Objective To investigate the change of serum matix metalloproteinase-2(MMP-2) level and its significance in patients with acute ischemic stroke of different subtypes. Methods Seventy-seven patients with acute ischemic stroke were classified into large-artery atherosclerosis (LAA) (n =29, 37. 66% ), small artery occlusion (SAO, lacunar infarction) (n =23, 29.87%), cardioembolism (CE) (n = 13,16. 88%), stroke of undemonstrated etiology (SUE) (n = 7, 9.09% ), and stroke of other demonstrated etiology (SOE) (n = 5, 6. 49%) according to the TOAST criteria. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum MMP-2 in patients with acute ischemic stroke at 24 hours and 7 days, and they were compared with 42 controls. Results The serum MMP-2 levels at 24 hours and 7 days of the onset of symptoms in the acute ischemic stroke group according to the TOAST criteria were 189. 55 ±24.79 and 307.46 ±84. 16 ng/ml respectively, and they were all significantly higher than 159.76 ± 10. 32 ng/ml in the control group (all P <0.05). Among all the TOAST subtypes, SOE and SUE were not analyzed because of the small numbers of cases; among other subtypes, the serum MMP-2 levels at 24 hours of the onset of symptoms in the LAA, SAO and CE groups were 218. 60 ± 13.42,175.21 ±9.92, and 167.26 ±9.7 ng/ml respectively, and they were all significantly higher than those in the control group (all P < 0. 05); at day 7 of the onset of symptoms they were 404.75 ± 10. 30, 293.18 ± 10.91, and 211.81 ±11.14 ng/ml respectively, and they were also significantly higher than those in the control group (all P < 0.05). Among those, the LAA group was increased significantly (P < 0. 01). Conclusions The serum MMP-2 levels were increased in patients with acute cerebral infarction. "l'ne changes of the serum MMP-2 levels in each TOAST subtype group were different. The LAA group increased most significantly, which supported the different views of the etiology of cerebral infarction subtypes. The serum MMP-2 plays an important role in the process of cerebral infarction of the LAA type.

