BACKGROUND:Transformation growth factor-β(TGF-β) and brain-derived neurotrophic factor (BDNF) are the main regulatory factors in the process of spinal cord injury. There are many researches for TGF-βand BDNF pathogenesis in the spinal cord injury, but the regulation of Ginsenoside Rg1 intervention on TGF-βand BDNF in the spinal cord injury is rarely reported.
OBJECTIVE:To observe the effect of Ginsenoside Rg1 intervention on TGF-βand BDNF expression at themolecular protein levels, and to study the protection effect of Ginsenoside Rg1 on the spinal cord and nerve function after spinal cord injury.
METHODS:Experimental rats were randomly divided into blank control group, model group and Ginsenoside Rg1 group. In the model and Ginsenoside Rg1 groups, spinal cord injury model was established with the impact method in rats. In the Ginsenoside Rg1 group, rats were intraperitoneal y injected with 10 mg/kg Ginsenoside Rg1 24 hours after modeling, once per day, for 14 days. Rats in the blank control and model groups were injected with equal saline.
RESULTS AND CONCLUSION:Compared with the control group, serum malondialdehyde levels increased, the content of superoxide dismutase decreased, TGF-βexpression levels in spinal cord tissue increased, and BDNF expression levels decreased in the model and Ginsenoside Rg1 groups. Compared with the model group, serum malondialdehyde levels decreased, the content of superoxide dismutase increased, TGF-βexpression levels in spinal cord tissue decreased, and BDNF expression levels increased in the Ginsenoside Rg1 group. Ginsenoside Rg1 can protect the injury spinal cord in rats after spinal cord injury.

BACKGROUND:Chinese herb extracts can restore and protect the nervous system of rats through intervention of neural stem cels. OBJECTIVE:To explore the role of ginsenosides Rg1 in the proliferation and protection of neural stem cels. METHOD:Sprague-Dawley rats at pregnant 19 days were dissected to take out fetal rats, and then the hippocampal tissues from fetal rats were isolated to extract neural stem cels. Neural stem cels were co-cultured with DMEM/F12 medium containing 50 g/L ginsenosides Rg1 as intervention group, with DMEM/F12 medium as blank control group, and with DMEM/F12 containing 0.64% phenol as positive control group, respectively. MTT assay was used to detect the proliferation of neural stem cels in each group, and western blot method to detect the protein expression of brain-derived neurotrophic factor and transforming growth factor-β in neural stem cels. RESULTS AND CONCLUSION:Rat neural stem cels were round single cels with clear border at early period after isolation but at 2 days after inoculation, the cels were adherent and aggregated into smal cel spheres. Compared with the blank control group, the proliferative rate of neural stem cels was significantly increased in the ginsenosides Rg1 group (P < 0.05), but decreased in the positive control group (P < 0.05). Compared with the blank control group, in the ginsenosides Rg1 group, the expression of brain-derived neurotrophic factor was elevated, and the expression of transforming growth factor-β was reduced, indicating ginsenosides Rg1 has a certain effect to promote the proliferation of neural stem cels as wel as to protect the neural stem cels.

Objective To improve the training system of the combined education mode between professional master degree students of clinical medicine and resident standardization training (RST) in Zhe-jiang province, and improve the professional quality of medical graduate students. Methods A question-naire was designed through literature review and expert interview, and the data of 77 clinical training post-graduates were collected, and the effect of the training was evaluated by taking the reaction level, learning level, behavior level and achievement level of Ke's evaluation as the breakthrough point. Statistical analysis was performed by SPSS 20.0, and the mean score was used as the standard deviation. The scores were compared with t test, and the scores of multiple groups were made variance analysis. Results The RST attitude value in reaction layer was 9.26±1.08, RST content value was 29.29±4.36, RST teacher enthusiasm value was 11.13±2.17, RST experience value was 17.38±3.10, which indicated that residents' overall satisfaction to RST was high, but the satisfaction on teachers, evaluation and compensation was relatively low;The grade difference before and after RST in learning layer was statistically significant (P<0.05), indicating that before and after RST the grades were obviously improved, and the sense of belonging is high. The behave layer showed the residents' behavior changed obviously before and after RST (P<0.05), and their abilities in various aspects such as ward round and dealing with common diseases were largely improved;The result layer showed 77 graduate students had no medical accident and complaint , and all of them passed the annual assessment and participated in the research projects. Conclusion In general, RST graduate students are relatively satisfied with the plan, content and methods of the training, on the other hand, there are problems such as the absence of timely information feedback, teachers' poor enthusiasm, lack of effective competition mechanism, etc. Kirkpatrick Model made a comprehensive and objective eval-uation on graduate students RST from a overall perspective, and it can be introduced into the effectiveness evaluation for graduate students RST.

