AIM Valproate (VPA) is widely used to treat epilepsy. Long-term treatment of women with VPA has been reported to be associated with a PCOS-like syndrome. The aim of the present study was to investigate the effects of clinically relevant concentrations of valproate on steroidogenesis and steroidogenesis acute regulatory protein (StAR),cholesterol side-chain cleavage enzyme (P450scc)and cytochrome P450 aromatase (P450arom) mRNA expression in human luteinized granulosa cells in vitro. METHODS Human luteinized granulosa cells were isolated from oocyte retrieval of in vitro fertilization procedure and were cultured with DMEM medium and treated with various concentrations of valproate (0, 100, 250 mg?L -1), the culture media was collected after 2 days for progesterone and estradiol measurements by standard radiommunoassay, StAR, P450scc and P450arom mRNA in granulose cells were detected by fluorescent real-time RT-PCR (TaqMan assay). RESULTS Valproate caused significant increase of progesterone (P

AIM: To observe the effect of cannabinoid receptor (CB1R) agonist WIN55-212-2 on the expression of brain-derived neurotrophic factor (BDNF), c-Fos and protein kinase A beta-catalytic subunit (PKAC-β) in cerebrum cortex after intracerebral hemorrhage (ICH) in rats. METHODS: The intracerebral hemorrhage model of rat was made by the injection of collagenase Ⅶ, and WIN55-212-2 was intraperitoneally (ip) injected 30 min later. The rats were killed for sampling the brain tissues as specimens 24 h after ICH. The methods of immunohistochemical analysis and Western blotting were adopted to detect the expression of PKAC-β and BDNF. The mRNA expression of PKAC-β, c-Fos and BDNF was determined by RT-PCR. RESULTS: WIN55-212-2 obviously improved some nervous deficit symptoms and increased the expression of BDNF at mRNA and protein levels with upregulating the mRNA expression of c-Fos and downregulating the expression of PKA at mRNA and protein levels in the ipsilateral cerebral cortex. The proteins of PKAC-β, c-Fos and BDNF were expressed on the membrane or nucleus of the neuron or in the cytoplasm of glial cells, respectively. CONCLUSION: The expression of BDNF is induced not only by upregulation of c-Fos, but also by downregulation of PKA in WIN55-212-2 treated rats.

Objective To evaluate the efficacy of different doses of ulinastatin for prevention of insulin resistance in the patients undergoing partial hepatectomy.Methods Sixty patients of both sexes,aged 33-71 yr,weighing 44-70 kg,of ASA physical status Ⅰ or Ⅱ,scheduled for electivepartial hepatectomy,were randomly assigned into 3 groups (n =20 each) using a random number table:control group (group C),low dose of ulinastatin group (group UL) and high dose of ulinastatin group (group UH).Before induction of anesthesia and at the beginning of operation,ulinastatin 2 500 U/kg and 5 000 U/kg (in 20 ml of normal saline) were injected intravenously in UL and UH groups,respectively.The equal volume of normalsaline was given instead of ulinastatin in group C.Before skin incision,before removal of the liver,after removal of the liver,and after closure of the abdominal cavity,blood samples were taken from the right internal jugular vein for determination of plasma glucose,insulin and glucagon concentrations.Insulin sensitivity index was calculated.Results Compared with group C,insulin sensitivity index was significantly increased,and the plasma glucose and insulin concentrations were decreased in UL and UH groups.Conclusion Ulinastatin 2 500 U/kg injected intravenously before induction of anesthesia and at beginning of operation can effectively prevent insulin resistance in the patients undergoing partial hepatectomy.

