Objective To investigate the effects of ciprofloxacin on dermal collagen synthesis and profibrotic gene expressions in an experimental mouse model of scleroderma induced by bleomycin. Methods Experimental mouse models of scleroderma were established by subcutaneous injection of bleomycin into the dorsal skin of 15 BALB/c mice for 4 consecutive weeks. Then, the mouse models were randomly and equally divided into 3 groups to be topically treated with 1% ciprofloxacin cream (ciprofloxacin group), 2.5% asiaticoside cream (asiaticoside group)and cream vehicle (model group)respectively for 5 consecutive weeks. Five mice firstly injected with sterile phosphate buffered saline (PBS)for 4 weeks then topically treated with cream vehicle for 5 weeks served as the blank control group. After the 5-week topical treatment, all the mice were sacrificed, skin specimens were resected from the dorsal skin of them, and subjected to HE staining and Masson staining. Further more, an immunohistochemical assay was performed to measure the expressions of type I collagen (COL-1), matrix metalloproteinase-1 (MMP1) and tissue inhibitor of matrix metalloproteinase-1 (TIMP1), semi-quantitative reverse transcription PCR to quantify the expressions of connective tissue growth factor (CTGF), transforming growth factor-β1 (TGFβ1)and Smad3 genes, and alkaline hydrolysis-spectrophotometry to determine the level of hydroxyproline in skin. Statistical analysis was carried out by one-way analysis of variance and the least significant difference(LSD)test with the SPSS 17.0 software. Results Compared with the blank control group, the model group showed increased dermal thickness at injection sites (432.76 ± 93.74 μm vs. 301.69 ± 79.47 μm, P < 0.01). Masson staining revealed thick and dense collagen bundles in an irregular arrangement in the dermis in the model group, which was consistent with dermal fibrosis in scleroderma. The total content of collagen and staining intensity of COL-1, MMP1 and TIMP1 were all significantly decreased in the ciprofloxacin group and asiaticoside group compared with the model group (F = 1628.54, 33.29, 84.82, 224.81, respectively, all P < 0.01), while no significant changes were observed in dermal thickness (both P > 0.05). Moreover, compared with cream vehicle, asiaticoside down-regulated the expressions of the three profibrotic genes(CTGF, TGFβ1 and Smad3)to different extents (all P < 0.05), while ciprofloxacin only inhibited the expressions of TGFβ1 and Smad3 genes (both P < 0.05)with no significant effect on CTGF gene expression (P > 0.05). Conclusion Ciprofloxacin may counteract dermal fibrosis by inhibiting the TGFβ1/Smad3 pathway and modulating the unbalanced expressions of MMP1 and TIMP1.

Objective To evaluate the clinical application of dynamic contrast-enhanced MRI of the breast.Methods In this study, 56 cases received dynamic contrast-enhanced MRI of the breast, among them 37 cases with a total 45 solid masses were confirmed by pathology.The clinical value of breast MRI was analyzed retrospectively with the combination of surgery and pathology.Results Except for multiple bilateral cysts in one case among the 45 solid masses, 17 masses were benign and 28 were malignant.MRI detected multiple carcinoma in 2 cases, residual carcinoma in one case and intraductal carcinoma in 2 cases.The smallest mass detected was 4 mm in diameter.Tumor detection rate in this series was 100%, with the diagnostic sensitivity, speciality and accuracy being 92%, 92% and 90% respectively.Conclusion Dynamic contrast-enhanced MRI of the breast has high sensitivity and helps to make a accurate diagnosis.

AIM: To investigate the short-term efficacy and safety of sulfasalazine (SASP) 3 g per day in the treatment of patients with mild and moderate ulcerative colitis (UC). METHODS: 122 patients were treated with SASP ( 1 g, t.i.d.) for 6 weeks. The data of clinical manifestations, colonoscopic and histological involvements were compared before and after the treatment of UC. The short-period efficacy and adverse reactions were evaluated in 110 patients. RESULTS: The therapeutic project was carried out in the 110 out of 122 patients. After 110 patients were treated for 6 weeks, the clinical, colonoscopic and histological remission were 71.8%, 21.8% and 16.4%, respectively. Among the 79 patients with clinical remission, 58.2% and 67.1% of them remained grade 1 in colonoscopic and histological findings, respectively. The curative rates and the effective rates were 63.9% and 82.0%, respectively. Among the 122 patients treated with SASP, 21 of them ( 17.2%) had adverse reactions. Except 4 patients suffered urticaria and leukopenia, no patients quitted the treatment because of obvious adverse reaction. CONCLUSION: SASP ( 3 g per day) can be an effective and safe medicine in treatment of patients with mild and moderate UC, but more than half of the patients in clinical remission still have light inflammation in colonoscopy and histology.

