Objective:To study the protective effect of electro-acupuncture on glutamate(GLU),glycine(GLY),aspartate(ASP)and NF-?B expression in rat with cerebral ischemia reperfusion.Methods:The middle artery occlusion(MCAO)model was established and high pressure liquid chromatography(HPLC)fluorescence assay was used to detect contents of glutamate(GLU),glycine(GLY)and aspartate(ASP)in rat brain.The effect of electro-acupuncture on the nervous dysfunction score,the water content of cerebral constitution and the expression of NF-?B were observed.The group with non-acupoint group was as control.Results:The nervous dysfunction score,the water content of cerebral constitution,NF-?B,GLUand ASP in model group were higher than those of the sham-operated group.GLY levels had no obvious changes,there was no significant diference between the model group and the non-acupoint group.The nervous dysfunction score,the water content of cerebral constitution,the expression of NF-?B,GLU and ASP in electro-acupuncture group were lighter than that of the model group,GLY levels had no obvious changes.Conclusion:Electro-acupuncture could protect brain cell from damage after focal cerebral ischemia reperfusion injury by inhibiting the cerebral expression of NF-?B and excitatory amino acid.

Objective To observe the clinical characteristics and efficacy of laser photocoagulation of aggressive posterior retinopathy of prematurity (AP-ROP).Methods Twenty-eight eyes of 14 infants with AP-ROP from May 2008 to December 2010 were enrolled in this study.The infants were examined using RetCam photography and indirect ophthalmoscopy.Among the 28 eyes,24 eyes were classified as zone one and 4 eyes zone two.All eyes were treated within 24 hours using binocular indirect ophthalmoscope and laser photocoagulation.The initial energy was 200 mW,using energy was 200 - 500 mW,exposure time was 200 ms.Every two photocoagulation spot was linked together,but no overlap.Follow-up ranged from 3 to 24 months,with a mean of 11.5 months. The retinal bloods,the iris surface vessels,the fiber hyperplasia on retina,retinal detachment or ruffle form were observed.Results Twenty-five of 28 eyes (89.3 ％) recovered or were classified as control; 1 of 28 eyes (3.6 ％) was suffered retinal detachment one month after treatment.The detachment was resolved through vitrectomy Surgery.Two of 28 eyes (7.1 ％)did poorly.The parents gave up treatment resulting in loss of vision.No treatment-related complications were observed during the follow-up period,such as damage to cornea,iris and lens. Conclusion Photocoagulation is a safe and effective way to treat most AP-ROP.

Objective To explore the association between urinary lactate/creatinine ratio and neonatal asphyxia,and to clarify the application value of urinary lactate/creatinine ratio in forecasting the hypoxie-ischemic encephalopathy (HIE)in neonates.Methods Using case-control study design method,40 cases of neonatal asphyxia infants were selected as asphyctic group and 40 healthy infants were used as control group.The urinary lactate/creatinine ratio in the first day after birth, urinary N-Acetyl-β-D-glucosaminidase (NAG)/creatinine and the score of Apgar of 80 infants were detected.The relationship between the urinary lactate/creatinine ratio,urinary NAG/creatinine ratio, as well as the score of Apgar and HIE were analyzed and compared in asphyctic group and control group.Results The Apgar scores at 1 and 5 min in asphyctic group were significantly lower than those in control group (P<0.01). The urinary lactate/creatinine ratio and urinary NAG/creatinine ratio in asphyctic group 1 d after birth were significantly higher than those in control group(P<0.01).There was significantly negative correlation between the urinary lactate/creatinine ratio and the 1-min and 5-min Apgar scores(r=-0.636,P<0.001;r=-0.883,P<0.01),but there was a significantly positive correlation between the urinary lactate/creatinine ratio and urinary NAG/creatinine ratio(r=0.433,P<0.01).Conclusion The urinary lactate/creatinine ratio may have decisive roles in prognosis evaluation of neonatal asphyxia,and so as the important foundation for the prediction of HIE.

