ObjectiveTo explore the operation effect and clinicopathologic characteristics of elderly patients with gastric carcinoma(GC) and the relationship between prognosis and age.MethodsThe clinical data and treatment outcomes of 112 elderly patients suffered from GC( elderly group≥70 years of age) and 135 younger patients (control group ＜50 years of age) were analyzed retrospectively.ResultsThe elderly GC patients had more preoperative comorbidities,and a well or moderately differentiated histology(P ＜0.05).And more young patients had a poorly differentiated histology and signet ring cell carcinoma,using the Borrmann classification,type Ⅳ was more frequent in the young patients(P ＜0.05 ) ; Whereas there were no significant differences beween the two groups in other factors ( including liver function,tumor invasion,nodal involvement,hepatic metastasis,peritoneal dissemination,tumor stage,type of surgery,post operation complication and 5-year survival rates of elderly patients and young patients) ( all P ＜0.05).ConclusionOutcomes in elderly patients with gastric carcinoma were comparable to young patients.The important prognostic factor was whether the patients undergo a curative resection.For the elderly patients without preoperative comorbidities or with controlled comorbidities,gastrectomy was a safe and effective treatment.

Lipoprotein-associated phospholipase A2(Lp-PLA2) can rapidly hydrolize and oxidize the oxidized phosphatidylcholine molecules produced in low density lipoprotein and atherogenic lipoprotein (a),generating the soluble proinflammatory and proapoptotic mediatorslyso-phosphatidylcholine and oxidized free fatty acids.It stimulates aggregation and activation of monocyte-macrophage system and induces apoptosis and damages the removal of dead cells.It plays an important role in the development of lipid necrotic core of atherosclerosis.Lp-PLA2 is not an independent risk marker of coronary artery disease and ischemic stroke,but also plays an important role in the development of atherosclerotic plaques.Selective Lp-PLA2 inhibitor reduces the development of necrotic cores.It may play a role in the stabilization of atherosclerotic plaques.At the same time,it may represent a novel target for the treatment of atherosclerosis.

Objective To investigate the role of contrast-enhanced ultrasound (CEUS) on the diagnostic efficacy of ultrasound-guided percutaneous biopsy of peripheral lung lesions. Methods Ninty-six patients with pleural-based lesions underwent percutaneous ultrasound-guided biopsy. Of the 96 patients,54patients underwent CEUS before biopsy and enhancement information was referred for the selecting of tissue sampling site. The rest of 42 patients didn' t undergo CEUS before biopsy. The difference in the diagnostic accuracy between the two groups was analyzed to evaluate the value of CEUS before biopsy.Results Of the 52 patients in the CEUS group,48 were malignant,and 6 were benign. Of the 42 patients in the un-CEUS group,36 were malignant, and 6 were benign. Necrosis (areas lacking of enhancement) was demonstrated in 41.7％ (20/48) of the patients with malignant lesions in CEUS group, and necrosis incidence was increased with the increase of the dimension of the malignant lesions. No necrosis area was demonstrated in 6 benign lesions. The rate of successful initial biopsy in CEUS group (98.1 ％ ,53/54) was statistically higher than that in un-CEUS group ( 85.7％, 36/42 ) ( P ＜ 0.05 ). Tissue necrosis and denaturalization attributed to most of the inconclusive pathologic diagnosis. Conclusions CEUS before transthoracic peripheral lung lesion biopsy improved the diagnostic accuracy of the procedure by providing information for differentiating viable or necrotic tissue and consequently provide more accurate information about the site of biopsy.

