusion injury.

The traditional view of bacterial life cycle consists of four phases,namely,lag phase,exponential or logarithmic phase,stationary phase and death phase.Although the standard textbook description of the bacterial life cycle has been useful,might not always provide us the whole visage of bacteria growth process.Recently,it has demonstrated that bacterial life cycle is expanded to five phases.It is a significant different growth phase after death phase:long-term stationary phase,which may be more akin to the nature environment in which microorganisms exist.Microbial cells survive due to mutating,and forming growth advantage during stationary phase (GASP) phenotype in this phase.It is very important for further study the microorganisms in this phase.

Objective To investigate the technique of transarterial embolization of dural carotidcavernous fistulas(DCCFs)with low concentration(14%-25%)of n-butyl-cyanoacrylate(NBCA)and determine its value.Methods Eight patients with DCCFs were treated by transarterial embolization with low concentration of NBCA using a wedged microcatheter.Of the 8 patients,5 had unsuccessful transvenous embolization and 3 could not be treated with transvenous embolization.Results Transarterial embolization with low concentration of NBCA using a wedged microcatheter resulted in complete obliteration of the affected cavernous sinus and related shunts in 5 patients,no residual arteriovenous shunt was demonstrated on postembolization angiography.On clinical and angiographic follow-up 6-12 months later,complete resolution of clinical symptoms was observed in all 5 patients and there were no recurrent or residual DCCFs found.Partial obliteration of the involved cavernous sinus and the related shunt was achieved in the remaining 3 patients on immediate post-procedure angiography,but the volume of shunt diminished significantly.On clinical and angiographic follow-up 3 months later,in 2 patients,clinical symptoms were improved and the arteriovenous shunts were diminished;in the third patient,clinical symptom resolved and the shunt was obliterated.There were no major complications except for the transient worsening of ocular symptoms due to Ⅵ cranial nerve palsy in 1 patient.Conclusions Transarterial embolization of DCCFs with low concentration of NBCA using a wedged microcatheter was a safe and effective treatment method.It is an optimal alternative for the patients with DCCFs in which transvenous route was unsuccessful,or impossible.

Objective Complicated aneurysms located in the cisternal segment of the internal carotid artery(ICA-CSA)present unique therapeutic difficulties.This study is to discuss the feasibility of the Willis stent-graft in treating complicated ICA-CSA by comparing its effect with that of coiling therapy.Methods Willis covered stents were employed in 19 complicated ICA-CSAs(group A),while coils were used in 17 complicated ICA-CSAs(group B).Follow-up angiography was performed to investigate aneurysm recurrence,endoleak and parent artery(PA)stenosis.Kaplan-Meier curves were constructed to compare the recurrencefree and PA stenosis-free rate in both groups.Results Total exclusion was immediately achieved in 13 ICACSAs and minor endoleaks presented in 5 cases in group A.Total or near-total occlusion was achieved in 7 ICA-CSAs.subtotal occlusion in 8 and partial occlusion in 2 cases in group B after coiling.Acute thrombosis occurred in 1 patient in either group and re-hemorrhage happened in 1 patient after coiling.Follow-up angiography in group A revealed that 16 ICA-CSAs were completely isolated,with two parent arteries showing mild in-stent stenosis.Eighteen months after the procedure,Kaplan-Meier analysis showed that the recurrence-free rate was 93.3%and 50%,while the stenosis-free rate of parent artery was 87.5%and 100% in group A and in Group B,respectively.In group A and group B the clinical neurological symptoms were fully recovered in 9 and 9,obviously improved in 3 and 5,unchanged in 2 and 2,and aggravated in one and 0 patients,respectively.Conclusion The implantation of Willis stent-graft is a feasible endovascular therapy for complicated ICA-CSAs.When the parent artery is very tortuous or when the risk that a main collateral branch may be wrongly covered and occluded is present,the implantation of Willis covered stent can not be taken as the treatment of first choice.

