[ABSTRACT]AIM:Toinvestigatetheeffectofhypoxiacombinedwithexercisetrainingonmitochondrialcon-tent, and the role of mitochondrial biogenesis and mitophagy in this process .METHODS:Male Sprague-Dawley rats were randomly divided into 4 groups:normoxia control (NC) group, normoxia+training (NT) group, hypoxia+control (HC) group, and hypoxia+training (HT) group.The hypoxic animals were housed in normobaric hypoxic tent (11.3 % oxy-gen) for consecutive 4 weeks.The exercise training animals were exercised on a motor-driven rodent treadmill (5°) at a speed of 15 m/min, 60 min/d, 5 d/week for 4 weeks.Mitochondrial membrane potential was determined using JC-1 fluo-rescent probe .ATP synthesis capacity was determined using a bioluminescence technique .The protein expression of cyto-chrome C oxidase IV (COXIV), voltage-dependent anion channel-1 (VDAC-1), peroxisome proliferator-activated receptor gamma cofactor 1 alpha (PGC-1α), mitochondrial transcription factor A (Tfam),Bcl-2/adenovirus E1B 19 kD-interacting protein 3 (Bnip3) and beclin-1 in the muscles was detected by Western blotting .RESULTS:Compared with NC group, hypoxia attenuated mitochondrial membrane potential , ATP synthesis capacity , and the expression of COXIV , VDAC-1, PGC-1αand Tfam.Furthermore, hypoxia increased the expression of Bnip 3 and beclin-1.Compared with HC group , the exercise training elevated mitochondrial membrane potential , ATP synthesis capacity , and the expression of COXIV , VDAC-1, PGC-1α, Tfam, Bnip3 and beclin-1.CONCLUSION:A combination of reduced mitochondrial biogenesis and increased mitophagy seems to be responsible for the decrease in mitochondrial content after hypoxia .Exercise training with hypoxia elevates mitochondrial content and function in hypoxia , which may be mediated by appropriate increase and co-reg-ulation of mitochondrial biogenesis and mitophagy .

Objective To assess the efficacy of using the Ilizarov bone transport combined with open bone grafting and vacuum sealing drainage (VSD) to treat infected tibial bone defect.Methods A retrospective case series study was made on 8 patients sustaining posttraumatic infectious tibial bone defect treated between March 2010 and May 2015.There were 7 male and 1 female patients between 22 and 51 years (mean,39.4 years).All patients underwent radical resection of the infected/necrotic bone and debridement of the soft tissue.Length of bone defects after debridement averaged 8 cm (range,3.5-13.5 cm) and wound size averaged 4.8 cm ×2.5 cm (range,2.3 cm× 1.1 cm-8.5 cm ×6.0 cm).Stabilization was finished with Ilizarov circular external frame in all patients.Six patients were candidates for single-or double-level bone transport,and the cancellous bone autograft was placed openly within the butterfly defect after docking.Other 2 patients were treated with one-stage shortening of the fracture ends and open cancellous bone grafting,and the bone lengthening was performed.Then the grafted wounds were covered by VSD.Data were recorded including the bone transport or lengthening time,wound healing time,union time of docking sites,consolidation time of regenerate zones,external fixation time and external fixation index.Bone results and functional results were evaluated according to the criteria given by association for the study and application of the method of Ilizarov (ASAMI).Results Duration of follow-up was 10.2-36.4 months (mean,12.2 months).All the wounds achieved successful healing and eradication of infection.Mean bone transport time was 50 days (range,30-69 days).Seven patients showed selfhealing wounds,and mean healing time was 3.4 months (range,1.2-6 months).One patient experienced wound closure by skin grafting.Union and consolidation were achieved in all docking sites and regenerate zones.Mean union time of docking sites after bone grafting was 6.8 months (range,5.3-10 months).Mean consolidation time of regenerate zones was 6.2 months (range,4.8-8.5 months).Mean external fixation time was 8.6 months (range,6.5-11.5 months) with a mean external fixation index of 1.2 months/cm(range,0.7-1.9 months/cm).According to the criterion of ASAMI,bony results were excellent in 7 patients and poor in 1 patient,and functional results were excellent in 4 patients and good in 4 patients.Conclusion Ilizarov bone transport technique combined with open bone grafting and VSD for infectious tibial bone defect can accelerate bone union and wound healing at docking sites and reduce external fixation time.

