Wallerian degeneration of the corticospinal tracts is the anterograde degener-ation of distal axons and myelin caused by the upper motor neuron injury or axonal injury.Stroke is the most common cause of Wallerian degeneration of the corticospinal tracts. Conventional magnetic resonance imaging (MRI) of Wallerian degeneration of the corticospinal tracts is a linear abnormal signal that connects the original lesion along the corticospinal tracts, but the conventional MRI signal does not reveal Wallerian degeneration until 4 weeks after stroke. Diffusion tensor imaging (DTI) detects early Wallerian degeneration of the corticospinal tracts, and dynamically observes the process of pathological changes from early subacute stage to chronic stage. 1his article reviews Wallerian degeneration of the corticospinal tracts on DTI after stroke, especially the effect in early Wallerian degeneration, as well as the values in predicting prognosis and late rehabilitation in patients with stroke.

Objective To investigate the changes in the abilities of invasion and metastasis in surviving human lung adenocarcinoma (A549) cells after X-ray irradiation and the related mechanism.Methods The change in radiosensitivity after X-ray irradiation was determined by colony formation assay.The abilities of invasion and metastasis were evaluated by MTF adhesion assay and Transwell invasion and migration assay in vitro.The mRNA and protein expression of E-cadherin,vimentin,tumor growth factor (TGF)-β1,matrix metalloproteinase (MMP)-2,and MMP-9 was measured by real-time RT-PCR using SYBR Green fluorescence and Western blot.Results The colony formation assay showed that the surviving A549 cells after X-ray irradiation were more resistant to irradiation (ratio of D0 values =0.94).Their abilities of adhesion,invasion,and migration were significantly increased by 1.46 times,1.40 times,and 1.45 times,respectively.In addition,the surviving cells showed enlarged intercellular spaces and had many long pseudopodi.Compared with those in the control group,the mRNA expression levels of vimentin,TGF-β1,MMP-2,and MMP-9 of surviving cells were increased by 1.37 times,2.37 times,1.80 times,and 1.50 times,respectively,the protein expression levels of the above substances were increased by 1.60 times,1.80 times,1.10 times,and 1.20 times,respectively,and the mRNA and protein expression levels of E-cadherin were decreased by 59.4％ and 74.6％.Conclusions The surviving A549 cells after X-ray irradiation have significantly increased abilities of invasion and metastasis.This may be due to radiationinduced TGF-β1 expression increase that in turn promotes epithelial-mesenchymal transition and also due to radiation-induced MMP-2 and MMP-9 expression increase.

AIM: To observe the effect of Qingluo Tongbi Granule(QLTBG)——containing serum on the proliferation of osteoblasts(OB) and osteoclasts(OC),the activity of AKP of OB. METHODS: (1) OB were separated from the skull of SD rats aged 1 d and OC from the thighbone and shinbone of SD rats aged 5 d.(2) The proliferation of OB and OC was detected by MTT method,and the activity of AKP of OB was examined by diazol method. RESULTS: The proliferation capability of OB was strengthened markedly by the rat sera containing 7.2,14.4 g/kg QLTBG,which could reinforce the activity of AKP obviously as well,while the proliferation of OB was inhibited remarkably by the rat sera containing 3.6,7.2,14.4 g/kg QLT. CONCLUSION: The sera containing QLTBG could enhance the proliferation of OB and the activity of AKP,restrain the proliferation of OC simultaneously.

Objective To compare the effects of two positions in the infant megacolon radical operation.Methods Sixty infants undergoing abdominal perineal megacolon radical operation were randomly divided into the control group and the observation group in equal number.The former took the traditional lithotomy position and the latter modified suspended lithotomy position.Results The operative exposures in the observation group were much more sufficient than that of the control group(P<0.05).While adverse skin reactions in the observation group were more uncommon than those of the control group(P<0.05).Conclusion The suspended lithotomy position may provide a better exposure and result in fewer adverse skin reactions during the abdominal perineal megacolon radical operation.

