Cerebral vasospasm is one of the most severe complications of subarachnoid hemorrhage. Its incidence is as high as 30-90%. It often causes severe regional cerebral ischemia or delayed ischemic brain damage, even resulting in cerebral infarction, and it thus becomes the primary cause of mortality and disability. In recent years, with the development of studies, people have realized that the oxyhemoglobin, inflammatory reaction, accumulation of vasoconstrictive substances, apoptosis, blood hypercoagulability and blood vessel cell proliferation play important roles in the development of cerebral vasospasm. Although its mechanism remains unclear, better effects have been achieved by using related treatment methods according to the available pathogenesis.

Aim To study the effect of As_2O_3(arsenic trioxide) on the expressions of telomeric repeat binding factor1,2 and telomeric stability of human gastric cancer MGC803 cells, and explore the mechanism of cell apoptosis. Method MGC803 cell growth inhibition was measured with MTT assay. Apoptosis was analyzed with flow cytometry. Influence on chromosome distal end was analyzed with chromosome end-end fusion analysis. Expressions of TRF1 and TRF2 were determined with Western blot analysis. Results MTT assay showed that As_2O_3 clearly inhibited the growth of MGC803 cells, depending on time and dosage. The apoptosis rates were significantly higher than those of the control group in a concentration and time-dependent manner. These changes were not found in the control group. After disposal with 5 ?mol?L -1 As_2O_3, chromosome fusion rate was obviously increased in 48 h. After 48 h of disposal with 5 ?mol?L -1 As_2O_3, the TRF1 of MGC803 cells was up-regulated while TRF2 was down-regulated. Conclusion As_2O_3 induced chromosome fusion and MGC803 cells apoptosis through up-regulating expressin of TRF1 and down-regulating expressin of TRF2.

Objective To discuss the ultrastructural pathological characteristics and dynamic changes of brain vessel after subarachnoid hemorrhage(SAH),and the mechanism of these changes in delayed cerebral vasospasm.Methods SAH model was made by infusing blood twice into the cistern magna of Japanese rabbits.The animals were divided randomly into SAH group,saline group,puncture group and blank group,at 1 h,3 d,5 d,7 d and 10 d after the first infusion the animals were perfused and basilar artery was harvested.Ultrastructural changes were observed under light microscope and electron microscope.Results Under the light microscope,the vessel wall became thick,the vessel cavity became narrow,the endothelia cells became swollen,vacuoles could be found in the chromatin,inner elastic membrane became reductus and broke.Under the electron microscope,the close connection between the endothelial cells disappeared,the membrane of the cells fell off,and the mitochondria became swollen,vacuoles could be seen,the chromatin became concentrated,heterochromatin could be seen,smooth muscle became deformed,chromatin became uneven, myofilament had derangement and fragmentation and dissolved,vacuolus could be seen in the kytoplasm,mitochondrion became swollen.The structural change of basilar artery under the light microscope got similar to that under the electron microscope;slight change was observed right after 1 h of SAH,significant change was observed at 3 d,and most obvious change was observed between 5 d and 7 d.Conclusion Ultrastructural changes were observed in the basilar artery after SAH,and significant dynamic changes were observed in the progress.The damage of endothelia cells may be the important factors which cause delayed cerebral vasospasm.

AIM To study the effects of growth inhibition of different concentrations of diallyl trisulfide(DATS) on gastric cancer MGC 803 cell line in vitro. METHODS The influence of different concentrations of DATS were examined by MTT assay, clonal formation rates and cell growth curve. RESULTS Suppression and decrease of MGC 803 cell proliferation was found after treatment by DATS in vitro. The inhibitory rates on MGC 803 cell growth of different concentration of DATS,4, 8, 12, 16 and 24 mg?L -1 , were 26%,46%,65%,76% and 89% respectively, and its half inhibitory concentration (IC 50 ) was 8 2 mg?L -1 . The clonal formation rates and clonal formation relative counts of 8, 12, 16 and 24 mg?L -1 were 32 4% and 58 7%,24 8% and 42 5%,19 0% and 33 5%?8 8% and 15 1% respectively.There was significant correlation between dose and effect in all, and the cell growth culve became lower and flatter when concentration of DATS increase gradually. CONCLUSION The effect of growth inhibition of DATS for gastric cancer MGC 803 cell in vitro is remarkable.

