Objective To observe the changes of microRNA‐214 (miR‐214) expression in rat pulmonary artery smooth mus‐cle cells (PASMCs) induced by different hypoxia time ,and lay the foundation to explore the effect and mechanism of regulation of miR‐214 on PASMCs proliferation .Methods The primary cultured PASMCs were cultured under hypoxic 0 h ,6 h ,12 h ,24 h ,48 h ,respectively .The real time quantitative PCR was used to detect miR‐214 expression in each group PASMCs .Results The ex‐pression of miR‐214 in hypoxia group PASMCs was sustained as time increased ,apart from hypoxic hypoxia 6h group and 0h group ,the expression of miR‐214 was no significant difference (P>0 .05);the expression of miR‐214 among other groups PASMCs was significantly different (P<0 .05) .Conclusion The expression of miR‐214 in PASMCs increased after induction of hypoxia .We speculated that miR‐214 may be involved in the regulation of hypoxia induced PASMCs proliferation .

Aim To identify whether the petroleum e-ther fraction of Gardenia jasminoides Ellis ( GJ-PE ) could effetive exhibit a rapid antidepressant effect and also to investigate the biological mechanism. Methods Tail suspension test ( TST ) , forced swimming test ( FST ) and novelty suppressed-feeding ( NSF ) were used to screen the rapid antidepressant potential of ef-fective fractions of GJ-PE in KM mice at 24 h post a single administration. Tail suspension test ( TST) was also used at 30 min and forced swimming test ( FST ) was used at 2 h to test the initial onset time of effective fractions of GJ-PE in KM mice. Western blot was per-formed to examine the expression of BDNF and p-eEF2 in hippocampus of KM mice at 2 h and 24 h. Results An acute administration of GJ-PE1 decreased the im-mobility time of KM mice in FST at 2 h and 24 h and decreased the latency time in NSF at 24 h. GJ-PE3 de-creased the latency time in NSF at 24 h. GJ-PE4 in-creased the unit food consumption in NSF at 24 h. At 2 h post a single GJ-PE1 treatment, the expression of BDNF was significantly up-regulated while the expres-sion of p-eEF2 was significantly down-regulated. At 24 h post a single GJ-PE1 treatment, the expression of BDNF was significantly down-regulated while p-eEF2 expression was significantly up-regulated. Conclusion GJ-PE1 has the most significant rapid antidepressant potential among the four fractions of GJ-PE. The effec-tive time of GJ-PE1 is 2 h after drug treatment. The mechanism of the rapid antidepressant effect of GJ-PE1 at 2 h is related to the up-regulation of BDNF and down-regulation of p-eEF2 . GJ-PE3 and GJ-PE4 also have some features of rapid antidepressants. GJ-PE2 doesn′t have the rapid antidepressant potential.

Objective To evaluate the clinical outcomes in patients with both column acetabular fractures involvement posterior wall using lag screw through single ilioinguinal approach.Methods Between August 2008 to August 2014,35 consecutive patients with both columns acetabular fractures and fracture also involved posterior wall and fixed by lag screws were retrospectively analyzed.There were 25 males and 10 females.The average age was 44.4+ 12.5 years (range,18-72 years).According to Letournel classifications,the acetabular fracture involved both columns and posterior wall in all cases,and 2 cases with additional seagull sign.The surgeon reduced posterior wall by pressing the fragment through a small tunnel in the soft tissue leaning against the external cortex of iliac bone and fixed the fragment using lag screws from the anterior side.Clinical and functional outcomes were assessed using the modified Merle d'Aubigné scoring system.Radiographic results were evaluated based on Matta scoring system.Results The patients were follow for an average of 44.7+ 18.9 months (range,24-96 months).The average operative time was 257.7±60.4 min (range,160-490 min).The average blood loss during the operating was 742.9±+614.5 ml (range,300-4 000 ml).Loss of reduction of the posterior wall was not found in any case.At the latest follow-up,radiographic results were excellent in 11,good in 19,and poor in 5.The average modified Merle d'Aubigné score was 16.4 (range,13-18).There were 8 cases of excellent,23 cases of good,and 4 cases of fair.Four patients developed deep venous thrombosis of the lower extremities after 3-4 days of operation.Warfarin was used for anticoagulation therapy and thrombi disappeared 6 months postoperatively.One case had superficial wound infection and was treat with vacuum sealed drainage (VSD) and anti-infection therapy.The incision healed without infection after one month.One case with poor quality of reduction and remaining seagull sign was treated with total hip arthroplasty after 35 months because of severe traumatic arthritis.The total reoperation rate was 5.7％ (2/35).latrogenic sciatic nerve injury as well as heterotopic ossification was not found in any case.Conclusion Satisfactory quality of reduction and good clinical outcomes can be achieved in patients with acetabular fractures involved both columns and posterior wall by single ilioinguinal approach and lag screw fixation for posterior wall.Iatrogenic sciatic nerve injury as well as heterotopic ossification was not found in any case.

