Objective To explore the anti-inflammatory and anti-angiogenic effect of miR-15a in diabetic retinopathy(DR).Methods High glucose model(HG)was established by treatment with 25 mmol/L glucose in human retinal pigment epithelial cell line HARPE-19,and HARPE-19 cells treated with 5 mmol/L glucose served as control(LG).HG group and LG group were divided into 4 subgroups:miR-15a mimic group,NC-mimic group,miR-15a inhibitor group and NC-inhibitor group.Cell proliferation ability was detected by MTT proliferation assay.Cell migration ability was detected by cell scratch assay.The relationship between miR-15a and ASM was identified by 3′UTR luciferase reporter assay.miR-15a,ASM,VEGF,IL-1β,IL-6,TNF-α mRNA expression was detected by RT-PCR method.Results In NC-mimic cells and NC-inhibitor cells,the expression of miR-15a in HG group was significantly lower than that in LG group(all P<0.05).The expression level of ASM mRNA in miR-15a mimic group was significantly lower than that in NC-mimic group (P<0.05),the expression level of ASM mRNA in miR-15a inhibitor group was significantly higher than that in NC-inhibitor group (P<0.05).The cell scratch width in miR-15a mimic group was significantly higher than that in NC-mimic group(P<0.05).The cell scratch width in miR-15a inhibitor group was significantly lower than that in NC-inhibitor group(P<0.05).The absorbance value in miR-15a mimic group was significantly higher than that in NC-mimic group(P<0.05),the absorbance value in miR-15a inhibitor group was significantly lower than that in NC-inhibitor group(P<0.05).In NC-mimic cells and NC-inhibitor cells,the mRNA expression levels of VEGF,IL-1β,IL-6 and TNF-α in HG group was significantly higher than those in LG group(all P<0.05).Conclusion miR-15a downexpression induces inflammatory reaction and angiogenesis in retinal cells.miR-15a is involved in the pathogenesis of DR by dual regulation of inflammation and angiogenesis.

Objective To compare the efficacy of supraclavicular approach and infraclavicular approach in ultrasound-guided brachial plexus block(BPB).Methods One hundred and twenty patients,ASA Ⅰ-Ⅲ,aged 18-80 yr,scheduled for upper extremity surgeries of both gender,were randomized into two groups(n =60):supraclavicular group(group SCB)and infraclavicular group(group ICB).The anesthetic mixture consisted of ropivacaine 0.375％ and lidocaine 1％ in equal volumes with epinephrine 1∶200 000,the total dose was 0.5 ml/kg.The block performance time,duration of anesthesia and success of anesthesia(surgery was accomplished without supplementary block)were recorded.A blinded observer assessed pinprick sensory block in the seven distal nerve territories(axillary,radial,musculocutaneous,median,ulnar,medial antebrachial and medial brachial cutaneous nerves)every 5 min up to 30 min after injection.Success of nerve block,side effects and complications were recorded during and after operalion.Results Group ICB was superior in success rate of anesthesia and nerve block of ulnar,medial antebrachial and medial brachial cutaneous nerves,the rate of parasthesia was lower and the block performance time was longer compared with group SCB(P ＜ 0.05).No major complications occurred in both groups.Conclusion Under ultrasound guidance,infraclavicular BPB is superior to supraclavicular approach.

ObjectiveTo determine whether there is correlation between the pathological classification and urinary level of transforming growth factor(TGF)-β1,macrophage inflammatory protein (MIP)-1α,and Neutrophil gelatinase-associated lipocalin (NGAL) of lupus nephritis.MethodsELISA was used to test the levels of urinary level of TGF-β1,MIP-lα and NGAL.The correlation between these three urinary markers and the pathological classifications,Austin score,histological semi-quantitative score and clinical data were analyzed.Comparisons between groups were performed with t-test,ANOVA and X2 test.Correlation analysis was performed with Pearson analysis.Results①There was significant difference in urinary TGF- β1,MIP1α,and NGAL levels when compared the lupus nephritis group,SLE patients without renal damage group and the normal control group [TGF-β1(351±219),(92±60),(74±29) pg/ml],[MIP-1α(18.0±15.5),(8.5±2.3),(7.1±1.9) pg/ml],[NGAL (1.104±0.519),(0.181±0.030),(0.146±0.024) ng/ml],while there was no significant difference between lupus nephritis (LN) group and patients with other glomerulonephritis.② There was significant difference in the three urinary markers when stratified the LN patients based on the pathological classifications,however,there was no significant difference between the LN group and other glomerulonephritis group.③ Analysis of the correlation between the three urinary markers and semiquantitative histopathological score of the LN patients showed that the urinary level of TGF-β1 and MsMI,GCI,TCI,VCI was closely related to each other,the urinary MIP-1α was related to and endol,and the dGAI and VCI was closely related, while the urinary NGAL was closely related with endol,dGAI and MsHI.The correlation analysis between the three urinary markers and acute and chronic pathological index score of the LN patients showed that TGF- β1 was correlated with the chronic index(r=0.89,P＜0.01 ),the MIP-lα and NGAL were significantly correlated with the activity index(r=0.71,P＜0.01 ; r=0.60,P＜0.01 ).Conclusion There is a positive correlation between the urine TGF-β1 level and chronic kidney disease.The urinary MIP-lαand NGAL are associated with active renal damage.

