Objective To explore the effect of linraglutide on expressions of plasminogen activator inhibitor 1 (PAI-1) and intercellular adhesion molecule 1 (ICAM-1) in cultured rat glomerular mesangial cells (RGMCs) stimulated by tumor necrosis factor α (TNF-α).Methods Cultured HBZY21 RGMCs were divided into 6 groups:normal control cells,TNF-α stimulated cells,liraglutide low (10 nmol/L),median (100 nmol/L) and high (1000 nmol/L) concentration incubated cells stimulated with TNF-α,PDTC intervention cells.The expressions of PAI-1 and ICAM-1 of each group were measured by ELISA and RT-PCR.Results The levels of PAI-1 and ICAM-1 protein and mRNA were remarkably increased by TNF-α (P＜0.05),and liraglutide could inhibit above up-regulated expressions (all P＜0.05).Compared with TNF-α-stimulated group,the expressions of PAI-1 and ICAM-1 were decreased by PDTC intervention (all P＜0.05).Conclusion Liraglutide can partly down-regulate the expressions of PAI-1 and ICAM-1 induced by TNF-α in RGMCs.

Objective:To observe the clinical efficacy of Pingxiao capsules in the treatment of benign thyroid nodules. Methods:Totally 240 patients with benign thyroid nodules were randomly divided into the treatment group and the control group with 120 ones in each. The control group received levothyroxine at low dose, the treatment group received Pingxiao capsules, and the treatment course was 3 months. The type B ultrasonic inspection and lab inspection ( for thyroid hormones and blood lipid) were carried out, the cura-tive effect was compared and the adverse reactions were recorded as well. Results:Three patients in the treatment group and five ones in the control group were lost during the follow-up. After the treatment, the max diameter of thyroid nodule and the thyroid volume de-creased in both groups (P<0. 05), and those in the treatment group were smaller than those in the control group (P<0. 05). The levels of TSH and TC in the control group decreased after the treatment, which were significantly lower than those in the treatment group (P<0. 05). The total effective rate in the treatment group was higher than that in the control group, and the incidence of ad-verse reactions was lower than that in the control group, and both had significant differences between the groups (P<0. 05). Conclu-sion:Pingxiao capsules are effective and safe in the treatment of benign thyroid nodules.

Carotid artery stenting possesses more advantages with lesser damage and pain. From the point of evidence medicine, it could replace the classical technique of carotid endarterectomy as the effective method to manage the carotid artery stenosis. The purpose of this article is to review the issues concerned about the carotid artery stenting. With the accomplishment of many successful clinical large scale experiments carried out by multiple centers ,it is believed that carotid artery stenting will play an important role in the prevention and treatment of cerebral stroke initiated by carotid artery stenosis.

Objective To explore the safety and effectiveness of percutaneous vertebrophasty(PVP)in the treatment of the metastatic tumor involved axis.Methods Ten patients(8 male,2 female)with osteolytic metastases involved axis were treated with PVPs.The anterolateral approach with fluoroscopy guidance was selected in 9 cases,while the posterolateral approach with CT guidance was selected in 1 case.Results Successful unilateral-paracentesis for PVP were achieved in all patients without intervention related complications such as bleeding and symptomatic polymethylmethacrylate(PMMA)leakage.CT scan taken following PVP showed that over 70% of the osteolytic metastatic area was well filled with PMMA in all cases.Varying degrees of pain relief were observed(CR in 7 cases,PR in 3 cases)within 7 days.All patients could support their heads without brackets.During a 3 to 24 months follow up after the procedures,No aggravated pain was found in the group.Two patients died in 4 months,3 Patients died in 8 to 11 months 4 patients died in 13 to 15 months,and 1 patient still was alive after 24 months.Conclusion Anterolateral or posterolateral approach to Aixs in PVP is safe and effective in treating osteolytic metastatic tumors.

Objective To investigate the features of intravertebral vacuum phenomenon (IVP)in vertebral compression fractures (VCFs). Methods Two hundred and nine patients with VCFs underwent percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP). The biopsies and the images of X-ray, CT, MRI of VCFs were obtained. The consistency between IVP and osteonecrosis on histology and the positive predictive value (PPV), negative predictive value (NPV), sensitivity, specificity and Youden index of IVP for diagnosing local osteonecrosis in VCFs were analyzed. Fisher exact probability test was used to analyze the coherence between IVP and osteonecrosis. Results Histological examination revealed 146(69.9%) osteoporoses, 10 (4.8%) osteonecroses with osteoporoses, 53 (25.4%) neoplasms. Prior to surgery,10 cases of IVP were found. Plain radiograph showed horizontally oriented lucent cleft in the vertebral body;CT further confirmed the location of gas;T_1-weighted MR image appeared hypointensity,while the signal intensity of T_2-weighted MR image differed, depending on the duration of recumbency. Nine of 10 patients with IVP showed osteonecrosis on histology, while 9 of 10 patients with osteonecrosis contained IVP. The association of osteonecrosis on histology and the IVP was statistically significant(P <0.01). The PPV, NPV, sensitivity, specificity, and Youden index for diagnosing local osteonecrosis was 90% (9/10), 99.5% (198/199), 90.0% (9/10), 99.5% (198/199), and 0.9, respectively. Conclusion The IVP is stongly suggestive of local osteonecrosis in vertebral compression fracture.