Objective To investigate the short-term clinical outcomes and perinatal risk factors in very low birth weight infants (VLBWI) with delayed enteral feeding (DEF).Methods Three hundred and fifty-five cases of VLBWI admitted to neonatal intensive care unit from Jan 2007 to Oct 2011 served as study objects,and the clinical data of which were analysed retrospectively.According to days to initiate enteral feeding after birth,355 VLBWI were divided into two groups:DEF group (initiate enteral feeds ≥5 days,n =55)and early feeding group (initiate enteral feeds ≤4 days,n =298).The short-term clinical outcomes were compared in 299 cases,including DEF group 44 cases and early feeding group 255 cases,in which cure or improvement were achieved and hospital stay ＞ 14 d.The perinatal risk factors were subjected to univariate and multivariate logistic regression analysis.Results The incidence of DEF was 16.05％ (57/355) in VLBWI.The time to regain birth weight in DEF group was significantly longer than early feeding group [(11.86 ± 3.86) d vs (9.76 ± 3.83) d,P ＜ 0.01],and the incidences of parenteral nutrition associated cholestasis [27.27％ (12/44)] and extrauterine growth retardation at discharge [79.55 ％ (35/44)] in DEF group were also significantly higher than early feeding group respectively [11.76％ (30/255) and 61.57％ (157/255),P ＜ 0.05].Multivariable logistic regression analysis showed that infants born to mother with placental abruption had higher risk of exposure for DEF than those without placental abruption (OR =2.74,95％ CI 1.06 ～7.05,P ＜ 0.05).Similarly,infants with mechanical ventilation had also higher odds of DEF than those with-out mechanical ventilation (OR =3.51,95 ％ CI 1.92 ～ 6.42,P ＜ 0.01).Conclusion Placental abruption and mechanical ventilation are independent risk factors for DEF in VLBWI.Improving neonatal outcome through enhancing obstetric quality and strengthening cooperation between obstetric and neonatology department is still the key to reduce DEF in VLBWI.

Objective To evaluate the clinical effect of salmeterol xinafoate and fluticasone propionate powder for inhalation combined ipratropium bromide aerosol in patients with stable chronic obstructive pulmonary disease (COPD).Methods One hundred and twenty patients with stable COPD was randomly divided into control group and observation group with 60 patients each.The control group was received ipratropium bromide aerosol inhalation,and the observation group was given salmeterol xinafoate and fluticasone propionate powder for inhalation and ipratropium bromide aerosol for 6 months.BODE index,SGRQ scores,plasma cortisol and bone mineral density were compared between two groups before and after treatment.Results BODE index scores had no significant difference between two groups before treatment (P＞0.05).After treatment,BODE index scores,dyspnea scale,FEV1％,6MWD and BODE index total scores in observation group were superior to those in control group [ (1.9 ± 0.5) grades vs. (2.3 ± 0.5)grades,(58.5 ± 7.3)％ vs.(50.4 ± 6.2)％,(411.1 ± 56.8) m vs.(347.5 ± 60.4) m,(3.3 ± 1.0) scores vs.(3.8 ± 1.3 ) scores ],there were significant differences (P＜0.05 ).SGRQ scores had no significant difference between two groups before treatment (P＞0.05 ).After treatment and in SGRQ scores,respiration symptom,limitation of activity,disease influence scores in observation group were significantly lower than those in control group [ (20.7 ± 10.3 ) scores vs.(37.9 ± 14.4) scores,(20.7 ± 9.5 ) scores vs.(34.8 ± 13.0) scores,(16.3 ± 6.7) scores vs.(27.2 ± 11.8) scores,(17.5 ± 7.0) scores vs. (34.6 ± 12.3) scores],there were signiticant differences (P＜0.01 ).There were no significant difference of plasma cortisol and bone mineral density between two groups (P＞0.05).Conclusions Salmeterol xinafoate and fluticasone propionate powder for inhalation and ipratropium bromide aerosol in patients with stable COPD can greatly improve the lung function and life quality and with less adverse reaction.

OBJECTIVETo study the effect of total saponins from Rhizoma Dioscoreae nipponicae (RDN) on the expression of stroma cell derived factor 1 (SDF1) and IKB kinase (IKK) in rIL-1beta induced fibroblast-like synoviocytes (FLS).

METHODSFLS were primarily cultured and the 3rd generation log phase growth FLS were divided into the normal control group, the model group, and the medication group. 10 microg/L rIL-1beta was used to induce the proliferation of FLS in the model group.10 microg/L rIL-1beta and 100 microg/L RDN were administered to co-incubate FLS in the medication group. No treatment was given to FLS in the normal control group. Expression levels of SDF1 and IkapaB kinase proteins (p-IKK) were detected using Western blot.

