Objective To investigate the protective effects of piceatannol on retinal ganglion cells (RGCs) in rats with glaucoma.Methods Forty rats were randomly divided into 4 groups:control group,model group,low dose piceatannol treatment group and high dose piceatannol treatment group.Photocoagulation method was used to establish the experimental glaucoma model in rats,and then rats were given 100 mg· kg-1 or 200 mg · kg-1 of piceatannol by gavage.The intraocular pressure was measured before and after the model was established.Rat retinal ganglion cells were labeled and counted using FG staining.Retinal tissue pathological morphology was observed by HE staining.The protein expression of p-JNK,p-c-Jun,p-ERK,p-p38 MAPK and TNF-α were measured by western blot.Results Compared with control group,the intraocular pressure,the protein expressions of p-JNK,p-c-Jun p-ERK,p-p38 MAPK and TNF-α were significantly increased in model group (all P ＜ 0.05).However,the number of RGCs were lower in model group(P ＜0.05).Furthermore,there were cavitation and edema changes in retinal tissue of model group.Compared with model group,piceatannol treatment markediy increased the number of RGCs(P =0.003,0.002),improved the pathological morphology of retinal tissue,and reduced the protein expressions of p-JNK,p-c-Jun p-ERK,p-p38 MAPK and TNF-α (all P ＜ 0.05),especially for the high concentration.Conclusion Piceatannol can protect against RGCs injury in glaucoma rats,and the mechanism may be associated with inhibition of MARK signaling pathway.

[ ABSTRACT] AIM:To investigate the effect of Ginkgo biloba extract ( GBE) on diabetic retinopathy ( DR) and its possible mechanism in rats .METHODS:Goto-Kakizaki ( GK) rats were used as a DR model, and were treated with different doses of GBE.Normal Wistar rats were used as the control.Blood glucose and retina barrier injury were analyzed, respectively.Ganglion cell apoptosis was detected by TUNEL staining.Moreover, the protein expression of nuclear factor E2-related factor 2( Nrf2) , ERK, Bcl-2 and P53, and ERK phosphorylation were examined by Western blot.RESULTS:GBE reduced blood glucose in the DR rats, attenuated retina barrier injury, and decreased the apoptosis of ganglion cells. Furthermore, the expression of Nrf2 and Bcl-2, and phosphorylation of ERK were increased after GBE treatment, whereas P53 expression was decreased.CONCLUSION:GBE protects ganglion cells against apoptosis in DR rats, which may be through activation of Nrf2/ERK pathway and regulating Bcl-2 and P53 expression.

Objective To investigate the application of automatic biopsy gun in CT-guided percutaneous biopsy for the diagnosis of pulmonary sub-centimeter nodules (≤1 cm).Methods A total of 78 patients with pulmonary sub-centimeter nodules were enrolled in this study. Under CT guidance, percutaneous multi-point and multi-sampling puncture biopsy with automatic biopsy gun was carried out in all patients. The success rate of puncturing, the complications and pathological results were analyzed. Results The success rate of puncturing was 91.0% (71/78). The incidence of pneumothorax was 17.9% (14/78) and the incidence of hemorrhage was 30.8%(24/78). In all patients, no pulmonary infection, tumor tract seeding or metastasis was observed during the follow-up period. Among the 71 patients who had a successful biopsy, squamous cell carcinoma was detected in 7, adenocarcinoma in 25, small cell carcinoma in 5, metastatic lesion in 3, chronic interstitial lung inflammation in 13, granulomatous inflammation in 12, pulmonary fungus in 4, pneumoconiosis nodule in one and pulmonary hamartoma in one. Conclusion For CT-guided percutaneous puncture biopsy of pulmonary sub-centimeter nodules, the use of automatic biopsy gun is safe and reliable with higher success rate.

