Objective To investigate the effects of ursolic acid and rhynchophylline in Uncariae Ramulus Cum Uncis on human hepatoma HepG2 cells; To discuss its antihepatoma mechanism. Methods Culture the human hepatoma HepG2 cells with 50, 25, 12.5, 6.25 μmol/L ursolic acid, rhynchophylline for 24, 48, 72 hours respectively. 1%DMSO was set as negative control group. CCK-8 based cytotoxicity assay was used to detect the growth of HepG2. Acridine orange fluorescent staining was used to observe human hepatoma HepG2 cells cultured with 50 μmol/L ursolic acid, rhynchophylline and 1%DMSO for 48 hours were observed. Results Ursolic acid significantly acted as a disincentive to the growth of HepG2 cells, which was in positive correlation with time and concentration. Inhibited effect by rhynchophylline on HepG2 cell proliferation was weaker than ursolic acid. Pathological observation showed that most of the cells in rhynchophylline group showed cell shrinkage, dense pulp coating and nuclear staining edge set, and most of the cells in the ursolic acid group showed apoptosis late changes, such as nuclear cleavage and apoptotic bodies. Conclusion Ursolic acid and rhynchophyllinein Uncariae Ramulus Cum Uncis can inhibit the proliferation of HepG2 cells and can induce apoptosis.

Objective To explore the methods of internal fixation for femoral neck fractures and evaluate the biomechanical characteristics of the interlocking expanding compressive screw (IECS)of Type HZS. Methods Based on the special biomechanical characteristics of the femoral neck fracture, the device of internal fixation was designed to consist of main screw, bifurcate screw, boost screw cap, washer, compressive screw cap, oblique interlocking screw and main screw cap. Its biomechanical performances were evaluated through comparison with those of the dynamic compressive screw (DCS), twin compressive screw (2CS) and three cannulated screws (3CS) respectively. Results The mechanical performances of the femoral neck fracture fixed with the interlocking expanding compressive screw were superior to those of the others in displacement ,axial and level stiffness, torsional strength and stiffness and terminal loading. Conclusion Interlocking expanding compressive screw can efficiently withstand the splitting, torsional, shearing, tensional and compressive forces in the fracture, and is simple, safe and easy to use. [

Objective Study the diagnostic value of CT to assess the transfer of right recurrent nerve nodes(RRNN) on the thoracic esophageal squamous carcinoma,so as to provide reference for thoracic segment esophageal surgery way.Methods A retrospective analysis from January 2011 to February 2014 in the first affiliated hospital of zhengzhou university at the records of 132 cases of thoracic segment esophageal thoracic surgery with preoperative CT image data,recorded each patient's right recurrent nerve nodes in the largest length to diameter and the average CT number,and compared with postoperative pathologic results.Results With the ROC curve analysis,considering transfer when the length of RRNN' s diameter 8.5 mm or more in CT,the area under the curve is 0.911,the sensitivity is 85.7％,specificity is 78.8％.Considering transfer when the RRNN average CT number acuity 32.50 HU,the area under the curve is 0.815,the sensitivity is 85.7％,specificity is 76.9％.Whether RRNN transfer has significant correlation(P ＜ 0.05) with the length of tumor,tumor location and whether lymph node of other station transfer,doesn' t have significant correlation (P ＞ 0.05)with patients'age,sex,tumor differentiation degree and the T stage.Conclusion When the RRNN length to diameter 8.5 mm or RRNN average CT numberr acuity 32.50 HU,right recurrent nerve nodes should be considered lymph node metastasis,and choose chest conclusion laparoscopic radical prostatectomy.The upper thoracic portion esophageal tumor's length is 5 cm or more,or clinical suspected lymph node metastasis of other station is the risk factor for metastasis of RRNN.

Objective To evaluate the clinical efficacy of emergent endoscopic injection of tissue adhesive (N-oclyl-a-cyanoacrylate) combined with endoscopic variceal ligation (EVL) for esophageal and gastric varices bleeding. Methods Data of 21 patients with acute esophageal and gastric varices bleeding who received emergent endoscopic injection of tissue adhesive and EVL were retrospectively studied. Results The instant hemostatic rate was 95% (20/21) with no severe complications. Conclusion Emergent endoscopic injection of tissue adhesive combined with EVL is an effective and safe therapy for esophageal and gastric varices bleeding.

