Malnutrition is significantly correlated with the high mortality and other poor outcomes of stroke;in turn,stroke can increase the incidence of malnutrition.Old age and swallowing dysfunction are independent risk factors of post-stroke malnutrition.The sequential nutritional support with enteral nutrition and parenteral nutrition can reduce or avoid the complications of both malnutrition and stroke,and therefore should be considered for stroke patients,especially those who are critically ill.

Risk factors related to malnutrition were prospectively studied in 82 cases with acute ischemic stroke in our hospital during December 1,2007 and December 31,2008. The incidences of malnutrition on the first and ( 14 ± 1 )th day were 18% (15/82) and 30% (25/82). Study showed that age ( P = 0. 007 ), dysphagia ( P = 0. 043 ), malnutrition on admission ( P = 0. 003 ) were risk factors related to malnutrition on the ( 14 ± 1)th day after admission; there was no interaction between dysphagia and the other two factors, dysphagia was an independent risk factor related to malnutrition after acute ischemic stroke.

Objective To screen the valid plasmid targeted toGCN5 among the constructed recombinant plasmids;and to explore the effects of histone acetylizad modification in regulating MSCs differentiation.Methods Exstract the constructed plasmids and transfect them into MSCs induced by 5-aza.For 24 h,observe MSCs;detect the transfect efficiency by flow cytometry;detect expression of protein GCN5 by Western-blot;detect the HAT activity by ELISA.Results Transfect efficiency was more than 20%;Expression of protein GCN5 and HAT activity had no difference in group ZJ1 and ZJ2,but had a significant difference to that in group ZJ3.HAT activity of experiment group was significantly lower than that of control groups.Conclusion The inhibition state of histone acetylation results in plasmid ZJ3,it can inhibit the differentiation process of MSCs.The results provide data for the clinical application of MSCs transplantation.

Objective To observe the effect of trichostatina to induce mesenchymal stem cells(MSCs) differentiating into cardiomyocyte cells and to explore the potential interference approaches.Methods MSCs were incubated with different concentrations of TSA and different time,then to detecte the histone deacetylase(HDAC) activity;the differentiation of MSCs was observed by phase-contrast mictmcopy;fluorescence immunohistochemistry assessed cardiac troponin T and RT-PCR detected the expression of Nkx-2.5,GATA-4 genes.Results HDAC activity was the lowest when incubated with 300 nmol/L TSA for 24 hours,expression of cTnT of the cells was enhanced after incubation with TSA.The expression of Nkx-2.5,GATA-4 genes was enhanced before interference.ConclusionTSA can promote MSCs to differentiate into cardiomyocyte cells in vitro in an optimized condition.

In this paper,the attachment of a China-made removable clear orthodontics appliances are introduced. The clinical attachment positions and considerations were illustrated with clinical pictures. A typical case was attached for demonstration.

BACKGROUND:The higher long-term absorption rate greatly influence the widely application of fat transplantation. Platelet-rich plasma contains a high concentration of growth factors, which benefits to the tissue healing and regeneration. OBJECTIVE:To observe the effects of platelet-rich plasma on grainy fat transplantation and to investigate the mechanisms preliminarily. METHODS:Ten 6-week-old nude mice were prepared. The right or left dorsal subcutaneous tissues were randomly selected as the platelet-rich plasma group (0.5 mL fat granule+0.1 mL platelet-rich plasma), and the contralateral side was regarded as the control group (0.5 mL fat granule+0.1 mL phosphate-buffered saline). At 10 and 90 days after implantation, five nude mice were selected from each group, and then the mice were sacrificed to obtain the grafts in each group for general appearance observation, volume determination and histological detection. Furthermore, we isolated adipose-derived stem cells from human subcutaneous fat tissue during the in vitro experiment. Cel counting kit-8 and real-time PCR were used to evaluate the influence of platelet-rich plasma on adipose-derived stem cel proliferation and adipogenic differentiation in vitro, respectively. RESULTS AND CONCLUSION:Comparison of the grafts obtained at 10 and 90 days after implantation, the residual volume in the platelet-rich plasma group was significantly larger than that in the control group (P<0.05), Moreover, more normal adipocytes and capil ary formation were observed in the platelet-rich plasma group (P<0.05). For in vitro experiment, platelet-rich plasma could significantly improve adipose-derived stem cel proliferation, and the expressions of adipogenic-related genes were up-regulated in platelet-rich plasma-induced adipose-derived stem cells. Al results demonstrate that platelet-rich plasma can improve the survival of fat grafts,which might be closely related to that platelet-rich plasma can promote the proliferation and adipogenic differentiation of adipose-derived stem cells and the revascularization in grafted fat tissue.

