ObjectiveTo study the effects and feasibility of Smart Equitest Balance Master training for severe balance disorder caused by cerebellar hemorrhage in children. MethodsA 10-year-old boy with severe ataxia caused by cerebellar hemorrhage were trained with Smart Equitest Balance Master. He was assessed with Smart Equitest Balance Master, Modified Barthel Index and Berg Balance Scale. ResultsAfter 22 weeks of balance training, he improved in equilibrium, gait, posture control, activity of daily living, dysarthria, and return to school to continue his study. ConclusionSmart Equitest Balance Master training can significantly improve balance function，motor function and activities of daily living after cerebellar hemorrhage.

The pathomechanisms of the progression of chronic kidney disease (CKD) include glomerulosclerosis, renal interstitial fibrosis and renal arteriosclerosis. Chinese herbal medicine can delay the progression of CKD by ameliorating the harmful factors of these pathological changes, such as podocyte and slit diaphragm injury, nephrotoxicity of proteinuria, hyperactivity of renin-angiotensin-aldosterone system, cytokines over-expression, tubular epithelial myofibroblast transdifferentiation, hyperlipidemia and hypertension.
Chronic Disease ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans ; Kidney Diseases ; drug therapy ; metabolism ; Renin-Angiotensin System ; drug effects ; Transforming Growth Factor beta ; metabolism

OBJECTIVETo explore the potential molecular mechanisms of multi-glycoside of Tripterygium wilfordii Hook. f. (GTW) for ameliorating glomerulosclerosis (GS) by observing its intervention effect on transforming growth factor (TGF)-beta1/Smad signaling pathway in adriamycin-induced nephropathy (ADRN) model rat.

METHODSFifteen female Sprague-Dawley (SD) rats were randomly divided into three groups, the sham-operation group (A), the untreated model group (B), and the GTW treated model group (C). Rats in Group B and C were made into ADRN model by right nephrectomy and intravenous injection of adriamycin (ADR, 0. 4 mL and 0. 2 mL respectively in 4 weeks). After the model was successfully established, rats in Group C were orally given GTW (50 mg/kg per day), while rats in Group B were intervened with distilled water. The intervention for two groups was 6 weeks. Rats' body weight were weighed and 24 h urinary protein excretion (Upro) detected by the end of the 2nd, 4th, 8th and 10th week. All rats were sacrificed at the end of 10th week after operation to withdraw blood and kidney tissue to examine serum biochemical parameters, glomerular morphological changes, alpha-smooth muscle actin (alpha-SMA), and collagen type I expression. Besides, the mRNA expressions of TGF-beta1, Smad3 and Smad7, as well as protein expressions of TGF-beta1, and phosphorylated Smad2/3 (p-Smad2/3) in glomeruli were detected by RT-PCR or Western blotting.

RESULTSAs compared with Group B, in Group C, Upro and serum albumin were improved significantly, but no difference between groups was found in levels of blood urea nitrogen(BUN), serum creatinine(SCr), or hepatic cell injury. Mesangial cell proliferation, extracellular matrix (ECM) and collagen deposition were suppressed by GTW. Expressions of alpha-SMA and collagen type I decreased, and the characteristic changes of GS were attenuated. The mRNA expressions of TGF-P,31, Smad3 and protein expression of TGF-beta1, p-Smad2/3 in renal tissues were down-regulated, while the protein expression of Smad7 mRNA was up-regulated.

CONCLUSIONGTW showed effect in ameliorating GS in vivo. It could reduce the ECM deposition and improve GS by way of intervening TGF-beta1/Smad signaling pathway in the kidney through regulating the mRNA or protein expressions of key signal molecules, such as Smad3 and p-Smad2/3.

Animals ; Doxorubicin ; adverse effects ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Fibrosis ; Kidney Diseases ; chemically induced ; drug therapy ; metabolism ; Phytotherapy ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; drug effects ; Smad Proteins ; metabolism ; Transforming Growth Factor beta1 ; metabolism ; Tripterygium

OBJECTIVETo investigate the mechanism of Mailuoning injection (MLN) in protecting facial nerve from injury.

METHODSThe New Zealand white rabbit model with facial spasm was established by compressing superficial temporal artery to make artificial demyelinated lesion of the main peripheral facial nerve trunk. The successful establishment was confirmed by using electrophysiological technique to determine abnormal muscle response (AMR) which is a characteristic for facial spasm. MLN was injected continuously through ear marginal vein for 2 weeks. The change of CGRP expression in facial nerve was detected by immunohistochemical technique.

RESULTSAs compared with the model group, CGRP expression in facial nerve was significantly increased in the MLN group (P <0.01), and CGRP immunoreactive positive fibers were not seen in the shamoperation group. In the model group, the facial nerve fibers degenerated obviously, myelin sheath loosened and dissociated, the turgent axons with vacuole or even completely disappeared. But the facial nerve lesion was lessened in the MLN group.

