Objective To investigate effects of Ginkgo biloba extract(EGb) on expression of CREB and pCREB in cortex of aging rats.Methods Male Wistar rats were divided into three groups:young control group,old control group and EGb group.Rats in EGb group were treated with intragastric administration of EGb,while rats in the other two groups were treated with distilled water.The spatial learning and memory were evaluated by Morris water maze,and the expression of CREB,pCREB were detected by western blot.Results( 1 ) Compared with young control group (9.6 ± 2.88,41.55 ± 6.30),the swimming time and times through platform in the target quardrant of rats in old control group(6.8 ± 2.49,34.92 ± 4.56) were reduced (P ＜ 0.05 ).The times passing through the platform and the time exploring the target quadrant were more and longer in EGb group(9.4 ± 2.63,41.0 ± 6.68 ) than those in old control group(P ＜ 0.05 ).(2)Compared with rats in young control group( 1.07 ±0.33,0.26 ± 0.04),relative contents of CREB and p-CREB proteins in cortex (0.70 ± 0.21,0.13 ± 0.05 ) weredecreased in old control group(P＜0.05 ).CREB and p-CREB Levels were higher in EGb group ( 1.02 ±0.18,0.18 ±0.02)than those in old control group(P ＜ 0.05 ).Conclusion EGb can ameliorate spatial learning and memory of rats by increasing the expression of CREB and p-CREB in cortex.

ObjectiveTo investigate the value of perfusion CT imaging in thyroid nodule. Methods Of the 40 cases of post-surgical thyroid nodule identified by pathology, nodular goiter was verified in 22 cases, thyroid adenoma in 6 cases,and thyroid carcinoma in 12 cases. All cases underwent CT perfusion scan at preoperative. The perfusion parameters including the blood flow ( BF), blood volume ( BV ), mean transit time ( MTT), and permeability of surface (PS) of region of interest (ROI) were calculated. The Mann-whitney test was used to comparing the differences of the different perfusion parameters. The ones with statistical significance would be introduced into the discriminatory analysis to distinguish the benign and malignant thyroid nodule. ResultsThe median MTT in 28 cases with benign thyroid nodule were 4. 33 s (Min 1.42 s,Max 10. 93 s), and that in 12 cases with malignant nodules were 2. 18 s( Min 1. 95 s, Max 2. 87 s). The difference had statistical significance ( P ＝ 0. 00 ) . The median BF in cases with thyroid carcinoma was 560. 23( Min 330. 66, Max 1000.00) ml ·100 g-1 ·min-1, and that in cases with the benign nodular were 374.79(Min 117.47,Max 1000.00) ml · 100 g-1 · min-1. There was a significant statistical difference ( P ＝0. 01 ). Through the discriminatory analysis, the difference of MTT between benign and malignant nodules were statistically significant (P ＝ 0. 00 ).After establing the Bayes discriminatory function, the overall diagnostic accuracy was 87.5％ (35/40).Conclusions MTT and BF are useful parameters in CT perfusion imaging to distinguish the benign and malignant thyroid nodules and the MTT is more accuracy.

AIM:To investigate the effect of RNA interference (RNAi)-mediated insulin-like growth factor 1 receptor ( IGF1R) gene silencing on the growth , migration, and invasion of hepatocellular carcinoma cells .METHODS:The most effective siRNA targeting IGF1R gene was designed and screened .After lentiviral expression vector pLVX-shR-NA2-IGF1R carrying the most effective siRNA sequence was constructed , it was transfected into 293T cells and packed into pLVX-shRNA2-IGF1R lentivirus.Huh7 and Hep3B cells were infected with the pLVX-shRNA2-IGF1R lentivirus to screen the positive clone Huh7 cells and Hep3B cells with the lentivirus .These Huh7 cells and Hep3B cells were cultured to ana-lyze the mRNA level of IGF1R, cell proliferation, cell cycle, cell apoptosis, cell migration/invasion, and the protein levels of IGF1R, Ki-67, p-AKT, p-ERK1, Gli1,β-catenin, cyclin D1, p21 and BCL-XL.RESULTS:The mRNA expression of IGF1R in Huh7 cells and Hep3B cells with pLVX-shRNA2-IGF1R lentivirus was significantly reduced .The proliferation of these cells was remarkably inhibited , and the number in G 1 phase was increased significantly .The percentages of apop-totic cells were increased markedly , and the number of cell migration/invasion was decreased markedly .The protein levels of IGF1R, Ki-67, p-AKT, p-ERK1, Gli1,β-catenin, cyclin D1, p21 and BCL-XL were decreased significantly compared with the blank control group and negative control group .CONCLUSION:The RNAi-mediated IGF1R gene silencing sig-nificantly suppresses the growth and the malignant biological characteristics of Huh 7 cells and Hep3B cells, which may be involved in the reduced protein levels of the above genes induced by down -regulation of IGF1R expression.

