Objective To systematically compare the operative and non-operative treatments of acute injury to the lateral ankle ligaments in terms of efficacy and complications.Methods The databases of MEDLINE (From January 1966 to October 2011 ),EMBASE (From January 1988 to October 2011 ),CBMdisc (From January 1978 to October 2011) and CNKI (From January 1980 to October 2011 ) were researched for eligible randomized-controlled trials (RCTs),controlled clinical trials,quasi randomized controlled trials and cohort study which compared operative and non-operative treatments for acute injury to the lateral ankle ligaments.The methodological quality of the eligible studies collected was evaluated.The data of the studies included were extracted for a Meta analysis to compare the motional recovery,functional stability,re-injury,residual pain and post-treatment complications of the ankle between operative and non-operative treatments.RevMan 5.0 software was used for statistical analysis.Results In all the eligible 13 studies included,713 patients were treated operatively and 817 patients non-operatively.The functional stability of the ankle was significantly better in the operative treatment group than in the non-operative treatment group [ OR =0.72,95％ CI,(0.52,0.99),P ＜ 0.05].The incidence of ankle arthrocleisis in the operative treatment group was significantly higher than in the non-operative treatment group [ OR =3.41,95％ CI (1.56,7.44),P =0.002].There were no statistical differences in the motional recovery [ OR =1.14,95％ CI (0.58,2.21),P＞ 0.05],incidence ofre-injury [OR=0.68,95％ CI (0.35,1.31),P＞0.05],residual pain [ OR =0.81,95％ CI(0.56,1.16),P＞ 0.05],or ankle dyskinesia [ OR =2.38,95％ CI (0.91,6.25),P＞ 0.05]between the 2 groups.The incidences,scar tenderness [01R=7.46,95％CI(1.32,42.08),P ＜0.05]and sensory nerve loss [OR=12.16,95％ CI(2.24,66.02),P ＜0.05]were significantly higher in the operative treatment group than in the non-operative treatment group.The total rate of complications was significantly higher in the operative treatment group than in the non-operative treatment group [0R=6.20,95％ CI (2.67,14.41),P ＜0.05].Conclusions Compared with non-operative treatments,operative treatments for acute injury to the lateral ankle ligaments can significantly improve the functional stability of the ankle,but make no significant differences in the motional restoration,re-injury or the residual pain of the ankle.In addition,operative treatments may increase the risk of complications.

Objective To compare the effects of nasogastric tube and spiral nasointestinal tube on patients with severe brain injury. Methods Pa?tients receiving enteral nutrition with spiral nasointestinal tube or nasogastric tube were collected and investigated to evaluate the two schemes of en?teral nutrition from aspects of coma score,nutrition improvement,and catheter complications and so on. Results Detection of levels of total protein and prealbumin were conducted for all patients at 7 and 15 days after intubation. Each index was higher in the spiral nasointestinal tube group than in the nasogastric tube group. The reflux and aspiration rate was lower in the spiral nasointestinal tube group than in the nasogastric tube group. The dif?ferences were significant(P<0.05). Conclusion Using spiral nasointestinal tube to give enteral nutrition in patients with severe brain injury can improve the nutritional status,reduce complications,which is more contributory to the recovery.

Objective To evaluate the effects of dexmedetomidine used to supplement analgesia with sufentanil on the stress response and inflammatory response after cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty-four patients of both sexes,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ),scheduled for elective cardiac valve replacement with CPB,were randomly divided into sufentanil analgesia group (group S,n =20) and dexmedetomidine supplementing sufentanil analgesia group (group DS,n=24) using a random number table.After induction of general anesthesia,the patients were endotracheally intubated and mechanically ventilated.Combined intravenous-inhalational anesthesia was used to maintain anesthesia.Dexmedetomidine was infused at 0.3 μg · kg-1 · h-1 from closure of the chest to the end of surgery in group DS,while the equal volume of normal saline was given instead in group S.The patient-controlled intravenous analgesia (PCIA) was used for postoperative analgesia.PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline in group S,or sufentanil 2 μg/kg plus dexmedetomidine 3 μg/kg in 100 ml of normal saline in group DS.The PCIA pump was set up with a 0.5 ml bolus dose,a 5 min lockout interval and background infusion at a rate of 1.5 ml/h.Visual analogue scale score was maintained ≤ 3.When visual analogue scale score ≥ 4,morphine 0.1 mg/kg was injected intravenously.The occurrence of analgesics-related respiratory depression,bradycardia and hypotension was recorded.At the end of surgery (T0),and 12,24,48 and 72 h after surgery (T1-4),blood samples were collected from the central vein for determination of serum cortisol,β-endorphin,C-reactive protein,interleukin-2 (IL-2),and IL-6 concentrations by enzyme-linked immunosorbent assay.Results No analgesics-related adverse events were detected in the two groups.Compared with group S,the requirement for morphine was significantly decreased,the serum cortisol concentration was decreased at T2-4 and the serum β-endorphin,C-reactive protein concentrations were decreased at T1-4,the serum IL-2 concentrations were increased at T1-4,and the serum IL-6 concentrations were increased at T3 in group DS (P＜0.05).Conclusion Dexmedetomidine used to supplement analgesia with sufentanil can alleviate the stress response and inflammatory response after cardiac valve replacement with CPB.

