Parkinson's disease (PD) is a commonly encountered central neurodegenerative disease in elderly people. According to theories of traditional Chinese medicine (TCM), PD is characterized by deficiency in the root and excess in the branch. Deficiency was referred to qi-blood deficiency of the liver and kidney. Excess was referred as the wind, fire, phlegm and stasis. Deficiency was the root and excess was the branch. Good efficacies have been obtained by treatment based on syndrome differentiation, treatment with specific prescriptions, acupuncture and moxibustion and comprehensive treatment. Some experiments had been conducted to elucidate its mechanisms. However, no uni-fied standard for therapeutic evaluation, poor control of medicinal quality, inferior quality of designed clinical trials, and unclear treatment mechanism in the clinical study on therapeutic effect of PD treatment with TCM require fur-ther studied.

Objective To explore the clinical efficacy and the dynamic changes of serum vascular endothelial growth factor(VEGF),connective tissue growth factor(CTGF),hypoxia inducible factor 1α(HIF-1α)and osteopontin(OPN)levels after transcatheter arterial chemoembolization(TACE)combined with sorafenib in the treatment of advanced hepatocarcinoma(HCC)patients.Methods A total of 113 HCC patients in Cancer Hospital of Taizhou,from September 2013 to December 2014 were elected and were randomly divided into control group(n=56)and experiment group(n=57)according to random number.Control group were treated with sorafenib and experiment group were treated with TACE combined with sorafenib.The serum VEGF,CTGF,HIF-1α and OPN levels were tested and compared using indirect ELISA method preoperative and postoperative 1,3,7 days and which were carried out Spearman correlation analysis.The long-term clinical efficacy and adverse reaction in two groups were statisticed.Results The serum VEGF,CTGF,HIF-1α and OPN levels of two groups postoperative 1 day increased than preoperative(P<0.05).From postoperative one to seven days,the serum VEGF,CTGF,HIF-1α and OPN levels of two groups present downward trend(P<0.05 or P<0.01),and there was significant difference between two groups(P<0.01).The level of HIF-1α significantly positive correlated with the levels of VEGF,CTGF and OPN(r=0.951,0.954,0.929,P<0.05).Compared with control group,the median survival time and 1-year-survival rate of experiment group increased significantly(P<0.01).The incidence of hand-foot reaction,alopecia and diarrhea in experiment group were higher than those in control group(P<0.05),while the others had no significant difference between two groups(P>0.05).Conclusion The levels of VEGF,CTGF,HIF-1α and OPN of HCC patients after treated with TACE combined with sorafenib are lower than that treated with TACE alone,Simultaneously,the survival is prolonged and adverse reactions don't increase.

Objective To study the clinical and pathological features of periodic paralysis.Methods The clinical and pathological data of 9 patients with periodic paralysis were analyzed.Results The clinical manifestation of 9 patients were consistent with the general manifestation of periodic paralysis.The typical tubular aggregates in many fibers were observed in 4 cases of 7 patients with skeletal muscle biopsy.A few degenerating fibers were observed,while necrotic fibers and regenerating fibers were not found.Electromicroscope showed Honeycomb appearance in tubular aggregates of cross section,which was filled with glycogen granule.Conclusions According to the clinical manifestation and the laboratory examination,periodic paralysis can be clinical diagnosis.The tubular aggregates in many fibers are important pathological characteristic of periodic paralysis.In electromicroscope analysis,tubular aggregates may be compose of transverse tubular system or sarcoplasmic reticulum expansion.

Aim To investigate the influence of Tanshinone ⅡA on cytokine secreted by kuppfer cells via LPS stimulation,and explore its mechanism of therapying chronic hepatic disease. Methods The liver cell and kupffer cells were isolated and the model of liver cell injuries was made induced by LPS and D-GlaN, and the effects of TanshinoneⅡA was observed on the injuries of liver cell induced by lipopoly-saccharide(LPS) and D-Galactosamine(D-GlaN). Cytokine were released secreted by kupffer cells through LPS stimulation and the contents of TNF-?,IL-6,IL-8 were determined by radio-immunoassay. The hepatocyte morphological character was observed by HE stain,the expressions of TNF-?、CD14、iNOS、eNOS in kupffer cell were explored by immunohistochemical, double-decker chamber was used for observing the damage of hepatocyte caused by cytokine secreted by kupffer via LPS stimulation. Results Tanshinone ⅡA could restore the injury of liver cell induced by D-GlaN and LPS, the levels of ALT、MAO、LDH-L、GSH-S and contents of MDA were significantly reduce.It could inhibit TNF-? IL-8 secreted by kupffer cells through LPS stimulation ,and the expressions of TNF-?、CD14 Inos、eNOS in kupffer cell through LPS stimulation were inhibited. Blocking injuries of the inflammatory cytokine release excessive on liver cell, it hadn′t the protect action on liver cell damage suffer from inflammatory cytokine.Conclusion The mechanism of Tanshinon ⅡA of blocking liver cell injuries induced by D-GlaN and LPS may be correlation with inhibiting the excessive cytokine by kupffer cells

