In teaching of intra-arterial thrombolysis of ischemic stroke, introducing the method of problem-based learning ( PBL ) to improve the students' learning initiative and stimulate the students' interest in search of knowledge, and guide students to form scientific clinical thinking. Through further participation in surgery, promoting the combination of theory and practice. PBL can help to improve students' ability to analyze and solve problems related to intra-arterial thrombolysis of ischemic stroke.

Intracranial atherosclerosis is one of the important causes of ischemic stroke. Because extra- and intracranial arteries have differences in the structure and hemodynamics, the effects of traditional vascular risk factors, including sex, age, hypertension, and diabetes mellitus, on extra-and intracranial atherosclerosis are also different. The early identification of the risk factors for intracranial atherosclerosis has important significance for aggressively preventing and treating intracranial atherosclerosis and reducing the incidence of ischemic stroke. However, many research conclusions aiming at the risk factors and intracranial ng andatherosclerotic correlation are not consistent. This article reviews the research status quo of the risk factors for intracranial atherosclerosis.

Atherosclerosis is the important pathologic basis of coronary artery disease,cerebrovascular disease,peripheral arterial disease and other vascular diseases.Studies have shown that the atheromatous plaques occur mainly in regions of curvature,bifurcation,and branching of the artery,indicating that low flow shear stress is closely associated with the occurrence of atherosclerosis.Low flow shear stress involves in the induction of atherosclerosis through acting on mechanosensitive molecules in endothelial cell that transduce mechanical stimuli into chemical signals,activate the corresponding intracellular signaling pathways.This article reviews the relationship between low flow shear stress and atherosclerosis.

Objective To investigate the correlation between the-1562 C/T polymorphism of matrix metalloproteinase-9 (MMP-9) and the risk of ischemic stroke.Methods All the relevant literatures published were searched from PubMed,Embase,MEDLINE,Web of Science as well as CBMdisc and CNKI before May 2013.After extracting data,a meta-analysis of the studies meeting the requirements was conducted by using Review Manager Version 5.0 and Stata 11.0 software.The effect size was pooled and odds ratio (OR) and 95％ confidence interval (CI) were calculated.Results Six studies were enrolled,including 1115 patients and 979 controls.The ORs after pooled analysis (95％ CIs) were C/T vs.C/C:1.10 (0.71-1.71) and T/T vs.C/C:1.78 (0.89-3.57) of the codominant genetic model,respectively; C/T + T/T vs.C/C:1.13 (0.76-1.67) of the dominant genetic model; T/T vs.C/T + C/C:1.79 (0.90-3.57) of the recessive genetic model,which suggested that there was no significant correlation between the-1562 C/T polymorphism of MMP-9 gene and the risk of ischemic stroke.The analysis of 5 studies in Chinese populations showed that the ORs (95％ CIs) of the above 4 genetic models were 1.24 (0.76-2.04),1.43 (0.52-3.92),1.25 (0.80-1.97),and 1.33 (0.49-3.62),respectively.There were also no significant differences.Conclusions According to the analysis of the available literatures,there was no significant correlation between the-1562 C/T polymorphism of MMP-9 gene and the risk of ischemic stroke.

