Objective To establish normal reference ranges for serum cystatin C (Cys C)in relatively healthy middle-aged and elderly(＞50 years)Chinese individuals.Methods A total of 1087 candidates were consecutively selected and serum Cys-C levels were measured by transmission turbidimetry.Frequency analysis and histogram were used to establish the 95％ confidence reference range according to methods provided by CLSI (C28-A2).Results Based on the definition and verification procedures for clinical laboratory reference ranges(CLSI C28-A2,second edition),Cys-C levels of 1087 participants fell within the range of 0.30-1.55 mg/L;Male participants had higher serum Cys-C levels than female participants(Z=-10.19,P＜0.01).The serum Cys-C level increased with age,regardless of gender(R =0.600,P＜ 0.01).Differences in Cys-C levels between age groups were statistically significant (x2=411.17,P＜ 0.01).The reference ranges of normal serum Cys-C levels for different age groups (50-,55-,60-,65-,70-,75-,) were 0.42-0.98mg/L,0.45-1.04mg/L,0.47-1.34mg/L,0.46-1.38mg/L,0.61-1.33mg/L,0.61-1.28 mg/L,respectively,for males,and 0.39-0.94mg/L,0.42-1.01mg/L,0.40-0.91mg/L,0.46-1.03mg/L,0.57-1.04mg/L,0.55-1.27mg/L,respectively,for females.Conclusions This study established preliminary normal serum Cys-C reference ranges for healthy middle-aged and elderly(＞ 50 years)individuals in this region,which can serve as parameters for disease diagnosis and treatment evaluation.

Objective To apply 3 .0T MRI in diagnosing injuries of anterior bundle of medial collateral ligament after elbow dislo‐cation .Methods The MRI features of the injuries of medial collateral ligament anterior bundle were analyzed retrospectively in 20 patients with elbow dislocation .The coronal ,sagittal ,axial and lamina oblique coronal were scanned routinely with SE T1WI ,T2WI‐FS sequences .Results Varying degrees of anterior bundle injuries of medial collateral ligament were observed in all the 20 patients ,in‐cluding the mild injury(n=8) ,part avnlsion(n=5) ,completely rupture(n=7) .Furthermore ,concomitant injuries including lateral collateral ligament(n=11) ,ringlike ligament(n=5) ,flex/stretch muscle tendon(n=9) ,and the fracture(n=7) were also observed . Conclusion The injuries of medial collateral ligament anterior bundle after elbow dislocation could be diagnosed accurately with 3 .0T MRI and the degree of injuries could also be defined on image .The 3 .0T MRI could be recommended as regular examination to pa‐tients with elbow dislocation .

AIM:To explore the involvement of oxidative stress and apoptosis in the pathogenesis of diabetic cataract induced by Streptozotocin ( STZ) and the interventions of puerarin in order to supply references for clinical treatment.
METHODS:Male SD rats were divided into four groups randomly, control group, diabetic group, apocynin group and puerarin group. The diabetic group were replicated by single injection of STZ (65mg/kg, ip). The expression of p22, p47, p67, Bax/Bcl2, Caspase 3 and P53 proteins were detected by Western Blotting.
RESULTS:The diabetic rats were replicated successfully and the expression of Bcl2 was downregulated while the expression of p22, p47, p67, Bax, Caspase 3 and P53 were upregulated in diabetic group with a significant statistical differences when compared with control group (P<0. 05). Apocynin and prerarin can reverse the abnormal expression of the aforementioned proteins dramatically (P<0. 05).
CONCLUSION: NADPH oxidase mediated oxidative stress and P53, Bax/Bcl2 mediated apoptosis are involved in the pathogenesis of diabetic cataract and puerarin can alleviate cataract greatly by inhibiting the aforementioned signal pathway.

Objective Using video tracking system to compare the effects of the locomotor activity between theophylline and caffeine in mice.Methods The KM mice were treated by theophylline and caffeine(both at 1,3,10,30,100 mg/kg)intraperitoneally respectively.After 10 min,the locomotor activity in the open field was recorded for 2 hours.The locomotor track,the total distance,the distances and distance ratio to total distance in central region were analyzed to evaluate the effects of these drugs on locomotor in mice.Results The mice administrated theophylline and caffeine both increased the total distances,and had similar bell-shaped dose-effect relationship.The distances reached the highest at 30 mg/kg theophylline((311±128)m)and 10 mg/kg caffeine ((279±89)m).The larger doses of caffeine inhibited the activity,and the total distance during 0～0.5 h was significantly decreased at the dose of 100 mg/kg(P＜0.05).Theophylline(30 and 100 mg/kg)and caffeine (30 mg/kg)significantly increased the distance ratio in central region(P＜0.01)and decreased the distance ratio in peripheral region(P＜0.01).Conclusion Theophylline and caffeine increase the total distance and the distance ratio in central region in mice,but have different valency and efficacy.

