BACKGROUND: Studies demonstrated that vertebral endplate can be remodeled during intervertebral disc degeneration.However,the relationship between morphology of the vertebral endplate and intervertebral disc degeneration remains poorly understood.OBJECTIVE: To explore the relationship between the morphology of the vertebral endplate and the lumbar disc herniation.METHODS: Forty cases without previous spine disorder and sixty-two cases symptomatic lumbar disc herinations lumbar vertebral were scanned by using spiral CT.Scan range was from superior L4 to superior S2.Scan protocols as below: 140 kV,345 mAs,FOV 160 mm,layer of thick 1 mm,pitch 1.0.Original images were carried through three-dimensional reconstructions using O2 image work station,W300,C80,ZOOM=1.5,Expand 1.Intervertebral disc maximum anteroposterior,transverse diameter,circumference,area and shape were measured based on curve planar reconstruction.RESULTS AND CONCLUSION: Endplate shape was strongly related to disc herniation(all the P value < 0.01).Endplate area was a less significant factor L4/5 in men and L5/S1 in men and females(P < 0.05).The shape of the intervertebral body endplate margin is an important factor contributing to the development of disc herniation at L4/5 and L5/S1.

Objective To understand the status and effect of implementation of curriculum of nursing postgraduates,providing a reference for further improvement of our programs system for nursing postgraduates.Methods The formation of the interview framework was based on professional degree programs.Nine postgraduates were enrolled by purposive sampling,and the data were collected by in-depth interview and were analyzed by Colaizzi's content analysis.Results The experience of our school curriculum included the following:course structure and content highlighted nursing specialization characteristics; stamina was limited,the curriculum had slightly shortcoming; the assessment forms were diversification,although had some stress,it improved their ability.Conclusions We should enhance students awareness of curriculum and training plan of postgraduates,focusing on the study of specialist theory; to learn from the training experience of the foreign clinical nurse specialists in order to improve the curriculum of nursing postgraduates.In addition,we should also address the different starting point of students,explore different training plan,to lay the foundation for training of high-quality clinical nursing talents.

Objective To investigate the anti-tumor effect and mechanism of curcumin in pancreatic cancer (PC). Methods Smad4 and Jab1 expressions were detected by immunohistochemistry in tumor tissues and pericarcinomatous tis?sue from 35 PC cases, and the correlation of Smad4 and Jab1 were analyzed based on the percentage of positive staining in?tissues from 21 random selected PC cases. The effect of curcumin on expressions of tumor suppressors p53, Smad4 and cell cycle inhibitor p27 were examined by Western Blotting after human pancreatic cancer cell line PANC-1 were divided into PANC-1 control group (no treatments were given) and PANC-1 curcumin group (treated with cell culture medium containing 10μmol/L curcumin). The effect of curcumin on expressions of combination of β-TrCP1 and Smad4 was examined by Co-Immunoprecipitation after human embryonic kidney cell line 293T were divided into 293T control group (no treatments were given), 293T curcumin group (treated with cell culture medium containing 10μmol/L curcumin) and 293T Jab1 group (trans?fected by HA-Jab1 plasmid). Results Compared with expressions in pericarcinomatous tissues, Smad4 was down regulated while the expression of Jab1 was upregulated in PC tissues (P<0.01), and the expression of Smad4 was negatively correlated with the expression of Jab1 (n=21, r=-0.71, P=0.007). After treated with curcumin, the protein expression of p53, Smad4 and p27 was increased in PANC1 cell, and the protein expression of the combination ofβ-TrCP1 and Smad4 was decreased in 293T cell (P<0.05). After transfected by HA-Jab1 plasmid, the protein expression of the combination ofβ-TrCP1 and Smad4 was increased in 293T cell (P<0.05). Conclusion Curcumin may have suppression effect of PC through increasing the protein expression of p53, Smad4 and p27, and the mechanism of Smad4 upregulation may be related with the inhibition of Smad4 ubiquitination process, while Jab1 may be also involved in Smad4 degradation through ubiquitination.

Objective To explore the expression of matrix metalloproteinase-14(MMP-14)protein in the human stomach carcinoma tissues and its correlation with carcinoma invasiveness and metastasis.Methods The MMP-14 protein expression was detected by immunohistochemistry in 59 cases of stomach carcinoma tissues (observation group)and 20 cases of normal stomach tissues (control group,the adjacent normal tissues from the tumor margin of 5 cm confirmed by pathology),and its correlation with the clinically pathological parameters was analyzed.The expression characteristics of MMP-14 among various TNM stages of stom-ach carcinoma were also analyzed.Results The positive rate of MMP-14 expression was 50.85%(30/59)in the observation group and 5.00% (1/20)in the control group,the positive rate of the observation group was significantly higher than that of the control group (P <0.01);the expression level of MMP-14 was correlated with the differentiation degree,regional lymph node metastasis degree,invasion depth,lymphatic invasion and TNM stage,which showing the statistical difference(P < 0.01);the expression of MMP-14 protein was up-regulated and showed the transferring trend from cytoplasm to cellular membrane along with the progres-sion of TNM stage.Conclusion The overexpression of MMP-14 protein exists in stomach carcinoma tissues,which contributing to the invasion and metastasis of stomach carcinoma cells.

