Objective To confirm the risk factors of poor prognosis in patients with severe acute epiglottitis by comparing symptoms and results of laboratory tests.Methods A total of 698 patients with acute epiglottitis from outpatient and emergency room from 1995 to 2014 were retrospectively studied.These patients were divided into severe or mild group as per the means of treatment of airway including invasive (n =115)and non-invasive (n =583).The past history,general conditions and laboratory tests were compared between the two groups by chi-square or t test;the spearman correlation between the degree of dyspnea and epiglottis edema was analyzed,and the risk factors of poor prognosis were detected by logistic regression.Results The ratio of male to female was 1.366/1.There was a high prevalence of sever acute epiglottitis in spring,winter and at night, respectively.More smokers were found in the severe group compared with the mild group (χ2 =41.957,P <0.01).Severe dyspnea and low PaO2 (r =0.573,P <0.01),but not the poor grading of epiglottis edema evaluated by pharyngo-fiberoscope (r =-0.024,P =0.525),were correlated with poor prognosis.Male (OR =1.84,95%CI:1.41 -3.22,P =0.001),an attack at night (OR =2.61,95%CI:1.98 -3.16),P =0.07), smoker (OR =1.63,95%CI:1.05 -3.39,P =0.04)and low PaO2 (OR =2.97,95%CI:1.58 -4.49,P =0.02)were independent risk factors for a poor prognosis.Conclusions Male,an attack at night,smoker and low PaO2 were independent risk factors for a poor prognosis of acute epiglottitis.A critical care should be given to patients with those risk factors,even their epiglottis edema was not very serious.

Objective To understand the medical staff's real experience after implementing patients participate and interactive health education method.Methods A qualitative method was conducted with 2 doctors and 7 nurses.Data were analyzed based on Colaizzi phenomenotogical research method.Results 3 themes were extracted:conflict,including the role and the education methods;the benefits of patients participate and interactive health education method,such as palliative the relationship between medical workers and patients,and help patients to manage diseases,etc;and obstacles as work burden and time limit of medical staff,patients with low health literacy,negative psychology,lack of supervision and timely feedback on both sides.Conclusions Patients participate and interactive health education method is beneficial and feasible,but some obstacles we should faced in the implementation process.Its smooth implementation needs medical staff change idea,and also needs the support of some objective factors.

Objective To establish an high performance liquid chromatography-evaporative light scattering detector (HPLC-ELSD) method for determination of glucosamine hydrochloride and its related substances in glucosamine and indometacin enteric-coated capsules.Methods Separation was carried out on a Inertsil C8 Column (250 mm ×4.6 mm,5μm) with a mobile phase composed of acetonitrile-water(70∶30) at a flow rate of 1.0 mL/min and the column temperature was 25℃.Results The linear ranges of calibration curve was 25 -312.5 μg/mL(r=0.9991, n=6).The average recovery was 98.0%, and the relative standard deviation was 1.3%( n =5 ) .The glucosamine hydrochloride was stable with acid destruction, but unstable with alkali, heat and strong light destruction.Conclusion The method is simple, accurate and reproducible for determination of glucosamine hydrochloride and related substances.

Objective To research the effect of GANT61 on epithelial‐mesenchymal transition (EMT) in human lung cancer H1703 and A549 cells lines ,and to preliminarily investigate its action mechanism .Methods DMSO was used as the control(DMSO group) .After treating H1703 and A549 cells with GANT61 for 24 h ,the gene changes of Gli‐1 ,Gli‐2 ,E‐cadherin and Vimentin were detected by using the real time fluorescence quantitative PCR method .The influence of GANT61 on the expression of E‐cad‐herin and Vimentin protein after acting on H1703 and A549 cells was observed by using the Western blotting assay .The scratch healing test was performed to evaluate the effect of GANT 61 on the tumor cell invasion ability after acting on H1703 and A549 cells .Results The real time fluorescence quantitative PCR showed that ,compared with the DMSO group ,GANT61 down‐regulated the mRNA expression of Gli‐1 ,Gli‐2 and Vimentin mRNA of H1703 and A549 cell lines and elevated the expression of E‐cadherin protein(P<0 .01);the Western blotting showed that GANT61 down‐regulated the expression of Vimentin of H1703 and A549 cell lines ,and elevated the expression of E‐cadherin(P<0 .01);the scratch healing test revealed the invasion ability of H 1703 and A549 cells in the GANT61 treatment group was significantly decreased (P<0 .01) .Conclusion EMT in lung cancer is related with aber‐rant activations of Gli1 and Gli2 in Hedgehog signal transduction pathway ,GANT61 could influence the EMT ability in lung cancer cells by down‐regulating the expression of Gli‐1 and Gli‐2 .Gli could become a new molecular target for inhibiting the lung cancer cell metastasis.

