Objective:To screen the plasma microRNAs( miRNAs) of differential expression in a high fat diet-induced insulin resistance in mouse models;further investigations on the mice with insulin resistance treated by TLR4 inhibitors TAK-242,and to study the changes of plasma miRNAs expression profile and the relationship among TLR4, miRNAs and high fat diet-induced insulin resistance. Methods:The plasma samples were from 3 mouse groups of previous study,namely,the control group with general basic diet ( low fat diet,LFD) ,TLR4 inhibitors TAK-242 treatment group with a high fat diet ( HFD-T) and the high fat diet control group( HFD-C) . The differential expressed miRNAs was screened by expression profiling of plasma miRNAs, which was detected using mouse miRNA microarray. The quantitative Real-Time PCR ( qRT-PCR ) was used to verify the results of microarray. The target genes of differential expressed miRNAs were predicted in TLR4 signaling pathway using bioinformatics methods,and the GO and KEGG database molecular annotation system were used to investigate the main effects of the miRNAs targeted genes on the biological functions or signal pathway. Results:The screening results of miRNA microarray chip showed that,comparing miRNAs expression between HFD group and LFD control group,185 miRNAs were significant in the high fat diet group,including 6 up-regulated and 179 down-regulated miRANs. A significant difference of miRANs was also found between HFD-T group and LFD control group,the total number of differential expression miRNAs was 171,and all of them were down-regulated. Comparing miRNAs expression between HFD-C group and HFD-T group,13
miRNAs were significant in HFD-T group,all of them were down-regulated. Bioinformatics analysis results showed that a total of 10 in-teraction proteins with TLR4 were predicted;the difference of mmu-miR-3095-3p,mmu-miR-5113,mmu-miR-709 and mmu-miR-335-3p expression levels was more than 1 000 times between HFD-C group and HFD-T group,and their target genes can be found in TLR4-in-teraction protein or Toll like receptor signaling pathway;GO and KEGG analysis showed 74% of these target genes belonged to the biological processes genes, and the transcription factors accounted for 82%. The expression of mmu-miR-3095-3p, mmu-miR-5113, mmu-miR-709 and mmu-miR-335-3p detected by qRT-PCR exhibited the similar patterns of down regulation to those shown in microarray results. Conclusion:When insulin resistance occurs,there is a change in plasma miRNAs expression profile,this change is associated with TLR4 and its signaling pathways. The finding enrichs the possible mechanisms of insulin resistance and provides a basis for finding miRNAs diagnostic markers for early diagnosis of insulin resistance.

OBJECTIVE To analyze the effect of advanced glycation end products(AGEs) on apoptosis of cultured mouse spiral ganglion cells(SGCs) and expression of receptor of AGEs(RAGE). To explore the pathway of AGEs in promoting apoptosis of SGCs. And to explore the possible mechanism of neural presbycusis. METHODS The effect of AGEs on apoptosis of SGCs was studied by Tunel technique and fluorescence microscope. The expression of RAGE mRNA was assayed by Real time RT-PCR. RESULTS AGEs induced apoptosis of cultured SGCs. The effects were dose-dependent and time-dependent. Meanwhile RAGE mRNA expression was enhanced in apoptosis cells. CONCLUSION AGEs induced apoptosis in SGCs,which may be mediated by RAGE. And this may be one of the mechanisms of neural presbycusis.

