BACKGROUND:Stem cells are a kind of cells characterized as species diversity, self-replication and renewal
ability, multiple differentiation potential and high proliferation potential. Then, the stem celltreatment for ischemic brain injury would be of great benefit. Stem celltherapy provides a new way for the treatment of ischemic stroke, but the mechanism is stil unclear.
OBJECTIVE:To describe the types of stem cells and review the mechanism underlying stem celltreatment for ischemic stroke.
METHODS:The first author retrieved PubMed database, Chinese Journal Ful-text Database for articles related to stem cellclassification and effectiveness, safety and mechanism of stem celltherapy for ischemic stroke
published from January 1992 to September 2012. The key words were“stem cells, brain ischemic stroke,
transplantation, treatment”in English and Chinese, respectively. A total of 168 literatures were retrieved, and 61 articles met the inclusion criteria.
RESULTS AND CONCLUSION:Stem celltherapy for ischemic stroke has shown a promising prospect though it is staged in the period of animal models. Stem celltransplantation for promoting functional recovery in the treatment of stroke has been completed in the clinical phase I or phase II trials. Stem celltransplantation for ischemic stroke appears to have no adverse reactions and to promote functional recovery. Main difficulties in stem celltransplantation for treatment of ischemic stroke include sources of stem cells, transplantation approach, stem cellsurvival in the host body, stem cellintegration with the host brain, therapeutic effectiveness and security. Based on the acquired results from the mechanism research and clinical trials, how to safely and quickly apply the stem celltherapy from the experiments to the clinic stil needs to work.

Objective To study the therapeutic effect of diltiazem and felodipine in treatment of hypertension after renal transplantation.Methods Sixty patients with hypertension after renal transplantation who were treated with tacrolimus as basic immunosuppressive therapy were divided into two groups by random digits table method with 30 cases each.The diltiazem group took diltiazem 90 mg orally once a day.The felodipine group received felodipine 2.5 mg orally twice a day.The drug dosages were adjusted according to the level of blood pressure.The patients were followed up for 1 year.The artery pressure,concentration-to-dose ratio of tacrolimus and renal function was detected and compared.Results Blood pressure was significantly decreased in both groups after 1 year treatment.Blood pressure was found to be significantly lowered from (153.6± 7.5)/ (97.7 ±6.7) mm Hg (1 mm Hg=0.133 kPa) to (119.1 ± 26.4)/ (72.6± 19.3) mm Hgin felodipine group; and from (152.0 ± 7.6)/(95.4 ± 6.9) mm Hg to (120.3 ± 25.5)/(73.2 ± 22.5) mm Hg in diltiazem group.There was no significant difference in blood pressure before and after treatment between two groups (P ＞ 0.05).The concentration-to-dose ratio of tacrolimus was increased after treatment in diltiazem group[(173.2 ± 59.3) g/L vs.(119.3 ± 78.3) g/L] (P ＜ 0.05),but there was no significant difference before and after treatment in felodipine group (P ＞ 0.05).The serum creatinine had no significant difference in two groups (P ＞ 0.05).Conclusion Diltiazem and felodipine can be used safely and effectively in the treatment of hypertension after renal transplantation,and diltiazem can lower the dose of tacrolimus.

Objective To explore the influence of mild hypothermia therapy on expression of heat shock protein(HSP)60,HSP70,HSP90 in lymphocyte in patients with severe craniacerebral injury.Methods 23 patients with severe craniacerebral injury were randomly divided into the mild hypothermia group (12 cases) and the normothermia group(11 cases).At the base of routine therapy,the mild hypothermia group received mild hypothermia therapy by the temperature control blanket to keep the body temperature among 32～34℃ for 4～6 d.The expression of HSP60,HSP70,HSP90 in lymphocyte were measured by Western Blot at the 1st d,4th d and 8th d after treatment.The infection incidence was observed at 7 d after treatment.And the expression of HSPs in lymphocyte at 32℃ and 37℃ in normal control group were measured respectively.Results Compared with normothermia group,the expression of HSP60 in mild hypothermia group was significantly lower at each time point(all P

