Objective To investigate expressions of microRNA-21 (miR-21),PTEN,NF-κB,and caspase-9 in colon carcinoma and their possible mechanisms in progression of tumor.Methods Expressions of above-mentioned indexes and percentage of apoptotic cells in colon carcinoma,colon adenoma,and normal tissue specimen were detected.Results Expressions of miR-21,PTEN,N F-κB,and caspase9 in normal tissue were 0.39 ±0.02,50％,25％,and 50％.Expressions of them in colon adenoma were 0.62 ±0.06,50％,35％,and 55％,and those in colon carcinoma were 0.88 ±0.04,30％,75％,and 20％.Percentage of apoptotic cells were (24.64 ± 7.66) ％,(15.86 ± 1.44) ％,and (6.20 ± 2.57) ％,respectively.The above P-values were all less than 0.05.Expression of miR-21 was positively correlated with TNM stage,depth of infiltration,differentiated level and expression of NF-κB while inversely correlated with PTEN and caspase-9 expressions and percentage of apoptotic cells.The r-values were 0.647,0.297,0.259,0.519,-0.299,-0.388,and-0.931,respectively.Conclusions Hyperexpression of miR-21 participated in progression of colon carcinoma probably through down-regulating expressions of PTEN and caspase-9 and up-regulating expression of NF-κB and then suppressing cell apoptosis.

Objective:To observe the anatomic characteristics of supratubal recess and the morphological change of it in the sick ear. To investigate the relation between the morphological changes of supratubal recess and otitis media.Method:Using high resolution CT to observe and measure the supratubal recess of the normal ears and the ailing ones.Result:For the normal adults, the anteroposterior diameter of the supratubal recess is(3.83±1.28)mm,the vertical diameter(3.67±1.14)mm,the height(3.76±0.36)mm;and the length of the cog is(2.84±0.38)mm.The size of the supratubal recess showed no significant difference between left and right(P＞0.05).There was no relationship between the size of the supratubal recess and pneumatization of mastoid cells (P＞0.05).There was significant differences in size of the supratubal recess between normal ears and the ears with cholesteatoma(P＜0.05),but there was no relationship between the size of the supratubal recess and pneumatization of mastoid cells(P＞0.05)in the ears with cholesteatoma.There was no significant differences in size of the supratubal recess between normal ears and the ears with chronic otitis media(P＞0.05).In the ears with cholesteatoma,40% had osseous destruction in supratubal recess.Conclusion:For the normal adults, the size of the supratubal recess showed no significant difference between left and right, and there was no relationship between the size of the supratubal recess and pneumatization of mastoid cells. Anterior tympanic isthmus , posterior tympanic isthmus and supratubal recess which is the supplement of the formers constitute the air way between attic and mesotympanum. The supratubal recess of the cholesteatoma is smaller than the normal, when the eustachian tube dysfunction occurs, the air way in the middle ear would herein be affected, and cholesteatoma forms eventually. There was no significant differences in size of the supratubal recess between normal ears and ears with chronic oti-tis media, as in the clinic.The effect of the supratubal recess should be taken into account when we consider the pathogeny and treatment of the middle ear cholesteatoma.

Objective To explore the rationality of clinical blood transfusion since the Ministry of Health enacted the The Technical Criterion of Clinic Blood Transfusion' in 2000. Methods Retrieved the literatures on the appraisal of rationality of clinic blood transfusion published in core journal between 2000 and 2010, and analyzed the rationality of clinical blood transfusion in recent 10 years. Results In 35 literatures entered, the proportion of appropriate blood transfusion of platelet was the highest compaved with the lowest proportion of plasma. the proportion of appropriate blood transfusion in operational department is higher than that in non-operational department. The primary reason of inappropriate blood transfusion is transfusion without indications. Conclusion The proportion of appropriate blood transfusion in china is low. The government should enhance the regulation of blood usage,and the public should he educated to realize the importarce of appropriote blood transfusion in order to promote it to develop healthily.

Objective:To study the histogenesis and cell differentiation of desmoplastic ameloblastoma.Methods:The expression of various protein filaments was detected by immunohistochemical stainning in 20 cases of desmoplastic ameloblastoma and the ultrastructure of the tumor was observed in 4 cases.Results:CKH,CK8 and CK19 were positive in spindle-shaped and polygonal epithlium tumor cells.Vimentin was positive in mesenchymal fibrocytes and smooth muscle actin in some mesenchymal cells.Ultrastructural observation found that tonifilaments were in epithelial cells and there were desmosomes between these cells.In stroma myofibroblasts were presented.Loose connective tissue could be seen around some epithelial cell nests.Conclusion:Desmoplastic ameloblastoma may be arise from the early stage of the dental germ formation, epithelial cells of the tumor had the tendency to differentiate to the keratinized cells.