Objective To evaluate the accuracy of Sysmex XT-4000i automated hematology analyzer on neonatal leukocytes count and classification results.Methods 213 cases of neonatal blood specimens were analyzed respectively by Sysmex XT-4000i automated hematology analyzer and microscope counting and staining of two categories of methods.Results The instrument that immature granulocyte,primitive cell,shift to the left,three kind of tip in any one or more specimens have 112,accounted for 52.58% (112/213),and staining immature cell or shift to the left of the specimens was 91,accounted for 42.72% (91/213).The instrument to nucleated erythrocyte specimens were 109,accounting for 51.17% (109/213),and staining of nucleated erythrocyte were 66,accounting for 30.99% (66/213).Classify or classification of incomplete instrument failed to leukocytes were 11,ac-counting for 5.16% (11/213).When the specimens without nucleated erythrocytes interference or the number of nucleated eryth-rocytes is low [≤ 10/100 white blood cells(WBC)],Instruments on leukocyte count and manual counting results,there was not statistically significant differences between the two groups(P >0.05 ),when the sample number of nucleated erythrocytes (>10/100 WBC),When the specimens were nucleated erythrocyte number for a long time(>10/100 WBC),Instruments on leukocyte count and manual counting results,there was significant difference between the two groups(P <0.05).Correlation analysis on the instrument detection and manual dyeing classification of leukocytes,neutrophils,lymphocytes,monocytes,eosinophils,basophils, the correlation coefficient is respectively 0.95,0.93,0.78,0.86,0.14.Conclusion Some errors exist in Sysmex XT-4000i auto-mated hematology analyzer to count and classification of leukocytes.On neonatal blood tests should be carried out at the same time man-ual microscopy,and on the basis of nucleated erythrocytes were corrected,to ensure the clinical blood routine reporting results.

Objective To compare the effects of application of clavicular hook plate combined with wire anchors anatomical coracoclavicular ligament reconstruction and application of clavicular hook plate in the treatment of NeerII distal clavicle fracture and Tossy Ⅲtype~V acromioclavicular joint dislocation. Methods A retrospective analysis of the clinical data from June 2006 to June 2013. Total 73 cases patients suffered with Neer Ⅱtype distal clavicle fractures and Tossy Ⅲtype~V acromioclavicular joint dislocation. Of which , 41 cases were subjected to treatment with clavicular hook plate , 32 patients subjected to treatment of using clavicular hook plate combined with anchors .The incision length, operative time, postoperative complications, length of hospital stay and postoperative 1 month, 6 month shoulder VAS score of two groups were analyzed; the shoulder function of both groups after 1 month, 6 months were assessed by using Constant shoulder function assessment method. Results Surgical incision length and operational time between the two groups were statistically significant (P<0.05), while the amount of bleeding was not statistically significant. All patients were followed up . The two groups did not occur any complications such as loosening, decoupling, acromioclavicular joint dislocation and wound infections. Hospitalization time was 5~14 d (averaged 10d), no significant difference between two groups. 4 the shoulder Constant score and VAS scores showed no significant difference 1 months postoperation; 6 months after hook plate removed, VAS score and Constant shoulder score improved significantly in anchors hook plate group (P<0.05). Conclusion Anatomical coracoclavicular ligament reconstruction by application of hook plate combined with anchors is a good biomechanical model characterized with simple surgery , less trauma and good clinical outcomes , worthy of clinical application.

