Objective To establish a Taqman real-time PCR assay for quantitative detection of the expression of metabolic syndrome related gene (MSRG) mRNA, and to study the function of a new gene. Methods Specific primers and probes were designed for real-time PCR according to the MSRG cDNA sequence. The plasmid standard preparations were constructed by T-A clone, and serial 10-fold dilutions of the extracted plasmid standard preparations were prepared for plotting the standard curve which was used for relative quantification of real-time PCR. The sensitivity, specificity and reproducibility of real-time PCR assay were detected. To compare with the semi-quantitative RT-PCR, the expression levels of MSRG were measured by real-time PCR and semi-quantitative RT-PCR, respectively, in HepG2 cells which were incubated with glucose in different concentrations [5.6mmol/L (G5.6), 22mmol/L (G22) and 33.3mmol/L(G33.3)]. Results An effective real-time PCR assay was established for detection of MSRG mRNA expression levels. Significant differences existed in MSRG expression in HepG2 cells between the G33.3, G22 and G5.6 groups detected by real-time PCR assay. The expression levels of MSRG in HepG2 cells increased significantly in G33.3 group, whereas no significant difference on the expression level of MRSG mRNA was found between G22 and G5.6 groups when semi-quantitative RT-PCR was used for detection. It suggested that the real-time PCR assay was more sensitive and even more precise than that of semi-quantitative RT-PCR. Conclusion The real-time PCR assay was a sensitive, specific, quantitative, and reproducible tool for studying the function of MSRG at the mRNA expression levels of gene.

AIM:To put forward the suggestions for standardizing the pharmacoeconomic research.METHODS:The background of formulation and main points of Canadian Guidelines for the Pharmacoeconomic Evaluation were introduced and its recent development was described.At the same time,we put forward our tentative plan about establishing Chinese guidelines for the pharmacoeconomic evaluation.RESULTS ＆ CONCLUSION:A series of guidelines for the pharmacoeconomic evaluation should be established,which is approved by departments of social safeguard,drug supervision and public health administration,to standardize the pharmacoeconomic research.The goverment should make corresponding policy publicized and make pharmacoeconomic evaluation connect with drug price,clinically rational drug use,catalog of classified management of drugs and catalog of drugs in medical insurance.A pharmacoeconomic framework,which conforms China's national conditions and is controlled by goverment,will established.

Objective To investigate the effect and mechanism of STAT3 gene silencing on the growth of xenografts in human pancreatic cancer SW1990 cells in nude mice.Methods The expression vector inserted with shRNA targeting at STAT3 gene was constructed and was stably transfected into SW1990 cells (SW1990-RNAi group).SW1990 cells transfected with negative control shRNA expression vector (SW1990-Con group) and parent SW1990 (SW1990 group) were used as controls.STAT3,VEGF,MMP-2 protein expressions in these groups were determined by using Western blot.The subcutaneous xenografts models were established in nude mice,and the growth of xenografts was observed,CD34 expressions were determined by immunohistochemistry and MVD was measured.Results The expression of STAT3 protein was 84.69 ± 9.31,82.00 ± 7.76,7.93 ± 1.24,repectively,in SW1990 group,SW1990-Con group,SW1990-RNAi group,and the expression of VEGF protein was 82.94 ± 8.97,80.86 ± 10.28,39.04 ± 6.23,respectively,and the expression of MMP-2 protein was 40.88 ± 5.09,38.26 ± 5.71,12.54 ± 2.15,respectively.The expression in SW1990-RNAi group was significantly lower than those in other 2 groups (P ＜ 0.05),while the expression of all three proteins between SW1990-Con group and SW1990 group was not significantly different.The weight of the xenografts in SW1990 group,SW1990-Con group,SW1990-RNAi group was (2.2 ± 0.4),(2.2 ± 0.3),(0.5 ± 0.3) g,respectively ; the MVD of the xenografts was (20.35 ± 2.41),(18.79 ± 1.94),(9.62 ± 1.06) per high power field,respectively,and the number in SW1990-RNAi group was significantly lower than those in other 2 groups (P ＜ 0.05 or P ＜ 0.01),while the difference between SW1990-Con group and SW1990 group were not significant.Conclusions Inhibition of STAT3 gene expression can significantly slow the growth of SW1990 xenografts in nude mice,and the mechanism may be related with down-regulation of VEGF and MMP-2 expression and inhibition of the angiogenesis of pancreatic cancer.

