Objective To observe the effect of hyperbaric oxygen on choline acetyltransferase ChAT levels in the neurons of rats with traumatic brain injury. Methods Traumatic brain injuries were modeled in rats using Feeney's method. Thirty male rats were randomly divided into 3 groups: a traumatic brain injury group (group A) , a traumatic brain injury plus hyperbaric oxygen ( HBO) group ( group B) , and a sham operation group (group C). Samples of each rat's brain were tested for ChAT using immunohistochemical staining and light microscopy. Results ChAT-positive fibers in the hippocampus almost vanished after traumatic brain injury, but positive fibers were markedly increased after HBO treatment. Conclusion HBO treatment can activate neurons in the hippocampus and inhibit regression of cholinergic neurons, which may be one of the mechanisms by which HBO therapy improves learning ability in injured rats.

Objective To explore the correlation between P300 and cognition, and to analyze its clinical meaning. Methods Thirty patients with traumatic brain injury diagnosed with a definite trauma history were recruited as the experimental group, and 20 normal subjects served as controls. All were examined with event-related potentials and the neurobehavioral cognitive status examination ( NCSE ). After two months of regular rehabilitation treatment, they were examined again with the same methods to observe any changes. Results N200 and P300 latencies in the experimental group were significantly longer compared with the control group, while the NCSE scores in the experimental group were significantly lower than in the control group. After two months of regular treatment, the NCSE scores rose and N200 and P300 latencies were significantly shorter than before. The P300 latencies and the NCSE scores were observed to be significantly correlated (r=-0.679,P≤0.01 ). Stepwise regression and multiva-riate analysis revealed that orientation ability and judgment were the components of the NCSE most closely correlated with the P300 latencies. Conclusion P300 latency can serve for the evaluation of cognition due to its significant correlation with orientation ability and time and space judgment.

BACKGROUND: To predict the functional outcome basing on hospitalization data as earlier as possible has important significance for evaluating the prognosis and discharged recovery. In recent years, researches on the balance function of stroke patients has drew more and more attentions, but less related reports about the relationship between balance and discharge functional outcome are available.OBJECTIVE: To predict the discharg functional outcomes of stoke patients basing on hospitalization data, as well as the relationship between it and scores for Fugl-Meyer balance(FMB) and Berg balance scale(BBS).DESIGN: Multiple factors and multi-variable study based on patient' s clinical presentation.SETTING: Rehabilitative department in a college hospital.PARTICIPANTS: Between August 2002 and May 2003, 40 patients with stoke for the first time were hospitalized in Rehabilitative and Neurological Department of Tongji Hospital, who accorded with the enrolling standards.METHODS: The available hospitalization data and discharge functional outcomes were subjected to single factor and multiple factor analysis, and collected data includes the history of disease, physical examination, scores for FMB and BBS when hospitalization, scores for daily life ability(ADL)and functional independence measure(FIM) . Functional outcome was presented by the discharge FIM.MAIN OUTCOME MEASURES: Simple correlative analysis of BBS, FMB and FIM, regressive analysis of discharge FIM influencing factors.RESULTS: Simple liner correlative analysis indicted that scores for BBS and FMB was strongly correlated with the scores for FIM at hospitalization and discharge( P ＜ 0. 001 or P ＜ 0.05), regressive analysis revealed that scores for FIM, ADL and BBS at hospitalization could be used for predicting the discharge functional outcomes of stroke patients.CONCLUSION: Predictors for discharge functional outcomes includes scores for FIM, ADL and BBS when hospitalization, which are closely correlated with BBS.

