Objective To investigate p75 NTR expressing neurons and hyperphosphorylated tau protein containing neurons in the hippocampal CA1 subfield of Alzheimer's disease. Methods Samples of hippocampus of 10 female AD patients and 10 non-demented female controls matched with age and postmortem delay were obtained from the Netherlands Brain Bank. The main body of hippocampus was dissected, dehydrated and embedded in paraffin. Serial 6-?m coronal sections were cut, and 3 successive sections were selected. The first section was stained with 0.5% thionin, the second was processed for p75 NTR immunocytochemistry and the third was processed for p75 NTR double-labeling immunocytochemistry with Alz-50. For quantitative analysis of the total number of neurons, p75 NTR expressing neurons and neurons colocalizing p75 NTR and Alz-50 in the CA1 subfields, a MetaMorph image acquisition and processing software (Universal Imaging Corp, USA) was used.Results The total number of neurons, p75 NTR immunoreactive neurons and ratio of the latter to the former in 1 mm2 of the CA1 subfield of AD patients were 293.2?37.0, 116.0?20.4 and 39.7%?5.3%, respectively, of controls were 473.6?63.1, 136.7?24.4 and 28.9%?3.7%, respectively. There was significant decrease in the total number of neurons of the AD patients in comparison with controls (P=0.000 2). However, the ratio of p75 NTR neurons to total number of neurons was significant increase in AD patients compared with controls (P=0.001). The number of Alz-50 neurons, Alz-50 and p75 NTR double-labeling neurons and ratio of the latter to the former in 1 mm2 of the CA1 subfield of AD patients were 87.5?29.2, 76.4?26.6 and 86.6%?5.0%, respectively. Furthermore, the number of p75 NTR containing neurons was significantly correlated to the number of Alz-50 expressing neurons (r=0.79, P=0.006). Conclusion The p75 NTR may interact with hyperphosphorylated tau protein and involve in the pathogenesis of Alzheimer′s disease.

Objective To investigate effects of α-crystallin on proliferation of lipopolysaccharide (LPS)-activated retinal microglia and bioactivity of iNOS.Methods The retinal microglial cells cultured in vitro were analyzed and their purity was identified by cell immunofluorescence and flow cytometry.After microglia cells being intervened using LPS and α-crystallin at various concentrations,influence of α-crystallin on activity of LPS-activated retinal microglia was detected by MTT method and level of NO was measured by RT-PCR to observe changes of iNOS expression in microglia.Results Purity of primary cultured microglial cells was 94.15％ by GSA-IB4 immunohistochemical identification and 93.34％ by CD11b flow cytometry.α-crystallin of 10-4g/L awakened activity of microglia induced by 10-6g/L LPS (P ＜ 0.01).Expressions of iNOS protein and mRNA showed significant decrease in combined treatment group (P ＜ 0.05).Conclusion In clinical condition,α-crystallin decreases the harm of microglial cells on retinal ganglial cells (RGCs) after optical nerve injury by inhibiting the microglia cells to produce NO and iNOS.

OBJECTIVE: To explore the effect of Mimics assisted virtual reduction and personalized additional fixation with proximal femoral nail anti rotation in the treatment of unstable intertrochanteric fracture of lateral wall. METHODS: From January 2015 to June 2018, 11 cases of intertrochanteric fracture with unstable lateral wall injury were analyzed retrospectively, including 3 males and 8 females, aged 64 to 81 years old. There were 3 cases of A3.1, 6 cases of A3.2 and 2 cases of A3.3 according to AO classification. All patients underwent CT scanning, according to the CT scanning data, three-dimensional reconstruction of fracture was performed by Mimics soft. Virtual reduction was performed first, and PFNA was implanted after satisfactory reduction. According to the relationship between the fracture characteristics of the lateral wall and the position of the lag screw tail in the lateral wall, 4 cases were treated with PFNA and titanium cable or steel wire, and 7 cases were treated with PFNA and reconstruction locking plate.The quality of reduction and healing were evaluated by follow up, and Harris score of hip joint was performed in the last reexamination. RESULTS: All patients were followed up for 12 to 18 months. No postoperative infection of incision and loosening of internal fixation occurred. The time of fracture healing was 12 to 20 weeks. At the final follow up, Harris score of hip joint was excellent in 6 cases, good in 3 cases and fair in 2 cases. CONCLUSION The treatment of intertrochanteric fracture of femur with Mimics assisted virtual reduction and PFNA is helpful to preoperative planning and improve the surgical effect.
Aged ; Aged, 80 and over ; Bone Nails ; Female ; Fracture Fixation, Intramedullary ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Software ; Treatment Outcome