Objective:To analyze the curative effect of discectomy under Quadrant expandable channel associated with annulus repair for the treatment of adolescent lumbar disc herniation (ALDH).Methods:10 ALDH patients received discectomy under Quadrant expandable channel associated with annulus repair (annulus repair group) and 12 patients received discectomy (control group) in Clinical Medical College of Yangzhou University from January 2013 to December 2017 were retrospectively collected. The length of skin incision, amount of intraoperative bleeding, operation time and duration of hospitalization were compared. The degree of pain was assessed by visual analogue scale (VAS) before operation, 24 h, 1 week and 1 year after operation, and the lumbar function was assessed by Oswestry disability index (ODI) before operation, 1 week and 1 year after operation. At the last follow-up, the curative effect was evaluated by MacNab Scale, and the recurrence of lumbar disc herniation during the follow-up was recorded.Results:There were no significant differences in the amount of intraoperative bleeding, operation time and duration of hospitalization between the two groups ( P>0.05). The skin incision length of the annulus repair group was less than that of control group ( P<0.05). The postoperative VAS score and ODI score at each follow up time point in both groups were significantly improved when compared with the preoperative ones ( P<0.05). There were no statistically significant difference between the two groups in the VAS score and ODI score 1 week postoperative and 1 year postoperative ( P>0.05). According to the MacNab criteria, there was no statistically significant difference between the two groups in the excellent and good rate (annulus repair group: 9/10, control group: 10/12; P>0.05). There was no recurrence case in the annulus repair group, but two cases of recurrence (one recovered by conservative treatment, the other needed second operation) in the control group ( P<0.05). Conclusions:Discectomy under Quadrant expandable channel associated with annulus repair can achieve early satisfied outcome, reduce surgery related trauma, pain in the early period postoperative and recurrence rate after operation in the treatment of ALDH.

Aim To study the expression of β-NGF gene in the mammlian cells and the biological activity of its expression products. Methods The β-nerve growth factor (β-NGF) cDNA which obtained from the plasmid pGEM-β-NGF by enzyme digestion analysis was cloned into the expression vector pcDNA3 to construct the recombinant plasmid pcDNA3-β-NGF. COS-7-cell line grown to log phase was transfected using lipofectamine reagent. The expression level of β-NGF mRNA and the biological activity were analyzed by Northern blot and observation of neurite outgrowth of PC12 cell line stimulated by supernatant, respectively. Results The β-NGF gene was expressed successfully in COS-7 cell lines. The culture supernatant of the positive COS-7 cells transfected with pcDNA3-β-NGF could stimulate the neurite outgrowth of PC12 cell line. Conclusion The target gene expressed successfully in the transfected COS-7 cell line and had good biological activity.

Objective To observe the effect of peroxisome proliferators activated receptor gamma(PPAR-?)on phenotypic transforming of vascular smooth muscle cells(VSMC)in hypertension.Methods Spontaneous hypertension rats(SHR)and WKY rats both aged 4 months were included.SHR rats as well as WKY rats were divided to be fed with normal chow,and chow added with rosiglitazone(10 mg?kg-1?d-1)for 16 weeks.VSMC were isolated from SHR rats and WKY rats and cultured by patch-attaching method,then respectively divided into 3 groups after treated with genetic recombination technology:normal VSMC,PPAR? overexpressed VSMC and PPAR? silenced VSMC.Expressions of OPN and ?-SMA,which respectively represent the undifferentiated and differentiated VSMC,were detected by Western blotting.Cell proliferation was determined by detecting DNA synthesis and cell counting.The changes of arteries were evaluated pathologically.Results Rosiglitazone decreased blood pressure and ameliorated vascular remodeling of aorta in SHR rats.Aorta of SHR showed an upregulation of OPN and downregulation of ?-SMA,which could be inhibited by rosiglitazone.VSMC from SHR rats showed an upregulation of OPN and downregulation of ?-SMA,and increased cell proliferation.These changes were all inhibited by rosiglitazone.In the cells that overexpressed PPAR?,the cell proliferation rate was lower,and the expressions of OPN and ?-SMA were depressed,compared with the corresponding control cells.Conclusion PPAR-? could inhibit the phenotypic transforming of VSMC,and this might be responsible for the amelioration of vascular remodeling in hypertension.

