Objective To investigate the clinical application of statins for secondary prevention and its efficacy in patients with ischemic stroke.Methods A total of 300 patients with ischemic stroke were divided into statins group (n=91) and control group (n=209) according to whether statins was received or not.Serum lipid parameters,liver and kidney function,carotid artery intimamedia thickness (IMT) and plaque area were compared between the two groups.Results In 209 patients not taking statins,68 cases (32.5％) were not advised by clinic doctor; 55 cases (27.8％)were reluctant to take statins in fear of adverse reactions; 77 cases (36.8％) discontinued stains when serum lipids were normal; 3 cases (1.4％) developed skin allergic reaction and the skin rash that disappeared after stains discontinuance; 3 cases (1.4％) had elevated liver enzyme levels and the enzyme levels were declined to normal after stains discontinuance.The levels of total cholesterol (TC),triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) were significantly lower in statin group than in control group [(4.93±0.45) mmol/L vs.(5.87±0.38) mmol/L,(1.68±0.61)mmol/L vs.(2.01±0.58) mmol/L,(2.49±0.57) mmol/L vs.(3.76±0.44) mmol/L,t=18.60,4.46,20.94,P=0.000,0.007,0.000,respectively].High density lipoprotein (HDL-C) level was significantly higher in stain group than in control group [(1.36±0.31) mmol/L vs.(1.03±0.25)mmol/L,t=9.75,P=0.001].There were no significant differences in liver and kidney function parameters such as alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,serum total bilirubin,direct bilirubin,indirect bilirubin,glutamyl transferase,blood urea nitrogen and serum creatinine between the two groups (all P＞0.05).The carotid IMT and carotid atherosclerotic plaque area were significantly lower in stain group than in control group [(1.62 ± 0.23) mm vs.(1.74±0.31) mm,(0.57±0.12) cm2 vs.(0.65±0.18) cm2,t=3.32,3.88,P=0.008,0.002,respectively].Conclusions Most patients with ischemic stroke are still not taking statin for secondary prevention.Statins can improve the blood lipid levels and carotid arteriosclerosis status,and no obvious adverse reactions are observed.

Objective To observe colorectal tumor's growth in hyperglycemia mice and its vascular endothelial growth factor (VEGF)'s expression, insulin-like growth factor-1 (IGF-1)'s variation of blood through the experiment, then to ascertain whether type 2 diabetes mellitus (T2DM) danger factors to promote colorectal cancer happen and progress or not. Methods The mouse model of colorectal cancer combined T2DM was established. The volume of tumor was observed. After 5 weeks, all mice were executed and IGF-1 in the blood and the expression of VEGF in the tumor tissue was examined. Results The average tumor volume of colorectal tumor-diabetes group [(1628.5±882) mm3] were larger than that of colorectal tumor group [(1950.2±726) mm3] (P <0.05), and its expression IGF-1 of blood [(105.33±32.32) ng/ml] were higher than that of the control group [(69.83±25.57) ng/ml] and colorectal tumor group [(70.17±25.27) ng/ml] (P <0.05). The expression of VEGF [(70.0±11.5)%] in colorectal tumor-diabetes group were significantly higher than that of colorectal tumor group [(42.9±7.5)%] (P <0.05), too. Conclusion The model of T2DM and transplanted colorectal tumor can be duplicated successfully in ICR mice. Diabetes mellitus may be one reason of promoting colorectal cancer progress. Besides high blood glucose, its mechanism is the high level of IGF-1 which can inhibit apoptosis, promote cell differentiation and hyperplasia, and through inducing VEGF duplicating, heighten its expression, promote the tumor vessel growth, lead to tumor happen and metastasis.

Objective To study the clinical features of follicular occlusion triad, and whether it is a hereditary disease. Methods Based on the clinical examination of a case who developed squamous cell carcinoma secondary to follicular occlusion triad, the pedigree of the patient was surveyed and analyzed. Results There were a total of thirteen patients in this pedigree, the age of onset was about 20 years old. The clinical features and laboratory examination of the proband was consistent with follicular occlusion triad. Conclusions Hereditary factor is important in the pathogenesis in follicular occlusion triad,and the disease maybe an autosomal dominant inherited disease.

