ObjectiveTo study the effect of hyperbaric oxygenation (HBO) treatment on post-stoke depression (PSD) and neurological functional rehabilitation.Methods60 patients with PSD were randomly divided into two groups, treatment group and control group. Patients in the treatment group were given HBO treatment in addition to the regular treatment. Changes of scores of Hamilton depression (HAMD), Chinese stroke scale (CSS), and activity of daily living (ADL) before and after treatment in two groups were observed and evaluated.ResultsAfter 1 month treatment scores of HAMD, CSS, and ADL in the treatment group got obviously better results than before treatment (P<0.01). While scores in the control group had no significant difference(P>0.05).Conclusions It is suggested that HBO may improve the depressive symptom and neurological functional rehabilitation in PSD patients.

[Objective] To investigate risk factors and the incidence rate of tracheotomy after cervical spinal cord injuries.[Method]A retrospective analysis was done on 1185 cases suffering from cervical spinal cord injuries statistically.The following correlation factors: ages,gender,type of job,reason of injuries,degree of spinal cord injuries,segment of spinal cord injures,nutritional status during therapy were evaluated by Binary Logistic Regression to discover tile influencing factors for tracheotomy.[Result]Totally 99 cases were undergone tracheotomy(male 87 and female 14).The rate of tracheotomy was 8.35%,Ages,degree of spinal cord injuries,segment of spinal cold injuries,reason of injuries had influence to rate of tracheotomy.The other factors were not correlation to tracheotomy.With increasing of age,the rate of tracheotomy was gradually increased.Nobody was undergone tracheotomy in patients who was younger than 20 years old,and the rate of tracheotomy was 38.7% in patients who was older than 60 years old.With aggravating and segment going up of cervical spinal cord injuries,the rate of tracheotomy was gradually increased.The rate of tracheotomy for cervical spinal cord injury at Grade D was 0.5%,While the rate of tracheotomy for cervical spinal cord complete injury was 19.1%.Tile rate of tracheotomy for cervical spinal cord complete injury was 4.3,22.3,21.6 and 32.7% from C7 to C4,while the rate wasn't high in C3 and C2,because most of these patients had died before they was undergone tracheotomy.The rate of tracheotomy was higher in patients who got injuries from fall than other.[Conclusion]Elder,cervical spinal cord severe injuries,high cervical spinal cord injuries was risk factors for tracheotomy.The patients who got cervical spinal cord complete injuries in C3 or higher than C3 need tracheotomy as early as possible.

OBJECTIVE:To evaluate the efficacy and safety of dronedarone for atrial fibrillation or atrial flutter.METHODS:The publicly published literatures about the clinical trials on dronedarone for atrial fibrillation or atrial flutter were retrieved from PubMed.The quality analysis of included studies and extraction and cross-check of data were conducted by two reviewers independently using Meta-analysis.Response indexes were tested in tests for heterogeneity and summarized and analyzed using RevMan 5.0.The safety of dronedarone was evaluated.RESULTS:Five RCTs were included.As compared with placebo,dronedarone reduced the hospitalization rate due to cardiovascular events and all-cause mortality(RR=0.76,95%CI=0.72～0.79,P

Objective To explore the dosimetry of simplified intensity modulated radiotherapy (sIMRT)in the spinal component of craniospinal irradiation(CSI)compared with conventional plan(3D-CRT).Methods Five previously treated patients were adopted to generate 3D-CRT,3-and 5-field slMRT plans.The prescribed dose was 36 Gy to the planning target volume(PTV)in 20 fractions.The dose distributions of target volume and normal tissues,and homogeneity index(HI)were ananlyzed using the dose volume histogram.The total monitor units(MUs)were also analyzed to compare the delivery time indirectly.Results For 3D-CRT plans,the region of the neighbouring fields only received 70％ of the prescribed dose,and the maximum dose delivered in the normal tissues was increased to approximately 140％ of the prescribed dose.The homogeneity index(HI)of 3-and 5-field sIMRT were 0.09 ± 0.01 and 0.08 ±0.01,respectively,superior to that of 3D-CRT(0.18 ± 0.02,t=7.80,7.65,P＜0.05).The values of V10 for the heart of 3-and 5-field sIMRT were(8.4 ± 1.9)％ and(8.4 ± 2.0)％,respectively,lower than that of 3D-CRT((36.0 ± 6.0)％(t=13.3,13.0,P＜0.05).V20 for the thyroid gland were (12.4±1.5)％ and(12.4±1.6)％,respectively,lower than(69.4±5.7)％ of 3D-CRT(t=26.3,26.4,P＜0.05).V20 for the larynx were(17.2 ± 1.2)％ and(17.9 ± 1.5)％,respectively,lower than that of 3D-CRT[(89.4±7.0)％(t=25.5,26.5,P＜0.05)].V30for the NTwas(4.4±1.4)％,(4.9± 1.9)％,lower than that of 3 D-CRT[(31.9 ± 6.1)％(t=8.5,10.1,P＜0.05)].The averaged values of total MUs for 3-and 5-field sIMRT were 1100 ± 177 and 1160 ±204,respectively,higher than that of 3D-CRT(640 ± 151).Conclusions Compared with the 3D-CRT CSI technique,3-and 5-field sIMRT have better dose distribution and can improve target dose uniformity and protect the organs at risk.

