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Abnormal expression of miR‐409‐3p has been found in several neurodevelopmental disorders, but whether it is dysregulated in the patients with acute cerebral infarction (ACI) has not been evaluated. The current study mainly focused on the clinical significance and the underlying mechanism of plasma miR‐409‐3p in the progression of ACI. The level of plasma miR‐409‐3p was determined in ACI patients (n = 80) and healthy controls (n = 30). Pearson correlation assay was performed to evaluate the association and cardiovascular risk factors. A receiver operating characteristic curve (ROC) was used to evaluate the diagnostic value of plasma miR‐409‐3p levels in patients with ACI. Dual luciferase reporter assay and western blot were performed to determine the possible target gene of miR‐409‐3p. Our data showed that the expression of plasma miR‐409‐3p in the ACI group was higher than that in the healthy controls. Furthermore, Pearson correlation analysis indicated a positive correlation between plasma miR‐409‐3p and the NIHSS score. ROC analysis indicated that plasma miR‐409‐3p could differentiate plasma miR‐409‐3p in ACI patients from healthy controls. Then, we explored the possible target genes of miR‐409‐3p. Interestingly, C1q and TNF‐related 3 (CTRP3), a novel adipose tissue‐derived secreted factor, was found to be a target gene of miR‐409‐3p. We found that knockdown of CTRP3 significantly induced PC12 cell apoptosis, even in PC12 cells transfected with miR‐409‐3p inhibitor. These data suggested that miR‐409‐3p induced PC12 cell apoptosis by targeting CTRP3. Altogether, elevated plasma miR‐409‐3p is correlated with disease severity and may be efficient for the early diagnosis of ACI.

Zicuiyin (ZCY) decoction created by Xichun Zhang in the Qing dynasty has been used on diabetes mellitus and complications for more than two centuries in China. Huangkui capsule (HKC) is a listed Chinese patent medicine to treat diabetic kidney disease (DKD). To determine whether ZCY is non-inferior to HKC in the treatment of DKD, a multicenter, parallel-control, open-label, randomized clinical trial was conducted.In this clinical trial, 88 DKD patients were recruited at three centers in Tianjin from January 2018 to December 2019. They were randomized to receive HKC (2.5 g, TID) or ZCY (crude drug amount 75 g, 150 ml, BID) for eight weeks based on routine treatment. The primary outcome was the change of estimated glomerular filtration rate (eGFR). The secondary outcomes included change of serum creatinine (SCr), urinary albumin excretion rate, 24 h urinary protein, urinary albumin-creatinine ratio, glycosylated hemoglobin A1c, symptom scores, and microbiota compositions profiles.The change of eGFR in HKC and ZCY groups were -7.08 ± 24.65 and 2.57 ± 18.49 ml/min/1.73 mZCY had better efficacy in improving and protecting kidney function. It would be an alternative option to treat DKD, especially those who decline eGFR and gut microbiota dysbiosis.Chinese Clinical Trial Registry: ChiCTR-OON-17012076. Registered July 21, 2017.

To investigate the effect of acupuncture on behavior changes and the expression of reactive oxygen species (ROS), cytochrome C, cysteine-containing aspartate-specific proteases-3 (caspase-3), apoptosis inducing factor (AIF) in the hippocampus of rats exposed to chronic restraint stress (CRS), so as to provide experimental evidence for the prevention and treatment of depression.Thirty two male SD rats were equally randomized into control, model, acupuncture and medication (Fluoxetine) groups according to the random number table. The depression model was established by chronic psychological stress stimulation (fasting, water deprivation, chronic restraint combined with solitary raising for 28 days). Manual acupuncture stimulation (2 circles/s) was applied to "Baihui" (GV20), "Yintang" (GV29) and bilateral "Sanyinjiao" (SP6) for 2 min, followed by retaining the needles for 20 min. Rats in the medication group were treated by gavage of Fluoxetine (0.18 mg/mL, 1 mL/100 g body weight). The treatment was conducted once daily for 28 days. The depression-like behavior was evaluated by using open-field test, sucrose preference test, and body weight. The content of ROS of the right hippocampus tissue was detected by using dichloro-dihydro-fluorescein diacetate (DCFH-DA) assay, and the expression levels of cytochrome C, caspase-3 and AIF proteins of hippocampus were determined by using Western blot.After 28 days' stress procedure, the depression rats in the model group showed a significant decrease in the numbers of crossing and rearing of open-field test, sucrose preference index and the body weight compared to the control group (Acupuncture intervention can significantly reduce ROS content and expression level of cytochrome C, caspase-3 and AIF proteins in the hippocampus possibly by inhibiting the chronic psychological stress-hippocampal oxidative stress-mitochondrial apoptotic pathway in psychological stress-induced depression rats, which may contribute to its effect in relieving depression.

