Objective To observe the changes in cerebral microcirculation after subarachnoid hemorrhage(SAH) and to study its correlation with cerebral vasospasm(CVS).Methods Eighty-five SAH patients and 35 controls,enrolled in this study as perspective study subjects,were divided into SAH group and control group,CVS group and non-CVS group(nCVS),symptomatic CVS(sCVS) group and asymptomatic CVS(asCVS) group.All the subjects underwent CT perfusion(CTP) and the associated parameters,including cerebral blood flow(CBF),cerebral blood volume(CBV) and mean transit time(MTT),were recorded for final analysis.Results Compared to the control group,the CBF and MTT were significantly changed in SAH group(P

Objective To investigate the association of uncoupling protein 2 ( UCP-2 ) gene promoter -866G＞A polymorphism and ischemic stroke in diabetic patients.Methods A total of 844 type 2 diabetic patients including 404 cases with ischemic stroke and 440 cases without ischemic stroke were selected for the 4 year prospective study,Genomic DNA was extracted from the whole blood samples of subjects,UCP-2 gene promoter -866G ＞ A polymorphism was detected by TaqMan MGB probe method,and then the genotype and allele gene frequencies were compared.Results The risk of ischemic stroke in type 2 diabetic female patients with AA+GA genotypes of UCP-2 was higher than that with GG genotype (P＜0.05),but there was no difference among male patients with three genotypes.Conclusions UCP-2 gene promoter -866G ＞ A polymorphism increases the risk of ischemic stroke in Chinese diabetic women.

OBJECTIVERadial corrective osteotomy is an established but challenging treatment for distal radial malunion. There is an ongoing discussion about whether an opening or closing-wedge osteotomy between should employed. The purpose of the present study was to retrospectively compare the clinical and radio graphic results between conventional opening-wedge osteotomy and closing-wedge technique.

METHODSFrom January 2004 and December 2012,42 patients with extra-articular distal radial malunion were managed with corrective osteotomy and were followed for a minimum of one year. Twenty-two patients (5 males and 17 females, ranging in age from 25 to 75 years old) were managed with radial opening-wedge osteotomy and implanting of interpositional bone graft or bone-graft substitute, and twenty patients (4 males and 16 females, ranging in age from 19 to 79 years) were managed with simultaneous radial closing-wedge and ulnar shortening osteotomy without bone graft. The selection of the surgical procedure was determined by the surgeon. Each patient was evaluated on the basis of objective radio graphic measurements, and functional outcomes were determined on the basis of clinical examinations, including range of wrist motion, grip strength, pain-rating score, Mayo wrist score, and Disabilities of the Arm, Shoulder and Hand (DASH) score.

RESULTSThe mean duration of follow-up was 36 months (ranged, 12 to 101 months) for the opening-wedge cohort and 28 months (ranged, 12 to 87 months) for the closing-wedge cohort. The two techniques were comparable in terms of complications. Post-operative volar tilt and ulnar variance were improved significantly in each cohort. The ulnar variance was more frequently restored to within defined criteria (22.5 to 0.5 mm) in the closing-wedge cohort than that in the opening-wedge cohort. The post-operative mean extension-flexion are of the wrist and Mayo wrist score were significantly better in the closing-wedge cohort. Differences in the pronation-supination arc, grip strength, pain-rating score, and DASH scores between these two cohorts were not significant.

CONCLUSIONThe closing wedge osteotomy technique is an effective reconstructive procedure for the treatment of extra-articular distal radial malunion. It is significantly better than the opening-wedge osteotomy technique in terms of the restoration of ulnar variance, the extension-flexion arc of wrist motion, and the Mayo wrist score.

Adult ; Aged ; Bone Nails ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Osteotomy ; Radius Fractures ; surgery ; Range of Motion, Articular ; Retrospective Studies ; Wrist Joint ; surgery ; Young Adult

Objective To compare the clinical effectiveness of external fixation,expert tibial nail (ETN) and minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of AO type 43A tibial fractures.Methods The clinical data of 102 patients with AO type 43A tibial fracture were retrospectively analyzed who had been treated from June 2010 to June 2014.They were 68 men and 34 women,from 18 to 71 years of age (average,36 years).By AO classification,there were 36 cases of type A1,45 ones of type A2,and 21 ones of type A3.External fixation was used in 30 cases,MIPPO in 42,and ETN in 30.The 3 groups were compared in terms of operation time,blood loss,fracture healing time,complications and functional evaluation according to American Orthopaedic Foot and Ankle Society (AOFAS) criteria for middle and fore foot.Results The operation time in external fixation group (72.7 ± 16.1 min) was significantly less than in MIPPO group (101.5±15.1 min) and ETN group (115.0±11.2 min) (P ＜0.05).The blood loss and fracture healing time in external fixation group were (320.6 ±40.8 mL) and (160.6 ± 25.0 days),significantly greater than in MIPPO group (125.5 ± 27.3 mL and 120.3 ± 20.2 days)and ETN group (124.2±25.4mL and 125.5±25.6 days) (P ＜0.05).The total complication rate in external fixation group (53.3％,16/30) was significantly higher than in MIPPO group (9.5％,4/42) and ETN group (10.0％,3/30) (P ＜ 0.05).The total AOFAS excellent to good rate in external fixation group (66.7％,20/30) was significantly lower than in MIPPO group (88.1％,37/42) and ETN group (90.0％,27/30) (P ＜ 0.05).However,there were no significant differences between MIPPO and ETN groups concerning all the above outcome indicators (P ＞ 0.05).Conclusions For AO type 43A tibial fractures,internal fixation should be the first choice.Both MIPPO and ETN can lead to good clinical efficacy.However,in cases where internal fixation is not suitable,external fixation with distal lateral tibial nails at the Chaput tuberosity can obtain satisfactory ankle function.