Objective To investigate the effect of triamcinolone acetonide(TA) with different dosage and place of production on retina.Methods Twenty-four rabbits were divided into 6 groups(A:untreated as a blank control;B: normal sodium;C:10mg imported TA;D:10 mg domestic-made TA;E:25 mg imported TA;F:25 mg domestic-made TA).Excepting group A every right eyeball underwent vitrectomy before intravitreal injection triamcinolone acetonide.All the eyeballs were extirpated on the 21st day after the intravitreal injection,and then pathological examinations were performed.Results Ganglion cell's light edemata had been seen in group B,C,D,E,F.Cell hyperplasia and vacuolar degeneration had been seen in the internal granular layer or external granular layer in some animals of group E,F.Two samples(1 in group E,1 in group F)observed there were a great amount of fibrinoid materials in cavum vitreum and cavum between amphiblestroid membrane and choroid membrane.Pathological changes in group E,F were severer than in group C,D.Conclusions Intravitreous injection TA at 25 mg can cause photoreceptor cells hyperplasia in rabbits,while there are no toxic effects at 10 mg.No obvious difference is observed between the groups of imported TA and domestic-made TA.

Objective:To observe the clinical efficacy of acupuncture with medication for post-stroke depression.Methods:A total of 96 patients with post-stroke depression were randomized into an observation group and a control group,with 48 cases in each group.The control group was treated with oral fluoxetine hydrochloride capsules,and the observation group was treated with acupuncture on the basis of the treatment of the control group.After 6 months of treatment,the traditional Chinese medicine (TCM) symptom scores,and Hamilton depression scale (HAMD) component scores and total scores of the two groups before and after treatment were observed,and the clinical efficacy and adverse reaction rate were compared between the two groups.Results:The total effective rate was 95.8％ in the observation group and 83.3％ in the control group,and the difference between the two groups was statistically significant (P＜0.05).After treatment,the intra-group differences in TCM symptom scores and HAMD score of both groups were statistically significant (all P＜0.01).In the observation group,the scores of indifferent expression,emotional restlessness,and sentimentality in the TCM symptoms were statistically different from those in the control group (all P＜0.01).The scores of desperate factor and sleep disorder factor and total score in HAMD in the observation group were significantly different from those in the control group (all P＜0.01).The incidence of adverse reactions was 6.3％ in the observation group and 4.2％ in the control group,and the difference was not significant between the two groups (P＞0.05).Conclusion:Acupuncture plus medication is an effective method for post-stroke depression,and it can further improve the patient's bad mood.

