Volume 91  ·   Issue 13  ·  2011

Human brain is the most complex substance in nature, and the realization of brain functions is based on structural networks of different levels and levels. Because of the complexity of human brain networks, there is little overall understanding of the attributes of brain networks at present. Regular networks and random networks do not reflect most networks in the real world well. In-depth research shows that almost all real networks exhibit some identical statistical characteristics, such as smaller average shortest distance and larger clustering coefficient, etc. These characteristics are called small-world networks. The concept of small-world networks provides new means and ideas for quantifying the properties of complex brain networks, and may provide great help for studying some functional brain diseases.

Objective To investigate the change of low-frequency blood-oxygenation-leveldependent fluctuation (LFBF) after cerebral ischemia by functional connectivity analysis in the resting state.Methods Superacute stroke rat-models with middle cerebral artery occlusion (MCAO) were employed in this study. Spontaneous fluctuations were recorded using a series of gradient-recalled echo-planar imaging (EPI) images before creation of the MCAO, and the same scan protocols were duplicated at the time of 60min, 2 h after creation of the MCAO. FMRI signal time series from the different ROIs of ischemic cortex and normal cortex were preprocessed and low pass filtered. After preprocessing, the serial fMRI data was obtained by fast Fourier transformation to calculate the amplitude of the low-frequency fluctuations.Meanwhile, time course signal changes from a seed voxel of normal cortex were correlated with every voxel in the brain. Statistical analysis was performed across all rats to determine the extent of spatial correlation between regions. Results The amplitude of LFBF in the ischemic cortex between 0. 01 and 0. 1 Hz was lightly decreased during the superacute ischemic stroke. Howerever, the amplitude of LFBF in contralateral cortex was increased after 2 hours. Spatial distribution of LFBF, from cross-correlation analysis, indicates that the substantial inter-hemispheric synchrony of ischemic region was decreased and of contralateral cortex was enhanced during the superacute ischemic stroke. Conclusion The contrast behavior of the resting state BOLD signal fluctuations and a intra-hemispheric symmetry in the LFBF with similar phase characteristics in most other regions during superacute ischmic stroke can be implied a new approach to detect the physiological activity functions and the distinct resting neural networks after the acute ischemic stroke takes place.

Objective To study the MRI and DWI appearance of diffuse lesion in the bilateral cerebral hemisphere. Methods 19 patients with diffuse lesion in the cerebral hemisphere were concluded in the study,9 were male and 10 were female. The age range is from 16 to 70 years old and mean age is 45 years old. All of the patients performed MR scan on Philips 1.5 T MRI system. The parameters of SE-EPI DWI sequence,TR/TE 6225/118. 7 ms, ETL 128, FLIP 90°, thickness 5 mm, matrix 128 × 128,b = 1000 mm2/s. Results 3 cases of CJD which showed bilateral diffuse high signal intensity in the cerebral hemisphere on DWI, 4 cases of polyvinyl chloride(PVC) adhesive toxication,2 cases of viral encephalitis,3 cases of liver failure- related brain edema, 1 cases of delayed encephalopathy of CO toxication, all of the lesions showed high signal intensity both on DWI and ADC sequences. On the following MRI, most of the high signal recovered and the high signal disappeared. 4 cases of asphyxia with coma, 2 cases of H2S toxication, The lesion of them showed high signal intensity on DWI and low signal on ADC. Conclusion DWI can sensitively show the lesion with limited diffusion. The patients with high signal intensity on both DWI and ADC indicating T2 effect.

Objective To observe and investigate the neuroimaging characters in early progression of transgenic Alzheimer's disease (AD) mice model, and make sure the diagnosis value of 7.0 T high field magnetic resonance microimaging(MRMI). Methods APP/PS-l transgenic mice aged 3,6, 9 months and the same aged wild type mice were each divided into 6 groups(6 mice in every groups) based on age. The mice brains were scaned with 7.0T high magnetic field MR. Then the mice were killed. The Aβ immunohistochemistry examination was analyzed in the mice brains specimens, and pathological changes were in comparison with the T2 weighted imaging in the mice brains. Results There were a few Aβ plaques in the brains of 6 months APP/PS-1 transgenic mice, while Aβ plaques were increased both in number and volume in the cerbral cortex and hippocampus of 9 months AD mice. The brains of APP/PS-1 double transgenic mice of 3, 6 months and the control group mice were not showed intensity loss on T2 weighted MR images, while the signal intensity loss was visualized in the cerbral cortex and hippocampus of 9 months AD mice. Conclusion 7. 0T high magnetic field MR could display Aβ plaques in the brains of APP/PS-1 double transgenic mice of 9 months and it is helpful to diagnosis early AD.

