Objective To observe the efficacy of folic acid combined with mecobalamine for the treatment of vascular mild cogni-tive impairment (VMCI) in patients with cerebral small vessel disease (SVD) and hyperhomocysteinemia(Hcy) .Methods A total of 84 VMCI patients with cerebral small vessel disease and Hcy were randomly divided into combination group and control group . Two groups received conventional therapy for 6 months .Besides ,the combination group received folic acid combined with mecobal-amin .The level of plasma Hcy and ADAS-cog score were observed before and after 3 months and 6 months treatment .Results Af-ter treatment ,plasma Hcy significantly lower in the combination group (P<0 .01) ,whereas it did not show any improvement in the control group .ADAS-cog scores in combination group decreased compared with that of before treatment ,but there was no statisti-cally significant difference after 3 months treatment(P>0 .05) .However ,after 6 months treatment ,the ADAS-cog scores decreased obviously than that in the before treatment group (P<0 .05) .ADAS-cog scores in control group increased compared with before treatment ,but there was no statistically significant difference in after treatment (P>0 .05) .After 3 months treatment ,there was no significant difference on ADAS-cog score between combination group and control group (P>0 .05) ,however ,there had significant difference between the two groups after 6 months treatment(P<0 .05) .Conclusion The level of plasma Hcy could be reduced by adding folic acid and mecobalamin .Treatment of hyperhomocysteinemia may delay the progression of vascular cognitive impairment w hich caused by cerebral small vessel disease .

Objective To investigate the feasibility of the lower cervical spine (C3 -C7 ) laminar screw technique for fixing adult posterior cervical spine .Methods We chose 9 formalin fixed moist adult cervical specimens ,which consist of male 6 and female 3 of the age 38 to 63 years old .The average age is 51 .9 years old and the average height is 165 .6 cm .Then we measured the thickness and heightof C3 -C7 lamina ,the lamina length of L1 ,L2 ,and the lamina of axis and the sagittal plane angle .Results The thickness and height of C3 -C7 lamina ,and the lamina length of L1 and L2 of adult male is bigger than adult women .There was statistical sig-nificance between the thickness ,height ,lamina length difference of different genders lamina (P<0 .05) ,but no significant difference between the left and the right (P> 0 .05) .The average lamina thickness of C2 ,C3 ,C4 ,C5 ,C6 ,C7 were respectively 4 .70 ,3 .87 , 3 .30 ,3 .84 and 5 .16 mm .The lamina thickness which was more than 4 .00 mm accounted for 54 .4% .The lamina thickness of C3 , C4 ,C6 ,C7 which was more than 4 .00 mm accounted respectively for 77 .8% ,61 .1% ,33 .3% ,and 88 .9% .Conclusion Crossing laminar screws in cervical spine is feasible in anatomy .The operation can make under direct vision ,and can accurately estimate the screw path length and entry angle .Patients with anatomic abnormalities can be used as an alternative fixation technique or as fixed in the fixed mode fails .So the results can provide a reference for clinical application .

Objective To research the effect of GGCX gene on MMP13 in rabbit osteoarthritis cartilage cells and investigate its effect on osteoarthritis cartilage degeneration.Methods Six Japanese big ear rabbits weighted (2.0±0.2)kg were randomly di vided into three groups,each group seted a rabbit as control.Anterior cruciate ligament transection method was used to build osteoarthritis cartilage degeneration model at second,forth,sixth week.Articular cartilage was separated successfully after the model were built,cartilage cells were divided from articular cartilage and cultured in 6-well cell culture plate.Cartilage cells were divided into blank group,negative control group and transfection group.PCR method and Western blot were conducted to detect GGCX and MMP13 expressed at the level of mRNA and protein.Results Compare with blank group and negative control group,the expressin level of GGCX incresed,while the MMP13 expression level dcresed(P＜0.05).Conclusion Over expression of GGCX gene can ob viously decrease the expression of MMP13,it provide experimental basis for osteoarthritis of the in vitro gene therapy.

Antineoplastic Agents ; administration & dosage ; adverse effects ; therapeutic use ; Asparaginase ; administration & dosage ; adverse effects ; therapeutic use ; Child ; Drug Administration Routes ; Drug Administration Schedule ; Forecasting ; Humans ; Leukemia ; drug therapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy

Objective To determine the median effective concentration (EC50) of epidural lidocaine inhibiting herpetic neuralgia.Methods The patients with thoracic or lumbar herpetic neuralgia,aged 20-60 yr,with body mass index of 18-25 kg/m2,of ASA physical status Ⅰ or Ⅱ,were included in the study.Epidural catheter was placed under the guidance of the digital subtraction angiography (DSA).An injection of iohexol mixed with lidocaine was given under the guidance of DSA to make sure that drug solution covered all the injured nerve roots.The initial concentration of lidocaine was 0.37％.The concentration was determined by up-and-down sequential allocation.Each time the concentration of lidocaine increased/decreased in the next patient depending on whether or not the analgesia was effective.The ratio between the two successive concentrations was 1.06.Effective analgesia was defined as VAS score ≤ 1 within 30 min after administration.The EC50 and 95 ％ confidence interval of lidocaine inhibiting herpetic neuralgia were calculated using Dixon formula.Results The EC50 of lidocaine inhibiting herpetic neuralgia was 0.199 ％ and the 95 ％ confidence interval was 0.168 ％-0.216 ％.Conclusion The EC50 of epidural lidocaine required to inhibit herpetic neuralgia is 0.199％.

