Objective To explore the effect of hemorrhage on cell apoptosis in the hippocampal CA1 region of rats under controlled hypotension (CH).Methods A total of 36 Sprague Dawley rats were randomly divided into 2 groups: Group C (with no CH) and Group H (with CH).According to different ratios of blood loss to total blood volume, Group C and Group H were redivided into 6 subgroups (6 in each group):C_1,H_1(10%);C_2,H_2(20%);C_3,H_3 (30%). Induced by so-dium nitroprusside and esmolol, the mean aterial pressure in Group H was decreased to 50～55 mmHg and kept for 10 minutes, and then blood loss was started, keeping the pump speed. Without CH, the same style of hemorrhage was performed in Group C. The aterial pressure was increased 60 minutes later after the hemorrhage.Expression of bcl-2 and caspase-3 protein was detected by immunohistochemical method, and apoptosis cells were detected by TUNEL staining. Results The average optical density of bcl-2 and caspase-3 was higher in Group H_3 than that in Group C_3(P＜0.05). There were more apoptosis cells examined by TUNEL in Group H_3 than in Group C_3(P＜0.05).Conclusion Thirty percent blood loss under controlled hypotension can induce cell apoptosis in hippocampal CA1 region in rats.

Objective To investigate the clinical application value of ductoscopic flushing in the treatment of early lactation acute mastitis.Methods 52 patients with early acute mammitis were divided into observation group (27 cases)and control group(25 cases)according to the principle of completely random.In the observation group, the patients were checked under the intervention of mammary duct firstly,and then the disease regions of the breast were flushed using ductoscope.In the control group,the patients were treated with artificial breast -milk.The two groups were all treated with the same antibiotics.The curative effect of the two groups was observed,and the statistical analysis was performed.Results In the observation group,the mass extinction time,pain relief time,pyretolysis time, hemogram recovery time,contralateral continued breast -feeding proportion,the proportion of abscess formation,the proportion of back -milk,the proportion of ipsilateral quadrant recurrence were (3.5 ±1.2)h,(5.0 ±0.9)h, (1.0 ±0.1)d,(1.0 ±0.3)d,92.6%,7.4%,7.4%,0.0% respectively,those in the control group were (24.0 ± 3.2)h,(2.0 ±2.1)h,(2.0 ±0.2)d,(3.0 ±0.3)d,88.0%,12.0%,12.0%,8.0% respectively.The differences between the two groups were statistically significant(t =1.72,0.36,0.43,0.72,χ2 =1.83,2.02,1.56,0.34,all P <0.05).Conclusion Ductoscopic flushing has good effect in the treatment of early lactation acute mastitis,and it is worthy of clinical promotion.

This study discussed the dual affiliated institutions of one author in a scientific paper.This issue could give rise to troubles such as the dispute over signature rights, dispute over intellectual property rights, etc. Moreover, it could bring negative effects on the development of science. In addition, some suggestions were put forward to deal with this issue.

Objective Objective The present study was to increase the awareness of nonalcoholic Wernicke's encephalopathy ( WE) to reduce its misdiagnosis.Methods The clinical features and MR imaging findings in 6 patients with nonalcoholic WE were retrospectively analyzed.Results All patients exhibited different degrees of unconsciousness.Only two patients presented with the typical triad of neuro-ophthalmologic manifestations, ataxia, and global confusion.All patients presented with typical MR features characterized by bilaterally altered signal of the medial thalamus, periventricular region of the third ventricle and periaqueductal area. In addition, two patients developed symmetric cortical and facial nerve nucleus involvements with deep coma, which was clinically rare.The average clinical recovery and MRI imaging recovery times were 7.5 months and 2.8 months, respectively,.Two patients with deep coma showed a poor prognosis:1 patient died, and the other had a sever spastic paralysis of her extremities and mental retardation during a follow -up of 2 years.Two patients with deep coma showed symmetric hyperintensities on diffusion -weighted imaging ( DWI) .Conclusions MRI images are useful in the early diagnosis of nonalcoholic WE.Cortical and cranial nerve nucleus involve-ment in nonalcoholic WE patients may be an indication of irreversible damage and a poor prognosis.In addition, hyperintensities on DWI may also indicate an unfavorable prognosis.

