Objective To explore the anti-inflammatory and anti-angiogenic effect of miR-15a in diabetic retinopathy(DR).Methods High glucose model(HG)was established by treatment with 25 mmol/L glucose in human retinal pigment epithelial cell line HARPE-19,and HARPE-19 cells treated with 5 mmol/L glucose served as control(LG).HG group and LG group were divided into 4 subgroups:miR-15a mimic group,NC-mimic group,miR-15a inhibitor group and NC-inhibitor group.Cell proliferation ability was detected by MTT proliferation assay.Cell migration ability was detected by cell scratch assay.The relationship between miR-15a and ASM was identified by 3′UTR luciferase reporter assay.miR-15a,ASM,VEGF,IL-1β,IL-6,TNF-α mRNA expression was detected by RT-PCR method.Results In NC-mimic cells and NC-inhibitor cells,the expression of miR-15a in HG group was significantly lower than that in LG group(all P<0.05).The expression level of ASM mRNA in miR-15a mimic group was significantly lower than that in NC-mimic group (P<0.05),the expression level of ASM mRNA in miR-15a inhibitor group was significantly higher than that in NC-inhibitor group (P<0.05).The cell scratch width in miR-15a mimic group was significantly higher than that in NC-mimic group(P<0.05).The cell scratch width in miR-15a inhibitor group was significantly lower than that in NC-inhibitor group(P<0.05).The absorbance value in miR-15a mimic group was significantly higher than that in NC-mimic group(P<0.05),the absorbance value in miR-15a inhibitor group was significantly lower than that in NC-inhibitor group(P<0.05).In NC-mimic cells and NC-inhibitor cells,the mRNA expression levels of VEGF,IL-1β,IL-6 and TNF-α in HG group was significantly higher than those in LG group(all P<0.05).Conclusion miR-15a downexpression induces inflammatory reaction and angiogenesis in retinal cells.miR-15a is involved in the pathogenesis of DR by dual regulation of inflammation and angiogenesis.

Objective To explore the technique and clinical outcome of the atlantoaxial pedicle screw system in the treatment of the unstable atlantoaxial dislocation post traction.Methods The study involved 32 patients with atlantoaxial dislocation(type T2 of TOI classification)admitted from March 2005 to September 2009.There were 17 patients with fresh odontoid fracture and two with old odontoid fracture,five with traumatic disruption of the transverse atlantal ligament and eight with congenital odontoid dysplasia.JOA scores of neurological function before operation was at a range of 5-13(average 8.38).The average of space available for the cord(SAC)was 9.15 mm.Before the atlantoaxial pedicle screw system was carried out,the skull traction was performed in all the patients preoperatively.Results A total of 128 pedicle screws were inserted safely,with mean operation time and perioperative blood loss for 1.5 hours and 300 ml,respectively.No injury to the vertebral artery or spinal cord was observed.All the patients were followed up for 12-24 months,which showed that JOA scores one year after operation was increased to 10-17(average 14.56),with the improvement rate of 71.70%,and that the SAC was average 14.86 mm.The X-ray and SCT scans verified the proper position of the screws,with no internal fixation failure or atlantoaxial redislocation.After 3-6 months,all the patients except for one patient achieved a solid bone fusion.One year after operation,the one patient with no bone graft fusion was removed of the internal fixation system and obtained satisfactory restoration of the rotational function.Conclusions Atlantoaxial pedicle screw system is an effective method for the treatment of the unstable atlantoaxial dislocation post traction,for it has the advantages of stable three-dimension fixation,direct screw placement,intraoperative reduction and high fusion rate.

