Safflower Yellow is the essential component of Chinese traditional medicine Carthamus tinctorius with the effect of promoting blood circulation and removing blood stasis .Clinical studies have found its obvious curative effect in cardiovascular and cere -bral vascular diseases .Clinical treatment of angina , hyperlipidemia , cerebral infraction and arterial type cervical spondylosis in recent years was reviewed , which can provide references for treatment of cardiovascular diseases with Safflower Yellow .

Objective To determine the threshold of stroke volume variation (SVV) in determining the volume expansion responsiveness during fluid therapy in patients ventilated with different tidal volumes. Methods Fifty ASA Ⅰ or Ⅱ patients aged 20-75 yr undergoing elective gastrointestinal surgery under general anesthesia were randomly divided into 2 tidal volume groups (n = 25 each):group Ⅰ VT 8 ml/kg (group V1) and group ⅡVT 10 ml/kg (group V2). Radial artery was cannulated and connected to Vigelo monitor for continuous monitoring of cardiac index (CI), stroke volume index (SVI), systemic vascular resistance index (SVRI) and SVV. Internal jugular vein was cannulated for CVP monitoring. Anesthesia was induced with milazolam, propofol, fentanyl and rocuronium and maintained with intravenous propofol and remifentanil infusion. BIS was maintained at 40-50 during anesthesia. The patients were intubatel and mechanically ventilated (VT 8/10 ml/kg, RR 8-12 bpm, oxygen flow 2 L/min). 6％ HES 130/0.4 7 ml/kg was infused iv at a rate of 0.4 ml·kg-1 ·min-1 after induction of anesthesia. MAP, HR, CVP, CI, SVV, SVI and SVRI were recorded before and at 3 min after fluid therapy. The changing rate of SVV (△SVV) and CI (△CI) were calculated. The criterion for effective volume expansion was △CI 15%. The ROC curve for SVV in determring the volume expansion responsiveness was plotted and the diagnostic threshold was determined. Results ROC curve showed that the diagnostic threshold of SVV was 10.5 % in group V1 and 13.5% in group V2. The sensitivity and specificity in determining effective volume expansion were 93.3 % and 75.0 % in group V1 and 87.5 % and 85.7 % in group V2 respectively. The area under the curve for SVV and 95% confidence interval (CI) were 0.946 (0.860-1.031) in group V1 and 0.951 (0.868-1.034) in group V2. △SVV was negatively correlated with △CI in group V1 (=0.553) and V2 (= 0.602). Conclusion The threshold of SVV in determining the volume expansion responsiveness during fluid therapy is 10.5% and 13.5% in mechanically ventilated patients with tidal volume of 8 and 10 ml/kg respectively.

miRNA ( microRNA) is a small molecule, which is composed of about 20 nucleotides, and has been a hot research topic in recent years.Many studies indicated that the expression level of miRNA in tumor changed, which played a role in the differentiation and proliferation of tumor cells, as a function of oncogene or tumor suppressor gene.The occurrence and development of colon cancer is related to the abnormal expression of many genes, and the data shows that the abnormal expression of miRNA is closely related to the development of colon cancer.In this paper, the influence of miRNAs on the development of colon cancer and its relevant mechanism were collected, then the colon cancer occurrence, development and miRNA molecular mechanisms were studied, which provided a theoretical basis for the molecular target treatment of colon cancer.

Objective To investigate the effects of different target effect-site concentrations (Ces) of remifentanil on the sedative effect of propofol. Methods Fifty ASA Ⅰ or Ⅱ patients aged 20-55 yr weighing 48-86 kg with body mass index ＜ 30 kg/m2 were randomly divided into 5 groups ( n = 10 each) . Anesthesia was induced with TCI of remifentanil (Ce = 0, 2, 4, 6 and 8 ng/ml in groups R0-R4 respectively) and propofol. The initial Ce of propofol was 2.0 μg/ml in the 5 groups, and then the Ce of propofol increased by 0.5 μg/ml every 1 min until BIS value decreased to 50. BIS value and Ce of propofol were recorded as the patient lost consciousness. The effect-site concentration and consumption of propofol and the time required were recorded when BIS value decreased to 50.Results BIS value was significantly increased, while the effect-site concentration of propofol was significantly decreased as the patient lost consciousness, and the effect-site concentration and consumption of propofol were significantly decreased and the time required was shortened when BIS value decreased to 50 in R2-R4 groups compared with group R0 (P ＜ 0.05 or 0.01) . Conclusion The sedative effect of propofol can be enhanced when the Ce of remifentanil reaches 4 ng/ml, and the effects are comparable when the Ce of remifentanil reaches 4, 6 and 8 ng/ml.

