Objective To investigate the expression of hMLH1 and hMSH2 in hilar cholangiocarcinoma and its relation to clinical features and prognosis of the tumor.Methods The expression of hMLH1 and hMSH2 was determined with immunohistochemistry in 54 specimens of hilar cholangiocarcinoma and 25 of normal bile duct tissue.Lahoratory data were then analyzed statistically together with the related clinicopathological data.Results 1)hMLH1 and hMSH2 were expressed in 24 and 21 out of the 54 cases of hilar cholangiocarcinoma(44.4%,38.9%)and 23 and 21 of the 25 normal cases(92%,84%),respectively(P＜0.05).2)The expression of hMLH1 and hMSH2 in hilar cholangiocarcinoma had no association with the age,gender,tumor size and Bismuth type(P＞0.05)but close relation to lymph node metastasis and pathological changes(P＜0.05).3)The 2-year survival rate was markedly lower in hMLH1-negative patients than in hMLH1-and hMSH2-positive ones (15%vs.45.4%,23.5%vs.44%,P＜0.05).Conclusions Joint action of hMLH1 and hMSH2plays an important role in the oncogenesis and metastasis of hilar cholangiocarcinoma.These two may be valuble factors to indicate prognosis of the tumor.

Lamin A,which is an important skeleton protein in the cell nucleus,can play an important role in maintaining the morphological structures of the cells.This article summarizes the location of LMNA gene in the chromosome,the shape and the structum of lamin A protein;the different diseases of the body which result from the mutations and deletions of LMNA gene in different sites;the differentiation functions of myoblast in which lamin A is involved:degradation of lamin A that may be promoted by Caspase-6;theexpression of lamin Athatmay bepromoted by NFAT5.

Objective To discuss the selection and clinical efficacy of operative methods for subaxial cervical dislocation without spinal cord injury. Methods A retrospective study was performed on 11 patients with subaxial cervical dislocation without spinal cord injury treated from January 2004 to June 2009. According to Allen' s classification, all patients suffered from retracted flexion injuries, including seven patients with Ⅰ degree dislocation, one with Ⅱ degree dislocation and three with Ⅲ degree dislocation. There were eighth patients with old dislocation and three with fresh dislocation, both of which were simple cervical trauma without other organ injuries. Open reduction, internal fixation and iliac bone graft spinal fusion were performed in seven patients and combined posterior and anterior open reduction,internal fixation and iliac bone graft spinal fusion in four. All the patients were followed up for observation of clinical effect. Results All operations were completed successfully. There were 11 patients at Frankel grade E preoperatively and 11 at grade E postoperatively. X-ray photographs showed that the sequence and curvature of the cervical spine recovered to normal after operation. All patients were followed up for 3-31 months postoperatively, which showed no redislocation or symptoms of spinal cord injury.Conclusion For lower cervical dislocation combined with locked facet, one-stage combined anterior and posterior reduction and internal fixation should be performed. While for those without locked facet, simple anterior reduction and bone graft spinal fusion is needed. Open reduction, internal fixation and bone graft spinal fusion are effective method for treatment of subaxial cervical dislocation without spinal cord injury.

Objective To explore the effects of an acute exercise on the contractile protein degradation and 26S proteasome activity in skeletal muscle.Methods Thirty-six male Sprague-Dawley rats were randomly divided into 6 groups,each group consisted of 6 rats.They were killed respectively at rest,immediately after half an hour of exercise(running on the treadmill at 25m/min,5% grade),and 1 hour,2h and 6h after one hour exercise.The 3-methylhistidine(3-MH)content,26S proteasome activity and C2 subunit mRNA expression in rat gastrocnemius muscle were detected.Resuits(1)3-MH content increased immediately and 6 hours after exercise,and reached its peak level immediately after half an hour of exercise(P<0.01).(2)26S proteasome activity increased immediately after half an hour of exercise and 6 hours after exercise(P<0.05).(3)Expression of 26S proteasome C2 subunit mRNA Was lower than baseline during and after exercise,but increased sharply 6 hours after exercise(P<0.01).Conclusion The increase in 26S proteasome activity regulated by subunits gene after exercise could enhance skeletal muscle contractile protein degradation

