Objective To explore the protective effect of Zhenbao pill on acute spinal cord injury of rat and its possible mechanisms.Methods 64 Wistar rats were randomly divided into a injury group and a drug group, with 32 rats in each group, A T10 acute incomplete spinal cord injury model was produced by using modified Allen technique in the two groups,Zhenbao pill mixed suspension of 0.6 g/kg was given by gavage method daily in the drug group 30 min after moding, the same amount of saline was given in the injury group. Behavior detection were conducted in the first day, third day, and the seventh day after modeling to each 8 rats of the two groups. Spinal cord specimens was got centered about the damage points after rats were executed. histopathological changes were observed under HE staining, the MDA content were determined by thiobarbituric acid spectrophotometer and the apoptotic cells were marked by TUNEL method.Results After 1, 3, 7 d, compared with the injury group, the MDA level in the rat spinal cord tissue in the drug group (15.12 ± 1.27 nmol/mgvs.19.71 ± 1.29 nmol/mg, 20.42 ± 1.33 nmol/mgvs.24.65 ±1.36 nmol/mg, 10.46±1.49 nmol/mg vs.15.46 ± 1.44 nmol/mg) decreased(P<0.05); the apoptosis rate of drug groups (19.61% ± 1.49%vs.26.61% ±1.52%, 21.49% ± 1.37% vs.32.37% ± 1.24%, 13.04% ±  1.30%vs.18.35% ± 1.27%)decreased (P<0.05); the BBB score of drug groups (6.52 ± 1.27vs. 2.63 ± 1.27), (12.68 ± 1.32 vs.6.17 ± 1.34), (15.47 ± 1.27 vs.11.57 ± 1.29) was higher than the injury group (P<0.05). Conclusion Zhenbao pill can significantly improve the histopathological examination,reduce the MDA content in the injured spinal cord specimen of the rat and the rate of neuronal apoptosis, which may promote recovery of neurologic function in the rat suffered from ASCI.

Objective To study the influence of anesthesia methoda on early postoperative cognitive function in elder orthopedics patients. Methods Fifty patients aged more than 65 years old with fractured femur randomly received general anesthesia(group G, 28 cases) or unilateral combined spinal epidural anesthesia(group E,22 cases). The assessment of postoperative cognitive {unction referred to the scores that achieved in neuropsychological testing with mini mental state examination (MMSE) by special psychological person on the day before and the first day after surgery. It was considered to he postoperative cognitive dysfunction (POCD) when the score was ≥1 standard deviation(SD). Results The score of MMSE was lower in group G than that in group E on the first day alter surgery(P<0. 05). The incidence of POCD on the first day after surgery was higher in group G than that in group E(42.9% vs. 13. 6%) (P<0. 05). Conclusion Compared to combined spinal epidural anesthesia, more POCD takes place in the eldedy underwent orthopedic surgery under general anesthesia.

OBJECTIVE To summarize the use of intraoperative neuromonitoring system for monitoring and protection of recurrent laryngeal nerve during thyroid surgery. METHODS There were 21 cases in this study, included 5 cases with thyroid cancer, 9 cases with thyroid benign tumor and 7cases with hyperthyroidism. Intraoperative neuromonitoring system includes the host monitor, stimulus detection pin of recurrent laryngeal nerve, special EMG endotracheal intubation tube which contacts vocal cord, grounding conductive circuit electrode, and anti-jamming probe. Operation method: a "three-step method" was adopted. First we revealed the cervical vagus nerve trunk and tested our instruments, and then dissected and protected the recurrent laryngeal nerve, followed by removal of thyroid tissue. RESULTS In all 21 patients, operative side recurrent laryngeal nerve were exposed from lower thyroid blood vessels to the larynx. All patients were phonated as well as before operation, and without drinking cough. CONCLUSION The intraoperative neuromonitoring system can avoid damage of the recurrent laryngeal nerves when we exposed the recurrent laryngeal nerve before resection of the thyroid tissue and tumor.

