Objective To discuss the surgical treatment of delayed acetabular fractures and factors that affect the clinical outcomes. Methods From February 2001 to July 2005, 37 cases of delayed acetabular fractures were surgically treated. There were 22 males and 15 females, with an average age of 36.8 years (17 to 58). 10 cases were simple fractures and 27 complicated ones. The interval between injury and surgery averaged 44.8 days (21 to 399 days). 6 cases were treated through Kocher- Langenbeck approach, 1 ilio- inguinal approach, 2 extended ilio- inguinal approach, and 28 combined approaches. The mean operation time was 226 min (120 to 490 min). The average blood loss was 1 798 mL. Results The mean follow- up period was 18.9 months (6 to 56 months). Evaluation was conducted with Matta' s reduction criteria and modified D’ Aubigne and Postel clinical scoring. Reduction was anatomical in 31 cases, unsatisfactory in 4 and poor in 2. Clinical outcomes were rated as excellent in 21, good in 9, fair in 5 and poor in 2. There was 1 case of femoral head necrosis. Heterotopic ossification developed in 11 cases. In addition, transient paralysis of the sciatic nerve happened in 4 patients. Conclusions In principle, combined or extended ilio- inguinal approach should be reserved for the delayed acetabular fractures with the exception of simple fractures of posterior wall or/and posterior column, anterior wall and anterior column which can be managed by a single approach. The occurrence of arthritis correlates with the severity of the fracture. No direct relation has been found in this series between femoral head necrosis and femoral head dislocation before operation. Severity of fracture, interval between injury and surgery, and skills of orthopedists determine the clinical outcome, operation duration, and perioperative blood loss.

MicroRNAisatypeofsingle-strandednon-codingRNA,directlybondingtothecomplemen-tary target gene mRNA.That leads to the inhibition of mRNA translation of the target molecule in order to reduce expression of the target gene.MicroRNAs are not only involved in the regulation of inflammatory reac-tion,but also play important roles in the formation of neoplasm.The researches showing that the inflammatory reaction interacting with miRNAs results in the differential expressions of microRNAs in lung cancer have been widespreadly concerned.Along with the deepening of the research on the mechanisms of inflammatory reaction and differential expression of microRNAs,it will provide new strategies for the prevention,diagnosis and treat-ment of lung cancer.

is lesion size and staging in pre-operative and etiologies are the risk factors associated with postoperative progression.

BACKGROUND: Puerarin, the main effective component of Chinese herb, Radix puerariae, is isoflavone monomer, which can counteract learning and memory impairment induced by scopolamine or D-galactose etc.OBJECTIVE: To investigate the protective effects of puerarin on β-amYloid peptide-induced learning and memory impairment of model mouse of dementia and the changes of superoxide dismutase activity and malondialdhehyde content in brain and blood.DESIGN: Randomized controlled trailSETTING: Department of Pharmacology, Capital University of MedicalSciencesMATERIALS: The experiment was conducted in Departmentof Pharmacology of Capital University of Medical Sciences from March to June 2002.A total of 40 ICR mice were selected and randomly divided into 4 groups:pseudooperation group, dementia model group, puerarin 25 mg/kg group and puerarin 50 mg/kg group, with 10 in each group.METHODS: ①Model preparation: After anaesthesia with pentobarbital sodium, single intraventricular injection of 3 μL β-amyloid peptide was conducted from right side on each mouse in dementia model group, puerarin 25 mg/kg group and puerarin 50 mg/kg group under aseptic manipulation. The same operation was carried out on the mouse in pseudooperation group but without injection of β-amyloid peptide. ②Giving medicine:10 mL/kg physiological saline was intraperitoneally injected into the mouse in pseudooperation group and model group; 25 mL/kg puerarin was intraperitoneally injected to the mouse in 25 mg/kg puerarin group; 50 mL/kg puerarin was intraperitoneally injected to the mouse in 50 mg/kg puerarin group.The medicines were given to each group from the day of model preparation on and behavioral test was carried out 12 days later. ③ Morris water maze examination was used to detect learning and memory ability of the mice.Time for finding the platform (escape latency) in 2 minutes, swimming distance, original angle and search strategy were recorded as learning results.④When the above experiment was finished, anaesthesia with ether was applied to the mice and blood was collected from the orbit to prepare serum.After that, the mice were put to death by decapitation and the tissue of right-brain of the mice were rapidly took out to prepare cerebral homogenate in ice bath, then superoxide dismutase activity and malondialdhehyde content were determined in brain and serum.MAIN OUTCOME MEASURES: ①Escape latency, swimming distance,search strategy and original angle for the mouse in each group to reach the latform. ②Superoxide dismutase activity and malondialdhehyde content in brain and blood of the mouse in each group.RESULTS: All the 40 mice were involved in result analysis. ① Escape latency and swimming distance were shortened in puerarin 25 mg/kg and 50 mg/kg groups (P ＜ 0.05-0.01). The results of search strategy and original angle indicated that as the number of training days increased, the frequency of randomization+magin strategy gradually decreased; The decreasing rates and extents in pseudooperation group and puerarin 25 mg/kg and 50 mg/kg puerarin were more rapid than that in dementia model group,meanwhile, the increasing rates and extents of frequency of tendency+directness strategy in these groups were more rapid than that in dementia model group. There was no significant difference in original angle between groups (P ＞ 0.05). ② The content of superoxide dismutase increased and that of malondialdhehyde decreased in brain and blood of the model mouse in puerarin 25 mg/kg group andpuerarin 50mg/kg group (P ＜ 0.05 -0.01).CONCLUSION: Puerarin can counteract the neurotoxicity of β-amyloid peptide, which improves learning and memory of model mouse. It is not relevant to the dosage but probably related with elimination of cerebral free radical and improvement of antioxidation activity.

