Dysfunction after spinal cord injury mainly focused on the loss of motor function and sensory function and its complications instead of cognitive impairment. In this paper, the relevant reports of cognitive impairment in patients with spinal cord injury were collected. The influencing factors mainly contained emotion, traumatic brain injury, alcohol intake, drug abuse and educational level, etc. The possible mechanisms included traumatic brain injury, structure change of brain, brain damage and functional change, and inappropriate treatment, etc.

Objective To investigate clinical results of the treatment of posterior shoulder instability in a combined way of bone block procedure and posterior capsulorrhaphy. Methods The double contrast CT arthrography was performed for 5 patients suffering from posterior shoulder instability so as to detect the pathology. The treatments combining bone block procedure and posterior capsulorrhaphy were carried out according to the pathological conditions of bone and soft tissue. Results The double contrast CT arthrography showed posterior bone defects, posterior glenoid labrum tear and enlargement of posterior capsular cavity. After the bone block procedure and posterior capsulorrhaphy, no patients complained shoulder instability in the follow-up of 5 to 38 months. Conclusions Many pathological factors may induce posterior shoulder instability, which should be corrected by an appropriate operation rather than a “standard”method of operation. For patients involving several pathological factors, a combined operation may be needed in order to correct various pathological changes.

OBJECTIVE:To establish a method for the contents determination of triamcinolone acetonide acetate and tretinoin in Dimensional ointment. METHODS:HPLC was performed on the column of Diamonsil C18 with mobile phase of methanol-0.1%Phosphoric acid solution(87:13,V/V),detection wavelength was 254 nm(0-5 min)and 350 nm(5-20 min),at a flow rate of 1.0 ml/min,column temperature was 25℃,and volume injection was 10 μl. RESULTS:The linear range was 0.5-5 μg/ml for triamcin-olone acetonide acetate(r=0.999 9)and 4.96-49.6 μg/ml for tretinoin(r=0.999 8);RSDs of precision,stability and reproducibility tests were lower than 1%;recoveries were 98.37%-100.03%(RSD=0.58%,n=6)and 98.21%-100.38%(RSD=0.78%,n=6). CON-CLUSIONS:The method is simple,accurate and fast,and suitable for the contents determination of triamcinolone acetonide ace-tate and tretinoin in Dimensional ointment.

Objective To determinate the heavy metal cadmium content in rice to ensure food safety.Methods Several brands and batch numbers of rice were collected and divided into groups A and B.Group A contained 24 pieces of rice from the canteens,and group B involved in 22 pieces from the farm product markets.Cadmium content in rice was detected quantitatively with X-ray fluorescence spectrometer,and then evaluated according to GB 2762-2012 which determined rice was not qualified in case cadmium content was more than 0.2 mg/kg.Results Group A had cadmium content between 0.00 and 0.477 mg/kg,the times of ultra standard being 2.385 and the disqualification rate being 29.2％ (7/24),and group B had cadmium content between 0.065 and 0.619 mg/kg,the times of ultra standard being 3.095 and the disqualification rate being 68.2％ (15/22).Excessive cadmium content in rice occurred in both canteens and markets,while the canteens was better than the markets.Conclusion X-ray fluorescence spectrometer detects cadmium content in rice rapidly and simply,and is worthy promoting in elementary facilities.

Objective To observe the surface structures of cardiovascular endothelial cells in situ with atomic force microscope (AFM). Methods Fresh aorta and aortic valve were dissected from 10 healthy male New Zealand white rabbits. Before fixed in 1% formaldehyde, the fresh tissues were washed in the buffer phosphate solution. Under general microscope, the fixed aorta or valve was spread on the double side stick tape which had already been stuck on the glass slide. The intima of aorta or the aorta side of valve was towards upside. Then the specimen was dried under 37 degrees centigrade in an attemperator and was washed with pure water. After dried again, the specimen was loaded on the platform ofNanoScope llla AFM and was scanned in tapping mode with the scanning speed of 0.5 HZ. Results The surface structures of endothelial cell on the fixed and dried tissue could be obsserved clearly in situ with AFM. Aortic endothclial cells were large, branched and arranged sparsely and parallel to the direction of blood flow, whereas endothelial cells on aorta valve surface were small, less branched and arranged intensively and vertical to the direction of blood flow. When the scanning range was dwindled, granular ultra-structures could be observed on the surface of endothelial cells, and, as the scanning range was dwindled further, fissure and convolution could be seen on the surface of granules from aortic endothelial cells. Centre cavity and surrounding swelling volcano-like structure could be seen on the surface of granules from endothelial cells of aortic valve. Conclusions It's feasible to observe the surface ultra-structures of cardiovascular endothelial cells in situ with AFM and morphological information provided by A FM might be of clinical value in future histopathological diagnosis.

Objective To explore the relationship between tumor necrosis factor (TNF) gene polymorphisms in donors and recipients and the incidence and severity of acute graft-versus-host diseases (aGVHD) after unrelated allogeneic hematopoietic stem cell transplantation (alIo-HSCT). Methods Single nucleotide polymorphisms (SNPs) of TNFα-238 (G/A), TNFα-857 (C/T), TNFα-863 (C/A), TNFα-1031 (T/C), TNFβ + 252 (A/G) were analyzed by Multiplex SNaPshot analysis in 76 pairs of donors and recipients. Results Transplantation involving donors with TNFα-857 CC genotype resulted in a higher incidence of grade Ⅱ-Ⅳ aGVHD than donors with CT genotype (91.3% vs 8. 7% , P =0. 039). In the 23 patients with grade Ⅱ-Ⅳ aGVHD, no patients had TNFβ +252 AA genotype, 19 (82.6%) had GA genotype and 4 (17.4%) had GG genotype. There was a significant difference in the distribution pattern of the TNFβ +252 (AA, GA and GG) genotypes in these patients (P =0.03). There was no significant association of TNFα-238 (G/A), TNFα-863 (C/A) and TNFα-1031 (T/C) polymorphisms with the risk of aGVHD. Conclusion These results suggest donor TNFα-857 CC genotype is related to a higher incidence of grade Ⅱ -Ⅳ aGVHD, and patients with TNFβ +252 AA genotype have protection against the risk of grade Ⅱ -Ⅳ aGVHD.

