Objective To compare the efficiency of gauze packing , internal iliac artery ligation and tran-scatheter arterial embolization for controlling pelvic fracture hemorrhoea .Methods The clinical data of 23 consecu-tive patients with pelvic fracture hemorrhoea were retrospectively analyzed .There were 8 patients who had undergone gauze packing,6 patients undergone artery ligation ,9 patients undergone angioembolization .The ISS,the preoperative shock index ,the operation time of control the shock ,the postoperative blood transfusion ,the days in ICU after opera-tion and the complication were all recorded respectively .Results The operation time of control the shock ,the postop-erative blood transfusion and the days in ICU after operation of the packing group were ( 70.00 ±24.50 ) min, (1 050.00 ±207.02) mL and (10.12 ±1.64) d;the ligation group were (40.83 ±12.01) min,(1 800.00 ± 400.00)mL and (11.17 ±1.72)d;the angioembolization group were (91.67 ±22.64)min,(1 644.44 ±421.64) mL and (7.22 ±1.56)d.The difference between the three groups had statistical significance with the indexes above all(F=10.323,9.265,12.235,all P<0.05),and the ligation group had the shortest operation time to control the shock,the packing group had the least postoperative blood transfusion ,the angioembolization group had the shortest days in ICU after operation .There were 4 cases in the packing group suffering the infection ,the infection rates as high as 50%,one of them died on the 8d;there were one case in the ligation group died of MODS on the 11th day. Conclusion The gauze packing is a sample and effective hemostasis ,suitable for the patients with open fracture and the fist aid for pelvic fracture in the basic level hospitals;the internal iliac artery ligation can control the shock timely but the hemostatic efficacy is not better than the other two kinds of operation; the transcatheter arterial embolization has micro injury and effective hemostatic efficacy ,however ,the strong profession and the lage difficulty may delay the patients'condition .So the doctors should use the methods of hemostasis flexiblely and comprehensively .

Objective To compare the short and long term effect of knee osteoarthritis treatment with two therapeutic methods which are simple high cut of fibula and arthroscopic lavage debridement combined with fibular osteotomy.Methods Data of 45 consecutive patients with knee osteoarthritis were retrospectively observed and selected,and then they were divided into two groups according to the operation method.23 patients with simple high cut of fibula were selected as the control group,and 22 patients with arthroscopic lavage debridement combined with fibular osteotomy were selected as the observation group.Results The VAS and AKS scores of the control group at the time of 3m,6m,1 2m were (4.1 3 ±0.76)points,(1 07.04 ±21 .53)points;(2.70 ±0.64)points,(1 41 .1 7 ±1 2.57)points;(2.43 ±0.79)points,(1 48.26 ±5.81 )points;and the scores of the observation group were (3.45 ± 0.60)points,(1 26.64 ±1 4.24)points,(2.70 ±0.73)points,(1 46.45 ±7.26)points,(2.41 ±0.85)points and (1 48.26 ±5.81 )points.The differences between the two groups were statistically significant at the time of 3 months after surgery(t =3.32,-3.62,all P <0.05),the effect of observation group was better than the control group;but the other indices had no statistically significant differences (t =0.51 ,-1 .72,0.1 1 ,-0.20,all P >0.05 ). Conclusion The simple high cut of fibula with small trauma,less cost,less surgical difficulty,and long -term clini-cal curative effect is not less than the arthroscopic lavage and debridement combined with fibular osteotomy.There-fore,it should be carried out in the primary hospitals widely.

Two new sesquiterpenoids, named as tyromols A and B (1 and 2), were isolated from cultures of basidiomycete Tyromyces chioneus, along with two previously reported 15-hydroxy-6 α, 12-epoxy-7β, 10αH, 11βH-spiroax-4-ene (3) and agripilol C (4). Compounds 1-4 were separated and purified by silica gel, RP-18, Sephadex LH-20 column chromatography. Their structures were elucidated on the basis of extensive spectroscopic analysis including IR, MS, 1D and 2D NMR experiments.

