Objective:To investigate the effect of long-term chronic ethanol consumption on the spontaneous discharge activity of Purkinje cells in the cerebellar cortex of mice.Methods:Fifty 3-week-old ICR mice, regardless of gender, were divided into control group and ethanol group according to the random number table method, with 25 mice in each group. The mice in ethanol group were administered 20% ethanol (1.6 g/kg, once a day) by gavage, and the control group mice were given the same volume of 0.9% sodium chloride solution by gavage, and the gavage cycle was 28 days.The electrical activity of cerebellar Purkinje cells induced by sensory stimulation was recorded by patch clamp amplifier and data acquisition software. Statistical analysis was conducted by Clampfit 10.3 software and SPSS 22.0 software, t-test and one-way ANOVA were used to compare the data between the two groups and the data before and after intervention of each group. Results:The electrophysiological results showed that the spontaneous simple spike discharge frequency of Purkinje cells in the cerebellar cortex of mice in ethanol group was lower than that of the control group ((26.8±2.5)%, (34.6±4.7)%; t=26.08, P<0.05), and the coefficient of variation was higher than that of the control group ((27.3±3.3)%, (19.2±2.3)%; t=22.95, P<0.05). After cerebral surface perfusion of GABAA receptor antagonist, the frequency of simple peak potentials in the cerebellar cortex of ethanol mice was higher than before administration ( t=10.19, P<0.05), and the coefficient of variation was lower than before administration ( t=28.36, P<0.05). After brain surface perfusion of GABAA receptor antagonist, there was no significant change in the spontaneous simple peak discharge frequency of cerebellar Purkinje cells in the control group( P>0.05), and the coefficient of variation decreased compared to before administration ( t=6.95, P<0.05). After administering AMPA receptor antagonists on the surface of the brain, there were no significant changes in the discharge frequency and coefficient of variation in both the ethanol group and control group compared to before administration (both P>0.05). After simultaneously blocking AMPA and GABAA receptors, it was found that the spontaneous discharge frequency in ethanol group increased after administration compared to before administration((107.3±4.3)%, (99.7±3.7)%, P<0.05), and the increased value of frequency in the ethanol group was also higher than that of control group ( P<0.05). After simultaneously blocking AMPA and GABAA receptors, the coefficient of variation of the alcohol group and the control group mice were both lower than those before administration (both P<0.05), and the decrease in the alcohol group was higher than that in the control group ( P<0.05). Conclusion:Chronic ethanol exposure significantly inhibited the spontaneous discharge of Purkinje cells in the cerebellum, and the enhancement of inhibitory components was achieved by the inhibitory input mediated by GABAA receptors.

Objective With the help of computerized tomography (CT) and susceptibility-weighted imaging (SWI) examinations, to analyze and compare the incidence and the prevalent sites of microbleeds (CMBs) in control group, diabetes group, hypertension group and diabetic hypertension group with intracerebral CMBs. The risk factors for the onset of CMBs also will be explored, in order to provide a basis for the selection of clinical diagnosis and treatment options for CMBs. Methods A collection of 174 non-acute patients in the Department of Neurology of Shandong Electric Power Central Hospital from May 2019 to October 2020, including 101 males and 73 females, aged 45-89 years, with an average age of 72 ± 5 years. Divided into four groups according to disease types: Hypertension with type 2 diabetes group, Hypertension group, Type 2 diabetes group, Control group (no hypertension and type 2 diabetes). All patients underwent CT and MRI SWI sequence scans. The 4 groups of patients were matched in terms of gender and age, excluding the influence of gender and age. The incidence, number and distribution of CMBs in the four groups were counted, and the CT and SWI imaging manifestations of CMBs in the four groups were analyzed and compared. Results CT did not find the incidence of CMBs in the brain of patients. SWI imaging showed that CMBs were detected in 58 of 174 patients (incidence rate 33.3%), and CMBs occurred in 24 cases of diabetes and hypertension group (incidence rate 57.1%). CMBs occurred in 21 cases in the hypertension group (incidence rate 46.7%), 8 cases in the diabetes group (incidence rate 22.2%), and CMBs occurred in 5 cases in the control group (incidence rate 9.8%). The incidence of CMBs in the hypertension group and the diabetes combined with hypertension group was significantly higher than that in the control group (P < 0.05). There was no significant difference in the incidence of CMBs in patients with simple diabetes compared with the control group. Also, there was no significant difference in the incidence of CMBs between the diabetes combined with hypertension group and the simple hypertension group. Conclusion CT did not find the incidence of CMBs in the brains of patients in the non-acute phase. SWI could clearly show the CMBs of the enrolled patients. Diabetes is less likely to cause an increase in CMBs. Hypertension is significantly related to the occurrence of CMBs. CMBs associated with hypertension or/and diabetes are common in the basal ganglia and thalamus, which is different from cerebral amyloid angiopathy, which provides a basis for the choice of clinical treatment options.

