Objective To investigate the clinical value of serum homocysteine (Hcy),Cystatin C (CysC) detection in coronary heart disease prevention,diagnosis and treatment.Methods A total of 200 cases of coronary heart disease patients including 50 cases of acute myocardiac infarction (AMI) (AMI group),85 cases of unstable angina pectoris (UAP)(UAP group.) and 65 cases of stable angina pectoris (SAP) (SAP group) were selected,and 120 cases of healthy controls were selected as control group.The serum levels of Hcy and CysC were detected and compared.Results The serum levels of Hcy and CysC in AMI group,UAP group and SAP group were significandy higher than those in control group[Hcy:(22.35 ± 8.18),(16.54±7.56),(14.52±6.38) μmol/Lvs.(9.35±3.23) μmol/L; CysC:(1.32±0.27),(1.88± 0.66),(1.19 ± 0.46) mg/L vs.(0.80 ± 0.33) mg/L],and there were significant differences between two groups (P＜ 0.01).The serum level of Hcy in AMI group was higher than that in UAP group and SAP group [(22.35 ± 8.18) μ mol/L vs.(16.54 ± 7.56),(14.52 ± 6.38) μ mol/L],and there was significant difference (P ＜ 0.01).Conclusions The relationship between Hcy,CysC level and coronary heart disease is close,and Hcy levels increase with increasing degree of coronary heart disease.Detection of Hcy and CysC has some clinical value on prevention,diagnosis,treatment of coronary heart disease.

Objective · To investigate antiemetic effect of aprepitant for moderately chemotherapy-induced nausea and vomiting in patients with gastrointestinal cancer. Methods · From 2014 July to 2015 August, 130 cases of gastrointestinal cancer patients were collected in Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, who received moderate emetogenic risk of chemotherapy for at least four courses. One hundred and nine patients were treated with aprepitant, palonosetron and dexamethasone on day 1, and aprepitant and dexamethasone on day 2 and 3. Twenty-one patients only received aprepitant and dexamethasone on day 1 and dexamethasone on day 2 and 3 in the first course of chemotherapy. During subsequent courses of chemotherapy they received aprepitant and treated in the same way as 109 patients. MASCC antiemetic tool (MAT) was used to evaluate the intensity of nausea. The primary endpoint was complete response (CR, no emesis and use of no rescue antiemetics) during the overall study phase (0-120 h after chemotherapy) at the second course. The secondary endpoint was complete protection (CP, CR plus no significant nausea) during the overall, acute (0-24 h), and delayed (24-120 h) phases at the second course. Results · The CR rates were 90.0%, 94.6% and 90.8% of patients in the overall, acute and delayed phases, respectively. The corresponding CP rates were 83.8%, 87.8% and 84.6 %, respectively. The CR rate increased from 42.9% to 57.1% during acute phase and increased from 9.5% to 90.5% during delayed phase for 21 patients after treatment with aprepitant. The main adverse reactions include constipation, anorexia and hiccups. Conclusion · Aprepitant combined with palonosetron and dexamethasone can effectively prevent moderately chemotherapy-induced nausea and vomiting in patients with gastrointestinal cancer. Aprepitant therapy can effectively maintain antiemetic effect in patients with many chemotherapy courses.

After the development of different medical social media in China was summarized , the advantages and trend of social media in medical field of China were analyzed , the challenges facing medical social media were pointed out and their countermeasures were proposed .

Aim To investigate the effect of phenyle-thanol glycosides from Cistanche tubulosa(CPhGs) on the proliferation and activation of rrPDGF-BB induced HSC and their target points for resisting hepatic fibro-sis,to elucidate the molecular mechanism in molecular level, and provide basic data for the further develop-ment of new drugs. Methods HSCs were cultivated by CPhGs with different concentrations ( 0 , 3. 91 , 7. 81 , 15. 63 , 31. 25 , 62. 50 , 125. 00 , 250. 00 , and 500 mg ·L-1 ) and IC50 of CPhGs was determined. CPhGs with different concentrations ( 25 , 50 , 75 , 100 mg · L-1 ) were selected, and after the cells were stimulated with rrPDGF-BB, cell proliferation was determined by MTT. ERK1/2 ,α-SMA, c-fos, c-jun and Collagen I mRNA and Erk1/2 ,P-Erk1/2 and CollagenⅠprotein ex-pressions were assayed by RT-PCR and Western blot. Results CPhGs of ( 50 ~100 ) mg · L-1 concentra-tions groups could effectively inhibit rrPDGF-BB-medi-ated proliferation(P<0. 05) and CPhGs of(25~100) mg·L-1 concentrations groups had no significant cyto-toxicity( P >0. 05 ) . CPhGs of ( 25 ~100 ) mg · L-1 concentrations groups could inhibit ERK1/2 ,α-SMA,c-fos, c-jun and CollagenⅠmRNA levels, and also ob-viously inhibited Erk1/2 ,P-Erk1/2 and Collagen Ⅰ pro-tein expression on HSC. Conclusions CPhGs has the protective effect against hepatic fibrosis. The mecha-nism of this process may involve the interference with PDGF/ERK1/2 signaling pathway and inhibiting the activation and proliferation of HSC.