ObjectiveTo investigate the association between catechol-O-methyl transferase (COMT)gene polymorphism and Gilles de la Tourette' s syndrome(GTS).MethodsUsing Amplification Refractory Mutation System(ARMS) PCR genotyping assay method,a polymorphism (val158met) of COMT gene was genotyped in 112 of all GTS patients ( total GTS group) including 54 GTS-alone patients group,48 GTS + ADHD patients group among of them and 71 healthy controls.The correlation between positive association of polymorphism (val158met)of COMT gene in GTS and the age of onset in patients with GTS was also analyzed.ResultsCompared with healthy controls group,genotype of val158met did not differ in total GTS patients group or alone-GTS patients group (χ2 =0.56,P=0.756;χ2 =1.05,P=0.600 respectively).There was also no significant difference (P＞0.05)in allele distribution of val158met in total GTS patients group or alone-GTS patients group compared with controls group respectively (χ2 =0.18,P=0.669;χ2 =0.29,P=0.593 respectively).However,genotype distribution of val158met was significantly different between GTS + ADHD patients group and controls group( χ2 =6.35,P =0.041 ).The frequency of the val allele of this locus was significantly higher in GTS + ADHD patients group than those in controls group ( χ2 =5.49,P =0.019 ).The mean age of onset (6.80 ± 1.54 ) in 36 children within GTS + ADHD patients group with the val/val geantype of COMT gene val158met polymorphism was significantly earlier than the mean age of onset (8.04 ± 1.54)in 12 children in val/val genotype (P =0.016 ).ConclusionPolymorphism (val158met) of COMT gene may be associated with GTS children with comorbid ADHD,which may play an important role to make the age of onset in children with GTS become earlier.

Objective To investigate the changes in the expression of acid-sensing ion channel 3(ASIC3)in the dorsal root ganglion(DRG)in a rat model of bone cancer pain.Methods Twenty-four female SD rats,aged 3-4 yr,weighing 180-220 g,were randomly divided into 2 groups:sham operation group(group S,n =8)and bone cancer pain group(group P,n =16).Bone cancer pain was induced by intra-tibial inoculation of 10 μl Walker 256 cancer cell suspension in group P,while group S received intra-tibial inoculation of 5 μl normal saline.Body weight and paw withdrawal threshold to mechanical stimulation with yon Frey filaments(MWT)were measured at 0,1,3,5,7,9,1 1 and 14 d after cancer cell inoculation.The tibia was removed at 14 d after cancer cell inoculation in group S and at 7 and 14 d after cancer cell inoculation in group P for pathological and imaging examinations.The tumor cell growth and bony destruction were observed.The expression of ASIC3 in the DRG was determined by immunolluorescence.Results Pathological damage occurred at 14 d after cancer cell inoculation,bony destruction was observed obviously,ant cortical bone was missing in many places.Compared with group S,body weight at T3-7 and MWT al T2-7:were significantly decreaed,and the expression of ASIC3 was up-regulated at 14 d after cancer cell inoculation in group P(P ＜ 0.05).Conclusion Up-regulation of the expression of ASIC3 in the DRG is involved in the developntent and maiutenence ot bone cancer pain in rars.

Objective To investigate the changes in the expression of acid-sensing ion channel 3 (ASIC3)in the dorsal root ganglion (DRG) in a rat model of bone cancer pain.Methods Twenty-four female Sprague-Dawley rats,aged 3-4 weeks,weighing 180-220 g,were randomized into 2 groups:sham operation group (group S,n =8) and bone cancer pain group (group P,n =16).Bone cancer pain was induced by inoculating Walker 256 carcinoma cells into the medullary cavity of the left tibia,while group S received normal saline instead.The pain threshold was measured after determination of body weight on the day of inoculation (T0) and on 1,3,5,7,9,11 and 14 days after inoculation (T1-7).The tibia was removed for microscopic examination of the inoculated tibia and X-ray examination.The growth of tumor cells and damage to the tibia were observed.The expression of ASIC3 in the DRG was detected using immunofluorescence.Results The tumor cell infiltration occurred in the medullary cavity and bone destruction was observed in P group.Compared with S group,the body weight was decreased at T3-T7,and the pain threshold was decreased at T4-T7,and the expression of ASIC3 in the DRG was upregulated at T7 in P group (P ＜ 0.05).Conclusion ASIC3 protein expression in DRG is significantly up-regulated in the rats with bone cancer pain,suggesting that the pathway may be involved in the mechanism of bone cancer pain.

