BACKGROUND: In the investigation of promoting fracture healing, exogenous growth factor is very instable, expensive and inaptitude to extend generally, so how to promote the expression of endogenous growth factor effectively is worthy of further studies. OBJECTIVE: To study the effects of Shenggu injection(SGI) on the expression of basic fibroblast growth factor(bFGF) and vascular endothelial growth factor(VEGF) in fracture healing. DESIGN, TIME AND SETTING: The randomized controlled animal experiment was performed at the Orthopaedic laborary, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology between July 2007 and August 2008. MATERIALS: Sixty clean male SD rats aged 3 months were enrolled. The components of 1 g/L SGI were angelica sinensis, ground beetle, barrenwort, etc., provided by Hubei TCM hospital. METHODS: After the tibial bone fracture model was established, the SD rats were divided into two groups with 30 rats in each group, experimental group and control group. The experimental group was injected with SGI at the bone stumps, the other group was injected with the same volume of saline. This was carried once every 2 days with 0.2 mL once. Five SD rats of each group were executed to get bony callus at the 1st, 2nd, 3rd, 4th, 5th and 6th weeks after operation. MAIN OUTCOME MEASURES: The methods of immunohistochemistry were used to detect the protein expression level and differences of bFGF and VEGF in the callus tissue during different periods of fracture healing. RESULTS: The immunohistochemistry findings showed that the expression levels of bFGF and VEGF in the experimental group were higher than those in the control group in each period. CONCLUSION: SGI can improve the expression levels of bFGF and VEGF in callus tissue during fracture healing, which is maybe one of the mechanisms of SGI to promote the healing of fracture.

Objective To study the bacteriology, clinical characteristics and treatment of ventriculitis fol-lowing ventricular-peritoneal shunt. Methods The clinical data and bacteriological results of eight patients with ven-triculitis following ventricular-peritoneal shunt from April 1998 to April 2007 were analyzed retrospectively. Shunt de-vice was removed in all patients. Intraventricular and intravenous antibiotics were given until the infection was con-trolled,and a secondary shunt device was placed. Results In eight patients,five were infected by Staph. Epidermi-dis,one by a mixed infection of Staph. Aureus and Pseudomonas acruginosa,one by Staph. Aureus,and one by E. Co-li. All patients were given intraventricular and intravenous antibiotics therapy. 8 cases recovered well after treatment. Conclusion Ventriculitis following ventricular-peritoneal shunt is a dangerous complication and is not easy to cure. After the removal of shunt device, a satisfactory result could be achieved by the administration of intraventricular and intravenous antibiotics.

Objective To evaluate the heterozygous ambiguity resolution primers (HARPs) method in resolving ambiguous genotyping results of human leukocyte antigen (HLA) genes in Chinese Hart population, and choose some appropriate HARPs primers. Methods HLA-A, HLA-B and HLA-DRB1 genes of 416 southern Chinese Han individuals were genotyped by sequence-based-typing(SBT) method and then the ambiguous genotyping samples were sequenced again by HARPs primers provided by American Atria company. Results The percentage of ambiguous genotyping samples resolved by HARPs for HLA-A, HLA-B and HLA-DRBI locus was 86.3% (132/153), 73.9% (130/176) and 38.1% (85/223) respectively. Among them, 48.5% (64/132)HLA-A, 80.0% (104/130)HLA-B and all HLA-DRB1(85/85)samples only need one primer, 47.7 % (63/132)HLA-A and 20.0% (26/130)HLA-B samples need two primers. Three to six different HARPs primers can resolve more than 90% ambiguities. Conclusion HARPs is a convenient method and could be a routine method to resolve ambiguities for HLA-A, HLA-B and HLA-DRB1 genes genotyped by SBT in Chinese Han population.

Objective To explore the diagnosis, treatment strategies and clinical outcomes of spontaneous subarachnoid hemorrhage in elderly patients. Methods A total of 68 patients aged over 60 years presenting with spontaneous subarachnoid hemorrhage underwent cerebral angiography. And 72 intracranial aneurysms were detected in 60 patients, among whom 47 patients with 59 aneurysms underwent endovascular coil embolization, 6 aneurysms in 6 patients were clipped in microneurosurgery operation, and 7 patients chose conservative treatment. Results A total of 57 aneurysms (96.6%) were embolized successfully, among which 40 aneurysms (70.2%) reached dense occlusion and 17 aneurysms (29.8%) reached incomplete occlusion. Among 47 patients undergoing endovascular treatment, 39 patients (83.0%) were evaluated as good, 7 patients (14.9%) were moderately to seriously disabled according to Glasgow Outcome Scale when they were discharged, and one patient died. Conclusions Active treatment such as endovascular coil embolization can acquire good outcome in elderly patients with spontaneous subarachnoid hemorrhage, especially in elderly patients detected with aneurysms.