Objective To observe the effects of hyperbaric oxygen (HBO) exposure on the expression of aquaporin-1 (AQP1) and aquaporin-5 (AQP5) in rats with simulated high-altitude pulmonary edema (HAPE).Methods Fifty-six rats were randomly divided into five groups:control (normal),HAPE (high altitude pulmonary edema model),1 HBOT (HAPE model and HBO therapy for 1 time),2 HBOT (HAPE model and HBO therapy twice) and NOT (normal pressure oxygen therapy) groups,and was intervened accordingly.Western blotting and real-time PCR techniques were used to analyze the expression of AQP1 and AQP5 in their lungs.The wet-todry (W/D) weight ratio and morphology of the lungs was also examined.Results The protein and gene expression of AQP1 and AQP5 in the HAPE group decreased significantly compared with the control group.There were obvious differences in the protein and mRNA expression of AQP1 and AQP5 between the 2 HBOT group and the HAPE group and between the 2 HBOT group and the 1 HBOT group.Compared with the control group and the 1 HBOT group,marked lung injury could be seen in the HAPE group.Compared with the NOT group and the 1 HBOT group,lung injury in the 2 HBOT group was relieved significantly.Conclusions HAPE in rats is associated with down-regulation of the expression of AQP1 and AQP5 in the lungs.This down-regulation can be attenuated and lung injury can be alleviated by HBOT.Two sessions of HBOT could be more helpful than one for promoting this improvement.

Objective To analyze the relevant factors influencing 18F-FDG uptake in the primary lesion of breast invasive ductal carcinoma (BIDC).Methods A total of 160 female patients underwent 18 F-FDG PET/CT examination from 2010 to 2015 and breast lesions were revealed.Lesions were divided into benign group (n =118) and malignant group (n =49,BIDC) according to pathological results.KruskalWallis H test and Mann-Whitney u test were performed to compare SUVmax of the two groups,and to investigate the relationship between the SUVmax of breast malignant lesion and patients' age as well as clinical pathological parameters including T stage,lymphatic vessel invasion,nuclear grade,route of metastasis,ER,PR,HER2 and Ki-67 expression,and subtype of breast cancer.The diagnostic efficiency of 18F-FDG PET/ CT in differentiating benign and malignant breast lesions was analyzed using ROC curve analysis.Results The SUVmax of BIDC was 6.09(3.88,9.26),higher than that of breast benign lesion (1.35 (0.95,2.35);u=341.0,P＜0.05).The SUVmax of BIDC showed statistically significant difference between groups with different T stage,with or without lymphatic vessel invasion,with different nuclear grade,different routes of metastasis and different Ki-67 expression (u:117.5-209.5,H=7.70,P＜0.01 or 0.05).For all breast lesions,lesions with the maximum diameter ≤ 2.0 cm and lesions with the maximum diameter ＞2.0 cm,the optimum cutoff values of SUVmax were ＞2.60,＞ 1.71 and ＞3.97,respectively.When the optimum cutoff values of SUVmax for breast lesions with the maximum diameter ≤2.0 cm were selected as ＞ 1.71 and ＞2.60,the Youden indexes were 0.66 and 0.61(z=0.566,P＞0.05).When the optimum cutoff values of SUVmax for breast lesions with the maximum diamter ＞2.0 cm were selected as ＞3.97 and ＞2.60,the Youden indexes were 0.89 and 0.81(z=0.748,P＞0.05).Conclusions T stage,lymphatic vessel invasion,nuclear grade,route of metastasis and Ki-67 expression of BIDC influence the uptake of 18F-FDG by tumor tissues.The SUVmax of the primary lesion of BIDC is related to the size of lesion,and thus the diagnostic threshold of SUVmax should be decreased appropriately for small lesions.

Objective To evaluate the value of whole body 18F-FDG PET/CT in the detection of recurrence/metastasis of cervical cancer.Methods A retrospective study was performed on 95 patients with cervical cancer who underwent 18F-FDG PET/CT after treatment.The lesion characteristics on 18F-FDG PET/CT were assessed visually and semi-quantitatively.A final diagnosis was confirmed by histopathology,diagnostic treatment and clinical follow-up imaging.The data were analyzed by Kappa test.Results 18 F-FDG PET/CT was positive in 54 patients,including 24 with local recurrence and 30 with distant metastases.The sensitivity,specificity and accuracy of 18F-FDG PET/CT for the detection of recurrence/metastasis of cervical cancer were 98.1％ (52/53),95.2％ (40/42) and 96.8％ (92/95),respectively.The positive predictive and negative predictive value were 96.3％ (52/54) and 97.6％ (40/41),respectively.18F-FDG PET/CT showed concordant results with pathological/clinical follow-up findings (Kappa =0.936,P＜0.05).Conclusion 18F-FDG PET/CT is a sensitive and specific modality for the detection of recurrence/metastasis of cervical cancer and might be useful for further treatment plan.