Objective To investigate the clinical effect of initiative content reduction surgery in the herniorraphy on the prevention and treatment of postoperative intra-abdominal hypertension of obese patients with giant ventral hernia.Methods The retrospective cross-sectional study was adopted.The clinical data of 62 obese patients with giant ventral hernias who were admitted to the Chao-Yang Hospital of Capital Medical University from January 2011 to December 2015 were collected.The initiative content reduction surgery was adopted during the herniorraphy of ventral hemia.Observation indices:(1) surgery situations:operation time,length of resected intestines,volume of intraoperative blood loss.(2) Postoperative recovery situations:change between preoperative and postoperative urethral bladder pressure,organ function of heart,lung,liver and kidney,time of gastrointestinal function recovery,time of drainage tube removal and duration of postoperative hospital stay.(3) Postoperative complications:incisional infection and intestinal fistula.(4) Follow-up situations.Follow-up using outpatient examination at 1 week,1 month,3 months and 6 months after surgery and using telephone interview at postoperative year 1 was conducted up to June 2016.The follow-up included hernia recurrence and chronic infection.Measurement data with normal distribution were represented as x ± s.Measurement data with skewed distribution were represented as M (range) and analyzed by rank-sum test.Results (1) Surgery situations:all the 62 patients received successful herniorraphy of giant ventral hemia combined with initiative content reduction surgery.Operation time,length of resected intestines and volume of intraoperative blood loss were (115 ±22)minutes,(207 ± 64)cm and (52 ± 35)mL.(2) Postoperative recovery situations:the preoperative urethral bladder pressure was 18 cmH2O (range,15-22 cmH2O,1 cmH2O =0.098 kPa) and postoperative urethral bladder pressure was 8 cmH2O (range,6-11 cmH2O),with a significantly statistical difference between before and after surgery (Z =-9.662,P ＜ 0.05).There was no abnormal function of heart,lung,liver and kidney after operation.The time of gastrointestinal function recovery,time of drainage tube removal and duration of postoperative hospital stay were 3.8 days (range,3.0-6.0) days,(3.8 ± 1.1) days and (14.5 ± 1.9) days.(3)Postoperative complications:of 62 patients,4 were complicated with incisional infection and improved after symptomatic treatment.There was no intestinal fistula.(4) Follow-up situations:all the 62 patients were followed up for (36 ± 19) months.During the follow-up,3 patients had incisional hernia recurrence and then were followed up without reoperation.No chronic infection occurred.Conclusion Initiative content reduction surgery is effective and feasible in the prevention and treatment of intraoperative intra-abdominal hypertension of obese patients with giant ventral hernia.

Objective To investigate the effect of somatic sense interactive game Kinect on executive dysfunction for patients with stroke. Methods 78 inpatients with first stroke were divided into intervention group and control group, and 35 cases in the intervention group and 36 cases in the control group finished the study. The control group accepted conventional rehabilitation, and the intervention group played the game of Sailing for Gold Coins and Golf of the Kinect in addition. They were assessed with Behavioral Assessment of Dysexecutive Syndrome (BADS) before and 4 weeks after intervention. Results The difference of scores of all the sub-scales and total of BADS before and after intervention were more in the intervention group than in the control group (P<0.05). Conclusion The somatic sense interactive game Kinect can be used to improve the executive function of the patients with stroke.

