Effects of corticospinal tract integrity on upper limb motor function recovery in stroke patients treated with repetitive transcranial magnetic stimulation.

BACKGROUND: The bimodal balance-recovery model predicts that corticospinal tract (CST) integrity in the affected hemisphere influences the partterns of brain recovery after stroke. Repetitive transcranial magnetic stimulation (rTMS) has been used to promote functional recovery of stroke patients by modulating motor cortical excitability and inducing reorganization of neural networks. This study aimed to explore how to optimize the efficiency of repetitive transcranial magnetic stimulation to promote upper limb functional recovery after stroke according to bimodal balance-recovery model. METHODS: 60 patients who met the inclusion criteria were enrolled to high CST integrity group (n = 30) or low CST integrity group (n = 30), and further assigned randomly to receive high-frequency rTMS (HF-rTMS), low-frequency rTMS (LF-rTMS) or sham rTMS in addition to routine rehabilitation, with 10 patients in each group. Outcome measures included Fugl-Meyer scale for upper extremity (FMA-UE), Wolf Motor Function (WMFT) scale and Modified Barthel Index (MBI) scale which were evaluated at baseline and after 21 days of treatment. RESULTS: For patients with high CST integrity, the LF group achieved higher FMA-UE, WMFT and MBI scores improvements after treatment when compared to the HF group and sham group. For patients with low CST integrity, after 21 days treatment, only the HF group showed significant improvements in FMA-UE and WMFT scores. For MBI assessment, the HF group revealed significantly better improvements than the LF group and sham group. CONCLUSIONS: For stroke patients with high CST integrity, low-frequency rTMS is superior to high-frequency rTMS in promoting upper limb motor function recovery. However, only high-frequency rTMS can improve upper limb motor function of stroke patients with low CST integrity.

Induction of cell death by pyropheophorbide-α methyl ester-mediated photodynamic therapy in lung cancer A549 cells.

Pyropheophorbide-α methyl ester (MPPa) was a promising photosensitizer with stable chemical structure, strong absorption, higher tissue selectivity and longer activation wavelengths. The present study investigated the effect of MPPa-mediated photodynamic treatment on lung cancer A549 cells as well as the underlying mechanisms. Cell Counting Kit-8 was employed for cell viability assessment. Reactive oxygen species levels were determined by fluorescence microscopy and flow cytometry. Cell morphology was evaluated by Hoechst staining and transmission electron microscopy. Mitochondrial membrane potential, cellular apoptosis and cell cycle distribution were evaluated flow-cytometrically. The protein levels of apoptotic effectors were examined by Western blot. We found that the photocytotoxicity of MPPa showed both drug- and light- dose dependent characteristics in A549 cells. Additionally, MPPa-PDT caused cell apoptosis by reducing mitochondrial membrane potential, increasing reactive oxygen species (ROS) production, inducing caspase-9/caspase-3 signaling activation as well as cell cycle arrest at G0 /G1 phase. These results suggested that MPPa-PDT mainly kills cells by apoptotic mechanisms, with overt curative effects, indicating that MPPa should be considered a potent photosensitizer for lung carcinoma treatment.

[Proximal Aorta Reconstruction for Type A Aortic Dissection Patients without Intimal Tear in Aortic Arch: the Early and Mid-outcomes].

