Objective To investigate the features of white matter impairment and its relationship with cognition in patients with amnestic mild cognitive impairment (aMCI).Methods Eighty-three cases of aMCI and 85 normal aging volunteers were scanned with diffusion tensor imaging (DTI) using MR system.All subjects completed the neuropsychological battery.We analyzed the differences between two groups using tract-based spatial statistics and the association between regions in difference and cognition using correlation analysis.Results There were significant differences between aMCI and normal control in the neuropsychological battery including the Mini-Mental State Examination(26.2 ± 2.6 vs 28.3 ± 1.3,F =43.224,P =0.000),Mattis Dementia Rating Scale-2 (131.4 ± 6.9 vs 138.0 ± 3.5,F =62.308,P =0.000),Auditory Verbal Learning Test-delayed recall(2.4 ± 1.6 vs 7.5 ± 2.0,F =324.018,P =0.000),Boston Naming Test(8.7 ± 1.4 vs 9.2 ± 1.0,F =6.821,P =0.010),Rey-Osterrich Complex Figure Test (12.1 ± 7.3 vs 18.5 ± 6.1,F =40.674,P =0.000),Symbol Digit Modulation Test (30.0 ± 10.1 vs 38.6 ± 9.8,F =30.786,P =0.000),Trail-Making Test Part B ((256.8 ± 124.5) s vs (178.1 ± 59.0) s,F =27.601,P =0.000).Significantly higher diffusivity indexes and radial diffusivity were also found in aMCI subjects compared to healthy elders in the parahippocampal,superior longitudinal fasciculus,inferior longitudinal fasciculus,superior fronto-occipital fasciculus,inferior fronto-occipital fasciculus,unciform fasciculus,corticospinal tract,corpus callosum,cingulum,corona radiate.We also found that axial diffusivity was significantly increased in the parahippocampal,superior longitudinal fasciculus,inferior longitudinal fasciculus,superior fronto-occipital fasciculus,inferior fronto-occipital fasciculus,unciform fasciculus,corticospinal tract and corpus callosum,whereas fractional anisotropy changes were not observed in aMCI.Diffusivity indexes values in bilateral frontal lobe (left r =0.67 ; right r =0.70),left cingulum (r =0.63),parietal white matter (r =0.69) and radial diffusivity values in left parietal (r =0.68) were significantly related to Trail Making Test A among aMCI (all P ＜ 0.05).Conclusions In aMCI patients,there was a wide range of white matter damage,with no brain region-specific.Executive function deficit was related to the white matter impairment in bilateral frontal lobe,left cingulate and parietal lobe.The specificity and sensitivity of four DTI parameters fordetecting white matter lesions are variant.Trial registration Clinical Research Center of Jiangsu Province (BL2013025)

We summarized the epidemiological investigation results of the first case of human infection with avian influenza A(H9N2) virus in Chengdu,China,in order to provide references for dealing with similar diseases scientifically in the future.The methods of field epidemiology and laboratory testing were used to collect the H9N2 case's clinical and epidemiological data,as well as collect and test the samples of the H9N2 case and the relevant environment,so that the possible sources of infection,the epidemiological characteristics and clinical features could be analyzed.Results showed that the H9N2 case contacted with poultry within 10 days before the onset of illness and the H9N2 virus nucleic acid was detected in the patient's specimen by PCR.This case suffered from several chronic diseases for a long time,although active treatments were taken this time,she died soon after onset.Her living environment,the chicken leftovers from cooking,and surrounding poultry markets were polluted by H9 avian influenza virus.Through the investigation,we could deduce that the infection source of this case was the chicken infecting H9N2 viruses from surrounding poultry markets.This would be the first fatality associated with influenza A (H9N2) virus infections in humans.And though avian influenza A(H9N2) virus was low pathogenic,infection could cause severe symptoms or death in people with severe underlying diseases.