AIM:To investigate the effect of RWDD3 gene silencing on the biological characteristics of human glioma U251 cells.METHODS: A lentiviral vector expressing RWDD3 shRNA was constructed and transfeeted into the U251 cells.The expression of RWDD3 at mRNA and protein levels was detected by real-time PCR and Western blot , re-spectively .The cell activity was determined by MTT assay .The colony formation ability was detected by the colony forma-tion assay .The cell proliferation ability was detected by BrdU incorporation assay .The cell invasion and migration were evaluated by Transwell assay .Flow cytometry was used to monitor the changes of cell cycle distribution and apoptosis .RE-SULTS:Recombinant lentivirus was successfully transfected into U 251 cells.Compared with the cells transfected with the scrambled shRNA and control cells, the cell activity, colony formation ability, and the invasive and migratory activities were inhibited, the cell cycle was arrested in G 0/G1 phase, and the apoptosis was increased in the U 251 cells transfected with RWDD3 shRNA ( P <0.05 ) .CONCLUSION: RWDD3 plays a vital role in proliferation and invasion of glioma cells.It may serve as a potential target of gene therapy for glioma .

Objective To investigate the effect of sulforaphane on 1-methyl-4-phenylpyridinium (MPP +)-induced cell viability loss in cultured PC12 cells and to explore the possible mechanism.Methods MPP + induced damage in PC12 cells was prepared as oxidative damage model.Sulforaphane (0.5,1.O,2.5,5.0 and 10.0 μmol/L) was added in each group cell growth medium.Subsequent experiments were divided into 4 groups:(A) normal control group,(B) sulforaphane group,(C) MPP+ injury group,(D)sulforaphane pretreatment + MPP+ injury group.Cell viability was detected by MTT assay,and the sulforaphane pretreatment PC12 cell viability was observed in different concentrations.Flow cytometry was used to detect changes in the rate of apoptosis in different packet PC12 cells,and protein expression levels of nuclear factor erythroid2-related factor 2 (Nrf2),heme oxygenase (HO-1) and human NAD (P) H dehydrogenase,quinone 1 (NQO1) were detected by Western blot when the PC12 cells were incubated with sulforaphane (2.5 μmol/L) and (or) MPP+ (500 μmol/L) for 24 h in vitro.Results Compared to control group (cell survival rate was 98.70％),the survival percents of PC12 cells were significantly decreased in MPP+-treated group (58.16％).A significant difference was showed between group A and C (F =21.83,P ＜ 0.05),and the cell survival rate in group D was significantly improved.Compared to control group,the rate of apoptosis in MPP+ injury group was increased,and the rate of apoptosis after pretreatment of the sulforaphane was significantly reduced.Compared to MPP+ injury group,the levels of Nrf2,HO-1 and NQO1 protein expression were significantly increased in sulforaphane pretreatment group.Conclusion Sulforaphane have a protective effect against MPP+-induced PC12 cell model damage,and the protective effect may be achieved by activating the Nrf2-antioxidant response element pathway.

Objective To understand the characteristics of High-density lipoprotein cholesterol (HDL-C) distribution through analyzing serum HDL-C levels in healthy checkup subjects among local urbanese.Methods The checkup results of 36 454 cases were collected from 2009 to 2013 in Tangshan Gongren hospital (male:n =20 343,female:n =16 111).The cases with liver injury,abnormal blood glucoses,kidney injury and defined cerebrovascular diseases and metabolic disease were excluded.25 197 cases were analyzed as normal subjects including 11 114 males and 14 083 females.Kolmogorov-Smimov test,kruskal-wallis test,and Dunn multiple comparison test was performed using Bioconductor software 3.0.2 for testing normality distribution and comparing the difference of two or multiple groups,respectively.Results were analyzed statistically with R 3.0.2.Results The results showed that the average level (1.22-± 0.31) mmol/L of HDL-C among the overall population is lower than that of national average level(1.30 mmol/L).The median serum HDL-C level in female is higher than in male (1.27 and 1.08,x2 =2 606.34,P ＜0.01).HDL-C levels in male continuously increase from 1.06 mmol/L to 1.11 mmol/L with aging,especially in groups of over 50 years old than in groups of below 50 years old (x2 =75.19,P ＜ 0.01).Conclusions Based on 2007 guidance on prevention and treatment by national health bureau,this study showed that there are 29.69％ of the apparent healthy subjects,especially about 42.94％ of the male,representing low HDL-C level under the low limit of 1.04 mmol/L.These results showed that serum HDL-C level in Tangshan urbanese is lower than that of national average level,and HDL-C level in male is tended to increase with aging.