Objective To investigate the effects ofTianqi-Yizhi granules on oxidative stress in the brain tissue, and learning and memory in Alzheimer's disease model rats.Methods A total of 90 male SD rats were randomly divided into 6 groups by random number table method: sham operation group, model group, huperzine A group and groups of low-, medium- and high-doseTianqi-Yizhi granules, with 15 rats in each group. The AD rat model was prepared by the left lateral ventricle injection of amyloid-β1-42. One week after modeling, the rats in the groups of low-, medium- and high-doseTianqi-Yizhi granules received intragastric administration of 0.8, 1.6 and 3.2 g/kgTianqi-Yizhi granules, respectively; the rats in the huperzine A group received intragastric administration of 0.02 mg/kg huperzine A solution; and the rats in the sham operation and model groups received intragastric administration of equivalent volume of normal saline for 30 days. Learning and memory were evaluated using the dark avoidance test. The activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), and malonaldehyde (MDA) level in the brain tissue were determined. ResultsIn comparison with the model group, the latencies to step into the dark chamber in the high- and medium-dose Tianqi-Yizhi granules groups were significantly longer (239.05 ± 48.42 s, 214.35 ± 74.52 svs. 97.39 ± 30.69 s; allP<0.01), the numbers of errors significantly decreased (1.93 ± 3.25, 2.27 ± 3.09vs. 6.62 ± 3.45; allP<0.05), the activities of SOD (177.27 ± 63.10 U/mg, 164.53 ± 72.58 U/mgvs.72.56±21.04 U/mg; all P<0.01) and GSH-Px (2 899.36 ± 362.27 U/g, 2 407.68 ± 472.14 U/gvs. 1 397.64 ± 442.17 U/g; allP<0.01), and MDA level (24.75 ± 9.94 nmol/mg, 27.74 ± 5.82 nmol/mgvs. 37.56 ± 17.23 nmol/mg; allP<0.01) in the brain tissue significantly increased. ConclusionTianqi-Yizhi granules could attenuate oxidative stress in the brain tissue, and improve learning and memory in AD rats.

Objective To investigate the action mechanism of Tianqi Yizhi Granules for Alzheimer disease. Methods Ninety SD rats were divided into sham-operation group, model group, positive medicine group, high, medium and low dosage of Tianqi Yizhi Granules groups. SD rats were injected with aggregated amyloid β1-42 protein (Aβ1-42) into their left ventricle to establish AD models. Treatment groups received gavage with Huperzine A or Tianqi Yizhi Granules. The sham-operation group and model group received gavage with the same volume of normal saline. The mitochondrial membrane potential, activity of complex Ⅰ, Ⅱ, Ⅲ and Ⅳ of mitochondrial respiratory chain, enzymatic activity of Na+-K+ATP, energy charge, and space leaning ability were detected. Results Compared with model group, Tianqi Yizhi Granules could significantly improve mitochondrial membrane potential, activity of complex Ⅰ, Ⅲ and Ⅳ of mitochondrial respiratory chain, enzymatic activity of Na+-K+ATP, space leaning ability, and energy metabolism of brain in AD rats. Conclusion Tianqi Yizhi Granules showed mitochondrial protective capacity, and could improve energy metabolism of brain in AD rats, and then improve AD rats’ space learning ability.

Objective To study the effect of paeonol on the proliferation and apoptosis of A375 human melanoma cells and its mechanism.Methods Cell counting kit-8 (CCK8) was used to evaluate the proliferative activity of A375 cells treated with paeonol of 0.5,1,2,4,8 mmol/L for 24,48 and 72 hours respectively.Subsequently,A375 cells were treated with paeonol of 1.25,2.5 and 5 mmol/L for 24 hours followed by double staining with annexin V and propidium iodide for the detection of cell apoptosis,fluorometric assay for the estimation of caspase 3,caspase 8 and caspase 9 activity,and Western blot for the determination of the levels of p53,nuclear factor-κB proteins and some of their target proteins.The A375 cells receiving no treatment served as the blank control group.Statistical analysis was carried out by t test.Results Within the investigated concentration and time ranges,paeonol significantly inhibited the proliferative activity of A375 cells in a concentration-and timedependent manner.Compared with the blank control group,a significant increase was observed in the early apoptosis rate in A375 cells treated with paeonol of 1.25,2.5 and 5 mmol/L for 24 hours (13.74％-± 1.73％,25.95％ ± 0.57％ and 46.44％ ± 0.81％ vs.3.11％ ± 0.53％,P ＜ 0.05 or 0.01),as well as in the activity of caspase 3,8 and 9 in A375 cells treated with paeonol of 2.5 and 5 mmol/L for 24 hours (P ＜ 0.05 or 0.01).After 24-hour treatment,the protein levels of p53 and Bax were elevated,but those of nuclear factor-κB,Bcl-2 and Bcl-XL were decreased in A375 cells with the increase of paeonol concentration.Conclusions Paeonol can inhibit the proliferation but induce the apoptosis of A375 cells,and the apoptosis-inducing effect may be realized through intrinsic and extrinsic pathways by modulating nuclear factor-κB and p53 genes.

