Objective To explore the effects of botulinum toxin type A (BTX-A) on the F-waves of the tibial nerve and the walking ability of stroke patients.Methods Twenty stroke patients with spastic hemiplegia of a lower limb were randomly divided into experimental and control groups with 10 patients in each group.All received four weeks of conventional rehabilitation,including walking training,balance training and muscle strength training.In the experimental group,a total of 300 IU of BTX-A was injected into the gastrocnemius (200 IU) and soleus muscles (100 IU)before the start of routine rehabilitation,guided by using the electrical stimulation.Muscle tone was assessed using the modified Ashworth scale(MAS).Walking ability was assessed with the timed up and go test (TUGT) and a 10 m free walking test.F-wave parameters were recorded in the tibial nerve before,two weeks and four weeks after the injection.Results In the experimental group there was a significant difference in F-wave amplitude between those recorded before treatment and after two weeks of treatment.The control group showed no statistically significant difference.In experimental group there was also a statistically significant difference in triceps muscle tension before and after treatment which was not observed in the control group.Walking ability improved significantly in both groups.Conclusions Local injection of BTX-A into the lower limbs can reduce the F-wave amplitudes of spinal cord motor neurons.BTX-A injection combined with rehabilitation training can significantly improve the walking ability of stroke patients.

Objective To analyze the application value of MSCT enhanced scanning in diagnosis of gastrointestinal mucoca associated lymphoid tissue(MALT) lymphoma.Methods 11 cases of gastrointestinal MALT lymphomas confirmed by pathology were analyzed retrospectively.The clinical data and imaging features of 11 cases were analyzed,including lesion sites, morphologic features and enhancement patterns of tumors,positions of lymph nodes,involvement of extranodal site excluding gastrointestinal tract.Results For morphologic features,8 cases (72.7%) were gastrointestinal wall thickening type, among them, 5 cases occurred in the stomach and 3 cases in the intestine;3 cases (27.3%) were localized mass/nodule type, among them, 2 cases occurred in the stomach and 1 case occurred in the intestine.The sign of aneurysmal dilatation was showed in 2 cases, which occurred in the intestinal tract.There was 1 case of localized mass/nodule MALT lymphoma in the ileocecal junction with local intestinal lumen stenosis.For the manifestations of enhanced scanning,10 cases (90.9%) of tumors were moderately or obviously enhanced, 9 cases (81.8%) showed homogeneous enhancement.For the involvement of lymph nodes and other extranodal organs, regional lymph nodes were involved in 5 cases(45.5%), regional lymph nodes and distant lymph nodes were involved in 1 case(9.1%), lymph nodes of both sides of the diaphragm were involved in 1 case (9.1%), extranodal sites excluding gastrointestinal tract were involved in 2 cases (18.2%).9 cases (81.8%) were classified as stage Ⅰ-Ⅱ, 2 cases (18.2%) were classified as stage Ⅳ.Conclusion MSCT enhanced scanning can provide a reliable basis for the diagnosis and staging of gastrointestinal MALT lymphoma.The chest and abdominopelvic cavity enhanced scanning is recommended as a routine examination.

Objective To investigate the teaching effectiveness of preventive medicine and ask the students for feedback on the curriculum in order to reform the teaching methods.Methods Questionnaire survey.Sampling survey.Results 89.2％ of students have realized the importance of preventive medicine.Respectively 16.4％ and 7.5％ of students have no interesting on the curriculum due to teachers'matter and students' idea that the course is uselessness for their major and future career.75.1％ of students are interest in Nutrition and Food Hygiene,35.2％ of students dislike Medical Statistics,and 45.3％ of students think the most tough part is Medical Statistics.78.9％ of students wish to have more practice lessons.30.5％ of students do not ask teachers questions because of no communication with teachers after class.Conclusions Preventive Medicine is still ignored by a few students.The more tough the content is,the less interest the students have. Repeatedly emphasizing the importance of Preventive Medicine in medical education,adopting and combining with the community practical cases in class lectures and frequently communicating between teachers and students after class are suggested.

