Objective To explore the correlation of B-type natriuretic peptide (BNP) with blood lipids and renal function in elderly patients with coronary heart disease (CHD).Methods According to the four quantiles of BNP level,325 subjects aged 65 years and over were divided into four groups:group A (≤32.4 ng/L),group B (32.5 ng/L),group C (62.4 ng/L),group D (＞ 162.5 ng/L).The left ventricular ejection fraction (LVEF),left ventricular end-diastole dimension (LVEDD),levels of blood lipids and renal function were compared among the groups.Results With the increase of BNP level,the LVEF was gradually decreased [(63.3±8.2) ％,(59.6±7.4) ％,(57.9±9.7)％,(55.2±10.6)％,respectively,F=11.54,P＜0.01] and the LVEDD was gradually increased (F=6.76,P＜0.01),the level of triglyceride (TG) was gradually decreased (F=2.73,P ＜0.05) in group A,B,C and D.Creatinine clearance was gradually decreased [(1.24±0.31) ml ·s-1 · 1.73 m-2,(1.21±0.31) ml· s-1 · 1.73 m-2,(1.24±0.29) ml · s-1 · 1.73 m 2,(1.09± 0.33) ml · s-1 · 1.73 m-2,respectively,F=3.62,P＜0.05],and blood urea nitrogen was gradually increased (F=4.43,P＜0.05) in group A,B,C and D.Multi-linear regression analysis showed that levels of total cholesterol,triglyceride,low density lipoprotein-cholesterol,high density lipoproteincholesterol,very low density lipoprotein-cholesterol,creatinine clearance and blood urea nitrogen were influencing factors for BNP (all P＜0.05).Conclusions BNP level can be used as a sensitive indicator for the diagnosis of heart failure and the assessment of its severity.The levels of blood lipids and renal function are associated with BNP.

Aim To investigate the inhibitory effect of schizandrin B( SchB) on ultraviolet radiation b ( UVB) radiation-induced apoptosis of HaCaT cells. Methods Methyl thiazolyl tetrazolium ( MTT ) assay was used to examine the effect of SchB on cell viability recovery. Cell apoptosis and necrosis were measured by Ho-chest33342 staining. The p53, p21 and Caspase-3 mRNA expressions were examined by RT-PCR. Results In this study, we found that Sch B attenuated UVB-in-duced toxicity in HaCaT cells. Through Hoechst 33342 stain, we visualized that SchB could inhibit UVB-in-duced HaCaT cell death. The result demonstrated that p53 , p21 and Caspase-3 mRNA levels decreased com-pared with the control group. Conclusions Sch B at-tenuates the UVB-induced toxicity of HaCaT by inhibi-ting apoptotic gene expression. It plays a role in anti-photoaging.

OBJECTIVE:To study the effects of podophyllotoxin derivative QW-83 on human cervical cancer HeLa cell apopto-sis and its mechanism. METHODS:After treated with 0(negative control),0.01,0.1,1 and 10 μmol/L QW-83 and positive drug etoposide(VP-16)for 48 h,proliferation inhibition rate and IC50 of HeLa cell were determined by MTT assay. The morphological changes of HeLa cell were observed by Hochest 33342 staining after treated with QW-83 [0(negative control),2.5,5,10μmol/L] for 48 h;flow cytometry was used to detect apoptosis rate;semi quantitative RT-PCR was adopted to detect the expression of apop-tosis related gene P53,Bax,Casepase-3,Casepase-8,Casepase-9 and Bcl-2 mRNA. RESULTS:Compared with negative control, 1,10 μmol/L VP-16 and QW-83 had obvious proliferation inhibition effect on HeLa cells (P<0.05 or P<0.01),and IC50 were (5.11±0.43)μmol/L and(4.96±0.54)μmol/L. Hochest 33342 staining results showed QW-83 could obviously induce cells apopto-sis and nuclear pyknosis. Flow cytometry showed QW-83 could increase apoptosis rate in concentration-dependent manner,being 16.89%-62.56%. RT-PCR showed mRNA expression of P53,Bax,Caspase-3,Casepase-8 and Casepase-9,Bcl-2/Bax increased, while mRNA expression of Bcl-2 decreased after treated with QW-83(P<0.05). CONCLUSIONS:Podophyllotoxin derivative QW-83 can induce HeLa cell apoptosis,and its mechanism may be associated with regulate mRNA expression of apoptosis related gene.