BACKGROUND: The studies about cellular cardiomyoplasty (CCM) of bone marrow stromal cell (BMSC) are centered on modeling autologous cell transplantation while the study of myocardium transplantation of allogeneic BMSC is seldom reported domestically.OBJECTIVE: To study the hypothesis that the allogeneic BMSC, after transplanted into the myocardial infarction (MI) regions, can survive, further proliferate, differentiate, and its effects on host hearts.DESIGN: A randomized and controlled trial with experimental animals as subjects.SETTING: Laboratory of Internal Cardiology, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: Ten Wistar rats of one-month old, body mass of 100-120 g and unconfined sex were used to culture BMSC while eighty female Wister rats of three-month old, body mass of 200-250 g were used for animal models.METHODS: The experiment was completed in the Laboratory of of Internal Cardiology, Affiliated Union Hospital, Tongji Medical College,Huazhong University of Science and Technology from June to December 2004. ①Eighty rats were used to establish the acute myocardial infarction (AMI) models by ligating the left anterior descending branch of coronary artery, and 45 of them were successful. ② After 4 weeks, the models were divided into 2 groups at random. In the experiment group (n=25), the passaged and uninduced BMSC cultured in vitro were injected into the MI region of the recipients while only medium was injected in the control group (n=20). ③At 4 weeks after implantation,the hemodynamic indexes of recipients' hearts were examined. Then the samples were obtained to detect the survival, differentiation and angiogenesis status of the removal cells.MAIN OUTCOME MEASURES: ①Comparison of hemodynamic indexes in rats of two groups②Results of the implantation cells③Changes of angiogenesis in rats of two groups.RESULTS: Totally 13 rats in the experiment group and 11 in the control group were involved in the result analysis. ①The hemodynamic indexes of rats were significantly improved in the experiment groups compared with the control group [Left ventricle systolic blood pressure (LVSBP): (88.61±5.99),(76.93±4.75) mm Hg, left ventricle end-diastolic pressure(LVEDP): (7.72±1.36),(12.77±2.76) mm Hg, P ＜ 0.05;The maximum changing velocity of LVSBP:(2 365.26±266.31),(2 025.04±230.25) mm Hg/s; The maximum changing velocity of LVDBP:(2 313.26±159.30),(2 140.12±191.03) mm Hg/s]. ②After implanted in the MI region, the allogeneic BMSC passed the acute inflammation period and did not induce the remarkable reject reaction of transplantation. The BMSC in the infarcted region were mainly differentiated into fibroblast. Some cells around the infarcted region were differentiated into endothelial cells, and improved the angiogenesis. ③The number of angiogenesis in and around the transplantation regions was significantly higher in the experiment group than in the control group (P ＜ 0.01).CONCLUSION: The allogeneic BMSC can not form cardiomyocyte in the infarcted region after cell transplantation, and the engendered endothelial cells of blood vessels may promote the angiogenesis after AMI and ameliorate the cardiac function.

Objective To investigate the difference between Asia-Pacific Colorectal Screening (APCS) scoring system and colorectal cancer sequential screening criteria issued by the Health Ministry of China (China sequential criteria) in the evaluation of high-risk colorectal neoplasm in patients undergoing coronary artery angiography (CAG) examination.Methods The data of 870 patients aged from 40 to 74 who underwent CAG examination were retrospectively analyzed.The measurement data were analyzed by t test and the count data were aralyzed by x2 test.Results There were 72 patients aged from 40 to 49 years old.Among them,eight patients were stratified as high-risk population according to the Chinese sequential criteria; however there was no high-risk population by APCS.There were 798 patients aged from 50 to 74 years old.There were 460 patients stratified as high-risk population by APCS.The percentage of CAG negative group (34.7％) was significantly lower than that of the coronary artery disease (CAD) group (68.0％,x2 =77.74,P＜0.01).According to the Chinese sequential criteria,and there were 134 patients stratified as high-risk population,and there was no significant difference between the CAG negative group (17.7 ％) and the CAD group (16.4％,P＞0.05).Among the patients aged from 50 to 74 years old without family history of colorectal cancer in first-degree relatives,72 cases (29.0％) of the CAG negative group and 316 cases (57.5％) of the CAD group were stratified as high-risk according to APCS,however not stratified as high-risk by the Chinese sequential criteria.About 90.5 ％ (351/388) of them were male smokers.According to APCS,30 cases (12.1％) of the CAG negative group and 32 cases (5.8％) of the CAD group were stratified as middle-risk population,however stratified as high-risk population by the Chinese sequential criteria.About 75.8％ (47/62) of them were female non-smokers.Conclusions The percentage of patients stratified as high-risk population by APCS was higher than that by the Chinese sequential criteria.In patients aged from over 50 to 74 years old and without family history of colorectal cancer in first-degree relative,APCS maybe overestimated the risk degree of colorectal neoplasm in male smokers and underestimated the risk degree in female non-smokers.

