Objective To evaluate the influence of lumbar disc herniation type on the curative effect of percutaneous lumbar discectomy (PLD). Methods 158 patients were classified into two groups including contained and discontained herniation according to clinical symptoms and diagnostic images. They were treated by meanes of the same technique in nonvascular intervention. Their curative effects were compared with each other in this study. Results The curative and total effective rates were 81.1% and 98.5% respectively in contained group, 7.7% and 38.5% in discontained group without serious complications. The duration of follow up ranged from 3 months to 73 months. Conclusions PLD is a effective procedure for lumbar disc herniation, which is relatively simple and safe with rapid recovery and without serious complications. It should be confirmed in simple contained herniation only.

Asthma is a chronic inflammatory respiratory disease accompanied with airway inflammation, airway remodeling and bronchial hyperresponsiveness. Chemokines are important for the recruitment of immune cells to the lung, which play an important role in the formation and development of asthma. Targeting the chemokine receptors to anti-inflammation and anti-asthma is a new strategy and some candidate drugs are discovered recently. This review is focused on the development of chemokine receptor antagonists for anti-asthma, which will promote the compound designations.

ObjectiveTo establish the rat model of multi-infarct dementia. MethodsSephadex (4 mg/ml, 8 mg/ml) was injected into the internal carotid artery through the common carotid artery. Neurological deficits were measured 24 h after the operation, and Morris water maze test as well as Nissl stain were observed 26～30 d after the operation. ResultsThere was significant difference between the model groups injected sephadex of 8 ml/ml and 4 mg/ml in the neurologic deficits. In the following experiment, the rats injected sephadex of 8 mg/ml were only used as model. For the water maze test, the escape latency was longer (P＜0.01) and the frequency across target area reduced (P＜0.01) in the model, while the apoptotic Nissl body could be observed. ConclusionA model of multi-infarct dementia could be established with the sephadex in rats.

Background and purpose:In the process of gastric cancer development, cytothesis and apoptosis, and endoplasmic reticulum stress (ERS) are very important pathological processes. Glucose regulated protein 78 (GRP78) and phosphorylated form of extracellular signal-regulated protein kinase (pERK) play important roles in it. This study aimed to investigate the expression of GRP78 and pERK in gastric adenocarcinoma, chronic atrophic gastritis and superficial gastritis, and the role of GRP78 and pERK in the development of gastric adenocarcinoma. Methods:Gastric adenocarcinoma, chronic atrophic gastritis and superifcial gastritis tissues in 60 cases respectively were employed in the study. We chose 25 fresh tissue samples from each group, and the level of GRP78 and pERK mRNA in different tissues were detected by RT-PCR assay. The expressions of GRP78 and pERK in different parafifn samples were detected using immunohistochemistry assay. In addition, the relationships between GRP78 and pERK expression and age, gender, differentiation, invasion, disease stage, and lymphoid node metastasis were analyzed. Results: The expression level of GRP78 and pERK mRNA in gastric adenocarcinoma(1.26±0.18, 2.35±0.36) were significantly higher than chronic atrophic gastritis (0.89±0.25, 1.18±0.25) and superficial gastritis (0.29±0.09, 0.68±0.10, P<0.01). The positive ratio of GRP78 expression in gastric adenocarcinoma, chronic atrophic gastritis and superficial gastritis were 78.3%, 46.6%, 6.7%. The positive ratios of pERK expression were 88.3%, 43.3%, 5.0%, respectively. The GRP78 and pERK expression in different tissues were signiifcantly different (P<0.01). GRP78 and pERK expression were positively correlated with differentiation, disease stage and lymph node metastasis. There was a positive correlation between the gene and protein expression of GRP78 and pERK with a Pearson correlation value of 0.307 and 0.368, respectively. Both univariate and multivariate analysis revealed that GRP78 was related to the prognosis of gastric adenocarcinoma. Conclusion:GRP78 and pERK may play an important role in the transition of normal gastric cells to malignant cells. The expression of these two genes enhances tumor progression. Overexpression of GRP78 and pERK is significantly correlated with poor prognosis in patients with gastric adenocarcinoma. The determination of the expression of GRP78 and pERK might be helpful for the prevention, early diagnosis of gastric carcinoma. Particularly, GRP78 is valuable for the judgement of prognosis, and might be a new target for the treatment of gastric adenocarcinoma.