Objective To compare the effica cy of three N,N-diethyl-m-toluamide (DEET) formulations against Schistosoma japonicum infection in mice. Methods Three 10% DEET formulations (DEET isopropanol solution,DEET cr eam and DEET vaseline ointment)were prepared and two experiments, no-dipping or dipping after applying DEET preparation ,were designed. In each experiment, mice were randomly divided into three experiment groups and three control groups . D ifferent DEET preparations were applied in the experiment groups and isopropanol solution, “yumeijing” cream , vaseline ointment were applied in the control g roups, respectively. At different time points after skin application (0.5, 1, 2 , 4 h and 8 h),the mice were infected with (50?5) Schistosoma j apon icum cercariae on the abdominal skin in no dipping experiment. I n dipping experiment,after mice skin were applied and were dipped for 10,30 min, 1 ,2 h and 4 h, respectively, the mice were infected with (50?5) cercariae. Af ter 6-7 weeks ,all the mice were sacrificed and the worms were collected by hea rt perfusion and counted.Worm reduction rates were calculated and rank sum tests w ere carried out. Results In no-dipping experim ent,three DEET formulations provided 100.0% protection in mice at least for 1 h .A t 2 ,4 h and 8 h ,the worm reduction rates were 94.8%,89.9% and 13.3% for DE ET isopropanol solution, 100.0%,97.8% and 50.7% for DEET cream and 100.0%,9 9.0% and 9 8.0% for DEET vaseline oinment, respectively. In dipping experi-ment, given 50.0% wor m reduction rate as efficient in preventing penetration by the cercariae, the e ffective times were 10 min for DEET isopropanol solution,30 min for DEET cream a nd 2 h for DEET vaseline oinment,respectively. Conclusion Three DEET formulations are effectiv e in preventing Schistosoma japonicum infection in mice.DEET vaseline oinment can provide better protection than the other two D EET formulations.

Objective To explore the technique and clinical outcome of the atlantoaxial pedicle screw system in the treatment of the unstable atlantoaxial dislocation post traction.Methods The study involved 32 patients with atlantoaxial dislocation(type T2 of TOI classification)admitted from March 2005 to September 2009.There were 17 patients with fresh odontoid fracture and two with old odontoid fracture,five with traumatic disruption of the transverse atlantal ligament and eight with congenital odontoid dysplasia.JOA scores of neurological function before operation was at a range of 5-13(average 8.38).The average of space available for the cord(SAC)was 9.15 mm.Before the atlantoaxial pedicle screw system was carried out,the skull traction was performed in all the patients preoperatively.Results A total of 128 pedicle screws were inserted safely,with mean operation time and perioperative blood loss for 1.5 hours and 300 ml,respectively.No injury to the vertebral artery or spinal cord was observed.All the patients were followed up for 12-24 months,which showed that JOA scores one year after operation was increased to 10-17(average 14.56),with the improvement rate of 71.70%,and that the SAC was average 14.86 mm.The X-ray and SCT scans verified the proper position of the screws,with no internal fixation failure or atlantoaxial redislocation.After 3-6 months,all the patients except for one patient achieved a solid bone fusion.One year after operation,the one patient with no bone graft fusion was removed of the internal fixation system and obtained satisfactory restoration of the rotational function.Conclusions Atlantoaxial pedicle screw system is an effective method for the treatment of the unstable atlantoaxial dislocation post traction,for it has the advantages of stable three-dimension fixation,direct screw placement,intraoperative reduction and high fusion rate.

Objective:To study the total serum IgE level of infant's asthmatic diseases in acute attacks and its effect on the development of wheezing.Method:The serum IgE levels of 964 children(younger than two years old)diag- nosed as asthmatic bronchitis or bronehiolitis were measured by immune dispersion nephelometer.Result:78.9% childrens had high E levels(females took up 25.9% and males,74.1%),asthmatic bronchitis accounted for 92.3% of the total and bronehiolitis,60.3%.Of the 328 infants involved in our research,76 were diagnosed as asthma at last,which accoun- ted for 23.2%.Conclusion:78.9% infants had a high level of IgE in an acute phase.There was a prominent relativity be- tween IgE and the development of asthma.The increased IgE level of asthmatic bronchitis was obviously higher than that of the bronchiolitis.There appeared to be a connection between the IgE level and the occurrence of asthmatic bronchitis to- gether with the development of asthma.