Objective To evaluate the clinical outcomes of ilioinguinal approach with short infrapectineal buttress plate fixing posterior column for patients with complex acetabular fractures. Methods Data of 29 consecutive patients (male 22, fe?male 7, age range 25-72 years, average age 53 ± 6.3 years) with complex acetabular who had operated by single ilioinguinal ap?proach with infrapectineal buttress plate from September 2008 to August 2012 were retrospectively analyzed. According to Letour?nel?Judet classifications, there were 4 cases of anterior column and posterior hemi?transverse, 11 cases of associated both?column, 4 of T?shaped and 6 with seagull sign. The acetabular fractures model was printed preoperatively by 3D printing technique for sur?gical simulation, open reduction and internal fixation through single ilioinguinal approach with a short infrapectineal plate fixing posterior column, particularly an ox horn shape K?wire sleeve was developed for drilling and screw insertion using flexible screw?driver. Clinical, radiographic, and functional outcomes assessed by the modified Merle d’Aubigné score were collected. Results Two patients were lost to follow?up, including one patient who died at 15 days postoperative because of pulmonary embolism, and the other one who had moved abroad at 12 months postoperative. The remaining 27 (93%) had a mean follow?up of 40 months (range, 24-75 months). The operating time was 180±35.5 min;the time for the fracture union was 3.5±0.9 month;blood loss during the operating was 500±43.9 ml;no case had fracture re?displacement. At the latest follow?up, radiographic grades were excellent in 17, good in 8, poor in 4, including one poor patient who had a total hip arthroplasty (3%) at 35 months after the internal fixation. The average modified Merle d’Aubigné score was 16 (range, 10-18), and categorized as excellent in 12, good in 8, fair in 5, and poor in 2. Three patients had developed deep venous thrombosis of the lower extremities, and one of them died of pulmonary embo?lism 15 days after operation; two cases of deep venous thrombosis of the lower extremity were found 3-4 days after operation. Thrombosis disappeared 6 months after anticoagulant therapy by warfarin. One case who had superficial wound infection after oper?ation was treated by anti?infection and VSD negative pressure, and incision was healed after one month. One case with poor quality of fracture reduction and seagull sign was treated with total hip arthroplasty after 35 months because of traumatic arthritis. The to?tal complication rate was 24%(7/29). Conclusion In the patient with complex acetabular fractures combining posterior column medial displacement, single Ilioinguinal approach with infrapectineal buttress plates could achieve a stable concentric hip joint, and immediate postoperative ambulation can result in reasonable clinical, radiographic, and functional outcomes.

Objective To assess the effect of preoperative administration of tranexamic acid (TXA) on the hidden blood loss in the surgery of intertrochanteric fractures with proximal femoral nail anti-rotation (PFNA).Methods Eighty patients with intertrochanteric fracture were treated with PFNA in our hospital from November 2015 to July 2016.They were 15 men and 65 women,with a mean age of 72.6 years.Of them,39 were included into TXA group where TXA was administered preoperatively and 41 were assigned into the control group where no TXA was used preoperatively.Blood routine examinations were carried out on one day before operation,the first and third days after operation.The surgical blood loss,operative blood transfusion,24-hour drainage after operation,and postoperative 3-day blood transfusion were recorded.The total and hidden blood losses were calculated according to the formula.The 2 groups were compared in terms of blood loss and complications.Results In TXA group,the total blood loss (1,632.3 ± 849.2 mL),the hidden blood loss (1,270.9 ± 623.3 mL) and the transfusion rate (28.2％) were significantly lower than those in the control group (2,014.8 ± 924.7 mL,1,549.1 ± 624.9 mL and 56.1％) (P ＜ 0.05).There was no significant difference between the 2 groups in visible blood loss (361.4 ± 154.3 mL for TXA group versus 465.7 ± 191.3 mL for the control group) (P ＞ 0.05).Deep venous thrombosis occurred in 2 patients,limb swelling in one patient and wound dehiscence in one patient in TXA group while deep venous thrombosis occurred in one patient,limb swelling in 3 patients and wound dehiscence in none in the control group,showing no significant differences between the 2 groups (P ＞ 0.05).No infection was observed in either group.Conclusion Preoperative administration of TXA can reduce surgical hidden blood loss and transfusion rate as well but will not increase the risk of deep vein thrombosis in the surgery of intertrochanteric fractures with PFNA.

