Objective: To investigate the effect of aqueous extract of Radix et Rhizome Rhodiolae on expressions of HIF-1?, HIF-1? and VEGF in human umbilical vein endothelial cells(HUVECs) exposed to hypoxia. Methods: The effect of different treatment time and concentrations of aqueous extract of Radix et Rhizome Rhodiolae on cellular proliferation were determined with XTT colorimetric assay. The mRNA and protein expressions of HIF-1?, HIF-1? and VEGF were analyzed respectively by quantitative real-time polymerase chain reaction with SYBR Green I and Western blot. Three groups were studied: normoxia control group, hypoxia control group, Radix et Rhizome Rhodiolae treatment group. Results: The optimal condition of Radix et Rhizome Rhodiolae treatment were 24h and 10?g/mL. The protein levels of HIF-1?, HIF-1? and VEGF were elevated by hypoxia (P

Evoked potentials can reflect the integrity of spinal sensory and motor conduction pathway.Evoked potential exami-nation not only provides relatively objective index for patients with spinal cord injury in preoperative diagnosis,intraoperative monitoring and prognosis judging,but also plays an irreplaceable role in evaluating animal models for spinal cord injury.This pa-per systematically reviews evoked potential in the clinical exami-nation of spinal cord injury and its application in evaluating ani-mal models.

Objective To investigate the correlation between acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) scores and delirium probability of senile severe pneumonia patients undergoing invasive mechanical ventilation (MV).Methods A retrospective study was conducted. Eighty-nine senile severe pneumonia patients undergoing invasive MV admitted to intensive care unit (ICU) of Hunan Provincial People's Hospital from January 2015 to March 2017 were enrolled. APACHE Ⅱ scores were collected 24 hours before invasive MV. Consciousness assessment method-ICU (CAM-ICU) was used to diagnose delirium, and the patients were divided into delirium group and non-delirium group. The first delirium occurrence time, duration of MV and the length of ICU stay were recorded. The patients were divided into ≤15, 16-20, 21-25, 26-30, 31-35, 36-40 groups according to APACHEⅡ score, and the incidence of delirium in all groups were observed. The linear regression and Pearson correlation were used to analyze the correlation between APACHE Ⅱ scores and delirium probability. Receiver operating characteristic (ROC) curve was plotted to analyze the predictive effect of APACHEⅡ score on delirium.Results Eighty-nine patients were enrolled in the final analysis, of which 35 had delirium, and 54 had no delirium, with delirium incidence of 39.33%, and the first delirium occurrence time of (1.85±1.30) days. The duration of MV and the length of ICU stay of delirium group were significantly higher than those of non-delirium group [duration of MV (days): 9.43±4.77 vs. 6.08±3.30, length of ICU stay (days): 14.60±6.59 vs. 9.69±4.61, bothP < 0.01]. The APACHE Ⅱ score in delirium group was significantly higher than that in non-delirium group (29.89±5.45 vs. 21.48±4.76,P < 0.01). With the increase in APACHE Ⅱ scores, the delirium incidence was gradually increased. Correlation analysis showed that there was a negative correlation between APACHE Ⅱ scores and first delirium occurrence time (r = -0.411,P = 0.014), and a significant linear positive correlation between APACHE Ⅱ scores and delirium incidence in all patients was found (r = 0.982, P = 0.000), which indicated the higher APACHE Ⅱ scores, the higher delirium incidences and the earlier first delirium occurrence time was. ROC curve analysis showed that the area under ROC curve (AUC) of APACHE Ⅱ scores on predicting delirium occurrence was 0.877, when the cut-off value of APACHE Ⅱ score was over 27, the sensitivity was 92.59%, the specificity was 71.43%, the positive predictive value was 83.33%, and the negative predictive value was 86.21%.Conclusions With the increase in APACHE Ⅱ score, the incidence of delirium was increased gradually in senile severe pneumonia patients receiving invasive MV. APACHE Ⅱ score played an important clinical value in evaluating the delirium probability of these patients

