AIM:To investigate the pathological changes of aquaporin 4 (AQP4) and related proteins in the rats with focal cerebral ischemia injury , and to observe the effect of silent information regulator 1 ( SIRT1) on the AQP4 ex-pression in order to explore the pathological mechanism of cerebral ischemia and brain edema .METHODS: Adult male SD rats were randomly divided into sham group and middle cerebral artery occlusion ( MCAO) model group.The MCAO model group was divided into the 4 time point (6 h, 12 h, 24 h and 48 h) subgroups.The animal model of MCAO was es-tablished by suture method in mature SD rats .The neural symptom score was measured at the corresponding time points . Morris water maze test was used to study the cognitive function .The cerebral infarction volume was evaluated by TTC stai-ning .The changes of brain water content was analyzed by a dry /wet weight method .The morphological changes of the brain tissues were observed under microscope with HE staining .The protein expression of SIRT 1, MMP-9 and AQP4 was deter-mined by Western blot .RESULTS: Compared with sham group , the neural function score of the rats in MCAO model group was significantly elevated .With the increasing reperfusion time , the cerebral infarction volume , brain tissue permea-bility and the brain water content were also increased .The increases in the protein levels of AQP 4 and the related proteins showed apparent changes .The protein expression of SIRT 1 was decreased , while the MMP-9 expression was increased .The most obvious differences of the protein level changes in MCAO-48 h model group were observed (P<0.01).CONCLU-SION:Accompanied with the aggravating cerebral injury after cerebral ischemia , the process of AQP4 expression is activa-ted with the increasing expression levels of MMP-9 and SIRT1.These factors are combined to induce the formation of brain edema.

Objective To set up a method for determining the protocatechuic aldehyde in Qingshenjianfei tablets. Method HPLC method, Elite HypcrsilC18 column (4.6 mm?250 mm, 5 ?m) was used, mobile phase:Methanol-0.5% Acetic Acid Glacial (12∶88), the detecting wavelength was at 280 nm. Result The standard curve was linear within a range of 0.05～0.60 ?g. The average recovery and RSD were 100.49% and 1.61%. Conclusion This method is accurate, reliable, and can provide a scientific index for quality control of Qingshenjianfei Tablets.

Objective To understand the clinical feature of the elderly patients with diabetes during coronary angiography,and analyze the risk factors of contrast-induced nephropathy (CIN).Methods The clinical data of 269 elderly patients who had undergone coronary angiography and percutaneous coronary intervention(PCI) from January 2007 to December 2009 in our hospital were analyzed retrospectively.The patients were divided into two groups:CIN group and non-CIN group.The possible risk factors for CIN,such as glycemic control,diabetic complication,renal function,volume of contrast medium,inflammatory state,therapy of perioperative period,past medical history were analyzed and compared between the two groups. Results In 269 elderly patients with diabetes,the incidence of CIN was 9.3 ％ (25/269).According to estimated glomerular filtration rate (e-GFR),the patients were divided into four subgroup:≥90 ml/min,89-60 ml/min,59-30 ml/min,＜29 ml/min.The incidences of CIN for the subgroups were 2.2％(1/45),4.4％(6/135),17.3％(14/81) and 50 ％ (4/8),respectively.Multivariate logistic gradual regressive analysis showed that loop diuretic use (OR＞ 6.07),preoperative e-GFR(＜60 ml/min) (OR＞3.27),volume of contrast medium (≥200ml) (OR＞3.26),chronic kidney disease(CKD) (OR＞2.80) (P=0.001,0.024,0.015,0.048) were indepen-dent risk factors for CIN (P＜0.05). Conclusions Loop diuretic use,preoperative GFR (＜60 ml/min),volume of contrast medium (≥200 ml) and CKD are independent risk factors of CIN.

e and feasible for postcolectomy patients.

Objective To study the influence of clinical nursing pathway on operative effects for patients with malignant tumout of bone. Methods 60 adult patients with malignant turnout bone were divided into the clini-cal nursing pathway gronp(32 cases) and control group(32 cases) randomly, routine nursing cares were used in con-trol group, while the clinical nursing pathway was used in the observation group. Compared the index between the two groups. Results All the indexes which had been compared between the two group were better in the clinical nursing pathway group than those in control group, the difference was significant (P < 0.05). Condusion The clinical nursing pathway can effectivly improve the compliance of patients for operation, avoid postoperative complications, and then imprpve their quality of life.

Objective To observe the healing effect of pertinent health education on patients with diabetic foot. Methods 116 cases of diabetic foot patients were randomly divided into group A (60 cases) and group B (56 cases). Group A accepted pertinent and one-to-one psychological nursing and group B received collective lecture of health education once a week. FPG, HbAlc changes and healing of wound was observed in the two groups. Results The clinical effect of group A was better than those of group B. Conclusions The pertinent health education can improve cognition and medical compliance of patients, promote healing of wounds, which proves to be superior than that of collective health education.