Objective To summarise the perioperative features of orthotopic liver transplantations(OLTs) in miniature porcine,to establish mature、stable OLT models.Methods In order to observe hemodynamics and blood changes and improved perioperative management and summarise the perioperative characteristics,8 preliminary experiments(group A) and 18 experiments(group B) of OLTs were performed without veno-venous bypass(VVB) in Chinese inbred miniature porcine.Results The mean operation time was(179.6?14.3)min in our 18 OLTs,and the mean anhepatic phase time was(27.3?3.4)min.Dramatic hemodynamic and metabolic changes were identified during anhepatic phase.The oneweek survival rate was 88.9% in group B,but all the 8 pigs in group A died.The experiment group pigs urinated after 3～5hours and had normal diet after 3days.Conclusions Decreasing the operation time and stability of hemodynamics in anhepatic phase are the keys for success in OLTs without VVB.

Objective To evaluate the clinical efficacy and safety of kyphoplasty with single balloon cross-midline expansion using unipedicular approach for osteoporotic vertebral body compressive fracture (OVCF).Methods Thirty six cases of painful OVCF were included in the study,with 61 vertebrae involved.Under X-ray fluoroscopy monitoring,kyphoplasty was performed using a unilateral,single,balloon via a unilateral transpedicular approach.A final balloon position was in the midline of the vertebral body with the balloon cross-midline expansions and bone cement filled. Clinical outcomes were determined by comparison of preoperative and postoperative VAS and ODI scores.Radiographic assessment included vertebral height restoration and correction of kyphosis.Follow-up was conducted for 6.0-12.0 months(mean 9.2 months).Results Thirty-six consecutive patients with 61 vertebrae were successfully operated with an operative time of(37.4±9.6)rain per vertebra.All patients had significant pain relief and functional recovery within 96 h after the procedure with no surgery-and device-related complications.VAS score improved from(7.3±1.0)preoperatively to(2.7±0.8)postoperatively(t=19.53,P＜0.01).ODI score was decreased from(71.1±10.9)%preoperatively to(26.6±6.4)%postoperatively(t=18.54,P＜0.01).The average anterior body height loss was(14.3±2.8)mm before procedure and(10.0±1.8)mm after procedure(t=14.68,P＜0.01).The average middle body height loss was(10.2±2.7)mm before procedure and(5.9±1.8)mm after procedure(t=16.44,P＜0.01).The Cobb's angle was corrected from 23.4°±5.0° to 16.2°±2.8°(t=15.60,P＜0.01).Some leakages of cement around the anterior margin of vertebra and inter-vertebral space were found in 2 patients,but there were no clinical symptoms.X-ray examination indicated there were no cement leakages in other vertebra.The pain relief and functional recovery were substantial and maintained to the last follow up without any re-collapse or adjacent level fracture.Conclusions A single-balloon cross-midline expansion using unipedicular approach in kyphoplasty for OVCF is effective and safety,less operation time,less radiation exposure compared to the conventional kyphoplasty technique.

