Objective: The barcoded ITS2 DNA sequence was used to identify 44 Tibetan medicinal plants. Methods: Genomic DNA of Tibetan medicinal plants were extracted with high salt and low pH method. The PCR technique was performed to obtain the ITS2. A total of 145 ITS2 sequences was obtained belonging to 24 families, 39 genera, and 44 species. Some homologous sequences were also selected according to sequence alignment from Genbank database. The ITS2 sequences were aligned using Bioedit and the intraspecific and interspecific Kimura 2-parameter genetic distance was calculated using MEGA, and the neighbor-joining (NJ) phylogenetic trees were constructed to analyze phylogenetic relationship. Results: ITS2 regions have significant intra-and inter-specific difference, phylogenetic analysis based on ITS2 regions concurred with the result of morphological classification, and it could also determine the phylogenetic relationship between species. In addition, the secondary structure of the ITS2 sequence of Tibetan medicinal plants is different, providing another method for species identification. Conclusion: ITS2 can be used as a very effective single-locus barcode in the identification and phylogenetic study of Tibetan medicinal plants. The barcoding technique provides a scientific baseline for the utilization of resources and conservation of Tibetan medicinal plants.

Objective To compare the clinical outcomes of posterior lumbar interbody fusion(PLIF) using simple cage alone fusion with pedicle screw fixation and autogenous bone grafting and cage fusion with pedicle screw fixation in adult spondylolisthesis. Methods From March 2003 to March 2004,Twenty-seven patients with lumbar spondylolisthesis were divided in two groups. In group A, 15 patients were treated by PLIF using simple cage alone fusion with pedicle screw fixation, including 4 males and 11 females, aging 53-68 years. Isthmic defects were located at L4 in 9 cases, at L5 in 6 cases. Four patients were smokers. The preoperative mean disc space height was 5.4±2.3 mm, the mean percentage of slip was 36.8%±7.2%. In group B, 12 patients were treated by PLIF using autogenous bone grafting and cage fusion with pedicle screw fixation, including 3 males and 9 females, aging 56 years. Isthmic defects were located at L4 in 8 cases, at L5 in 4 cases. Five patients were smokers. The preoperative mean disc space height was 5.7±2.5 mm, the mean percentage of slip was 37.8%±6.2%. Two groups were compared in the amount of blood loss, duration of hospitalization, back pain, radiating pain, fusion rate, the intervertebral disc space height, the postoperative degree of slip and the fusion rate. Results All patients were followed up for 24-38 months. The mean follow-up was 29(24-36) months in group A and 26(24-38) months in group B. There were no statistically significant differences in follow-up period, age,sex, the location of isthmic defects, smoking, the preoperative disc space height and the percentage of slip between two groups (P>0.05). There were no statistically significant differences in the amount of blood loss, the duration of hospitalization, the fusion time between two groups(P>0.05). But there were statistically significant differences in the back pain score, the radiating pain score and the fusion rate between two groups(P<0.05).The postoperative disc space height and the degree of slip of the last follow-up were 5.8±2.2 mm and 25.6%±7.2% in group A, 6.2±2.5 mm and 24.1%±7.4 % in group B, showing statistically significant difference (P<0.05). Conclusion The PLIF using autogenous bone grafting and cage fusion with pedicle screw fixations is more beneficial to improving the fusion rate and preventing long-term instabilities than simple cage alone fusion with pedicle screw fixation in adult spondylolisthesis.

Objective To explore the feasibility and efficacy of selective arterial embolization for the treatment of hemobilia occurred after biliary tract surgery.Methods The clinical data of 16 patients with massive hemobilia after biliary tract operation,who were treated in our hospital during the period from March 1989 to August 2009,were retrospectively analyzed.Conservative treatment of hemobilia was initially adopted in all patients,and,if it failed,interventional management was carried out.Emergent artery angiography was performed in all patients,which was followed by selective arterial embolization of the bleeding arteries with Gelfoam particles and coils.Results Of the total 16 cases,15 received selective arterial embolization therapy and the remaining one died.No re-bleeding occurred during a follow-up period of 8 months to 3 years.Conclusion For the treatment of arterial hemobilia occurred after biliary tract surgery,selective arterial embolization with Gelfoam particles and coils is a safe,mini-invasive and effective therapy with few complications.