Autoimmune encephalitis is a kind of inflammatory disease of central nervous system caused by abnormal immune response of body immune system to neuronal antigen,and is generally considered to be reversible encephalitis caused by noninfectious factors.Its characteristic manifestations include acute and subacute onset of cognitive dysfunction,epilepsy and mental disorder.With the discovery of related antibodies,summaries of clinical syndrome and application of new functional imaging instruments,the diagnosis of autoimmune encephalitis is increasingly standardized.The priority treatment of autoimmune encephalitis is immunomodulatory therapy,including glucocorticoid,immunoglobulin,plasma exchange and immunosuppressant.The other treatments could be the related tumor resection,electroshock therapy,etc.The symptoms in most patients can get substantial relief with active treatment.The present paper would focus on the research progress in treatment of autoimmune encephalitis.

Objective To determine the expression of Notch pathway receptors (Notch1 and Notch4) and ligands (Jagged1 and Dll4) in cutaneous malignant melanoma (CMM) tissues,and to preliminarily explore the role of the Notch signaling pathway in the pathogenesis of CMM.Methods Immunohistochemical study was performed to determine the expression pattern and intensity of Notch1,Notch4,Jagged1 and Dll4 in 40 paraffin-embedded CMM specimens and 15 paraffin-embedded pigmented nevus specimens.Statistical analysis was carried out by chi-square test and Spearman rank correlation analysis with the SPSS 21.0 software.Results Notchl was detected in 31 (77.5％) of 40 CMM specimens,as well as in 3 of 15 pigmented nevus specimens,and the positive rates significantly differed between the two groups (x2 =15.281,P ＜ 0.001).However,no significant difference in the expression intensity of Notch1 was observed between 18 in situ melanoma tissues and 22 invasive melanoma tissues (x2 =0.631,P =0.427).In addition,the positive rates of Notch4,Jagged1 and Dll4 were also significantly higher in the CMM group than those in the pigmented nevus group (all P ＜ 0.05),and the expression intensity of Notch4,Jagged1 and Dll4 significantly differed between in situ and invasive melanoma tissues (all P ＜ 0.05).In CMM tissues,the expression of Notch1 was positively correlated with that of Jagged1 (rs =0.350,P =0.027) and Dll4 (rs =0.562,P ＜ 0.001),while the expression of Jaggedl was negatively correlated with that of Dl14 (rs =-0.734,P ＜ 0.001).Conclusion Abnormality of the Notch signaling pathway may be involved in the pathogenesis of melanoma,but further researches are still needed to elucidate the detailed mechanism.

Nitrate not only remarkably stimulates the rifamycinbiosynthesis in Amycolatopsis mediterranei, but also influences the primary metabolisms, including the inhibition of fatty acids biosynthesis in the bacterial. This phenomenon has been designated as "Nitrate Stimulating Effect" by the late Prof. J.S. Chiaosince its discovery in the 1970's, and has been found in many other antibiotics-producing actinomycetes subsequently. Based on the research in his laboratory, we have revealed that the nitrate stimulation effect mainly manifests in two aspects over the last two decades. First, nitrate promotes the supply of rifamycin precursors, e.g., UDP-glucose, AHBA, malonyl-CoA and methylmalonyl-CoA. Specifically, the biosynthesis of fatty acids is inhibited by nitrate consequently the acetyl-CoA is shunted into malonyl-CoA. Second, nitrate facilitates the expression of genes in the rifclulsterthat encodes rifamycin biosynthetic enzymes. Following our current understanding, the future research will focus on the signals, the signal transduction pathway and the molecular mechanisms that dictate nitrate-mediated transcriptional and post-translational regulations.
Actinomycetales ; classification ; metabolism ; Acyl Coenzyme A ; chemistry ; Anti-Bacterial Agents ; biosynthesis ; Nitrates ; chemistry ; Rifamycins ; biosynthesis

