Objective Impedance control plays an important role in stability.This paper intends to explore such mechanism through modeling human reaching movement.Method Implemented with revised model,we ap-ply optimal control theory to neuro-muscle-skeleton model to calculate the stiffness ellipses.Result Com-pared with the original model and experimental figures,the model we proposed could overcome the shortage of monotonous changing of the original one and fit the data better.Conclusions So that this paper concludes that co-contraction contributes to impedance control even during free upper limb planar movement.

Objective:To investigate whether VLA-5 and VLA-6 are involved in facilitating en-dothelium-oriented transmigration of hematopoietic stem/progenitor cells. Methods:Purified hu-man CD34+ cells were subject to ex vivo transmigration assay and blocking experiments throughtranswell filter inserts coated with human umbilical vein endothelial cells (HUVECs). Four-colorfluorescence-activated cell sorting (FACS) analysis was applied to detect the expression profilesof adhesion molecules and chemokine receptor CXCR-4 on CD34bright cells. Results:Stromal cell-derived factor (SDF)-1-induced transmigrations of both mobilized peripheral blood (mPB)-(56.6±20. 1)% and bone marrow (BM)- (15. 6±1. 8)% derived CD34+ cells were significantlyfacilitated through HUVECs-coated transwell filter insters compared with noncoated ones, whichwere efficiently blocked by preincubation of CD34+ cells with neutralizing antibodies to VLA-5,or VLA-6, or both of them; meanwhile the proportions of migrating CD34+ cells through bothHUVECs-coated and noncoated transwell filter inserts in BM were significantly lower than thosein mPB; the different percentages of migrating CD34+ cells between in mPB and BM were corre-lated with their variable expressions of VLA-5 and VLA-6, but not for VLA-4 or chemokine re-ceptor CXCR-4. Conclusion:Facilitating HS/PCs transmigrations through HUVECs are involvedin both VLA-5 and VLA-6.

Objective Toinvestigatethecorrelationsofthelevelsofplasmasolublereceptorfor advanced glycation end product (sRAGE )with the National Institutes of Health Stroke Scale (NIHSS ), grade of white matter lesions,and risk factors for cerebral vascular disease in patients with acute cerebral infarction.Methods Atotalof120patientswithacutecerebralinfarctionwereenrolledretrospectively. They all underwent head MRI. The plasma sRAGE levels of the acute cerebral infarction group and 120 healthy subjects were detected with enzyme-linked immunosorbent assay (ELISA)and were compared. According to the interquartile range (P25 =540 ng/L,P50 =1030 ng/L,P75 =1400 ng/L ),the plasma sRAGE levels were divided into 4 quartiles (Q1 to Q4). Q1:sRAGE<540 ng/L (n=29),Q2:540 ng/L≤sRAGE≤1030 ng/L (n=31),Q3:1030 ng/L < sRAGE≤1400 ng/L (n =30),and Q4:sRAGE >1400 ng/L (n =30 ). The plasma sRAGE levels in the acute cerebral infarction group and the healthy control group were compared using the Wilcoxon rank sum test. Multiple linear regression analysis was used to analyze the correlations of the sRAGE levels with NIHSS scores,grade of cerebral white matter lesions,and cerebrovascular risk factors. Results (1 )The median level of plasma sRAGE was 870 (540.0,1403. 8)ng/L in the acute cerebral infarction group,which was lower than 1032 (727. 5,1721. 5) ng/L in the healthy control group. There was significant difference (P<0. 05). (2)Single factor analysis showed that the smoking rate,NIHSS scores,the types of deep white matter hyperintensity (DWMH),and the estimated glomerular filtration rate(eGFR)among Q1,Q2,Q3 and Q4 quartiles were significant different (all P<0.05). The smoking rate,ratio of patients with high NIHSS score,incidence of severe DWMH and percentage of the patients with normal eGFR in Q1 (n=29)were 62. 1%(n=18), 44. 8%(n=13),55.2%(n=16)and 51. 7%(n=15),respectively,and they had a higher trend than other quartiles. (3)Multiple linear regression analysis showed that the smoking,NIHSS score,eGFR,and severity of DWMH were the influence factors of the levels of plasma sRAGE in patients with acute cerebral infarction.Thereweresignificantdifferences(allP<0.05).Conclusion Theexpressionlevelsofthe plasma sRAGE in patients with acute cerebral infarction group is significantly lower than those in the healthy subjects,and smoking,neurological defect,eGFR,and severity of DWMH are associated the low level of sRAGE. sRAGE may be used as a reference index for predicting the conditions of acute cerebral infarction.