BACKGROUND:The traditional surgical method have large trauma in the treatment of tibiofibular syndesmosis injury, and cannot wel complete the repair of ligament. But the suture anchor has clear effect for ligament repair, ligament reconstruction and bone connection. OBJECTIVE:To investigate the biomechanical properties of the suture anchor in the treatment of tibiofibular syndesmotic injury, and to compare with lag screw internal fixation. METHODS:Eight ankle joint specimens were col ected, and the biomechanical experiment was performed for stress analysis. The suture anchor technology and lag screw internal fixation were used respectively to treat the tibiofibular syndesmotic injury. The biomechanical properties of the stress strength, stiffness and stability were compared. RESULTS AND CONCLUSION:The biomechanical properties of the stress strength, stiffness and stability of suture anchor technology for the treatment of tibiofibular syndesmotic injury were better than those of lag screw internal fixation, and there were significant differences in the strength and stiffness between two methods (P<0.05);the stress shielding rate of suture anchor technology was lower than that of lag screw internal fixation, and the difference was significant (P<0.05);the tibiofibular syndesmosis separated displacement of suture anchor technology was lower than that of lag screw internal fixation, and the difference was significant (P<0.05). The results indicate that the suture anchor technology is a minimal invasion and good method to realize physiological reconstruction and elastic fixation with stable fixation strength and less trauma, and without secondary operation.

Objective To evaluate previous gastroscopy before percutaneous coronary intervention (PCI) for the risks and benefits of concomitant use of proton pump inhibitors (PPIs) after PCI in patients with non-acute coronary syndrome (non-ACS).Methods The data of 673 non-ACS patients who underwent PCI with stenting were retrospectively analyzed.They were divided into concomitant use of PPIs group and non-PPIs group,then subdivided into high-,moderate-and low-risk groups according to risk factors associated with adverse upper gastrointestinal (GI) events.The incidences of adverse cardiovascular events and adverse upper GI events were compared among groups.Findings of previous gastroscopy were also included.Results Only 82 patients (12.2％) underwent gastroscopy within 5 years before PCI,of whom,27 (32.9％) were diagnosed as having peptic ulcer,and 55.6％ (15/27) of whom were in concomitant use of PPIs.Compared with the non-PPIs group,the rate of adverse cardiovascular events in the concomitant use of PPIs group was significantly higher (22.6％ vs.8.9％,P ＜0.01),and the highest rate (41.7％) was in the high-risk group.However,the corresponding rate of adverse upper GI events was the lowest (4.2％).In the moderate-risk group,90.5 ％ (344/380) of patients were older than 65 years with concomitant use of NSAIDs.The rate of gastroscopy within 5 years before PCI in these patients was remarkably lower than that in patients who had the history of upper GI disease with concomitant use of NSAIDs (concomitant use of PPIs group 14.1％ vs.54.5％ ; non-PPIs group 7.5％ vs.28.0％ ; P ＜ 0.01).In the concomitant use of PPIs group,the rate of adverse cardiovascular events in the former was notably higher than that in the latter (20.5％ vs.9.1％,P ＜0.01),but the rate of adverse upper GI events within 1 year after PCI were similar (9.0％ vs.9.1％).Conclusion Previous gastroscopy before PCI could provide the baseline information of upper GI disease,which may be helpful for the evaluation of concomitant use of PPIs after PCI so as to decrease the incidence of adverse cardiovascular events.Special attention should be paid to those patients older than 65 years in the moderate-risk group and concomitant use of NSAIDs.

