Objective To investigate the effect of donepezil hydrochloride on the expression of Calpain Ⅰ-Cdk5/p25 pathway in the hippocampal CA1 area by cerebral ischemia and reperfusion in mice.Methods Mice were divided into model group,sham-operated group and donepezil-treated group.The expression of Calpain Ⅰ in hippocampal CA1 area was measured by immunohistochemistry staining respectively at 4,6 and 8 weeks post cerebral ischemia and reperfusion.Western blot was used to evaluate Cdk5 and p25 protein expression.Results The abilities of learning and memory performance was damaged significantly at 4,6 and 8 weeks after surgery compared to sham-operated group (P＜ 0.05).The expression of Calpain Ⅰ of model group were (0.098 ± 0.009),(0.129 ±0.01),(0.116 ± 0.01),which were higher than that of sham-operated group (0.03 ± 0.003),(0.031 ± 0.003),(0.029 ±0.003) and there was significant difference (P ＜ 0.05).The expression of Cdk5 in model group was (0.54 ± 0.05),(0.73 ± 0.07),(0.7 ± 0.06),which were higher than that of sham-operated group (0.23 ±0.02),(0.31 ± 0.02),(0.33 ± 0.02) and there was significant difference (P ＜ 0.05).The expression of p25 in model group was (0.44 ± 0.04),(0.51 ± 0.04),(0.55 ± 0.06),which were higher than that of sham-operated group(0.19 ± 0.02),(0.24 ± 0.02),(0.2 ± 0.02) and there was significant difference (P ＜ 0.05).The expression of Calpain Ⅰ of donepezil-treated group was (0.041 ± 0.004),(0.054 ± 0.004),(0.046 ± 0.003),which were lower than that of model group.The expression of Cdk5 was (0.28 ± 0.02),(0.33 ± 0.03),(0.38 ± 0.02),and expression of p25 was (0.26 ± 0.02),(0.25 ± 0.03),(0.21 ± 0.02),which were lower than that of model group respectively(P ＜ 0.05).Conclusion Donepezil hydrochloride probably improve the learning and memory abilities by reducing the expression of Calpain Ⅰ and Cdk5/p25.

BACKGROUND:Radiation-induced brain injury has recently become an increasing area of research, in particular in animal experimental studies. Domestic and international researches show that there have been no uniform scanning parameters used for examination of animal models of radiation-induced brain injury by magnetic resonance imaging. In this study, we performed magnetic resonance imaging in rabbits to determine related sequence parameters. OBJECTIVE:To establish the New Zealand rabbit models of radiation-induced brain injury, and obtain the brain magnetic resonance images of rabbits using LOOP7 coil, so as to provide experimental evidence for diagnosis of radiation-induced brain injury by magenetic resonance imaging. METHODS:Each of T2-weighted imaging, diffusion tensor imaging, magnetic resonance spectroscopy and magnetic susceptibility-weighted imaging were performed several times through the use of LOOP7 coil, to determine the optimal scanning parameters for each sequence. Rabbit models of radiation-induced brain injury were established and then their right hemispheres were irradiated using 6 MV X-rays at a single dose of 40, 80 and 120 Gy. The daily performance and dynamic magnetic resonance signs of rabbits were observed. The brain tissue was taken for pathological examination once abnormal magnetic resonance findings were observed or after 20 weeks of folow-up. RESULTS AND CONCLUSION:Only one rabbit model in the 40 Gy group had subdural hemorrhage. In the 80 Gy group, abnormal T2-weight imaging signals were observed in al rabbit models, which were pathologicaly confirmed as scattered degenerated neurons and infiltrated neutrophils. The abnormal signals that gradualy expanded over time were seen in rabbits from the 120 Gy group by magnetic resonance imaging and were pathologicaly confirmed as radiation-induced brain injury loci. The results confirm that establishing rat models of radiation-induced brain injury using radiation therapy system can better simulate the pathological process of radiation-induced brain injury; moreover, this model can be applied to receive routine magnetic resonance examination with LOOP7 coil.

The papor made a classification and summary on content and pattern of digitizing researches on chinese ancient medical books in mainland China, highlighted the major achievements and put forward a few issues to be solved.

