Stroke is characterized by high incidence,high morbidity,and high mortality.It seriously threats to human life and the quality of life.Studies have confirmed that neuroendocrine dysfunction occurs after the onset stroke and dkectly inpact on the outcomes of patients.It has great value for identifying the clinical conditions and outcomes,and has a guiding significance for clinical treatment.This article reviews neuroendocrine biomarkers of the neurological outcomes after stroke.

BACKGROUND: It is believed that repetitive transcranial magnetic stimulation (rTMS) may produce such neurophysiological effects as regulating regional cerebral blood flow, neurotransmitters, local metabolism, and neuronal remodeling after nerve tissue injuries. The prognosis ofischemic stroke is related with the cortical function reconstruction in the ipsilateral and contralateral hemisphere of the lesion. Currently studies have not defined whether rTMS can affect the cortical function, protect ischemic neurons and promote motor functional recovery after cerebral ischemia.OBJECTIVE: To investigate the effects of rTMS on rat motor cortical excitability and neural function in acute stage of cerebral ischemia-reperfusion injury.DESIGN: Completely randomized experiment.SETTING: Electroneurophysiological Laboratory of Peking Union Medical College Hospital.MATERIALS: The experiment was completed in the Zoological Research Center of Peking Union Hospital from January to June 2004. Totally 22adult male healthy Wistar rats were randomly divided into treatment group and the control group with 11 in each.METHODS: After determination of the average motor threshold of the right hind limbs, which was 22% of the maximum output, the rats were subjected to middle cerebral artery occlusion for 1 hour followed by reperfusion for 72 hours. At each time point of immediately and at 12, 36 and 60 hours after the initiation of reperfusion, the rats in the treatment group received rTMS treatment (20 Hz, 40% maximum output, 5 seconds for each session with an between-session interval of 2 minutes for a total of 10 sessions), and the site for motor threshold evaluation was used for rTMS stimulation; the rats in the control group recevied no treatment after model establishment. Motor threshold testing was performed in both groups 4 hours after the last session of treatment to avoid immediate-early effects of rTMS on the motor threshold. At 24 and 72 hours of reperfusion, the scores of neural function were recorded according to evaluation systems. All the rats with scores between 1 and 3 were enrolled in statistical analysis were evaluated between.MAIN OUTCOME MEASURES: ① Motor threshold of the rats in both groups before and after injury; ② Neural function scores at 24 and 72 hour reperfusion; ③ Infarct volume at 72 hour of reperfusion.RESULTS: Totally 13 rats entered the final result analysis. Before injury,motor threshold in the treatment and control group was similar (P=0.71),and after the injury, the motor threshold of the control group was 1.49times that of the treatment group but such difference was not statistically significant [(41.62±24.73)% vs (28.00±9.35)%, t=-1.17, P=0.27]. At 24hours of reperfusion, the functional scores of the treatment group and control group were not significantly different (P=0.46), but at 72 hours, the scores of the treatment group were significantly lower than that of the control group (1.60±1.52 vs 7.75±3.62, t=-3.57, P=0.004). The average infarct volume of two groups was (62.00±60.88) mm3 and (20.00±12.41) mm3 at 72 hours of reperfusion, respectively, which, after logarithm transformation,was not significantly different between the two group (t=-1.31, P=0.22),but when the infarct volume was transformed into Log10 values, a significant difference occurred between them (P=0.045).CONCLUSION: rTMS may stabilize and prevent the increment of the motor threshold, time-dependently relieve the neural function disability and reduce the infarct volume after cerebral ischemia-reperfusion injury.

Therapies for malignant glioma include surgery,radiotherapy and chemotherapy.In recent years,the overall effective rate of temozolomide is better than other chemotherapy drugs,but partly patients have resistance to temozolomide.Angiogenesis inhibitors show promising activity,but it is expensive.Celecoxib has antiangiogenic activity,which has become a new option.

