Objective To explore the effect of particulate matter (PM) 2.5 on the expression of pigment epithelium-derived factor (PEDF) protein in bronchial epithelial cells (BEAS-2B). Methods Human BEAS-2B were subcultivated, followed by low, medium and high concentrations of PM2.5 (25μg/ml, 50μg/ml, 100μg/ml) stimulation for 24 hours. The expression of PEDF protein in supernatant was ana-lyzed by enzyme-linked immunosorbent assay (ELISA), and the expression in BEAS-2B cells was detected by Western blotting. Results Compared with the control group, the expression of PEDF protein in supernatant and BEAS-2B cells induced by PM2.5 (25 μg/ml) in-creased, but no significance was found (t=-0.730, t=-1.840, P>0.05), and the expression induced by PM2.5 with the concentrations of 50μg/ml and 100μg/ml significantly increased (t>5.798, P<0.05). Conclusion PM2.5 with the concentrations of 50μg/ml and 100μg/ml could increase the expression of PEDF protein in a concentration-dependent manner both in supernatant and BEAS-2B cells.

Objective To investigate the effects of constraint-induced movement therapy (CIMT) on the function of hemiplegic upper extremity in the early subacute stroke patients.Methods A prospective,single-blinded,randomized controlled study was conducted.Forty-seven stroke patients with hemiplegic upper limb dysfunction were randomly divided into 2 groups:a CIMT group and a control group.The CIMT group received constraintinduced movement therapy and the control group was treated with conventional rehabilitation therapy.Both groups were treated 3 h daily,5 d a week for 2 weeks.The Wolf motor function test (WMFT) and Fugl-Meyer Assessment (FMA) were used to evaluate upper extremity motor function,and motor activity log (MAL) was used to assess upper extremity ability in activities.WMFT,FMA and MAL were measured before and after 1 day and 6 months of treatment.Results After 1 day of treatment,FMA,WMFT,MAL-AU and MAL-HW were 53.81 ± 2.59,66.68 ± 3.54,1.89 ± 0.88 and 3.26 ± 0.65,respectively,in the CIMT group,and 48.61 ± 4.48,62.10 ± 7.97,1.25 ± 0.64 and 2.65 ± 0.93,respectively,in the control group.After 6 months of treatment,FMA,WMFT,MAL-AU and MAL-HW were 57.53 ±2.01,69.57 ± 3.00,3.00 ±0.82 and 3.84 ±0.69,respectively,in the CIMT group,and 53.30 ± 2.88,66.20 ±3.59,2.20 ± 1.06 and 3.25 ±0.64,respectively,in the control group.The scores of FMA,WMFT,MAL in the CIMT group were all higher than those in the control group at 1 day and 6 months post-treatment,and the differences were statistically significant (P ＜ 0.05).Conclusion Constraint-induced movement therapy can significantly improve the patients' hand function in the early stage of subacute stroke,which maintain up to 6 months of follow-up.

Objective This study aimed to investigate the characteristics of maternal death cases, the cause of maternal death and the cause of medical dispute,and recommended the relative prevention measures. Methods We retrospectively analyzed 35 cases of maternal death identified in the College of Forensic Medicine in Kunming Medical University from January 2002 to December 2012. Results In 35 maternal death cases: (1) Most maternal deaths are over 30 years old (14 cases, 40%), followed by 17 to 19 years old (6 cases, 17.1%) . And most maternal deaths came from countryside (25 cases,71.4%) . (2) 26 cases maternal deaths happened during the perinatal period (68.5%) . (3) 26 cases happened in county hospitals, township hospitals and informal medical organizations (74.3%) . 5 maternal deaths happened on the way to the hospital or at home (14.3%) . (4) 17 cases died of obstetric hemorrhagic shock (48.6%), 11 cases died of amniotic fluid embolism (31.4%), 2 cases died of amniotic fluid embolism and obstetric hemorrhagic shock (5.7%) . (5) 30 cases of medical disputes were caused by maternal death. Among them, the clinical diagnosis was not consistent with the pathological diagnosis in 20 cases (The misdiagnosis rate was 66.7%) . (6) The causes of medical dispute:clinical diagnosis was unknown in 11 cases (36.7%),11 cases were suspected that rescue was not timely or improper (36.7%),and 8 cases were suspected of misdiagnosis (26.6%) . Conclusion Obstetric hemorrhage and pulmonary amniotic fluid embolism were the main reasons of the maternal death. The incidence of maternal death and medical disputes could be reduced by improving the ability of obstetric staff,and strengthening the diagnosis and treatment about obstetric hemorrhage and pulmonary amniotic fluid embolism. At the same time, women should improve their self-care awareness, reduce early marriage and early pregnancy,and enhance the consciousness of hospital treat and cure.