Traditional ophthalmic pharmaceutical preparations are mostly eye drops or eye ointments, which have the disadvantages of low efficiency and poor patient compliance in application.Drug-loaded contact lenses can overcome these shortcomings and have attracted much attention.Improving drug loading capacity and enhancing sustained-release performance of drug-loaded contact lenses are the main focus of research and development.In recent years, drug-loaded contact lenses made of molecularly imprinted hydrogel can significantly improve drug loading capacity and sustained-release performance, and have been widely studied.The application status of molecularly imprinted hydrogel drug-loaded contact lenses in the delivery of ophthalmic drugs, as well as the effects of various factors on drug loading capacity and sustained-release performance were reviewed in this article.

Objective The aim of this study was to investigate the relationship between peripheral plasma stem cell factor (SCF)/c-kit levels and the types of dipper and non-dipper hypertension in hypertensive patients. Methods This cross-sectional study included newly diagnosed hypertensive patients who underwent 24-hour ambulatory blood pressure monitor (ABPM) between January 2009 and 2012 in Jiangning city. Patients were divided into the dipper group and the non-dipper group according to ABPM measurements. The levels of SCF and its receptor c-kit, tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) in peripheral blood were measured via enzyme-linked immunosorbent assays. The serum levels of glucose and lipid were examined as well. The levels of SCF/c-kit were compared between the dippers and the non-dippers; and their correlation with 24-hour mean systolic blood pressure (MSBP), 24-hour mean diastolic blood pressure (MDBP), TNF-α and IL-6 were investigated using linear regression analyses statistically. Results A total of 247 patients with newly diagnosed hypertension were recruited into the study, including 116 non-dippers and 131 dippers. The levels of peripheral plasma SCF were higher in non-dipper group (907.1±52.7 ng/L vs. 778.7±44.6 ng/L; t=2.837, P<0.01), and the levels of c-kit were higher in non-dipper group too (13.2±1.7 μg/L vs 9.57±1.4 μg/L; t=2.831, P<0.01). Linear regression analysis revealed that SCF/c-kit levels were significantly positively correlated with MSBP, MDBP, plasma TNF-α, and IL-6 levels (all P<0.01). Conclusions Peripheral plasma SCF/c-kit levels are higher in patients with non-dipper hypertension than those with dipper one, and significantly correlate with 24-hour MSBP, 24-hour MDBP, serum TNF-α and IL-6 levels.

OBJECTIVETo analyze the clinical application value of the 7th edition UICC-AJCC TNM pT classification of gastric cancer.

METHODSThe classification of tumor invasion depth of 874 cases of gastric cancer was determined using the 7th edition UICC-AJCC TNM classification and the relationships of prognosis with clinicopathological factors was compared with that obtained using the 6th edition TNM classification.

RESULTSThe 5-year survival rates according to the 6th edition pT1, pT2, pT3, pT4 were 98.4%, 55.8%, 26.0% and 24.5%, respectively, showing a significant difference among the four substages (P<0.001). The 5-year survival rates according to the 7th edition pT1a, pT1b, pT2, pT3, pT4a, and pT4b were 98.6%, 98.2%, 75.8%, 48.9%, 26.0% and 24.5%, respectively, and there were significant differences in survival time among the six substages (P<0.001). According to the 7th edition TNM classification, for the pT2 and pT3 patients groups, the 5-year survival rates of the 7th edition pN0 (without lymphatic metastasis) were 84.8% and 77.9%, respectively, showing no significant difference between the two survival rates (P=0.204). The 5-year survival rates according to the 7th edition pNx (with lymphatic metastasis) were 66.9% and 37.5%, respectively, and there was a significant difference between the two survival times (P<0.001). In multivariate analysis, the 7th edition pT stage, vascular or lymphatic invasion, the 6th edition pT staging and primary tumor site were independent prognostic factors in patients with gastric cancer (P<0.05), and the relationship of the staging of the 7th version of pT was more close with the prognosis of patients with gastric carcinoma than that of the 6th edition of pT staging system.