BACKGROUND: The fracture of femoral neck in adults is very common. Most of them can be cured by operation or conservative treatment, but a few can develop into old fracture. At present, there is no clear and effective treatment for old fracture of femoral neck in adults. OBJECTIVE: To explore the clinical effect of sartorius pedicle iliac bone flap combined with proximal femoral locking plate in the treatment of old femoral neck fracture in adults. METHODS: Twelve adult patients with old femoral neck fracture were treated with sartorius pedicle iliac bone flap combined with proximal femoral locking plate, 9 males and 3 females, aged 18-47 years, with an average age of 33. 5 years. Garden classification: Type I in 0 cases, type II in 1 case, type III in 7 cases, and type IV in 4 cases. All of them were incised by Smith Petersen (S-P) approach. The 2/3 sartorius pedicle iliac bone flap of the anterior superior iliac spine was chiseled with a bone knife, about 4. 0 cm×1. 0 cm×1. 0 cm in size. After reduction, the proximal femur was fixed with steel plate and screw. Finally, the sartorius pedicle iliac bone flap was implanted into the defect of the femoral neck and fixed. At 3, 6, 12, and 24 months after the operation, X-ray films were reexamined to evaluate the fracture healing and Harris score of hip joint was used to evaluate the recovery of hip joint function. RESULTS AND CONCLUSION: (1) Twelve patients were followed up for at least 24 months. (2) Harris scores of hip were significantly higher at 3, 6, 12, and 24 months after surgery (54. 4±6. 4, 68. 7±6. 8, 82. 3±4. 2, 90. 3±4. 6) than those before surgery (46. 3±6. 1) (P < 0. 05). (3) There were no complications, such as wound nonunion, infection, or venous thrombosis. Finally, 11 patients finally achieved bony healing at the fracture site. One patient had nonunion at 28 months postoperatively with avascular necrosis of the femoral head (ARCO stage IV), followed by artificial hip replacement. Harris score before operation was 38, and Harris score at 3 months postoperatively was 98. (4) The results show that the combination of sartorius pedicle iliac bone flap and proximal femoral locking plate is a good method for the treatment of old femoral neck fracture in adults, with high healing rate and low necrosis rate of femoral head.

Objective To evaluate the clinical effectiveness of 5-aminolaevulinic acid (ALA)-based photodynamic therapy (PDT) for the treatment of moderate to severe acne vulgaris.Methods From January to June 2013,a total of 43 patients with moderate to severe acne vulgaris were treated by 5 aminolaevulinic acid based PDT with red light.All patients were received three times of treatment at 2-week intervals.Clinical assessment was conducted before and at 2,4,6 and 8 weeks after treatment.Results The lesion counts of both inflammatory and non-inflammatory lesions were reduced significantly after treatment.The mean percentage reduction in inflammatory lesions was 88.9 ％ at 8 weeks after the treatment,meanwhile that in non-inflammatory lesions was 73.4％.After 8 weeks of treatment,55.8％ patients (24/43)showed clinical cure,and 41.9％ patients (18/43)showed excellent response and 2.3％ patient (1/43) showed good response.Only 4.7％ patients (2/43)showed signs of recurrence after 4 months after ALA-PDT.After one course of ALA-PDT,the symptoms in this recurrent case were significant improvement.The common adverse effects included pain,edema and transient hyperpigmentation.They could gradually disappear without a need of special intervention.Conclusions ALA-PDT is a safe and effective therapeutic option for the treatment of moderate to severe acne vulgaris.

Objective To investigate the clinicopathologic and immunohistochemical characteristics of breast carcinosarcoma with osteosarcoma components and its differential diagnosis. Methods The pathologic features and clinical manifestations of the two patients were retrospectively reviewed. Immunohistochemistry was performed and the literature was reviewed. Results Histopathologically, the neoplasm consisted of invasive ductal carcinoma of no special type and poorly ( case 1 ) or well (case 2) differentiated osteosarcomatoid elements. The morphological transition from carcinoma to sarcomatoid elements was seen. Immunohistochemically,the carcinoma cells were positive for CK and EMA , the sarcomatoid elements were stained positive for vimentin, and a few cells of two elements were positive for S-100 protein. Ki-67 and VEGF were over expressed in both elements of Case 1.In case2 Ki-67 expression was low in both elements and VEGF over expression was only seen in sarcomatoid elements. Some of the carcinoma cells were positive for ER. Conclusions Carcinosarcoma of the breast with osteosarcomatoid elements is a rare type of mixed epithelial/mesenchymal metaplastic breast carcinoma. The types and proportion of carcinoma and sarcomatoid elements determine the diagnosis.