Early diagnosis of CKD patients at risk for microalbuminuria or macroalbuminuria could facilitate clinical outcomes and long-term survival. Considering the few and limited efficacy of current biomarkers in early detection, we aim to discover plasma lipids that effectively predict the development of CKD paitents with microalbuminuria or macroalbuminuria. A total of 380 healthy controls and 1156 patients with CKD stages 3 to 5 were stratified by urine albumin-creatinine ratio as microalbuminuria (30-300 mg/g) and macroalbuminuria (>300 mg/g). Fasting plasma samples were determined by UPLC-HDMS based on lipidomics. Quantitative real-time polymerase chain reaction, Western blot and immunohistochemical analyses were used to validate the lipid metabolism-associated pathways. Pathway analysis demonstrated that these lipids were closely associated with PPARγ, inflammatory mediator regulation of TRP channels and RAS signaling, which were intimately involved in activated NF-κB and Nrf2 pathways. We further carried out pathway validation and demonstrated that NF-κB pathway was activated in patients with macroalbuminuria compared with CKD patients with microalbuminuria, while Nrf2-associated protein expression was downregulated, which was accompanied by the up-regulation of Wnt/β-catenin signaling pathway. Four lipids including DTA, 5,8-TDA, GGD3 and DHA that showed great potential in the discrimination of CKD patients with microalbuminuria and healthy controls were selected by logistic regression analysis. Additionally, six lipid species including CDCA, glucosylceramide, GGD2, TTA, DHA and EDA that contributed to the discrimination of CKD patients with microalbuminuria and macroalbuminuria were selected by logistic LASSO regression Gangliosides were first identified and might be promising therapeutic targets for CKD patients with the different degree of albuminuria. Collectively, this study first demonstrates the association of plasma inflammation, oxidative stress, Wnt/β-catenin and lipid metabolism in CKD patients with microalbuminuria and macroalbuminuria.

To investigate the effect of acupuncture intervention on the depression behavior and expression of extracellular signal-regulated protein kinases (ERK 1/2), p-ERK 1/2 and brain-derived neurotrophic factor (BDNF) in the prefrontal cortex of chronic unpredictable mild stress (CUMS) induced depression rats, so as to explore its antidepressant mechanism.Sixty-four male SD rats were randomly divided into control, model, acupuncture, Fluoxetine, model ＋ Dimethyl sulfoxide (DMSO), model ＋ PD 98059(an ERK pathway inhibitor), acupuncture ＋ PD 98059 and Fluoxetine ＋ PD 98059 groups (Compared with the control group, the sucrose consumption and the expression levels of p-ERK 1/2 and BDNF protein in the prefrontal cortex were significantly reduced in the model and model＋DMSO group (Acupuncture intervention has an anti-depressive role in CUMS induced depression rats, which may be related to its effects in up-regulating the expression of p-ERK 1/2 and BDNF in the prefrontal cortex tissue.

The aim of this study was to review the ultrasonographic features of secondary intussusception (SI) in children and assess the value of ultrasound in the diagnosis of pediatric SI. The authors performed a retrospective analysis on the ultrasound findings of 1977 cases of primary intussusception (PI) and 37 cases of SI in children. The SI cases were diagnosed by ultrasonography and confirmed by laparotomy or histopathologic diagnosis. The clinical and ultrasonographic features were analyzed and compared between these two groups. The age, no flatus or defecation, position, diameter and length of intussusception, the presence of free intraperitoneal liquid, and intestinal dialation at the proximal end present, all contributed to the differentiation between PI and SI (all P < 0.05). Ultrasound was able to demonstrate the pathological lead point (PLP) shadows in all of the 37 SI cases, either in the cervical part or intussusceptum of the intussusception. Among the 37 SI patients, 21 cases (56.8 %) were accurately categorized with lesions, including intestinal polyps, cystic intestinal duplication, intestinal wall lymphoma, and a small part of Meckel's diverticulum. Ultrasound can be used as a feasible and effective method to discriminate PI from SI. Once the PLP is detected, a definite diagnosis can be made. • The clinical and ultrasonographic features were compared between SI and PI. • The age, location, diameter and length of intussusception, and intestinal dilation were distinguishing features. • The causes of SI were found to be polyps, intestinal duplication, lymphoma, and Meckel's diverticulum. • Ultrasound can be used as an important method to diagnose SI. • Demonstration and confirmation of PLP are vital to diagnosing SI.