Objective To explore the operative methods and clinical outcomes in emergency or sube- mergency repair for the complicated tissue defects in hand in first stage applying microsurgical technique. Methods From Jan.,2000 to Aug.,2005,49 emergency cases of complicated hand tissue defects were re- paired in the first stage with replantation,reconstruction,free flaps,combined finger reconstruction and flap transplantation,including 21 cases in mini tissue mass replantation or reconstruction,15 cases in replantation combined with free flap transplantation,8 cases in replantation and reconstruction combined with free flap transplantation,5 cases in combined multiple digits reconstruction with free flap transplantation.The free flap transplantation included the anterolateral femoral flap,the latissimus dorsi myocutaneous flap,the dorsalis pe- dis flap,the media pedis flap and the instep flap.Results All the flaps,the replanted and reconstruceted finger survived uneventfully except for one replanted finger necrosis.45 cases healed in the first stage and the other 4 cases healed in the second stage.During a follow-up from 6 months to 3 years postoperatively,a satis- factory appearance and function of the reconstructed hand was achieved.The excellent and good rate was 85.7% assessed with provisional functional assessment criterion for upper limbs issued by Chinese Society of Hand Surgery.Conclusion The emergency or subemergency repair for the complicated tissue defects in hand has the advantage of short-term treatment and desirable functional outcome.The emergency replantation and reconstruction combined with various flaps or tissue mass can be applied to repair tissue defect in hand in the first stage according to the position and area of the defect along with the technique level of the surgeon, having been proved to achieve desirable clinical outcomes.And the key points leading to a successful operation is the correct treatment for the raw surface of the defects,suitable choice for various flaps,logical design of combination pattern and prevention and timely treatment for vessel crisis.

Objective To explore the methods for coverage of the defect of great toe after the wrap-a- round flap transferand decrease the morbidity of donor site in great toes.Methods Twenty-five patients received three kinds of procedure for immediate resurfacing of donor defect of the great toes during wrap-around flap transferAmong them9 cases received the free flaps for coverage of defect in donor great toes12 cases was repaired by local pedieled dorsal or plamarpedis flapsand the other cases were treated by the nail-flap of second toe.Results All the flaps were survivalTwo patients received the flap thinning procedure in 6 months laterall patients were satisfied with cosmetic and functional outcomeThe appearance and sensory function of donor toe repaired by second toe nail-flap was best among three methods.Conclusion Accord- ing the detect situation of great toesthree kinds of flap were selected for immediate coverage of donor site, which can decrease the complication of donor great toe at the most.

OBJECTIVE:To study the effect and its mechanism of Fuzheng Jiedu Quyu formula(short forFuzheng formula) combined with oxaliplatin (L-OHP) on human colon cancer HT-29 cell proliferation and apoptosis. METHODS:HT-29 cells were divided into blank control group(without drugs),Fuzheng formula group(1000 mg/L),L-OHP group(31.25 mg/L)and combi-nation group (1000 mg/L Fuzheng formula+31.25 mg/L L-OHP). After cultured with corresponding drug for 48 h,MTT method was used to detect the cell proliferation;the changes of cellular morphology were observed by invert microscope;flow cytometry was used to detect the cell cycle and apoptosis rate. Proapoptotic gene Bax,apoptotic gene Bcl-2 mRNA expressions were deter-mined by real-time fluorescence quantitative polymerase chain reaction method;Bax,Bcl-2 protein expressions were assayed by Western blot. RESULTS:Compared with blank control group,cell proliferation was inhibited in L-OHP group and combination group;cell proportion was increased in S stage,G2/M stage and decreased in G0/G1 stage(P<0.05). Cell apoptosis rate in L-OHP group,Fuzheng formula group and combination group was increased;Bax mRNA and protein expression were up-regulated,Bcl-2 mRNA expression was downregulated(P<0.05);and combination group changed more obviously than the single drug groups(P<0.05). CONCLUSIONS:Fuzheng formula combined with L-OHP can inhibit HT-29 cell proliferation and promote its apoptosis, showing better effects than either of the two drugs alone. The mechanism may be associated with up-regulation of Bax gene and pro-tein expressions and down-regulation of Bcl-2 gene expressions in cells.