Objective To investigate the structural and functional changes of lower motor neuron distal to the site of spinal cord injury in rats. Methods Seventies Sprague-Dawley rats were divided randomly into 6 groups: sham-operation group (controls, n=10) and 3 day group (n=10), 1 week group (n=10), 2 week group (n=10), 4 week group (n=15) and 8 week group (n=15) after spinal cord transaction at T10. Neuronal apoptosis and acetylcholinesterase (AChE) activity of spinal cord at L4- 6 were observed by using the terminal deoxynucleotidal transferase- mediated DUTP-biotin nick end labeling (TUNEL) method and the semiquantitative enzyme cytochemistry, respectively. Results The assessment of apoptosis by TUNEL labeling showed that fluorescent markers were observed occasionally in anterior horn distal to the site of injury. The optical density (OD) value of AchE positive motor neurons (area > 300 μm2) initially decreased about 3 days after transaction and then overshot 1 week or so. However, after that, the OD value decreased again, the lowest about 4 weeks. Then the OD value increased again, though at 8 weeks was still lower than that of controls (P<0.05). Conclusion The findings on indistinctive apoptosis provided the proof of no significant changes of lower motor neuron distal to the site of transection. Semiquantitative histochemical results about AChE reflected marked metabolic changes of motoneurons caudal to the transaction, which represented as part of functional reorganization.

ObjectiveTo investigate the changes and relevance of H reflex and spasticity after cervical or thoracic spinal cord injury (SCI).MethodsH reflex of 13 healthy adults as controls and 30 SCI patients (subacute, n=18; chronic, n=12) was measured twice from soleus muscle once a month. In the same time, the evaluation of spasm was performed by the modified Ashworth scale.ResultsThere was no significant difference in the mean Hmax amplitude and Hmax/Mmax ratio between different SCI stages(P>0.05). However, the mean Hmax amplitude of the patients was smaller than that of controls(P<0.01). During subacute stage there was quadratic correlation between the mean Hmax amplitude and spasticity, Hmax/Mmax ratio and spasticity. But there was linear correlation between Hmax/Mmax ratio and spasticity during chronic stage.ConclusionThere was closer relation between spasticity and Hmax/Mmax ratio after spinal cord injury. However, the quantitative evaluation need to be proved by larger samples.

Objective To evaluate the efficacy of intravertebral augmentation which including transpedicular bone graft, transpediclebody augmenter and vertebroplasty in preventing the correction loss and implant failure of short-segment pedicle instrumentation for thoracolumbarfractures through meta-analysis. Methods Experimental studies (randomized controlled trails, non-randomized controlled trails)and observational studies (cohort studies, case control studies) related with application of posterior short-segment pedicle instrumentationwith intravertebral augmentation for thoracolumbar fractures were searched from Pubmed, EMBASE and CNKI according to the inclusionand exclusion criteria, and hand-searched in Chinese and English journals. RevMan 5.0.18 provided by Cochrane was used to analyse the data.Results 1 randomized controlled trail and 7 observational studies were included. There were 442 patients, in which 216 patients werewith and 226 patients without intravertebral augmentation. There was no significant difference in correction loss and risk of implant failurebetween these two groups. Conclusion Intravertebral augmentation does little about the risk of correction loss and implant failure associatedwith posterior short-segment pedicle instrumention for patients with thoraculumbar fractures.

Objective To investigate the effect of seasonal and meteorological factors on the onset of stroke in Qinghai Plateau area.Methods Patients with stroke admitted to Qinghai Provincial People's Hospital from December 1,2011 to November 30,2016 were enrolled retrospectively.The meteorological data provided by Qinghai Meteorological Bureau were used to analyze the distribution of the number of cases in different seasons in Qinghai area and the relationship between the incidence of stroke and plateau meteorological factors.Results A total of 9 412 patients with acute ischemic stroke were enrolled,aged 15～95 years.There were significant statistical differences in the number of cases of ischemic stroke,cerebral hemorrhage,and subarachnoid hemorrhage in different seasons (all P ＜ 0.05).Among them,the number of cases with ischemic stroke increased first and then gradually decreased with the changes of spring,summer,fall and winter,while cerebral hemorrhage and subarachnoid hemorrhage showed a trend of decreasing first and then increasing gradually.There were significant differences in the number of cases in different relative humidity,temperature,and temperature differences (all P ＜ 0.05).Conclusion There are seasonal differences in the incidence of stroke in the plateau area,which may be associated with the influence of plateau meteorological factors.