Objective:To explore the effect of group psychotherapy on damage of theory of mind (TOM) in patients with early-onset schizophrenia.Methods:Totally 60 patients with early-onset schizophrenia were included and divided into the intervention group (n ＝ 30) and the health education group (n ＝ 30).The patients in the intervention group were offered 10 twice a week 2-hour sessions of group psychotherapy,and those in the control were offered group health education twice a week.All participants completed baseline measures and post-intervention measures with the Eye Emotion Recognition and Theory of mind Picture-sequencing Task (TOM-PST).Results:Totally 23 patients in the intervention group and 29 patients in the health education group finished the post-intervention measures.After 5-week intervention,subscores of sad and fear and total score of emotion recognition,total score of TOM-PST,understanding first order error belief,second order error belief,third order error belief,sense of reality,detecting fraud compared to baseline had statistically significant difference in intervention group.In health education group,subscores of joy emotion recognition,understanding first order error belief,third order error belief,total score of TOM-PST compared to baseline had statstically significant difference.The patients with group psychotherapy got higher scores of total score of TOM-PST and understanding second order error belief and third order error belief than the health education group after 5-week intervention (P ＜ 0.05).Conclusion:This study suggests the group psychotherapy could partially improve theory of mind with early-onset schizophrenia,and promote the recovery of social cognition.

Objective To investigate the value of platelet, serum sodium and serum creatinine levels in the prognosis of patients with liver failure. Methods The clinical data of 155 patients with liver failure were retrospectively analyzed, and the patients were divided into improvement survival group (87 cases) and deterioration died group (68 cases) according to the prognosis. The hospitalization time of every patient was divided into 4 roughly equal time period, and observed at 5 points of time:T1-T5. The levels and abnormal rates of platelet, serum sodium and serum creatinine were compared. Results The T3 - T5 serum creatinine levels in deterioration died group were significantly higher than those in improvement survival group: (102.14 ± 75.67) μmol/L vs. (78.21 ± 26.68) μmol/L, (116.45 ± 110.64)μmol/L vs. (78.77 ± 29.25) μmol/L, (161.43 ± 153.23) μmol/L vs. (76.40 ± 27.26) μmol/L, and the T1 - T5 serum sodium and platelet levels were significantly lower than those in improvement survival group:(135.05 ± 6.24) mmol/L vs. (137.52 ± 5.26) mmol/L, (137.01 ± 4.99) mmol/L vs. (139.00 ± 3.89) mmol/L, (134.80 ± 16.74) mmol/L vs. (139.15 ± 3.77) mmol/L, (134.40 ± 11.69) mmol/L vs. (138.30 ± 8.75) mmol/L, (133.30 ± 8.93) mmol/L vs. (139.01 ± 9.10) mmol/L, and (122.46 ± 72.59) × 109/L vs. (149.70 ± 71.70) ×109/L, (110.18 ± 65.10) × 109/L vs. (152.09 ± 82.79) ×109/L, (107.32 ± 70.49) ×109/L vs. (169.32 ± 100.65) ×109/L, (97.06 ± 58.15) ×109/L vs. (183.57 ± 112.68) ×109/L, (94.66 ± 57.00) × 109/L vs. (191.36 ± 118.64) ×109/L, and there were statistical differences (P<0.05). The abnormal rates of T3-T5 serum creatinine, T2 - T5 serum sodium and T1 - T5 platelet in deterioration died group were significantly higher than those in improvement survival group, the serum creatinine: 22.06%(15/68) vs. 6.90% (6/87), 27.49% (19/68) vs. 8.05% (7/87) and 42.65% (29/68) vs. 10.34% (9/87), the serum sodium: 32.35% (22/68) vs. 13.79% (12/87), 39.71% (27/68) vs. 14.94% (13/87), 48.53% (33/68) vs. 12.64%(11/87) and 60.29%(41/68) vs. 11.49%(10/87), the platelet:45.59%(31/68) vs. 21.84%(19/87), 55.88% (38/68) vs. 24.14% (21/87), 54.41% (37/68) vs. 25.29% (22/87), 55.88% (38/68) vs. 21.84%(19/87) and 61.76% (42/68) vs. 20.69% (18/87), and there were statistical differences (P<0.05). Abnormal rate of platelet was highest in each time point. Conclusions In the course of pathological changes in deterioration and dead patients, the platelet is the first and most easily affected compare with serum sodium and serum creatinine; the platelet may be a sensitive marker for predicting clinical outcome in patients with liver failure.