Objective:To investigate the safety and efficacy of sacral neuromodulation(SNM)therapy for the treatment of lower urinary tract dysfunction(LUTD)in elderly patients.Methods:Clinical data of 91 elderly patients with LUTD from multiple medical institutions who received SNM during the period from January 2012 to December 2016 were retrospectively analyzed.Patients were divided into four groups: the interstitial cystitis(IC)group(n=28), the neurogenic bladder(NB)group(n=36), the overactive bladder syndrome(OAB)group(n=13)and the idiopathic dysuria(ID)group(n=14). Different sets of evaluation parameters were used for different diseases.Patients’ baseline data and data in stage I(test phase)and stage Ⅱ(permanent SNM)were recorded, statistically analyzed and compared.Results:Ninety-one people underwent SNM treatment.Of them, 53 patients received permanent implants(stage Ⅱ), and the total conversion rate of stage I to stage Ⅱ was 58.2%(53/91). Patients receiving permanent implants(stage Ⅱ)had a preoperative period ranging from 3 months to 30 years, and were followed up for 2 to 58 months after treatment, with an average follow-up of 19.6 months.The improvement rates in stage I for urinary urgency, daily urination frequency, daily nocturnal urination frequency, maximum urine volume, daily average urine volume, daily urine leakage frequency, and quality of life score were 35.4%, 31.6%, 33.7%, 32.6%, 49.2%, 43.2% and 13.2%, respectively.The improvement rates in stage Ⅱ for urinary urgency, daily urination frequency, daily nocturnal urination frequency, maximum urine volume, daily average urine volume, daily urine leakage frequency, and quality of life score were 43.2%, 40.0%, 37.8%, 50.5%, 70.5%, 70.4% and 43.2%, respectively.Three adverse events occurred, including 1 case of recurrent symptoms, 1 case of moderate infection, and 1 case of electrical lead dislocation.Conclusions:Sacral nerve stimulation has definitive and consistent curative effects on LUTD in elderly people.The follow-up time should be extended to further study the safety of sacral nerve stimulation.

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

Objective To analyze the hospitalization costs of new rural cooperative medical system (NCMS)-covered inpatients received by tertiary hospitals in Tianjin with their expenses reimbursed in other localities,for reference of policy making by government departments.Methods NCMS-covered patients who were admitted by 23 tertiary hospitals from May to October in 2017 were followed up and analyzed using their online reimbursement data.Patient expenses were compared among groups of different sources and diseases, using one-way variance analysis and LSD-t for multiple comparison.Results The online reimbursement data of 118 NCMS-covered patients from eight provinces including Liaoning province were collected.The total cost per person averaged 26 744.92 yuan,with 8 890.68 yuan reimbursed,accounting for 33.24%of the expenses incurred.Conclusions The higher proportion of the out-of-pocket payment by patients'results from such factors as higher ratio of non-covered drugs,the lower compensation rate by other provinces on expenses at tertiary hospitals,the medical charges outside the catalog and the medical materials at own expense.Therefore, the compensation policy and medical insurance payment policy should be improved to ensure that the NCMS patients enjoy more reasonable policy treatment.

Objective To learn the present acceptance of patients from outside Tianjin by local hospitals, for improving the management of their medical services.Methods A study of the hospitals′ network system identified 5 306 inpatients from other places in 2016 as evidenced by their hospital settlement account, with analysis of the patient flow from other places by the hospitals surveyed.Medical workers of eight medical institutions which signed the online settlement contract for non-local patients were subject to questionnaire survey.Results Of the 876 respondents,the number of patients willing to receive non-local insured patients accounted for 78.08%.Non-local patients aged 60 or above accounted for 82.31% among the total non-local patients, of whom 48.55% selected hospitals with national key disciplines, and 30.53% chose those with municipal key disciplines.Conclusions An analysis is required for the demand of non-local patients in terms of the social background and population characteristics.Based on such, non-local patient population needs a better management while those with irrational needs should be discouraged with rules and regulations.

