Objective To study the improvement of hemorheology and prognosis of vertebral artery type cervical spondylosis by combination of strong Dingxuan tablet.Methods106 cases of vertebral artery type cervical spondylopathy were randomly divided into observation group and control group.Fifty-three patients in each group were treated with manipulation in the control group, and the patients in the observation group were enrolled.The blood viscosity, whole blood low shear viscosity, plasma viscosity, whole blood reduction viscosity, hematocrit, erythrocyte aggregation index, fibrinogen and so on were compared between the two groups before and after treatment.Rheological parameters of the situation, the two groups of patients for 1 year follow-up observation, compared with 1 year recurrence rate.ResultsThe total effective rate was 92.45% in the observation group and 77.36% in the control group (P<0.05).The whole blood low shear viscosity (7.01±1.52) mPa·s, the whole blood viscosity (1.18±0.28) g/L was significantly higher than that in the control group (7.88±1.65) mPa·s, (1.47±0.34) mPa·s, (4.51±0.98) g/L, respectively (P<0.05).The recurrence rate was 13.21% in the observation group and 30.19% in the control group (P<0.05).ConclusionThe combination of strong Dingxuan tablet combined with manipulation of vertebral artery type cervical spondylopathy is significant, the blood viscosity of the patients is reduced, the blood circulation function is improved, the recurrence rate after treatment is low, and it is worthy of clinical application.

Objective To investigate the effects of broadband ultraviolet B (BB-UVB) on the proliferation of, tyrosinase activity and melanogenesis in melanocytes.Methods Melanocytes isolated from human foreskin were subjected to primary culture.Some cultured primary melanocytes were irradiated with BB-UVB at 10, 20, 30, 40, 50, 100, 200 and 300 mJ/cm2.Then, CCK-8 assay was performed to evaluate the proliferative activity of melanocytes, dopa oxidation assay to estimate the activity of tyrosinase, and sodium hydroxide (NaOH)-lysis method was used to determine melanin content.Real-time fluorescence-based quantitative PCR was conducted to measure the mRNA expressions of genes involved in non-canonical Wnt pathways in melanocytes after irradiation with BB-UVB at 30, 50 and 100 mJ/cm2.Western blot was carried out to determine the expressions of proteins involved in non-canonical Wnt pathways in melanocytes before and after irradiation with BB-UVB of 100 mJ/cm2.The melanocytes receiving no treatment served as the control group.Statistical analysis was carried out by one-way analysis of variance followed by least significant difference (LSD)-t test for multiple group comparisons and by the independent sample t test for two-group comparisons.Results After irradiation with BB-UVB at 10-300 mJ/cm2, the proliferative activity of melanocytes was gradually reduced compared with the control group (all P ＜ 0.05), and the survival rate of melanocytes was less than 50％ when the irradiation dose of BB-UVB was higher than 100 mJ/cm2.Furthermore, tyrosinase activity gradually increased in melanocytes after irradiation with BB-UVB at 10-100 mJ/cm2 compared with the control group, and the increase was statistically significant at the radiation dose of 100 mJ/cm2 (P ＜ 0.05).Compared with the control group, the WIF-1 mRNA expression level decreased, while c-Jun N-terminal kinase (JNK), microphthalmia-associated transcription factor (MITF), Ras-related C3 botulinum toxin substrate 1 (RAC 1) and tyrosinase (TYR) mRNA expression levels increased in melanocytes after irradiation with BB-UVB at 30, 50 and 100 mJ/cm2 (all P ＜ 0.05);the WNT5A mRNA expression significantly decreased in melanocytes irradiated with 30 and 50 mJ/cm2 BB-UVB, but increased in those irradiated with 100 mJ/cm2 BB-UVB (all P ＜ 0.05).The radiation with 100 mJ/cm2 BB-UVB significantly decreased the expression of WIF-1 protein, but enhanced the expressions of WNT5A, JNK, MITF, RAC1 and TYR proteins in melanocytes compared with the control group (all P ＜ 0.05).Conclusions BB-UVB can decelerate the proliferation of, elevate tyrosinase activity and melanin level in, melanocytes.The WIF-1 gene may inhibit melanogenesis, and the decrease in its expression may promote melanogenesis by activating the JNK/MITF/TYR pathway through the combined effects of proteins involved in non-canonical Wnt pathways.