The interactions between genetic variations and dietary factors in type 2 diabetes mellitus have attracted some attention. Several studies revealed that dietary carbohydrate quality and quantity and increased dietary fat intake might interact with genetic variations of type 2 diabetes mellitus and increase risk of this disease. Genome-wide association studies suggest that genetic variance may modulate the association between dietary pattern and type 2 diabetes mellitus.

Objective To investigate the effect of 3-bromopyruvate (3-BrPA) on transplanted rectal tumors in experimental rabbit models. Methods A total of 60 New Zealand white rabbits with transplanted rectal tumor were randomly and equally divided into low-dose (0.5 mmol/L), medium-dose (1.0 mmol/L), high-dose (2.0 mmol/L) treatment groups and saline control group with 15 rabbits in each group. Arterial perfusion of 10 ml 3-BrPA with concentration of 0.5 mmol/L, 1.0 mmol/L and 2.0 mmol/L via caudal mesenteric artery was respectively employed for the rabbits of the corresponding treatment group; the control group was perfused with equal amounts of saline. Four days later, rectal tumors were removed by vivisection. The necrosis degree of tumor cells was determined by microscopic examination, and the necrosis rate was calculated. The effect of different 3-BrPA concentrations on the rectal tumor was evaluated. Results The rectal tumor transplantation and transcatheter 3-BrPA or saline perfusion was successfully completed in all 60 experimental rabbits. Microscopically, tumor cells showed different degrees of damage in experimental rabbits. In low-dose (0.5 mmol/L) treatment group, gradeⅠnecrosis was observed in 3 rabbits, gradeⅡin 11 rabbits, and gradeⅢin one rabbit;the effective rate was 6.7%. In medium-dose (1.0 mmol/L) treatment group, gradeⅡnecrosis was seen in 2 rabbits, grade Ⅲ in 10 rabbits, and grade Ⅳ in 3 rabbits; the effective rate was 86.6%. In high-dose (2.0 mmol/L) treatment group, gradeⅢnecrosis was detected in 2 rabbits and gradeⅣin 13 rabbits;the effective rate was 100.0%. In the saline control group, grade I necrosis was observed in 15 rabbits. Statistically significant differences in tumor necrosis rate and effective rate existed between medium-dose (1.0 mmol/L) treatment group and high-dose (2.0 mmol/L) treatment group (P<0.05). Statistically significant differences in tumor necrosis rate also existed between each other among the four groups with necrosis of gradeⅠto gradeⅣ(P<0.05). 3-BrPA had obvious therapeutic effect, while it showed no damage to the normal intestinal tissue. Conclusion For the treatment of transplanted rectal tumor in rabbit models, arterial infusion of 3-BrPA has certain therapeutic effect. In the high-dose group, the necrosis rate and effective rate are the highest, and the therapeutic results are the most significant.

ObjectiveTo examine the relation between pulse wave velocity (PWV) and impaired fasting glucose (IFG),then evaluate the modification effects of age,BMI,hypertension and lipids in Chinese adults.Methods5099 cases from a community-based health examination survey in Xuzhou,Jiangsu prownce,China,were enrolled in this study.Blood pressure,weight,height,waist circumference,neck circumference,body fat ratio and determination of fasting glucose,lipidsand pulse wave velocity were measured in all cases.IFG was defined as 6.1 mmol/L≤FBG ＜7.0 mmol/L.ResultsThe odds ratios (OR,95％ CI ) of IFG across increasing variable of cf-PWV were 1.00,1.07(0.83 - 1.39),1.20( 1.08 -1.34),1.13(1.04 - 1.23),1.14(1.05 - 1.25) ( Pfor trend ＜0.01).Age and neck circumference levels significantly interacted with cf-PWV in relation to IFG risk ( P ＜0.01 ).ConclusionsThe present data indicate serum cf-PWV concentration was associated with the risk of IFG,and the association was modified by age and neck circumference levels.