Objective To determine the frequency of Toll-like receptor 4 (TLR4)polymorphisms Asp299Gly and Thr399Ile in a cohort of hematopoietic stem cell transplant recipients and their donors in China.Method We examined the polymorphisms in 208 peripheral blood samples collected from 104 recipients and their donors in a single center between 2007-2012 in Zhejiang Province,China,and Asp299Gly and Thr399Ile TLR4 gene polymorphisms were detected using the sample DNA amplification products direct sequencing and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.Result Both methods didn't demonstrate TLR4 polymorphisms Asp299Gly or Thr399Ile base mutation in our samples.Conclusion The TLR4 Asp299Gly and Thr399Ile polymorphisms are very rare in our part of the population of hematopoietic stem cell transplantation.

Both diabetes and hepatocellular carcinoma are important global health issues. A large number of studies have confirmed that diabetes and hepatocellular carcinoma are inseparable. The main reasons include the imbalance of insulin-like growth factor system caused by insulin resistance, increased reactive oxygen species and disorder of adipokines. Hepatitis C virus infection may also cause diabetes. This article reviewed the common pathogenesis and related pathways of the two diseases, and provided therapeutic options for the diseases.

OBJECTIVE: To investigate the effects of Enalapril maleate folic acid tablets on carotid atherosclerosis in H type hypertension patients with type 2 diabetes mellitus (T2DM) and its potential mechanism.METHODS: In prospective control study, 182 H type hypertension patients with T2DM were selected from Chongqing People's Hospital during Jan. 2014-Jan. 2016, and then randomly divided into observation group and control group, with 91 cases in each group. All patients received basic or hypoglycemic treatment of premixed insulin; observation group was additionally given Enalapril maleate folic acid tablets (containing enalapril maleate 10 mg, folic acid 0. 8 mg in each tablet) orally, one tablet, qd; control group was additionally given Enalapril maleate tablets (containing enalapril maleate 10 mg in each tablet) orally, one tablet, qd. Treatment course lasted for 12 months. The levels of blood pressure, plasma homocysteine (Hcy), fasting blood glucose (FBG), C-reactive protein (CRP) and carotid plaque score were detected in 2 groups before treatment, 12 months after treatment. RESULTS: Compared to before treatment, SBP and DBP of 2 groups were decreased significantly in 2 groups after 12 months of treatment (P<0. 05); there was no statistical significance between 2 groups (P>0. 05). The levels of plasma Hcy, FBG and CRP, carotid intima-media thickness and carotid plaque integral in observation group were significantly lower than control group (P<0. 05). CONCLUSIONS: Enalapril maleate folic acid tablets can relieve inflammation by reducing plasma Hcy, FBG and CRP so as to treat carotid atherosclerosis in H type hypertension patients with T2DM.

Objective To investigate the efficacy of dexmedetomidine on sedation in post-cardiac surgery patients with NIV intolerance.The changes of respiratory function and hemodynamics of the patients as well as non-invasive ventilation (NIV) failure rate were also under evaluation.Methods Thirty-five post-cardiac surgery patients with NIV intolerance and hypoxemia were enrolled in this prospective study.All patients were sedated with dexmedetomidine.NIV was standardized according to the uniform protocol.The main outcome was NIV success (avoiding endotracheal intubation) or NIV failure (requiring endotracheal intubation or die).The cardiorespiratory parameters (BP,HtR and RR) and artery blood gas analysis were prospectively recorded before and after sedation.The respiratory function and hemodynamics changes in both groups (NIV success group and NIV failure group) were then evaluated.Factors independently associated with NIV failure were identified using a logistic regression model.Results Twenty out of 35 patients (57.14％) survived while 15 (42.86％) patients failed NIV.After 1 h and 4 h of NIV with dexmedetomidine sedation,respiratory rate in both groups were decreased compared with baseline,especially in NIV success group.The PaO2/FiO2 was also improved after 1h and 4h of NIV treatment compared with baseline.The improvement was more significantly in NIV success group.The heart rate was decreased compared with baseline with no differences between two groups.There were no significant changes on PaCO2 and mean arterial pressure (MAP) during the treatment.The respiratory and hemodynamics variables identified as predictors of NIV failure were included in a multivariate logistic regression.RR ＞ 23 time/min (OR =3.2,95％ CI:2.043 ～ 4.301,P ＜ 0.01) 1 h after NIV,RR ＞ 20 time/min (OR =2.1,95％ CI:1.659～3.231,P=0.025) 4 h after NIV,PaO2/FiO2 ＜178 mmHg (OR=2.4,95％CI:1.892 ～ 3.287,P ＜0.01) 1 h after NIV and PaO2/FiO2 ＜ 185 mmHg (OR =1.7,95％ CI:1.243 ～ 2.365,P =0.041) 4 h after NIV independendy predicted NIV failure.Conclusions Dexmedetomidine might be considered as an effective and safe sedative for post-cardiac surgery patients with NIV intolerance.Early identification of predictors of NIV failure may facilitate early intervention.