BACKGROUND: Mesenchymal stem cell transplantation for treatment of hypoxic-ischemic brain damage (HIBD) has obtained some outcomes in adult animals, but studies are few in neonatal animal models. Mesenchymal stem cells are commonly harvested from bone marrow. A few studies are on umbilical cord blood-mesenchymal stem cells (UCB-MSCs). OBJECTIVE: To investigate the feasibility and timeliness of UCB-MSC transplantation after injecting UCB-MSCs into neonatal rat models of HIBD. DESIGN, TIME AND SETTING: The complete randomized controlled animal experiment was performed at the Laboratory of Department of Neurology of First Hospital Affiliated to Nanchang University from October 2004 to July 2005. MATERIALS: A total of 38 healthy neonatal SD rats aged 7 days old were used to create rat models of HIBD. Three rats died. METHODS: Cord blood samples were collected after normal full-term delivery of 23-35 healthy pregnant women for culturing UCB-MSCs. MSCs were labeled with 4',6-diamidino-2-phenylindole 2hci (DAPI) in vitro before transplantation. Thirty-five rat models were divided into three groups. UCB-MSCs were injected into tail vein of twelve rat models in the early transplantation group two days after modeling. UCB-MSCs were injected into tail vein of twelve rat models in the late transplantation group one week after modeling. Same volume of saline was injected into eleven rats of the control group. Six rats from early transplantation and late transplantation groups each were respectively obtained at day 2 after transplantation and at week 2 after modeling. Three, four and four rats from control group were obtained respectively 2 days, 1 and 2 weeks after modeling, and sacrificed after anaesthesia. Ischemic brain tissues from the brain and hippocampal gyrum were sliced into frozen sections. MAIN OUTCOME MEASURES: Brain tissue pathomorphology was measured by Haematoxylin and Eosin Staining. Brain tissue DAPI-positive cells were detected with a fluorescence microscope. RESULTS: Brain edema at ischemic region, neural cell swelling and a decrease in cell number were tested in the control group. DAPI-positive UCB-MSCs were few in focal brain tissues, and swelling degree,extracellular space improvement and increased cell number were insignificant in the early transplantation group. One week after modeling, brain tissue extracellular space became small, cell number increased, and brain swelling reduced; A mass of DAPI-positive cells in rat focal brain migrated and diffused, without significant boundary in the late transplantation group. CONCLUSION: UCB-MSCs effectively traverse blood-brain barrier, and migrate, disperse and conform around focal brain tissues. A good outcome of transplantation is obtained at week 1 after HIBD.

Dietary management plays an important role in the diabetes mellitus therapies. Effective dietary management can find the deficit of dietary management in patients with diabetes mellitus. Recently these tools primarily were consisted in the comprehensive diabetes mellitus management instruments and a fraction of the ones aim at the evaluation of the dietary management for diabetes. Timely and effective assessment of the effect on diabetes diet management depends on these tools. Therefore, the feasibilities, usefulness and deficit about these instruments were analyzed to prompt the application and investigation of the instruments in the future.

Objective To investigate the clinical efficacy and toxicity of comparison of the pemetrexed combined with cisplatin and docetaxel of advanced non small cell lung cancer(NSCLC).Methods The clinical data of 102 patients with advanced NSCLC were retrospectively analyzed.Fifty-two patients received pemetrexed combined with cisplatin (Group PC) (pemetrexed 500 mg/m2 intravenous drip in first day,cisplatin 75 mg/m2,intravenous drip in first day to third day,repeated every 21 days); Other 50 patients received the docetaxel combined with cisplatin (Group TP) (docetaxel 75 mg/m2 intravenous drip in first day,cisplatin 75 mg/m2 ntravenous drip in first day to third day,repeated every 21 days).The disease control rate (DCR),progress free survival,median survival time and 1 year survival rate were compared between two groups.Results The efficacy and side effects of all the patients could be evaluated.There was no case with complete remission,43 of partial remission,38 cases of stable and 21 cases of progress.No statistical significance were found between the two groups in DCR (80.8％ (42/52) vs.78.0％ (39/50)),progression-free survival (5.69 vs.4.71 months,P =0.334),median survival time (10.49 vs.10.48 months,P =0.851) and 1 year survival rate (32.0％ vs.24.0％,x2 =1.59,P =0.210).The most common toxicities were arrest of bone marrow and alimentary tract reactions.Pemetrexed could reduce the Leukopenia (P =0.010),the alopecia (P =0.004),the febrile (P =0.024) and tetter (P =0.048); but no significant difference was found in anaemia (P =0.873),thrombocytopenia (P =0.541),nausea and vomiting (P =0.114) and impaired liver function (P =0.403) and impaired renal function (P =0.541).Conclusion Pemetrexed and docetaxel combined with cisplatin for the treatment of advanced NSCLC have similar treatment effects,and the side effect of pemetrexed combined cisplatin is lower.

