Objective To design and identify small interfering RNA (siRNA) targeting tumor necrosis factor‐α (TNF‐α) ex‐pression ,siRNAs were electroporated into synovial cells of Human to screen those which can effectively suppress TNF‐α expres‐sion .Methods Three TNF‐α specific double stranded siRNA were designed targeting different regions of TNF‐α mRNA(compared with negative control group) .RT‐PCR and Elisa were applied to detect TNF‐α ,mRNA expression and the secretion of TNF‐α in cell supernatant ,respectively .Results Two of the three customized TNF‐α siRNA could inhibit the expression of TNF‐α mRNA in synovial cells of Human (P< 0 .01) .At the same time ,the secretion of TNF‐α decreased in cell supernatant ,the difference was sig‐nificant statistically compared with the control group(P< 0 .01) .Conclusion TNF‐α siRNA can be successfully designed and syn‐thesized ,which can specifically and effectively suppress TNF‐α mRNA expression .

Objective To evaluate the diagnostic value of MRI in patients with trigeminal neuralgia. Methods MR manifestations and operative results of 104 patients with trigeminal neuralgia were reviewed retrospectively. Results (1)Of 104 patients with trigeminal neuralgia,75 patients had neurovascular compression or contact of the cisternal portion of the trigeminal nerve at MR imaging and 69 patients were verified by operation;14 patients had C P angle tumors, 13 cases were diagnosed by MRI and the remaining one was verified by the operation and pathology;5 patients had vascular lesions at MR imaging which were verified by microvascular decompression.(2) The percentages of the neurovascular compression or contact,tumors and vascular lesions which were the etiologles of trigeminal neuralgia were 66 3%(69/104),13 5%(14/104) and 4 8%(5/104) respectively.(3)The sensitivity and specificity of MR diagnosis was 89 4% and 96 6% respectively.Conclusion Neurovascular compression of cisternal portion of the fifth cranial nerve is the main cause of trigeminal neuralgia.MR plays an important role in demonstrating the relationship of the fifth cranial nerve to surrounding vascular structures or tumors.

A total of 101 lipid metabolism disorder patients with traditional Chinese medicine (TCM) syndrome of phlegm and turbidity retardation were collected and randomly divided into group A:Jiangzhi Decoction (JZF) alone (n =30),group B:atorvastatin (ATV) alone (n =39) and group C:JZF plus ATV (n =32).Lipid level,liver and kidney function,total effective rate and TCM scores were observed after a course of 2 weeks.Total effective rate:Group C was significantly superior to group B (90.62％ vs.76.92％,u =1.97,P ＜ 0.05) ; TCM score:Group C had a statistically superior advantage over groups A andB (C vs.A,90.62％ vs.80.00％,u=1.98,P＜0.05; Cvs.B,90.62％ vs.51.28％,u=4.11,P ＜0.01); TC and Improvements of total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C):Group C demonstrated marked decreases in both TC and LDL (CTC & CLDL-C vs.group A,P ＜ 0.01 ; CTC & CLDL-C vs.group B,P ＜ 0.01),no abnormal liver or kidney function occurred during the follow-up period.Thus JZF and ATV may have synergic lipid-lowering effects.And single uses of JZF and ATV have no marked differences in short term efficacy.

A bacterial strain capable of utilizing p-nitroaniline as sole carbon source to growth was isolated from sewage sludge. This strain was identified as Microbacterium sp. PNA8 based on its morphology, physiological, biochemical properties and 16S rRNA sequence analysis. Results indicated that the optimal temperature and pH for cell growth and for p-nitroaniline degradation was 30?C and 7.0. Strain PNA8 growth and p-nitroaniline degradation was considerably faster in the presence of yeast extract. Optimum conditions, in the culture medium added to 0.4 g/L yeast extract, 0.3 mmol/L p-nitroaniline degradation rate to 100% in 4 days.

