Objective:To explore the clinical effect and safety of modified microvascular decompression (MVD) on the recurrent trigeminal neuralgia.Methods:50 patients with recurrent trigeminal neuralgia from 2010 to 2015 in the Center of Cranial Nerve of Shanghai Jiaotong University (including Shanghai Tongren Hospital and Xinhua Hospital) were retrospectively analyzed,patients before 2012 were given regular MVD (MVD group,n=22),patients after 2012 were given improved MVD (modified MVD group,n=28).MVD group was given trigeminal nenre root decompression by traditional MVD,the method was described as follows:the skin,myofascial was cutted in turn along the first incision,the scar tissue on the edge of bone window was separated,and the bone window was appropriately expanded until the dura mater was fully exposed.Then dura mater was cutted open to sharply dissect the arachnoid,Meckel cavity was probed up to neurological brain regions (REZ),the trigeminal nerve segment was closely examined to separate the responsible blood vessels of oppressive nerve and the Teflon pad of cotton imbedding at the first operation.Modified MVD group was given detection of intracranial trigeminal nerve and its surrounding structures,dissection of brainstem extended segment of trigeminal neuralgia,and the compression of superior cerebellar artery to brainstem extended segment of trigeminal neuralgia was fended off.The postoperative remission rate,recurrence and complications between two groups were compared.Results:The postoperative remission rate in modified MVD group was 100.0％,which was significantly higher than that of the MVD group (P＜0.05).There was no statistical significance in the incidence of postoperative complications between two groups (P＞0.05).The recurrence rate at 1 year after surgery in modified MVD group was 0％,which was significantly lower than that of the MVD group (22.7％,P＜0.05).Conclusions:Decompression of trigeminal nenrerootcombined with brainstem extended segment of trigeminal neuralgia in MVD for recurrent trigeminal neuralgia could effectively relieve the pain,reduce the risk of postoperative recurrence,and wouldn't increase the postoperative complications.

Objective To investigate the effects of alantolactone on cell proliferation,cell-cycle and cell cycle-related proteins in human chronic myelogenous leukemia drug-resistant cell line K562/ADR.Methods K562/ADR cells were treated with 0,1.0,2.0,4.0,6.0,8.0,and 10.0 μmol/L of alantolactone for 12,24 and 48 h,with its cell viability analyzed by MTT assay.Flow cytometry was used to examine the effect of alantolactone on the cell-cycle of K562/ADR cells.The cell cycle-related proteins were analyzed by using Western blot after treatment with alantolactone.Results The results of MTT showed that alantolactone effectively inhibited the proliferation of K562/ADR cells in dose and time-dependent way,and the IC50 value of alantolactone in K562/ADR cells was about 5 μmol/L.Flow cytometric analysis displayed that alantolactone could arrest cell cycle at G2/M phase.The percentage of accumulated cells in the G2/M phase was increased from (15.8±1.7) ％ in the control group to (21.0±2.4) ％,(26.4±2.7) ％,and (30.1±3.9) ％ in cells treated with 2.5,5.0,and 7.5 μmol/L of alantolactone for 24 h,respectively (P ＜ 0.05).Alantolactone significantly decreased the expression of CDK1 and CyclinB1 and increased the expression of cyclin-dependent kinase inhibitor p21.Meanwhile,the treatment of K562/ADR with alantolactone led to a dose-dependent decrease in bcr-abl protein levels.Conclusion Alantolactone can significantly inhibit the proliferation and cell-cycle arrest in G2/M phase of K562/ADR cells,in which mechanism may be associated with the regulation of cell cycle-related proteins and downregulation of bcr-abl protein.