Objective To discuss the relationship between heart rate (HR), rate of perceived exertion (RPE) and oxygen consumption in therapeutic exercises for stroke patients. Methods Eighteen stroke patients a-ble to walk independently participated in the test. K4b2 Pulmonary Function Equipment was used to record their heart Rates(min-1)and specific oxygen consumption(ml·min-1·kg-1)during the following exercises:relaxed sitting,sit-to-stand transfers, leaning against a wall and elevating the hips (strength training of the gluteus maximus) , raising the unaffected leg while the affected leg is weight bearing, raising the affected leg while the unaffected leg is weight bearing, climbing up and down stairs, and walking 60 meters. RPE was surveyed after each exercise. Results The correlation between HR and oxygen consumption was moderate (r = 0.618, P≤0.001), but it was weak between RPE and oxygen consumption (r = 0.325 ,P≤0.001). Conclusion Heart rate is a better index than RPE for eval-uating exercise intensity with stroke patients able to walk independently.

BACKGROUND: Both antioxidant and cytokine can induce the differentiation of umbilical cord blood-derived mesenchymal stem calls (UCB-MSCs) towards neuron-like cells in vitro. It remains unclear regarding how to select an inductor that has the ability of either neuro-protection like cytokines or powerful antioxidation. After wide screening, baicalin has been included in this study. OBJECTIVE: To observe the effects of baicalin on in vitro purification, amplification, and differentiation towards neuron-like cells of hUCB-MSCs.DESIGN, TIME AND SETTING: A randomized, controlled, cytological in vitro observation was performed at the laboratory of Department of Neurology, First Affiliated Hospital of Nanchang University between February and April 2005. MATERIALS: Ten portions of UCB were collected from healthy full-term normal delivery pregnant women aged 23-25 years old. Baicalin with purity > 95% was purchased from Department of Pharmaceutics, Xiangya Medical College of Central South University. Antioxidant additive J -mercaptoethanol was provided by Sino-American Biotechnology Company, China. METHODS: The collected UCB was anticoagulated with heparin to separate mononuclear cells. After concentration adjustment (1 ×109/L), UCB mononuclear cells were purified and amplified with dulbecco's modified eagle's medium containing fetal bovine serum (0.2 volume fraction), glutamine, B27, granulocyte colony-stimulating factors, and stem cell factors. According to antioxidant additive application, 4 groups were set: baicalin, blank control, β -mercaptoethanol, and baicaUn+ β -mercaptoethanol. Cells in each group were cultured for a total of 4 consecutive weeks. MAIN OUTCOME MEASURES: (1) Detection of CD 34 and CD 29 immunoreactive expression on days 7, 14, 21, and 28 after cryopreservation. (2) Cellular morphology observation. (3) Detection of surface antigen expression of MSCs by flow cytometry. (4) Detection of neuron-specific enolase (NSE), microtubule associated protein 2 (MAP-2), and glial fibrillary acidic protein (GFAP) expression after 4 weeks of culture by immunocytochemistry. RESULTS: O Compared with prior to cryopraservation, trypan blue exclusion rate of UCB-MSCs was significantly reduced on days 7, 14, 21, and 28 after cryopreservation (P < 0.05). (2) Morphological observation: UCB mononuclear cells adhered to the wall 2-3 days after culture, reached a peak level at 2 weeks, and formed a confluence of approximately 80%-90% 3 weeks after culture; at this time, all UCB-MSCs displayed a spindle shaped appearance. Four weeks later, in the baicalin group, some spindle-shaped UCB-MSCs began to present shrinkage, with slender processes on the cell edge, and some UCB-MSCs tended to be spherical-, conical-, and triangle-shaped appearance, with many slender processes on the pseudopodia. In the β-mercaptoethanol and baicalin+β -mercaptoethanol groups, an increasing number of cells defoliated and died with culture time in addition to above-mentioned appearances. (3) Four weeks after culture, cells were positive for CD45 in the blank control group, while cells in the remaining groups were positive for CD29 and CD 83, in particular in the baicalin+ β -mercaptoethanol group, followed by the baicalin group, and lastly the β -mercaptoethanol group. Significant difference in CD29 and CD 83 immunoreactivity exhibited between groups (P < 0.01). No CD34 immunoraactive calls were found in each group. (4) Four weeks after culture, NSE and MAP-2 immunoreactive expression was significantly lower in the blank control and β -mercaptoethanol groups than in the baicalin group (P < 0.01). The percentage of cells expressing GFAP was lower than 1% in each group. CONCLUSION: 100 μmol/L baicalin can promote the in vitro amplification of UCB-MSCs in a time-dependent manner and also can induce the differentiation of UCB-MSCs towards neuron-like cells in vitro to some extent.

