Cerebralvasospasmisthemostcommonandmostdangerouscomplicationofsubarachnoid hemorrhage (SAH). If it can not be diagnosed and treated early, it w il result in delayed cerebral ischemia and delayed ischemic neurological deficits, and seriously affect the outcomes of patients. SAH can cause oxidative stress and inflammation, causing vasospasm, and leading to brain tissue damage. Numerous studies have show n that the concentrations and activities of numerous metabolites w il change in these pathological physiological processes. Identification of the changes of location, time and trend of these markers has important clinical significance for investigating the mechanism of cerebral vasospasm after SAH and seeking better therapeutic targets. This article review s the molecular markers of cerebral vasospasm after SAH.

Objective To evaluate the clinical efficacy and safety of long-term repeated treatment of facial wrinkles with application of botulinum toxin A (BTXA). Methods A total of 52 patients had received 8 injections in seven years with BTXA against facial wrinkles, including forehead wrinkles, fishtail lines, glabellas wrinkles, and nasal dorsum transverse wrinkles. Besides day 1 (baseline) and day for the next injection (end-point), follow-up visits were scheduled on 1 week, 1 month, and 3 months after every injection. The therapy effect and safety were evaluated. Results For all the patients, it began to take effect on day 3 or 4 after the treatment and best effect appeared on 1 month post-treatment. Patients' selfevaluation as grade 1 for the improvement of forehead wrinkles, fishtail lines, glabellas wrinkles and nasal dorsum transverse wrinkles, accounted for 100%, 97.1%, 99.8% and 99%, respectively. Correspondingly, cases as grade 2 accounted for 0, 2.9%, 0.2% and 1.0%. Grades 3 to 5 had not been reported. With the repetition of treatment, the efficiency increased. The average of effective duration was (7.8±1.1) months, which lasted longer with the injection times increased (r= 0.256, P= 0.02). Adverse reactions observed in the previous several injections, including ecchymosis, feeling of tightness, rigid expression and severer wrinkles near the injected site, which were mild and the incidence rate decreased after the following injections (r= 0.850, P= 0.01). Severe adverse effects, such as allergic reaction,headache, blepharoptosis and dysraphism of eyes had not happened in all the 52 patients. Conclusion Long-term repeated application of BTXA against facial wrinkles is safe and the efficacy is confirmed. The approach can be applied repeatedly to those who have indications and good tolerance.

Irritable bowel syndrome(IBS)is one of the most common functional gastrointestinal disorders,which impacts on patients’quality of life as well as physical and mental health. Studies have shown that visceral hypersensitivity (VHS)is an important pathophysiological factor in the pathogenesis of IBS,and neural regulation plays a key role in the process of VHS. This article reviewed the advances in study on effect of neural regulation pathway on pathogenesis of VHS in IBS.

OBJECTIVE In order to improve the traditional management mode,we try to explore the application of information technology for management of antimicrobial drugs during perioperative period. METHODS Through analysis of our research program case,the differences between the traditional management mode and the information-based management mode were compared by the method of reviewing literature data and analyzing hierarchy process of administration. RESULTS There were obvious limitations in the traditional management mode,but the information-based management mode exhibitsed evident advantages,because it focused on node control and process management. CONCLUSIONS The information-based management mode can establish a long-term management mechanism of antimicrobial drugs during perioperative period,and also can individualizedly implement precise management goal.It is an innovation of the traditional management mode.

Microglia are activated and involve in the pathological and physiological processes of early brain injury and delayed cerebral ischemia after subarachnoid hemorrhage, thus impact the outcome of patients. Numerous studies have shown that microglia have different typings, signaling pathways,and functions. Interference with microglial activation or reduction of cytotoxic metabolites is important for improving the prognosis of SAH patients.