Objective To explore the characteristics of chest multi-slice spiral CT and dynamic changes in adult patients with se-vere adenovirus pneumonia.Methods Clinical and CT data of 6 patients with severe pneumonia in an epidemic of the respiratory ade-novirus infection were retrospectively analyzed.The impact of hormone therapy was also studied.Results The first chest CT exami-nations in 6 patients were performed 2.22 ± 0.75 days after fever.CT showed segmental consolidation with ground-glass opacity (GGO)in one case,patchy consolidation with GGO in 3 cases,patchy interstitial changes in one case and small nodules in one case. The duration reaching the standards of severe pneumonia was 6.1 7 ± 0.37 days from the onset.During severe phase chest CT showed a range of lobar consolidation in one case,lobar in 2 cases,segmental in 2 cases or patchy in one case,consolidation with GGO in 5 cases.In all cases the lesions were commonly seen in the lower lobes of bilateral lungs.Multiple lobes were involved in 2 cases.After methylprednisolone treatment,no new lesion was showed but the early lesion was enlarged.During the first 2 to 4 days GGO absorbed completely in 6 cases,consolidation absorbed completely in one case and mostly in 5 cases.Conclusion Chest CT findings of severe adenovirus pneumonia in adult are single or multiple lobar or segmental consolidations with or without GGO which distribute mainly at lower lobes.

Objective To examine the expressions of serum growth hormone (ghrelin), leptin (LP), in sulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP3) in children with id-iopathic short stature (ISS), and their significance. Methods A total of 40 patients with ISS were selected from May. 2012 to Oct. 2014 in Fuyang Maternal and Child Health Hospital, while a total of 40 children in good health were selected as the control group. Serum ghrelin and LP levels were measured by ELISA. Serum IGF-1 and IGF-BP3 levels were detected by chemiluminescence immune assay. Results were analyzed statistically. Results The height, weight, BMI, GH, serum LP, IGF-1, and IGFBP3 levels in the observation group were significantly lower than those in the control group, while serum ghrelin expression level was significantly higher than that in the control group(P<0.05). The correlation analysis showed that ghrelin and LP were negatively correlated(r=-0.611, P<0.01), ghrelin and IGF-1 levels were negatively correlated(r=-0.520, P<0.05), Ghrelin and IGFBP3 were pos-itively correlated (r=0.586, P<0.01), IGF-1 and IGFBP3 was negatively correlated (r=-0.576, P<0.01), and LP and IGFBP3 were negatively correlated (r=-0.609, P<0.01). Conclusions It shows that ghrelin, LP, IGF-1, and IGFBP3 levels in children with ISS are related to growth hormone secretion status. The interactions between ghre-lin and insulin-like growth factor axis regulate growth and development of children.

Objective To evaluate the value of spiral CT in analyzing correlation of growth pattern with pathology and prognosis in gastric stromal tumor(GST).Methods CT findings and pathological data including immunohistochemical staining sections of 43 patients with GST were reviewed and all patients were followed.The correlation between growth pattern,pathology and prognosis was studied.Results Of the 43 GST,there were benign in 9 and malignant in 34.the benign or malignant GST closely correlated with the growth pattern.Of the 17 intra-and extra-luminal growth patients,16 cases were malignant and 5 cases recurred in 3 years.Conclusion The GSTs that appear intra-and extra-luminal gowth hint the poor prognosis.

Objective To evaluate the correlation between spiral CT ( SCT ) features and expression of cyclooxygenase-2 , nm23 in esophageal carcinoma.Methods Spiral CT scans were preformed in 44 patients with esophageal carcinoma before operation, and the results were compared with that of operation and pathology. Immunohistochemical streptavidin peroxidase conjugate method was used to analyze the expression of Cox-2 and nm23 in esophageal carcinoma. Statistical analysis was performed with SPSS 12.0 software. Results (1) The accuracy of spiral CT scan in judging adjacent- infiltration and lymph node metastasis in 44 patients was 88.6%(39 of 44) and 90.9% (40 of 44) respectively,there was significant coincidence with operation and pathology(P