Objective To discuss the correlation of perioperative brain function state quantitative monitoring results with postoperative cognitive dysfunction (POCD) in elderly patients. Methods The clinical data of 200 patients with lumbar spinal decompression fusion surgery were analyzed retrospectively. They were divided into the POCD group (134 patients) and the non POCD group (66 patients) by Z count scores . The results of test indexes including wavelet index (WLI), concentration index (i_22) and brain activity index (i_20) were compared. Results Perioperative elderly patients Brain function characteristics analysis results of perioperative elderly patients showed that the level of WLI at postoperative day 7(96.24 ± 2.41)was higher than that at preoperative day 1(98.76 ± 2.65) and postoperative day 3(98.68 ± 3.01), and there were significant differences (t=4.475, 4.475, P=0.000, 0.000). The level of i_22 at preoperative day 1, postoperative day 3 and postoperative day 7 had no significant difference (F=7.365, P=0.075). The level of i_20 at preoperative day 1, postoperative day 3 and postoperative day 7 had no significant difference (F=6.663, P=0.068). At preoperative day 1, the level of i_22 in POCD group was significantly lower than that in non POCD group(t=15.875, P=0.000). Conclusions Brain function index of perioperative elderly patients has certain characteristics in different time points, and i_22 may could be considered as a judge index of POCD.

Objective To explore the toxic effect and application safety of ropivacaine after transversus abdominis plane block for caesarean section.Methods Sixty cases puerperas who were suffered with transversus abdominis plane block for caesarean section in the People' s Hospital of Yan' an were retrospectively analyzed.Blood sample was collected after TAP block at different times and at the same time asked if they had neurotoxicity.The collected blood was measured for the concentration of ropivacaine.The ages,weight,height,BMI and total doses of ropivacaine were compared,and the mean total peak ropivacaine concentrations and the mean time to the maximum concentration in symptomatic and asymptomatic puerperas were compared to assess the reasonable threshold for clinical in symptomatic puerperas and suitable ropivacaine concentration.Results The BMI and total doses of ropivacaine of symptomatic group was (70.30±7.90) kg,(225.80±17.60) mg,significantly higher than the asymptomatic group ((62.60±12.40) kg,(189.00±22.40) mg),the differences were significant(t=4.613,7.143,P＜0.05).The mean total peak ropivacaine concentrations in symptomatic group was increased compared with asymptomatic group ((2.82±0.55) mg/L vs.(1.33±0.47) mg/L,t=0.779,P＜0.05),and the mean time to the maximum concentration in symptomatic group was decreased compared with asymptomatic group ((26.80±5.40) min vs.(39.20±6.30) min,t=4.158,P ＜0.05).Conclusion There is a certain neurotoxicity when applying ropivacaine after transversus abdominis plane block for caesarean section.Ropivacaine concentration 2.2 kg/ml as a reasonable threshold for clinical toxicity in puerperas undergoing TAP block,and 2.5 mg/L ropivacaine is fit for puerperal on lean body mass,and further reduction may be required as puerperal weight increases.