BACKGROUND:Studies have shown that sacral nerve-root stimulation based on anodes block technique can effectively reconstruct the bladder voiding function of the rabbits with spinal cord injury. But the corresponding technology of stimulating electrode has not been reported so far.
OBJECTIVE:To design and develop the stimulating electrodes matching with both rabbit sacral nerve roots and anodal blocking technique, to observe the ultrastructure and morphological change of rabbit sacral nerve roots which implanted in electrode stimulation for a long-term and to assess the safety of stimulating electrodes.
METHODS:Thirty New Zealand rabbits were included, 10 rabbits were randomly selected from them and sacrificed after anesthesia, and then cut the anterior roots of bilateral S 2 and S 3 immediately;after measuring the diameter under the light microscope, the sleeve type stimulation electrode matched with the diameter was made. The remaining 20 rabbits were randomly divided into control group and implantation group, with 10 rabbits in each group. In the implantation group, the stimulating electrodes were implanted into the forepart of S 2 and S 3 nerve roots after anesthesia, and then sacrificed after fed for half a year for col ecting the samples. Then ultrastructure change of sacral nerve roots with the implantation was observed.
RESULTS AND CONCLUSION:Structure of nerve cel s of sacral nerve roots remained in good condition under a light microscope after long-term implantation of the stimulating electrodes. No obvious degeneration of axons, no inflammatory infiltration and glial scar formation were observed. In the implantation group, myelins arranged closely without demyelination phenomenon, and there was no atrophy of neuronal nuclear, no nuclear sag, no increased nuclear decompression and heterochromatin in neurons under the light microscope. Immunohistochemical analysis showed, compared with the control group, there were no significant differences in the expressions of glial fibril ary acidic protein, Bax, Bcl-2 and Caspase-3 proteins of nerve roots in the implantation group. The stimulation electrode of rabbit sacral nerve root is developed successful y, that is, the implantation is simple and safe as it can be used for long-term implantation without histopathological changes and apoptosis.

Objective To establish a method of inducing dendritic cells(DC)from rat bone marrow cells in vitro,and identify the phenotype and function characteristics.Methods The rat bone malToW cells were collected and cultured in vitro under the condition of recombinant rat GM-CSF(rrGM-CSF)and recombinant rat IL-4(rrIL-4).After 2 weeks,the morphological character of DCs was observed under light microscope and scanning electron microscope.Expression of MHC-Ⅱ,CD80 and CD86 were detected by flow cytometry.The ability to stimulate allogenic T cells of the cultured DCs was detected by mixed lymphocyte reaction.Results DCs showed typical morphology with elongated dendritic processes under inversion microscope and scanning electron microscope.DCs at day 6 revealed immature phenotype,including MHC-Ⅱ(29.03 ±4.39)%,CD80(21.98±7.08)%and CD86(25.94±6.80)%.DCs at day 12 showed higher expression of MHC-Ⅱ(74.05±5.97)%,CD80(79.85±6.53)%and CD86(81.00±7.47)%,and stimulatory capacity of allogenic T cells,compared with that in DCs at day 6.Conclusion Matured DCs could be generated from rat bone marrow cells and attendance with rrGM-CSF and rrIL-4,which present the feasibility for further research on its application to allograft immunorejection.