Objective To study the effect of nutrition supports in aged mechanically ventilated patients fol-lowing thracic trauma. Methods 48 aged mechanically ventilated patients following thracic trauma were randomly divided into two groups,patients in treatment group( n = 24) received EEN and PN,control group( n = 24) only re-ceived TPN. Compared the nutritional index, time of mechanical ventilation and compared the complications such as windy,intestine paralysis, alimentary tract heorrhage, second heavy infection, hypohepatia and high blood glucose.Results The nutritional index between treatment group and control group had no statistical difference,but the time of mechanical ventilation and the ratio of the complications in control group were higher than that in-treatment group (P < 0.01). Conclusion EEN and PN can improve nutritional condition, have less complieations, promoting the pa-tient recovers form illness.

Objective To investigate the effect of aminophylline and pentoxyverine on serum CRP, monocyte chemotaxis protein 1(MCP-1) and serum immune factors in elderly patients with sleep apnea syndrome .Methods 112 elderly patients with apnea syndrome were divided into the control group and the experiment group by order of medical treatment and 56 cases in each group.The control group were treated by rosiglitazone hydrochloride tablets and bay three ramie snore capsule and the experiment group were treated on the control group with Aminophylline Tablets and Pentoxyverine Citrate Tablets.Follow up 3 months, the CRP, MCP-1,IFN-γ,IL-4,IL-8 and IL-10 were tested and compared.Results Compared with the control group after treatment, the CRP,MCP-1,IFN-γand IL-8 level were lower(P <0.05),the IL-4 and IL-10 level were higher(P <0.05).Conclusion Aminophylline and pentoxyverine can be effective in treatment of elderly patients with apnea syndrome and its complications , suggesting that the mechanism may be related to reduce the patients serum CRP, MCP-1, IL-8 and IFNγ-levels, is related to the increasing of the levels of IL-4, IL-10.

BACKGROUND:The factors to affect spinal fusion are suitable bone graft location,good graft bed,enough bone grafts,strict fixation measure and enough fixation time. However,it is unclear which method should be used between intervertebral bone grafting and intertransverse bone grafting,as well as which material should be used between autogenous iliac bone and autogenous spinous process and vertebral lamina of resection. OBJECTIVE:To compare the fusion rate and improvement of clinical symptoms among different bone graft materials and methods which used in bone fusion for lumbar spondylolisthesis. DESIGN:A control observational experiment. PARTICIP ANTS:A total of 92 patients with lumbar spondylolisthesis who received bone fusion treatment. According to Meyerding classificantion,there were 50 cases of degree Ⅰ,40 cases of degree Ⅱ,1 case of degree Ⅲ,and 1 case of degree Ⅳ. There were 1 case in L3,58 cases in L4,and 33 cases in L5. METHODS:All patients received spinal canal decompression. After reduction and fixation was performed by spondylolisthesis reduction system(SRS) ,bone grafting fusion was performed in all patients. They were divided into four groups:autogenous spinous process and vertebral lamina graft placed between transverse processes group(n=21) ,autogenous spinous process and vertebral lamina graft placed between the vertebral bodies group(n=27) ,autogenous iliac bone graft placed between transverse processes group(n=21) ,autogenous iliac bone graft placed between the vertebral bodies group(n=23) . MAIN OUTCOME MEASURES:The fusion rate and the improvement of clinical symptoms were evaluated according to the X-ray pre and post operative,as well as the JOA score. RESULTS:At 6 months after operation,the fusion rate in the autogenous iliac bone graft placed between the vertebral bodies group were significantly higher than that in the other three groups(P 0.05) . According to the JOA score,at 6,9,and 12 months after operation,there were no differences in the score among the four groups. CONCLUSION:Posterior bone graft fusion of the vertebral body or transverse process using the vertebral lamina,spinous process,or iliac bone as autograft along with internal fixation for lumbar spondylolisthesis are effective. However the use of the iliac bone as autograft contributes to a higher fusion rate in the same method at 6 months. Further using the same material as autograft,the fusion rate of the autograft placed between vertebral bodies is better than that of the autograft placed between transverse processes at 6 months.

Parkinson′s disease(PD)is a common disease caused by multiple factors and characterized by pathological degen?eration in the dopaminergic neural system. Based on its pathogenic factors,PD can be divided into several subtypes,so it is essential to develop therapeutic agents based on the main pathogenic factor of each subtype of PD. Recently it is confirmed that the mutation of leucine-rich repeat kinase 2(LRRK2)gene leads to increased activity of the LRRK2 notably,and then causes neurodegeneration. Thus developing LRRK2 inhibitors to modulate the kinase activity will be a novel therapy for the PD subtype which is caused by LRRK2 gene mutation. LRRK2,either a kinase or a GTPase,has two drug binding sites. Therefore,two types of LRRK2 inhibitors are being studied,one is the kinase inhibitor and the other is GTPase inhibitor. This paper summarizes the recent progress in the dis?covery and development of LRRK2 inhibitors.