Objective To investigate the effects and mechanism of visfatin on matrix metalloproteinases-9(MMP-9)expression and invasive activity in macrophages.Methods THP-1 monocytes were induced into macrophages.To investigate the effects of visfatin on MMP-9,cells were divided into 2 groups:①macrophages+visfatin 12 h;②macrophages+visfatin 24 h.The concentrations of visfatin in each group were:0(control),50,100,200,400 ng/mL.MMP-9 mRNA and protein expression were analysed by RT-PCR and Western blotting,and MMP-9 invasive activity was assayed by gelatin zymography.To investigate the mechanism of visfatin on MMP-9,cells were divided into 5 groups:①macrophages without stimulation(control);②macrophages pretreated with MAPK p38,ERK1/2,JNK pathway inhibitor for 1 h,then stimulated with visfatin(200 ng/mL)for 24 h;③macrophages pretreated with retinoid X receptors(RXR)nature ligand or peroxisome proliferators-activated receptor ?(PPAR?)natural/synthetic ligand for 1 h,then stimulated with visfatin(200 ng/mL)for 24 h;④macrophages stimulated with visfatin(200 ng/mL)for 24 h;⑤macophages+visfatin(200 ng/mL)for different time(5,10,15,30,60 min).MMP-9 expression,PPAR? expression,and the effect of visfatin on MAPK phosphorylation were analysed by Western blotting.Results Visfatin not only significantly enhanced MMP-9 mRNA and protein expression in macrophages(P

Objective To investigate the basis of ultrasound microbubble technology enhanced thermal ablation effect.Methods All 48 rabbits bearing hepatic tumors were averagely randomly divided into four groups:only laser group,sham,destruction + laser group,and blank group.The filling defect area changes of before and after treatment were observed and the differences between groups were compared.Results Pathology confirmed ablation of tumor tissue could produce coagulation necrosis for experiment group.The conventional ultrasound showed there was no significant variation in the maximum diameter and area in the pre and post treatment of experiment group and control group(P ＞0.05).There was no change for the control group.Ultrasound imaging showed an area of filling defect were:laser treatment alone group (0.83 ± 0.06) cm2,microbubbles false break combined with laser therapy group (0.65 ± 0.05) cm2,microbubbles break combined with laser therapy group (2.40 ± 0.16)cm2,blank control group (0.01 ± 0.01) cm2.The filling defect area of the treatment group,which was combined with ultrasound microbubble break technology and laser ablation was increased,there was significant variation in the each group (P ＜0.05).Conclusions Microbubble burst combined laser ablation could expand the single needle laser ablation area of rabbit VX2 liver tumor and increase the therapeutic effect.

Objective To compare the prophylactic effect of laminar closure between titanium miniplate and anchor fixation in open-door cervical laminoplasty.Methods Between January 2010 and December 2010,63 patients with cervical spondylotic myelopathy were treated by open-door laminoplasty.Of them,30 patients underwent laminoplasty by titanium miniplate fixation and 33 by anchor fixation.During follow-up,multi-detector CT was performed preoperatively,at 1 week and 6 months after surgery.At each level,the anteroposterior diameter (APD) of the spinal canal and opening angle (OA) were measured.And the spinal canal expansion rate are calculated.MRI was performed preoperatively and 1 year after surgery to evaluate the severity of cord compression.Results All incisions healed by first intention.The incidence of postoperative axial symptoms in miniplate fixation group and anchor fixation group were 33.3％ (10/30) and 39.4％ (13/33),respectively.The OA,APD,and the spinal canal expansion rate of patients in both groups improved significant postoperatively,but differing from miniplate fixation group.The OA,the APD and the spinal canal expansion rate in anchor fixation group after 6 months were reduced than one week after surgery,and the difference between the groups was statistically significant.Lamina close in two groups was not found.CT images at 6 months showed complete fusion of the hinge area by mature bone or callus in two groups,by cervical sagittal MRI assessment.The severity of spinal cord compression was improved after 1 year.Preoperative and 1 year after the surgery,the severity of spinal cord compression between the two groups showed no significant difference.The severity of spinal cord compression after 1 year in both groups were no more than three grade.Conclusion Open-door cervical laminoplasty by anchor fixation or titanium miniplate can effectively prevent the occurrence of postoperative lamina closure,which can help patients to do functional exercises early,but improvement of spinal cord compression has no significant difference between both of them.However,titanium miniplate fixation for maintenance of the expansive spinal canal is better.