Objective To analysis the relationship between the single nucleotide polymorphisms (SNPs) of G196A, C270T, G11757C, G712A and haplotypes frequencies of brain-derived neurotrophic factor (BDNF) gene and Chinese Han population with sporadic Alzheimer's disease (sAD). Methods The genotype and allele frequencies of BDNF G196A, C270T, G11757C and G712A were analyzed by polymerase chain reaction-restriction fragment length polymorphism technology in 106 sAD patients and 110 healthy controls. The software SHEsis was used to analyze the linkage disequilibrium and the haplotypes between the two groups. Results There were statistically differences in T allele frequeny of C270T (sAD vs control: 0.9% vs 4.5%) and A allele freguency of G712A (sAD vs control: 0.5% vs 4.5%) and in GG genotype frequeny of G712A (sAD vs control: 95.4% vs 91.8%) (all P

Objective To analyze features of clinical manifestation, electrophysiology, imageology and molecular ge?netics of familial carpal tunnel syndrome (FCTS), especially research progress in genetics. Methods Clinical data, labo?ratory and electrophysiologyical results as well as medical images were collected from the propositus. In addition, genetic analysis around peripheral neuropathy was performed on the proband, son of the proband and the affected relatives in the family. Result Patients showed a typical bilateral CTS with early onset. The mode of inheritance in this family was auto?somal dominant.. Gene sequencing revealed point mutations in INF2, KIF1B, TRPV4 and SCN9A. Besides, the possibili?ty of having hereditary neuropathy with liability to pressure palsy(HNPP)or familial amyloidosis (FAP) was excluded by the molecular genetic studies. Conclusion Primary FCTS exists as a separate autonomic entity, which may be caused by other unknown genes and therefore warrants further exploration.

Objective To compare the clinical effectiveness,safety,cost-effectiveness of Targeting Gene Therapy with conventional therapy on patients with Essential Hypertension by metoprolol.Methods 300 cases of patients with Essential Hypertension were included.165 cases were chosen and assigned to conventional therapy group(Group A)at random.The subjects of Group A were administrated with metoprolol for 100 mg,twice per day.Polymorphism of CYP2D6 and ?1 adenoreceptor gene of the remain 135 subjects were detected,133 cases with of ?1-AR gene carrying Arg 389 allele were devided into three groups according to CYP2D6 genetype:the poor metabolism group(PM,43 cases),intermediate metabolism group(IM,54 cases)and extensive metabolism group(EM,36 cases).The subjects of PM,IM and EM were administrated with metoprolol for 25,100,200 mg/d respectively,twice per day.Blood pressures and side effects were observed during 8-week following-up.The health economic evaluation on Gene Targeting Therapy was determined by using the cost-effectiveness analysis.Results Total effective rate in Group PM,IM or EM were obviously higher than that in Group A(P

Objective To evaluate the differences in image quality and radiation dose in the neck CTA between low tube voltage scanning method combined with exact calculation of contrast dosage and conventional scanning methods.Methods Ninety patients who had undergone neck CTA examination from October 2012 to June 2013 were prospectively selected to perform study.Patients were randomly divided into Group A,B and C,each with 30 cases.Tube voltage and contrast amount were,respectively,120 kV and 70-80 ml for Group A (conventional group),100 kV and exact calculation for Group B,80 kV and exact calculation for Group C.Using ANOVA test,radiation dose,contrast amount,CNR were statistically analyzed among three groups.Subjective evaluations were made of image quality by two experienced radiologists based on a 5-point system.Results The effective doses in Group B and C were (4.5 ± 0.7) mSv and (2.1 ± 0.4) mSv,respectively,significantly lower than (6.6 ± 0.9) mSv in Group A,with statistically significant difference(F =72.4,P ＜ 0.05).The amounts of contrast were significantly lower in Group B and C than that in Group A,which respectively were (73.2 ± 8.2) ml for Group A and (48.2 ± 5.1) for Group B and (48.6 ± 5.4) ml for Group C,with statistically significant difference (F =56.8,P ＜ 0.05).CNRs increased respectively by 42.2％ in Group B and by 42.2％ in Group C compared with Group A,with statistically significant difference (F =72.6,P ＜ 0.05).Venous artifact images were found in 10 patients of Group A,having different effects on image quality,whereas in Group B and C,there were not vein artifacts to found.Conclusions The low tube voltage (80 kV) scanning method combined with exact calculation of contrast features not only significantly lower radiation dose and lower contrast amount used,but also improved image quality in comparison with conventional method.

