Objective To investigate the effects of sulforaphane (SFN) on the proliferation of prostate cancer DU145 cells and hypoxia-inducible factor-1α(HIF-lα) expression,and to explore the possibility of SFN in the prevention of prostate cancers.Methods The DU145 cells were treated with different doses and different time of SFN.The cell proliferation viability were measured by 3-(4,5)-dimethylthiahiazo (-zy1)-3,3,5-di-phenytetrazo`liumromide (MTT) proliferation and cytotoxicity assay kit.The hypoxia tumor microenvironment was stimulated by pretreating cells with 1％ O2,HIF-lα expression and vascular endothelial growth factor (VEGF) activitity were detected by Western-blot and ELISA,respectively.Results SFN had an inhibitory effect on the proliferation of human prostate cancer DU145 cells in a dose-and time-dependent manner.The cell proliferation inhibition rate exceeded 50％ in more than 20 μ mol/L SFN-treated groups after 48 hours.SFN could inhibit the expression of HIF-1α induced by 1％ O2 and VEGF activity.10 μmol/L SFN showed inhibitory effect on the expression of HIF-1α after 24 hours.20 μ mol/L SFN showed a significant inhibitory effect on the expression of HIF-1α after 12 hours.And peroxidase had synergistic inhibition on HIF-1α.Conclusions SFN can inhibit the proliferation of DU145 prostate cancer cells and HIF-lα expression.SFN can be used as a potential chemotherapeutic agent against human prostate cancer.

Objective To investigate the reason for hidden hemorrhage of hip fracture in elder.Methods All of 94 elder patients,who were diagnosed with intertrochanteric fracture or femoral neck fracture and received treatment in our department from October,2013 to September,2015,were included in this study.The time between injuries to admission was less than 4 hours of the two groups of patients.And the patients whose hemoglobin was less than 100 g/L were removed when admission,in order to avoid the interference of primary anemia.All information,including height,weight,and the value of hemoglobin (Hb) and hematocrit (Hct),were collected.Blood tests were performed immediately after admission,at daily morning preoperatively,and at the morning of the day of surgery.Preoperative blood loss (hidden hemorrhage) was recorded.With respect to blood loss of hidden hemorrhage,statistical analysis was performed at different times (immediate time after admission,and day 1,2,and 3 postoperatively)in the group of intertrochanteric fracture or in the group of femoral neck fracture,and subsequently performed between the two groups.Results The blood loss in the group of intertrochanteric fracture was 196.3 ml,310.1 ml and 418.3 ml in the 1st day,the 2nd day and the third day after admission.There was a significant difference among different time with respect to blood loss.The blood loss was 39.8 ml,65.7 ml and 82.9 ml in the 1st day,the 2nd day and the third day after admission in the group of femoral neck fracture.There was also a significant difference among different time with respect to blood loss.In experimental group,mean blood loss was 418.3 ml and mean Hb decreased by 23.7 g/L at day 3 postoperatively.In control group,mean blood loss was 82.9 ml and mean Hb decreased by 6.7 g/L at day 3 postoperatively.A significant difference was observed between the two groups.The blood loss in patients with intertrochanteric fracture was higher than that in patients with femoral neck fracture.Conclusion The blood loss was gradually increased in elder patients with intertrochanteric fracture over time.There was a significant difference in different time with respect to blood loss.Moreover,a significant difference was found in blood loss of hidden hemorrhage between intertrochanteric fracture and femoral neck fracture.