AIM: To study the protective effect of ethyl pyruvate(EP) on hepatocytes in septic mice.METHODS: The cecal ligation-perforation was made in mice as septic model.Ringer's ethyl pyruvate solution(REPS) and Ringer's lactic solution(RLS) were used to resuscitate septic mice.Anti-oxidative capacity of hepatic tissue and liver function were detected in different groups.RESULTS: Anti-oxidative capacity in septic mice was significantly lower than that in sham group(P

To study the effect of alpha1-acid glycoprotein 1 (ORM1) polymorphism on the concentration of free nortriptyline in serum, genotyping analysis was employed in ORM1 by sequencing. Eighteen unrelated male adults were chosen and given a single dose of 25 mg nortriptyline orally, then the blood samples were taken at 0, 1, 2, 3, 4, 6, 8, 12, 24, 32, 48, 72, 96 and 168 hours after drug administration. Nortriptyline and 10-OH-nortriptyline in serum and ultrafiltrate were detected for the total and free concentration by using HPLC-MS/MS. Pharmacokinetic parameters were compared among different ORM1 genotypes. No significant differences were shown in the pharmacokinetic parameters of total nortriptyline and 10-OH-nortriptyline. The mean AUC(0-infinity) of free nortritpyline in ORM1 * F/ * F1 subjects was significantly higher than that in ORM1 * F1/ * S and ORM1 * S/ * S subjects [(119.1 +/- 74.4) ng x mL(-1) x h vs (51.4 +/- 23.2) ng x mL(-1) x h and (42.4 +/- 11.6) ng x mL(-1) x h]. The percentage of protein binding in subjects with ORM1 * F1/ * F1 genotype at 2, 3, 4, 6, 8 and 12 h after administration was slightly lower than in those with ORM1 * F1/ * S and ORM1 * S/ * S genotypes while the distinct difference was shown at 4 h (P < 0.05). Different ORM1 genotypes might affect the protein binding percentage and the concentration of serum free nortriptyline. The ability binding to the drug was higher in subjects with ORM1 * S/ * S genotype than in those with other two genotypes, so as to cause the lower concentration of free nortriptyline.
Adult ; Area Under Curve ; Genotype ; Humans ; Male ; Nortriptyline ; analogs & derivatives ; blood ; pharmacokinetics ; Orosomucoid ; genetics ; metabolism ; Polymorphism, Genetic ; Protein Binding

OBJECTIVE To investigate the nasopharynx carriage status of opportunistic pathogens in non-infectious old people.METHODS The totally of 592 pharyngeal samples from old persons were collected.RESULTS The isolated rates of main opportunistic pathogens were Haemophilus parainfluenzae,Stomatococcus mucilaginosus,Streptococcus pneumoniae and Klebsiella pneumoniaa.The isolated rate of single opportunistic pathogen was 45.8% and that of multiple opportunistic pathogens was 3.9%.The total carriage rate of opportunistic pathogen was 49.7%.The carriage rate of G+ or G-bacteria was 13.2% or 86.8%,respectively.The isolated rates of 2 multiple pathogens,S.pneumoniae and K.pneumoniae were increased with aging.The isolated rate of K.pneumoniae was higher in persons with more than 3 kinds of underlying diseases.CONCLUSIONS Aging,pharyngeal carriaging of S.pneumoniae,H.parainfluenzae,K.pneumoniae,et al and with multiple underlying diseases might be the risk factors for elder people to suffer from infectious respiratory disease.Isolating pharyngeal opportunistic pathogen among non-infection people is necessary and significant for prevention and treatment of infectious respiratory disease.

Objective To investigate the effect of statin on trabecular bone microstructure by using trabecular bone score (TBS), a new type of bone microstructure evaluation index. Methods A total of 253 middle and aged patients hospitalized in the First Affiliated Hospital of Nanjing Medical University between January 2014 and March 2016 were retrospectively analyzed. According to whether statin was used or not, patients were divided into two groups: 90 patients in the statin use group (statin was use for more than 1 year) and 163 in the control group (not taken any statin). Serum biochemical indicators, such as triacylglycerol, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, alkaline phosphatase, fasting blood glucose and 25 hydroxy vitamin D, were compared between the two groups. Dual energy X-ray absorptiometry (DXA) was used to measure the bone mineral density (BMD) of lumbar spine and femoral neck. TBS was calculated with TBS iNsight? software, and the DXA image of lumbar spine were analyzed. Results Values of total cholesterol and low density lipoprotein cholesterol were significantly lower in statin group compared with those of control group (P<0.001), while no significant differences in other biochemical indicators between two groups (P>0.05). There was higher lumbar spine BMD statin group compared to that of control group (g/cm2:1.04 ± 0.19 vs. 0.96 ± 0.14, P<0.01). There was higher lumbar spine BMD and higher TBS (1.31±0.09 vs. 1.26±0.09, P<0.01) in statin group than that of control group. There was no difference in the femoral neck BMD between the two groups (P>0.05). Conclusion Statin increases lumbar spine BMD and improves trabecular bone microstructure in middle and aged people.

