BACKGROUND:For treatment of spinal cord injury, exogenous neural stem cell transplantation still faces many problems.Thus, the strategy of supplementary treatment of activating exogenous neural stem cells has been a hot focus.It has been found that lithium chloride can significantly inhibit differentiation and promote proliferation of neural stem cells, whose effects are correlated to Wnt signal pathway.OBJECTIVE:To investigate the effect of lithium on endogenous neural stem cells after spinal cord injury in rats.DESIGN, TIME AND SETTING:The randomized controlled animal study was performed at the Central Laboratory, Zhujiang Hospital from March to August 2008.MATERIALS:A total of 55 adult female Wistar rats were assigned into normal control group(n=5), simple injury group(n=25), and lithium chloride group(n=25).Lithium chloride was purchased from Guanghua, Guangzhou, China.METHODS:In the simple injury group and lithium chloride group, rat models of acute spinal cord injury at T10 segment were made by Allens method.From 1 hour following model induction, rats in the lithium chloride group received 3 mmol/kg per day lithium chloride through intraperithoneal injection.Samples were directly obtained.In the simple injury group, rats received an equal volume of saline.Rats in the normal control group were left intact.24 hours before samples were obtained, rats in each group were intraperitoneally injected with Brdu solution for labeling, once every 8 hours, totally 3 times.Spinal cord at 5 mm from the center of damage region received Brdu, catenin immunohistochemistry.MAIN OUTCOME MEASURES:BrdU-positive cell number and area of catenin-positive expression were measured.RESULTS:There were a few Brdu-positive cells and less expression of catenin in the center canal and adventitia of spinal cord in the normal control group.Many Brdu-positive cells and a little expression of catenin were found in gray matter and ependyma of injury area in the simple injury group 24 hours after model induction, which reached the peak at 1 week, and declined gradually at 2 weeks.Just a few Brdu-positive cells and little expression of catenin existed at 4 weeks.Compared with the simple injury group, there was no difference in Brdu-positive cells and the expression of catenin at 24 hours following model induction in the lithium chloride group.There were more Brdu-positive cells and the expression of catenin in the center canal and adventitia of spinal cord at 1 week(P

BACKGROUND: Super-resolution reconstruction has been extensively studied and used in many fields,such as medical diagnostics,military surveillance,frame freeze in video,and remote sensing.OBJECTIVE: In order to obtain high-resolution magnetic resonance images,gradient magnetic field is required and the signal-to-noise will be reduced due to the decrease in voxel size with traditional scan.The present study used a self-adaptive regularized super-resolution reconstruction algorithm to acquire high-resolution magnetic resonance images from four half-pixel-shifted low resolution images.METHODS: The least squares algorithm was used as a cost function.The dedvative of the cost function was calculated to obtain an iterative formula of super-resolution reconstruction.In the process of iterative process,the parameter and step size of image resolution were regularized.RESULTS AND CONCLUSION: The new regularization parameter makes cost function of the new algorithm convex within the definition region.The piori information is involved in the regularization parameter that can improve the high-frequency components of the restored image.As shown from the results obtained in the phantom imaging,the proposed super-resolution technique can improve the resolution of magnetic resonance image.

BACKGROUND: Ions doping is an important method for the modification of bioceramic.OBJECTIVE: To evaluate a novel co-substituted bioceramic scaffolds as bone repair material.METHODS: The microstructure and crystallization of the scaffolds were detected by scanning electron microscope and X-ray diffraction. Compression strength test,degradation test and cell culture experiment were assumed to evaluate the properties of KSCPP in vitro. After a short period of muscle pouches implantation,the performance of KSCPP in vivo was evaluated.RESULTS AND CONCLUSION: The results show that KSCPP scaffold has a higher compressive strength and degradation rate. Moreover,the MTT assay and implantation test reveal that the KSCPP scaffold exhibits lower cytotoxicity and better tissue biocompatibility than CPP and HA. The study proved the great potential of KSCPP in bone repair applications.

Objective To investigate the effects of emodin on the triglyceride metabolism and oxidative stress in steatosis in HepG2 cells and possible underlying mechanisms.Methods The appropriate concentration of emodin on HepG2 cells were detected by methyl thiazolyl tetrazolium (MTT) assay.HepG2 cells were induced to fat overaccumulation by 1 mmol/L free fatty acids (FFA) (oleate∶ palmitate =2∶1).The model group exposed to 10 μmol/L,20 μmol/L,40 μmol/L emodin.The intracellular lipid accumulation was documented by Oil Red O staining and the content of triglyceride and total cholesterol was observed.Reactive oxygen species (ROS) was determined by flow cytometry.Western blotting was performed to analyze the protein levels of adenosine monophosphate-activated protein kinase (AMPK),phosphorylated AMPK,and sterol regulatory element-binding protein 1 (SREBP-1).Results Emodin reduced lipid accumulation and triglycerides (TG) content (P ＜ 0.05).At the same time,it significantly reduced ROS production (P ＜ 0.05).Moreover,the levels of AMPK and p-AMPK protein were significantly upregulated,and SREBP-1 protein was significantly downregulated with the treatment of emodin (P ＜ 0.01).Conclusions This study has demonstrated that emodin can reduce fatty degeneration induced by FFAs in hepatocytes,and this effect may be partially mediated by the AMPK/SREBP-1 pathway.

