Objective To evaluate the characteristics of two angiographic manifestation of ocular fundus in choroidal metastatic carcinomas. Methods Fundus fluoresein angiography (FFA) and indocyanine green angiography (ICGA) were performed on 17 patients (24 eyes) with choroidal metastatic carcinomas, and the characteristics of these two kinds of angiograms were analyzed and compared each other. Results According to various clinical features, e.g., locations of metastatic tumor in ocular fundus, disease course, and different kinds of original malignancy, the findings of ocular fundus were divided into (1) Isolation type: FFA showed pinpoint and mottled leaks against hypofluorescence background, increased and confluent fluoresecence in later stage. ICGA showed the similar images as in FFA, except later appearance of leaks and the choroidal vesseles could be seen beneath the thin metastatic tumor mass.(2) Diffusion type: Tumors showed hypofluorescence in early stage and uneven ill defined hyperfluorescence both in FFA and in ICGA. (3) Small metastatic carcinomas: Hypofluorescence in early stage and mild mottled hyperfluorescence were found in FFA as well as in ICGA. Conclusion Both FFA and ICGA are helpful in the diagnosis of choroidal metastatic tumors and ICGA may be conducive if there are some troubles in diagnosing the tumors with FFA.

BACKGROUND: Mechanisms related to bone fracture and nonunion have been clarified, but the healing time and treatment strategy of delayed union remain controversial. OBJECTIVE: To establish a reliable model of femoral delayed union using external fixation in the New Zealand white rabbit. METHODS: Seventy-two New Zealand white rabbits were randomized to three groups. After removal of 10-mm femoral middle bone cortex with internal and external periosteum and bone marrow, a uniplanar external fixator was used. There was a 1 mm gap between broken ends (group A), and the broken ends were sealed by bone wax (group B). For controls, only bone cortex was cut and then fixed to contact the broken ends. The gross, radiological and histological observations were performed to observe the bone healing at 4, 8 and 12 weeks after modeling. RESULTS AND CONCLUSION: The control group achieved bone healing at the 4th week, which was considered as the normal time of bone healing. The groups A and B achieved healing at the 12th week, which was remarkably longer than that in the control group. The rabbit femoral delayed union model showed the typical X-ray imaging and pathological features of delayed union. Our results suggest that the model is reasonable and reliable, which can provide reference for clinical research.

AIM:To investigate the effects of bcl-3 gene on the migration and apoptosis of human colon cancer cell line RKO, and the changes of cyclin D1 and apoptosis-related proteins.METHODS:After silencing of bcl-3 gene expression in human colon cancer cell line RKO by lentiviral vector with RNA interference, the changes of RKO cell migration ability were investigated by wound healing assay.The changes of RKO cell apoptotic rate after bcl-3 gene silencing were detected by flow cytometry with Annexin V/PI staining.The protein expression of cyclin D1 and apoptosis-related proteins in the RKO cells after bcl-3 gene silencing was determined by Western blot.RESULTS:The wound healing rates of the RKO cells were 84.00% and 40.00% before and after bcl-3 gene silencing, respectively, with statistically significant difference (P<0.05).Annexin V/PI staining showed that the cell apoptotic rates were 12.89% and 59.67% before and after bcl-3 gene silencing, respectively, when RKO cells were treated with 5 μmol/L cisplatin for 24 h, with statistically significant difference (P<0.05).The expression of cyclin D1 decreased, while the expression of Bax increased after bcl-3 gene silencing (P<0.05).CONCLUSION:After bcl-3 gene silencing, the migration ability of RKO cells decreases, and the apoptotic rate increases, accompanying with the changes of cyclin D1 and Bax.bcl-3 gene can affect the apoptosis of RKO cells by changing the expression of cyclin D1 and Bax.

