Objective Preparing platelet rich gel through two-times centrifugal technique and co-culturing chondrocytes with PRG, then observing the proliferation and gene expression of chondrocytes, in order to provide a favorable way to prepare tissue engineering cartilage. Methods Centrifugating venous blood of rabbit through two-times centrifugal technique to obtain platelet rich plasma( PRP) ,then detecting the concentration of various growth factor in PRP. Admixing PRP with chondrocytes of rabbit and activating them with activator. After co-culti-vation,the proliferation of chondrocytes through MTT method and expression of ACAN,CollagenⅡand SOX-9 through realtime-PCR were ob-served,and compared with common cultured chondrocytes. Results The concentrations of PDGF-AB,TGF-β1,IGF-1 and VEGF in PRG were significantly higher than those in blood(P<0. 05). After co-cultivation, the proliferation rate of chondrocytes and the expression of ACAN,Collagen Ⅱ and SOX-9 were significantly higher than that of common cultured chondrocytes(P<0. 05). Conclusion Co-culturing chondrocytes with PRG is able to promote the proliferation and gene expression of chondrocytes. We considered that it is a excellent method to construct tissue engineering cartilage.

Objective To investigate the distribution characteristics and risk factors of intracranial atherosclerotic stenosis ischemic stroke. Methods We retrospectively collected 342 consecutive patients with first-ever ischemic stroke. Clinical data was collected including demographics, the presence of risk factors,MRI with MRA and other routine admis?sion laboratory tests. Results Intracranial atherosclerotic stenosis (ICAS) was located most frequently in MCA (47.0%), Extracranial internal carotid artery was the most common affected artery (65.0%) among extracranial atherosclerotic steno? sis (ECAS). MetS (OR=1.586,95%CI:1.232~2.268), ApoB/ApoA1 ratio (OR=1.926,95%CI:1.051~4.288), were as?sociated with ICAS (vs ECAS), whereas hypertension (OR=3.603,95%CI:1.675~12.485), MetS (OR=2.268,95%CI:1.274~6.103), HbA1c (OR=2.015,95%CI:1.182~5.613) and ApoB/ ApoA I ratio (OR=1.948,95%CI:1.157~4.285) were related to ICAS (vs NCAS). Hypertension (OR=2.437,95%CI:1.492~3.505,P=0.005), Hcy (OR=2.437,95%CI:1.492~3.505,P=0.005) and HbA1c (OR=1.769,95%CI:1.034~3.121, P=0.005) were the independent risk factors re?lated to posterior circulation strokes (vs anterior circulation strokes ) in ICAS strokes. Conclusions The occurrence of ICAS may be more frequent than that of ECAS in ischemic stroke. Posterior circulation ICAS strokes seems to be close?ly associated with metabolic derangement.

In this paper, time courses of discrete cortical current sources evoked by target and distractor stimulus are presented in a visual three-stimulus oddball paradigm. 64-channel electroencephalogram (EEG) signals were recorded in healthy subjects in the paradigm where the P3b component of the P300 is evoked in the detection of rare events (target and distractor) and the P3a component is mainly produced by distractor events. A regional source model with constraints of spatial coordinates from fMRI was then applied to event-related potentials (ERPs) data in the target and distractor conditions. Activities of regional sources indicated bilateral inferior parietal lobe, posterior parietal cortex and inferior temporal cortex mainly contribute to the P3b, while the P3a was mainly produced by bilateral insula, bilateral precentral sulcus and cingulate gyrus. Target processing involved parietal lobe, inferior temporal cortex and left insula engaged in stimulus-driven attention process, goal-directed attention process, categorization of visual stimuli and memory retrieval, while distractor processing involved right insula and cingulate gyrus engaged in attention switching and reengagement of attention resource.
Adolescent ; Adult ; Brain ; physiology ; Electroencephalography ; Event-Related Potentials, P300 ; physiology ; Evoked Potentials, Visual ; physiology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Photic Stimulation ; methods ; Visual Perception ; physiology ; Young Adult

