Objective To study the role of beta endorphin (?-EP) in the pathogenesis of vitiligo. Methods Radioimmunoassay (RIA) was used to measure the levels of ?-EP in plasma from 40 patients and tissue fluid of lesional and non lesional skin from 33 patients with vitiligo. Results Plasma levels of ?-EP were significantly higher in patients with generalized(11.74?3.47 pmol/L), local(8.31?2.57) and segmental(8.61?2.61) vitiligo than those in normal controls(6.69?1.46). Tissue fluid levels of ?-EP were significantly higher in lesional skin (9.25?4.49 and 10.24?4.37) than those in non lesional skin (5.50?2.84 and 6.12?1.61) from patients with local and segmental vitiligo. Increased levels of ?-EP were observed in tissue fluid from both lesional and non lesional skin in patients with generalized vitiligo, however, no significant difference of ?-EP levels was found between the two kinds of skin tissue. Conclusion It is suggested that ?-EP might play a role in the pathogenesis of vitiligo.

Objective To observe the effect of kinesiotherapy-combined scalp acupuncture plus rehabilitation on the joint range of motion (ROM) and activities of daily life (ADL) in kids with spastic cerebral palsy. Method Fifty-one eligible patients with spastic cerebral palsy were divided into a treatment group of 23 cases and a control group of 28 cases by the random number table. The control group received conventional rehabilitation, whereas the treatment group received kinesiotherapy-combined scalp acupuncture in addition to the rehabilitation therapy. Before and after treatment, a joint protractor was used to measure the passive ROM of ankle, knee, and hip joints; the Modified Ashworth Scale was used to evaluate the muscular tension of the adductor muscles of lower limbs, hamstring muscles, and gastrocnemius; the scale for ADL was adopted to evaluate the ADL. Result The joint ROM was significantly improved by different degrees in the treatment group after intervention (P<0.05), and the popliteal angle and dorsal flexion of foot in the treatment group were significantly different from that in the control group (P<0.05). In the treatment group, the muscular tension of hamstring muscles and gastrocnemius after treatment was significantly different from that before treatment (P<0.05); the change of the muscular tension of gastrocnemius in the treatment group after intervention was significantly different from that in the control group (P<0.05); the change of ADL in the treatment group after intervention was significantly different from that in the control group (P<0.05). Conclusion Kinesiotherapy-combined scalp acupuncture plus conventional rehabilitation can markedly improve the ROM and ADL in patients with spastic cerebral palsy.

Objective To investigate the effects of treatment of proximal humeral fracture in the elderly with anatomical plate internal fixation.Methods Twenty-seven cases of proximal humeral fractures received operative treatment with anatomical plate.According to Neer classification,there were 18 patients with three-part fractures of the bone,there were 9 patients with four-part fractures of the bone.Results Twenty-seven patients were followed up for 6-24 months.According to the evaluation of Herscovici scales,the result were excellent in 17 cases,and good in 8,92.6％ (25/27) of all reductions were excellent or good.The excellent and good rate of Constant-Murley score was 88.9％(24/27 ).Conclusion It is an ideal way to treat the displaced proximal humeral fracture with anatomical plate,which can provide rigid fixation,it allows early functional treating.

Objective To explore the relationship between the postoperative prophylactic antibiotics and surgical site infection rates after breast cancer surgery.Methods Retrospective review of patients with breast surgical procedures between March 2007 to March 2016 were included,267 cases only preoperative antibiotic prophylaxis as control group,and 117 cases of preoperative and postoperative prophylactic antibiotics as research group.The surgical site infection( SSI) rates were compared.Results There was no statistically significant association between research groups and control group of SSI rates for both a 30-day postoperative period and beyond.Further,There was also no statistically significant association between research groups with drains and control group with drains of SSI rates for both a 30-day postoperative period and beyond.Conclusion There is no significant relationship between postoperative prophylactic antibiotics and surgical site infection rates after breast cancer surgery.

Objective To evaluate the safety and feasibility of retroperitoneal laparoscopic adrenalectomy for different diameter adrenal tumor.Methods The clinical dam of 61 patients who underwent retroperitoneal laparoscopic adrenalectomy from January 2009 to June 2013 were retrospectively analyzed,the patients were divided into A group (the diameter of adrenal tumor ＞ 6 cm,24 cases) and B group (the diameter of adrenal tumor 3-6 cm,37 cases) according to the diameter of adrenal tumor.The therapeutic effect was compared between 2 groups.Results All procedures were performed successfully.There were statistical differences in operative time and estimated blood loss between A group and B group [(138 ± 66) min vs.(106 ± 45) min and (324 ± 168) ml vs.(165 ± 50) ml] (P ＜ 0.05).There were no statistical differences in the rate of complication and blood transfusion between 2 groups (P ＞ 0.05).There was no statistical difference in hospital stay after operation between 2 groups [(6.7 ± 1.2) d vs.(5.4 ± 0.6)d] (P ＞ 0.05).A group was followed up for (22 ± 10) months,during which time no local recurrence was noted in 19 cases by B-mode ultrasonography,3 cases were missed,and 2 cases were alive with hydronephrosis or pancreatic cyst.B group was followed up for (24 ± 11) months,during which time no local recurrence was noted in 32 cases by B-mode ultrasonography,4 cases were missed,and 1 case was found with renal dysfunction.The pathology of most tumors in A group included medullary lipoma,pheochromocytoma and ganglioneuroma,in B group included adenoma,pheochromocytoma and medullary lipoma.Conclusion Minimally invasive and safe procedure for skillful surgeons in the treatment of tumor diameter larger than 6 cm.