Objective: To evaluate the effect of platelet activating factor(PAF) antagonism on the blood content in the random survival flap. Methods: A lipophilic PAF receptor antagonist BN52021 was administered to treat flaps through a local subcutaneous injection route 30 min prior to transplantation. The flaps were imaged in situ by a gamma camera. Results: The PAF receptor antagonist significantly augmented the accumulation of radioactivity of middle and end part within treated flaps( P

Objective To analyze the associations of age and gender with post-operative outcomes after pilon fracture and the effect of interaction between age and gender on the outcomes.Methods A retrospective cohort study was performed of the 101 successive patients with pilon fracture who had been treated by open reduction and internal fixation from March 2009 to November 2013 and completely followed up.The distributions of potential prognostic factors (diabetes,injury mechanism,open fracture,Rüedi-Allg(o)wer classification and AO classification) were analyzed in different age and gender groups.The outcomes were evaluated in terms of reduction quality by the Burwell-Charnley criteria,time for return to work,traumatic osteoarthritis by Kellgren-Lawrence grading scale and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score.The odds ratio and regression coefficients were estimated by Logistic regression and linear regression model;P values for interaction between age and gender were estimated by likelihood ratio tests.Results Of all the 101 pilon patients,84 were male and 12 were the aged.The distributions of gender (P =0.028) and mechanism (P =0.032) were significantly different between the aged and the younger patients,showing there were more females in the aged patients and low-energy injury was more likely to cause a pilon fracture in the aged patients.As multivariate analyses suggested,with the above influencing factors controlled,a median follow-up of 41.2 months revealed age was an independent favorable prognostic factor for reduction quality (OR =3.919,P =0.041).The association between gender and time for return to work was significantly different between the aged and the younger patients,as indicated by interaction analyses (P =0.030).Conclusions There may be more females in the aged patients with pilon fracture than in the younger ones.It is likely that the aged patients sustain a pilon fracture because of low-energy injury and achieve a fracture reduction of poorer quality.Although the quality of reduction may be poorer for the aged,there may be no significant difference between the aged and the younger patients in the mid-long-term AOFAS score.It is advisable for surgeons to provide personalized treatment to better help the patients.

Objective:To investigate the correlation between 24 h blood pressure variability and early neurological improvement (ENI) in patients with large vessel occlusion (LVO) after endovascular thrombectomy (ET).Methods:Patients with LVO received ET in the Emergency Department, the Affiliated Hospital of Nantong University from January 2012 to February 2018 were enrolled retrospectively. During the first 24 h after ET, the blood pressure was recorded every 2 h, and blood pressure variability was evaluated by standard deviation (SD) and successive variation (SV). At 24 h after ET, the National Institutes of Health Stroke Scale (NIHSS) score was evaluated again. The re-evaluation of 0 point or a decrease of ≥4 from the baseline score was defined as ENI. Multivariate logistic regression analysis was used to evaluate the relationship between blood pressure variability and ENI. Results:A total of 74 patients with LVO received ET were enrolled, of which 39 (52.7%) had ENI. Univariate analysis showed that the proportion of patients with good recanalization in the ENI group after procedure were significantly higher than that in the non-ENI group ( P<0.05), while the average systolic blood pressure, average diastolic blood pressure, systolic blood pressure variability (SBPV) -SD and SBPV-SV within 24 h after ET and baseline total cholesterol level were significantly lower than those in the non-ENI group (all P<0.05). Multivariate logistic regression analysis showed that higher SBPV-SV was an independent risk factor for non-ENI (odds ratio 1.223, 95% confidence interval 1.038-1.440; P=0.016). Conclusion:Higher SBPV-SV after ET is associated with poor early neurological improvement in patients with LVO, and it is expected to be a potential target for blood pressure management in patients after ET.

Objective:To evaluate the efficacy of remimazolam for induction and maintenance of general anesthesia in patients undergoing abdominal surgery.Methods:A total of 100 patients of both sexes, aged 18-64 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing elective abdominal surgery with general anesthesia requiring tracheal intubation, were enrolled in this study and divided into 2 groups ( n=50 each) using a random number table method: remimazolam group (group R) and propofol group (group P). Anesthesia was induced by intravenously infusing propofol 1.0-2.5 mg/kg in group P and remimazolam 0.15-0.35 mg/kg in group R. Sufentanil 0.4-0.5 μg/kg and rocuronium 0.6 mg/kg were intravenously injected in group R and group P. Anesthesia was maintained by intravenously injecting remimazolam 0.3-1.0 mg·kg -1·h -1 in group R and propofol 4-12 mg·kg -1·h -1 in group P. Remifentanil 8-15 μg·kg -1·h -1 was intravenously injected in group R and group P. Narcrotrend index (NI) was maintained at 37-64 (D 0-D 2). The success of sedation, time for loss of consciousness, time of disappearance of eyelash reflex, time when NI dropped to D 0, incidence of tidal volume, respiratory rate and apnea after the patients lost consciousness, duration of stay in post-anesthesia care unit, the fluctuation range of mean arterial pressure at 1, 3 and 5 min of induction, and the development of intraoperative and postoperative adverse events. Results:The success rate of sedation in group R and group P was 100%.Compared with group P, time for loss of consciousness, time of disappearance of eyelash reflex and time when NI dropped to D 0 were significantly prolonged, tidal volume and respiratory rate were increased, the incidence of apnea after the patients lost consciousness was decreased, awakening time was shortened, the incidence of intraoperative sinus bradycardia, injection pain and dream was decreased, fluctuation range of blood pressure at 1, 3 and 5 min of induction was decreased in group R ( P<0.05). Conclusion:Remimazolam can be safely and effectively used for induction and maintenance of general anesthesia in patients undergoing abdominal surgery, and its induction dose is 0.15-0.35 mg/kg, and maintenance dose is 0.3-1.0 mg·kg -1·h -1.

A type of designated hospitals in Medicare is referred to as Long-Term Care Hospital (LTCH). LTCH is one of Post-Acute Care settings(I. e. Intermediate care)and the only facilities certified by length of stays. This article reviewed the milestones and payment methods of Medicare Long-Term Care Hospital payment system, for perfection of the medical insurance and construction of China′s intermediate care system.