Apoptosis is a main death pattern in many nervous system disease.Erythropoietin(Epo)has been originally characterized as the principal regulator of erythropoiesis by stimulating the proliferation and differentiation of erythroid precursor cells.In recent years,many experimental studies have shown that both Epo and EpoR(erythropoietin receptor)are functionally expressed in the nervous system and that this cytokine exerts a remarkable neuroprotection against nerve cell apoptosis.This article reviews neuroprotective of Epo against apoptosis and outline the involved molecular mechanisms.

Objective To observe the influence of Qizhi Yifei containing serum on the expression of MMP-9 and TIMP-1 mRNA in lung fibroblasts, and explore its mechanism. Methods Trypsin digestion method was used to extract fibroblasts from lung tissue in rats. All fibroblasts were cultured and trained to the fourth generation. Then they were randomly divided into control group, model group and drug serum group. The model group and drug serum group were firstly treated by DMEM with 0.002 5 μg/mL TGF-β1. The control group was treated by DMEM only. The control group and model group were then treated by DMEM with blank drug serum in concentration of 5%, and the drug serum group was treated by DEME with Qiahi Yifei containing serum in same concentration. After 48 and 72 hours, RT-PCR was performed to test the expression of MMP-9 mRNA and TIMP-1 mRNA of each group. Results After 48 hours, MMP-9 and TIMP-1 mRNA were significantly increased in model group and drug serum group compared with control group. There was no difference between model group and drug serum group. After 72 hours, MMP-9 mRNA was up-regulated in model group and was decreased in drug serum group compared with control group. There was no significant difference among the three groups on the expression of TIMP-1 mRNA. Conclusion Qizhi Yifei containing serum can decrease the up-regulated expression of MMP-9 mRNA in lung fibroblasts stimulated by TGF-β1.

BACKGROUND:There is evidence that internal fixation through an anterior or posterior approach for treatment of severe kyphotic deformity in spinal tuberculosis exhibits good curative effects. However, few prospective, long-term fol ow-up case control studies are reported. OBJECTIVE:To investigate the efficacy and safety of cobalt al oy pedicle screw implantation for treatment of severe kyphotic deformity in spinal tuberculosis. METHODS/DESIGN:This is a prospective, single-center, self-control, open-label trial, which wil be performed at the Affiliated Hospital of Hebei University, China. Eighty-four patients with severe kyphotic deformity in spinal tuberculosis wil be included according to the diagnosis criteria. Among 52 patients with tuberculosis of the thoracic spine, 28 wil undergo surgery through a posterior approach, and 24 through an anterior approach. According to the Frankel Grade classification, grade C, D and E spinal cord function wil be assessed in 8, 31 and 13 patients, respectively. Surgery through a posterior and anterior approach wil be respectively performed in half of 32 patients with tuberculosis of the lumbar spine. Grade C, D and E spinal cord function wil be assessed in 7, 14 and 11 patients, respectively. The primary outcome measure of this study wil be the Cobb angle at the thoracic spine segments before and 2 years after surgery, which wil be used to evaluate the angle of the spine curvature at the thoracic segments. The secondary outcome measures wil be X-ray scan or MRI findings before and 2 years after surgery, which wil be used to evaluate vertebral fusion after internal fixation;and Frankel Grade before and 2 years after surgery, which wil be used to evaluate recovery of spinal cord function after injury. Other outcome measures wil include multiple logistic regression analysis results of the factors that influence patient's curative effects and the incidence of adverse events 2 years after surgery. The trial protocol has been approved by the Ethics Committee, Affiliated Hospital of Hebei University, China and wil be performed in strict accordance with the Declaration of Helsinki, formulated by the World Medical Association. Signed informed consent regarding the trial protocol wil be obtained from each participant. DISCUSSION:This study is to validate that cobalt al oy pedicle screw implantation shows precise curative effects in the treatment of severe kyphotic deformity in spinal tuberculosis and to analyze through what approach, posterior or anterior, internal fixation wil be more beneficial to surgery performance. The outcomes of this study wil provide objective long-term fol ow-up evidence for internal fixation treatment of severe kyphotic deformity in spinal tuberculosis in the clinic.

