Objective To investigate the clinical value of butylphthalide in patients with acute cerebral infarction.Methods 120 patients with acute cerebral infarction were randomly divided into study group and control group according to the method of random number table,60 cases in each group.The study group used butylphthalide on the basis of routine treatment,while the control group only received routine treatment.Main outcome measures included the National Institutes of Health Stroke Scale (NIHSS)table,activities of daily living Barthel index,blood viscosity,clinical curative effect and health related quality of life (HRQL)score.Results There was no significant difference in NIHSS score,Barthel score,blood viscosity and HRQL between the two groups on admission (P >0.05 ).When compared with the control group after 3 months,NIHSS score of the study group decreased significantly [(948 ±3.84)points vs.(14.38 ±3.29)points,t=5.395,P=0.000],Barthel score increased significantly[(84.44 ± 10.59)points vs.(75.89 ±8.39)points,t=3.854,P=0.015];blood viscosity decreased significantly[(5.09 ± 0.64)mPa.s vs.(648 ±0.71 )mPa.s,t =7.493,P=0.000];HRQL scores increased significantly [(80.47 ± 1 5.39)pointsvs.(69.58 ±14.39)points,t=4.395,P=0.002];clinical curative effect in the study group was significantly higher than control group (χ2 =6.122,P=0.013).Conclusion Butylphthalide is helpful to improve the prognosis and quality of life in patients with acute cerebral infarction.

Blood Replenishing Angelica Decoction [Danggui Buxue Tang (DGBXT)]is a wellknown TCM prescription composed of Radix Angelicae Sinensis and Radix Astragali with the actions ofinvigorating "Qi" and enriching blood. Its action to curtail endothelial permeability induced by histaminewas studied. Endothelial cells isolated from the aorta of neonatal calf were cultured on polycarbonate mi-croporus filter membrane to develop a confluent endothelial monolayer. After purfused with either plainHank's balanced salt solution or that containing 5 g/L albumin, the monolayer was treated with 10-4 mol/L histamine for 30 min either with or without preincubation for 60 min with 10-4 g/mL of DGBXT. Fluidfiltration coefficient (Kf), filtration volume (Jv) and osmotic reflective coefficient (σ) of protein were thenmeasured. The findings showed that DGBXT could curtail the lowering of Kf and Jv and elevation of σ in-duced by histamine, indicating that DGBXT could inhibit the action of histamine on endothelial permeabili-ty, but its mechanism of action needs further study.

Objective To investigate clinical value of miRNA-27-3p expressed in colorectal cancers,liver metastasis,and the peripheral blood,and analyze its target genes.Methods Among 78 cases of colorectal cancer patients,sera,colorectal cancers,and liver metastases were used to detect miRNA-27a-3p expressions with real-time quantitative polymerase chain reaction (RT-PCR) and analyze its clinical significance.We predicted miRNA-27-3p target genes,and confirmed the target genes and their correlation between miRNA-27a-3p and target genes.Results The expression level of miRNA-27a-3p in 78 cases of colorectal cancers was 3.13 ± 1.72,which was significantly higher than that in matched adjacent cancer tissues (1.06 ± 0.42) and control group (0.68 ± 0.27) (P ＜ 0.05).The expression level of miRNA-27a-3p in 27 cases of liver metastases was 3.48 ± 1.15,which was significantly higher than that in paired colorectal cancer tissues (2.34 ± 1.03) (P ＜0.05) and adjacent tissues (0.81 ± 1.14) (P ＜0.05).Expression levels of miRNA-27a-3p in patients with colorectal cancer tissues and peripheral blood had no significant difference in age,sex,serum carcinoembryonic antigen (CEA) levels,tumor location,and pathological types (P ＞ 0.05);however,it had positive significant difference in lymph node metastasis,liver metastasis,tumor node metastasis (TNM) staging (P ＜ 0.05).The expression of miRNA-27a-3p was negatively correlated with the expression of target gene GP73.Conclusions The higher expression was miRNA-27a-3p in peripheral blood and colorectal cancer tissues,higher risk of liver metastasis occurs.MiRNA-27a-3p might participate in the occurrence and development of colorectal cancer by regulating target gene expression of GP73.In peripheral blood of colorectal cancer patients,miRNA-27a-3p might be used for potential auxiliary diagnosis and predict liver metastasis.