Objective Brainstem clinically isolated syndrome (BCIS) may herald multiple sclerosis (MS) or neuromyelitis (NMO),or it may occur as an isolated syndrome.However,the role of anti-aquaporin 4 antibodies in the conversion of BCIS to NMO remains uncertain.Methods Thirty-one BCIS patients hospitalized in our hospital from July 2006 to December 2010 were chosen in our study;their clinical data were retrospectively analyzed;according to the presence of anti-AQP4 antibodies,they divided into two groups:anti-AQP4(+)BCIS group (n=14) and anti-AQP4(-)BCIS group (n=l 7).The differences of clinical manifestations,imaging features and cerebrospinal fluid level between the two groups were compared and the conversion of patients from the two groups was analyzed.Results Nine (64.29％) anti-AQP4 (+)BCIS patients converted to NMO,while only two (11.76％) anti-AQP4 (-)BCIS patients progressed to NMO,over a mean follow-up period of 36.10± 18.94 months;significant difference of conversion rate was noted between the two groups (P＜0.05).Anti-AQP4(+)BCIS patients demonstrated a higher immunogamm globulin (IgG) index (0.68±0.43 vs.0.47±0.19,P=0.018) and Kurtzke Expanded Disability Status Scale (EDSS) scores at the last visit of follow-up 0.64±0.92 vs.2.71±0.81,P=0.000) than anti-AQP4 (-)BCIS patients.Gastroenterology-related brainstem symptoms occurred more frequently in anti-AQP4(+)BCIS patients than that in anti-AQP4(-)BCIS patients (71.43％ vs.23.53％,P=0.001).In brainstem MR imaging,the anti-AQP4(+)BCIS patients were observed having medulla-predominant involvement in the sagittal view (78.57％) and dorsal-predominant involvement in the axial view (78.57％),which were significantly different as compared with those in the anti-AQP4(-) BCIS patients (35.29％ and 41.17％,P＜0.05).Conclusion anti-AQP4(+)BCIS may represent an early,isolated syndrome of NMO spectrum disorder.

Background: and Purpose: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe central nervous system disorder mediated by NMDAR antibodies that damages neurons. We investigated the correlation between cytoskeletal autoantibodies and the clinical severity in patients with anti-NMDAR encephalitis. Methods: Non-NMDAR autoantibodies were identified by screening matched cerebrospinal fluid (CSF) and the serum samples of 45 consecutive patients with anti-NMDAR encephalitis and 60 healthy individuals against N-methyl-D-aspartate receptor 1-transfected and nontransfected human embryonic kidney 293T cells. Immunocytochemistry was performed to assess antibody binding in rat brain sections and primary cortical neurons. Cell-based assays and Western blotting were applied to identify autoantibodies targeting medium neurofilaments (NFMs). We compared clinical characteristics between patients with NMDAR encephalitis who were positive and negative for anti-NFM-autoantibodies. Results: Anti-NFM autoantibodies were detected in both the serum and CSF in one patient (2%) and in the serum only in six patients (13%). No antibodies were detected in the serum of healthy controls (7/45 vs. 0/60, p=0.0016). Four of the seven patients with anti-NFM autoantibodies in serum were children (57%), and three (43%) had abnormalities in brain magnetic resonance imaging. These patients responded well to immunotherapy, and either no significant or only mild disability was observed at the last follow-up. Anti-NMDAR encephalitis did not differ with the presence of anti-NFM autoantibodies. Conclusions Anti-NFM autoantibodies may be present in patients with anti-NMDAR encephalitis, indicating underlying neuronal damage. A large cohort study is warranted to investigate the clinical differences between patients with NMDAR encephalitis according to their antiNFM antibody status.

Objective To study the seropositive ratio of the antibody to aquporin 4 (AQP4-IgG) and myelin oligodendrocytes glycoprotein antibody(MOG-IgG)in patients with autoimmune-associated central nervous system (CNS) diseases. Meanwhile, epidemiology and clinical manifestation and diagnosis,laboratory examination and magnetic resonance imaging(MRI)of AQP4-IgG seropositive and MOG-IgG seropositive patients are described. Methods 2068 patients serum samples were collected and enrolled in the multi-center research. The methodology of cell-mediated immunofluorescence staining was used to detect serum AQP4-IgG and MOG-IgG. Clinic medical records were collected and characteristics of epidemiology and manifestation were compared. Results 681 patients were AQP4-IgG seropositive and 110 patients were MOG-IgG seropositive. The female/male ratio and age of onset of patients with AQP4-IgG seropositive(616 female and 65 male,female:male=9.50:1.00;Age of onset=41.7±14.9)were significantly higher than that of patients with MOG-IgG (57 female and 53 male, female:male=1.08:1.00, P<0.0001; Age of onset=27.0 ±17.7, P<0.0001). The optic neuritis was significantly higher in patients with AQP4-IgG seropositive and patients with MOG-IgG seropositive (38.4% vs.53.5%, P<0.05).Among patients with AQP4-IgG seropositive, 42.14% conformed the diagnostic criteria of neuromyelitis optica (NMO),which was higher than that of patients with MOG-IgG seropositive (13.64%, P<0.0001). Laboratory examination showed that there was no significant difference in cerebrospinal fluid protein levels between patients with AQP4-IgG seropositive and those with MOG-IgG seropositive.MRI imaging suggested that AQP4-IgG positive patients were more common in cervical thoracic spinal cord lesions, while MOG-IgG positive patients were more involved in thoracolumbar spinal cord. The study also found that these two groups of patients could be comorbid with other autoimmune antibodies. Conclusions This multi-center research has revealed that patients with AQP4-IgG seropositive and those with MOG-IgG seropositive display differences in epidemiology,clinic manifestations and diagnosis,laboratory examination and MRI imaging. AQP4-IgG and MOG IgG auto-antibody detection are necessary for clinic diagnosis and differential diagnosis.