Objective To evaluate the potential link between high-risk human papilloma virus (HPV) DNA testing and histological diagnosis in women referred for atypical glandular cells ( AGC) at Pap smear. Methods All cervical cytological examinations with the diagnosis of AGC between January 2007 and Dec 2009 were identified by means of a computerized database in 97 patients. The histopathological results of cervix were analyzed by colposcopic biopsy, dilatation and curettage ( D&C), cervical loop electrosurgical excision procedure(LEEP) and high-risk human papilloma virus DNA testing. Results ( 1 ) All patient were monitored by colposcopy, histopathology and HPV DNA test. Sixty-four patients had pathologic lesions. (2)In predicting the presence of high-grade of cervical intraepithelial neoplasia, the sensitivity of human papilloma virus was 96%, specificity 92. 86%, positive predictive value 96% and negative predictive value 92. 86%. (3)98. 9% of the AGC patients received colposcopic, cytological examinations and HPV test at follow-ups: 3 cases of PAP smear and 6 cases of HPV testing were abnormal at the first follow-up, and 100% negative for cytological examination and HPV test at the second follow-up visit. Conclusion HPV DNA test and colposcopic examination are effective in the initial evaluation and subsequent follow-ups of cytological atypical glandular cells.

Objective To investigate the association between viral load, genomic integration frequency of HPV 16 and cervical carcinogenesis and assess the probability that HPV 16 integration frequency may be utilized as a marker for cervical cancer. Methods Forty cases of HPV16 single infection were selected from 337 cervical scrape samples by PCR (polymerase chain reaction) amplification and DNA sequencing. The copy numbers of E2, E6 and β-actin were quantified to evaluate the viral load and integration status by real-time PCR. Results ( 1 ) The median number of adjusted viral load of normal group, LSIL (low-grade squamous intraepithelial lesion) group, HSIL (high-grade squamous intraepithelial lesion) group and squamous cervical cancer group were 0. 11, 18. 55, 44. 63 and 7.6 copies per cell respectively. The viral load was higher in LSIL-HSIL group than that in normal group while lower in squamous cervical cancer group than that in HSIL group. (2) The median number of E2/E6 was 0. 93 in normal group, 0. 84 in precancerous group (LSIL-HSIL) and 0. 64 in squamous cervical cancer group respectively. It showed a descending trend with the progression of cervical disease. (3) With the disease development, the proportion of episomal form decreased ( normal group 4/5, LSIL group 4/6, HSIL group 10/16, cervical squamous cancer group 5/13 ) whereas that of integrated form ( mixed and totally integrated)increased (normal group 1/5, LSIL group 2/6, HSIL group 6/16, cervical squamous cancer group 8/13).Both totally integrated cases were cervical squamous cancer. Conclusion ( 1 ) HPV 16 viral load may not be an ideal marker to predict cervical carcinogenesis. (2) Due to a positive correlation between HPV16 genomic integration frequency and cervical neoplastic progression, HPV 16 integration frequency may be a potential marker of early diagnosis for cervical lesion progression.

Objective To investigate the primary culture and adipogenic process of pre-adipocytes from infrapatellar fat pad of osteoarthritic patients. Methods The pre-adipocytes were isolated by enzymatic digestion. The morphological changes of cultured cells were observed and the growth curve was drawn by CCK-8 method. During the adipogenic process, the intracytoplasmic lipid of differentiated cells was determined by oil red O staining. And the adiponectin levels in the culture supernatants were measured by ELISA (enzyme-linked immunosorbent assay). Results The primary cultured fibroblast-like cells were spindle-shaped. In the process of adipogenesis, the intracytoplasmic lipid droplets were observed at Day 3and over 80% of the cells differentiated into adipocytes at Day 21. With the increasing number of adipocytes, the adiponectin levels in the culture supemant elevated and peaked at Week 3. The differentiated cells were proven to be adipocytes functioning actively. Conclusion The primary culture and adipogenic process of pre-adipocytes in infrapatellar fat pad of osteoarthritic patients has been successfully established. Thus it may provide an ideal model for the study of endocrine function of infrapatellar fat pad and understanding its role in the pathogenesis of osteoarthritis.