Objective: To investigate the quality of life and its influencing factors among patients with gestational diabetes mellitus (GDM), so as to provide insights into the improvements in the quality of life among patients with GDM. Methods: GDM patients admitted to Department of Obstetrics and Gynecology, Hangzhou First People's Hospital Affiliated to Zhejiang University Medical School from June 2021 to June 2022 were recruited. Participants' demographics, diagnosis and treatment, sleep quality, depression and social support level were collected. Patients' quality of life was evaluated using the Quality of Life Scale for Pregnant Women with Gestational Diabetes Mellitus, and the factors affecting the quality of life were identified among patients with GDM using a multivariable linear regression model. Results: A total of 300 questionnaires were allocated, and 284 valid questionnaires were recovered, with an effective recovery rate of 94.67%. The respondents had a mean age of (32.81±4.93) years, and the mean scores for the quality of life was (92.63±14.10) points. Multivariable linear regression analysis identified depression (β'=-0.293), sleep disorder (β'=-0.177), insulin therapy (β'=-0.316), regular exercise (β'=0.272) and social support level (medium: β'=0.153; high: β'=0.381) as factor affecting the quality of life among GDM patients. Conclusions GDM patients have a low quality of life. Depression, sleep disorders, insulin therapy, and lack of exercises may cause a decline in the quality of life among GDM patients, and strong social support facilitates the improvements in the quality of life among GDM patients.

OBJECTIVETo explore the clinical effects of Dynesys system combined with posterior lumbar interbody fusion (PLIF) in treating multiple lumbar degenerative disease.

METHODSThe clinical data of 46 patients with multiple lumbar degenerative diseases treated by Dynesys system combined with PLIF from September 2010 to May 2013 were retrospectively analyzed. There were 17 males and 29 females, aged from 38 to 68 years old with an average of (56.38±11.63) years. Operation section was in L2-L5 of 16 patients (6 with fusion of L4,5 and 10 with fusion of L4,5,L5S1) and in L3-S1 of 30 patients (11 with fusion of L5S1 and 19 with fusion of L4,5,L5S1). Patients were followed up for three times: postoperative 3 months, 1 year and final follow-up. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to assess clinical symptoms preoperatively and postoperatively. All patients underwent flexion/extension radiographs examinations before surgery and at final follow-up. Range of motion (ROM) and disc height index (DHI) were recorded.

RESULTSAll patients were followed up from 16 to 48 months with the mean of (23.23±7.34) months. At third follow-up after operation, ODI and VAS of lumbago and leg pain were significant improved than that of preoperative (P<0.01). DHI of fusion segment was significantly increased than that of preoperative (P<0.05). There was no significant difference in adjacent non-fusion segment between preoperative and postoperative (P>0.05). Postoperative ROM of fusion and non-fusion segments were obviously decreased than that of preoperative. There was no significant difference in ROM of upper adjacent non-fusion segment between 3 months and 1 year after operation (P>0.05), but at final follow-up, the ROM was increased (P<0.05).

CONCLUSIONThe preliminary clinical results of the Dynesys system combined with PLIF in the treatment of multiple lumbar degenerative diseases are satisfactory. It can be determined in fusion or non-fusion according to the individual needs and can reserve the some intervertebral motion, prevent the early degeneration of adjacent segments. However, its long-term clinical efficacy should be verified with long time.

Humans ; Lumbar Vertebrae ; surgery ; Range of Motion, Articular ; Retrospective Studies ; Spinal Diseases ; physiopathology ; surgery ; Spinal Fusion ; methods ; Visual Analog Scale

Aim To explore how MCP-1 induces neu-rodisorder by determing the effects of MCP-1 on excita-tory postsynaptic current(EPSCs) in the CA1 region of rat hippocampal brain slices .Methods EPSCs, the AMPA receptor-mediated EPSC (EPSCAMPAR ), NMDA receptor mediated EPSCs(EPSCNMDAR) and NR2BR re-ceptor-mediated EPSC ( EPSCNR2BR ) were recorded u-sing whole-cell patch recording techniques to observe the effects of 2.3 nmol· L-1 MCP-1 on pyramidal neu-rons in hippocampal CA1 region.Microtubule-associat-ed protein-2 ( MAP-2 ) staining was used to study whether MCP-1 induced dendritic injuries in hippocam-pal CA1 region and whether NMDAR , AMPAR or CCR2 receptor antagonists had protective effects a-gainst dendritic damage caused by MCP-1.Results ① Bath application of MCP-1 produced a significant enhancement of the amplitudes of EPSCs , EPSCAMPAR and EPSCNMDAR .②Further studies revealed that MCP-1 potentiated EPSC NR2BR; ③ The MCP-1-associated dendritic injuries were blocked by NMDAR , AMPAR and CCR2R antagonists respectively .Conclusions Our results suggest a potential role of MCP-1 which may play in neuroexcitotoxicity and neural injury via NMDA receptor(especially NMDAR subtype NR2BR) and CCR2 receptor .The antagonists of these receptors may have potential therapeutic effect for neurodegener-ation.

