Objective To explore the normal number of lumbar lateral recess and the relationship between the CT pathology and clinical manifestation in the patients who suffered from lumbar lateral recess stenosis. Methods Lumbar specimen of 15 normal adult corpse and 20 healthy volunteers were observed, and the anterior and posterior(AP) sagittal diameters of normal lumber lateral recess were measured. The CT pathology and clinical manifestation of 174 patients who suffered from lumbar lateral recess stenosis were analysed. Results At the levels of L1 and L2, the lateral recess was found in about 34% normal persons.At the levels of L3 to S1, the lateral recess was found in all healthy persons.All patients who suffered from lumbar lateral recess stenosis had narrow AP sagittal diameters of lumbar lateral recess (

OBJECTIVE:To evaluate the efficacy and toxicity of docetaxel plus xeloda in the treatment of advanced gastric cancer. METHODS: Forty patients with advanced gastric cancer were treated with docetaxel 75 mg?m-2 on day 1 and xeloda 2 000 mg?m-2 (in two divided oral doses) for the first 14 days. The chemotherapy repeated every 3 weeks. Efficacy and toxicities were reviewed after 3 to 4 cycles of chemotherapy (1 cycle = 21 days). RESULTS: Among the 40 evaluable patients, 1 (2.5%) showed complete remission, 23 (57.5%) partial remission, 13 (32.5%) stable and 3 (7.5%) disease progression, and the overall response rate was 60.0%. The main adverse reactions were myelosuppression, alopecia, diarrhea, and hand-foot syndrome. CONCLUSION: The combination of docetaxel and xeloda is well tolerated and effective in the treatment of advanced gastric cancer.

Objective Systemic chemotherapy for metastatic pancreatic cancer is still a difficult problem in clinical practice. The standard chemotherapy of pancreatic cancer has been gemcitabine, but the response rate is low. Therefore, it is in urgent need to explore an effective clinical therapy for this cancer. This paper, a case report, is aimed at discussing the effectiveness of vinorelbine and cisplatin combined with endostatin as the first-line therapy for metastatic pancreatic cancer. Methods A 52-year-old female patient was diagnosed with pancreas cancer with liver metastasis at the time of the first visit to our hospital. Systemic chemotherapy with vinorelbine and cisplatin combined with endostatin was conducted. Results Liver metastases almost disappeared after the first cycle of chemotherapy. The primary tumor decreased by one third in size after four cycles and disappeared after the sixth cycle according to the CT scan evaluation. Conclusion Vinorelbine and cisplatin combined with endostatin can be a promising regimen for metastatic pancreatic cancer.

Objective To evaluate the effect of dexmedetomidine on retinal ischemia-reperfusion (I/R) injury in mice.Metbods Forty-eight C57BL/6 male mice,aged 8 weeks,weighing 20-24 g,were divided into 3 groups (n =16 each) using a random number table:control group (C group),I/R group and dexmedetomidine group (D group).The model of retinal I/R injury was established by elevating intraocular pressure for 60 min using anterior chamber cannulation followed by 24 h of reperfusion.At 15 min before ischemia and 5 min before reperfusion,dexmedetomidine 25 μg/kg was intraperitoneally injected in group D,and the equal volume of normal saline was intraperitoneally injected in C and I/R groups.Eight mice were sacrificed at 24 h of reperfusion,and the retina was removed for microscopic examination of pathologic changes (with light microscope) after haematoxylin and eosin staining and for determination of cell apoptosis in retinal tissues (by TUNEL).Apoptosis index (AI) was calculated.Eight mice were sacrificed at 24 h of reperfusion,and the retina was removed for determination of the expression of Bcl-2,Bax,caspase-3 and CCAAT/enhancer-binding protein homologous protein (CHOP) in retinal tissues (by Western blot).Bcl-2/Bax ratio was calculated.Results Compared with group C,AI was significantly increased,the expression of Bax,caspase-3 and CHOP was up-regulated,the expression of Bcl-2 was down-regulated,Bcl-2/Bax ratio was decreased (P＜0.05),and pathologic changes were found in retinal tissues in group I/R.Compared with group I/R,AI was significantly decreased,the expression of Bax,caspase-3 and CHOP was down-regulated,the expression of Bcl-2 was up-regulated,Bcl-2/Bax ratio was increased (P＜0.05),and pathologic changes of retinal tissues were significantly attenuated in group D (P＜0.05).Conclusion Dexmedetomidine can reduce retinal I/R injury,and the mechanism mav be related to inhibiting cell apoptosis in mice.