Objective To investigate the clinical outcomes of transanal local excision (LE) and transabdominal radical surgery (RS) for T1 rectal cancer with distance from anal verge (DAV) ≤ 8.0 cm,and analyze the prognostic factors after non-palliative resection of T1 rectal cancer with DAV ≤8.0 cm.Methods Theretrospective cohort study was conducted.The clinicopathological data of 82 T1 rectal cancer patients with DAV ≤8.0 cm who were admitted to the Fujian Medical University Union Hospital between December 2000 and December 2014 were collected.Among 82 patients,42 undergoing transanal LE and 40 undergoing transabdominal RS were allocated into the LS and RS groups,respectively.Forty-two patients in the LE group received transabdominal RS or postoperative adjuvant radiochemotherapy if results of postoperative pathological examination showed high risk.Observation indicators:(1) comparisons of surgical and postoperative situations between the 2 groups;(2) followup situations;(3) prognostic factors analysis after non-palliative resection of T1 rectal cancer with DAV ≤ 8.0 cm.Follow-up using outpatient examination and telephone interview was performed to detect the defecation and sexual functions,survival and tumor recurrence up to January 2017.Measurement data with normal distribution were represented as (x)±s,and comparisons between groups were evaluated with an independent sample t test.Comparisons of count data were analyzed using the chi-square test or Fisher exact probability.The Kaplan Meier method was used for calculating overall survival rate and tumor-free rate,and survival was analyzed using the Logrank test.Multivariate analysis was done using the COX regression model.Results (1) Comparisons of surgical and postoperative situations between the 2 groups:all the 82 patients underwent successful surgery.Of 42 patients in the LE group,28 underwent single transanal LE,2 underwent additional transabdominal RS within 1 month postoperatively,6 underwent postoperative adjuvant radiochemotherapy,5 underwent postoperative adjuvant radiotherapy and 1 underwent postoperative adjuvant chemotherapy (didn't complete course due to poor tolerance).Forty patients in the RS group underwent transabdominal anterior resection of rectum or combined with abdominal perineal resection for rectal cancer.DAV,operation time,volume of intraoperative blood loss,time of postoperative gastrointestinal function recovery,cases with pulmonary infection and duration of postoperative hospital stay were (4.9±1.3)cm,(65±33) minutes,(11±7)mL,(1.2±0.4) days,0,(2.2±0.9)days in the LEgroupand (6.7±1.9)cm,(256±35)minutes,(65±47) mL,(2.4±0.8)days,6,(6.9±1.1) days in the RS group,respectively,with statistically significant differences (t =4.882,12.448,3.553,4.025,x2 =6.797,t =10.367,P＜0.05).Cases with intraperitoneal infection,wound infection,urinary tract infection,inflammatory intestinal obstruction,anastomotic fistula,chyle leakage,rectovaginal fistula and positive surgical margin were 0,0,0,0,0,0,0,1 in the LE group and 1,0,0,1,0,2,l,0 in the RS group,respectively,with no statistically significant differences between the 2 groups (x2 =1.063,1.063,2.153,1.063,P＞0.05).All patients with complications were cured by conservative treatment.(2) Follow-up situations:of 82 patients,67were followed up for defecation function (37 in the LE group and 30 in the RS group),40 were followed up for sexual function (25 in the LE group and 15 in the RS group),76 were followed up for survival.Follow-up time was 1-145 months,with a median time of 31 months.Cases with fecal incontinence and sexual dysfunction were respectively 0,0 in the LE group and 4,3 in the RS group,showing statistically significant differences (x2 =5.247,5.405,P＜0.05).Cases with 5-year local recurrence,5-year overall survival rate and 5-year tumor-free survival rate were respectively 1,94.1％,91.0％ in the LE group and 0,87.6％,87.6％ in the RS group,showing no statistically significant differences (x2 =0.833,2.313,0.849,P＞0.05).(3) Prognostic factors analysis after non-palliative resection of T1 rectal cancer with DAV ≤ 8.0 cm:results of multivariate analysis showed that age was an independent factor affecting prognosis of T1 rectal cancer patients with DAV ≤8.0 cm after non-palliative resection (RR =1.254,95％ confidence interval:1.055-1.491,P＜0.05).Conclusions Transanal LE in treatment of T1 rectal cancer patients with DAV ≤ 8.0 cm is consistent with RS in local control and long term prognosis,and the protection of defecation and sexual functions in LE is superior to that in RS.Age is an independent factor affecting prognosis of T1 rectal cancer patients with DAV ≤ 8.0 cm after non-palliative resection.

Objective To explore the relation between prostaglandin E2(PGE2) and the mechanosensitivity of osteoblasts and to analyze its action mechanism in cellular level .Methods Osteoblasts cell line MC3T3-E1 cells were performed the pre-treatment by using 16 ,16-dimethyl prostaglandin E2(dmPGE2) .Then the regulating effect of PGE2 on intracellular calcium ion signal was ob-served;the activator agent and inhibitor of the protein kinase A (PKA) signal path were adopted to detect the participating effect of the PKA signal path in the regulating process .Results Compared with the blank treatment group ,dmPGE2 pre-treatment signifi-cantly increased the calcium ion signal intensity induced by hypotonic swelling stimulation in MC 3T3-E1 cells .This effect of dmPGE2 was mimicked by 8-bromo-cAMP(8br-cAMP) ,an activator of PKA pathway ;but blocked by PKI ,an inhibitor of PKA pathway .Conclusion dmPGE2 is able to up-regulate the calcium response induced by hypotonic swelling stimulation by activating PKA pathway ,which provides an important cellular mechanism for explaining PGE2′s anabolic effect in bone tissue .

Total 118 patients with pyogenic liver abscess admitted to Zhongshan Hospital were classified into pypgenic liver abscesses of cryptogenic origin (PLAC,n =54),pyogenic liver abscesses of biliary origin (PLAB,n =48) and pyogenic liver abscesses of hemagenous origin (PLAH,n =16)according to the causes.The clinical features of three groups were compared and analyzed.The results showed that no statistically significant difference existed among three groups in clinical manifestation and signs.Compared to PLAB,the abscesses in right lobe of liver were more common in PLAC,diabetes mellitus was more prevalent in PLAC,but the co-existing diseases including chronic liver disease,non biliary malignant tumor and ALP elevation were less in PLAC.Klebsiella pneumoniae was frequently detected in PLAC,but there was no significant difference comparing to other two groups.No significant difference was found among three groups in the choice of therapeutic methods,the course of antibiotics,length of hospital stay and the days from admission to diagnosis.

