Objective:To establish a HPLC for determination of Gracillin in Rhizoma Paridis and Yunnan white on the bases of determining anti tumor cytotoxic bioactivities of more than 20 varieties of chinese medical materials and traditional Chinese patent medicines.Methods: The determination was carried out by HPLC on KR 100-5C18 column, with acetoitrile water (43∶5) as a mobile phase. The detection wavelength was 210nm. and the flow rate was 0.8ml/min.Results: The recoveries are 99.8% (RSD in 2.6%, n=6) and 98.8% (RSD is 1.5%, n=6), respechrely. The within day and between day accuracies are 1.4% of RSD(n=6) and 1.8% of RSD (n=4), respectively.Conclusion: The results showed that water, methanol and alcohol extracts of Rhizoma Paridis and Yunnan white had strong inhibition on 6 kinds of neoplasm cells of human body and their component Grarillin also had the inhibition on tumor cells.

Objective To investigate the mechanism of platelet inhibitor from Agkistrodon halys venom (AHV-PI) on platelet aggregation. Methods Protein kinase Akt phosphorylation levels in platelet were measured by Western blot. XS-1000I blood cell counter was used for platelet count. The plasma content of 5'-NT and platelet membrane GPIb were determined by Enzyme-Linked Immunosorbnent Assay (ELISA). The effect of AHV-PI on binding rate between the fluorescence labeled monoclonal antibody CD61 (FITC-CD61) and platelet membrae glycoprotein Ⅱb/Ⅲa (GPⅡb/Ⅲa) was observed by flow cytometry (FCM). Results AHV-PI can reduce the level of Akt-phosphorylation level and the number of platelet. AHV-PI can increase the content of 5'-NT in plasma, reduce the expression of platelet GPIb. Flow cytometry displayed AHV-PI can not affect the rate of combination between platelet GPⅡb/Ⅲa and FITC-CD61. Conclusion The mechanism of inhibition of platelet aggregation may be inhibit protein kinase Akt phosphorylation to block the signal transduction pathway of Akt. Limit cell grouth and reduce platelet number, also it may be related to its 5'-NT activity, it can degradate ADP to prevent the formation of platelet thrombus.

Objective To evaluate the short-term outcomes of minimally invasive percutaneous plate osteosynthesis(MIPPO) combined with locking compression plate(LCP) in the treatment of distal tibial fractures.Methods From June 2004 to March 2006,16 patients with distal tibial fractures were treated using MIPPO combined with LCP in our department.According to the AO classification,there were 7 cases of type 43A1,5 type 43A3,2 type 43B1 and 2 type 43C3.After reduction of tibial fracture with three methods,LCP was inserted and fixed with locking screw.All the cases were followed up periodically after the operation.Results All the cases were followed up for 5 to 20 months(mean,11.5 months).Primary wound healing was achieved in 16 patients.No complications,such as non-union,abnormal union and breakage of the plate,occurred in the cases.Callus formation was seen on X-rays at 7.6 weeks(4 to 12 weeks) after the surgery,when the patients began part weight-bearing exercises.The bone union was detected at 16 weeks(8 to 20 weeks),when the patients began full weight bearing.3 patients felt uncomfortable at the distal tibia around the implant.According to the AOFAS Ankle-Hindfoot Scale,14 cases(87.5%) were excellent and 2(12.5%) were good.Conclusions MIPPO combined with LCP technique is an effective treatment for the fractures of the distal tibia.This minimally invasive method can achieve stable fixation,promote bone healing,and permit early functional rehabilitation.

Bone marrow-derived mesenchymal stem cells(BMSCs)exist in and can be isolated from the bone marrow of adult human being and animals and can be induced to differentiate into different cells.They are easy to be isolated,cultivated,and amplified.They are also less immunogenic in the body and can avoid ethical dispute when applied in transplantation.Studies have shown that BMSCs can be induced to differentiate into neural cells under certain conditions in vitro.This article reviewed the recent development in the research on the induction protocols for neural differentiation of BMSCs and the possible mechanisms.