Objective To investigate the relationship among the spinous process open degree,the relative displacement of the lumbar facet joints(LFJ),and the morphologic change of the intervertebral foramina.Methods From Nov 2010 to Jun 2012,a total of 6 human fresh cadaveric spines was used in this study.All the ligaments were kept.The relative displacement of the corresponding segments LFJ,and the change of height and width of intervertebral foramen were measured through the corresponding open L3-4 and L4-5 spinous process,respectively.Results Lumbar degeneration was described with the following indices including the proliferation and displacement of LFJ,deformation of the intervertebral foramen morphogenesis,nerve root oppression,and lumbar intervertebral stenosis.When the interspinous process spacer was opened up to 2 mm,lumbar intervertebral foramen heights at the L3-4 and L4-5 [(15.62 ± 0.73) mm,(14.67 ± 0.75) mm] were significantly increased (t =26.00,16.02,P ＜ 0.01) compared to the original state [(13.89 ± 0.77) mm,(12.48 ± 0.80)mm].When the interspinous process spacer was opened up to 4mm,lumbar intervertebral foramen heights at the L3-4 and L4-5 [(17.13 ± 0.78) mm,(16.74 ± 0.76) mm] were significantly increased (t =36.15,30.69,P ＜ 0.01) compared to the original state.The foraminal height with a 4 mm distraction was significantly greater than the 2 mm distraction (t =20.82,21.72,P ＜0.01).When the interspinous distraction was 2 mm,L FJ displacement at the L3-4and L4-5 [(0.31 ±0.04) mm,(0.34 ± 0.07) mm] was significantly better than the original state [(0.63 ± 0.03) mm,(0.56±0.05)mm] (t =61.97,58.91,P ＜0.01).When the interspinous distraction was 4 mm,LFJ displacement at the L3-4 and L4-5 [(0.10 ±0.04) mm,(0.12 ±0.06) mm] was significantly better than the original state (t =18.69,18.88,P ＜0.01).No significant difference was found in the change of the intervertebral foramen width [(8.65 ± 0.38) mm,(7.78 ± 0.37) mm] at the 2 mm interspinous distraction compared to the original state(P ＞ 0.05),but a statistically significant difference was found at the 4 mm interspinous distraction compared to the original state [(9.03 ± 0.41) mm,(8.05 ± 0.32) mm] (t =7.78,7.97,P ＜ 0.01).Conclusions Spinous process shove off can effectively improve LFJ displacement,and increase the intervertebral foramen height,but the increase of its width needs to shove off enough distance.

Objective To explore the specific ultrasonic manifestation features of intracranial foreign bodies after firearm injury,and to evaluate the value of ultrasonography in detecting intracranial foreign bodies.Methods ① The specific ultrasonic manifestation features of intracranial foreign bodies were summarized by making ultrasonic scanning over known foreign bodies of different types inserted before hand in around the injury tracts.②With the summary,ultrasonic scanning was made to the foreign bodies with unknown size and types,the result was confirmed with the fetched-out foreign bodies,and the coincidence of ultrasonography in scanning the intracranial foreign bodies after firearm injury was evaluated.Results Ultrasonography could distinguish intracranial foreign bodies from brain parenchyma,intraeranial foreign bodies of different types had different ultrasonic manifestation features.The size and the materials of the foreign bodies had certain affection on the result of ultrasonic scanning.The accuracy of qualitative judgement in scanning the intracranial foreign bodies was 71.52％,and the accuracy in scanning the foreign bodies with diameter ＞ 0.5 cm was higher than that with the diameter ＜ 0.5 cm.The coincidence in qualitative judgement of the foreign bodies of different materials ranged as follows:bullet (97 ％ )＞ steel ball (81.13％),bone pieces (78％) and glasses (72％) ＞gauze (54.67％) and wood pieces (54.67％).Conclusions The intracranial foreign bodies of different materials have specific ultrasonic manifestation features and ultrasonography can scan out their locations.The coincidence of qualitative judgement in scanning the bodies with diameter over 0.5 cm is high.Ultrasonography may be of important significance in guiding the fetch-out of intracranial foreign bodies on the spot and in raising the rescuing level of firearm injury.