Objective To investigate the prognostic value of right ventricular end-diastolic diameter (RVDD) in patients with chronic systolic heart failure (CHF).Methods A retrospective study was conducted with clinical data of inpatients from 12 third-grade class-A hospitals of Hubei Province between 2000 to 2010,followed up by phone calls.Based on RVDD,patients diagnosed with chronic systolic CHF were divided into four groups:＞38 mm,31-38 mm,25-30 mm and ＜25 mm groups;based on prognosis,patients were divided into the death group and the survival group.Of the death group,patients were further divided into the heart failure death subgroup and the sudden cardiac death subgroup.Single-factor and multi-factor Cox survival analyses were conducted to analyze the relationships between RVDD and mortality,including all-cause mortality,CHF mortality and sudden cardiac death (SCD).Results A total of 16681 patients were enrolled in this study.They were followed up for 1-4 years,during which 6453 died.Multivariate Cox survival analysis showed that the mortality risk for patients with RVDD between 25-30 mm,between 31-38 mm,and ＞38 mm groups was 1.87,2.41,3.95 times that for patients with RVDD＜25 mm,respectively (95％CI:1.64-2.13,2.06-2.80,3.61-4.32,all P＜0.01).The risk of sudden cardiac death for patients with RVDD＞38mm was 3.82 times that for patients with RVDD＜25 mm (95％CI:2.27-5.94,P＜0.01).The areas under the ROC curve for death by the best prediction model alone and RVDD combined with the best respectively.RVDD increased the areas under the ROC curve for all cause mortality,CHF mortality and sudden cardiac death.The best prediction model combined with RVDD could discriminate between total mortality,heart failure mortality and sudden cardiac death for patients with different causes of death in multivariate analysis.Conclusions RVDD has a predictive value in the prognosis of patients with chronic systolic heart failure.RVDD increases the sensitivity and specificity of the best prediction model for total mortality prediction in patients with chronic systolic heart failure.RVDD increases the sensitivity and specificity of the best prediction model to discriminate between all-cause mortality,heart failure mortality and sudden cardiac death in patients with different causes of death.RVDD＞38 mm can serve as an indicator for the assessment of sudden cardiac death in CHF patients.

[Abstract ] Objective The purpose of this study was to observe the effects of dl-3n-butylphthalide (NBP) sodium chloride injection post-processing on the expressions of X-inhibitor of apoptosis (XIAP) and Bcl-2/adenovirus E1B19kDa interacting protein 3 (BNIP3) in the hippocampus CA1 neurons of focal cerebral ischemia reperfusion (IR) rats, and to investigate the brain-protection mechanisms of NBP. Methods A total of65 adult male Sprague-Dawley rats were divided into five groups of equal number, sham op-eration, IR, and low-,medium -and high-dose NBP, according to the random number table. The IR models were established by modified ligation of the middle cerebral artery.The animals in the NBP groups received intra-abdominal injection of NBP at 2, 4, and 6 mg/kg, re-spectively.All the rats were sacrificed at 24 hours after modeling,neurological scores obtained by Zea Longa, the volume of infarction measured by TTC staining, the number of apoptotic cells counted by TUNEL, and the expressions of XIAP and BNIP3 detected by immunohistochemistry and real-time PCR. Results The neural function defect scores were markedly lower in low-, medium-and high-dose NBP groups than in IR model rats (P<0.05), with statis-tically significant differences among the three dose groups (P<0.05).The volume of infarction was remarkably higher in the low-dose than in the medium-and high-dose NBP groups (P<0.05).The number of apoptotic cells in the hippocampus CA1 neurons was de-creased in the NBP groups as compared with the IR models (P<0.05).The XIAP-and BNIP3-positive cells were significantly in-creased in the IR model rats as compared with the sham operation group ([22.31 ±0.94] and [60.13 ±2.59]/HP vs [3.07 ±1.43] and [5.78 ±0.44]/HP, P<0.05).In comparison with the IR models, the NBP-treated rats showed a progressively increased number of XIAP-positive cells in low-, medium-, and high-dose groups ([28.70 ±1.18], [32.79 ±0.88], and [37.01 ±1.24]/HP) (P<0.05) but a decreased number of BNIP3-positive cells in the three dose groups ([52.07 ±1.02], [40.30 ±2.00], and [31.04 ± 0.43]/HP) (P<0.05).Similarly, the expression of XIAP mRNA was up-regulated while that of BNIP3 mRNA down-regulated in the NBP treatment groups as compared with the IR model rats, both in a dose-dependent manner (P<0.05). Conclusion NBP post-processing has a neuroprotective effect on IR rats, which is associated with its impact on the expressions of XIAP and BNIP3.