BACKGROUND: The key point in the treatment of acute cerebral infarction lies in inproving the blood supply of brain effectively as soon as possible as well as rescue ischemic and half diazonal nerve cells, so as to contract the local of infarction as great as possible.OBJECTIVE: To observe the effect of traditional treatment of cerebral piamatral microcirculation in gerbil with cerebral ischemic reperfusion injury by supplementing qi and activating blood circulation.DESIGN: Contrast animal experiment at random.SETTING: Zhabei Branch of Shanghai Changzheng Hospital.MATERIALS: The experiment was performed in the Institute of Naval Medicine (key laboratory of the whole army). Twenty-two healthy Monglian gerbils of clean grade (six months old) were selected and randomly divided into medicine group and control group with 11 gerbils in each group.METHODS: Animals were routinely anaesthetized and fixed in prone position to open the cranium window in median line and expose the pia mater. The cranium window was protected by being covered with a cotton ball containing artificial cerebrospinal fluid (ACSF) after operation. Gerbils were fixed in dorsal position with an median incision made in the lateral cervical nucleus to isolate and expose bilateral common carotid artery (CCA). The bilateral CCA were occluded by atraumatic micro-bulldog clamp, and the occluded blood flow in the distal end was observed under the microscope. Thirty minutes after occlusion of bilateral CCA, the vascular clamp was unclamped to recover the cerebral blood reperfusion. Gerbils in the medicine group were abdominally injected with 0.4 mL of Huangqi injection (containing 0.8 g of crude drug), 0.3 mL of compound Danggui injection (containing Danggui, Chuanqiong and Honghua, 0.09 g for each)and 0.3 mL of Danshen injection (containing 0.45 g of Shengyao). Animals in the control group were abdominally injected with same-volume of normal saline. The changes of pial microcirculation were quantitatively observed in two groups through cranium window respectively before blockage, at the reperfusion after blockage as well as in 120 minutes after injection by laser microcirculation microscope and the TV video system.MAIN OUTCOME MEASURES: The changes of piamatral microcirculation as well as comparison in venous blood flow velocity in gerbils of each group before and after ischemic reperfusion.RESULTS: All gerbils were involved in the analysis of results with no animal died in the experiment.①When the CCA of animals in the two groups were blocked, obvious contraction of piamatral microcirculation was seen and partial blood vessels were blocked up. Platelet and red blood cells etc.adhered to the arteriolae of grade Ⅰ and veinules below grade Ⅲ with microthrombus formed and large ischemic area appeared. The blood flow rate was obviously slowed down. Moderate and severe aggregations were found in red blood cells, and the white blood cells were significantly increased.There was obvious exudation in the periphery of microvessels. After CCA reperfusion, the arteriolae and veinule were in different thickness, and the thrombus in veinule of grade Ⅰ and Ⅱ formed in the cerebral ischemia were difficult to be removed by blood flow. Red blood cell moderately aggregated, and the number of white blood cells greatly increased. White small thrombus could be seen sometimes, while the exsudation in the periphery of microvessel was not significantly ameliorated. Great changes were found in gerbils of the medicine group after abnormal injection of supplementing qi and activating blood circulation medicine: almost all arteriolae and venulae were opened, and the rate of blood flow was accelerated with the blood flow rate remarkably increased. Deposit in the venulae began to decreased, and the thrombus was gradually dissolved. Red blood cells were moderately aggregated or normal. Blood flow in ischemic spot was improved significantly than that after reperfusion. The exudation in the periphery of microvessels was gradually lessened even dissolved. However,no obvious change was found in gerbils of the control group. ②The blood flow rate of arteriole in the medicine group was 1.04-1.50 mm, which was obviously higher than that in the control group with significant differences (P ＜ 0.5-0.01).③The blood flow rate of veinule in the medicine group was 0.96-1.12 mm/s, which was remarkably higher than that in the control group with marked differences (P ＜ 0.05-0.01).CONCLUSION: The effect on piamatral microcirculation of gerbil with cerebral ischemic reperfusion by supplementing qi and activating blood is exact, which is directly related with accelerated blood flow rate, expanded veinule and arteriolae as well as ameliorated blood-supply of brain.

Aging changes of somatostatin (SS) mRNA-positive neurons in the dorsal hippocampus of old rats were studied by in situ hybridization histochemistry and image analysis. In the young rats,SS mRNA-positive cell bodies were mainly located in the pyramidal and polymorphic cell layers of the CA1 and CA2 regions, and in the strata radiatum and polymorphic cell layer of the CA3 region, and in the polymorphic cell layer of dentate gyrus. In the old rats,SS mRNA-positive cell bodies were concentrated in the polymorphic cell layer and denate gyrus. A marked decrease of number of SS mRNA-positive cell bodies and a significant increase of gray value of SS mRNA-positive cell bodies were found in the dorsal hippocampus and dentate gyrus of the old rats as compared with the young rats. No significant age difference in the sectional area of SS mRNA-positive cell bodies was observed in the dorsal hippocampus. The results showed that there were apparent changes with aging of the SS mRNA-positive cell bodies in the dorsal hippocampus of the rats. The significance of the changes remains to be studied further.

Objective To investigate the application of ear endoscopic in artificial stapes surgery of otosclerosis.Methods Artificial stapes surgery was performed by two amplification device, microscope or ear endoscope, in 64 cases of patients with otosclerosi. Then compare the operation time and analyze the effect of surgery.Results Patients postoperative hearing of the two groups were signiifcantly improved, the difference of air bone conduction was statistically signiifcant (P < 0.05). There has no postoperative complications of all the patients. While the operation time was slightly longer in ear endoscope group than that in microscope group, and the difference has statistical significance (P > 0.05).Conclusion Compared with microscopic surgery, ear endoscope artificial stapes surgery has its’ unique advantages with clear image and small trauma.