Objective To investigate the feasibility and clinical results under laparoscopic resection of colorectal cancer.Methods Clinical data of 17 colorectal cancer patients with laparoscopic resection from October 2009 to September 2011 were analyzed.Results There were 16 cases of successful completion of laparoscopic surgery,conversion to open surgery in 1 case.Postoperative of incomplete intestinal obstruction and rectal vaginal fistula are each 1 case.Oncology did not occur metastasis through puncture holes in postoperative follow-up up to 2 years.Conclusion Laparoscopic resection of colorectal cancer should be widely applied,and it had more advantages such as less trauma,safety,recover quickly,consistent with the effect of laparotomy.

Objective To investigate the efficacy and selection of anterior and posterior approaches for segmental severe ossification of posterior longitudinal ligament (OPLL)of the cervical spine.Method From January 2007 to May 2011,59 patients with segmental severe OPLL underwent surgical treatment,including 41 males and 18 females,with an average age of 55.7 years.Among them,24 patients underwent anterior corpectomy and fusion,and 35 patients underwent laminectomy and lateral mass screw fixation.In two groups,the operation time,intraoperative blood loss,change of cervical curvature,neck axial symptoms,and JOA (Japanese Orthopaedic Association) score were recorded and compared.Result All patients were followed up for 12 to 18 months (average,15.4 months).The average JOA score in anterior approach group increased from preoperative 7.33 ± 1.09 to 13.63±0.82 at final follow-up,with an average improvement rate of 65.16％ ±7.50％; the average JOA score in posterior approach group increased from preoperative 7.20 ± 1.05 to 12.23 ± 1.11 at final follow-up,with an improvement rate of 51.46％±9.64％; and the difference between two groups was statistically significant.Immediately after the operation,the segmental curvature of the operative site was 5.38°±1.14° in anterior approach group and 3.89°±1.65° in posterior approach group,and the difference was statistically significant.At final follow-up,the rate of neck axial symptoms was 20.83％ in anterior approach group and 51.43％ in posterior approach group,and the difference was also statistically significant.Conclusion For severe OPLL with not more than 3 segments of ossification,the anterior approach can remove the ossified mass directly,get a better neurological recovery,provide a good biomechanical alignment,and decrease the postoperative axial symptoms.However,posterior laminectomy and lateral mass screw fixation also can obtain enough decompression and maintain the segmental curvature.

Objective The purpose of this sturdy was to conduct a meta-analysis of published randomised controlled trials(RCT) comparing the clinical outcomes of radiofrequency ablation(RFA) versus surgery alone(SA) in all patients with cardiac surgery.Methods PubMed, Embase, the Cochrane Controlled Trials Register databases, CNKI, CBM disc and VIP datebases were searched, and study eligibility and conducted data abstraction were determined independently and in duplicate.Literature searches from database establishment to November 2014.The heterogeneity and data were analyzed by the software of Rev Man 5.2.Results Of 564 studies identified, 8 studies met eligibility criteria, and included a total of 591 patients.In efficacy, The number of patients in sinus rhythm(SR) was signifcantly improved in RFA group compared to SA group at discharge(OR =10.59;95％ CI: 3.81-29.45).This effect on SR remained at all follow-up periods until ＞ 1 year.In safety, there was no significant difference in the incidence of hospital mortality(OR =1.17;95％ CI: 0.41-3.35) and mortality rate in follow up period(OR =0.77;95％ CI: 0.35-1.69) between RFA group and SA group.Similar results were shown in the incidence of permanent pacemaker(OR =0.65;95 ％ CI: 0.28-1.52;P =0.32) , thromboembolic events (OR =1.61;95 ％ CI: 0.54-4.84;P =0.40), postoperative re-intervention for bleeding (OR =0.45;95 ％ CI: 0.12-1.70;P =0.24).Conclusion The results of the current randomized trials demonstrates that concomitant surgical radiofrequency ablation and cardiac surgery is safe and effective at restoring sinus rhythm.

