音含美 乐孕哲——根植于音乐“本体”的“音乐”美学与“音乐”哲学

音含美,乐孕哲。音乐美学与音乐哲学是"音乐美(学)"之美学与哲学,"美"与"哲"本包含在音乐之中,孕育在音乐之中。

针刺治疗同家族多人罹患周身窜痛病例报告

1病例简介 例1.患者,女,64岁,2007年5月就诊。患者55岁时出现持续性肩背疼痛,渐至四肢及周身多个部位窜痛,胸腔腹腔内有明显牵拉性疼痛,服止痛药有效。经多家医院各科检查未发现相关的器质性病变,未予明确西医诊断,曾接受抗抑郁药物治疗。针刺治疗前2年内未服抗抑郁及止痛药物。唇黯,舌质黯,舌苔白,脉弦。腧穴诊察：膻中、至阳、肝俞有明显压痛,视觉模拟量表（VAS）自评5.5分。

The JNK Pathway and Neuronal Migration

The c-Jun N-terminal kinases （JNKs） are important regulators of a variety of physiological and pathological processes both in the central and in the peripheral nervous systems. JNKs are considered as crucial mediators of neuronal cell death in response to stress and injury. However, recent studies have provided substantial evidence that the JNK pathway plays an important role in neuronal migration. Here, we will give a brief introduction of the JNK signaling pathway and put more emphasis on its role in nettronal migration.

Migratory properties of cultured olfactory ensheathing cells by single-cell migration assay

Olfactory ensheathing cells （OECs） are a unique type of glial cells that have axonal growth-promoting properties. OEC transplantation has emerged as a promising experimental therapy of axonal injuries and demyelinating diseases. However, some fundamental cellular properties of OECs remain unclear. In this study, we found that the distinct OEC subpopulations exhibited different migratory properties based on time-lapse imaging of single isolated cells, possibly due to their different cytoskeletal organizations. Moreover, OEC subpopulations displayed different attractive migratory responses to a gradient of lysophosphatidic acid （LPA） in single-cell migration assays. Finally, we found that OEC subpopulations transformed into each other spontaneously. Together, these results demonstrate, for the first time to our knowledge, that distinct OEC subpopulations display different migratory properties in vitro and provide new evidence to support the notion of OECs as a single cell type with malleable functional phenotypes.

A patient with spinal metastasis from hepatocellular carcinoma discovered from neurological findings

Although spinal tumors are uncommon, they may reduce survival or cause serious functional disorders in the extremities. Metastatic spinal tumors from malignant tumors can induce symptoms of spinal cord compression, such as paraplegia, quadriplegia, and vesicorectal disturbance, which are aggravated with progression of the diseases and time. We report a patient with hepatocellular carcinoma (HCC) who was suspected of having spinal lesions based on neurological findings, and a metastatic spinal tumor was found by imaging examination. Assuming that metastasis had occurred at the time lumbar pain developed, the patient reached the level of gait disturbance within only 4 mo, showing a rapid advancement of symptoms. If early diagnosis had been possible, treatment could be performed before acute myelopathy progressed to complete paralysis. We speculate that the terminal stage of HCC is not only liver failure associated with intrahepatic lesions but also metastasis to other regions, treatment for individual pathologies therefore, will be needed, which constitutes an important issue.

Liver transplantation for metastatic neuroendocrine tumor: A case report and review of the literature

Neuroendocrine tumors are divided into gastrointestinal carcinoids and pancreatic neuroendocrine tumors. The WHO has updated the classification of these lesions and has abandoned the term ＂carcinoid＂. Both types of tumors are divided into functional and non-functional tumors. They are characterized by slow growth and frequent metastasis to the liver and may be limited to the liver for long periods. The therapeutic approach to hepatic metastases should consider the number and distribution of the liver metastases as well as the severity of symptoms related to hormone production and tumor bulk. Surgery is generally considered as the first line therapy. In patients with unresectable liver metastases, alternative treatments are dependent on the type and the growth rate. Initial treatments consist of long acting somatostatin analogs and/or interferon. Streptozocin-based chemotherapy is usually reserved for symptomatic patients with rapidly advancing disease, but generally the therapy is poorly tolerated and its effects are short-lived. Locoregional therapy directed such as hepatic-artery embolization and chemoembolization, radiofrequency thermal ablation and cryosurgery, is often used instead of systemic therapy, if the disease is limited to the liver. However, liver transplantation should be considered in patients with neuroendocrine metastases to the liver that are not accessible to curative or cytoreductive surgery and if medical or Iocoregional treatment has failed and if there are life threatening hormonal symptoms. We report a case of liver transplantation for metastatic neuroendocrine tumor of unknown primary source and provide a detailed review of the world literature on this controversial topic.

