Hypoxia-inducible factor-1 (HIF-1), as a nuclear transcription regulator of the hypoxic response, is up-regulated during hypoxia, and it regulates a series of downstream target gene expression, such as vascular endothelial growth factor, glucose transporter and erythropoietin through binding with hypoxia response element. It plays important roles in angiogenesis, anerobic metabolism, cell survival, proliferation, migration, and differentiation.This article reviews the structure, function and activity regulation of HIF-1 and its roles in acute ischemic brain injury.

Objective To investigate the mechanism of the kidney injure in the newborn rats with endotoxemia.Methods Eighty Wistar rats aged 7 days were randomly divided into 2 groups:control group (intraperitoneal injection of saline of 0.1 ml;n = 40),lipopolysaccharide(LPS) group(intraperitoneal injection of LPS of 5 mg/kg;n =40).The rats in either group were killed at 1 h,4 h,8 h and 12 hours after intraperitoneal injection,respectively.The expressions of NF-κB and TGF-β1 in the kidney were detected by using the immunohistochemical assay.Renal ultrastructural changes was observed with a CM100 Philips electron microscope.Results The NF-κB in control group had no expression.NF-κB in LPS group mainly expressed in the renal tubular epithelial cell,increased at 1 h after test and peaked at 8 h,and slightly descended at 12 h.The expression of TGF-β1 in control group was slight,and had not show significant difference from control group at 1 h,4 h and 8 h,but significantly higher than that in control group at 12 h.In LPS group,newborn rat renal glomerular basement membrane was complete,part epithelial cell foot processes were fused and renal tubules epithelial cell mild mitochondria vacuolization was found at 4 h.Renal glomeruli epithelial cell foot processes obvious confluenced,quantities of mesangial cells mitochondria vacuole,and renal tubules epithelial cell mitochondria expanded to bubbles at 12 h.Conclusion The NF-κB involves in the pathogenesis of kidney damage induced by endotoxemia,but TGF-β1 may help to repair the damaged kidney,and may repress the production of NF-κB.

Objective To summarize our clinical experience of prophylaxis and treatment for complications associated with catheterization of brachial artery. Methods 87 patients underwent endovascular treatment via brachial artery. Complications associated with catheterization of brachial artery were retrospectively analyzed. Results Under ultrasonic guidance the catheterization procedure of brachial artery was successful in all 87 patients. The success rate of cannulation was 100%. In 53 patients(61% ) ultrasonic guided cannulation was successful at the first attempt, the other 35 (39% ) with 2 or more than 2 times puncture. Complications associated with catheterization of brachial artery were detected in 16 cases. The complication rate was 18. 4%. Guidewire insertion into peri vascular compartment took place in 4 cases (4. 6% ). Episodes of local hematomas were noted in 11 cases( 12. 6% ) and in three of the 11 cases nerve injuries were detected (one of which was of late-onset type). Brachial artery pseudoaneurysm was found in 1 case(1.2%). Conclusion Familiarity with the anatomical features of the brachial access, skillful application of the techniques for the catheterization, full understanding of complications and sufficient preparation of treatment strategies can prevent those complications effectively.

Objective To evaluate clinical effects of endovascular angioplasty and stenting for treating lower extremity arteriosclerotic occlusion(ASO).Methods After the identification of the stenosis or occlusion by angiography via femoral artery access by percutaneous puncture or incision puncture,recanalization of the occlusion was done by ultrasound ablation or guildewire clearance.Then the percutaneous transluminal angioplasty(PTA) was performed and an endovascular stent was introduced.Results A total of 45 cases(53 legs) had undergone endovascular angioplasty and stenting.The procedure was technically successful in all the patients.The ankle brachial index(ABI) increased from 0.36?0.14 preoperatively to 0.77?0.21 on the 7 postoperative day((t=2.397),P=0.021).Follow-up checkups in all the cases for 6~54 months(mean,23 months) revealed a primary patency rate of 90.6%(48/53).Conclusions Endovascular angioplasty and stenting is a safe and effective method for treating lower extremity arteriosclerotic occlusion.

Objective To study and observe the clinical efficacy of using non skid plate by posteromedial approach for fixing splitting or compression tibial plateau fracture.Methods Twenty eight cases of patients who were treated for fixing splitting or compression tibial plateau fracture from January 2014 to January 2016 in people's hospital of Xinyu were retrospectively reviewed.All patients were treated byposterior medial approach with non skid plate for fixation,all patients were followed up by postopera tive imaging and clinical follow-up to observe its clinical curative efficacy.Results Twenty-eight patients were followed up,the mean follow-up time was 12 months.All patients had no internal fixation loosening fracture,send,vascular and nerve damage and other adverse reactions.All the patients were healed within 4 to 7 months,the average healing time was 18.5 weeks.After healing,knee joint function was evaluated,18 cases were excellent,5 cases were good,the excellent and good rate was 82.1 ％.Conclusion The efficacy of using non skid plate by posteromedial approach for fixing splitting or compression tibial plateau fracture is good,it is worthy of clinical application.