The clinical data of 118 patients with bacterial liver abscess admitted to a tertiary hospital from January 2007 to December 2009 were analyzed retrospectively.Etiology study showed that 45.8％(54/118) cases of bacterial liver abscess were cryptogenic,40.7％ (48/118) were biliary source and 13.5％ (16/118) were hematogenous.The positive rate of pus culture was 57.1％ (36/63),among which klebsiella pneumoniae accounted for 72.2％ (26/36).The positive rate of blood culture was 31.2％(20/64) and klebsiella pneumoniae accounted for 95％ (19/20).One hundred and sixteen patients (98.3％) underwent color ultrasound examination with an accuracy rate of 93.2％.84 patients (71.2％)underwent the CT scan with an accuracy rate of 95.3％ and 20 patients underwent MRI with an accuracy rate of 85％.Seventy five patients (63.6％)accepted ultrasound-guided percutaneous aspiration and catheter drainage combined with antibiotic therapy; 40 patients(33.9％)were treated with antibiotics alone.On the discharge 27 patients(22.9％) achieved clinical cure,87 patients (73.7％) were classified as effective,4 patients (3.4％) had no effect and no death in this group of patients.The average length of hospital stay was 16 days.Cryptogenic was the most common cause of bacterial liver abscess,biliary source took the second place.Kleibsiella pneumoniae was the predominant organism.Detailed medical history inquiry,physical examination and assistant examination may increase the accuracy rate of diagnosis.Needle biopsy should be performed if necessary.Ultrasound-guided percutaneous aspiration and catheter drainage combined with antibiotics should be the first-line treatment.

Objective To determine the effectiveness of ETCD ( endoscopic transpapillary cyst drainage) in treatmen! of pancreatic pseudocysts. Methods Twenty-six patients with pancreatic pesudocysts were selected. They are presented some indications for treatment and the pesudocyst were ranged in size from 1.5 to 15 cm. Of 23 cases 38 sessions of ETCD were performed. In two of thirty-eight cases the cyst bulges were invisible in the stomach or duodenum due to its compression. In one case ETCD was employed after percutaneous drainage of the pseudocyst, the other one was treated after combination therapy of plastic stent ing because of jaundice. Results Improvement of abdominal pain, changes in appetite, body weight and fat in stool were recorded in follow-ups of 60 ~ 850 days. There was only one asymptomatic recurrence. One case was complicated with pancreatic abscess. There was no mortality related to the procedure. Surgical intervention became necessary in three cases because of inadequate drainage or complication. Conclusion ETCD treatment of symptomatic pancreatic pseudocysts with ductal communication, the transpapillary pancreatic duct stenting is a safe, effective modality and should be considered as the first line therapy; on the other hand for those pancreatic pseudocyst without communication to the main pancreatic duct it is not effective.