Animals ; Humans ; MicroRNAs ; physiology ; RNA, Small Interfering ; physiology ; RNA, Untranslated ; physiology

Objective To investigate the roles of transforming growth factor(TGF)-β1 gene polymorphisms in severe acute respiratory syndrome-coronavirus(SARS-CoV)infection and the interstitial lung fibrosis after recovered.Methods Sixty-five recovered SARS patients,37 health care workers and 66 healthy controls were enrolled in this case-case study.The association between genetic polymorphisms of TG F-β1 and suscept ibility to SARS or interstitial lung changes after SARS reco,vered was carried out.Polymerase chain reaction-sequencing based typing(PCR-SBT)method was used to determine the polymorphisms of TGF-β1 gene at locus+869 and+915.Data were analyzed using t test and chi square test.Results There was no significant association of TGF+β1 gene polymorphisms at locus+869 and+915 in recovered SARS patients,health care workers and heahhy controls.And gene linkage of this two loci was not related with SARS-CoV susceptibility.Furthermore,no association between interstitial lung changes in recovered SARS palients and TGF-β1 gene polymorphisms or genetic linkage of this two loci.Conclusions It may not be related between TGFβ1 gene polymorphisms at locus+869 and+915 and SARS-CoV susceptibility.And interstitial lung changes in recovered SARS patients may not be influenced by TGF-β1 gene polymorphisms.

Objective To compare clinical effect of gonadotropin releasing hormone agonist(GnRH-a) alone and GnRH-a combined with low-dose dydrogesteronea and estradiol valerate on sex hormone, hypoestrogenic symptoms, quality of life and bone mineral density (BMD)in treatment of endometriosis.Methods Seventy patients with moderate or severe endometriosis, who were diagnosed by laparotomy or laparoscopic surgery within two months, were randomly assigned into two groups.35 patients in GnRH-a group were treated by goserelin (3.6 mg)for three months, and 35 patients in add-back group were treated by goserelin (3.6 mg)combined with estradiol valerate 0.5 mg and dydrogesteronea 5 mg daily.Before and after the treatment, clinical parameters were recorded and analyzed, including visual analog scale (VAS), medical outcomes survey short form 36 (SF-36), Kupperman menopausal index(KMI), BMD, the serum level of follicle stimulating hormone (FSH), estradiol (E_2) and bone gla-protein (BGP) .The first menstruation and VAS were also followed up after treatment.Results Every 3 cases in two groups lost follow-up.(1)Reproductive hormone: the level of E_2 in add-back group [(94 ± 71) pmol/L]was significantly higher than (54±52) pmol/L in GnRH-a group(P <0.01).The level of FSH in add-back group [(3.0 ± 1.9) U/L]was significantly lower than (5.7 ± 2.9) U/L in GnRH-a group (P < 0.05).(2) VAS: after treatment, VAS in both group decreased significantly when compared with that before treatment(P < 0.05), and remained until menstruated.(3) KMI: KMI in add back-group (10 ± 8) was significantly lower than (14 ± 6) in GnRH-a group (P < 0.05).(4) BMD: compared with that before treatment, BMD decreased significantly after treatment in GnRH-a group (P < 0.05), no remarkable difference of BMD was observed before and after treatment in add-back group.Before treatment, serum BGP in both groups did not show statistical difference.After treatment, the level of BGP in GnRH-a group [(7932±5206) ng/L]was significantly higher than (5419±2917) ng/L in add-back group (P <0.05).Conclusions GnRH-a combined with estrogen-progesterone regimen could relieve pain from endometriosis as effectively as GnRH-a alone and reduce hypoestrogenic symptoms and bone loss.Therefore,it is a safe and effective treatment.

BACKGROUND: Traditional treatment of intertrochanteric fractures includes dynamic hip screw (DHS), dynamic condylar screw (DCS), proximal femoral nail (PFN) and locking compress plate (LCP), most of them have positive results. However, these techniques are not utility for all patients with intertrochanteric fractures, especially for the senile patients whose ages are over 75 years. The intertrochanteric fractures are usually unstable, and most of them have medical complications, thus all these lead to a high failure rate of internal fixation. OBJECTIVE: To identify the methods and the therapeutic effects of hemiarthroplasty or arthreplasty with bone cement for unstable intertrochanteric fractures in senile patients. METHODS: There were 27 senile patients with unstable intertrochanteric fractures, including 11 males and 16 females, with the mean age of 84.6 years. All patients were adopted improved Gibson approach, and greater trochanter should be reduced anatomically as an important sign for measuring the lengths of the lower extremities and fixing of prostheses. Long-stem cementless calcar-raplacements were used in all patients, 2 arthroplasty owing to preexisting osteoarthritis and 25 hemiarthroplasty. RESULTS AND CONCLUSION: Nobody was dead during perioperative period. Weight bearing was permitted as soon as acute pain subsides (7-16 days after operation); 27 patients were followed up for 6 to 48 months, for 20 months on average. No prosthetic looseness and sinking happened, and the calluses were well mineralized. The Harris score was used to evaluate the therapeutic effect at 6 months after operation, which was 78 to 94, of 85.4 points on average, and the rate of fineness was 78%. One posterior hip dislocation and two deep venous thrombosis (DVT) of lower extremities occurred owing to improper caring. The results showed that the prosthetic replacement with bone cement is a reasonable preference for unstable intertrochanteric fractures in senile patients because of many virtues, such as earlier period weight bearing out of bed, low incidence of complications, and satisfaction of functional recovery of extremities.

