Objective To investgate the electromyographic and pathological features of peripheral nerve involvement in MS,and clarify factors that affect the involvement of PNS Methods Thirty three multiple sclerosis(MS) patients were selected according to Poser's definite diagnosis of MS,without other nervous system disorders and thirty volunteers served as controls All subjects received nerve conduction study:MCV,SCV,F wave and H reflex Sural nerve biopsy and pathological change were observed in light and electronic microscope Results Electromyograph findings:decreased CMAP of the median,tibial and peroneal nerves,and high amplitude of SAP of median and ulnar nerves were observed in MS Our study also showed the prolonged F wave response and H reflex in median and tibial nerves,low F wave rates Electrophysiologic abnormalities in MS showed close relationship to the EDSS,duration and lesion position in spinal cord Sural nerve biopsy revealed myelinated nerve fibers with segmental demyelination by light microscope Inflammatory cellular infiltration and onion bulb formation were not found? Axonal degeneration and laminae dissociation in myelin sheath were demonstrated by electromicroscope Conclusion MS is a demyelinating disease attacking to CNS In some MS patients,both CNS and PNS might be involved at the same time The peripheral demyelinating lesions seem to be common in spinal nerve root But the secondary axonal degeneration in distal segment should be another pathologic feature of MS EMG is a useful test method to evaluate the peripheral nerve damage and prognosis of MS

Objective To realize the relationship between substance P(SP) and abnormal gastrointestinal tran- sit. Methods By radioimmunoassay, concentration of SP in sigmoid mucosa was determined in 12 healthy volun- teers, 15 slow and 10 fast transit patients. ResultsThe concentration was (27.68±15.42)μg/g, (24.07+5.76)μg/g and (28.61± 18.34)μg/g,respectively. They had no statistical difference. Conclusion There was no relationship be- tween concentration of SP in sigmoid mucosa and abnormal gastrointestinal transit.

Objective To report a case of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) combined with idiopathic intracranial hypertension (IIH) and review the relationship between the IIH and OSA. Methods A case of increased intracranial pressure in a middle-aged male patient who was diagnosed as IIH after the MRI and angiography ruled out intracranial lesions was reported. This patient presented with drowsiness, obesity and other symptoms. An overnight polysomnography (PSG) confirmed severe OSA. The simple use of intracranial pressure lowering therapy could not achieve sustained effective control of symptoms of high intracranial pressure. The clinical effects of comprehensive treatment for the OSA including CPAP and weight loss were observed. Results After 3 months treatment, the body mass index of this patient dropped from 35.7 to 31.4, apnea hypopnea index dropped from 72.6 to 10. 1, and the minimum SaO2 increased from 67% to 82%. And the symptoms of high intracranial pressure including headache and papillaedema were continuously improved. Conclusion Sleep apnea is a risk factor for IIH, especially for obese male patients. PSG monitoring could help us to find the important but easily overlooked factor of OSA. Taking active measures to treat OSA can effectively relieve the high intracranial pressure symptoms in patients with IIH.

OBJECTIVE To investigate the bone development activity and differences in safety of ethanol extract (EE) and water decoction (WD) of Psoralea corylifolia L.efficiently.METHODS Zebrafish larvae were co-exposed to prednisolone 25 μmol· L-1 and different concentrations of EE and WD (0.1,1.0,10 and 100 mg crude drug· L-1),and etidronate disodium (ED) 30 mg·L-1.All these groups were incubated at 28.5℃ until 9 dpf.The medium solution was changed every other day.Zebrafish skeleton at 9 dpf was stained with alizarin red and inspected under an optical microscope,in addition,the death toll and organ toxicity of zebrafish were also observed.The mRNA expression of osteoprotegrin (OPG) and receptor activator of NF-κB ligand (RANKL) in 9 dpf zebrafish were determined with fluorescence quantitative PCR.Zebrafish embryos (1 dpf) were exposed to various concentrations of EE (10,20,30,35,40,50 and 60 mg crude drug· L-1),WD (10,50,100,125,150,175,200 and 500 mg crude drug· L-1),psoralen (12.5,25.0,50.0,100.0,200.0 and 400.0 μmol·L-1) and bakuchiol (1,5,10,25 and 50 μmol· L-1).Embryonic morphology of zebrafish (3 dpf) was inspected with an optical microscope and the death toll of embryos or larvale was counted from 2 dpf to 9 dpf and LC50was calculated.Components of EE and WD ware analyzed by HPLC method.RESULTS Both EE (0.1 mg crude drug· L-1) and WD (1.0 mg crude drug· L-1) groups could increase the staining area and optical density values of zebrafish skeleton compared with prednisolone group (P＜0.01),indicating the increase in bone mineralization;the OPG mRNA expression in both EE and WD (1.0 mg crude drug· L-1) groups increased,while the RANKL mRNA expression decreased (P＜0.01) and the ratio of OPG/RANKL improved obviously (P＜0.01).Embryos exposed to EE,WD,psoralen and bakuchiol showed swelling of the heart and yalk sac,and decrease in GOT.The LC50 of WD and psoralen was 5～8 and 5～21 times that EE and bakuchiol,respectively.The composition and relative content of EE and WD also varied considerably.CONCLUSION Bone development activity and toxicity of EE are both stronger than those of WD.The lipid soluble characteristic components of Psoralea corylifolia L.,may be critical components of toxicity.