Objective: To study the optimal combined ratio of baicalin, icariin and Astragalus saponin I from a Chinese herbal compound Biminne. Methods: Firstly, a mouse model of allergic rhinitis was established by intraperitoneal injection of ovalbumin (OVA) and aluminum hydroxide gel suspension, and the effective dose range of baicalin, icariin and Astragalus saponin I was detected by 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide inner salt method. Secondly, 10 groups of combinations of baicalin, icariin and Astragalus saponin I assembled by U*(10)(10(8)) form were employed to determine the optimal combination by means of analyzing of the inhibitory effect on the splenocyte proliferation. Finally, the effects of each effective ingredient and the optimal combination were compared by observing the splenocyte proliferation, the contents of interleukin-4 (IL-4), IL-5, interferon-gamma (IFN-gamma) in supernatant of the splenocyte cultures and the ratio of IL-4 to IFN-gamma in order to verify the result. Results: Baicalin or icariin at concentrations ranging from 2 to 10 mumol/L, and Astragalus saponin I from 1 to 10 mumol/L effectively suppressed the splenocyte proliferation. When the proportion of baicalin, icariin and Astragalus saponin I was 1:2.14:2.65, the inhibitory effect was most remarkable. Further research confirmed the rationality of the optimal combination. Conclusion: An optimal combination of the major effective ingredients from Chinese herbal compound Biminne most effectively suppresses the proliferation of splenocytes from sensitized mice and regulates the cytokine secreting.

BACKGROUND:Vertebroplasty and kyphoplasty have been widely applied in the treatment of osteoporotic thoracolumbar compression fracture. However, cement leakage is a major problem in the application of this technology, especial y for the vertebral posterior wal ruptured patients. OBJECTIVE:To investigate the therapeutic efficacy of high viscosity bone cement and vertebroplasty in the treatment of osteoporotic thoracolumbar compression fracture. METHODS:A retrospective study was conducted in 20 cases receiving high viscosity bone cement and vertebroplasty surgery for osteoporotic thoracolumbar compression fracture. Clinical outcomes were evaluated mainly with use of Visual Analog Scale for lower back pain. Function of lower back pain was assessed using Oswestry Disability Index questionnaire. Quality of life was evaluated using 36-Item Short Form Health Survey and Frankel score was applied to evaluate neurological function. The anterior vertebral height of the fractured vertebrae was assessed with X-ray. The bone cement leakage, pulmonary embolism, incidence of nearby vertebral fractures and other complications were evaluated during fol ow-up. RESULTS AND CONCLUSION:Al patients were fol owed up for 12-18 months. The anterior vertebral height of the fractured vertebrae, the lower back pain and function, and quality of life were improved significantly after treatment (P<0.05). Al patients got the same neurological symptoms before surgery. The bone cement dispersion was good after treatment, detected by X-ray and CT scan, only two cases appeared with bone cement leakage, but no clinical symptoms were found. There was no cement toxicity or al ergic complications, pulmonary embolism, infection, nerve injury or new fractures. The high viscosity bone cement used in the treatment of osteoporotic thoracolumbar vertebral compression fractures can significantly relieve thoracic back pain, improve lower back function and quality of life, and greatly reduce the risk of bone cement leakage.

Objective To investigate the hospitalized patients incidence of nutritional risk and nutritional support in six departments (general surgery, thoracic surgery, gastroenterology, neurology, urology and respirology) in a middle hospital and in the medical/surgical departments in a small hospital, so provide reference for rational nutritional support for patients. Method Nutritional Risk Screening 2002 was used to assess the existence of nutritional risk and the necessity of nutritional support. Results The overall prevalence of the nutrition risk was 25% in the six departments in the middle hospital; more specifically, the prevalence of nutrition risk arranged from 18% to 31% in these six departments: 31% in the department of respiratory medicine, 29% in the department of neurology, 27% in the department of urology, 23% in the department of thoracicsurgery, 22% in the department of gastroenterology, and 18% in the department of general surgery. For those at nutritional risk, the nutritional support rate was 24%. For non-risky patients, 9% received nutritional support. The overall prevalence of nutrition risk was 18% in the small hospital; more specifically, the prevalence of nutrition risk was 29% in the department of internal medicine and 7% in the department of surgery. For those at nutritional risk, the nutritional support rate was 24%.For non-risky patients, the nutritional support rate was 4%. Conclusions Certain nutritional risk and malnutrition exist in inpatients in the middle and small hospitals in Shijiazhuang. The applications of parenteral and enteral nutritions still have some problems. It is of particular importance to further promote the application of evidence-based parenteral/enteral nutrition guidelines in middle and small hospitals to standardize the application of nutritional support.