Transcranial magnetic stimulation (TMS) is a non-invasive technique that can activate cortical motor areas and the corticospinal tract without causing the subject discomfort. Since TMS was introduced, numerous applications of this technique have been developed for the evaluation of neurologic diseases. They allow the evaluation of cortex excitability and motor conduction in the central nervous system and have been proved useful in monitoring motor abnormalities and the recovery of motor function. TMS also gives informations on the pathophysiology of the processes underlying the various clinical conditions and contribute to investigate the mechanisms of diseases. In addition, therapeutic use in depression, Parkinson's disease, epilepsy, spinal cord injury and stroke has raised great interest over the past decade. Theapplication of TMS has great potential both as an investigational and as a therapeutical tool in neurology and psychiatry. However, as an infant techniology, there should be further investigation and large randomized trials to be conducted.

Objective: To observe the changes of plasma levels of omentin-1 and vaspin in patients with acute coronary syndrome (ACS). Methods: Our research included in 2 groups: ACS group, the patients with conifrmed diagnosis in our hospital from 2013-05 to 2013-09,n=100 including 52 male, 48 female and Control group, the patients with simultaneous coronary angiography excluded CAD,n=88. Plasma levels of omentin-1 and vaspin were examined by ELISA and the differences were compared between 2 groups. Results: Plasma levels of omentin-1 and vaspin in ACS group were lower than Control group (t=2.718,P<0.05) and (t=2.416,P<0.05). Correlation analysis presented that in ACS group, omentin-1 level was negatively related to total cholesterol (TC) (r=-0.702,P<0.05) and C-reactive protein (CRP) (r=-0.714,P<0.05); vaspin was negatively related to TC (r=-0.655, P<0.05) and CRP (r=-0.587,P<0.05); Omentin-1 was positively related to vaspin (r=0.643,P<0.05). Multiple linear stepwise regression analysis showed that plasma levels of omentin-1 and vaspin might be affected by CRP, TC and LDL-C. Conclusion: ACS patients had decreased plasma levels of omentin-1 and vaspin; in addition, omentin-1 and vaspin might be involved in lipid metabolism.

Animals ; Brain ; metabolism ; physiopathology ; Brain Ischemia ; genetics ; metabolism ; pathology ; Gene Expression ; Male ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the gender differences in neuromuscular blockade induced with rocuronium in patients undergoing abdominal surgery. Methods Twenty-four ASA Ⅰ or Ⅱ patients aged 20-59 yrs undergoing abdominal surgery under general anesthesia were enrolled in this study. Their body mass index (BMI) ranged between 18.5-25 kg?m-2. Patients with neuromuscular disease were excluded and no patient was taking any drug that might influence the effect of muscle relaxant. The patients were divided into male group ( n = 12) and female group (n = 12). The neuromuscular function was monitored and recorded using accelerography (DK-5210, Biometer, Denmark). The response of adductor pollicis muscle to train-of-four (TOF) stimulation of ulnar nerve were recorded. Body temperature was maintained at 36.0-36.9℃ and room temperature at 24-26℃ during surgery. The premedication included intramuscular atropine 0.01 mg?kg-1 and oral diazepam 10 mg. Anesthesia was induced with fentanyl 2-4 ?g?kg-1, propofol 2-3 mg?kg-1 and rocuronium 0.6 mg?kg-1. The patients were intubated and mechanically ventilated (VT = 7-10 ml RR = 12-14 bpm). PET CO2 was maintained between 35-45 mm Hg. Anesthesia was maintained with propofol by TCI (effect-site concentration was set at 3-4 ?g?ml-1) and intermittent i.v. boluses of fentanyl. Rocuronium (1 mg?ml-1) was infused and T1 was maintained at 5%-10% of the control height. At the end of surgery rocuronium infusion was terminated and neostigmine 0.05 mg?kg-1 was given i.v. .Results There were significant differences in body weight and height between male and female groups ( P