OBJECTIVETo analyze the incidence and treatment of Clostridium difficile infection (CDI) in pediatric patients with antibiotic-associated diarrhea (AAD).

METHODClinical data of totally 577 pediatric patients with AAD seen from January 2012 to January 2014 were collected; those children were divided according to age into 4 groups, 0.25 -1 year, >1 -4 years, >4 -12 years and >12 -18 years old groups, and 220 healthy children were enrolled as controls. CDI was tested by C. Diff Quik Chek Complete (QCC) and BD GeneOhm™ C. Diff Assay (BD-PCR) in all children, and the CDI incidence of four groups was added up. All pediatric patients with AAD were divided into mild, general and severe type according to different symptoms of diarrhea, and grading treatment, the general type and severe type of CDI children were treated with metronidazole and (or) vancomycin, afterwards, the results of grading treatment were analyzed.

RESULTThe number of pediatric patients with AAD were 178, 177, 132 and 90 in 0. 25 - 1 year, > 1 -4 years, > 4 - 12 years and > 12 - 18 years old group, respectively. The positive rate of CDI (22. 0% (39/177)) in > 1 -4 years old AAD patients was very significantly higher compared to the controls (4% (4/91), P < 0. 001), the rate of CDI (21. 2% (28/132)) in > 4 - 12 years old AAD pediatric patients was significantly higher compared to the controls (4% (2/53), P = 0. 004), the rates of CDI in 0. 25 - 1 year and > 12 - 18years old AAD groups were not significantly different from that of the controls (P >0. 05). There were 285 mild type AAD children (no CDI children), 176 general type AAD children (including 47 CDI children), and 116 severe type AAD children (including 81 CDI children). After grading and symptomatic treatment, there were 16 recurrent diarrhea in 128 CDI patients (severe type AAD), and the rest recovered. Two cases were transferred for referral treatment, 2 cases died, and the rest 12 recurrent diarrhea children fully recovered after administration of metronidazole, vancomycin, probiotics and symptomatic treatment.

CONCLUSIONThe > 1 -12 years old AAD children had higher CDI rate than healthy children; administration of metronidazole and (or) vancomycin was effective for CD infection.

Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Case-Control Studies ; Child ; Child, Preschool ; Clostridium Infections ; drug therapy ; Clostridium difficile ; Diarrhea ; microbiology ; Humans ; Incidence ; Metronidazole ; therapeutic use ; Probiotics ; therapeutic use ; Vancomycin ; therapeutic use

UNLABELLEDOBJECTIVE To evaluate the aesthetic effect of restorations with custom pressable metal ceramic abutments for defective soft and hard tissue in the maxillary anterior zone.

METHODSFifty-two patients with missing anterior teeth in the maxillar were selected, who had problems such as exposure of abutment metal, excessively large angle deviation, excessively long ceramic crown and missing gingival papilla, affecting the aesthetic effect of implant denture. Custom pressable metal ceramic abutments were made on the conventional castable metal abutment surface and restored with all-ceramic crowns to overcome the blackness at the implant neck.

RESULTSClinical evaluation for aesthetic effects 3 and 6 months after the restorations were placed. In 63 restorations of 52 patients, the blackness at the implant neck were eliminated and the aesthetic effect were ideal. The gingival was in healthy condition, showing no further gingival retreat or inflammation around the implant denture.

CONCLUSIONCustom pressable metal ceramic abutments can effectively improve the aesthetic appearance of the implant denture in maxillary anterior zone.

Ceramics ; Crowns ; Dental Abutments ; Dental Implants ; Dental Porcelain ; Esthetics ; Humans ; Maxilla ; Metals