Objective To compare the morbidity and efficacy of tension-free vaginal tape(TVT)and transobturator tape (TVT-O) procedures in the treatment of stress urinary incontinence. Methods A total of 315 women were randomly assigned to undergo the procedure of either TVT (n = 160) or TVT-O (n =155). Some patients underwent vaginal repair, hysterectomy, hysterosalpingo-oophorectomy, posterior intravaginal slingplasty or sacrospinous ligament fixation as concomitant procedures as indicated. Results Fifteen patients were lost to follow-up. And the median follow-up period was 27 months. The curing rates were 93.5%, 89. 6%, 87. 2% and 82. 9% in the TVT group and 91.1%, 89. 8%, 86. 2% and 83.3% in the TVT-O group at 6, 12, 24 and 36 months respectively. No significant difference could be found for the curing rates between two groups at the same follow-up time and between 6 - 36 months follow-up in each group( P ＞0. 05). The median operative duration of the TVT-O group was significantly shorter than that of the TVT group [( 18. 7 ± 4. 2 ) vs ( 24. 3 ± 4. 5 ) min] ( P ＜ 0. 01 ). Compared with the TVT group, the TVT-O group had more patients complaining of groin and thigh pain ( P ＜ 0. 05 ). Conclusion Both approaches appear to lower the peri- and post-operative complication rates and have an equal efficacy in the surgical treatment of stress urinary incontinence during a 3-year follow-up. However, TVT-O has a shorter operative duration with a higher rate of groin and thigh pain.

Objective To identify the incidence and morbidity rates of haptolenticular degeneration (HLD) at Hanshan County, Anhui Province. Methods According to the principles of age stratification,cluster and random sampling, a total of 112 810 subjects were screened by cornea slit-lamp examination during the period of November 2008 to October 2009. The subjects were from recruited from schools,factories, communities, institutions and villages at Hanshan County. And they belonged to the age group of 7 -75 years. At the same time, each subject was evaluated by the clinical examination with regards to the presence of such clinical manifestations as brain, liver, kidney, skin and other organ damage. And the examinations of copper biochemistry and abdominal ultrasound were performed for those subjects with K-F rings or their clinical manifestations suspicious of HLD. In order to confirm or exclude HLD, the penicillamine challenge test (PCT) was performed if necessary. Results Seven HLD patients had a definite diagnosis of HLD. There were classical Wilson type ( n = 1 ), peudosclerosis type ( n = 1 ), mental disorder type (n = 1 ) , liver type (n = 1 ) and presymptomatics (n = 3). The incidence rate was 2.66/100 000 and the prevalence rate 6.21/100 000 at Hanshan County, Anhui Province. Conclusion HLD is a common disease. In order to avoid a misdiagnosis and prevent an incorrect treatment, physicians should pay more attention to this curable disease and try their best to achieve early detection, early diagnosis and early treatment.

Objective To quantitatively analyze the effects of ankle-foot orthosis (AFO) on gait stability and explore its use for walking capacity, gait stability and balance control in post-stroke patients.Methods A total of 25 inpatients with prior chronic hemiparesis from stroke who could walk at least 10meters without assistance were recruited. The maximal walking speed and gait asymmetry index were examined by a motion analysis system. Functional balance was assessed by the Functional Ambulation Categories, Berg Balance Scale and Five-Times-Sit-to-Stand Test. Results AFO had positive effects on the hemiplegic gait parameters of improving walking speed, gait stability and functional balance ( P ＜ 0. 01 ).Pair wise comparisons suggested that there were significant differences in the maximal walking speed,Functional Ambulation Categories and gait asymmetry index after an immediate use of AFO ( P ＜ 0.05 ). At Week 4, there were significant differences in the parameters of walking speed, gait asymmetry index and functional balance control ( P ＜ 0.01 ). Conclusion The use of AFO may compensate the instability of gait and balance. Functional tests improve significantly with orthosis.