Objective To investigate the effect of nerve cells apoptosis induced by endoplasmic reticulum stress (ERS) on brain injury after asphyxiating cardiac arrest and cardiopulmonary resuscitation (CA/CPR) in rats.Methods A total of 40 male Sprague-Dawley rats were randomly divided into control group and CA/CPR group (n=20).The CA/CPR models were established by asphyxia method/CPR.The levels of neuron specific enolization enzyme (NSE) and S100 beta protein (S100β protein) in serum at baseline and 0,3 and 6 h after CPR were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA).The mRNA expressions of CCAAT-enhancer binding protein homologous protein (CHOP),activate transcription factor 4 (A TF4) and X-4 box binding protein 1 (XBP1) in the hippocampus were detected by reverse transcription-polymerase chain reaction (RT-PCR).The protein expressions of CHOP,B-cell lymphoma-2 (Bcl-2),Bcl-2 associated X protein (Bax) and cysteinyl aspartate specific proteinase 3 (caspase-3) in the hippocampus were measured by Western boltting.Neuronal apoptosis were detected by terminal dexynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL).Morphological and ultrastructural changes of the hippocampi were observed by light microscopy and electron microscopy.Results As compared to that in the control group,S100β protein in the CA/CPR group at 0,3 and 6 h after resuscitation was statistically different (P＜0.05);NSE protein level in the CA/CPR group at 6 h after resuscitation was significantly higher than that in the control group (P＜0.05).As compared with those in the control group,the mRNA expressions of CHOP,A TF4 and XBP-1 in the hippocampus of the CA/CPR group were obviously increased (P＜0.05).Significantly increased protein expressions of CHOP,Bax,and caspase-3,and statistically decreased Bcl-2 expression in the CA/CPR group were noted as compared with those in the control group (P＜0.05).The neuronal apoptosis rate in the CA/CPR group (29.74％±6.26％) was significantly higher than that in the control group (7.48％±4.34％,P＜0.05).The morphology changes and ultramicrostructure injuries of the hippocampus in the CA/CPR group were more obvious as compared with those in the control group.Conclusion CA/CPR in rats causes significant damage to brain tissues,and brain injury is aggravated gradually along with the prolongation of time,and the mechanism of brain injury may be connected with ERS-induced apoptosis of nerve cells.

Objective To investigate the effect ofdexmedetomidine (Dex) on endoplasmic reticulum stress (ERS) and apoptosis in brain injury after asphyxiating cardiac arrest and cardiopulmonary resuscitation (CA/CPR) in rats.Methods A total of 60 clean male Sprague-Dawley rars were randomly divided into sham-operated group,CA/CPR group and Dex precondition group (n=20).Rats in the control group did not receive CA/CPR;and rats in the CA/CPR group and Dex precondition group were performed cardiac arrest induced by asphyxia,and then,CPR was performed.Dex with dose of 4.0 microgram/kg (body weight) was intravenously injected into rats in the Dex precondition group prior to 5 min of asphyxia.The same volume of saline by intravenous injection was given to rats in control group and CA/CPR group.Brain tissues were collected after the experiment,and wet to dry weight (W/D) ratio was tested.The mRNA expressions of CCAAT-enhancer binding protein homologous protein (CHOP),activation of transcription factor 4 (A TF4) and X-4 box binding protein 1 (XBP1) in the hippocampus were detected by reverse transcription-polymerase chain reaction (RT-PCR).The protein expressions of CHOP,B-cell lymphoma-2 (Bcl-2),Bcl-2 associated X protein (Bax) and cysteinyl aspartate specific proteinase 3 (caspase-3) in the hippocampus were measured by Western boltting.Neuronal apoptosis was detected by terminal dexynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL).Morphological and ultrastructural changes of brains of rats were observed by light microscopy and electron microscopy.Results As compared with the control group,CA/CPR group and Dex precondition group had significantly increased W/D ratio of brain tissues and mRNA expressions of XBP1,A TF4 and CHOP in the hippocampus,significantly higher protein expressions of CHOP,Bax and caspase-3,and statistically lower Bcl-2 expression (P＜0.05).As compared with the CA/CPR group,Dex precondition group had significantly decreased W/D ratio of brain tissues and mRNA expressions of XBP1,A TF4 and CHOP in the hippocampus,significantly lower protein expressions of CHOP,Bax and caspase-3,and statistically higher Bcl-2 expression (P＜0.05).TUNEL indicated that the neuronal apoptosis rate in the control group (7.49％±4.33％) was significantly lower than that in the CA/CPR group and Dex precondition group (29.73％±6.27％ and 16.82％±5.75％,P＜0.05);significant difference was noted between CA/CPR group and Dex precondition group in the neuronal apoptosis rate (P＜0.05).Changes in the morphology and ultramicrostructure injuries of brain tissues were more significant in CA/CPR group,while the changes were obviously alleviated in Dex precondition group.Conclusion Dex can alleviate brain injury after asphyxiating CA/CPR in rats,whose mechanism may be related to ERS and inhibition on apoptosis of nerve cells.