Objective To evaluate the clinical effect of endovascular embolization for the treatment of cerebellar arteriouvenous malformations (AVMs) associated with aneurysm, and to discuss its technical points. Methods The clinical data of 142 patients with cerebellar AVMs were retrospectively analyzed. Of the 142 patients, 42 had concomitant aneurysms. The patients were divided into concomitant aneurysm group and without aneurysm group. Using univariate and multivariate statistical models, the patient’s gender and age, the presence or absence of hemorrhage, the lesion’s location and size, and the presence or absence of deep venous drainage were analyzed. Results A total of 61 concomitant aneurysms were detected in the 42 patients, which were located within the malformation mass (n=14) or on the feeding artery (n=47). The concomitant aneurysms located in the malformation were closely related to AVM hemorrhage and the deep venous drainage. During the follow-up period after endovascular embolization, no recurrence of bleeding was observed in all the 42 patients. Conclusion In order to reduce the relapse rate of hemorrhage, the formulation of therapeutic measures should be based on the management of the concomitant aneurysm when endovascular embolization treatment is employed for AVM associated with aneurysm.

Objective To observe the therapeutic effect of the Valpar system combined with computer-aided technology in treating early vascular cognitive impairment (VCI).Methods Forty patients in the early stage of VCI were randomly divided into a treatment group and a control group,each of 20.Regular and computer-aided cognition training were applied in both groups,while training using the Valpar system was additionally used in the treatment group.Patients in both groups were assessed using the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and the modified Barthel Index (MBI) before,and after 4 and 8 weeks of treatment.Results Before the treatment,there were no significant differences between the 2 groups in LOTCA and MBI scores (P＞0.05).After 4 and 8 weeks of treatment,the average total LOTCA score in the observation group was significantly better than before the treatment,as were the average scores on the various dimensions,and the average MBI score (P＜0.05).After 4 weeks of treatment the control group showed significant improvement in the patients' orientation (3.50±0.89),visual perception (13.50± 1.43),spatial perception (2.40±0.50),visuomotor construction (24.00± 1.17) and attention (2.30±0.87).However,after both 4 and 8 weeks of treatment,all the measurements of the observation group were significantly better than those of the control group at the same time point (P＜0.05).Conclusion The Valpar system can significantly improve the recovery of cognitive function and ability in the activities of daily living of patients in the early stage of VCI.It is worth applying in clinical practice.

Objective To summarize 500 cases of surgical experience in restoration of adult congenital heart disease ( ACHD) treatment and early postoperative.Methods During January 2012 to December 2014 in Fuwai Hospital, 500 cases of ACHD treated by operation were chosen to collect the clinical data .We divided the groups according to whether the case was a complex malformation and whether the case had an ICU retention time is more than the 5 days.Results The average age was 35, the average weight was 59 kg.The operation average cardiopulmonary bypass(CPB) time was 102min.The average ICU treatment time was 2 days, the average duration of mechanical ventilation was 23 hours, 3 early deaths occurred.The complex malformation group had younger age and less weight than the simple malformation group , the complex malformation group had longer time of cardiopulmonary bypass time, aortic cross clamping time, mechanical ventilation time and ICU treatment time, had higher rate of complication and blood transfusion peri-operative period than the simple malformation group.(P<0.05) The group of ICU retention time less than 5 days had higher rate of the male proportion, had younger age and less weigh, had longer time of cardiopulmonary bypass time , mechanical ventilation time and ICU treatment time , had higher rate of complication and blood transfusion peri-operative period than the control group(P <0.01).Conclusion Although ACHD patients have long medical history and complicated pathological and physiological changes , when they get proper surgical operation and periopera-tive treatment, they should obtain satisfied effect.Professional medical team or organization service for the ACHD patient is very important and urgent to build.

OBJECTIVE To explore the effect of bisphenol A (BPA) on the differentiation potential of embryonic stem cells, and provide an experimental basis for evaluation of safety of BPA. METHODS Mouse embryonic fibroblasts (MEFs) and embryonic stem cells (ESCs) were treated with BPA 0.1, 1, 10, 100 and 1000 μmol.L-1 for 8 d respectively. The viability of MEFs and ESCs was measured by CCK-8 and lC50 was calculated. The mRNA expression of α-myosin heavy chain in ESCs was tested by RT-PCR to determine lD50 . The embryonic body cultured by suspension method was treated with BPA 0.001, 0.01, 0.1 and 1 μmol.L-1 for 10 d respectively. The changes of marked genes in each blastoderm were detected by RT-PCR. RESULTS lC50 of BPA to mouse ESCs was 5.22×10-4 mol.L-1 , and to MEFs was 6. 25 × 10-4 mol.L-1 . lD50 of BPA to mouse ESCs differentiating to cardiomyocytes was 7.0×10-7 mol.L-1 . BPA 0.001 and 0.01 μmol.L-1 upregulated the expression of the marked genes of mesoderm, fetal liver kinase-1 and globin transcription factor 1. CONCLUSION BPA is a strong embry-otoxic compound. BPA of low concentration can promote the differentiation of mouse ESCs to mesoderm.