Objective To explore the role of serum bilirubin,homocysteine in the pathogenesis of acute cerebral infarction.Methods 150 patients with cerebral infarction were selected as the study group,and at the same time,110 healthy people were selected as the control group.We used automatic biochemical analyzer to determine the serum bilirubin level and enzyme-linked immunoassay was used to quantitatively determine the plasma homocysteine levels.At last,the data were statistically analyzed.Results (1) The concentrations of total bilirubin,indirect bilirubin and direct bilirubin of the study group were (9.74 ± 3.36) μmoL/L,(5.82 ± 1.65) μmol/L (3.80 ± 1.47) rnol/L,respectively,which were obviously lower than those of the control group [(14.35 ± 4.27) μmol/L,(8.22 ± 2.53) μmol/L,(6.07 ± 2.03) μmol/L,t =-2.528,-2.366,-2.256,all P ＜ 0.05].The concentration of homocysteine of the study group was (22.56 ± 7.35)pmol/L,which was obviously higher than (6.98 ± 3.35)μmol/L of the control group,the difference was statistically significant (t =16.973,P ＜ 0.05).The concentration of homocysteine was related to both total bilirubin(rs =-0.101,P =0.004) and indirect bilirubin (rs =-0.153,P =0.037).But there was no correlation between homocysteine and direct bilirubin (rs =-0.067,P =0.231).Conclusion Homocysteine may be a risk factor for cerebral infarction.Serum bilirubin may be protective factor for cerebral infarction involved in the occurrence and development of cerebral infarction.

Objective: To explore the effects of Layhey’s and Lawrence’s reconstruction procedures on nutritional status and digestive symptoms following total gastrectomy for gastric cancer.Methods: To analyze retrospectively 146 patients performed total gastrectomy for gastric cancer.Among them,83 cases were operated by Lahey’s reconstruction procedures and 63 cases by Lawrence’s.It was focused on the comparision of the body weight changing,nutritional status and digestive symptoms in 6 months after operation.Results: In 6 months after operation,the weight loss of Lawrence group was less than that of Lahey group significanly.For the level of total protein and albumin at that time,they increased in Lawrence group,but decreased in Lahey’ group,and the difference was significant.The changing tedency for hemoglobin level in Lawrence group was less than that of Lahey group,but there was no significant difference between them.For the quantity and frequency of food intake,there was no significnat difference between them.In Lawrence group,the number of patients with vomiting were less than that in Lahey’group significantly.Conclusion:The Lawrence reconstruction procedure is more reasonable following total gastrectomy for gastric cancer.

Objective To evaluate the effects of remifentanil on the proliferation,the cell cycle and apoptosis of human liver carcinoma cell line HepG2 in vitro.Methods Human liver carcinoma cells HepG2 were cultured in vitro.The HepG2 cells of the test group were incubated in the RPMI-1640 medium with remifentanil at different concentration(0.001,0.01,0.1,1,10,100,200 μmol/L).The HepG2 cells of the control group were incubated in the RPMI-1640 medium for 48 hours.The level of the cell proliferation was evaluated with methylthiazolyldiphenyl-tetrazolium bromide (MTT) method.The cell cycle was detected with flow cytometry (FCM).The morphological change of apoptosis cell was observed by fluorescence microscopy after staining by Hoechst33258.Results Remifentanil inhibited the proliferation of the HepG2 cells with a dose-dependent effect.Compared with control group,the cell proliferation capability was apparently decreased in the test group (P ＜ 0.05) when the concentration of remifentanil was over 1 μmol/L (P ＜0.05).However,no significant difference in cell proliferation was found when remifentanil was 100 and 200 μmol/ L.The ratio of G0/G1 phase of HepG2 cells was significantly enhanced and the ratio of S phase of HepG2 cells was significantly decreased when remifentanil was over 1 μmol/L.The fluorescent microscopy stained by the Hoechst33258 showed part of HcpG2 cells apoptosis in test group,and the apoptotic rate was significantly increased when remifentanil was over 1 μmol/L (P ＜ 0.05).Conclusions The data suggest that remifentanil would inhibit the proliferation of HepG2 cells and induce apoptosis when remifentanil was over 1 μmol/L.

