The differentiating of neurons and other distinct cell types during embryonic development requires the selective activation or repressing of many different sets of genes. Gene expression patterns in neurons are modulated by multiple extracellular and intracellular stimuli. The transcriptional regulation of individual gene is mediated by small DNA sequences such as silencer and enhancer, and the expression pattern can be determined by the integration of the effects of a very large number of these cis-acting elements. These DNA elements either activate or repress promoter activity depending upon the nature of the transcription factors that bind to them. It is possible that there are different regulatory mechanisms of gene expression in the nerve system.

[Objective]To analyze the treatment effect of degenerative scoliosis. [Method]A group of degenerative scoliosis patients and their symptoms,signs,imaging,treatment,treatment outcome,statistical analysis of clinical complications were analyzed. [Result]Degenerative lumbar vertebral height was lowered by scoliosis,the facet joint X-ray showed high density,joint process,and some patients MRI imaging performance for the lumbar spinal canal stenosis,nerve root compression. [Conclusion]Scoliosis propose severe degenerative lumbar degenerative disease concept : as the result of the lumbar vertebral height lower after the annex being not parallel with the extent of the decrease is the main reason leading to degenerative scoliosis,and the pathogenesis of idiopathic scoliosis contrary,health scoliosis cause sudden stress-induced arthritis of the joints is a major reason leading to low back pain.The clinical characteristics of severe back pain and / or nerve root pain or intermittent claudication and clinical classification : degenerative scoliosis patients divided into two main types :(1) in accordance with the breakdown of the causes of scoliosis : ①physiological; ②pathological scoliosis;(2) conducted in accordance with the germs are : ①ankylosis,②non-tonic type(third degree,second degree,first degree);(3)in accordance with lumbar scoliosis :①simple shapes into curved,② lumbar curved(lumbar mainly,affect some thoracic),③combined compensatory thoracic-lumbar bends.Treatment principles :in general,under the circumstances permit for scoliosis surgery,orthopedic principles : lumbar curving not totally stressed.

Objective To systematically review the short-term and long-term efficacy of eversion carotid endarterectomy (eCEA) and patch carotid endarterectomy (pCEA) for the treatment of carotid artery stenosis.Methods The published literature on eCEA and pCEA control studies in medline,PubMed,Ovid,CNKI and CBM (1970.5-2016.10) databases were retrieved by computers.Two reviewers selected literature and extracted data independently according to the inclusion and exclusion criteria.Cochrane Collaboration Network Special Software Rev Man 5.2 was used to analyze the meta-analysis of short-term and long-term outcome measures.Results A total of 1 137 articles were retrieved.Ten studies were included and analyzed (3 of them were randomized controlled trial).A total of 3 213 patients were enrolled,including surgical intervention 3 299 case/time (1 512 in the eCEA group and 1 787 in the pCEA group).The results of meta-analysis showed that:(1) the mean operative time in the pCEA group was shorter 22±8 min than that in the pCEA group.The intraoperative utilization ratio of shunt tube,eCEA was significantly lower than pCEA,they were 12.6 %(53/421) and 50.2% (357/711) respectively (OR,0.11,95%CI 0.08-0.15,P<0.01).The postoperative incidence of stroke within 30 d (OR,0.42,95%CI 0.23-0.76,P=0.004) and the incidence of stroke after 30 d in eCEA were lower than those in pCEA (OR,0.26,95%CI 0.09-0.78,P=0.02).There was significant difference.(2) eCEA reduced the incidence of restenosis at day 30 after procedure (OR,0.57,95%CI 0.38-0.86,P=0.008).Conclusion Compared with pCEA,eCEA has the advantages of reducing the operation time and lowering the utilization rate of shunt tube.At the same time,eCEA can reduce the occurrence of stroke within 30 d and 30 d after procedure,and significantly reduce the incidence of restenosis.

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 investigate the clinical features and treatment of aggressive angiomyxoma of the genitourinary system. Methods Two cases of aggressive angiomyxoma of the genitourinary system were reviewed. One case was a 55 year old man.He presented with a painless inguinal mass which was indicated in low echo by ultrasound;and he underwent surgical complete excision.The other case was a 14 year old female presenting with frequent urination,hematuria,dysuria and urethral mass.After the IVU,CT and 3 dimensional CT examination revealed the extent and blood supply,partial cystectomy and ureteroneocystostomy were performed on her. Results The 2 patients were followed up for 2 to 6 months after surgery,with no recurrence and metastasis.Case 1 was diagnosed with aggressive angiomyxoma involving the spermatic cord and the immunohistochemical testing was positive for Vimentin and SMA,negative for Desmin and S 100.Case 2 was diagnosed with aggressive angiomyxoma of the urinary bladder and the immunohistochemical testing showed that the cancer cell was positive for CD 34 ,SMA,Vimentin,and negative for Desmin,Caldesmon,ER,PR and S 100. Conclusions Aggressive angiomyxoma is a rare,benign and locally aggressive neoplasm.The histopathologic and immunohistochemical studies reveal the definite diagnosis.The therapy is surgical excision as complete as possible.Radiotherapy combined with endocrinotherapy may be used for recurrence and difficult excision of the tumor.Long term follow up and close monitoring with imaging techniques are essential for timely identification of recurrence and for prompt resection.

