Objective To evaluate the relationship between the degree of corticospinal tract (CST) injury and motor function prognosis in patients with cerebral infarction using magnetic resonance diffusion tensor imaging (DTI)and diffusion tensor teactography (DTT)imaging. Methods Sixty-eight patients with cerebral infarction were selected prospectively. They underwent conventional MRI,DWI,and DTI examinations,and the DTT technique was used to perform CST 3D reconstruction. The white matter fractional anisotropy (FA)of the infarct zones and contralateral corresponding regions was measured within 7 days and at 3 months after onset. The Fugl-Meyer scale was used to perform motor function defect score. The CST involvement degrees were divided into four grades. The patients were divided into Group 1 (96-99,roughly return to normal;n=16),Group 2 (51-95,partial recovery;n=34),and Group 3 (<50,poor recovery;n=18)according to the Fugl-Meyer scale scores after treatment. The analysis of variance,Pearson,and Spearman correlation analysis were used to analyze the relationship between FA values,CST involvement degrees and motor function recovery. Results There were significant differences in the amplitude of variation of FA within 7 d (0. 05 ± 0. 06,0. 08 ± 0. 07,and 0. 18 ± 0. 02)and at 3 months after onset (0. 11 ± 0. 02,0. 21 ± 0. 06,and 0. 39 ± 0. 03)(within 7 d F=32. 821,at 3 months F=192. 372,all P<0. 05). DTT showed that the lesion sides of CST were presented as compression,deformation,displacement,and interruption. The CST grades were negatively correlated with the neurological functional rehabilitation of the patients within 7 d after onset (r= -0. 682,P <0. 01). The CST grades were negatively correlated with the neurological functional rehabilitation of the patients at 3 months (r= -0. 728,P<0. 01). Conclusion The decreased FA values in infarct areas and the degrees of CST involvement were associated with the motor function prognosis. MR DTT can directly display the degrees of CST involvement of cerebral infarction. It can provide an important basis for early identifying the prognosis of cerebral infarction.

Objective To investigate a new technique to increase the survival rate of free autogenous pellet fat graft. Methods Many methods were used to graft free autogenous fat, and the results compared to look for the best method for it. Results After 3 and 6 months, the volume rate in the treatment group and control group were 70%, 60% and 40%, and 30%. The times of fat injection were 2 and 4 . Conclusion Some vasodilators, low negative pressure and plasma can enhance the survival rate of free autogenous pellet fat graft.

Objective To study the effect of Interleukin-22 (IL-22) on murine asthmatic airway inflammation and airway remodeling, observe the effect of budesonide on IL-22 of asthmatic mouse model, explore the mechanism of budesonide in the treatment of asthma.Methods Ovalbumin(OVA) was used as an allergen to sensitize and challenge the mice.24 female specific-free (SPF) BALB/c mice aged four weeks were randomly divided into 3 groups:control group, asthma group and budesonide treatment group (BUD group).For Histopathological Examination, HE staining was used to measure the inflammation scores, AB-PAS staining was used to measure the hyperplasia of goblet cells and mucin.Enzyme-linked immunosorbent assay(ELISA) was used to analyze IL-22 levels in bronchoalveolar lavage fluid (BALF).Quantitative Real-time PCR was performed to analyze the effects of budesonide on IL-22 mRNA levels in lung tissue.Results The inflammation scores of asthma group were elevated compared with the control group.An overall change towards less severe asthmatic airway inflammation by the end of the trial was observed in the BUD group.IL-22 levels in BALF were significant decreased after the treatment of budesonide, the mRNA levels of IL-22 were obviously decreased in BUD group, too.A significant positive correlation was observed between the mRNA levels of IL-22 and airway inflammation.Conclusions The increasing IL-22 secretion can lead to the occurrence of airway inflammation of asthma.Budesonide can inhibit the expression of IL-22, thereby Budesonide could inhibit the development of airway inflammation of asthma.

