Objective:To investigate the effect of β-elemene on mitochondrial structure and function of the A549 cells of non-small cell lung cancer(NSCLC),and to elucidate the mechanism of β-elemene in the treatment of NSCLC.Methods:The A549 cells at logarithmic growth stage were divided into blank control group(0 mng·L-1 β-elemene),low,medium and high doses of β-elemene groups(10,25 and 50 mg·L-1),and solvent control group(0.5％ethanol in equal volume).After treatment for 24 h,the cell activities in various groups were detected by MTT assay;the morphology changes of mitochondria in the cells in various groups was observed by transmission electron microscope;the levels of adenosine 5′-triphosphate(ATP)in the cells in various groups were detected by colorimetry;the mitochondrial membrane potential of the A549 cells in various groups were detected by JC-1 flow cytometry;mitochondrial membrane permeability transfer hole assay was used to detect the mitochondrial membrane permeabilities of the cells in various groups.Results:The MTT results showed that compared with blank control group,the cell activities in low,medium and high doses of β-elemene groups were decreased gradually(P＜0.05),while the cell activity in solvent control group had no significant change,and the difference was not significant(P＞0.05).The transmission electron microscope results showed that compared with blank control group,the mitochondria of A549 cells in low,medium and high doses ofβ-elemene groups showed swelling,vacuolation,disordered arrangement and dissolution,while the mitochondrial morphology of the A549 cells in solvent control group had no significant changes.The colorimetric method results showed that compared with blank control group,the ATP levels in the A549 cells in low,medium and high dose β-elemene groups were gradually decreased(P＜0.05),while the ATP level in the A549 cells in solvent control group had no significant change,and the difference was not significant(P＞0.05).The JC-1 flow cytometry method results showed that compared with blank control group,the mitochondrial membrane potential of the A549 cells in low,medium and high doses ofβ-elemene groups were decreased,and the percentages of the cells in Q2-4 region were increased(P＜0.05);the percentage of the A549 cells in the Q2-4 region in solvent control group had no significant change.The results of mitochondrial membrane permeability transfer hole experiment showed that compared with blank control group,the mitochondrial membrane permeabilities of the A549 cells in low,medium and high doses of β-elemene groups were increased,and the percentages of the cells in M4 region were increased(P＜0.05);the mitochondrial membrane permeability of the A549 cells and the percentage of the M4 cells in solvent control group had no significant changes,and the difference was not significant(P＞0.05).Conclusion:β-elemene can inhibit the proliferation of the A549 cells,and the mechanism may be that the mitochondrial structure of A549 cells is damaged by reducing the level of ATP and mitochondrial membrane potential,changing the mitochondrial morphology and increasing the mitochondrial membrane permeability.

Atypical lipomatous tumor(ALT)is a rare soft tissue sarcoma originating from adipocytic tissue.The clinical manifestations,imaging findings,and pathological examinations of one patient with ALT in the lower extremity were reported to provide reference for the clinical diagnosis and treatment of this disease.The patient was a 64-year-old male who was admitted due to a mass in the left thigh with swelling and pain for 5 years.The physical examination results showed a subcutaneous mass was palpable on the medial side of the left thigh,soft in texture,demonstrating good mobility and positive tenderness.The magnetic resonance imaging(MRI)non-contrast scan showed a well-defined lesion with an intact capsule.The lesion presented high signal intensity on T1-weighted image(T1WI),similar to subcutaneous fat signal;on T2-weighted image(T2WI)-Ideal in-phase images,the lesion showed high signal,while water images showed low signal,with multiple high-signal foci inside.On T2WI fat-suppression sequence,a low-signal mass was observed with multiple patchy high signals inside.Three days after admission,the patient underwent lesion resection.Intraoperatively,the tumor was located within the fascia,between the medial quadriceps muscles,presenting as lipomatous tissue with an intact capsule,mildly adherent to surrounding tissue,and with partial muscle invasion.The mass and invaded muscle were completely excised.The postoperative pathological examination results revealed a gray-yellow nodule measuring 16.0 cm.× 10.0 cm×4.0 cm,with a smooth surface and intact capsule.The cut surface was gray-yellow,fatty-like,and soft in texture.Additional gray-yellow tissue fragments were found,with a total volume of 5.0 cm×4.0 cm×1.2 cm,exhibiting a gray-brown cut surface with moderate texture.Under microscope,the lesion consisted mainly of relatively mature adipose tissue.Enlarged and hyperchromatic nuclei were observed,with scattered mononuclear or multinuclear atypical stromal cells.Fibrous septa contained variable numbers of univacuolated or multivacuolated lipoblasts.The immunohistochemistry results showed positivity for cyclin-dependent kinase 4(CDK4)and murine double minute 2(MDM2).The fluorescence in situ hybridization(FISH)results demonstrated MDM2 gene amplification in tumor cells.The pathological diagnosis was ALT of the left lower extremity.At 6-month follow-up after operation,no tumor recurrence was observed.The preoperative MRI detection may provide effective evidence for the diagnosis of ALT,while postoperative pathological examination can confirm the diagnosis and help evaluate the prognosis of the patients.