OBJECTIVETo compare efficacy of unilateral external fixators and locking compression plates in treating type C fractures of the distal radius.

METHODSFrom January 2009 to June 2010, 76 patients with distal radius fracture were treated with LCP and external fixators, 54 patients were followed up. Among them, 29 cases were male and 25 cases were female with an average age of 45.31 (ranged, 24 to 68) years old. There were 29 patients in LCP group. According to AO classification, 8 cases were type C1, 7 cases were type C2 and 14 cases were type C3. There were 25 cases in external fixators group. According to AO classification, 6 cases were type C1, 8 cases were type C2 and 11 cases were type C3. Radial height, volar tilt and radial inclination were compared, advanced Gartland-Werley scoring were used to assessed wrist joint function after 6 and 12 months' following up.

RESULTSTwo cases were suffered from nail infection in external fixators group. Fifty-four patients were followed up from 12 to 24 months with an average of 21.3 months. Radial height was (9.60 +/- 0.72) mm, volar tilt was (9.55 +/- 0.80) degrees and radial inclination was (21.40 +/- 0.78) degrees in LCP group,while those were (9.40 +/- 0.70) mm, (9.47 +/- 0.71) degrees and (21.20 +/- 0.73) degrees in external fixtors group, and with no statistical significance (P>0.05). Advanced Gartland-Werley score after 6 months' following up was 3.31 +/- 1.17 in LCP group, 5.56 +/- 1.58 in external fixtors group, and with significant difference (t=-5.99,P<0.05); after 12 months' following up, advanced Gartland-Werley score was respectively 2.66 +/- 1.01 and 3.08 +/- 1.00, but with no statistical meaning (t=-1.55, P>0.05).

CONCLUSIONLCP and external fixtors can receive good curative effects in treating type C distal radius fracture, and LCP can obtain obviously short-term efficacy, while there is no significant difference between two groups in long-term results. For serious distal radius comminuted fracture which unable to plate internal fixation, external fixators is a better choice.

Adult ; Aged ; Bone Plates ; External Fixators ; Female ; Fracture Fixation, Internal ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Radius ; surgery ; Radius Fractures ; surgery ; Treatment Outcome ; Young Adult

Objective To elucidate the immunologic mechanism and clinical effect of high intensity focused ultrasound (HIFU) combined with dendritic cell and cytokine induced killer cell (DC-CIK) immunotherapy on patients with pancreatic cancer.Methods Seventy-two pancreatic cancer patients were divided randomly into 2 equal groups,one treated with HIFU only the other treated with HIFU and DC-CIK immunotherapy.Ultrasound imaging and a variety of immunological indexes were recorded before and after treatment and the clinical effects in the two groups were compared.Moreover,autogenous tumor cells were isolated from the combination therapy group and the killing activity of DC-CIK which loaded tumor antigen processed by HIFU on autogenous tumor cells was observed.Results Tumor antigen processed by HIFU can improve the killing activity of DC-CIK on autogenous tumor cells.After treatment,the immunological indexes,of all patients were better than before treatment.(58.26 ± 17.97 versus 52.15 ± 14.22 pg/ml with IL-12 22.14 ± 6.39 versus 17.36 ± 5.73 ng/ml with HSP70 and 0.94 ± O.34 versus 1.32 ± O.61 ng/ml with TGF-β,P ＜ 0.05 ) ; The combination group was significantly better than the HIFU group with regard to the average scores of quality of life (75.89 ± 19.65 versus 67.22 ± 16.34,P＜0.05),pain (3.15 ±0.82 versus 3.59 ± 1.04,P ＜0.05),tumor markers (107.55 ±27.58 versus 123.63 ±34.12 U/ml) and survival time (18.92±6.47 versus 13.36 ±5.78 mos).Conclusion HIFU can improve the immunologic status and anti-tumor response in patients with pancreatic cancer.HIFU combined with DC-CIK has good synergistic therapeutic effect for treating pancreatic cancer.

