Objective: To observe the difference between borneol-induced opening of blood-brain barrier (BBB) and its pathological opening . Methods: The expression of inducible nitric oxide synthetase (iNOS) in brain microvascular endothelial cells in normal rats and brain-injury rats before and after treatment of borneol was examined by immunohistochemical methods with S-P staining and iNOS antibody. Results: iNOS expression was not different in normal rats before and after treatment. However, iNOS expression was increased in brain-injury rats and borneol could inhibit the expression of iNOS. Conclusion: Borneol-induced opening of BBB is different from pathological opening of BBB. Borneol can increase the pathological opening of BBB and has a protective effect on brain tissue.

Objective To analyze the risk factors of failure of internal fixation of unstable femoral intertrochanteric fractures treated with proximal femoral nail anti-rotation (PFNA) in elderly patients,and to provide reference for clinical treatment.Methods Collected the clinical data of 251 aged and unstable femoral intertrochanteric fracture patients who have recieved PFNA treatment from January 2012 to December 2016.Preoperative clinical general data and intraoperative clinical factors were used as analysis variable to analyze the high risk factors and risk factors of internal fixation failure in PFNA treatment by χ2 test ,Wilcoxon rank sum test and Logistic regression.Results Through the analysis of 78 aged patients with internal fixation failure after PFNA treatment,the χ2 test and Wilcoxon rank sum test showed that,type of fractures,osteoporosis Singh index grade, tip-apex distance,application of hormone,basic diseases were risk factors for internal fixation failure after PFNA treatment (P<0.05).Among thses factors,type of fractures,osteoporosis Singh index grade, tip-apex distance were independent high risk factors for internal fixation failure after PFNA treatment(P<0.05).Conclusion Severe type of fractures (type Ⅲ and Ⅳ),osteoporosis of grade 4 to 6,and tip-apex distance greater than 25 mm are high risk factors of failure of internal fixation of unstable femoral intertrochanteric fractures treated with PFNA,and it is better to give more attention and effective intervention or other treatment.

Objective To establish the rabbit model of main portal vein VX2 tumor thrombus by using orthotopic implantation and to observe its radiological and pathological features.Methods 24 New Zealand white rabbits were randomly divided into study group (n=16) and control group (n=8).In study group,VX2 tumor tissue fragments were fixed on the inner wall of the main portal vein by using a surgical approach.In control group, autologous muscle fragments were fixed on the inner wall of the main portal vein in the same way.CT examinations were performed in both group on 7 days, 14 days, 21 days and 28 days after the procedure.At each observation point,3 rabbits of the study group were inspected by using digital subtraction angiography (DSA),and then sacrificed for histologic examination.Meanwhile,1 rabbit of the control group was sacrificed for histologic examination after CT scanning.The survival time of the remaining rabbits were recorded.Results Among 16 rabbits of the study group, successful implantations were achieved in 15 rabbits (93.8%).Tumor thrombus formed in the main portal vein successfully for all these 15 rabbits.The mean survival time of the remaining 3 rabbits in the study group was (39.3±2.1) days.The imaging characteristic of tumor thrombus could be demonstrated by CT and DSA examinations.Tumor thrombus and the inner neovascularization were confirmed by histological examination.Conclusion It is feasible to establish an animal model of main portal vein tumor thrombus by orthotopic implantation.The radiological and pathological features of animal model are similar to hepatocellular carcinoma patients with portal vein tumor thrombus.

Objective Using Eclipse and Pinnacle3 V 7.4f treatment planning sytems (TPS) for dose calculation of the CT images of simulation phantom,patients and homogeneous organization phantom,to compare the differences between the two TPS for the calculation of non-uniform organizations.Methods For the CT images of simulation phantom,patients and homogeneous organization phantom,the calculating results between the two TPS were compared,including the common used clinical indexes of V20 and V30 of the lung,D95 of the planning target volume,the doses of the ISO and eight points of interest inside ISO slice.Resuits For simulation phantom and patients,although the calculating differences of the isocenter doses between the two TPS were small,the differences of other indicators were large.For example,when using secondary collimator irradiation,the maximal D95 difference of planning target volume reached 10.17%for patients and 4.64%for simulation phantom.When using muhileaf collimator irradiation,the maximal D95 difference reached 10.74%for patients and 5.66%for simulation phantom.Sometimes the dose differences of points 1-4 at the edge of planning target volume were more than 10%.In addition,the V30 differences of the lung were large too.But for the homogeneous organization phantom,the calculating differences were small.Conclusions The calculating differences between the two TPS are less for simulation phantom than for patients,and more for simulation phantom and patients than for homogeneous organization phantom.

