[Summary] Limb numbness is a common symptom of diabetic peripheral neuropathy(DPN),which is similar to lumbar vertebra disease and spinal cord tumor compression syndrome. Diabetes mellitus (DM) combined with lumbar spondylosis and spinal cord tumor compression is rarely occurred and is difficult to distinguish from DPN . Here we reported a case of DM combined with spinal neurilemoma that was misdiagnosed as DPN for half a year.

OBJECTIVE: To investigate the molecular mechanism of Huanglian Jiedu Decoction (HLJDD), a traditional Chinese compound herbal medicine, in treating type 2 diabetes mellitus (T2DM) by observing its effects on glucose transporter 4 (GLUT4) protein expression and translocation in adipose and skeletal muscle tissues of rats with T2DM. METHODS: T2DM was induced in rats by intravenous injection of a small dose of streptozotocin (STZ, 30 mg/kg) plus high fat and high caloric laboratory chow. Then animals were divided into untreated group, aspirin-treated group and HLJDD-treated group. Normal rats fed with common chow were designated as normal control group. Ten weeks later, the oral glucose tolerance test (OGTT) was performed in all animals, and the changes of murine body weight, fasting blood glucose (FBG), fasting serum insulin (FINS) and the expression of GLUT4 protein in skeletal muscle and adipose tissues before and after insulin treatment were routinely determined. RESULTS: Compared with the untreated group, the result of OGTT of HLJDD-treated group was improved. The levels of the body weight and FBG were decreased, while the GLUT4 protein expression and translocation were elevated obviously. CONCLUSION: It is suggested by the present results that the therapeutic effects of HLJDD on T2DM might be related to its ability of increasing GLUT4 protein expression and translocation in adipose and skeletal muscle tissues of T2DM rats.

s Objective To observe the changes in neurochemical metabolites at early stage of DAI in rats with MRS technique. Methods DAI was induced by a self-made rotating injury device in Sprague-Dawley (SD) rats (n=16). MRS was used to evaluate the changes in neurochemical metabolites before-trauma, 2 hours and 3 hours after the trauma. The data were analyzed by statistical analysis system. Results MRS demonstrated that contents of both NAA/Cr and Cho/Cr of corpus callosum were decreased obviously 3 hours posttrauma, and differences between those before trauma and those after trauma were statistically significant. The content of NAA/Cr of the brain stem was declined at 2 hours also with significant difference compared with that before trauma. There was no significant difference in values between 2 and 3 hours. The content of Cho/Cr of the brain stem was significantly decreased 3 hours after the trauma. Conclusions MRS technique has a high sensitivity in diagnosing microscopic pathology following DAI and functional defect of neuron and axon, as shown by significant decrease in NAA/Cr and Cho/Cr at early stage (i.e. 2-3 hours) after trauma.

Objective To discuss the diagnosis and treatment of a variety of multiple nerve entrapment in the brachial plexus and around anterior and middle scalene muscles in 179 cases.Methods From July 2003 to January 2006,179 outpatients in our department were diagnosed as thoracic outlet syndrome(TOS)with a variety of symptoms of the nerve entrapment in the brachial plexus and around anterior and middle scalene muscles.They were treated with drugs,local block injections,or operations,depending on their severity of the condition. Results Of the 128 cases who were followed up for one to 29 months,the symptoms were significantly relieved with drugs and massage in 55 cases,with local block injection in 58 cases of whom 24 received the second in- jection,with operation in 15 cases of whom 10 returned to work.One of the operated cases reported symptoms of injury to the long thoracic nerve which responded to further therapy.The visual analogue scale(VAS)evaluations after the first injection were one point in two cases,two points in 16 cases,three points in 20 cases,four points in 12 cases,five points in three cases,six points in three cases,and seven points in two cases.The VAS scores after the second injection were two points in five cases,three points in 16 cases,and four points in three cases. Conclusions The entrapment of the anterior anti middle scalene muscles can affect many nerves around the muscles,and cause clinical symptoms other than the TOS ones.The conservative treatment,such as drug,massage, and local block injection,can work well.When the non-operative methods do not work,operation can be consid- ered.

