Objective To investigate the correlation of vertebral artery dominance (VAD) with incidence and laterality of posterior circulation infarct,and observe the correlation of VAD and basal artery (BA) curvature.Methods Total incidence of posterior circulation infarcts,incidence of separate territory infarcts in posterior circulation and incidence of BA curvature were compared between 68 VAD patients and 66 controls.VA dominance,laterality of BA curvature and separate territory infarcts,and their directional relationships were observed in VAD group.Results The total incidence of posterior circulation infarcts in VAD group was significantly higher than that in controls(45.6％ (31/68) vs 21.2％ (14/66),x2 =8.922,P =0.003 ).The incidences of posterior inferior cerebellar artery (PICA) territory infarct and BA territory infarct were both significantly higher than that in controls ( 11.8％ ( 8/68 ) vs 0,x2 =8.250,P =0.004 ;20.6％ (14/68) vs 7.6％ (5/66),x2 =4.660,P =0.031 ).No differences were found in superior cerebellar artery (SCA) and posterior cerebral artery ( PCA ) territory infarcts between two groups.87.5 ％ (7/8) PICA infarcts were on the opposite side of dominant VA.42.9％ (6/14) BA infarcts were on the side of dominant VA.The incidence of BA curvature was significantly higher than that in controls(50.0％ (34/68) vs 9.1％ (6/66),x2 =26.768,P =0.000 ).No differences were found in the incidences of posterior circulation infarcts between BA curvature patients and BA straight patients(52.9％ (18/34) vs 38.2％ ( 13/34),x2 =1.482,P =0.223 ).97.1％ (33/34)patients had an opposite directional relationship between dominant VA and BA curvature in 37 BA curvature patients in VAD group.Conclusions The incidence of posterior circulation infarcts is higher in VAD patients,especially in PICA infarct and BA infarct patients.Most PICA infarcts occurred on the opposite side of dominant VA.The incidence of BA curvature is higher in VAD patients,and BA usually bends to the opposite side of dominant VA.

It has been found by sorting out and analyzing ancient and modern doctors’ green tortoise exploring point acupuncture manipulation that ancient and modern doctors use Xu Feng's manipulation as the foundation and make some innovations on that b asis and according to their own clinical experiences. The clinical application range of different doctors’ green tortoise exploring point acupuncture manipulation is proposed by summarizing recent over 10 years’ clinical reports and the authors’ clinical practice. It is considered that the shortcomings of green tortoise exploring point acupuncture manipulation are lack of manipulation standardization and modern mechanism study and that manipulation standardization should be closely connected with clinical practice for further application and popularization.

Objective To explore the clinical effect of bone allograft plus interlock plate internal fixation in the treatment of tibial plateau fractures.Methods 43 patients with tibial plateau fractures were treated by open reduction,bone allograft,locking plate fixation and early knee joint function training.Results All patients were followed up for 8 ～ 14 months with an average of 10 months.All patients achieved bone union and the duration of union was averaged 6.9 months.Knee joint function was rated based on HSS score system as excellent in 30 cases,good in 9 cases,fair in 3 cases and poor in 1 case.The excellent and good rate was 90％.Conclusion Reliable effect can be achieved for fracture of tibial plateau treatment with bone allograft plus interlock plate internal fixation.It provides satisfactory function of the knee.It has many advantages,such as stable and durable fixation and avoidance of secondary compression of tibial plateau.

Objective To investigate the antitumor effect of cynanauriculoside A(CA) isolated from the root of Cynanchum auriculatum and its effect of apoptosis induction in tumor cells.Methods CA was evaluated for its cytotoxicity in vitro against MCF-7,BEL-7402,and HO-8910 cells by determining MTT assay and its antitumor effects in vivo on S180 tumor-bearing mice by calculating tumor-inhibited rate.Measures of apoptosis including Wright′s-Giemsa staining and flow cytometry(FCM) assay were involved to explore the mechanism.And the toxcity of CA on normal cells was also evaluated on in vitro cultured rat cortical neurons.Results CA showed a definite cytotoxicity to three tumor cell lines with IC50 in the range of 35.68—39.78 mg/L.And it significantly inhibited the tumor growth of S180 tumor-bearing mice at the dose of 40,50,and 160 mg/kg by ig administrated,the inhibitory rates were 20.0%,28.0%,and 48.1%,respectively.At the concentration of 80 mg/L,CA induced obvious apoptosis in MCF-7 cells(P

