Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

Objective To explore the clinical effects of sequential flap of thigh perforator for closure of the anterolateral thigh free flap donor site.Methods From March,2014 to May,2015,8 consecutive patients underwent elective anterolateral thigh free flap reconstruction for limb soft tissue defect.To design a sequential flap of thigh perforator to achieve primary closure of the anterolateral thigh free flap donor site.The area of anterolateral thigh free flap ranged from 9.0 cm×6.0 cm to 20.0 cm×1 1.0 cm,respectively.The area of thigh perforator flap ranged from 7.0 cm×3.0 cm to 12.0 cm×7.0 cm.Results All flaps healed uneventfully.Distal skin flap necrosis appeared in 1 flap which was healed after local transposition flap.All the patients were followed up for 1 to 6 months,with mean time of 4 months.The color,texture and appearance of flaps were satisfactory.Conclusion Sequential flap of thigh perforator,with reliable blood supply and constant position,represents an ideal model to close the anterolateral thigh free flap donor site of small defect.

Objective To explore the role of chromokinesin KIF4A in gastric cancer cell invasion using gastric cancer cells SGC-7901 and chromokinesin KIF4A deficient gastric cancer cells (SGC-shKIF4A).Methods Expression levels of KIF4A in controlling gastric cancer cells (SGC-shNC) and SGC-shKIF4A cells were determined by Western Blot.Invasion of gastric cancer cells were assessed using Transwell invasion assay and the number of cells passing through the matrigel was counted.Changing numbers of cortactin in SGC-7901,SGC-shNC,and SGC-shKIF4A cells were analyzed by immunofluorescence staining.Results Compared to the SGC-shNC cells,invasion ability of SGC-shKIF4A cells was increased.Compared to other cells,the numbers of cortactin in SGC-shKlF4A cells was also increased suggesting invadopodia in these cells was increased(P＜0.01).Conclusions Chromokinesin KIF4A acts as a tumor suppressor by inhibiting gastric cancer cells invasion and the results provides strong evidences for KIF4A serving as one of potent targets for gastric cancer prognostics and treatment in clinic.

The controversial results of several studies suggest that certain everyday-use chemicals may be linked to breast cancer. ln recent years, extensive researches have been carried out to under-stand breast carcinogenesis and the hedgehog(Hh) signaling pathway has emerged as a critical determi-nant of human breast cancer. Aberrant Hh signaling in adults results in carcinogenesis, angiogenesis, and metastasis. This review is focused on the Hh signaling pathway and chemicals in the regulation of breast cancer development and provide an updated survey of pre-clinical and clinical trials of novel strategies to target them.

OBJECTIVE To explore the effect of bisphenol A (BPA) on the differentiation potential of embryonic stem cells, and provide an experimental basis for evaluation of safety of BPA. METHODS Mouse embryonic fibroblasts (MEFs) and embryonic stem cells (ESCs) were treated with BPA 0.1, 1, 10, 100 and 1000 μmol.L-1 for 8 d respectively. The viability of MEFs and ESCs was measured by CCK-8 and lC50 was calculated. The mRNA expression of α-myosin heavy chain in ESCs was tested by RT-PCR to determine lD50 . The embryonic body cultured by suspension method was treated with BPA 0.001, 0.01, 0.1 and 1 μmol.L-1 for 10 d respectively. The changes of marked genes in each blastoderm were detected by RT-PCR. RESULTS lC50 of BPA to mouse ESCs was 5.22×10-4 mol.L-1 , and to MEFs was 6. 25 × 10-4 mol.L-1 . lD50 of BPA to mouse ESCs differentiating to cardiomyocytes was 7.0×10-7 mol.L-1 . BPA 0.001 and 0.01 μmol.L-1 upregulated the expression of the marked genes of mesoderm, fetal liver kinase-1 and globin transcription factor 1. CONCLUSION BPA is a strong embry-otoxic compound. BPA of low concentration can promote the differentiation of mouse ESCs to mesoderm.

Objective To purify pre-ribosome and ribosome of mammalian ceils using continuous sucrose density gradient ultracentrifugation.Methods Continuous sucrose density gradient was established by ultracentrifugation,and the continuous sucrose density gradient of 10％-30％ and 10％-45％ were used to extract the pre-ribosome and ribosome in mammalian cells,respectively.The mammalian cell lysis buffer was added to the established continuous sucrose density gradient.Pre-ribosome and ribosome with different sedimentation coefficients were collected and the A260 absorbance of each sample was measured.Proteins of each sample were extracted to detect the large subunit protein,RPL15 by Western Blot.Results Large subunit ribosomal protein RPL15 exists on 60S of the pre-ribosome,and also on 60S,80S and polyribosome of mature ribosome.Conclusions The continuous sucrose density gradient,which is established by the swing-out rotor,can be used to isolate the pre-ribosome and ribosome of mammalian cells rapidly.This method has the advantages of good separation effect and simple operation,which provides a good method for rapid and large amount preparation and separation of various kinds of ribosomes.