Objective To explore the relevance of the microRNA-192 (miR-192) levels and prognosis in patients with diabetic nephropathy (DN).Methods A total of 59 cases with duration of type 2 diabetes mellitus (T2DM) ≥10 years from January 2010 to July 2011 were retrospectively admitted.The miR-192 levels were determined after admission,and other relevant clinical data were collected.And the patients were followed-up for 24 months.According to the patient's prognosis,the patients were divided into DN group(20 cases) and non-DN group(39 cases),and the relevant information was analyzed in two groups.Results The miR-192 levels in DN group were lower than those in non-DN group[(4.47 ± 2.27) μ g/L vs.(7.28 ± 2.39) μ g/L],and there was significant difference (P ＜ 0.05).Multivariate Logistic regression analysis showed that hypertension history,smoking history,high glycosylated hemoglobin,low fasting C-peptide,low 24 h urine protein,low miR-192 level,high body mass index was the independent risk factors of prognosis of T2DM (P ＜ 0.05).The area under the receiver operating characteristic (ROC) curve was 0.697 in miR-192 levels individual predicting progression to DN stage,0.823 in six others without miR-192.After joining seven indicators forecast area under the curve increased significantly(0.856,95％ CI:0.832-0.904).The miR-192 levels 5.14 μ g/L was the best predictive value to the critical value of community,and the patients were divided into miR-192 ＜ 5.14 μ g/L group (28 cases) and miR-192 ≥ 5.14 μ g/L group (31 cases).The number of progression to DN within 24 months in miR-192 ＜ 5.14 μg/L group was more than that in miR-192 ≥5.14 μ g/L group (16/28 vs.4/31,P ＜ 0.05).Conclusions A reduced level of miR-192 is an independent risk factor that can lead to poor prognosis in patients with DN,and can predict adverse outcomes in patients with T2DM effectively.

Objective To evaluate the influence of ProTaper rotary nickel-titanium files root preparation on root canal filling . Methods 30 cases of molars pulpitis and 20 cases of premolars pulpitis or periapical periodontitis were equally divided into two groups .The group A(30 cases) used the ProTaper rotary nickel-titanium files in root canal preparation and the group B (30 cases) adopted the common K files modified step-back technique for root canal preparation .The influence of the root preparation by 2 sets of apparatus on the effect of root canal filling ,and the several aspects of the root canal filling time ,the matching degree of main root canal file and master gutta-percha ,proper filling rate ,postoperative reaction of root canal filling were compared for conducting the e-valuation .Results In the mean root canal filling time of the group A ,average premolar time was 4 min 25 s and molar was 1 min 30 s ,however in the group B ,average premolar was 5 min 30 s and molar was 11 min 41 s ,the time in the group A was greatly short-ened with statistical difference(P<0 .05);the matching degree of main root canal file and master gutta-percha in the group A was 86 .37% for premolar and 88 .89% for molar ,however in the B group ,which was 62 .50% for premolar and 26 .67% for molar ,the matching degree in the group A was greatly improved with statistical difference between them (P<0 .05);the proper filling rate of upper premolar from the X-ray film was 72 .73% in the group A and 70 .83% in the group B ,while which of molar was 80 .0% in the group A and 77 .78% in the group B ,here was no statistical difference between them (P>0 .05);the postoperative pain reaction of root canal filling in both groups were very low and weak without statistical difference .Conclusion The ProTaper rotary nickel-titanium files root preparation can accelerate the root canal filling speed ,improve the matching degree of main root canal files and master gutta-percha and simplify the root-filling therapy procedure .

