Objective To evaluate the value of cranial MRI on diagnosing nonalcoholic Wernickes encephalopathy (WE). Methods The clinical characters, cranial MRI features, and outcomes materials in six cases of nonalcoholic Wernickes encephalopathy were analyzed.Results Cranial MR and Flair imaging of the patients exhibited areas of increased T 2W and flair signals symmetrically surrounding the aqueduct and third ventricle and within the medial thalamus. One patient who became persistent vegetative state coexistenced increased T 2W and flair signal of the cortex. According to the follow-up results, the alterations of four patients in T 2W and Flair signals showed to resolve being consistent with the clinical recovery. One patient with persistent vegetative state had no change within two years of the follow-up.Conclusions Cranial MRI is of great value in diagnosing nonalcoholic Wernickes encephalopathy and reflects appropriately the pathological evolution of this disease.

Objective To investigate the effect of microRNA-101 (miRNA-101) on atrial fibrosis in human chronic atrial fibrillation (AF). Methods Right atrial appendages were obtained from 59 patients (30 with AF) undergoing cardiac surgery, including 47 patients with valve heart disease and 12 patients with congenital heart disease. The expression of miRNA-101 was determined by quantitative real-time PCR in the right atrial appendages of patients with and without AF. The cell-specific localization of miRNA-101 was detected by in situ hybridization assay. The mRNA and protein expression levels of transforming growth factor β typeⅠreceptor (TGFβRⅠ) and collagen type I (COL1) were determined by quantitative real-time PCR and Western-blot assay, respectively. Collagen in the right atrial appendages was observed by Masson staining assay. Results The expression of miRNA-101 was found to be significantly down-regulated in AF patients compared with patients with sinus rhythm (SR) (P < 0.05). The result of miRNA-ISH showed that miRNA-101, which was highly distributed within the connective tissues of heart, was down-regulated at about 24.9% in patients with AF compared with patients with SR. No significant differences at the mRNA expression level of TGFβRI was found between patients with AF and patients with SR (P > 0.05). But the protein expression of TGFβRI in patients with AF was significantly higher than that of patients with SR (P < 0.05). The mRNA and protein expressionsl of COL1 were significantly higher in patients with AF than thoset of patients with SR (P < 0.05). The collagen was significantly increased in patients with AF than that of patients with SR (P < 0.05). Conclusions Downregulation of miRNA-101 may contribute to atrial fibrosis in human atrial fibrillation by targeting TGFβRⅠ.

Objective To evaluate the application of CT perfusion in the assessment of muscle perfusion in ischemic rabbit hindlimb treated by implantation of bone marrow mesenchymal stem cells.Methods Twenty rabbits were divided into two groups randomly (each n =10).Bone marrow mesenchymal stem cells were injected into the left ischemic hind limbs of animal models of intravenous injection group,with same volume of normal saline injected into the control group.Twenty-eight days later,the collateral circulation and blood vessel neogenesis were examined by Toshiba Aquilion One 320-MSCT and pathological approaches.t test and Pearson test were used to compare the parameters.Results The results show that rAF,rBV,rClearance,rMVD were 1.15 ±0.67,1.19 ±0.32,0.62 ±0.20,and 1.34 ±0.28 in intravenous injection group and 0.57 ±0.17,0.74 ±0.19,2.06 ±0.15,0.62 ±0.19 in the control group respectively.There was significant difference of rAF,rBV,rClearance and rMVD between the intravenous injection group and the control group(t =5.75,5.01,-2.81,6.43 respectively,P ＜ 0.01).There was significant correlation between rBV,rAF,rC and rMVD (r =0.857,0.811,0.615,P ＜ 0.01).Conclusion CT perfusion imaging is a relatively accurate technique to assess changes of muscle perfusion in ischemic rabbit hindlimb treated by implantation of bone marrow mesenchymal stem cells.