Vasoepididymostomy (VE), as the most challenging procedure in microsurgeries, is often carried out with a double-armed two-suture technique. In this study, we evaluated the efficacy and safety of the single-armed two-suture VEs on humans and studied the factors that could possibly affect the patency rates. From July 2012 to July 2013, we reviewed 81 patients with consecutive primary epididymal obstruction who underwent single-armed two-suture longitudinal intussusception microsurgical VEs by a single surgeon, Kai Hong (KH). At the same time, we analyzed seven factors that possibly related to the patency rates. With the single-armed technique, a total of 81 men underwent the microsurgical VEs. Data on 62 patients were completely recorded. 19 patients were lost to follow-up. Mean age was 31 years old. Mean follow-up time was 8.8 (2-17) months. The patency rate was 66.1% (41/62). Natural pregnancy rate was 34.1% (14/41). Overall pregnancy rate was 22.6% (14/62). No severe surgical complications were noted. With logistic regression test analysis, there were two factors related to a higher patency rate: anastomosis sites (P = 0.035) and motile sperm found in the epididymal fluid (P = 0.006). Motile sperm found in the epididymal fluid were associated with a higher patency rate (OR = 11.80, 95% CI = 1.79, 77.65). The single-armed two-suture longitudinal VE technique is feasible for microsurgical practice. The patency and pregnancy rates are comparable to the doubled-armed technique. Anastomosis sites and motile sperm found in the epididymal fluid were the most two important factors related to higher patency.

Background/Aims: Cerebral ischemia-reperfusion (I/R) injury involves multiple independently fatal terminal pathways. CK2α/NADPH oxidase is an important signaling pathway associated with ischemia-reperfusion injury, and miR-125b can regulate oxidative stress-related injury. In this study, we investigated whether the effect of miR-125b in rat brain I/R injury occurs through its modulation of the CK2α/NADPH oxidase pathway. Methods: Rats were subjected to 2 h of cerebral ischemia followed by 24 h of reperfusion to establish an I/R injury model. Neurological deficit was evaluated using a five-point score. Infarct volume was evaluated with 2, 3, 5-triphenyltetrazolium chloride (TTC) staining, and RT-PCR was used to detect expressions of miR125b and CK2α. We then examined the association between miR-125b expression and the CK2α/NADPH oxidative signaling pathway in a PC-12 cell oxygen-glucose deprivation and reoxygenation (OGD/R) injury model. Transfection with miR-125b mimics, an miR-125b inhibitor, and luciferase reporter gene plasmid was accomplished using commercial kits. In these cells, Western blots were used to detect the levels of expression of CK2α, cleaved caspase-3, NOX2, and NOX4. RT-PCR was used to detect the expressions of CK2α, miR125b, NOX2, and NOX4. We evaluated Lactate Dehydrogenase (LDH) level, NADPH oxidase activity, and caspase-3 activity using commercial kits. Mitochondrial reactive oxygen species (ROS) were measured by fluorescence microscopy. For both PC-12 cells and rat brains, histological analyses were conducted to observe morphological changes, and apoptosis was measured using a commercial kit. Results: I/R rats exhibited an increase in neurological deficit score, infarct volume, and cellular apoptosis, along with miR-125b elevation and CK2α downregulation. OGD/R treatment increased PC-12 cells’ injuries, cellular apoptosis, and ROS levels. These changes were associated with miR-125b elevation, CK2α downregulation and activations of NOX2 and NOX4, mimicking our in vivo findings. All of these effects were reversed by the inhibition of miR-125b, confirming a strong correlation between miR-125b activity and the CK2α/NADPH oxidase signaling pathway. Conclusions: Based on these observations, we conclude that inhibition of miR-125b protects the rat brain from I/R injury by regulating the CK2α/NADPH oxidative signaling pathway.