The conception,sources and research focus on environmental estrogens of effluent from sewage treatment plants were briefly introduced and the advances on environmental estrogens of effluent from sewage treatment plants were reviewed in the present paper.The study and applications of biomarker-vitellogenin (Vtg) was also discussed.The future research direction of environmental estrogens was proposed.

Objective To investigate the effect of the side of cerebral lesion on the outcome in patients with ischemic stroke.Methods A total of 407 consecutive anterior circulation ischemic stroke patients within 14 days after symptom onset were recruited prospectively.The basic data ofthe e,~ISes were collected,such as the National Institutes ofHealth Stroke Scale (NU-ISS)and the side ofcerebral lesion.The modified Rankin Scale(mRS)was used to evaluate the prognosis of the patients at 6 raomhs.Results Of the 407 patients recruited,230 patients (56.5%)Were left hemisphere stroke,177(43.5%)were fight hemisphere stroke.After multivariable logistic recession analysis,the age(odds ratio[OR]1.022,95% confidence interval[CI]1.001-1.043,P=0.040),the side of lesion(OR 1.999.95%CI1.179.3.389.P=0.010),the time from onset to admission(OR1.006,95%(7/1.002-1.010,P=0.007),the outcome of the anterior circulation ischcmic stroke at 6 months aftel"onset.The outcome of the right hemisphere stroke Was significantly worse than that of the left hemisphere stroke.The onset-admission time in patients with right hemisphere stroke(median 12 h,median 39.61 h)was significantly delayed compared to the patients with left hemisphere stroke(median 12 h,median 22.72 h;Z=-2.962,P=0.003).Condusions The outcome of the left hemisphere stroke at 6 months after onset is superior to the right hemisphere stroke,and it mau be associated with the delayed admission.

Objective To study a possible correlation between the duration of reproductive period ( from puberty to menopause) and the prognosis of ischemic stroke. Methods Female in-patients with acute ischemic stroke confirmed by CT/MRI in the Neurology Department of the First Affiliated Hospital of Zhengzhou University from 09/03/2006 to 08/30/2008 were enrolled in this study. The probable risk factors of prognosis were analyzed and recovery was assessed by modified Rankin score (MRS) at 6 months followup. Multivariate Logistic regression was used for statistic analysis. Results 371 female patients were enrolled. The average age was (66. 2 ± 10. 0) years; average menopause age was (48. 5 ± 3.9 ) years and average duration of reproductive period was (33.3 ± 4. 3) years. There is a negative correlation between the duration and MRS (OR =0. 285, 95% CI: 0. 095-0. 850, P =0.024). There is no correlation between menopause age and prognosis of stroke. Conclusions Duration of reproductive period is a predictor for prognosis of ischemic stroke. Patients with longer reproductive period have better prognosis.

