Cell polarity is a common feature of many different types of cells,and it is essential to the normal differentiation and function of cells. Partitioning defective 6( PAR6)gene encodes PAR6 protein, which is crucial to asymmetric cell division and polarized growth. PAR6 protein as a member of the PAR6 polarity complex,affects the synthetic of centrosome and protein recruitment to the centrosome. The abnormal number of centrosomal and the loss of cell polarity may eventually lead to the occurrence of tumor.

Though the mechanisms involved in the induction of pancreatic islet β cell dysfunction and apoptosis under diabetes conditions are still not clear, previous studies have shown that triggered or aggravated endoplasmic reticulum stress and oxidative stress play essential roles in impairment of β cell functions, especially the JNK pathway which can be activated by both of them.

Objective To study the correlation between dopamine and glutamate receptor NMDA NR_1 and NMDA NR_(2A),and to share the understanding of the mechanism of dopamine in the synaptic complex of inner hair cells.Methods Forty guinea pigs were divided randomly into four groups and the whole intacochlear perfusions were performed.The perfused cochleas were taken out as preparations 2 hours after perfusing,the contralateral cochleas were also taken out as the normal control group in the group perfused with artifical perilymph solutions.All the preparations were divided into 5 groups:①normal control cochleas;②perfused with artificial perilymph solutions;③perfused with artifical perilymph solutions containing 10 mmol/L dopamine；④perfused with artificial perilymph so lutions containing 30 mmol/L dopamine；⑤perfused with artifical perilymph solutions containing 50 mmol/L dopa mine.The semi-quantitive RT-PCR was used to observe the difference in the amount of glutamate receptor NMDA NR_1、NMDA NR_(2A).Results Dopamine inhibited the compound action potential(CAP),the increase of CAP threshold was observed and correlated with the contentration of dopamine in the perfusion solution.Regarding the amount of glutamate receptor NMDA NR_1 mRNA,there was no significant difference between group ① and group ② (P＞0.05).But a significant difference was observed the other 3 groups when compared to group ①(P＜0.05).No significant difference was detected among the 5 groups in the amount of glutamate receptor NMDA NR_(2A) (P＞0.05).Conclusion Dopamine may inhibit the cochlear auditory afferent nerve.The significant correlation between dopamine and glutamate receptor NMDA NR_1 was observed,the amount of glutamate receptor NMDA NR_1 decreased along with the increasing of the contentration of dopamine in the perfusion solution.And there was no significant correlation between dopamine and glutamate receptor NMDA NR_(2A).

Objective To evaluate the efficacy of internal fixation with or without fusion in the treatment of thoracolumbar burst fractures.Methods Clinical controlled trails related to the application of pedicle screw instrumentation with or without fusion for thoracolumbar fractures before March,2012were obtained by searching PubMed,Science Direct,Medline and CNKI.Quality evaluation was made on the included literature,from which data were extracted to integrate various rescarch results by using RevMan 5.1.The quantitative data were analyzed based on the effect scale of mean difference (MD) and bilateral 95％ confidence interval (CI).The numeration data were analyzed in the use of effect scale of odds ratio (OR) and bilateral 95％ CI.The merging of some data was manually completed.Results After retrieving,eight English and one Chinese papers of the clinical controlled trials,and two related Meta analysis were obtained.With exclusion of one repetitive research,eight papers were involved in the review.Meta analysis demonstrated that fusion and non-fusion fixation had no significant differences in aspects of correction of kyphotic angle,correction and correction loss of vertebral body height,neurological function improvement,complication rate,and length of hospital stay.While compared with the fusion fixation,non-fusion fixation showed a more serious correction loss of kyphotic angle,a fewer blood loss and a shorter operation time.Conclusions Non-fusion fixation shows the similar efficacy with fusion fixation in the treatment of some thoracolumbar burst fractures pertaining to releasing compression,restoring spinal stability and preventing complications,but it can also significantly decrease operation time and blood loss.Furthermore,non-fusion fixation may markedly improve patients' quality of life since it restores motion of the instrumented segment after removal of implant and decreases the risk of adjacent segmental degeneration.

Objective To explore the clinical effect of laparoscopy combined with choledochoscopy on choledocholithiasis.Methods Totally 134 elderly patients with choledocholithiasis were treated in our hospital from Jan 2013 to Dec 2014, who were randomly divided into observation group and control group (n=67 for each), treated with laparoscopy combined with choledochoscopy, and traditional surgery, respectively.The operation time, bleeding volume, exhaust time, in-hospital stay, complications and residual stones rate were compared between the two groups.Results The operation time was higher in observation group than in control group [(124.6±21.2) min vs.(94.7± 17.9) min, t=8.821, P＜0.001].The bleeding volume were less in observation group than in control group[(43.8±10.4) ml vs.(113.5±37.6) ml, t=14.624, P＜0.001].The exhaust time and in hospital time were decreased in observation group than in control group[(27.6 ±5.5) h vs.(43.4±8.1) h, (7.4±2.4) d vs.(10.3±2.8) d, t=13.209 and 6.437, P＜0.001 for both].The incidences of postoperative pain and other complications were lower in observation group than in control group [6.0％ vs.28.4％, 16.4％ vs.43.3％, x2=11.810and 11.547, P=0.001 for all].Conclusions The laparoscopy combined with choledochoscopy has advantages to minimize the surgical injury, reduce the bleeding volume and promote the postoperative recovery in treating choledocholithiasis in elderly patients.