OBJECTIVE: To investigate the effects of PUW (a fraction containing 60% corilagin from a Chinese herbal plant Phyllanthus urinaria) on thrombosis and coagulation system. METHODS: Myers's method was used to evaluate the protection of intravenously administered PUW against the male mouse sudden death caused by injection of 75 mg/kg arachidonic acid in the tail vein; Charlton's method was modified to observe antithrombotic effect of PUW in rat electrically stimulated carotid artery thrombosis model; and the model of venous thrombosis was produced to investigate the antithrombotic effect of PUW. Rosette assay was used to observe the effect of PUW on platelet-neutrophil adhesion. The effects of PUW were monitored on euglobulin lysis time (ELT), prothrombin time (PT), kaolin partial thromboplastin time (KPTT), and bleeding time (BT) in rats, according to the methods of Kowalski, HUANG Zheng-Liang, and GU Yue-Fang, et al, respectively. RESULTS: The results showed that PUW administered intravenously significantly decreased the mouse mortality, prolonged the occlusion time of rat carotid arteries, and reduced the wet and dry thrombus weight of the inferior vena cava, respectively. PUW markedly inhibited the binding of activated platelets to neutrophils, obtaining 39.7 mg/L of the medium inhibitory concentration. Intravenously administered PUW significantly shortened ELT, prolonged KPTT while had no influence on PT; PUW increased BT in rat tail tips but the BT caused by PUW was much shorter than that by aspirin or urokinase. CONCLUSION: It is suggested that PUW has the potential of antithrombosis due to its inhibition of platelet-neutrophil adhesion. PUW shows the tendency to bleeding, however, it could not cause serious bleeding side effect as compared with aspirin or urokinase.

Previous studies suggest that NGAL (neutro phil gelatinase-associated lipocalin) is involved in the transformation and development of esophageal carcinoma. Alteration of NGAL expression can trigger the change of cellular morphology in esophageal carcinoma cells. However, the mechanisms remain unclear. To get a better understanding of NGAL function in esophageal carcinoma, NGAL protein was expressed in methylotrophic yeast, Pichia pastoris, and purified by chromatography. EC1.71 cells expressed high levels of NGALR (NGAL receptor) and EC109 cells expressed low levels of NGALR were used as cells model. The trafficking and the possible function of NGAL protein were then analyzed in the esophageal carcinoma cells. The results showed that 5-FAM-labeled recombinant NGAL protein could internalize into the EC1.71 and EC109 cells. Furthermore, the internalized NGAL protein could induce the alteration of cellular morphology, resulting in generation of autophagosome, transcriptional up-regulation of genes associated with autophagy and increase of phospho-ERK1/2 (p-ERK1/2). Interestingly, the treatment with the NGAL protein did not affect the intracellular iron level. These data indicate that induced autophagy by exogenous NGAL protein is a mechanism that internalized NGAL plays important roles in esophageal carcinoma cells, independent with NGAL-mediated iron transport process, while ERK1/2 signal pathway is involved in activation of autophagy by exogenous NGAL protein.

Objective To investigate the clinical effect of laparoscopic splenectomy combined with pericardial devascularization for the treatment of portal hypertension.Methods The retrospective cross-sectional study was conducted.The clinical data of 310 patients with portal hypertension who underwent laparoscopic splenectomy combined with pericardial devascularization in the Tangdu Hospital of Fourth Military Medical University between January 2012 and June 2016 were collected.All the patients underwent laparoscopic splenectomy combined with pericardial devascularization.Observation indicators:(1) surgical and postoperative situations;(2) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the gastrointestinal rebleeding and postoperative survival of patients up to January 2017.Measurement data with normal distribution and skewed distribution were respectively represented as average number (range) and M (range).Results (1) Surgical and postoperative situations:all patients underwent successful operation.Twelve patients converted to open surgery due to intractable bleeding and 298 underwent totally laparoscopic splenectomy combined with pericardial devascularization.Average operation time,average volume of intraoperative blood loss,average time of gastrointestinal function recovery and average time of postoperative abdominal drainage-tube removal of 310 patients were 192.5 minutes (range,120.0-300.0 minutes),402.3 mL (range,150.0-1 200.0 mL),2.4 days (range,1.0-4.0 days) and 4.2 days (range,2.0-8.0 days),respectively.Among 11 of 310 patients with postoperative complications,1 died of acute severe hemorrhage of upper digestive tract,5 with intra-abdominal bleeding received successful hemostasis (3 undergoing reoperation and 2 undergoing conservative treatment),2 with pleural effusion were improved by thoracentesis and drainage,2 with pancreatic leakage and 1 with pulmonary infection were cured by conservative treatment.Other 299 patients didn't have postoperative complications.Duration of postoperative hospital stay of 310 patients was 6.4 days (range,5.0-9.0 days).(2) Follow-up situations:260 of 309 patients were followed up for 6-60 months,with a median time of 26 months.During the follow-up,1 patient died of acute portal vein thrombosis at 1 month postoperatively;15 with gastrointestinal rebleeding and melena were cured by conservative treatment;other patients had survival.Conclusion Laparoscopic splenectomy combined with pericardial devascularization for the treatment of portal hypertension is safe and effective.