Objective To investigate the effects of cyclooxygenase-2 inhibitor celecoxib on proliferation , invasion and migration of human pancreatic cancer cell line PANC-1 and then determine the optimal concentration of cele-coxib and the most suitable application time .Methods Human pancreatic cancer cell line PANC-1 was treated with diverse concentrations of celecoxib (20,60,100 μmol/L) for different durations (24,48,72 h).Cell prolifer-ation, invasion and migration capabilities were measured by MTT colorimetry , Transwell invasion assay , and scratch assay respectively .Results The proliferation capability of PANC-1 cell was reduced by celecoxib in a con-centration-and time-dependent manner ( P <0.05 ) .In addition , the invasion and migration capabilities were decreased by celecoxib in a concentration-dependent manner(P<0.01).Conclusions Celecoxib attenuates the proliferation of human pancreatic cancer cell line PANC-1 in a concentration-and time-dependent manner .Cele-coxib attenuates the invasion and migration in a concentration-dependent manner .

Objective To investigate the correlation between deep vein thrombosis(DVT) and clinical laboratory tests in the regulation of hemostasis. Methods Endothelin-1 (ET-1), thrombomodulin (TM), P-selectin, prothrombin fragment _ 1+2 (F_ 1+2 ), thrombin-antithrombin complex (TAT), thrombus precursor protein (TpP) and D-Dimer (D-D) were measured in DVT patients (n=72) and normal individuals (n=20) with ELISA method. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy were evaluated for each of the items, and the area of the underlying receiver operating characteristic curve (AUC ROC ) was used to appraise diagnostic efficiency. Results Except ET-1, there were significant differences between the DVT group and normal control group in the other items. The AUC ROC of P-selectin, F_ 1+2 , TpP and D-D was bigger than that of ET-1, TM and TAT (P0.05). The TpP had the highest sensitivity, NPV and accuracy, and the D-D had the highest specificity and PPV. Conclusion The increase of D-D and TpP could reflect the occurrence of continuous coagulation and fibrolysis respectively. Thus the combination of measuring TpP and D-D could provide better laboratory evidence for the diagnosis of patients with DVT.

The calcaneus bone strength was assessed by quantitative ultrasonography in 47 postmenopausal women with type 2 diabetes mellitus (T2DM group) and 30 healthy postmenopausal women (control group).Speed of sound (SOS),broadband ultrasound attenuation (BUA) and stiffness index (SI) in T2DM patients were (1 015 ± 170)m/s,(84 ± 14) dB/MHz and 45 ± 8,respectively,which were significantly lower than those of control group (1 403 ± 232) m/s,(111 ± 18) dB/MHz and 66 ± 12 (all P ＜ 0.001).Stepwise multiple regression analysis showed that homeostasis model assessment of insulin resistance (IR) was independently correlated with the parameters of quantitative ultrasonography in T2DM patients.The results suggest that calcaneus bone strength is reduced in postmenopausal women with T2DM.

Objective To evaluate the safety, feasibility and efficacy of CT-guided percutaneous hollow screw fixation in the treatment of patients with sacroiliac complex injury. Methods Forty-five patients (at age range of 15-58 years) with sacroiliac complex injuries including 20 males and 25 females were enrolled in this study. There were 28 traffic injuries and 17 fall injuries. Fourteen patients with sacral fractures ( 15 patients with Dennis type Ⅰ fractures and nine with Dennis type Ⅱ fractures), 12 with sacroiliac joint dislocation, six with sacral fracture combined with sacroiliac joint dislocation and nine with sacroiliac joint complex injury. All patients were treated by CT-guided percutaneous hollow screw fixation. The functional exercise was performed early after operation. Results Seventy-two hollow screws were installed in 45 patients, with the operation time for 21-68 minutes ( average 37 minutes) and the operative blood loss for 30-75 ml. Of all, 38 patients were followed up for 6-26 months. According to the Majeed functional criteria, the score of the patients was 72-96 points (average 90. 3 points ), which showed that the results were excellent in 33 patients and good in two, with excellence rate of 92%. No iatrogenic nerve injury, incision infection or screw fracture were detected. Conclusion CT-guided percutaneous hollow screw fixation takes advantages of precise direction, stable fixation and safe operation and hence is one of safe and effective methods for treatment of sacroiliac complex injury.

