BACKGROUND: Clusterin has many biological functions, especially the great protection effects on histiocytes in pathological conditions. It will be helpful to discuss the expression of clusterin in the spinal cord injury tissue to further identify the mechanism of secondary spinal cord injury and to provide possible treatments.OBJECTIVE: To observe the expression of clusterin in acute spinal cord injury tissue.DESIGN: Randomized controlled animal study.SETTING: Department of Orthopaedics, First Affiliated Hospital, China Medical University.MATERIALS: The experiment was performed in Experimental Animal Department, China Medical University from January 2003 to January 2006.A total of 65 adult healthy SD rats of 250-300 g provided by Experimental Animal Department, China Medical University were selected. METHODS: All the rat models by modified Allen assay for acute spinal cord injury were randomized into injury group, sham operation group and normal control group with 30, 30 and 5 rats in each group, respectively.The rat injury models in dorsal spinal cord were prepared by modified Allen assay: the target injury site was T10 segment; the sham operation group was given T10 total laminectomy. The normal control group received no operation. Rats in the injury group and sham operation group were killed at hour 12, days 1, 3, 7, 14 and 21 after spinal injury and operation with 5 rats at each time point, respectively. Frozen sections of the injury part were made at different time point after injury. Degeneration and necrosis of spinal cord injury tissues were observed with hematoxylin-eosin (HE) staining. Deposition and disposition of positive reactants of clusterin were observed with clusterin immunohistochemical staining. Average gray value of positive reactants of clusterin was detected with semi-quantitative image analysis (went with the intensity of clusterin immunoreaction in inverse ratio).MAIN OUTCOME MEASURES: ①Degeneration and necrosis as well as positive expression of clusterin of spinal cord injury tissues of rats in each group. ②Average gray value of clusterin positive reactants in spinal cord injury tissues of rats in each group.RESULTS: A total of 65 rats were involved in the result analysis, without dropout. ①In the injury group, positive expression of clusterin began to increase at day 1 after injury, reached peak at about day 7, declined gradually at day 14 and tended to be stable at day 21 after injury. This dynamic course of change was along with the prolongation of time. The expression of clusterin appeared in the sham operation group and normal control group at each time point, and the expression was stable. There was no dynamic change with the prolongation of time. ②In the injury group average gray value of positive reactants of clusterin was significantly lower at days 1, 3,7, 14 and 21 as compared with that in the sham operation group and normal control group (t=6.33-15.57, P ＜ 0.01 ). There was no significant difference in average gray value of positive reactants of clusterin at each time point in the sham operation group as compared with the normal control group (P ＞ 0.05).CONCLUSION: The expression of clusterin increases greatly in acute spinal cord injury tissues, and has dynamic change, which is the same with spinal cord injury.

Objective To observe the effect of blood-cooling and blood-stasis-removing Decoction on anti-double-strain DNA ( anti-dsDNA) antibody, anti-nucleosome antibody ( AnuA) and serum levels of interleukin ( IL) -6, 17, 21 in spontaneous systemic lupus erythematosus ( SLE) MRL/lpr experimental rats. Methods The experimental rats were divided into blank control group, model group, and high- and low- dose Chinese medicine groups ( 25.2, 12.6 g/kg respectively) , the treatment lasting 8 weeks. At the end of the experiment, the blood taken from the orbital veins was separated for obtaining serum, and then the serum anti-dsDNA antibody, AnuA, IL-6,17,21 levels were tested by enzyme-linked immunosorbent assay ( ELISA). Results The serum autoantibody and IL-6, 17, 21 levels of rats in the model group were increased significantly as compared with the blank control group ( P<0.01). The serum antibody and cytokine levels of Chinese medicine groups were reduced as compared with the model group, the difference between high-dose Chinese medicine group and model group being significant ( P<0.01). Conclusion Blood-cooling and blood-stasis-removing Decoction has certain effect on reducing the serum levels of anti-dsDNA antibody, AnuA, and IL-6,17,21, which may coniribute to one of its therapeutic mechanisms for SLE.

Objective To investigate the clinical value of homocysteine(Hcy) ,coagulation function ,platelet parameters and he-morheology detection in patients with cerebral infarction .Methods 114 patients with cerebral infarction were served as cerebral in-farction group ,while 112 healthy people as control group .Their platelet parameters ,coagulation function ,Hcy and hemorheology were detected .Results Hcy ,Fibrinogen(Fib) and D-dimer(D-D) of patients in cerebral infarction group were higher than those in control group(P<0 .05) ,while the differences of prothrombin time(PT) ,activated partial thromboplastin time(APTT) and throm-bin time(TT) between the two groups showed no statistically significant (P> 0 .05) .In cerebral infarction group ,platelet count (PLT) of patients was lower ,and platelet distribution width(PDW) and mean platelet volume(MPV) were higher than those in the control group(P<0 .05) while plateletcrit(PCT) showed no statistically significant difference between the two groups (P<0 .05) . Whole blood viscosity ,plasma viscosity and hematocrit of patients in the cerebral infarction group were higher than those in the con-trol group(P< 0 .05) .Conclusion Hcy ,coagulation function ,platelet parameters and hemorheology detection have important significance for prediction and early diagnosis and treatment of cerebral infarction .