OBJECTIVE: To investigate the location, staging, clinical symptoms, imaging features, and surgical treatment of the congenital cholesteatoma of middle ear (CCME). METHOD: This was a retrospective review of 20 CCME cases. RESULT: Of 20 cases with CCME, 2 cases were classified as Postic stage I, 0 as stage II, 13 as stage III, 5 as stage IV. Conductive hearing loss was the most common clinical symptom. The mean preoperative PTA was 54.1 dB, and the mean ABG was 41.7 dB. One case underwent a modified mastoidectomy and a second-stage ossicular reconstruction; 2 cases experienced a radical mastoidectomy without ossicular reconsturction for extensive cholesteatoma; 5 cases underwent modified mastoidectomy and a one-stage tympanoplasty, with one case diagnosed as congenital malformation of ossicular chain (stapes hypoplasia); other 12 cases underwent a one-stage tympanoplasty. The cholesteatoma localized to the posterior-epitympanum or mesotympanum in all patients, mainly located in the incudostapedial joint. The mean postoperative PTA from 16 cases was 35.3 dB, and A-B gap was 20.2 dB. All patients were followed-up for at least 1 year after operation and recurrence was found in 2 cases. Three cases were accompanied with congenital malformation of ossicular chain. CONCLUSION CCME is a rare entity and diagnosis is usually delayed in clinical practice due to the silent nature of disease in its early stage. The prognosis of CCME mainly depended on the stage of the lesions.
Adolescent ; Adult ; Child ; Child, Preschool ; Cholesteatoma ; classification ; congenital ; pathology ; surgery ; Cholesteatoma, Middle Ear ; classification ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Young Adult

BACKGROUND:Posterior maleolar fractures are often accompanied by ankle joint instability,if the stability of ankle joint is not recovered,it is prone to traumatic arthritis of the ankle.However,the indications of internal fixation of posterior maleolar fractures remain controversial.OBJECTIVE:To explore the indications for internal fixation of posterior maleolar fractures by comparing the clinical effects of posterior maleolar fractures treated with internal fixation or not.METHODS:42 patients with maleolar fractures involving posterior ankle were recruited from the First Affiliated Hospital of Chongqing Medical University from January 2007 to January 2012.According to preoperative CT scans of ankle joint,42 cases were divided into the internal fixation group and the non-fixation group.27 cases in the fixation group had posterior maleolar fractures in more than 10％of the distal tibial articular surface and/or dislocation of the posterior maleolar fractures greater than 2 mm,and were treated with screws.15 cases in the non-fixation group had posterior maleolar fractures in less than 10％of the distal tibial articular surface anddislocation of the posterior maleolar fractures less than 2 mm,and were treated with non-operation.The average healing time of posterior maleolar fractures,postoperative complications,ankle-hindfoot scores of American Orthopedic Foot and Ankle Society were compared during the folow-up postoperatively.RESULTS AND CONCLUSION:Al of 42 patients with ankle fractures achieved bony union within 6 months.In the fixation group,1 case had postoperative superficial infection of the wounds in the medial ankle and lateral ankle,and the wound got healed completely with anti-infection therapy.One case in each group had postoperative superficial necrosis in the incisional edges,and got healed by dress changing.For the other cases,there was no wound infection,internal fixation loosening,breakage or failure and other adverse events during the folow-ups.Ankle functions were evaluated one year after operations according to the ankle-hindfoot score standard of American Orthopedic Foot and Ankle Society.The score of the fixation group was (83.74±10.35) points,with excelent ankle functions in 10 cases,good in 12 cases,fair in 5 cases,and no poor case,and the rate of patients achieving excelent and good ankle functions reached 82％; the score of non-fixation group was (85.60±10.40) points,with excelent ankle functions in 7 cases,good in 5 cases,fair in 3 cases and no poor case.The rate of patients achieving excelent and good ankle functions reached 80％.The ankle function evaluation results of both groups showed no statistical difference (P＞0.05).It is reasonable to consider posterior maleolar fractures is higher than 10％of the distal tibial articular surface and/or dislocation of the posterior maleolar fractures greater than 2 mm as the indications for internal fixation of posterior maleolar fractures.

Objective To investigate the effects of reciprocal inhibition on motor function connectivity in the brains of stroke patients.Methods Thirty patients with stroke were randomly divided into a treatment group (n =15) and a control group (n =15).The control group underwent normal limb positioning,medium frequency electrotherapy,circulated compression of the limbs,etc.The treatment group received conventional rehabilitation treatment plus reciprocal inhibition treatment for 30 min daily,6 times a week for 4 weeks.All of the patients were assessed before and after treatment using the Canadian neurological scale (CNS),the Frenchay activities index (FAI),the motricity index (MI) and functional magnetic resonance imaging of the motor cortex in a resting state (rs-fMRI).Results In both groups the average CNS,FAI and MI scores improved significantly.Compared with the control group,the changes in FAI and MI scores in the treatment group improved significantly more.The coefficient of functional connectivity of the bilateral motor cortex decreased significantly after treatment in both groups.In the treatment group the motor cortex functional connectivity correlated significantly with the improvements in MI scores.Conclusions Reciprocal inhibition can accelerate the improvement of extremity motor function and ability in the activities of daily living significantly after stroke.It reduces functional connectivity in the bilateral motor cortex in ways significantly correlated with improvements in motor function.