Objective To compare the clinical efficacy between continuous and intermittent androgen deprivation in high risk prostate cancer.Methods Sixty-four patients with high risk prostate cancer were treated from January 2008 to April 2009,36 cases who accepted goserelin and bicalutamide were taken as intermittent hormonal therapy (intermittent treatment group),while 28 cases who accepted bilateral orchiectomy in addition to flutamide were regarded as continuous hormonal therapy (continuous treatment group).The comparison of tumor specific mortality,time of prostate specific antigen (PSA) to nadir,tine to PSA recurrence,serum testerone and quality of life score were assessed between the two groups.Results In continuous treatment group and intermittent treatment group,follow-up period was (26.4 ± 10.3) and (28.1 ± 8.7) months,the time of PSA to nadir was (3.8 ± 2.1 ) and (4.0 ± 3.6) months,the time to PSA recurrence was (20.1 ± 12.3) and (24.5 ± 14.6) months,respectively.There was no significant difference between the two groups.At the time of 18,24 and 30 months after therapy,serum testerone was 0.85,0.88,0.89 μg/L in continuous treatment group,while 1.21,1.36,1.48 μg/L in intermittent treatment group,respectively (P ＜ 0.05 ).Similarly,quality of life score was 38.7,40.5,39.8 scores in continuous treatment group,while 49.2,51.4,52.3 scores in intermittent treatment group at the time of 12,18 and 30 months after therapy,respectively (P ＜ 0.05 ).Conclusions Clinical efficacy could not been found between continuous and intermittent endocrinic therapy of prostate cancer.During intermittent,quality of life seems to be better and increases in accordance with serum testerone recurrence at given time.

Background and purpose: Multidrug resistance (MDR) of tumor cell is the main reason for clinical chemotherapy failure as well as cancer recurrence and metastasis. This study was to construct a lentiveral vector of RNA interference of MDR1 gene and observe its inhibitive role on the expression of MDR1 in A549 and A549/DDP cells. Methods: Oligos of base pairs for hairpin RNA targeting MDR1 were chemically synthesized. Via annealing and inserting them into the down-stream of H1 promoter of linearized pSUPER, we obtained the siRNA constructs for MDR1, which were afterwards transfected into A549, a human lung cancer cell line expressing high level MDR1, the impact of constructs was observed on the expression and interference efficiency of siRNA against MDR1. The effective sequence of siRNA targeting MDR1 gene was confirmed. Both sense and antisence oligo DNA of the targeting sequence was designed, synthesized and cloned into the PTM vector, containing a promoter and a green fluorescent protein (GFP). The resulting lentiviral vector containing MDR1 siRNA was named PTM-siMDR1 and then transfected into A549 and A549/DDP cells after being confirmed by PCR and sequencing. Results: Restriction digestion and DNA sequencing showed that the siRNA constructs for MDR1 were successfully produced and the expressed siRNA could effectively down-regnlate the expression of MDRI. PCR demonstrated that the lentivirus RNAi vector of MDR1 producing PTM-siMDR1 was constructed successfully. The chemosensitivity of A549/DDP cells to cisplatin were enhanced obviously after trartsfection. Conclusion: The lentivirus RNAi vector of MDR1 can significantly revise the resistance ofA549/ DDP cells with eisplatin after infection.

Objective To investigate the cerebral blood flow in migraine without aura with three-dimensional arterial spin labeling technology .Methods From January 2013 to February 2016, magnetic resonance perfusion imaging was operated in 20 migraine patients without aura and 20 healthy controls by using arterial spin labeling, to determine their regional cerebral blood flow (rCBF) during migraine attacks and attack-free period.The significant difference was analyzed in rCBF between the two groups .Results The rCBF was significantly lower at the headache side during migraine period ( ( 52.77 ±5.97 ) ml? 100 g-1? min-1 ) than symmetrical side in the migraine patients without aura ((62.72 ±6.65) ml? 100 g-1?min-1 , t=3.780,P<0.01).The rCBF of temporosphenoid lobe in headache side in the migraine patients without aura ((53.97 ±5.87) ml? 100 g-1? min-1) was significantly lower than corresponding region in the control group ((59.21 ±2.35) ml? 100 g-1? min-1, t=4.449, P=0.001).And no significant difference in rCBF was found in migraine patients without aura under attack-free period. Conclusions Three-dimensional arterial spin labeling could quantitatively analyze the cerebral blood flow .Monitoring the perfusion difference in migraine patients could provide some references in the pathogenesis research and therapy.