BACKGROUND: During the repair of thoracolumbar fracture, pedicle screw fixation is a commonly used treatment method. In the process of fixation, the different approaches can be used. OBJECTIVE: To compare effect and biocompatibility of pedicle screw by percutaneous approach, posterior median approach, and intervertebral space approach for thoracolumbar fracture. METHODS: 118 cases of thoracolumbar fracture were included after pedicle screw fixation. Al patients were divided into three groups according to the approach: posterior median approach group (38 cases), intervertebral space approach group (40 cases) and percutaneous approach group (40 cases). After 12 months of folow-up, perioperative conditions, pain score, vertebral height of anterior border, kyphosis correction effect, adverse events and biological compatibility were compared among three groups. RESULTS AND CONCLUSION:(1) Operation time, intraoperative bleeding and time in bed after surgery were shorter or less in the percutaneous approach and intervertebral space approach groups than in the posterior median approach group. Postoperative drainage was better in percutaneous approach and intervertebral space approach groups than in the posterior median approach group (alP < 0.05). Except drainage in the percutaneous approach and intervertebral space approach groups, no significant difference in other indicators was found. (2) Patients received imaging examination at different time points. The percentage of anterior vertebral height and kyphosis were significantly improved immediately after treatment and in final folow-up (alP < 0.05). No significant difference was detected before treatment, immediately after treatment and in final folow-up. (3) Visual Analogue score was identical before treatment. Visual analogue score was lower in the percutaneous approach and intervertebral space approach groups than in the posterior median approach group at 24 hours and 3 days after treatment and in final folow-up (alP < 0.05). No significant difference was detectable at 24 hours and 3 days after treatment and in final folow-up between the percutaneous approach and intervertebral space approach groups. (4) No rejection or wound non-healing was seen at 12 months after treatment. Some patients suffered from mild low back pain, which was improved by active symptomatic treatment. (5) These findings suggest that intervertebral space approach percutaneous approach obtained satisfactory outcomes compared with posterior median approach for treatment of thoracolumbar spine fractures, and good biocompatibility was found.

OBJECTIVETo investigate the effects of Egb761, an extract of ginkgo biloba , and dipyridamole on inducible NO synthase (iNOS) in rabbits after myocardial ischemia-reperfusion injury.

METHODSAfter being established into ischemia-reperfusion injury model, 35 rabbits were divided randomly into 5 groups: Group A (the sham group), Group B (the model group), Group C (treated with dipyridamole 0.8 mg/kg), Group D (treated with Egb761, 40 mg/kg), and Group E (treated with Egb761 40 mg/kg combined with dipyridamole 0.8 mg/kg), all the medications were administered by intravenous injection 30 min after reperfusion. After administration, myocardial iNOS mRNA expression was detected by RT-PCR and western blot.

RESULTSMyocardial iNOS mRNA transcriptive expression in the 5 groups were A 0, B 157.11 +/- 17.73, C 202.6 +/- 21.84, D 356.13 +/- 24.18 and E 562.34 +/- 35.19 respectively, showing significant difference between the treated groups and group B (P <0.01). The translative expression of myocardial iNOS in the 5 groups were A 34.24 +/- 15.78, B 75.70 +/- 13.71, C 116.89 +/- 22.57, D 143.75 +/- 16.05 and E 195.09 +/- 22.25 respectively, showing significant difference between the treated groups and group B as well (P < 0.05, P < 0.01).

CONCLUSIONBoth Egb761 and dipyridamole could increase myocardial iNOS expression in transcriptive and translative levels in rabbits after myocardial ischemia-reperfusion injury, and the combined treatment of them shows a more significant effect.

Animals ; Dipyridamole ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Ginkgo biloba ; Male ; Myocardial Reperfusion Injury ; drug therapy ; enzymology ; genetics ; Myocardium ; enzymology ; Nitric Oxide Synthase Type II ; biosynthesis ; genetics ; Phytotherapy ; RNA, Messenger ; biosynthesis ; genetics ; Rabbits ; Random Allocation ; Transcription, Genetic