BACKGROUND:Perioperative treatment of emergency liver transplantation for acute hepatic failure is extremely different from common liver transplantation, due to complex conditions, high risk, several complications, and high mortality. OBJECTIVE:To summarize the experience of emergency liver transplantation for acute hepatic failure during the perioperative period, and to increase the success rate in treatment of acute hepatic failure. METHODS:A retrospective analysis was undertaken on the clinical data of 38 cases undergone emergency liver transplantation for acute hepatic failure. There were 21 male and 17 female, who aged 15-69 years. Among them, 23 cases had hepatitis B virus (including 2 cases with hepatitis B and C virus), 7 cases had Wilsons disease, 3 cases had mushroom poisoning, 2 cases had unknown liver damage, 1 case had Tripterygium wilfordi poisoning, 1 case had decompensation after partial liver resection due to trauma, and 1 case had liver transplantation from corpse. RESULTS AND CONCLUSION:The survival time of the involve patients was 13-1 740 days, and the median survival time was 634 days. Perioperative survival rate was 76%, 1-year survival rate was 63%, and 2-year survival rate was 58%. During the perioperation nine cases died of brain edema and intracranial hypertension, renal failure, severe pulmonary infection, multiple organ failure, coagulation disorders (intracranial hemorrhage, upper digestive tract hemorrhage), acute respiratory distress syndrome and primary graft non-function. At present, emergency liver transplantation is stil the most effective way for acute liver failure. Hemorrhage, infection and rejection are the leading causes of the death. Each perioperative treatment is of great significance for the success of liver transplantation and long-term survival.

ObjectiveTo determine whether there is correlation between the pathological classification and urinary level of transforming growth factor(TGF)-β1,macrophage inflammatory protein (MIP)-1α,and Neutrophil gelatinase-associated lipocalin (NGAL) of lupus nephritis.MethodsELISA was used to test the levels of urinary level of TGF-β1,MIP-lα and NGAL.The correlation between these three urinary markers and the pathological classifications,Austin score,histological semi-quantitative score and clinical data were analyzed.Comparisons between groups were performed with t-test,ANOVA and X2 test.Correlation analysis was performed with Pearson analysis.Results①There was significant difference in urinary TGF- β1,MIP1α,and NGAL levels when compared the lupus nephritis group,SLE patients without renal damage group and the normal control group [TGF-β1(351±219),(92±60),(74±29) pg/ml],[MIP-1α(18.0±15.5),(8.5±2.3),(7.1±1.9) pg/ml],[NGAL (1.104±0.519),(0.181±0.030),(0.146±0.024) ng/ml],while there was no significant difference between lupus nephritis (LN) group and patients with other glomerulonephritis.② There was significant difference in the three urinary markers when stratified the LN patients based on the pathological classifications,however,there was no significant difference between the LN group and other glomerulonephritis group.③ Analysis of the correlation between the three urinary markers and semiquantitative histopathological score of the LN patients showed that the urinary level of TGF-β1 and MsMI,GCI,TCI,VCI was closely related to each other,the urinary MIP-1α was related to and endol,and the dGAI and VCI was closely related, while the urinary NGAL was closely related with endol,dGAI and MsHI.The correlation analysis between the three urinary markers and acute and chronic pathological index score of the LN patients showed that TGF- β1 was correlated with the chronic index(r=0.89,P＜0.01 ),the MIP-lα and NGAL were significantly correlated with the activity index(r=0.71,P＜0.01 ; r=0.60,P＜0.01 ).Conclusion There is a positive correlation between the urine TGF-β1 level and chronic kidney disease.The urinary MIP-lαand NGAL are associated with active renal damage.

Objective To compare the efficacy of supraclavicular approach and infraclavicular approach in ultrasound-guided brachial plexus block(BPB).Methods One hundred and twenty patients,ASA Ⅰ-Ⅲ,aged 18-80 yr,scheduled for upper extremity surgeries of both gender,were randomized into two groups(n =60):supraclavicular group(group SCB)and infraclavicular group(group ICB).The anesthetic mixture consisted of ropivacaine 0.375％ and lidocaine 1％ in equal volumes with epinephrine 1∶200 000,the total dose was 0.5 ml/kg.The block performance time,duration of anesthesia and success of anesthesia(surgery was accomplished without supplementary block)were recorded.A blinded observer assessed pinprick sensory block in the seven distal nerve territories(axillary,radial,musculocutaneous,median,ulnar,medial antebrachial and medial brachial cutaneous nerves)every 5 min up to 30 min after injection.Success of nerve block,side effects and complications were recorded during and after operalion.Results Group ICB was superior in success rate of anesthesia and nerve block of ulnar,medial antebrachial and medial brachial cutaneous nerves,the rate of parasthesia was lower and the block performance time was longer compared with group SCB(P ＜ 0.05).No major complications occurred in both groups.Conclusion Under ultrasound guidance,infraclavicular BPB is superior to supraclavicular approach.