Objective To evaluation the efficacy and safety of endovascular stenting for intracranial artery stenosis.Methods By the checking of DSA,39 patients with intracranial artery stenosis were divided into the anterior circulation group [26 cases,including 11 cases of transient ischemic attack(TIA),15 cases of cerebral infarction(CI)] and posterior circulation group(13 cases,including 3 cases of TIA,10 cases of CI).All the patients were treated with endovascular stents.The rates of the stenting success,improvement rate of stenosis post-stenting and incidence of complications were compared between the two groups.In 6～12 months follow-up,DSA reexamination was performed,and the scores of mRS and BI in patients with CI between pre and post-stenting were compared.Results The rate of stenting success in anterior circulation group was 92.3%,and 100% in posterior circulation group.The improvement rates of stenosis compared pre-stenting in the two groups were all above 70%.The incidence of complications was 19.2% in anterior circulation group and 7.7% in posterior circulation group.There was no statistical difference between the two groups.There were 10 cases in anterior circulation group and 5 cases in posterior circulation group received DSA reexamination,and 50% restenosis was found in the 2 cases(1 case in each group).In the period of the follow-up,the score of mRS and BI at the 6 months and 12 months post-stenting of patients with CI were significant improved than pre-stenting(all P

Objective To investigate the effect of miR-210 on angiogenesis of human renal clear cell carcinoma . Methods Detect the expression of miR-210 in 40 cases of renal clear cell carcinoma tissues , and analyze the rela-tionship between the expression of miR-210 and microvessel density ( MVD) .miR-210-ASO was lipotransfected in-to renal clear cell carcinoma cell line 786-O.RT-qPCR was used to verify the transfection effect .The effect of the supernatant of control group , negative control group and miR-210-ASO group tumor cells on the lumen formation of human umbilical vein endothelial cells ( HUVEC) was observed in a 3-D culturesystems .The transplantation tumor model of nude mice was established , and the effect of miR-210 on the formation of the transplanted tumor micro vessel was observed by endomucin and VEGF immunofluorescence staining under laser scanning confocal micro -scope.Results The expression of miR-210 was positively correlated with microvessel density in renal clear cell carcinoma ( P<0.05 ) .The expression of miR-210 was significantly decreased in 786-O cells transfected with miR-210-ASO( P<0.05 ) .The lumen formation of HUVEC cells co cultured with miR-210-ASO group cell supernatant was significantly less than that of control group and negative control group ( P<0.05 ) .The tumor volume of miR-210-ASO group was less than that of the control group , and the number of the micro vessel and the VEGF expres-sion were significantly less than that of the control group ( P<0.05 ) .Conclusions Inhibition of miR-210 can suppress blood vessel formation in renal clear cell carcinoma .

Objective To compare the effect and safety between lightwand and general-laryngo-scope application of trachea cannula in cervical spine fracture patients undergoing general anesthesia. Methods Forty cervical spine fracture patients with tracheal intubation anesthesia were selected,including twenty-eight males and twelve females,aged 18-65 years,ASA physical statusⅡor Ⅲ.These patients were randomly divided into two groups,twenty cases in each group.After anesthesia induction,group L was giv-en general laryngoscope intubation,whereas group C was taken lightwand guided tracheal intubation.The success case of intubation at first,intubation time,adverse reaction of intubation,changes of MAP and HR at intubation and 5 minutes after intubation were observed.Results Compared with group L,success rate of intubation at first was higher (90% vs.60%),intubation time was shorter [(31.3±11.1)s vs.(46.6 ±15.2)s]in group C (P <0.05).The changes of MAP and HR were more stable during intubation in group C compared with group L.Four cases of arrhythmia (20%)occurred in group C,while none in group L.Conclusion Compared with intubation by general laryngoscope,application of tracheal intubation led by lightwand in cervical fracture patients is more effective and safer.

