Objective To explore the influence of bacteria lipopolysaccharide on the cytokine production of flour mite allergic rhinitis patients. Methods 8 cases with perennial allergic rhinitis were selected. Then the heparin anticoagulation venous blood was taken from the same patient and was added to fetal calf serum,with ultimate volume 1 ml. The two experimental groups were added 10μg LPS and 1 μg LPS respectively, forming the high LPS dose group and low LPS dose group,while the control group was added nothing. Results The contents of IL-4、IL-5、IL-10、IL-12、IFN-γwere tested by enzyme-linked immunosorbent assay. The findings were that there was significant difference in the productive contents of IL-4、IL-5、IL-10、IL-12 and no significant difference in that of IFN-γ between the high LPS dose group and the low LPS dose group. When compared in two groups,significant difference was found in the productive contents of IL-4 ,IL-10 and IL-12 between the two experimental groups and between the high LPS dose group and the control group, while no obvious difference existed between the low LPS group and control group. However, significant difference was altogether found in the productive content of IL-5 when compared one with another among the three groups,and the result was that low dose of LPS obviously promoted the production of cytokine while high dose of LPS restrained the production of cytokine; no significant difference was found in the production of IFN-γ in all comparisons between the three groups. Conclusion This research, through the experiments in vitro, proved that LPS could effectively adjust the cytokine production of perennial flour mite allergic rhinitis patients and the balance of Th1/Th2 ,whose effect depends on the dose of LPS. This research suggested that the practical future in which special cytokine target treatment will be adopted on perennial flour mite allergic rhinitis patients.

Objective To investigate the effects of rapamycin which is an autophagy inducer and 3-adenine (3-MA) which is an autophagy inhibitor on motor behavior and autophagy related protein LC3 in C57BL/6 mice of Parkinson's disease(PD).Methods 40 C57BL/6 male mice were randomly divided into control group and experimental groups which consist of MPTP model group,rapamycin group and 3-MA group,with 10 in each group.Mice in experimental groups received intraperitoneal injection with MPTP to establish PD models,and mice in control group received intraperitoneal injection with the same amount of saline solution for 1 week.Mice in rapamycin group received intraperitoneal injection with rapamycin and mice in 3-MA group received intraperitoneal injection with 3-MA at the same time when MPTP was injected.Animal behavior detections were carried out on the 1 th,7th and 14th day after the last injection.After the last injection,mice were sacrificed and sections of midbrain nigra were gained for the detection of expression of autophagy specificity protein LC3 by Western Blot.Results Compared with MPTP model group,rapamycin could improve the general condition and behavioral manifestation of mice in pole test((14.89± 1.14) s vs (16.24±1.39) s,P＜0.05;(15.18±1.36) s vs(17.93±1.11s),P＜0.01),traction test((1.7±0.5) vs (1.2±0.4),P＜ 0.05;(1.5±0.5)vs (1.1±0.3),P＜0.05) and open field test which contained total activity distance((5 875.3 ± 1148.9) cm vs (5 061.5±773.1) cm,P＜0.05;(5 753.2± 1 106.7) cm vs (4 669.3±969.1) cm,P＜0.01) and average speed((19.29±2.35) cm/s vs (16.47±3.01) cm/s,P＜0.05;(18.71±2.71)cm/s vs (15.80±2.50) cm/s,P＜0.01),while 3-MA aggravated behavioral deficits of mice in pole test(19.92± 1.61s vs 17.93± 1.11 s,P＜0.05),and both total activity distance((3 879.7±575.0) cm vs (4 669.3±969.1) cm,P＜0.05) and average speed((13.34± 1.87) cm/s vs (15.80±2.50) cm/s,P＜0.05) in open field test were decreased.The results of Western Blot confirmed that rapamycin could increase the expression of LC3-Ⅱ,however 3-MA could re duce the expression of LC3-Ⅱ.Conclusion This study confirmed that rapamycin could alleviate behavioral symptoms of PD model mice and increase the level of LC3 in midbrain nigra,while 3-MA could exacerbate behavioral symptoms in PD model mice and decrease the level of LC3 in midbrain nigra.Thus it can be speculated that drugs which can regulate autophagy may be potential treatment protocols for PD.

Objective To probe the value of varied magnetic resonance imaging(MRI) techniques applied in differential diagnosis of tuberculous pyonephrosis from hydronephrosis.Methods Features of MRI,including in T_1WI with/without enhancement,T_2WI,urology MRI and diffusion weighted image(DWI),in seven cases with tuberculous pyonephrosis and 10 cases with hydronephrosis pathologically confirmed were retrospectively analyzed.Results Regular T_1WI and T_2WI could show morphology of the whole kidney,destruction of renal parenchyma and empyema.T_1WI with enhancement could manifest abnormally reinforced walls of pyoid cavity,renal pelvis and calyx and ureter.Urology MRI could show morphology of the whole urinary passage with pathological changes more clearly.Accuracy of these techniques was 84.7%.DWI had the advantage of analyzing diffusion image and ADC map to understand diffusion features of water molecule,and of quantitating ADC value to differentiate tuberculous pyonephrosis from hydronephrosis,with an accuracy of 91.2% combining with DWI and other methods.Conclusion Combined application of varied MRI techniques should be highlighted in differentiation of tuberculous pyonephrosis and hydronephrosis with a higher accuracy of diagnosis.