Objective To evaluate the feasibility of a low-dose contrast medium protocol for 64-slice CT angiography (CTA) of head using a low-tube-voltage setting.Methods ① Phantom study:64-slice spiral CT respectively sets 80,100,120,140 kV and 100,200,300,400,500 and 600 mA as scanning parameter lines.Analysis of the best Signal-to-noise ratios (SNR) and contrast to noise ratios (CNR).②Clinical study:to prospectively continuous select sixty-six patients with suspected intracranial aneurysm and arteriovenous malformation and so on from April to October of 2012 to perform hand CTA inspection.The random number table method for A,B two groups,33 patients in each group.Group A (conventional group)scanning parameters:120 kV,400 mA and amount of contrast agent:1 ml/kg; Group B(test group) scanning parameters:80 kV,600 mA,amount of contrast agent 0.5 ml/kg.Using independent samples t test for each group radiation dose,SNR,CNR were statistically analyzed.By two experienced radiologists to 5 points on two groups of image quality subjective evaluation.Mann-Whitney U test was used for statistical analysis of subjective evaluation.Results Group A and B group CTDIvol respectively is 59.1,27.5 mGy.Group B than in group A,CTDIvol decreased by 53.5％.A,B groups of the SNR,CNR were 71.5 ± 10.7,92.0 ± 7.4; 58.5 ± 10.5,79.6 ± 7.7,Group B than in group A SNR,CNR were enhanced by 22.3％,26.4％,differences were statistics significance (t =584.0,388.6,P ＜ 0.01).The subjective image evaluation of group B was bigher than group A (Z =31.2,23.4,P ＜ 0.05),differences were statistics significance.Two physicians on CTA images to assess the consistency of uniform height(Kappa =0.904,P ＜0.05).Conclusion In the head CTA examination,use of low tube voltage combined with low contrast dose not only can improve the image quality but also radiation dose were significantly lower.

Objective To probe the feasibility of gemstone spectral CT in imaging pulmonary angiography with low dose contrast medium.Methods A prospective study with multi-slice spiral CT pulmonary angiography was performed in consecutive 48 patients suspected with pulmonary embolism.Two groups (n=24 respectively)were divided at random including Group A used Gemstone spectral CT with 35 mL of contrast medium and Group B using 64-slice CT with conventional 80~90 mL of contrast medium.The CT values of the pulmonary trunk,lobe artery,pulmonary vein and ascending aorta were measured.The contrast to noise ratio of the pulmonary artery was also calculated.In addition,the image quality of CTA was evaluated independently by two experienced ra-diologists.Results The CT values of the pulmonary trunk and the subsegmental branches,and the CNR in Group A were signifi-cantly higher than those in group B,exhibiting statistical differences (t=8.6,P <0.001;t=12.2,P <0.001;t=1 1.3,P <0.001 respectively).However,the CT value of aorta in Group A was significantly lower than that in Group B (t=-7.6,P <0.001).The evaluation results of the CTA images by two radiologists showed that the image quality in Group A was better than that in Group B (Z =-8.6,P <0.001;Z =-9.0,P <0.001 ).Conclusion The image quality of pulmonary angiography with gemstone spectral CT using low contrast medium dose can be improved compared with the conventional spiral CT.

Objective To describe the clinical features of patients with hemorrhagic fever with renal syndrome (HFRS) in popular period and other period.Methods All the HFRS patients from epidemic areas in Xi' an were surveyed retrospectively.The sociodemographic data,symptom characteristics and laboratory test results were collected.Chi-square test,rank test were used to analyze the data.Results Totally 429 HFRS cases were recruited including 280 male (65.3％) and the male/female ratio was 1.9 ∶ 1.Adults with 16-60 years of age were the main group,which accounted for 74.8％ of the total cases.The constituent ratios of cases with 16-60 years of age in popular period and other period were 76.1％ (245/322) and 71.0％ (76/107),respectively; the sex ratios were 1.93∶1 and 1.74∶1,respectively; the time from fever onset to hospitalization was 3 d and 4 d,respectively; the time of hospitalization was both 10 d; the proportions of emergency cases were 59.8％ (189/316) and 67.6％ (71/105),respectively; the proportions of cured cases were 56.4％ (181/321) and 43.4％ (46/106),respectively.The clinical features were not significantly different between popular period and other period (all P＞0.05).The immunoglobulin M (IgM) antibody positive rate was 85.4％ (315/369) and those in popular period and other period were 88.4％ (251/ 284) and 75.3％ (64/85),respectively (x2 =8.968,P＜0.01).There was a positive correlation between symptom severity and outcome of discharge (x2=18.558,P＜ 0.01),the more slight symptoms were related with the better outcome.Conclusion The clinical features are similar in cases from popular period and other period from Jan 2008 to Jun 2011.