Objective:To valuate the relationships between operation modus,pathological characteristics and the prognosis on hilar cholangiocinoma(HCC). Methods:The clinical features,diagnostic methods,operation modus and histopathology results of the 223 cases with HCC were analyzed retrospectively. Results:1) Radical excision had been performed in 85 cases with the excision rate of 38.1%,1,3,5 years survival rates were 58.8%,30.9%,8.8% respectively. Palliative therapy had been performed in 110 cases; the median life span was 8 months. The average life span of those who had given up treatment was about 5 months. 2) In 132 cases of HCC,121 cases were adenocarcinoma,accounting for 91.7%. Well-differentiated was 29 cases (24.0%),medium-differentiated was 43 cases (35.5%),and poor-differentiated was 49 cases(40.5%). The others accounted for 8.3%,in total. The 1,3,5 years survival rate after radical excision of the well-differentiated and the medium-differentiated groups were 55.0%,40.0% and 15.0% respectively,those of the poor-differentiated group were 45.8%,16.7% and 0% respectively. 3) According to the Bismuth Corlette grouping type I was 20.1%,type II was 23.2%,type IIIa was 10.3%,type IIIb was 23.2%,type IV was 7.2%,and the others were 16.0%. Conclusions:1)Radical excision is the key to raise the long-term survival rate. The average life span of those who had given up treatment was about 5 months,which can reflect the natural life span. 2) Poor-differentiated adenocarcinoma accounted for considerable proportion in histopathology types of the hilar cholangiocarcinoma. 3)Bismuth Corlette grouping has some certain limit and disadvantages in the application.

Objective To investigate the effects of extracellular ATP on the recovery of motor function after spinal cord injury in rats.Methods Twenty healthy adult rats were randomly divided into two groups after contusion injury was performed by the weight drop method at T10 with Allen impactor.Group A(ATP group) and group B(control group) each had ten rats.At days 1,3,7,14 and 28 after injury,the recovery of motor function after spinal cord injury in rats was assessed with modified Tarlov scores and slanting board test.Results Modified Tarlov scores and slanting board test were better in group A than in group B after spinal cord injury in rats.Significant difference was found in modified Tarlov scores and slanting board test between the two groups at days 14 and 28 after injury(P

Objective To explore the clinical efficacy of using the disposable whole laminectomy, laminoplasty and microsurgical tumor removal to treat intraspinal extramedullary benign tumors. Methods Sixty-four patients, 71 cases adult intraspinal extramedullary benign tumors were removed by the disposable whole laminectomy, laminoplasty and microsurgical tumor removal operation, all postoperative patients were followed up to observe the clinical efficacy. Results Patients with small tumors and large tumors all had a faster recovery of neurological function than preoperative, recent and long-term efficacy were all better than preoperative, and long-term efficacy was superior to short-term efficacy; Patients with giant tumors had a slow-er recovery of neurological function than preoperative, short-term efficacy was not better than preoperative, but the long-term efficacy was superior to preoperative. Conclusion The disposable whole laminectomy, laminoplasty and microsurgical tumor removal is an excellent method of treating intraspinal extramedullary be-nign tumors.