Objective The purpose of the study is to understand the epidemiology,distribution and molecular characteristics of oxacillin susceptible mecA positive Staphylococcus aureus (S.aureus).Methods Totally 1588 S.aureus isolates collected from 12 hospitals in 10 cities of China between 2010 and 2012 were retrospectively characterized.The isolates were characterized by antimicrobial susceptibility test of 20antimicrobial drugs.Three different methods (cefoxitin disc diffusion,agar dilution for oxacillin and cefoxitin) to detect oxacillin susceptible and mecA positive S.aureus were also compared.All the strains were confirmed to be S.aureus by detecting S.aureus specific genes by PCR (including nuc,femB,and mecA gene),which was viewed as the golden standard of MRSA.The molecular typing methods included SCCmec and spa typing.The statistical analyses were carried out in statistical product and service solutions (SPSS),Version 18.0.The significance level P was set at 0.05.Results According to the MICs of cefoxitin and oxacillin,a total of 60 isolates were oxacillin susceptible methicilin resistance Staphylococcus aureus (MRSA).Based on the differences of the specimen collection date,it is found that oxacillin susceptible MRSA have increased from 2010 to 2012 (P =0.05,95％ CI 0.045-0.056,X2 =6.099).These isolates were distributed in 9 major cities,and the highest prevalence is 30.0％ (18/60) in Guangzhou,followed by Beijing (18.3％,11/60),Wuhan (15.0％,9/60),Hangzhou (13.3％,8/60).Most of the isolates were from skin soft tissue infection (35％,21/60),blood stream infection (30％,18/60) and respiratory infection specimens (18.3％,11/60).The resistance rate to cefoxitin,erythromycin,clindamycin and tetracycline was 100％ (60/60),86.7％ (52/60),66.7％ (40/60) and 50％ (30/60),respectively.The molecular characterization showed that 21 spa and 5 SCCmec types were detected.The most predominant clone was spa t437-SCCmec Ⅳ (25.0％,15/60),followed by spa t437-SCCmecV (13.3％,8/60).Conclusions The detection rate of oxacillin susceptible MRSA is significantly higher from 2010 to 2012.The major clone is t437-SCCmec Ⅳ.The use of cefoxitin should replace oxacillin in detecting this type of MRSA.Further study is needed to confirm whether beta lactam antimicrobial agents should be used in the treatment of oxacillin susceptible mecA positive S.aureus.

Objective To investigate the effect of lacosamide on expression of Nav1 .8 in dorsal root ganglia (DRG) in a rat model of chronic neuropathic pain.Methods Thirty-six female specific-pathogen-free (SPF)SD rats were randomly assigned into 3 groups ( n = 12 each): sham operation group (group S), model group (group M) and lacosamide group (group L) . Chronic neuropathic pain was produced by insertion of a small stainless steel rod (4.00 mm in length and 0.63 mm in diameter) into the L, intervertebral foramen in the rat, producing a chronic steady compression of the DRG in M and L groups. The mechanical threshold was measured 2 days before operation and on the 2, 4, 6, 7, 8, 9 and 10 days after operation (T0-7 ) . Intraperitoneal lacosamide 20mg/kg (in normal saline 0.5 ml) was injected at T4-7, twice a day in S and L groups. In group M, normal saline 0.5 ml was injected at T4-7 twice a day and the mechanical threshold was measured after the last administration everyday . The L, DRG on the operated side was removed after measurement of pain threshold to detect the expression of Na, 1.8 mRNA and protein by RT-PCR and immuno-histochemistry respectively. Results Compared with group S, the mechanical pain threshold was significantly decreased at T1-7 and the expression of Navl .8 mRNA and protein was up-regulated in M and L groups ( P < 0.05) . Compared with group M, the mechanical pain threshold was significantly increased at T4-7 and the expression of Nav 1.8 mRNA and protein was down-regulated in group L ( P < 0.05) . Conclusion The mechanism by which lacosamide reduces chronic neuropathic pain is related to the down-regulation of the expression of Nav 1.8 in rat DRG.

AIM: To investigate the effect of insulin on vascular smooth muscle cells (VSMCs) proliferation and to evaluate the intracellular signaling pathways involved. METHODS; VSMCs separated from Sprague - Dawley rats were used in this study. The proliferation of VSMCs induced by insulin was assayed by [~3H ] - thymidin incorporation. The protein expression and activity of p -ERK1/2 were determined by immunblot and [~(γ-32)P]ATP incorporation. RESULTS: Insulin induced cell proliferation in a concentration - dependent manner. The proliferative effect of insulin on VSMCs was inhibited partly by LY294002 (48.8% ) , an inhibitor of PI -3 kinase, and the ERK1/2 inhibitor PD98059 (43.6% ) , respectively. Moreover, phosphorylation of ERK1/2 and activity of ERK1/2 induced by insulin were also inhibited partly by LY294002.CONCLUSION: PI -3 kinase and ERK1/2 are involved in insulin induced VSMCs proliferation.