Objective To investigate the risk factors of diabetic foot by observing the changes of the relative index. Methods 134 pa-tients were randomly divided into non-diabetic foot (NDF) group and diabetic foot (DF) group,the changes of blood glucose,HbA1c,creati-nine,uric acid,microalbuminuria and the complications of diabetes were observed. Results There no difference in blood glucose level be-tween 2 groups (P>0. 05). The HbA1c levels of DF group was higher,with a significant difference(P<0. 05). The levels of uric acid in fe-male of DF group was higher than those in female of NDF group(P<0. 05). there was significant differernces in levels of microalbuminuria (P<0. 05),but no statistic difference in levels of potassium and sodium between 2 groups. Conclusion The changes of HbA1c,uric acid and microalbuminuria could indicate the diabetic foot in clinic.

Objective To investigate different dosage of dexmedetomidine for preventing elderly postanes-thetic shivering.Methods 100 ASAⅠ~Ⅱ elderly patients (60~80 ages)scheduled for laparotomy were enrolled in this study.According to a computer-generated list of random numbers,patients were randomly allocated to receive dexmedetomidine in the four groups:group A (0.9%normal saline),group B (dexmedetomidine 0.25μg/kg),group C (dexmedetomidine 0.5μg/kg),group D (dexmedetomidine 0.75μg/kg).The occurrence of postanesthetic shive-ring and adverse reactions in perioperative period and post operation were observed.Results The incidence rate shiv-ering were 24% and 20% in group C and D,which were significantly lower than 64% in group A (χ2 =5.333,6. 876,all P<0.05),but there was no difference between C and D groups(χ2 =0.117,P>0.05).Rectal temperature was no difference among four groups(F=1.271,P>0.05).Extubation time was shorter in group A(21.6 ±4.0)min than that in group D(24.4 ±2.8)min(F=6.194,P<0.05).Conclusion Our results suggest that dexmedetomi-dine 0.5 or 0.75 μg/kg can prevent shivering after general anesthesia effectively.But potential for delayed extubation time with dexmedetomidine was noted.The loading dose of 0.5 μg/kg dexmedetomidine is recommeded to prevent eld-erly shivering after general anesthesia.

Objective To explore the expression of transcriptional regulation factor FHL 1 in pancreatic fibrosis of chronic pancreatitis (CP) and clinical significance.Methods Serum samples from 20 CP patients treated in the Department of Gastroenterology , Nanjing General Hospital and 20 healthy controls in the corresponding period were collected .The level of FHL1 in the serum was detected by ELISA .Twenty male Wistar rats were randomly divided into control group and CP group according to the body weight .The CP rat model was established by injecting dibutyltin dichloride ( DBTC) through tail vein .All the rats were killed at 28 days after injection and the pancreas was collected , which was observed using hematoxylin and eosin ( HE) staining to investigate pathological changes . The expression of FHL1 in pancreas was measured by immunohistochemistry (IHC) and Western blotting (WB).Results The average of serum FHL1 level in two groups were (0.86 ±0.22)g/L and (1.18 ±0.22)g/L, respectively.The level of FHL1 in serum of CP patients was significantly lower than that of healthy cases , and the difference was statistically significant (t=10.54, P=0.001).Damaged pancreatic lobular structure , acinar atrophy and the obvious fibrous hyperplasia were observed in CP rats .The pathological score of abnormal structure , acinar atrophy, fibrosis, and inflammatory cell infiltration in the pancreas of the CP group was (2.2 ±0.4),(2.0 ±0.7),(2.4 ±0.3) and (2.8 ±0.6), respectively, but was all 0 in control group.The difference between two group was statistically significant ( t value =17.24, 9.01, 25.22 and 14.75, respectively, all P<0.001).The expression of FHL1 in the pancreatic tissue of CP group were less than that of normal group , and the difference was statistically significant (IHC:15 798 ±3 247 vs 37 570 ±9 254, t=2.438,P=0.016;WB:0.44 ±0.11 vs 0.89 ±0.03, t=4.289, P=0.002).Conclusions The protein of FHL1 was in low expression in the pancreas of CPs , indicating that FHL1 may participate in the formation of pancreatic fibrosis .