Objective To evaluate the long- term results of intracystic corticosteroid injection for the treatment of simple bone cysts. Methods Seventy- six children with simple bone cysts treated by intracystic injection of corticosteroid from 1985 to 1995 were followed- up for an average of 8.2 years（ 5－ 13 years） . Forty- one of the cysts were situated at the proximal end of the humerus, 20 at the proximal end of the femur and 15 at other sites. The mean injection times were 4.2(2－ 13 times). Results Forty- two(55.3％ ) cysts were healed up completely, 16(21.1％ ) basically healed up, 9(11.8％ ) healed up partially and 9(11.8％ ) failures. Satisfactory and effective rate was 76.4％ and 88.2％ respectively. Conclusion Intracystic corticosteroid injection appears to be the initial choice of treatment for simple bone cysts, because it is an effective, and non－ invasive method which can be carried out easily.

To evaluate whether different doses of X ray irradiation can induce apoptosis of rat C6 glioma cells. A rat C6 glioma cell was irradiated with X ray in different doses in vitro. Apoptosis was identified by the classical “ladder” pattern (oligonucleosome sized fragments) in DNA agarose gel electrophoresis. Results: The results showed that significant apoptosis was found in 15, 20 or 30 Gy groups at 4 hours and 1 day after X ray irradiation compared with control, whereas this phenomenon could only be seen vaguely in the 40 Gy group. The latter group showed more necrosis than apoptosis. It suggested that the apoptotic mode of cell death and necrosis may represent the response in this X ray irradiated rat C6 glioma cells in vitro.

OBJECTIVE:To improve rational drug use and reduce potentially inappropriate medication (PIM). METHODS:PIM of 700 elderly inpatients in internal medicine department of our hospital was evaluated by Beers criteria(2012 edition)and STOPP/START criteria. RESULTS:700 inpatients whose mean ages were (76.3 ± 7.2) years old took (12.1 ± 4.9) kinds of drugs per patient. 144 cases involved PIM(20.6%). The number of PIM was 220 in total,among which there were 117 cases/times relat-ed to drugs and 22 cases/times related to disease in according to Beers criteria,9 cases/times of STOPP and 72 cases/times of START. Drug with most frequency of PIM in accordance with Beers was benzodiazepines and most frequency in STOPP was thia-zides that used by patients with gout histonry. The most omission frequency of START prescription were absence of metformin thera-py for type 2 diabetes and absence of antiplatelet therapy for diabetes complicated with cardiovascular risk. CONCLUSIONS:A high prevalence of PIM in elderly inpatients in our hospital requires various measures to prevent its occurrence.

Objective To evaluate the role of spinal Toll-like receptor 4 (TLR4) signaling pathway in the development of inflammatory pain in rats.Methods Thirty-six adult male Sprague-Dawley rats were divided into 3 groups (n=12 each) using a random number table:control group,inflammatory pain group and TLR4 signaling pathway inhibitor epigallocatechin gallate (EGCG) group (EGCG group).Inflammatory pain was induced by injecting 50 μl of complete Freund's adjuvant (CFA) into the ankle joint cavity of the left hindpaw of rats anesthetized with isoflurane.At 1-3 days after injection of CFA,EGCG 30 μg was intrathecally injected once a day in group EGCG.At 1,3 (30 min after intrathecal injection),5and 7 days after injection of CFA,the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured.The ipsilateral L4.5 segments of the spinal cord were removed at 3 days after CFA injcction for determination of TLR4 expression (by Western blot) and contents of tumor necrosis factor-alpha (TNF-oα),interleukin-6 (IL-6) and IL-1β in the spinal dorsal horn (by enzymelinked immunosorbent assay).Results Compared with control group,the MWT was significantly decreased and the TWL was shortened at each time point after injection of CFA,the expression of TLR4 in the spinal dorsal horn was up-regulated,and contents of TNF-α,IL-6 and IL-1β in the spinal dorsal horn were increased in inflammatory pain group (P＜ 0.05),and no significant change was found in the parameters mentioned above in EGCG group (P＞0.05).Compared with inflammatory pain group,the MWT was significantly increased and the TWL was prolonged at each time point after injection of CFA,the expression of TLR4 in the spinal dorsal horn was down-regulated,and contents of TNF-α,IL-6 and IL-1β in the spinal dorsal horn were decreased in EGCG group (P＜0.05).Conclusion Spinal TLR4 signaling pathway is involved in the development of inflammatory pain in rats.