：Objective To explore thetherapeutic effects of aspirin on postmenopausal osteoporosis and understand its actionmechanism. Methods Forty three-month-old female SD rats were randomly divided into 5groups ( n = 8 each): sham group, OVX group and aspirin groups ( A1, A2 & A3 ). TheOVX and aspirin groups were ovariectomized (OVX). All rats underwent BMD (bone mineraldensity) scan at the time of OVX and 3 months after OVX. After the animal model ofosteoporosis was established, aspirin groups were intragastrically administered at a doseof 8.93 mg· kg-1 · d-1 (A1), 26. 79 mg · kg-1 · d-1(A2) and80.36 mg · kg-1 · d-1 (A3) daily in OVX rats. Three months later, the BMDand microarchitecture of vertebrae were measured by dual-energy X-ray absorptiometry andmicrotomograph. Alkaline phosphatase and osteocalcin were measured in peripheral blood.The trabecular architecture changes were observed by histomorphology. Axial compressiontests were used to evaluate the mechanical properties of vertebral specimens andthree-point bending tests used for femur shaft. Results Three months after ovariectomy,BMD was significantly lower than preoperative. BMD in aspirin treated groups wassignificantly higher than that in OVX group. Alkaline phosphatase in peripheral blooddecreased significantly in aspirin groups than those in OVX, but osteocalcin had nosignificant difference between aspirin and OVX groups.The microtomograph reconstructionanalysis also showed that the trabecular thickness, trabecular number and BMD increasedsignificantly in aspirin groups than those in OVX. And there was no significant differencebetween A3 and sham groups. The results of biomechanical test showed that the maximumcompression load of lumbar spine and three-point bending load of femur shaft weresignificantly higher in aspirin groups than those in OVX group. Conclusion Aspirin canpromote trabecular bone remodeling, improve threedimensional structure of trabecular boneand increase bone density of cancellous in osteoporotic rats by stimulating boneformation. It may become a new drug for the treatment of osteoporosis.

Objective To explore the effect of low frequency vibration (LFV)on the osteogenic differentiation regulating capability of bone marrow stromal cell (BMSC) and the expressions of OPG (osteoprotegerin) mRNA and RANKL (nuclear factor kappa B ligand) mRNA through living animal experiment. Methods Both BMSC transplantation and low-frequency vibration were employed to treat bone defects. The groups were randomized into non-vibration and vibration of different frequencies. The vibration group received vibrating interventions at Day 7 for 5 weeks. After vibrations, the BMSC OPG and RANKL mRNA of different frequency groups were detected. Results The BMSC OPG and RANKL gene expressions significantly increased ( P ＜ 0. 05 ), especially at 25 Hz (P ＜ 0. 01 ). And for the vibration group at 100 Hz,the BMSC OPG and RANKL gene expressions decreased ( P ＜ 0. 05). Conclusion Low-frequency vibration may promote the osteogenic differentiation capability of BMSC probably through regulating the OPG/RANKL mRNA expression, directly promoting bone formation and inhibiting bone resorption.