BACKGROUND:Large numbers of experimental data have confirmed that bone marrow mesenchymal stem cel s have a positive therapeutic effect on cerebral ischemia-reperfusion injury, but there are few reports about intravenous administration of bone marrow mesenchymal stem cel conditioned medium in the treatment of stroke.
OBJECTIVE:To investigate the effects of the conditioned medium of rat bone marrow mesenchymal stem cel s on the recovery of neurological function in rats after cerebral ischemia-reperfusion injury.
METHODS:The bone marrow mesenchymal stem cel s were isolated from rat bone marrow. When cel s at passage 2 or 3 reached 90%confluence, the original culture medium was removed. Then the cel s were cultured in serum-free DMEM for 18 hours. After that, the culture solution was col ected as the conditioned medium of rat bone marrow mesenchymal stem cel s. Adult rats were subjected to 2 hours of right middle cerebral artery occlusion. Ischemia-reperfusion injury rats were randomly assigned to three groups:control group, simple culture medium group and conditioned medium group, and respectively given injection of normal saline, DMEM, conditioned medium (10 mL/kg) via the tail vein at 2, 24, 48 hours after operation.
RESULTS AND CONCLUSION:There was no difference in the behavioral tests among the three groups at postoperative 2 hours (P>0.05). Compared with the control and simple culture medium group, neurological impairment was significantly improved in the conditioned medium group at postoperative 1, 3, 5 days (P<0.05), but there was no significant difference between the control and simple culture medium groups. At postoperative 5 days, brain edema was significantly eased in the conditioned medium group in comparison to the control and simple culture medium groups (P<0.05), and there was also no difference between the latter two groups (P>0.05). These results suggest that rat bone marrow mesenchymal stem cel s-conditioned medium via intravenous administration can significantly ease brain edema and improve the neurologic function after cerebral ischemia-reperfusion injury.

OBJECTIVETo observe the influences of Panax notoginsenosid(a compound of Chinese Traditional Medicine) on the spontaneous contraction of small intestine smooth muscle of rabbits in vitro and explore the mechanism.

METHODSThe influences of Panax notoginsenosid on the spontaneous contraction of small intestine in intacted rabbits(male or female) after the isothermal perfuse of small intestine in vitro were observed. Bay K8644 and nitro-L-arginine methylester (L-NAME) were added to the normal Tyrode's solution respectively before Panax notoginsenosid. In the Ca2+ free Tyrode's solution, rynodine was added before Panax notoginsenosid. The mechanism of Panax notoginsenosid was studied.

RESULTSPanax notoginsenosid reduced the amplitude of contraction of small intestine smooth muscle in rabbits in a does-depended manner. Bay K8644 and L-NAME could completely block the inhibition of Panax notoginsenosid on the contraction of small intestine smooth muscle. Panax notoginsenosid inhibited significantly the intracellular calcium-depended contraction induced by rynodine in the Ca2+ free Tyrode's solution.

CONCLUSIONPanax notoginsenosid inhibits significantly the contraction of small intestine smooth muscle of rabbits in vitro. The mechanism may be related to increase NO concentration in small intestine smooth muscle so that inhibit extracellular Ca2+ inflowing via cell membrane and intracellular Ca2+ releasing via sarcoplasmic reticulum.

Animals ; Calcium ; metabolism ; Depression, Chemical ; Drugs, Chinese Herbal ; pharmacology ; Female ; In Vitro Techniques ; Intestine, Small ; physiology ; Male ; Muscle Contraction ; drug effects ; Muscle, Smooth ; metabolism ; physiology ; Nitric Oxide ; metabolism ; Panax notoginseng ; chemistry ; Rabbits

