MicroRNAs(miRNAs,miR) is a class of 21～22 nt small non-protein-coding single strand RNA molecules.In the liver,the phenotypic alternation or expressed abnormality of many miRNAs can influence the hepatitis virus replication at the gene level,which would provocate the development from hepatitis to hepatic fibrosis,cirrhosis,and even primary hepatic carcinoma on target.And so,several miRNAs are confirmed to be a new class of related gene to carcinoma.Furthermore,the dysfunction or abnormal quantity of miRNAs will promote the formation of fatty liver disease by interfering with signal transduction of insulin,inducing insulin resistance and then influencing normal metabolism of endosomatic lipid,Therefore,the specific medicine or methods,which might retrieve the expression or function of miRNAs in the hepatocytes,will provide a new valuable method to manage human liver disease.

Objective: To explore the effects of 17 β-estrogen (E2) and 2-methoxyestradiol (2ME) on hypoxic induced factor-1α (HIF-1α) and alkane hydroxylase (AlkB) in experimental rats with ovariectomy and hypoxic pulmonary hypertension. Methods: A total of 60 healthy female SD rats with castrated surgery were randomly divided into 6 groups:①Routine oxygen group,②Routine oxygen + E2 group, the rats received subcutaneous injection of E2 (20 μg/kg?d),③Routine oxygen + 2ME group, the rats received 2ME (240 μg/kg?d) and④Hypoxia group,⑤Hypoxia + E2 group,⑥Hypoxia + 2ME group.n=10 in each group and all animals were treated for 8 weeks to establish the hypoxic pulmonary hypertension model. The mean pulmonary artery pressure (mPAP) was measured after bloodletting, right ventricle hypertrophy index (RVHI) was calculated and small pulmonary artery remodeling was observed by HE staining. The expression level of HIF-1α and AlkB were examined by RT-PCR and Western blot analysis. Results: Compared with Routine oxygen group, the rats in Hypoxia group had obviously thickened small pulmonary artery wall with narrowed lumen, increased mPAP and RVHI; the above changes in Hypoxia + E2 and Hypoxia + 2ME groups were relatively smaller, their mPAP and RVHI were higher than Routine oxygen group, while mPAP and RVHI were similar between Hypoxia + E2 and Hypoxia + 2ME groups. There were no real morphological changes in small pulmonary vessels in Routine oxygen + E2 and Routine oxygen + 2ME groups. The HIF-1α expression was obviously elevated in Hypoxia group than Routine oxygen group, while the elevation was less in Hypoxia + E2 and Hypoxia + 2ME groups. HIF-1α expression had no real changes in Routine oxygen+E2 and Routine oxygen + 2ME groups. The AlkB expression was obviously reduced in Hypoxia group than Routine oxygen group, while the reduction was less in Hypoxia + E2 and Hypoxia + 2ME groups. AlkB expression had no real changes in Routine oxygen + E2 and Routine oxygen + 2ME groups. Conclusion: Estradiol E2 and 2ME could remit pulmonary hypertension which might be via up-regulating AlkB expression and down-regulating HIF-1α expression in experimental rats with hypoxic pulmonary hypertension.

The activation of NK cell , mediated by natural killer group 2 ( NKG2 ) family receptor , plays an important role in antiviral immune response and disease progression after hepatitis B virus (HBV) infection.To explore the NKG2 receptors-mediated NK cell activation and its mechanism may be of value for anti-HBV targeting immune treatment .This article reviews the recent research progress on the role of NK cells and its NKG2 family receptors in immunity of chronic HBV infection and its mechanisms .