Objective To study the inner diameter and hemodynamics of ophthalmic artery(OA)and central retinal artery(CRA)in hyperuricemia by Enhance-flow(eFlow)imaging and spectral Doppler.Methods One hundred and one patients with hyperuricemia and 30 volunteers were selected,the inner diameter in eFlow imaging and the peak systolic velocities(PSV),the end diastolic velocities(EDV),the resistive index(RI)were measured,and pulsatility index(PI)of OA and CRA were measured by spectral Doppler.The 101 patients were divided into two groups according to the time of diagnosing hyperuricemia,one group had a diagnosis of hyperuricemia for more than five years and the other had such a diagnosis for less than five years.The data were compared by t-test.Then,the patients were further divided into a group of hyperuricemia combined with hypertension and the other without hypertension.The differences between the experimental group and the group of volunteers were carried out by One-way ANOVA,the comparison between two groups were analyzed with SNK.Results The RI(0.68±0.09)and PI(1.3±0.4)of OA in patients who were diagnosed as hyperuricemia for more than 5 years was higher[RI:0.63±0.09,PI:1.1±0.3(t=3.504,P=0.001 ;t=3.164,P=0.002)],the EDV[(6±3)cm/s]of OA was lower than those patients with a diagnosis of hyperuricemia for less than 5 years[(8±5)cm/s,t=1.988,P=0.049].The PSV[(11.5±3.5)cm/s]and EDV[(3.7±1.1)cm/s]of CRA in hyperuricemia combination hypertension group was lower,and the RI (0.88±1.40)was higher than hyperuricemia without hypertension group[PSV:(13.5±4.0)cm/s,EDV:(4.1±1.2)cm/s,RI:0.67±0.08].Conclusion By eFlow and spectral Doppler,we have found that hyperu-ricemia could accelerate OA and CRA atherosclerosis.The eFlow and spectral Doppler are valuable methods to study the hemodynamics in ophthalmic artery of patients with hyperuricemia.

Objective To explore the effect of salvianolate combined with Qumei trimetazidine on cardiac function in patients with chronic heart failure.Methods Seventy-four patients with chronic heart failure were randomly divided into treatment group and control group (37 cases per group).Patients in control group were treated with the regular treatment scheme including digitalis,diuretics,vasodilators,angiotensin converting enzyme inhibitor(ACEI),angiotensin receptor blockers (ARB) or β blocker therapy for 24 weeks treatment.Patients in treatment group were given the regular treatment scheme plus salvianolic acid and Qumei trimetazidine treatment,of which,the dose of salvianolic was 0.2 g into 5％ glucose injection 250 ml or 0.9％ sodium chloride injection 250 ml by intravenous injection,1 times/day,and Qumei trimetazidine for 20 mg,3 times/day,for 24 weeks.Cardiac function was observed in patients of two groups before and after treatment.The level of brain natriuretic peptide (BNP) was measured.Results Heart function were improved,the total effective rate in treatment group was 91.9％ (34/37),higher than that of control group (70.3％ (26/37),x2 =5.638,P ＜ 0.05).In treatment group,left ventricular ejection fraction (LVEF),stroke volume (SV),cardiac output (CO) of patients after treatment were (52 ± 7) ％,(65.10 ± 12.87) ml,(5.65 ± 1.18) L/min respectively,significant different from that before treatment ((39 ±5)％,(46.53 ± 12.14) ml,(4.79 ± 1.02) L/min,and the differences were statistic significant (t =9.192,6.384,3.352,P ＜ 0.05).Meanwhile,in treatment group,systolic pressure,diastolic pressure,heart rate,left ventricular end diastolic diameter (Dd),left ventricular diastolic posterior wall thickness(PWT),interventricular septal thickness (IVST),left ventricular mass (LVMW),plasma brain natriuretic peptide of patients after treatment were (105 ± 8) mmHg,(75 ± 9) mmHg,(76±8) time/min,(48.7 ±3.7) mm,(9.1 ±1.4) mm,(8.7 ±1.2) mm,(170±59) g,(104.1 ±19.5) ng/L respectively,significant different from that of before treatment((134 ± 12) mmHg,(84 ±8) mmHg,(118 ±11) time/min,(55.2 ±7.8) mm,(11.7 ±2.3) mm,(10.5 ±2.4) mm,(228 ± 111) g,(568.7±179.5) ng/L t=-12.231,-4.546,-18.782,-4.579,-5.874,-4.080,-2.806,15.652,P ＜ 0.01).The same trend was seen in control group in terms of LVEF,SV,systolic blood pressure,heart rate,PWT,plasma BNP before and after treatment(LVEF:(38 ±6)％ vs.(43 ± 8)％ ;:(46.76 ± 11.80) ml vs.(58.69 ± 11.58) ml; systolic blood pressure:(132 ± 10) mmHg vs.(116 ± 11) mmHg; heart rate:(116 ± 10) time/min vs.(77 ±9) time/min;PWT:(11.5 ±2.6) mm vs.(10.4 ±2.0) mm;plasma BNP:(570.2 ± 177.3) ng/L vs.(211.6 ± 21.2) ng/L;t =3.041,4.389;-6.546,-17.632,-2.039,12.21 ;P ＜ 0.05 or P ＜ 0.01).Moreover,after treatment,systolic pressure,diastolic pressure,LVEF,SV,CO,Dd,PWT,IVST,LVMW,plasma brain natriureticpeptide in treatment group were significantly better than that of control grouo (t =-4.919,-2.867,5.510,2.252,2.581,-2.319,-3.238,-3.628,-2.231,-22.701,P ＜0.01 or P ＜ 0.05).Conclusion The effect of salvianolate combined Qumei trimetazidine on treating chronic heart failure is significant,and there is a reverse effect on the left ventricle.