Objective:To study on the effect of ultrasound-guided thoracic paravertebral nerve (TPVB) block on quality of recovery from general anesthesia in tuberculosis patients with fiberboard exfoliation in post anesthesia recovery unit (PACU).Methods:From May 2018 to December 2019, 40 tuberculosis patients in Changsha Central Hospital with pulmonary fibreboard exfoliation and focal abscess lesions cleaning were randomly divided into two groups, with 20 patients in each group. The patients in group A received endobronchial general anesthesia and in group B received ultrasound-guided TPVB combined with endobronchial general anesthesia. Patients in the two groups were maintained under anesthesia by propofol, and the bispectral index (BIS) was maintained within the range of 40-50. The dosage of propofol and sufentanil was adjusted according to changes in BIS and hemodynamics. The mean arterial pressure (MAP), heart rate (HR) in two groups of patients were recorded at before anesthesia induction (T 0), before cutting leather (T 1), cut skin after (T 2), the end of operation (T 3), extubation time (T 4), and T 5 (time of leaving PACU). The visual analogue scale (VAS) of all patients in resting and cough state was recorded at 5, 30 min after extubation and the time of leaving PACU. The dosage of propofol and sufentanil in the operation and the additional dosage of sufentanil in PACU were recorded in both two groups. And the respiratory recovery time, consciousness recovery time, extubation time and sedation agitation scale(SAS) were observed. The adverse reactions such as nausea, vomiting, drowsiness and hypotension were observed in PACU. Results:Compared with group A, MAP and HR of patients at T 2, T 3, T 4, T 5 in group B were more stable during anesthesia, and VAS of patients in group B were lower than that in group A at each time point after extubation ( P<0.05). The dosage of sufentanil and propofol in group B were (35.92±8.12)μg and (749.56±95.30)mg respectively, which were significantly lower than those in group A [(45.74±4.42)μg and (862.83±105.34)mg, P<0.05]; the dosage of sufentanil in postoperative anesthesia recovery room of group B was (5.26±2.10)μg, significantly less than that of group A (10.35±5.86)μg ( P<0.05). The respiratory recovery time, consciousness recovery time and extubation time in group B were (12.92±5.12) min, (20.56±5.10) min and (26.87 ± 6.16) min, which were shorter than those in group A [(15.74±4.72)min, (25.83±5.34)min and (35.35±5.80)min, P<0.05]. The incidence of postoperative nausea, vomiting, lethargy and hypotension in group B were 10%, 10%, 35% and 20%, which were significantly lower than those in group A (30%, 20%, 75% and 45%, P<0.05). Conclusions:Ultrasound-guided paravertebral nerve block may significantly reduce the dosage of opioid analgesics for general anesthesia in tuberculosis patients with fiberboard exfoliation, accelerate the speed of anesthesia recovery, reduce the agitation during recovery, and improve the quality of anesthesia recovery.

OBJECTIVETo evaluate the role of Jiangzhi Xiaoban Tablet (JXT) in improving heartfunction of coronary heart disease (CHD) patients by tissue Doppler imaging (TDI) and speckle trackingimaging (STI) technology.

METHODSRecruited were 60 inpatients with confirmed CHD by coronary angiography at First Affiliated Hospital, Hunan University of Traditional Chinese Medicine from October 2013to November 2014. They were assigned to the treatment group (group A) and the control group (groupB) according to random digit table, 30 cases in each group. Patients in group A took JXT, 0.45 g/tablet,4 tablets each time, 3 times per day, while those in group B took Simvastatin Tablet, 20 mg/tablet, 1 tablet each time, once per evening. The therapeutic course for all was 8 weeks. The long axis view of theheart of 18 segments STI Peak strain LS and TDI peak systolic Sa parameters were performed in all patients before and after treatment.

RESULTSBefore treatment segments of STI strain LS and TDI longitudinal peak systolic peak Sa were not statistically different between the two groups (P > 0.05). Each segment of STI peak longitudinal strain LS and TDI peak systolic Sa in the two groups were higher after treatment than before treatment (P < 0.05). After treatment each segment of STI parameters of LS and eachTDI segment parameters of Sa were significantly lower in group B than in group A (P < 0.01).

CONCLUSIONJXT could improve heart function of CHD patients to different degrees, and its curative effect was betterthan that of routine Western medicine (Simvastatin Tablets) treatment.

Coronary Artery Disease ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Echocardiography, Doppler ; Heart ; drug effects ; Humans ; Simvastatin ; therapeutic use ; Tablets