Objective The aim of this study is to observe the effect of our surgical treatment method for abductor defects in hip revision cases. Methods We retrospectively evaluated a consecutive series of eight patients (eight hips) with a defect of the hip gluteus medius muscle from April 2012 to April 2014 who underwent revision and gluteus medius muscle reconstruction. 7 patients with loosening of components (2 periprosthetic joint infections), 1 repeated dislocation after hemiarthroplasty. There was one case with moderate pain and 7 cases with severe pain. 8 cases were severe limp, needed crutches or braces walking aids, glu?teal medius muscle strength was ≤3, and the Trendelenburg sign was positive in all patients. The average age was 50 years old (31-69 years old), 2 men and 6 women. One patient with a gluteus medius muscle completely disrupted from insertion at greater trochanter, which underwent knit suture. One patient had a greater trochanter fracture resulted in ascending of gluteus medius mus?cle. During revision, fracture was reducted and fixed by 2.0 Kirschner wire and cable. Three patients with defects of gluteus medi?us muscle;we applied gluteus maximus fascia lata muscle valvuloplasty. One patient with deficiency of both gluteus medius mus?cle and greater trochanter. Gluteus maximus was directly reattached to the proximal of femoral stem. Results All patients were followed up for an average of 18 months (range, 14-35 months). The mean Harris Hip score increased from 57 to 85, pain was remarkably relieved, ROM of hip and myodynamia was improved. Preoperative abductor strength ≤3, 6 months after surgery abductor strength was increased with average of 1-2 level. Conclusion Reconstruction of hip abductor tendon of gluteus medi?us muscle deficiency would be effective in hip revision surgery.

The blocking action and selectivity of 1 - (? -naphthylmethyl)-2 - methyl - 6,7 - dimethoxy -1,2,3,4 -tetrahydroisoquinoline (86040) on a - a-drenoceptor have been investigated in isolated tissues. 86040 suppressed the inhibition of clonidine for the electrically stimulated twitch response of rat vas deferens ( - adre - noceptor), with pA2 value of 5. 85. 86040 could competitively inhibit anococcygeus muscle contraction (?1 -a-drenoceptor ) induced by phenylephrine with pA2 value of 7. 62. 86040 was found that the selectivity radio to block ?2 - and ?2 adrenoceptor(?1/?2)was 60. these results indicate that 86040 is a potentant relatively selective ?1 - adrenoceptor blocker.

Objective To analyze imaging infarct patterns and features in patients with severe stenosis or occlusion of internal carotid artery (ICA) and middle cerebral artery (MCA)from the point of view of diffusion-weighted imaging (DWI) and to investigate the infarction related mechanism. Methods Eighty-eight patients with acute ischemic stroke who had moderate to severe ICA or MCA stenosis or occlusion confirmed by cerebral angiography were analyzed retrospectively. They were divided into ICA lesion and MCA lesion groups. The infarct patterns were classified as single and multiple according to DWI. The former were reclassified as perforating artery infarct (PAI), pial infarct (PI), watershed infarct, and large infarct. Results There were 11 types of infarct patterns in MCA territories. The DWI multi-infarct pattern accounted for 62.5% of all patients (55/88). PI with watershed infarction appeared more often in the ICA lesion group (11/45, P=0. 040), and PI with PAI appeared more often in the MCA lesion group (10/43, P = 0. 037). Conclusions In patients with cerebral infarction associated with ICA or MCA severe stenosis or occlusion, most of them showed multi-infarct pattern,which suggested the mixed mechanisms such as embolization, hypoperfusion/impaired clearance of emboli, and local perforating branch occlusion were the main mechanisms of the occurrence of cerebral infarction. The main mechanism of cerebral infarction in the ICA lesion group was embolization combined with hypoperfusion/impaired clearance of emboli, while in the MCA lesion group was embolization combined with local perforating branch occlusion.

An offline two-dimensional system combining a rat cardiac muscle cell membrane chromatography time-of-flight mass spectrometry (CMC-TOF/MS) with a high performance liquid chromatography time-of-flight mass spectrometry (HPLC-TOF/MS) was established for investigating the parent components and metabolites in rat urine samples after administration of the roots of Aconitum carmichaeli.On the basis of the analysis of the first dimension,retention components of the mine sample were collected into 30 fractions (one fraction per minute).Then offline analysis of the second dimension was carried out.34 compounds including 24 parent alkaloids and 10 potential metabolites were identified from the dosed rat urine,and then binding affinities of different compounds on cell membranes were compared and influences of some functional groups on activity were estimated with the semi-quantification and curve fitting method.As a result,binding affinities decreased along with the process of deacylation,debenzoylation and demethylation,which may be related to the alleviation of toxicity in the procedure of herb processing or metabolism.Moreover,some minor components in rat urine (Songorine,14-benzoylneoline,Deoxyaconitine,etc.) exerted relatively strong affinity on cell membranes are worth exploring.The results delivered by the system suggest that the CMC can be applied to in vivo study.