This paper presents the preliminary investigation on chondromalacia patella at our department in recent years. A random cluster sampling survey covering 2743 normal persons was carried out. The prevalence rate is 36.2%. It was found that, applying transmission electron microscope and immunohistochemical methods on to cartilage tissues of the abnormal region, articular cartilage necrosis was in direct proportion with the abnormal pressure, while the restoration capability of local chondrocytes was in inverse proportion with pathological changes and the pressure. The chondromalacia patella was produced by repeated abnormal stress acting on the carilage. The stress derived from the uncongruency and the decreasing in the contact area of patellofemoral joint when the subluxation or tilt of patellae was caused by the abnormal anatomical and biomechanical relationship. The initial lesion was at the matrix of cartilage,the collagen network was disrupted, then proteoglycan was lost. The microenvironment of chondrocytes was changed with degradation of matrix. So the chon drocytes became degenerative and necrosis from superficial to deep layer, then feed back the matrix again. Finally, the total cartilage layer might disappear, and the bone under cartilage might proliferate. At late stage, the cartilage was completely destroyed and had no self-restorative ability. Therefore, early diagnosis and treatment are necessary. It is highly suggested axis radiograph of the knee with the tibiae tuberositas localization are helpful to early diagnosis. Furthermore, JKY-Muscle Rehabilitation Instrument is invented for non-operative therapy. It enhances muscle power by selective training of the vastus medialis muscle using electrical stimulator to relieve pain and correct subluxation of patella with 90% efficiency (63% of excellent-effective rate) . In late stage, patellofemoral replacement is recommended. The excellent-effective rate is 86.3%.

Objective To investigate the correlation between ganglioside (Gg) injection and serum neuron-specific enolase (NSE) and S100B protein concentration in patients with severe craniocerebral injury.Methods Sixty-eight patients with acute craniocerebral injury were randomly divided into control group (n =34) and treatment group (n =34).Patients in control group were intravenously infused mannitol injection 200 mL,twice a day and orally given norepinephrine 1.2 g,3 times a day.Patients in treatment group were given intravenous infusion of monosialoglycoside ganglion glucoside 100 mg,once a day.All patients were treated for 2 months.Serum NES and S100B protein levels were measured by enzyme-linked immunosorbent assay in two groups in 24,48,72,and 120 h after hospitalization.And the adverse drug reactions in two groups were observed.Results After 120 h treatment,the serum NSE levels in treatment group and control group were (13.21 ± 2.78),(18.52 ± 3.45) ng· mL-1.The S100 in treatment group and control group were (2.08 ±0.85),(3.76 ±2.14) ng · mL-1(P＜0.05).The effective rate was 82.35％ (28/34 cases) in treatment group,had significant difference with that in control group,which was 58.82％ (20/34 cases,P ＜ 0.05).The MMSE scores in treatment group after 2,4 weeks were 23.44 ± 3.15,27.41 ± 3.48,had significant difference with those in control group,which were 20.35 ± 2.35,22.24 ± 2.97 (P ＜ 0.01).There were no adverse drug reactions in two groups during the treatment.Conclusion Gg injection can effectively reduce the levels of serum NSE and S100B protein in patients with severe traumatic brain injury.

Objective To discuss the application of awaking anesthesia and intraoperative cortico-subcortical electrostimulation in the surgery for patients with secondary epilepsy induced by lesions in eloquent areas. Methods A total of 11 patients initiated with epileptic seizure were collected in our study. All patients were right-handed and 5 had neurological dysfunction, and the mean Karnofsky performance status (KPS) scores were 87. Skull MRI and long-term video-EEG monitoring were performed for all patients, and 6 of them got functional MRI. The surgeries were performed under intravenous anesthesia: 4 got trachea intubation and the other 7 were performed pharyngeal esophageal intubation under awaking anesthesia. Electrocorticographic recordings were adopted to confirm the epileptogenic zone, and then cortical electrical stimulus was performed to locate the cortical functional area. Under subcortical electrostimulation monitoring, we resected the lesions by the methods of focal cortical resection or multiple subpial transaction (MST) according to the relation between epileptogenic zone and functional cortex; during the resection, subcortical electrostimulation was adopted to protect the tracts lay in the sub-cortex. Results Total resection was achieved in 10 patients, and subtotal excision in 1. The epileptogenic zone was performed cortical resection or pia mater-fiber transverse amputation.Two cases got transient hemiparalysis after operation. Followed up for 6-20 months, none of the patients had neurologic deficit, and the average KPS scores were 100. Epilepsies were well-controlled using only one antiepileptic drug. Conclusion Pharyngeal esophageal intubation under awaking anesthesia is safe and convenient. With the monitoring of intraoperative cortico-subcortical electrostimulation, we can resect the lesions up to the hilt and protect the eloquent areas effectively, and improve the life quality of patients.