This study is to determine the preventive effect and mechanism of targeting IL-17A on pulmonary inflammation and fibrosis after acute lung injury. Mice were treated with anti-IL-17A antibody on the day 7 and sacrificed on the day 14 after bleomycin lung injury. The pulmonary inflammatory status and the deposition of collagen were measured by HE and Sirius stains staining. The contents of hydroxyproline and collagen were measured by using commercial kits. The survival rate of mice was calculated by Kaplan-Meier methods. The inflammatory cytokines in bronchoalveolar lavage fluid were measured by ELISA and the expressions of inflammation-related molecules were detected by Western blotting assay. Targeting of IL-17A could prevent the development of lung inflammation, decrease collagen deposition and the contents of hydroxyproline, and protect against the development of pulmonary fibrosis, which together led to an increase in the animal survival. Moreover, blocking IL-17A decreased the expression ofpro-fibrotic cytokines such as IL-17A, TGF-beta1 and IL-13; increased the expression of anti-fibrotic or anti-inflammatory factors such as IFN-gamma, COX-2, 5-LOX, 15-LOX. Indeed, IL-17A antagonism suppressed the activation of pro-inflammatory p65NF-kappaB but enhanced the activation of pro-resolving p50NF-kappaB. In conclusion, that blockade of IL-17A prevents the development of pulmonary fibrosis from acute lung injury, is because blocking IL-17A may prevent acute inflammation converting to chronic inflammation.

AIM: To evaluate the clinical efficacy of surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia.
●METHODS: A total of 22 eyes of 11 patients received surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia were included. Objective and subjective duration of the operation, degree of cooperation during surgery, postoperative recovery, recurrence and complications were observed.
●RESULTS: In the process of surgery, patients without pain and being-cooperated were recorded in 17 eyes. The patients who occasionally felt slight pain, but within endurance after adding topical anesthesia once and the operation was completed successfully were recorded in 5 eyes ( the second eye surgery ) . The operation was successfully completed in all the patients. Compared the coordination degree during surgery of Gradel with GradeⅡ, the difference was statistically significant ( t=-3. 123, P<0. 01). All eyes were healed well after operation.
● CONCLUSION: The surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia can ensure satisfactory anesthetic effect and get better quality of operation. It′s a simple, safe and effective anesthesia method for spontaneous subconjunctival orbital fat prolapse.

Objective: To conifrm the omentopexy decreasing the susceptibility of ventricular arrhythmia in experimental rats with chronic myocardial infarction (MI) by nerve remodeling.
Methods: The MI model of SD rats was established by left coronary artery ligation. 3 weeks later, the qualiifed animals were randomized into 3 groups for the 2nd operation. ① Sham operation group, the rats received the 2nd operation without ligation, ② Isolated MI group, the rats received the 2nd operation without omentopexy, ③ Omentopexy group, the rats received the 2nd operation with omentopexy. n=20 in each group. 4 weeks after the 2nd operation, the electrophysiological characteristics were assessed by relevant techniques, the new and sympathetic nerves in MI border zone were examined by immunohistochemistry, the protein expressions of connexin43 and nerve growth factor (NGF) were measured by western blot analysis and the cardiac endothelin-1 (ET-1) level was evaluated by ELISA.
Results: Compared with Isolated MI group, Omentopexy group showed decreased susceptibility of arrhythmia (3.5 ± 1.2) vs (0.9 ± 0.2), improved electrical transduction (1.5 ± 0.2) mV vs (3.4 ± 0.3) mV and decreased capture threshold (5.5 ± 0.3) mV vs (2.2 ± 0.2) mV, all P<0.05. Compared with Isolated MI group, immunihistochemisty indicated that Omentopexy group had decreased new and sympathetic nerves in MI border zone, as for GAP43:(1388.4 ± 244.9)μm2/mm2 vs (768.6 ± 144.1)μm2/mm2, for TH:(1552.4 ± 270.3)μm2/mm2 vs (1018.5 ± 124.7)μm2/mm2, all P<0.05. Western blot analysis showed that Omentopexy group had the lower NGF expression and higher connexin43 expression;ELISA demonstrated that Omentopexy group had the lower ET-1 expression, P<0.05.
Conclusion: Omentopexy may decrease the susceptibility of ventricular arrhythmia after MI in experimental rats, which might be related to the cardiac nerve remodeling.