Objective To investigate the clinical curative effect of“Qing Dynasty Palace manipulation” in combination with plaster immobilization and foot bath with traditional Chinese medicine for acute soft tissue sprain of the ankle.Method A total of 90 patients with acute soft tissue sprain of the ankle from emergency department of WangJing Hospital, CACMS were recruited from July 2013 to April 2014 and randomly divided into two groups with 45 patients in each. The patients in the treatment group were treated with the court manipulation, plaster and Chinese herbs washing, and those in the control group were only treated with cast immobilization. The clinical curative effect was evaluated using Baird-Jackson score system(excellent: 96-100; good: 91-95; fair: 81-90; poor: 0-80).Result At the second, third week after treatment, the excellent/good rates in the treatment group were significantly higher than those in the control group(at week 2: 73.3%vs. 44.4%;χ2=11.468,P<0.01; at week 3: 86.7%vs.60.0%;χ2=6.875,P<0.05). At week 2 and 3, Baird-Jackson scores in the treatment group(87.41±14.12, 93.16±9.51)and in the control group(76.32±11.41, 82.54±9.22)were significantly higher than those before treatment(treatment group: 72.11±12.61; control group: 71.67±13.12, allP<0.05); at week 3, Baird-Jackson score in the treatment group were significantly higher than that in the control group(P<0.05).Conclusion“Qing Dynasty Palace manipulation” in combination with plaster immobilization and foot bath with traditional Chinese medicine can increase Baird-Jackson score and aid recovery of the ankle function in patients with acute soft tissue sprain of the ankle.

Objective To investigate the relationship between circulating tumor cells(CTCs) in peripher-al blood and the prognosis of pancreatic cancer patients. Method From Mar 2010 to Mar 2015, patients with pancreatic cancer in guangzhou first people′s hospital were enrolled in this study. Immunomagetic negative en-richhment together with immunofluorescence were used to identify CTCs. The clinical data of all patients were analyzed. Result No CTCs were found in peripheral blood of healthy control cases. The detection date of CTCs was 60.0%. The positive rate of CTCs was closely correlated with cell differentiation and the clinical stage. Con clusion CTCs count in old patients with pancreatic cancer can reflect the status of the patients and is help-ful for the diagnosis of micrometastasis , re-determination of the clinical stage and the guidance of patients′s treatment. CTCs count can predict the survival time of elderly patients with pancreatic cancer.

Objective To investigate the efficacy of peritoneal dialysis(PD) in the children with complex congenital heart disease after surgery.Methods 65 children with complex congenital heart disease were divided into group A(33 cases) and group B(32 cases).Group A was given PD when diuretics or urine output was less than 0.5ml per hour,while group B was given PD when urine output was less than 0.5ml per hour after 6h.The survival effect and indicators of PD before and after treatment were observed.Results The effective rate of group A (84.85％ ) was significantly better than group B ( 53.12％ ) ( x2 =5.18,P ＜ 0.05 ).The fatality rate of group A (9.09％ ) was significantly lower than group B ( 18.75％ ) ( x2 =5.32,P ＜ 0.05 ).The renal function was significantly improved.Urine output increased to the normal level,serum potassium,blood urea nitrogen,serum creatinine concentration were effectively controlled,the changes of indicators had significant differences before and after PD (t =5.22,3.46,46,4.89,4.77,all P ＜ 0.05).Conclusion PD was an effective support method for heart,renal insufficiency after the surgery of complex congenital heart disease,and it had good clinical effect for early application.

Objective To discuss the feasibility and long-term effect of free latissimus dorsi muscle flap in repair of severe lower extremity injury in children. Methods From July 1999 to June 2004, nine child patients (at age of 6-13 years) with severe lower extremity injury involving soft tissue defects a-round the calf and the foot associated with complex open fractures, bare dislocation, and injury of the nerve, tendon and artery were repaired with free latissimus donsi flap, with flap area ranging from 30 cm ×12 cm to 10 cm × 5 cm. Results All the latissimus dorsi flaps survived, with success rate of 100%. A follow-up for 4-9 years showed that the flap had sound shape and function and normal blood supply, without significant influence on donor area. Conclusion Latissimus dorsi flap has advantages of constant anatomical site, abundant blood supply, massive area, strong anti-infection ability and less in-fluence on donor area and hence is an ideal method for repairing severe lower extremity injury in children.