OBJECTIVE: To evaluate the early and mid-outcomes of proximal aorta reconstruction for type A aortic dissection (AAD) patients without intimal tear in aortic arch, and assess the safety and efficacy of this surgical strategy. METHODS: From January 2010 to February 2013, there were 23 AAD patients without intimal tear in the aortic arch received proximal aorta reconstruction surgery. Clinical data of these patients were analyzed retrospectively, the mean age was (48.04 ± 12.37) years old (21-73 yr.). Twelve cases were acute aortic dissection, the others were chronic dissection. Bentall surgery was performed for 13 cases, Cabrol surgery for 2 cases, Wheat surgery for 1 case, ascending aorta replacement and aortic valve repair was employed for 1 patient, simple ascending aorta replacement for 6 cases. The patients received follow-up every 3 to 6 months after the surgery. RESULTS: The duration of CPB time was (182.83 ± 36.98) min, cardiac arrest time was (111.87 ± 18.82) min, circulatory arrest time was (24.22 ± 6.38) min. The complications were lung infection (4 cases, 17.4%), tracheotomy (2 cases), peritoneal dialysis (1 case), 2 cases suffered transient neurological dysfunction. None stroke, paralysis, and permanent neurological dysfunction occurred. All the patients were discharged. Mean time of follow-up was (38.35 ± 11.95) months (18-56 months). All patients were alive and return to normal life, the proportion of false lumen closure was 65.22% (15 cases). None patients need secondary surgery. CONCLUSION: Proximal aorta reconstruction is safe and effective for AAD patient without intimal tear in aortic arch, the operation strategy can be used individually.

[Clinical significances of plasma interleukin-6,C-reaction protein and tumor necrosis factor-alpha in patients with aortic dissection].

OBJECTIVE: To investigate the clinical significances of plasma IL-6, CRP and TNF-alpha concentration changes in aortic dissection. METHODS: Plasma concentrations of IL-6, TNF-alpha and CRP were determined in 68 aortic dissection patients,50 patients with essential hypertensionand 50 healthy volunteers. The changes of plasma IL-6, CRP and TNF-alpha concentration were analyzed in aortic group along with the progression of the disease which was divided into 9 differenttime courses. RESULTS: Compared with essential hypertension and healthy control group, significantly elevated CRP, IL-6 and TNF-alpha concentrations were detected in aortic dissection patients (P<0.05, respectively). All the concentrations of CRP, IL-6 and TNF-alpha reached the peak in acute phase of aortic dissection and then gradually declined in subacute and chronic phase. CONCLUSION: Increased plasma inflammatory factors were significantly associated with aortic dissection.

Time-dependent changes of plasma inflammatory biomarkers in type A aortic dissection patients without optimal medical management.

OBJECTIVES: To investigate the time-dependent changes in plasma levels of interleukin-6, C-reactive protein, and tumor necrosis factor-α in patients with type A aortic dissection (TAAD) who received unoptimal medical management since the onset of dissections. DESIGN AND METHODS: Plasma levels of interleukin-6, C-reactive protein, and tumor necrosis factor-α were detected by ELISA and immuno-turbidimetric assay in 92 TAAD patients at hospital admission. Blood samples from 78 patients with uncontrolled hypertension and 82 healthy volunteers were also analyzed as controls. The occurrence of TAAD-related complication and its relationship with the plasma levels of these inflammatory biomarkers was also investigated. RESULTS: The concentrations of inflammatory mediators were significant higher in TAAD than those in the uncontrolled hypertension and the healthy group. The time to peak plasma level of IL-6.and TNF-α was shorter than that of CRP in TAAD group. In the TAAD group, 51 patients suffered TAAD-related complications, and their plasma level of CRP was significantly higher than that in patients without TAAD-related complications (94.5 ± 58.8 mg/L versus 47.4 ± 47.8 mg/L, p < 0.001). Also, CRP levels strongly correlated with the value of PaO2/FiO2 ratio (r = -0.69, p < 0.001) and creatinine (r = 0.60, p < 0.001). The time to the peak level of CRP was shorter and the duration of persistently high CRP level was longer in the complication group than those in the complication-free group. CONCLUSIONS: Elevated and persistently high levels of plasma CRP, IL-6 and TNF-α were associated with progressively development of the TAAD. The changing pattern of CRP might be a marker for diagnosis and prophylactic treatment of complications. Our findings suggested a critical role of the inflammation in the progression of dissection and TAAD-related complications.

[Analysis of cytogenetic characteristics in patients with myelodysplastic syndrome].