Objective To discuss the selections of surgical treatment for lower cervical spine fracture and dislocation and the treatment outcome.Methods Clinical data of 50 cases of lower cervical spine fracture and dislocation were analyzed retrospectively.There were 37 males and 13 females at mean age of 41 years (range,20-80 years).Forty-four cases underwent anterior fusion,but 4 with ankylosing spondylitis and 2 with extremely unstable cervical spine were treated with combined posterior fusion.Two cases sustaining ankylosing spondylitis and being unable to be operated via the anterior approach due to the maximum neck flexion limits were treated with posterior decompression and fusion.Two cases developed delayed fracture and underwent posterior release prior to the anterior fixation and fusion.Two cases underwent a second surgery with the posterior release,anterior fusion and posterior fusion performed successively.Neurological performance was evaluated using the American Spinal Injury Association (ASIA)scale.Results All the patients were followed up for mean 28 months (range,12-48 months).Implant loosening and redislocation occurred in one ankylosing spondylitis case 2 months after anterior fusion.Other 49 cases achieved bony fusion in 6 months.Neurological function showed no recovery in complete spinal cord injury cases,but improved for average ASIA 1-2 grades for incomplete spinal cord injury cases.Conclusions Anterior surgery provides good reduction and neurological improvement in treatment of lower cervical spine fracture and dislocation.For extremely unstable cases or difficult anterior reduction cases,posterior surgery or combined anterior/posterior surgery should be considered.

Objective To compare the efficacy of reversed less invasive stabilization system (LISS) and intramedullary fixation devices for treatment of femoral trochanteric fractures.Methods Data of 362 consecutive patients with femoral trochanteric fractures who were treated with reversed LISS or intramedullary fixation devices at our institution between March 2004 and May 2011 were retrospectively analyzed.There were 32 males and 38 females treated with reversed LISS.The mean age at injury was 73.4 years.There were 125 males and 167 females treated with intramedullary fixation.The mean age at injury was 74.7 years.The operation time,intraoperation blood loss and length of hospitalization were compared.The patients were asked to fill in a questionnaire of Harris hip score,and radiographs were used to evaluate the bone healing situation.Results The mean operation time was 120 min in reversed LISS group and 80 min in intramedullary group.The length of hospitalization was 12 days in reversed LISS group and 10 days in intramedullary group.More operation time and longer length of hospitalization were needed in reversed LISS group.The intraoperation blood loss was 100 ml in reversed LISS group and 100 ml in intramedullary group.There were 3 DVT in reversed LISS group,10 DVT and 3 PE in intramedullary group.No difference was found in the aspect of intraoperation blood loss,postoperative deep venous thrombosis and pulmonary embolism rate.A total of 320 patients were successfully followed-up,including 63 in LISS group and 257 in intramedullary group.The median Harris score was 75 in LISS group and 77 in intramedullary fixation group respectively.There was no difference of hip function score between two groups.The implant-related complication rate was 11.1％ in reversed LISS group,including 7 implant breakages.In intramedullary fixation group,there were neck screw exiting in 2 patients and cutout in 9 patients.So the implant-related complication rate was 4.3％ in intramedullary fixation group,which is statistically lower.Conclusion Both reversed LISS and intramedullary are effective for the treatment of proximal femoral fractures.There were no major difference in functional outcome between LISS and intramedullary nail.Intramedullary nail is still the choice of priority in most unstable proximal femoral fractures.The implants related complications in reversed LISS group are higher than Intramedullary nail group.However,for the unstable fractures proximal femoral fractures with lateral wall fracture,in which nailing may be difficult,reversely using LISS may be a good alternative.