Objective To investigate the current status of moral distress in clinical nurses,and analyze its influential factors.Methods A total of 240 clinical nurses were recruited by stratified sampling method.They were investigated with general situation questionnaire and moral distress scale.Results The average score of moral distress was (2.66±0.41).Multiple linear regression analysis showed that department of work and qualification were influencing factors on moral distress of clinical nurses.Conclusions This study found that nurses' moral distress was above the middle level.Some targeted measures should be taken by nursing managers,in order to help decrease nurses' moral distress.

OBJECTIVE To study the radiose-nsitization by Topotecan on human nasopharyngeal carcinoma in nude mice. METHODS ①To study the maximum tolerance dose of TPT and detect the effective rate of TPT and RT on nude mice. ② Plan of radiosensitization practice:53 nude mice xenografts were distributed to 5 groups:RT 20 Gy group,RT 40 Gy group,TPT 12.5 mg/kg group,TPT 12.5 mg/kg+RT 20 Gy group and the controlgroup. After treatment,the volume of tumors were measured every 3 days in order to value the effective rate [complete remission(CR) + partial remission(PR) ]and regrowth delay time(TGD) and to fit the growth curve. RESULTS This study showed that the effective rates had significant difference among RT20 Gy+TPT 12.5 mg/kg group,RT20 Gy group and TPT12.5 mg/kg group,while that of RT20 Gy +TPT 12.5 mg/kg group and RT40 Gy group had no statistical difference. SER reached to 1.34. CONCLUSION Topotecan has been shown a radiosensitizing effect on human nasopharyngeal carcinoma in vivo.

Objective To investigate the expression of BAMBI in pancreatic carcinoma tissue and its clinical value.Methods Expression of BAMBI was detected by immunohistochemistry in 69 cases of pancreatic cancer and 15 normal pancreatic samples.The survival and its association with clinicopathologic parameters were analyzed.Results The expression of BAMBI in the cancer tissue was much higher than that in the normal tissues (56.5％ vs 16.7％,P ＜0.01).The expression of BAMBI was not associated with age,sex and tumor size,differentiation,but expression of BAMBI in patient with lymph node metastasis was higher than that in patient without lymph node metastasis (67.4％ vs 38.5％,P =0.019),the expression of BAMBI in TNM stage Ⅲ was higher than that in stage Ⅰ + Ⅱ (75.0％ vs 31.0％,P =0.001).The median survival of BAMBI-positive group (6 months) was lower than that of BAMBI-negative group (10 months).Conclusions BAMBI is over-expressed in pancreatic carcinoma,and its expression is associated with lymph node metastasis,TNM staging,differentiation and prognosis.

Objective To investigate the expression of peripheral blood (PB) CD4+ CD25+ Foxp3+ regulatory T cells (Tregs) in patients with benign end-stage liver disease after liver transplantation and the relationship between levels of PB Tregs and acute rejection. Methods A prospective analysis was performed on 55 consecutive patients who underwent liver transplantation.Fourteen out of 55 cases suffered from acute rejection after liver transplantation were defined as rejection group,while the rest patients were classified into no acute rejection group. PB was obtained from liver transplant patients at different time points longitudinally: pre-transplant, post-transplant within one year and acute rejection. The circulating CD4+ CD25+ Foxp3+ Tregs in PB were measured by flow cytometry. Blood samples were drawn during acute rejection, at the same time, liver biopsies were performed. The circulating CD4+ CD25+ Foxp3+ Tregs were compared between two groups.Results There was no difference between two groups in levels of circulating CD4+ CD25+ Foxp3 + Tregs cells pre-transplant. However, the levels of circulating CD4+ CD25+ Foxp3+ Tregs in rejection group were decreased significantly as compared with no-rejection group (2. 23 % ± 0. 54 % vs. 2. 99 % ±0. 86 %,P＜0.01). The frequency of CD4+ CD25+ Foxp3+ T cells was negatively correlated with rejection activity index (RAI) (r = - 0. 80, P＜0. 01 ). Conclusion Monitoring PB CD4+ CD25+ Foxp3+ Tregs levels may be helpful in evaluating the immune state and act as a more sensitive marker for acute rejection diagnosis in the patients following liver transplantation.