This study was aimed to investigate the distribution of chromosomal aberrational karyotype in myelodysplastic syndrome (MDS) subgroups, the characterizations of numerical and structural aberration. The chromosome was prepared with simple culture of bone marrow, and the karyotype was analysed by G banding technique. The results showed tht 54 out of 127 patients (42.5%) had clonal chromosome aberrations, and the abnormal rates were different in subgroups: 30% (3/10) in MDS-RA, 35.9% (23/64) in MDS-RCMD, 22.2% (2/9) in MDS-RAS, 45% (9/20) in MDS-RAEB-I, 66.7% (14/21) in MDS-RAEB-II, 100% (3/3) in 5q-syndrome, respectively. Among 54 abnormal chromosome patients, 21 patients showed numerical aberration, 14 patients showed structural aberration, and the other 19 patients showed both numerical and structural aberration. The order of frequent aberrations was as follows complex karyotype (11.02%, 14/127), single +8 (10.24%, 13/127), -7/7q- (3.9%, 5/127), 1q+ (3.15%, 4/127), -X/-Y (3.15%, 4/127), 20q- (2.36%, 3/127), 5q- (2.36%, 3/127). The frequency of complex karyotype in MDS-RAEB (including RAEB-I and RAEB-II) was higher than that in non MDS-RAEB (including RA, RCMD, RAS, 5q-syndrome) (P < 0.05), and the frequency of balanced translocation was lower than that in non-balanced translocation (P < 0.05), and both of the two balanced translocation patients were found in MDS-RAEB. It is concluded that MDS is highly heterogeneous clonal disorder, a great majority of cytogenetic changes can be detected and most of which are recurrent aberrations, balanced translocations are rare, and only found in MDS-RAEB. The frequency of complex karyotype in MDS-RAEB is higher, and the patients with dup (1) (q21q32) recurrent abnormality is common in this study.

[6-(4-Bromo-phen-yl)-2,2'-bipyridine-κN,N']bis-(triphenyl-phosphane-κP)copper(I) tetra-fluoridoborate.

The title compound, [Cu(C(16)H(11)BrN(2))(C(18)H(15)P)(2)]BF(4), is composed of one Cu(I) atom, one 6-(4-bromo-phen-yl)-2,2'-bipyridine (L) ligand, two triphenyl-phosphane mol-ecules and one tetra-fluoridoborate anion. The Cu(I) ion is four-coordinated in a distorted tetra-hedral configuration by two N atoms from L and two P atoms from triphenyl-phosphane ligands. In the L ligand, the two pyridine rings are not coplanar; the mean planes making a dihedral angle of 15.3 (5)°. In the crystal, the ions are linked by weak C-H⋯F inter-actions.

[Analysis of ITD characteristics in acute myeloid leukemia patients with FLT3-ITD positive].

The aim of this study was to analyze the FMS-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) allelic ratios (AR), number of ITD, ITD length and positions of ITD insertions in de novo acute myeloid leukemia (AML) patients with FLT3-ITD positive, and the relationship between mutant level and therapeutic efficacy. Genomic DNA was amplified by PCR, capillary electrophoresis was used to detect the ITD characteristics in 31 de novo AML patients, and DNA sequences analysis of FLT3-ITD(+) were performed in 13 patients. The results showed that the ratios of mutant to wild type FLT3 allele ranged from 0.01 to 2.8; 28 patients (90.32%) had a single ITD, the remaining 3 patients had more than one ITD; the ITD length ranged from 3 to 144 bp in all FLT3-ITD(+) patients. 13 sequence-analyzed patients, 4 patients were of pure duplications, and 2 patients had foreign bases inserted, and the other 7 patients were partial duplications. The ITD occurred in the regions from p.E573 to p.P606 of the FLT3 protein, with the majority clustered in a stretch between p.F590 and p.R595. The complete remission (CR) rate in AR < 0.5 patients (43.75%) were more prevalent as compared with AR ≥ 0.5 patients (16.67%) (p > 0.05). It is concluded that the ITD length and AR are vary widely. Some of the insertions are foreign bases, and all of the 13 sequences-analyzed ITD were concentrated on the juxtamembrane domain. The CR rate in patients of AR < 0.5 had no statistical significance compared with patients of AR ≥ 0.5.