OBJECTIVETo evaluate clinical significance of waist soft tissue tension detection in treating chronic nonspecific low back pain.

METHODSFrom August 2011 to March 2012,60 patients with chronic nonspecific low back pain were divided into two groups (sliver needle group and TCM fumigation group) according to propotion of 1:1. In sliver needle group, there were 17 males and 13 females aged from 28 to 55 years old with an average age of (45.70 +/- 4.15), treated with sliver needle; In TCM fumigation group,there were 19 males and 11 females aged from 27 to 55 years old with an average age of (43.03 +/- 5.86), treated with TCM fumigation. Changes of force-displacement distance (FDD), specific absorption rate (S) of two groups were observed before treatment, 1 week and 3 months after treatment respectively, VAS scoring and Roland-Morris disability questionnaire (RMDQ) were used to access clinical effects.

RESULTS(1) VAS score of silver needle group was 4.77 +/- 0.78, 1.99 +/- 1.08 and 2.55 +/- 0.94, respectively before treatment, at 1 week and 3 months after treatment,while VAS score in TCM fumigation group were 4.43 +/- 0.61, 2.48 +/- 0.71 and 3.05 +/- 0.86, respectively. VAS score of two groups after treatment were sigificant decrease than that of before treatment (P < 0.05). There was no sigificant differences between two groups before treatment, but sliver needle group performed well in analgesia than TCM fumigation group, and had obvious differences (P < 0.05). RMDQ score of silver needle group was 13.63 +/- 1.96, 5.87 +/- 2.33 and 6.53 +/- 2.89, respectively before treatment, at 1 week and 3 months after treatment, while RMDQ score in TCM fumigation group were 13.40 +/- 2.01, 6.90 +/- 2.31, 9.23 +/- 2.87, respectively. There was no significant differences between two groups before treatment and 1 week after treatment (P > 0.05), and had obvious differences between two groups at 3 months after treatment (P < 0.01). Both groups could obvious improve dysfunction caused by chronic low back pain, and curative effect of sliver needle groups was more endurable. (2) Following-up at 3 months after treatment, FDD of multifidus, erector spinae of effected side and multifidus of healthy in sliver needle group were obvious increased (P < 0.05); In TCM fumigation group, FDD of multifidus and erector spinae on both side were increased at 1 week after treatment (P < 0.05), but had no significant meaning at 3 months after treatment on health side (P>0.05). There was no significant meaning before treatment (P > 0.05), FDD of multifidus, erector spinae of effected side in sliver needle group were obvious increased at 1 week after treatment (P < 0.05); but no obvious meaning on health side. FDD of both side in sliver needle group were obvious increased at 3 months after treatment. (3) There was correlation among differences of FDD in multifidus and erector spinae, VAS score and differences of RMDQ, and Spearman correlation coefficient R was 0.517, 0.811, 0.746 and 0.625; There was correlation between items of soft tissue tension and sympotoms, function and life quality. Conclusion:Soft tissue tension detection can effectively manifest degree of pain and dysfunction of low back, and improve objectivity of therapeutic evaluation for chronic low back pain.

