The identification of the specific cause in every patient has important clinical implications, because ischemic stroke is an etiologically heterogeneous disease. The Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification can be used to define the etiology of stroke. However, TOAST classification can not be completed timely on admission of patients with acute stroke, which has impacted early guidance of clinical treatment. This article reviews the biological markers of early differential-diagnostic significance of the TOAST classification.

Regional anatomy of inguinal hernia is one of the teaching difficulties.The students always feel confused due to deficiency of visual and vivid teaching materials.The thesis analyzed the efficacy of using high-definition video of laparoscopic inguinal hernia repair (LIHR) in the clinical teaching of inguinal region anatomy aiming to deepen the understanding,inspire the enthusiasm and initiative of students and improve the quality of teaching.

OBJECTIVETo study the effect of beta-hydroxyisovaleryl shikonin (beta-HIVS) combined cisplatin on activities of ovarian cancer cell line SKOV3 in vivo and its possible mechanisms.

METHODSCells were divided into the blank control group and six beta-HIVS groups (2 - 30 micromol/L). Effect of beta-HIVS at different concentrations on the activities of ovarian cancer cell line SKOV3 was detected using MTT assay. SKOV3 cells were treated with cisplatin (10, 20, and 40 micromol/L) and beta-HIVS (0.25, 1, and 2.5 micromol/L) combined cisplatin. Effect of beta-HIVS combined cisplatin on the activities of ovarian cancer cell line SKOV3 was determined by MTT assay. The expression of Bcl-2 and Bax after treated by different concentrations of beta-HIVS was detected by Western blot.

RESULTSThe activities of SKOV3 were inhibited by different concentrations of beta-HIVS dose-dependently. The 50% inhibition rate (IC50) was 7.37 micromol/L. There was statistical difference in IC50 between each concentration beta-HIVS group and the blank control group (P < 0.05). There was statistical difference in IC50 between the beta-HIVS (1 and 2.5 micromol/L) combined cisplatin groups and the cisplatin group (P < 0.05, P < 0.01). The synergistic effect on beta-HIVS showed dose-dependent manner. Results of Western blot showed beta-HIVS at different concentrations (5, 7.5, and 10 micromol/L) could obviously up-regulate the expression level of Bax protein and inhibit the expression level of Bcl-2 protein, showing statistical difference when compared with the control group (P < 0.01). CONCLUSIONS; HIVS could obviously inhibit in vitro growth of SKOV3 in a dose-dependent manner. With the range of concentration, beta-HIVS showed synergetic effect with cisplatin. Besides, along with increasing beta-HIVS concentrations, the synergetic effect was more significant. The synergetic effect might accelerate the apoptosis of SKOV3 through up-regulating Bax expression and inhibiting Bcl-2 expression.

Apoptosis ; drug effects ; Cell Line, Tumor ; Cisplatin ; pharmacology ; Female ; Humans ; Naphthoquinones ; pharmacology ; Ovarian Neoplasms ; metabolism ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; bcl-2-Associated X Protein ; metabolism

Animals ; Chlorine ; toxicity ; Interleukin-8 ; metabolism ; Lung ; drug effects ; metabolism ; pathology ; Male ; Pulmonary Emphysema ; chemically induced ; metabolism ; Rats ; Rats, Wistar ; Time Factors ; Tumor Necrosis Factor-alpha ; metabolism

Objective To compare the effects of fundus-first laparoscopic cholecystectomy and laparoscopic subtotal cholecystectomy in complicated cholecystolithiasis cases. Methods The effects of fundus-first laparoscopic cholecystectomy (n = 21) and laparoscopic subtotal cholecystectomy (a = 18) in the 39 cases of complicated chole-cystolithiasis from our hospital within 2 years were analyzed retrospectively. Results The operation time in subtotal laparoscopic cholecystectomy group was shorter than in fundus-first laparoscopic cholecystectomy group (88.89±18.11) min vs. (109.52±21.79) min, P < 0.05). Less blood lose (82.78±44.96) ml and fluid replacement (847.22±169.32)ml during the operation were observed in the former group than those in the later group (116.67±53.23) ml and (964.29±147.60) ml, respectively, P < 0.05). However, the patients' postoperative recovery time and the duration of postoperative hospital staying were similar in the two groups(5.56±1.20) days vs. (5.29±1.38) days, P > 0.05). Conclusions Proper use of subtotal laparoscopic cholecystectomy in complicated cholecystolithiasis cases can simplify the operation and obligate the operation time, which will increase the safety of the operation with the outcome similar to fundus-first laparoscopic cholecystectomy.