Objective:To investigate the value of the decrease rate of parathyroid hormone (PTH) in predicting permanent hypoparathyroidism (PHP) in one month after operation of papillary thyroid carcinoma (PTC) .Methods:The clinical data of 322 patients with PTC who underwent at least total thyroidectomy and unilateral central lymph node dissection in the Thyroid Surgery Center of West China Hospital of Sichuan University from Jan. 2013 to Jun. 2018 were retrospectively analyzed. There were 257 women and 65 men. According to the time when PTH returned to normal, they were divided into 307 cases in the temporary hypoparathyroidism (THP) group and 15 cases in the PHP group. The decrease rate of PTH and the incidence of hypoparathyroidism in one month after operation were counted, the clinical characteristics and operation information were observed, and the risk factors of PHP were analyzed. SPSS 23.0 statistical software was used for data processing. χ 2 test and t test were used for comparison between THP and PHP. The related factors were analyzed by multivariate logistic regression. Results:307 cases of THP and 15 cases of PHP were included. Multivariate logistic analysis showed that age ≥ 55 years old ( OR, 35.193; 95% CI, 2.936 - 421.870; P=0.005) and PTH before operation closer to normal lower limit ( OR, 2.349; 95% CI, 1.161 - 4.755; P = 0.018) were independent risk factors for PHP. Patients with PHP had a higher rate of PTH decline in 1 month after operation ( OR, 373.439; 95% CI, 26.568 - 5248.983; P=0.000) . The ROC curve showed that the sensitivity and specificity of predicting PHP were 86.7% and 94.8% respectively. Conclusions:The age of patients with PTC ≥ 55 years old and PTH before operation closer to normal lower limit are independent risk factors for the occurrence of PHP. The decline rate of PTH in one month after operation which more than 73.2% can predict PHP.

Objective To evaluate the clinical treatment of unstable pelvic fractures by posterior ring fixation using percutaneous minimally invasive pedicle screws following anterior ring fixation.Methods From January 2010 to January 2016,31 patients with unstable pelvic fracture were treated at our department.They were 20 males and 11 females,with an average age of 44.4 years (range,from 18 to 65 years).According to the Tile classification,6 cases were type B2,8 cases type B3,12 cases type C1,and 5 cases type C2.The anterior pelvic ring was fixated in supine position first,and the posterior pelvic ring was fixated next using percutaneous minimally invasive pedicle screws.The operation time,intraoperative bleeding,and frequency of fluoroscopy needed for the posterior ring fixation were recorded.Reduction quality,complications like loss of reduction and pelvic function at the final follow-up were also assessed.Results For the posterior ring fixation in the 31 patients,the operation time ranged from 40 to 60 minutes (average,50.7 minutes),blood loss from 30 to 80 mL (average,42.9 mL),and fluoroscopic frequency from 7 to 12 times (average,9.7 times).By the Tornetta evaluation,the reduction was rated postoperatively as excellent in 15 cases and as good in 16 ones,yielding an excellent and good rate of 100％.Twenty-nine patients obtained complete follow-up for 12 to 83 months (average,34.7 months),and they achieved bone union after an average of 14.5 weeks (range,from 12 to 16 weeks).According to the Majeed criteria for pelvic function at the final follow-up,10 cases were rated as excellent,16 cases as good,and 3 cases as fair,giving an excellent and good rate of 89.7％.No reduction loss,incision infection,vascular or nerve injury,screw loosening or breakage,or fracture displacement was observed during follow-up.Conclusion In the treatment of unstable pelvic fractures,posterior ring fixation using percutaneous minimally invasive pedicle screws following anterior ring fixation can lead to less operation time,intraoperative bleeding and fluoroscopic radiation,and satisfactory fracture reduction and functional recovery of the pelvis as well.

Objective To investigate the therapeutic efficacy of contralateral less invasive stabilization system (LISS) through a medial-posterior approach for fractures of femoral medial condyle.Methods From December 2010 to December 2014,14 patients with fracture of femoral medial condyle were treated surgically at our department.They were 10 males and 4 females,aged from 33 to 64 years (average,44.6 years).By AO classification,10 cases were type 33-B2 and 4 cases type 33-B3.Causes of injury included traffic accident in 7 cases,falling in 6 and heavy object crush in one.Internals from injury to operation ranged from 3 to 10 days (average,5.4 days).All the patients were treated by open reduction and internal fixation with contralateral LISS plate or T plate through a knee medial posterior approach.Results The 14 patients were followed up for 12 to 24 months (average,18 months).All fractures got bony healing after 3 to 5 months (average,3.5 months).No collapse of joint surface,joint stiffness,joint infection,malunion or nonunion occurred.According to the Schatzker-Lambert criteria for functional recovery of the distal femoral fractures,the function of the affected knee was assessed at the last follow-up as excellent in 9 cases,good in 3,fair in one and poor in one.Conclusion Open reduction and internal fixation with contralateral LISS plate through a medial-posterior approach is effective for fractures of femoral medial condyle due to its strong buttress,rigid fixation,advantage for early functional exercise,and satisfactory therapeutic outcome.