Objective To evaluate the clinical efficacy of integration of traditional Chinese and western medicine (ITWM) or pure western medicine on the patients with immune thrombocytopenia (ITP). Methods Randomized controlled trials (RCTs) on ITWM treatment of ITP were searched in PubMed, EMBASE, Wanfang database, CBMDisc, CNKI and VIP. Quality of the RCTs was evaluated strictly, and statistical analysis was performed with Cochrane Collaboration’s RevMan5.1.7 software. Results Twenty-two trials involving 1527 patients were included. The results of Meta-analysis showed that the ITWM treatment of ITP significantly improved the total effective rate [RR=1.23, 95%CI (1.17, 1.29), P<0.000 01] compared with that of pure western medicine treatment. Funnel plot showed that publication bias was small. Meanwhile, peripheral platelet count and the number of megakaryocyte which can generate platelet in bone marrow increased, obvious advantage was showed in long-term effect, and adverse reactions were reduced with ITWM treatment in ITP patients. Conclusion The existed limited evidences suggest that ITWM treatment of ITP can significantly improve clinical efficacy. The quantity and quality of research literature were limited, and well-designed randomized double-blind controlled trials with large sample and multi-centers are required for a more reliable conclusion.

Objective To study the effect of Xuebijing, a Chinese traditional medicine injection, on the THP-1 cells challenged by endotoxin, and to explore whether it induces endotoxin tolerance. Methods The THP-1 cells were pretreated with Xuebijing in different concentrations (10, 25, 50 mg/mL) and times (4, 12, 24 hours), and then challenged by endotoxin. The level of TNF-α in culture supernatant was detected by ELISA assay, and the expression of TLR4 and IRAK-M mRNA were detected by Real time-PCR technique. Results There was no significant difference in TNF-α level among all the groups (pretreated with different concentrations of Xuebijing for different time) (P>0.05). Only in 50 mg/mL Xuebijing group, TLR4 mRNA was 1.547-fold increase in 24 h than in 4 h group (P<0.05). Only when pretreated for 24 h, IRAK-M mRNA was 1.349-fold increase in 50 mg/mL Xuebijing group than in control group (P<0.05). However,there was no significant difference among other groups (P>0.05). Conclusions Xuebijing can not block the release of TNF-α from the THP-1 cells challenged by endotoxin;and it does not induce endotoxin tolerance. When pretreated with high concentration of Xuebijing for long time, the expression of both TLR4 and IRAK-M mRNA is up-regulated, but its significance is not yet clear.

In clinical practice,regional portal hypertension is infrequent,but it is the only type which could be cured of portal hypertension.Pancreatic diseases are the chief pathogeny of regional portal hypertension,and the obstruction of spleen vein is the basic reason.The common clinical manifestation is isolatism varicose veins of pylorus.The golden standard of its iconography diagnosis is DSA,and the treatment should follow the individual principle.The splenectomy is the basic measure for them who have UGIB or hypersplenism.This is a review about recent advance in regional portal hypertension of etiology and classification,pathology and physiology,clinical manifestation,diagnosis,radiographic examination,cure,and so on.

BACKGROUND: A variety of cages for lumbar interbody fusion have been used, which have good mechanics and clinical effects. Conventional posterior fusion requires parallel implantation of two cages, but some researchers believe that single lumbar fusion cage in oblique way is also possible.OBJECTIVE: Through in vitro biomechanical tests, to find a method with favorable effect and little trauma by combination of percutaneous lateral oblique way into the single expansive lumbar fusion cage between the fixed-line operations.DESIGN, TIME AND SETTING: A randomized, controlled experiment was performed at the Shanghai Institute of Biomechanical Engineering between May 2005 and May 2008.MATERIALS: Expansile lumbar interbody fusion cage was simulated from B-Twin Cage (Disc-O-Tech, Israel). Fresh calf lumbar specimens were used.METHODS: Biomechanical tests were performed in 18 specimens of calf lumbar function spinal units (FSU), which were divided into 3 groups: 6 in control group, 6 in single cage groups and 6 in two-cage groups. The biomechanical tests of two experimental groups were performed following tests of intact specimens. Stiffness tests were conducted in the WE-10A MTS,including axial compression, flexion, extension, lateral bending, and torsion.MAIN OUTCOME MEASURES: Axial and torsion stiffness results of each group.RESULTS: The stiffness was greater in two-cage groups compared with single cage group in axial compression and extension, but significant differences were only found in axial compression and extension tests (P < 0.05). The torsion stiffness of single cage group was significantly greater than two-cage groups (P < 0.05).CONCLUSION: Percutanous lumbar interbody fusion by single expansile lumbar interbody fusion cage from lateral approach is feasible theoretically. Biomechanical properties of FSU with B-Twin cage are improved, which contributes a lot to lumbar stability. Compared with posterior approach of single cage, two-cage can provide better stiffness and stability but its torsion stability is lower.