Objective To explore the anatomical basis for the flexor pollicis brevis branch of median nerve transfer to the deep branch of ulnar nerve.Methods Eight fresh upper limb were dissected and observed.The specimen were dissected under the loup.Observed the number of the flexor pollicis brevis branch and measured the distances from pisiform bone to the flexor pollicis brevis branch.Then the transfer operation on the cadaver were imitated.After the anastomosis was completed,the stumps of the nerves were sectioned and stained with HE.The crossing-sectional area and the density of nerve fiber were obtained by Image-Pro Plus version 6.0,then the number of the nerve fiber were calculated.The data analyzed by SPSS 17.0.Results The flexor pollicis brevis branch constantly appear,there were two branches in 2 specimens,one branch in 6 specimens.The flexor pollicis brevis branch could transfer to the deep branch of ulnar nerve by end-to-end surture without tension.The regeneration distances was (37.3 ± 5.76) mm.The crossing-sectional area were (0.0575 ± 0.0086)mm2 and (0.2039 ± 0.0396)mm2,the number were (492.50± 62.62) and (1651.13± 79.01),the density were (8781.4246 ± 1676.2894)/mm2 and (8371.1592 ± 1677.6509)/mm2 in the flexor pollicis brevis branch and the deep branch of ulnar nerve,respectively.There were no significant differences in the density of the nerve fiber between the donor and recipient nerve (P ＜0.05).But there were differences in the crossing-sectional area and number of the nerve fiber(P ＜ 0.05).Conclusion The flexor pollicis brevis branch transfer to the deep branch of ulnar nerve can provide a short regenerating distance,but can supply a part of recipient nerve to reinnervate.

There are two phenotypes of microglia, M1 and M2. Microglia in M2 polarization may associate with the phagorytosis of be-ta-amyloid and inhibition of Tau hyperphosphorylation, as well as in other pathology. Electroacupuncture can impact the phenotypes of mi-croglia, which may play a role in the treatment for Alzheimer's disease.

Objective To analyze CT features of adrenal non-functional pheochromocytoma and non-functional adenoma and to provide reference for the diagnosis and differential diagnosis.Methods 17 cases of adrenal non-functional pheochromocytoma and 31 cases of non-functional adenoma confirmed by pathology were analyzed retrospectively.The imaging findings of two groups of cases were statistically analyzed, including size, shape, density, enhanced degree, visible tumor blood vessels, necrosis and cystoid variation and so on.Results The average diameter of the pheochromocytoma was (52.2±20.2) mm, and the average diameter of the adenoma was (27.8±17.6) mm, the difference was statistically significant (P<0.05).The average CT value of pheochromocytoma was higher than that of adenoma in plain, arterial and venous phases(all P<0.05).Of the 17 cases of pheochromocytoma, 14 cases (82.4%) can be seen tumor blood vessels in the arterial phase, 12 cases (70.6%) can be seen necrosis and cystoid variation, the margins of the tumors were no circular or arc-like enhancement;of the 31 cases of adenoma, 3 cases (9.7%) can be seen tumor blood vessels in the arterial phase, 2 cases (6.5%) can be seen necrosis and cystoid variation,10 cases (32.3%) can be seen circular or arc-like enhancement;all the differences were statistically significant (all P<0.05).Conclusion Adrenal non-functional pheochromocytoma and non-functional adenoma have characteristic imaging findings, dual phase enhanced scanning of MSCT is helpful for clinical diagnosis and treatment, one of the distinguishing points is to find tumor blood vessels in arterial phase.

OR group,moreover the differences were significant(P0.05),however,both genes in the 2 groups′ expression level significantly were lower than that in control group(Pa

Objective To understand the drug resistance situation of clinical common bacteria in hospital.Methods VITEK-2 was adopted to perform the identification and antimicrobial susceptibility test.The drug resistance data were analyzed by adopting the WHONET 5.5 software.Results 13 841 strains of bacteria isolated for the first time from the patient were collected from Jan-uary 2009 to December 2012,in which Gram positive bacteria accounted for 29.3% and Gram negative bacteria accounted for 70.7%.Meticillin-resistant Staphylococcus aureus (MRSA)and meticillin-resistant coagulase-negative staphylococci (MRCNS) accounted for 78.3% and 88.4% of staphylococci aureus and coagulase-negative staphylococci,respectively.No vancomycin and tigecycline resistant strains of staphylococci were found.4.3% of enterococcus faecalis and 7.5% of enterococcus faecium were re-sistant to vancomycin.The detection rates of E.coli and Klebsiella spp (Klebsiella pneumoniae +Klebsiella bacteria producing acid )producing extended spectrum beta-lactamases (ESBLs)were 58.5% and 24.4%,respectively.Enterobacteriaceae strains were still more sensitive to carbapenem antibiotics.The resistance rates of pseudomonas aeruginosa and Acinetobacter spp strains to imipenem were 24.9 % and 42.6%,respectively.Conclusion Bacterial drug resistance still constitutes a serious threat to the clini-cal anti-infection therapy.So the antibacterial agents should be rationally used for reducing the bacterial drug resistance.