OBJECTIVETo explore the effect of glimepiride on the glucose uptake as well as glucose transporter (GLUT)-1 and GLUT-3 expression levels of rat mandibular osteoblasts in hyperglycemia.

METHODSPrimary osteoblasts were isolated and cultured. Then, the cells were placed in an osteogenic medium containing two glucose concentrations (5.5 and 16.5 mmol X L(-1)), with or without glimepiride (10 micromol x L(-1)). Glucose uptake was determined by employing 18F-deoxyglucose (18F-FDG) in the cells, and GLUT-1 and GLUT-3 expression levels were evaluated by Western blot analysis.

RESULTSGlucose at 16.5 mmol x L(-1) significantly inhibited 18F-FDG uptake and downregulated GLUT-3 protein expression in osteoblasts. Hyperglycemia increased GLUT-1 protein expression. Glimepiride significantly increased glucose uptake and upregulated GLUT-1 and GLUT-3.

CONCLUSIONGlimepiride enhance the glucose transporter in rat osteoblasts at two different glucose concentrations.

Recently,the traditional English teaching model can not match the social demand to the medical postgraduate students.This paper analyses the effective factor of English teaching and learning.We hope to explore a new set of capability cultivation basal English teaching model of medical postgraduate students through editing teaching outline,evaluating demand,implementing classified teaching,giving medical electives and improving examination means.

In recent years,assisted reproductive technology(ART)is developing rapidly,especially in vitro fertilization and embryo transfer(IVF-ET)technology.The rate of clinical pregnancy in our country is about 40％,and how to improve the rate of clinical pregnancy of IVF-ET has been the focus of the scholars research content.Environmental factors including culture system,temperature,humidity,pH value and volatile organic compounds,all of these can affect the success of IVF-ET.Now the common environmental factors affecting IVF-ET research progress were reviewed as follows.

Objective To optimize the registration template of kilovohage cone-beam CT (CBCT) guided radiotherapy in whole breast irradiation(WBI)after lumpectomy of breast cancer.Methods From April 2006 to July 2009,twelve patients undergoing WBI with intensity-modulated radiotherapy (IMRT)were recruited in this study.All patients were performed with both conventional planning CT and CBCT integrated on Varian 23 EX.Six distinguishable referenee points(the diameter 1 mm)around the lumpectomy cavity and the surrounding gland on the planning CT image were marked.The images were manually registered offline based on the breast surface,surgical clips,breast gland,contiguous rib,ipsilaterai lung and its external contours,respectively.The same six reference points were then marked on the CBCT image.The performance of the five registration templates was compared using the concept of registration error,while the registration time was taken into account.The registration error was calculated based on the six reference points'translations between the planning CT image and CBCT image,and analyzed with SPSS 13.0 software using one-way ANOVA.Results The values of the registration error for the breast surface,surgical clips,breast gland, contiguous rib,ipsilateral lung and its external contours were(0.60±0.20),(0.43±0.15),(0.49±0.19),(0.69±0.36)and(0.94±0.49)cm,respectively,and the registration time were(3.8±1.1),(3.0±0.9),(4.7±1.7),(4.3±1.3)and(4.5±1.3)min,respectively.There was no statistical difforence between the breast surface,surgical clips and breast gland registration template(t=0.48-1.36,P>0.05),the same result trend to contiguous rib compared with ipsilateral lung(t=2.00,P=0.055),however,there was significant difference between surgical clips and the last two registration methods(t=2.08-4.08,P<0.05).Conclusion In this initial study with a modest number of patients,surgical clips show a best registration template from the standpoint of accuracy and efficiency,whereas contiguous rib and ipsilateral lung are not an ideal method.