Objective To investigate the changes of T lymphocyte subsets in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). To evaluate the clinical efficacy of Xuebijing injection in the treatment of AECOPD and its influence on T lymphocyte subsets. Methods From October 2016 to October 2017, 58 AECOPD patients and 20 healthy subjects at the same period in the First People's Hospital of Luoyang were selected. The levels of T - lymphocyte subsets were detected in healthy subjects and AECOPD patients. The 58 cases patients were divided into observation group(n = 28) and control group(n = 30) using random number table. The control group was treated with conventional therapy. The observation group was treated with Xuebijing injection on the basis of the control group. The scores of CAT,APACHE Ⅱ in both two groups before and after treatment were evaluatedThe levels of C - reactive protein(CRP),procalcitonin(PCT) and T lymphocyte subsets were compared between the two groups before and after treatment. Results The levels of CD +3 ,CD +4 and CD +4 / CD +8 in the peripheral blood of patients with AECOPD were (0. 64 ± 0. 10)％ ,(0. 33 ± 0. 14)％ and (0. 95 ± 0. 48),respectively,which of the healthy controls were (0. 70 ± 0. 10)％ , (0. 41 ± 0. 17)％ , (1. 25 ± 0. 51), respectively. There were statistically significant differences between the two groups(t = 2. 09,7. 19,2. 32,all P < 0. 05). After treatment,the scores of CAT and APACHE Ⅱ in the observation group were (13. 2 ± 3. 6)points and (14. 1 ± 3. 8)points,those in the control group were (16. 6 ± 4. 1) points and (16. 9 ± 4. 2) points. The scores of CAT and APACHE Ⅱ in the two groups after treatment were lower than those before treatment(observation group: t = 3. 08,13. 25,control group: t = 2. 94,11. 31,all P < 0. 05). There were significant differences in CAT and APACHE Ⅱ scores between the two groups after treat-ment(t = 8. 90,3. 27,all P < 0. 05). The levels of CRP,PCT,CD +3 ,CD +4 and CD +4 / CD +8 in the control group were (22. 4 ± 8. 8)mg/ L,(0. 9 ± 0. 6)μg/ L,(0. 67 ± 0. 09)％ ,(0. 36 ± 0. 13)％ ,(1. 12 ± 0. 50),respectively,which in the observation group were (15. 6 ± 6. 3)mg/ L,(0. 5 ± 0. 6)μg/ L,(0. 72 ± 0. 82)％ ,(0. 43 ± 0. 13)％ ,(1. 43 ± 0. 47),respectively. The differences between the two groups were statistically significant(t = 2. 75,6. 16,2. 03,2. 69, 4. 90,all P < 0. 05). Conclusion Patients with AECOPD have immune dysfunction. Xuebijing injection is effective in the treatment of patients with AECOPD. The mechanism may be related to the regulation of immune function.

Objective To investigate the related risk factors of cerebral microbleeds (CMBs) and their relations with leukoaraiosis and lacunar infarction in patients with cerebrovascular disease.Methods One hundred and sixty-four patients with cerebrovascular disease,admitted to our hospital from January 2015 and January 2017 were chosen;susceptibility weighted imaging (SWI) was performed,and the distribution and number of CMBs were recorded by Microbleed Anatomical Rating Scale (MARS).The demographic data,personal history,previous medical history,biochemical indices and imageological examination results of the patients were collected and multivariate Logistic regression analysis was carried out on the basis of these data.Spearman dependence analysis was used to analyze the relations of CMBs with leukoaraiosis and lacunar infarction.Results Age (OR=1.071,P=0.024,95％ CI:1.009-1.137),hypertension (OR=3.875,P=0.012,95％CI:1.347-11.148),leukoaraiosis(OR=2.080,P=0.005,95％ CI:1.245-3.475),lacunar infarction (OR=2.326,P=0.003,95％ CI:1.336-4.050) were independently associated with CMBs.And number of CMBs had positive correlation with severity of leukoaraiosis and number of lacunar cerebral infarcts (r=0.564,P=0.000;r=0.762,P=0.000).Conclusion Age,hypertension,leukoaraiosis,and lacunar infarction are the independent risk factors of CMBs;the severity of CMBs is positively correlated with severity of leukoaraiosis and lacunar infarction.

OBJECTIVETo explore the feasibility, effect, and clinic value of total laparoscopic gastric resection in patients with benign gastric disease.

METHODSThe clinical materials of 50 cases underwent total laparoscopic gastric resection (LG group) and 104 cases open surgery (OG group) between January 2002 and June 2006 were compared. The operation time, intraoperative blood loss, mean time of stay in hospital and postoperative complications were studied.

RESULTSAll operations in LG group were successfully preformed with laparoscopic technique, and the mean operation time was 105 min, mean intraoperative blood loss was 50 ml, and mean hospital stay was 7 days. Incisional wound infection occurred in 2 cases and no serious complications occurred in this group. In OG group, the mean operation time was 118 min, mean intraoperative blood loss was 108 ml, and mean hospital stay was 12 days. Wound infection occurred in 7 cases, disorder of gastric emptying was found in 3 cases, fistula of anastomotic stoma happened in 1 case and bowel obstruction occurred in 1 case. There was significant difference in operation blood loss and hospital stay between the two groups (P < 0.05).