Objective To investigate the process that chromosome kinesin KIF4A promote cisplatin resistance in lung cancer cells.Methods Reverse transcription PCR (RT-PCR) and Western Blot experiments were performed to analyze the expression of KIF4A in lung cancer cells A549 and cisplatin (DDP) resistant cells A549/ DDP.Cell transfection, RNA interference (RNAi) experiments and thiazolyl blue tetrazolium bromide (MTT) assays were carried out to examine cell proliferation of A549 cells with overexpression of exogenous KIF4A and A549/DDP cells with depletion of endogenous KIF4A after cisplatin treatment.Results Expression of KIF4A in A549/DDP cells was higher than that in A549 cells.With overexpression of exogenous KIF4A, A549 cells displayed drug resistance to cisplatin.On the contrary, depletion of endogenous KIF4A in A549/DDP cells resulted in cisplatin sensitivity.Conclusions Chromosome kinesin KIF4A involves in the regulation of cisplatin resistance in lung cancer cells and KIF4A may be a potential and effective new biological target for treatment of lung cancer cisplatin resistance.

Objective To discuss the standard of endoscopic diagnosis of duodenal white spot syndrome and to test its accuracy by pathological diagnosis standard. Methods A total of 6,995 patients undergoing gastroscopy were detailedly examined through gastrofiberscope or electrogastroscope and endoscopic diagnosis were made by the standard of endoscopic diagnosis of duodenal white spot syndrome. Then, pathological examination was done to test and verify the accuracy of the standard of endoscopic diagnosis. Results There were 533 patients suffering from duodenal white spot pathological changes, accounting for 7.62%. And duodenal mucositis was confirmed by pathological findings in all 90 cases of the patients undergone their biopsy at the same time. Conclusions The appropriate standard of endoscopic diagnosis can improve the detection rate of duodenal white spot syndrome and there is a high coincidence rate between endoscopic diagnosis and pathological diagnosis.

Objective To construct stable chromokinesin KIF4A knockdown gastric cancer cell lines (SGC-7901) and study the mitotic spindle midzone formation in these cells.Methods Short hairpin RNA (shRNA) expression plasmids of pGPU-GFP-shKIF4A,pGPU-GFP-shNC specific targetting KIF4A and non-sense DNA sequences were constructed respectively and then transfected into SGC-7901 cells.The cells were cultured in selection medium containing G418 to form single clones.Stable KIF4A shRNA expressing SGC-7901 cells were picked up under an fluoroscent microscope and identified by Western Blot.The spindle midzone in these cells was analyzed after immunofluorescence staining.Results Three cell lines stably expressing KIF4A shRNA and one with shNC were successfully constructed.Compare to the control cell line,KIF4A knockdown cell lines represented remarkable elongation of spindle midzone and the less the KIF4A,the longer spindle midzone.Conclusions Stable KIF4A knockdown SGC-7901 cell lines were successfully constructed that can serve for further study of KIF4A ' s function and its role in proliferation and development of gastric cancer.

Objective To study the effects of serum of the Zhuartgguqiang jin tablets on the proliferation and osteogenic differentiation of bone marrow stromal stem cells (BMSCs) of aged rats.Methods The BMSCs were obtained from male SD rats of 18 months.The cell surface markers CD34,CD31,CD29 were detected by flow cytometry.The proliferation of BMSCs treated by different concentration of medicated serum (2.5％,5％,10％) at 24,48,72hours was detected by CCK-8 method.The BMSCs were divided into 4 groups,which were osteogenic induction group,the Chinese medicated osteogenic induction group,Chinese medicine group,the blank group.After the BMSCs were cultured for 7 days,alkaline phosphatase (ALP) vitality was detected.After the BMSCs were cultured for 14 days,the BMSCs were stained by alizarin red,the mRNA of ALP and osteocalcin(OC) was detected.Results The expressionof CD29 was positive,and the expression of CD31 and CD34 were negative.2.5％,5％ of the medicated serum could promote cell proliferation.The ALP vitality of osteogenic induction group[202.76 ± 15.44(U/gprot)],the Chinese medicated osteogenic induction group [240.48 ± 18.55 (U/gprot)],Chinese medicine group [178.87 ± 17.29 (U/gprot)]were significantly higher than that of blank group [111.24 ± 20.71 (U/gprot)] (t =22.50,7.985,3.535,all P ＜0.01).The ALP activity of Chinese medicated osteogenic induction group was higher than that of osteogenic induction group (t =3.103,P ＜ 0.05).The ALP gene relative OD value of osteogenic induction group (0.40 ± 0.20) and Chinese medicated osteogenic induction group (0.60 ± 0.06) were higher than the blank group (0.09 ± 0.03) (t =2.372,9.547,all P ＜0.01).The ALP gene expression of Chinese medicated osteogenic induction group was obviously higher than that of the osteogenic induction group(P ＜0.05).The OC gene relative OD value of osteogenic induction group(0.58 ± 0.09) and Chinese medicated osteogenic induction group(0.76 ± 0.11) were higher than the blank group(0.41 ± 0.02) (P ＜ 0.05,P ＜ 0.01).The OC gene expression of Chinese medicated osteogenic inductiongroup was obviously higher than that of the osteogenic induction group(t =2.673,P ＜ 0.05).Conclusion Medicated serum of Zhuangguqiangjin tablets can promote the proliferation and osteogenic differentiation of BMSCs of aged rats,which may be the mechanism of prevention senile osteoporosis.