Objective To establish the nonalcoholic fatty liver disease(NAFLD) model in SD rats and to investigate if endoplasmic reticulum stress(ERS) plays a role in the pathogenesis of NAFLD. Methods A total of 36 male SD rats were randomly divided into 4 groups: normal control group 1(N1,n=8), normal control group 2 (N2,n=8), model group 1(M1,n=10) and model group 2(M2,n=10). The two control groups were fed with normal diets, whereas the two model groups were provided diets enriched in fat (10% lard oil and 2% cholesterol). The rats in N1 and M1 groups were sacrificed at the 12th week, and those in N2 and M2 groups were sacrificed at the 20th week. The serum alanine aminotransferase (ALT), aspartate aminotransferase(AST), alkaline phosphatase (ALP), total protein (TP), triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) were measured. The steatosis, immflamation and fibrosis of the liver were observed with HE and Masson staining. The expressions of GRP78, CHOP and procaspase-12 mRNA were tested using real-time PCR and the activation of procaspase-12 protein was detected by Western blot. Results At the 12th week, the liver index and the serum levels of ALT, AST,ALP,TP,TC,LDL in M1 group were significantly higher than those in N1 group (P<0.01), but HDL level was significantly lower in M1 group than that in N1 group (P<0.01). At the 20th week, the concentrations of TC and LDL in M2 group were significantly increased in comparison with N2 group. The histochemical study revealed that the hepatic steatosis and inflammation in M1 and M2 groups were more serious than those in N1 and N2 goups(P<0.01). The slight fibrosis was seen in M2 group. At the 12th and 20th weeks, the expressions of GRP78,CHOP and procaspase-12 mRNA and protein in M1 and M2 groups did not differ in N1 and N2 groups. Conclusions The fat-rich diet might successfully induce NAFLD in rats and there is no ERS observed in the study, which suggests that ERS may not be involved in the pathogenesis of NAFLD.

Objective To investigate the effect of recombinant human endostatin(rh-Endostatin) combined with transcatheter arterial chemoembolization(TACE) on the growth and metastasis of the implanted hepatic tumor in rabbits.Methods Thirty New Zealand white rabbits were randomly divided into three groups (10 in each group)and VX_2 carcinomas were implanted in the left lobes of the livers. Fourteen days later, a catheter was inserted into the hepatic artery of rabbits with VX2 hepatic tumor and infusion was performed via the hepatic artery using physiological saline (group A), TACE (group B) and rh-Endostatin combined with TACE (group C),respectively. Five weeks later, all ribbits were sacrificed, the body weight and liver weight of animals were assessed, the hepatic index(HI) was calculated, the volume and necrotic area of the implanted tumor were measured. The presence of metastases in the liver, lungs were recorded. Results Five weeks after inoculation, the body weight of all animals decreased, the liver weight increased, His were 10.2±2.8, 8.5±6.1and 6.2±4.4 in groups A, B and C, respectively. The mean volume and necrostic areas of the implanted tumor were (36.2±3.4) cm~3 and (52.0±2.3)% in group A, (23.6±4.5) cm~3 and (63.6±3.5)% in group B, (10.9±5.1) cm~3 and (78.6±4.8)% in group C, respectively. There were statistical significance about tumor volume and necrostic areas of the tumors between group C and group A,B ( P<0.01). The numbers of metastases in the lungs were 50.3±31.3,53.6±35.1 and 16.8±18.4 , and the diameters of metastases in the lungs were (3.6±1.4) mm, (3.8±0.6) mm and (1.2±0.6) mm in groups A, B and C, respectively, the difference between group C versus other groups( P<0.01) was statistically significant. The differences of opportunity, tumor numbers and size of metastases in the liver were statistically significant. (P<0.01).Conclusion Treatment with rh-Endostatin combined with TACE can suppress the growth of tumor and tumor's metastases in lungs inVX2 implanted tumors of rabbits.

Objecfive To investigate the effects of endotoxin on nuclear factor-κB p65(NF-κB p65)mRNA expression and ahtosteron secretion in rat hepatic stellate cells(HSCs).Methods Cultured rat HSCs(HSC-T6)were divided into endotoxin-treated group and control group.Cells in endotoxin-treated group were exposure to 1 mg/ml.endotoxin.Aldosteron secretions of HSCs were determined by radioimmunoassay,and NF-κB p65 mRNA expressions of HSCs were detected by one-step RT-PCR.Results At 6,12,24 and 48 h,aldosteron secretions in endotoxin-treated group were significantly hisher than those in the control group(t=3.063,4.577,6.847 and 9.317,P<0.05),and the expressions of NF-κB p65 mRNA in endotoxin-treated group were also higher than those in control group(t=5.155,6.095,7.875 and 9.313,P<0.01).Aldosteron secretions and NF-κB p65 mRNA expressions in HSCs displayed a positive correlation(r=0.886,P<0.01).Conclusion Endotoxin can up-regulate the aldosteron secretion and NF-κB p65 mRNA expression in rat HSCs,which may be one of the mechanisms of liver fibrosis induced by endotoxin.

Distal radius fractures (DRFs) are one of the most common injuries in orthopaedics,accounting for up to 20％ of all fractures seen in the emergency room.At present,the optimal treatment of these fractures remains controversial.Although most DRFs can be treated non-operatively,such as immobilized by plaster,splint or brace,surgical management has become more and more popular with people's living standards improved and expecting better functional outcome.Surgical treatments for DRFs include percutaneous fixation with Kirschner wires,skeletal external fixation,open reduction and internal fixation,intramedullary nails,fixation using the mini-invasive approach,arthroscopy,and total wrist arthroplasty.Currently,open reduction with volar plate fixation is the most popular and widely way for DRFs,while a mini-invasive approach is a new reliable and reproducible procedure with few complications.Despite recently surgical treatment has become more and more popular,it is also unclear whether surgical intervention will produce better long-term outcomes.The aim of this paper is to present the studies in the literatures about the treatment for DRFs and an update of existing techniques.