Objective:To summarize the drug repercussion data in outpatient pharmacy and analyze the reasons to provide sugges-tions for the improvement. Methods: The information was collected from the hospital information system ( HIS) during January 1, 2013 and December 31, 2015, including drug name, category, quantity, amount, reasons for drug repercussion and the other statisti-cal data. Results:During the three years, the number of prescription drugs, amount of money and varieties of drug repercussion were increased. The most common reasons for drug repercussion were the other reasons, withdrawn by doctors and the request of patients. The sum of drug repercussion was positively correlated with the drug price and the amount of drug repercussion. Conclusion:The op-tion simplicity for drug repercussion in HIS is the main reason for drug repercussion bythe other reasons. The occurrence of drug re-percussion should be intervened by such methods as gradually improving the HIS, establishing intervention measures, enhancing the professional quality of pharmacists and so on.

AIM: To express chimeric toxin Stx2a’-LHRH a nd to investigate the cytotoxic activity of recombinant toxin Stx2a’-LHRH to huma n carcinoma cells.METHODS: Stx2a’-LHRH sequences that added the res tri ction endonucleases NcoⅠ and EcoRⅠ at the 5' and 3 ends were amplified by PCR a nd digested with appropriate restriction enzymes. The digested fragment was subc loned into the vector obtatined by digestion of plasmid pET-28a(+) with NcoⅠ an d EcoRⅠ. E. coli BL21 (DE3) cells were transformed with plasmids of interst and cultured in LB medium containing ampicillin. Expression of the recombinant protein was induced by the addition of isopropylthio-?-D-galactoside (IPTG). T h e cytotoxity of Stx2a’-LHRH to Hep-2 cells was observed under the microscop y. RESULTS: Recombitant plasmid pET-SL was constructed successfu lly and the clones expressing pET-SL stablely were obtained. A special electroph oretic band in SDS-PAGE (a glycoprotein of 28kD) was noted. Stx2a’-LHRH killed He lp-2 cells clearly. CONCLUSION: In this study, construction of c himeric toxin Stx2a’-LHRH and its expression were described. Moreover, it has o bvious cytotoxity to Hep-2 cell. These finding could open up new vistas in the s tudy of targeted durgs.

Objective To explore the effect of preventing adhesion after the orbital blowout fracture on orbit tissue by amniotic membrane. Design Experimental study. Participants Twenty-six New Zealand rabbits. Methods Establishing rabbit orbital blowout fracture model, the right orbit of twenty rabbits was repaired by hydroxyapatite (HA) parceled of amniotic membrane, and left orbit was only repaired by HA, the orbits of the other six rabbits weren't repaired. Then we got the tissue around bone after one week and one month, and compared the difference of three groups. Main Outcome Measures Inflammatory response of tissue around bone was ana- lyzed by HE, picric acid Sirius Scarlet dying, TGF-?immunohistoehemical observation. Results One week after operation, HE and im- munohistochemistry showed that the difference was not significant in inflammatory response between experimental group and control group (P=0.351, P=0.413), and difference is significant between blank group and experimental group (P=0.012, P=0.041). One month after operation, HE and immunohistoehemistry showed that the difference was significant in inflammatory response between experimental group and control group(P=0.037, P=0.048), and there is no significant difference between experimental group and blank group(P=0.285, P=0.472). Conclusion It has an important role of anti-inflammatory and anti-adhesion in the chronic stage of inflammatory after orbital blowout fracture repaired by man-made plates of amniotie membrane.