Objective:To investigate the possible role of miR-181d in regulating the multidrug resistance (MDR) of small cell lung cancer (SCLC) and its clinical significance. Methods: Quantitative reverse transcriptase-polymerase chain reaction (QRT-PCR) and Western blot were used to investigate the differential expression of miR-181d and BCL2 from mRNA and protein levels in the chemo-sensitivity cell H69 and the chemo-resistance cell H69AR. The miR-181d expression in H69AR was then upregulated. More-over, CCK8 assay was employed to detect the sensitivities of the cells to chemotherapy drugs, such as ADM, DDP, and VP-16. Mean-while, the expression of miR-181d in the specimens of 87 cases with SCLC were detected using QRT-PCR. All patients received the chemotherapeutic regimen of EP (etoposide+cisplatin). Correlation of the miR-181d expression with clinicopathological features, prog-nosis, and survival time of the patients was studied. Results:miR-181d was downregulated in the SCLC multidrug-resistant cell line H69AR and chemo-resistant patients. Moreover, miR-181d was concurrent with the upregulation of BCL2 protein compared with the parental H69 cell line and chemo-sensitive patients (P<0.001). miR-181d expression in H69 cells resistant to chemotherapy drugs (ADM, DDP, and VP-16) was inhibited (P<0.01). Enforced miR-181d expression reduced the BCL2 protein level and sensitized H69AR cells to chemotherapy drugs (P<0.01). miR-181d expression was associated with tumor stage, sensitivity of chemotherapy, and survival time (all P<0.001). Patients with high miR-181d expression had longer overall survival and progress-free survival time com-pared with those with low miR-181d expression (P<0.001). Conclusion: miR-181d may play a role in the development of MDR in SCLC and may be a potential predictive factor for treatment efficacy.

Purpose To investigate the clinicopathological changes of the diffuse-type giant cell tumor of the bone and joint. Methods 42 cases of the diffuse-type giant cell tumor of the bone and joint were studied and the follow-up data were reviewed. Results The male patients were 19 and the female were 23, with the male to female ratio of 1 ∶ 1. 2. The age of the patients was 8~69 years (the average age was 37. 6). It was displayed that the patients presented local pain and swelling (34 cases), including dysfunction (18 ca-ses) of the bone and joint. Clinically, the lesions located on the knee joint ( 71. 4%) in 30 cases, the hip and ankle in 9 cases (21. 4%), and the wrist elbow in 3 cases (7. 1%). 27 cases were examined by MRI. Among them, the diffuse-type giant cell tumor was diagnosed in 9 cases (33. 3%). The effusive lesions of the joint presented in 5 cases, the non-specific synovial lesions and others in 3 cases. The obviously diffuse hyperplasia of synovial cells with nodular growth pattern was found. However, a high proliferative in-dex of the tumor cells and the rich-cell tumor were found. But there was no tumor necrosis. Histopathologically, the tumor cells of dif-fuse-type giant cell tumor contained marked brown pigments, multinucleated giant cells formation and a lot of lymphocytes proliferation or follicular reaction in 17 cases (40. 5%) with invasive growth and involvement of the joint and surrounding tissue. 6 cases recurred (20%) , including 2 cases with 2 times. Conclusions The diffuse type-giant cell tumors most commonly involve the knee, followed by the hip and ankle. Preoperative examination of MRI can be help for the diagnosis of the tumor. Histopathologically, diffuse-type gi-ant cell tumor with synovial cells rich-hyperplasia and the villous structures formation more likely recur. The main biological character-istics of diffuse-type giant cell tumor are invasive growth pattern, usually into the soft tissue around the joints.

Aim To investigate the effects of rosmarinic acid on H2O2-induced apoptosis in rat VSMCs and its related mechanisms. Methods Flow cytometry was used to determine apoptotic rate of VSMCs. nuclear staining by acridine orange for morphologic change,MTT assay for cell viability and Western blot for expression of Bcl-2,Bax, fas and FasL. Results After being treated by H2O2(0,250,500,750 ?mol?L-1),apoptotic rate of VSMCs was 3.71%?0.56%,17.6%?6.92%,34.9%?2.55 %, and 85.6%?5.22% by FACS analysis,and VSMCs appeared nuclear condense and nuclear fragmentation after being treated by 500 ?mol?L-1 H2O2 for 24 hours,which were typical morphological changes of apoptosis. ① VSMCs treated with 500 ?mol?L-1 H2O2 for 24 hours had a significantly decrease on cell viability compared with control,and the apoptosis rate was increased to 35.7%?1.33%; Bcl-2 protein expression decreased,Bax protein expression increased, Bcl-2/Bax protein ratio decreased and Fas receptor and Fas ligand expression also increased.② Pre-incubation with rosmarinic acid(10, 20, 40 ?mol?L-1)for 30 min enhanced the cell viability, and decreased the apoptotic rate to 31.1%?1.38%,21.2%?1.18%,13.6%?0.51% in a dose-dependent manner. Moreover, Bcl-2/Bax protein ratio increased and Fas and FasL expression decreased. Conclusions ① Rosmarinic acid antagonizes H2O2-induced apoptosis of VSMCs. ② The antagonism of rosmarinic acid on apoptosis may be correlated with an increase Bcl-2/Bax protein ratio and a decrease expression of Fas and FasL protein.