Objective To evaluate safety and validity of 3D video-assisted thoracoscopic technology in cardiac surgery.Methods Between October 2013 and July 2014,50 patients underwent 3 D Video-assisted thoracoscopic cardiac surgery including:5 atrial septal defect closure,1 ventricular septal defect closure,repairment of 1 unroofed coronary sinus,1 partial atrioventricular septal defect and 1 cor triatriatum,28 mitral valve replacement (1 re-MVR),1 tricuspid valve replacement,9 mitral valvuloplasty,2 left atrial myoxoma resection,and 1 left internal mammary artery harvest + minimally invasive direct coronary artery bypass.All procedures were performed under extracorporeal circulation,using 30° thoracoscope and 3D high resolution monitor.Results There was no perioperative death.One patient was converted to median sternotomy because of pericardial adhesions.Mean operative time was(232.8 ± 54.7) min,mean cardiopulmonary bypass time was(128.0 ±42.5) min,mean aortic cross-clamp time was (74.7 ± 25.1) min.Mean ICU stay was (30.4 ± 22.0) h,mean duration of mechanical ventilation was(13.7 ± 11.9) h.Mean postoperative drainage time was (3.34 ± 1.91) d,mean hospital stay was (6.52 ± 3.06) days.There were 11 (22％) operative complications,including 4 intrathoracic bleeding,1 wound infection,3 hemothorax,1 brachial plexus injury,1 intractable hiccup and 1 mild paravalvular leakage.Compared with 20 mitral valve replacement by 2D thoracoscopy,the 3 D group was slightly less time consuming(P ＞ 0.05).Conclusion 3 D video-assisted thoracoscopic cardiac surgery is feasible and safe,and it' s worthwhile to promote this promising technology.

Objective To investigate the clinic results of treatment of distal tibiofibular fractures by in- direct reduction and plate fixation through inferior fibula.Methods Between 2002 and 2005,32 cases of distal tibiofibular fractures were treated with indirect reduction and plate fixation through inferior fibula.According to the AO/ASIF classification,there were 17 cases of type A,nine cases of type B,and six cases of type C.Twenty of them also received iliac autograft through a limited median incision at the lower tibia to repair their lateral tibial defects.After operation their ankle joints were fixated at 90?with piaster brace and cast for three months.The bone union,wound and the function of the ankles were observed after surgery.Results All the patients were followed up for an average of 16 months.The average bone union time was 14 weeks.No nonunion,screw loosening,broken plate,or infection of the wounds was found in this series.The excellent and good rate was 84.4% according to Mazur's ankle joint function scoring.Conclusion Indirect reduction and plate fixation through inferior fibula is a satisfactory technique in the treatment of distal tibiofibular fractures.

Objective Base on the theory of traditional Chinese medicine (TCM), obtained human diagnostic information available for joint syndrome differentiation is integrated based on subjective and objective combined syndrome differentiation, in the form of data expression of TCM four diagnosis, forms multiple information fusion of open platform for TCM diagnosis and treatment, and provides some revelation for promoting the development of depression and treatment technology. Methods Totally 30 depression patients and 30 normal people were selected according to the inclusion criteria. TCM four diagnostic and auxiliary diagnosis instrument was used to collect information of four diagnosis, and the statistical software was used for the analysis on pulse diagnosis, and information features of digitalized tongue and listening diagnosis of patients in depression group and normal group were studied. Results Compared with depression group, pulse frequency, fluency, and heart rate of normal group were a bit higher than depression group, without statistical significance (P>0.05);There was statistical significance among pulse frequency, strength, tightness, and pulse wave velocity between the normal group and depression group (P<0.05). 30 patients had 6 depression syndrome types:heart-gallbladder qi deficiency (8 cases), phlegm-heat attacking internally (6 cases), fire excess from yin deficiency (6 cases), liver depression forming fire (6 cases), intense heart fire (3 cases), and heart-spleen deficiency (3 cases). Conclusion The results of differences in pulse diagram parameters were consistent with the theory of classical TCM pulse theory. The results of differences in pulse wave velocity conform to the modern medical research conclusion. TCM four diagnostic auxiliary diagnosis and treatment technology can realize the dynamic detection of depression patients with four diagnostic information, and establish diagnostic methods for depression based on digitalized four diagnostic auxiliary diagnosis.

