Objective : To investigate the effect of aluminum exposure on expression of miR-497-5p, wingless murine breast cancer virus integration site family member 3a (Wnt3a), β-catenin protein, glycogen synthase kinase-3β (GSK-3β) protein and tau protein in rat adrenal pheochromocytoma PC12 cells, so as to provide insight into unraveling the mechanisms underlying aluminum exposure-induced abnormal phosphorylation of tau protein. Methods: PC12 cells were exposed to Al(mal)3 at concentrations of 0, 100, 200, 400 μmol/L for 24 h. The viability of PC12 cells was measured using cell counting kit-8 (CCK-8) assay. The relative expression of miR-497-5p and Wnt3a was detected using a real-time fluorescent quantitative PCR (RT-qPCR) assay, and the expression of Wnt3a, β-catenin, GSK-3β, P-GSK-3β (Ser9), tau and p-tau (Ser396) proteins were determined using Western blotting. Results : The viability of PC12 cells appeared a tendency towards a decline with the increase of aluminum dose (Ftrend=323.473, P=0.001). RT-qPCR assay detected that the relative miR-497-5p expression appeared a tendency towards a rise with the increase of aluminum dose (Ftrend=14.888, P=0.031), and the relative Wnt3a expression appeared a tendency towards a decline with the increase of aluminum dose (Ftrend=165.934, P<0.001). The miR-497-5p expression negatively correlated with the relative Wnt3a expression (r=-0.693, P=0.012). The expression of Wnt3a (Ftrend=357.656, P=0.001), β-catenin (Ftrend=208.750, P=0.001) and p-GSK-3β (Ser9) proteins (Ftrend=512.583, P<0.001) appeared a tendency towards a decline with the increase of aluminum dose, and the expression of GSK-3β (Ftrend=39.965, P<0.001), tau (Ftrend=277.929, P=0.006) and p-tau (Ser396) proteins (Ftrend=96.247, P=0.002) appeared a tendency towards a rise with the increase of aluminum dose. Conclusion Up-regulation of miR-497-5p and GSK-3β expression and down-regulation of Wnt3a and β-catenin expression may be a mechanism underlying aluminum exposure-induced abnormal phosphorylation of tau protein.

Objective To investigate the effects of Porous tantalum rod implantation and autologous peripheral blood stem cell transplantation on the treatment of avascular necrosis of femoral head (ANFH).Methods Thirty-six cases with early ANFH (19 cases on the left side and 17 cases on the right side) treated by Porous tantalum rod implantation and matrix induced autologous peripheral blood stem cell trans-plantation from July 2009 to March 2011.The 36 cases had osteonecrosis of the femoral head(ONFH) lesions Ⅰ and Ⅱ according to the international bone circulation Research Association (ARCO) classification of ONFH lesion.All patients were followed up for 12-15 months.Clinical evaluation included preoperative and postoperative pain score,the Harris hip score,percentage of low signal MRI area in the volume of femoral head.Results All the patients were followed up for 12 to 15 months.The postoperative Harris hip score was significantly higher than pre-operation ((91.70 ± 6.90) vs.(68.32 ± 7.10) ; t =4.364,P ＜ 0.01).Pain symptoms reduced markedly ((15.55 ±6.60) vs.(29.78 ±5.67);t =3.423,P ＜0.05).Hip flexion and external rotation function was restored.MRI showed that after the operations the volume of areas with femoral head necrosis significantly reduced in compared with the pre-operation ((38.20 ± 8.30) ％ vs.(21.43 ± 5.10) ％ ; t =6.527,P ＜ 0.05).Conclusion Porous tantalum rod implantation and autologous peripheral blood stem cell transplantation can significantly reduce joint pain,dramatically restore joint function,effectively prevent collapse of the femoral head,retard progression and has good clinical efficacy in the treatment of early femoral head necrosis.

Objective To analyze the influence of different types of seizures and nonepileptic events on peripheral white blood cell (WBC)counts. Methods We prospectively collected blood samples from all patients and detered WBC count to evaluate the relation of each type of seizure,duration,frequencies,and ttme lapse between a seizure and collection of blood sample to peripheral WBC count. Results Peripheral WBC count was elevated in about 50% cases after a generalized seizure. The length of a seizures was positively associated, whereas its frequencies and the lapse time was negatively correlated with the increase in WBC counts. Conclusion Peripheral WBC counts increase significantly after a generalized seizure.

The pediatric risk of mortality Ⅲ(PRISM Ⅲ) score and pediatric critical illness score(PCIS) are physiology-based scores for assessing the severity of illness and mortality risk in pediatric patients.The PRISM Ⅲscore was revised version of the PRISM and was first developed in 1996.It includes 17 physiologic variables subdivided into 26 ranges.It had been validated by numerous studies worldwide and is the most widely known and used at pediatrics intensive care unit(PICU).The PCIS was first developed in 1995 in China,which included 10 physiologic variables.It had been validated by numerous studies nationwide and was simple,effective and suitable to Chinese situations.The scoring systems also can be used for quality assessments,grading the severity of illness in clinical study,and(stu)-dies of ICU resource utilization and management.There were no such study for validating the PRISM Ⅲ at present,comparing the performance of the PRISM Ⅲ score and the PCIS in China.

