Objective To detect the percentage of cultured neuron apoptosis after the neurons were treated with anoxia and specific inhibitors of protein kinase A (PKA) and protein kinase C (PKC). Methods After establishment of the model of neurons cultured under hypoxic condition, the neurons were cocultured with different concentrations of Rp-cAMP and Calphostin C, specific inhibitors of protein kinase A and C, respectively. Then neurons were cultured under an ischemic condition until the number of survived neurons, the activity of mPKA,and mPKC, and the apoptotic neurons stained by TUNEL in each group were observed. Results The activity of mPKA and mPKC significantly increased after the onset of hypoxia. With the increases in concentrations of Rp-cAMP or Calphostin C, the percentage of apoptotic neurons obviously decreased or increased, respectively. Conclusion The pathways of PKA and PKC signal transduction may participate in the hypoxic neuron injury. The functions of these two kinases are opposite for apoptotic regulation. It suggests that the signal transduction of PKA and PKC in hypoxic neurons belongs to a monophasic controlling system and the ratio of PKA to PKC in cells may determine the survival of hypoxic neurons.

BACKGROUND: Botulinum toxin A has been applied to treat muscular convulsion by local injection and shows obvious effects in reducing muscular hypertonia with fewer side effects.OBJECTIVE: To assess the effect of botulinum toxin A on Meige's syndrome concerning facial convulsion, therapeutic effect, and side effects.DESIGN: Randomized self-control clinical study.SETTING: Neurological Department of Southwest Hospital Affiliated to the Third Military Medical University of Chinese PLA.PARTICIPANTS: Between June 2000 and May 2003, 24 outpatients were confirmed of having Meige's syndrome at the Neurological Department of Southwest Hospital, the Third Military Medical University of Chinese PLA and volunteered to receive botulinum toxin A (BTA) injection. Meige's syndrome was presented by convulsive eyelid closure in 10 cases, grinding teeth and smacking movement in 3 cases, involuntary blinking in 2 cases,frowning in 1 case, and mixed manifestations in 8 cases.METHODS: Totally 24 patients with Meige's syndrome were subjected to BTA injection at multiple spots of convulsive muscles by dosage of 2.5-5 U in each spot. Improvement of facial convulsion and curative effects were assessed at least once by clinical examination or telephone follow-up. Convulsion was graded in four degrees according to Cohen's scaling standard.Curative effects: [1] Complete alleviation: Convulsion was reduced to grade 0. [2] Obvious alleviation: Convulsion dropped by more than two grades. [3]Partial alleviation: Convulsion dropped by one grade. [4] Ineffective: Convulsion was not attenuated.MAIN OUTCOME MEASURES: [1] Changes of muscular convulsion intensity after BTA injection in patients with Meige's syndrome; [2] improvement of various symptoms after BTA injection; [3] side effects of BTA.RESULTS: Totally 24 patients entered the result analysis. [1] Before treatment, there were one case of grade 0- Ⅰ, 7 cases of grade Ⅱ, 10 cases of grade Ⅲ and 6 cases of grade Ⅳ, as compared to 16, 6, 2 and 0 cases, respectively, after treatment (χ2 = 95.489 4, P = 7.313 41×10-10). [2] BTA could alleviate eyelid convulsion in an average of 3 days, with curative effect reaching the peak in 2 weeks. Symptoms were found to be completely alleviated in 75% (18/24), obviously alleviated in 17% (4/24) and partially alleviated in 8% (2/24), with the total efficiency of 100%. The effective duration was 8-44 weeks with the average of 24.4 weeks. [3] Muscle weakness at the injected spot and incomplete muscular paralysis at the uninjected spots occurred for a short time after injection, but were alleviated automatically within 1-8 weeks.CONCLUSION: BTA can obviously reduce convulsive degree and enhance the effects in treating Meige's syndrome; moreover, selection of muscles to be injected into and injection spots will help reduce side effects.

Aim To observe the expression of MRTF-A in rat glomerular mesangial cells(GMCs) induced by advanced glycation end products(AGEs) and its effect on ICAM-1 and FN;to explore whether MRTF-A is involved in the process of diabetic nephropathy by affecting NF-κB pathway.Methods Under the condition of AGEs, CCG-1423 and anti-MRTF-A small interfering RNA were used to knock down MRTF-A and MRTF-A plasmid was used to activatt MRTF-A, The expression level of MRTF-A, ICAM-1, FN and p65 in nucleus were detected by Western blot.Results The protein expressions of MRTF-A was increased in AGEs-induced GMCs.The expressions of FN and ICAM-1 and p65 in nucleus were downregulated by knocking down MRTF-A.However, the expressions of FN, ICAM-1 and p65 in nucleus were upregulated by overexpressing MRTF-A.Conclusions AGEs can upregulate the expression of MRTF-A in GMCs, and MRTF-A mediates the protein expressions of FN and ICAM-1 by affecting NF-κB signaling pathway in AGEs-induced GMCs.

