Objective:To investigate the hippocampus neuron injury,mitochondrial function and mitochondrial apoptosis related protein expression in kainic acid(KA) induced epilepsy rat,and to explore the role of mitochondrial pathways of apoptosis in the neuron injury.Methods:KA induced epilepsy model was produced by injection of KA into the hippocampus.Forty SD rats were randomly divided into five groups: control and KA group(6 h,1 d,3 d and 7 d),n=32.The concentration of Glu in hippocampus CA3 area was detected by HPLC.The apoptosis of hippocampus neurons and the concentration of free calcium ion were assayed by flow cytometry.The expression of cytochrome C and caspase-9 in hippocampus CA3 area was determined by Western blot.Results: ①The concentration of Glu in hippocampus CA3 area was increased in the fourth day after KA injection.②The concentration of free calcium ion,mitochondrial membrane potential,and the number of apoptosis neurons was significantly changed after 6 h of KA injection.Seven days after KA injection,these changes were more significant.③The hippocampus neuron expressed low levels of cytochrome C and caspase-9,and the expression of cytochrome C and caspase-9 was dramatically increased in a time dependent manner which increased by 4.37and 3.20 fold 7 d after KA injection.Conclusion:Mitochondrial pathways of apoptosis involve in hippocampal neuron apoptosis in KA induced epilepsy rat.

Objective: To evaluate the rationality of the use of antibiotic prophylaxis in the perioperative period of herniorrhaphy. Methods: Seventy-five cases of herniorrhaphy discharged in March, June and September of 2009 were collected. Parameters including indications, the types of antibacterial drugs, time of administration, solvent choice, usage and dosage, combination, etc, were assessed for the rationality according to the "the guiding principles of clinical use of antibacterial drugs"and other relevant documents. Results: The antibacterial drugs application rate was 100%, while the rationali-ty of the drug selection, the drug administration route, the single dose and the number of dosing, was 70.7%, 100% , 100% and 93.3% respectively. Sixty-two patients(82.7%)were treated with antibacterial drugs at 0.5～2 hours before surgery, and the average time course of the prophylactic use of antibiotics after surgery was 2.3 days. Conclusions: Some problems existed for the use of antibiotic prophylaxis in the perioperative period of herniorrhaphy. Surgeon should ensure the correct use of the antibacterial drugs to make the safety, efficiency, rationality, and economy for the patients.

Objective To observe the initial therapy outcomes of Valproic acid for childhood absence epilepsy (CAE),and to assess its therapeutic reaction and short-term prognosis,and to investigate the risk factors for initial therapy failure.Methods From January 2010 to December 2015,absence seizures as key words were used to search CAE in the video-electroencephalogram(VEEG) database of Children's Hospital Affiliated to Nanjing Medical University.Sixty-seven children fulfilled the CAE diagnosis criteria of International League Against Epilepsy in 1989.These patients were separated into 2 groups based on the therapy outcome after 6 months,including seizure control failure group and seizure control group.The patients' clinical characteristics and VEEG characteristics were reviewed.The gender,age of seizure onset,a family history of epilepsy or febrile seizures (FS),consistent with 2005 Panayiotopoulos diagnostic criteria,and VEEG findings were analyzed to evaluate the predictive ability of independent variables and the relationship between these features and treatment outcomes by using a stepwise multivariate Logistic regression model.Results The age at seizure onset was (5.89 ± 2.91) years old,and follow up duration was 6 months.Approximately 23 cases (34.3％) of CAE patients had poor response.No statistical correlation was made for gender,age at onset,the occurrence of generalized tonic clonic seizures,and family history of FS or epilepsy between 2 groups (all P ＞0.05).Compared with seizure control group,patients of the seizure control failure group had significantly higher rates of focal epileptic discharge (87.0％ vs.6.8％),higher rates of intermittent photic stimulation (IPS) induced seizures (52.2％ vs.6.8 ％),fewer rates of occipital intermittent delta activity (8.7 ％ vs.77.3 ％),and fewer rates of patients met the new diagnostic criteria proposed by Panayiotopoulos in 2005 (8.7％ vs.88.6％) (all P ＜ 0.001).The presence of occipital intermittent rhythmic delta activity during wake stage and the interictal focal epileptiform discharges on VEEG during sleep stage were significantly associated with the therapy outcomes in a multivariable Logistic regression analysis (OR =133.714,P ＜ 0.05;OR =0.068,P ＜ 0.05).Conclusions The presence of focal epileptiform discharges,and a typical absence induced by IPS are important factors for first-drug treatment failures with CAE,and conversely the occipital intermittent rhythmic delta activities have a good efficacy.There is no statistical correlation between clinical characteristics and treatment outcomes.