Objective To explore the predictive value of brain lobe location of stroke lesion to development of long-term post-stroke depression(PSD)in the first-episode ischemic stroke patients for providing evidence for early intervention.Methods In the prospective study,158 patients aged 60 and over with first-episode ischemic stroke were continuously admitted into Department of Neurology of Shangqiu First People's Hospital from January 2013 to July 2013.The 2 to 3 years follow-up after stroke episode was performed in 126 cases for inquiring into correlation between brain lobe location of stroke lesion and development of PSD.The diagnosis of depression was in accordance with Mental Disorders Diagnostic and Statistical Manual 4(DSM-Ⅳ)standard,and divided into groups of stroke with depression(n=52)and stroke without depression(n=74).The degree of depression was evaluated by 17-item Hamilton Rating Scale for Depression(HAMD17).The location,number and volume of stroke lesions were determined by head MRI.The relationship between PSD and pathogenetic loci was analyzed by unconditional Logistic regression analysis.A difference in hemisphere commensalism.Results The morbidity of PSD was 41.3%(52/126),with 21.4%(27/126),12.7%(16/126),7.1%(9/126)in mild,moderate and severe PSD respectively.The frontal lobe(OR=2.824,95%CI=1.189-6.706)and the temporal lobe(OR=3.579,95%CI=1.233-10.393)cerebral infarction were correlated with the occurrence of PSD.The long-term PSD severity was more in frontal lobe than in temporal lobe(χ2=6.399,P<0.05).The average volume of cerebral infarction was larger in PSD group than in non-PSD group(t=3.271,P<0.05),and the average number of cerebral infarction loci was more in PSD group than in non-PSD group(t=3.176,P<0.05).The more severe the degree of depression according to HAMD17,the larger the average volume of cerebral infarction(F=6.280,P<0.05)and the more the average number of lesions(F=6.132,P<0.05).Conclusions The development of long-term PSD in the first-episode elderly patients is affected by the invasion site.The frontal lobe and temporal lobe infarction are independent risk factors for long-term PSD in patients with ischemic stroke,and the PSD was more severe in frontal lobe infarction than in temporal lobe infarction.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in China. Unfortunately, most of HCC patients were diagnosed at the intermediate or advanced stage, losing the chance to receive the surgical intervention. Locoregional interventional treatment is one of the major therapeutic options for inoperable HCC treatment and prolongs the survival of the patients. Evaluation of the efficacy of the treatment is the important to determine the further therapy strategies. Currently, the evaluation of patients’ response is mainly based on CT and MR anatomic morphological images, but characteristics of tumor biology changes can be observed earlier than the morphological changes. In the recent years, with the development of diffusion weighted imaging (DWI), its value in clinical application has been continuously explored, and it has been increasingly used for quantitative evaluation the diffusion of water molecular and microcirculation perfusion of blood flow in tumor tissue, with some progress in evaluating the tumor response. This paper mainly reviewed the recent research findings of DWI on locoregional interventional treatment for HCC, thereby providing guidance on clinical practice.

Objective:To understand the current situation of physicians′ competency in China and statistically analyze its influencing factors, hence providing referential evidences for promoting their competency.Methods:The evaluation scale for Chinese physicians′ competency was developed by referring to sophisticated overseas evaluation frameworks. Based on the electronic platform of the medical alliance, stratified sampling was conducted at 39 hospitals in 13 provinces, from which 2 156 physicians were surveyed, and statistical analysis was made on the current situation and influential factor of their competency in 6 dimensions(medical knowledge, diagnosis and treatment, scientific research and teaching, interpersonal communication, spirit of professionalism, population health)Results:The score range in multiple dimensions of physicians′ competency was between 2.85 and 3.89(5 in total), among which spirit of professionalism dimension scores the highest, and teaching and research dimension scores the lowest. Logistic regression analysis shows that their competency level in 6 dimensions is correlated to a range of factors, including gender, degree, title, supervisor qualifications, standardized training program of specialist physicians, and affiliation or not to teaching hospitals( P<0.05). Conclusions:Their overall competency is expected to be elevated. To name a few, they are lack of teaching and research abilities, and need to conduct clinical-oriented scientific research; they are expected to enrich knowledge structure, and need to embrace a wider concept of health; they need to improve their non-technical service abilities, and should further emphasize their humanistic quality; physicians′ practice competency depends upon their extent of medical education, and ensuring the quality of standardized training becomes the key measure.