OBJECTIVE： To study the effects of glycyrrhizic acid on the pharmacokinetics of nifedipine in rats. METHODS： Rats were randomly divided into experimental group and control group， with 10 rats in each group. Experimental group was given glycyrrhizic acid 5 mg/kg and control group was given 0.5％ CMC-Na （sodium carboxymethylcellulose） solution， once a day， for 14 consecutive days. On 14th day after 30 min of intragastric administration， both groups were given nifedipine 3 mg/kg intragastrically. Blood samples 0.5 mL were collected from intraocular vein plexus before and at 0.25， 0.5， 0.75， 1， 1.5， 2， 3， 4， 6， 8， 12 and 24 h after intragastric administration. The concentration of nifedipine was determined by HPLC using diazepam as internal standard. The determination was performed on ODS-C18 column with mobile phase consisted of methanol-water （62 ∶ 38，     V/V，pH adjusted to 4.5 with acetic acid） at the flow rate of 1.0 mL/min. The column temperature was 30 ℃. The detection wavelength was set at 238 nm， and sample size was 20 μL. The pharmacokinetic parameters were calculated with Winonlin 6.0 software， and statistical analysis was performed by t-test. RESULTS： The main pharmacokinetic parameters of the experimental group and the control group were as follows as tmax was （1.40±0.15）， （1.50±0.01） h； cmax was （0.15±0.03）， （0.29±0.09）      mg/L； t1/2 was （4.70±1.17）， （5.20±1.38） h； AUC0-24 h were （1.00±0.10）， （1.89±0.37） mg·h/L； AUC0-∞ was （1.00±0.16）， （1.98±0.32） mg·h/L； MRT was （6.76±0.64）， （6.60±1.36） h， respectively. Compared with control group， cmax， AUC0-24 h and AUC0-∞ of nifedipine were decreased significantly in experimental group， with statistical significance （P＜0.05）. CONCLUSIONS： Glycyrrhizic acid can reduce the bioavailability of nifedipine in rats. It is suggested that the dosage of nifedipine should be increased in order to achieve effective blood concentration.

Heterotopic ossification is a rare complication of burns, and its incidence and risk factors are still unclear. Through summarizing the literature on heterotopic ossification caused by burns at home and abroad, the author searched for the risk factors of heterotopic ossification after burn and the new progress of its prevention and treatment. It was realized that the size, depth and healing time of burn wounds were related to heterotopic ossification; the nonsteroidal anti-inflammatory drugs, radiation therapy, and their combination therapy can be used for the prevention of heterotopic ossification; surgery is an effective means of treating heterotopic ossification.

Objective: To evaluate the curative effect of proximal fibula graft of vascular anastomosis for giant cell tumor(GCT) of distal radius of bone. Methods: 38 patients with distal radius GCT were treated with proximal articular graft of anastomotic vessels. We evaluated the wrist joint function before and after surgery using wrist activity, visual analogue scale(VAS)pain score, grip recovery rate and Cooney scoring system. Results: All patients′ wounds healed in stage I, and recovered smoothly during the perioperative period. No obvious wrist deformity was observed during the follow-up period. Bony union was achieved at the tibial and humerus osteotomy ends. The average healing time was 11 weeks. At third month postoperatively, the patient′s wrist motion ranged from dorsiflexion to palmar flexion (69.15±15.24)°, ulnar/spasm deviation was (22.74±10.55)°, grip strength was (88.69±12.75)%, wrist VAS pain The score was (2.45±1.11) points and the Cooney score was (89.58±11.25) points, which was significantly better than preoperation (all P<0.05). No recurrence or metastasis occurred during follow-up in all patients. Conclusions Distal humerus GCT treated with distal radius with vascular anastomosis with proximal graft of vascular has little effect on the activity of the lower extremities. However, its reconstruction of the wrist joint function might achieve better results.