Objective To evaluate the efficacy of the parathyroidectomy (PTX) in the treatment of severe secondary hyperparathyroidism (SHPT) with Sagliker syndrome (SS). Methods A retrospective review was undertaken among 212 SS patients underwent PTX in our hospital and with more than 3 years' follow up. The definitions of the efficacy were based on the postoperative intact parathyroid hormone level (iPTH). Cure showed that the iPTH was ＜ 150 ng/L; marked effectiveness was 150-300 ng/L; effectiveness was 301-500 ng/L;ineffectiveness was ＞500 ng/L. The status was defined as persistent SHPT if iPTH was ＞ 150 ng/L after surgery. The status was considered as SHPT recurrence if iPTH was ＜ 100 ng/L in the first week after surgery, and gradually increased and ＞ 150 ng/L with the follow-up. Results ( 1) Ten patients were involved and the average dialysis time was 142 months [male/female: 4/6; age 30-54 (39. 3 ± 10. 4) years]. All patients had severe bone and joint pain, accompanied with progressive facial increases, chicken breast, kyphosis, hip bone deformities, and body height shortening. (2) Preoperative tests: the median of iPTH 2000(1800-2863) ng/L; serum calcium (2. 45 ±0. 21) mmol/L, phosphorus (2. 19 ±0. 51) mmol/L, alkaline phosphatase ( ALP) (1189. 8 ± 780. 0) IU/L. Two to four enlarged parathyroid glands were confirmed by ultrasound and 99Tcm-MIBI parathyroid scintigraphy. ( 3 ) Surgical procedures: local or general anesthesia for PTX. Supplement with calcium and calcitriol implemented low serum calcium after PTX. (4) Follow-up: symptoms, including bone pain, muscle weakness, skin itching, and insomnia, were significantly improved after surgery. Transient hoarseness occurred in 2 cases. The iPTHs of all patients were decreased significantly after surgery. The median of iPTH was 55.5 ( 10-967) ng/L at 1 month post PTX, and was significantly less than prior to PTX (P＜0. 001). Eight patients were cure , 1 marked effectiveness ,and 1 ineffectiveness. Two patients were persistent SHPT, and 1 died of heart failure in the 4th year after PTX. The development of bone deformities was stopped and malnutrition was improved in long-time follow up. The level of iPTH 135(28-390)ng/L(P＜0. 001 ) , serum calcium, phosphorus, and ALP showed normal in the third year. The SHPT recurrence was appeared in the 2nd and 3rd year in 2 out of 8 patients, respectively. Conclusions Total PTX can effectively treat SS by SHPT. It can improve prognosis for patients, such as bone pain disappearing, bone deformities stopping and malnutrition improving, etc. The level of iPTH may rise again in some patients in the future. Therefore, more attentions should be paid to monitoring.

Objective To observe the effects of ACEI( enalapril) on expression of MMP-2 and MMP-9 in renal hypertension rats with focal cerebral ischemia-reperfusion injury. Methods Twenty-eight Wistar male rats were randomly divided into two groups: hypertension group and normaltension group. The former which formed model of renal hypertension rats by constricted renovascular were randomly divided into enalapril group (Y) and hypertension ischemia and reperfusion group(HIR),which fed with enalapril 2mg/kg and equal volum saline respectively;The latter were divided into sham-operation group ( N) and normaltension ischemia and reperfusion group (IR). The focal cerebral ischemia model was established in Wistar rats by using the method of thread inserting left middle cerebral artery occlusion(MCAO) for 2h. After ischemic 24h,the expression of MMP-2 and MMP-9 were measured by immunohisto-chemistry,and the gray scale value was measured by imaging analysis. Results Compared with N,the gray scale values of MMP-2 and MMP-9 in IR were higher(P <0. 01); Compared with IR, the gray scale values of MMP-2 and MMP-9 in HIR were higher(P<0. 05);Compared with HIR,the gray scale values of MMP-2 and MMP-9 in Y were lower(P<0.01). Conclusion Hypertension can increase the expression of MMP-2 and MMP-9 in rats with focal cerebral ischemia-reperfusion. ACEI (Enalapril) could inhibit the expression of MMP-2 and MMP-9 in renal hypertension rats with focal cerebral ischemia-reperfusion.