Aim To explore the effect of Osthole (Ost)on the right ventricle remodeling in monocrot-alinetreated rats and the possible mechanism.Meth-ods ♂ SD rats were randomly divided into normal control group,model group,low dose of Ost treatment group (10 mg·kg -1 )and high dose of Ost treatment group (20 mg·kg -1 ).All rats were given a single dose of MCT 50 mg·kg -1 subcutaneously to establish the right ventricle remodeling except normal control group.Then the rats in Ost treatment group were ga-vaged once daily.After 28 days of administration,the right ventricle(RV)and left ventricle plus septum(LV+SEP)were weighed separately.RV hypertrophy in-dex (RVHI)were measured by the relative weight rati-o of RV to LV +SEP.The morphological changes of right ventricle were executed by HE staining.The pro-tein expression of PPARαand PPARγwere detected by Western blot.Results Compared with the control group,RVHI was increased obviously (P <0.05 ), myocardial hypertrophy and structure disorders were observed in model group.The protein expression of PPARαand PPARγwere down-regulated significantly in model group (P <0.05).Compared with the model group,the value of RVHI (P <0.05),myocardial hy-pertrophy,structure disorders were improved signifi-cantly in Ost treatment group.The protein expression of PPARαand PPARγwere up-regulated in Ost treat-ment group (P <0.05).Conclusion Ost can attenu-ate the right ventricle remodeling induced by MCT in rats,which may be related to up-regulating the expres-sion of PPARαand PPARγ.

BACKGROUND:Insulin-like growth factor-1(IGF-1), a main active factor in growth hormone (GH), plays various biological functions, such as improving cognitive ability and anti-apoptotic action.
OBJECTIVE:To detect the expressions of GH and IGF-1 in the temporal cortex of Lewis dwarf rats, and to explore the effect of different concentrations of GH on the differentiation of hippocampal nerve stem cels (NSCs).
METHODS:Lewis dwarf rats aged 11(adult) and 20 (senile) month olds and normal wild-type rats were euthanized by decapitation, underwent the craniotomy quickly, and the temporal cortex in the cold saline was extracted. GH and IGF-1 levels were detected using western blotting. After isolation, purification and identification of the rat hippocampal NSCs, the effect of GH in different concentrations (10, 30, 90μg/L) on the NSCs differentiation was determined at 96 hours after culture.
RESULTS AND CONCLUSION:The GH level in the temporal cortex did not differ significantly among rats (P > 0.05). While the IGF-I level in the temporal cortex of Lewis dwarf rats was significantly higher than that of the wild-type rats (P < 0.05). The GH level in the temporal cortex of adult female Lewis dwarf rats was significantly lower than that of the male rats (P < 0.05). Immunofluorescence showed that the proportion ofβ III-tubulin-positive neurons was significantly higher than that in the control group (P < 0.05) after the hippocampal NSCs and precursor cels cultured for 96 hours with GH (30μg/L), but there was no significant difference between the control group and treatment group with GH of 10 or 90μg/L. These results suggest that GH and IGF-I are expressed in the temporal cortex of both Lewis dwarf and wild-type rats which are independent from pituitary GH and the peripheral circulating IGF-1. Additionaly, GH can promote the differentiation of hippocampal NSCs and precursor cels into neurons.

OBJECTIVETo compare the effectiveness of percutaneous microwave ablation ( MWA) versus hepatectomy for multifocal hepatocellular carcinoma.

METHODSFrom August 2002 to March 2012, one hundred and twenty-two patients with multifocal hepatocellular carcinoma (diameters 1 to 7 cm, 2 to 4 lesions) were treated by either complete MWA or radical hepatectomy, and their clinical data were collected and analyzed.The patients were divided into MWA group (n = 50) and resection group (n = 72), and the resection group was matched by MWA group based on clinical parameters. The survival and complications in the two groups were compared.

RESULTSThe overall 1-, 3- and 5-year survival rates were 100.0%, 73.0% and 62.0%, respectively, in the MWA group, and 80.0%, 56.0%, and 41.0%, respectively, in the resection group (P < 0.05). The corresponding recurrence-free survival rates were 88.0%, 63.0%, and 52.0% in the MWA group, and 68.0%, 45.0%, and 36.0%, respectively, in the resection group (P< 0.05). The multivariate Cox regression analysis indicated that albumin level, performance status, treatment modality, and tumor size were independent prognostic factors.

