Objective To investigate the effect and its underlying mechanism of repetitive transcranial magnetic stimulation(rTMS)on dopaminergic neurons and glial cell line-derived neurotrophic factor(GDNF)in the substantia nigra(SN)in mice with Parkinson's disease(PD). Methods Thirty-two male C57 BL/6J mice were randomly divided into a normal saline group,a sham-rTMS group,a PD model group and an rTMS group,with 8 mice in each group. All the mice except those in the normal saline group were administered with 4 times of subcutaneous in jection of 1-methyl,4-phenyl-1,2,3,6 tetrahydropyridine(MPTP)15 mg/kg at 2-hour intervals in 1 day to induce neuronal injury in the SN and to establish acute mice PD model.The mice in the rTMS group received 5 trains of 1 Hz rTMS for 25 s,at the intensity of 1 Tesla(T)daily for 2 weeks.After rTMS,the effect of rTMS on PD mice was observed by immunohistoehemieal technique with regard to the expression of tyrosine hydroxylase(TH)and GDNF in the SN,and the quantitative analysis was performed by an advanced image-analysis system. Results Compared with normal saline group,the number of TH and GDNF immunoreaetive(TH-ir and GDNF-ir)cells and the corrected optical density(COD)values of PD model group and sham-rTMS group were significantly lower(P＜0.01);Com pared with PD model and sham-rTMS groups,the numbers of TH and GDNF positive cells and COD values in rTMS group were significantly higher(P＜0.05).There was a significant positive correlation between the count of TH-ir and that of GDNF-ir cells(r=0.836,P＜0.01).The correlation between the COD values of TH-ir and that of GD-NF-ir cells was also significant(r=0.921,P＜0.01).Conclusion rTMS markedly increased the number and the COD values of TH-positive dopaminergic neurons and simultaneously increased the number and the COD value of GD NF-ir cells in the SN of PD mice.These findings suggest that rTMS has neuroprotective effects on dopaminergic neurons in the MPTP-induced PD mice,which might be mediated by up-regulation of the expression of GDNF protein in the SN.

Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on dopaminergic neurons in substantia nigra and nigrostriate fibers in the striatum in cases of Parkinson's disease (PD).Methods Forty male C57BL/6J mice were randomly divided into a control group,a PD model group,a sham-rTMS (srTMS) group and an rTMS group with 10 mice in each group.A PD model was established by subcutaneous injection of a solution of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP),and the mice were treated with rTMS or sham rTMS for 14 days.Tyrosine hydroxylase (TH) expression in the substantia and striatum were detected using an immunohistochemical technique,and the corrected optical densities (CODs) of TH in the striatum were analysed using an image analysis system.The Nissl bodies were detected by Nissl staining.The morphological disposition of nerve fibers in the striatum was detected using Warthin-Starry staining.Results The fraction of neurons expressing TH decreased significantly more in the substantia nigras of mice in the rTMS group than in the control group,the PD group and the srTMS group.In the control group the neural plasm of dopaminergic neurons was full of dark blue and granular Nissl bodies.Many Nissl bodies were lost in the PD and srTMS groups,and the remaining Nissl bodies were colored lightly.Few Nissl bodies were lost in the rTMS group.Positive TH reactions in the striatum were significantly decreased in the rTMS group compared to the control group.The average COD was also significantly lower.But positive TH reactions in the striata of the rTMS group mice were significantly greater than in the PD and srTMS groups,and the average COD was significantly higher.In the control group,the disposition of nerve fibers in the striatum was typically fasciculated,concentrated and ordered; in PD and srTMS groups,many fibers were lost,and the remaining nerve fibers were rare,ruptured and scattered ; in the rTMS group fewer nerve fibers were lost and the disposition of the remaining fibers was more fasciculated,concentrated and ordered than in the PD and srTMS groups.Conclusion rTMS may play a role in treating Parkinson's disease by protecting dopaminergic neurons as well as nigrostriate fibers and by improving the synthesis and transport of dopamine.

Objective To investigate the clinical application of percutaneous transluminal angioplasty(PTA)in treating dysfunctional central vein caused by tunnel-cuffed catheter(TCC)under digital subtraction angiography(DS A)guidance.Methods A total of 13 patients with indwelling TCC-related central vein complications,who were admitted to the Department of Nephrology of the Affiliated Hospital of Qingdao University of China between July 2018 and July 2022,were enrolled in this study.The average indwelling duration of TCC was 35.2 months(range of 6-70 months).The dysfunctional TCC was removed with the help of a stiff guide wire,and angiography showed that the central vein was narrowed or occluded.PT A was performed to reopen the central vein,and a new TCC was placed in situ or in another site.Results Of the 13 patients,original TCC was successfully removed in 12,and failure of removal was seen in one.The site of central venous stenosis included the right jugular vein,innominate vein,superior vena cava,and right iliac vein,and successful placement of a new TCC was accomplished in all patients after PTA,and no stent implantation was employed.The average follow-up period was 23.1 months(range of 6-48 months),and the TCC functioned well.Conclusion Under DSA guidance,the recanalization of TCC-related central venous stenosis or occlusion by PT A and the implantation of a new TCC catheter can successfully establish a new dialysis access for patients with poorly functioning TCC,in this way the lifespan of the pathway can be extended.

Objective:To investigate the expression of HBV X, gene mutation in M type phospholipase 2 receptor (PLA 2R) in hepatitis B associated membranous nephropathy (HBV-MN) and its possible pathogenesis. Methods:According to the result of PLA 2R immunofluorescence detection in renal tissue, 103 patients with HBV-MN confirmed by renal biopsies were divided into two groups: PLA 2R positive group (n=66) and PLA 2R negative group (n=37). T test was used to compare the clinical biochemical measurements between the two groups. According to MN I stages (mild pathological injury) and MN II-III stage (severe pathological injury) of HBV-MN pathological stage, One-way ANOVA analysis was used to compare the pathological injury of kidney between the two groups. Spearman correlation analysis was used to compare the expression intensity of PLA 2R and pathological injury of kidney. Finally, the mutation sites of HBx gene in the two groups were analyzed. Results:There was significant difference in 24 h urinary protein between the two groups ( t=2.803, P=0.006). However, there was no significant difference in serum albumin level ( t=-0.313, P=0.755), serum creatinine ( t=-0.332, P=0.741), cholesterol ( t=0.312, P=0.756) and complement C3 ( t=0.589, P=0.557) between the two groups. There was significant difference between the two groups in MN stage I ( X2=7.449, P=0.006) and MN stage II-III ( X2=10.15, P=0.034). Secondly, the correlation analysis of Spearman between PLA 2R staining intensity and different MN pathological stages was statistically significant ( r=0.325, P=0.008). Finally, the mutation of HBx gene sequence between the two groups was analyzed, and it was found that the mutation at nt1753 site might be related to the expression of PLA2R. Conclusions:The positive expression of PLA 2R in renal tissue was found in 2/3 HBV-MN patients. The PLA 2R positive group was accompanied by the increase of urinary protein excretion and the aggravation of renal pathological injury. At the same time, nt1753 site mutations in HBx gene are related to the expression of PLA 2R, which may be an important pathogenesis of PLA 2R positive HBV-MN.