In plants, UDP-L-rhamnose is one of the major components of cell wall skeleton. Rhamnose synthase plays a key role in rhamnose synthesis which converts UDP-D-glucose into UDP-L-rhamnose in plants. In this study, we isolated the 1058 bp promoter region of the rhamnose synthase gene AtRHM1 from Arabidopsis genome by PCR, and created a series of deletions of AtRHM1 promoter ranging from -931 bp to +127 bp. The full length of the promoter and its deletion derivatives fused with GUS reporter gene were introduced into wild-type Arabidopsis by Agrobacterium-mediated transformation respectively. The GUS staining and GUS enzymatic activity assay showed that the expression of AtRHM1 is induced at transcriptional level by glucose and the regulatory elements involved in the glucose response are located in the region of -931 bp - -752 bp which contains three G-box motifs.
Arabidopsis ; genetics ; Arabidopsis Proteins ; genetics ; Glucosyltransferases ; genetics ; Plants, Genetically Modified ; genetics ; Promoter Regions, Genetic ; Uridine Diphosphate Glucose ; genetics ; metabolism ; Uridine Diphosphate Sugars ; genetics ; metabolism

ObjectiveTo describe the modified (narrowed) gastric tube and two methods on the establishmentof enteral feeding pathway in esophagectomy.MethodsFrom July 2003 to April 2006,we made traditional gastric tube for patients underwent esophagectomy to substitute the dissected esophagus while from May 2006 to November 2009,we made modified gastric tube for the same purpose.From July 2003 to November 2009,enteral nutrition tubes for all these patients are placed intraoperatively by two different ways,which made early post-operative nutrition support possible for these patients.ResultsNo perioperative death occurred among the patients.The length of the modified gastric tube ensured the anastomosis by circular stapler at the apex thorax or in the bases of cervical region.No statistical differences were found between the two group in terms of survival rate.The intraoperative establishment of enteral nutrition pathway ensured the early enteral nutrition support after the operation.ConclusionThe utility of the modified gastric tube extends the length of gastric tube to make mechanical anastomose easier and safer; meanwhile,the intraoperative establishment of enteral nutrition pathway ensures the early enteral nutrition support after the operation.

Objectives To analyze the clinical characteristics, treatment and prognosis of necrotizing pneumonia caused by Mycoplasma pneumoniae (MP) infection in children. Method The clinical data of children with necrotizing pneumonia cause by MP infection from October 2016 to October 2017 were retrospectively analyzed. Results A total of 26 children (10 males and 16 females) with an average age of (5.76±2.60) years, were enrolled in the study. All children were characterized by fever and cough. High fever ( ≥ 39.0 ℃) was seen in 23 cases (88.5％) and the total duration of fever was (16.88±7.42) days. Pulmonary auscultation showed a reduction in respiratory sounds in all children. The range of peripheral blood leukocytes were (9.0～36.8) ×109/L, mean peak neutrophil ratio was (69.2±13.2) ％, and the range of C-reactive protein (CRP) was (1～202.5) mg/L. The mean value of lactic dehydrogenase (LDH) was (448±247) U/L. At the beginning of the disease, the chest images showed homogeneous solid high-density images over the whole lung lobe and 20 cases (76.9％) were complicated with pleural effusion. At the later stage, lung CT showed thin-walled cavities or multiple air-containing cysts on the basis of lung consolidation. Fiberoptic bronchoscopy showed lumen obstruction caused by mucus plugs in 23 cases (88.5％) . All the children were treated with methylprednisolone. The dose of 2 mg/ (kg·d) was effective in 21 cases and the fever was relieved in 5 cases after the dose was adjusted to 4 mg/ (kg·d) , and the average hormone application time was (13.08 ± 8.38) d. The median length of hospital stay was [16.5 (7～32) ] d. Two cases were lost to follow-up and 24 cases finished 6-month follow-up. Lung CT showed almost complete recovery of the lungs in 16 cases, residual pleural hypertrophy in 5 cases, and bronchiectasis in 1 case and bronchiolitis obliterans in 2 cases. Conclusion Necrotic pneumonia in children caused by MP infection is characterized by persistent high fever, decreased respiratory sounds, lung consolidation and mucus plugs induced lumen obstruction. The prognosis is relatively good after active anti-infection and hormone therapy.