Coronary heart disease(CHD) is the leading cause of death among women worldwide.Recent technological advances in cardiovascular diagnosis and treatment have not led to significant declines in mortality for women with CHD when compared to the dramatic declines for men.Owing to the gender differences of physiology and social circumstances,women with CHD may have different manifestations as compared to men with CHD.Recently,research has shown that women with CHD had mainly the following characteristics:special risk factors,atypical ischemia symptoms,multiple risk factors and comorbidities at initial physician consultation,higher under-treatment rate and higher mortality rate.At the same time,most CHD researches have paid little attention to women.Therefore,the current CHD guidelines may not be completely suitable for women.In order to improve the prevention and treatment of CHD in women,we advocate to enhance research and clinical work for women with CHD. Abstract:Summ ary:Coronary heart d isease(CHD) is the lead ing cause of death among wom en worldw ide.Recent technological advances in card iovascu lar d iagnosis and treatm ent have not led to sign ificant dec lines in mortality for wom en w ith CHD when compared to the dram atic dec lines form en.Ow ing to the gender d ifferences of physiology and soc ial c ircum stances,wom en w ith CHD m ay have d ifferent m an ifestations as compared to m en w ith CHD.Recently,research has shown that wom en w ith CHD had m ain ly the follow ing characteristics: spec ial risk factors,atyp ical ischem ia symptom s,mu ltip le risk factors and comorb id ities at in itial physic ian consu ltation,h igher under-treatm ent rate and h igher mortality rate.At the sam e tim e,most CHD researches have paid little attention to wom en.Therefore,the current CHD gu idelines m ay not be comp letely su itab le forwom en.In order to improve the prevention and treatm ent of CHD in wom en,we advocate to enhance research and c lin ical work for wom en w ith CHD.

AIM To study the effect of arsenic trioxide(As 2O 3) on inhibition of proliferation human melanoma A 375 cells METHODS The cell proliferation inhibition was measured by MTT colorimetric assay; The expressions of nm23 was determined by immunohistochemistry.RESULTS As 2O 3 could result in the concentration dependent inhibition of A 375 cells proliferation. The volume of IC 50 was 13.05 ?mol?L -1 . The expression of nm23 anti transfergene in A 375 cells could be induced by As 2O 3 (2 ?mol?L -1 ). CONCLUSION As 2O 3 can inhibit proliferation and induce anti transfer protein of A 375 cells.

Objective To investigate the effects of the c-Jun N-terminal kinase (JNK)pathway on isoflurane induced neuronal apoptosis and the proteins expression of phospho-JNK,Bcl-2 and Bax in the hippocampi of neonatal rats.Methods Forty-eight neonatal rats at postnatal day 7 (P7) were randomly assigned into 4 groups:DMSO control group (group D),SP600125 control group (group SP30),isoflurane + DMSO group (group Iso +D),isoflurane + SP600125 group (group Iso + SP30).Rats were exposed to air (control group) or 1.1％ isoflurane (isoflurane group) for 4 h.The JNK inhibitor SP600125 at 30 μg or 12％ DMSO 5 μl was intraventricularly administered 20 min before the exposure.The brains of some rats in each group were perfused and embedded by paraffin 6 h after the exposure.Neuronal apoptosis in the hippocampi CA1 area was detected by TUNEL (n =6).The fresh hippocampi of other rats in each group were dissected 6 h after the exposure and the proteins expression of phospho-JNK,Bcl-2 and Bax were detected by Western blot (n =6).One way ANOVA were used for data analysis among groups.Results The number of TUNEL positive cells in the hippocampal CA1 regions in group Iso +D (135.72 ±21.26 per mm2) increased by 5 folds compared with group D (24.07 ± 1.35 per mm2) (P＜0.01) ;while the number of apoptotic cells in group Iso + SP30 (42.49 ± 5.56 per mm2) decreased by 84％ (P ＜ 0.05)compared with group Iso + D.The expression of phospho-JNK p46 kd in group Iso + D increased by 44.1％ (P ＜0.01),while both phospho-JNK at p46kd and at p54kd in group Iso + SP30 decreased significantly (P＜0.05,P ＜0.01) compared with group Iso + D.The protein expression of Bax increased 1.5 folds (P＜0.05) and Bcl-2 decreased by 42.2％ (P＜0.05) in group Iso + D compared to group D;while SP600125 significantly decreased expression of Bax (P ＜0.05) and increased expression of Bcl-2 (P＜0.01).Conclusion JNK activation contributes to isoflurane-induced neuroapoptosis in the developing brain.Maintaining Bcl-2 expression and inhibiting Bax expression may be involved in the neuroprotective effects of SP600125.