BACKGROUND:Studies have shown that percutaneous vertebroplasty is a better method to repair osteoporotic vertebral compression fractures, but there are stil less specific schemes of transpedicular approach. Whether unipedicular or bipedicular approach is preferred is stil controversial. OBJECTIVE:To compare the clinical efficacy of percutaneous verterbroplastyviaunipedicular and bipedicular approach on osteoporotic vertebral compression fractures. METHODS:Totaly 118 patients with osteoporotic vertebral compression fractures who had been admitted at the Department of Orthopedics, the First People's Hospital of Kashi from June 2010 to June 2013 and folowed up over 1 year were enroled and randomly divided into unipedicular and bipedicular groups, with 59 in each group. These two groups were compared in terms of bone cement volume, bone cement leakage, kyphosis correction, vertebral height restoration, visual analog scale score, Oswestry disability index, activity of daily living scale score, SF-36 score, and postoperative complications. RESULTS AND CONCLUSION: The cement leakage rate was lower in the unipedicular group (34%) than the bipedicular group (37.3%), but there was no significant difference (P=0.701 > 0.05). The kyphosis correction and scoliosis correction had no statistical significance between the two groups (P > 0.05). The mean vertebral height was improved significantly in both two groups at 1 year after operation (P < 0.05), but there was no difference between the two groups before and after operation (P > 0.05). There were also no significant differences between the two groups in terms of visual analog scale score, Oswestry disability index, activity of daily living scale score, SF-36 score before and after operation, but these indexes were al improved significantly in each group at 1 year after operation than before operation (P < 0.05). The bone cement amount of the unipedicular group was lower than that of the bipedicular group (P=0.001 < 0.05), and the operation time was also shorter in the unipedicular group than the bipedicular group (P=0.000 < 0.05). No serious complications occurred in the two groups. These findings indicate that percutaneous verterbroplasty via unipedicular and bipedicular approach has good analgesic and repair outcomes in patients with osteoporotic vertebral compression fractures, and the unipedicular approach is better than the bipedicular approach in the folowing aspects: less bone cement volume, lower cement leakage and shorter operation time.

Objective To study the expression and clinical meaning of tight junctions protein regulator PKC θ in human meningioma tissue.Method The expression of PKC θ in 30 non-invasion and 30 invasion meningioma tissue is tested by using immunohistochemistry S-P method,with the goal of analyzing the relationship between the expression of PKC θ and pathology character.Results The positive rate ofPKC θ in invasion meningioma tissue is obviously lower than in non-invasion meningioma tissue.The difference is significant(P<0.05)Conclusions The lower expression of PKC θ in invasion meningioma tissue pmbably affects occurrence and invasion of the meningioma by ehang4ng the structure and function of TJs.

Objective To investigate the levels of lipoprotein associated phospholipase A2(Lp-PLA2),D-dimer(D-D),antithrombin Ⅲ (AT Ⅲ) in acute cerebral infarction (ACI)patients,and to analyzed their correlation with ACI.Methods Sixty-nine patients with ACI(ACI group) and 40 individuals undergoing healthy physical examination(control group) were selected in this study.The levels of Lp-PLA2,D-D and ATⅢ were compared between the two groups and their positive rates were statistically analyzed.Then the correlation between Lp-PLA2,D-D and ATⅢ with ACI was analyzed.Results The levels of Lp-PLA2 and D-D in the ACI group were higher than those in the control group,while the ATⅢ level was lower than that in the control group(P<0.05).Their positive rates in the ACI group were higher than those in the control group (P<0.05).Lp-PLA2,D-D and ATⅢ were correlated with ACI occurrence and had mutual correlation (all P<0.05).Conclusion Lp-PLA2,D-D and AT Ⅲ participate in the occurrence process of ACI,and their detection can be applied to screen out ACI high-risk groups,and may guide early prevention and early diagnosis of ACI.