Objective To investigate the risk factors of cerebral palsy in newborns with periventricular leukomalacia(PVL).Methods Sixty-one infants with sequela of cerebral palsy among 806 neonates born at the Second People'S Hospital of Liaocheng,Shandong,China,during December 2000 to November 2005 were studied for its etiology.Diagnosis of cerebral palsy in 26 of the 61 infants was established by type B ultrasonic scanning or magnetic resonance imaging(MRI)for the head at least twice and excluded of other diseases.Thirty-five infants without PVL hospitalized at the same hospital were enrolled as control group during the same period.Logistic regression analysis was performed for the risk factors of PVL. Results Twenty-six infants were diagnosed as PVL.accounting for 42.6％of those with cerebral palsy.Main high-risk factors of PVL included severe asphyxia(x3),low gestational age(x1),intraventricular hemorrhage(x14)and low blood pressure(x8),with odds ratios of 2.843,3.575,3.268 and 1.947,respectively,and a fitted regression model as logistic(P)=β0+0.7952 x3-1.428x1-1.328 x14+0.8256x8.Pregnant hypertension,neonate respiratory distress syndrome(NRDS),and intrauterine infection could also affect occurrence of PVL,all with statistical significance(P＜0.05).Conclusion PVL is one of main causes of cerebral palsy,with severe asphyxia,low gestational age,intraventricular hemorrhage and low blood pressure as main high-risk factors.

ObjectiveTo study the effect and mechanisms of nourishing Piyin Remedy (nPR) and bovine brain extract (bBE) on experimental spinal cord injury (SCI) of rat.Methods80 healthy SD rats were divided into 5 equal groups randomly: bBE group supplied through subarachnoid cavity, normal saline (NS) group supplied through subarachnoid cavity, nPR group, NS orally taken group, combined group. Animal models were made by Allen's equipment on T8～T9 segment. The spinal nerve function, somatosensory evoked potentials (SEP), retrograde and label technique of horseradish peroxidase, gross observation, histological and morphometric analysis were taken as the observed indices.ResultsThe values of observed indices of bBE group and nPR group improved evidently compared with their own control groups; that of combined group was prior to sole administration.ConclusionnPR can hold back the secondary SCI and accelerate the recovery of spinal nerve function; bBE can stimulate the improvement of injuried nerve fibers; the joint of nPR and bBE can make a synergic effect.