Objective To explore the clinical value of urethral dilation in treatment of female bladder outlet obstruction. Methods Thirty-five female bladder outlet obstruction patients were selected, and all the patients failed for more than 1 month inαreceptor blocker treatment. The patients underwent urethral dilation under local anaesthesia, once a week, for a total of 12 times. The international prostate symptom score (IPSS), quality of life score (QOL) and residual urine volume before and after treatment were examined. Results The IPSS, QOL and residual urine volume after treatment were significantly lower than those before treatment: (10.23 ± 6.31) scores vs. (21.41 ± 3.71) scores, (2.31 ± 0.65) scores vs. (5.43 ± 0.60) scores and (20.73 ± 10.59) ml vs. (85.23 ± 12.15) ml, and there were statistical differences (P<0.01). Conclusions The urethral dilation is one of the effective treatments for female bladder outlet obstruction patients who fail in αreceptor blocker treatment. It can make a part of patients avoid invasive examination and surgery, and it is worth to be popularized in clinic and primary hospital.

AIM:To observe whether modified epitopes from osteosarcoma high-expressing antigen papilloma-virus-binding factor (PBF) have HLA-A2 restricted antitumor ability,and to develop peptide-based immunotherapy for os-teosarcoma. METHODS:RT-PCR and Western blot were used to determine the expression of PBF in the osteosarcoma cell lines U2OS and Saos-2. HLA-A2 epitopes from PBF protein were predicted by NetCTL 1.2, SYFPEITHI and IEDB. The modified peptides from PBF containing HLA-A2 binding anchor motifs were designed by replacing the anchor residues. The peptides were synthesized by standard solid-phase methods,and the binding affinity of the peptides to HLA-A?0201 was evaluated by T2A2 cell binding assay. ELISPOT assay was used to investigate the seretion of interferon-γ(IFN-γ) from the peptide-induced specific cytotoxic T-lymphocytes (CTLs). The ability of inducing T-cell response was analyzed by lactate dehydrogenase (LDH) release assay and carboxyfluorescein succinimidyl ester (CFSE) cytotoxicity assay in vitro. RE-SULTS:The expression of PBF was observed in the U2OS and Saos-2 cells. The candidate peptides P75-1Y2L,P412-1Y, P416-1Y2L9V, P107-1Y and P435-1Y2L showed moderate affinity toward HLA-A2 molecule. The modified peptides showed significantly higher affinity with HLA-A2 than the native peptide. ELISPOT assay showed that P412, P412-1Y, P416,P416-1Y2L9V and P435-1Y2L induced specific CTLs to secrete IFN-γ, and P412-1Y and P416-1Y2L9V induced more secretion of IFN-γ than the native peptide. The CTLs induced by P412, P412-1Y, P416 and P416-1Y2L9V lysed U2OS cells. P412-1Y and P416-1Y2L9V peptide-specific CTLs showed higher cytotoxicity against U2OS cells than the native peptide-specific CTLs. CONCLUSION:Compared with the native peptide,modified epitopes P412-1Y and P416-1Y2L9V have higher binding affinity with HLA-A?0201 and retain immunogenecity. In addition,the anti-tumor immunity effects of modified epitopes P412-1Y and P416-1Y2L9V are stronger than the native peptide. The peptides P412-1Y and P416-1Y2L9V is excellent HLA-A?0201 restricted CTL epitopes from tumor antigen PBF,which could serve as new can-didates towards antitumor peptide vaccines.

Objective To analyse the clinical effect of Quantianma capsules combined with flupentixol and melitracen tablets on chronic migraine. Methods 130 patients with chronic migraine were treated with flupentixol and melitracen tablets, were divided into control group and observation group, 65 patients in each group. The observation group were given to Quantianma capsules. Results The effective rate of observation group with 90.77% was higher than control group with 73.85%(P<0.05). After treatment, the number of migraine attacks, duration time, VAS score, HAMA and HAMD score and mean flow velocity of cerebral artery of two groups were lower than pre-treatment and observation group were lower than that of control group(P<0.05). Adverse reactions were similar in the two groups. Conclusion Quantianma capsules can improve the efficacy of treatment of chronic migraine combined with flupentixol and melitracen tablets and improve condition with few adverse effects.