AIM:As a factor that can improve cell growth,there are few studies about the effect of insulin-like growth factor Ⅰ(IGF-Ⅰ) on the apoptosis of endothelial cell.The study investigated the inhibition and mechanism of IGF-Ⅰ on the apoptosis of human umbilical vein endothelial cells(HUVEC) induced by oxidized low density lipoprotein(ox-LDL).METHODS:The experiment was performed in the Institute of Cardiovascular Disease,Union Hospital of Huazhong University of Science and Technology from December 2006 to July 2007.①Fresh human umbilical cord was obtained(the informed consent) to isolate and culture HUVECs.The cells were divided into four groups.Except the control group,HUVEC cells were cultured with IGF-Ⅰ(1?10-9mmol/L),ox-LDL(200 mg/L)+IGF-Ⅰ(1?10-9mmol/L),and ox-LDL(200 mg/L),respectively after cultured for 24 hours.②Cell viability was determined by MTT assay,morphology and apoptosis by DAPI fluorescence staining,and expressions of caspase-3 were analyzed.RESULTS:①Ox-LDL could significantly inhibit HUVEC cell proliferation.After treated with both IGF-Ⅰand ox-LDL,the cell proliferation increased obviously compared with the cells treated with ox-LDL(P

20ng/ml.The total three-year survival rate is 87%(33/35).Conclusion The effect and prognosis of ?-knife on prostate cancer treatment can be evaluated by the value of PSA before and after the treatment.

This study examined the change of p16(INK4a) and PNCA protein expression in myocardium after injection of hIGF-1 gene modified skeletal myoblasts into post-infarction rats. HIGF-1 gene modified skeletal myoblasts (hIGF-1-myoblasts) were injected into hind limb muscles of 18 post-infraction rats (experimental group). Primary-myoblasts were injected into 18 post-infraction rats (control group) and 12 non-infarction rats (sham group). Expression of p16(INK4a) and PCNA protein in myocardiums were separately detected immunocytochemically 1, 2 and 4 weeks after the inuection. The level of hIGF-1 and rIGF-1 protein in serum and myocardium were detected by enzyme-linked immunosorbent assay (ELISA). Compared with the sham group, the percentage of p16(INK4a) and PCNA positive cells reached a peak after 1 week in the control group and the experimental group (P<0.01). Moreover, the percentage of p16(INK4a)-positive cells in the experimental group was lower than in control group whereas the percentage of PCNA-positive cells was lower in the control group than in the experimental group (P<0.01). The percentage of p16(INK4a)-positive cells in the experimental group and the percentage of PCNA-positive cells in the control group were close to that in the sham group from the 2nd week (P>0.05). ELISA analysis disclosed that the myocardium level of rIGF-1 protein increased gradually in the controls and especially in the experimental group (P<0.01). The serum level of rIGF-1 decreased significantly in post-infraction rats, but these conditions were improved in the experimental group (P<0.01). The hIGF-1 protein in serum and myocardium were detected from the 1st week to the 4th week in the experimental group. Statistical analysis revealed significant associations of myocardium level of hIGF-1 protein with expression of p16(INK4a) and PCNA protein (r=-0.323, P<0.05; r=0.647, P<0.01). It is concluded that genetically hIGF-1-myoblast provides a means for constant synthesis and release of hIGF-1. It could not only improve the expression of rIGF-1 and PCNA protein in myocardium, but also suppress the expression of p16(INK4a) protein for 30 days in post-infraction rats. Myoblasts-mediated IGF-1 gene therapy may provide a new alternative for the clinical treatment of heart failure.

Objective To evaluate bone marrow mesenchymal stem cells combined with VEGF gene in the treatment of limb ischemia in rabbits.Methods The right hind limb ischemia model of New Zealand rabbit was established by superficial femoral artery excision and deep femoral artery ligation.Rabbits then were divided randomly into 4 groups: empty plasmid control group(EP group),bone marrow mesenchymal stem cells group(BMSC group),VEGF gene therapy group(VEGF group),combination bone mesenchymal stem cells and VEGF gene therapy group(BV group).There were 8 rabbits in each group.Angiogenesis was detected by arteriography on day 28 after treatment and expression of VEGF was detected by immunohistochemical staining on day 30 after treatment.Results There were no differences of collateral vessel count between the EP group,BMSC group and VEGF group.The collateral vessel count in BV group was higher than that of the other three groups.Immunohistochemistry of VEGF showed that the integrated optical density(IOD)in BMSC and VEGF groups increased significantly compared with the EP group; the IOD in BV group was the highest compared with the other three groups.Conclusions Combination bone marrow mesenchymal stem cells and VEGF gene in the treatment of limb ischemia in rabbits can obtain stable and effective expression of VEGF along with significant improvement of limb ischemia.