Objective To study the prevalence and sequence homology of virulence genes exoU and exoS in 53 strains of pan-drug-resistant Pseudomonas aeruginosa .Methods The virulence genes exoU and exoS were detected by PCR.Sequence homo-logy was analyzed by BOX-PCR.Results Of the 53 clinical isolates of pandrug-resistant Pseudomonas aeruginosa ,the exoS+/exoU- genotype was identified in 40 strains,exoU+/exoS - genotype in 10 strains,exoS +/exoU+ genotype in 1 strain, and exoS-/exoU- genotype in 2 strains.BOX-PCR results showed that 41 exoS+ isolates belonged to 24 genotypes,and 11 exoU+ strains could be grouped into 7 genotypes.Conclusions The prevalence of virulence genes is high in clinical isolates of pandrug-resistant Pseudomonas aeruginosa .BOX-PCR fingerprint analysis combined with sequence homology analysis is help-ful for effective monitoring and control of hospital pandrug-resistant pseudomonas aeruginosa infection.

Objective To investigate the resistance and ?-lactamase of cefoxitin-resistant Klebsiella pneumoniae. Methods The minimal inhibitory concentrations were determined by standard agar dilution.Isoelectric focusing was used to measure the PI(s) of an isolate,s ?-lactamase,AmpC and ESBLs activity was confirmed by a three-dimensional extract method. Results The resistant rates of 40 strains were as follows: imipenem and meropenem 0.0%,cefepime 20.6%,cefotaxime(22.5%),ceftazidime 60.0%.The most isolates were demonstrated two or more ?-lactamase bands by IEF.Of 39 strains tested,ESBLs was detected in 31(70.5%) strains and AmpC-type?-lactamase in 16(41.0%) strains by three dimensional extract test. Conclusions These cefoxitin-resistant Klebsiella pneumoniae produced two or more ?-lactamases.It is imperative for clinical microbiology laboratories to detect and research ?-lactamases,especially AmpC enzyme.

Objective To discuss the clinical presentations and imaging features of a novel avianorigin influenza (H7N9).Methods Anteroposterior chest radiographs and serial thin-section CT images in 5 patients with H7N9 were reviewed retrospectively by two radiologists,the predominant inaging patterns of lung abnormalities and clinical data were recorded and analyzed.Results The large consolidation of the right lung with air bronchograms was the most common radiographic appearance in all patients with H7N9 at admission,and the abnormalities were more severe in the bilateral lower lobes.Both lungs developed large,scattered consolidations and ground-glass opacities with the progression of disease.The lesions in the left lung were more rapidly absorbed than those in the right lung.Conclusion Influenza H7N9 has certain chest imaging characteristics in the onset,progression and recovery of disease.

ObjectiveTo explore clinical characteristics and diagnosis of patients with granulocytic sarcoma (GS),and to evaluate the value of FCM in diagnosing it.MethodsClinical data of one patient with GS was reviewed and related literature was reviewed. ResultsThe patient was diagnosed as AML-M2,chromosomal karyotype was 46.XY, t (8;21)(q22;q22)and the AML/ETO gene was positive. Systemic chemotherapy with daunorubicin plus cytarabine was given and complete remission was received. Then a nodular in medial angle of right eye was found. Result of CT indicated the possibility of leukemia infiltration.Needle aspiration cytology was conducted and many blast cells were found by microscope.CD34+ CD117+ CD13+ CD33+CD45dim SSC+ can be found by FCM. The cytology was complete remission and minimal residual disease was negative. Finally diagnosis was GS, relapse of AML. After a systemic chemotherapy with large dose of cytarabine plus teniposide (cytarabine 6.0 g/d, d1-3;teniposide 50 mg/d, d1-3), the mass could not be touched and the follow-up was continued.Conclusion Although relapse of AML often occurs in the testicle or the central nervous system,it pay attention to the possibility of relapse of AML presenting as GS.Fine needle aspiration cytology(FNAC)combined with FCM can provide an convenient, handy, practicable and less invasive way of the diagnosis and can be a preferred detection technique.