Objective To investigate clinical anti-hypertension effect,clinical traditional Chinese medicine (TCM) syndrome improvement and endothelium function such as cardio-ankle vascular index (CAVI),flow-mediated dilatation (FMD) and endothelial micro-particle (EMP) protection of Tianma Gouteng Granule in interfering primary hypertension patients with hyperactivity of liver-yang.Methods Sixty six primary hypertension patients with hyperactivity of liver-yang were randomly divided into the control group (standardized treatment,n =35) and the treatment group (Tianma Gouteng Granule + standardized treatment,n =31) according to the random number method.In four weeks' follow-up treatment,the changes in clinical efficiency,TCM syndrome improvement,CAVI,FMD and EMP were observed.Results (1)Total clinical efficiency ratio was 71.43％ in control vs.70.97％ in treatment without statistical significance (P ＞0.05).(2) TCM syndrome improvement was better in treatment group than that in control group (93.55％ vs 74.29％,x2 =4.39,P ＜ 0.05),especially in improving symptoms such as dissiness,headache,dysphoria in chest,palms and soles,insomia and tinnitus (P ＜ 0.05).(3) In the aspect of endothelium protection,treatment group can greatly improve CAVI compared with control (L-CAVI ∶ t =2.11,P ＜0.05;R-CAVI∶ t =2.15,P ＜0.05) ; the levels of FMD(t =-4.65,P ＜0.01) and EMP (t =4.35,P ＜ 0.01)were significantly improved after treatment (P ＜ 0.05) while no statistical meaning was found between two group.Conclusions Tianma Gouteng Granule can improve TCM syndrome,decrease CAVI level.FMD and EMP were significantly decreased in treatment group.Multi-factor regression analysis showed that EMP level was related to pulse pressure.

Objective To investigate the safe zone and the soft tissue damage of two-incision minimally in-vasive total hip replacement,and to retrospectively analyze the clinical result.Method 20 adult cadavers(40 hips) were used for anatomic research.The Course of the later femoral cutaneous nerve was recorded.The angle between the intermission of the piriformis muscle and gluteus medius muscle with horizontal plane was also recorded.Analogue operation was taken on 3 fresh cadavers to assess the injury extent of soft tissues around incisions.27 cases under-went two-incision minimally invasive total hip replacement.Results LFCN was found potentially at risk as far as 6～71 mm medial to anterior superior iliac spine(ASIS)along the inguinal ligament,as much as 21～112 mm distal on the lateral border sartorius muscle from the ASIS.With the operative leg fully adducted,flexed over the nonopera～tire leg and the patella placed horizontal,the angle between the intermission of the piriformis muscle and gluteus medius muscle with horizontal plane is(60±5)°(range 55°-68°).Imitating modified two-incision THA on 3 freshhips revealed muscle contused on gluteus medius-piriformis muscle and gluteus minimus muscle.The average length of the anterior incision was 5.0 cm(4.6～6.5 cm)and of the posterior incision 3.7 em(3.0～4.2 cm).All of the patients were ambulant the day after surgery.Blood transfusion was carried out in 4 cases including one case of femo-ral neck fracture.The patients were followed up for 18 months(13～25 months).No other complications occurred.The mean Harris score was 94.5(92～96).Conclusion Front incision from the point inferior ASIS 3 cm and 1cmlater from ASIS vertically 6 cm should be chosen and the real incision should be 60°with horizontal plane.GIuteus medius,piriformis muscle and ghteus minimus muscle will be contused in two-incision minimally invasive surgeryto-tal hip replacement.Two-incision total hip replacement has the advantage of being muscle sparing and minimally in-vasive with less blood loss and rapid recovery.However,this technique is time consuming,technically demanding,and requires fluoroscopy.

To study the chemical constituents from the root of Berchemia lineata (L.) DC., nine compounds were isolated from the EtOAc extract by using silica gel, RP-C18 silica gel column chromatography and preparative HPLC. Based on the spectroscopic analysis, their structures were identified as 5-hydroxy-7-(2'-hydroxypropyl)-2-methyl-chromone (1), (-)-(1'R, 2'S)-erythro-5-hydroxy-7-(1', 2'-dihydroxypropyl)-2-methyl-chromone (2), naringenin (3), eriodictyol (4), (+)-aromadendrin (5), (+)-taxifolin (6), (+)-catechin (7), (+)-epigallocatechin (8) and quercetin (9). Among them, compound 2 is a new chromone derivative. Compound 1 is a known chromone derivative and isolated from this genus for the first time. Compounds 3-9 are known flavonoids and isolated from this plant for the first time.