OBJECTIVETo study clinical effects of short-segment fixation and injured vertebra bone grafting through injured pedicle for the treatment of thoracolumbar burst fractures under MAST Quadrant retractor via a paraspinal muscle approach.

METHODSThe data of 42 patients with thoracolumbar burst fractures treated from June 2009 to September 2012 were reviewed. There were 19 males and 23 females, with an average age of (55.2±11.9) years old. The mean injury time was (5.8±4.3) days. Fracture segments included T10 in 3 cases, T11 in 6 cases, T12 in 13 cases, L1 in 9 cases, L2 in 7 cases, and L3 in 4 cases. According to Denis classification, 9 patients were type A, 21 patients were type B, 5 patiens were type C, 5 patients were type D, and 2 patients were type E. All the patients were treated with short-segment pedicle screw-rod system fixation under MAST Quadrant via the paraspinal muscle approach. The operative time, blood loss, complications and the height of vertebra, kyphosis Cobb angle, VAS scores, JOA scores were measured before and after treatment.

RESULTSAfter treatment, the vertebral height and kyphosis Cobb angle were restored. Compared with preoperative results, postoperative vertebral height and kyphosis Cobb angle, VAS scores and JOA scores were all improved. But there was no statistically significance in vertebral height, kyphosis Cobb angle between postoperative at 1 week and 1 year.

CONCLUSIONInternal fixation combined with injured vertebra bone grafting through the injured pedicle for the treatment of thoracolumbar burst fractures via the paraspinal intermuscular approach under MAST Quadrant is a safe, minimally invasive, effective and satisfactory method.

Adult ; Aged ; Aged, 80 and over ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery

OBJECTIVETo explore the effectiveness of absorbable hemostatic fluid gelatin in preventing postoperative cerebrospinal fluid leakage.

METHODSThe clinical data of 17 patients with dura mater tear were retrospectively analyzed from March to September in 2003. There were 16 males and 1 female, aged from 16 to 67 years old with an average of (39.6 ± 15.4) years. The injury site was at cervical vertebrae in 1 case, thoracic vertebrae in 9 cases, thoracolumbar junction in 4 cases, lumbar vertebrae in 3 cases. There were burst fracture in 4 cases and fracture-dislocation in 13 cases. According to ASIA grade, 12 cases were grade A, 2 cases were grade B, 2 cases were grade D, 1 case were grade E. Two cases caused by traffic accident, 10 by high falling, 4 by heavy parts crash, 1 by stairs fell during the earthquake. Absorbable hemostatic fluid gelatins were used to plug the dura mater tear,in order to prevent postoperative cerebrospinal fluid leakage. Postoperative drainage were recorded every day.

RESULTSOf 17 patients, 15 cases did not develop with cerebrospinal fluid leakage. Two cases develop with cerebrospinal fluid leakage after operation and their drainage were removed at 6 to 7 days after operation. In all cases, no complications related with cerebrospinal fluid leakage occurred, such as headache, dizzy, fever,neck resistance, rash, incision disunion, incision infection, hematoma, neurologic symptoms aggravation. No abnormal phenomena was found on incision surrounding at follow-up of 9 months.

CONCLUSIONUsing absorbable hemostatic fluid gelatin to plug the dura mater tear during operation is an effective method in preventing postoperative cerebrospinal fluid leakage.

Adolescent ; Adult ; Aged ; Cerebrospinal Fluid Leak ; prevention & control ; Female ; Gelatin ; administration & dosage ; Hemostatics ; administration & dosage ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control

mRNAs of alpha-adrenoceptor (α-AR) subtypes are found in neurons in dorsal root ganglion (DRG) and change after peripheral nerve injury. In this study, the distribution of α-AR subtype proteins was studied in L5 DRG of normal rats and rats with chronic constriction injury of sciatic nerve (CCI). Using immunofluorescence technique, it was found that α1A-, α1B-, and α2A-AR proteins were expressed in large, medium, and small size neurons in normal DRG, and significantly increased in all size neurons 14 days after CCI. α1D- and α2C-AR was also expressed in all size neurons in normal DRG. However, α1D-AR was significantly increased and α2C-AR was decreased in small size neurons 14 days post CCI. α2B-AR neurons were not detectable in normal and CCI DRG. Co-expression of α1A- and α2A-AR in the same neuron was observed in normal DRG and increased post CCI. Collectively, these results indicated that there is distinct distribution of α-AR subtypes in DRG neurons, and the distribution and levels of expression of α-AR subtypes change differently after CCI. The up-regulation of α-AR subtypes in DRG neurons may play an important role in the process of generating and transmitting neuropathic pain.