Maturity-onset diabetes of the young (MODY)is a heterogeneous monogenic diabetes, in which MODY1, MODY2, and MODY3 are the most common subtypes. In recent years, new hypoglycemic drugs such as glucagon-like peptide-1 receptor agonists (GLP-1RA), dipeptidyl peptidase-4 inhibitors (DPP-4i), sodium-glucose co-transporter 2 inhibitors (SGLT2i), and glucokinase activators (GKA)have made good progress in the treatment of diabetes. Based on the latest basic and clinical evidence, the article reviews the pathogenesis, clinical features, diagnosis and treatment progress of new hypoglycemic drugs of the above three types of MODY, aiming to develop safer and more effective new ways for the diagnosis and treatment of MODY.

Aim To investigate the effect of indirubin derivative PHⅡ-7 and TRAIL on proliferation in breast cancer cell MCF-7 and its MDR counterpart MCF-7/ADR and the mechanism.Methods Growth inhibition rate was examined respectively by MTT assay under treatment with TRAIL or PHⅡ-7 or in combination. Cell apoptosis and ROS production were examined by flow cytometry.The change of TRAIL receptors(DR4/DR5 )in mRNA was analysed by realtime PCR.Re-sults IC50 of PHⅡ-7 on MCF-7 and MCF-7/ADR was (4.49 ±1.55 ),(3.44 ±0.90 )μmol · L-1 respec-tively;MDA-MB-231 was TRAIL sensitive cell line, and apparently TRAIL induced apoptosis in MDA-MB-23 1 .Low concentration of PHⅡ-7 in combination with TRAIL could augment TRAIL-induced cytotoxic effect including apoptosis while TRAIL or PHⅡ-7 treatment alone had limited cytotoxity to those cells.Besides, PHⅡ-7 at this concentration had little toxicity to hu-man peripheral blood mononuclear cells even if in com-bination with TRAIL.PHⅡ-7 generated ROS produc-tion inside MCF-7 and MCF-7/ADR cells and up-regu-lated DR4/DR5 expression concentration dependently. Once upon ROS scavenger NAC involved,the effect of TRAIL receptors up-regualtion by expression was abro-gated.Conclusions PHⅡ-7 at low concentration could improve the sensitivities of breast cancer cell MCF-7 and MCF-7/ADR to TRAIL,the mechanism of which may be the ability of ROS production by PHⅡ-7 help up-regulated TRAIL receptor DR4,DR5 .Our re-search set a solid foundation for PHⅡ-7 in combination with TRAIL in future clinical application.

Objective To explore the treatment effect and failure patterns associated with different clinical target volume on patients with esophageal carcinoma treated with 5-filed intensity modulated radiotherapy (IMRT), and to determine whether involved field irradiation (IFI) is practicable in these patients. Methods A total of 88 patients with esophageal carcinoma between January 2012 to June 2014 underwent IMRT in our hospital, were divided into IFI group and elective nodal irradiation(ENI) group according to the CTV range for a concurrent control study. Results One-year and two-year survival rate in IFI group and ENI group were 75.0%, 45.5% and 70.5%, 43.2% respectively (P > 0.05). Local failure rate in IFI and ENI groups was 27.3% and 22.7% respectively, distant metastasis failure rates 22.7% and 18.2% respectively and regional failure rate outside the radiation field 11.4% and 4.5%, which showed no statistical difference (P > 0.05). Subgroup analysis indicated failure outside the radiation field tended to increase for primary lesion located in the up thoracic or clinical stageⅠ in IFI group. The volume dose histogram of lung V5, V20, V30 and mean lung dose of ENI group were greater than that of IFI group, while V5 of lung and the mean lung dose had statistical difference. Conclusions The survival rate and local control rate have no significant differencein IFI group and ENI group, so IFI is feasible for some esophageal carcinoma, but it should be cautious to choose IFI for those primary lesion located in the up thoracic or clinical stageⅠ.