Objective To evaluate the efficacy and prognostic factors of combined medical thera-py with amitriptyline, cimetidine and intravesical resiniferatoxin post-hydrodistention for patients with painful bladder syndrome/interstitial cystitis (PBS/IC). Methods Twenty-nine patients with PBS/ IC according to NIDDK criteria were enrolled. There were 6 males and 23 females with average age of 52±14 years and average duration of symptoms of 3.7±1.9 years before diagnosis. The patients were divided into 2 groups. Non-concomitant disease group included 10 cases without concomitant disease and 7 cases with unrelated diseases such as hypertension and diabetes mellitus. Concomitant disease group included 5 cases with history of bladder neck incision, 3 cases with history of transurethral re-section of the prostate, 2 cases with history of gynecologic disease and 2 cases with history of gyneco-logic operation. Patients of concomitant disease group still had the painful bladder syndrome after 3 months when the primary disease had been cured. All patients were treated with amitriptyline (25 mg twice a day), cimetidine (800 mg per day) and intravesical resiniferatoxin (1-2 times) post-hydrodis-tention. The primary assessment index was O'Leary-Sant score. The secondary assessment index was pelvic pain score, mean voiding times per day and mean volume of each micturating. The data of pa-tients before treatment and after follow-up≥9 months were collected to evaluate the efficacy and prog-nostic factors of the combined treatment. Results The mean follow-up for all patients was 9.2±6.0 months. Patients were followed up at month 1 and month 6 after discharge. Then, patients would be followed up at each 6 months interval. The overall remission rate was 65.5% (19/29). Complete re-mission rate was 41.4% (12/29). Partial remission was 24. 1% (7/29). Non-remission rate was 34.5% (10/29). For all patients, the pre-treatment mean voiding times per day were 29±15, voiding volume each time was 64±36 ml, average O'Leary Sant score was 23. 8±4.8, and they were signifi-cantly improved post-treatment (17±12 times, 172±108 ml, 13. 3±10.4, respectively, P<0.001). O' Leary-Sant score of concomitant disease group was lower than that of non-concomitant disease group (21.5±4.7 vs 25.4±4.3, P=0.030). However, complete remission (8.3%, 1/12) of con-comitant disease group was lower than that(64. 7%, 11/17) of non-concomitant disease group (P= 0. 003). In independent variables of patients age, sex, duration of symptom, O'Leary Sant score pre-treatment, and whether or not with concomitant disease, according to the results of Logistic Regres-sion, patients with concomitant disease would have poor prognosis (P-0.008, partial regression coef-ficient was -3. 899, OR was 0. 020). Conclusions Treating PBS/IC patients with amitriptyline, ci-metidine and intravesical resiniferatoxin post-hydrodistention is effective. However, concomitant dis-eases such as gynecologic disease or urethra operation history can impair the effectiveness of these treatment.

Objective To elucidate if detrusor overactivity(DO)has influence on patients with benign prostate hyperplasia.Methods Forty-seven patients who were suspected to suffered from BPH were divided into two groups according to whether have DO in pre-operative urodynamic analysis.There were 22 patients in DO group and 25 in non-DO group.All patients received transurethral resection of prostate (TURP).Pre-operative variables such as relevant clinical data,International Prostate Symptom Score (IPSS),quality of life (QOL) index,maximum urine flow rate(Q~(max)) and pressure-flow study data were recorded.Patients were monitored after operation and the corresponding data were recorded.Results Prostate size in DO group was (77±25)ml,and in non-DO group was (56±27) ml,P=0.02;first desire bladder volume in DO group was (104±36) ml,and in non-DO group was (161±54) ml,P=0.001;urgent desire bladder volume in DO group was (245±73) ml,and in non-DO group was (328±94)ml,P=0.006;pre-operative residual urine in DO group was (71±49)ml,and in non-DO group was (149±125)ml,P=0.015;linPURR obstruction grade in DO group was 4.63±0.95,and in non-DO group was 3.35±1.90,P=0.014.The IPSS and QOL before and after operation had no significant differences between the 2 groups.Conclusions The patients with larger prostates and more severe bladder outlet obstruction are more likely to have DO.Patients with DO had smaller bladder volume and residual urine volume before operation.DO has no significant effect on BPH patient's IPSS and QOL.

This paper analyzes the reason of spurious image and discusses how to control quality and correct image for the requirement of quality control.

Objective To study the imaging manifestations and clinical significance of simple cochlear nerve canal(CNC)stenosis. Methods The HRCT findings of 14 patients(1 7 ears)with simple CNC stenosis diagnosed sensorineural hearing loss(SNHL)were retrospectively analyzed.The width of CNC and internal auditory canal was measured and compared with the normal ears,the data were statisti-cally analyzed by SPSS1 6.0.Thin-sliced MRI of internal auditory canal (axial and oblique sagittal position)was performed in 8 cases. Results HRCT displayed obvious CNC stenosis in all 14 patients(1 7 ears),2 ears with cochlear nerve canal atresia.Width of CNC and internal auditory canal was (0.5±0.3)mm and (4.6±1.0)mm,it was (2.1±0.2)mm and (5.1 ±1.3)mm in normal ears (1 1 ears),the width of CNC was of significant difference between normal ears and ears with SNHL,and there was no statistical sig-nificant difference in width of internal auditory canal.12 ears(from 1 7 ears with simple CNC stenosis)were lacking of fissure in the cribriform area,1 1 ears(normal ear)were existence of fissure in the cribriform area;cochlear nerves were not shown in 8 patients with MRI examination.Conclusion CNC stenosis can be isolated from internal auditory canal stenosis,MRI could display cochlear nerve dysplasia(CND).