Experience of Cervical Plexus Reinnervation for Patients with Unilateral Recurrent Laryngeal Nerve Invasion or Injury

OBJECTIVE To explore the clinical and therapeutic effects of cervical plexus reinnervation for infiltrated or injured unilateral recurrent laryngeal nerve （URLN）. METHODS Functional neck dissection for removal of differentiated thyroid carcinoma （DTC） in patients was performed, in which cervical plexus reinnervation was adopted for patients with stage I disease and URLN with injury or with tumor invasion. Outcomes of surgery were evaluated by examination under fibrolaryngoscope, and the patients＇ voices were evaluated before and after surgery. RESULTS All cases were followed up for 3 mon-2 years （average 8 mon）. Abductory motion of the vocal cords of 15 patients was completely or partly restored, but 3 patients＇ vocal cords were immovable. The recovery rate of abductory motion of the paralyzed vocal cords was 83.33% （15/18）. The function of phonation in the 16 patients was restored to normal or near normal limits, and their hoarseness was improved significantly. CONCLUSION Cervical plexus-URLN reinnervation should be considered when treating patients with unilateral vocal cord paralysis. Removing the tumor simultaneously with cervical plexus reinnervation during surgery for repair of unilateral recurrent laryngeal nerve injury was convenient and easy to perform with less functional damage compared with other methods of reinnervation. The abductory motion of vocal cord could be satisfactorily restored by this reinnervation. Surgical performance skills and application of neurotrophic drugs were important for the success of the surgery.

Effect of sunitinib on metastatic gastrointestinal stromal tumor in patients with neurofibromatosis type 1: A case report

Gastrointestinal stromal tumor （GIST） represents the most common mesenchymal malignancy of the gastrointestinal （GI） tract. In neurofibromatosis （NF）, the increased incidence of tumor needs to be considered even in non-symptomatic individuals. Patients with neurofibromatosis NF type 1 have an increased risk of developing GI tumors including rare types such as GIST. We report a case of GIST in a 53-year-old male patient with neurofibromatosis. The patient was diagnosed with NF four years ago and his medical history revealed that he was hospitalized 5 times with a provisional diagnosis of massive lower gastrointestinal bleeding. GIST was diagnosed at explorative laparotomy and the tumor was 21 cm × 13 cm × 7 cm in size. Immunohistochemical examination showed that vimentin, actin and CDl17 were positive. Computerized tomography showed peritoneal implants three months later. Imatinib mesylate （600 mg/d） was initiated. However, control computerized tomography revealed liver and omental metastasis. The dosage was elevated to 800 mg/d. Despite high dosage, the progression of the metastatic lesions continued in the liver and omentum. The patient started oral sunitinib malate （Sutent~ Pfizer Inc, New York, NY, USA） 50 mg per day for 4 consecutive weeks, followed by 2 wk off per treatment cycle. The metastatic lesions in the liver and omentum were decreased in size after four courses, suggesting that sunitinib is also an effective treatment modality for metastatic GIST in NF patients.

Repair of glutamate-induced excitotoxic neuronal damage mediated by intracerebroventricular transplantation of neural stem cells in adult mice