Objective To explore the circadian rhythm of neurally mediated syncope (NMS)in children. Methods There were 21 6 children with NMS included in the study,including 91 male and 1 25 female,aged from 4 to 1 7 years old with a mean age of (1 1 .34 ±2.65)years,who came from the Specialist Syncope Outpatient Department or Inpatient Department of the Second Xiangya Hospital of Central South University from December 201 3 to October 201 5. The patients were divided into vasovagal syncope (VVS)group and postural tachycardia syndrome (POTS)group ac-cording to head -up tilt test (HUTT)results,including 1 78 VVS patients and 38 POTS patients.Ninety -four patients with NMS were in the <1 2 years old group[(8.88 ±1 .88)years old]and 1 22 subjects with NMS were in the ≥1 2 years old group[(1 3.24 ±1 .1 8)years old].All patients or guardians were carefully asked about the number of synco-pal attacks and the periods in which episodes occurred in before HUTT [24 hours of a day were divided into 4 periods:morning (0600 AM-1 200 AM),afternoon (1 200 AM-1 800 PM),evening (1 800 PM-2400 PM), night (0000 AM-0600 AM)].Results (1 )General data:the total syncopal episodes of 21 6 children with NMS were 61 4 episodes,including 1 78 VVS patients with 471 syncopal episodes in total and 1 43 attacks of 38 children with POTS.There were 273 episodes of 94 patients in the <1 2 years old group and 341 episodes of 1 22 subjects in the ≥1 2 years old group.There were no significant differences in the diurnal variation of syncopal episodes between the VVS group and POTS group regarding age and gender (P >0.05).(2)The number of syncopal episodes in patients with VVS which occurred in the morning hours was strikingly higher than that of afternoon,evening or nighttime (P <0.05).But there was no significant difference in the frequency of episodes in different periods through the day in the POTS group (P >0.05).Patients with VVS had a higher proportion of episodes in the morning but a lower proportion in the evening when compared with the POTS group (P <0.05).(3)The male children with NMS tended to have a higher proportion of episodes in the morning than the female patients(χ2 =1 1 .001 ,P =0.01 2).(4)There seemed to be no difference in the frequency of syncopal episodes through the day between the <1 2 years old group and the ≥1 2 years old group(χ2 =1 .995,P =0.573).Conclusions The frequency of syncopal episodes in children with VVS displayed a clear circadian rhythm,with a peak in the morning,but the POTS patients did not show a circadian variation.The male children with NMS tended to have a higher proportion of episodes in the morning than the female patients.

Objective To evaluate the clinical results of Willis covered stent implantation and coil embolization in the treatment of cranial internal carotid artery (CICA) aneurysm. Methods Eighty-nine patients with CICA aneurysms were selected for treatment with Willis covered stents (n = 43, group A) or coil embolization (n =46, group B) according to the patients'will. Data on the technical success, initial procedure time and in-hospital interval, initial and final angiographic results, mortality, morbidity, and final clinical outcomes were collected and analyzed for the two groups at 6 months post-procedure. Results Endovascular covered stent placement and coil embolization were technically successful in all patients,except for one patient in group A. The initial angiographic results showed complete occlusion in 34 patients of group A (81%, 95% CI: 69%, 93% ) and 24 patients of group B (52%, 95% CI: 37%, 67% ) ( P ＜0. 05). The final angiographic results indicated complete occlusion in 39 patients of group A (39/41,95%,95% CI: 88%, 102% ) and 22 patients of group B (22/45,49%, 95% CI: 34%, 64% ,P ＜0. 01 ). The average procedure time was(103 ± 13)min in group A and (143 + 39) min in group B (P＜0. 01). No significant differences were seen between the two groups in technique success, mortality, morbidity, or final clinical outcomes. Conclusion In this nonrandomized, prospective trial, CICA aneurysm treatment with covered stents yielded midterm angiographic results that were superior to those of coil embolization.

The occlusal interference model in rats was established. In the masseter the level of MDA was increased, but both SOD and GPX were decreased in the presence of the occlusal interference, while the expression of UCP3 was higher than that in the control group (P ＜ 0. 05) .The findings indicate that the occlusal interference can induce the oxidative damage of masseter in rats, which has a correlation with UCP3.