Objective To explore the ultrasonographic characteristics in craniocerebral gunshot injured areas and the value of ultrasound technology for judging the activity of wound tissues. Methods After establishment of the model of penetrated craniocerebral gunshot wound, the ultrasonographic characteristics of the tissues in the injured areas were observed by conventional ultrasound and contrastenhanced ultrasonography(CEUS) ,and compared with the pathological changes of the wound area. Results ①A straight-looking, irregular-edged, easily distinguishable pipe-shaped high-level echo can be seen by conventional ultrasound in craniocerebral gunshot injured areas. ②The pipe-shaped strong echo usually shows non-enhancement by the CEUS,or shows homogeneous hypo-enhancement in some areas. ③Tissues around the pipe-shaped echo usually appears that the homogeneous hypo-enhancing area and non-enhancing area exist together. ④Around the above-mentioned the hypo-enhancing area and non-enhancing area, a hyper-enhancing area can be seen, and appears to be a typical ring-shaped high-level echo in short-axis section of the pipe-shaped echo. ConclusionsConventional ultrasound can easily shows the distribution of craniocerebral gunshot injured areas characterized by pipe-shaped high-level echo, and CEUS can precisely demonstrate necrotic tissues in the gunshot injured areas,distinguish them from the degenerative tissues and normal tissues. The application of ultrasound technology will greatly improve the therapeutic and treatmental level of the craniocerebral gunshot wound.

Objective To compare the efficacy and side effects between systemic chemotherapy and hepatic arterial infusion by combination of oxaliplatin and 5-fluorouracil (FOLFOX-6) with 5-fluorouracil in the patients who have developed hepatic metastasis after colorectal cancer operation. The factors that would affect the prognosis without operational treatment were also analyzed. Methods 46patients who had signed the informed consents were allocated into two groups: the group with general chemotherapy (Trial Group includes 26 cases) and the one with hepatic arterial infusion chemotherapy (Control Group includes 20 cases). The total effective rate, the prognosis, the cytoxicitic side effects,quality of life, the total survival rate and the responses were the main parameters determined. Kaplan-Meier was used to analyze Mono-factor to the prognostic responses and the Cox mode was used to analyze poly-factor to the prognostic responses. Results The overall survival rate was significantly higher by using systemic treatment versus HAI(median, 15. 0 v 11.2 months;P＜0.05). The difference in overall responsive rate (CR+PR) between the two groups was statistically significant (50% v 10%;P=0. 011). No significant difference was found in PS scale during the treatment. (P=0. 126). Except for myelosuppression and abdominal pain, no significant difference was found in the other side effects. Univariate analysis revealed that the invasive lesions to serosa, the distribution of liver metastases, the size and number of liver metastases, primary carcinoma involving lymph nodes and the treatment were correlated with prognoses. Cox regression analysis showed that the larger diameter of liver metastases, the number of liver lesions, primary carcinomas involved in serosal layer and the treatment modules were independent prognostic factors. Conclusions The oxaliplatin-based FOLFOX-6 chemotherapy regiment has a better responsive rate and survival rate than the traditional infusion with 5-fluorouracil to the main hepatic artery for interventional therapy. The diameter of the hepatic metastasis larger than 5em, multiple hepatic metastasis and the primary lesions penetrating serosal layer suggest the poor prognosis. The oxaliplatin-based systematic chemotherapy has a better prognosis. Therefore,it is worth carrying on further study on modification of traditional hepatic arterial infusion and on evaluation of therapy by combination of the hepatic arterial infusion with the systematic chemotherapy.