BACKGROUND: Lentivirus-mediated RNA interference technology has been widely used in the study of gene function because of its specificity, high inhibition efficiency and persistent effects. Virus packaging, transfection, as well as small hairpin RNA (shRNA)-coding sequence could affect the inhibition efficiency. Therefore, impact factors of RNA interference for human Bax inhibitor 1 (BI-1) was studied in this experiment.OBJECTIVE: To find the valid small interference RNA (siRNA) targeting human BI-1 gene by Lentivirus.DESIGN, TIME AND SETTING: Single sample observation was completed in Department of Medical Genetics, Basic Medical College, Peking University Health Science Center from September 2007 to December 2008.MATERIALS: 293T cell and SH-SY5Y cells were preserved in this laboratory; 4 shRNAs were designed through a use of online design tool by Ambion (www.ambion.com). METHODS: Several recombinant plasmids which expressed shRNAs targeting different regions of the BI-1 gene and labeled enhanced green fluorescent protein as a fusion gene were constructed. Four types of shRNA-expressing virions were obtained by cotransfection of shRNA-expressing plasmid and package protein-expressing plasmids into 293T cells. Green fluorescent protein expression was determined using flow cytometry to search the optimal package conditions. Real-time PCR and beta actin mRNA was used as an internal control, four types of recombinant viral supernatant and control viral supernatant were added on the SH-SY5Y cells, knock-down efficacies of the endogenous BI-1 gene were determined, and the RNA interference effective sequences were optimized. MAIN OUTCOME MEASURES: Intracellular green fluorescent protein expression rate of the cells infected with different packaging virus. RESULTS: The optimal infective packaging virus could be obtained when the ratio of plasmids pLentiLox3.7, REV, VSVG and RRE was 2:1:1:1 and the supernatants were collected 48 hours after transfection. Replacement of culture media 24 hours after transfection could increase the infection efficacy of the virions. shRNA targeting-2-17nt (start coding region) of BI-1 gene was most valid interference efficiency and could decrease the gene expression to 40%. CONCLUSION: Influencing factors of Lentivirus-mediated RNA interference technology virus packages were investigated in this study, which could be a foundation for constructing stable BI-1 knocked down neuronal cell model and for studying the abnormal expression of BI-1 related to the neuron apoptosis disease.

Objective To investigate the effect of ethanol on level of the main hippocampal subtype of muscarinic receptor(M1)in mice,and evalu?ate whether the content change on this receptor could be linked with alterations in cognition,so as to further reveal the mechanism of brain damage in?duced by ethanol. Methods Sixty female mice were randomly divided into four groups. The model mice were induced by intragastric administration of ethanol at dose of 8%,16%,and 32%respectively of 0.2 mL/10 g for 8 weeks according to the protocol,and control group were treated with intra?gastric administration of distilled water. The capability of learning and memory were examined by Morris water maze,and ELISA method was used to measure the M1 receptor content in hippocampus in each group of mice. Results Compared with first day,the mean escape latency period on the fifth day was significantly shortened in each group. There was no significant difference between ethanol and control group for the mean escape latency period on the fifth day. Compared with the control group,the active time in the target quadrant was significantly shortened in 16%and 32%ethanol group. M1 receptor content in hippocampus formation was significantly decreased in all the ethanol group mice. The ethanol concentration was nega?tive correlated with the M1 receptor content. Conclusion Chronic alcoholism can induce the memory impairment in mice,which might be associat?ed with the low level of M1 receptor subtype in hippocampus of mice.