Objective To compare the safety and effectiveness of endoscopic retrograde biliary drainage ( ERBD ) and endoscopic nasobiliary drainage ( ENBD ) in treatment of acute cholangitis. Methods A retrospective analysis was performed on data of 272 patients with acute cholangitis who underwent emergent endoscopic retrograde cholangiopancreatography ( ERCP ) in Beijing Chaoyang Hospital from January 2009 to June 2017. Patients were divided into ERBD group ( n=143) and ENBD group ( n=129) according to the drainage measures. In the ERBD group, there were 63 cases of gradeⅠ(mild) acute cholangitis, 51 of grade Ⅱ ( moderate) , and 29 of grade Ⅲ ( severe) , and the corresponding cases in the ENBD group were 54, 37 and 38, respectively. The rate of improvement of inflammation, ERCP-related complications and interventions to drainage were compared between the two groups in all patients and each grade. Results The rates of improvement of inflammation in the ERBD group and the ENBD group were 89. 5％ (128/143) and 94. 6％ (122/129), respectively, in overall patients (χ2=2. 399, P=0. 126), 93. 7％ (59/63) and 98. 1％ (53/54), respectively, in grade Ⅰ patients (χ2 =0. 548, P=0. 459), 90. 2％ (46/51) and 94. 6％ (35/37), respectively, in grade Ⅱ patients (χ2=0. 125, P=0. 724), and 79. 3％ (23/29) and 89. 5％ (34/38), respectively, in grade Ⅲ patients (χ2=0. 657, P=0. 418). The incidence of ERCP-related complications in the ERBD group and the ENBD group were 11. 9％ ( 17/143) and 7. 8％ ( 10/129) , respectively, in overall patients (χ2=1. 298, P=0. 225) , 9. 5％ ( 6/63) and 7. 4％( 4/54) , respectively, in grade Ⅰ patients (χ2=0. 006, P=0. 939) , 13. 7％ ( 7/51) and 8. 1％ ( 3/37) , respectively, in grade Ⅱ patients (χ2=0. 230, P=0. 632), and 13. 8％ (4/29) and 7. 9％ (3/38), respectively, in grade Ⅲ patients (χ2=0. 144, P=0. 705) . There were no significant differences in the rate of improvement of inflammation and ERCP-related complications between the two groups. The incidences of interventions to drainage in the ERBD group and the ENBD group were 10. 5％ ( 15/143 ) and 3. 1％(4/129), respectively, in overall patients (χ2=5. 699, P=0. 017), 6. 3％ (4/63) and 1. 9％ (1/54), respectively, in grade Ⅰ patients (χ2 = 0. 548, P = 0. 495 ) , 9. 8％ ( 5/51 ) and 5. 4％ ( 2/37 ) , respectively, in grade Ⅱ patients (χ2=0. 125, P=0. 724), and 20. 7％ (6/29) and 2. 6％ (1/38), respectively, in grade Ⅲ patients (χ2 = 3. 965, P= 0. 046 ) . There were significant differences in the incidence of interventions to drainage between the two groups in overall and gradeⅢpatents. Conclusion ERBD and ENBD are equally safe and effective in treatment of different grades of acute cholangitis, but ENBD can reduce the incidence of interventions to drainage.

Objective:To investigate the expression of coxsackievirus-adenovirus receptor (CAR) in thymic carcinoma and the relationship between CAR and the antitumor activity of oncolytic adenovirus H101.Methods:The expression of CAR in thymic carcinoma tissues and cells were detected by RT-qPCR and Western blot. H101 expression and virus titers in Bcap-37, MP59 and T1889 cells after infection were detected by RT-qPCR and 50% tissue culture infectious dose (TCID 50). The proliferation activity and apoptosis rates of T1889 cells infected with H101 at different multiplicity of infection (MOI) were detected by CCK-8 and flow cytometry. CAR expression in T1889 cells treated with different concentrations of trichostatin A (TSA), a histone deacetylase inhibitor, was detected. H101 expression and virus titers in the TSA-treated and H101-infected cells were detected. Cell activity was detected by CCK-8. The phosphorylation levels of MARK and ERK1/2 and the expression of CAR at protein level in TSA-treated or TSA+ TBHQ (ERK activator) treated cells were detected. Results:CAR expression at both mRNA and protein levels were significantly lower in thymic carcinoma tissues than in adjacent normal tissues ( P<0.01), and lower in MP59 and T1889 cells than in thymic epithelial cells (TEC) and Bcap-37 cells ( P<0.01). H101 expression in MP59 and T1889 cells and the titers of H101 in culture supernatants were significantly lower than those in Bcap-37 cells ( P<0.01). Compared with Bcap-37 cell, the activity of MP59 and T1889 cells was significantly increased and the apoptosis rates were significantly decreased 48 h after H101 infection ( P<0.01). The expression of CAR at both mRNA and protein levels in T1889 cells treated with different concentrations of TSA increased in a dose-dependent manner. When T1889 cells were treated with 0.25 μmol/L of TSA, the expression of H101 at mRNA level and H101 titers were significantly increased ( P<0.05); the phosphorylation levels of MAPK and ERK1/2 proteins were continuously decreased; the expression of CAR was continuously increased. Compared with the TSA treatment group, the expression of CAR at protein level in the TSA+ TBHQ treatment group decreased significantly ( P<0.01), and the p-ERK1/2/ERK1/2 ratio increased significantly ( P<0.01). Conclusions:TSA could up-regulate CAR expression in thymic carcinoma by inhibiting the MARK/ERK1/2 pathway, thereby enhancing the antitumor activity of H101.

Based on the suMmary of the implementation of two-way referral system in Changning district,the article describes the system construction,path design,information platform support and achievements,taking into account of general practitioners,specialist and patients.Through a series of reforms,a two-way referral service and its operation mechanism with the local characteristics has been established in Changning district,which guides the first contact care at community and two-way referral as a rational medical service system.