Objective To observe the changes of PI3K/Akt signaling pathway and endoplasmic reticulum stress related protein GRP78 and CHOP in CCl4 induced liver fibrosis and to explore their effects on hepatic fibrosis.Methods Thirty SD rats were randomly divided into normal control group, 4 and 8 weeks liver fibrosis group (hypodermic injection of 40% CCl4).Pathological changes of liver tissue was observed by HE staining.The techniques of real-time PCR was applied to detect mRNA of GRP78 and CHOP in liver.Detected expression of Akt1, phospho-Akt1, GRP78 and CHOP protein by western blot.Meanwhile, the cell apoptosis in liver was detected by TUNEL.Results Compared with the normal control group, GRP78 and CHOP mRNA and protein in 4 and 8 weeks liver fibrosis group was increased(P<0.05), while expression of Akt1, phospho-Akt1 in 4 and 8 weeks liver fibrosis group was lower than that in normal control group(P<0.05).Compared with normal control group, the apoptosis of hepatocytes in 4 and 8 weeks liver fibrosis group was elevated (P<0.05).Conclusions PI3K/Akt signaling pathway and endoplasmic reticulum stress may play important roles in the induction of apoptosis of hepatocytes in rats with hepatic fibrosis.

Objective:To prepare resveratrol microemulsions by high pressure homogenization method and characterize the microe-mulsions. Methods:Using the particle size, polydispersion index and encapsulation efficiency as the indicators, the independent varia-bles of the preparation were inspected, and the microemulsions were characterized. The stability of resveratrol microemulsions was stud-ied by long term stability test preliminarily. Results:The mean particle size, polydispersion index and zeta potential of resveratrol mi-croemulsions was (231 ± 37. 8) nm, 0. 228 ± 0. 047 and ( -42. 5 ± 4. 3) mV, respectively. The microemulsions were found to be small and spherical with smooth surface under a transmission electron microscope. Long term stability studies showed that the microe-mulsions were stable in 3 months after stored at 25℃. Conclusion:The preparation process of high pressure homogenization method for resveratrol microemulsions is simple and feasible.

Diabetes mellitus is an independent risk factor for ischemic stroke. Epidemi-ological studies have shown that intensive glucose control can reduce stroke risks in patients with type 2 diabetes. However, the current prospective clinical trials have failed to validate a definite causal relationship between them. This article reviews the clinical trials about the roles of intensive glucose control in patients with type 2 diabetes in the primary and secondary prevention of stroke.

Objective To study the effect of magnesium citrate combined with compound polyethylene glycol electrolyte powder in bowel preparation before colonoscopy.Methods One hundred and six colonoscopy patients with lower digestive tract symptom were divided into study group (54 cases) and control group (52 cases) by random digits table method,the bowel preparation in study group was magnesium citrate combined with compound polyethylene glycol electrolyte powder,in control group was compound polyethylene glycol electrolyte powder.The lesions detection rate,bowel preparation quality,time of first defecation,number of defecation,time of colonoscopy,results of the electrolyte level and liver and kidney function after medication and adverse reaction were compared between two groups.Results There were no statistical differences in lesions detection rate,time of colonoscopy,results of the electrolyte level and liver and kidney function after medication between two groups (P ＞ 0.05).The total effective rate of bowel preparation quality in study group was significantly higher than that in control group [96.3％(52/54) vs.82.7％ (43/52)],the time of first defecation was significantly shorter than that in control group [(32.5 ± 26.1) rmin vs.(47.2 ± 22.4) min],the number of defecation was significantly much than that in control group [(8.2 ± 2.9) times vs.(6.2 ± 2.6) times],there were statistical differences (P ＜ 0.05).The incidence of nausea in study group was significantly lower than that in control group [22.2％ (12/54) vs.48.1％ (25/52)],there was statistical difference (P ＜ 0.05).There were no statistical differences in the incidences of vomiting,abdominal distention and abdominal pain between two groups (P ＞ 0.05).Conclusion Magnesium citrate combined with compound polyethylene glycol electrolyte powder used in preoperative bowel preparation for colonoscopy has better clinical application value.

BACKGROUND:Studies have shown that tibial plateau posterolateral fractures can be treated by posterolateral knee approach, however, there is no clear anatomical research to deeply evaluate and analyze this approach. OBJECTIVE:To evaluate the efficacy and safety of posterolateral knee inverted“L”shaped pathway in invloving tibial plateau posterolateral fractures. METHODS:Eight fresh frozen adult corpses, 16 knees side, were al dissected using posterolateral inverted“L”shaped pathway. During the dissection, the exposure range was observed and important parameters of anatomical structure were measured. RESULTS AND CONCLUSION:The pathway may be ful y exposed to the posterolateral aspect of tibial plateau and posterior cruciate ligament tibial insertions. The operations completed by out team did not create any obvious interference to superior tibiofibular joint, fibular head and posterolateral corner structure. The exposed mean length of common peroneal nerve in incision was 56.48 mm, with a mean angle of 14.7° tilt towards the axis of the fibula. The mean distance between the neck of the fibular and fibular head tip was 31.26 mm, an average of 42.18 mm to the joint line. The mean distance between the opening of the interosseous membrane and the articular surface was 48.78 mm. The divergence of the fibular artery from the posterior tibial artery was an average of 76.46 mm from articular surface. These results confirm that posterolateral inverted“L”shaped pathway met the requirements of anatomical reduction and buttress fixation for posterolateral tibial plateau fracture. Exposure of the common peroneal nerve can be minimized or even avoided by modifying the skin incision. Because the popliteal artery branches anterior tibial artery passed through interosseous membrane hole and peroneal artery and then separated from the posterior tibial artery, pathways dissection to distal deep area should be carried out careful y. Placement of a posterior buttressing plate carries a high vascular risk if the plate is implanted beneath these vessels.