Objective To investigate the different expression pattern of Src-homology2 domain phosphatase (SHP)-1 and SHP-2 in human papiilomavirus (HPV)6/11 infected condyloma acuminatum (CA) and the significance of the difference. Methods HPV6/11 related CA cases were diagnosed by in situ hybridization. The expression and distribution of SHP-1 and SHP-2 were examined by SP immunohistochemistry technique in skin samples from 40 HPV 6/11 positive CA cases and 20 healthy control (foreskins). Results The positive rates of SHP-1 and SHP-2 were 80% and 85% respectively in CA, which were significantly higher than those in healthy control cases (only 35% and 30%, respectively, X2=11.87,P<0.01; X2 =18. 15,P<0. 01) . The SHP-1 and/or SHP-2 positive cells in CA skin lesions were mainly distributed in prickle layer, showing as brown yellow, with the positive staining located in cytoplasm. Contrastively, the SHP-1 and/or SHP-2 positive cells in healthy controls were rare and mainly distributed in basal layer, showing as pale yellow with the positive staining located in cytoplasm. There was no significant correlation between the expression of SHP-1 and SHP-2 in CA( rs = 1.0, P>0.05 ). Conclusion The expressions of SHP-1 and SHP-2 increase in HPV6/11 positive CA, which suggest that with the infection of HPV6/11, SHP-1 and SHP-2 may play a regulatory role in the proliferation of keratinocytes.

[Objective]This study was designed to explore the dynamic changes of cytokines in the local tissues of radiationinduced oral mucositis in a rat model.[methods]The rat oral mucosal tissues were obtained at 5 d,8 d,and 14 d after irradiation.which were received single X-ray irradiation of 30 Gy locally.RayBio~((R)) Rat Cytokine Array was applied to analyze the 19 cytokines.The mRNA levels of the 8 inflammatory-related cytokines were analyzed by real time-PCR.ELISA was employed to detect IL-1α,IFN-γ,and TIMP-1 protein levels.[Results]Cytokine array detection showed that cytokines such as Frac,IL-4,IL-6,IL-10,and TNF-α were down-regulated after irradiation.IL-1β,LIX,VEGF,and β-NGF were no obviously changed at the same time corse.The elevate range less than 2 fold of the CINC-2,GM-CGF,Leptin,MCP-1,and MIP-3α after irradiation were detected.The increasing range more than 2 fold of CINC-3,INF-γ,IL-1α,and TIMP-1 post irradiation were detected.The mRNA levels of anti-apoptosis,such as Bcl-2,and TNF-α,IL-6,VEGF,and IL-1β were low down,while the levels of promoting apoptosis cytokine such as Bax,and neutrophil recruitment associated cytokines,CINC,and TLR-9 were up-regulated after irradiation.The ELISA results of IL-1α,IFN-γ,and TIMP-1 were identical with the results of the two previom analyses.[Conclusion]The results of the three methods in the study should present evidences to prove each other.Some cytokines in the local lesion of oral mucositis during the initiate,development,and progression stages were blocked,while others were positively up-regulated to involving the control of the pathogensis of oral mucositis.