Objective To investigate the effect of scalp acupuncture plus MOTOmed virtual scene training on gross motor function and ADL in patients with spastic cerebral palsy. Methods Thirty patients with spastic cerebral palsy meeting the inclusion criteria were randomly allocated to a treatment group of 12 cases and a control group of 18 cases. The control group received routine rehabilitation therapy and the treatment group, scalp acupuncture plus MOTOmed virtual scene training in addition. Adductor, gastrocnemius and hamstring muscle tensions were determined using the Modified Ashworth Scale (MAS), gross motor function was measured using the Gross Motor Scale and the activities of daily living were assessed using the ADL in the two groups of patients before and after treatment. Results There were statistically significant pre-/post-treatment differences in adductor, gastrocnemius and hamstring muscle tensions in the treatment group (P<0.05). There was a statistically significant pre-/post-treatment difference in adductor muscle tension in the control group (P<0.05). There were statistically significant post-treatment differences in gastrocnemius and hamstring muscle tensions between the treatment and control groups (P<0.05). There were statistically significant pre-/post-treatment differences in the foot dorsiflexion angle and popliteal fossa angle in the treatment group (P<0.05). There was a statistically significant pre-/post-treatment difference in the posterior femoral angle in the control group (P<0.05). There were statistically significant post-treatment differences in the foot dorsiflexion angle and popliteal fossa angle between the treatment and control groups (P<0.05). There were statistically significant pre-/post-treatment differences in the GMFM score and the ADL score in the two groups (P<0.05). There were statistically significant post-treatment differences in the GMFM score and the ADL score between the treatment and control groups (P<0.05). Conclusions Scalp acupuncture plus MOTOmed virtual scene training is an effective way to treat spastic cerebral palsy. It can improve gross motor function and the ADL score in the patients.

Objective To investigate the variations of multi-segments of the Willis' circle in cases with ACA-A1 variation.Methods Retrospective comparative analysis was applied to images of 2 246 healthy cases which were excluded from abnomalities of physical and biochemistry examination and angiostenosis caused by angiosclerosis.We divided variant group and contrast group according to variation of ACA-A1 segment.Several aspects were carried to comparison:the variation between bilateral ACA-A1 segment within the variant group was studied by x2 test; the proportion of FTP and developing of PCA-P1 were put into test.Finally we use trend x2 test to compare the variation degree of ACA-A1,ipsilateral FTP formation and PCA-P1 variation.Results Variants of ACA-A1 contains 634 cases whereas normal cases were 1 612.A prominence in variation revealed in right side of ACA-A1 (x2=26.19,P＜0.01) which revealed by 429 cases in right side versus 205 cases in lefi side respectively.Parallelled with contrast group,the variant group showed immensely advantages in high proportion of FTP (x2=14.165,P＜0.01) which indicated by variant group 22.56％ (143/634)and contrast group 18.30％ (295/1 612); but crippled in PCA-P1 formation (x2=4.32,P＜0.05)which illustrated by proportions of by dysplasia and deficiency compared by variant group and contrast group was 17.35 ％ (110/634),14.21％ (229/1 612).AC A-A 1 normal,slight variation,dysplasia and deficiency together with FTP dyformation was 9.15％ (58/634),15.62％ (52/333),16.50％ (34/206),23.16％ (22/95) respectively.Within the variation group,a pattern between ACA-A1 and FTP which fluctuated simultaneously with significant statistical discrepancies (x2=51.117,P＜0.01; linear by linear x2=13.340,P＜0.01)which demonstrated by ACA-A1 normal,slight variation,dysplasia,deficiency together with FTP formation was 4.57％ (29/634),12.91％ (43/333),16.02％ (33/206),20.00％ (19/95) respectively,as far as ACA-A1 variation was concerned,The variant group were more prone to develop PCA-P1 dysplasia or deficiency (x2=45.87,P＜0.01; linear-by-linear x2=43.474,P＜0.01).Conclusions There were more multi-variation of Willis' circle in the cases with ACA-A1 variation,MRA can value the anatomy and variation of the Willis' circle.MRA can also guide the clinic diagnosis,treatment and prognosis of the cerebrovascular diseases.