This study aimed to summarize the diagnosis and treatment of uncommon complications in esophageal and cardiac cancer operations as well as obtain lessons from the failure. Methods:The etiology, clinical diagnosis, treatment, prevention measures, and factors that contribute to the failure of the uncommon complications were analyzed retrospectively. Results: Results showed ten cured cases and eight death cases (except for the reported eight cases). Conclusion:The following conclusions were ob-tained. 1) The complications described in this paper were rare, but they sometimes occur clinically. If wrong treatment was taken, seri-ous consequences would be expected. 2) Once a jet-like bleeding of aortic esophagus avulsion injury occurs, the surgeon must be calm and take proper treatment to successfully patch up the wounds. 3) The right thoracic approach is a new approach to prevent the injury of azygos vein. 4) Patients with anastomotic stoma fistula easily cause a delay in diagnosis if the leakage was wrapped in the inferior phrenic. 5) Taking preventive measures is the key method for the anastomotic aortoesophageal fistula. 6) Occurrence of pulmonary em-bolism after operation should be monitored. 7) Thoracic gastric mediastinal hernia would cause serious consequences if treatment was not taken at a proper time.

Objective To explore the relationship between the osteonecrotic volume (lesion size), angle and the index of necrotic extent on the femoral head. Methods Fifty-one hips in 39 patients with non-traumatic avascular osteonecrosis on the femoral head were divided into 12 equal segments from the head to the neck junction (a turning point of the spherical curve of the head) with whole hip displacement, each with 30 degrees on a coronal plane of weight-bearing surface. The osteonecrotic angle of the arc of each necrotic segment from the center of the femoral head was measured at the point of one- to 12-o'clock on imaging of two dimensional reconstruction of computerized tomography (CT) scans and anteroposterior and lateral radiographs. Necrotic volume on each segment of the femoral head was calculated with fluid displacement method. The index of osteonecrotic extent on the femoral head was calculated using direct anatomical measurements. Results Osteoneerotic volume on the femoral head at the point of 12- to one-o'clock on coronal plane was (74. 5 ± 7.4)% of the sphere equivalent of the whole femoral head, which was positively correlated to its necrotic angle [ (41.9±8. 3) degrees] at the point of one-o'clock on the plane, with a coefficient of correlation of 0. 843, and that at the point of one- to two-o'clock on the plane was (73.7 ±0. 4) %, which was positively correlated to its necrotic angle [ (41.9 ± 1.8) degrees] at the point of two-o'clock, with a coefficient of correlation of 0. 543. Osteonecrotic volume on the point of 11- to 12-o'cleck was (83.6±8.6)%, and the necrotic angle at the point of 12-o'clock was (44. 9±3.9) degrees, which were positively correlated each other, with a coefficient of correlation of 0. 701 (P <0. 01 ). Osteonecrotic volume on the femoral head was positively correlated to its necrotic angle , modified index of necrotic extent, index of necrotic extent and Kerboul conjugated necrotic angle, with coefficients of correlation of 0. 798, 0. 701, 0. 377 and 0. 398 ( P < 0. 01 ), respectively, at the point of one o' clock. Conclusions Measurements of osteonecrotic volume was positively correlated to the index of necrotic extent and necrotic angle on the femoral head, respectively. Necrotic angle on the plane at 30-degree of the trochanter on the femoral head can well reflect its necrotic volume.

One hundred and fifty femoral head necrosis patients with intramedullary decompression received autologous stem cell transplantation. The blood was taken from unilateral or bilateral iliac, in each group the volumes of blood taken were 200, 300 or 400 ml respectively. The number of mononuclear cells was counted before and after centrifugation. The mononuclear cell count in subgroup of 200 ml,300 ml and 400 ml taken from unilateral iliac after centrifugation was (3. 11 ±1. 42) × 1010/L, (2. 62 ±1. 31 ) × 1010/L and(2. 13 ±. 91) × 1010/L. The concentration was significantly lower in subgroup of 400 ml than that of 200 ml (t=5. 118, P<0. 01). The mononuclear cells count in subgroup of 200 ml,300 ml and 400 ml taken from bilateral iliac was(4. 51 ±. 21) × 1010/L, (3. 89 ±. 06) × 1010/L and (2. 98 ±1. 39) × 1010/L, the concentration was significantly lower in subgroup of 400 ml than that of subgroup of 200 ml (t = 6. 446, P < 0. 01). Whether 200 ml or 300 ml or 400 ml blood were taken, the mononuclear cell count in blood taken from bilateral iliac after centrifugation was significantly higher than that from unilateral iliac(t = 3. 119,P < 0. 01; t = 5. 544, P < 0. 01 ;t = 2. 207 ,P < 0. 05). The results indicate that the concentration of isolated bone marrow mononuclear cells is higher from bilateral iliac than unilateral iliac. The concentration of isolated monocytes is reduced gradually with the increased blood volume.

This retrospective study was to compare the clinical effects of arthroscopie drilling with arthroscopic microfracture technology on full-thickness chondral defects in 68 patients treated between March 2003 and June 2005. The patients were followed up for an average of (20 ± 5 ) months. Lysholm score and Tegner scale were used to evaluate the efficacy. For the arthrescopic drilling group (n = 15 ) and the microfracture surgery group (n =27) , total effective rates were 12/15 and 85% (23/27), respectively. Our data suggest that those two methods provide simple and effective surgical procedure for the treatment of chondral defects of the knee; the results of arthroscopic microfracture were significantly better than arthroscopic drilling.