Objective To investigate the effect of fatigue and restraint stress on the expressions of CPT (carnitine palmitoyltransferase )-Ⅰ , PPAR (peroxisome proliferator-activated receptor) δ, 5-HT (hydroxytryptamine) 1D and 5-HT2A receptors in aorta of rats. Methods A total of 45 healthy male Wistar rats were randomly divided into control group, excessive fatigue group and restraint stress group (n =15 each). The general condition, morphological changes of aortic endothelium cell and the blood levels of ET-1 (endothelin) and NO (nitric oxide ) were observed. The real-time reverse transcription PCR (polymerase chain reaction) and Western blot were used to detect the gene and protein expressions of CPT-Ⅰ , PPAR δ, 5-HT1D and 5-HT2A receptors in aorta. Results Compared with control group, the structural damages of endothelial cell were induced by excessive fatigue and restraint stress. The plasma levels of ET-1 increased [( 124 ± 18)ng/L vs( 161 ± 18 ) ng/L, ( 154 ± 17 ) ng/L] (P ＜ 0.01, P ＜ 0.05 )while the serum levels of NO decreased [(63 ± 16) μmol/L vs(39 ±8) μmol/L, (41 ±7) μmol/L] (P ＜0. 05); the mRNA expressions of CPT- Ⅰ and PPARδ decreased in excessive fatigue rats, [( 1.23 ± 0.21 )vs (0.42 ± 0.05 )], [( 1.09 ± 0.10) vs (0.25 ± 0.07 )] ( P ＜ 0.01 ); the protein expressions of CPT- Ⅰ and PPARδ decreased in excessive fatigue rats, [( 1.32 ± 0.07 ) vs (0. 83 ± 0.04 )], [( 1.41 ± 0.05 ) vs.(0.75 ± 0. 06)]; the mRNA and protein expressions of 5-HT1 D receptor decreased in excessive fatigue rats and restraint stress rats, [(1. 10 ±0.15)vs (0.46 ±0.13) ,(0.45 ±0.02)], [( 1. 19 ±0.05)vs (0.71±0. 06), (0.70 ±0.05 )] (P ＜ 0.01 ); the mRNA and protein expressions of 5-HT2A receptor increased in excessive fatigue rats and restraint stress rats, [(0.99 ± 0. 08 ) vs (6.73 ± 0.46 ), ( 7.01 ± 1.56 )],[(0.64±0. 03)vs (0. 79 ±0. 05), (0. 82 ±0. 03)] ( P ＜0. 01). Conclusion Excessive fatigue and restraint stress can injure the structure and function of endothelial cell. The changes in energy of abnormal carnitine metabolism and 5-HT receptors may play important roles.

A 44-year-old male was admitted to Peking Union Medical College Hospital on August 26, 2008 due to rash for 20 years, multiple joint swelling and pain for 10 years, and chest tightness for 1 year. The patient developed a rash in 1988, with red patchy shape, higher than the skin surface, thickened epidermis and desquamation. After desquamation, red bleeding spots could be seen below, mainly distributed in the scalp, periumbilical area, back, elbow, knee and calf. The other hospital diagnosed it as "psoriasis", and the effect of external medication (details unknown) was not good. In 1998, he developed swelling and pain of right knee joint, right dorsum and toe, and the joint swelling and pain improved after treatment with traditional Chinese medicine (details unknown) in the local hospital.

uncoupling proteins 2 (UCP2) is a kind of anion transporter, which is one of the subtypes of uncoupling proteins family. It is localized on the mitochondrial inner membrane and uncoupled by the electron transfer process and the synthesis of ATP on the mitochondrial inner membrane, so that the electrical energy on the inner membrane is released in the form of heat energy [1]. UCP2 is distributed in many tissues of organisms, and plays an important role in regulating the heat balance, ATP generation, reactive oxygen species generation and calcium ion balance, and participates in the pathological changes of blood vessels and nerve tissues.

A 37-year-old male was seen for 7 months because of repeated left upper abdominal pain. Seven months ago, he developed left upper abdominal pain without obvious trigger, which was intermittent dull pain and aggravated. In severe cases, it was knife-like pain, radiating to the chest and low back, accompanied by nausea, no vomiting, and not accompanied by fever, acid reflux, nausea, stool characteristics and habit changes, etc., and his body weight decreased by 20 kg since the onset of the disease. No obvious abnormality was found on gastroscopy in the local hospital, and abdominal CT examination revealed abdominal aortic aneurysm (Figure 1,2). The history of gastric ulcer, hepatitis, tuberculosis, etc. was denied, and the family history was denied. In the past six months, he had repeated oral ulcers, which did not heal, and nodular erythema appeared in the lower limbs. Vulvar ulcers and ophthalmitis were denied. Physical examination: blood pressure 190/110 mm Hg (1 mm Hg =0.133 kPa), body loss, superficial lymph nodes were not palpable.

Methadone is a complete μ-opioid receptor agonist and is recommended as an alternative therapy for opioid dependence during pregnancy. However, neonatal exposure to methadone is accompanied by neurological withdrawal symptoms (NAS), characterized by increased central nervous system stress and autonomic nervous system dysfunction, which often require drug therapy and long-term hospitalization. Buprenorphine, a partial μ-opioid receptor agonist, can be used as an alternative therapy for opioid dependence, but its use during pregnancy has not been extensively studied.