Objective To reveal the characteristics of S gene sequence of hepatitis B surface antigen (HBsAg) in hepatitis B virus (HBV)-infected patients with low HBsAg level.Methods From February 2016 to December 2017, 1 308 serum samples of inactive HBsAg carriers were collected from the 903rd Hospital of PLA and Hangzhou Jianggan District People′s Hospital.The cases were divided into high-level group and low-level group according to the level of serum HBsAg (10 IU／mL) expression.The HBV S gene was sequenced in patients with low-level HBsAg expression.In addition, in patients with high-level HBsAg, 100 patients were randomly selected (stratified sampling) for HBV S gene sequencing based on the matching of age and serological pattern (hepatitis B e antigen [HBeAg] negative) of low-level HBsAg group.A comparative analysis was conducted between HBV S gene sequences from inactive HBsAg carrier in low HBsAg expression group and the HBV reference S gene sequences from inactive HBsAg carrier in high HBsAg expression group .The results of normal distribution data were expressed as Mean ±SD, and analyzed using t-test.The results of non-normal distribution data were expressed by M(QR), and analyzed using Mann-Whitney U test.Chi-square test or Fisher exact test was used to compare continuous variables and classification variables between the two groups .Results There were 276 serum samples from the low level group and 1 032 serum samples from the high level group , including 257 HBsAg／HBeAg／anti-HBc-positive cases, 753 HBsAg／anti-HBe／anti-HBc-positive cases, and 22 HBsAg／anti-HBc-positive cases.Successful HBV S gene sequencing was performed on 126 out of 276 patients in the low-level HBsAg group.According to the age inthe low-level HBsAg group, 100 samples with negative HBeAg in the high-level HBsAg group were randomly selected , among which 94 patients were genotyped and hemotyped.The results showed that there were statistically significant differences in HBV serological markers , HBV DNA level and HBV genotype distribution between the high level group (94 cases) and the low level group (126 cases) (all P＜0.05).The ASC-R-B and ASC-R-C genotypes reported in this study had high homology (99.6%-100.0%) with those reported in Shanghai , Chengdu, Wuhan, Yunnan and Beijing of China , and high homology (98.2%-99.6%) with those reported in Japan and Korea of NCBI genotype B and C reference sequences, but had low homology with patients far away from China (98.2% in Canada and 98.7% in Indonesia).In genotype B of the low level group , the amino acid mutation number of SHB protein was 71, and the hot spot mutation number was 19, both higher than those in the high level group (39 and 8, respectively). The difference was statistically significant (χ2 ＝12.303 and 4.766, respectively, both P＜0.05).Amino acid mutation sites in the low HBsAg group were mainly distributed on both sides of the major hydrophilic region (MHR) (amino acid residues 40 -49 and 198 -220).There were no significant differences in amino acid mutation number and hot spot mutation number between the two groups of C genotype (χ2 ＝0.383 and 0.409, respectively, both P＞0.05).For genotype B, 12 single point mutations and 4 dual co-mutations were found in low level group.Among them, one single point mutation (S210R) and 3 dual co-mutations (G44E／V+T45P／I, G44E／V+L49P／R and N40S+I208T) were not hot spot mutations , while 2 dual co-mutations and 2 single point mutations were found in high level group.The difference between two groups was statistical significant (χ2 ＝7.533,P ＝0.006).For genotype C, 5 single point mutations ( T5A, A45T, T47A／K, Q101R and I126S／T) were found in low level group and 1 single point mutation (N3S) in high level group.The difference in mutation frequency between two groups were statistical significant (χ2 ＝47.914,P＝0.000).Conclusions Significant mutations in multiple regions and at multiple sites ( including co-mutations) on both sides of the MHR may be one of the causes of low HBsAg expression level in this population .

Objective To explore the clinical effect of surgery-first approach (SFA) for correcting adult skeletal class Ⅲ malocclusion deformity patients.Methods A total of 28 adult patients diagnosed with skeletal class Ⅲ malocclusion were treated.Bilateral sagittal split ramus osteotomy (BSSRO) and geniplasty were performed without presurgical orthodontics treatment;postoperative orthodontics treatment was carried out after a healing period of 2-4 weeks.Lateral cephalometric radiographs were taken preoperatively (T1),within a week posoperatively (T2) and six months posoperatively (T3);cephalometric measurements were carried out by the software.Results All the patients were satisfied with the effect,no complications occured.The mean postoperative orthodontics treatment duration was 13.2 months.The mean setback of mandible at Po and B point was (7.74 ± 3.93) mm (P＜0.01) and (8.13±3.84) mm (P＜0.01),and superior movement lengths were (2.73±1.83) mm and (2.76±1.67) mm,respectively.Compared to T2,Po and B point moved forwardly with (2.36±1.23) mm and (2.66±1.65) mm,and inferior movment were (2.16±1.37) mm and (1.21±0.87) mm,respectively.The mean decrease of SNB and GA was (3.74± 1.61)° (P＜ 0.01),(3.41± 1.87)° (P＜0.01),respectively.During postoperative period,both of them increased,although these were no statistical differences.Conclusions SFA combined postoperative orthodontics therapy is feasible for the correction of adult skeletal class Ⅲ malocclusion,which has shorter treatment duration than traditional joint orthognathic-orthodontic.With the advantages of earlier improvements in patient's facial aesthetics and dental function,the reduction in difficulty and treatment duration of orthodontic management,and increasing patient acceptance.