BACKGROUND: In kyphoplasty procedure, two balloons are inserted into the vertebral body and inflated simultaneously for height symmetric restoration of the vertebral body. However, the expensive cost of balloon of kyphoplasty limits the extensive development of this procedure in developing countries. In this study, we try to inflate single balloon with bilateral transpedicular routes alternatively to achieve vertebral body height balanced restoration and reduce operation expenditure. But biocompatibility of bone cement and effect of kyphoplasty still need further observation.OBJECTIVE: To investigate the biocompatibility of bone cement and the clinical efficacy of bipedicular kyphoplasty for osteoporotic vertebral compression fractures by inserting single inflatable balloon into injured vertebral body and filling bone cement in the cavity caused by inflating balloon via bipedicular approach.DESIGN: Controlled observation.SETTING: Department of Medical Imaging, General Hospital of Jinan Military Area Command of Chinese PLA.PARTICIPANTS: Twenty-two patients (31 vertebral bodies) undergoing kyphoplasty with single balloon in Department of Medical Imaging, General Hospital of Ji'nan Military Area Command of Chinese PLA from May 2004 to May 2005 were selected, including 5 males and 17 females aged 68-85 years. Patients with painful compression fractures caused by osteoporosis were enrolled, and confirmed by CT and MRI with complete vertebral posterior wall but no spine deformity. The informed consent was obtained from all subjects, and the experiment and treatment were approved by Ethics Committee. METHODS: The especial instrument for kyphoplasty including puncturing device and balloon were provided by Shandong Guanlong Medical Utensils Co., Ltd. [LDAI (T) 2004 No. 2150017]; bone cement (Polymethymethacrylate) was made in China [MAIT 2005(T) No. 3650267]. Under X-ray fluoroscopy monitoring, single inflatable balloon was inserted into fractured vertebral body by puncturing needle and inflated via bipedicular approach to restore vertebral height. MAIN OUTCOME MEASURES: ①Bone cement biocompatibility during and after surgery; ②pain relief within 72 hours after surgery, restoration of vertebral height and correction of kyphotic deformity.RESULTS: ①Bone cement biocompatibility: Little cement leakage was observed at one intervertebral space of one patient by X-ray film, but no clinical symptoms, inflammatory reaction or rejection were found. ②Obvious pain relief was found in 22 cases with within 72 hours after kyphoplasty. ③The height loss of the anterior and middle vertebral body reduced from (14.70±4.21) mm and (10.62±4.11) mm preoperatively to (10.38±4.23) mm and (6.45±4.04) mm postoperatively after single balloon inflation and cement filling. Cobb angle was corrected averagely from (21.15±6.33)° preoperatively to (11.64±4.33)° postoperatively. CONCLUSION:Biocompatibility of bone cement is good, and no specific adverse effects are found in despite of cement leakage. Bipedicular kyphoplasty with single balloon for painful osteoporotic vertebral compression fractures effectively restores vertebral heights and relieves pain.

BacKground:AchaIasia of cardia is categorized into 3 subtypes by Chicago cIassification criteria defined by high-resoIution manometry( HRM). These different subtypes present different cIinicaI and esophageaI dynamic characteristics. Aims:To study the cIinicaI and esophageaI dynamic characteristics of patients with achaIasia of cardia categorized by Chicago cIassification criteria. Methods:Twenty-five untreated achaIasia of cardia patients from January 2012 to ApriI 2014 at Beijing Friendship HospitaI,CapitaI MedicaI University were enroIIed. CIinicaI data incIuding cIinicaI symptoms, manifestations of endoscopy and barium meaI radiography and data of HRM were anaIyzed retrospectiveIy. Results:Of the 25 patients,5 patients(20. 0%)were cIassified as type Ⅰ,15(60. 0%)as type Ⅱ and 5(20. 0%)as type Ⅲ. AII patients compIained as having dysphagia,and 26. 7%( 4/15 ) of type Ⅱ patients had chest pain. Incidences of regurgitation in typeⅠ,ⅡandⅢwere 60. 0%(3/5),53. 3%(8/15)and 20. 0%(1/5),respectiveIy,no significant difference was found among the three types(P>0. 05). Incidences of diIatation of esophagus in type Ⅰ,ⅡandⅢwere 60. 0%(3/5),73. 3%(11/15)and 20. 0%(1/5),respectiveIy,no significant difference was found among the three types (P=0. 11). No differences in Iength of Iower esophageaI sphincter(LES),abdominaI LES Iength,LES resting pressure, upper esophageaI sphincter( UES)resting pressure and integrated reIaxation pressure( IRP)among the three types were found(P>0. 05). Incidences of muItipIe swaIIowing and spontaneous UES reIaxation were 32. 0%(8/25)and 24. 0%(6/25),respectiveIy,no significant difference was found among the three types(P>0. 05). Conclusions:Of the patients with achaIasia of cardia ,typeⅡis more common. Large-sampIe muIticenter studies are needed for further research.

Objective To investigate the biological effects of Wnt gene in kidney cancer Caki?2 cells. Methods The Wnt gene was silenced in kidney cancer Caki?2 cells by lentivirus vector. The cell proliferate ability of cells in each group were assayed by CCK?8 kit at different time points. The apoptosis of Caki?2 cells was observed after silencing Wnt gene by transmission electron microscope. The invasion ability of each group cells was tested using Transwell chambers. The genes expression changes of Wnt/β?catenin signaling pathway and apoptosis related gene were determined by realtime PCR. Results Compared with the other two groups,the cell proliferate ability of the cells after silencing Wntgene was suppressed,and the difference was statistically significant(P<0.05). Apoptosis increased significantly in shRNA+Caki?2+Wnt group cells with silencing of Wntgene, and apoptotic body appeared in these cells. In invasive experiment,the number of emigrated cells in shRNA+Caki?2+Wnt group were significantly lower than other groups(P<0.05). The expression of Wnt mRNA,β?catenin mRNA and Bcl?2 mRNA in shRNA+Caki?2+Wnt group cells was lower than other groups(P<0.05). Conclusion Silencing of Wnt gene of kidney cancer Caki?2 cells can affect the proliferation rate of the cells, promote the cell apoptosis,and inhibit the invasion ability,which provide certain theoretical basis for the research and development of new drugs and new therapeutic targets.