Objective To study the effect of hyperbaric oxygen (HBO) on the proliferation and differentiation of neural stem cells (NSCs) in rats after middle cerebral artery occlusion (MCAO).Methods Seventy-two adult,male,Sprague-Dawley rats were randomly divided into a control (CON) group,a hyperbaric air (HBA) group,a normobaric oxygen (NBO) group and a hyperbaric oxygen (HBO) group.All were subjected to MCAO.Rats in the CON group did not receive any treatment; those in the other groups were treated with HBA,NBO or HBO daily beginning 2 hours after the operation.Western blotting was applied to detect the expression of nestin,MAP2 and GFAP at 2,3,7 and 14 days after the MCAO.Results The expression of nestin in the HBO group was significantly higher than in the other groups on the 3rd,7th and 14th days.It peaked at day 3 but remained high until day 14.Similarly,expression of MAP2 was significantly higher than in the other groups at least until day 14.GFAP expression was significantly lower than in the other groups.Conclusion HBO can increase neural stem cell proliferation and neuronal differentiation,and inhibit the proliferation of astrocytes.

BACKGROUND: After the damage of central nervous system, F-waves of electromyography is the valuable way for detecting tendon reflex and muscular tension below injured segment. The increase of spasm, stiffness and muscular tension induced by upper motor neuron injury can revoke change of F-waves.However, change of F-waves after spinal injury, and relationship between Fwaves and spasm of lower limb after injury are still unclear at present.OBJECTIVE: To analyze the correlation of minimal latency, occurrence rate and every index of dispersion-time degree of F-waves with post-injured spinal cord spasm in patients with spinal injury.DESIGN: Case-control observation.SETTING: Department of Rehabilitative Medicine, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology.PARTICIPANTS: Totally 29 patients with traumatic spinal cord injury,who were hospitalized at Department of Rehabilitative Medicine, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology between June 2002 and March 2004, were selected as spinal injury group. Another 29 normal healthy volunteers were enrolled as normal control group in the same period. METHODS: Spasm level of both lower extremities in patients with spinal injury was graded with Ashworth scale to assess flexion of both coax, flexion of knee joint and Ashworth grade of dorsiflexion of ankle. F-waves was detected with Kepoint1.5 type EMG instrument produced by Denmark.Minimal latency, maximal latency and occurrence rate of F-waves of tibial nerve of both lower extremities were recorded. The discrete-time degree (difference value of maximal latency of F-waves and minimal latency of Fwaves) and mean occurrence rate of F-waves were calculated.MAIN OUTCOME MEASURES: The difference of each index between patients with spinal injury and normal persons was compared and the correlation of spasm with discrete-time degree, occurrence rate and minimal latency of F-waves in patients with spinal injury was analyzed.RESULTS: A total of 29 patients and 29 normal persons were involved in the result analysis. ①The discrete-time degree of F-waves in patients with spinal injury was higher than that in the normal persons, which had significant difference [(9.2±1.9), (6.7±1.0) ms, P ＜ 0.000 1]. ②The occurrence rate of F-waves in patients with spinal injury was lower than that in normal persons, which had significant difference [(84.5±6.2)%, (89.5 ±5.7)%, P ＜ 0.05]. ③The minimal latency of F-waves in patients with spinal injury was higher than that in normal persons, which had insignificant difference ( P ＞ 0.05). ④The discrete-time degree of F-waves in patients with spinal injury had positive correlation linearly with score of spasm Ashworth (r=0.790 31, P＜ 0.000 1). The occurrence rate of Fwaves in patients with spinal injury had positive correlation linearly with score of spasm Ashworth (r=0.742 03, P ＜ 0.000 1 ). The minimal latency of F-waves in patients with spinal injury had insignificant correlation with score of spasm Ashworth (r=0.081 68, P ＞ 0.05).CONCLUSION: The discrete-time degree and occurrence rate of F-waves can be used as sensitive index to evaluate electrophysiology in patients with spinal injury so as to assess the level of spasm in patients with spinal injury.

