Objective To retrospectively review the mortality and morbidity after orthopedic surgery for aged patients with reference to orthopedic version physiological and operative severity score for the enumeration of mortality and morbidity (O-POSSUM) and Portsmouth POSSUM (P-POSSUM) and validate the score' s accuracy in operative risk prediction.Methods O-POSSUM and P-POSSUM for mortality and morbidity were applied to 839 aged patients who had undergone orthopedic surgery between January 2008 and December 2011.Observed mortality and morbidity were compared with the expected values.Results O-POSSUM predicted 230 morbidities,but the observed value was 182 (x2 =2.718,P ＞ 0.05).O-POSSUM predicted 46 deaths,higher than the observed 3 deaths (x2 =38.870,P＜0.01).P-POSSUM predicted 16 deaths,higher than the observed 3 deaths (x2 =8.997,P ＜ 0.01).Conclusions O-POSSUM accurately predicts postoperative morbidity in aged orthopedic patients.However,O-POSSUM and P-POSSUM overpredicts the mortality and should be used with caution.

Objective To detection analysis of blood infectious disease markers in patients before blood transfusion or before surgery .Methods HBsAg ,anti-HBs ,HBeAg ,anti-HBe ,anti-HBc ,anti-HCV ,anti-HIV ,TP-Ab were detected for 3 542 cases of se-rum using chemiluminescence immunoassay(CLIA) and ELISA .Results For HBsAg ,there were 704 cases of positive among 3 542 cases ,the proportion was 19 .8% ;For anti-HCV ,there were 52 cases of positive among 3 032 cases ,the proportion was 1 .72% ;For anti-HIV ,there were 3 cases of positive among 3 049 cases ,the proportion was 0 .09% ;For TP-Ab ,there were 200 cases of positive among 3 153 cases ,the proportion was 6 .34% .The infection rate was different in different gender of HBV ,anti HCV ,anti HIV and TP-Ab .But for HBV ,anti-HCV and TP-Ab ,the detection rate of male was higher than female(P<0 .05);The infection rate was different in different age of HBV ,anti HCV ,anti HIV and TP-Ab different age .The detection rate of HBV and Anti-HCV in 21-40 years old was the highest ,They were 31 .9% and 2 .33% ;The detection rate of TP-Ab increases with age increased ,more than 60 years old was the highest ,up to 7 .55% .Detection of the above two methods ,for HBsAg ,there were 51 cases did not match ,the proportion was 1 .44% ;for anti-HCV ,there were 1 case did not match ,the proportion was 0 .03% ;for Tp-Ab ,there were 3 cases did not match ,the proportion was 0 .1% ;for anti-HIV ,CLIA agrees well with ELISA ,there were 3 cases of positive .The samples that did not match were detected by the third party verification of the reagent .The result displayed that CLIA was more accurate . Conclusion CLIA is a high-sensitivity detection method which could effectively avoid positive specimens missed ,detection of infec-tious disease markers in patients before transfusion or before surgery by CLIA had important significance .

Objective:To observe autophagy induced by aminophylline in human peripheral blood T lymphocytes.Methods:Peripheral blood T lymphocytes from health adults were separated with Percoll(1.073 g/ml) and harvested by using nylon column.The cultured cells were divided into control group,aminophylline group(10-8～10-3mol/L,or 0.001 8～180 ?g/ml)and dexamethasone(DXM) group,and the rates of autophagy and apoptosis were analyzed by flow cytometry.Results:①The purities of T lymphocyte were 81.3%～94.5%。②In control group for 72 h cultivation,the autophagic rate of T lymphocytes was significantly lower than those of 10-5～10-3mol/L aminophylline group(P0.05);In 10-5mol/L aminophylline group,the autophagic rate of different T lymphocyte density after cultivation(0,24,48,72 h) had a tendency of increase along with time lasting and decrease of cell density,but the difference did not show significance.③There was significant statistic difference in incidence rate of apoptotic T lymphocytes between control and DXM group in 72 h cultivation(P=0.000);But there was no significant statistic difference in the rate of autophagic(P=0.481).Conclusion:10-3～10-5mol/L aminophylline can induce autophagy in peripheral blood T lymphocytes,10-3～10-8mol/L aminophylline could induce both autophagy and apoptosis,and there is no significant correlation between autophagy and apoptosis;DXM can induce apoptosis in peripheral blood T lymphocytes,which indicates different programmed cell death of T lymphocytes could be induced by different medicines.

Objective To systematically evaluate the effect of routine insertion of double-J stents to prevent major urological complications(MUCs)in kidney transplant recipients.Methods Medline,Embase,Cochrane Library,and Chinese Biomedicine database were searched to locate relevant randomized controlled trials(RCT).Data extraction and assessment of methodologic quality were performed independently by two reviewers.Meta-analysis was performed by Revman 5.0 software.Results Ten RCT(including 1616 patients)were identified.By comparing the routine stent group with the no stent group,the meta-analysis showed:(1)incidence of urine leak,urinary obstruction and UTI was 4 times lower,6 times lower,increased by 52 % respectively(P＜0.0001);(2)Patient and graft survival,rate of acute rejection,delayed graft function and hematuria were of no significant difference.In subgroup analysis,it was found:(1)Compared with the no stent group,the group in which stent duration was≤ 4 weeks had a lower incidence of MUCs and a higher incidence of UTI;meanwhile,the group in which stent duration was ＞ 4 weeks had a much lower incidence of MUCs and the rate of UTI was increased without significant difference;(2)In the RCT of which urethral catheter duration was ＜ 5 days,there were no significant differences between the two groups in MUCs and UTI.In the RCT of which urethral catheter duration was ≥5 days,the stent group had a lower incidence of MUCs and a higher incidence of UTI.Conclusion Routine stenting reduces the incidence of MUCs.Although the double-J stent increases the risk of UTI,it seems that UTI doesn't affect the outcome of transplantation.The stent duration should be within 4 weeks.For the stent recipients,the longer duration of urethral catheter,the lower incidence of MUCs,the higher incidence of UTI;thus,it is up to clinicians to decide the optimal duration of urethral catheter.Long term prescription of 480 mg cotrimoxazole once daily,from the operation day till after stent removal,effectively reduces the risk of UTI associated with stent placement.