Objective To systematically evaluate the role of laparoscopic living donor hepatectomy in living donor liver transplantation (LDLT).Methods A systematic literature search was conducted on Medline-Pubmed,Embase,Cochrane Library to find studies on laparoscopic living donor hepatectomy for LDLT.All extracted data were analyzed using the RevMan 5 software.Results Ten studies with a total of 1 059 participants were included in this analysis.Laparoscopic donor hepatecomy (LDH) was associated with significantly less intraoperative blood loss [SMD =-0.39,95％ CI (-0.73,-0.05),P ＜ 0.05],lower peak level of postoperative total bilirubin [SMD =-0.24,95％ CI (-0.47,-0.01),P ＜ 0.05]and longer operative time [SMD =0.50,95％ CI (0.04,0.96),P ＜0.05] when compared with those operated with open surgery.On subgroup analyses,hospitalization stay decreased in patients who underwent LDLT with grafts obtained by complete living donor hepatectomy (LDH) and left lateral sectionectomy (both P ＜ 0.05).LDH was comparable to open surgery in donor complication rates and in-hospital cost (P ＞ 0.05).There were no differences on the harvested liver graft size,ischemic time,recipient postoperative liver function and complications between the two groups (P ＞ 0.05).Conclusions Laparoscopic hepatectomy in living donor is a safe procedure for graft-harvesting,which improved the clinical outcomes of the donor,liver graft and recipient in LDLT.It has also the advantages of reduced blood loss,low peak levels of postoperative total bilirubin and short hospitalization stay.

Objective To observe the change of serum leptin in different risk stratifications of coronary heart disease (CHD) and to investigate its relationship with the severity of coronary artery lesion and the coronary artery Gensini score and its value in the coronary heart disease risk stratification .Methods According to coronary angiography ,120 research subjects were enrolled and di-vided into 4 groups :the non-CHD group ,stable angina(SAP) group ,unstable angina pectoris(UAP) group and myocardial infarc-tion group(AMI) ,respectively .The serum leptin levels in 4 groups were determined by immunoassay and the correlation between the leptin level with the coronary heart disease risk factor and biochemical markers of risk assessment was analyzed .Results The serum leptin level in the AMI group was significantly higher than that in the non-CHD group and the SAP group ,the leptin level showed the increasing trend with the increase of the coronary lesion severity and the Gensini scores and was positively related with the CHD risk stratification indicators cTnT and smoking index ,and negatively related with blood uric acid .Conclusion The serum leptin may be used as the valuable marker for evaluating the occurrence of acute coronary event and has good correlation with usual biochemical markers of CHD risk stratification and the severity of coronary artery lesion .

BACKGROUND:Stromal cellderived factor 1 in chemotactic migration of endogenous neural stem cells plays a very important role, but the specific migration mechanism is unclear
OBJECTIVE:To observe the effects of exogenous stromal cellderived factor 1 on chemotactic migration and proliferation of neural stem cells in the rat hippocampus
METHODS:Exogenous stromal cellderived factor 1 (5μL, 500μ/L) was injected into the hippocampus of Sprague-Dawley rats to establish animal models. Brain tissues were taken after days 3, 7, 14 and 21 of perfusion to prepare paraffin sections. Thereafter, nestin expression in the injection region and hippocampus was detected using immunohistochemical method. Experimental control and blank control groups were set.
RESULTS AND CONCLUSION:Paraffin section immunohistochemical results displayed the number of nestin-positive cells in the injection and the hippocampus was gradual y increased. At 3 and 7 days, nestin expression was a little and increased at 14 days, forming a migration tendency to the injection region. At 21 days, there were more nestin-positive cells in the injection area and hippocampus. However, there were no changes as above in the experimental control and blank control groups. The results showed that exogenous stromal cellderived factor 1 may induce the proliferation of neural stem cells in the hippocampus and may be involved in chemotactic migration of endogenous neural stem cells.

Objective To apply the exogenous monocyte chemoattractant protein-1 (MCP-1) to induce the neural stem cells in vivo.Methods 64 adult male Sprague-Dawley rats were randomly divided into blank (n=4), control (n=30) and experimental (n=30) groups. The experimental group was injected with MCP-1 into the cerebra, and the control group with PBS, and the blank group with no intervention.The number of nestin positive cells in brain was observed with immunohistochemistry 3, 5, 7, 14, 21 days after injection. Results The number of nestin positive cells increased with time in the cortex and hippocampus in the experimental group (P<0.001). There was no significant difference between the control group and the blank group (P>0.05). Conclusion Exogenous MCP-1 may induce the increase of neural stem cells in vivo.