Objective To investigate the protective effect of RLN revealed for RLN in high -risk thyroid surgery,and the clinical value of detecting nerve,thus to provide a reference for clinical treatment.Methods 132 patients of thyroid high -risk surgery were selected,according to whether to explode recurrent laryngeal nerve,they were divided into exposed group (80 cases)and non -exploded group(52 cases).The recurrent laryngeal nerve damage rate,clinical indicators of operation time were compared between the two groups.In the explode group,80 patients according to whether implementation of the nerve monitoring,were divided into the monitored group (36 cases)and non -monitored group(44 cases).The hours to find the nerve,recurrent laryngeal nerve injury rates and other indicators were compared.Results The operative time of the exploded group was (133.66 ±21.48)min,which was significantly longer than the non -exploded group,difference was statistically significant (t =3.994,P =0.025 ).The exposed group had similar incidence of hypocalcemia compared with the other groups,there was no statistically significant difference (P >0.05).The revealing recurrent laryngeal nerve injury rate of the exposed group was 2.50%,which was significantly lower than the non -exploded group,difference was statistically significant (χ2 =5.794,P =0.008).The recurrent laryngeal nerve positioning time of the monitoring group was (4.78 ±0.94)min,which was significantly shorter than the unmonitored group,difference was statistically significant (t =7.168,P =0.001).The recurrent laryngeal nerve injury rate of the monitoring group was 2.78%,showed no significant difference (χ2 =0.911,P =0.338).Conclusion In a high risk thyroid surgery,explode recurrent laryngeal nerve can reduce the rate of recurrent laryngeal nerve damage,nerve monitoring can effectively speed up the nerve localization time,but has no significant effect on reduce the rate of recurrent laryngeal nerve injury.

Eleven patients with small or comminuted displaced tibial avulsion fractures of posterior cruciate ligament admitted in the Department of Orthopaedics,Second Affiliated Hospital,Fujian Medical University between January 2003 and January 2008 were selected.With diameter of 4.0 mm,the length of 35 mm or 40 mm cancellous bone screw,and internal diameter of 4.0 mm spiked washer was implanted for fixation.For cases of large comminuted facture,two cancellous bone screws and spiked washer were used.Postoperatively,the limb was immobilizated in a cast plaster at a 30 degrees flexion for 2-4 weeks,followed by active exercise rehabilitation.All 11 patients were followed up with an average of 18 months(ranged 7 to 36 months).No electrolysis,corrosion reaction to metal material,or allergic response to the spiked washer were detected in patients.At 2 months,all patients achieved bony union,no fragment redisplacement,no knee laxity or instability was detected,and the affected knees regained full range of motion.The knee function was significantly improved.

Objective:To observe the effect of electroacupuncture at Baihui and Dazhui on cognitive function of vascular dementia rats and explore its possible mechanism. Methods:Male Sprague-Dawley rats were randomly divided into the sham operation group, model group and electroacupuncture group, with 10 rats in each group. Rats in the model group and the electroacupuncture group were made as vascular dementia models by carotid artery ligation of the two sides. After 2 weeks of modeling, the electroacupuncture group received electroacupuncture at Baihui and Dazhui for 4 weeks. Before and after the intervention, take the novel object recognition behavior test to detect the 1, 24 h new object preference coefficient; and use magnetic resonance spectroscopy to scan the levels of NAA/Cr and Cho/Cr neurometabolites in the hippocampus. q-PCR was used to detect the expression of caspase-3 and Bax in apoptotic cells. Immunohistochemistry was used to detect synapsin SYN expression. Results:Compared with the model group, the preference coefficient of new object of the electroacupuncture group at 1 h [(69.85 ± 11.26)% vs. (50.26 ± 8.85)%] and 24 h [(60.85 ± 11.86)% vs. (43.26 ± 10.25)%] significantly decreased ( P<0.01). The content of NAA/Cr (1.344 ± 0.149 vs. 0.892 ± 0.178) significantly increased ( P<0.01), and the content of Cho/Cr (0.661 ± 0.142 vs. 0.902 ± 0.178) in the hippocampus significantly decreased ( P<0.01). The expression of hippocampus caspase-3 (1.342 ± 0.041 vs. 2.437 ± 0.089), Bax (2.135 ± 0.083 vs. 4.358 ± 0.137) significantly decreased ( P<0.01), and the expression of SYN (0.577 ± 0.035 vs. 0.315 ± 0.025) significantly increased ( P<0.01). Conclusion:Electroacupuncture at Baihui and Dazhui can effectively improve the cognitive dysfunction of rats with vascular dementia, which may be related to the improvement of neuronal metabolites NAA, Cho content and inhibition of neuronal apoptosis and improvement of neuronal touch function.