AIM:To investigate the effects of high plasma triglyceride (TG) caused by apolipoprotein C Ⅲ( ApoC Ⅲ) transgene on the occurrence and development of abdominal aortic aneurysm ( AAA) .METHODS:The animal models of hypercholesterolemia and hypercholesterolemia combined with hypertriglyceridemia were established by feeding high-fat diet to LDLR-/-and ApoC Ⅲ+LDLR-/-mice, respectively.AAA was induced in these mice by pancreatic elastase. By evaluating the incidence of AAA, relative maximal abdominal aortic diameter, disruption of the elastic lamellar structure and expression of matrix metalloproteinases ( MMPs) in the aorta walls of the AAA, the occurrence and development of AAA were compared in LDLR-/-and ApoC Ⅲ+LDLR-/-mice fed with either chow diet or high-fat diet.In addition, an in vitro TNF-α-induced aneurysmal microenvironment model on vascular smooth muscle cells ( VSMC) was used to study the impact of triglyceride-rich lipoproteins ( TRLs) from mice with normal or high contents of ApoCⅢon elastin protein expres-sion.RESULTS:Feeding the high-fat diet aggravated the severity of AAA in the LDLR-/-mice.ApoC Ⅲ+LDLR-/-mice fed with high-fat diet had less severe AAA than LDLR-/-mice fed with high-fat diet.TRLs inhibited degradation of VSMC elas-tin protein induced by TNF-α, and in vitro TRLs from the mice with high content of ApoC Ⅲ, compared to those with nor-mal content of ApoC Ⅲ, had better inhibitory effect on the degradation of elastin.CONCLUSION:High plasma TG caused by ApoC Ⅲtransgene alleviates AAA of the LDLR-/-mice induced by elastase and high-fat diet.The effect is probably attrib-uted to the hypertriglyceridemia caused by ApoC Ⅲtransgene.

BACKGROUND: Glucocorticoid has been shown to be a major factor of osteonecrosis of the femoral head (ONFH), so constructing a reliable, effective and low mortality ONFH model will be helpful for searching for a better treatment strategy of ONFH.OBJECTIVE: To construct a rabbit model of early ONFH by intravenous injection of different concentrations of glucocorticoids and horse serum.METHODS: Thirty healthy male New Zealand rabbits were randomly allotted to six groups, followed by given the injection of 10 mg/kg horse serum combined with 5 mg/kg dexamethasone (group A), 10 mg/kg horse serum combined with 10 mg/kg dexamethasone (group B), 20 mg/kg horse serum combined with 5 mg/kg dexamethasone (group C), 20 mg/kg horse serum combined with 10 mg/kg dexamethasone (group D), 10 mg/kg dexamethasone (group E), and 2 mL/kg normal saline (control group) via ear veins, respectively.RESULTS AND CONCLUSION: Abnormal MRI signal of the femoral head appeared in the group D at postoperative 2 weeks, while abnormal signal was seen at postoperative 4 weeks in the other groups except the controls. Six weeks postoperatively, 80% rabbits in the group D showed abnormal signals, which were significantly more than those in the groups C (50%), B (40%), A (25%), and E (20%) (P < 0.05). The serum levels of triglyceride and total cholesterol in the groups A, B, C, D were significantly higher than those in the control group at 3, 7, 14 and 30 days after injection (P <0.05). Compared with the control group, the ratio of empty lacuna sigmificantly increased in the group D (P < 0.05).These results indicate that the injection of high concentration of horse serum combined with the high concentration of dexamethasone is successful and safe to make an animal model of early ONFH.