Objective To explore the therapeutic effect influencing factors of intra-aortic balloon pump(IABP) support during cardiac surgery perioperative period and countermeasures.Methods Clinical data of 42 patients using IABP in the cardiac surgery was analyzed retrospectively.The patients were classified into 2 groups:living group (32 patients) and died group (10 patients).The time of IABP implantation,preoperative cardiac function,the duration of cardiopulmonary bypass(CPB) and aorta block,mean arterial pressure (MAP) and inotropic score (IS) before using IABP and postoperative complications were recorded and compared.Results In died group,2 patients were used IABP preoperatively,1 patient was used intraoperatively,7 patients were used postoperatively,8 patients were in NYHA cardiac function class Ⅲ or Ⅳ preoperative,the duration of CPB and aorta block were (144.43 ± 49.03),(97.29 ± 39.99)min respectively,MAP and IS before using IABP were (57.34 ±7.25) mm Hg (1 mm Hg =0.133 kPa) and (28.22 ±17.72) scores,IABP time was (86.00 ±52.31) min.Compared with living group,all above comparisons showed significant difference [(100.43 ± 35.03) min,(60.45 ± 20.55) min,(69.34 ± 8.05)mm Hg,(10.82 ± 15.75) scores,(49.00 ± 25.23) min] (P ＜ 0.05).Postoperative complications in died group included 7 patients of ventilator dependency,6 patients of acute renal failure,5 patients of refractory metabolic acidosis,2 patients of malignant arrhythmia,1 patient of acute myocardial infarction,significantly higher than those in living group (0,4,2,0,0) (P ＜ 0.05).Conclusions Erroneously choose the timing of using IABP,poor preoperative cardiac function,prolonging CPB and aorta block time,MAP less than 60 mm Hg and high dose positive inotropic agent before using IABP,and postoperative complications are main influencing factors for clinical outcomes of IABP in cardiac surgery.Reasonably choosing adaptive indication and timing of IABP,preventing and treating postoperative complications effectively can improve effects of IABP in cardiac surgery.

OBJECTIVE To study the changes in matrix metalloproteinase-9 (MMP-9) mRNA, tissue-inhibitor of metalloproteinase-1 (TIMP-1) mRNA and the ratio of MMP-9 mRNA/TIMP-1 mRNA in the lungs of paraquate poisoning rats, and to investigate the protective effects of sodium dimercaptopropane sulfonate (DMPS, Unithiol). METHODS One hundred and twenty male SD rats were divided into 12 groups (n=10) randomly: normal control, DMPS control, PQ poisoning 1, 3, 7, 14 and 28 d model groups, (DMPS+PQ) 1, 3, 7, 14 and 28 d groups. PQ poisoning model was established by intraperitoneal injecting paraquate. The expression of MMP-9 mRNA and TIMP-1 mRNA in lung tissues was detected by RT-PCR. RESULTS ①By observing the changes of action and observing the lung tissues sections, the rats' PQ poisoning models was successfully established. ②The histopathology of lung showed infiltration of inflammatory cell in acute phase(within 2 weeks), the inflammation decreased gradually after 2 weeks, hyperplasia of collagen and pulmonary fibrosis were instead. Howerer, the pathological changes were alleviated obviously in the (DMPS+PQ) groups. ③Compared with the PQ groups, the expression of MMP-9 mRNA and TIMP-1 mRNA in lungs diminished greatly in the DMPS+PQ groups after rats injected DMPS(P<0.05); the ratio of MMP-9/TIMP-1 mRNA was bigger at 7, 14 and 28 d in the DMPS+PQ groups after rats injected DMPS. CONCLUSION Down-regulation of the expression of MMP-9 mRNA and TIMP-1 mRNA and up-regulation ratio of MMP-9 mRNA/TIMP-1 mRNA by DMPS may be one of mechanisms by which pulmonary injury and pulmonary fibrosis are prevented in the acute paraquate poisoning.

Objective To study hcpatitis B virus (HBV) reactivation and related risk factors for ≤5 cm hepatocellular carcinoma (HCC) by radiofrequency ablation (RFA) or hepatic resection.Methods From Sep 2006 to Jan 2013,193 patients received hepatectomy and 146 patients received RFA.Univariate and multivariate logistic regression analysis was used to assess risk factors.Stratified x2 test for HBV reactivation,Unpaired student's t-test for CD4 +,CD8 +,CD4+/CD8+ and NK cell proportions.Results (1) Antiviral therapy,Child-Pugh grade,vascular invasion and treatment modality were significant risk factors of HBV reactivation (P ＜ 0.05).(2) HBV reactivation was lower in patients receiving antiviral therapy than those who did not (16/181 vs.25/158,x2 =3.869,P =0.049),the reactivation in hepatectomy group was higher than RFA group in those not using antiviral therapy (20/92 vs.5/66,x2 =5.788,P =0.016),but the difference was not significant in the antiviral therapy patients (10/101 vs.6/80,x2 =0.319,P =0.572).(3)CD3+,CD4+,CD4+/CD8+ and NK cell proportions after 7 days treatment decreased in different degree for both hepatic resection and RFA group with or without antiviral therapy (P ＜0.05).For patients who did not received antiviral therapy,the proportions of RFA after 7 days treatment were higher than the hepatic resection group (P ＜ 0.05).Conclusions Compared with ≤5 cm carcinoma treated by RFA,hepatic resection decreased the proportions of immune cells,preoperative antiviral therapy relieves immune suppression,decreases the incidence of HBV reactivation.