Acupuncture Therapy ; instrumentation ; Adult ; Aged ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; Female ; Humans ; Low Back Pain ; drug therapy ; physiopathology ; therapy ; Male ; Middle Aged ; Muscle Tonus ; drug effects ; Needles ; Paraspinal Muscles ; drug effects ; physiopathology

OBJECTIVETo observe the clinical effect of Huikangling Tablet (HT, extracted from Scabrous Patrinia root) on peripheral blood micrometastasis of differentiated thyroid carcinoma (DTC) patients.

METHODSTotally 87 DTC patients with positive micrometastasis were randomly assigned to the treatment group (45 cases) and the control group (42 cases). DTC endocrine inhibition treatment standards were executed in all patients. They all took levothyroxine sodium (50 microg/tablet, from low dose, 25 microg each time, once per day, 0.5 h before breakfast), and its dosage was gradually added one week later. The dosage was adjusted according to tested results of TSH combined recurrence risk stratification and endocrine suppression induced adverse reactions risk stratification. Patients in the treatment group took HT (0.4 g per tablet, 3 tablets each time, three times per day for a total of 12 weeks) combined TSH suppression therapy, while those in the control group only received TSH suppression therapy. Peripheral micrometastatic cytokeratin 19 (CK19) and polymorphic epithelial mucin1 (MUC1) were detected by FCM at week 4 and 12. Meanwhile, distant metastasis and adverse reactions were observed.

RESULTSAfter 4-week treatment positive micrometastasis was shown in 18 cases (40%) of the treatment group and 29 cases (69%) in the control group with statistical difference (chi2 = 5.68, P < 0.05). After 12-week treatment positive micrometastasis was shown in 7 cases (15.6%) of the treatment group and 17 cases (44.7%) in the control group with statistical difference (chi2 = 8.49, P < 0.01). Pulmonary metastasis occurred in 2 cases and bone metastasis in 1 case of the control group at follow-ups. Cervical lymph node metastasis without accompanied recurrence of thyroid cancer occurred in one case of the treatment group. No obvious liver or renal abnormalities occurred.

CONCLUSIONHT inhibited peripheral blood micrometastasis of DTC patients and its mechanism needed to be further studied.

Antineoplastic Agents ; pharmacology ; therapeutic use ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans ; Neoplasm Micrometastasis ; drug therapy ; Neoplasm Recurrence, Local ; Tablets ; Thyroid Neoplasms ; drug therapy

Objective To investigate cause analysis and treatment strategy of cage migration after lumbar interbody fusion.Methods Retrospective study was performed on 9 cases with cage migration after lumbar interbody fusion from January 2009 to February 2015 in our hospital.There were 4 males and 5 females,and mean age was 61.6 years (rang,38-75 years).The types of cage included Titanium metal cage used in 3 cases,cylindrical thread cage in 1 case and PEEK cage in the other cases.Bilateral instrumented posterior lumbar interbody fusion was found in 7 cases,and unilateral fixation in 2 cases.Analyze the risk factors of cage migration and the strategies of revision surgery,and evaluate the radiological outcomes and clinical efficacy of revision surgery.Results Risk factors of cage backward migration are as follows:nucleus pulposus left too much in 6 cases,poor cartilage endplate resection in 4 cases,small size of cage selection in 5 cases,unsatisfied cage placement in 2 cases,and improper operation in 1 case.Follow-up survey was fulfilled in all patients,the follow-up time was 6 to 32 months,and bony union was detected in all patients.No cage re-migration,non-fusion,or loosen pedicle screw was found during follow-up period.Clinical symptoms were all improved after revision.Conclusion The causes of cage migration after bilateral or unilateral instrumented transforaminal lumbar interbody fusion were complicated.Risk factors of cage migration may be poor intervertebral space preparation,small cage size,and improper cage placement,which may be not associated with unilateral fixation.Excellent or good radiological outcomes and clinical efficacy depend on a reasonable revision surgery.