OBJECTIVE: To study the feasibility of the establishment of the orthotopic transplantation tumor model of hepatocellular carcinoma in mice and its tumor biological characteristics. METHODS: H22 cells of hepatocellular carcinoma were inoculated to form ectopic transplanted model in mice by subcutaneous injection. Then the subcutaneous tumors were implanted into the liver of mice, and the orthotopic transplantation tumor model of hepatocellular carcinoma was established. RESULTS: The successful rate of the orthotopic transplantation tumor model was 95.6% and the spontaneous metastatic rate was 81.8%, the rate of mass ascites was 40.9% and the natural extinctive rate was 0%. The natural survival time in the orthotopic transplantation tumor model was 28 days and the proliferation of tumor in transplanted model was accelerated after 2 weeks or so. CONCLUSION: The orthotopic transplantation tumor model in mice is an ideal model for studying the metastatic mechanism and screening anti-tumor drugs for liver cancer, just because of its high successful rate and high spontaneous metastatic rate with no natural extinction.

Objective:To analyze long-term therapeutic effect and safety of warfarin anticoagulant therapy of differ- ent intensity on aged patients with nonvalvular atrial fibrillation (NVAF). Methods:According to age,a total of 197 NVAF patients followed up for five years were divided into advanced aged group [n=65,≥80 (85.00±2.09) years],aged group [n=75,65-79 (76.50±2.27)years]and middle-aged group [n=57,<65 (57.40±2.18) years].All enrolled patients received long-term warfarin anticoagulant therapy,advanced aged group and aged group received low intensity anticoagulation,international normalized ratio (INR)was 1.6~2.5,while middle-aged group received standard intensity anticoagulation and the INR was 2.0~3.0. Thrombus events and incidence rates of hemorrhage etc.over five years were compared among three groups,and the safe dose range of warfarin was ex- plored.Results:During five-year follow-up,no acute cerebral infarction occurred in three groups.The bleeding and other adverse reaction among three groups were no significant difference (P>0.05).Compared with middle- aged group,there were significant reductions in warfarin dose [(3.29±0.49)mg/d vs.(2.95±0.38)mg/d,(2.85 ±0.49)mg/d],INR [(2.54±0.43)vs.(2.20±0.29),(2.16±0.32)]and CHA2DS2-VASc [(3.02±0.89) scores vs.(2.64±0.77)scores vs.(2.33±0.48)scores]in aged group and advanced aged group,P<0.01 all;but there were no significant difference between aged group and advanced aged group (P>0.05).There were no signif- icant difference in incidence rates of mild hemorrhage (21.1% vs.14.7% vs.24.6%)and severe hemorrhage (1.8% vs.1.3% vs.1.5%)among middle-aged group,aged group and advanced aged group,P>0.05 all.Conclu-sion:When INR is closely monitored,INR controlled within 1.6-2.5 warfarin anticoagulation is safe and effective for in aged patients with nonvalvular atrial fibrillation.

Background: The side effects of glucocorticoid in treatment of systemic lupus erythematosus (SLE) have been the focus of debate, and our preliminary study indicates that ginsenosides can enhance the efficacy of dexamethasone. Objective: To observe the effects of ginsenosides combined with prednisone in SLE patients. Design, setting, participants and interventions: A total of 60 SLE patients from Department of Rheumatology and Immunology, Changhai Hospital, Second Military Medical University, were randomly divided into treatment group and control group, with 30 patients in each group. Patients in the treatment group were given routine treatment with prednisone plus ginsenosides, while those in the control group were given routine treatment with prednisone plus placebo. They were all treated for 3 months. Main outcome measures: After three-month treatment, syndrome score in traditional Chinese medicine (TCM), total response rate and symptom improvement rate were measured and evaluated. Results: Twenty-eight cases in treatment group and twenty-seven cases in control group were included in analysis. The total response rates in the treatment group and control group were 89.28% and 66.67% respectively, and there was a significant difference between the two groups (P<0.05). After treatment, the TCM syndrome scores in the two groups were lower than those before treatment (P<0.01), and prednisone plus ginsenosides was better in decreasing the TCM syndrome score than prednisone plus placebo (P<0.05). The symptoms were improved in the treatment group as compared with the control group (P<0.05). Conclusion: Prednisone combined with ginsenosides can increase the clinical effective rate and improve the clinical symptoms of SLE patients.

Objective: To analyze long-term therapeutic effect and safety of warfarin anticoagulant therapy of different intensity on aged patients with nonvalvular atrial fibrillation (NVAF). Methods: According to age, a total of 197 NVAF patients followed up for five years were divided into advanced aged group [n=65，≥80(85±2.09)years], aged group [n=75, 65-79(76.5±2.27) years] and middle-aged group [n=57, ＜65(57.4±2.18)]. All enrolled patients received long-term warfarin anticoagulant therapy, advanced aged group and aged group received low intensity anticoagulation, international normalized ratio (INR) was 1.6~2.5, while middle-aged group received standard intensity anticoagulation and the INR was 2.0~3.0. Thrombus events and incidence rates of hemorrhage etc. over five years were compared among three groups, and the safe dose range of warfarin was explored. Results: During five-year follow-up, no acute cerebral infarction occurred in three groups. The bleeding and other adverse reaction among three groups were no significant difference（P＞0.05). Compared with middle-aged group, there were significant reductions in warfarin dose [(3.29±0.49) mg/d vs. (2.95±0.38) mg/d, (2.85±0.49) mg/d],INR [(2.54±0.43) vs. (2.20±0.29), (2.16±0.32)] and CHA2DS2-VASc [(3.02±0.89) score vs.( 2.64±0.77) score vs.( 2.33±0.48) score]in aged group and advanced aged group, P＜0.01 all; but there were no significant difference between aged group and advanced aged group (P>0.05). There were no significant difference in incidence rates of mild hemorrhage (21.1% vs. 14.7% vs. 24.6%) and severe hemorrhage (1.8% vs. 1.3% vs. 1.5%) among middle-aged group, aged group and advanced aged group, P>0.05 all. Conclusion: When INR is closely monitored, INR controlled within 1.6~2.5, warfarin anticoagulation is safe and effective in aged patients with nonvalvular atrial fibrillation.