Objective To evaluate the value of diffusion-weighted MRI in the functional study of kidney.Methods Fifteen volunteers as control group and 32 patients with chronic kidney disease(CKD) were underwent DW MR imaging in a dehydrated state.In CKD group,12 cases were with normal serum creatinine(Scr) level(CKD group 1) and 20 cases with Scr increased in different level(CKD group 2).Apparent Diffusion Coefficient(ADC) value of each kidney of all groups was measured and compared of their relationships with clinical data.Results The ADC values of 15 volunteers in different b values(50,100,400) were(405.366?35.9639)?10~(-5)mm~2/s,(339.646?23.0594)?10~(-5)mm~2/s,and(254.532?13.6763)?10~(-5)mm~2/s,respectively.The ADC values of CKD group 1 were(336.622?12.879)?10~(5)mm~2/s,(308.142?20.998)?10~(-5)mm~2/s,and(211.398?14.604)?10~(-5)mm~2/s,respectively.And of CKD group 2 were(307.717?84.930)?10~(-5)mm~2/s,(265.415?57.754)?10~(-5)mm~2/s,and(201.672?26.411)?10~(-5)mm~2/s,respectively.The ADC values in CKD group were lower than those of the normal kidneys(t values compared between the control group and CKD group 1 were 9.720,5.190,11.093 separately,between the control group and CKD goup 2 were 6.533,7.382,10.864 separately in different b values,with all P values less than 0.05).In CKD group 2,it had been showed negtive correlation between the level of Scr and ADC values of kidney,with mean level of Scr of(828.490?699.350) ?mol/L,but this was confirmed of no statistical meanings(the coefficient correlation were(-0.272、)-0.283、-0.023 separately in different b values,with p values more than 0.05).For the creatinine clearance rate(Ccr),it showed a weak positive correlation with ADC values of CKD group 2(the coefficient correlation were 0.511、0.430、0.335 separately,with P values less than 0.05).Conclusion(Diffusion-weighted) MRI imaging and in vivo measurement of ADC values have the potential for use as a noninvasive means to explore the functional status of the kidney.

Objective To evaluate the predicting value of the marker of endothelial injury: plasma matrix metalloproteinase-9( MMP-9) and high sensitivity C-reactive protein( hsCRP) level on the progression of acute anterior circulating territory infarction progressing to malignant middle cerebral artery infarction (m-MCAI). Methods 90 patients with acute anterior circulating territory infarction, in which 46 patients progressed to m-MCAI, were collected and sampled consecutively. The plasma MMP-9 and hsCRP of all patients were determined by ELISA and immunotur-bidimetry,respectively,at admission. And the clinical characters and cranial CT features of the patients were analyzed. Results At admission,the plasma MMP-9 level in the patients with m-MCAI(242.0 ±58.0)ng/ml was significantly higher than that in the patients with non m-MCAI( 169.0 ± 50.0) ng/ml( P < 0. 01) ,the plasma hsCRP level in the patients with m-MCAI(6.25 ±1.2) ng/ml was significantly higher than that in the patients with non m-MCAI( 1.55 ± 0.9) mg/ml( P <0. 01).Conclusion The increased level of plasma MMP-9 and hsCRP could be predictors for the m-MCAI proceeding.

Objective To investigate the effects of the treatment of open injury and orthopedic postoperative wound infections with Vacuum Sealing Drainage.Methods Retrospective analysis of the clinical results of 32 patients with open injury or orthopedic postoperative wound infections in our hospital.Results Follow the indications and contraindications strictly and ensure right pressure,all the infection of wounds was controlled,and split skin graft survived.Without the package and pressurized fixation,the wounds healed better.Conclusion Vacuum Sealing Drainage can be considered one of the effective methods to treat the open injury or orthopedic postoperative wound infections and is worthy to be carried out as a routine.For patients with vascular rupture or defect,when there was still skin defects after vascular graft repair,as long as covered vascular anastomosis with the surrounding skin and soft tissue during the operation,there was still can use closed vacuum sealing drainage to cover the wound to prevent infection.