Objective To investigate the incidence of and risk factors for benign prostatic hyperplasia (BPH) in transplant recipients.Methods 197 males aged 50 years and older who received kidney transplants were recruited if they were clinically stable.They were divided into three age groups:50 to 59 years (87 cases),60 to 69 years (64 cases) and ≥ 70 years (46 cases).Two hundred and forty people who had not undergone kidney transplant were randomly selected from the community as controls.A cross-sectional study was performed to study the BPH incidence in kidney transplant recipients according to standard diagnostic criteria.At the same time,the expression levels of keratinocyte growth factor,transforming growth factor-β and serum testosterone and the CD4/CD8 ratio in T lymphocytes were determined.Results There was no significant difference in age,PSA and the postmicturition residual volume between the study group and the control group.The total BPH incidence in kidney transplant recipients was 16.2％ (32/197).The symptomatic BPH incidence was 6.9％ (6/87) in the 50-to 59-year-old study group and 20.2％ (19/94) in the control group,representing a significant statistical difference in the symptomatic BPH incidence between the two groups (P =0.010).The symptomatic BPH incidence was 18.8％ (12/64) in the 60-to 69-year-old study group and 41.9％ (34/81) in the control group,indicating a significant statistical difference in the symptomatic BPH incidence between the two groups (P =0.004).The symptomatic BPH incidence was 30.4％ (14/46) in the ≥ 70-year-old study group and 52.3％ (34/65) in the control group,indicating a significant statistical difference in the symptomatic BPH incidence between the two groups (P =0.032).Compared to the control group,the peripheral blood serum testosterone level (9.4 ± 4.7,18.2 ± 5.6,P =0.040) and the CD4/CD8 ratio (1.1±0.3,1.8±0.3,P=0.014) of kidney transplant recipients was lower.The transforming growth factor-β expression level (5015± 1087,1829±963,P＜0.001) was higher in kidney transplant recipients than in the control group.The kasatinocyte growth factor expression levels (35.8±20.7,21.0± 18.3,P =0.064) was not statistically different than in the control group.Conclusions Kidney transplant recipients who had long-term administration of calcineurin inhibitor might have a low benign prostatic hyperplasia incidence,which might be related to transforming growth factor-β and keratinocyte growth factor expression,testosterone levels and the lymphocyte infiltration.Further high-quality prospective studies are still needed to confirm the conclusions.

Objective To study the effect of applying gastro-bile duct drainage in iatrogentic injury in the bile duct and reasons of iatrogentic injury in the bile duct. Methods Clinical data of 9 cases with iatrogentic injury in the bile duct were studied retrospectively. Results Nine patients with iatrogentic injury in the bile duct were found in time by affnsion examination, choledochoendoscopy or cholangiography intraoperation, including 5 cases in-jured by metal divining rod,2 cases caused by lithotomy, 1 case injured by laparoscopic elastic separating plier and 1 case injured by common hepatic duct transection. The gastro-bile duct was placed into common bile duct through pa-pilla of duodenum, pylorus and the former wall of gastric. All the cases recovered smoothly. The gastro-bile duct was removed in 8 cases in 6 to 10 days later,in 1 cases in 30 days later,who were followed up for 9 months to 5 years, finding no complications such as stricture of bile duct and retroperitoneal infection. Conclusions Intraoperative cho-ledochoendoacopy,affusion examination and cholangiography are helpful to diagnosis. The better results are achieved by appling gastro-bile duct drainage in iatrogentic injury in the bile duct.