Objective To explore the operation indication feasibility,operation technique and clinical effect of complex tibial plateau fractures with semilateral position through combined approaches.Methods From April 2011 to June 2013,data of 25 patients with complex tibial plateau fractures who were treated by open reduction and interal fixation with semilateral position through anterior lateral incision and an inverse L shaped incision were retrospectively analyzed.There were 15 males and 10 females,with an average age of 49.7 years old (range,30 to 70 years old).21 cases were traffic accident injuris and 4 cases were hurt by falling injuries from bicycle.All of the fracture patterns were three pillars of closed fracture of type Ⅵ according to Schatzker classification.The time at surgery was 5-21 days (mean,9.5 days) after injuries.The posterior condylar and medial condylar fractures were dealt with inverse L shaped incision,and fixated with anatomical locking plate and T shaped plate.The lateral condyle fractures were dealt with anterior lateral incision,and fixated with anatomical locking plate.Results Operating time was 150-250 min with an average time of 197.6 min.Intraoperative blood loss was 150-300 ml with an average of 232 ml.25 patients were followed-up,and the average duration of follow-up was 17.8 months (range,12-24 months).Fracture healing time was 16-24 weeks with an average of 19 weeks.At the time of the latest follow-up,X-ray showed all the knee joint had smooth surface,and there was no obvious varus or valgus deformity.One year later,the flexion of the knees achieved 115.2° (range,100°-130°),and the straighten reached 0°.The mean Rasmussen's score of all the patients were 14-18 (average,16.6),and there were excellent in 11 cases and good in 14.Bassed on the KSS score,the mean score was 88.6 (range,66-96) one year after operation.The excellent and good rate was 96％ (24/25).2 patients had fat liquefaction of anterolateral incision wound dehiscence,local skin necrosis,and they got good outcomes after debridement dressing and secondary suture.Conclusion Multi plate fixation is more effective and safty treatment for complex tibial plateau fractures which can be operated completely through fixed half lateral position,and the knee joint is allowed to do early functional exercise,achieving good clinical efficacy and good knee function.

Objective:Characteristics of the retroperitoneal tumor blood supply arteries were analyzed to evaluate the safety and effec-tiveness of preoperative interventional embolization for benign and malignant retroperitoneal tumors. Methods:A total of 241 cases were divided into benign retroperitoneal tumor group and malignant retroperitoneal tumor group. Each group was divided into groups A, B, and C according to the long diameter of the tumor tissue. Group A>10.0 cm, 5.0 cm0.05). Significant differences in intraoperative bleeding and intraoperative blood transfusion were found between groups A and B (P<0.05). Main arteries of the abdominal retroperitoneal tumor are the lumbar, internal iliac, and adrenal arteries. The main artery of pelvic retroperitoneal tumor is the internal iliac artery. Conclusion:Preoperative interventional embolization can effec-tively reduce the risk of bleeding during malignant retroperitoneal tumor surgery and improve the perioperative safety of patients. No significant benefit of benign retroperitoneal tumors and no increased risk of bleeding during surgery were observed. Retroperitoneal tumor preoperative embolization should focus on investigating the lumbar, internal iliac, and adrenal arteries.

This study examined the value of volume rendering (VR) interpretation in assessing the growth of pulmonary nodular ground-glass opacity (nGGO). A total of 47 nGGOs (average size, 9.5 mm; range, 5.7-20.6 mm) were observed by CT scanning at different time under identical parameter settings. The growth of nGGO was analyzed by three radiologists by comparing the thin slice (TS) CT images of initial and repeat scans with side-by-side cine mode. One week later synchronized VR images of the two scans were compared by side-by-side cine mode to evaluate the nGGO growth. The nodule growth was rated on a 5-degree scale: notable growth, slight growth, dubious growth, stagnant growth, shrinkage. Growth standard was defined as: Density increase ≥ 30 HU and (or) diameter increase (by 20% in nodules ≥10 mm, 30% in nodules of 5-9 mm). Receiver operating characteristic (ROC) was performed. The results showed that 32 nGGOs met the growth criteria (29 nGGOs showed an increase in density; 1 nGGO showed an increase in diameter; 2 nGGOs showed an increase in both diameter and density). Area under ROC curve revealed that the performance with VR interpretation was better than that with TS interpretation (P<0.01, P<0.05 and P<0.05 for observers A, B and C respectively). Consistency between different observers was excellent with both VR interpretation (κ=0.89 for observers A&C, A&B, B&C) and TS interpretation (κ=0.71 for A&B, κ=0.68 for A&C, κ= 0.74 for B&C), but time spending was less with VR interpretation than with TS interpretation (P<0.0001, P<0.0001 and P<0.05 for observers A, B and C, respectively). It was concluded that VR is a useful technique for evaluating the growth of nGGO.

