In some conditions,autophagy serves a protective role;but in other conditions it has an anti-cancer role. There is still contradiction on the mechanisms that autophagy induces tumor cells death. During the genesis and development of tumors,autophagy has tumor promoting or inhibiting properties at different times.

In recent years, lumbar non-fusion as a novel technique of spinal surgery, can reserve the integrated function of intervertebral disc and zygapophysial joint, maintain or recover the segmental movement to a normal level, and have no adverse effect on the neighboring segments. It is possible for the lumbar non-fusion to substitute lumbar fusion, but its application requires a reasonable and perfect verification. The implants’ safety and biocompatibility with the host need further clinical researches for the satisfactory outcomes.

Objective To explore the prognostic effect of fluid-attenuated inversion recovery imaging vascular hyperintensity (FVH)on intravenous thrombolysis of acute ischemic stroke.Methods We retrospectively reviewed the clinical and imaging data of intravenous thrombolytic patients with acute anterior circulation infarction admitted from May 2009 to December 2013.The presence of FVH was evaluated,and its associations with reperfusion and clinical outcome after thrombolysis were assessed.Results Ninety-three patients were analyzed.FVH was detectable in 55 (59.1％) cases.Patients with FVH had higher NIHSS scores (11.8 ± 6.0 vs 7.2 ± 4.5,P ＜ 0.01),larger initial DWI lesions (5.5 ml vs 2.0 ml,Z =-3.030,P=0.002) and perfusion lesions (42.0 ml vs 3.0 ml,Z=-6.104,P =0.005),compared with those without FVH.The history of hyperlipidemia (OR =0.264,95％ CI 0.07-0.90,P =0.048) and proximal large vessel occlusion(OR =48.874,95％ CI 11.6-205.924,P ＜ 0.01) were independently associated with the presence of FVH.The presence of FVH independently predicted the poor neurological outcome at 3 months (OR =4.143,95 ％ CI 1.440-11.919,P =0.008).However,early reperfusion was associated with favorable outcome in patients with FVH after intravenous thrombolysis (OR =8.500,95％ CI 1.964-36.790,P =0.004).Conclusions The presence of FVH is associated with proximal large vessel occlusion,which predicts poor outcome in patients with intravenous thrombolysis.However,early reperfusion among patients with FVH can improve the outcome.

Objective To explore the effect of time tracking on speed of tissue-type plasminogen activator treatment in patients with acute ischemic stroke,and the correlation between door to needle time (DNT) and onset to door time (ODT).Methods Time tracking tables had been prospectively collected since October 2012.The data of intravenous thrombolytic candidates with acute ischemic stroke were retrospectively reviewed from June 2009 to September 2013.Baseline characteristics and the correlation between ODT and DNT were assessed respectively before and after the implementation of time tracking.Results Three hundred and forty-two cases were finally included.Before the implementation of time tracking,ODT was negatively correlated with DNT (r =-0.169,P =0.015) ; Patients with transient ischemic attack (TIA)/stoke history (β =-0.168,P =0.020) and ODT (β =-0.246,P =0.001)accounted for the length of DNT independently.Since the implementation of time tracking,the elderly accounted for more (19.4％ (25/129) vs 10.3％ (22/213) ; x2 =5.552,P =0.018),the baseline nervous impairment was NIHSS scores (milder 11.0 ± 6.3 vs 12.5 ± 6.7 ; t =2.065,P =0.040),the proportions of patients taking multi-modality imaging were larger (63.6％ (82/129) vs 51.6％ (110/213) ; x2 =4.638,P =0.031) and the DNT decreased significantly ((87.6 ± 33.2) min vs (108.4 ± 52.4) min;t =4.274,P =0.000),which was especially seen in patients arrived within 1 hour after onset ((90.3 ±21.0) min vs (132.5 ± 46.0) min; t =5.048,P =0.000),and the previous inversely correlated DNT and ODT (r=-0.169,P=0.015) became irrelevant (r=-0.013,P=0.885).Conclusion Implementation of time tracking reduces DNT,and clears up the effect of ODT on DNT.

Object To determine the structures of three saponins isolated from leaves of Aralia elata (Miq ) Seem Methods HPLC and electrospray ionization and tandem mass spectrometry were used for purification and structure identification Results Three saponins were identified as congmunoside Ⅴ, congmunoside Ⅶ, and congmunoside Ⅹ Conclusion These saponins are obtained from the leaves of A elate for the first time

20?) or vertebral semiluxation and vertebral pathological fracture group (n=14),which was treated with full laminectomy and limited correction with pedicle screw/rod internal fixation system by augmentation and restoration with bone cement in the screw tract; mild coronal plane deformity (Cobb’s angle

Objective To summarize the experience chest small incision closure of atrial septal defects treatment,evaluation of the efficacy and safety of operation.Methods Eight patients with secondary pore pathogenesy,atrial septum defect size 16-45 mm,take right next to the sternum surgery incision between 3 or 4 ribs 3-4 cm,in the cardiac ultrasound guided into occluder.Results All successful surgery,no postoperative shunt and abnormal,1 huge successful closure of atrial septal defect in 45mm.Conclusion After transcatheter closure of atrial septal defect with small incision in the chest,easy,small trauma,recover fast,safe and reliable.