ObjectiveTo explore the effects of recombinant human growth hormone(rhGH)on myocardial inflammatory cytokine expression and heart function in rats with acute myocardial infarction (AMI). MethodsRats with AMI induced by left anterior descending coronary branch ligation were randomized to rhGH and control groups compared with sham-operated group. The effects of 4 weeks of therapy with GH starting 24 hours after myocardial infarction on myocardial cytokines expression and heart function were studied. Myocardial inflammation was examined by analyzing the myocardial cytokine production including the pro-inflammatory cytokines: interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α and the anti-inflammatory cytokine: IL-10. Echocardiography was used to evaluate heart function. ResultsThe levels of TNF-α, IL-1β, IL-6 and IL-10 in the infarcted and non-infarcted region of control group were markedly elevated compared to sham-operated group (all P＜0.05). After 4 weeks therapy, rhGH reduced the expression of TNF -α, IL-1β, IL-6 and increased IL-10 expression in the infarcted and non-infarcted region of rhGH group compared to control group (all P＜0. 05 ). Echocardiography showed that rhGH markedly improved left heart function (P＜0. 05 ). ConclusionsEarly rhGH treatment can improve heart function and myocardial inflammatory cytokine expression after AMI. One of immunopharmacologic mechanisms underlying the beneficial effects of rhGH on heart function improvement may involve the attenuation of pro-inflammatory cytokines and the increase of anti-inflammatory cytokine levels in cardiac myocytes.

The efficacy of decompressive craniectomy (DC) in reducing traumatic brain injury mortality has been affirmed,but there are also many serious complications.Syndrome of the trephined (ST) and paradoxical herniation (PH) are rare complications.ST is characterized by a series of neurological deterioration due to skin flaps subsidence from weeks to months after DC.These neurological impairments are closely related to the subsequent repair of skull defects.PH shows progressive decrease in consciousness on the basis of ST,changes in pupils on the side of skull defects,low touch pressure at the defect window,and obvious midline shift and brain stem compression on CT.ST and PH have common inducements in pathophysiology,including cerebrospinal fluid dynamics,atmospheric pressure,cerebral blood flow and brain material metabolism.There is no consensus on the diagnosis of ST and PH,and early cranioplasty is suggested in terms of treatment.This article reviews the clinical manifestations,pathophysiological changes,diagnosis and treatment of ST and PH after DC operation,so as to provide references for clinicians to further understand ST and PH.

Objective: To investigate the clinical practicability and prognostic value of Helsinki CT score in patients with traumatic brain injury (TBI). Methods: A retrospective case series study was conducted to analyze the clinical data of 124 TBI patients admitted to First Affiliated Hospital of Xinjiang Medical University from September 2016 to October 2018. There were 91 males and 33 females, aged 14-84 years, with an average age of 49 years. Glasgow coma score (GCS) at admission ranged from 3-8 points in 45 patients, 9-12 points in 42 patients, and 13-15 points in 37 patients. According to Glasgow outcome scale (GOS) at 6 months after injury, 26 patients were classified into the poor prognosis group with GOS of 1-3 points and 98 patients were in the good prognosis group with GOS of 4-5 points. The prognosis-related risk factors were analyzed, and the role of Helsinki CT score to predict the adverse prognosis and mortality of TBI patients in the two groups was investigated. The sensitivity and specificity of Helsinki CT Score for 6-month poor prognosis were evaluated by receiver operation characteristic (ROC) curve and area under the curve (AUC). Results: Univariate analysis suggested that there were significant differences in terms of subdural hematoma, intracranial hematoma, extradural hematoma, hematoma volume >25 cm^3, intraventricular hemorrhage and suprasellar cistern pressure between the poor prognosis group and good prognosis group (P<0.05). Multivariate logistic regression analysis showed that the mortality and bad prognosis were related to the hemorrhage of ventricles, the pressure of suprasellar cistern and the disappearance of suprasellar cistern in the poor prognosis group and the good prognosis group (P<0.05), while intracranial hematoma and hematoma volume showed no association with mortality and poor prognosis (P>0.05). The Helsinki CT score could independently predict the adverse prognosis and mortality of TBI patients at 6 months (multivariate logistic regression: OR_death=1.21, OR_{adverse prognosis}=1.14). Helsinki CT score had a better predictive ability of 6-month mortality (AUC=0.85) than that of 6-month adverse prognosis (AUC=0.76), and had a predictive value for 6-month mortality and adverse prognosis. Conclusions Subdural hematoma, extradural hematoma, intraventricular hemorrhage and suprasellar cistern state (compression or disappearance) are the risk factors for the poor prognosis of TBI patients. Intraventricular hemorrhage and suprasellar cistern state are the main risk factors for predicting the mortality of 6 months. Helsinki CT score can independently predict the adverse prognosis and mortality of TBI patients at 6 months, and has relatively better value in predicting the mortality.