Objective To discuss the method and efficiency of less invasive stabilization system (LISS) in treatment of comminuted tibia[ fractures. Methods A total of 14 patients with comminuted tibial fractures were treated with LISS between January 2005 and July 2006. There were 10 males and four females, at age range of 19-61 years (mean 34 years). Of all, 11 patients were with proximal fractures of tibia and three with distal ones, including six with open fractures and eight with closed ones. The period from injury to operation was 2-13 days. An observation was done on postoperative soft tissue recovery and fracture healing. Results The average period of follow-up was 9.4 months (4-16 mouths). All frac-tures were healed up after average 7.8 months (4-12 months). All incisions were healed up at one stage, with no complications on nerves, blood vessels or soft tissues. The axes of tibia were good, with sound function of knee and ankle joints. Conclusion LISS is characterized by easy operation, minor trauma, high healing rate and low complications in treatment of comminuted tibial fractures.

3.0 cm in diameters.Contrast-enhancement CT showed tumors with abundant blood vessel,1 case appeared as uniform enhancement and was difficult to distinguish between tumor body and internal carotid and external carotid because of the iso-density of them.On MRI,the flow void blood vessels inside the tumors could be identified and internal carotid and external carotid separated.MRA displayed all the relation between the tumors and carotid and its branches.DSA could demonstrate the supply arteries of the tumors.Conclusion Ultrasonics,CT,MRI and DSA have own definitely characteristic value in diagnosing carotid body tumor.

Objective To evaluate the minimally invasive technique of laparoscopy by retroperitoneal access for the treatment of parapelvic cyst. Methods Twelve patients(7 men and 5 women;mean age,52 years;age range,34-75 years) with parapelvic cysts were included.The cyst size ranged from 2.8 cm?3.0 cm to 2.5 cm?11.5 cm.The cysts were on the left side in 6 cases and on the right in another 6 cases.Laparoscopic resection or de-roofing of the parapelvic cysts by retroperitoneal access was performed in them.The relevant parameters of the procedures were summarized.Results The success rate of the operation was 100%.The mean operative time of the first 6 patients was 190 min,while it was 86 min in the rest 6 patients.The mean intraoperative blood loss was 25 ml.No injury to the kidney pedicle or pelvis occurred.The mean hospital stay was 9 d.In 11 patients,no recurrence of the cyst occurred during a follow-up of 7-31 months.Only 1 patient with concomitant renal cyst had recurrence of the cyst found by B-ultrasound 2 years after operation.Conclusions Therapeutic laparoscopy by retroperitoneal access has advantages of minimal trauma,less blood loss,rapid recovery and better effect,therefore it is the ideal treatment choice for parapelvic cyst.

Objective: To report our prelimilary experience of laparoscopic radical prostatectomy (LRP) for clinically localized prostatic cancer.Methods:23 cases with localized prostatic cancer underwent LRP in our institution from October 2000 to August 2003. The median age was 64.5 years old, the median PSA was 13 ng/ml and median Gleason score of biopsy specimens was < 7. The operations were performed according to Montsouris technique. Briefly, operations were carried out transperitonealty, combining posterior and anterior approachs to the prostate, transecting the bladder neck, lateral dissection of the prostate, urcthrovesical anastomosis, completing the operation.Results:No death and no conversion rate were observed in this series of 23 cases of LRP. No re-intervention was needed. The median operating time was 325 minutes (range 270 to 660 min) including the lymphadenectomy phase that was considered necessary in the case whose PSA value was 51ng/ml and pathological reading was negative to thoses lymph nodes; The median intraoperative blood loss was 430 ml(rang 200 to 1100 ml). Postoperative bladder catheterization time was 20 days. Surgical positive margin was found in I case of pathlogical stage of pT2b and Casodex 50 mg had been used on this case for 3 mon after the PSA value was < 0.2 ng/ml. Postoperation follow-up of 3 to 24 mo. showed no signs of complications such as urethral stricture or urine incontinence. The PSA concentrations was < 0.3 ng/ml in all cases.Conclusions: LRP provides a clear and magnified anatomical image to allow a more precise and safer dissection.

AIM: To investigate the expression level of transcriptional factor Elf-1 in mononuclear cells, CD4~+ and CD8~+ T cells from umbilical cord blood (UCB). METHODS: Real-time PCR with SYBR green I technique was used for detecting the Elf-1 expression in mononuclear cells, sorted CD4~+ and CD8~+ T cells from 12 cases of umbilical cord blood. The relative mRNA expression level of Elf-1 was analyzed by a formula of 2~(-△Ct)×100%. The expression level of β_2-microglobulin gene (β_2M) was used as an endogenous reference. The peripheral blood from 10 cases of healthy adults was served as control. RESULTS: Elf-1 mRNA expressed in all blood samples collected from both UCB and healthy adults. The expression level showed apparent diversity in different individuals. The relative mRNA expression of Elf-1 in both mononuclear cells (18.55%±2.48%) and CD8~+ T cells (3.52%±0.45%) from UCB were significantly higher than those from healthy adults (9.16%±1.92%, 2.02%±0.27%, respectively, P<0.01, P<0.05). CONCLUSION: The results of Elf-1 expression level from umbilical cord blood indicate that the over-expression of Elf-1 gene in mononuclear cells and CD8~+ T cells might be one of the features of T cell immune state in umbilical cord blood.