Objective To compare the efficacy and adverse effects of 5 days' and 7 days' course of combination chemotherapy regimen HA in the treatment of chronic phase of chronic myelogenous leukemia (CML-CP). Methods 18 cases of CML-CP had received 5 days' course of combination chemotherapy regimen HA including homoharringtonine 4 mg/d and cytarabine 200 mg/d for 5 days. At the same time,another 18 patients diagnosed as CML-CP who were given 7 days' course of HA regimen including homoharringtonine 4 mg/d and cytarabine 200 mg/d for 7 days were compared on the efficacy including peripheral white blood cells, spleen size and cytogenetic responses and adverse effects. Results The complete remission(CR) rate was 50.0 % and 61.1 % in 5 days' and 7 days' treated groups, respectively (P >0.05). The incidence of severe bone marrow suppression in 7 days' group(16.7 %) was higher than that in 5 days' group(0)(P <0.05). Conclusion The 5 days' course of combination chemotherapy HA regimen is same as 7 days' course of HA regimen about their curative effects in CML-CP. But the incidence of severe bone marrow suppression in 7 days' group(16.7 %) was higher than that in 5 days' group (0).

Objective To observe the neural protection of 3-n-butylphthalide (NBP) injection in focal cerebral ischemia-reperfusion rats. Methods 160 male Sprague-Dawley rats were randomly divided into sham group (n=10), ischemia-reperfusion group (IR group, n=50), high-dose NBP treatment group (high-dose group, n=50), middle-dose NBP treatment group (middle-dose group, n=25) and low-dose NBP treatment group (low-dose group, n=25). The later 4 groups were occluded the middle cerebral artery for 2 hours and reperfused. The sham group was sacrificed 24 hours after operation, and the other groups at 6, 12, 24, 48 and 72 hours after reperfusion, in which 5 of them were stained with TdT mediated dUTP Nick End Labeling (TUNEL) to observe the neuronal apoptosis, and immunohistochemistry to observe the expression of silent information regulation 2 homolog 1 (SIRT1) and peroxisome proliferator-activated receptorγcoactivator-1α(PGC-1α);the other 5 of sham group, IR group and high-dose group were observed with quantitative real-time PCR of SIRT1 and PGC-1α. Results Compared with the IR group, the number of apoptotic cells decreased and the SIRT1 and PGC-1αpositive cells increased in all NBP groups at each time (F>160.60, P<0.001), and it was the least of apoptotic cells and most of SIRT1 and PGC-1α positive cells in the high-dose group (P<0.05), while there was significant difference between the low-dose group and the middle-dose group, excluding 6 hours after reper-fusion (P<0.05). Compared with IR group, the expression of SIRT1 and PGC-1αmRNA increased in the high-dose group at each time (t>4.13, P<0.01). Conclusion NBP can protect brain from apoptosis in focal cerebral ischemia-reperfusion rats, which may relate to more ex-pression of SIRT1 and PGC-1α.