Objective To study the expressions of Cx43,CD105 and VEGF in HBV related HCC tissues and the relationships between Cx43 expression and recurrence and prognosis after cancer radical resection in HCC patients stratified by serum AFP levels. Methods The expressions of Cx43,CD105,VEGF in 234 HBV related HCC tissues were examined by tissue microarray and two-step methods of PV-6000 of immunohistochemistry and the expressions of Cx43 in 20 frozen HCC specimens were examined by RT-PCR. Results Cx43 in HCC tissues was positive as examined by both immunohistochemistry and RTPCR methods.Positive Cx43 expression is correlated with lower early recurrence ( Log Rank P =0.001 ),longer disease free survival (Log Rank P =0.026 ) and overall survival( Log Rank P =0.000 ) as showed by the Kaplan-Meier analysis in patients with AFP ＜ 400 μg/L. The expression of Cx43 is an independent prognostic factor.The positive expression of Cx43 related with lower positive expression of CD105 and VEGF (P =0.018,0.023 ),and correlated with histological differentiation (P =0.002),the number of focus (P =0.033 ),blood vessel tumor embolism ( P =0.029 ). Conclusions The expression of Cx43 is correlative with the expression of CD105 and VEGF,and is predictive of HCC early recurrence and poor prognosis after radical hepatectomy in HBV related HCC patients with serum AFP ＜ 400 μg/L.

Objective To report treatment of infectious bone and soft tissue defects caused by tibial shaft fracture of Gustilo type Ⅲ B using free flap and Ilizarov bone transport.Methods Nineteen patients who had suffered from infectious bone and soft tissue defects following tibial shaft fracture of Gustilo type Ⅲ11 B were treated from May 2010 to February 2015.They were 15 men and 4 women,aged from 21 to 58 years (average,45.3 years).Their course of disease ranged from 16 to 21 months,averaging 17.9 months.The area of their infectious defects ranged from 10 cm × 6 cm to 21 cm × 12 cm,and the length of their bone defects from 5 to 11 cm (average,7.4 cm).They were treated with debridement,simple external fixation to reconstruct bony support,coverage of wounds with free flap,and stuffing the dead space with antibiotic concrete beads,followed by Ilizarov bone transport and bone graft after control of infection to reconstruct the defective tibia and function of the affected limb.Results All the flaps survived.Necrosis occurred at the distal margin of one flap but responded to dressing.Pin tract infection occurred in 4 cases but also responded to dressing and antibiotic therapy.Autografts of iliac cancellous bone were implanted into the gliding and traction ends of the bone fragments one month after bone transport had come to rest.All the patients achieved direct bony union.The patients were followed up for an average of 25 months(range,from 19 to 36 months).No secondary fractures or angular deformity was observed.The total treatment time averaged 17.9 months,with no recurrence of infection.According to the Puno score system for functional evaluation at the last follow-up,7 cases were rated as excellent,6 as good and 6 as fair.Conclusion The infectious bone and soft tissue defects caused by tibial shaft fracture of Gustilo type Ⅲ B can be treated by free flap and Ilizarov bone transport,resulting in definitely positive outcomes.

Objective To investigate the increased expression of microRNA-146a(miR-146a) in peripheral blood mononuclear cells (PBMC) of patients with chronic immune thrombocytopenic purpura (ITP) and its clinical significance. Methods Twenty-eight patients with chronic ITP and 28 healthy controls matched with age and gender were enrolled in this study. Fluorescent quantitative PCR reaction was used to detect the relative expression of miR-146a in their PBMC. The serum concentration of TNF-α, IL-2,IL-1 β and IFN-γ were measured by ELISA. CCK-8 method was used to detect the proliferation ability of PBMC , which transfected with miR-146a mimics or inhibitor and then stimulated with platelet . Results The relative expression of miR-146a in ITP patients was higher than that of healthy controls. The increased expression of miR-146a was negatively correlated with the serum TNF-α, IL-2 and IFN-γ. The PBMC transfected with miR-146a mimics had reduced expression of IL-2 and proliferation when stimulated with platelet.In contrast, the opposite effect was observed with the miR-146a inhibitors transfection. Conclusion MiR146a was involved in the pathogenesis of chronic ITP by controlling IL-2 production and PBMC proliferation.Thus, it may be a potential therapy target for chronic ITP.