Objective:To inhibit the Itch gene expression of T-lymphocytes and investigate the immune activity of T lymphocytes using ultrasound-targeted microbubble destruction (UTMD).Methods:T lymphocytes were separated by magnetic bead, and to establish an Itch gene targeted short hairpin RNA (shRNA) plasmid. There were three groups in this study: ①experimental group, Itch-shRNA plasmid-SonoVue microbubbles combined with ultrasound irradiation; ②control group, negative control shRNA plasmid-SonoVue microbubbles combined with ultrasound irradiation; ③blank group, untreated. Forty-eight hours after UTMD transfection, transfection efficiency was detected and analyzed by fluorescence microscopy and flow cytometry, the expression of Itch protein was measured with Western blotting.Seventy-two hours after UTMD transfection, the secretion of interleukin 2 (IL-2) and interferon γ (IFN-γ) in the cell supernatant were measured by enzyme-linked immunosorbent assay (ELISA). One-way ANOVA was used to compare the differences between groups, and LSD- t test was used to compare the differences between groups. Results:The UTMD mediated shRNA transfection rate was 52.3%, and the relative expression levels of Itch protein in the experimental group, control group and blank group were 0.301±0.080, 0.773±0.101 and 0.719±0.090, respectively, and the difference was statistically significant( F=24.441, P<0.01). The Itch gene expression can be effectively suppressed in the experimental group. Seventy-two hours after transfection, the concentrations of IL-2 in the experimental group, control group and blank group were (417.3±37.1)ng/L, (158.7±17.3)ng/L and (147.0±10.2)ng/L, respectively, and the difference was statistically significant( F=118.701, P<0.001) and the concentrations of IFN-γ were (168.3±12.1)ng/L, (74.3±3.7)ng/L and (74.6±7.1)ng/L, respectively, and the difference was statistically significant ( F=126.833, P<0.001). The expression levels of IL-2 and IFN-γ in the experimental group were significantly higher than those in the control group and the blank group. Conclusions:UTMD mediated shRNA transfection can significantly decrease the expression of Itch and promote immune activity of T lymphocyte.

Objective To analyze the implementation of intervention programs targeted on AIDS high risk sexual transmission groups since 2008,when the relative prevention and control information systems on HIV/AIDS were developed.Methods Data from both aggregated interventions and sentinel surveillance programs from 2008 to the end of 2014 were used.Descriptive statistics were performed to analyze the trends of implementation on high risk groups including men who have sex with men,female sex workers (FSW) and migrant workers.Results From 2008 to 2012,the monthly average numbers receiving intervention programs and the average monthly coverage rate on intervention for MSM,increased from 49000 to 252000,and from 8.6％ to 78.5％ respectively.The FSW related indicators increased from 329 000 to 625 000,and from 30.9％ to 87.0％ respectively.Above indexes on the two populations had dropped slightly in 2013 and 2014.Sentinel surveillance data showed that knowledge and behavior indicators observed from the MSM and FSW populations increased annually.The coverage of intervention programs on migrant workers increased from 4.7％ to almost 10.0％,but the surveillance data on migrant men showed that the knowledge and behavior indicators were still lower than the other high-risk groups.Conclusion Intervention related to sexual transmission on HIV/AIDS among high-risk populations were effectively implemented,with some achievements seen.However,as sexual contact currently became the main route of AIDS epidemic,new challenges called for serious attention.

Objective To assess and compare the incidence,clinical characteristics,treatment,and prognosis of acute heart failure patients from different grades hospitals in Beijing.Methods In this prospective internet prognosis registered study (Beijing AHF Registry),a total of 3 335 consecutive patients admitted to 14 emergency departments in Beijing from January 1st 2011 to September 23rd 2012 were enrolled.According to hospital grade,these patients were divided into two groups,349 patients were from secondary hospitals,and 2 956 patients were from tertiary hospitals.Results Among the 3 335 patients,the medium age was 71 (58,79) years,and male accounted for 53.16％.The most common underlying disease were coronary disease (43.27％),hypertension (17.73％),cardiomyopathy (16.07％) etc.The average treatment time in Emergency Department was 66.82 h.The emergency department mortality rate was 3.81％ (127 cases).The 30-day and 1-year cumulative all-cause mortality were 15.3％ and 32.27％,respectively.The 30-day and 1-year cumulative all-cause readmission were 15.64％ and 46.89％,respectively.Compared with patients in tertiary hospitals,patients in secondary hospitals had more onset acute heart failure patients (63.64％ vs.49.93％),shorter emergency department treatment time (12 h vs.41 h),lower discharge rate (3.43％ vs.37.45％) and emergency department mortality(1.58％ vs.4.09％).Compared with those in tertiary hospitals,1-year cumulative all-cause mortality (25.6％ vs.33.2％),cardiovascular disease mortality (20.2％ vs.26.0％),aggravated heart failure mortality (22.4％ vs.28.8％) were lower in secondary hospitals.Following propensity score matching,compared to tertiary hospitals,patients in secondary hospitals showed lower utilization rate of beta-blockers and ACEFARB (4.51％ vs.28.17％,1.41％ vs.9.58％),except the pironolactone.Conclusion Acute heart failure in emergency department is associated with a high mortality rate and readmission rate.There is still a big gap between guidelines recommend medication current treatments for acute heart failure.