Objective To investigate a possibility of repairing damaged brain by intracerebroventricular transplantation of neural stem cells （NSCs） in the adult mice subjected to glutamate-induced excitotoxic injury. Methods Mouse NSCs were isolated from the brains of embryos at 15-day postcoitum （dpc）. The expression of nestin, a special antigen for NSC, was detected by immunocytochemistry. Immunofluorescence staining was carried out to observe the survival and location of transplanted NSCs. The animals in the MSG＋NSCs group received intracerebroventricular transplantation of NSCs （approximately 1.0×10^5 cells） separately on day 1 and day 10 after 10-d MSG exposure （4.0 g/kg per day）. The mice in control and MSG groups received intracerebroventricular injection of Dulbecco＇s minimum essential medium （DMEM） instead of NSCs. On day 11 after the last NSC transplantation, the test of Y-maze discrimination learning was performed, and then the histopathology of the animal brains was studied to analyze the MSG-induced functional and morphological changes of brain and the effects of intracerebroventricular transplantation of NSCs on the brain repair. Results The isolated cells were Nestin-positive. The grafted NSCs in the host brain were region-specifically survived at 10-d post-transplantation. Intracerebroventricular transplantation of NSCs obviously facilitated the brain recovery from glutamate-induced behavioral disturbances and histopathological impairs in adult mice. Conclusion Intracerebroventricular transplantation of NSCs may be feasible in repairing diseased or damaged brain tissue.

Science Letters:Brain metastases of melanoma-mechanisms of attack on their defence system by engineered stem cells in the microenvironment

This report gives a better emphasis on the role of targeted effectors (e.g. a combination of 5-FC with CD-NSPCs as compared to the application of NSPCs alone) and how such delivery of pro-drug activating enzymes and other tumor-killing substances may overcome melanocytic defence system, interact with and promote the host defence and immune response modulations not only in melanoma but, potentially, in other highly-metastatic cancers.

Neural network and genetic algorithm based global path planning in a static environment

Mobile robot global path planning in a static environment is an important problem. The paper proposes a method of global path planning based on neural network and genetic algorithm. We constructed the neural network model of environmental information in the workspace for a robot and used this model to establish the relationship between a collision avoidance path and the output of the model. Then the two-dimensional coding for the path via-points was converted to one-dimensional one and the fitness of both the collision avoidance path and the shortest distance are integrated into a fitness function. The simulation results showed that the proposed method is correct and effective.

EXPERIMENTAL STUDY OF NERVE GRAFT WITH VASCULAR IMPLANTATION

Objective To study the performance of free nerve graft with vascular implantation Material and method Three groups of rats were used A 10 mm nerve defect was made in the sciatic nerve It was repaired respectively with vascularised nerve graft(VNG), free nerve graft with vascular implantation(NGV) or free nerve graft(NG) Before 30 days the revascularisation of the nerve graft was assessed;at 2 to 3 month regeneration of nerve was evaluated Histochemical staining, vascular morphology and electrophysiological examination were undertaken Result and conclusion The number of regenerated blood vessels in VNG and NGV was significantly increased than that in NG before 30 days The ratio of regenerated nerve fiber area and conduction velocity in the first two groups were much better than those in NG at 2 to 3 months

Effects of NGF and TrkA on GAP-43^+ nerve regeneration in rat autotransplanted splenic tissue

Objective:To study the time-course of the regeneration of GAP-43+ nerve, and the effects of NGF and TrkA on this process. Methods: Adult Wistar rats underwent splenectomy and splenic autotransplantation, or sham-operation. On day 7, 14, 30, 60, 90, 120, and 180 after surgery, the density of GAP-43+ nerve fibers in spleen tissues were measured with the immunohistochemistry followed by computer image analysis. The expressions of GAP-43, NGF and TrkA were determined with in situ hybrdization, and their mRNA levels were detected with RT-PCR and image analysis qualification. Results: (1) The GAP-43+ nerve fibers began their regeneration on 30 d after operation and extended from greater omentum into splenic autotransplants. Density of the nerve fibers gradually became greater and almost normal 180 d after operation. (2) In splenic autografts, the mRNA expression of GAP-43, NGF and TrkA appeared on day 30 after the operation, gradually reached the peak on day 90. Conclusion: The renascent GAP-43+ nerve fibers may come from the greater omentum packaging the splenic autografts and NGF and TrkA can promote the nerval regeneration in the autotransplant spleen tissues.

SURGICAL TREATMENT OF METASTATIC SPINAL TUMOR

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Clustering in mobile ad hoc network based on neural network

An on-demand distributed clustering algorithm based on neural network was proposed. The system parameters and the combined weight for each node were computed, and cluster-heads were chosen using the weighted clustering algorithm, then a training set was created and a neural network was trained. In this algorithm, several system parameters were taken into account, such as the ideal node-degree, the transmission power, the mobility and the battery power of the nodes. The algorithm can be used directly to test whether a node is a cluster-head or not. Moreover, the clusters recreation can be speeded up.