BACKGROUND:Animal model of infection is established using bioluminescent gene-labeled bacteria, which stimulate local environment of spine infection and reveal the pathophysiological mechanism of spine infection.
OBJECTIVE:To evaluate the feasibility and safety of anterior one-stage debridement, autogenous iliac bone grafting and titanium plate internal fixation in the management of pyogenic spinal infections in spine.
METHODS:Total y 24 Chinese dogs were adopted in the study to develop a canine model of acute pyogenic spondylodiscitis using a bioluminescent strain of Staphylococcus aureus Xen29. The animal models were detected by X-radiography, CT and MRI examinations. After 4 weeks of modeling, al the animals underwent one-stage debridement, autogenous iliac bone grafting and anterior titanium plate internal fixation. Antibiotics contained Cefazolin and Gentamicin were administrated daily since perioperative period to 4 weeks after surgery. The titanium plate and adjacent vertebra were removed surgical y at various postoperative time points (4, 8, 12, 24 weeks) when the dogs were kil ed. The excised tissues and retrieved implants were cultured with conventional bacteria, bacteria 16S rRNA and specific Nuc gene of Staphylococcus aureus. PCR and bioluminescence imaging technique were used to detect the presence of bacteria.
RESULTS AND CONCLUSION:The surgical wound was healed uneventful y. Gross observation and MRI examination of the specimens showed that there was no abscess formation or signs of infection recurrence. The infection rate was 41.7%(10/24) and 75%(18/24) in the procedure of conventional bacteria and bacteria 16S rRNA cultivation. The results showed that the sensibility of PCR technique used to detect the presence of bacteria by amplifying the highly conservative gene sequence of 16S rRNA was significantly higher than that of conventional bacterial cultivation procedure (P<0.05). The PCR detection of specific Nuc gene of Staphylococcus aureus showed the existence of Staphylococcus aureus (1/24). However, Staphylococcus aureus Xen29 with genetic marker was not detected around the implant by bioluminescence imaging technique (0/24). Al of the results showed that bacterium adhering to prosthesis in vivo is an universal phenomenon. The bacteria identified from prosthesis which was taken during the surgery and the bacteria by which the spine was infected before the surgery was not homologous. The one-stage debridement, autogenous bone grafting and anterior titanium plate internal fixation is safe and effective in the management of pyogenic spinal infections. Using of internal fixator can not lead to recurrence or persistence of infection.

Objective To investigate the effects of 2-methoxyestradiol (2-ME) on the proliferation and apoptosis of a mouse malignant melanoma cell line B16,and to explore their mechanism.Methods B16 cells were cultured in vitro,and divided into a negative control group receiving no treatment and several intervention groups treated with 2-ME at final concentrations of 5,10,20,40 mmol/L,respectively.After different durations of treatment,inverted phase-contrast microscopy was conducted to observe the morphologic change of B16 cells,sulforhodamine B (SRB) assay to evaluate proliferative activity and to draw growth curve of B16 cells according to the absorbance value at 490 nm,flow cytometry to detect cell cycle and apoptosis,and reverse transcription PCR and real-time PCR were performed to measure the expressions of the apoptosis-inducing gene gadd45b and proto-oncogene c-myc.Results As repeated measures analysis of variance showed,there were significant differences in the inhibitory effect on B16 cell proliferation among different concentrations (5,10,20,40 mmol/L) and different treatment durations (24,48,72 hours) of 2-ME (F =1170.94,1843.04,respectively,both P ＜ 0.01),and there was a significant interaction effect between these concentrations and treatment durations (F =272.79,P ＜ 0.01).After 48-hour treatment with 2-ME at 10,20 and 40 mmol/L,the apoptosis rate of B16 cells was increased to (4.13 ± 1.12)％,(11.25 ± 2.380)％ and (19.46 ± 2.9)％ respectively,compared to (0.23 ± 0.5)％ in the negative control group (all P＜ 0.01); the proportion of B16 cells in G0/G1 phase was increased to (59.5 ± 5.6)％,(63.4 ± 8.2)％ and (70.8 ± 4.4)％ respectively,compared to (44.1 ± 3.4)％ in the negative control group.There was a significant difference in the proportion of B16 cells in G0/G1 phase among the negative control group and intervention groups (F =13.56,P ＜ 0.05).Moreover,the mRNA expression of gadd45b was significantly enhanced after 24-hour treatment with 2-ME at concentrations of 20 and 40 mmol/L (both P＜ 0.01),while that of c-myc was significantly weakened after treatment with 2-ME at 10,20 and 40 mmol/L (all ＜ 0.05) compared with the negative control group.Conclusion 2-ME can inhibit the proliferation of B16 cells in vitro,upregulate the expression of gadd45b gene and downregulate the expression of C-myc gene.