Objective:To investigate the correlation between low-density lipoprotein cholesterol (LDL-C) and hemorrhagic transformation (HT) after intravenous thrombolysis in patients with acute ischemic stroke (AIS).Methods:Patients with AIS received intravenous thrombolysis using standard dose alteplase in the First Hospital of Shanxi Medical University from January 2014 to December 2019 were enrolled retrospectively. Head CT scan was performed within 24 h after thrombolytic therapy to identify the occurrence of HT. The demographic and baseline clinical data were compared between the HT group and the non-HT group. Multivariate logistic regression analysis was used to determine the correlation between LDL-C and HT after thrombolysis. Results:A total of 323 patients with AIS who received intravenous thrombolytic therapy were enrolled, their age was 65±12 years (range, 54-78 years), and 219 were males (67.8%). The median baseline National Institutes of Health Stroke Scale (NIHSS) score was 4 (interquartile range, 3-9). Ninety one patients (28.17%) developed HT, of which 8 (2.48%) had symptomatic intracerebral hemorrhage. Univariate analysis showed that there were significant differences in LDL-C, age, baseline NIHSS score, baseline systolic and diastolic blood pressure, baseline fibrin degradation products, and the proportion of patients with atrial fibrillation and stroke etiology between the HT group and the non-HT group (all P<0.05). Multivariate logistic regression analysis showed that lower LDL-C (odds ratio [ OR] 0.531, 95% confidence interval [ CI] 0.358-0.788; P=0.002), higher baseline NIHSS score ( OR 1.063, 95% CI 1.010-1.120; P=0.020) and higher baseline systolic blood pressure ( OR 1.015, 95 CI 1.004-1.026; P=0.008) were the independent risk factors for HT after intravenous thrombolysis in patients with AIS. Conclusions:Low LDL-C is an independent risk factor for HT in patients with AIS after intravenous thrombolysis. The patients with lower LDL-C should be cautious in lipid-lowering therapy and be alert to the occurrence of HT.

Objective To explore the mechanism of spontaneous seizures in adaptor protein complex type 3B knockout mice(AP3M2KO mice).Methods AP3M2KO mice were generated.Seizures and electroencephalogram(EEG)were monitored using video camera and telemetry system.Glutamate and GABA releases were determined using in vivo microdialysis method.Results AP3M2KO mice began to suffer from spontaneous seizures 8 weeks after the birth,but did not show any other behavior abnormality.The onset of ictal discharge over the temporal region was synchronized with seizures.There were no significant differences in basal glutamate and GABA releases in hippocampus between AP3M2KO((0.35±0.08)pmol/20μl and(2.94±1.69)fmol/20μl,respectively)and wild-type mice.However,the 50 mmol/L K+-evoked GABA release was impaired in AP3M2KO mice((63.5±11.8)fmol/20μl vs(209.2±63.7)fmol/20 μl,t=4.405,P＜0.05),whereas no significant difference was found in K+-evoked glutamate release.Conclusions AP3M2KO mice suffer from epileptic seizures similar to the clinical features of human epilepsy.The impairment of inhibitory GABAergic transmission iS involved in the mechanism of spontaneous seizures in AP3M2KO mice.

Objective To observe microvascular architecture and free radical metabolism in hippocampus after focal cerebral ischemia/reperfusion and to explore the effect of NBP (3-n-butylphthalide). Methods Fifty-four SD rats were ran?domly divided into NBP pretreatment group, ischemia/reperfusion group and sham operation group (n=18 in each group). The model of middle cerebral artery occlusion(MCAO)was established by suture method. The neurological scores were counted and the volume of infarction was measured;TA-Fe method was applied to observe the microvascular architecture of hippo?campus, Mivnt image analysis system was used to analyze the microvessel density(MVD)and the microvessel area density (MVA)of hippocampus quantitatively;The activity of SOD and content of MDA were measured by colorimetric method. Re?sults Compared to the ischemia reperfusion(IR)group, the neurological scores and the volume of infarction were decreased sharply in NBP group. What′s more, the activity of SOD, MVD and MVA were all enhanced but the content of MDA and the count of closed microvessels were both reduced(P < 0.01). Conclusion NBP can improve microvascular architecture of hippocampus and reduce the free radical injury. There is a protective effect on hippocampus of rats who suffered focal cere?bral ischemia reperfusion.