CONCLUSIONThe 7th edition UICC-AJCC classification of pT staging of gastric cancer patients has a better prognostic predictive value than the 6th edition.

Humans ; Lymphatic Metastasis ; Neoplasm Staging ; Prognosis ; Stomach Neoplasms ; diagnosis ; Survival Rate

Objective To evaluate the effect of epidural block on postoperative long-term quality of life in patients undergoing radical operation for lung cancer under general anesthesia. Methods A total of 348 patients with primary non-small cell lung cancer of both sexes, aged 18-80 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, with body mass index of 18-30 kg∕m2, with International Associa-tion for the Study of Lung Cancer staging criteria stage 1-2, scheduled for elective radical operation for lung cancer under general anesthesia, were divided into 2 groups ( n＝174 each) using a random number table method: general anesthesia plus patient-controlled intravenous analgesia ( PCIA) group ( group G) and general anesthesia plus epidural anesthesia plus patient-controlled epidural analgesia group ( group GE). Anesthesia was induced by target-controlled infusion of propofol and fentanyl and intravenous injection of rocuronium. The patients were tracheally intubated and mechanically ventilated to maintain the end-tidal pressure of carbon dioxide at 30-40 mmHg. Anesthesia was maintained by target-controlled infusion of propofol and intravenous injection of remifentanil. An increment of fentanyl was given immediately after chest opening and closing, and cisatracurium besylate was injected intravenously. In group GE, 0. 375%ropivacaine was epidurally injected in a initial dose of 5-8 ml followed by continuous epidural infusion at 5 ml∕h, and infusion was stopped before closing the chest. Bispectral index value was maintained at 40-60 during operation. PCIA was performed at the end of operation with fentanyl, flurbiprofen, ramosetron or palonosetron hydrochloride, and the PCA pump was set up with a 0. 5 ml bolus dose, a 15-min lockout in-terval and background infusion at a rate of 2 ml∕h in group G. Patient-controlled epidural analgesia was per-formed with 0. 15%-0. 18% ropivacaine 250 ml, and the PCA pump was set up to deliver 2-3 ml bolus dose with a 20-min lockout interval and background infusion at 4-5 ml∕h in group GE. Postoperative analge-sia was performed until 48 h after operation in both groups. Patients were followed up by telephone at half a year and 1 and 2 yr after operation. The 12-item short-form scale was used to evaluate the quality of life. Physical component summary (PCS-12) and mental component summary (MCS-12) scores were calculated. Results PCS-12 and MCS-12 scores were significantly lower at 2 yr after operation than at half a year in both groups (P＜0. 05). Compared with group G, PCS-12 and MCS-12 scores were significantly increased at 2 yr after operation in group GE (P＜0. 05). Conclusion Compared with general anesthesia alone, epi-dural block provides better effect on postoperative long-term quality of life in patients undergoing radical op-eration for lung cancer under general anesthesia.

Objective To assess the influence between managements in emergency room(ER) andoutcome of severe traumatic brain injury (TBI),in order to provide inference for treatment.Methods A retrospective analysis was performed in severe TBI patients and recorded next indexes.(1) The managements in ER,including endotracheal intubation and oxygenation,fluid resuscitation,and mannitol intake.(2) The vital signs arriving at ICU,including systolic pressure and blood oxygen saturation.(3) Prognostic indicators including inhospital mortality and days during ICU,the scores of Glasgow outcome scale (GOS) at discharge and 6 months after injury.Results In 140 severe TBI patients,65 patients (46.4％) died during ICU.The mortality of patients with endotracheal intubation [65.0％ (39/60)] was significantly higher than that without endotracheal intubation [32.5％(26/80)](P＜ 0.01).The mortality in whether fluid resuscitation and using mannitol had no significant difference [44.7％ (46/103) vs.51.4％ (19/37),49.2％ (31/63) vs.44.2％ (34/77)] (P ＞0.05).In days during ICU,there was no significant difference among the three treatment measures (P＞ 0.05).In GOS grade at discharge and 6 months after injury,the proportion of 4 and 5 grade were 8.3％ (5/60) and 25.0％ (15/60) in patients with endotracheal intubation,while 27.5％ (22/80) and 52.5％ (42/80) in patients without endotraeheal intubation (P ＜ 0.01).In fluid resuscitation and using mannitol patients,there were no significant difference(P ＞ 0.05).Conclusion Treating severe TBI patients in ER,endotracheal intubation should be carefully chosen,fluid resuscitation and mannitol may not be given.