Aim: A new derivative LC-MS method was developed for the simultaneous determination of zofenopril and its active metabolite zofenoprilat to investigate the pharmacokinetic characteristics of zofenopril and zofenopri-lat in healthy Chinese volunteers after single and multiple oral doses of zofenopril calcium tablets. Methods: Ten Chinese healthy volunteers were given three single oral doses of 15,30, and 60 mg, respectively, and consecutively the multiple doses of 30 mg. The concentration and pharmacokinetic parameters of both the parent drug and the active metabolite were simultaneously determined by derivative LC-MS method using p-bromophenacyl bromide (p-BPB) as the derivative reagent. Results: After the single oral administrations of 15, 30, and 60 mg of zofeno-pril calcium, there was no significant difference in the t_(1/2) of both zofenopril and zofenoprilat among the three do-ses. The values of AUC_(0-24h) and c_(max) for both zofenopril and zofenoprilat showed the good linearities to the dosage over the dose range from 15 mg to 60 mg. There were no significant differences in AUC_(0-24h) and c_(max) for both com-pounds between female and male volunteers. After multiple oral administration( 30 mg once daily for 6 days ), the average steady state plasma concentration( c_(av)) for zofenopril was (5. 07 ±1. 06) ng/mL with the degree of fluctu-ation (DF) of 14. 26 ± 2. 94. The c_(av) for zofenoprilat was (6. 28 ± 1. 87) ng/mL with the DF of 11. 61 ±4. 68. The accumulation index values for zofenopril and zofenoprilat were 0. 94 ± 0. 31 and 0. 83±0. 13, respec-tively. Conclusion: Both zofenopril and zofenoprilat were demonstrated of linear kinetics after single administra-tion and showed no accumulation after multiple administration of the test zofenopril calcium tablets. There was significant difference in the pharmacokinetic characteristics for zofenopril calcium between healthy Chinese and European volunteers.

BACKGROUND:At present, percutaneous vertebroplasty has been widely used in clinical treatment of osteoporotic vertebral fractures. Considering the limitations of the underlying disease in elderly patients (> 65 years of age) at surgery, the relevant detailed studies have gradualy attracted the attention of clinicians. OBJECTIVE:To compare and analyze the clinical effects of vertebroplasty with bone cement and conventional fracture reduction for elderly osteoporotic thoracolumbar fractures. METHODS:Totaly 24 elderly patients with osteoporotic thoracolumbar fractures were voluntarily divided into bone cement treatment and conservative treatment groups (n=12 per group) and subjected to vertebroplasty with polymethylmethacrylate bone cement and conventional reduction therapy, respectively. RESULTS AND CONCLUSION:Compared with the conservative treatment group, the visual analog scale scores, Oswesty dysfunction index and Cobb angle were significantly reduced in the bone cement treatment group, while the degree of anterior vertebral compression was increased. These results suggest that minimaly invasive spine treatment is conducive to improve the fracture healing and enhance the quality of life in elderly patients with osteoporotic vertebral compression fractures in stable conditions.

Objective To discuss the features of nosocomial infection in patients with multiple trauma in intensive care unit and the preventive measures. Method The nosocomial infections occurred in 137 patients with multiple trauma were analyzed including site of infection, pathogenic organisms and bacterial strains. Results The rate of nosocomial infection was 62.8%, mainly the lower respiratory tract infection and wound infection, the G-negative bacteria infection accounted for 67.8%, mostly Escherichia Coli, Pseudomonas aeruginosa and A cinctobacter baumanni I. The G-positive bacteria infection accounted for 32.2%, mainly Staphylococcus aureus and Coagulase negative staphylococcus. The positive detection rates of Klebsiella and pseudomonas aeruginosa were increasing year afer year. Conclusions The incidence of nosocomial infection in patients with multiple trauma is high, suggesting some appropriate preventive measures should be taken to reduce the rate of infection.

BACKGROUND:Although bone marrow mesenchymal stem cels from multiple myeloma patients present a variety of abnormalities, it is unclear how these abnormal mesenchymal stem cels influence the chemotactic function of myeloma cel lines.
OBJECTIVE:To investigate thein vitro effects of bone marrow mesenchymal stem cels from normal donors versus multiple myeloma patients on the chemotactic capacity of myeloma cel lines.
METHODS:In vitro cultured bone marrow mesenchymal stem cels derived from either normal donors (N-MSCs group) or newly-diagnosed multiple myeloma patients (MN-MSCs group) were directly co-cultured with U266 cels, in the presence or absence of bortezomib; and then harvested U266 cels were assayed for Transwel migration and mRAN expression of chemotaxis-related genes. U266 Transwel migration to conditioned medium derived from either N-MSCs or MN-MSCs was also tested.
RESULTS AND CONCLUSION:After co-cultured with N-MSCs or MN-MSCs, U266 cels harvested from MN-MSCs group showed increased spontaneous Transwel migration and up-regulated CCR1 mRNA level than those from N-MSCs group (P < 0.05), whatever bortezomib was present or not. However, there was no evident difference between U266 cel Transwel migration to conditioned medium derived from either MM-MSCs group or N-MSCs group. Our study implies that there may be some intrinsic aberrance in bone marrow mesenchymal stem cels derived from multiple myeloma patients, which can modulate the chemotactic migration of myeloma cel lines when they directly interact with each other.