Objective To investigate the effect of different operations for cardia carcinoma on the postoperative anastomotic stoma complications.Methods Between December,2000 and May,2007,the clinical data 156 patients with carcinoma of gastric cardia who received different operations were analyzed retrospectively.Results The thoracoabdominal incision was performed in 57 cases,abdominal incision in 68 and left thoracic incision in 31 cases.The occurrence rate of anastomotic stoma complications in the patients with thoraco-abdominal,abdominal and left thoracic incision was 7.0%(4/57),7.4%(5/68),and 12.9%(4/31),respectively.The occurrence rate of anastomotic stoma complications in the patients using 25 mm end-end autosuture was 4.2%(4/95),in using of the 28mm autosuture group was 16.1%(P=0.0102).Conclusions The occurrence rate of anastomotic stoma complications can be reduced by choosing correct operation methods and using autosuture correctly.

96 anterior teeth with different degree of caries in 80 patients were randomly divided into 2 groups(n =48 teeth,40 patients). In the experimental group the teeth were repair with nanometer resin filling,in the control group with ceramic crown.In 0.5 to 1 year follow-up,the satisfaction rate and the clinical success rate were similar in the 2 groups(P >0.05).Application of nano resin aesthetic restoration can lower tooth injury,postoperative complications and the cost.

Background and purpose:The pro-oncogene Bmi-1 is a member of the polycomb-group family, can regulation of the proliferation and self-renewal of normal and tumor stem cells. In recent years, Bmi-1 has been found that it is overexpressed in varieties of human malignant tumors. The study aimed to observe the effects of Bmi-1-siRNA on the growth capacity of lung cancer cell line A549 in vivo and in vivo, and explore its mechanism. Methods:The most effective one as a target sequence was chosen from four Bmi-1 siRNA sequences which were designed by our lab, and one random sequence was chosen as a negative control. In short, the chemically synthesized siRNA and control sequences were connected to a retrovirus expressing vector, pSUPERretro-Neo plasmid, and then transfected into A549 cells. The stably transfected cells were cultured and passed. The level of mRNA and protein of Bmi-1 in A549 cells were assessed by RT-PCR and Western blot respectively. The proliferations of A549 cells in vivo was analyzed with MTT, trypan blue exclusion and plate colony forming methods. Flow cytometry was used for cell cycle analysis. The potency of tumorigenesis was observed in nude mouse through hypodermic inoculation of A549 cells. The expressions of cyclin D, p21/27, p-AKT and PTEN were analyzed by Western blot. Results:Compared to A549-ctr and A549-wt cells, Bmi-1 mRNA and protein levels all signiifcantly reduced in A549-Bmi-1-siRNA cells. Bmi-1-siRNA inhibited the growth, colony formation in vitro and tumorigenesis in vitro of A549 cells, and the interference cells cell cycle arrested in G1 phase. In A549-Bmi-1-siRNA cells, p-AKT and cyclinD1 expression were down-regulated while p21/p27 and PTEN were up-regulated. Conclusion:Silencing Bmi-1 gene inhibits the proliferation of A549 cells through G1 phase arrest, which involves the downregulation of cyclin D/p-AKT and upregulation of p21/p27/PTEN.

Objective To investigate the mechanism and effect of the spinal cord outlet of the skull base on Chiari Ⅰ malformation with syringomyelia.Methods The cervical spinal cord stem angle (Anbc),slope angle of cervical vertebra (Ansc) of Chiari Ⅰ malformation were measured.In foramen magnum (Llf) and anterior vertebral canal level (Laf),spinal canal(Ac),spinal cord (As) and inferior hernia area (Ah) were measured.Angle,area and ratio were compared in Chiari Ⅰ malformation with syringomyelia,Chiari Ⅰ malformation without syringomyelia and normal control group.Results Ansc,Anbc-Ansc had significant differences among control group and Chiari Ⅰ malformation patients (all P＜0.001).In Llf,Laf,As had significant differences among three groups (all P＜0.05),further comparison of the two showed there were significant differences between Chiari Ⅰ malformation with syringomyelia patients and control group,Chiari Ⅰ malformation without syringomyelia patients and control group in Llf(all P＜0.05).In Llf,Laf,Ac in Chiari Ⅰ malformation with syringomyelia was smaller than control group (P＜0.05).Ah in Llf,Lafand Lh in Llf had no statistical significant difference between Chiari Ⅰ malformation with and without syringomyelia patients (all P＞0.05).In Llf,Laf,As/Ac had statistical significant difference among Chiari Ⅰ malformation with and without syringomyelia patients,control group (all P＜0.001),further comparison of the two showed As/Ac in Llf had statistical significance difference between Chiari Ⅰ malformation with syringomyelia patients and control group (P＜0.05),As/Ac in La had statistical significance difference between Chiari Ⅰ malformation with syringomyelia patients and control group,between Chiari Ⅰ malformation without syringomyelia patients and control group (all P＜0.05),Conclusion The cervical spinal cord,Ansc reducing,narrow vertebral proportion increase are important factors to promote Chiari Ⅰ malformation syringomyelia.