Objective To investigate electroencephalographic (EEG) characteristics of anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis during different courses of the disease. Methods This study enrolled 30 cases of anti-NMDA receptor encephalitis patients. A total of 58 EEG monitoring reports and their clinical data were retrospectively analyzed based on different disease courses and severity of disease. According to the clinical stages, EEG data was divided into 4 phases: the initial stage (4), the peak stage (23), the improvement stage (16) and the recovery stage(15). Based on severity of disease during the peak stage, patients were divided into mild group(10 cases) and severe group (13 cases). Results Occipital background activity of the EEG was presented in all patients (100%) in the initial stage and in the recovery stage, in 39.1%(9/23)in the peak stage and in 13/16 (81.2%)in the improvement stage. Generalized rhythmic delta activity (GRDA) pattern could only be detected in the peak stage and the improvement stage. In the peak stage, the main presentation of abnormal EEG was diffuse slow-wave (9 cases, 90%) in mild group. GRDA and extreme delta brush(EDB) were more common in severe group than in mild group(P<0.05). Three focal epilepsy including one status epilepticus were detected in three patients in the peak stage. Focal epileptiform discharges in EEG existed in the whole course. Conclusion Occipital background activity and GRDA pattern are evolved and gradually recovered during the course of the disease. The EEG patterns of GRDA and EDB are common in severe anti- NMDA receptor encephalitis patients in the peak stage. Focal epileptiform discharges in EEG can be detected during the whole course.

ObjectiveTo explore the pharmacodynamic effect of the water extract of Citri Grandis exocarpium （WEC） on mice with alcohol-induced acute liver injury and provide data support for the development of this medicinal for anti-alcoholism and liver protection. MethodThe main components of WEC were determined by high performance liquid chromatography （HPLC）. Sixty Balb/c mice were randomized into 6 groups： control group （equal volume of 0.5% carboxymethyl cellulose sodium solution）， model group （equal volume of 0.5% carboxymethyl cellulose sodium solution）， low-， medium-， and high-dose WEC groups （0.5， 1.0， 2.0 g·kg^-1）， and Haiwang Jinzun tablet positive control group （2.0 g·kg^-1）. The administration lasted 14 days. One day before the end of the administration， mice were fasted for 12 h with free access to water. The mice， except the control group， were given 56° Chinese liquor （13 mL·kg^-1）. After 2 h， blood was taken from eyeballs and the liver was dissected and weighed. Automatic biochemical analyzer was employed to detect the expression of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， and alcohol dehydrogenase （ADH）. The pathological changes of liver tissues were observed based on hematoxylin-eosin （HE） staining， and apoptosis of hepatocytes based on TUNEL/DAB staining. The expression of proteins related to apoptosis was detected by Western blot. ResultAccording to the HPLC fingerprint， the main components of WEC were rhoifolin and naringin. Compared with the control group， the model group showed increase in liver/body weight ratio （P<0.01） and the expression of ALT and AST （P<0.05， P<0.01）， decrease in the expression of ADH （P<0.05）， blurred structure of hepatic lobules， pathological changes of liver tissue， loose cytoplasm with edema， severe steatosis， rise of the TUNEL-positive rate （P<0.01）， reduction in expression of Bcl-2 （P<0.01）， and increase in Bax and Caspase-3 （P<0.01）. Compared with the model group， medium-dose WEC lowered liver/body weight ratio （P<0.05）. All doses of WEC depressed the activity of ALT and AST （P<0.05， P<0.01）， up-regulated the expression of ADH （P<0.05）， significantly improved the pathological features of alcohol-induced cytoplasmic porosity， edema， and steatosis， down-regulated the TUNEL-positive rate （P<0.05， P<0.01）， enhanced the expression of Bcl-2 （P<0.05）， and decreased Bax and Caspase-3 （P<0.01）. ConclusionWEC regulates the expression of ALT， AST， and ADH and improves hepatic steatosis and hepatocyte apoptosis to fight against acute liver injury.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.