Objective To study the expressions of matrix metalloproteinase-1 3 (MMP-1 3)and p73 in gastric adenocarcinoma,and to explore the associations of the expressions of MMP-1 3 and p73 with the clinico-pathological features,and to evaluate their clinical significances for the prognosis of gastric adenocarcinoma metastasis.Methods The immunohistochemistry SP methods was used to evaluate the expressions of MMP-1 3 and p73 in 1 43 cases of gastric adenocarcinoma and 55 normal tissues adjacent to carcinoma,and their associa-tions to the clinicopathologic features were analyzed.Results The expression of MMP-1 3 in gastric adenocarci-noma was significantly higher than that in adjacent tissues of cancer (67.1 3% vs 1 6.35%),with a significant difference (χ2 =41 .1 0,P =0.000).The expression of p73 in gastric adenocarcinoma was significantly higher than that in adjacent tissues of cancer (58.74% vs 1 2.73%),with a significant difference (χ2 =33.86,P =0.000).In the gastric adenocarcinoma,the expression of MMP-1 3 was associated with peripheral lymph node metastasis (χ2 =1 1 .835,P =0.001 ),depth of invasion (χ2 =5.1 77,P =0.032)and TNM stage (χ2 =1 1 .1 07,P =0.001 ),but it was not correlated with the ages of patients (χ2 =0.1 1 3,P =0.853),tumor size (χ2 =0.338,P =0.591 )and tumor differentiation level (χ2 =3.628,P =0.072).In the gastric adenocarci-noma,the expression of p73 was associated with peripheral lymph node metastasis (χ2 =1 1 .440,P =0.001 ), tumor differentiation level (χ2 =5.407,P =0.025)and TNMstage (χ2 =9.497,P =0.003),but it was not correlated with the ages of patients (χ2 =1 .567,P =0.222),tumor size (χ2 =0.841 ,P =0.392)and depth of invasion (χ2 =0.554,P =0.498).The expression of MMP-1 3 was positively correlated with the expression
of p73 in gastric adenocarcinoma group (r =0.684,P =0.000).Conclusion Both MMP-1 3 and p73 may participate in the development of gastric adenocarcinoma,which can be used as an important index for the eval-uation of invasiveness and metastasis in gastric adenocarcinoma.

Objective:To evaluate the effect of remimazolam combined with remifentanil used for painless gastroscopy.Methods:A total of 150 patients of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 18-64 yr, with body mass index of 18-30 kg/m 2, scheduled for elective painless gastroscopy, were divided into 3 groups ( n=50 each) using a random number table method: propofol combined with remifentanil group (group P), remimazolam 0.3 mg/kg combined with remifentanil group (group R1) and remimazolam 12 mg combined with remifentanil group (group R2). Drugs were administrated according to body weight, and calculation was carried out according to ideal body weight.Remifentanil 0.25 μg/kg was injected intravenously, propofol 1.5 mg/kg was then injected intravenously in group P, remimazolam 0.3 mg/kg was injected intravenously in group R1, and remimazolam 12 mg was injected intravenously in group R2.When Modified Observer′s Assessment/Alertness and Sedation (MOAA/S) score was≤3, gastroscopy was performed.It was defined as sedation failure when MOAA/S score was still ≥4 at 3 min after administration of propofol or remimazolam.When intraoperative body movement occurred, 1/4 of the initial dose of propofol was injected intravenously in group P, 1/4 of the initial dose of remimazolam was injected intravenously in group R1, and remimazolam 2.5 mg was injected intravenously in group R2 to maintain MOAA/S score ≤3.It was defined as sedation failure when sufficient sedation was not maintained after the additional drugs were given more than 3 times within 15 min.The success of sedation, time for gastroscopy, emergence time and discharge time were recorded.The occurrence of intraoperative body movement, bradyeardia, hypotension, respiratory depression, hiccup, coughing and injection pain was recorded. Results:Compared with group P, no significant change was found in the success rate of sedation ( P>0.05), and the incidence of intraoperative body movement, bradyeardia, hypotension, respiratory depression, hiccup, coughing and injection pain was decreased in group R1, and the success rate of sedation was significantly decreased, the incidence of intraoperative body movement, bradyeardia, hypotension, respiratory depression, coughing and injection pain was decreased, and the incidence of hiccup was increased in group R2 ( P<0.05). Compared with group R2, the success rate of sedation was significantly increased, and the incidence of intraoperative body movement, coughing and hiccup was decreased in group R1 ( P<0.05). Conclusion:Remimazolam 0.3 mg/kg combined with remifentanil can be safely and effectively used for painless gastroscopy.