Age-dependent bone loss occurs in humans and in several animal species, including rodents. The underlying causal mechanisms are probably multifactorial, although an age-associated increase in the generation of reactive oxygen species has been frequently implicated. We previously reported that aromatic amino acids function as antioxidants, are anabolic for bone, and that they may potentially play a protective role in an aging environment. We hypothesized that upon oxidation the aromatic amino acids would not only lose their anabolic effects but also potentially become a catabolic byproduct. When measured in vivo in C57BL/6 mice, the tryptophan oxidation product and kynurenine precursor, N-formylkynurenine (NFK), was found to increase with age. We tested the direct effects of feeding kynurenine (kyn) on bone mass and also tested the short-term effects of intraperitoneal kyn injection on bone turnover in CD-1 mice. μCT analyses showed kyn-induced bone loss. Levels of serum markers of osteoclastic activity (pyridinoline [PYD] and RANKL) increased significantly with kyn treatment. In addition, histological and histomorphometric studies showed an increase in osteoclastic activity in the kyn-treated groups in both dietary and injection-based studies. Further, kyn treatment significantly increased bone marrow adiposity, and BMSCs isolated from the kyn-injected mice exhibited decreased mRNA expression of Hdac3 and its cofactor NCoR1 and increased expression of lipid storage genes Cidec and Plin1. A similar pattern of gene expression is observed with aging. In summary, our data show that increasing kyn levels results in accelerated skeletal aging by impairing osteoblastic differentiation and increasing osteoclastic resorption. These data would suggest that kyn could play a role in age-induced bone loss. © 2017 American Society for Bone and Mineral Research.

Aneurysm recurrence is a principle limitation of endovascular coiling procedures, especially in posterior communicating artery aneurysms, with reported recurrence rates of >30%. The adjunctive use of self-expandable stents has revolutionised the treatment of intracranial aneurysms, especially for complex morphologies, wide necks, or unfavourable dome-to-neck ratios. However, there are limited data concerning a direct comparison between simple coiling and stent-assisted coiling in posterior communicating artery aneurysms. This study aimed to compare the durability and outcomes of coiling versus stent-assisted coiling procedures. Imaging data of patients with posterior communicating artery aneurysms treated with coiling or stent-assisted coiling between January 2008 and October 2012 were retrospectively analysed. The initial angiographic results, procedural complications, and clinical outcomes were assessed at discharge. Imaging follow-up was performed with cerebral angiography. Complete aneurysm occlusion was achieved on initial angiography in 23/56 (41.1%) stent and 83/235 (35.3%) non-stent patients. At the latest follow-up (mean follow-up 14.3 ± 10.4 months for stent and 13.2 ± 9.5 months for non-stent patients), aneurysms had recurred in 5/47 (10.6%) stent and 57/203 (28.1%) non-stent patients (p = 0.014). Procedural complications occurred in 6/56 (10.7%) stent and 27/235 (11.5%) non-stent aneurysms. No rebleeding occurred during clinical follow-up (mean duration, 46.7 months). Recurrence rates at the latest follow-up were significantly lower in patients undergoing stent-assisted coiling than those undergoing simple coiling. Thus, use of the stent-assisted neck remodelling technique in the treatment of wide-necked posterior communicating artery intracranial aneurysms appears to improve the long-term clinical outcome.

To discover novel cell division cycle 25 (CDC25) B inhibitors and elucidate the mechanisms of inhibition in cancer cells. Nineteen 2'-hydroxy-4'-isoprenyloxychalcone derivatives (a-s) were evaluated the inhibition CDC25B activity. The enzymatic activities of the CDC25B catalytic domain were determined by monitoring the dephosphorylation of OMFP. Cell growth inhibition was detected by MTT assay. The results showed that sixteen compounds significantly inhibited cycle 25B phosphatase in vitro. Among, three compounds k, r and s had the best inhibition activity and significantly inhibited CDC25B with inhibition rates against CDC25B of 99.95%, 99.75%, and 97.77%, respectively, which is similar to the reference drugs Na3VO4 (98%). Cytotoxic activity assays showed compounds k and r are the potent against HCT116, HeLa, and A549 cells, moreover, compound k delayed the potent tumor inhibitory activity in a colo205 xenograft model in vivo.

Rhynchosia volubilis Lour has been a major drug in a folk prescription for contraception in China, whereas its mechanism remains unknown. Its antifertility effects on male mice and antimicrobial activities on sexually transmitted infection (STI) pathogens were previously reported. This study was undertaken to develop the n-Butanol extract of Rhynchosia volubilis Lour (BERVL) as a spermicidal agent with STI prevention. The spermicidal activities of BERVL with different doses were assessed using selected high-motile sperms of normal human semen samples, and their inhibitory effects on Lactobacillus acidophilus were determined. The mechanism of the spermicidal activity was explored by aqueous Eosin Y and Hoechst 33342/PI staining. The results showed spermicidal activities and inhibitory effects of BERVL on Lactobacillus acidophilus were dose-dependent. Dose of 90 mg/mL BERVL terminated all progressive sperm motility within 2 min, and had slight inhibitory effect on Lactobacillus acidophilus, suggesting it was an effective and safe dose for contraception use. About 80% sperms exposed to BERVL displayed changes consistent with high permeability of head membrane. It is concluded that BERVL as spermicide has advantages over N-9 with strong ability to instantaneously kill human sperm and possesses light inhibitory effect on Lactobacillus acidophilus.