Objective To explore the relationship between uric acid (UA) level and cognitive function in elderly patients with Parkinson,s disease (PD) and analyze the cognition related factors.Methods The clinical data of 60 elderly PD cases in our hospital from 2001 to 2009 were retrospectively analyzed. The 60 healthy people receiving medical examination in our hospital and matched by gender and age, were as control group. The information including gender, age, illness duration, Hoehn & Yahr stage (H-Y stage), serum UA level and Mini-Mental State Examination (MMSE) scale were recorded. Results The serum UA level was significantly lower in PD group than in control group [(262±53) μmol/L vs. (332±45) μmol/L, t=-6.724, P＜0.001]. In PD group, the serum UA level was slightly higher in males than in females [(271 ±48) μmol/L vs.(254±39) μmol/L, t=3. 282, P=0. 058]. The serum UA level was significantly lower in male PD patients than in male controls [(353± 62) μmol/L, t=- 5. 625, P＜0. 001], and was lower in female PD patients than in female controls [( 294 ± 59) μmol/L, t = - 4. 721, P = 0. 012]. There were no significant differences in serum UA level among different H-Y stage subgroups (P＞0. 05), but the serum UA level was lower in different H-Y stage subgroups than in control group (F=22. 039, P＜0. 01 ). There was no correlation between the UA level and the illness duration (r=0. 961, P＞0.05).The MMSE score had significant difference between elderly PD group and control group (t= -3. 168,P＜0. 001). In PD patients, the MMSE score was positively correlated with serum UA level (r=0. 789, P= 0. 000), and was negatively correlated with H-Y stage (r= - 0. 577, P = 0. 019 ), age (r= -0. 333, P=0. 034), but was not correlated with illness duration (r= -0. 333, P=0. 207) and BMI (t=- 0. 410, P= 0. 115). Conclusions The level of serum UA is lower in elderly patients with PD than in normal controls. There is correlation between the serum UA level and cognitive impairment. Lower serum UA level predicts worse cognitive scores.

Objective To Investigate the influence of high-intensity pulsed electromagnetic field (HIPEMF) on neural differentiation of neonatal rats neural stem cells in vitro.Methods Neural stem cells (NSCs) were isolated from the subventricular zone of 3-day-old neonatal rats and cultured with serum-free condition medium for 14 days.All the NSCs were then randomly classified into an experimental group which received the stimulation of HIPEMF (0.1 Hz,4 T,8 pulses) and a control group which received no special intervention.Differentiation of the culture was induced by addition of 10％ fetal bovine serum on the first day after intervention,the morphological changes of cells were observed under the microscope at different time points.The NSCs adhered to the wall and differentiated for seven days,the immunofluorescence was employed to observed and calculate the ratio of differentiated cells with astrocyte marker GFAP or neuronal markers TUJ1.RT-PCR and western blotting were used to measure the expression levels of the differentiated cells based on gene and protein levels,respectively.Results Immunofluorescence staining showed the number of TUJI positive cells in the experimental group(33.4％ ± 5.1％)was significantly more than the control group (26.5％ ± 7.0％),while the number of GFAP positive cells was decreased(23.9％ ± 5.0％) as compared with the control group(36.2％ ± 2.2％).RT-PCR showed that the TUJ1 mRNA expression levels in the experimental group was (1.682 ± 0.086) times of the control group.Western blot showed that the expression of TUJ1 (0.729 ±0.061) in the experimental group was higher than in the control group (0.590 ± 0.157),while the expression of GFAP in the experimental group (0.566 ± 0.056) was less than in the control group(1.034 ± 0.051).Conclusions HIPEMF facilitates differentiation of neural stem cells to neurons,at the cost of reducing astrocytic differentiation.