Objective To compare the difference of dose distribution between inverse planning simulated annealing (IPSA) and hybrid inverse treatment planning and optimization (HIPO) in 3D brachytherapy plan of cervical cancer,and to provide evidence for selection of reverse planning optimization method for cervical cancer brachytherapy.Methods From Dec 2016 to May 2017,totally 43 cases of patients with cervical cancer radical surgery were selected.Original IPSA brachytherapy treatment plan optimization was applied to all cases.Based on the information of original image,IPSA and HIPO plans were established according to the same initial conditions.Parameters of Dg0,D100,V100％,Homogeneity Index (HI),and conformal index (CI) of the bladder,rectum and sigmoid D2 cm3 data for High-Risk Clinical Target Volume (HR-CTV) were assessed.Results There was no statistically significant difference in D90,D100 and CI for HR-CTV between the two groups.But the V100％ of HR-CTV in HIPO group was significantly higher than that in IPSA group [(87.72 ±0.49)％ vs.(85.01 ± 0.55)％,t =2.54,P ＜0.05].Furthermore,HI in HIPO group was (0.51 ±0.08),which was higher than that in IPSA group (0.42 ± 0.06),and the difference was statistically significant (t =3.02,P ＜ 0.05).Compared with IPSA,bladder D2 cm3 and rectum D2 cm3 [(3.04 ± 0.37) Gy] for HIPO plan were lower [(3.42 ± 0.17) Gy vs.(3.57 ± 0.28) Gy,(3.04 ± 0.37) Gy vs.(3.57 ± 0.28) Gy],which had reached statistical significance (t =0.27,0.19,P ＜ 0.05).There was no statistical significance in the D2 cm3 dose of sigmoid.Conclusions In the treatment of cervical cancer,better target area HI and less irradiated dose of bladder and rectum can be obtained by HIPO optimization than IPSA optimization.

Objective:To customize the individualized 3D printed head film for patients with head tumors undergoing radiotherapy, and to evaluate the physical properties of the material and the precision of this technology compared with the thermoplastic head film.Methods:The 3D printed head film and thermoplastic head film were placed on the solid water surface, and the depth and surface dose were measured at 5 cm by ionization chamber and film, respectively. Thirty patients with head tumors receiving radiotherapy were randomly divided into the control and experimental groups. The patients were fixed with thermoplastic head film and 3D printed head film. The translational and rotational errors in the x, y and z direction were obtained by CBCT.Results:The radiation attenuation rate of two materials at the depth of 5 cm was less than 1%. The dose of thermoplastic head film in the surface position was increased by 27%, and increased by 18% in the 3D printed head film. In two groups, 116 sets of setup errors were collected. The average translational setup errors in the control and experimental groups were 1.29 mm and 1.16 mm, 1.42 mm and 1.24 mm, 1.38 mm and 1.16 mm, respectively, and the average rotational setup errors were 1.29°and 1.08°, 1.02°and 0.96°, 1.01°and 1.00°, respectively. The translational setup errors in the y and z direction and rotational setup errors in the x direction significantly differed between the control and experimental groups (all P<0.05), but no statistical significance was found in the other direction (all P>0.05). Conclusion:The 3D printed head film fixation meets the precise setup requirements of modern radiotherapy, which deserves further application in clinical trials.