BACKGROUND: Present studies have verified that Baicalin has protective effects on various brain damage in the nervous system.OBJECTIVE: To study the possibility of intravenous transplantation of human umbilical blood mesenchymal stem cells (hUBMSCs) and Baicalin after hypoxic-ischemic brain damage (HIBD) in neonatal rats.DESIGN, TIME AND SETTING: The randomized controlled animal study was performed at the Laboratory of the Department of Neurology, First Affiliated Hospital, Nanchang University from February 2007 to January 2008.MATERIALS: Totally 10 umbilical blood samples from healthy full-term pregnant women were obtained from the Department of Obstetrics, First Affiliated Hospital, Nanchang University. A total of 85 clean Sprague Dawley neonatal rats aged 7 days were randomly assigned to a normal control group (n=15), a model group (n =20), a cell transplantation group (n =25), a cell transplantation + Baicalin group (n =25).METHODS: The umbilical blood mononuclear cells were isolated by the gelatin sedimentation + density gradient centrifugation method, and amplified in vitro. Cells at the fifth passage were used for transplantation. Cells were labeled by DAPI at 6-12 hours before use. Neonatal rats in the model, cell transplantation and cell transplantation + Baicalin groups were used to establish HIBD models. Rats in the blank control group were left intact. At 2, 3,4, 5 weeks following model induction, rats in the cell transplantation and cell transplantation + Baicalin groups were injected with DAPI-labeled hUBMSCs (5-10 μL/g) via caudal vein at the density of 1 ×10~9/L. From the first day of transplantation, rats in the cell transplantation + Baicalin group were injected with 120 mg/kg Baicalin via intraperitoneal injection, once a day, for three successive days.MAIN OUTCOME MEASURES: The following parameters were measured: brain tissue lesion, DAPI-positive cell number, location of hUBMSCs following transplantation.RESULTS: Lesion rate of brain tissue was significantly lower in the cell transplantation + Baicalin group compared with the model and cell transplantation groups at 4 weeks following transplantation (P < 0.05). Compared with the cell transplantation group,DAPI-positive cell number was significantly increased in the cell transplantation + Baicalin group at 1, 2, 4 weeks (P < 0.01). From the 3~(rd) week following model induction, abundant DAPI-labeled cells were found surrounding the lesion site, without obvious boundary integrated with the host brain. Few DAPI-positive hUBMSCs were found in non-ischemic region. At 4 and 5 weeks following model induction, DAPI-positive cells were significantly decreased in the lesion site.CONCLUSION: The third week following HIBD is an optimal time for cell transplantation. Baicalin can make a large number of hUBMSCs across the blood-brain barrier to distribute and scatter around the disease focus integrated with host brain tissue.

Objective To evaluate the efficacy and safety of dorsal root entry zone (DREZ) incision for pain induced by brachial plexus injury. Methods A cohort study was performed in 41 consecutive patients with pain induced by brachial plexus injury treated with DREZ incision from July 2005 to December 2007. Of all, 19 patients were amputated and had phantom limb sensation. Oral pain relief (0%-100%) and complications were followed up by one professional doctor. Oral pain relief rate ≥50% was considered satisfactory outcome. Results The proportion of patients with satisfactory pain relief was 90% (37/41), 81% (30/37), 77% (24/31) and 70% (16/23) at 2 weeks, 3 months, 6 months and last follow-up (over one year) after surgery. At last follow-up, 15 out of 16 patients with over 10 years of pain duration got satisfactory pain relief; while only 16 out of 25 patients with less than 10 years of pain duration got satisfactory pain relief (x2 =4.682, P =0.030). In 16 amputees who were followed up for more than three months, seven patients with alteration of phantom limb sensation got satisfactory pain relief, while only four out of nine patients without alteration of phantom limb sensation got satisfactory pain relief. Among 37 patients followed up for more than three months, severe neurological defects were found in three patients including one with mild motor disturbance in the ipsilateral lower limb and two with severe sensory disturbance in the ipsilateral lower limb. Conclusions DREZ incisions are effective and safe neurosurgical procedure for relieving pain induced by brachial plexus injury. The possible predictive factors of better outcome are the long preoperative pain duration and postoperative phantom limb sensation among amputees.

Objective To assess the antimicrobial resistance and resistance-related mutations in rpoB and katG genes in Mycobacteria tuberculosis isolates from patients with cutaneous tuberculosis. Methods Seven strains of Mycobacteria were isolated from lesions or secretions of patients with cutaneous tuberculosis and identified as M. tuberculosis. Proportion method was used to test the susceptibility of M. tuberculosis isolates to rifampicin, isoniazid, streptomycin and ethambutol. PCR and sequencing were performed to analyze the mutations in rpoB and katG genes. Results Of the 7 isolates of M. tuberculosis, 1 was resistant to rifampicin,isoniazid and ethambutol simultaneously, and the other 6 were sensitive to rifampicin, isoniazid, streptomycin and ethambutol. All the 7 isolates were positive for the amplification of rpoB and katG genes by PCR. DNA sequencing revealed two mutations at codon 531 (TCG to TTG) and codon 315 (AGC to ACC) in the multi-drug resistant strain, which were absent in the other 6 strains. Conclusion Multi-drug resistance has emerged in M. tuberculosis isolates from patients with cutaneous tuberculosis, which is likely to be related to improper treatment.