Objective To investigate the change of CD_4~+CD_(25)~(high)CD_(127)~(low)> regulatory T cells (Trcg cells) sub-group level in peripheral blood of non-Hodgkin lymphama (NHL) patients, and to explore its clinical significance. Methods Treg cells levels in peripheral blood of lymphoma patients and normal were detected by flow cytometry, followed by statistical analysis. Results In the 65 cases of NHL patients, Treg cells in peripheral blood were (6.72±1.38) %, higher than that in the normal control group (5.65±0.68) % (P <0.05). Percentage of Treg cells are significantly different between clinical stages and normal: [P <0.05, normal control group (5.65±0.88) %, Ⅰ -Ⅱ period (6.08±1.18) %, Ⅲ-Ⅳ period (6.95±0.85) %]. The percentage of Treg cells are also different among pathological types of patients and normal [P <0.05, normal control group (5.65± 0.68) %. The percentage of Treg diffuse large B-cell lymphoma (5.83±0.95) % and other subtypes of lymphoma (7.83±1.76) %]were observed. It is not sure that Treg cells percentage among patients with different levels of lactate dehydrogenase and normal are significantly different. [P >0.05, normal control group (5.65±0.68) %, patients with normal LDH group (6.97±1.20) %, patients with lactate dehydrogenase (6.54±1.02) %]. Conclusion Treg cells induced by tumor and could inhibit the immune cells, Treg cells percentage in peripheral blood of tumor patients is higher than that the normal control group, and increased with the clinical staging, so the percentage of Treg cells may serve as a clinical indicator to evaluate tumor load.

Objective To compare the setup errors between single-site and two-site image guidance in treating multiple metastases using Tomotherapy.Methods A total of 1 220 sets of megavoltage CT (MVCT) images from 50 multiple metastases patients were collected.The setup errors of two anatomic sites were determined by registration of MVCT images with planning images.Bland-Altman plot analysis was used to assess the coincidence of these two methods.Pearson correlation analysis was performed to evaluate the correlation of the setup errors determined by two sets of data and to analyze the deviation values of setup errors.Results The deviation values of setup errors more than 3 mm between two sites were 34％,46％ and 28％ in lateral (x),longitudinal (y),vertical (z) directions,respectively.The deviation values of setup errors more than 5 mm were 10％,16％ and 8％,respectively.The BlandAltman plot analysis showed that the 95％ agreement limits of agreement were (9.3,-10.6),(10.5,-11.7),(7.3,-6.9) mm in x,y,z directions,respectively,which were all out of 5 mm tolerance.The Pearson coefficient of correlation along all three directions was less than 0.05,and R2 was 0.074,0.475,and 0.178 in x,y,z directions,respectively.Conclusions To determine the setup errors for patients with multiple metastases,single-site image guidance method is not consistent,and the two site image guidance method would be recommended.

Objective To investigate the correlation of P-gP,bel-2,STAT3,IL-6,IL-10 and the resistance lymphoma cells to chemotherapeutic agents.Methods There were 28 patients,among them were divided into three groups:refractory lymphoma,lymphoma which is sensitive to agents and lymphodenitis.P-glycoprotein(P-gp)on lymphoma cell membrane,STAT3,bcl-2,IL-6 and IL-10 level into lymphonla cell were detected using FCM,and the correlation between them and chemotherapy efficacy were analysed. Results In refractory lymphoma patients,P-gp and hcl-2 are significant higher than that of the group which is sensitive to agents(P:0.01,P=0.039),but STAT3,IL-6 and IL-10 were not significant different between these two groups(P>o.05).P-gp is significant higher in lymphoma than in lymphodenitis(P=0.01).STAT3 in lymphoma is significant lower than that of in lymphodenitis (P=0.04).The level bcl-2,IL-6 and IL-10 between lymphoma and lymphodenitis are not significant different(P>0.05).Conclusion The expression level of bel-2 and p-gP is correlated to resistance to the chemotherapeutic agents in lymphoma cells.STAT3 play a role in lymphoma cell signal transduction,but it is not certain in lymphoma cell muhidrug resistance.

Objective To study the value of deferred stent implantation in patients with high thrombus burden of acute ST-segment elevation myocardial infarction (STEMI). Methods Select 106 cases with a high thrombus burden within 12 hours of onset in patients with STEMI ,the infarct-related artery thrombus aspiration after antegrade flow of TIMI 2-3 and≤2 points of the thrombus aspiration(TS)patients were randomly divided into immediate stenting group(n = 43)and deferred stenting group(n = 40). Two groups of patients were compared with the myocardial blush grade(MBG),the incidence of slow-/no-reflow ,the incidence of compound endpoints in 6 months and the cardiac function after PCI for 6 months. Results After stenting,the MBG of deferred group was significantly higher than that of immediate group ,the incidence of slow-/no-reflow and the compound endpoints events within 6 months in deferred group was significantly lower than that in the immediate group. After PCI for 6 months,the improvement of LVEF in the deferred group was significantly higher than that in the immediate group, the left ventricular end diastolic dimension(LVEDD)in deferred group was significantly lower than that in immedi-ate group,and the differences were statistically significant(P < 0.05). Conclusions The high thrombus burden in patients with acute STEMI after thrombus aspiration ,deferred stent implantation can significantly reduce the rate of slow-/no-reflow ,improve myocardial perfusion ,reduce the incidence of compound endpoints events ,im-prove cardiac function in patients.