Temozolomide and radiotherapy in newly diagnosed glioblastoma patients:O^6-methylguanine-DNA methyltransferase (MGMT) promotor methylation status and Ki-67 as biomarkers for survival and response to treatment

Objective:This phase II study aimed at investigating the correlation between O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation and protein expression,together with Ki-67 labeling index (LI),to response,time to progression (TTP),and overall survival (OS) in newly diagnosed glioblastoma multiforme (GBM) patients treated with temozolomide (TMZ) concomitant with and adjuvant to radiotherapy (RT).Methods:From June 2005 to August 2008,34 adult patients (18-65 years),PS ≥70,with newly diagnosed GBM received TMZ 75 mg/m2 plus RT up to 60 Gy,followed by TMZ 175 mg/m2 5 days every 4 weeks for 12 doses.MGMT Methylation-specific PCR assay,MGMT protein expression,and Ki-67 expression using immunohistochemistry (IHC) were performed on the tissue blocks.The patients were followed by MRI while MR spectroscopy (MRS) was performed for the stable cases or to confirm progression and accordingly Bevacizumab 10 mg/kg every 2 weeks was added to 7 patients till further progression was proved.Results:31 cases were evaluable,12 (38.7%) had unmethylated MGMT,while 19 (61.3%) were methylated.Seventeen cases (55%) were MGMT immunonegative while 14 cases (45%) were immunopositive.The cut off value of Ki-67 LI in relation to survival was 17%,where 15 were < 17% (48.4%),and 16 were ≥ 17% (51.6%).Response evaluation started after the second dose of the adjuvant TMZ and was repeated every 2 months.The overall disease control rate (ODC) was 74.2%,where 2 patients had complete response (CR),14 had partial response (PR),and 7 had stable disease (SD),while 8 (25.8%) had progressive disease (PD).The ODC was significantly higher among methylated patients and in those with Ki-67 < 17% (P=0.0003).The median overall TTP was 12 months and the median OS was 20 months for all the patients including those who received Bevacizumab for some stable cases or as a salvage treatment in patients with good PS,the MGMT-methylated patients had a higher median TTP of 13 months (range 8 to 18 months,95% CI of 9.36 to 12.9),and OS of 24 months (range 12 to 31 months,95% CI of 16.1 to 21.32),while the unmethylated patients had a median TTP of 6.5 months and a median OS of 12 months,such correlations were highly significant (P=0.0001).MGMT immunoexpression failed to show significant correlation with MGMT promotor methylation or the outcome of the patients.Patients with Ki-67 < 17% had a median TTP of 16 months and median OS of 24 months compared to 7 and 12.5 months respectively for the patients with Ki-67 ≥17%.Significant correlation was found between the ODC,TTP,and OS with age < 52,near total excision,and TMZ doses received ≥ 10.The commonest grade 3 and 4 toxicities was neutropenia recorded in 3 patients (9.67%),thrombocytopenia in 4 patients (12.9%),and one patient with G3 nausea,vomiting,and constipations (3%),all were medically manageable.Conclusion:MGMT promotor methylation status and Ki-67 LI (but not the MGMT protein expression),could serve as prognostic markers for survival,also MGMT could identify the newly diagnosed GBM patients who will have better response to TMZ.

I Move, Therefore I Am. Neuroscience Meets Process Thinking

In this brief essay, we will argue that modem neuroscience and Whitehead＇s process thinking arrive at rather similar conclusions about the essence of human experiences. Important issues evolving from neuroscientific research, specifying the identity of human beings, are explained as resulting from the development and stepwise changes of highly dynamic neuronal networks. These conclusions appear to fit the （meta）physical concepts developed by Whitehead, who claims that the elucidation of immediate experience, proceeding from objectivity to subjectivity, is the sole justification of our thought. Both lines of thought assume that our bodily experience, emerging from the perception of various bodily organs, is the basis of our existence.