Objective To detect differentially expressed genes between human normal skin and photoaging skin, and to investigate the molecular and biological mechanisms of human skin photoaging at transcriptional level. Methods Full-thickness skin specimens were obtained during full-face rhytidectomy from sun-exposed (anterior ear skin) and sun-protected (retroauricular skin) sites of 6 patients with facial photoaging from 2007 to 2008. Genomic microarray analysis was conducted to identify differentially expressed genes between the two groups of specimens followed by gene-cluster analysis. Results The normalization of microarray data showed that the number of differentially expressed genes was 2163 between skin samples from sun-exposed and sun-protected sites in one patient, significantly higher than that in the other 5 patients (less than 200);therefore, the data from the patient with 2163 differentially expressed genes were excluded from further analysis.Totally, 172 differentially expressed genes were identified with Beadarray chip, including 99 up-regulated genes and 73 down-regulated genes. Based on Genebank research, 118 functionally classified genes werefound, which were associated with a series of biological processes, including cell adhesion, receptor regulation,signal transduction, metabolism, and so on. Conclusions There are a lot of differentially expressed genes between human photoaging skin and normal skin. Rhytidectomy may be associated with the differential expression of skin photoaging-related genes.

BACKGROUND: miRNA plays a critical regulatory role in the development and plasticity of spinal cord, and pathological changes after spinal cord injury. OBJECTIVE: To study the effect of miR-136-5p on the A20 expression in mouse astrocytes stimulated by interleukin-17 (IL-17). METHODS: C57BL/6 mouse astrocytes were cultured in vitro, identified by immunofluorescence staining, and then stimulated by 100 μg/L IL-17 for 0, 3, 6, 12 and 24 hours, respectively. The relative mRNA expression levels of IL-6 and tumor necrosis factor-α were detected by RT-PCR to determine the optimal stimulation time of IL-17. The mouse astrocytes were respectively stimulated by 10, 20, 50, 100 and 200 μg/L IL-7 for 6 hours, and similarly, the relative mRNA expression levels of IL-6 and tumor necrosis factor-α were detected to determine the optimal concentration of IL-17. At 6 hours after IL-17 (50 μg/L) stimulation, the mRNA expression levels of miR-136-5p and A20 in mouse astrocytes were detected by RT- PCR, and the protein expression level of A20 was detected by western blot assay. In addition, the lentiviral expression vector (miR-136-5p-inhibition) was constructed and transfected into the mouse astrocytes that were also stimulated by IL-7 to detect the expression levels of miR-136-5p, A20 mRNA and A20 protein. RESULTS AND CONCLUSION: Compared with the blank control group, the expression level of miR-136-5p in the miR-136-5p-inhibition group was significantly decreased after 6-hour IL-17 stimulation (P < 0.05). The expression levels of A20 mRNA and protein in each group were significantly decreased after 6-hour IL-17 (50 μg/L) stimulation (P < 0.05). The expression levels of A20 mRNA and protein in the miR-136-5p-inhibition group were significantly higher than those in the blank control group (P < 0.05), while there were no significant differences in the expression level of A20 protein between blank control and negative groups (P > 0.05). To conclude, miR-136-5p makes certain effect on the expression of A20 protein in astrocytes after IL-17 stimulation.

Objective To assess the perioperative hidden blood loss in aged patients with femoral intertrochanteric fracture.Methods Clinical data of 243 patients (111 males and 132 females) with intertrochanteric fracture admitted from 2009 September to 2015 September were retrospectively reviewed.Two hundred and seventeen patients aged 60-98 years received surgical treatment and 26 patients aged 62-91 years received conservative treatment (non-surgical group).In surgical group,17 cases were operated within 1 d after fracture,71 within 3 d,73 within 7 d,31 within 14 d,and 25 cases were operated after 14 d.Hidden blood loss was evaluated and blood routine was tested.Results The hidden blood loss was (340 ± 216) ml in non-surgical patients,(602 ± 216) ml in patients operated after 14 d,(671 ± 327) ml in patients operated 8-14,(596 ± 362) ml in patients operated 4-7 d,and (505 ± 119) ml in patients operated 2-3 d,(498 ± 244) ml in patients operated within 1 d;there was significant difference among groups (F =14.758,P =0.001).The hemoglobin level in non-surgical group was (121.8 ± 17.6) g/Lwithin 1 d after fracture,(101.1 ±23.3) g/L on 1-3 d,(91.5 ±31.9) g/L on4-7 d,(92.2 ±31.6) g/L on 8-14 d,and (108.3 ± 22.4) g/L after 14 d;there was statistically significant among groups (F =12.457,P =0.001).Conclusions Hemoglobin level in elderly patients with femoral intertrochanteric fracture is dynamically changed,and reaches the lowest point within 1-2 weeks after injury;and operation is an important factor of hidden blood loss in femoral intertrochanteric fracture patients.