Objective To explore the differences of the joint function and the patient's satisfaction between two different methods to reconstruct limb length for unilateral Crowe Ⅳ developmental dysplasia of the hip (DDH).Methods The clinical controlled study were used.21 cases with unilateral DDH Crowe Ⅳ treated with total hip arthroplasty were divided into 2 groups randomly.The patients in the first group were reconstructed the limb with the compensatory length and those in the second group were did with the real length.The patients were followed up 10 years.Two independent sample t-test was used to compare these two operations.Harris scores and SF-36 scores were used in the test.Survival analysis with Kaplan-Meier method was involved in the survival of the prosthesis and then test with Log-rank test.X-ray films of different period were compared to confirm the prosthetic loosening.Results Seventeen patients were followed up 8-10 years.There were no significant differences both in Harris score and most of the SF-36 scores at the median follow-up of 10 years.The item mental healthy of SF-36 expressed significant difference.Five patients required revision.There were 10 cases suffered with polyethylene wear,6 cases with severe osteoporosis in greater trochanter,and 3 cases with osteolytic reaction.Conclusion There are no significant differences between the two surgical method in the survival rate of prosthesis and the joint function in the median follow up.The satisfaction of the control groups is lower than the trial groups both at the early stage after the operation and the median follow up.The revision rate between the two groups is similar but the reason is different.

OBJECTIVETo explore indication and approaches of neurotomy of tibial nerve for the treatment of the talipes equinovarus and spastic paralysis.

METHODA total of 25 patients including 15 patients with cerebral paralysis and other 10 patients were diagnosed with clear etiology, spastic muscles with supplied nerves were analyzed in detail, neurotomy of the tibial nerve was performed under microscope, during operation, motor nerve was lovated with electronic stimuli and monitored with induced electromyography. The surgical results were analyzed.

RESULTSA total of 36 of 37 (97%) neurotomy of the tibial nerve were improved with dorsum flex of ankle at 10 - 45 degree, and 22 of 24 (85%) talipes equinovarus improved clinically. Of 37 feet with surgery, 24 feet (65%) were in normal position and could touch ground completely, 9 feet (24%) had 10 degree with ground or could contact ground with external one third of the feet, 4 feet (11%) were abnormal. Of 25 patents, 21 (84%) had improvement of motor activity at discretion, 5 patients (20%) improved dramatically. All the 4 patients failed after the operation were cerebral paralysis, and were presumably related to disorders of spinal function, abnormal reflex and the disappearance of inhibitory reflex.

CONCLUSIONNeurotomy is an effective method to treat talipes equinovarus, and can improve the motor activity of low extremity.

Adolescent ; Adult ; Child ; Child, Preschool ; Clubfoot ; surgery ; Equinus Deformity ; surgery ; Female ; Humans ; Male ; Microsurgery ; Middle Aged ; Neurosurgical Procedures ; methods ; Tibial Nerve ; surgery ; Treatment Outcome