Objective: To compare the effects of pericardium patch aortoplasty and pulmonary patch aortoplasty for treating the infants with aorticcoarctation (AC) combining hypoplastic aortic arch in order to provide a better surgical choice in clinical practice.
Methods: A total of 57 patients with AC combining hypoplastic aortic arch treated in our hospital from 2009-01 to 2014-12 were retrospectively studied. The patients were divided into 2 groups: Pericardium patch aortoplasty group,n=26 and Pulmonary patch aortoplasty group,n=31. The changes of the pressure gradient at post-operation and follow-up period were compared.
Results: There were 2/57 (3.5%) patients died, 1 in Pericardium patch aortoplasty group by pulmonary hypertension crisis, the other 1 in Pulmonary patch aortoplasty group by respiratory distress syndrome. No renal failure or neurological complication occurred in neither groups. The cardiopulmonary bypass time, aortic clamping time, ventilator time and ICU stay time were similar between 2 groups,P>0.05. Selective cerebral perfusion time in Pericardium patch aortoplasty group was shorter than Pulmonary patch aortoplasty group (30.5 ± 8.6) s vs (35.6 ± 10.3) s,P<0.05. By ultrasound estimation, the post-operative AC pressure gradients were decreased than they were before, as in Pericardium patch aortoplasty group (9.5 ± 7.5) mmHg vs (39.9 ± 15.5) mmHg and in Pulmonary patch aortoplasty group (11.8 ± 11.3) mmHgvs (39.2 ± 14.5) mmHg, bothP<0.05; while post-operative pressure gradients were similar between 2 groups,P>0.05. Follow-up study was conducted in 51 patients for (17.6 ± 16.6) months, Pericardium patch aortoplasty group had 6 patients with re-stenosis, 3 of them would receive balloon angioplasty and 3 would be continuously followed-up; Pulmonary patch aortoplasty group had 6 patients with re-stenosis, 2 of them ifnished balloon angioplasty and their pressure gradients were obviously decreased, 4 would be continuously followed-up. Kaplan-Meier curves presented that Pulmonary patch aortoplasty group was superior to Pericardium patch aortoplasty group in re-stenosis occurrence during follow-up period.
Conclusion: Both pericardium patch aortoplasty and pulmonary patch aortoplasty were effective for treating the patients with AC combining hypoplastic aortic arch, the early post-operative efifcacy was similar, while the mid-term follow-up result was better in pulmonary patch aortoplasty.

Objective To establish a rat model of ulcerative colitis by immunological sensitization combined with local acetic acid irritation.Methods Thirty healthy 2-3-month-old Wistar rats were randomly divided into 3 groups:normal control group,model group and SASP-treated model group(n=10 rats per group).The ulcerative colitis in the model group and positive group was developed by immunological sensitization with rabbit colon mucosal proteins and local irritation with 5%acetic acid.The rats of the model and positive groups were fed with sulfasalazine,and rats of the control group fed with normal saline.The rats of positive control group were treated with sulfasalazine.Two weeks later,all rats were killed and colon mucosal and blood samples were collected.The concentrations of NO,NOS,MDA,SOD and GSH-Px in the colonic mucosal homogenate were measured by biochemistry,the contents of IL-4 and TNF-α were measured by RIA,and the serum concentration of IFN-γ was measured by ELISA.Results Compared with the normal control group,the concentration of MDA,NO,NOS in the colonic mucosa was increased,and SOD and GSH-Px levels significantly decreased in the model group.Compared with the model group,the concentrations of MDA,NO,and NOS in the colonic mucosal tissue were decreased,and the levels of SOD and GSH-Px decreased in the SASP-treated model group.The contents of IL-4 in the serum and colonic mucosal homogenate of model group were significantly lower, and the contents of TNF-α in the serum and colonic mucosal homogenate were significantly increased than those of the normal control group. The IL-4 levels in the serum and colonic mucosal homogenate was increased, and that of TNF and IFN-γ significantly decreased in the SASP-treated model group, compared with those of the normal control group.Conclusion The rat model of ulcerative colitis established by immunological sensitization combined with local acetic acid irritation, as described in the present study, can better simulate the characteristic chronic alterations in human ulcerative colitis,and may better serve studies and evaluation of treatment of this disease.

Objective To evaluate the short term results of endovascular laser for the treatment (ELVT) of great saphenous varicosity. Methods Twenty one cases (a total of 27 lower extremities) were enrolled. Treatment included EL combined with ligation and resection of communicating branches. One patient underwent high ligation and resection of the great saphenous vein for the purpose of pathology after ELVT treatment. Result Twenty patients were followed-up for a period of 2～6 months. Color Duplex ultrosonography was conducted 2 weeks,4 weeks,and 6 mos,respectively. Thrombotic obliteration was found in all cases. Pathology study showed perforation of the vein with intimal injury and thrombosis. Conclusion The short term efficacy of EL treatment is definite with insignificant side-effect,and quick patient recovery. The mechanism is related to direct thermal injury of laser to the venous intima resulting in thrombotic obliteration.