Objective To compare the effectiveness and safety of different concentrations of elastin-like polypeptides (ELP) as novel submucosal injection material for endoscopic submucosal dissection.Methods Forty healthy New Zealand white rabbits were randomly divided into two groups (n=20).The first group by submucosal injection of different drugs were randomly divide into five groups (n=4).Four concentrations of 50 ku ELP (0.05,0.025,0.012 5,0.005 g/ml) were used separately in each group,while glycerin fructose was used for control group.Each solution (2 ml) was injected into the submucosa through the resected margin,the increase of mucosal thickness and surface changes were observed and recorded at 0,5,10,and 30 min.The subgroup by submucosal injection of different drugs were randomly divide into five groups (n=4).The injection pressure of each solution (2 ml) with the 25-gauge needle was calculated by a manometer,which was connected between the needle and syringe.Results The submucosal uplift heights in groups using the 0.05 g/ml ELP and 0.025 g/ml ELP injection were significantly thicker than that of glycerin fructose (P＜0.05),the 0.012 5 g/ml ELP and glycerin fructose injection showed no significant difference (P＞0.05),whereas the uplift height in glycerin fructose group was thicker than that of the 0.005 g/ml ELP (P＜0.05).The injection pressure correlated with the ELP concentration.The injection pressures of 0.05,0.025,0.012 5,0.005 g/ml ELP solutions were (332±36) kPa,(223±24) kPa,(174±22) kPa and (142±19) kPa,respectively,and that of glycerin fructose was (269±17) kPa.The 0.025 g/ml ELP solution was easily injected into the porcine stomach to create submucosal uplift.The injection pressure of the 0.025 g/ml ELP solution showed significantly lower value compared with that of glycerin fructose (P＜0.05).Conclusions ELP might be a promising agent for submucosal injection for endoscopic submucosal dissection (ESD),and 0.025 g/ml ELP might be efficient concentration for maintaining mucosal elevation,injection pressure and safety.

Objective To evaluate the predictive value of ABCD3-I score for early stroke risk after transient ischemic attack (TIA). Methods A total of 136 consecutive patients with TIA admitted to the Department of Neurology,the First Hospital of Shangqiu from January 2010 to December 2012 were enrolled. The clinical data,medical history and image findings of the patients were collected. The incidence of stroke was observed within 90 days. The occurrence of stroke risk after TIA were scored with the ABCD2 and ABCD3-I. Logistic regression analysis was used to analyze the impact of risk factors for early stroke after TIA. The area under the curve (AUC)of receiver operating characteristic was used to compare the predictive values of the two kinds of scores. Results Of the 136 eligible patients with TIA,19 cases (14. 0%)had cerebral infarction within 90 days after TIA. There were no death and hemorrhagic stroke. The results of multivariate regression analysis showed that the duration of TIA≥60 min (OR,1. 060,95%CI 1. 012-1. 112)was an independent risk factor for early progressing stroke after TIA (P<0. 05). In the ABCD2 scoring model for risk stratification of low-,moderate-,high-risk groups,the incidences of stroke within 90 days were 5. 6%(4/72),18. 5%(10/54),and 50. 0%(5/10),respectively. In the ABCD3-I score model for risk stratification of low-,moderate-,high-risk groups,the incidences of stroke within 90 days were 0,7. 1%(6/84),and 52. 0%(13/25),respectively. In the low-,moderate-,high-risk groups,there were significant differences in the incidences of stroke in 90 days between the ABCD3-I and ABCD2 scoring models (P<0.01). The AUC of ABCD3-I score (0. 839,95%CI 0. 766-0. 896)was higher than that of ABCD2 score (0.783,95%CI 0. 704-0. 849;P<0. 01). Conclusion The ABCD3-I score may effectively predict the risk of early stroke after TIA,and its accuracy is better than ABCD2 score.