Objective To investigate the correlation of the 24?hour ambulatory systolic blood pressure (SBP) and carotid intima?media thickness(CIMT) in the elderly. Methods A total of 2 464 who were more than or equal to 60 years old participants were selected with random sampling in accordance with the inclusion criteria from the retired workers in Tangshan Kailuan Company. Dynamic blood pressure monitoring, neck vascular ultrasound and other examination were performed for the participants. . Multivariable linear regression analysis was used to analyze correlation between the SBP of 24?hour, daytime and nightime with CIMT, respectively. Results ( 1) The observation population was divided into three groups according to the tertiles of SBP of 24?hour, daytime and nightime, respectively. With the levels of different SBPs inceasing, CIMT values thickened markedly ( P<0. 01 ) . ( 2 ) Multivariable linear regression analysis showed that after adjusting for confounding factors,the SBP of 24?hour,daytime and nightime associated with CIMT positively and linearly(P<0. 05),and regression coefficient(95%CI) were 0. 022(0. 009-0. 035), 0. 021(0. 008-0. 035), 0. 019 ( 0. 006-0. 032) respectively. In addition,clinic SBP step into the multivariable linear regression,and regression coefficient ( 95%CI ) were 0. 016 ( 0. 003-0. 029 ) , 0. 016 ( 0. 003-0. 030 ) , 0. 019 ( 0. 007-0. 032 ) , respectively. Conclusion The effect of increased 24?hour ambulatory SBP on CIMT was greater than the clinic SBP. Active monitoring of 24 h ambulatory blood pressure and maintaining a low level of blood pressure is essential for preventing and delaying atherosclerosis.

ObjectiveTo study the efficacy of different doses of tamsulosin hydrochloride sustained release tablets for treatment of premature ejaculation (PE). MethodsEighty PE patients from September 2010 to January 2011 were divided into two groups randomly,the 0.2 mg dose group and the 0.4 mg dose group.The therapeutic effect was assessed by the changes of the patients' CIPE-5 scores.ResultsThe intra-vaginal ejaculation latency time (IELT) of the two groups were (0.98 ± 0.47 ) and ( 0.89 ± 0.47 ) min respectively before treatment,and (4.40 ± 1.86 ) and (6.40 ± 5.10) min respectively after treatment.There were significant differences ( P ＜ 0.01 ).As for satisfaction degree of sexual life,lessening the patients' sexual anxiety and nervousness,and decreasing the difficulty in retarding ejaculation,the group of 0.4 mg had better effect than the other group.ConclusionLarge dose of tamsulosin hydrochloride sustained release tablets could prolong IELT and increase the sexual satisfaction.