CONCLUSIONMLN has a significant protective effect on facial nerve demyelination in rabbits with facial spasm, which is closely related with its effect in improving CGRP expression in the facial nerve.

Animals ; Calcitonin Gene-Related Peptide ; biosynthesis ; genetics ; Drugs, Chinese Herbal ; therapeutic use ; Facial Nerve ; metabolism ; ultrastructure ; Female ; Hemifacial Spasm ; drug therapy ; metabolism ; pathology ; Injections ; Male ; Phytotherapy ; Rabbits ; Random Allocation

Objective: To explore the sensitivity and specificity of the Chinese version of the volume and viscosity swallowing test with modified safety and effectiveness indicators (VVST-CV) in assessing deglutition disorders. Methods: The solvent, volume, viscosity, and test index of the volume and viscosity swallowing test were modified before it was used to evaluate 89 patients with swallowing disorders. The positive rates of the safety indexes (coughing, voice changes and blood oxygen saturation decline at least 3%) and the efficiency indexes (poor lip closure, oral residue, pharynx residue and swallowing) were recorded and compared and compared with the positive rates of penetration, aspiration and food residue determined by means of according to the videofluoroscopic swallowing study, then the sensitivity, specificity, positive predictive value and negative predictive value of the modified VVST-CV with regard to the safety and efficiency of swallowing were calculated. Results: The VVST-CV′s sensitivity in detecting dysphagia was 0.97. For impaired safety it was 0.85 and for impaired swallowing efficiency it was 0.95. The sensitivity of the coughing index was 0.65, that of sound change was 0.60 and that of oxygen saturation decrease was 0.42. The positive predictive values for coughing, sound change and oxygen saturation decrease were 0.98, 0.94 and 0.94, respectively. Conclusion The VVST-CV is simple, feasible and sensitive. It can be widely useful in the evaluation of dysphagia in clinical practice.

Objective To explore surgical treatment of gliomas involving the motor eloquent area. Methods Twelve cases of gliomas involving precentral gyrus were underwent awake surgery procedures assis- ted with neuronavigation and brain functional mapping by cortical electrical stimulation.Results Eleven ca- ses acquired accurate location of both lesions and eloquent areas by neuronavigation and direct cortical stimula- tion.7 cases of motor cortices and 2 cases of motor speech centers were confirmed during the operation.Re- section,verified by postoperative MRI,was total in 8 cases (66.7%) and subtotal in 4 patients.Histological examination revealed an infiltrative glioma in all cases (8 low grade astrocytomas,2 high grade astrocytomas and 2 glioblastoma).Four patients had no postoperative deficit,while the other 8 patients were impaired, with,in all cases except one,complete recovery in 7 days to one month.Conclusion Direct cortical elec- trical stimulations and awake surgery offer a reliable,precise and safe method,allowing functional mapping es- pecially useful in case of infiltrative cerebral tumors in eloquent areas.This technique allows improvement in the quality of tumoral resection and concurrently a minimization of the risk of definitive postoperative neurologi- cal deficit.

AIMTo investigate the abilities of recombinant adeno-associated virus type 2 (rAAV2) transfecting neurospheres.

METHODSThe rAAV2 conjugated with FITC (rAAV2-FITC) was added into the culture medium of neurospheres and 30 minutes later the neurospheres were detected with a fluorescence microscopy to determine if the AAV can combine with neurospheres. The rAAV2 containing GFP reporter gene (rAAV2-GFP) was incubated with the neurospheres for a month and then detected the ability of transfecting neurospheres. The neurospheres transfected with rAAV2-containing GFP were transplanted to the brain of rats. A month later the rats were sacrificed and the brains were removed to detect if there are expressions of the reporter gene. The neurospheres were transfected with rAAV2 containing hypoxia responds elements (HRE) and vascular endothelium growth factor(VEGF) gene and reporter gene GFP (rAAV2-HRE-VEGF-GFP) and then cultured in low oxygen density environments. Seventy-two hours later the neurospheres were detected through a fluorescence microscopy.

RESULTSThe neurospheres incubated with rAAV2-FITC present bright green fluorescence. GFP, the reporter gene, can be seen clearly 1 month after being transfected with rAAV2-GFP. The same green fluorescence protein can be observed ex vivo as well. The fluorescence can be seen in neurospheres transfected by rAAV2-HREVEGF-GFP only in low oxygen density.

CONCLUSIONThe rAAV2 can transfect neurospheres specifically and efficiently. Reporter gene can be expressed in the neurospheres in vivo and ex vivo. Expression of reporter gene can be adjusted by HRE.