Objective To investigate the effect of cystatin C (Cys C) on adventitia in rabbit abdominal aorta restenosis after angioplasty and its mechanism.Methods 48 New Zealand white rabbits were randomly divided into injury group (receiving balloon dilation of abdominal aorta),the treatment group (taking Cys C monoclonal antibody therapy) and the control group (receiving femoral artery puncture and catheter sheath without balloon dilation and intervention of Cys C monoclonal antibody injection),and each group had 16 rabbits.Peripheral vein blood was drawn to measure the serum level of cystatin C before and 8 h,1 day,1 week,3 weeks,6 weeks after the operation in all rabbits.After 6 weeks of operation,the abdominal aorta were taken and stained with HE.Vascular morphometry analysis and adventitial cell count were conducted.Smooth muscle actin (SM-actin) and proliferating cell nuclear antigen (PCNA) expressions in the adventitia were observed by immunohistochemical staining.The number of PCNA positive cell in the adventitia was counted and the PCNA proliferation index was calculated.The vascular remodeling index,vascular external elastic lamina area (EELA),internal elastic lamina area (IEIA) were used to evaluate the vascular remodeling and the residual stenosis and vascular cavity area was used to measure the vascular stenosis.Results Plasma Cys C level began to rise at 8h after operation and reached the peak at 1 week after operation,and continuously increased for 5 weeks in injury group,and reached to respectively at 3 weeks and 6 weeks after operation.The Cys C levels were significantly higher in injury group than in the treatment and control groups at different time points (all P＜0.05).There were no significant differences in Cys C levels at different time points between the treatment group and the control group.The injury group showed that the number of PCNA positive cells was higher in injury group than in treatment and control groups,both P＜0.05).Compared with the control group,the vascular luminal area,EELA and IELA were significantly increased (all P＜0.05).After treated with the monoclonal antibody Cys C intervention,the treatment group showed that lumen area,vascular EELA,IELA was significantly decreased (P＜0.05),and the vascular remodeling index and residual stenosis rate were decreased as compared with the injury group (0.871 vs.0.784,33.1％ vs.19.7 ％,both P＜0.05).Correlation analysis showed that Cystatin C level was positively correlated with the vascular lumen area,neointimal area,internal elastic lamina area,external elastic lamina area and the number of PCNA positive cells (r=0.812,0.797,0.876,0.932 and 0.822 respectively,all P＜0.01).Conclusions Plasma Cys C level is increased in rabbit after abdominal aorta balloon injury and has a positive correlation with the severity of arterial stenosis.High Cys C level can induce adventitial fibroblast activation,proliferation,phenotype transformation and migration,and accelerate the processes of atherosclerosis and stenosis.Cys C level is the independent risk factor for abdominal aortic stenosis.

Objective To investigate whether curcumin protects dopamine neurons in Parkinson's disease (PD) by activating autophagy and discuss its specific mechanism.Methods In vitro,SH-SY5Y human neuroblastoma cells were treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPP+) to induce PD cell models.In vivo,C57BL/6 male mice were performed intraperitoneal injection of 30 mg/kg 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) once daily for 7 d continuously to establish PD models.SH-SY5Y human neuroblastoma cells and C57BL/6 male mice were,respectively,divided into normal control group,model group,curcumin group,curcumin and 3-methyladenine (3-MA) group,and 3-MA group.Curcumin was used as intervention treatment,and 3-MA,an autophagy inhibitor,was used individually or concurrently with curcumin as intervention controls:curcumin (40 μmol/L),curcumin (40 μmol/L)+3-MA (4 mmol/L),and 3-MA (4 mmol/L) were added into the cells of curcumin group,curcumin and 3-MA group,and 3-MA group at the time of MPP+ addition;curcumin (80 mg/kg),curcumin (80 mg/kg)+3-MA (2 mg/kg),and 3-MA (2 mg/kg) were added into the mice of curcumin group,curcumin and 3-MA group,and 3-MA group at the time of MPTP injection once daily.In the normal control group,sterile saline was injected into the abdomen simultaneously (30 rmL/kg).In cell groups,after 48 h of drug treatment,the number of surviving dopamine neurons was detected by tyrosine hydroxylase (TH) immunofluorescence;Western blotting was used to detect protein expressions of α-synuclein (α-Syn),and autophagy related proteins lysosome-associated membrane protein 2A (LAMP2A) and microtubule-associated protein 1 light chain 3 (LC3);transcription factor EB (TFEB) levels in the cytoplasm and nucleus were detected separately by Western blotting;reverse transcription (RT)-PCR was used to detect the α-Syn mRNA expression.In mice groups,14 d after the last injection,mice were sacrificed and sections ofmidbrain nigra were gained for detection of TH level by immunohistochemistry,expressions of α-Syn and LC3 were detected by Western blotting.Results (1) As compared with model group,curcumin group had significantly larger number of surviving dopamine neurons both in vitro and in vivo,significantly decreased α-Syn protein and mRNA expressions in vitro,and significantly decreased α-Syn protein expression in vivo (P＜0.05);curcumin group had statistically increased LAMP2A and LC3-Ⅱ protein expressions in vitro and LC3-Ⅱ protein expression in vivo as compared with model group (P＜0.05).(2) As compared with curcumin group,curcumin and 3-MA group had statistically smaller number of surviving dopamine neurons in vitro and in vivo,and statistically increased α-Syn protein expression in vitro (P＜0.05).(3) In vitro,as compared with model group,curcumin group had significantly increased TFEB protein expression in nucleus (P＜0.05),and curcumin and 3-MA group had statistically increased TFEB protein expression in cytoplasm and statistically decreased TFEB protein expression in nucleus (P＜0.05).Conclusion Curcumin has protective effect on dopamine neurons of PD;one of the main mechanisms is that curcumin can activate the autophagy function and promote the clearance of α-Syn;increasing the TFEB expression,promoting the transfer of TFEB to nucleus to perform the transcription function,and then promoting the synthesis of autolysosome may be the main ways to activate the autophagy function.