Objective:To investigate the role of plasma neurofilament light chain (NfL) in diagnosing and differentiating Parkinson's disease (PD) and multiple system atrophy-Parkinsonian subtype (MSA-P).Methods:Forty PD patients and 23 MSA-P patients admitted to Department of Neurology, Henan Provincial People's Hospital from June 2019 to December 2021 were recruited; 27 healthy subjects accepted physical examination during the same period were selected as controls. Ultrasensitive Simoa technology was used to measure the plasma NfL. Differences in clinical data and plasma NfL were compared among all subjects. Correlations of plasma NfL with clinical characteristics, such as disease course, Hoehn-Year (H-Y) staging, Unified Parkinson's Disease Rating Scale (UPDRS), Montreal Cognitive Assessment (MoCA), Scale for Outcomes in Parkinson's Disease for Autonomic Symptoms (SCOPA-AUT) and levodopa equivalent daily dosage (LEDD), were analyzed with Pearson correlations. Receiver operating characteristic (ROC) curve was used to analyze the value of plasma NfL in diagnosing and differentiating PD and MSA-P.Results:Compared with MSA-P group, PD group had significantly longer disease course and statistically lower scores of UPDRS-II and SCOPA-AUT ( P<0.05). The plasma NfL in MSA-P group, PD group and healthy control group was decreased successively ([37.69±10.47] pg/mL, [17.85±4.23] pg/mL, [12.86±3.14] pg/mL, respectively), with statistical differences ( P<0.05). In MSA-P patients, Pearson correlations showed positive correlation between plasma NfL and age ( r=0.442, P=0.035); and Partial correlations showed positive correlations between plasma NfL and scores of UPDRS-I and UPDRS-III ( P<0.05), and plasma NfL showed no significant correlation with H-Y staging, UPDRS-III, MoCA, LEDD or SCOPA-AUT scores ( P>0.05). In PD patients, Pearson correlations showed that plasma NfL was positively correlated with age ( r=0.342, P=0.031); partial correlations showed that plasma NfL was positively correlated with H-Y staging and UPDRS-III, and negatively correlated with MoCA scores ( P<0.05); plasma NfL showed no significant correlation with disease course, scores of UPDRS-I and UPDRS-II, LEDD, and SCOPA-AUT scores ( P>0.05). ROC curve showed that the area under the curve (AUC) of plasma NfL in diagnosing PD was 0.814 (95% CI: 0.712-0.920, P<0.001); AUC of plasma NfL in differentiating and diagnosing PD and MSA-P was 0.980 (95% CI: 0.954-1.000, P<0.001); AUC of plasma NfL in diagnosing MSA-P was 0.998 (95% CI: 0.993-1.000, P<0.001). Conclusions:Plasma NfL is correlated with severity of motor symptoms in MSA-P patients; plasma NfL is correlated with cognitive function and disease course in PD patients. Besides, plasma NfL has high sensitivity and specificity in differentiating PD and MSA-P, therefore, plasma NfL could serve as a biomarker to diagnosis and differentiate PD.

OBJECTIVETo compare the differences in the clinical therapeutic effects on reflux esophagitis among the combined therapy ofdecoction (the decoction for resolving the turbid, detoxification and reducing the pathologic upwardin short) and acupuncture, omeprazole and Chinese herbal medicine.

METHODSNinety patients were randomized into 3 groups, 4 cases of them were dropped off. Finally, there were 29 cases in the combined therapy group with acupuncture and the decoction, 29 cases in the western medication group and 28 cases in the Chinese herbal medicine group in the statistical analysis. In the combined therapy group with acupuncture and the decoction, the decoction was prescribed recurrence rate. The therapeutic effects are better than the simple application of either Chinese herbal medicine or omeprazole. for oral administration. Additionally, acupuncture was applied to Neiguan (PC 6), Zusanli (ST 36), Zhongwan (CV 12), Ganshu (BL 18), Danshu (BL 19) and Taichong (LR 3). The decoction was applied one dose a day and acupuncture was once a day. In the western medication group, omeprazole capsules, 20 mg were prescribed for oral administration, twice a day. In the Chinese herbal medicine group, the decoction was simply applied. The treatment was 8 weeks in the 3 groups and the follow-up visit was 6 months. The score of reflux disorder questionnaire (RDQ) and the changes in esophageal mucosa under gastroscope were observed before and after treatment; the clinical therapeutic effects and recurrence rate were evaluated in the 3 groups.

RESULTSIn 4 and 8 weeks of treatment, RDQ scores in the 3 groups were all reduced as compared with those before treatment (all<0.05). In 4 weeks of treatment, RDQ score in the combined therapy group with acupuncture and Chinese herbal medicine was lower than that in the western medication group (<0.05). In 8 weeks of treatment, RDQ score in the combined therapy group with acupuncture and Chinese herbal medicine was lower than those in the western medication group and the Chinese herbal medicine group (both<0.05). In follow-up visit for 6 months, the recurrence rate in the combined therapy group with acupuncture and the decoction was lower than those in the other two groups (both<0.05). In 8 weeks of treatment, the total effective rate for clinical symptoms and that observed under gastroscope in the combined therapy group with acupuncture and the decoction were all better than those in the western medication group and the Chinese herbal medicine group (all<0.05).

CONCLUSIONSThe combined therapy ofdecoction and acupuncture achieve the definite therapeutic effects on reflux esophagitis, relieve the symptoms, protect gastric mucosa and reduce the.