Objective To evaluate the effects of isokinetic quadriceps training with different ranges of motion for improving mal-patellar tracking after total knee replacement (TKR). Methods Isokinetic quadriceps training was administered to 52 TKR cases, involving 66 knee joints with poor patellar tracking. The subjects were randomly allocated into 3 groups for isokinetic training with ranges of 0-30°, 30-60° or 60-90°, with 22 knee joints in each group. The angular velocity was set at 30°/second. X-rays with loading and with 45° knee flexion were taken before and after the training. The lateral patello-femoral angle,the patella index and the patello-femoral index were recorded along with the maximum torque ( MT), the total work ( TW ), and the average work(AW) in the three different ranges of motion. Hospital for Special Surgery (HSS) scores were also recorded. Results After 3 months of training, the average lateral patello-femoral angle, patella index, and patello-femoral index in the 0-30° training group were all significantly better than before the training. However, there was no significant difference in these measures for the 30-60° and 60-90° groups. After training average MT, TW and AW increased significantly in all groups, but the improvements were significantly correlated with the differences in lateral patello-femoral angles, patella indices and patello-femoral indices only for the 0-30°group. When compared with the baseline values, a statistically significant difference in HSS score after training was observed only in the 0-30° training group. Conclusions Isokinetic quadriceps training with a 0-30° range of motion can best realign patellar tracking after TKR, and best improve knee function.

OBJECTIVETo observe the long-term outcome of implantable cardioverter-defibrillator (ICD) implantation in Brugada syndrome patients and to explore how to reduce the frequency of ICD nappropriate schocks.

METHODSThis study included 14 symptomatic patients (mean age (44.3 ± 8.3) years old; all males) with Brugada syndrome implanted with ICD in our hospital between 1998 and 2012, and these patients were followed up routinely every 6 months. The initial ICD parameters were set according o conventional experience. The ventricular tachycardia (VT) zone was programmed to ventricular rate 150-188 bpm/cycle length (CL) 400-320 ms and the ventricular fibrillation (VF) zone was programmed to ventricular rate ≥ 188 bpm/CL ≤ 320 ms. The total events were recorded by ICD. The ICD parameters revision was made by electrophysiological (EP) experts in case of inappropriate shocks.

RESULTSPatients were followed up for mean (43.0 ± 28.3) months. A total of 297 VF/VT events were recorded by ICD. Electrophysiological experts found that 90% (178/198) episodes were true VF ( CL 130-250 ms) among of 198 VF episodes and 147 VF episodes were terminated by one shock and 21 VF events were terminated by two or more shocks, and the rest 10 VF terminated spontaneously. Only 9% (9/99) VT events were true VT (CL 320-360 ms) among of 99 VT episodes. Eight VT episodes were converted by antitachycardia pacing therapy (ATP) and the other one terminated spontaneously. The rest 90 VT episodes (91%) were supraventricular arrhythmias (SVT, CL 340-390 ms). About 90% inappropriate shocks can be reduced by Wavelet discrimination function and optimal programming (VF zone ventricular rate ≥ 222 bpm/CL ≤ 270 ms and/or VT zone ventricular rate 167-222 bpm/CL 270-360 ms ) according to the characteristics of arrhythmia of individual patient.

CONCLUSIONICD can effectively prevent sudden cardiac death and syncope in high-risk patients with Brugada syndrome. The most common complication is inappropriate shock due to SVT. Optimal ICD programming with Wavelet discrimination function can effectively reduce the frequency of inappropriate shock rate.

