Objective To evaluate the therapeutic effect of plasmid encoding interleukin 4 (pIL-4) administered via gene-gun delivery and intradermal injection on collagen-induced arthritis (CIA). Methods IL-4 plasmid was administered by gene-gun delivery and intradermal injection to DBA/1 mice immunized with type Ⅱ collagen (CⅡ). Its effect on the development of CIA was evaluated clinically with the visual analogue scoring method for arthritis and serologically by enzyme linked immunosorbent assays (ELISA) and polymerase chain reaction. Results Treatment with IL-4 plasmid could significantly reduce the incidence and severity of CIA including a reduction in the anti-CⅡ antibody level. Gene-gun delivery had a stronger immunosuppressive effect on CIA compared with intradermal injection. As shown by in vitro stimulation assay, the speen cells from mice immunized with CⅡ and treated with IL-4 plasmid via gene-gun exhibited higher Th2 cytokine responses compared with cells treated with control plasmid after in vitro stimulation with CⅡ. Conclusion The results of this study suggest that treatment with IL-4 plasmid may constitute a new approach of cytokine gene therapy for rheumatoid arthritis.

Objective To explore the role and possible mechanism of transforming growth factor (TGF)-β autocrine in CDH17 regulating invasion of gastric cancer cells.Methods Construction and transfection of siRNA-CDH17 into MKN-45 gastric cancer cell line to silence the expression of CDH17.Expression of TGF-β and concentrations of TGF-β in supernatants were detected before and after CDH17 silence by immunofluorescence,immunoblotting and ELISA.The autocrine situation of TGF-β was observed.Meanwhile,the activation of TGF-β/Smad3 signaling pathway was also detected by immunoblot.After giving signaling pathway inhibitor,the changes of invasion ability of MKN-45 cells were observed by Transwell invasion experiment.The role of TGF-β autocrine and related signaling pathway activation in CDH17-regulated invasion of gastric cancer cells was evaluated.Results After transfecting siRNA-CDH17 for silencing CDH17 expression in MKN-45 cells,the expression of TGF-β was significantly decreased compared with non-transfection group,its concentration in supernatants was also significantly reduced[(510 ±55)pg/mL vs.(115±20) pg/mL,P<0.01].The immunoblots revealed that phosphorylation level of Smad3 after CDH17 silence was also significantly diminished.However,giving the TGF-β/Smad3 signaling inhibitor SIS3 (10 μmol/L) could also suppress the phosphorylation level of Smad3 when CDH17 was highly expressed,meanwhile silencing CDH17 and inhibiting Smad3 phosphorylation could significantly decrease the invasion of MKN-45 gastric cancer cells (P<0.05).Conclusion CDH17 could participate in the invasion of gastric cancer cells by promoting TGF-β autocrine to activate TGF-β/Smad3 signaling pathway.

Objective To discuss the clinical feature, diagnostic main points and treatment of diffuse axonal injury(DAI). Methods The clinical materials and imaging findings and treatment and prognosis of 48 cases with DM were analyzed retrospectively. Results 18 cases showed a good outcome, while 12 were moderately disabled, 10 severely disabled or survived in a permanent vegetative state and 8 cases died. Conclusion To preserve the fluent respiratory tract, to control intracranial pressure, to treat with hyperbaric oxygenation and high-dose naloxone in early time were crucial in clinical practice to DAI.

Objective To investigate the clinical results and prognosis between proximal and total gastrectomy in proximal advanced gastric cancer.Methods The clinicopathological data of 221 patients with proximal advanced gastric cancer who undcrwent radical gastrectomy were retrospectively analyzed.82 patients and 139 patients underwent proximal and total gastrectomy respectively.The number of dessected lymph nodes,postoperative complications and mortality were compared.Kaplan-Meier survival rate curves and Log-rank test were drawn and compared.Results A total of 1 411 (11-34) and 3 345 (14-35) lymph nodes were harvested from the surgical specimens of 82 and 139 patients with proximal and total gastrectomy respectively,the average number of harvested lymph nodes was 17 ± 11 and 24 ± 10 (t =2.586,P ＜0.05).The overall complications in proximal gastrectomy were higher than total gastrectomy (73.2％ vs.30.2％,x2 =38.291,P ＜0.01).The ratio of functional delayed gastric emptying,anastomotic leakage and stenosis,reflux esophagitis in proximal gastrectomy patients was higher than total gastrectomy.The survival rate in proximal gastrectomy were lower than total gastrectomy in proximal advanced gastric cancer (P ＜0.01).Conclusion Total gastrectomy is recommended for proximal advanced gastric cancer.