Objective To determine the effects of β-estradiol on vasoconstriction in human umbilical artery and vein and its potential mechanisms.Methods Human umbilical cord samples were obtained from 96 term neonates of healthy singleton pregnant women born in the First Hospital of Soochow University between December 2013 and June 2015 (multiple pregnancy,pregnancy complications,cesarean delivery and low birth weight were excluded).Human umbilical arteries and veins were isolated and suspended in 37 2 organ baths containing 5 ml Krebs solution and exposed to β-estradiol followed by phenylephrine (PE) for vasoconstriction test.The subjects were divided into β-estradiol group and control group according to the presence or absence of β-estradiol incubation.To determine the effects and the possible underlying mechanisms of β-estradiol on PE-induced vasoconstriction,human umbilical artery and vein rings were pretreated with N ω-nitro-L-arginine (L-NMMA,nitric oxide synthesis inhibitor),fulvestrant (ICI182780,estradiol receptor antagonist),indomethacin (prostaglandin synthesis blocker),and removal of endothelium,then incubated with β-estradiol for 60 min followed by PE,and the concentration-response curves to PE were recorded.The concentrationresponse curves to phorbol 12,13-dibutyrate (PDBU,protein kinase C agonist) in Krebs solution in the presence or absence of β-estradiol were also obtained.Nonlinear regression and fitting curve were performed,and the two-sample ANOVA was used for analysis.Results (1) β-estradiol suppressed PE-induced vasoconstriction of human umbilical vein and artery.In human umbilical vein and artery of the control group,the maximum contraction intensity induced by PE was (59.17± 5.98)％ and (43.35± 5.02)％ of that induced by potassium chloride,respectively.The maximum contraction induced by PE in β-estradiol group was (5.87± 1.32)％and (4.52±1.22)％ of that induced by potassium chloride.(2) In both groups,incubation with L-NMMA or endothelium removal enhanced the vasoconstriction of human umbilical artery and vein,indicating that the inhibitory effect of β-estradiol was not influenced by the endothelium.(3) The suppression of β-estradiol on PE-induced vasoconstriction in human umbilical artery and vein was not significantly decreased by estrogen receptor antagonist.(4) β-estradiol did not affect human umbilical artery and vein vasoconstriction induced by PDBU.(5) In the control group,incubation with indomethacin did not affect human umbilical artery and vein vasoconstriction induced by PE.In the β-estradiol group,indomethacin significantly enhanced the contraction response induced by PE,suggesting that prostacycline synthesis was partly involved in β-estradiol-suppressed contractility in human umbilical artery and vein.The contractile response induced by phenylephrine was still lower in the β-estradiol group than in the control group,which was induced by indomethacin.Conclusions (1) β-estradiol can suppress vasoconstriction in human umbilical artery and vein,which is not dependent on endothelium and estrogen receptors,or protein kinase C activity,(2) Prostacycline synthesis is partly involved in β-estradiol-suppressed vasoconstriction in human umbilical artery and vein.

Objective To investigate the diagnosis and treatment of solid-pseudopapillary tumor of pancreas (SPTP). Methods The clinical manifestations, imaging findings, treatment and prognosis of 36 patients with SPTP from September 2005 to December 2015 were retrospectively analyzed. Results All patients were female, with the average age of 30.5 years. There were 11 cases of abdominal mass and 15 cases of abdominal tenderness. Thirty-three patients underwent ultrasonography, which showed pancreatic solid heterogeneous hypoechoic, echogenic light clusters or cystic mixed echogenic masses;the tumors boundary were clear, and some tumors were separated in the center; most tumors were not accompanied by pancreatic duct and bile duct dilatation. CT plain scan showed that most tumors were single circular mixed density shadow with clear capsule;CT enhanced scan showed that the arterial phase of the cyst wall and solid area was mild or moderately enhanced, and the portal phase and the delayed phase continued to strengthen, and the cystic part was not strengthened in each period. All patients underwent surgical treatment. Postoperative pancreatic fistula occurred in 8 cases, edematous pancreatitis in 6 cases, incision infection in 2 cases, all of which were cured after symptomatic treatment. The patients were followed up for 5 to 120 months with an average of 56 months. All patients were not treated with postoperative radiotherapy or chemotherapy. Thirty-four patients had a good prognosis and no signs oftumor recurrence and metastasis;1 patient died of acute leukemia 2 months after discharge, and 1 patient was lost in follow-up after 1 year of postoperative liver metastasis. Conclusions The main patient group of SPTP is young women. The clinical symptoms are mostly abdominal mass and tenderness. Preoperative diagnosis is difficult. Imaging examination is great significance for the preoperative diagnosis of SPTP. Surgical resection is the only effective treatment. The choice of surgery should be based on the location of the tumor, the invasion tendency of the tumor seen during surgery, and the rapid pathology of the operation. Most patients with SPTP have a good prognosis, and the recurrence rate and metastasis rate are low.