Objective To explore the clinical and radiographic outcomes of minimally invasive transforarninal lumbar interbody fusion (MIS-TLIF) with unilateral pedicle screw fixation in treatment of one-level lumbar degenerative disease.Methods A total of 65 patients suffered from one-level lumbar degenerative disease between October 2009 and December 2011.They were divided into 2 groups according to different fixation ways.31 patients were given MIS-TLIF with unilateral pedicle screw fixation.The other 34 patients were given MIS-TLIF with bilateral pedicle screw fixation.Microscopic tubular retractor system (METRxMD) and Sextant system were used in all the procedures of treatment.The whole lumbar lordosis (WL),the segmnental lordosis (SL),fusion level disc space angle,lumbar scoliosis angle,and segmental scoliosis angle were measured pre and post operation according to standarded X-rays.The disc height index (DI) and the lumber curvature index (LI) were also evaluated.The Oswestry disability index (ODI) score and visual analog scale (VAS) pain score data were obtained from all the patients pre-operation and during each following-up procedure.Results All the patients were well followed up 18 months to 36 months(average 26.6 months).All the 65 patients were proved to achieve bone fusion in 12 months post-operation.The ODI and VAS scores post-operation improved significantly in each group,but showed no significant difference between the 2 groups.Likewise,there were no significant differences between the 2 groups in datas of WL,SL,fusion level disc space angle,lumbar scoliosis angle,segmental scoliosis angle,DI,and LI.But there was a positive linear correlation between the LI and WL in the 2 groups.Conclusion MIS-TLIF with unilateral pedicle screw fixation is as good as MIS-TLIF with bilateral pedicle screw fixation in patients of one-level lumbar degenerative disease.

Objective Although minimally invasive thoracoscopic surgery has unique advantages, there are still some difficulties in the complete resection of the thymus.Video-assisted thoracoscopic surgery has made up for the lack of thoracoscopy.This article summarize and analyze the clinical effects of DaVinci robotic surgery and thoracic surgery in the treatment of thymic diseases.Methods 116 cases of patients with thymic lesion were included in the study.According to the different treatment methods, 65 cases were included in da Vinci robotic group and other 51 cases were thoracoscopic group.Comparison was made in operating time, time of chest tube extubation, bleeding volume during surgery and amount of drainage within 24h after the operation between two groups.Results There were no statistical differences between robot group and thoracoscopic group in operating time(P>0.05).The time of pulling out the chest tube in robot group, postoperative days in surgical intensive care unit (SICU), and postoperative hospitalization days were significantly shorter than those in thoracoscopic group ([2.54±0.32]d vs [2.87±0.49]d, [0.75±0.04]d vs [0.81±0.06]d, [5.17±0.15]d vs [5.50±0.23]d, P<0.05).The bleeding volume during surgery and amount of drainage within 24h after the operation in robot group had a significant advantage over those in thoracoscopic group ([125.7±7.5]mL vs [136.6±8.2]mL, [117.38±11.45]mL vs [122.41±13.14]mL, P<0.05).Conclusion The da Vinci robotic surgery has the advantages of minimal trauma and rapid recovery, which makes up for the deficiency of thoracoscopy to a certain extent.

Objective To investigate the most sensitive methods for diagnosing spontaneous internal carotid artery dissection (sICAD) and spontaneous vertebral artery dissection (sVAD) respectively,for the sake of earlier and more accurate diagnosis.Methods Consecutive patients with sICAD and sVAD who visited the Department of Neurology and Radiology,Huashan Hospital Affiliated to Fudan University during 2008-2013 were retrospectively reviewed and the sensitivity of CT angiography (CTA),magnetic resonance T1-weighted fat-suppressed images (MR T1-FS) and digital subtraction angiography (DSA) for the diagnosis of sICAD and sVAD was compared.Results Eighty patients (62 male,18 female; mean age (45.7 ± 11.9) years) were included in the study.There were 99 arterial dissections in total,45 cases of sICAD,52 cases of sVAD and 2 cases of spontaneous middle cerebral artery dissections.The sensitivity of CTA,DSA and MR T1-FS for diagnosing sICAD was 97.5％ (39/40),90.0％ (36/40) and 69.6％ (16/23) respectively,while for sVAD was 89.8％ (44/49),84.6％ (44/52) and 100.0％ (27/27) respectively.Conclusions sICAD and sVAD have significant differences in many aspects including diagnostic strategies.CTA and MR T1-FS seem to be the most sensitive methods for the diagnosis of sICAD and sVAD respectively.Although DSA has been considered as the gold standard for the diagnosis of artery dissection,this imaging technique does not allow analysis of artery wall thickness,thus also has limitations.It is likely that the diagnostic sensitivity will be improved by combining CTA and MR T1-FS.