OBJECTIVESTo explore the mechanisms of neuronal loss and apoptosis in the brains of Alzheimer's disease (AD) patients, through studying the expression of proteins related to signal transduction pathways, which are important for neuron survival.

METHODS(1) Immunohistochemistry: Sections were double stained with Tunel and NSE antibodies. (2) The hippocampal tissue taken from 6 cases of AD and 6 cases of non-AD brains was homogenized. Protein estimation was done by Lowry method. Equal amounts of protein were taken from each specimen and immunoprecipitation was performed and analyzed by Western blot; color development was done by alkaline phosphatase method or luminol reagent.

RESULTS(1) Tunel positive neurons were found in both AD and non-AD brains, but the number in the former was more than the latter. (2) The AD hippocampal tissue showed diminished expression of Akt/PKB, CREB, P-CREB, increased expression of apoptosis-related protein apoptosis-inducing factor, and diminished expression of apoptosis-related protein bcl-2. The expression of bax did not change.

CONCLUSIONSDiminished expression of CREB, P-CREB, bcl-2 in AD hippocampus indicates that the neuron survival signal transduction pathway in AD brains is impaired. Neurons are in apoptotic or pro-apoptotic state. In addition, increased expression of apoptosis-inducing factor, diminished expression of bcl-2, which is an anti-apoptotic factor, promotes further neuron apoptosis.

Aged ; Aged, 80 and over ; Alzheimer Disease ; metabolism ; pathology ; Apoptosis ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Humans ; Male ; Neurons ; metabolism ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Signal Transduction ; physiology

OBJECTIVETo investigate the neuroprotective effects of glycyrrhizin (Gly) as well as its effect on expression of high-mobility group box 1 (HMGB1) in rats after traumatic brain injury (TBI).

METHODSMale Sprague-Dawley rats were randomly divided into three groups: sham group, TBI group, and TBI+Gly group (n=36 per group). Rat TBI model was made by using the modified Feeney's method. In TBI+Gly group, Gly was administered intravenously at a dosage of 10 mg/kg 30 min after TBI. At 24 h after TBI, motor function and brain water content were evaluated. Meanwhile, HMGB1/HMGB1 receptors including toll-like receptor 4 (TLR4) and receptor for advanced glycation end products (RAGE)/nuclear factor-κB(NF-κB) signaling pathway and inflammatory cytokines in the injured brain tissues were detected using quantitative real-time polymerase chain reaction, western blot, electrophoretic mobility shift assay and enzyme-linked immunosorbent assay. Furthermore, HMGB1, RAGE and TLR4 immunohistochemistry and apoptosis were analyzed.

RESULTSBeam walking performance impairment and brain edema were significantly reduced in TBI+Gly group compared with TBI group; meanwhile, the over-expressions of HMGB1/HMGB1 receptors (TLR4 and RAGE)/NF-κB DNA-binding activity and inflammatory cytokines were inhibited. The percentages of HMGB1, RAGE and TLR4-positive cells and apoptotic cells were respectively 58.37% ± 5.06%, 54.15% ± 4.65%, 65.50% ± 4.83%, 52.02% ± 4.63% in TBI group and 39.99% ± 4.99%, 34.87% ± 5.02%, 43.33% ± 4.54%, 37.84% ± 5.16% in TBI+Gly group (all P<0.01 compared with TBI group).

CONCLUSIONGly can reduce secondary brain injury and improve outcomes in rat following TBI by down-regulation of HMGB1/HMGB1 receptors (TLR4 and RAGE)/NF-κB-mediated inflammatory responses in the injured rat brain.

Animals ; Brain Injuries ; drug therapy ; Glycyrrhizic Acid ; pharmacology ; therapeutic use ; HMGB1 Protein ; metabolism ; Male ; Neuroprotective Agents ; therapeutic use ; Rats ; Rats, Sprague-Dawley