The authors analyzed the status quo of the indicators, outcomes and uses,methodology, procedures and technologies of the variations management of clinical pathways in China the abroad. The outputs of the study point to the following assignments in such a management, such as further identification of the contents of such variations, and further clarification of variation analysis indicators.

Objective To determine the effect of COMMD7 inhibition on invasion and migration in liver cancer stem cells (LCSCs),and investigate the possible mechanism.Methods After LCSCs were infected by shRNA lentiviral vectors of COMMD7,adhesion assay and Transwell assay were used to detect the invasion and migration,and phalloidin staining was employed to observe the morphological changes.Western blotting was adopted to measure the expression of E-cadherin,N-cadherin and Vimentin.Results COMMD7 knockdown significantly inhibited the invasion and migration of LCSCs.The relative cell quantity of adhesion was 1.00 ± 0.12 and 2.35 ± 0.20 respectively in control cells and infected cells,suggesting there were significantly more adhesive cells in the infected group (P ＜ 0.05).The relative cell quantity per visual field of migration was 1.00 ±0.04 and 0.24±0.03,and that of invasion was 1.00 ±0.05 and 0.24 ±0.04 respectively in the control cells and infected cells,and there were significantly less invasive and migrated cells in the infected group (P ＜0.05).What's more,COMMD7 knockdown also induced some morphological changes of cells corresponding to the weakened abilities of migration and invasion.All the changes above were associated with up-regulation of E-cadherin (P ＜ 0.05) and down-regulation of N-cadherin and Vimentin (P ＜0.05),the molecules related to mesenchymal-epithelial transition (MET).Conclusion COMMD7 knockdown inhibits the invasion and migration in LCSCs,which may be through its regulation on the MET course.

The rising of evidence-based medicine requires high quality for clinical research and randomized controlled trial is considered as clinical research of the most level of evidence degree and contidence activity.This article illustrates several important and instructive designs of randomized controlled trials,which can give some reference for clinical research on acupuncture.And the developing direction of future clinical research on acupuncture is discussed.

The optimized cultural medium of fermentation for Candida sp.mutant strain YQ5 to produce S-adenosylmethionine was studied.The results of single factor experiment showed that the most favorable pH value,carbon source,nitrogen source organic nutrient is 6.0,8% sucrose,1.5% tryptone and 2% yeast extract,respectively.As to inorganic salts,MgSO4?7H2O,CaCl2,FeSO4?7H2O,CoCl2,CuSO4?5H2O,H3BO3 could improve accumulation of the intercellular SAM.The ingredients of the culture medium are also opti-mized by the orthogonal experiment.Fermentation for 48 h under the optimal condition resulted in AdoMet production at 1740.0 mg/L.

The overexpression of doublecortin-like kinase 1 (DCLK1) is closely related to the occurrence and development of various malignant tumors. Discovery of novel anti-tumor agents targeting DCLK1 represents a hot spot in this field. So far, several DCLK1 small molecule inhibitors with excellent anti-tumor activity in vitro and in vivo have been designed and synthesized, which is expected to provide a new strategy for tumor therapy. This article reviews the research progress in the discovery, structure type, structural optimization, biological activity and mechanism of action of DCLK1 small molecule inhibitors, and provides research basis for the development of new anti-tumor small molecule inhibitors targeting DCLK1.

OBJECTIVETo investigate the effect of extract of Ginkgo Biloba(EGB) on nerve growth factor(NGF) and Neurotrophin-3(NT-3) expression of hippocampus neurons in streptozotocin-induced type I diabetic rats.

METHODSThirty male SD rats were divided into three groups (n = 10): the control group, diabetic group and EGB-treated group. Strepozotocin were injected intraperitoneally in the later two groups to induce diabetes. EGB-treated group was injected intraperitoneally with EGB, and the same volume of normal saline was injected to the other groups. Concentration of blood glucose and body weight and behaviour were dynamicly monitored. At the end of the 12th week, morphological changes of the hippocampus neurons were observed under microscopy by HE stain. The expression of NGF and NT-3 were assayed by Western blot and RT-PCR respectively.

RESULTSCompared with diabetic group, the behaviour and body weight (P < 0.05) and the concentration of blood glucose (P < 0.05) were significantly improved and the escape latency of Morris water maze test (P < 0.05) was significantly shortened, while the platform searching score was significantly increased (P < 0.01) in EGB treated group; The pathological changes of hippocampus neurons were significantly attenuate by EGB treated; The expression of NGF and NT-3 in hippocampus neurons were significantly increased which assayed by Western blotting and RT-PCR respectively (P < 0.05) in EGB treated group.

CONCLUSIONEGB may improve the learning and memory ability of diabetic rats the mechanism may be attributed to its improvement of the expression of NGF and NT-3 and reducing apoptosis in hippocampus neurons.

Animals ; Diabetes Mellitus, Experimental ; metabolism ; psychology ; Ginkgo biloba ; Hippocampus ; cytology ; Male ; Maze Learning ; drug effects ; Nerve Growth Factor ; metabolism ; Neurons ; drug effects ; metabolism ; Neurotrophin 3 ; metabolism ; Plant Extracts ; pharmacology ; Rats ; Rats, Sprague-Dawley