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 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.

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 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.

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.

Objective To observe whether rabbit blood leptin can leak into the brain after craniocerebral trauma (CCT),and to dynamically detect serum levels of leptin,growth hormone (GH),and insulinlike growth factor-1 (IGF-1),and leptin level in cerebrospinal fluid (CSF) after CCT.Methods The FITC labeled leptin was injected into blood vessels of 15 adult male rabbits after anesthesia.Then 9 rabbits underwent unilateral fluid percussive impact,while 6 rabbits underwent sham operation.Thirty minutes postoperatively,brain tissue was taken to make frozen sections which were used to observe fluorescence labeled leptin range.Thirty three adult male rabbits were randomly divided into serum group,serum-control group,CSF group and CSF-control group.Rabbits in serum group and CSF group received fluid percussive impact,while rabbits in serum-control group and CSF-control group were drilled a 7 mm window in skull.Rabbits in serum group and serum-control group were phlebotomized 2 ml at 1 d,3 d,7 d and 14 d after operation,and rabbits in CSF group and CSF-control group were extracted CSF 0.5 ml at the same time points.Then serum levels of leptin,GH,and IGF-1,and leptin level in CSF were tested by ELISA.Results The fluorescence imaging could be seen in the injured brain tissue of rabbits with CCT,which was more than those in brain tissue of rabbits receiving sham operation.Serum leptin levels of rabbits in serum group at each time point were higher than those in serum-control group.Serum levels of GH and IGF-1 and leptin level in CSF were higher in rabbits with CCT than those in rabbits without CCT at 1 d,3 d and 7 d after operation.Conclusion The blood leptin can leak into the brain after CCT,which can cause increase of blood GH and IGF-1.And the latter may be the endocrine factors promoting fracture healing after CCT.

Objective:To probe the effect of intermittent aerobic exercise on adrenomedullin secretion of kidney in hypertensive nephropathy rat (HNR),and investigate the renal mechanism for exercise in the prevention and treatment of hypertension.Method:Thirty-two HNRs were divided into two groups:intermittent exercise group (Group IAE) and control group (Group C).The IAE group performed intermittent treadmill exercise for 8 weeks and their blood pressure was measured before and after exercise by tail pressure of HNR,and serum ADM was detected by enzyme linked immunosorbent assay.Adrenomedullin (ADM) was expressed in kidney by immunohistochemistry.Quantification of specific receptor RAMP2 and CRLR in kidney ADM was detected by immunoblotting.Result:The blood pressure in the Group IAE was significantly lower than that in the Group C(P＜ 0.05).The expression of ADM of kidney and serum in the Group IAE was obviously higher than that in the Group C.The quantity of RAMP2 and CRLR in kidney was obviously increased(P ＜ 0.05).Conclusion:Intermittent aerobic exercise increases serum ADM of HNR with the up-regulated expression of ADM in kidney and their specific receptor CRLR and RAMP2.The increase of serum ADM induced by intermittent aerobic exercise may be related to the change of ADM and the regulation of its specific receptor which may be one of the mechanisms for intermittent aerobic exercise in the prevention and treatment of hypertension.

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.

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.

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.