BACKGROUND:The majority of published article on cardiopulmonary resuscitation (CPR) used healthy animals. In fact, patients commonly have severe heart diseases before CPR, leading to ventricular fibrillation. OBJECTIVE: To investigate outcome of myocardial function and cardiopulmonary resuscitation in myocardial infarction rats treated with bone marrow mesenchymal stem cells (MSCs) transplantation.DESIGN, TIME AND SETTING: A randomized, controlled animal experiment was performed at the University of Southern California and Second Hospital of Sun Yat-sen University from April to August 2007.MATERIALS: A total of 18 adult male SD rats were randomly divided into model control and cell transplantation groups with 9 animals in each group. In addition, 1 SD rat aged 1 month was used to prepare bone marrow MSCs.METHODS: Myocardial ischemia was induced by ligation of the left anterior descending artery (LAD). Animals respectively received 5×106 MSCs (0.1 mL) marked with PKH26 in phosphate buffer solution (PBS) or PBS alone 4 weeks after LAD ligation. Ventricular fibrillation and CPR were performed 4 weeks after MSCs or PBS injection.MAIN OUTCOME MEASURES: Heart function was evaluated by ultrasound cardiography 2, 4 weeks after transplantation; hemodynamics was measured before and 4 hours following CPR. Myocardial tissues were harvested 72 hours after CPR for pathological exanimation.RESULTS: Compared with model control group, ejection fraction of transplantation group was significantly increased 2 and 4 weeks after transplantation (P<0.01), and cardiac index, dp/dt40, and -dp/dt were significantly improved before and within 4 hours after CPR (P<0.01, P<0.05). Moreover, the rats survived longer in transplantation group (72 hours) after CPR compared with control group (P<0.05). Pathological section results showed a large number of PKH26-1abeled MSCs in the rnyocardium.CONCLUSION: Myocardial function, hemodynamics and survival time after CPR were significantly improved in animals treated with MSCs transplantation.

Objective To investigate the application value of CT/MR image fusing in gross tumor volume (GTV) delineation of esophageal squamous cell carcinoma.Methods Twenty-nine patients with esophageal squamous cell carcinoma to be treated with radical surgery underwent routine CT scanning,MR T2-weighted imaging (T2WI) and diffusion weighted imaging (DWI) before surgery.Diffusion-sensitive gradient b values were taken at 400,600,and 800 s/mm2.GTVs were delineated on the CT image,CT/ MR T2WI,and CT/MR DWI respectively.The MR T2W1 image was used as the intermediary for the fusion of the CT image and MR DWI image.The length of GTVs measured under different imaging conditions were compared with the length of the resected specimen of esophagus.Results The GTV length was (44.94 ± 18.46) and (45.05 ±21.47) mm on the CT images and CT/MR T2WI images respectively.When the b values were 400,600,and 800 s/mm2,the esophageal carcinoma GTV length on CT/MR DWI images was (42.12 ± 17.79),(41.18 ± 17.17) and (39.77 ± 17.66) mm,respectively.The coefficient between the esophageal carcinoma GTV lengths on CT/MR DWI images and the pathological lesion lengths was 0.928,0.926 and 0.927 respectively.Conclusions CT/MR DWI images displays esophageal carcinoma GTV length more accurately,thus guiding the delineation of GTV effectively.

