Objective To study the effects of repetitive transcranial magnetic stimulation(rTMS) of the supplementary motor area(SMA)on the cortical excitability in patients with Parkinson's disease(PD).Methods Sixteen patients with PD were included in this study.The motor evoked potentials(MEP)and the N30 component of somatosensory evoked potentials(SEP) were assessed for each patient before and after 1200 pulses of rTMS of the SMA at 5 Hz and an intensity of 100% of relaxed motor threshold (RMT) for the abductor pollicis brevis.Results Ten minutes after the rTMS intervention,the peak-to-peak amplitude of the SEP component P20-N30 increased significantly(P<0.05),with the P/F index decreased simultaneously(P<0.05).The MEP amplitude increased significantly,and reached the highest value at 10min after the rTMS intervention. Conclusion 5 Hz rTMS of the SMA can improve the excitability of the SMA itself temporarily.Meanwhile,it can induce a short-lasting facilitation of the excitability of M1 connected with SMA.

Objective To construct vectors expressing small interfering RNA targeting the Toll like receptor-4 (TLR4) gene and obtain TLR4 knock downed vascular smooth muscle cells (SMC). Methods Three small hairpin RNA (shRNA) targeting the TLR4 gene were designed, synthesized and cloned into the pSilence 2.1-U6 neo vector. Positive clones were verified with double enzyme digestion and sequencing. Then the recombinants were transfected to SMC by the cationic lipid method respectively.SMC were stably transfected with an expression plasmid and screened by G418. TLR4 mRNA and protein expression were detected by RT-PCR and Western blot methods. Results The pSilence2.1-siTLR4 ex-pression vectors were successfully constructed and a TLR4 knock-downed SMC cell line was established. RT-PCR and Western blot analysis confirmed that the expression of TLR4 was significantly down-regulated in the infected SMC cell line, and pSilence2.1-siTLR4-1was the most efficacious recombinant vector.Conclusion Recombinant vectors carrying shRNA targeting the TLR4 gene were successfully constructed and the TLR4 expression in vascular SMCs was inhibited.

Objective To study the therapeutic effects of low frequency repetitive transcranial magnetic stimulation(rTMS)in cranial dystonia.Methods Twenty cranial dystoina patients were treated with low frequency rTMS.Their motor threshold,cortical silent period(CSP)were evaluated before and after the rTMS and after 1,2,6 months as well as the spares and Toronto Western Spasmodic Torticollis Rating Scale(TWSTRS)to evaluate the effects of rTMS in the treatment of cranial dvstonia.Results The patients scored(23.5±14.0)significantly lower after l and 2 months(17.6 ±14.3,18.5±14.2,t=2.632,2.149.both P<0.05).But there was an increasing tendeney of the score after 2 months.The 2-month efficient rate of low-frequency rTMS Was 60%(12/20),yet the long-term effect of rTMS was still to be studied.There was a very significant improvment of relaxed(46.5%±7.3%vs49.9%±9.2%,t=-3.235.P<0.05)and active threshold(40.2%±5.9%/)5 43.9%±8.8%,t=-2.339,P<0.05),prolongation of CSP((96.1±24.5)ms vs(121.6±27.7)ms,t=-7.223,P=0.000).Conclusion The low frequency rTMS is efficient to relieve the clinical symptoms of cranial dystonia.

Objective To investigate procalcitonin (PCT) and C reactive protein (CRP) expression in patients with puerperal infection after cesarean section and its clinical significance.Methods From January 2014 to January 2016,134 cases of cesarean section puerperal infection patients in our hospital were enrolled in observation group,according to 1∶3 matching,we selected 402 cases of cesarean section without puerperal infection as the control group.Then the levels of PCT and CRP in two groups were detected.Results CRP and PCT levels of 24 h,48 h and 72 h of the patients in the observation group were (13.16 ± 1.06)mg/L and (1.05 ±0.42)g/L,(15.15 ± 1.50)mg/L and (1.67 ±0.31)g/L,(16.01 ± 2.32) mg/L and (2.10 ± 0.92) g/L respectively,significantly higher than the control group (P ＜ 0.05);72 h CRP and PCT levels of pelvic cavity peritonitis patients were (17.13 ± 1.46)mg/L and (2.81 ± 0.97) g/L respectively,significantly higher than that in patients with vulvovaginal and cervicitis,endometritis and fallopian tube (P ＜ 0.05);72 h CRP and PCT in patients with endometritis and fallopian tube inflammation were (15.89 ± 1.06) mg/L and (2.06 ± 0.83) g/L,significantly higher than that of vaginal and Cervicitis Patients (P ＜ 0.05).Conclusions CRP and PCT increase rapidly in patients with puerperal infection after cesarean section,and there are a certain relationship with puerperal infection disease and they are of certain clinical application value.

Objective:To study the effects of Zuogui Pills on the expressions of miR-133b-3p and RhoA in osteoclasts of postmenopausal osteoporosis rats; To discuss its potential mechanism.Methods:SD female rats were randomly divided into normal group, model group, sham-operation group, and Zuogui Pills group using a random number table method, with 6 rats in each group. The model group and Zuogui Pills group were treated with oophorectomy to construct a rat model of osteoporosis. Zuogui Pills group was orally administered with Zuogui Pills decoction at a concentration of 10 g/kg for 12 consecutive weeks. Colorimetric method was used to measure the serum calcium and phosphorus levels of rats, and ELISA method was used to detect ALP levels. Bone density meter was used to measure the bone density of the femurs of rats in each group. The osteoclast of each group were cultured, and the expressions of RANKL and RUNX2 protein were detected by Western blot. MiRNA sequencing and differential expression analysis were performed on bone tissues of rats. Osteoclasts were treated with miR-133b-3p mimic and its negative control. The cell proliferation activity of osteoclasts was detected by cell counting kit-8 (CCK-8). The osteoclast differentiation activity was detected by the tartrate-resistant acid phosphatase staining. The dual-luciferase reporter assay was used to detect the relationship between miR-133b-3p and RhoA. The "rescue" experiment of miR-133b-3p mimic and RhoA co-expression were used to study the molecular regulatory mechanism of Zuogui Pills on osteoclast activity.Results:Compared with the model group, the bone mineral density of Zuogui Pills group significantly increased ( P<0.05, P<0.01), the levels of calcium and phosphorus in serum increased, the level of alkaline phosphatase ALP decreased ( P<0.05), the expression of RANKL protein decreased, and the expression of RUNX2 protein increased. Sequencing results showed that rno-miR-133b-3p was down-regulated in osteoclasts of postmenopausa osteoporosis rats treated with Zuogui Pills with the maximum difference ( P<0.01). Q-PCR results showed that the expression of miR-133b-3p in osteoclasts of Zuogui Pills group was significantly lower than that of the model group. The upregulation of miR-133b-3p could significantly promote the cell proliferation and differentiation of osteoclasts. RhoA overexpression could reverse the excessive proliferation and differentiation of osteoclasts caused by miR-133b-3p overexpression. Conclusions:RhoA is the target gene regulated by miR-133b-3p. Zuogui Pills can inhibit the activity of osteoclasts by regulating miR-133b-3p/RhoA axis, relieving the symptoms of osteoporosis.