Objective To investigate the effects of 3-N-butylphthalide ( NBP ) pretreatment on the score of neurological deficit , oxidative stress and pathomorphology in rats with cerebral ischemia reperfusion injury ( CIRI ) . Methods Ninety male SD rats were randomly divided into sham operation group ( Sham group ) , model group ( IR group), NBP pretreatment low dose group (NBPⅠgroup), NBP pretreatment middle dose group(NBPⅡgroup) and NBP pretreatment high dose group(NBPⅢgroup), 18 rats per group.Pretreatment was given once a day within 1 week before establishing the model of cerebral ischemia reperfusion injury .The model of middle cerebral artery occlusion ( MCAO) was subjected by suture method .The score of neurological deficit was executed after ischemia for 2h and reperfusion for 24h in all the rats.The cerebral infarction was observed by TTC staining .The pathologic change of brain was observed by HE staining under the microscope .Hydroxylamine method was used to detect activity of SOD , chemical colorimetry method was used to measure activity of GSH-PX, and TBA method was used to detect content of MDA .Results (1) In Sham group, the score of neurological deficit and the percentage of infarction volume were zero , the morphology of nerve cell was regular , and activity of SOD, GSH-PX and content of MDA of brain tissue were normal .(2) Compared with IR group , the score of neurological deficit was significantly reduced in NBP pretreatment groups (all P<0.01); the score of neurological deficit was decreased progressively in turn in NBP Ⅰ,Ⅱ,Ⅲgroup (all P<0.05).(3) Compared with IR group, the percentage of infarction volume was cut down progressively in turn in NBPⅠ,Ⅱ,Ⅲgroup (all P<0.05), and neuron injury was also induced obviously in NBP pretreatment groups .(4) Activity of SOD, GSH-PX was largely increased , and content of MDA was greatly decreased in NBP pretreatment groups ( P<0.01 ) .Activity of SOD , GSH-PX went up progressively in turn , and contents of MDA were cut down progressively in turn in NBP Ⅰ,Ⅱ,Ⅲgroup ( all P<0.05 ) .Conclusion 3-N-butylphthalide can significantly up-regulate the activity of SOD and GSH-PX, decrease the content of MDA , reduce the percentage of infarction volume , and relieve the damage of nerve cell to preventively protect the rats with cerebral ischemia reperfusion injury .

Objective To investigate the vancomycin trough concentration in elderly patients with severe infection and provide references for clinical use of drugs effectively .Methods According to the Ccr of elderly patients (56 cases), who were ≥65 years old, the patients were divided into two groups , one with Ccr≥50 ml/min, which named group A , the other with Ccr between 20 ml/min and 50 ml/min, which named group B .The use of vancomycin , vancomycin steady-state plasma trough concentration and the differences of renal function were analyzed before and after in both two groups .Results There were 31cases of patients in group A (25 cases of them use vancomycin 1 g,q 12 h;other 6 cases use 0.5 g,q 12 h), 25 cases of patients in group B (15 cases of them use vancomycin 1 g, q 12 h;other 10 cases use 0.5 g,q 12 h) .The percentage that the trough concentration of the patients who use two different scheme of using drugs in group A was between 10 mg/L and 20 mg/L is 12%(3/25) and 66.67%(4/6).The percentage that the trough concen-tration of the patients who used two different scheme of using drugs in group B was between 10 mg/L and 20 mg/L is 20%(3/15) and 60%(6/10).The percentage that trough concentrationis more than 20 mg/L is 73.33%(11/15) and 30%(3/10).The serum creat-inine value of the 15 patients of all cases except for group B of which vancomycin dosage was 1 g, q 12 h had significantly risen after using the drug(P<0.05).The urea nitrogen had no obvious change (P>0.05).The serum creatinine value and urea nitrogen of oth-er patients had no significant change after using the drug (P>0.05).Group B had kidney toxicities observed in 5 patients, the dosage of vancomycin was 1 g, q 12 h, valley concentration >30 mg/L.There was no kidney toxicities observed in group A .Conclusion The use of vancomycin in elderly patients must depend on their Ccr .If the Ccr was larger than 50 ml/min, the use of vancomycin should be 1 g,q 12 h, and the Ccr was between 20 ml/min and 50 ml/min, the use should be 0.5 g.In addition, blood trough concentration need to be paid more attention in elderly patients in order to regulate the regimens according to the individual differences .