Objective To assess the change of left ventricular wall motion at ventricular pacing(VP)by using global circumferential strain (GCS) and segmental circumferential strain of speckle tracking imaging(STI). Methods Seven adult pigs were sedated,followed by median sternotomy and opening of the pericardium. Temporary pacing leads were placed on the right ventricular (RV) epicardium and LV epicardium for RV or LV pacing. A LV short axis view at the mid-level LV was acquired at sinus and VP rhythm. Analysis of circumferential strain by STI was performed offline. The onset of QRS wave was used to characterize the beginning of the cardiac cycle, and the ratio of beginning systolic time, end systolic time and total systolic time to cardiac cycle dyssynchrony was analyzed at sinus and VP rhythm. Results Compared with sinus rhythm,in VP rhythm all of the ratio of the beginning systolic time,end systolic time and total systolic time to cardiac cycle were increased (all P ＜0.05), and the construction of six segments were dyssynchrony,even segmental paradoxical movement. At VP ≥130 beats/min,both LV global and LV segments sometimes showed irregular motion while the EKG remained normal, which included: ( 1 ) multiple construction and diastole in one heart cycle; (2) A large variability of construction amplitude in several consecutive cardiac cycles. Conclusions VP can lead to several kinds of disturbance of left ventricular wall motion, including delay and lengthening of LV systole, dyssynchrony, and irregularity of systole and diastole.

Objective To evaluate the repeatability of the aperture sizes based on the Iris variable aperture collimator (Iris collimator) of CvberKnife VSITM.Methods Radiochromic films were placed at 800 mm of source-to-axis distance (SAD),and Iris quality assurance (QA) software was used to extract the information from the digital images,which were exposured by X-ray beams.Results The average aperture accuracy of Iris collimator was better than 0.11 mm over the beam range 5-40 mm,and the accuracy for 50 mm and 60 mm beams was within 0.19 mm.Conclusions The results suggest a good repeatability of aperture sizes for the CyberKnife VSITM Iris collimator.

OBJECTIVE: To retrospectively evaluate the effect of locking compression plate (LCP) combined with scaled cancellous bone graft on postoperative nonunion of humeral shaft fracture. METHODS: A total of 19 cases with postoperative nonunion of humeral shaft fracture were collected from Department of Orthopaedics, Affiliated Hospital, Xiangnan University between August 2005 and January 2009. There were 12 males and 7 females, aging 28-59 years with the mean age of 36 years. All patients were treated with LCP fixation combined with scaled cancellous bone graft. The key points of the operation were as follows: beck-median or lateral approach, protection of the radial nerve and ulnar nerve, removal of the cicatrix, reopening of humeral canal, and limited periosteum striping. For minimally invasive plate osteosynthesis technique, length of LCP was appropriate, 3-4 locking screws at least were used on either stump, and double cortices were penetrated with locking screws and treated with scaled cancellous bone graft. RESULTS: All the fractures healed with a mean period of 7.2 months (from 6 to 8 months). Two cases showed temporary radial nerve palsy after the operation, which gradually recovered 3 and 6 weeks, respectively after appropriate treatment. Shoulder and elbow functions were somewhat impaired in 7 cases, but the dysfunction could not influence daily living. Infection, screw loosening, blade plate breakage, and other complications were not found. CONCLUSION:The integrity of locking screws and plate prevents screw breakage and plate loosening. The combination of autoallergic cancellous bone graft and scaled decorticating technique can improve healing of humeral shaft fracture.