Objectives To compare total laparoscopic gastrectomy with intracorporeal hand-sewn Gl reconstruction and laparoscopy-assisted gastrectomy for gastric cancer. Methods Between July 2009 and July 2010, 21 patients of gastric cancer underwent total laparoscopic D2 radical gastrectomy with intracorporeal hand-sewn reconstruction and 28 did laparoscopy-assisted D2 radical gastrectomy in Xijing Hospital of Digestive Diseases. All patients were operated on by an experienced surgeon. Patient demographics, TNM stage, location of tumor, the intraoperative and postoperative details of the two groups were compared. Results In the 21 patients undergoing total laparoscopic gastrectomy, there were 15 of distal gastrectomy and 6 of total gastrectomy, compared with 21 and 7 in laparoscopy-assisted group. In total laparoscopic group, intracorporeal hand-sewn technique was used for gastro-jejunal and jejuno-jejunal (J-J)anastomosis, and 25 mm circular stapler was used for esophago-jejunal anastomosis. The operation time was significant longer in total laparoscopic group than in laparoscopy-assisted group of (279 ± 65 ) min vs.(232 ±40) min (P ＜ 0.05 ). No significant difference was observed between the two groups in proximal margin [(5.7 ± 1.5 )cm vs. (5.1 ± 1.4) cm, P ＞ 0.05] and distal margin [( 3.1 ± 0.9 )cm vs. ( 2.9 ±0.9) cm,P ＞0.05]. The iv narcotic use in laparoscopy-assisted group was 1.8 d but it was not used in total laparoscopic group. The first passing flatus was on day 3 in total laparoscopic group compared with 4.8 d in laparoscopy-assisted group. Both groups had 2 postoperative early complications, one intra-abdominal infection and one lung infection in total laparoscopic group compared with one wound infection and one lung infection in laparoscopy-assisted group. There was no anastomosis-related complications after 4 months of follow-up. Conclusions The operation time and postoperative early complication was acceptable for selected patients treated by total laparoscopic D2 radical gastrectomy with intracorporeal hand-sewn GI tract reconstruction in hands of experienced laparoscopic surgeon.

Objective To analyze the clinical characteristics of suspected acute aortic dissection with ST-segment elevation detected by inferior leads in order to avoid the misdiagnosis of acute aortic dissection facilitating an appropriate treatment strategy carried out in time.Methods A total of 14 patients with suspected acute aortic dissection with ST-segment elevation detected by inferior leads were enrolled.Their clinical presentation,ECG features,imaging findings,laboratory testing,coronary angiography results, treatment and outcome were retrospectively analyzed.Results Clinical characteristics of suspected acute aortic dissection with ST-segment elevation detected by inferior leads suggested that hypertension as a single risk factor accounted for 79%.The patients with normal blood pressure or high blood pressure in emergency visits accounted for 86%.The amplitude of ST elevation in lead Ⅲ was greater than that in lead Ⅱ,and lead Ⅲ accompanied with ST elevation in lead V1 or V4R accounted for 86%.Significantly elevated D-dimer >2 000 ng/mL was found in those patients.Coronary angiography showed that the opening of coronary artery not seen,normal coronary arteries or a simple right coronary artery proximal lesion.Transesophageal echocardiography and computed tomography angiography were used to identify the diagnosis with 100%accuracy.The mortality rate of this group was 50%.Conclusions Patients with acute aortic dissection evidenced by ST-segment elevation detected by inferior leads are in critical setting of high mortality. Emergency surgical treatment can significantly improve the survival rate of patients.

Objective To evaluate the efficacy of clemastine fumarate in antagonizing atracuriuminduced release of histamine in the patients undergoing surgery under general anesthesia.Methods Eighty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 21-59 yr,with body mass index of 17-26 kg/m2,scheduled for elective modified radical mastectomy,were divided into 2 groups (n=40 each) using a random number table:control group (group C) and clemastine fumarat group (group CF).Clemastine fumarate 2 mg was injected intramuscularly at 20 min before induction of anesthesia.Anesthesia was induced with iv midazolam 0.1 mg/kg,etomidate 0.3 mg/kg,fentanyl 4-6 μg/kg and atracurium 0.8 mg/kg.The patients were mechanically ventilated after insertion of the larygeal mask airway.Anesthesia was maintained with inhalation of 2％ sevoflurane.Before administration of clemastine fumarate,at 20 min after administration,immediately before administration of atracurium,and at 2,5,10 and 20 min after administration of atracurium,arterial blood samples were taken for determination of plasma histamine concentrations,and the peak airway pressure and degree of cutaneous color were recorded.The development of histaminemia and adverse cardiovascular events was assessed.Steward recovery scores and Ramsay sedation scores were recorded at 10 min after removal of the laryngeal mask airway.Results The incidence of histaminemia was 60％ and 8％ in C and CF groups,respectively.Compared with group C,the plasma histamine concentrations,incidence of histaminemia,degree of cutaneous color,and incidence of hypotension and tachycardia were significantly decreased (P＜0.05),and no significant change was found in the peak airway pressure,Steward recovery scores and Ramsay sedation scores in group CF (P＞0.05).Conclusion For atracurium-induced release of histamine in the patients undergoing surgery under general anesthesia,clemastine fumarate 2 mg injected intramuscularly before operation can not only antagonize histamine at H1 level,but also reduce histamine release,and exerts no influence on recovery from anesthesia and produces good antihistamine efficacy.