Objective To explore the expression of N-myc downstream regulated gene 1 (NDRG1) in gastric carcinoma and the relationship with clinicopathological parameters and prognosis. Methods The expression of NDRGI was detected by immunohisto chemistry in formalin-fixed and paraffin-embedded sections with a total of 220 specimens including 110 gastric carcinoma and 110 corresponding paraneoplastic tissue. The correlation between clinicopathological parameters and the expression of NDRG1 in gastric carcinoma were also analyzed. Results Low expression of NDRG1 was detected in most gastric carcinoma sections. Among the gastric cancer tissues, NDRG1 protein expression was significantly lower in tumors with more advanced pathological stage, local tumor invasion and lymphatic metastases. There was no significant difference in sex, age, tumor differentiation and gross types of the tumor. The 1-, 3- and 5 year survival and disease free survival in patients with low NDRG1 protein expression was 84.2%, 53.9%, 21.1%, and 60.5%, 31.6%, 19.7%, respectively, which was signifivantly poorer when compared with patients with high NDRG1 protein expression. Conclusion The expression of NDRG1 is low in the majority of patients with gastric carcinoma, which was in a close relationship with advanced stage, local invasion and lymphatic metastases of gastric carcinoma. NDRG1 may be a candidate metastasis suppressor gene.

Objective To study the clincial effectiveness and safety of endoscopic sphincteropapillotomy combined with balloon dilation for decompensated cirrhosis accompanied with choledocholithiasis.Methods Data of 79 cases of decompensated cirrhosis patients with choledocholithiasis who underwent limited endoscopic sphincterotomy plus endoscopic papillary balloon dilation (ESBD,the ESBD group) and 42 cases who underwent endoscopic papillary balloon dilation(EPBD,the EPBD group)were retrospectively analysed and compared for complete stone clearance rate,one-time stone clearance rate and complications.Results The rate of complete stone clearance and one-time stone clearance were 94.9％ (75/79) and 77.2％ (61/79)in ESBD group,and those were 88.1％ (37/42) and 59.5％ (25/42) in EPBD group respectively.The rate of complete stone clearance was a little higher in ESBD group than that in EPBD group.In ESBD group,ERCP-related bleeding occurred in 3 patients (3.8％),post-ERCP hyperamylasemia in 3 (3.8％)and post-ERCP pancreatitis in 2 (2.5％) ; while in EPBD group,post-ERCP hyperamylasemia occurred in 8 patients(19.0％),post-ERCP pancreatitis in 6(14.3％) and ERCP-related bleeding did not occur.There were no significant difference in ERCP-related bleeding between ESBD group and EPBD group (P =0.551).However,the rates of post-ERCP pancreatitis and hyperamylasemia in ESBD group were significantly lower than those in EPBD group(P ＜ 0.05).Conclusion ESBD is a safe and effective procedure for choledocholithiasis accompanied by decompensated cirrhosis,with several advantages over EPBD in terms of higher one-time stone clearance rate,reduced risk of post-ERCP pancreatitis and hyperamylasemia,and without noticeable increase in the risk of bleeding related to ERCP.

The purpose of this study is to investigate the enantioselectivity of norgestrel (NG) transdermal permeation and the potential influence of linalool and lipids on the enantioselectivity. In vitro skin permeation studies of NG across the excised rat skins were performed with Valia-Chien diffusion cells, and the permeation samples were analyzed by enantioselective HPLC. The possible enantioselective permeation of NG across intact rat back skin and lipids extracted rat back skin and the influence of linalool were evaluated. The skin permeation rate of dl-NG was two times higher than that of l-NG when donor solutions (EtOH/H2O 2 : 8, v/v) containing l-NG or dl-NG. It may be mainly attributed to the solubility discrepancy between enantiomer and racemate. The enantioselective permeation of dl-NG across intact rat skin was observed when the donor solutions containing dl-linalool. The permeation flux of l-NG was 22% higher than that of d-NG. But interestingly, the enantioselective permeation of dl-NG disappeared under the same experimental condition except that the lipid extracted rat skin was used. Attenuated total reflection-fourier transform infrared spectroscopy analysis of stratum corneum showed that the wave number for asymmetric CH2 stretching vibrations of lipids treated with dl-linalool was greater than that of the control. The results indicated that the enantioselective permeation of NG may be contributed by the interaction between dl-linalool and lipids. More than half of lipids were composed of ceramides. The stereospecific interaction maybe existed among chiral enhancer (linalool), lipids (ceramides) and/or chiral drugs (NG).