Objective To evaluate the effect of ion chamber sensitive volume on absolute dose verification in CyberKnife plan.Methods Solid water phantoms were scanned by a CT scanner, single-field plan, multi-field isocentric plan and sequential optimized plan were designed by the treatment planning system.Absolute doses were measured at the specified point in each plan using the ion chambers with sensitive volumes of 0.007 cm3(A16), 0.24 cm3(A12 s), and 0.6 cm3(PTW30013) and compared with calculated values.Results For the single-field plan, the relative error increased as the aperture size of collimator decreased;with relative errors within ±2%, the smallest aperture sizes of collimator were 12.5 mm (A16), 25 mm (A12 s), and 30 mm (PTW30013).For the multi-filed isocentric plan, the relative errors were 0.26%±3.90%(A16),-6.28%±14.33%(A12 s), and-9.41%±14.10%(PTW30013).For the sequential plan optimized with 15 mm cone, the relative error was 0.79%±1.43%;for the sequential plan optimized with 7.5 mm cone, the relative error was 2.01%±8.39%.In absolute dose verification for clinical plans, there was no significant difference between the results measured by these ion chambers (P=0.985).Conclusions There is no significant effect of ion chamber sensitive volume on absolute dose verification in CyberKnife plan under the following two situations:(1) the collimator with a relatively large aperture is used;(2) the sensitive volume of ion chamber is totally covered by the prescription isodose line.

BACKGROUND:Active surgical treatments are preferred for elderly hip fractures. Individual fixation method is chosen according to fracture site, type, age and whether there are basic diseases in internal medicine, which plays an important role in the successful treatment of elderly hip fractures.
OBJECTIVE:To explore the effects of optimized surgical treatment on osteoporotic hip fracture in the elderly.
METHODS: Totally 176 patients with osteoporotic hip fracture were treated by different methods between January 2000 and January 2012, including 63 males and 113 females, with a mean age of (76.7±6.3) years. Out of the 84 cases of interchanteric fracture, seven cases were treated with conservative methods, 34 cases were treated with dynamic hip screw internal fixation, 18 cases were treated with cannulated screw internal fixation, seven cases were treated with anatomical plate internal fixation, 12 cases were treated with bipolar femoral placement, and six cases were treated with total hip arthroplasty. Out of the 92 cases with femoral neck fractures, 40 cases were treated with bipolar femoral placement, 37 cases were treated with total hip arthroplasty and 15 cases were treated with cannulated screw internal fixation. Modified Harris hip function scores were used to evaluate the therapeutic effects of different treatment methods. Complications were observed.
RESULTS AND CONCLUSION:Seventy-six cases of interchanteric fractures and 85 cases of femoral neck fractures were fol owed-up for 8-26 months with an average of (5.7±1.3) months. Three cases suffered from post-operative infection, and one case died due to cardio-pulmonary failure in 10 days after operation. Both intraoperation and postoperative complications included femoral head cutting, intraoperative fracture, internal fixation and prosthetic loosening, postoperative fracture, avascular necrosis of femoral head, coxa vara, legs shorten, and delayed fracture healing. The incidence rates of complications in patients undergoing bipolar femoral placement and total hip arthroplasty were significantly lower than those treated with conservative methods, dynamic hip screw internal fixation, cannulated screw internal fixation, and anatomical plate internal fixation (P<0.05). The outcomes of the treatment according to Harris scoring criterion were better in patients treated with bipolar femoral placement and total hip arthroplasty than in patients treated with conservative methods, dynamic hip screw internal fixation, cannulated screw internal fixation, and anatomical plate internal fixation (P<0.05). No significant differences were found in the incidence rate of complications and Harris scores among patients treated with conservative methods, dynamic hip screw internal fixation, cannulated screw internal fixation, and anatomical plate internal fixation (P>0.05). No significant differences were found in the incidence rate of complications and Harris scores between patients treated with bipolar femoral placement and total hip arthroplasty (P>0.05). These findings indicate that the treatment of osteoporotic hip fracture in the elderly can achieve satisfactory results if the comprehensive therapies are given. Bipolar femoral placement and total hip arthroplasty are preferred for elderly femoral neck fractures.