Objective To discuss the surgical technique of delayed acetabular fractures and its possible prognosis factors.Methods From April 2001 to November 2008,61 patients with delayed acetabular fractures were surgically treated.There were 47 males and 14 males,with an average age of 38 years.According to Letourael classification,16 simple fractures included 7 cases of posterior wall fractures,2 of posterior column fractures,1 of anterior column fractures and 6 of transverse fractures.Forty-five patients with mixed fractures included 3 cases with both fractures posterior column and wall,7 of transverse and posterior wall fractures,4 of T-shape fractures,6 of posteriorly semi-transverse fractures and 25 of both-columns fractures.Fifty-two patients suffered from traffic accident;6 patients were caused by falling from height and 3 suffered from crush injuries.Brain injuries occurred in 11 cases,thorax-abdominal injuries in 15,urinary tract injuries in 7,multiple fractures in 25.The injury of sciatic nerve was found in 3 patients preoperatively.The average interval form injury to surgery was 39 days.A single approach was employed in 13 cases,and combined antero-posterior approaches were employed in 48.The operation time was (248±45) min with a blood loss of (2160±100) ml averagely.Results The average follow-up was (61±8) months.The clinical result was evaluated by Matta reduction criteria,modified Merle d'Aubingne and Postel scoring system.Anatomical reduction was achieved in 45 cases;however,13 were unsatisfactory and 3 were poor.For clinical results,38 were graded as excellent,13 as good,6 as fair and 4 as poor.Osteonecrosis of the femoral head occurred in 3 cases (4.9%),and heterotopic ossification developed in 28 cases (45.9%).Additionally,4patients (6.6%) had a transient sciatic nerve paralysis.Conclusion Open reduction and internal fixation is a liable method for delayed acetabular fractures.Single approach is suitable for simple fractures;in principle and combined approaches are for compound delayed acetabular fractures.The reduction quality is closely related to surgeon's experience.

Based on the practice of bilingual education in medical biochemistry,this paper discussed the advantages,problems and solutions of bilingual education in medical biochemistry of teaching-centred medical college or university.This study will be helpful for developing bilingual teaching of biochemistry in other teaching-centred medical colleges or universities.

BACKGROUND:Subdermal contraceptive implants as a novel contraceptive method have been extensively used worldwide.OBJECTIVE:To review the research progress in the non-biodegradable and biodegradable long-term subdermal contraceptive implants and to explore their advantages and disadvantages.METHODS:A computer-based search of CNKI,Wanfang,and PubMed (1967-2015) was performed by the first author for relevant articles,using the key words of contraceptive implants,non-biodegradable,biodegradable in Chinese and English,respectively.Initially 240 articles were retrieved,and finally 70 articles were included in result analysis.RESULTS AND CONCLUSION:Long-term subdermal contraceptive implants that pass through the local capillaries into the blood circulation system can avoid the gastrointestinal absorption,improve the bioavailability of drugs,and reduce adverse drug reactions.According to the performance,there are two kinds of drug carriers,non-biodegradable and biodegradable.Although non-biodegradable implants have been widely used and the contraceptive effect is excellent,the implants must be removed surgically because they cannot be absorbed or metabolized in the body.Significant efforts have been devoted to developing biodegradable implants because they can degrade at the end of use.However,the utility of some biodegradable polymers as drug carriers in implantable applications has been hampered by their shortcomings,and further study on alternative materials is urgently required.