Measurement of whole blood CL was carried out to evaluate phagocytic of function of PMNL and opsonic activity of plasma from children (22 cases), adults (31), newborn infants (umbilical cord blood, 21), patients with bacterial infection (31), viral infections (21),and mild anemia (10). The following results were obtained: first, phagocytic function of PMNL and opsonic activity of plasma from normal children was compared to adults; second, phagocytic and/or metabolic activity of PMNL and opsonic ativity of plasma from newborn infants were lower then normal, third, PMNL of the patients with bacterial infections had been preactivated in vivo, their phagocytic function being enhanced, but, blood from the patients with viral infections showed almost no abnormalities; fourth, phagocytic activity of PMNL from the patients with mild anemia was similar to normal human. The significance of the results was also discused in the paper.

Objective To investigate the effect of restriction decision wheel and grade ICU patients with critical consciousness disorder. Methods Two hundred and fifty four patients in ICU with critical consciousness disorder from July to December 2012, who were intubated and constrained with their limbs due to the risk of unexpected extubation, were divided into the control group (n=125) and the experiment group (n=129), according to registration sequence. The former were constrained to their limbs after evaluation referring to the constraint nursing form and the latter was constrained by using the constraint decision-making wheel and grade. The two groups were compared in terms of restraint rate, unplanned extubation rate, and incidence of skin abnormality. Results The restraint rate of the observation group was significantly lower than that of the control group (P<0.01). There was no incidence of abnormal skin in the two groups. There was no significance in the rate of unplanned extubation between the two groups (P>0.05). Conclusion Constraints decision making wheel and grade is effective in ensuring patients'safety and improving the quality of nursing safety management by reducing unnecessary constraints or the incidence of delayed constraints.

OBJECTIVETo compare clinical effects between percutaneous compressing plating (PCCP) and proximal femoral nail antirotation (PFNA) for the treatment of patients with intertrochanteric fracture with risk external wall.

METHODSFrom September 2007 to June 2010, 43 patients with intertrochanteric fracture with risk external wall were treated by PCCP or PFNA according to different kinds of internal fixations. There were 22 cases in PCCP, including 9 males and 13 females with an average age of 68.4 (ranged, 60 to 86) years old, and 13 cases with type A2.2 and 9 cases with type A2.3; while 21 cases in PFNA, including 7 males and 14 females with an average age of 67.7 (ranged, 57 to 93) years old, and 10 cases with type A2.2 and 11 cases with type A2.3. Blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up were observed and compared.

RESULTSAll patients were followed up for 12 to 22 (means 18.4) months, and all patients were obtained fracture healing, and recovered walking ability as before injury. There were no significant differences in blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up (P>0.05). One case occurred displacement on the top of greater trochanter, and 1 case injuried weakness of hip abduction. One case occurred screw breakage in PCCP, while 1 case occurred hip joint pain in PFNA.

CONCLUSIONBoth of PCCP and PFNA in treating patients with intertrochanteric fracture with risk external wall can receive good clinical effects, while the effects and therapy strategy for displacement of bone on the top of lateral wall should further study.

Aged ; Aged, 80 and over ; Bone Nails ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Intramedullary ; Fracture Healing ; Hip Fractures ; physiopathology ; surgery ; Humans ; Male ; Middle Aged

Objective To investigate the effect of PBL combined with EBM applied in the teaching of fever of unknown origin. Methods PBL combined with EBM teaching was applied in fever of unknown origin course for 30 clinical medicine specialty(eight years) students of Tongji class of grade 2009(experiment group), while PBL teaching was applied in fever of unknown origin course for 30 clinical medicine specialty (eight years) students of Tongji class of grade 2008 (control group). After teaching, the theory examination for both basic knowledge and case analysis was organized for all students of both groups. At the same time the questionnaire survey was conducted to 30 students of grade 2009 to evaluate the teaching effect. The results were assessed by using SPSS 18.0 statistical software for the T-test of the experimental group and the control group.Inspection level was α=0.05. Results The theory test score of students in the experimental group was (93.5±3.2) point, signifi-cantly higher than that of the students in the control group(84.7±2.8). There was statistically signifi-cant difference between the scores of the two groups of students (P=0.00). Survey results showed 19 students ( 63 . 33%) thought that the development of PBL teaching combined with evidence-based medicine teaching had its necessity, and 16 students(53.33%) thought that the teaching method im-proved their clinical thinking ability of logical reasoning. Conclusion The concept of PBL combined with EBM has achieved significant resultsinthe teaching offever of unknown origin, and it is necessary to carry out this teaching mode in medical colleges with certain teaching strength.

AIM: To determine the contents of tetrandrine and fangchinoline in Qingshenjianfei Tablets by RP-HPLC. METHODS:In this method Zorbax C 18 column was used, and methanol—0.3%diethylamine (75∶25) as a mobile phase , the detection wavelength was at 242 nm. RESULTS:The recovery of tetrandrine was 103.65% and RSD was 1.59% .The recovery of fangchinoline was 97.11% and RSD was 1.91% (n=6). CONCLUSION: This method is simple,quick,reproducible and can be used for the quantitative analysis。

A patient was treated by multiple dental implants,the implanted 6 was adjucent to impacted 8 .Immediately after implanta-tion,4 month and 3 year after implantation the distace between 8 and 6 implant central line was 4.4,3.2 and 2.5 mm,the angle between 8 long axis and 6 implant central line was 42.3°,45.5°and 50.3°.Then 8 was extracted.