Objective To compare clinical outcomes of modified hand-assisted versus total laparoscopic splenectomy and esophagogastric devacularization for treatment of portal hypertension due to cirrhosis.Methods From Jan 2007 to Dec 2011,modified hand-assisted laparoscopic splenectomy plus esophagogastric devascularization (MHLSED) and total laparoscopic splenectomy and esophagogastric devascularization (LSED) were performed on 47 and 38 patients with portal hypertension due to cirrhosis,respectively.For the MHLESD group,we performed hand-assisted laparoscopic splenectomy first,then converted during operation to totally laparoscopic esophagogastric devascularization.The operating time,intra-operative blood loss,postoperative complications and postoperative hospitalization time were analyzed.Results MHLSED were performed on 47 patients successfully without any need to convert to open surgery,and LSED were performed on 36 patients with 2 patients having to convert to open surgery.The mean operative time [(154 ±32)min] and mean intra-operative blood loss [(115± 73)ml] in the HLSED group were significantly lower than the LSED group [(212±45)min and (172±57)ml,respectively].There was no mortality.There were no significant differences in the time period for gastrointestinal function to recover,postoperative hospital stay and overall complication rate between the two groups.Conclusions MHALSD is a relatively safe and efficacious treatment for portal hypertension due to cirrhosis.It combines the advantages of hand-assisted and totally laparoscopic operations.

ObjectiveTo evaluate the safety and efficacy of a modified hand-assited laparoscopic splenectomy (HALS) plus pericardial devascularization for the treatment of cirrhotic portal hypertension.MethodsFrom March 2009 to Dec 2011,modified hand-assited laparoscopic splenectomy plus pericardial devascularization was performed on 47 patients with portal hypertension and liver cirrhosis.We performed HALS first, thenconvertedtototallylarparocopicpericardialdevascularizationduring operation.ResultsAll patients received modified HALS plus pericardial devascularization without convertion to open surgery,the mean operative time was ( 154 ± 32) min,the mean intraoperative blood loss was ( 115 ±73) ml,and the mean postoperative hospitalization was (9.2 ± 1.6) days.The perioperative complications included plural effusion in 3 cases,ascites in 4 cases,pancreatic leakage in 1 case and wound dehiscence in 1case. Therewasnoperioperativemortality.ConclusionsModifiedHALSpluspericardial devascularization is a relatively safe and effective procedure in the treatment of portal hypertension due to liver cirrhosis,it has the advantage of hand-assisted and totally laparoscopic procedures.

Objective To investigate the mechanisms modulating the functions of dendritic cells (DCs) and suppressing the activation and proliferation of T cells by transforming growth factor-β (TGF-β).Methods Mouse splenic DCs were purified with CD11c+ immunomagnetic beads and the purity of isolated DCs were detected by flow cytometry.Gene chip was used to detect gene expression in DCs after stimulation with TGF-β, and then real-time PCR was performed to analyze the differentially expressed genes in microarray at mRNA level.The activation and proliferation of CD4+ T cells which were co-cultured with DCs after stimulation with TGF-β were detected by flow cytometry.Results The purity of DCs reached over 95% after isolation.TGF-β down-regulated the expression of cell surface markers CD53, CD69, CD33, CD74 and CD93 on DCs;decreased the expression of chemokines Ccl3, Ccl5, Ccl9, Ccl6, Ccl17, Cxcl10, Ccl22, Ccl4, Ccr7, Ccl2, Cxcl9 and Ccl7;inhibited the expression of inflammatory cytokines IL-2ra, IL-12rb2, IL-15ra, IL-1b and IL-15.Moreover, the DCs-mediated activation and proliferation of CD4+ T cells were suppressed by TGF-β.Conclusion TGF-β inhibits the DCs-mediated activation and proliferation of CD4+ T cells by suppressing the expression of surface markers on DCs and down-regulating the expression of chemokines and inflammatory cytokines.