Objective To investigate effects of interleukin-35 (IL-35) on proliferation,invasion and migration of a HepG2 cell line in vitro.Methods Enzyme-linked immunosorbent assay (ELISA) was used to determine peripheral blood expression levels of IL-35 in hepatocellular carcinoma patients and in normal healthy subjects.The effects of exogenous IL-35 on cell proliferation activity of HepG2 in vitro were measured using CCK-8 assay.The transwell invasion and scratch test were used to study the invasive and migration abilities.Results The content of IL-35 protein in hepatocellular carcinoma patients (HCC) was significantly higher than in healthy individuals [(118.45 ±28.66) ng/L vs (39.56 ± 11.15) ng/L,P ＜0.05].Exogenous IL-35 significantly promoted proliferation,invasion and migration abilities of HepG2 cells in vitro (P ＜ 0.05).Conclusions The level of IL-35 was elevated significantly in hepatocellular carcinoma patients.IL-35 had biological characteristics of promoting HCC cell proliferation,invasion and migration.

Objective To observe the mortality of fragile hip fractures and evaluate the death-associated risk factors.Methods 100 men and 186 women aged 50 to 97 (mean,77.09± 10.65) years old who had fragile hip fracture over 50 years old from 2010 to 2012 were followed up,and the clinical data were retrospectively analyzed.Three months,one year and the total mortality of following time were calculated.Mortality-related risk factors were evaluated including age,gender,and surgery,duration from injury to operation,pulmonary infection,number and kind of complications.Results The 286 patients were followed up between 6 months and 42 months,with 21.42±9.88 months in average.The three month mortality was 7.69％,the patients who were followed up over one year were 231 cases,the one year mortality was 16.02％,and the total mortality of following time was 17.48％.The mortality was associated with age,gender,surgery,duration from injury to operation,number of complications,pre-injury cardiovascular disease and respiratory system diseases,and pulmonary infection.A Binary Logistic Regression analysis revealed that the independent risk factors affecting the mortality included age (OR=5.385,P=0.003),surgery (OR=21.217,P=0.000),number of complications (OR=9.038,P=0.000),pre-injury cardiovascular disease (OR=3.201,P=0.041).Conclusion The early mortality of fragile hip fractures was high and was associated with many risk factors.Age,surgery,number of complications and pre-injury cardiovascular disease were the independent risk factors affecting the mortality of fragile hip fractures.The positive treatment with complications,early surgery in condition allowed,can lower the early mortality.

The authors of this paper confirm the goal, factors and principles in arrangement of clinical practice, design a transplacement algorithm to solve the model, and after estimating the capacity to interns of affiliated hospital, make the schedule by that algorithm so as to relieve the relative short supply of good clinical education resourses.

Objective To study the changes of bone mineral density (BMD) and structural parameters of femoral neck in fragile femoral neckfracture,and to investigate the relationship between the changes and occurrence of fragile fracture of femoral neck.Methods 102 patients were divided into fracture group (n=59) and non-fracture group (n=43).There were 18 males and 41 females [[mean age (74.0±9.3) yrs,ranged 53-88 yrs] in fracture group and 16 males and 27 females [mean age (64.3±9.9)] yrs,ranged 50-82 yrs in non-fracture group.CT scan and BMD in the femoral neck were collected in all patients.The structural parameters of the femoral neck in CT scan were measured with medical image analysis software.Results BMD was lower,cortical thickness of femoral neck (FNCT) was thinner and the ratio (FNCT/FNW) of cortical thickness (FNCT) over femoral neck width (FNW) was lower in fracture group than in non-fracture group (all P＜0.001),but there were no statistically significant differences in femoral neck width (FNW) and femoral medullary cavity width (FMCW) between the two groups (both P＞0.05).The BMD of femoral neck was markedly decreased in the fracture group as compared with the non-fracture group in patients aged 50-64 yrs (P ＜0.05),and there were no statistically significant differences in the changes of the femoral neck BMD between the two groups in patients aged over 65 yrs (P＜0.05).In both of patients aged 50-64 yrs and more than 65 yrs,FNCT was thinner and ratio of FNCT/FNW was lower in the fracture group than in the non-fracture group (both P＜0.05).The patients with osteopenia and osteoporosis had thinner FNCT and lower ratio of FNCT/FNW in the fracture group than in the non-fracture group of the patients with osteopenia and osteoporosis (both P＜ 0.01).Conclusions Lower BMD and thinner cortical thickness of femoral neck are closely related to the fragile fracture of femoral neck.The phase of femoral neck BMD rapid decline is mainly in the age of 50-65 yrs,which is consistent with the risk assessment for fragile fracture in femoral neck.The decrease of cortical thickness of femoral neck on FNCT is the main factor for the decreased femoral neck strength in patients aged over 65 yrs,which is also an important factor for the fragile fracture of femoral neck in the elderly aged over 65 yrs.