Objective:Based on the National Patent Database, this paper analyzes the medication rule of Traditional Chinese Medicine (TCM) compound patents for the treatment of colorectal cancer in the past 10 years.Methods:By searching for and extracted screening out TCM compound patents for the treatment of colorectal cancer and after the dada selection, data entry , data specifications, the compound patents database for the treatment of colorectal cancer was established. then used IBM SPSS Modeler and IBM SPSS Statistics software to perform frequency analysis, attribute analysis, association analysis and cluster analysis of TCM.Results:A total of 97 compound patents were included, including 411 TCM, among which the core medicines are Atractylodis macrocephalae rhizoma, Hedyotis diffusa, Astragali radix, Glycyrrhizae radix et rhizoma, Scutellariae barbatae herba, Poria, etc. The medicine is mainly cold and warm; The medicine mainly tastes bitter and sweet; The spleen meridian is the main meridian. The cluster analysis result shows there are 7 categories, and the paired TCM with strong correlation includes Hedyotis diffusa- Scutellariae barbatae herba, Atractylodis macrocephalae rhizoma- Curcumae rhizoma, Astragali radix- Codonopsis radix and so on. Conclusions:Treating colorectal cancer should take those medicine which could invigorate the spleen and nurture the deficiency, such as Atractylodis macrocephalae rhizoma, Astragali radix, Codonopsis radix, while for clearing away heat, detoxifying, promoting blood circulation and removing blood stasis, such as Hedyotis diffusa, Scutellariae barbatae herba, and Curcumae rhizoma. At the same time, it can be combined as appropriate, attacking and replenishing simultaneously, regulating qi and blood.

Objective To analyze the correlation between function of liver and kidney and blood lipid inde-xes and the prognosis of acute cerebral infarction.Methods 100 patients with acute cerebral infarction were selected.Serum levels of uric acid (UA),serum creatinine (Scr),serum triglyceride (TG),total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),and blood calcium (Ca2+).Fasting blood glucose (FPG),fibrinogen (FIB),D two polymer (D-D),serum homocysteine (Hcy),total bilirubin(TBIL),direct bilirubin (DBIL),and indirect bilirubin (IBIL)UA,Scr,TG,TC,LDL-C, HDL-C,Ca2+,FPG,FIB,D-D,Hcy,TBIL,DBIL and IBIL were measured in all the patients the next morning after admission.According to the CSS score,the patients were divided into mild group (0 -15 points,35 ca-ses),medium group (16~30 pointsminutes,34 cases),heavy group 3(31~45 pointsminutes,31 cases).The NIHSS score difference betweenin the scores of the two patients at admission and three months after the onset of the disease was calculated.The patients were divided into the improved group(score difference >0 points, 58 cases),no change group (score difference = 0,36 cases) aAnd worsening group(score difference < 0 point,6 cases).The levels of serum UA,Scr,TG,TC,LDL-C,HDL-C,Ca2+,FPG,FIB,D-D,Hcy,TBIL, DBIL,IBILof different severity and different prognosis of patients were compared and the relevance were ana-lyzed.Results The levels of UA,Hcy,FIB,DD and,LDL-C were the highest in the heavy group and the low-est in the light group.The levels of Ca2+,TBIL,DBIL and IBIL were the lowest in the heavy group,and the highest in the light group.The differences of above indexes between the three groups were statistically signifi-cant (P<0.05).There were positive correlations between the severity of the disease with serum levels of UA, Hcy,FIB,D-D and LDL-C (P<0.05),and a negatively correlations with serum levels of Ca2+,TBIL,DBIL and IBIL (P<0.05).The levels of UA,Hcy,and LDL-C were the highest in the worsening group and the low-est in the improved group,the levels of TBIL,DBIL and IBIL were the lowest in the worsening group and the highest in the improved group.The differences between the three groups were statistically significant (P<0. 05).The prognosis was positively correlated with serum levels of UA,Hcy and LDL-C (P<0.05),and nega-tively correlated with serum levels of TBIL,DBIL and IBIL(P<0.05).Conclusion The serum levels of UA, Hcy,FIB,D-D,LDL-C,Ca2+,TBIL,DBIL and IBIL were significantly correlated with the severity of acute cer-ebral infarction.The serum levels of UA,Hcy,LDL-C,TBIL,DBIL and IBIL were also correlated with pro-longed prognosis.