Objective To investigate effects of exogenous sonic hedgehog (Shh) on proliferation of neural stem cells (NSCs) in ependymal area and recovery of motor function after spinal cord injury (SCI) in adult rats.Methods Fifty-five female SD rats were involved in the study:five were selected as normal control group and fifty as Shh group (n =25) and SCI group (n =25) after being subjected to SCI at T10 segment using the modified Allen' s method according to the random number table.At 1,3,7,14,and 28 days after operation,restoration of hindlimb motor function of SD rats was assessed with modified Tarlov scale and changes of double positive cells of Brdu and Nestin with double-stained immunofluorescence.Results Tarlov scale revealed statistical difference between Shh and SCI groups since days 7 postoperatively (P ＜ 0.05).In the double-staining test,number of double positive cells of Brdu and Nestin was greater in Shh Group than in SCI Group since day 3 postoperatively [(97.20 ± 18.23) vs (72.60± 15.60),(153.60 ±25.76) vs (112.20 ±23.63),(133.80 ±21.02) vs (94.20± 18.70),(89.80 ± 15.42) vs (43.40 ± 10.62),P ＜ 0.05].Conclusion Exogenous Shh is conducive to the proliferation of ependymal NSCs and the recovery of motor function in SCI rats.

ObjectiveTo investigate the protective effect and mechanism of monosialotetrahexosyl gangliosides ( GM-1 ) on neurons after spinal cord injury (SCI) in rats by observing the effect of GM1 on the expression and motor function of microtubule-associated protein 2 (MAP-2) and Choline acetyltransterase (ChAT). MethodsSixty-six adult female Wistar rats (weighing 260-300 g) were enrolled in the study and six were selected randomly as the normal control group. The rest were divided into GM1 group (group A, n =30) and normal saline control group (group B, n =30) after acute contusion injury was made at T10 level according to the improved Allen's method. At days 1,3, 7, 14 and 28 after operation, the neurological function of the low extremities was assessed with the improved Tarlov scale. Then,the rats were sacrificed to obtain the spinal cord tissues. There were six rats in each group at different time points. The expressions of MAP-2 and ChAT were detected with immunohistochemistry after SCI in rats. ResultsThe improved Tarlov scale in the Group A was higher than that in the Group B after SCI since the 7th day after operation, with statistical difference at day 7, 14 and 28 after operation ( P ＜0. 05). The expressions of MAP-2 and ChAT in the Group A were higher than that in the Group B after SCI ( P ＜ 0.05 ). ConclusionsThe neurological function recovery of the low extremities has some correlations with the expressions of MAP-2 and ChAT after SCI in the rats. GM-1 can protect the neurons by promoting the expressions of MAP-2 and ChAT after SCI.

Objective: To create a model for early prediction of essential hypertension (EH) based on the TreeNet algorithm, so as to provide a tool for early monitoring of EH. Methods: The health examination data were collected from individuals receiving health examinations in Hangzhou Haiqin Health Examination Center or Shanghai Yibao Health Management Co., Ltd from 2014 to 2016, and a predictive model for EH was created based on the TreeNet algorithm. The effectiveness of the model for early prediction of EH was evaluated using root mean square error (RMSE), mean absolute deviation (MAD), coefficient of determination (R2) and receiver operating characteristic (ROC) curve. Results: A total of 12 variables were included in the model, and the highest contributing variable was body mass index (BMI), followed by BMI difference, two-year BMI difference, two-year triglyceride (TG) difference, two-year total cholesterol (TC) difference, high-density lipoprotein cholesterol (HDL-C) in 2014, TG in 2014, low-density lipoprotein cholesterol (LDL-C) in 2014, body weight in 2015, fasting blood glucose in 2015, TG in 2015, urea nitrogen difference and platelet in 2015. The highest predictive accuracy was 100.00%, and the lowest was 56.89%. The risk of EH significantly increased among individuals with BMI in 2015 of >25 kg/m2, two-year BMI difference of >0.5 kg/m2, two-year TG difference ranging from 1.3 to 3.3 mmol/L, TC in 2015 of 2.0 to 2.4 mmol/L and HDL-C in 2014 of <0.52 mmol/L. The model presented RMSE of 0.082, MAD of 0.064, R2 of 0.811, area under the ROC curve of 0.788 (95%CI: 0.741-0.815), sensitivity of 69.05% and specificity of 66.21% for prediction of EH Conclusion The TreeNet algorithm-based model is effective for early monitoring of high-risk individuals for EH.