Objective:To investigate the effect of long non-coding RNA (lncRNA) tumor susceptibility candidate gene 9 (CASC9) on the proliferation and apoptosis of pancreatic cancer cell BxPC-3, and to identify the targeting relationship between miR-195-5p and CASC9.Methods:40 pairs of pancreatic cancer tissues and adjacent normal pancreas tissues resected by surgery and diagnosed by histopathology in Xiangyang Hospital of Integrated Traditional and Western Medicine from April 2017 to May 2018 were collected. Four pancreatic cancer cells (AsPC-1, HPAC, BxPC-3, PANC1) and normal pancreatic ductal epithelial cells HPDE6-C7 were used in experiments. The expression level of CASC9 in pancreatic cancer tissues and cell lines were detected by real-time quantitative PCR. The BxPC-3 cells were divided into si-CASC9 group (transfected with siRNA against CASC9), si-control group (transfected with siRNA that did not match CASC9), CACS9 group (transfected with CASC9 overexpressed plasmid), and CASC9/miR-195-5p group (co-transfected with CASC9 overexpressed plasmid and miR-195-5p mimics). Cell proliferation activity was detected by MTT assay. Western blot was used to detect the protein expression of Bax and Bcl-2. The targeting relationship between CASC9 and miR-195-5p was identified by bioinformatics analysis and luciferase assay.Results:The expression level of CASC9 in pancreatic cancer tissues was significantly higher than that in adjacent normal tissues (4.7±1.25 vs 2.15±0.82, P=0.04), and the expression levels of CASC9 in pancreatic cancer cell lines AsPC-1, HPAC, BxPC-3, and PANC1 cells were 1.43±0.12, 1.86±0.13, 2.03±0.14, and 1.73±0.15, respectively, which were significantly higher than that in HPDE6-C7 cells (1.00±0.10, P<0.001). The expression in BxPC-3 cells was the highest. The proliferation activity of cells in si-CASC9 group decreased significantly compared with that in si-control group (on day 3 0.57±0.05 vs 0.72±0.04, P=0.01; and on day 4 0.75±0.07 vs 0.95±0.07, P=0.02). Bax expression was up-regulated (1.39±0.13 vs 1.07±0.11, P=0.03), while Bcl-2 expression was significantly down-regulated (1.44±0.11 vs 1.71±0.12, P=0.04). The cell proliferation activity of CASC9/miR-195-5p group was significantly decreased compared with that of CASC9 group ( P<0.005). The expression level of Bax was significantly higher than that of CASC9 group (0.68±0.04 vs 0.56±0.03, P=0.01), and the expression level of Bcl-2 was significantly lower than that of CASC9 group (1.05±0.03 vs 1.47±0.04, P<0.001). Conclusions:miR-195-5p can reverse the effect of CASC9 on promoting proliferation and inhibiting apoptosis of pancreatic cancer cells by targeting lncRNA CASC9.

Objective:By comparing the comprehensive differences between volume-modulated arc therapy (VMAT)-and CyberKnife-6D Skull (CK-6D Skull) tracking technology-based stereotactic radiotherapy (SRT) plans in the treatment of multiple brain metastatic tumors, and explore the advantages of multi-target intracranial technology.Methods:Clinical data of 42 patients with more than 2 brain metastases who received STR between January 2017 and August 2018 were retrospectively analyzed. For each patient, two radiotherapy plans were designed by selecting CK-6D Skull and VMAT technologies. The quality of VMAT and CK-6D Skull was compared by calculating the gradient index (GI), dose sag volume and organ at risk (OAR) of target area. The total number of monitor unit and single treatment time were recorded to compare the execution efficiency of these two technologies.Results:The GI of intracranial 2-target and 3-target plans of CK-6D Skull technology was significantly superior to that of VMAT technology ( P<0.05). The GI did not significantly differ between the 4-target and the 5-target groups ( P>0.05). The contribution of these two technologies to the maximum dose of OAR was not significantly different ( P>0.05), whereas the treatment time of VMAT technology was shorter ( P<0.05). Conclusions:Both technologies can meet the requirements of clinical SRT for multiple brain metastatic tumors. From the perspective of treatment plan and implementation, SRT based on CK-6D skull technology is recommended for patients with less than 4 intracranial metastatic tumors, and VMAT-based SRT is considered for those with > 4 metastatic tumors. Patients with poor physical condition and difficulty in maintaining a fixed position for a long time shall give priority to VMAT technology. More differences between these two technologies in the implementation of SRT for intracranial multiple brain metastases remain to be elucidated by more case data for statistical analysis.