Total hip arthroplasty (THA) is a well developed technique to which the spatial orientation of acetabular component is crucial. Since the idea of "safe zone" being proposed, such idea has long been obeyed by hip surgeons but has also been challenged in recent years. This is because post-operative instability could happen even if acetabular components are placed within "safe zone" . The latest researches have demonstrated that sagittal spinal balance and spino-pelvic mobility can affect the spatial orientation of acetabular components. Factors including spinal degenerative changes, long lumbosacral changes and spinal ankyloses can lead to sagittal spinal imbalance and/or influence spino-pelvic mobility, which subsequently affect pelvic retroversion. Proper pelvic retroversion is a way to compensate for sagittal spinal imbalance and is beneficial to post-operative stability. It is necessary for hip surgeons to rethink "safe zone" before performing THA and understand spinal balance as well as spinopelvic mobility. The goal is to reduce the rate of dislocation. This review started by introducing the related spinopelvic parameters frequently seen in papers published recently and the definitions of acetabular cup orientations. After the spinal sagittal balance and its compensatory mechanisms session, discussed its clinical relevance, as well as the significance of spinal mobility, in spinopelvic motion under three different postures.

OBJECTIVE： To study the protective effects of Polygonum orientale extract on myocardial ischemia-reperfusion injury （MIRI） model rats， and to provide reference for it’s deeply development of medicinal source. METHODS： Totally 24 rats were randomly divided into sham operation group （normal saline）， model group （normal saline）， Compound danshen tablet group （positive group， 0.17 g/kg） and P. orientale extract group （86 g/kg， calculated by crude drug）， with 6 rats in each group. All groups were given drugs 2 mL/100 g intragastrically once a day. After 4 d of consecutive administration， MIRI model was induced by the left anterior descending branch of arteria coronaria in all groups except for sham operation group. 24 h after reperfusion， they were given related medicine again. After medication， the changes of electrocardiogram ST segment were monitored in each group. The plasma levels of LDH， CK-MB， CK， cTn-I， SOD and NO were detected in each group. The myocardial infarction rate in each group was calculated and the pathomorphological changes in the myocardium were observed. RESULTS： Compared with sham operation group， ST segment of myocardial electrocardiogram was increased in model group （P＜0.01）. The plasma levels of LDH， CK， CK-MB and cTn-I were increased significantly （P＜0.01）， while the plasma levels of SOD and NO were decreased significantly （P＜0.01）. The rate of myocardial infarction was increased significantly （P＜0.01）， and pathomorphological changes were observed in myocardial tissue such as infiltration of inflammatory cells and loose cytoplasm of cardiac myocytes. Compared with model group， ST segment of myocardial electrocardiogram was decreased significantly in Compound danshen tablet group and P. orientale extract group （P＜0.05）； the plasma levels of LDH， CK， CK-MB and cTn-I were decreased significantly （P＜0.05）， while the plasma levels of SOD and NO were increased significantly （P＜0.05）； the rate of myocardial infarction was decreased significantly （P＜0.05）， and inflammatory cell infiltration and tissue edema in myocardium were relieved to varying degrees. CONCLUSIONS： The protective effect of P. orientale extract protect on MIRI may be exerted by anti-oxidative damage.

OBJECTIVE： To study in vitro metabolism pathway of effective component of Bletilla striata as Militarine in liver microsomes and kinetics characteristics of enzyme-catalyzed reactions. METHODS： The in vitro incubation system of rat and human liver microsomes was established， and incubation reaction of Militarine was performed. UPLC-QTOF-MS was used to identify the structure of its metabolites in combination with UNIFI database and references. Using puerarin as internal standard， UPLC-Triple Quad-MS was used to quantitatively analyze metabolic transformation of Militarine in rat liver microsomes. The kinetic parameters （vmax， km， CLint） of Militarine enzyme-catalyzed reactions with/without reducing coenzyme Ⅱ （NADPH） were calculated by fitting the curves with GraphPad Prism 5.0 software. RESULTS： After incubation in rat and human liver microsomes， Militarine produced a chemical formula C21H29O11， which was presumed to be a metabolite of Militarine ester bond hydrolysis. The kinetic study of enzyme-catalyzed reactions showed that vmax of Militarine enzyme-catalyzed reactions with/without NADPH were 1.955， 2.129 nmol/（h·mg）； km were 8.601， 9.854 nmol/mL； CLint were 0.227 3， 0.216 1 mL/（h·mg）； there was no significant difference between with NADPH and without NADPH. CONCLUSIONS： The main metabolic pathway of Militarine in liver microsomes is the hydrolysis of C1 and C4 ester bonds. Its metabolism does not depend on the pathway of cytochrome P450 enzymes initiated by NADPH.