Objective To study the efficacy and safety of Shuganjieyu capsule alone or in combination with other antidepressants for the treatment of post-stroke depression (PSD).Methods Wanfang database,China National Knowledge Infrastructure (CNKI),Chinese VIP journals database,PubMed,EMbase,Cochrane Library,and Chinese dissertations full text database were retrieved by computers.The randomized controlled trials (RCTs) on Shuganjieyu capsule for the treatment of PSD from January 1995 to September 2017 were collected.After literature screening,data extraction,and methodological quality evaluation,RevMan 5.1 software was used to conduct a Meta-analysis.The bias was evaluated with the Stata 12.0 software using Begg's rank correlation and Egger's linear regression.Results A total of 19 RCTs were included,including 1 814 participants.The Meta-analysis results showed that compared with other antidepressants,there were no significant differences in the effective rate and cure rate of Shuganjieyu capsule (combinedeffects:RR=1.04 [95％ CI0.97-1.11],Z=0.99,P=0.32 and RR =1.06 [95％ CI 0.85-1.32];Z =0.52,P =0.60).Compared with other antidepressants,there were significant differences in the effective rate and cure rate of Shuganjieyu capsule in combination with other antidepressants (combined effects:RR =1.19 [95％ CI 1.13-1.26];Z =6.43,P ＜0.01 and RR =1.54 [95％ CI 1.26-1.88];Z =4.17,P ＜0.01).The incidence of adverse events of Shuganjieyu capsule alone was less than that of other antidepressants (combined effect:RR =0.39 [95％ CI 0.27-0.55];Z =5.30,P ＜ 0.01).The incidence of adverse events of Shuganjieyu capsule in combination with other antidepressants was the same as other antidepressants (combined effect:RR =0.99 [95％ CI 0.77-1.26];Z =0.10,P =0.92).Conclusions Shuganjieyu capsule is effective for post-stroke depression.The efficacy of Shuganjieyu capsule alone is as effective as other antidepressants,however,Shuganjieyu capsule in combination with other antidepressants is superior to other antidepressants,and the safety is better than other antidepressants.

Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on social function and life quality of schizophrenia in long-term hospitalization.Methods Sixty patients met with ICD-10 for schizophrenia in long-term hospitalization were enrolled in this study.The group was divided randomly into research (n =40) and control (n =40) groups.They were given rTMS or sham stimulation,respectively.The treatment was given 20 times,and the course of treatment was 4 weeks.The research and control groups were assessed with measured the scale of social function in psychosis inpatients and personal and social function scale and schizophrenia quality of life scale before and'after 4 weeks treatment.Each test result of all groups before and after treatment was compared with each other,respectively.Results Compared to rTMS before treatment,the study group scale of social function in psychosis inpatients (SSPI) total score,factor Ⅰ,Ⅱ and personal and social function scale (PSP) scores were significantly increased (P ＜ 0.05),no change of SSPI factor (P ＞ 0.05);the study group Schizophrenia Quality of Life Scale (SQLS) total score,psychological and social power,the energy scale scores were significantly reduced (P ＜ 0.05),SQLS symptoms and side effects scale showed no significant difference (P ＞ 0.05).No significant change was found in the scores of project SSPI,PSP and SQLS in control group before and after treatment (P ＞ 0.05);the difference of each parameter between two groups after treatment were statistically significant (P ＜ 0.05).Conclusions Repetitive transcranial magnetic stimulation could improve on social function and life quality of schizophrenia in long-term hospitalization,rTMS could provide a new way for the individual rehabilitation of schizophrenia in long-term hospitalization.