Objective To provide regional anatomical data for clinical application through observing the type, length and diameter of variation in the medial cubital vein of upper limb. Methods Dissected the medial cubital vein of upper limb in 35 (70 sides) adult cadavers (male 38, female 7), and observed the morphological structure. The length and vessel diameter of the medial cubital vein were measured. Results The variation of the medial cubital vein of upper limb was divided into six type. TypeⅠincluded 29 cases (41. 43%) of male and 8 cases (11. 43%) of female;Type Ⅱ included 14 cases (20. 00%) of male and 4 cases (5. 71%) of female;Type Ⅲ included 7 cases (10. 00%) of male and 2 cases (2. 86%) of female;TypeⅣincluded 3 cases (4. 29%) of male and 0 cases of female;TypeⅤincluded 2 cases (2. 86%) of male and 0 cases of female;TypeⅥincluded 1 cases (1. 43%) male and 0 cases of female. Conclusion This study enriched anthropology data of the medial cubital vein and it has the role of guiding in clinical applications.

To explore the expression of Beclin1 in osteosarcoma and investigate the effects of down-regulation of autophagy on the chemotherapeutic sensitivity to cisplatin (DDP), the expression of Beclin1 in 28 specimens of osteosarcoma (group A) and 19 specimens of normal bone tissues (group B) were immunohistochemically detected. The expression of Beclin1 mRNA in MG63 cells treated with different concentrations of DDP was examined with RT-PCR. After down-regulation of autophagy in MG63 cells by an autophagy inhibitor, 3-methyladenine (3-MA), the cell proliferation inhibition rate of MG63 cells treated with DDP was evaluated by using the MTT assay. The positive rates of Beclin1 were 67.85% in group A and 94.73% in group B. Its expression was lower in osteosarcoma than in normal bone tissues, with a significant difference found between them (P<0.05). RT-PCR showed that the expression of Beclin1 mRNA in the cells treated with high-dose DDP were higher than that in the non-treated cells, and no significant difference in the expression of Beclin1 mRNA was found between the cells treated with low-dose DDP and the non-treated cells. There was a positive correlation between the level of Beclin1 mRNA expression and the concentration of DDP. MTT assay showed that the proliferation inhibition rates of the cell treated with 3-MA and DDP combined were substantially increased when compared with those treated with DDP alone (P<0.01). This study demonstrated that autophagy may be implicated in the carcinogenesis of osteosarcoma, and DDP may induce autophagy in the MG63 cells. It also suggests that the down-regulated autophagy could increase chemotherapeutic sensitivity of DDP to osteosarcoma.

Objective To investigate whether cerebral microbleeds (CMBs) can predict hematoma expansion in hypertensive cerebral hemorrhage bleeding.Methods One hundred and forty-four patients with hypertensive cerebral hemorrhage bleeding in 6 hours after the onset of symptom were included.Gradient echo pulse sequence-T2 WI (GRE-T2 WI) and computed tomography (CT) were performed to detect the size of hematoma in half an hour after hospital admission.Based on the performance of GRE-T2 WI,patients were divided into microbleeds group and no microbleeds group.CT was performed 24 and 72 hours later to check whether hematoma was enlarged,the ratio of hematoma enlargement and the increased hematoma volume were compared between 2 groups.Results A variable number of CMBs were found in 74 cases by GRE-T2WI on admission.The hematoma volume was increased in 12.5％ (18/144) of patients by CT 24 hours later,and in 13.9％ (20/144) by CT 72 hours later.The ratio of CMBs in microbleeds group was higher than no microbleeds group significantly (70.0％ (14/20) vs 48.4％ (60/124),x2 =4.221,P ＜0.01).Besides,the ratio of the patients with the increased hematoma volume in microbleeds group was significantly higher than no microbleeds group(17.6％ (13/74) vs 10.0％ (7/70),x2 =3.172,P ＜ 0.05).Logistic multiple regression showed that CMBs was the only risk factor which could enter regression equation (OR=2.213,95％CI 1.320-2.972,P＜0.01).Conclusion CMBs patients with hypertensive cerebral hemorrhage bleeding in GRE-T2WI can predict the high risk of hematoma expansion.