Objective To analyze long-term efficacy after surgical treatment of primary liver cancer with fluorouracil plus oxaliplatin plus gemcitabine joint implementation to prevent the overall intervention effect of hepatic arterial infusion chemotherapy and radical resection of hepatocellular carcinoma following ascension.Methods60 cases of primary hepatocellular carcinoma were randomly divided into study group and control group according to the random number method in our hospital from February 2011 to November2013, 30 cases in each group.All patients underwent radical resection of liver cancer and liver (partial) resection.In the control group, the patients were treated with anti viral or immune enhancement after surgery, and the follow-up treatment was not carried out.In study group were given anti-virus or immune intensive treatment and at the end of surgery 3 and 7 weeks after the implementation of a prophylactic transcatheter arterial infusion chemotherapy and selecting drug 5-FU, oxaliplatin and gemcitabine.During 3 years of follow-up, the incidence of adverse reactions in the 3 groups was statistically analyzed, and the recurrence free survival rate, disease-free survival rate and overall survival rate of the two groups were statistically analyzed.ResultsAll patients completed the follow-up, there was no loss of follow-up cases.In adverse reactions, the study group patients were successfully tolerated hepatic artery infusion chemotherapy, no obvious adverse reactions or drug toxicity, more no interruption of chemotherapy cases.The recurrence free survival rate, disease-free survival rate and overall survival rate of the study group were 83.33%, 70.00%, 86.67%, respectively, which were significantly higher than those in the control group (60.00%, 43.33%, 63.33%) (P<0.05).ConclusionPrimary hepatocellular carcinoma should be treated with prophylactic hepatic arterial infusion chemotherapy in time after radical operation, which can greatly improve the survival rate of patients and ensure long-term curative effect.

ObjectiveTo review the experience with surgical removal of meningiomas in the falx cerebri and sagittal sinuses.MethodsThirteen patients with meningiomas in the falx cerebri and sagittal sinuses were retrospectively analyzed.ResultsTumors in eleven patients were totally removed( Simpson Grade Ⅰ and Ⅱ ),while in two patients they were subtotally resected( Simpson Grade Ⅲ and Ⅳ ).After operations,no patient died.ConclusionAdequate surgical exposure,efficient management of operative bleeding,protection and replacement of the sagittalsinus,and avoidence of damage to the brain tissues were the key factors to improve operative effect.

Objective To explore the significance, indicatinos and complications of emergency tracheotomy for patients with severe craniocerbral trauma. Methods The clinical data of 42 patients with severe craniocerbral trauma were retrospectively analyzed. Results Of them, 20 were basically cured (48%), 12 had improvement (29%) ,3 were released from the hospital(7 % ), 1 survived(2 % ) in a vegetative state,and 6 died(14%). Conclu- sion Emergent tracheotomy should be performed on patients with severe craniocerbral trauma to resolve respiratory tract obstruction, improve air current, prevent cerebral anoxia, prevent and treat pulmonary infection, increase the therapeutic efficacy.

Objective To explore treatment methods and prognosis of external ventricular drainage .Methods A retrospective analysis of 66 cases with severe intraventricular hemorrhage patients were selected ,36 cases underwent bilateral ventricle drainage and urokinase ( UK ) intraventricular fibrinolysis therapy +terminal cistern drainages , 30 cases with bilateral ventricle drainage and urokinase for intraventricular fibrinolysis .The prognosis of the patients with modified Rankin Scale score was assessed .After multiple cerebral CT examination hematoma imaging changes were observed.Results A group of intraventricular hemorrhage clearing time (5.3 ±1.5)d,B group of intraventricu-lar hemorrhage clearing time (8.2 ±2.5)d,there was significant difference (t=-5.820,P=0.000).Rate in group A was 83.3%(30/36),group B was 66.7%(20/30), there was no significant difference (χ2 =2.475,P=0.116). Conclusion This study suggests that intraventricular hemorrhage were given bilateral ventricle drainage and uroki -nase for intraventricular fibrinolysis therapy +terminal cistern drainages effect is better .

Objective To evaluate the clinical value of endovascular embolization in the treatment of intracranial aneurysm.Methods 41 patients with 46 intracranial aneurysms were treated by endovascular embolization with different treatment protocols and the clinical data were analyzed.Results Intracranial aneurysms were embolized with detachable coil in 33 patients with 38 aneurysms,rupture of aneurysm occurred during the operation in 1 patient.Seven patients with 7 aneurysms were treated with intraeranial covered stentand,no nerve dysfunction occurred.One patient with 1 aneurysm was embolized by parent artery,no occlusion nerve dysfunction occurred.Conclusion Endovascular treatment is a minimally invasive,safe and effective technique for treating intracranial aneurysms.

Objective To construct the recombinant RIP3 over-expressed plasmids and transfect them in breast cancer MCF7 cells, and identify the expression and localization of fusion protein, as well as its effect on the death way of MCF7 cells. Methods The expression levels of RIP3 mRNA in four breast cancer cell lines and normal mammary epithelial cells were detected by reverse transcription polymerase chain reaction (RT-PCR). The RIP 3 coding sequence was amplified by polymerase chain reaction and subcloned into mCherry vector to construct recombinant plasmids. The plasmids were transfected into MCF7 cells by lentivirus after DNA sequencing, then screened by basticidin (4 mg/L) for 1 week. The efficiencies of RIP3 expression were validated by Western blotting assay. The death way of mCherry-RIP3-MCF7 cells was observed under the treatment of TNF-αand Z-VAD-FMK. Results The lowest expression of RIP3 mRNA was found in MCF7 cells. The sequencing results validated the well recombinant plasmids. The expression of mCherry-RIP3 fusion pro-tein with a molecular weight of 85 ku was detected by Western blot assay. The mCherry-RIP3 expression enhanced the sensi-tivity of MCF7 cells to TNF-αand Z-VAD-FMK induced cell death. Conclusion The recombinant RIP3 over-expressed plasmids were successfully constructed, and the stable MCF7 cells with ectopic RIP3 transfection were obtained. The mCher-ry-RIP3 fusion protein was expressed in the cytoplasm and was conformed to mediate TNF-αinduced necroptosis.