Objective To explore the effects of rehabilitation for adult cervical spinal cord injury without radiological abnormality. Methods 80 patients were studied retrospectively. Results The increase of motor score of anterior, posterior and conservative group were around 5, 2 and 2, whereas that of FIM were 11, 17 and 15, respectively. The changes of sensory score were uncertain.Conclusion The effect of surgical or conservative treatment is limited on neurological recovery, while rehabilitation can bring more functional independence to patients with cervical spinal cord injury without radiological abnormality.

ObjectiveTo investigate related factors for stone recurrence after endoscopic minimally invasive gallbladder-preserving cholecystolithotomy, and to establish a nomogram model for predicting the risk of stone recurrence after surgery based on independent risk factors. MethodsA retrospective analysis was performed for the clinical data of 144 patients with gallstones who underwent endoscopic minimally invasive gallbladder-preserving cholecystolithotomy in Qinghai University Affiliated Hospital from January 2012 to January 2018, and according to postoperative stone recurrence, the patients were divided into non-recurrence group and recurrence group. The chi-square test was used for comparison of categorical data between two groups. LASSO and logistic regression analyses were used to analyze independent risk factors for postoperative stone recurrence, and the corresponding nomogram prediction model was plotted according to regression coefficient. The calibration curve was plotted to evaluate the reliability of the predictive nomogram; Harrell consistency index was used to quantify the discriminatory performance of the predictive nomogram; the receiver operating characteristic (ROC) curve was used to evaluate the sensitivity, specificity, and area under the ROC curve (AUC) of this predictive nomogram. ResultsAll 144 patients underwent successful endoscopic minimally invasive gallbladder-preserving cholecystolithotomy, among whom 14 patients (9.7%) experienced stone recurrence after surgery. The multivariate analysis showed that family history (odds ratio ［OR］= 3.245, 95% confidence interval ［CI］: 0.752-13567, P=0.104), regular diet (OR=3.752, 95% CI: 1.067-14.141, P=0.041), stone homogeneity (OR=5.871, 95% CI: 1636-25.390, P=0.010), and medication compliance (OR=0.225, 95% CI: 0.057-0.799, P=0.024) were independent risk factors for recurrence. The nomogram model had an index of concordance (C-index) of 0.835 (95% CI: 0.732-0.938) in the modeling sample and 0.7925 in the verification sample, suggesting that the nomogram model in this study had good accuracy and discrimination. The predictive nomogram had an AUC of 0.835, suggesting that this nomogram had a relatively high predictive value. ConclusionFamily history, regular diet, stone homogeneity, and medication compliance are independent risk factors for stone recurrence after endoscopic minimally invasive gallbladder-preserving cholecystolithotomy, and the nomogram constructed based on these independent risk factors may help to predict the risk of postoperative stone recurrence.

Objective To explore the clinical effect of indobufen combined with clopidogrel on acute cerebral infarction and analyze the drug safety.Methods Using a randomized and controlled clinical study method,72 patients with acute cerebral infarction selected in Wenzhou Central Hospital from June 2021 to December 2022 were included in the study.They were randomly divided into control group and experimental group.The experimental group was given indobufen tablets 200mg(twice daily),and clopidogrel 75mg every day.The control group was treated with clopidogr el 75mg every day.The two groups were treated with conventional internal medicine in the department of neurology.They were given Xingnaojing Injection 20mg every day,and Butylphthalide Injection 100ml(twice daily).And they were given symptomatic support treatment with drugs to improve cerebral circulation and drugs to reduce blood fat and stabilize plaque.In addition,we control patients'basic diseases such as hypertension and hyperglycemia.The indexes of cerebral infarction related scale were evaluated before treatment and after 3 weeks.Results After 3 weeks of treatment,the scores of stroke scale in the experimental group and the control group were lower than those before treatment.The total effective rate in the experimental group was higher than that in the control group,the difference was statistically significant(P<0.05).The score of Quality of Life in the experimental group was significantly higher than that before treatment(P<0.001).The score of Quality of Life in the control group was higher than that before treatment(P<0.05).Compared with the control group,the Quality of Life score of the experimental group was higher,with statistical significance(P<0.05).The incidence of stomachache and acid reflux in the two groups was low,and there was no statistically significant difference between the two groups(P>0.05).No gastrointestinal bleeding and intracranial hemorrhage occurred in the two groups.Conclusion Indobufen combined with clopidogrels can improve the treatment effect and Quality of Life score of patients with acute cerebral infarction,and is more obvious than clopidogrel alone.In addition,compared with clopidogrel monotherapy,indobufen combined with clopidogrel did not significantly increase the incidence of adverse reactions in patients.