Objective To compare the surgical outcome and long-term follow-up after mitral valve replacement through either minimally invasive(MI) or traditional median stemotomy(ST) surgery.Methods All 1 096 patients who received either MI or ST mitral valve replacement surgery,between January 1,2012 and July 30,2015 were analyzed for outcome differences due to surgical approach using propensity score matching(MI group n =405,ST group n =691).Find out the best matched with the 202 cases of the two groups.The clinical data of patients were collected including operativedata,postoperativecomplications,and follow-up.Results MI Group was longer in CPB time [(145.97 ±34.65)min vs.(92.24 ±25.58)min,(P ＜ 0.001)],aortic clamping time [(93.89 ± 25.25) min vs.(56.42 ± 18.09) min,(P ＜ 0.001)],and operating time[(237.49 ± 47.48) min vs.(217.31 ± 55.95) min,(P ＜ 0.001)].The MI group was associated with more less in transfusion(24.26％ vs 33.66％ P=0.037),mechanical ventilation[(15.29 ±11.45)h vs.(21.34 ±40.36)h,(P=0.041)],ICU stay[(44.12 ±39.51)h vs.(61.15 ± 106.01) h,(P =0.033)],volume of thoracic drainag[(404.11 ±485.84)ml vs.(674.82 ±585.37)ml,(P＜0.001)],postoperative drainage time[(2.59 ±1.75)d vs.(4.25 ±1.91)d,(P ＜0.001)],hospital stay [(5.64 ± 3.07) d vs.(1 1.44 ± 6.71) d,(P ＜ 0.001)].There were no significant difference in the complications of follow-up(P ＞ 0.05).SF-36 score had no significant difference either(P ＞ 0.05).Conclusion The minimally invasive thoracoseopic has longer in CBP time and cross-clamp time,;but it didnot increase the risk of mortality and complications.What's more,havingless trauma,fewer transfusions,lcss wound infection,faster rccovcry,and high satisfaction with the incision in long-term follow up and other advantages.Minimally invasive thoracoscopic cardiac surgery is safe,effective and feasible.

BACKGROUNDTo investigate sequence of the complete E region of genotype 2a hepatitis C virus genome and to set up the basis for the further study on biological functions of envelope proteins of HCV.

METHODSTwo cDNA fragments of 770bp, 1,100bp long, from serum of a patients infected HCV, were amplified by reverse transcription nested polymerase chain reaction (RT-nPCR). After being digested with two restriction endonucleases, the two fragments were cloned into JM105 respectively, then sequenced.

RESULTSThe two corresponding nucleotide sequences were obtained and ligated. The complete nucleotide sequences of envelope region and corresponding deduced amino acid sequences were compared with those of HCV-1, HC-C2, HCV-BK, HC-J6 and HC-J8. The homology of nucleotide sequence of the isolated strains was 60.5%, 60.1%, 59.7%, 87.8% and 67.5% respectively; the amino acid sequence homology to the isolated strains was found to be 67?3%, 66.4%, 65.0%, 87.8%, 79.0%, respectively.

CONCLUSIONSThe results indicate that the isolated strain (HCV-JS) belongs to genotype 2a, but there is heterogeneity between HCV-JS and HC-J6 strain.

Amino Acid Sequence ; Cloning, Molecular ; DNA, Complementary ; genetics ; DNA, Viral ; genetics ; Genotype ; Hepacivirus ; genetics ; Hepatitis C ; virology ; Humans ; Molecular Sequence Data ; Sequence Analysis, DNA ; Sequence Homology, Nucleic Acid ; Viral Envelope Proteins ; genetics ; Viral Nonstructural Proteins ; genetics

BACKGROUND: The spine structural unit of the cervical spine is a common site of degeneration and trauma. Establishing a good cervical spine model is of great practical significance for studying the biomechanical changes of cervical vertebrae under various conditions, preventing and treating cervical injuries, and improving the treatment methods of neck and effects. OBJECTIVE: To establish a three-dimension finite element model of the whole cervical spine (C0-T1) in normal human and provide a good experimental application basis for further biomechanical research. METHODS: A healthy adult volunteer was selected as the object for data collection. The original data obtained by 256-row CT thin layer scanning, which then has been extracted and edited by software to implement reverse reconstruction. The three-dimensional finite element model of whole cervical spine (C0-T1) was established by the numerical simulation. The range of motion at various directions and mechanical characteristics were verified. RESULTS AND CONCLUSION: The model had 208 631 nodes and 660 876 solid elements. The range of motion in all directions was good. In addition to the larger C0-C1mobility, all the rest of the segmental motions were consistent with previous literatures. The geometric and biomechanics characters of three-dimensional finite element model of the whole cervical spine (C0-T1) were highly similar to the intact one. The validation of the model was positive.