CONCLUSIONCompared with hepatectomy, percutaneous microwave ablation is a minimally invasive and reproducible procedure, and can improve the survival in patients with multifocal hepatocellular carcinoma.

Carcinoma, Hepatocellular ; mortality ; radiotherapy ; surgery ; Catheter Ablation ; Genetic Engineering ; Hepatectomy ; mortality ; Humans ; Liver Neoplasms ; mortality ; radiotherapy ; surgery ; Microwaves ; therapeutic use ; Regression Analysis ; Survival Rate ; Treatment Outcome

Objective To explore the method and effect of prosthetic replacement for the management of intertrochanteric fracture in the elderly.Methods 24 elderly patients with intertrochanteric fracture were treated with prosthetic replacement.According to the Evans classification,there were 4 cases of Evans Ⅱ,16 Evans Ⅲ and 4 Evans Ⅳ.Results The mean time to ambulation following the surgery was (6.0 ± 2.2) days.No prosthetic loosening or infection were observed in the follow-up of 6 to 27 months(average 12 months).According to the Harris hip score,the excellent and good rate was 83.3％.Conclusion Prosthetic replacement is safe and effective for intertrochanteric fractures in elderly patients,which allows early ambulation and have a relatively low rate of complications.

Objective To evaluate the usefulness of DiversiLab system for genotyping of Acinetobacter baumannii.Methods Fifty-eight non-duplicated clinical Acinetobacter baumannii isolated from 15 cities in China in 2005 were typed by rep-PCR-based DiversiLab system.The results were compared with those of PFGE and multilocus sequence typing. Simpson's index of diversity was used to compare the discriminatory power among DiversiLab system, PFGE and MLST.Results Fifty-eight Acinetobacter baumannii isolates were differentiated into 5 clusters and 25 unique types by DiversiLab system. MLST identified 35 distinct sequence types, which fell into one clone complex of CC22 and 35 singletons, while PFGE resolved 5 pulsotypes and 34 unique types.Simpson's diversity indices for DiversiLab system, MLST and PFGE were O.876, O.944 and 0.961, respectively.Conclusions The discriminatory power of DiversiLab system is lower than that of PFGE and MLST.But as a simple, fast and reproducible typing method, it could be used as a first-line typing tool for the analysis of a large number of isolates.

OBJECTIVE To observe and compare the cytotoxicity induced by andrographolide (AD)and its water soluble derivatives:andrographolide sodium bisulfite(ASB),active pharmaceutical ingredients of Chuanhuning and Yanhuning on human renal tubular epithelial cells (HK-2),and to explore the ASB-induced endoplasmic reticulum stress(ERS)mechanism. METHODS HK-2 cells were treated with the above four drugs respectively. The survival rate was examined by methyl thiazolyltetrazolium (MTT) assay and 50% inhibitory concentration (IC50) was calculated. In ASB treated group, Hoechst33342 staining and flow cytometry analysis were used to determine cell apoptosis, intracellular superoxide dismutase(SOD)activity and malondialdehyde(MDA)content were examined, and the protein expressions of binding immunoglobulin protein (Bip),C/EBP-homologous protein (CHOP)and cysteine-containing aspartate-specific protease 4(caspase 4)were detected by Western blotting. RESULTS The four drugs inhibited HK-2 cell growth in a time-dependent and concentration-dependent manner. At 24 h,the IC50 of AD (30.6 μmol · L- 1) was lower than that of others. Active pharmaceutical ingredients of Chuanhuning and Yanhuning (16.2 and 15.6 mmol · L- 1) were very close,ASB was 29.4 mmol · L-1. ASB(0,15,30 and 60 mmol · L-1)increased the apoptotic rate and caused the decrease in SOD activity and the increase in MDA content in a dose-dependent manner. Compared with control group,the protein expression of CHOP increased (P<0.01) at 8 h with ASB (30 and 60 mmol · L-1)treatment,Bip and caspase 4 had no significant change. In addition,at 24 h, ASB(60 mmol·L-1) decreased the expression of Bip(P<0.05),ASB(30 and 60 mmol·L-1)promoted the expression of CHOP(P<0.01),and the protein expression of activated caspase 4 increased in a concentration-dependent manner(P<0.01). CONCLUSION AD and its water soluble derivatives have a toxic effect on HK-2 cells. CHOP and caspase 4 pathway related to ERS is involved in ASB-induced apoptosis.