Objective: To investigate the changes of ambient dose equivalent rate in 99mTcO4- single photon emission computed tomography (SPECT) of the thyroid among patients with hyperthyroidism, so as to provide insights into radiation protection guidance. Methods: Patients with hyperthyroidism who underwent 99mTcO4- SPECT of the thyroid in a tertiary hospital were enrolled. The ambient dose equivalent rate was measured at different time points following 99mTcO4- infection and at sites with different distances from patients' neck, and the effects of time post-injection, distance from patients' neck, 24-hour thyroidal radioiodine uptake and thyroid weight on the ambient dose equivalent rate were examined using a generalized linear mixed model. Results: Totally 100 patients with hyperthyroidism were enrolled, including 24 men and 76 women and with a mean age of (38.5±14.0) years. The generalized linear mixed model was statistically significant (F=6 610.165, P<0.001), and patients' thyroid weight, time post-injection and distance from patients' neck significantly affected the ambient dose equivalent rate (F=57.967, 15 988.574, 11 200.645, all P<0.001), and the ambient dose equivalent rate positively correlated with patients' thyroid weight and negatively correlated with time post-injection and distance from patients' neck. Conclusions The ambient dose equivalent rate is affected by patients' thyroid weight, time post-injection and distance from patients' neck among patients with hyperthyroidism undergoing 99mTcO4- SPECT of the thyroid. Delay in contact with patients or keeping distance from patients may be effective for radiation protection.

Objective:To study the effect of changing operator on the detection rate of colorectal polyps during surgery in patients who had been diagnosed with colorectal polyps by electronic colonoscopy for the first time.Methods:From June 2016 to June 2019, the patients who had been diagnosed with colorectal polyps by electronic colonoscopy for the first time, they were performed by electronic colonoscopy for the second time after 3 months by 5 doctors in the No.946 Hospital of PLA who had engaged in endoscopic work longer and been with rich experience. The results of the electronic colonoscopy were recorded and compared.Results:Fived hundred and seventy-six patients were found have colorectal polyps through electronic colonoscopy for the first time. Among them, 423 patients came to the hospital within 3 months and were eligibled for the research. The detection rate of newly detected polyps by the same operator was 22.7%(96/423), after changing the operator, the detection rate became 24.3% (103/423), but there was no significant difference ( P>0.05). The detection rates of newly detected polyps were respectively 20.8% (220/1 059) and 25.9%(294/1 133), the proportion of newly detected polyps with diameter ≤ 5 mm was respectively 73.6%(162/220) and 82.0%(241/294), the ratio of flat polyps to total newly detected polyps was 71.8%(158/220) and 79.9%(235/294), and there were significant differences ( P<0.05). The proportion of polyps in sigmoid colon was respectively 35.0% (77/220) and 39.1%(115/294), and there was no significant difference ( P>0.05). Conclusions:For patients with colorectal polyps detected by electronic colonoscopy, the operator should be changed during surgery, so that more missed polyps can be detected during surgery, especially flat polyps with diameter ≤ 5 mm. The operator should be changed to improve the detection rate and reduce the probability of missed diagnosis.

Objective To understand the prevalence and cause of eye diseases in the middle and old aged population in community was of important significance for the prevention and treatment of relevant diseases.The present study attempts to survey the prevalence of common eye diseases and conditions of blindness and low vision in 50 years and older population in community of Beijing.MethodsThis was an ophthalmologic epidemiology survey.The 2 833 target population was included and registered in Western Chang'an street community in door-to-door and questionnaire manner between October,2006-October,2007.Multiple factors,such as demography,general conditions,lifestyles,education degree,economical status,medical status and the awareness of relevant ophthalmic knowledge of participants were recorded and evaluated.Relevant eye examinations including uncorrected visual acuity,pinhole visual acuity,non-contact intraocular pressure test,slit-lamp,funduscopy and optometry examinations were performed in Beijing No.2 Hospital by trained ophthalmologists.Blindness and low vision were evaluated based on WHO criteria.The causes of leading-blindness and low vision were analyzed.Oral informed consent was obtained from all of the subjects.Results2 410 individuals of 2 833≥50-year-old participants received complete surveys according to the designed process in this study with an examined rate of 85.07%.The incidence of blindness and low vision in examinees was 0.79% and 5.64% respectively.The positive factors related to blindness and low vision appeared to be age,education and an awareness of relevant ophthalmic knowledge (χ~2=26.62,18.28,21.32,P＜0.001).The primary causes of blindness in examined population,in order,were cataract,glaucoma and retinopathy,and those of low vision were cataracts,refractive error and diabetic retinopathy.ConclusionIt is emphasized that early prevention and treatment for cataract,glaucoma,diabetic retinopathy and refractive errors can reduce the prevalence of blindness and low vision in people over 50 years in the Western Chang'an street community of Beijing.