AIM: To explore the clinical features of insulin autoimmune syndrome (IAS) induced by methimazole in Chinese population. METHODS: The literature on IAS cases caused by methimazole in the Chinese population published before and after June 30, 2019 was collected for retrospective analysis.RESULTS:The age of onset of men was earlier than that of women, and the sex ratio was 1:2.31 in 95 patients.After taking methimazole 30 mg/d, IAS occurred most from one month to three months,characterized by neuropathic hypoglycemia as the first symptoms at night and early in the morning,blood sugar below 2 mmol/L,insulin concentration≥100 mU/L, IAA positive and no obvious abnormalities in pancreas imaging.The symptoms gradually relieved after symptomatic treatment and stopped taking methimazole. There was no significant difference in the time of hypoglycemia disappearance between the 54 patients who received hormone therapy and non-hormone therapy.CONCLUSION:Methimazole-induced IAS is a clinically rare autoimmune disease. It should be treated promptly occuring hypoglycemia or hyperglycemia during medication.The prognosis of IAS is generally good after proper treatment.

Objective To investigate the clinical effect of proximal femoral nail anti rotation intramedullary nail (PFNA)in the treatment of intertrochanteric osteoporotic fractures in elderly patients.Methods 42 cases of femoral intertrochanteric fracture were treated with proximal femoral nail anti rotation intramedullary nail (PFNA)in cases (AO type,A1 type 13 cases,A2 type 24 cases,type A3 5 cases).Results The group of 42 patients after 12 -36 months of follow -up,the average follow -up time of 18 months,all the patients were healed,1 case of deep venous thrombosis,1 case of mild coxa vara.According to the Harris evaluation standard:excellent 32 cases,good in 9 cases,fair in 1 case,the excellent rate was 97.6%.Conclusion The proximal femoral nail anti rotation (PFNA) anti tensile,anti sliding and anti rotation function is good,and has the advantages of simple operation,small trauma,for osteoporotic intertrochanteric fracture patients can be applied.

Objective To provide the new method for repairing degloving injury of the single finger.Methods From August 2007 to June 2010,eleven patients were repaired with the second free toe dorsal wrap around flap and fibula side flap of great toe.Patients including 9 men and 2 women.The mean age were 31 years(17-49 years).The finger including 6 index fingers,two middle fingers and 3 ring fingers,in which 4 patients were type I and 7 patients were type Ⅱ.All of them were emergency debridement VSD closed negative pressure attraction,surgical repair in 3-5 days after injury.The plantar digital nerve in the second free toe dorsal wrap around flap and fibula side flap of great toe with the digital nerve of the stump by end-to-end nerve anastomosis.The donor sites were covered with a free flap.Results All of 11 flaps survived,but 2 cases developed partial native second toe skin grafting necrosis,by dressing healed,one case of phalanges exposed through survival skin,the part of the exposed phalanx healed after surgical cut.All the 11 patients were followed up from 3 monthes to 3 years.The flaps survived completely with satisfactory cosmetic results and good sensibility.The sensation recovery was reached above S3.The great toe fibular flap for repair of finger pulp full,two-point discrimination was 6-9 mm,the mean was 7.0 mm.Finger flexion function by finger total activity (TAM) score assessment,excellent 9 cases,good 2 cases.Conclusion Transfer of the second free toe dorsal wrap around flap and fibula side flap of great toe to repair degloving injury of the single finger is an ideal method of treatment.

AIM: To identify proteins involved in insulin stimulation and the molecular mechanism of proliferation and migration in vascular smooth muscle cells (VSMCs). METHODS: A series of methods, including 2-D electrophoresis, PDQuest software analysis of 2-DE gels, peptide mass fingerprinting based on matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) and SWISS-PROT database searching, were used to separate and identify the differentially expressed proteins. The difference of some proteins was proved by Western blotting. Proliferation and migration of VSMCs treated with insulin were also observed. RESULTS: DNA synthesis were increased in VSMCs. ~3H-thymidine incorporation in VSMCs from SHR (14.40?0.85) was higher than that in VSMCs from WKY (9.21?0.93, P