Objective To study curative efficacy of radix notoginseng saponin dispersible tablets combined with rivaroxaban in treatment of tibial fracture after operation and its effects on joint function and the leves of inflammatory factors .Methods 90 patients of tibial fracture who received therapy from March 2014 to March 2016 in our hospital were selected.According to random number table,all elective surgery,those patients were divided into the observation group (n=45) and the control group (n=45),the control group was treated with radix notoginseng saponin dispersible tablets,while the observation group was treated combined with rivaroxaban.After two weeks of treatment, the hemorheology, inflammatory factors, joint function were compared between two groups.Results The patient swelling time and bed time in the observation group were shorter than the control group (P<0.05);after treatment,the levels of red cell volume, whole blood viscosity,fibrinogen in the observation group were lower than the control group (P<0.05);the levels of tumor necrosis factor TNF-α, IL-1,IL-6 in the observation group were lower than the control group (P<0.05);after treatment three months and six months,the Baird-Jackson scores in the observation group were higher than the control group (P <0.05).Conclusion Radix notoginseng saponin dispersible tablets combined with rivaroxaban is well for tibial fracture after operation,which can improve hemorheology,reduce the level of inflammatory factors,promote joint functional recovery.

Objective To study the interactions between the highly pathogenic avian influenza H5N1 nucleoprotein (H5N1 NP) and NF-κB-inducing kinase (NIK),and to reveal the effect of H5N1 NP on NIK-induced NF-κB transcriptional activity.Methods The gene encoding NIK protein was amplified by RT-PCR from total RNA of HeLa cell line.Eukaryotic expression plasmid pCMV-Myc-NIK and prokaryotic expression plasmid pGEX-4T-1-NP (GST-NP) were constructed by cloning from HeLa cell cDNA and pcDNA3-Flag-NP vector,respectively.Co-immunoprecipitation (co-IP) and GST pull-down were used to test the interactions between H5N1 NP and NIK.Dual-luciferase reporter gene analysis system was used to test the effect of H5N1 NP on NIK-induced NF-κB transcriptional activity.Results Co-IP and GST pull-down showed that pCMV-Myc-NIK and pGEX-4T-1-NP (GST-NP) could express Myc tagged NIK protein and GST tagged NP protein in HEK293T cells and E.coli,respectively,and that H5N1 NP was associated with NIK in vivo and in vitro.Dual-luciferase reporter gene analysis suggested that H5N1 could inhibit NIK-induced NF-κB transcriptional activity.Conclusion H5N1 NP interacts with NIK and inhibits NIK-induced NF-κB transcriptional activity.This finding can facilitate further study of H5N1.

BACKGROUND:For patients with degenerative mitral annulus dilatation complicated by atrial fibrilation, atrial fibrilation is needed to be treated concomitant with artificial valve ring implantation. Although Cox maze III procedure is the gold standard for treatment of atrial fibrilation, its safety has been questioned. OBJECTIVE:To evaluate the safety of artificial valve rings implantation and Cox Maze III procedure for treatment of degenerative mitral annulus dilatation complicated by atrial fibrilation. METHODS: A total of 43 patients with degenerative mitral annulus dilatation and atrial fibrilation were enroled and were randomly divided into test group (n=21) and control group (n=22). Patients in the test group were treated with mitral valvuloplasty and Cox Maze III procedure. Patients in the control group were only treated with mitral valvuloplasty. RESULTS AND CONCLUSION: (1) Intraoperative safety indexes: the durations of cardiopulmonary bypass and aortic clamping. and the incidence of hemoglobinuria in the test group were higher than those in the control group (P < 0.001). There was no significant difference in the urine output between these two groups. (2) Postoperative safety indexes: the incidence of atrial dysrhythmia (i.e., any atrial dysrhythmia other than atrial fibrilation), proportion of patients requiring a temporary pacemaker and hospital stays in the test group were higher than those in the control group (P < 0.05). There were no significant differences in the secondary-thoracotomy bleeding rate and incidence of stroke between these two groups. (3) Postoperative outcomes: the rates of cardioversion to achieve sinus rhythm at the day of surgery and at discharge in the test group were significantly higher than those in the control group (P < 0.001). At discharge, patients in both groups were al at NYHA functional class Ior II. Echocardiography showed trace to mild mitral regurgitation and complete closure of the tricuspid valve. There were no significant differences in the left atrial diameter, left ventricular diameter, left ventricular volume, and ejection fraction between these two groups. However, the proportions of mitral and tricuspid valve peak A-waves were significantly higher than those in the control group (P < 0.001). These results show that artificial valve ring implantation and Cox Maze III procedure is a safe and effective method for treating degenerative mitral annulus dilatation complicated by atrial fibrilation during operation.