Objective To evaluate the effect of As2O3 combined with paclitaxel(PTX)on the treatment of lung cancer.Methods The anti-proliferation efficiency of As2 O3 combined with PTX was evaluated by MTT assay.Tumor spheroids were used to evaluate anti-tumor ability of As2 O3 combined with PTX.Transmission electron microscope (TEM)were used to observe the apoptosis morphous.A549 cell were xenografted in mice to establish the animal model,and the nude mices were devided into four groups,saline group,As2 O3 group,PTX group and As2 O3 +PTX group.The animal model were used to evaluate the effect of anti-tumor.The tumor size of every group were measured.HE was used to observe the apoptosis of cancer cells. Results The cell inhibition rate of A549 cell were(3.35 ±0.21)%,(47.55 ±2.25)%,(64.64 ±3.35)%and(84.58 ±3.76)%after treatment with saline,As2O3,PTX and As2O3combined with PTX after 48h respectively(P<0.01).The early apoptosis rate of cancer cells were 0.26%,9.7%, 17.8% and 42.5% for saline group,As2 O3 group,PTX and As2 O3 +PTX group respectively(P<0.01 ).The final tumor spheroid volumes in saline group increased 1.36 times after 7 days.The final tumor spheroid volumes reduced to(77.35 ±2.31)%,(61.68 ±2.44)% and(44.85 ±3.34)% in As2O3,PTX and As2O3 combined with PTX group respectively(P<0.01).The inhibition of lung cancer in vitro demonstrated the inhibition rate of tumor growth compared with saline group were(22.4 ±4.5)%,(39.5 ±6.2)% and(69.5 ±7.3)% for As2O3,PTX and As2O3 +PTX,respectively(P<0.01 ).Conclusion As2 O3 combined with PTX can effectively inhibit the proliferation of A549 cells and ectopic tumor growth in nude mice and it may be a potentially effective treatment for lung cancer.

Objective To explore the application of video laryngoscope in patients with pituitary adenoma during endotracheal intubation.Methods Fifty-one patients (19 males, 32 females, aged 18-71 years, ASA physical status I or II) scheduled for resection of pituitary adenoma under general anesthesia were enrolled.These patients were randomly divided into two groups: Macintosh laryngoscope Group (group M, n=25) and Video laryngoscope Group (group VL, n=26).When performing endotracheal intubation, Macintosh laryngoscope was used to expose the glottis in group M, and video laryngoscope was used in group VL.Head tilted backward angle, mouth opening, thyromental distance, neck circumference, mandibular ramus length, modified Mallampati classification and the difficulty classification of mask ventilation of the patients in two groups were recorded during peri-operation period.The Cormark-Lehane grade, needed pressing of the cricoids cartilage, the ratio of a second attempt during intubation and the intubation time consumed were recorded.Results Less patients in group VL needed cricoids cartilage press (7.7% vs 48.0%) during the intubation than that in group M (P<0.01).Compared with group M, the Cormack-Lehane grade was significantly lower (P<0.01) and the intubation time consumed was significantly shorter in group VL [(32.4±11.7)s vs (45.8±12.6)s] (P<0.01).Conclusion In patients with pituitary adenoma,video laryngoscope may improve the glottis exposure and the success rate of intubation, as well as shorten the intubation time.