Objective To evaluate the acute effects of mirtazapine on sleep polysomnographic variables in patients with major depressive disorder (MDD) using polysomnography (PSG). Methods Twenty-five MDD patients took mirtazapine 15 mg an hour before bedtime during the first three days and then 30 mg during the following four days. Polysomnographic and clinical data were collected at baseline and on the 7th day. Results The scores on the Athens Insomnia Scale (AIS,7.92±3.86,t=10.255,P=0.000), the Hamilton Anxiety Rating Scale (HAMA,6.84±5.57,t=6.137, P=0.000) and the Hamilton Depression Rating Scale (HAMD-17,9.80±4.41,t=12.132,P =0.000) decreased rapidly after a 7-day medication. PSG showed mirtazapine administration significantly increased the total sleep time (402.46±80.75,t=-2.990,P=0.006), the sleep efficiency (76.17%±10.65%,t=-2.750,P=0.011), and the slow wave sleep percentages(19.66%±11.43%,t=3.236, P=0.004) and decreased the wake time after sleep onset (80.38±48.02,t=2.972,P =0.007). However, there was no significant difference in the sleep latency, the number of awakening, the rapid eye movemert (REM) sleep latency, the ratio of REM sleep and the frequency of REM sleep episode. Conclusion Mirtazapine as monotherapy in the treatment of MDD has relieved depressive symptoms rapidly and significantly, increased the total sleep time, the sleep efficiency and the slow wave sleep percentages thus to achieve better sleep quality.

Objective To study the clinical,electrophysiological,athological and genomic features of hereditary neuropathy with liability to pressure palsies (HNPP) and increase the understanding and diagnostic level of this disease.Methods Eleven patients with HNPP,met Gouider diagnostic criteria and admitted to our hospital from March 1999 to December 2014,accepted detailed clinical examinations,electromyogram,sural nerve biopsies.Multiplex ligation-dependent probe amplification was used to detect peripheral myelinprotein 22(PMP22) gene deletion on chromosome 17P11.2.Results Eight patients came from two families and it was consistent with automsomal dominant inheritance.Age at onset was on teen-agers.Clinical manifestations were characterized by recurrent mononeruopathies.Symptoms often disappeared spontaneously after a few days or a few months.Nerve conduction studies showed a sensori-motor demyelinating polyneuropathy with conduction abnormalities preferentially localized at common entrapment sites.The nerve biopsy showed the presence of some large thickened myelinated fibers,but the axons were normal.Gene mutation analysis showed that two patients had large fragment tandem deletions containing PMP22.Conclusions Although HNPP is concerned with heredity,there are also some sporadic cases to be found.Electrophysiologic examination is an important screen method.The definitive diagnosis is dependent on PMP22 mutation detection.

The sense of stigma is common in young and middle-aged diabetic patients, which greatly affects their quality of life. This article reviews the concepts related to stigma, the current status of stigma in young and middle-aged diabetic patients at home and abroad, the influencing factors and their effects on patients, aiming to provide a theoretical basis for the intervention of stigma in young and middle-aged diabetic patients.

Objective To identify core genes of Alzheimer's disease(AD)through bioinformatic analysis and explore potential pathogenic signaling pathways.Methods Gene expression profiling da-ta related to AD were downloaded from the Gene Expression Omnibus(GEO)database,with datasets GSE227221 and GSE162873 selected for analysis.GEO2R online analysis software was applied to screen differentially expressed genes(DEGs)between AD tissue samples and normal brain tissue sam-ples.The Disease Ontology(DO)enrichment analysis of DEGs was performed using the DOSE pack-age in R software,while Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses were conducted through the online data analysis tool DAVID.Protein-protein interactions(PPI)among genes were analyzed using the STRING database,and a PPI network was constructed with Cytoscape software.Hub genes within the PPI network were identified and screened using the MCODE plugin.Based on MCODE scores,further analysis was conducted to select core genes.Results A total of 1,373 DEGs with consistent expression trends involved in the onset and progression of AD were identified from the two datasets,with the core genes of GIMAP genes(in-cluding GIMAP1,GIMAP4,GIMAP5,GIMAP6,GIMAP7,and GIMAP1-GIMAP5).DO enrichment analysis revealed the strongest associations between DEGs and three diseases:systemic lupus erythematosus,lupus erythematosus,and atherosclerosis.GO functional enrichment analysis indicated that DEGs were primarily enriched in three signaling pathways:the classical Wnt signaling pathway,phospho-lipase C-activated G protein-coupled receptor pathway,and plasma membrane lateral domain path-way.KEGG pathway enrichment analysis showed that DEGs were primarily enriched in pathways such as cytokine-cytokine receptor interaction,neuroactive ligand-receptor interaction,and cancer-related transcriptional dysregulation.Conclusion The core pathogenic gene of AD may be the GIMAP gene,and the associated pathways are complex,potentially implicating immune dysfunction.