BACKGROUND:Incidence of degenerative mitral regurgitation show a gradual increase tendency,but there is no report on degenerative mitral regurgitation due to pure mitral valve ring expansion in China.OBJECTIVE:To summarze the early and midterm outcomes of pure mitral valve annuloplasty in the treatment of degenerative mitral regurgitation due to pure mitral valve ring expansion. METHODS :Forty-eight patients with degenerative mitrlal regurgitation due to pure mitral valve ring expansion underwent pure mitral valve annuloplasty, including 23 cases treated with Carpentier-Edwards Physio ring and 23 with SJMTM rigid saddle ring.Affter discharge,echocardiography was used to evaluate heart function and mitral regurgitation degree during the follow-up.The outcomes were compared between the two groups. RWSULTS AND CONCLUSION:There was no early death after operation and all cases were cured and discharged.All patients were followed up for 3 months to 4years,and the cardiac function and mitral valve regurgitation were significantly improved (no mitral regurgitation in 36 cases,trivial regurgitation in 10 cases and mild mitral regurgitation in 2cases).According to NYHA grading,there were 32 cases of level 1 and 16 ceses of level Ⅱ. The echocardiography showed that postoperative left atrium diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, pulmonary artery systolic pressure and the ratio of regurgitation beam area to left atrial area were significantly lower than those before operation (P < 0.01). The left ventricular ejection fraction increased greatly (P < 0.01). There was no ring rupture, ring avulsion and hemolysis. Postoperative transvalvular pressure was less than 3 mm Hg. However, there were no significant differences in the above-mentioned parameters between the Carpentier-Edwards Physio ring and SJMTM rigid saddle ring groups. The results suggest that the pure mitral valve annuloplasty is excelent in the treatment of degenerative mitral regurgitation due to pure mitral valve ring expansion, through the right surgical techniques and the right choice of artificial valve ring.

BACKGROUNDBilateral transpedicular screw fixation in conjunction with interbody fusion is widely used to treat lumbar degenerative diseases; however, there are some disadvantages of using this fixation system. This study comparatively analyzes the results of unilateral and bilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion (TLIF) for one-level lumbar degenerative diseases.

METHODSSixty-six cases with one-level lumbar degenerative diseases were studied. The patients were divided according to surgical approach into a unilateral group (Group A) and a bilateral group (Group B). The patients were evaluated for pain by visual analog scale (VAS) and Oswestry Disability Index (ODI). Operating time, blood loss, duration of hospitalization, and complication rate were also evaluated. Patients were examined at 1, 3, 6, and 12 months postoperatively and every year thereafter.

RESULTSGroup A patients' average preoperative VAS and ODI scores were 7.03 ± 0.98 and (64.22 ± 6.38)%, respectively, significantly decreased to 2.91 ± 0.88 and (14.42±2.08)%, respectively, at the last follow-up (P = 0.000). In Group B, the average preoperative VAS and ODI scores were 6.79 ± 0.86 and (63.22 ± 4.70)%, respectively, significantly decreased to 3.12 ± 0.96 and (14.62 ± 2.08)%, respectively, at the last follow-up (P = 0.000). No significant difference in the duration of hospitalization was found between groups. Operating time and blood loss of (125.9 ± 13.0) minutes and (211.4 ± 28.3) ml, respectively, in Group A were significantly less than (165.2 ± 15.3) minutes and (258.6 ± 18.3) ml, respectively, in Group B (P = 0.000). All patients achieved good bone union and had no pseudarthrosis at the last follow-up.

CONCLUSIONSThere are no clinical differences between unilateral and bilateral pedicle screw fixation combined with TLIF for one-level lumbar degenerative diseases. Unilateral fixation reduces operating time, bleeding, and cost of hospitalization.