Objective To investigate the clinical efficacy of percutaneous kyphoplasty(PKP) in treatment of elderly osteoporotic vertebral compression fractures(OVCF).Methods 122 elderly OVCF patients from Oct.2009 to Oct.2013 in Lihuili Hospital of Ningbo Medical Center were selected,and were randomly divided into group A,and group B.There were 61 cases in each group.Group A received percutaneous kyphoplasty(PKP),and group B were treated with percutaneous vertebroplasty(PVP).The two groups were observed in terms of pain,activity,vertebral compression rate and Cobb angles after treatment.The two groups were followed up at least for 3 months.The postoperative side effects were recorded and analyzed.Results After the treatment,the two groups significantly improved in VAS score and activity(P ＜ 0.05),but no significant difference was found between the two groups (P ＞ 0.05).After the treatment,vertebral compression rate and Cobb angle got better than before in the two groups,but group A recovered more obviously than group B,and the difference had statistical significance (P ＜ 0.05).The postoperative recurrence rate was 18.03 ％ (11/61) in the observation group and 9.84 ％ (6/61) in the control group,and the difference had statistical significance (P ＜ 0.05).Conclusion PKP and PVP can significantly relieve pain,but PKP had better effect than PVP in vertebral body and spinal kyphosis improvement,which is worth of clinical application.

Objective: To investigate the effects of culture medium osmolarity on the proliferation of human hepatoma cell line HHCC. Methods:Cell proliferation was analyzed by MTT assay and cell cycle analysis was carried out by flow cytometry. Results:Hyperosmolarity decreased significantly the absorbance (A) of HHCC cells and cell number, and hyposmolarity have counter effects. Compared with control, hyperosmolarity blocked cell cycle progression at the G 1 phase, while hyposmolarity accelerated cells into S phase from G 1 phase, and the effect of hyposmolarity was weakened by chloride channel blocker NFA. Conclusion:Culture medium osmolarity influenced the proliferation of HHCC cells by mediating cell cycle.

Objective To analyze the diagnostic accuracy and safety of adenosine stress 99mTc-MIBI myocardial perfusion single photon emission computed tomography(SPECT)for assessing coronary artery disease(CAD)in the elderly. Methods 63 elderly patients(≥65 years old)without myocardial infarction were enrolled in the research.They were admitted into hospital because of suspected CAD or suffering from acute coronary syndrome.Adenosine was infused intravenously at a rate of 140μg·kg-1·min-1 for 6 minutes.During the period.all patients were given electrocardiogram monitor and blood pressure detection,the uncomfortable symptoms were recorded.At the end of 3 minutes of adenosine infusion,925MBq of 99mTc-MIBI was injected intravenously.Then adenosine stress SPECT myocardial imaging acquisition was obtained.If the results were abnormal.the rest SPECT myocardial imaging would be performed next day.All patients underwentcoronary angiography(CAG)within 1 week before or after SPECT. Results In the 53 CAD patients diagnosed by CAG,there were 51 cases with positive adenosine 99mTC-MIBI myocardial perfusion SPECT.In 10 cases with normal CAG there were 7 cases with negative adenosine myocardial imaging.The results showed the sensitivity,specificity and accuracy of adenosine stress SPECT in detection of CAD in comparison with CAG were 96.2%,70.0%,92.1%respectively.The results of CAG also showed that 74 coronary arteries had been affected(defined as≥50%coronary vessel lumen reduction).There were 44 cases with affection in left anterior descending(LAD),18 eases in left circumflex(LCX)and 25 cases in right coronary artery(RCA).Correspondingly,there were 42 patients with lowering myocardial perfusion in anterior wall territory,10 patients in lateral wall territory and 21 patients in inferior wall territory.The sensitivity of adenosine 99mTc-MIBI myocardial perfusion SPECT for diagnosing LAD lesion was 95.5%,which was higher than for the other 2 coronary arteries,but the specificity for detecting LCX lesion was 100%.The adverse effects during the adenosine stress test were found in 50%patients,no serious events occurred.Conclusions Adenosine stress 99mTc-MIBI myocardial perfusion SPECT is a good noninvasive method with high diagnostic accuracy and safety in detection of CAD in the elderly,especially.highly accurate for detection and localization of significant CA D.