Objective:To study the characteristics and influencing factors of coping styles of clinical ophthalmic interns under psychological stress, so as to provide scientific basis for promoting the mental health development of medical students.Methods:In 2019, 103 students of Sun Yat-sen University who participated in clinical practice of ophthalmology were investigated by cluster sampling with general situation questionnaire and simple coping style questionnaire. The database was established by Epidata, and the data was statistically analyzed by SPSS 25.0 software.Results:The scores of positive coping and negative coping were (1.70±0.10) and (1.30±0.05) respectively, which were all lower than the norm ( P < 0.001). The scores of non first time practice students were 0.087 points higher than those of first time practice students; the scores of eight-year students were 0.124 points higher than those of five-year students; the scores of positive coping increased by 0.015 points for each level of family income increase. Men scored 0.027 points higher than women in negative coping scores; eight-year students scored 0.053 points lower than five-year students in negative coping scores; family income increased by one grade, negative coping scores decreased by 0.017 points; rural registered residence students scored 0.035 points higher than urban registered residence students in negative coping scores; non first practice students scored 0.074 points higher than the first practice students in negative coping scores. Conclusion:Educators should pay close attention to the coping styles of clinical ophthalmic interns, carry out mental health education and guidance of coping methods according to the characteristics of different groups, take effective measures to improve students' stress coping ability and promote the smooth development of clinical practice in ophthalmology.

Objective To investigate the correlations between expression of CASC2 and hepatocellular carcinoma(HCC) prognosis.Methods A total of 129 patients including 80 males and 49 females with HCC were includedin this study,ranging from 21 to 73 years in Xuanwu Hospital of Capital Medical University and Beijing You'an Hospital were retrospectively analyzed from September 2007 to January 2014.Expression of CASC2 was assessed using reverse transcription quantitative-polymerase chain reaction in HCC tissue and the adjacent normal tissue.The correlations between CASC2 mRNA level and clinicopathological parameters was investigated.The relationship between the expression of CASC2 and the prognosis of patients with HCC was analyzed by Kaplan-Meier method.A log-rank analysis was performed to identify group differences.Univariate and multivariate Cox analysis were used to analyze the variables affecting the patient's prognosis.Results In 129 HCC samples,the level of CASC2 expression (0.84 ± 0.05) was lower than (3.35 ± 0.11) adjacent normal tissue (P ＜ 0.05).There were significant differences between CASC2 expression and tumor size,histological differentiation,and tumor stage in 129 HCC speciments.The median expression level of CACS2 in HCC tissues,0.84-fold,was used as the cut-off value to divide the 129 patients into two groups:low-expression group (n =72) and high-expression group (n =57).Overall survival rate of HCC patients with high CACS2 expression was significantly higher than those of patients with low CACS2 expression(P ＜0.05).Multivariate analysis indicated that histological differentiation (HR =0.20,95％ CI:0.05 ～ 0.59),tumor stage (HR =1.71,95％ CI:1.02 ～ 2.99) and CACS2 expression (HR =O.51,95％ CI:O.08 ～0.92) were an independent predictor of overall survival.Conclusion Low expression of CACS2 might be associated with the occurrence and development of HCC.

Objective To introduce the tibial intercondylar eminence hole (TIEH) and study its structure.Explore the connection between TIEH and the pathway how proximal tibial aggressive tumor break into the bony structure from articular cavity.Methods This retrospective study included 200 patient's CT 3-dimensional reconstruction materials from May 2017 to November 2017 in Qilu hospital randomly.There were 115 males and 85 females,the average age was 49 years (ranged from 12 to 90 years).To observe the existence of TIEH and identify its location and measurement with imaging techniques.According to 50 tibial plateau specimen after TKA and 5 specimen after car accident or amputation due to tumor,physical proof the existence of TIEH.The specific location,peripheral structure,coverage,content of TIEH as well as its top,walls and bottom were researched and analysed.Pathological staining was used and 1 cases undertook preoperation contrast agent observation.1 cases of typical cases were reviewed.Results TIEH was ubiquity according to all of the 200 cases.TIEH was located on the depression of tibial plateau,between the attachments of ACL and PCL.The hole was round type,and the diameter was 1.6±0.3 mm,the depth was 9.1±2.1 mm.1-3 Paraforamen (semidiamete≤7 mm) were found around the main TIEH in 53％ patients (106/200),the diameter and depth was less than the main hole.The CT value showed the orifice (472.5±30.1 HU) ＞ the pore wall (312.3±22.5 HU) ＞ the pore bottom (202.4±17.3 HU) ＞ the pore (118.3±10.4 HU) ＞ the orifice covering (75.0±11.1 HU).The synovial tissue septum was only 1 mm between the top of hole and the articular cavity.The top of TIEH was surrounded by articular cartilage,the walls and bottom were spongy bone,the content was dense connective tissue that didn't attach to the walls tightly.The peripheral spongy bone was easy to infiltrate by methylene blue.Preoperation radiography showed that TIEH had poor barrier function.Conclusion Tibial intercondylar eminence hole is an intrinsic structure of the human body.The coverage is weak,and it is easy to cause the tumor to hide and recur.The tumor may pass through this hole and bidirectionally enter between the proximal humerus and the joint cavity.