Polyunsaturated fatty acids (PUFAs) are important structural fatty acids of biological membrane. They play important roles in regulation of lipid metabolism,stimulation of growth and development,protection a gainst cancer,retardation of aging,immuno-regulation, cardiovascular health,and bodymass loss. In recent years, researchers have found t hat ω-6 PUFAs can promote tumor angiogenesis,while ω-3 PUFAs have the properties of inhibiting tumor angiogenesis. This review focuses on the effects of these two types of fatty acids on tumors,especially on the regulation of tumor angiogenesis.

BACKGROUND:The studies about biomechanics of total knee arthroplasty were more, but the research on finite element analysis of the effect of total knee arthroplasty on proximal tibial reconstruction was not much.
OBJECTIVE:To study the effect of total knee arthroplasty on proximal tibial reconstruction using finite element analysis.
METHODS:We designed knee models of two materials:one was functional y graded material models of col agen and titanium composite materials;another was titanium al oy material model. We created two prosthesis material tibia-knee prosthesis model, and analyzed bone density distribution of proximal tibia, the maximum stress value of the medial tibia and the lateral tibia, and the maximum stress value of medial tibia and prosthesis junction, as wel as lateral tibia and prosthesis junction after knee arthroplasty.
RESULTS AND CONCLUSION:(1) Bone density of proximal tibia after total knee arthroplasty:The bone density of the knee prosthesis handle with medial and lateral tibia at the junction of tibial plateau was decreased than that of the initial state. Stress shielding effect was lower in col agen and titanium composite materials of functional y graded material models than that of titanium al oy material model. The bone density of shank end of the tibial prosthesis was obviously increased compared with the medial and lateral tibia, showing stress concentration. (2) The maximum stress value of the medial and the lateral tibia:The maximum stress value of the medial and the lateral tibia in col agen and titanium composite models was lower than that of titanium al oy material model. The maximum stress values of the lateral tibia of col agen and titanium composite models and titanium al oy material model were lower than that of medial tibia. (3) The maximum stress of medial tibia, lateral tibia and prosthesis junction:The stress distribution of col agen and titanium composite models was relatively uniform. The stress distribution of titanium al oy material model showed fluctuation. Stress concentration appeared in pal ets and prosthesis junction and the shank end of the prosthesis. The maximum stress values of lateral tibia and prosthesis junction of col agen and titanium composite models and titanium al oy material model were lower than that of medial tibia and prosthesis junction. (4) These findings showed that knee prosthesis has a certain stress shielding effect on tibia after total knee arthroplasty. The stress shielding effect of col agen and titanium composite material prosthesis was lower than titanium al oy material prosthesis, and could improve tibial incurred stress.

AIM: To investigate the effects of tripchlorolide (TP) on proliferation and autophagy of human lung cancer A549 cells, and explore its mechanism.METHODS: MTT assay was performed to analyze the effect of TP on the viability of human lung cancer A549 cells.The A549 cells were treated with TP, and their autophagy was observed un-der the fluorescence microscope through acridine orange staining.Green fluorescence spots were observed by fluorescence microscopy through GFP-LC3 plasmid transfection experiment.The levels of LC3 and p-ERK in the A549 cells after TP treatment were determined by Western blot.RESULTS: The viability of human lung cancer A549 cells was significantly inhibited by TP in a dose-time dependent manner (P <0.05).The number of the intracellular acidic follicles dyed with bright red fluorescence was significantly increased after TP treatment in A549 cells.The number of green dot-like con-gregate autophagosomes in cell cytoplasm was significantly increased after TP treatment in the A549 cells transfected with GFP-LC3 plasmid, while the normal treatment only induced a few cells with autophagosome formation.At the same time, we did not observe the dot-like congregate autophagosomes after TP treatment in the A549 cells transfected with GFP-control plasmid.Compared with control group, the expression of LC3-II protein was up-regulated in A549 cells after TP treatment (P <0.01).Furthermore, treatment with TP in A549 cells for 48 h also led to a significant upregulation of phosphorylated form of ERK (P <0.01).In contrast, no significant change in the levels of total ERK protein was observed.Compared with 100 nmol/L TP group, TP +3-MA group down-regulated the protein levels of LC3-II (P <0.01) and p-ERK (P <0.01) in the A549 cells.CONCLUSION: TP significantly inhibits the growth of A549 lung cancer cells and induces the
autophagy, which may be correlated with upregulation of p-ERK protein.