Objective To evaluate the effect of reference mAs on radiation dose and image quality characteristics of chest CT scanned with CARE kV technique compared with CARE Dose4D.Methods According to the date of examination,158 consecutive patients were selected in our department and randomly divided into 5 groups:CARE Dose4D group (30 cases,group 1); using CARE kV technology,reference mAs were 110 (32 cases),90 (31 cases),70 (33 cases),50 (32 cases),which were recorded asthe group from 2 to 5,respectively.Volume CT dose index (CTDIvol),dose length product (DLP) and the effective dose (ED) were analyzed.CT value and objective image noise were measured in the lungparenchyma and descending aorta.Two radiologists assessed the images for subjective noise,artefacts and diagnostic acceptability.The radiation dose,CT value and objective noise were compared with the analysis of variance,and the difference between two groups was compared with SNK test; the rank sum tests (Kruskal-Wallis) were used in subjective image quality score,and difference between two groups was compared with K-W test.Results The CTDIvol,DLP,ED values in five groups were (7.7±1.7),(7.7±2.0),(5.5±1.4),(4.2±1.5),(2.8±1.2)mGy,(290.7±67.4),(290.1±85.2),(194.2±52.1),(150.7±63.8),(96.5±38.9) mGy· cm,(4.1±0.9),(4.1±1.2),(2.7±0.7),(2.1 ± 0.9),(1.3±0.5) mSv,respectively.There were significant difference among the 5 groups(F=59.305,57.76,57.76,P＜0.01).With the decrease of the reference mAs,the radiation dose decreased significantly.There were no significant difference among the 5 groups on the average CT values of lung parenchyma and descending aorta(F=0.353,0.102,P＞0.05).The objective noise of 5 groups in pulmonary parenchyma and the descending aorta were (48.7 ± 9.1),(49.2 ± 10.0),(55.5± 11.2),(56.5± 8.3),(63.7 ± 13.2) HU; (9.2± 1.6),(9.5 ± 2.1),(10.7 ± 2.6),(11.6 ± 2.7),(13.6 ± 2.6) HU respectively,and the difference was significant(F=10.774,17.157,P＜0.01).Level assessment onsubjective noise of five groups by radiological expertsalso showed the significant difference (U=33.967,P＜0.01),butthe evaluation on motion,streak,blotchy pixellatedartefacts and diagnostic acceptability had no statistical difference (U=8.847,2.054,6.186,5.296,P＞0.05).Conclusion Comparedwith CARE Dose4D,the use of CARE kV technique of suitable reference mAs for unenhanced chest CT can reduce radiation dose significantly with diagnostically acceptable image quality.

Objectives: To investigate the significance of CT multi-planar reconstruction of vertebral artery CT angiography(CTA) in C2 pedicle screw placement. Methods: The vertebral artery CTA images of 77 pa-tients were reviewed retrospectively by CT multi-planar reconstruction. The positions in three dimensions were adjusted according to the screw′s ideal direction, and the cross section of the screw passing through the pedicle was displayed based on CT multi-planar reconstruction. A circle was demarcated on the former plane to simulate the cross section of the screw. The diameter of the circle, the accommodation of screw in C2 pedicle, and the positions of the screw related to the vertebral artery were taken into account to assess the feasibility of pedicle screw placement. And meanwhile, the feasibility was assessed by measuring the inner di-ameters of pedicle complex. The results of the two methods were compared. Results: The simulation of place-ment of C2 pedicle screw basing on CT multi-planar reconstruction illustrated the accommodation of screw in C2 and its relationship with surrounding structures. According to this method, 10(13%) cases of left side and 19 (25%) cases of right side could not accommodate the circle with the diameter of 4mm and could not be placed pedicle screw, while operation was unavailable for 12(16%) cases of left side and 20(26%) cases of right side by measurement of inner diameters. The P value of McNamara test was 0.5 in the left and 1 in the right. There was no significant differences between the results of two methods(P>0.05). The result of Kap-pa test was 0.770 in the left and 0.732 in the right, and the P value of the Kappa test in the both sides was 0, which showed good consistency. Conclusions: The simulation of placing pedicle screw in axis basing on CT multi-planar reconstruction can illustrate the screw accommodation in C2 and its relationship with sur-rounding structures, which can provide good reference for the operation.

Objective:To explore the plasma catecholamines (CAs) concentration of postnatal depression and to analyze the relationships between postnatal depression and CAs level. Methods:Using high performance liquid chromatography (HPLC) to measure the subjects' plasma noradrenaline (NE)?adrenaline (E) and dopamine (DA) concentration. The postnatal depression group was compared with depression, ante partum and normal group.Results: NE level of plasma in the depression group and the postnatal depression group were all higher than those of normal group P 0.05) .Conclusion:the plasma NE increase is relative to postnatal depression episode,the plasma DA may be relative to postnatal depression episode. The relationship between plasma and postnatal depression remains unclear.