Objective To analyze the sensitivity of auxiliary examinations in different periods of sporadic Creutzfeldt-Jakob disease (sCJD).Methods The clinical data of 53 sCJD patients were retrospectively analyzed including the different stages of skull diffusion-weighted magnetic resonance imaging (DWI),24-hour ambulatory electroencephalogram (EEG),18F-FDG PET/CT (PET-CT)and cerebrospinal fluid 14-3-3 protein.When calculating the sensitivity of an auxiliary examination,the diagnostic criteria were defined by combining the specific clinical manifestations with two or more positive results of other auxiliary examinations.Results There were 24,53 and 22 sCJD patients,respectively,met the criterion of early (E),middle (M) and later (L) stage of disease (some patients fit 2 or 3 stages).The sensitivity ofDWl (E:58.3％ M:85.4％,L:94.7％),EEG (E:45.8％,M:62.7％,L:77.8％),14-3-3 protein in cerebrospinal fluid (E:11.1％,M:52.9％) and PET-CT (E:80％,M:100％) increased gradually with disease progression,The sensitivity of PET-CT was higher than the other auxiliary examinations for E and M stages;no PET-CT was conducted in L stage.High signal regions mainly distributed in the cortex in E and M stages,but in L stage,no significant difference was found on the distribution of high signal regions between cortex and basal ganglia.Conclusions The sensitivities of the auxiliary examinations were different for sCJD patients in different stages.Reexaminations in different periods may improve the sensitivity for sCJD diagnosis.The sensitivity of PET-CT was high,and the combination of PET-CT and other auxiliary examinations may play a key role in the diagnosis of sCJD.

Objective 99Tcm-ciprofloxacin(Infecton)and 99Tcm-HIgG are both radiopharmaceuticals for inflammation and infectious disease imaging.It was reported that99Tcm-ciprofloxacin (Infecton)Was able to distinguish inflammation from infection.while 99Tcm-HIgG was a nonspecific agent.The study Was designed to compare the in vivo characteristics between 99Tcm-ciprofloxacin(Infecton)and 99Tcm-HIgG in rabbit model of inflammation.Methods Eight rabbits were grouped as inflammation model(the first group).infection model(the second group),concomitant inflammation and infection model(the third group),and control(the fourth group)groups.A total of 185 MBq(0.5 m1)99Tcm-ciprofloxacin(Infecton)Was administered intravenously to each rabbit.a serious dynamic images were acquired till 24 h post-injection.Repeated examination with99Tcm-HIgG was carried out 2 d later.Resuits 99Tcm-ciprofloxacin(Infecton)scan was negative in the inflammation models and controls.and was positive in the infection models.In the third group99Tcmciprofloxacin(Infecton)showed infection focus in the left thigh but negative uptake at inflammation focus in the right thigh.99Tcm-HIgG scan were positive in all models.The optimal image time for99Tcm-ciprofloxacin(Infecton)was 3 h after administration.but positive image could still be observed 24 h later.Conclusion 99Tcm-ciprofloxacin(Infecton)appears to specifically accumulate in the infective lesion.

BACKGROUND: Demineralized bone matrix and bone morphogenetic protein have been shown to have good bone induction, but less studies concerned nanometer demineralized bone matrix. Its physical and chemical properties and biological security are not yet clear.
OBJECTIVE:On the basis of preparing the nanometer human demineralized bone matrix in previous experiment, we mixed the recombinant human bone morphogenetic protein-2 together to obtain the new bone graft substitute and to research its physical and chemical properties and biological security.
METHODS:The human demineralized bone matrixes were prepared by the method of modified Urist and nano-processed then mixed with the bone morphogenetic protein-2 in specific proportions in order to be lyophilized to complete the fol owing experiments. (1) Pyrogen experiment:the material extracts were injected in the rabbits by ear intravenous. (2) Toxicity experiments:material extracts and saline were separately injected via the tail vein of mice in vivo. (3) Implantation experiments:experimental materials andβ-tricalcium phosphate were implanted into rabbits on both sides of the hindlimb muscle.
RESULTS AND CONCLUSION:After lyophilized shaping, the nanometer demineralized bone matrix material had dense surface and it’s pore diameter was 100-400μm. The pore distribution was less uniform and the porosity was of less than 30%. The main elements were carbon, oxygen and nitrogen. Nanometer human demineralized bone matrix with recombinant human bone morphogenetic protein-2 did not have pyrogen effect and the rabbits’ body temperature had no significant fluctuations after injection. The acute systemic toxicity test results showed that the nanometer human demineralized bone matrix with recombinant human bone morphogenetic protein-2 complied with the relevant provisions of the State, without obvious toxic reaction. The inflammatory response of nanometer human demineralized bone matrix with recombinant human bone morphogenetic protein-2 was significantly lighter than the reaction ofβ-tricalcium phosphate. The results showed that the nanometer human demineralized bone matrix with recombinant human bone morphogenetic protein-2 is a nanometer al ogeneic bone graft substitutes with nontoxicity, good biocompatibility, high bioavailability, and less inflammatory reaction.