This study aims to evaluate the bioactivity of five components of the traditional Chinese medicine complex prescription Jiangzhi granules against hepatocellular steatosis.

Objective To investigate the effect of the side of cerebral lesion on the outcome in patients with ischemic stroke.Methods A total of 407 consecutive anterior circulation ischemic stroke patients within 14 days after symptom onset were recruited prospectively.The basic data ofthe e,~ISes were collected,such as the National Institutes ofHealth Stroke Scale (NU-ISS)and the side ofcerebral lesion.The modified Rankin Scale(mRS)was used to evaluate the prognosis of the patients at 6 raomhs.Results Of the 407 patients recruited,230 patients (56.5%)Were left hemisphere stroke,177(43.5%)were fight hemisphere stroke.After multivariable logistic recession analysis,the age(odds ratio[OR]1.022,95% confidence interval[CI]1.001-1.043,P=0.040),the side of lesion(OR 1.999.95%CI1.179.3.389.P=0.010),the time from onset to admission(OR1.006,95%(7/1.002-1.010,P=0.007),the outcome of the anterior circulation ischcmic stroke at 6 months aftel"onset.The outcome of the right hemisphere stroke Was significantly worse than that of the left hemisphere stroke.The onset-admission time in patients with right hemisphere stroke(median 12 h,median 39.61 h)was significantly delayed compared to the patients with left hemisphere stroke(median 12 h,median 22.72 h;Z=-2.962,P=0.003).Condusions The outcome of the left hemisphere stroke at 6 months after onset is superior to the right hemisphere stroke,and it mau be associated with the delayed admission.

Objective To study a possible correlation between the duration of reproductive period ( from puberty to menopause) and the prognosis of ischemic stroke. Methods Female in-patients with acute ischemic stroke confirmed by CT/MRI in the Neurology Department of the First Affiliated Hospital of Zhengzhou University from 09/03/2006 to 08/30/2008 were enrolled in this study. The probable risk factors of prognosis were analyzed and recovery was assessed by modified Rankin score (MRS) at 6 months followup. Multivariate Logistic regression was used for statistic analysis. Results 371 female patients were enrolled. The average age was (66. 2 ± 10. 0) years; average menopause age was (48. 5 ± 3.9 ) years and average duration of reproductive period was (33.3 ± 4. 3) years. There is a negative correlation between the duration and MRS (OR =0. 285, 95% CI: 0. 095-0. 850, P =0.024). There is no correlation between menopause age and prognosis of stroke. Conclusions Duration of reproductive period is a predictor for prognosis of ischemic stroke. Patients with longer reproductive period have better prognosis.

Objective To investigate the application of statins in secondary prevention of ischemic stroke and transient ischemic attacks (TIA) in different risk groups,and to identify the factors influencing the compliance of statins. Methods Data were prospectively collected on consecutively encountered ischemic stroke or TIA patients admitted to the First Affiliated Hospital of Zhengzhou University from April 2009 to January 2010.All clinical characteristics and possible factors influencing the compliance of statins were collected; the application of statins was investigated at 3-month follow-up.The multivariate Logistic regression analysis was used for the analysis of influence factors of the compliance of statins.Results All 369 patients were collected,52.8％ of cases were prescribed statins for therapy during hospitalization.The application rate of statins in accordance with guidelines in high-risk group,extremely high-risk Ⅱ group and extremely high-risk Ⅰ group was 25.0％ (16/64),44.1％ (30/68) and 71.4％ (135/189),respectively. Logistic regression analysis showed that the statins application during hospitalization was associated with diabetes history ( P =0.032,OR =1.789,95％ CI 1.052-3.043 ) and the presence of carotid vulnerable plaques(P =0.000,OR =5.308,95％ CI 3.340-8.434).The general application rate of statins was 22.3％ (81/363),which was significantly lower than that during hospitalization. The application rate of statins in accordance with guidelines in high-risk group,extremely high-risk Ⅱ group and extremely high-risk Ⅰ group was 9.7％ ( 6/62 ),25.8％ (17/66) and 29.4％ (55/187) respectively.Logistic regression analysis showed that good compliance of statins was associated with discharge instructions on statins application ( P =0.000,OR =34.852,95％ CI 14.673-175.452 ). Conclusions The compliance of statins in secondary prevention of ischemic stroke and TIA is poor,and there is still a large gap between clinical practice and guidelines; Discharge instructions on statins application increase the compliance of statins.

Objective To investigate the rule of the cerebral tissues aquaporin-4(AQP-4) expression in acute and chronic hepatic failure mice.To study the molecular biologic mechanism of the diffusion weighted imaging(DWI).Methods Sixty five male Sprague-Dawley rats were divided into 3 groups randomly,including acute(n=25),chronic hepatic failure(n=25)and control group(n=15). Thioacetamide(TAA)intraperitoneal injection produces the acute and chronic hepatic failure models.All rats in groups were examined with MR DWI.We Observed the distribution of abnormal signal on DWI.The DWI single values of top and lateral cortex of parietal lobe,peripheral region of lateral ventricle in the highest hyperintensity section of brain were measured.Blood ammonia values were examined.The pathologic and immuno-histochemistry and RT-PCR examination for brain specimen were performed.All date were analyzed with statistical methods.Results The mean values of blood ammonia were significantly different (P0.05).Conclusions Increase of the blood ammonia was the main cause for the brain energy metabolic abnormality and AQP-4 mRNA and protein expression.The hyperammonemia was the key factor in the occurrence and development of the hepatic brain edema.The abnormal findings in DWI signal could reflect the range and degree of the brain edema and AQP-4 protein expression.