RESULTSExpression levels of SDF1 and p-IKK increased significantly higher in the model group than in the normal control group (P<0.01). Compared with the model group, expression levels of SDF-1 and p-IKK significantly decreased in the medication group (P <0.01).

CONCLUSIONSTotal saponins from RDN could inhibit the activation of both SDF1 and p-IKK. It might further regulate the expression of IKB kinase by regulating the expression of SDF1.

Cells, Cultured ; Chemokine CXCL12 ; metabolism ; Dioscorea ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Epithelial Cells ; Fibroblasts ; Humans ; Interleukin-1beta ; metabolism ; Saponins ; metabolism ; Synovial Membrane ; metabolism

Objective To analyze the basics and influencing factors for the medical expenditure of poor patients of tumor and end-stage renal diseases in Hubei province,and put forward policy recommendations for the critical illness insurance and health poverty alleviation.Methods 535 patients with tumor and end-stage renal diseases in Wuhan,Xiangyan and Shiyan in Hubei province were selected for a questionnaire survey,with 415 of the questionnaires subject to data analysis.Single factor variance analysis and multiple linear regression were used to analyze the influencing factors for their medical expenditure.Results 83.9% of the patients held their medical costs as too high;84.6% of them complaining significant drop of their annual family income due to their diseases; disposable household income of urban patients higher than their rural counterparts both before and after their disease; types of medical insurance and diseases are significant influencing factors for medical expenditure.Conclusions Poverty rate is high among patients of such patients.To reduce their financial burden,the government is recommended to cover more major diseases,enhance support for those of critical illness and improve the medical assistance system.

OBJECTIVE:To improve rational drug use and reduce potentially inappropriate medication (PIM). METHODS:PIM of 700 elderly inpatients in internal medicine department of our hospital was evaluated by Beers criteria(2012 edition)and STOPP/START criteria. RESULTS:700 inpatients whose mean ages were (76.3 ± 7.2) years old took (12.1 ± 4.9) kinds of drugs per patient. 144 cases involved PIM(20.6%). The number of PIM was 220 in total,among which there were 117 cases/times relat-ed to drugs and 22 cases/times related to disease in according to Beers criteria,9 cases/times of STOPP and 72 cases/times of START. Drug with most frequency of PIM in accordance with Beers was benzodiazepines and most frequency in STOPP was thia-zides that used by patients with gout histonry. The most omission frequency of START prescription were absence of metformin thera-py for type 2 diabetes and absence of antiplatelet therapy for diabetes complicated with cardiovascular risk. CONCLUSIONS:A high prevalence of PIM in elderly inpatients in our hospital requires various measures to prevent its occurrence.

Objective We observed influence of different handgrip exercise on the changes of blood flow velocity and blood vessel diameter of basilic vein before and after the PICC placement and discuss the best model for handgrip exercise.Methods 60 patients with PICC were chosen and divided into group A,B and C with 20 patients in each groups.Group A received routine guidance on unarmed handgrip exercise,group B used electronic handgrip,the frequency was 25 times/min,the time period was 2 min with 4 times a day,once every 4 hours,group C adopted the same model as that of group B and 6 times a day,once every 3 hours.The venous blood flow velocity and blood vessel diameter was measured by pulsed Doppler ultrasound one hour before the PICC placement and one hour,1 day,3 days,7 days,10 days,14 days,21 days after placement.Results The venous blood flow velocity before and after PICC placement had statistically significant differences at different time points (F=2.934,P ＜ 0.05).The effect of group B and C was better than that of the group A and group C showed the best effect.The blood vessel diameter before and after PICC placement had significant differences at different time points(F=3.940,P ＜ 0.05).There was significant differences in the blood vessel diameter 1h before and 1h after PICC placement.Conclusions Handgrip exercise can effectively promote the upper limb venous blood flow velocity in patients with PICC,but shows little effect on the blood vessel diameter.Using the electronic hand grip in weak tap position,25 times/min,2 min every time,and 6 times a day (once every 3 hours),can obviously promote the upper limb venous blood flow velocity.