Objective To explore the effects of injection of wnt3a gene-modified bone marrow mesenchymal stem cells (MSCs) on acute graft-versus-host disease (aGVHD) in a murine allogeneic bone marrow transplantation (allo-BMT) model.Methods C57BL/6 mice were used as the donors and Balb/c mice as the recipients in the murine allo-BMT model.The recipient mice were divided into four groups by random number table method: transplantation control group (group A) (infusion of 5 × 106bone marrow cells via the tail vein of recipient mice); aGVHD group (group B) (infusion of 5 × 106bone marrow cells and 5 × 106 splenocytes via the tail vein of recipient mice); aGVHD + empty vector group (group C) (infusion of 5 × 106 bone marrow cells,5 × 106 splenocytes and 1 × 106 pAd-GFP-transfected MSCs via the tail vein of recipient mice) ; experimental group (group D) (infusion of 5 ×106 bone marrow cells,5 × 106 splenocytes and 1 × 106 wnt3a gene-modified MSCs).The general performance and survival were monitored,the occurrence of aGVHD was observed,the changes of donor T lymphocyte quantity present in the spleen,and interleukin-2 (IL-2) and interferon-γ (IFN γ)levels of the recipient mice were detected in each group after transplantation.Results The survival time of recipient mice in group A was all more than 60 d,and that in groups B,C and D was (19.1 ±6.19),(32.6 ± 19.6) and (47.2 ± 15.6) d,rcspcctivcly.The survival time in group D was significantly longer than in groups B and C (P＜0.05).After the transplant,the aGVHD score points in groups B,CandDwere (8.0±0.41),(6.7±0.29) and (4.0± 1.0),respcctively.The aGVHD score points in group D were significantly less than in groups B and C (P＜0.05),and the pathological grade in group D was significantly reduced.The number and proliferation rate of T lymphocytes were reduced significantly in group D as compared with groups B and C at 3rd and 5th day after transplantation (P ＜ 0.05).The levels of IL-2 and IFN-γ in peripheral blood were decreased significantly in group D as compared with those in groups B and C at 7th,14th,21st and 28th day after transplantation (P＜0.05).The chimeric rate of the murine H-2Kb cells in the bone marrow cells of long-term survival mice was all in the range of 95％ to 100％ 60 d after transplantation.Conclusion The injection of wnt3a gene-modified MSCs can more effectively alleviate aGVHD in murineallo-BMT model,which may be correlated with the Wnt3a overexpression which activating the Wnt/β-catenin signaling pathway of MSCs,thereby inhibiting the early activation and amplification of donor T lymphocytes and the IL-2 and IFN-γ expression.

Objective To investigate the changes of plasma adrenomedullin(ADM),endothelin-1(ET-1) in infants with severe pneumonia complicated by acute congestive heart failure,and its relationship with heart function.Methods Forty-seven bronchopneumonia patients in their acute phase were divided into three groups:group A1,severe pneumonia complicated by acute congestive heart failure without congenitive heart disease(CHD)(n=15);group B1,severe pneumonia complicated by acute congestive heart failure with CHD(n=12);group C1,mild bronchopneumonia(n=20).A2,B2 and C2 groups were the convalescence groups of A1,B1 and groups C1 respertively.Group D,20 healthy infants were used as control group.Plasma ADM,ET-1 levels of patients in acute phase(pre-treatment)and convalescent phase and controls were measured by specific radioimmunoassary.Results 1.The plasma ADM levels significantly increased in the acute phase of A1,B1 and C1 compared with healthy controls(Pa0.05).3.The plasma ADM,ET-1 levels in A2 and B2 groups significantly decreased compared with those in group A1 and B1(Pa0.05).Conclusions The ADM,ET-1 play very important roles in the pathophysiological processes of pneumonia and congestive heart failure in infants.ET-1 may play an important role in the pathogenesis of severe pneumonia in infants complicated with congestive heart fai-lure.The level of plasma ET-1 is related with the degree of congestive heart failure.

Objective:To valuate the treatment value and analyse the effect on the cellular immune functions by studying the differences of T-lymphocyte subsets and CD4+CD25+Treg cells in peripheral blood after adoptive immunotherapy ( dendritic cells and cytokine-induced killer cells,DC-CIK) combined with chemotherapy on MM.Methods:50 patients with MM were randomly divided into two groups.24 patients in chemotherapy group were treated by chemotherapy only,26 patients in joint group were treated by adoptive immunotherapy( DC-CIK) combined with chemotherapy,and the clinical outcomes and the levels of T-lymphocyte subsets and CD4+CD25+Treg cells in peripheral blood between two groups were compared.Moreover,the differences of cellular immune indicators (Th1/Th2,the ratio of AgNOR,and TGF-β)between two groups were also compared.Results: After treatment,quality of life,clinical index and survival in joint group were better than in chemotherapy group( P<0.05);the proportion of CD3+CD8+,the ratios of CD4+CD25+,CD4+CD25+/CD4+and the level of TGF-βof joint group wes clearly lower than chemotherapy group(P<0.05),and the ratios of CD3+CD4+/CD3+CD8+, Th1/Th2 and AgNOR of joint group wes clearly higher than chemotherapy group .Conclusion: DC-CIK combined with chemotherapy could be an effective and promising treatment to patients with MM,and it maybe strengthen the anti-tumor action of bodies by regulating the balance between Th1 and Th2 reaction.