EphA3 functions are regulated by collaborating phosphotyrosine residues

Ephrin ligands interact with Eph receptors to regulate a wide variety of biological and pathological processes. Recent studies have identified several downstream pathways that mediate the functions of these receptors. Activation of the receptors by ephrin binding results in the phosphorylation of the receptor tyrosine residues. These phospho- rylated residues serve as docking sites for many of the downstream signaling pathways. However, the relative contributions of different phosphotyrosine residues remain undefined. In the present study, we mutated each individual tyrosine residues in the cytoplasmic domain of EphA3 receptor and studied the effects using cell migration, process retraction, and growth cone collapse assays. Stimulation of the EphA3 receptor with ephrin-A5 inhibits 293A cell mi- gration, reduces NG108-15 cell neurite outgrowth, and induces growth cone collapse in hippocampal neurons. Muta- tion of either Y602 or Y779 alone partially decreases EphA3-induced responses. Full abrogation can only be achieved with mutations of both Y602 and Y779. These observations suggest a collaborative model of different downstream pathways.

Transferring superior gluteal nerve to pudendal nerve in reconstructing functional impairment in simple conus medullaris or pudendal nerve injury

Objective: 1Department of Anatomy, College of Basic Medical Sciences, Second Military Medical University, Shanghai 200433, China 2Department of Orthopedic Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China Abstract Objective: To study the anatomical basis of transferring the superior gluteal nerve to the pudendal nerve in reconstructing the functional impairment in simple conus medullaris or pudendal nerve injury. Methods: Superior gluteal nerve and pudendal nerve were observed and measured by the gross and microsurgical anatomical methods in 62 sides of 31 adult cadavers. Results: Superior gluteal nerve came out of the superior foreman of piriformis as 1 to 4 branches(29.03%,56.45%,12.90% and 1.61% respectively) and the pelvic-leaving points were mainly in the middle 1/3(85.48%) of the line from the posterior superior iliac spine to the ischial tuberosity. The length of the inferior branch of the superior gluteal nerve was more than 5 cm, and the distance between the pelvic-leaving points of the superior gluteal nerve and pudandal nerve was about 4 cm only. The pudendal nerve left the pelvis mainly in the middle 1/3(48.39%) of the line from the posterior superior iliac spine to the ischial tuberosity,or at the junction of its inferior-middle 1/3(46.77%). In clinic, we have successfully made the operation transferring the superior gluteal nerve to the pudendal nerve in 3 patients suffered from the injury of conus medullaris. Conclusion: Distance between the pelvic-leaving points of the superior gluteal nerve and the pudendal nerve is close, so the inferior branch of the gluteal nerve can be anastomosed with the pudendal nerve directly. Transferring the superior gluteal nerve with higher spinal segemental origin to the pudendal nerve of a lower spinal segemental origin is practical and easy.

Central nervous system complications in renal transplant recipients: Report of 68 cases

Objective: To observe the central nervous system (CNS) complications among 1083 consecutive renal transplant (RT) recipients. Methods: Systemic analyses of the incidence, time of onset and clinical outcome of CNS complications were conducted in 1083 patients receiving cadaveric RT in Nanfang Hospital during Jan 1992 to Dec 1999. Results: Various CNS complications occurred in a total of 68 RT recipients (6. 28%, 68/1083) with a mortality of (1.29%, 14/1083). Of all the 1 083 recipients enrolled in this study,diffuse encephalopathy occurred in 31 cases (2.86%), cerebrovascular accidents in 17 (1.56%), seizure in 11 (1.02%) and CNS infection in 9 (0. 83%). Immusuppressive agents was the major cause for diffuse encephalopathy (93.5 %, 29/31), and cerebrovascular accidents were associated with a mortality rate of 70. 5%(12/17) and CNS infection with a mortality rate of 22. 22% (2/9). Most of the complications took place within the first month after RT, especially the first 2 weeks, but the majority of CNS infection occurred 1 year after RT. Conclusion: About 6% of renal transplant recipients develop CNS complications that result in a mortality of 1. 29%, which require early diagnosis and vigorous treatment. Diffuse encephalopathy and cerebrovascular accidents are the two most common CNS complications, and immunosuppressive agents play a important role in the occurrence of encephalopathy. Most of the CNS complications occurred early after RT, but CNS infections may occur rather late, and cerebrovascular accidents and CNS infection are the two major causes of death.