Acute-On-Chronic Liver Failure ; blood ; pathology ; Case-Control Studies ; Cytochrome Reductases ; metabolism ; Humans ; Prospective Studies ; alpha-Fetoproteins ; metabolism

Objective To explore the safety and efficiency of patients with impacted upper ureter calculus combined with renal intrarenal infection treated by ureteroscopic pneumatic lithotripsy (URL ) and minimally invasive percutaneous nephrolithotomy (MPCNL) .Methods 126 cases of impacted upper ureteral calculi combined with renal intrarenal infection were treated in this hos-pita1 from July 2007 to July 2011 ,including 58 cases of URL ,68 cases of MPCNL .The success rate of primary lithotripsy ,stone-free rate ,postoperative adjuvant therapy ,operative time ,hospital stay ,incidence of postoperative complications and other data were analyzed .Results The success rate of group URL was 82 .76% (48/58) ,the success rate of group MPCNL was 100 .00% .The stone-free rate seven day after operation :URL was 62 .07% (36/58) ,MPCNL was 98 .53% (67/68)(P<0 .05) .The stone-free rate was 100 .00% in MPCNL group and 81 .03% in URL group one month After operation(P<0 .05) .In MPCNL group ,the rate of adjuvant ESWL was 1 .47% ,significantly lower than 37 .93% in URL group(P<0 .05) .In URL group the operative time (65 .34 ± 26 .72)min and hospital stay(4 .54 ± 1 .87)d were significantly shorter than those (96 .32 ± 30 .94)min and(7 .62 ± 1 .93)d in URL group(P<0 .05) .After the operation ,in MPCNL group ,6 patients developed high fever ,in URL group ,5 patients had high fever (P<0 .05) .Culture of blood after operation found 3 patients and 2 patients in MPCNL group and URL group were positive(P<0 .05) .There were no significant differences in the rates of hemoglobin decline between the two groups (P>0 .05) .Conclusion It has higher successful rate and stone-free rate in patients with upper ureter calculus combined with renal intrarenal infection by MPCNL than those treated by URL .The safety and efficency of the former is better that of the latter .MPCNL can be the first choice for the upper ureter calculus combined with renal intrarenal infection .

Objective To observe the level of serum hepatocyte growth factor (HGF) in patients with impaired glucose tolerance (IGT). Methods Thirty patients with IGT (IGT group), 30 patients with type 2 diabetes mellitns (T2DM) (T2DM group) and 30 healthy controls (control group) were recruited for this study. Such indexes as HGF, fasting plasma glucose (FBG), postprandial plasma glucose (2hPG), glycosylated hemoglobin A1c( GHbA1c ), fasting insulin(FINS), systolic blood pressure(SBP), diastolic blood pressure (DBP) were examined and these related factors were analyzed. Results The levels of serum HGF in IGT group and T2DM group were higher than those in control group [(413.22 ± 102.48), (422.76 ± 126.77 ), ( 120.45 ± 25.11 ) ng/L, respectively ] (P < 0.05 ). There was no significant different between IGT group and T2DM group (P> 0.05). There was positive correlation between HGF and FBG (r = 0.326, P< 0.05 ). Multiple regression analysis indicated significant correlation between HGF and DBP (r = 4.730, P< 0.05). Conclusion Higher levels of HGF are found in IGT patients, which indicates that function of vascular endothelium is abnormal in this period.

Objectives To detect genetic causes of dystrophic epidermolysis bullosa (DEB). Methods Next-generation sequencing was used to detect a neonate with DEB. Sanger sequencing was used to confirm the results and detect his parents and grandmother on his mother side from the family. Results The neonate was found to have heterozygous mutation c.6781C>T of exon 86 in COL7A1 gene.This mutation results in R2261X nonsense mutation in typeⅦcollagen. His mother and grand-mother on his mother side have the same mutation. Conclusion Next-generation sequencing technology is a useful tool for the detection of mutations of COL7A1 gene, which is valuable for clinical application.