Objective Ischemic preconditioning and postconditioning can provide certain protection for myocardium .The ar-ticle was designed to observe the protective effect of salidroside on myocardial ischemia reperfusion injury ( MIRI) and explore its mech-anisms. Methods SD rats were randomly divided into 6 groups with 6 rats for each: sham operation group (S group), ischemia-reperfusion group(I/R group), salidroside preventive group(salidroside treatment followed by ischemia-reperfusion), salidroside treat-ment group (ischemia-reperfusion followed by salidroside treatment ), salidroside preventive+LY group(LY294002 preventive group) and salidroside treatment+LY group(LY294002 treatment group).Salidroside was administered once a day for three days before mod-elling in both salidroside preventive group and LY 294002 preventive group;while salidroside was given immediately after the reperfu-sion in both salidroside treatment group and LY 294002 treatment group .The same volume of NS was administered only to the rats in S group and I/R group.The PI3K inhibitor(LY294002) was given additionally 35 mins before LAD ligation in both LY294002 preventive group and LY294002 treatment group .All injections were given intraperitoneally .Akt, p-Akt, GSK-3βand p-GSK-3βin myocardium were examined with immunocytochemical method in all groups .The protein expression and phosphorrylation status of Akt /GSK-3βwere determined by western blot. Results The levels of Akt/GSK-3βin myocardium of S group(0.246 ±0.002), I/R group(0.457 ± 0.012), LY294002 preventive group(0.303 ±0.005), LY294002 treatment group(0.361 ±0.019) decreased significantly in com-parison to those of salidroside preventive group (0.857 ±0.014) and salidroside treatment group(0.683 ±0.009)(P<0.05).The levels of p-GSK-3β/GSK-3βin myocardium of S group (0.137 ±0.004), I/R group(0.380 ±0.026), LY294002 preventive group(0.148 ± 0.013), LY294002 treatment group(0.267 ±0.050) also decreased significantly in comparison to those of salidroside preventive group (0.944 ±0.045) and salidroside treatment group (0.895 ±0.043) (P<0.05).As to the comparison between salidroside preventive group and salidroside treatment group , there was no significant difference (P>0.05). Conclusion The result indicates that salidro-side protects myocardium against MIRI in rats .The cardioprotective effect might be associated with the increased protein expression and the phosphorylation rate of Akt/GSK-3β.

OBJECTIVE To study the expressions and significance of Fas/APO-1 protein and caspase-3 in human middle ear cholesteatoma and to investigate the relationship between their expressions and the apoptosis of cholesteatoma. METHODS The specimens from the middle ear cholesteatoma tissue of 20 cases and external ear skin of 10 cases were examined by immunohistochemical SP method and TUNEL method. RESULTS There was a significant difference in the expressions of Fas/APO-1 and caspase-3 positive cells between choleseatoma epithelium and normal external ear canal skin(P

OBJECTIVE:To study and analyze the impact of rosuvastatin on function changes of endothelial cell. METHODS:30 patients with coronary heart disease were selected from our hospital during Jun. 2013 to Jun. 2014,and 15 healthy persons were included. They were divided into healthy control group,drug intervention of coronary heart disease group and coronary heart disease group with 15 cases in each group. The levels of asymmetric dimethylarginine (ADMA),NO and nitric oxide synthase (NOS) were determined by ELISA and compared among those groups. Its relationship with OD value was analyzed. After cultured for 4 h and 8 h,human umbilical vein endothelial cells (HUVEC) were divided into 5 groups,i.g. control group 0 μmol/L,0.1 μmol/L group,1 μmol/L group,10 μmol/L group,100 μmol/L group. The change of DDAH mRNA expression in endothelial cells treated with different concentrations of rosuvastatin was detected. RESULTS:The level of ADMA in drug intervention of coronary heart disease group were significantly lower than in coronary heart disease group,but still higher than that in healthy control group;NO and NOS levels were significantly higher than coronary heart disease group,but still lower than healthy control group,with statisti-cal significance (P<0.05). According to Pearson method correlation analysis,OD value was positively correlated to ADMA,NO and NOS. 4h after HUVEC culture,RT-PCR showed that mRNA expression of DDAH were increased in 0.1 μmol/L,1 μmol/L, 10μmol/L and 100μmol/L rosuvastatin groups,there was statistically significant difference between 10μmol/L and 100μmol/L ro-suvastatin groups and control group (P<0.05). 8 h after HUVEC culture,RT-PCR showed mRNA expression of DDAH were in-creased in 0.1 μmol/L,1 μmol/L,10 μmol/L and 100 μmol/L rosuvastatin groups,and there was statistically significant difference between 10 μmol/L rosuvastatin group and control group(P<0.05). CONCLUSIONS:Rosuvastatin is a new type of lipid-lowering drugs,which has a good protective effect on endothelial cells,it is worthy of attention in the clinic.

Objective To investigate the significance of measuring carotid arterial intima-media thickness(IMT) and diabetic retinopathy(DR).Methods 76 diabetic patients were divided into three groups:no diabetic retinopathy(NDR),nonpmliferative diabetic retinopathy(NPDR),and proliferative diabetic retinopathy(PDR).20 helath people were chosen as control All subjects were examined by ColorDoppler imaging on the carotid arterial intima-media thickness.Results The mean IMT was significantly higher in T_2DM patients than in normal control group(P