Appendectomy involves several key concepts in the foundation course of operative surgery. So it is the best choice to test whether the students can be flexible in using and fully under-stand what they learned about the basic theories and skills of appendectomy. Changzheng Hospital applies Wechat-ald team-based learning and problem-based learning teaching in appendectomy-related courses by actively delivering messages with content of educational administration, basic knowledge, clinical images and videos to the micro-groups, achieving instantly efficient information dissemination and interactive communication. It breaks the shackles of traditional classroom in space and time, mo-bilizes students' enthusiasm for learning, enhances their communicational skills and sense of team-work and improves students' comprehensive analysis and practical ability, therefore achieving better teaching results.

The Coat protein and Maturase gene of E.coli bacteriophage MS2 was amplified by PCR,then the gene was cloned into pET32a to construct the intermediate vector pET32aCP.The conservative sequence of FMDV internal ribosome entry site(IRES) was cloned into the downstream of pET32aCP bacteriophage gene to construct the prokaryotic expression vector pCPES.The recombinant plasmid pCPES transformed into E.coli strain BL21(DE3) was induced to express with 1mmol/L IPTG.The expression products were purified by sucrose density gradient centrifugation.The expression products observed by TEM were circular viruslike particles,and the diameter of these particles was about 26nm.The stability of viruslike particles was detected,and the viruslike particles was identified by RTPCR.The results showed that the viruslike particles contain the FMDV IRES RNA and have good stability.The viruslike particles have great prospect as the standard and quality control in the area of RNA virus detection.

Objective To determine the correlation between intestinal epithelial cell apoptosis; and STAT3 activation during murine severe acute pancreatitis (SAP).Methods Wistar rats were divided into four groups (12 in each group): S (sham), C (control), A (SAP), N (NAC was given 1 hour before SAP).Samples were obtained 3 or 24 hours after for the determination of plasma D-lactate, intestinal mucosa MDA and XO, immunohistochemical staining for PCNA.Apoptosis of the epithelial cell was examined with TUNEL and DNA laddering.The expressions of Bcl-2? Bax? p-STAT3 in intestinal mucosa were assessed by Western blot.Results Plasma D-lactate and intestinal epithelial cell apoptosis increased in group A, especially at 24 hours after operation ( P

AIM: To evaluate the anatomic and visual outcomes of 25-gauge vitrectomies combined with air tamponade for the treatment of idiopathic macular hole (IMH).METHODS: Thirty eyes of 27 patients with IMH were included in this prospective interventional study.All patients underwent 25-gauge pars plana vitrectomy (PPV) combined with phacoemulsification and air tamponade.Best corrected visual acuity (BCVA, logMAR), perimetry and multifocal electroretinography (mfERG) were conducted before and after the operation.Anatomical changes were evaluated with optical coherence tomography (OCT).RESULTS: The macular holes closed successfully in 28 eyes after the primary vitrectomy.The mean BCVA improved from 0.72±0.22 logMAR preoperatively to 0.29±0.18 logMAR postoperatively (P<0.001).In the visual field of central 10°, the average mean deviation (MD) decreased from-3.59±1.83 dB preoperatively to-2.51±1.36 dB postoperatively (P<0.001) and the average pattern standard deviation (PSD) decreased from 1.86±0.68 dB preoperatively to 1.33±0.32 dB postoperatively (P=0.001).The retinal response densities of mfERG in the foveal and perifoveal area increased significantly, and implicit times of rings 4-6 prolonged significantly (P<0.05).The symptom duration and baseline N1 amplitude densities at ring 1 had a significant impact on postoperative BCVA (P<0.001, P=0.001, respectively).CONCLUSION: The 25-gauge PPV and air tamponade with 1 day prone positioning produce favorable anatomic and functional outcomes.