ObjectiveTo analyze the complications of cerebral palsy (CP) children.Methods195 CP children (113 boys and 82 girls, 7 months to 11 years old) were examined by electroencephalogram, eye consultation, auditory brainstem response and Gesell developmental schedule except routine examinations to detect the complications.Results27(13.8%) CP children had motor delay as the only sign. 168 CP children had one or more complications, 168(86.2%) cases with mental retardation, 92(47.2%) cases with visual disability, 40(20.5%) cases with growth delay, 25( 12.8 %) cases with epilepsy, 12(6.2%) cases with hearing disability, 11(5.6%) cases with microcephaly, 3(1.5%) cases with abnormal behavior. 15(7.7%) cases of CP children had at least two kinds of complications, 123(63.1%) cases had three kinds of complications, 30(15.4%) cases had four kinds of complications.ConclusionMost of the CP children have one or more complications.

BACKGROUND:Currently, there is stil no clear conclusion on the pros and cons of arthroscopic anterior cruciate ligament reconstruction with or without stump preservation residues as wel as the impact of reconstruction with stump preservation on proprioceptive sensation. OBJECTIVE:To compare the curative effect of arthroscopic anterior cruciate ligament reconstruction with or without stump preservation on the function and stability of the knee joint during a 1-year folow-up. METHODS: A retrospective analysis of 75 cases of arthroscopic anterior cruciate ligament reconstruction was done, including 37 cases of anterior cruciate ligament reconstruction without stump preservation and 38 cases of anterior cruciate ligament reconstruction with stump preservation. Autologous hamstring tendons were selected as implants. Evaluation of preoperative (6 months before operation) and postoperative (6 months and 1 year after operation) knee function and stability was implemented on the basis of Lysholm scores, IKDC Scores and KT2000. The comparative analysis was carried out as wel on repeated passive angle for proprioception testing. RESULTS AND CONCLUSION:Al of the patients were folowed up for 12 to 20 months. Range of motion of the knee joint was basicaly restored in the two groups 6 months after operation. The results showed the Lysholm scores, IKDC scores and KT-2000 scores at 6 months and 1 year after operation were significantly improved in the two groups as compared with the preoperative data (P < 0.05), and there was no statisticaly difference between the two groups. The proprioception difference between the healthy and affected sides was lower in the patients with stump preservation than those without stump preservation at 6 months and 1 year after operation (P< 0.05). There were two cases in each group whose bone tunnel of the tibia was found deviating from the ideal position through postoperative X-ray examination, but cyclopia was unseen. Anterior cruciate ligament reconstruction with stump preservation is beneficial to the recovery of postoperative proprioception without increasing of postoperative complications.

Objective: To explore the correlation of plasma level N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with non-diabetic acute myocardial infarction (AMI) combining stress hyperglycemia.
Methods: A total of 327 non-diabetic AMI patients treated in our hospital from 2012-02 to 2014-05 were studied. The patients were divided into 2 groups according to fasting blood glucose level:Stress group, the patients with blood glucose≥7.0 mmol/L, n=182 and Non-stress group, the patients with blood glucose<7.0 mmol/L, n=145. The basic clinical condition, laboratory tests within 24 hours of onsets, echocardiography and 24 h dynamic electrocardiogram were examined;the incidence of major adverse cardiovascular events (MACE) including arrhythmia, heart failure, cardiac shock and sudden cardiac death in 2 weeks of onsets were analyzed and compared between 2 groups.
Results: The patients’ age, gender, history of hypertension, smoking, drinking, and blood levels of TC, TG, HDL-C, LDL-C were similar between 2 groups, P>0.05. Plasma levels of NT-proBNP, CK-MB, MYO, ultra-TnI, ALT, AST and blood glucose level were signiifcantly different between 2 groups P<0.01. NT-proBNP level was positively related to
ultra-TnI (r2=0.811, r=0.901, P<0.01). Stress group presented obviously higher incidence of MACE (P<0.05), lower LVEF (P<0.01), and signiifcantly increased left ventricular end diastolic diameter, left ventricular end systolic diameter (P<0.01) than those in Non-stress group.
Conclusion: Plasma levels of NT-proBNP may judge the severity and evaluate recent prognosis in patients with non-diabetic AMI combining stress hyperglycemia, it could be used as a risk indicator for relevant patients in clinical practice.