Background and purpose:The human oncogene B-cell-speciifc moloney murine leukemia virus integration site 1 (Bmi-1) is an important member of the polycomb group family, and it regulates cell proliferation and senescence via INK4a/ARF locus. This study investigated the effects of Bmi-1-siRNA on the proliferation of lung adenocarcinoma cell line SPC-A1 cells with INK4a/ARF locus and clarify the mechanism of Bmi-1-mediated effect on proliferation of lung adenocarcinoma cells. Methods:In this study, we chose the most efifcient siRNA chain the pGeneshl-2-Bmi-1 sense-1 and inserted into a pSUPER-retro-neo retroviral vector. The packaged si-Bmi-1 pSUPERret-ro-neo retroviral vector was stably transfected into lung adenocarcinoma SPC-A1 cell line. The stably transfected cells were cultured and passed. After transfection, the levels of Bmi-1 mRNA and protein expression of SPC-A1 cells were analyzed by RT-PCR and Western blot respectively. Trypan blue, MTT and plate colony forming assay were performed to observe the proliferation capibility of SPC-A1 cells and evaluate the cloning forming ability in vitro. The potency of tumorigenesis was observed in nude mouse through hypodermic inoculation of SPC-A1 cells. Cell cycle distribu-tion was analyzed by lfow cytometry (FCM) in SPC-A1 cells. The expression levels of proliferation proteins including p16INK4a, p53, Cyclin D1, PTEN, Akt and Ser473p-Akt were analyzed by Western blot. Results:The mRNA and protein expression levels of Bmi-1 were signiifcantly reduced in SPC-A1-Bmi-1-siRNA cells transfected with pSUPER-retro-neo retroviral vector. Knockdown of Bmi-1 could inhibit the growth, colony formation in vitro and tumorigenesis in vivo of SPC-A1 cells (P<0.01). The transfected SPC-A1 cells were arrested in G1 phase [(64.6±1.2)%, P<0.05]. Compared with two control groups, p16INK4a, p53 and Akt were not affected (P>0.05), while Cyclin D1 and Ser473p-Akt were downregulated (P<0.01) and PTEN was up-regulated (P<0.01) in the SPC-A1-Bmi-1-siRNA cells. SPC-A1-Bmi-1-siRNA cells were treated with various concentrations of PTEN inhibitor to determine expression levels of PTEN, Bmi-1 and Ser473p-Akt protein. Ablation of PTEN rescued Bmi-1 and Ser473p-Akt expression in SPC-A1-Bmi-1-siRNA cells. Conclusion:Knockdown of Bmi-1 gene can arrest the proliferation of SPC-A1 cells through G0/G1 phase arrest by inhibiting Cyclin D1 expression indirectly, which may be not associated with p16INK4a signaling pathway.

Objective To examine whether the boundary patterns of the superior mesenteric artery (SMA) in the preoperative contrasted enhanced computer tomography (CE-CT) could predict poor postoperative prognosis.Methods From January 2010 to December 2015,104 patients of pancreatic head ductal adenocarcinoma received radical pancreaticoduodenectomy by a single group of surgeons.All patients underwent CE-CT before operation.The clinicopathological characteristics and the prognosis were comparatively analyzed among the patients with different SMA boundary patterns.Results The patients with obscure SMA boundary in CE-CT had a lower overall survival rate (P =0.012) and a higher liver metastasis rate (P ＜ 0.01) compared to the patients with clear SMA boundary.38.2％ of patients with obscure SMA boundary died within 6 months,69.1％ of them died within 12 months while the mortality rate was 6％ within 6 months and 29.2％ within 12 months in patients with clear SMA boundary.Only 2.2％ of patients with clear SMA boundary presented liver metastasis within 6 months,but that was 53％ in patients with obscure SMA boundary.18.4％ of patients developed liver metastasis within 12 months in patients with clear SMA boundary,whereas the rate was 82％ in patients with obscure SMA boundary.Furthermore,the tissues around the SMA presented a higher CT value in any phase in patients with obscure SMA boundary than in patients with clear SMA boundary (P ＜ 0.01).Conclusions The patterns of the SMA boundary in CE-CT is a potential prognostic factor in pancreatic head ductal adenocarcinoma after radical operation,and the obscure SMA boundary may be associated with early liver metastasis and high mortality.