Polypeptide fragment of rabies virus glycoprotein(RVG)has become one of the most popular polypeptides in drug delivery field,because of its advantages of neurotropiam,penetration of blood-brain barrier and biosafety.Polypeptide fragment of RVG can directly deliver proteins and nucleic acids into brain.Additionally,when polypeptide fragment of RVG couples with drug-loading polymers,nanoparticles or liposomes,it can mediate the latters into brain.The application of the RVG polypeptide fragment provides a safe and effective approach for the treatment of brain diseases with biomolecules,such as chemicals,proteins.plasmids,siRNA,miRNA.

Objective To compare the onset time, duration and adverse effects of stellate ganglion block (SGB) with different concentrations of lidocaine. Methods Two hundred and forty ASA Ⅰ or Ⅱ patients (97 male, 143 female) aged 37-76 yr weighing 48-79 kg were randomly divided into 3 groups ( n = 80 each): group A, B and C received unilateral SGB with 8 ml of 0.6%, 0.8% and 1.0% lidocaine respectively. Unilateral SGB was performed by the same anesthesiologist in all patients. Successful SGB was verified by Homer's syndrome. The onset time, duration and adverse effects were recorded. Results Homer's syndrome was observed in all patients. There was no significant difference in onset time among the 3 groups. The duration of action was significantly longer in group B and C than in group A and in group C than in group B. There was no significant difference in the adverse effects including recurrent laryngeal nerve block, brachial plexus block, local anesthetic intoxication and transient loss of consciousness among the 3 groups. Conclusion SGB can be induced with either 0.6%, 0.8% or 1.0% lidocaine with comparable effectiveness. We suggest using lower concentration of lidocaine.

OBJECTIVEThis paper aims to study the effects of gossypol acetic acid (GAA) on proliferation and methylation level of human MutL homologue 1 (hMLH1) gene in human tongue cancer cell line Tca8113.

METHODSThe MTT assay was used to determine the effects of the acid on the proliferation inhibition in Tca8113 cells treated with different GAA concentrations. Nested methylation-specific polymerase chain reaction (nMSP) was used to detect the change in the methylation level of hMLH1 after 48 and 72 h with 30 and 15 micro mol L(-1) GAA treatment.

RESULTSMTT assay results showed the growth and proliferation inhibition of Tca8113 cells in the experimental GAA group after 24 h to 72 h of GAA treatment. The nMSP results indicated that the average optical density of hMLH1 in the Tca8113 cells significantly changed after the GAA treatment (30 micro mol L(-1) GAA for 48 h and 15 micro mol L(-1) for 72 h) (P<0.05) compared with that of the control group.

CONCLUSIONGAA does not only inhibit Tca8113 proliferation but also has a demethylation effect on the hMLH1 gene. These phenomena may be part of an underlying tumor-suppression mechanism of GAA.

Antineoplastic Agents ; administration & dosage ; adverse effects ; Asparaginase ; administration & dosage ; adverse effects ; Child ; Child, Preschool ; Combined Modality Therapy ; Dose-Response Relationship, Drug ; Drug Hypersensitivity ; prevention & control ; Female ; Humans ; Hyperglycemia ; chemically induced ; prevention & control ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Severity of Illness Index ; Time Factors ; Treatment Outcome

Objectives To investigate the clinical significance of CYP2C19 genotype detection for antiplatelet therapy of elder cardiovascular and cerebrovascular diseases(CCVD).Methods We enrolled all elderly patients with either cardiovascular or cerebrovascular disorders who received clopidogrel as mono drug or in combination with another antiplatelet drug aspirin as secondary prevention for more than 12 months in our hospital from January to August 2015.Somatotypes of CYP2C19 genotypes of all participants were assessed to analyze the relapse of cardiac-cerebral vascular diseases in these patients.Results A total of 250 patients were enrolled,including 179 male and 71 female,with average age of (85.2 ± 7.9) years.Among these patients,there were 97 (38.8％) cases with EM CYP2C19 genotypes,110 cases(44.0 ％) with IM CYP2C19 genotypes,43 cases(17.2 ％) with PM CYP2C19 genotypes.When treated with clopidogrel for antiplatelet in secondary prevention process,the rate of the relapse in cardiovascular event was 34.9％ and higher in PM CYP2C19 genotype than in EM and IM CYP2C19 genotype (19.6 ％ and 15.5 ％,respectively) (x2 =7.251,P =0.027).This phenomenon was similar to patients who received stent implantation(x2=6.393,P =0.041).However,no statistically significant difference was observed in the recurrence rate of cerebral vascular disease between three different genotypes(EM 29.9 ％,IM 20.0 ％,PM 27.9％,x2 =2.880,P =0.237).Conclusions Our results highlight that CYP2C19 genotype might be a potential guidance for secondary prevention of cardiovascular and cercbrovascular disorders among elderly patients.Clopidogrel may be less effective in patients with SM CYP2C19 genotype than those with EM or PM CYP2C19 genotype for secondary prevention of cardiovascular disease.