CONCLUSIONSLaparoscopic gastric resection is a safe and feasible minimally-invasive surgery, it brings less pain, less bleeding, shorter hospital stay.

Adult ; Aged ; Feasibility Studies ; Female ; Gastrectomy ; methods ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Stomach Diseases ; surgery ; Treatment Outcome

OBJECTIVETo introduce a new prefabricated flap with matched colour, texture, thin enough thickness, large enough dimension and reliability for reconstruction of massive defect of face and neck.

METHODSThe patients with massive scar of face and neck were selected for treatment with prefabricated flap. Flap prefabrication involved two stages. The "sandwich" structure including the descending branch of the lateral femoral circumflex vessels and surrounding muscle fascia was harvested from the thigh and anastomosed to superior thyroid artery or facial vessels. Flap prefabrication was performed by inserting the fascia flap between the cervicothoracic skin and the tissue expander placed beneath the skin. After a period of expansion, the flap was transferred to the recipient site based on the implanted vessels. The results including complications were examined during follow-up.

RESULTSNine patients received this treatment. The average dimensions of fascia flap harvested was 6.3 cm x 11.2 cm. After mean interval of 16.7 weeks, the expanders were filled to a mean volume of 1670cc. The size of prefabricated flap ranged from 12 cm x 15 cm to 15 cm x 32 cm. In all cases, the flap efficiently covered the entire defect of the face and neck, and the donor site of the flap is closed primarily. All of the flaps developed venous congestion in some degree after the second operation. Partial flap necrosis occurred in two cases. Three flap was thinned to contour the bulky pedicle. During follow-up, the transferred flap was matched well to the adjacent skin. The reconstructed face restored nature contour and expression. Muscle weakness or paraesthesia was not found in the donor thigh.

CONCLUSIONSCervicothoracic Prefabricated Flap, is reliable and versatile in the reconstruction of massive soft tissue deficits with restoration nature surface and expression of the face and neck.

Adolescent ; Adult ; Child ; Face ; surgery ; Female ; Humans ; Male ; Middle Aged ; Neck ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Thorax ; Tissue Expansion ; Young Adult

Adult ; Anastomosis, Roux-en-Y ; methods ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Pancreatic Pseudocyst ; surgery

OBJECTIVETo examine the temporal and spatial expression of vascular endothelial growth factor (VEGF) and angiopoietins (Ang) in rat brain after cerebral ischemia, and to elucidate the roles they played in angiogenesis and vascular permeability.

METHODSRats were subjected to either middle cerebral artery occlusion (MCAO) or sham operation. Reverse transcriptase-polymerase chain reaction, Western blotting, and immunohistochemistry were used to detect the expression of VEGF, Ang-1 and Ang-2 at different time points after ischemia. CD31 was used to label endothelial cells after MCAO. Vascular permeability was determined by Evans blue.

RESULTSVEGF was markedly increased at 2 h, had an initial peak at 12 h (0.7249 ± 0.1933, P < 0.01), and a second peak at 7 days (0.5264 ± 0.1519, P < 0.01). Ang-2 mRNA and protein significantly increased after MCAO, both of them peaked at 12 h (0.6747 ± 0.2416, P < 0.01; 1.1197 ± 0.1780, P < 0.01). In contrast, Ang-1 mRNA and protein gradually decreased after MCAO, respectively reaching a minimum at 3 d (0.3220 ± 0.1427, P < 0.01) and 1 d (0.1298 ± 0.0293, P < 0.01). Changes in the expression of these factors correlated with the progress of angiogenesis and vascular permeability. Evans blue test revealed that the vascular permeability gradually increased, and peaked at day 1 after ischemia [(6.219 ± 0.887) µg/g, P < 0.01].

CONCLUSIONDynamic temporal changes in VEGF, Ang-1 and Ang-2 expression stimulate the cerebral angiogenesis after focal cerebral ischemia.

Angiopoietin-1 ; genetics ; metabolism ; Angiopoietin-2 ; genetics ; metabolism ; Animals ; Blotting, Western ; Capillary Permeability ; Immunohistochemistry ; Infarction, Middle Cerebral Artery ; metabolism ; pathology ; physiopathology ; Male ; Neovascularization, Physiologic ; RNA, Messenger ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Vascular Endothelial Growth Factor A ; genetics ; metabolism