Objective To analyze the results and complications of the treatment of intra articular calcaneal fractures with internal plate fixation. Methods From January 1998 to October 2004, 31 patients with calcaneal fracture (36 calcanea) were treated in our hospital. According to Sanders classification, there were 2 type Ⅱ,22 type Ⅲ,and 12 type Ⅳ. They were treated with reconstruction of the joint surface, internal fixation with screw and plate through the extensile lateral approach, and bone graft. The preoperative and postoperative data were statistically analyzed with SPSS 10.0. Results Follow ups lasted from 6 to 33 months with an average of 25 months. All the fractures healed 3 months after operation. On average, Bhlers angle was improved from preoperative 13.2?to postoperative 38.5?, Gissanes angle from 75?to 115.5?, and step distance from 5.0mm to 0.3mm. The differences between the preoperative and postoperative data were statistically significant(P

Objective To compare 3 kinds of preoperative scoring systems used to predict 30-day mortality in a hip fracture population,Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity (POSSUM),Portsmouth modified POSSUM (P-POSSUM) and Estimation of Physiologic Ability and Surgical Stress (E-PASS).Methods A retrospective study was conducted to analyze the aged 654 patients who had undergone surgery for femoral intertrochanteric fracture or femoral neck fracture from January 2010 through June 2014 at our hospital.They were 225 men and 429 women,60 to 103 years of age (average,71.7 years).There were 363 femoral intertrochanteric fractures and 291 femoral neck fractures.Closed reduction and intramedullary nailing was performed in 363 cases,artificial dipolar replacement in 242 cases,and total hip replacement in 49 cases.POSSUM,P-POSSUM and E-PASS scoring systems were used to predict the 30-day mortality.The discrepancy between the predictive risk and the actual observation was analyzed.Results Of the 654 patients,25 died within 30 days after operation.According to POSSUM scoring system,the predictability (observed deaths/POSSUM deaths) was 0.30,showing a significant difference between the predictive deaths and the actual deaths(x2=34.840,P=0.009).According to P-POSSUM and E-PASS scoring systems,the predictability was respectively 0.83 and 1.04,demonstrating no significant differences between the predictive deaths and the actual deaths(P ＞ 0.05).Conclusion P-POSSUM and E-PASS scoring systems may predict 30-day mortality more accurately than POSSUM scoring system in elderly patients undergoing hip fracture surgery.

Objective To provide a good anatomical foundation for transposition of the branch of median nerve superficial flexor muscle repairing the movement branch of ulnar nerve to recover the function of intrinsic muscle, by anatomic study of the muscle branch of the superficial flexor muscle of the median nerve and the movement branch of ulnar nerve. Methods Twenty adult upper limb specimens immersed fixed by formalin were elected and expose the midian nerve and ulnar nerve. Then every anatomical index was measured. Simulate to manipulate that the branch of superficial flexor muscle repair the motor b ranch of ulnar nerve. Calculate the number of myelinated nerve fibers of the branch of superficial flexor muscle. Results The distance between the position into muscle and styloid process of radius and styloid process of ulna: (21.4±1.8)mm, the distance that can be separated: (27.1±1.2)mm, the transverse diameter: (1.2±0.2)mm, anteroposterior diameter: (0.7 ± 0.1 )mm. No injury separated distance between the sensory branch and motor branch of ulnar nerve: (7.1 ± 0.7)cm. The 4th muscular branches of median nerve flexor digitorum superficialis was 1378.9± 107.9. Conclusion The 4th muscular branches of median nerve flexor digitorum superficialis can be used to repair the motor branch of the ulnar nerve to recover the function of intrinsic muscle of hand.

Objective To analyze the results of HBsAg weakly positive and both HBsAg and HBsAb simultaneously positive in 5 items of hepatitis B detected by ELISA .Methods 115 cases of HBsAg weakly positive and 95 cases of both HBsAg and HBsAb simultaneously positive were screened out from 35 280 cases of 5 items detection results of hepatitis B .210 screened samples were performed the electrochemiluminescence immunoassay (ECLIA) quantitation .Results 115 cases of HBsAg weakly positive were re‐detected by using ECLIA ,90 cases had the consistent results with the coincidence rate of 78 .3% .After ECLIA re‐detection in 95 cases of HBsAg and HBsAb double positive results ,11 cases had the consistent results with the coincidence rate of 11 .6% .Conclu‐sion The results of HBsAg weakly positive and both HBsAg and HBsAb double positive in 5 items of hepatitis B detected by ELISA must be cautious .In the detection results of HBsAg weakly positive ,the majority are the samples of HBsAg ,HBeAb and HBcAb positive and HBsAg and HBcAb positive .The results of HBsAg and HBsAb simultaneously positive have poor reliability , which should be careful to issue the detection reports .