Objective To investigate the 3D reconstruction of multislice spiral CT technology applications in the diag-nosis and postoperative ankle fracture assessment. Methods DR using X-ray and 3D reconstruction of multislice spiral CT technique in patients with ankle fractures preoperative examination and classification, for review after observing the quality of reduction and fixation into quality. Results Preoperative DR typing results compare with intraoperative find-ings, PAB, PER, SAB SER type Kappa values were 0.76, 0.80, 0.77, 0.75, had a good consistency . Preoperative CT reconstruction with intraoperative findings result of the comparison , PAB, PER, SAB SER type Kappa values were 1, 0.92, 0.90, 0.90, excellent consistency, CT reconstruction typing and intraoperative findings consistent results. The sensitivity and specificity were far superior to DR. DR and CT reconstruction after treatment in PAB, PER, SER type reset mass were significantly different (P<0.05), CT three reconstruction PER, fixed into the SER type mass was signif-icantly different (P<0.05). Conclusion Spiral CT reconstruction of ankle fracture before surgery and postoperative re-duction treatment, quality assessment and internal fixation into a higher accuracy than the X-ray examination, and more reliable.

Objective To summarize the effect of eye socket reconstruction in patients with severe depressed eye socket combined anophthalmos and to assess the methods of eye socket reconstruction.Methods Forty patients of severe depressed eye socket combined anophthahnos,from Oct,2001 to Mar,2014,underwent eye socket reconstruction in Beijing Tongren Hospital.Thirty four eye sockets were reconstructed with free flap,the scapular flap in 2 cases,the forearm flap in 17 cases,the lateral arm flap in 15 cases.The reversed submental island flap was utilized in 2 patients.The other 4 cases were treated by implant-retained orbital prosthesis.Results All the patients were followed up for more than 2 years.The flaps survived.The artificial eye could be fitted satisfactorily and the appearance of the ill eye socket was improved significantly.The implant-bodies in orbital bone and the prosthesis were stable without peri-implantitis.Conclusions The flap transfer is effective for eye socket reconstruction in patient with severe depressed eye socket combined anophthalmos.The implant-retained orbital prosthesis is also alternative.The treatment choice must be based on the patient 's own conditions.

ObjectiveTo explore the antidepressant effect of Sophora flavescens seed extract and its molecular mechanism. MethodA mouse depression model was established by intraperitoneal injection of lipopolysaccharide（LPS）， and normal group， model group， fluoxetine group（2.5 mg·kg^-1）， and S. flavescens seed low， medium and high dose groups（200， 400， 800 mg·kg^-1） were set up for 7 d of consecutive gavage. Then the antidepressant effect of S. flavescens seed extract was evaluated by using open field test， elevated plus maze test and forced swimming test. Pathological morphological changes in the hippocampal tissue was observed by hematoxylin-eosin（HE） staining. Protein expression levels of G₁/S-specific cyclin D₁（Cyclin D₁）， Wnt1， β-catenin and phosphorylated glycogen synthase kinase-3β（p-GSK-3β） in mouse brain tissues were detected by Western blot. Hippocampal cell apoptosis was detected by terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate（dUTP） nick end labeling（TUNEL）. ResultThe results of mouse behavioral experiments showed that compared with the normal group， the speed of movement in the open field and the distance of movement in the central area of the open field， and the time spent on the open arms of the elevated plus maze were significantly reduced in the model group（P<0.01）， while immobility time in the forced swimming test was significantly increased（P<0.05）. Compared with the model group， the S. flavescens seed medium and high dose groups had increased speed of movement in the open field test and time spent on the open arms of the elevated plus maze test（P<0.05， P<0.01）， and decreased immobility time in the forced swimming test（P<0.05）， the distance of movement in the central area of the open field test increased in the high dose group（P<0.05）. HE staining results showed that compared with the normal group， the hippocampal neuron structure of mice in the model group was damaged. Compared with the model group， after treatment of S. flavescens seed extract， the pathological state of the mouse hippocampal neuron structure was alleviated， and the neurons increased， were neatly arranged， and the cytoplasm was clear. Western blot results showed that the protein expression levels of Wnt1 and β-catenin in mouse brain tissue were significantly decreased（P<0.01）， while the protein expression levels of Cyclin D₁ and p-GSK-3β were significantly increased（P<0.01） after LPS injection. Compared with the model group， protein expression levels of Wnt1 and β-catenin in brain tissue of S. flavescens seed medium and high dose groups were significantly increased（P<0.01）， while the protein expression levels of Cyclin D₁ and p-GSK-3β were significantly decreased（P<0.01）. TUNEL staining results showed that the hippocampal cell apoptosis rate in the model group was significantly increased compared with that of the normal group（P<0.01）， while the hippocampal cell apoptosis rate in the S. flavescens seed medium and high dose groups was significantly decreased compared with that of the model group（P<0.01）. ConclusionS. flavescens seed extract can effectively improve the severity of depression in LPS-induced depressed mice， and its molecular mechanism is related to the regulation of neuroinflammation and hippocampal neuronal apoptosis mediated by Wnt/β-catenin signaling pathway.