Objective To detect the level of serum fragmented cytokeratin 18 (CK-18 M30) in patients with nonalcoholic steatohepatitis (NASH), to explore the relationship between the expression of CK-18 M30 and NASH. Methods 33 healthy people as control group, 24 nonalcoholic simple fatty liver (NAFL) patients, and 21 NASH patients were included in this study. CK-18 M30, ALT, AST and GGT were detected in all patients’ vein blood. NAFLD activity points (NAS) was examined in biopsy specimens of NAFL patients and NASH patients. Pearson correlation was applied to analyze the correlations between serum CK-18 M30, ALT, AST, GGT and the NAS of liver tissue in NASH group. Results Serum CK-18 M30 level of healthy control, NAFL and NASH group were (96.557 2 ± 41.226 8)U/L, (104.321 7 ± 45.167 3)U/L, (263.125 5 ± 61.578 1)U/L respectively. Serum CK-18 M30 level in NASH patients positively correlated with both NAS of liver tissue and serum ALT, which correlation coefficient r values were 0.601 5 and 0.420 6. Conclusion The concentration of serum CK-18 M30 could be used as a marker in the diagnosis of NASH.

OBJECTIVE:To investigate the effects of neoadjunctive chemotherapy(NAC)of docetaxel and epirubicin com-bined with cyclophosphamide on clinical efficacy and tumor markers of breast cancer patients with different molecular types. METH-ODS:A total of 88 female patients with locally advanced breast cancer collected from our hospital during Jan. 2014-Jan. 2016 were divided into Luminal A type(23 cases),Luminal B type(21 cases),basal-like type(11 cases),HER2-over expressing type(18 cases)and normal breast-like type(15 cases)according to molecular type. All patients were given Docetaxel injection+Epirubicin hydrochloride injection+Cyclophosphamide for injection for consecutive 6 cycles(21 d as a cycle). Total response rates and patho-logical complete remission(pCR)rates were compared among breast cancer patients with different molecular types. The expression of serum tumor markers [CEA,CA125,CA153] were compared before and after treatment,and the occurrence of ADR was record-ed. RESULTS:Total response rate of 88 patients was 63.64%,among which that of basal-like breast cancer patients was 72.73%, significantly higher than other molecular types,with statistical significance(P<0.05). There was no statistical significance in total response rates of pairwise molecular type comparison(P>0.05). The pCR rate of 88 patients was 27.27%,and that of basal-like breast cancer patients was the highest(45.45%). There was statistical significance in pCR rates of pairwise molecular type compari-son(P<0.05),except there was no significant difference in pCR rate between HER2-over expressing type and normal breast-like type(P>0.05). Before treatment,there was no statistical significance in the expression of CEA,CA125 and CA153 in breast can-cer patients with different molecular types(P>0.05). After treatment,the expression of CEA,CA125 and CA153 in different mo-lecular types were decreased significantly,with statistical significance(P<0.05). There was no statistical significance in the expres-sion of above markers among different molecular types(P>0.05). There was no statistical significance in the incidence of ADR among different molecular types(P>0.05). CONCLUSIONS:NAC plan of docetaxel and epirubicin combined with cyclophospha-mide can reduce the expression of tumor markers and shows certain therapeutic efficacy for breast cancer patients with different mo-lecular types. Total response rate and pCR rate of basal-like type are better than those of other molecular types,so NAC plan is the preferred treatment for basal-like type breast cancer.

Problem-based Learning(PBL)in medical education is the method of instruction using problems of clinical medicine to stimulate students' driving force of learning and guide them to grasp the learning contents.Compared with the traditional teaching method,it has the fundamental difference in the designing idea,implementing mode,evaluation system and actual effect.The management of PBL teaching process and the active creation of teaching environment and conditions are the key factors to ensure the successful implementation of PBL.