Objective To observe the effect of antihypertension treatment at different time after acute onset of stroke on patients' prognosis.Methods Ninety-six patients with ischemic stroke were randomly divided into three groups who received antihypertension treatment separately at the 4th,7th and 10th day after onset.Patients' neurologic deficit and ischemic events were observed at 1 month and 3 months in follow-up.Results Patients who received antihypertension at the 4th day after onset had severer neurologic deficit and more ischemic events than those who received antihypertension at the 7th or 10th day.The patients who received antihypertension treatment at the 7th and 10th day did not show significant difference in prognosis and occurrence rate of ischemic event.Conclusion It is preferable to start antihypertension treatment at the 7th day after onset for patients with ischemic stroke.

The clinical internship is an important transitional period for humanistic spirit cultivation of the medical students.But in this period there are some problems exposed.For example,there is the lack of transitional link in management; the clinical instruction doctors lack educational consciousness or guidance ability,the medical students pay little attention to enhancing the individual humanistic spirit level and there is a gap between theory and practice of humanistic spirit for them.Strengthening training for students,attaching importance to training,selection and incentive of clinical instruction doctors and revising handbook of clinical internship will help to solve the problems.

Objective To explore the efficacy of intervention combined with traditional Chinese medicine for the treatment of early femoral head necrosis. Methods 62 cases of early femoral head necrosis were treated with interventional and traditional Chinese medicine, all patients were assessed for clinical efficacy before treatment and 6 months after treatment. The clinical hip function, pain index evaluation and rating of the femoral head venography were recorded. Results 41 cases were cured, 18 cases improved,no improvement in 3 cases,the total effective rate was 95. 2%. Clinical hip function after treatment compared with before treatment increased by 32.5%,there was a statistically significant difference (P＜0.01); compared with before treatment, significantly reduced pain (P＜0. 01). After treatment, Ⅲ and Ⅳ were significantly increased number of cases, respectively, compared with the preoperative increase of 146.2% and 160.0%,femoral venography ratings before and after treatment had significant difference(P＜0.01). Conclusion Intervention combined with traditional Chinese medicine treatment could significantly improve the early femoral head necrosis.

Objective To investigate the medical cost of 70 patients with panic attack and efficacy of selective serotonin reuptake inhibitors (SSRIs) in the treatment Methods The course, medical cost, types and times of main examination of all 70 patients were reviewed and analyzed The effect of SSRIs on the patients was studied with Anxiety and Depression Scale Results The 70 patients had long course, high medical cost and received many unnecessary medical examinations SSRIs were effective on patients with panic attack in light of Anxiety and Depression Scale Conclusion Patients with panic attack have long course and spend much unnecessary cost before final diagnosis SSRIs is useful and safe in the treatment of panic attack

Objective To investigate the relationship between the protein kinase A (PKA) and apoptosis of cultured neurons after hypoxia Methods Model of cultured rat neuron under hypoxia condition was established. Rp cAMP, a specific inhibitor for PKC, at 4 different concentrations were separately cocultured for 2 h with the neurons having been cultivated under hypoxic condition for different times The activity of PKA, the expression of caspase 3 and the situation of neuron apoptosis were studied Results With the prolonging of hypoxic time the activity of PKA was increased significantly And the expression of activated caspase 3 and apoptotic DNA were increased as well The positive rate of fluorescence staining and the average fluorescent intensity of caspase 3 and TUNEL were significantly decreased along with the increasing concentration of Rp cAMP Conclusion ① PKA and caspase 3 are involved in the neuronal apoptosis after hypoxia ② Rp cAMP can attenuate the hypoxic neuronal apoptosis through the signal transduction of caspase 3 ③ The activating of PKA can aggravate hypoxic neuron apoptosis

Objective To explore the effect and possible mechanism of protein kinase C (PKC) on the apoptosis of cultured neurons after hypoxia Methods Model of cultured rat neurons under hypoxia condition was established. Calphostin C, an inhibitor for the catalytic subunit of PKC, at 4 different concentrations were separately cocultured for 2 h with the neurons having been cultivated under hypoxic condition for different times The activity of membrane PKC (mPKC), the expression of Bcl 2 and the situation of neuron apoptosis were studied Results With the prolonging of hypoxic time the activity of mPKC was increased significantly And the expression of Bcl 2 was decreased obviously and positive rate of TUNEL were significantly increased in a calphostin C concentration dependent manner Conclusion ① The activation of mPKC and Bcl 2 are involved in the apoptosis of neurons after hypoxia ② Hypoxia and calphostin C can aggravate the hypoxic neuronal apoptosis through the signal transduction of Bcl 2 ③ The activation of PKC can protect neuron against hypoxia

Alzhelmer's disease (AD) is an important neurodegenerative disease. Recent evidence has indicated that the production and loss of the myelin,sheath are associated with AD because the particular vulnerability of oligodendrocytes produced in the late stage makes the loss of the myelin sheath take a core position in the changes of the earliest stage of AD. The loss of the myelin sheath disrupts synchronization of impulses on which normal brain functions highly depend, and ultimately results in the function disruption of cortical association regions and subsequent neuronal loss. Meanwfiile, there are diverse mechanisms that make oligodendrocytes degeneration exist in the brains of AD. Therefore, elucidating its specific mechanism may help better understanding of AD, and thus provide some help for its treatment.