Objective To report a new approach of splenic hilar lymph nodes dissection in radical gastrectomy for gastric cancer. Methods 193 cases of gastric cancer patient receiving radical resection of gastric cancer between May 2008 and October 2008 were studied. The tail and body of spleen and pancreas were thoroughly freed with retroperitoneal way retrogressively and extruded out of abdominal cavity in 80 cases. The other 113 cases received operation with routine way. Results In 80 cases who received operation with retroperitoneal approach retrogressively, the total splenic hilar lymph nodes were 519, the positive ones were 65, the positive rate was 12.5 %; In the other 113 cases the total splenic hilar lymph nodes were 565, the positive ones were 58, the positive rate was 10.3 %. The positive rate had statistic significance between these two groups. Conclusion Extruded splenic hilar lymph nodes dissection with retroperitoneal approach retrogressively is safe and has the same effect with splenectomy in gastric cancer operation.

Objective To evaluate the clinical efficiency and safety of thiazolidinediones (TZDs) on treat-ment of patients with nonalcoholic fatty liver disease (NAFLD). Methods The published controlled clinical trials about TZDs on treatment of patients with NAFLD from 1998 to 2008 were identified by searching in the full-text data base,such as Medline, PubMed, Ovid, EMCC, CBM Disc, CNKI, Wanfang, Weipu data and so on, as well as by searching of cross references from original articles and reviews. The enrollment standard was formulated strictly ac-cording to the designs of trials, and Meta analysis was performed by software package of Review Manage 4.2. Further-more, the statistic test, sensitivity and publication bias about the combined statistic data were revealed by referring to forest-graph and funnel-plot. Results All of the 473 patients in 18 controlled clinical trials were enrolled in this study. The weighted mean diffrerence of serum ALT, AST,TC,TG and BMI, HOMA-IR before and after treatment with TZDs 32. 24 (18.98-45.49) (Z=4.77,P<0.05),20.32 (2.30-38.35) (Z=2.21,P<0.05),0.26 (-0.01-0.54)(Z=1.88,P=0.06),0.63 (0.33-0.93) (Z=4.14,P<0.01),and -0.06 (-0.66-0.55) (Z=0.19, P=0.85),2.63 (1.33-3.93) (Z=3.96, P<0.01). In all papers, the improvement of hepatic tissue after treatment with TZDs in patients with NAFLD was observed in only 6 articles, which demonstrated the hepatic steatosis, inflammation and fibrosis [WMD (95% CI) 1.59 (1.08-2.10), 1.45 (0.90-2.00), 0.72 (0.12-1.32), Z= 6.08,5.16,2.33,P<0.05],especially the degree of NASH activity index,whose WMD (95% CI) was 4.21 (3.13-5.28) and Z=7.66,P<0.01, were improved significantly in the 104 NASH patients taken this kinds of drugs. There were 7 patients exiting from the all chnical trial, and the main adverse effects in patients accepting treat-ment with TZDs were debility, dizziness, edema of lower extremity, weight gain, indisposition of gastrointestinal tract, elevated liver enzyme and so on, which were similar to the control group. Conclusions The therapeutic effects of TZDs on NAFLD is confirmed. Not only are the serum liver enzyme,TC,TG and HOMA-IR in patients with NAFLD improved, but this new euglycemic agent has no acutely adverse effect in clinical application,which confirms the clin-ical efficiency and safety of TZDs on treatment of patients with NAFLD.