Objective To investigate the changes in angiopoietin 2 and endoplasmic reticulum stress,and the prognosis of acute phase of coronary syndrome (ACS) in type 2 diabetic patients with glycemic fluctuations.Methods Seventy-eight cases of consecutive diabetic patients with ACS within 7 days were enrolled.Another 78 cases of non-diabetic patients with ACS were selected as control.Risk assessment with global acute coronary events (GRACE) score in patients with ACS,dynamic blood glucose monitoring system (CGMS) for three days,realtime PCR analysis of angiopoietin-2,within the reticulum stress-related heavy chain binding protein (Bip),inositol kinase demand Ⅰ (IREI),endoplasmic reticulum class should PKR kinase (PERK),oxygen-regulated protein 150 (ORP150),activating transcription factor 6 (ATF6),X-box binding protein 1 (XBP1)mRNA expression change,phosphorylation of eukaryotic translation initiation factor 2oα (p-eIF2α) by western blotting angiopoietin-2,parameters were compared between the two groups.Correlation analysis with GRACE score ; while angiopoietin-2 parameters and glycemic fluctuation,endoplasmic reticulum stress-related genes correlation analysis were made.Results (1) ACS group average daily blood glucose fluctuations(MAGE),mean absolute difference daytime blood glucose (MODD),and postprandial blood glucose fluctuation (MPPGE) and the maximum amplitude of glycemic excursions (LAGE) were significantly higher [MAGE(5.13 ± 1.19) vs (3.19 ± 0.55) mmol/L,MODD (2.59 ± 0.72) vs (1.72 ± 0.63) mmol/L; MPPGE (3.51 ± 1.01) vs (2.58 ± 0.55) mmol/L and LAGE (7.75 ± 2.39) vs (4.34 ± 0.85) mmol/L,all P＜0.05].(2)In ACS group angiopoietin-2,endoplasmic reticulum associated genes Bip,IREI,PERK,ORP150,ATF6,XBP1,and monocyte chemoattractant protein 1 (MCP-1) mRNA expression levels as compared with the control group were statistically significant(all P＜0.05) ; Angiopoietin-2,protein p-eIF2α were higher(P＜0.05).(3) In the ACS group with pearson correlation analysis,angiopoietin-2 and MAGE,LAGE,MPPGE correlation (r =0.432,0.279,0.386,all P＜0.05),Bip and MAGE,LAGE,MPPGE correlation(r =0.783,0.589,0.887,all P＜ 0.05) ; IREI and MAGE,LAGE,MPPGE,MODD correlation (r =0.567,0.783,0.569,0.823,all P＜0.05) ; PERK and MAGE,MPPGE,MODD correlation(r =0.687,0.902,0.709,all P＜0.05) ; ORP150 and MAGE,LAGE,MPPGE,MODD correlation(r=0.779,0.871,0.775,0.689,all P＜0.05) ; ATF6 and MAGE,LAGE,MPPGE,MODD correlation(r =0.873,0.675,0.893,0.884,all P＜0.05),while XBP1 with no correlation with glycemic fluctuations (P＞0.05).(4) The endoplasmic reticulum stress gene was related to MCP-1 and blood glucose fluctuation parameters.(5) Multiple Logistic regression analysis revealed that LAGE,MPPGE,Bip,IREI,PERK,ORP150,ATF6 were risk factors affecting angiopoietin-2,and angiopoietin-2,ages,MAGE,homeostasis model assessment for insulin resistance,Bip,ATF6 were risk factors affecting GRACE.(6) The ejection fractions of the ACS patients showed negative correlation with MAGE and LAGE,multiple linear regression analysis showed that age,HOMA-IR,Ang-2,and MAGE,Bip,ATF6 established the linear regression relation with ejection fraction.Conclusion Glycemic fluctuations cause angiopoietin-2 to rise and lead to increased endoplasmic reticulum stress and affect the prognosis of diabetic patients with ACS.

Objective To explore how to decrease the incidence of anastomotic stricture after the operation of esophageal cancer by improving anastomosis.Methods Clinical data of 374 cases aged ＞ 60 years who had undergone left thoracotomy radical resection of esophagus cancer at our hospital from April 2013 to August 2015 were collected.Patients were divided into double-layers anastomosis group (n=187) and conventional anastomosis group (n=187).During process of stapling anastomosis,double purse string anastomosis on esophagus and gastric wall were performed in doublelayers anastomosis group,with no purse string suture in conventional anastomosis group.Incidence rate of anastomotic stricture was compared between the two groups.Results Conventional anastomosis group versus double-layers anastomosis group showed that a mild anastomotic stricture occurred in 17 cases (9.1 ％) versus 7 cases (3.7 ％) (x2 =4.452,P =0.035),a moderate anastomotic stricture in 12 cases(6.4 ％) vs.4 cases (2.1 ％) (x2 =4.179,P =0.041),a severe anastomotic stricture in 9 cases (4.8％)vs.3 cases(1.6％)(x2 =3.099,P=0.078),total number of anastomotic stricture in 38 cases vs.14 cases (x2 =12.866,P =0.000),showing that double-layers anastomosis was relatively superior to conventional anastomosis.Conclusions Double-layers anastomosis can effectively reduce the incidence of anastomotic stricture after surgery.