Objective To investigate the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) at different intensities on the ultrastructure of an ischemic brain penumbra and the expression of brainderived neurotrophic factor (BDNF) using rats with permanent middle cerebral artery occlusion (MCAO).Methods Forty-two rats were randomly divided into a blank control group,an MCAO model control group,a sham stimulation control group and an rTMS group.The rTMS group was divided further into 3 subgroups:an 80％ of motor threshold (MT) subgroup,a 100％ of MT subgroup and a 120％ of MT subgroup.The cerebral infarction model was established by right MCAO.rTMS treatment was given 24 hours after the MCAO model was successfully established.The rTMS group and sham stimulation control group were given 20 Hz rTMS with the planned intensities.The MCAO model control group was not given any stimulation.After 14 days of treatment,transmission electron microscopy,immunohistochemical and Western blotting ( WB ) methods were used to investigate the ultrastructure of the ischemic penumbra and the expression of BDNF.Results Damage reflected in the ultrastructure in the 3 rTMS subgroups was less than in the model control group and the sham stimulation control group.Expression of BDNF protein increased significantly in 100％ of the MT group and blank control group rats as compared with that in the sham stimulation control group,while the blank control group and the 3 rTMS subgroups had no statistically significant difference in comparison with the MCAO model control group.The expression of BDNF protein had no statistically significant difference between any of the groups.Conclusion 20 Hz rTMS might,especially at 100％ of the MT,promote the recovery of the ultrastructure of neural tissues in the ischemic penumbra after acute cerebral infarction and enhance the expression of BDNF in the ipsilesional hemisphere.This may be one of the important mechanisms of rTMS's effectiveness in the treatment of ischemic stroke.

Objective To investigate the effects of 20 Hz repetitive transcranial magnetic stimulation (rTMS) with different intensities on neurobehavior and expression of glial fibrillary acidic protein (GFAP) in ischemic penumbra of rats with cerebral infarction,so as to explore the probable mechanism. Methods Forty-three rats were randomly divided into a blank control group( n =7 ),a model control group( n =7),a sham stimulation control group(n =8) and a rTMS group (n =21) ; the rTMS group was further subdivided into 3 subgroups:80％ MT subgroup,100％ MT subgroup and 120％ MT subgroup,with 7 rats in each subgroup.The cerebral infarction model was established by right middle cerebral artery occlusion (MCAO) in each group except the blank control group.The 3 rTMS subgroups were given 14 successive blocks of 20 Hz rTMS with corresponding intensity.The sham stimulation control group received sham treatment (without any output).The model control group was given no stimulation,and the blank control group did not receive any special treatment.Functional assessments were performed at 3 different time points.After 14-day treatment,the expression of GFAP proteins in ischemic penumbra were detected by immunohistochemistry technique. Results Functional outcome reflected from 3 behavioral tests in 100％ MT subgroup after 14-day stimulation was better than 1 day after operation,while in the other rTMS subgroups functional outcomes were just better in 2 behavioral tests.The expressions of GFAP in 3 rTMS subgroups were all less than that in model control group. Conclusions The 20 Hz rTMS with 80％ MT and 100％ MT might be safe and effective to improve the functional outcome in rats with acute cerebral infarction,especially 100％ MT.Decrease of expression of GFAP in ischemic penumbra might be one of the mechanisms of beneficial effects of rTMS in ischemia brain injury.