Objective To explore the effect of exercise on the expression of the LINGO-1 gene after intra cerebral hemorrhage (ICH).Methods Seventy-two Sprague-Dawley rats were randomly divided into a sham operation group,a control group and an exercise training group,each of 24.The three groups were further divided into 1 d,3 d,7 d and 14 d groups.ICH was induced using intra-parenchymal injection of autologous blood.The exercise training group was then forced to exercise on a treadmill.Any recovery of neurological functional was evaluated using Longa scoring,and the expression of LINGO-1 mRNA and protein were detected using the reverse transcription-polymerase chain reaction and western blotting.Results The sham operation group displayed no obvious neurological deficiency,with little expression of LINGO-1 mRNA or protein at any time point.The control group's average Longa score reached a maximum of 3 seven days after the operation,decreasing to 2 after another 7 days.The average expression of LINGO-1 mRNA and protein in that group peaked at 1.335±0.393 three days after the ICH,then decreased to 0.429±0.035 on the 7th day and 0.371±0.038 on the 14th day.In the exercise training group the average Longa score on the 7th day was 2,the average LINGO-1 mRNA level was 0.257±0.042 and the average protein level was 1.142±0.287,all significantly lower than in the control group.Moreover,in the exercise group there was a significant positive correlation between LINGO-1 protein expression and the Longa scores.Conclusion Exercise can decrease the expression of LINGO-1 mRNA and protein and promote the recovery of neural function after ICH.

Objective:To discuss the application and effectiveness of the flipped classroom based on Wechat platform in the teaching of neurology.Methods:clinical students of grade 2014 of binjiang college of Zhejiang Chinese Medical University were selected as teaching subject. The students were divided into experimental group which contained a total of 74 students in class one and class three and the control group which contained a total of 38 students in class two. Peripheral neuropathy and neuromuscular-junction disease were selected as teaching contents. The experimental group adopted flipped classroom as the teaching mode and Wechat platform for pre-class preparation, after-school review and interactive communication. The control group was taught by traditional teaching mode. Before and after class, students in the two groups had a small-scale test and were surveyed by questionnaire, respectively. Students in the two groups took the same final exam which included case analysis when the course was over. The scores of the final exam and the results of the case analysis of each group were recorded and analyzed. All data were processed with statistical software SPSS 20.0, and t-test or chi-square test was used. Results:Students in the experimental group had significantly higher test scores in the after-class small-scale test than those in the control group ( P=0.038). Their final exam scores were higher than those in the control group ( P=0.046), and their scores of case analysis in the final exam were higher than those in the control group ( P=0.026). The results of pre-class questionnaire survey showed that the proportion of students who chose "good" in the experimental group was higher than that in the control group on the understanding of the learning content and the preparation ( P<0.05). In the after-class questionnaire survey, the proportion of students who chose "excellent" and "good" in the evaluation of learning interest in the experimental group was higher than those in the control group ( P<0.05), the proportion of students in the experimental chose "good" in evaluating their self-learning ability was higher than that in the control group ( P<0.05), the proportion of "excellent" on clinical thinking ability and teaching satisfaction was higher in the experimental group than that in the control group ( P<0.05), and the overall proportion of students who chose "excellent" and "good" in all items in the experimental group were higher than that in the control group ( P<0.05). In the experimental group, the overall proportion of students who selected "excellent" and "good" in on the evaluation of their learning interest was significantly increased in the after-class questionnaire survey compared with the pre-class questionnaire survey ( P<0.01). Conclusions:The application of flipped classroom based on Wechat platform is feasible and effective in the teaching of neurology. It can make up for the deficiency of traditional teaching methods. It is helpful to improve students' learning interest and self-learning ability, and is also helpful to exercise their clinical thinking ability. Thus this method deserves further popularization.