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 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 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.

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.

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.

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.

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.

The purpose of this study is to investigate the transdermal delivery characteristics of Gentiana macrophylla complex components system through different parts of the skin under micro-needles conditions. Two-chamber diffusion cells were used, different parts of isolated skin and micro-needle pretreated isolated mouse skin were applied separately, high performance liquid chromatography (HPLC) similarity evaluation methods were used to evaluate transdermal delivery characteristics of Gentiana macrophylla complex components system on receiving pool and the permeation rate and penetration amount of Gentiopicroside at different parts of mouse skin. In the 24 h, the similarity between receiving fluid which was on passive transdermal delivery and micro-needle transdermal delivery conditions and original fluid were ranged from 83.0% to 98.9%; By the micro-needle pretreatment with different parts of the mouse skin, the time that Gentiana macrophylla complex components system though abdominal skin to the receiving fluid which reached 90% similarity compared with that of original fluid was 4 h, which was 18 h at back skin and 12 h at neck skin separately. Micro-needles can be used as the ideal ingredients for traditional Chinese medicine complex transdermal delivery; transdermal absorption time delay could be greatly reduced and its bioavailability was improved. The permeation rate and similarity to original liquid of Chinese medicine complex components increased significantly in the abdominal skin relative to the neck and back skin under micro-needle conditions.

Objective To assess the effects of health management on high-risk diabetic populations.Methods A total of 307 diabetic high-risk adults from 6 communities of Tianjin were recruited by using diabetes risk screening technology.Three-month intensive health management and nine-month follow-up were conducted in this participants.Paired t test for continuous variables and paired contingency table x2 test were used for data analysis.Results Energy intake (1989.8 vs.1766.4 kcal,t =6.84,P ＜0.05),effective exercises (120.4 vs.157.5 kcal,t =-5.00,P ＜ 0.05),body weight (73.0 vs.71.5 kg,t =6.92,P ＜0.05),systolic blood pressure (130.4 vs.124.6 mm Hg (1 mm Hg =0.133 kPa),t =8.36,P ＜0.05),diastolic blood pressure (81.8 vs.78.4 mm Hg,t =7.40,P ＜ 0.05),serum total cholesterol (5.21 vs.5.08 mmol/L,t =2.73,P ＜ 0.05),fasting plasma glucose (6.4 vs.5.8 mmol/L,t =16.37,P ＜ 0.05)and 2 h postprandial blood glucose (7.7 vs.6.9 mmol/L,t =9.67,P ＜ 0.05) were significantly improved after the intervention.Conclusions Community-based health management may provide an effective way to prevent and control the risk factors of diabetes.

Objective To assess the role of health education in outcomes of diabetes mellitus among high-risk populations.Methods The community physicians who participated this investigation received standardized training,and 307 community residents at high risk of developing diabetes obtained three-month intense health education and nine-month follow-up study.Paired t-test,and Analysis of Variance were used for data analysis.Results After systematic health education,professional level of community physicians was improved.Cognitive level of health knowledge was also significantly improved (5.5 vs 12.6,t=-28.511,P＜0.05).In addition,health knowledge of variant age (F=4.036,P＜0.05),education level (F=15.27,P＜0.05) and occupation (F=9.80,P＜0.05) subgroups was significantly increased.In comparison with baselines,the scores of each age subgroups (F=0.204,P＞0.05) showed no significant differences,although scores of different education level (F=4.71,P＜0.05) and occupation (F=4.87,P＜0.05) subgroups were significantly different.The risk factors of diabetes were effectively controlled.Conclusions Health education should be the key to health management of diabetes,which plays important roles in improving cognitive level of health knowledge among populations at high risk of developing diabetes and reducing the incidence of this condition.