Objective To probe into the operative techniques and clinical outcomes of treating bi-columnar acetabular fractures. Methods From April 2001 to December 2006, 609 cases undergoing operation for aeetabular fractures were followed up. Of them, 193 eases, 147 males and 46 females with an average age of 34.4 years, were of bi-columnar type. Their complications involved the articular cartilage of the femoral head in 37, eranioeerebral trauma in 31, injury to bladder and/or urethra in 27, injury to thorax and/or abdomen in 68, injury to pelvis and/or sacroiliac joint in 59, and injury to sciatic nerve in 11. The interval between injury and surgery was within 1 week in 15 cases, within 2 weeks in 121, within 3 weeks in 34, and beyond 3 weeks in 23. A single ilioinguinal approach was adopted for 4 cases and combined ap-proaches for 189. Results The mean operating time was 238 (150 to 330) minutes, and the blood loss averaged 1453 (450 to 4400) mL. The mean follow-up period was 44.2 (14 to 84) months. All the eases were evaluated by Matta reduction criteria, X-ray manifestations and the modified Merle d'Aubingne and Postel clinical scoring. One hundred and sixty-eight patients got anatomical reduction, 17 unsatisfactory reduction, and 8 poor reduction. The X-ray manifestations were excellent in 162 patients, good in 16, fair in 8, and poor in 7. The clinic results were excellent in 152 patients, good in 27, fair in 9, and poor in 5. The Kendall coefficient correlation between reduction and clinical outcome and that between reduction and X-ray manifes-tation were 0.74 and 0.77, respectively. Ectopic ossification happened in 77 eases and transient post-operative sciatic nerve paralysis occurred in 3. Conclusions The combined approaches facilitate exposure and synergetie reduction of the bi-colunmar fractures of acetabulum. Reduction of the acetabular roof is essential to restoration of the normal contour of the acetabulum. Reduction bears a positive correlation to the clinical results as well as experience of surgeons.

PURPOSE: Sorafenib, a multikinase inhibitor, is the standard therapy for patients with advanced-stage hepatocellular carcinoma (HCC). However, resistance develops to the treatment, therefore, we tried to unravel the underlying mechanism in the resistance of HCC cells to sorafenib via the development of more effective therapeutic strategies. MATERIALS AND METHODS: Various liver cancer cell lines were treated with either sorafenib only or with sorafenib after infection of adenovirus expressing short hairpin RNA (shRNA) against transforming growth factor-β (TGF-β) and p38 activity was examined using western blotting. RESULTS: p38 MAP kinase activity was inhibited by low concentrations of sorafenib, which could potentially lead to sorafenib resistance in HCC cell lines. Subsequently, we used constitutive form of MKK3/6 (MKK3/6E) to confirm that massive cell death was induced by the activation of p38, and demonstrated the ability to activate p38 without any stimulation. In addition, sorafenib resistance was reduced by the activation of p38. Subsequently, we confirmed that TGF-β shRNA effectively recovered the phosphorylation of p38 inhibited by sorafenib, and increased the sensitivity of HCC cells to sorafenib, thereby inducing cell death and overcoming the resistance of HCC cells to sorafenib. CONCLUSION: Our study provides a new therapeutic strategy for HCC that overcomes the resistance of HCC to sorafenib by down-regulation of TGF-β.
Adenoviridae ; Blotting, Western ; Carcinoma, Hepatocellular* ; Cell Death ; Cell Line ; Down-Regulation* ; Humans ; Liver Neoplasms ; p38 Mitogen-Activated Protein Kinases ; Phosphorylation ; RNA, Small Interfering

Objective To analyze the status of sleep disorders in patients with functional gastrointestinal disease (FGID) and its relation with symptom characteristics .Methods From January to December 2014 ,questionnaire was carried out in FGID patients who met the Rome Ⅲ criteria and visited the outpatient department of gastroenterology at six third-level general hospitals in Tianjin City to assess the severity of symptoms ,sleep quality (Pittsburgh sleep quality index ,PSQI) ,and psychological state (anxiety and depression) .Chi-square test and Mann-Whitney rank sum test were performed for statistical analysis .Results Among 931 patients with FGID ,651 (69 .92％ ) patients had sleep disorders and 280 (30 .08％ ) patients had no sleep disorders .Among 828 patients with functional dyspepsia (FD) ,360 (43 .48％ ) patients had sleep disorders complicated with and depression .Among 292 patients with irritable bowel syndrome (IBS ) , 138 (47 .26％ ) had sleep disorders complicated with anxiety and depression .Among 618 patients with FD complicated with sleep disorders , 70 (11 .33％ ) patients overlapped with IBS ;among 210 patients with FD ,but without sleep disorder ,11 (5 .24％ ) patients overlapped with IBS and the percentage of the former was higher than the latter ,and the difference was statistically significant (χ2 =6 .580 , P=0 .01) .The proportion of lower abdominal pain ,sheep fecal or hard stool ,laborious defecation or incomplete defecation in FGID patients without sleep disorder were 22 .14％ (62/280) ,11 .79％ (33/280) ,19 .29％ (54/280) and 27 .86％ (78/280) ,respectively ;which were lower than those of FGID patients with sleep disorders (36 .10％ (235/651) ,21 .20％ (138/651) ,32 .41％(211/651) and 44 .39％ (289/651));and the differences were statistically significant (χ2 =17 .552 ,11 .569 , 16 .566 and 22 .419;all P<0 .01) .FGID patients with sleep disorders have more severe symptoms such as lower abdominal pain , lower abdominal discomfort (non-pain ) , sheep fecal or hard stool , laborious defecation incomplete defecation , and urgency than FGID patients without sleep disorders ;and the differences were statistically significant (Z= -4 .423 ,-1 .973 ,-3 .360 ,-4 .467 ,-4 .550 and -2 .420 ;all P<0 .05) . Conclusions Sleep disorders ,anxiety and depression often coexist in patients with FGID .Sleep disorders are closely related with lower gastrointestinal symptoms in patients with FGID .