Adult ; Brugada Syndrome ; Cardiac Conduction System Disease ; Death, Sudden, Cardiac ; Defibrillators, Implantable ; Humans ; Male ; Syncope ; Tachycardia, Ventricular ; Treatment Outcome ; Ventricular Fibrillation

Objective To investigate the correlation between G753A and C1040T polymorphisms in the gene encoding region of thrombin-activatable fibrinolysis inhibitor (TAFI )and cerebral infarction in patients with cerebral infarction in Chinese Han population. Methods C1040T and G753A poly-morphisms in the TAFI gene encoding region in 130 patients with cerebral infarction and 118 healthy subjects (control group)were analyzed retrospectively and they were detected by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP ). Results The GG genotyping of the TAFI gene G753A polymorphism in the cerebral group was 41. 5%(n=54)and the A allele carriers were 58. 5%(n=76),while those in the control group were 44. 9%(n=53)and 55. 1%(n=65)respectively. There were no significant differences in the GG genotyping of TAFI gene G753A polymorphism and the A allele carriers between the cerebral infarction group and the control group (χ2 =0. 288,P=0. 592). In the cerebral infarction group,the CC genotyping of C1040T polymorphism was 50. 0%(n=65)and T allele carriers were 50. 0%(n=65),while those in the control group were 51. 7%(n=61)and 48. 3%(n=57)respectively. There were no significant differences in the GG genotyping of C1040T polymorphism and the T allele carriers between the two groups (χ2 =0.071,P =0.790 ). Multivariate logistic regression analysis showed that G753A and C1040T single nucleotide polymorphisms (GA or AA genotype)in the TAFI gene encoding region were not the independent risk factors for cerebral infarction. Conclusion There are no significant differences in the correlation between the G753A and C1040T polymorphisms in the TAFI gene encoding region and cerebral infarction. They are not the independent risk factors for the onset of cerebral infarction.

Objective:To explore changes of central retinal vascular caliber and fractal dimension (Df) and their cor‐relation with blood pressure in hypertensive population .Methods :A total of 2169 subjects>30 years old were en‐rolled in this cross‐sectional study .They were divided into hypertension group (n=819) and non‐hypertension group (n=1350) .Fundus photos were collected in all subjects ,and semi‐automatic software was used to quantitatively ana‐lyze central retinal vascular caliber and Df ,and they were compared between two groups .Results:Compared with non- hypertension group ,there were significant reductions in central retinal arteriolar equivalent [CRAE ,(135.2 ± 10.72) μm vs .(132.25 ± 11.56) μm] ,central retinal venular equivalent [CRVE ,(184.95 ± 16.29) μm vs . (182.52 ± 17.07)μm] and Df [ (1.38 ± 0.05) vs .(1.34 ± 0.05)] in hypertension group , P<0.01 all .After adjus‐ting for age and gender ,analysis of covariance indicated that CRAE and Df of hypertension group were still signifi‐cantly lower than those of non - hypertension group (P<0.01 both) .Linear correlation analysis indicated that sys‐tolic blood pressure (SBP) ,diastolic blood pressure (DBP) and pulse pressure (PP) were inversely correlated with CRAE and Df ( r= -0.340~ -0.174 , P<0.01 all) .After adjusting for cardiovascular risk factors ,multi‐factor linear regression analysis indicated that CRAE and Df were still inversely correlated with SBP ,DBP and PP (stand‐ardizedβ= -0.190~ -0.134 ,P<0.01 all) .Df of hypertension course >5 years group was significantly lower than that of ≤5 years group [ (1.33 ± 0.05) vs .(1.35 ± 0.05)] , P<0.01. Conclusion:CARE ,Df are significantly in‐versely correlated to SBP ,DBP and PP in hypertensive population ,while correlation of Df is most .

A unique one-step ethanol fermentation process was developed with the inulinase-producing strain Kluyveromyces marxianus YX01. Firstly, the impact of temperature on ethanol fermentation was investigated through flask fermentation, and the temperature of 35 degrees C was observed to be the optimum to coordinate inulinase production, inulin saccharification and ethanol fermentation. And then, the impact of aeration and substrate concentration was studied through batch fermentation in the 2.5 L fermentor, and the experimental data indicated that the average ethanol fermentation time was decreased at the aeration rates of 50 mL/min and 100 mL/min, but higher ethanol yield was obtained under non-aeration conditions with more substrate directed to ethanol production. The ethanol concentration of 92.2 g/L was achieved with the substrate containing 235 g/L inulin, and the ethanol yield was calculated to be 0.436, equivalent to 85.5% of its theoretical value. Finally, Jerusalem artichoke grown in salina and irrigated with seawater was fermented without sterilization treatment, 84.0 g/L ethanol was obtained with the substrate containing 280 g/L dry Jerusalem artichoke meal, and the ethanol yield was calculated to be 0.405, indicating the Jerusalem artichoke could be an alternative feedstock for grain-based fuel ethanol production.
Bioreactors ; microbiology ; Ethanol ; metabolism ; Fermentation ; Helianthus ; metabolism ; Kluyveromyces ; metabolism ; Seawater ; Temperature