Background: Placental multidrug resistance?associated protein 2 (MRP2), encoded by ABCC2 gene in human, plays a significant role in regulating drugs'' transplacental transfer rates. Studies on placental MRP2 regulation could provide more therapeutic targets for individualized and safe pharmacotherapy during pregnancy. Currently, the roles of epigenetic mechanisms in regulating placental drug transporters are still unclear. This study aimed to investigate the effect of histone deacetylases (HDACs) inhibition on MRP2 expression in the placental trophoblast cell line and to explore whether HDAC1/2/3 are preliminarily involved in this process. Methods: The human choriocarcinoma?derived trophoblast cell line (Bewo cells) was treated with the HDAC inhibitors?trichostatin A (TSA) at different concentration gradients of 0.5, 1.0, 3.0, and 5.0 μmol/L. Cells were harvested after 24 and 48 h treatment. Small interfering RNA (siRNA) specific for HDAC1/HDAC2/HDAC3 or control siRNA was transfected into cells. Total HDAC activity was detected by colorimetric assay kits. HDAC1/2/3/ABCC2 messenger RNA(mRNA) and protein expressions were determined by real?time quantitative polymerase chain reaction and Western?blot analysis, respectively. Immunofluorescence for MRP2 protein expression was visualized and assessed using an immunofluorescence microscopy and ImageJ software, respectively. Results:TSA could inhibit total HDAC activity and HDAC1/2/3 expression in company with increase of MRP2 expression in Bewo cells.Reduction of HDAC1 protein level was noted after 24 h of TSAincubation at 1.0, 3.0, and 5.0 μmol/L (vs. vehicle group, all P < 0.001), accompanied with dose?dependent induction of MRP2 expression (P = 0.045 for 1.0 μmol/L, P = 0.001 for 3.0 μmol/L, and P < 0.001 for 5.0 μmol/L), whereas no significant differences in MRP2 expression were noted after HDAC2/3 silencing.Fluorescent micrograph images of MRP2 protein were expressed on the cell membrane. The fluorescent intensities of MRP2 in the control, HDAC2, and HDAC3 siRNA?transfected cells were week, and no significant differences were noticed among these three groups (all P > 0.05). However, MRP2 expression was remarkably elevated in HDAC1 siRNA?transfected cells, which displayed an almost 3.19?fold changes in comparison with the control siRNA?transfected cells (P < 0.001). Conclusions:HDACs inhibition could up?regulate placental MRP2 expression in vitro,and HDAC1 was probably to be involved in this process.

OBJECTIVETo explore the in vitro anti-tumor effect and mechanism of dendritic cell (DC) tumor vaccine induced by astragalus polysacharin (APS).

METHODSPeripheral blood mononuclear cells (PBMCs) isolated from human peripheral blood. DCs obtained from human peripheral blood were cultivated and added with culture solution for in vitro inducing them to immature DCs. On the 5th day of culture, 100 microg/mL (as the final concentration) APS was added to cells in the APS group. DCs were induced to mature in the cytokine groups by adding 20 ng/mL rhTNF-alpha (as the final concentration). Changes of morphology and phenotype of DCs were observed. Mature DCs were sensitized with tumor antigen SGC-7901 and co-cultured with allogeneic T cells. The proliferative function of T lymphocytes was detected by MTT assay. Levels of IL-12 and IFN-gamma in co-cultured supernatant were detected by ELISA. Cytotoxic lymphocytes (CTL) activated by DC were co-cultured with tumor cell SGC-7901. The specific killing capacity of CTL to target cells was detected by LDH release assay.

RESULTSThe morphological observation and phenotypic identification of APS induced DCs were in accordance with the characteristics of mature DCs. APS induced mature DCs could stimulate the proliferation of allogeneic T lymphocytes. The proliferation index of T cells increased with increased ratio of stimulator cells to effector cells (P < 0.05). Levels of IL-12 and IFN-gamma in co-culture supernatant significantly increased in a time-dependent manner (P < 0.05). CTL cells activated by sensitization of DCs could significantly kill tumor cells, and the killing effect increased along with increased effector-to-target ratio.

CONCLUSIONAPS could in vitro induce DCs to mature, promote its antigen-presenting capacity, effectively activate CTLs, and enhance anti-tumor function of the organism.

Antigen-Presenting Cells ; cytology ; drug effects ; immunology ; Cancer Vaccines ; immunology ; Cell Line ; Cell Proliferation ; drug effects ; Coculture Techniques ; Dendritic Cells ; cytology ; drug effects ; immunology ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Interferon-gamma ; immunology ; Interleukin-12 ; immunology ; Leukocytes, Mononuclear ; cytology ; immunology ; Lymphocyte Activation ; T-Lymphocytes, Cytotoxic ; cytology ; drug effects

OBJECTIVETo investigate the impact of ethanol extracts from Sedum sarmentosum (ESB) on STAT-3 signaling and its probable molecular mechanism in inducing apoptosis.