Animals ; Cells, Cultured ; Dependovirus ; genetics ; Female ; Genes, Reporter ; Genetic Vectors ; Neural Stem Cells ; cytology ; Rats ; Rats, Sprague-Dawley ; Transfection

OBJECTIVETo investigate the proliferation and plasticity of neural stem cells in situ in adult rats after cerebral infarction.

METHODSCerebral infarction models of rats were made and the dynamic expression of bromodeoxyuridine (BrdU) and BrdU/polysialylated neural cell adhesion molecule (PSA-NCAM) were determined by immunohistochemistry and immunofluorescence staining.

RESULTSCompared with the controls, the number of BrdU-positive cells in the subventricular zone (SVZ) and hippocampus increased strikingly at day 1 (P < 0.05), reached maximum at day 7, and decreased markedly at day 14, but it was still elevated compared with that of the controls (P < 0.05); The number of BrdU-labeled with PSA-NCAM-positive cells increased strikingly at day 7 (P < 0.05), reached maximum at day 14, and markedly decreased at day 28, but it was still elevated compared with that of the controls (P < 0.05), and was equal to 60% of the number of BrdU-positive cells in the same period.

CONCLUSIONSOur results indicate that cerebral infarction stimulate the proliferation of inherent neural stem cells in situ and most proliferated neural stem cells represent neural plasticity.

Animals ; Bromodeoxyuridine ; Cell Division ; Cerebral Infarction ; pathology ; Hippocampus ; pathology ; Male ; Neural Cell Adhesion Molecule L1 ; Neuronal Plasticity ; Neurons ; pathology ; Rats ; Rats, Wistar ; Sialic Acids ; Stem Cells ; pathology

OBJECTIVETo investigate the value of measuring the concentration of soluble CD44 splice variant 6 (sCD44v6) in peripheral blood in patients with invasive and non-invasive pituitary adenomas.

METHODSThe concentrations of sCD44v6 in peripheral blood were measured with ELISA in 68 patients with invasive pituitary adenomas and 100 patients with non-invasive pituitary adenomas.

RESULTSThe serum concentration of sCD44v6 in patients with invasive pituitary adenomas was lower than that in patients with non-invasive pituitary adenomas, while the latter was lower than that in healthy controls. The serum concentrations of sCD44v6 were (44.63 +/- 7.21), (34.53 +/- 6.41), and (26.34 +/- 4.95) ng/ml in patients with invasive microadenoma, macroadenoma, and giant adenoma, and (60.78 +/- 9.61), (57.78 +/- 10.00), and (37.22 +/- 5.17) ng/ml in patients with non-invasive microadenoma, macroadenoma, and giant adenoma, lower than that in the healthy control group (68.73 +/- 6.00) ng/ml. Significant differences were observed among groups (P < 0.005). The concentration of sCD44v6 in peripheral blood decreased as the tumor size increased (P < 0.01), which was particularly significant in invasive pituitary adenomas. The positive rate in the patients with invasive pituitary adenomas reached 89.71%.

CONCLUSIONSerum concentration of sCD44v6 in the peripheral blood is inversely correlated with tumor size and its invasive growth, which may provide certain value in the early diagnosis, treatment and prognosis of invasive pituitary macroadenoma and giant adenoma.

Adenoma ; blood ; diagnosis ; pathology ; Adult ; Biomarkers, Tumor ; Female ; Glycoproteins ; blood ; Humans ; Hyaluronan Receptors ; blood ; Male ; Middle Aged ; Neoplasm Invasiveness ; Pituitary Neoplasms ; blood ; diagnosis ; pathology ; Prognosis

Objective:To explore the value of flexible endoscopic evaluation of swallowing (FEES) in guiding the decannulation of neurological disease patients with dysphagia after a tracheotomy.Methods:The FEES results of 188 neurological disease patients with dysphagia who had undergone a tracheotomy were analyzed retrospectively. The utility of FEES evaluation indexes (including glottis activity, the classification of pharyngeal secretions and residues as well as penetration-aspiration grade) for predicting the success of decannulation was explored.Results:One hundred and nine of the patients (the success group) were decannulated successfully and 79 (the failure group) were not, a success rate of 57%. The abnormal glottis activity rate among the failure group was 55%, significantly higher than among the success group (21%). The pharyngeal secretion classifications and penetration-aspiration grades among the success group were also significantly lower than among the failure group, on average. The average course of recovery from the tracheotomy was 184 days in the success group, significantly shorter than that of the failure group (292 days). No significant differences in residues were observed.Conclusion:The glottis activity, secretions and intake aspiration evaluated using FEES are of great value for guiding the decannulation of neurological disease patients with dysphagia after a tracheotomy.