Folic acid-O-carboxymethyl chitosan ultrasmall superparamagnetic iron oxide nanoparticles (FA-OCMCS-USPIO-NPs) are a novel molecular targeting MR contrast agent. This paper reperts the pharmacokinetics and magnetic resonance response characteristics of FA-OCMCS-USPIO-NPs in normal rats and mice, and discussed its distributing regularity in animals, providing basis for tumor targeting imaging. O-phenanthroline method was used to determine iron content in rats' plasma and mice's organs following high and low doses of nanoparticles injected through tail vein, and the blood concentration-time curve was drawn, the calculated t1/2 of two groups were greater than 7 h. The results of tissue distribution showed that only a small part of nanoparticles were swallowed by the liver and spleen, while none in the heart, lung and kidney. At the same times, the phagocytosis of nanoparticles did not change with the dose. The results of MRI showed that renal excretion occurred 4 hours after injection, and signal to noise ratio (SNR) of liver and kidney returned to normal levels 24 hours after injection. There were no nanoparticles in the lungs. So a part of nanoparticles escaped from phagocytosis of liver and spleen, and it owned lower toxicity and longer half-life. indicated its use for tumor-targeting imaging. All of these indicated its use for tumor-targeting imaging.

AIM:To probe whether CpG oligodeoxyribonucleotides 7909 (CpG ODN7909) combined with Toll like receptor (TLR)9 affected the chemotherapeutic sensitivity of doctaxel (DOC) in human lung cancer A549 and H520 cell lines.METHODS:Sequences of TLR9 siRNAs were designed.A549 and H520 cells were transfected with TLR9 siR-NA by lipofectamine.The expression of TLR9 was detected by Western blot .The cell activity was measured by CCK-8 as-say.The experiments were divided into blank control group , control siRNA group and TLR9 siRNA interference group.The cell cycle distribution and cell apoptosis were analyzed by flow cytometry .The expression of P38 and Bax was determined by Western blot .The cells in each group were exposed to CpG ODN 7909 and/or DOC.RESULTS: In A549 cells and H520 cells, CpG ODN7909 alone had no obvious effect on the cell activity , G2/M phase arrest and apoptosis , but in-creased the protein expression of P 38 and Bax ( P<0.01) .In addition, there was no significant changes of the above inde-xes in CpG ODN7909 treated-TLR9 siRNA group was observed .DOC alone significantly inhibited the cell activity , higher the G2/M phase fractions, apoptotic rates and Bax expression (P<0.01), but didn’t affect the expression of P38 in all 3 groups.Compared with the cells treated with DOC alone , the cells treated with CpG ODN7909 combined with DOC exhibi-ted lower cell activity, higher G2/M phase fractions, apoptosis rates and more Bax expression (P<0.01), showed no sig-nificant change of P38 expression.In addition, there was no significant change of the above indexes in CpG ODN 7909 com-bined with DOC treated-TLR9 siRNA group was observed .CONCLUSION:CpG ODN7909 may enhance the chemothera-peutic sensitivity of DOC in human lung cancer cells by combining with TLR 9.The mechanism might be related to enhan-cing the inhibitory effect and apoptosis of DOC on the cell activity in vitro, arresting the cells at G 2/M phase of the cells .

Objective:To evaluate the relationship of vitamin D deficiency(VDD) between sepsis and septic shock among critical ill children, and investigate the influence of VDD on etiology and prognosis of sepsis.Methods:The observational cohort studies, involving vitamin D and critically ill children, were searched in Medline, Web of Science, EBSCO host and China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform.The quality assessment was conducted on the basis of the Newcastle-Ottawa Quality Assessment Scale.Consistent definitions of sepsis and septic shock were applied and standardized data were obtained following the study design.We retrieved the clinical outcomes related to septic shock and serum 25-hydroxyvitamin D 3concentrations and made a meta-analysis for the relation between VDD and clinical outcomes at two cut-offs. Results:In the analysis of collected data including severe VDD as a risk factor for incidence of sepsis and septic shock, the pooled RRwas 1.71(95% CI1.11 to 2.63, P=0.01) and 2.05(95% CI1.35 to 3.10, P<0.001) respectively, which were all higher compared with VDD.And severe VDD was also associated with cv-SOFA score( RR0.68, 95% CI0.45 to 0.91, P<0.001). However, no significant differences in mortality or the duration of vasopressor was found at severe VDD or VDD cut-off levels among septic shock patients. Conclusion:Among pediatric critical illness, severe VDD is more likely related to the incidence for sepsis and septic shock compared with VDD.And comorbidity with severe VDD could increase the cv-SOFA score of septic children.