Objective To investigate the predictive value of early prognosis of the 40 Hz auditory steady-state response (40 Hz ASSR) in patients with coma following cardiopulmonary resuscitation (CPR). Methods Thirty patients with coma following CPR admitted in the Neurological Intensive Care Unit (NICU) were examined with the 40 Hz ASSR and shortlatency somatosensory evoked potential (SLSEP), and both were graded. Using transferred out of NICU as the short-term outcome end point, the patients with coma following CPR were divided into a survival group (n =21) and a death group (n =9; including brain death). The correlation between the 40 Hz ASSR and SLSEP grading and prognosis was analyzed. Results The grades of the 40 Hz ASSR (r = 0. 722, P = 0.000) or SLSEP (r = 0. 430, P = 0.018) was significantly correlated with the short-term prognosis. The sensitivity, specificity and accuracy of the 40 Hz ASSR for predicting the short-term prognosis were 77. 8%, 100% and 93.3%, respectively; and those of SLSEP were 88. 9%, 61. 9% and 70. 0%, respectively. Conclusions The 40 Hz ASSR has a certain prognostic value in patients with coma following CPR. The higher the grade of the 40 Hz ASSR is, the greater the likelihood of the recent death.

Objective To investigate the predictive value of prognosis of the 95% spectral edge frequency (SEF95) and total power (TP) in quantitative electroencephalography (qEEG) in patients with disturbance of consciousness. Methods The patients with disturbance of consciousness admitted in the neurointensive care unit (NICU) in Nanfang Hospital from January 2008 to June 2010 were included. Glasgow Coma Scale (GCS) scores were performed on admission and EEG monitoring was performed simultaneously. The patients were divided into either a survival group or a death group according to the survival status of the patients at the time of leaving NICU. The age, sex, hypertension, diabetes, GCS scores, SEF95, and TP were compared between the two groups. A multivariate logistic regression analysis was performed for the above factors. The prognostic indicators were analyzed with the receiver operating characteristic (ROC) curves and the of qEEG predictive ability of death in patients with disturbance of consciousness were determined. Results A total of 109 patients with supratentorial lesions were enrolled in the study, 79 of them were in the survival group and 30 of them were in the death group. The GCS scores (5 ±3vs. 9 ±3, P =0. 000) and SEF95 (7. 0 ±4.0 vs. 10. 0 ±4. 0, P = 0. 002) in the death group were significantly lower than those in the survival group. Multivariate logistic regression analysis showed that GCS scores (odds ratio 0. 100, 95% confidence interval 0. 029-0. 353) and SEF95 (odds ratio 0. 853, 95% confidence interval 0. 740-0. 983) were the independent predictors of recent prognosis. ROC curve analysis showed that the lower the GCS scores and SEF95 were, the greater the likelihood of death in patients. When SEF95 was ＜7. 75, the sensitivity to determine the death was 60. 0%, the specificity was 72. 2%, the positive predictive value was 82. 6%, and the negative predictive value was 45. 0%; when the GCS score was ＜8, the sensitivity to determine the death was 83. 3%, the specificity was 73. 4%,the positive predictive value was 82. 6%, and the negative predictive value was 45. 0%. Conclusions SEF95 helps determine the prognosis of patients with disturbance of consciousness, and it is expected to become an important means of bedside assessment of prognosis in patients with disturbance of consciousness in NICU.