Objective To study the anatomical characteristics of the medial sural vessels and the clinical effects of treatment for leg skin and soft tissue defect with free flaps.Methods 6 adult lower limbs were treated by latex perfusion and then observed the origin of the blood supply to gastrocnemius muscle,measure the number of the arteries and veins,the length and diameter of the medial sural vessels.From July 2009 to May 2013,15 clinical cases of serious skin and soft tissue defect were repaired by using free flap with medial sural vessels.The areas of wound surface were ranging from 13 cm × 7 cm-24 cm × 12 cm.10 of them were treated by anterolateral thigh flap,the other of them were treated by latissimus dorsi flap.The donor site were directly sutured or repaired by free skin graft.Results The blood supply of gastrocnemius mucle was multifocal.The medial sural arteries and lateral sural arteries were both origin from popliteal artery.The medial sural vessels include 1 artery and 2 veins.With the length 4-7 cm (average,5.4 cm),the arterial diameter of the origin 2.6-2.9 mm (average,2.7 mm) and the entry point 1.9-2.3 mm (average,2.1 mm),the vein diameter of the origin 1.8-2.2 mm (average,2.0 mm)and the entry point 2.7-3.4 mm(average,2.9 mm).Totally 15 cases flaps were survived with primary healing.The mean follow-up period was 16.5 months(range,11-21 months),The flaps had satisfactory appearance,soft texture,good elasticity and achieved protective sensation at the last followed-up.Conclusions The medial sural vessels are with constant anatomical position,deeply position,hardly damage,long pedicle.Thus,the medial sural vessels combine with free flap is an good choice for the reconstruction of leg skin and soft tissue defect.

Objective To study the anatomical characteristics of the medial sural vessels and the clinical effects of treatment for leg skin and soft tissue defect with free flaps.Methods 6 adult lower limbs were treated by latex perfusion and then observed the origin of the blood supply to gastrocnemius muscle,measure the number of the arteries and veins,the length and diameter of the medial sural vessels.From July 2009 to May 2013,15 clinical cases of serious skin and soft tissue defect were repaired by using free flap with medial sural vessels.The areas of wound surface were ranging from 13 cm × 7 cm-24 cm × 12 cm.10 of them were treated by anterolateral thigh flap,the other of them were treated by latissimus dorsi flap.The donor site were directly sutured or repaired by free skin graft.Results The blood supply of gastrocnemius mucle was multifocal.The medial sural arteries and lateral sural arteries were both origin from popliteal artery.The medial sural vessels include 1 artery and 2 veins.With the length 4-7 cm (average,5.4 cm),the arterial diameter of the origin 2.6-2.9 mm (average,2.7 mm) and the entry point 1.9-2.3 mm (average,2.1 mm),the vein diameter of the origin 1.8-2.2 mm (average,2.0 mm)and the entry point 2.7-3.4 mm(average,2.9 mm).Totally 15 cases flaps were survived with primary healing.The mean follow-up period was 16.5 months(range,11-21 months),The flaps had satisfactory appearance,soft texture,good elasticity and achieved protective sensation at the last followed-up.Conclusions The medial sural vessels are with constant anatomical position,deeply position,hardly damage,long pedicle.Thus,the medial sural vessels combine with free flap is an good choice for the reconstruction of leg skin and soft tissue defect.

Objective To investigate the effect of bone flap reduction on unilateral acute subdural hematoma (ASDH) under intracranial pressure monitoring.Methods A retrospective case control study was conducted to analyze the clinical data of 139 patients with unilateral ASDH admitted to the First Affiliated Hospital of Xinjiang Medical University from July 2014 to December 2017.There were 84 males and 55 females,aged 19-87 years (mean,53 years).At the time of admission,the Glasgow Coma Score (GCS) was 3-5 points in 63 patients and 6-8 points in 76.There were 40 patients with unilateral cavity dilation and 16 cases with bilateral pupil dilation.According to the different surgical methods,the patients were divided into study group (n =61) and control group (n =78).The study group removed the cranial hematoma under cranial pressure monitoring and determined whether to perform bone flap reduction according to the actual intracranial pressure.The control group was treated with craniotomy hematoma removal and standard large bone decompressed craniectomy (DC).The success rate of bone flap reduction in the study group was recorded.The complications at postoperative 3 months and the Glasgow Outcome Score (GOS) at postoperative 6 months were compared.Results All patients were followed up for 1-6 months,average 5.5 months.In the study group,23 patients underwent bone flap reduction,and the bone flap reduction rate was 38％.At postoperative 3 months,the study group showed better efficacy in subdural effusion (9:25),hydrocephalus (7 ∶19),and brain swelling in the skull defect area(5 ∶ 18) than the control group (P ＜0.05).Based on the GOS at 6 months after operation,in the study group,25 patients were with good results,nine with moderate disability,10 with heavy disability,seven with plant survival,and 10 died;in the control group,six patients were with good results,21 with moderate disability,15 with heavy disability,10 with plant survival,and 26 died.The number of patients with good prognosis (good and moderate disability) and the number of deaths in the study group were statistically different from those in the control group (P ＜ 0.05).Conclsion In the treatment of unilateral ASDH,bone flap reduction under intracranial pressure monitoring can reduce the incidence of complications and improve the life quality of patients.