Objective To explore the independent influencing factors on the survival of patients with cervical cancer .Methods Five hundreds and nintheen surgery patients with cervical cancer ,and hospitalized in the Tumor Hospital Affiliated to Harbin Medical University between January 2007 and December 2008 were cho-sen as our research object .We analyzed the influence of different biological behaviors on the outcome of patients with cervical cancer by using univariate and multivariate COX regression ,and then explored the prognostic factors of patients with cervical cancer.Results Among all biological behaviors,tumor size(P=0.015),lymph node metastasis(P<0.001),ovarian metastasis(P<0.001),utero-tissue infiltration(P<0.001),vaginal stump(P=0.040),myometrial in -vasion(P=0.001)and lymph vascular space involvement (P<0.001)affected pa-tients′outcomes significantly.The results of univariate COX regression showed that the tumor size (RR=2.325), histological grade(RR=3.195),lymph node metastasis(RR=3.196),ovarian metastasis(RR=7.016),utero-tissue infiltration(RR=7.487),myometrial invasion(RR=4.688)and lymph vascular space involvement (RR=4.014)were significantly associated with the prognosis of cervical cancer .In addition,the results of multivariate COX regression indicated that histological grade (RR=2.092),ovarian metastasis(RR=5.680),utero-tissue infiltration(RR=4.114),myometrial invasion(RR=2.065)and lymph vascular space involvement (RR=3.11) were significantly associated with the prognosis of cervical cancer .Conclusion Histological grade ,ovarian metas-tasis,utero-tissue infiltration,myometrial invasion and lymph vascular space involvement were independent influ -encing factors of prognosis of cervical cancer .

Objective To investigate the effect of early acupuncture at Huatuo jiaji points on striatalβ-endorphin and dynorphin levels in rats with post-stroke limb spasm.Methods Seventy SD rats were randomized into group A (normal) of 9 rats and group B (sham operation) of 10 rats. After a model of post-stroke limb spasm was made in the remaining rats, they were randomized into groups C (model), D (acupuncture at Huatuo jiaji points) and E (baclofen). Group D received acupuncture at Huatuo jiaji points and group E, an oral gavage of baclofen tablets. After seven days of treatment, striatalβ-endorphin and dynorphin levels were neasured by radioimmunoassay.Resultsβ-endorphin levels increased significantly in groups C, D and E compared with groups A and B (P<0.01) and also in groups D and E compared with group C (P<0.01,P<0.05). There was no statistically significant difference inβ-endorphin levels between groups D AND E (P>0.05). Dynorphin levels increased significantly in groups C, D and E compared with groups A and B (P<0.05,P<0.01). There was no statistically significant difference in dynorphin levels between groups D and E (P>0.05).Conclusions Acupuncture at Huatuo jiaji points can increase striatalβ-endorphin levels but not change striatal dynorphin levels, which conforms to the relationship between enkephalin and spasm, and improve the animal’s spasticity.

BACKGROUND:Current clinical studies seldom concern biomechanical properties of lateral plate combined with medial percutaneous lag screw. Moreover, effects of clinical application to distal tibial fractures are not investigated. OBJECTIVE:To explore biomechanical properties of lateral plate combined with medial percutaneous lag screw, and to analyze the repair effect on distal tibial fractures. METHODS:Six adult antiseptic tibia specimens were studied. Bone saw was used to make a bone defect in 1 cm length, which was fixed with lateral plate and lateral plate combined with medial percutaneous lag screw. Three point bending test, axial compression test and rotation test were performed. Clinical data of twenty cases of distal tibial fracture patients from the Department of Orthopedics of Hebei Medical University were analyzed and randomly divided into lateral plate groupand lateral plate combined with medial percutaneous lag screw group (n=10). Clinical repair effects were compared between the two groups. RESULTS AND CONCLUSION:(1) Biomechanical indexes of cadaver specimens: no significant difference in torsional strength was determined between the two groups (P> 0.05). Bending stress and axial displacement were significantly lower in the lateral plate combined with medial percutaneous lag screw group than in the lateral plate group (P< 0.05). (2) Repair surgery related indicators: operation time, intraoperative blood loss, length of stay and fracture healing time were significantly less in the lateral plate combined with medial percutaneous lag screw group than in the lateral plate group (P< 0.05). (3) Repair effects: There were nine cases of fracture healing in the lateral plate combined with medial percutaneous lag screw group 3 months after treatment. The total effective rate was significantly higher in the lateral plate combined with medial percutaneous lag screwgroup (90%) than in the lateral plate group (70%) (P<0.05). (4) These findings indicate that lateral plate combined with medial percutaneous lag screw has a unique advantage in resisting axial compression, torsion and bending. Its application to distal tibial fractures obtains ideal effects, can improve the clinical efficacy and stability.