Objective To explore the value of serum microRNA-155-5p and -133a-3p (miR-155-5p and miR-133a-3p) expression for the diagnosis and prognosis evaluation of sepsis. Methods A prospective observational study was conducted. 105 sepsis patients admitted to emergency intensive care unit (EICU) of the First Affiliated Hospital of Zhengzhou University from January 2015 to January 2016 were enrolled. They were divided into three groups according to the severity: 35 patients with sepsis, 35 with severe sepsis, and 35 with septic shock. At the same time, 35 healthy persons were selected as the control group. According to the prognosis, the patients were divided into improved group (n = 70) and in-hospital death group (n = 35). The clinical data of all the subjects were collected. The mRNA expressions of miR-155-5p and miR-133a-3p were determined by reverse transcription-polymerase chain reaction (RT-PCR). The receiver-operating characteristic curve (ROC) was plotted to evaluate their clinical value for the diagnosis and prognosis of sepsis. The binary logistic regression was used to analyze the risk factors affecting the prognosis of sepsis patients. Results ① The mRNA expressions of serum miR-155-5p and miR-133a-3p were gradually increased with the aggravation of sepsis. The mRNA expression of miR-155-5p (2-ΔCt) in sepsis, severe sepsis, sepsis shock groups was 1.89±0.48, 2.21±0.41, 2.79±0.73 (F = 23.737, P = 0.000), and the mRNA expression of miR-133a-3p (2-ΔCt) was 1.38±0.31, 1.74±0.65, 2.08±0.47, respectively (F = 27.710, P = 0.000). It was shown by ROC curve analysis that the area under the ROC curve (AUC) of serum miR-155-5p and miR-133a-3p for the diagnosis of sepsis was 0.855 [95% confidence interval (95%CI) = 0.761-0.949] and 0.769 (95%CI = 0.666-0.872) respectively. The cut-off value of miR-155-5p for the diagnosis of sepsis was 1.64, the sensitivity was 85.3%, and specificity was 80.6%. While the cut-off value of miR-133a-3p was 0.82, the sensitivity and specificity were 97.9% and 54.8% respectively. ② Compared with improved group, the patients of in-hospital death group were more serious, and procalcitonin (PCT), C-reactive protein (CRP), D-dimer, lactic acid (Lac), sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, and the mRNA expressions of miR-155-5p and miR-133a-3p were significantly increased (all P < 0.05). While there was no statistically significant difference in gender, age, white blood cells (WBC), serum creatinine (SCr) between the two groups (all P > 0.05). It was shown by binary logistic regression analysis that Lac [odds ratio (OR) = 0.514, 95%CI = 0.260-0.893, P = 0.024], sepsis severity (OR = 0.039, 95%CI = 0.023-2.955, P = 0.016), SOFA score (OR = 0.668, 95%CI = 0.474-0.825, P = 0.001), serum miR-155-5p expression (OR = 0.117, 95%CI = 0.020-0.530, P = 0.007) were the risk factors affecting the prognosis of patients with sepsis. Conclusions The expression of serum miR-155-5p and miR-133a-3p may be used as specific indicators for the diagnosis of sepsis. And the expression of miR-155-5p can be used as independent impact factor for the estimation of sepsis prognosis.

Objcetive: To investigate the effect of resveratrol (RES)combined with cisplatin (DDP)on the cholangiocarcinoma cell line FRH-0201 in vitro. Methods: FRH-0201 cells were exposed to different concentrations of RES or (and)DDP. Cell morphological changes were observed by light and fluorescence microscopy. Inhibition of cell proliferation was measured by MTT and colony-forming assay. And the flow cytometry were performed to detect the cell apoptosis rate and cell cycle. Results: Resveratrol inhibited the proliferation of FRH-0201 cells in a time-and dose-dependent manner in the concentration of 5～320 ?mol/L and the IC50 values after the exposure of 24, 48, and 72 h were 55.35, 32.84, and 28.01 ?mol/L respectively. RES and DDP had synergetic effect in the inhibition of FRH-0201 cells. Conclusion: RES can inhibit the growth of FRH-0201 cells and has the synergetic effect with DDP.