Object To investigate the features of health related quality of life ( HRQOL) among elderly hypertensive patients with different body mass index (BMI) so s to provide evidence for the health promotion of hypertensive. Methods A cross-sectional survey of health status data from a population of 1281 elderly hypertensive patients from Beijing and 8 provinces of China ( Jiangsu, Anhui, Gansu, Qinghai, Fujian, Jilin, Jiangxi, and Henan) was made in the study. Analysis of variance was applied to compare the differences in HRQOL of elderly hypertensive patients in different BMI categories. Results For the elderly hypertensive patients with low body mass index, the scores of 8 dimensions and scores in physical component summary (PCS) and mental component summary( MCS) of SF-36 were the lowest;except the role-emotional(RE) dimension,the scores of other 7 dimensions,PCS and MCS were significantly different(PF,RP,BP,GH,VT,MH, P<0.01; SF,PCS,MCS, P<0.01). Comparing the scores between any two groups in PCS, the scores of patients with low body mass index were significantly lower than normal weight group (62.30 ± 22. 12 vs72.40 ±20.86, P<0.05) .overweight group (62.30 ± 22.12 vs 74.97 ± 19.20, P<0.05 ) and obese group (62.30 ± 22.12 vs 74.57 ± 19. 22, P < 0.05 ). Comparing the scores between any two groups in MCS,the scores of patients with low body mass index were significantly lower than normal weight group (68. 81 ± 20. 48 vs 74. 70 ± 20.41, P < 0. 05), overweight group (68. 81 ± 20. 48 vs 78.08 ±18.23, P<0.05) and obese group (68.81 ±20.48 vs 78. 69 ± 17.77, P<0.05); the score of normal weight group was significantly lower than the overweight group (74. 70 ±20. 41vs 78. 08 ±18.23, P<0.05). Gender Stratification showed that females with low body mass index had worse HRQOL than males. Conclusion The HRQOL of elderly hypertensive patients with low body mass index is significantly lower than normal weight patients, overweight patients and obese patients, the health promotion of elderly hypertensive patients with low body mass index should be paid more attentions, especially females with low body mass index.

Objective To investigate the causes, prevention and treatment of recurrent laryngeal nerve (RLN) injury during operation in patients with thyroid cancer. Methods Clinical data of 192 patients undergone thyroidectomy operation were reviewed. Results RLN was exposed during operation in 192 patients. There were 3 cases of RLN injury, then RLN anastomosis was happened immediately during operation. It was significantiy improved in pronunciation after operation. 2 ～ 3 d after surgery, transitory hoarseness was observed in 3 patients. Unilateral RLN resection performed in 1 case with cancer involving RLN. Conclusions There were some causes of RLN injury. Exposure of RLN selectively,delicate operation and thyroid gland surgery specialist were the key point for prevention of the injury of RLN. Once RLN injury occured ,repairing should be performed as soon as possible.

Objective To study the relationship between soluble CD147 (sCD147) level in peripheral blood and serum lipid level and explore the effect of sCD147 on atherosclerosis in rheumatoid arthritis (RA). Methods The level of sCD147 in 36 patients with RA,36 patients with coronary artery disease (CAHD) and 30 healthy volunteers was detected by enzyme linked immunosorbent assay (ELISA) .The disease activity score (DAS28) in RA patients was evaluated and the correlation between sCD147 level and DAS28 score was analyzed.The serum lipid level of RA patients was detected by an automatic biochemical analyzer and the cor relation between sCD147 level and serum lipid level was analyzed.Results The level of sCD147 in serum of RA patients was significantly higher than that in patients with CAHD and healthy volunteers,sCDI47 level in the RA group with high DAS28 score was significantly higher than that with low or medium DAS28 score.In RA patients,elevated total cholesterol (TC) and triglyceride (TG) level was positively correlated with serum sCDI47 level (r=0.84,P＜0.05;r=0.87,P＜0.05;while slightly elevated,normal TC and normal TG had no correlation with serum sCDI47 level (r=0.41,P=0.21;r=0.14,P=0.57;r=0.49,P=0.87).Elevated or slight ly elevated LDL-C was positively correlated with serum sCD147 level (r=0.86,P＜0.05;r=0.81,P＜0.05), while no correlation could be found in the group with normal LDL-C level (r=0.78,P=0.22).The high density lipoprotein-cholesterol (HDL-C) level decrease in RA patients had no correlation with serum sCD147 level (r--0.04,P=0.96;r=0.13,P--0.87).Conclusion sCD147 may be involved in the pathogenesis of RA and associate with disease activity.Elevated sCD147 level may be associated with abnormal serum lipid in RA.

Objective To observe the osteogenic and/or chondrogenic differentiation potential of cartilage endplate derived stem cells ( CESCs) .Methods The cartilage endplate ( CEP) was obtained from 5 patients who underwent posterior discectomy procedure for the lumber degenerative disease.The agarose culture was used to select CESCs.The expanded CESCs were injected into the hydroxyapatite ceram-ic(HA) and incubated for 7 days.After that,the HA contained CESCs were implanted into the subcutaneous of nude mouse for 7 weeks.Then the HA was obtained and sliced for the specific stain and immunohistochemisty.The expanded CESCs were injected into the degenerated in-tervertebral disk of the rabbit for 16 weeks.Then MRI was used to detect the repair of the degenerated disc.Results The metachromasia of toluidin blue indicated that cartilage matrix was formed in the vacant space of HA.Mallory stain indicated that there was bone matrix was formed.The results of immunohistochemistry indicated that there was more collageⅠand collageⅩ,and a small quantity of collage Ⅱ.MRI results indicated that the CESCs could be induced into the chondrocyte-like cells in the rabbit intervertebral disk.Conclusion The CESCs could be induced into the bone/cartilage in vivo.