Objective:To introduce the discovery and nomenclature of the intercondylar foramen of femur (IFF) and foramen of tibial intercondylar eminence (FTIE) and research the close relationship between the high recurrence rate of aggressive tumors around the knee joint and the foramina around the knee joint.Methods:①Radiographic observation and measurement: 3D reconstruction of CT scan of 200 patients in our hospital were used to obverse the common feature、position and measure of Inter-condylar foramen of femur and Foramen of tibial intercondylar eminence. ②Anatomical and histological observation: To proof the existence of IFF and FTIE through the anatomy of 15 cases of car accidents or tumor amputations and 60 cases of autopsy. Then the specific location, the surrounding structure, the proximal coverage, the contents, the apical construction, the wall and the bottom tissues of the IFF and FTIE were studied and analyzed. ③Histological and pathological observation of tumor anatomy: Through the study of the distal femur and tibia malignant tumor tissues(including primary bone tumors and metastatic tumors), we observed the relationship between the foraminal structures and the tumor, judged the situation of concealed transmission and two-way spread through the foramina, and analyzed the relationship between tumor recurrence and foraminal structures. ④The synovial membrane of foramina, especially in cases where the synovium was suspected to be involved by the lesions judged by the radiography was analyzed to observe whether the synovium was infiltrated by the tumor.Results:IFF and FTIE were the inherent physical structure of the human. Their physiological function was the vascular foramina that lead the branches of arteria media genus into the Intercondylar fossa of femur and tibial intercondylar eminence. Their opening was separated with the joint cavity by the synovial tissues, so IFF and FTIE were isolated with joint cavity by the synovial tissues、meniscus and cruciate ligaments. After invading the IFF and FTIE, the aggressive tumors did not break into the joint cavity immediately, but conceal in the foramina and invade the synovium with specific biological behavior with the sequence: reactive edema, hyperplasia, degeneration, calcification, hyaline degeneration (infiltration in some cases), synovial rupture, and then tumor invasion of the articular cavity. Usually, tumors or recurrence has been observed before synovial rupture. We also observed the tendency of tumors to spread along the arteria media genus to the popliteal vessels, peripheral soft tissues and lymphatic vessels with typical radiographic performance like popliteal lymphadenectasis. Color nodules and tumors in other parts could also invade or metastasize into bone through these foramina.Conclusions:IFF and FTIE are foramina nutricium of arteria media genus. They are the inherent physical structure of the human. The foramina play an important role in the spread, concealment and recurrence of peripheralkneeaggressive tumor.

Phytocannabinoids are bioactive terpenoids that are exclusive to Cannabis sativa L. The main pharmacologically active phytocannabinoids are Δ9-tetrahydrocannabinol and cannabidiol, both target endogenous cannabinoid receptors. Δ9-tetrahydrocannabinol and cannabidiol have extensive therapeutic potential due to their participation in many physiological and pathological processes in human body by activating the endocannabinoid system. At present, Δ9-tetrahydrocannabinol, cannabidiol and their analogues or combination preparations are used to treat epilepsy, vomiting in patients with cancer chemotherapy, spasticity in multiple sclerosis and relieve neuropathic pain and pain in patients with advanced cancer. With the further exploration of the application value of Δ9-tetrahydrocannabinol and cannabidiol as well as the increasing demand for standardization of pharmaceutical preparations, it is imminent to achieve large-scale production of Δ9-tetrahydrocannabinol and cannabidiol in the pharmaceutical industry. In this article, pharmacological research progress of phytocannabinoids in recent years, biosynthetic pathways of phytocannabinoids and the mechanism of key enzymes as well as various product development strategies of cannabinoids in pharmaceutical industry are reviewed. By exploring the potential of synthetic biology as an alternative strategy for the source of phytocannabinoids, it will provide a theoretical basis for the research and development of microbial engineering for cannabinoids synthesis, and promote the large-scale production of medicinal cannabinoids.
Cannabidiol ; Cannabinoids/biosynthesis* ; Cannabis ; Humans ; Receptors, Cannabinoid