Objective: To evaluate the therapeutic efficacy of acupuncture plus Dang Gui Bu Xue Qu Feng Tang for benign essential blepharospasm (BEB). Methods: A prospective randomized controlled trial was performed. A total of 105 participants were randomized 1:1:1 into an acupuncture group, a herbal medicine group and an acupuncture plus herbal medicine group. Participants in the acupuncture group received manual acupuncture treatment, twice a week. Participants in the herbal medicine group received Dang Gui Bu Xue Qu Feng Tang, oral administration, once a day. Participants in the acupuncture plus herbal medicine group received both treatments. The therapeutic effects of the three groups were evaluated after four weeks of treatment. The primary outcome was the Jankovic rating scale (JRS) score, and the secondary outcome was the blepharospasm disability index (BSDI) score. Results: After four weeks of treatment, the JRS total scores significantly decreased in all three groups versus baseline (P<0.05). A greater reduction in the JRS total score was reported in participants in the acupuncture plus herbal medicine group (P<0.05), but there was no significant difference between the acupuncture group and the herbal medicine group (P>0.05). The acupuncture plus herbal medicine group had a greater decrease in the JRS severity score than the herbal medicine group (P<0.05). The reduction in the JRS frequency score was not significantly different among the three groups (P>0.05). The BSDI scores significantly decreased in all three groups versus baseline (P<0.05), but the reduction in the BSDI score was insignificantly different among the three groups (P>0.05). Conclusion: It is effective in the treatment of BEB either to use acupuncture and Dang Gui Bu Xue Qu Feng Tang alone or in combination. The combination therapy shows a more significant effect than either of the treatment alone.

Objective To observe dynamically the influence of Insulin-like growth factor-1 (IGF-1) on the nerve function and expression of bFGF protein and Basic fibroblast growth factor(bFGF) mRNA after cerebral ischemic reperfusion in rats.Methods Seventy-two SD rats were randomly divided into sham-operated group,cerebral ischemia group,and IGF-1 treated group.The rat model of middle cerebral artery occlusion (MCAO) and reperfusion was performed.The evaluation of etiology was performed with mNSS at 12 h,24 h,3 d,7 d after ischemia-reperfusion,expression of bFGF protein was determined with immunohistochemical technique and expression of bFGF mRNA was determined with RT-PCR.Results The ratings of mNSS in IGF-1 treated group((8.67± 1.21),(7.50± 1.52),(4.33± 1.03),(3.67± 1.37)) were lower than those in ischemia group((11.0±1.26),(9.83±1.33),(7.83±1.17),(7.17±1.72) at 12 h,24 h,3 d or7 d after reperfusion(P＜0.05).For the IGF-1 treated group,the expression level of bFGF protein was higher than that of the cerebral ischemia group (P＜0.05),especially at 12 h after reperfusion (P＜0.01).The expression level of bFGF mRNA in the IGF-1 treated group was higher than that of the cerebral ischemia group (P＜ 0.05),especially at 24h after reperfusion (P＜ 0.01).Conclusion IGF-1 treatment has a protective effects on cerebral ischemia injury,which may contribute to its action on regulating expression of bFGF protein and bFGF mRNA.

Objective To investigate the therapeutic efficacy of minimally invasive modified transforaminal lumbar interbody fusion (TLIF) combined with unilateral nail holding system in patients with extreme lateral lumbar disc herniation.Methods Thirty-eight patients with extreme lateral lumbar disc herniation were divided into minimally invasive modified TLIF combined with unilateral nail holding system group (observation group) and conventional open TLIF group (control group) with 19 cases each according to random digital table method.The therapeutic efficacy was compared between 2 groups.Results Surgery was completed successfully in 2 groups,and there was no perioperative complications.The amount of bleeding and hospital stay length in observation group were significantly less than those in control group:(152 ± 82) ml vs.(258 ± 104) ml and (6.5 ± 2.3) d vs.(12.7 ± 3.6) d,and the rate of fusion and score of Japan Orthopaedic Association 6 months after surgery in observation group were significantly higher than those in control group:18/19 vs.10/19 and (14.5 ± 2.1) scores vs.(12.6 ± 1.9) scores.There were statistical differences (P ＜ 0.01).There was no statistical difference in complications between 2 groups (P ＞ 0.05).Conclusion Minimally invasive modified TLIF combined with unilateral nail holding system in patients with extreme lateral lumbar disc herniation has less blood loss and shorter hospital stay,and it is effective and safe.