Aim To study the effect of (S) -1, 8-(2-methyl phosphate ethoxy )-6-fluorine-7-( 4-methyl- pi-perazine-1-base )-3-[ S-benzyls-based-4-( for nitroben-zene methylene group amino )-1 , 2 , 4-all triazole-3 base]-quinoline ( 1-H )-4-ketone ( M18 ) on apoptosis of hepatocarcinoma SMMC-7721 cells in vitro. Meth-ods With different concentrations of M18 at different time used to treat SMMC-7721 cells, human breast cancer MB-231cells, human colon cancer HCT-116 cells, human hepatocarcinoma HEPG-2 cells, mouse bone marrow mesenchymal stem cells ( BMSCs ) in vitro,the inhibition effects of M18 on cell proliferation were examined by MTT assay. Cell apoptosis was de-termined using Hoechst 33258 fluorescence staining and TUNEL method. Mitochondrial membrane poten-tial (△ψm ) was measured using a high content screening image system. Protein expression of caspase-3 , p53 and cytochrome C was detected with Western blot analysis. Results Treatment with M18 ( 4 ~32μmol·L-1 ) potently inhibited the proliferation of the cancer cells in time-and dose-dependent manners ( the IC50 value at 24 h in SMMC-7721 cells, MB-231cells,
HCT-116 cells and HEPG-2 cells was 8. 65 μmol · L-1 , 9. 37 μmol · L-1 , 12. 74 μmol · L-1 and 9. 40μmol · L-1 , respectively ) . In contrast, M18 had weak cytotoxicity against BMSCs with IC50 value of 38. 96 μmol·L-1 . Levofloxacin had weak cytotoxicity against SMMC-7721 cells with IC50 value of 735. 10μmol·L-1 . Treatment of SMMC-7721cells with differ-ent concentrations of M18 for 24 h increased the per-centage of the apoptosis cells ( P <0. 05 ) and de-creased the mitochondrial membrane potential. In ad-dition, M18 increased protein expression of p53, caspase-3 and the cleaved activated forms of caspase-3 in SMMC-7721 cells. Treatment of SMMC-7721 cells with M18 significantly increased cytochrome C in the cytosol, and decreased cytochrome C in the mitochon-drial compartment. Conclusion The mitochondrial-dependent pathways are involved in M18 induction of apoptosis of SMMC-7721 cells.

Objective To study the correlation between the cytochrome P450 3A5 gene polymorphism and essential hypertension (EH) in Chinese population .Methods The real-time PCR genotyping at CYP3A5*3(6986A>G) position was established using Taqman minor groove binding (MGB) probes .Total 170 EH patients and 193 matched controls of Chinese Han population were genotyped at CYP3A5*3(6986A>G) position using this method .Results The GG ,GA ,AA genotyped frequencies were 51 .2% , 42 .4% and 6 .5% for the EH patients and 39 .9% ,50 .8% and 9 .3% for the control group respectively .The risk of EH for person carrying GG genotype was 1 .579 fold of the persons carrying at least one A allele(95% CI:1 .041-2 .395) .Conclusion CYP3A5*3(6986A>G) polymorphism may be associated with EH in Chinese population .The risk of EH is decreased in the persons carrying allele A ,slightly lower levels of systolic blood pressure exists .