Objective:To evaluate the effects of weight-bearing area compression injury of the femoral head on the prognosis of elderly acetabular fractures after open reduction and internal fixation.Methods:A retrospective analysis of 36 elderly patients with acetabular fractures treated with open reduction and internal fixation during January 2014 to January 2018 were conducted. All patients with compression injury of the weight-bearing area of the femoral head, including 22 males and 14 females with 73.2±6.5 years old (range 60-87 years old), were included. The compression injury of weight-bearing area of the femoral head was not treated. According to the Letournel-Judet classification of acetabular fractures, there were 14 cases with both-column, 12 cases with anterior column and posterior hemitransverse, 4 cases with T type, 4 cases with transverse, and 2 cases with posterior column+ posterior wall. A total of 14 cases were accompanied by acetabular joint surface compression, while 29 cases were accompanied by joint dislocation. The Merle d'Aubigné score was used to evaluate the hip function during follow-up. The Matta classification method was used to evaluate the results of acetabular fracture reduction. The Kellgren-Lawrence classification standard and Ficat-Alert staging method were used to evaluate the traumatic arthritis of the hip and femoral head necrosis, respectively. During the follow-up, the femoral head necrosis with stage III, IV, or traumatic arthritis III, IV, or with indications for joint replacement was defined as surgery failure. CT scans of the pelvis were performed before and at 2-5 days after operation. The compression size of the femoral head on the coronal and axial planes of the CT scan was calculated for the compression volume. The compression severity was divided into small (<1 cm 3), medium (1-2 cm 3) and large (>2 cm 3) according to the volume. Binary Logistic regression analysis was used to analyze whether the postoperative measurement of the femoral head compression volume was associated with the risk of surgical failure. Results:All patients were followed up for 34.7±8.9 months (range 25-54 months). There were 7 cases with large compression of femoral head, 14 cases with medium, and 15 cases with small pre-operatively. However, there were 12 cases, 10 cases and 14 cases with large, medium and small at 2-5 days after operation, respectively. Six cases were excellent reduction, 22 cases were good, and 8 cases were poor. Thus, the excellent and good rate was 78% (28/36). At the last follow-up, Merle d'Aubigné score was excellent in 2 cases, good in 8 cases, fair in 5 cases, and poor in 21 cases. The excellent and good rate was 28% (10/36). There were 20 cases with surgery failure with 56% (20/36) failure rate. There were no statistically significant differences in the patient's age, body mass index, operation duration, blood volume, fracture type, fracture reduction, combined acetabular joint surface compression, and combined joint dislocation between the two groups. However, there was a statistically significant difference in the frequency distribution of compression volume in the weight-bearing area of the femoral head after surgery (χ 2=22.047, P<0.001). In patients with large, medium, and small-volume compression of the femoral head weight-bearing area, the surgery failure rates were 92%, 80%, and 7%, respectively. The large and medium-volume compression of the femoral head weight-bearing area were independent risk factors for surgical failure. Conclusion:Open reduction and internal fixation can be used to treat elderly patients with acetabular fractures combined with femoral head compression injury. Despite satisfactory reduction for acetabular fractures, the larger volume of femoral head compression affects the clinical outcomes with extremely high rate of surgical failure within 2 years.

AIM:To explore the impact of Delta-like ligand 3(DLL3)on the progression of prostate cancer(Pca)and to elucidate its potential molecular mechanisms.METHODS:Overexpression and interference plasmids of DLL3 gene were constructed,and the effects of DLL3 on the proliferation,migration and invasion of Pca cells were as-sessed.Tumorigenesis assay was employed to determine whether DLL3 influenced the proliferation of PC-3 cells in vivo.The impact of DLL3 on epithelial-mesenchymal transition(EMT)and mitogen-activated protein kinase(MAPK)signaling was investigated through Western blotting.RESULTS:Overexpression of DLL3 significantly enhanced the proliferation,migration,invasion and EMT processes of Pca cells compared with empty vector group and blank control group(P＜0.05).Conversely,knockdown of DLL3 expression yielded opposite effects(P＜0.05).Moreover,up-regulation of DLL3 promoted tumor growth in the nude mouse xenograft model(P＜0.05).Further investigation demonstrated that DLL3 up-regulation led to increases in the levels of MAPK signaling pathway-related proteins.Interestingly,MAPK inhibitor effec-tively reduced the proliferation,migration and invasion of Pca cells caused by DLL3 overexpression(P＜0.05).CON-CLUSION:DLL3 promotes the proliferation,migration and invasion of Pca through the MAPK pathway.