BACKGROUND: Adipokines are secreted by adipose tissue, including a series of cytokines and chemokines. Additionally, adipokines have been found to play certain roles in pro- and anti-inflammatory regulation. OBJECTIVE: To analyze the regulatory effect of various adipokines in the inflammatory process of autoimmune response and immune diseases, thus providing the strategy for controlling and treating autoimmune diseases and searching effective indexes for assessing disease development, incidence of complications and prognosis. METHODS: CNKI and PubMed databases were retrieved for the articles addressing the role of adipokines in autoimmune diseases published from 1986 to 2016 using the keywords of adipokine, autoimmune in English and Chinese, respectively. RESULTS AND CONCLUSION: Adipose tissue plays a critical role in metabolism regulation, and its effect on the immune system has emerged through a series of studies concerning adipokines regulating immune response. Adipokines exert various functions, and regulate metabolism and inflammation. In the development and occurrence of autoimmune diseases, some factors for immune responses remain unclear, and in-depth studies on adipokines will be helpful for lifting the veil of autoimmune diseases.

Objective To study genomic polymorphic DNA and genetic distance of 7 species of ticks.\ Methods\ Ticks used in this study were Dermacentor nuttalli, D.silvarum, Haemaphysalis qinghaiensis, H.formosensis, H.punctata, Amblyomma testudinarium, and Ixodes ovatus. DNA extracts of the 7 species of ticks were amplified by random amplified polymorphic DNA (RAPD) and PCR technique using 5 primers with different arbitrary single chain polynucleotide sequences. DNA fingerprint maps were analyzed and the genetic distance among 7 species of ticks were counted. \ Results \ The amplified products of the 7 species of ticks by RAPD all showed their specific DNA band. The average genetic distance among them was 0\^71. Conclusion RAPD can differentiate the 7 species of ticks.

Evidence-based medicine(EBM)is an inevitable development tendency of clinical medicine education in 21 century.Its core thinking is to combine evidence,personal experiences and patients'actual situation.The thinking of EBM will magnificently promote the conversion of conception and model of clinical education and will make significant influence on clinical teaching,scientific research and clinical practice.

We made our specific teaching program for these students with evidence-based medicine theory,according to their teaching characteristics. They studied the research methods of evidencebased medicine,and learned to search informations,write reviews,discuss clinical cases, design subjects under the guidance of teachers. Their scientific research ability was improved after these practices and training program.

Objective To compare the effica cy of three N,N-diethyl-m-toluamide (DEET) formulations against Schistosoma japonicum infection in mice. Methods Three 10% DEET formulations (DEET isopropanol solution,DEET cr eam and DEET vaseline ointment)were prepared and two experiments, no-dipping or dipping after applying DEET preparation ,were designed. In each experiment, mice were randomly divided into three experiment groups and three control groups . D ifferent DEET preparations were applied in the experiment groups and isopropanol solution, “yumeijing” cream , vaseline ointment were applied in the control g roups, respectively. At different time points after skin application (0.5, 1, 2 , 4 h and 8 h),the mice were infected with (50?5) Schistosoma j apon icum cercariae on the abdominal skin in no dipping experiment. I n dipping experiment,after mice skin were applied and were dipped for 10,30 min, 1 ,2 h and 4 h, respectively, the mice were infected with (50?5) cercariae. Af ter 6-7 weeks ,all the mice were sacrificed and the worms were collected by hea rt perfusion and counted.Worm reduction rates were calculated and rank sum tests w ere carried out. Results In no-dipping experim ent,three DEET formulations provided 100.0% protection in mice at least for 1 h .A t 2 ,4 h and 8 h ,the worm reduction rates were 94.8%,89.9% and 13.3% for DE ET isopropanol solution, 100.0%,97.8% and 50.7% for DEET cream and 100.0%,9 9.0% and 9 8.0% for DEET vaseline oinment, respectively. In dipping experi-ment, given 50.0% wor m reduction rate as efficient in preventing penetration by the cercariae, the e ffective times were 10 min for DEET isopropanol solution,30 min for DEET cream a nd 2 h for DEET vaseline oinment,respectively. Conclusion Three DEET formulations are effectiv e in preventing Schistosoma japonicum infection in mice.DEET vaseline oinment can provide better protection than the other two D EET formulations.