[FMS-like tyrosine kinase 3 gene mutation in acute myeloid leukemia detected by denaturing PAGE and its clinical significance].

The aim of this study was to analyze the frequency of flt3 length mutation (flt3-LM) in de novo acute myeloid leukemia patients and the relationship between flt3-LM and chromosome alterations, FAB subgroups, as well as efficiency of therapy. Genomic DNA was amplified by PCR; 2% agarose gel or 8% denaturing PAGE were used to detect the length mutation of flt3 gene in 99 de novo acute myeloid leukemia patients; karyotyping in 72 AML patients was performed by G banding technique. The results showed that the flt3-LM was detected in 20.2% (20/99) patients by agarose gel electrophoresis, and in 29.9% (29/99) by denaturing PAGE. The flt3-LM was not detected in M(0) (only one patient was available), but flt3-LM occurrence in AML subtypes was as follow: in M(2) (9/30), M(3) (6/27), M(4) (4/14), M(5) (7/19), M(6) (3/8) respectively. flt3-LM in patients with normal karyotypes (39.13%) was more prevalent as compared with patients of abnormal karyotype (24.49%), but there was no statistical difference (p > 0.05). The complete remission (CR) rate in flt3-LM positive patients (36.36%) was lower than that in flt3-LM negative patients (62.75%) in the 73 patients (p < 0.05) whose karyotypic detection was performed. The distributions of flt3-LM were observed in 8 out of 40 CR patients, 8 out of 21 PR patients, and 6 out of 12 NR patients. It is concluded that the denaturing PAGE is more sensitive and reliable to detect the flt3-LM. The flt3 mutation represents a common genetic abnormality in AML patients, and the flt3-LM is associated with lower CR rate.

[Study on the determination of iron by silica gel H phase-diffuse reflectance spectrometry].

In this paper a new method for the silica gel H phase-diffuse reflectance spectrophotometric determination of iron(III) with piperonal fluorine (PIF) has been developed. In the presence of cetyltrimethyl ammonium bromide and in a NH4 Cl-NH3.H2O medium at pH 9.6-10.3, iron(III) reacts with PIF to form a stable blue complex which is absorbed by silica gel H with a diffuse reflectance absorption peak at 640 nm. The calibration curve is linear over the concentration range 0-25 ng of iron(III) in 1 mL. The linear regression equation is AR = 0.022 1c-0.005,5(r = 0.999,7), where c is expressed as ng per 1 mL. The method has high analytical speed and sensitivity. The effect of a number of foreign ions has been studied by carrying out determining of 200 ng.(10 mL)-1 of iron (III), 1 mg K+, Na+, F-, Cl-, NO3-, PO(4)3-, 0.6 mg Ca2+, Mg2+, 35 micrograms Sr2+, 20 micrograms Cr(III), 6 micrograms Mn2+, 4 micrograms Pb2+, 3.5 micrograms Cd2+, 2.5 micrograms Cu2+, Ag+, 1.5 micrograms Cr(VI), 1 microgram Ni2+, 0.75 microgram Zn2+, Sn4+ et al don't interfere with the measurement. The method has been applied to the determination of microamount iron in magnesium oxide with satisfactory results.

[Atomization efficiency of graphite furnace in atomic absorption spectrometry].

In this paper, the advance of study of atomization efficiency for graphite furnace atomic absorption spectrometry was reviewed. The fundamental theory and the various calculated equations of atomization efficiency, as well the relationship among beta m, beta i(exp) and beta i(cal) were described. Problems requiring further improvement in the investigation of atomization efficiency of graphite furnace atomic absorption spectrometry were discussed. Peak area atomization efficiency is more practical than peak height. Because the mean residence time (tau R) of atoms in the furnace is larger than tau D (tau D = l2/8D, l is the tube length and D is the diffusion coefficient), calculated peak area atomization efficiency in the furnace is larger than experimental. Part of the atomization efficiency is affected by atomic loss mechanism. An important aspect of researching atomization efficiency is conducted mainly to improve the sensitivity and limit of detection of the analysis method.