Objective To investigate the efficacy and safety of microsurgery for trigeminal neuralgia (TN) in elderly patients.Methods Totally 143 patients with intractable primary TN who received microsurgery were retrospectively analyzed.There were 92 cases in the elderly group with age of 65-82 years,and the other 51 cases in control group with age of 40-62 years.All the patients in both groups were classified as American Society of Anesthesiologists (ASA) Scale Grade 1 to 3.After suboccipital retrosigmoid craniotomy,microvascular decompression (MVD) was performed in 136patients and partial sensory trigeminal rhizotomy in 7 patients.The complications and efficacy were compared between the two groups.Results 87 cases in the elderly group and 49 cases in control group underwent MVD procedure,complete and part pain relief were achieved in 78 cases and 9 cases in the elderly group,45 cases and 4 cases in control group,respectively.After an average follow-up period of 2.6 and 2.1 years,4 cases (5.1％) among 79 follow-up cases and 3 cases (6.5％) among 46follow-up cases experienced TN recurrences in the elderly and control groups,respectively.No statistically significant differences existed in the efficacy and recurrence rate between the two groups (P＞0.05).There were 3 cases with aseptic meningitis,1 cases with hearing decrease,1 case with cerebrospinal fluid leakage,1 case with pulmonary infection and 1 cases with deliration in the elderlygroup,meanwhile,1 cases with aseptic meningitis,1 case with tinnitus and 1 case with cerebrospinal fluid leakage after surgery in control group (P＞0.05).No facial hypoesthesia appeared in the patients receiving MVD.5 cases in the elderly and 2 cases in control group underwent partial trigeminal rhizotomy with facial hypoesthesia,but the pain released,and no recurrence was found.There were no dead cases in both groups.Conclusions With cautious and proper treatment,microsurgical procedure can be performed safely and effectively in the elderly TN.

Objective To investigate the inhibitory effect and molecular mechanism of Huaier granule on the growth of sorafenib resistant hepatocellular carcinoma (HCC) cells. Methods The gradient concentration of Huaier granule was used to treat HCC cells, and the effect of Huaier granule on the proliferation, migration and invasion of sorafenib resistant HCC cells was analyzed. Bioinformatics methods were used to analyze the possible interaction between microRNA-31-5p (miR-31-5p) and sprouty-related proteins with an EVH1 domain 1 (SPRED1). The expression levels of miR-31-5p and SPRED1 in HCC cells were detected by real time fluorescence quantitative polymerase chain reaction (qRT-PCR); cell viability, proliferation, migration, invasion and apoptosis were detected by CCK-8, colony formation, scratch healing, Transwell and flow cytometry; RNA immunoprecipitation (RIP) assay and dual luciferase assay were used to verify the binding relationship between miR-31-5p and SPRED1. Results Huaier granule could significantly inhibit the proliferation, migration and invasion of sorafenib resistant HCC cells, and induce apoptosis. Bioinformatics analysis showed that miR-31-5p was highly expressed in HCC, and Huaier granule was able to down-regulate the expression of miR-31-5p, inhibit the proliferation and metastasis of sorafenib resistant HCC cells, and induce apoptosis; miR-31-5p showed a targeted inhibition effect on the expression of SPRED1. SPRED1 was down-regulated in HCC, and overexpression of SPRED1 was able to reverse the promoting effect of overexpression of miR-31-5p on proliferation and metastasis of sorafenib resistant HCC. Conclusion Huaier granule can inhibit sorafenib resistant HCC metastasis through the miR-31-5p/SPRED1 axis, indicating that Huaier granule has the potential to be used as a novel drug for HCC treatment.

Objective:To investigate the characteristics of attentional bias in adolescents with anxiety disorder.Methods:Totally 40 adolescents with anxiety disorder who met the DSM-5 diagnostic criteria were recruited as the case group, 40 normal adolescents matched with the case group in terms of gender, age and education level were served as the control group.Symptom was assessed by the screen for child anxiety related emotional disorders (SCARED), and attention bias was assessed by attention bias test on both groups.All data were analyzed using SPSS 21.0.Results:(1) In the test of attentional bias, the negative reaction of the case group was lower than the neutral response((647.14±94.44)ms, (661.08±112.07)ms), and the attention bias value of the case group was higher than the control group((13.93±33.27)ms, (-0.13±18.49)ms), the differences were statistically significant (both P<0.05). (2) In the total score and each factor score of SCARED, total score of SCARED was negatively correlated with the negative accuracy rate ( r=-0.38), and the separation anxiety score was negatively correlated with the negative accuracy rate ( r=-0.52), social terrorism scores were negatively correlated with negative accuracy ( r=-0.45) and neutral accuracy ( r=-0.43) (all P<0.05). The correlation between somatization, generalized anxiety and school terror with attention bias test were not significant( P>0.05). Conclusion:Adolescents with anxiety disorder are more concerned with negative stimuli, and it is difficult to shift attention from negative stimuli to others.The avoidance to neutral stimuli may be a risk factor for the severity of symptoms in adolescents with anxiety disorders.