METHODMTT assay was used to detect the impact of ESB on HepG2 cell proliferation. FITC-Annexin V-FITC /PI double-labeling were used to investigate the impact on hepatoma carcinoma cell apoptosis. Western blot analysis was used to test the expression levels of cell apoptosis-related proteins Caspase-3, Caspase-9, PARP, P-STAT-3 (Tyr705) , STAT-3, Bcl-2, Mcl-1.

RESULTESB could notably inhibit proliferation of HepG2 cells, and induce HepG2 cell apoptosis, with the dose-dependent inhibitory effect. In addition, ESB could inhibit STAT-3 signaling, down-regulate Mcl-1 and Bcl-2 expressions, and induce degradation/activation of apoptosis-related proteins Caspase-3 and Caspase-9 and PARP degradation in a dose-dependent manner.

CONCLUSIONESB inhibits HepG2 cell proliferation and induces apoptosis by inhibiting STAT-3 signaling and Mcl-1 and Bcl-2 expressions.

Apoptosis ; drug effects ; Blotting, Western ; Caspase 3 ; metabolism ; Caspase 9 ; metabolism ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Ethanol ; chemistry ; Flow Cytometry ; Hep G2 Cells ; Humans ; Myeloid Cell Leukemia Sequence 1 Protein ; metabolism ; Plant Extracts ; chemistry ; pharmacology ; Poly(ADP-ribose) Polymerases ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; STAT3 Transcription Factor ; metabolism ; Sedum ; chemistry ; Signal Transduction ; drug effects ; Time Factors

Objective To observe the curative effect of low molecular heparin for treating secondary high coagulation state in the patients with nephrotic syndrome(NS) .Methods Total 87 cases of NS in our hospital were divided into the conventional treat‐ment group (n=42) and the low molecular heparin treatment group (n=45) .The routine treatment group was given the prednisone treatment and the low molecular heparin treatment group was treated by low molecular heparin combined with prednisone .The re‐lated indicators of blood coagulation before and after treatment were detected and the clinical curative effects in two groups were an‐alyzed .Results The coagulation related indicators in the conventional treatment group had no statistically significant difference be‐tween before and after treatment (P>0 .05) ,the prothrombin time(PT) and activated partial thrombin time(APTT) after treat‐ment in the low molecular heparin treatment group were significantly extended compared with before treatment ,while the concen‐trations of D‐dimer and fibrinogen were significantly decreased and the concentration of antithrombin Ⅲ was markedly increased compared with before treatment ,showing statistically significant differences between the two groups (P<0 .05);the patients of the low molecular heparin group patients had no bleeding after treatment .Conclusion Low molecular heparin combined with predni‐sone can reduce the secondary high condensation state in NS without bleeding and has a significantly clinical effect .

Objective To compare the dosimetric parameters of volumetric modulated arc therapy(VMAT),fixed field intensity modulated radiation therapy(IMRT)and three-dimensional conformal radiotherapy(3D-CRT)in the radiotherapy for the patients with locally recurrent nasopharyngeal carcinoma, and to analyze their characteristics. Methods Twelve patients with locally recurrent nasopharyngeal carcinoma were treated with VMAT, IMRT and 3D-CRT plan designed by Pinnacle 9.2 and Preciseplan 2.03 treatment planning system.The dosimetric parameters of targeted volumes and organs at risk were compared between three groups. Results The conformation indexes (CI)of VMAT and IMRT plans were similar,and they were both better than 3D-CRT plan,the difference was significant(P<0.05).The homogeneity index(HI)in three groups were similar,there were no statistically significant differences between them(P>0.05).The monitor units(MU)and beam time in 3D-CRT group were better than those in other two groups,and VMRT group was better than IMRT group,the statistical differences were observed between three groups (P<0.05 ).There were no statistical differences of organs at risk such as brainstem and lens between three groups(P>0.05).The doses of the spinal cord,optic nerve,optic chiasm and temporal lobe of brain in VMAT and IMRT groups were better than those in 3D-CRT group,there were statistical differences between them(P<0.05),and the data in VMAT and IMRT groups were similar,and there were no statistical differences(P>0.05).Conclusion There are differences of the targeted dose distribution between the three kinds of radiation technology, while VMAT and IMRT plans can cover the targeted areas and reduce the received doses of organs at risk.The CI,MU and beam time of VMAT plan are better than those of IMRT plan. 3D-CRT plan only has advantage in the MU and beam time.