BACKGROUND:Perioperative treatment of emergency liver transplantation for acute hepatic failure is extremely different from common liver transplantation, due to complex conditions, high risk, several complications, and high mortality. OBJECTIVE:To summarize the experience of emergency liver transplantation for acute hepatic failure during the perioperative period, and to increase the success rate in treatment of acute hepatic failure. METHODS:A retrospective analysis was undertaken on the clinical data of 38 cases undergone emergency liver transplantation for acute hepatic failure. There were 21 male and 17 female, who aged 15-69 years. Among them, 23 cases had hepatitis B virus (including 2 cases with hepatitis B and C virus), 7 cases had Wilsons disease, 3 cases had mushroom poisoning, 2 cases had unknown liver damage, 1 case had Tripterygium wilfordi poisoning, 1 case had decompensation after partial liver resection due to trauma, and 1 case had liver transplantation from corpse. RESULTS AND CONCLUSION:The survival time of the involve patients was 13-1 740 days, and the median survival time was 634 days. Perioperative survival rate was 76%, 1-year survival rate was 63%, and 2-year survival rate was 58%. During the perioperation nine cases died of brain edema and intracranial hypertension, renal failure, severe pulmonary infection, multiple organ failure, coagulation disorders (intracranial hemorrhage, upper digestive tract hemorrhage), acute respiratory distress syndrome and primary graft non-function. At present, emergency liver transplantation is stil the most effective way for acute liver failure. Hemorrhage, infection and rejection are the leading causes of the death. Each perioperative treatment is of great significance for the success of liver transplantation and long-term survival.

BACKGROUND:Core decompression and autogenous bone grafts are widely used in treatment of early avascular necrosis of femoral head. According to the report, the success rate of this therapy has obvious difference;the reasons may be related to inaccurate puncture location and secondary damnification of repeated puncture. OBJECTIVE:To reconstruct three-dimensional model of femoral head necrosis by Mimics software for reappearance of lesions in the necrotic area to realize measurement of necrotic area of the femoral head and estimation of its volume. METHODS:We restructured images by using multi-slice spiral CT Syngommvvp VE23A workstation, Inspace software and NeuroDSA software. Hip CT data in DICOM format were imported into Mimics 13.0 software systems. Necrotic area of the femoral head was reconstructed with Mimics SimuIation software to truly reproduce the integrated form, scope and stereochemical structure of the necrotic area so as to achieve the measurement of the necrotic area of the femoral head and the volume estimation. We designed the best core decompression channel, simulated core decompression surgery, so that the patients could refer to the best simulated decompression path in the operation of core decompression. RESULTS AND CONCLUSION:(1) Among 36 patients (48 hips) with avascular necrosis of femoral head, there were phase I in 8 hips, accounting for 17%, phase II in 28 hips, accounting for 58%, and phase III in 12 hips, accounting for 25%. (2) The volume of necrotic area was (1 475.48±647.342) mm3 in the phase I, (4 571.77±2 344.55) mm3 in the phase II, and (4 836.46±2 969.33) mm3 in the phase III. (3) We simulated the core decompression based on the radius of the sphere of the necrotic area as parameter in the Mimics Simulation software module, and then completely cleared the necrotic area. (4) Surgery can more clearly understand information and stereochemical structure of the necrotic area with Mimics software to simulate the core decompression. It is the theoretical basis of operation.

Purpose With the progression of brain tissue aging, the transport and drainage characteristics of metabolites and secretory products for neurons in extracellular space occurs irreversible change. This paper aims to investigate and quantify MR tracer diffusion characteristics in cerebral interstitial fluid of elderly SD rats. Materials and Methods MR contrast agent Gd-DTPA was injected into the caudate nucleus of two groups of rats including 8 in experimental group (15-17 month old) and 15 in control group (7-10 month old). MR scan was performed at 0.25 h, 0.5 h, 1 h, 2 h, 3 h and 4 h to observe the dynamic distribution in the caudate and measure the diffusion and clearance rate. Results There was no statistically significant difference in diffusion rate and D* between control group with (3.32±0.70)×10-4 mm2/s and experimental group with (3.25±0.46)×10-4 mm2/s (t=1.739, P>0.05). The clearance rate k' was significantly different between control group (0.62±0.12)×10-4/s and experimental group (0.29±0.08)×10-4/s (t=11.602, P<0.05). Conclusion The degeneration of aging brain tissue changes the composition of extracellular space resulting in decreased speed of ISF clearance. This may cause accumulation of metabolites which eventually triggers a variety of age-related diseases.

Objective To compare the therapeutic effect of combined fascia sheath suspension and frontal muscle flap suspension in the treatment of congenital severe congenital ptosis.Methods 46 cases (58 eyes) with congenital severe upper eyelid prolapse who were treated from March 2015 to March 2016 in Eye Hospital of Hebei Province were selected.The patients were divided into two groups:combined fascial sheath suspension group and frontalis muscle flap suspension.Comparisons of postoperative patients with eyelid height,eyelid radian,corneal exposure with eyes closed,eyelid activity,complication of the situation were carried out.And patient satisfaction survey was conducted.Results The effective rate of combined fascial sheath suspension group was 93.10％,the complication rate was 6.9％,and the patient satisfaction rate was 91.22±0.37,significantly better than the frontal muscle flap suspension group of patients (75.86 ％,24.14 ％ and 75.05 ± 0.28,respectively).The time of closure of the eyelid was shortened,the complications were less,and the eyelid had better activity.The difference between the two groups was statistically significant (P＜0.05).Conclusions Combined fascia sheath for congenital severe upper eyelid droop is significant,with fewer complications and a higher rate of satisfaction,which is worth clinical promotion.