The purpose of this study was to characterize clinical features and evaluate the clinical outcome of endovascular embolization treatment intracranial arteriovenous malformations in pediatric patients. A cohort of children (age ≤ 18 years) with arteriovenous malformations (AVMs) from 2000 to 2012 was included. Predictors studied included patient gender, age, and angioarchitectural features, including AVM location, nidus morphology and size, venous drainage, and associated aneurysms. Treatment method, complications and outcomes were recorded. The features of AVMs were evaluated before the treatment. One hundred twenty-seven children (77 males, mean age 13.2 years) were included; 90/127 (70.9 %) children were presented with hemorrhage. AVM size and deep venous drainage were independently associated with hemorrhage; 66/127 patients (52 %) treated with endovascular embolization. Complete obliteration at the end of all endovascular procedures was achieved in 14/66 patients (21.2 %), with an average of 78 % (range, 20–100 %) volume reduction. A mean of 2.9 (range, 1–9) feeding pedicles was embolized per patient. Overall, nine complications occurred in a total of 123 procedures (7.3 %). There was no procedure-related death in this study population. There was no significant difference between patients with and without complications in terms of AVM grade, demographic characteristics, or embolization features. AVM size and deep venous drainage were independently associated with hemorrhage in pediatric patients. Endovascular procedure is feasible and safe for pediatric AVMs, and complete embolization can be achieved in small AVMs, while large AVMs can be adequately reduced in size for additional microsurgery or stereotactic radiosurgery.

BACKGROUND AND PURPOSE: The incidence of unruptured intracranial aneurysms is increasing in the elderly population as life expectancy increases, and patients often present with headache. The goal of this study was to determine the effect of endovascular treatment on headache and identify factors associated with headache outcome in elderly patients with unruptured intracranial aneurysms. MATERIALS AND METHODS: A retrospective study was conducted for elderly patients (≥ 65 years old) being treated for unruptured intracranial aneurysms. Headache assessment was performed by a quantitative 11-point headache scale in all patients before and after endovascular treatment. Factors associated with headache outcome were investigated by univariate analyses. RESULTS: A total of 72 patients (mean age, 70.0 years; age range, 65–80 years; 41 women) fulfilled the inclusion criteria. There were 52 patients (72.2%) who presented with preoperative headache (headache score ≥ 1). Among them, 40 (76.9%) reported that headache score had an improvement according to their self-reported quantitative headache score after endovascular treatment. The average headache score was 5.63 preoperatively vs 2.50 postoperatively ( P = .000). Twenty patients (27.8%) had no headache before treatment (headache score = 0), of whom 2 (10.0%) reported new onset of headache postoperatively. Only a preoperative headache score was associated with treatment outcome of headache, and a higher headache score predicted a lack of headache relief after endovascular treatment ( P = .003). CONCLUSIONS: Endovascular coiling of unruptured intracranial aneurysms resulted in relief of headache in most of the elderly patients. Preoperative headache score was the only statistically significant predictor of headache outcome.

The aim of this study was to assess the diagnostic value of ultrasonography for juvenile polyps in children and their sonographic characteristics. A retrospective analysis was performed of the ultrasound findings in 27 children who were diagnosed preoperatively with juvenile polyp within the intestinal tract by ultrasonography and then confirmed by colonoscopy, laparotomy and histopathology. The ultrasonic finding common to all polyps was an isolated intraluminal nodular or massive protrusion, associated with multiple mesh-like fluid areas of different sizes. In 25 children, surrounding pedicle-like low echoes of varying lengths were seen connecting with the polyps to form “mushroom” sign. The color Doppler showed abundant blood flow signals within all polyps and pedicles in a shape of a branch or an umbrella. For seven children with an intussusception, the polyp shadow was detected in the cervical part or interior of the intussusception. Ultrasonography is, thus, considered to be a feasible method for diagnosing intestinal juvenile polyp.

Background At present, little information has been made available in the evaluation of renal volume in pediatric groups of different ages. Purpose The purposes of the study are to evaluate the relationship between anthropometric measurements and renal volume measured with three-dimensional ultrasonography in Chinese children who have normal kidneys, and to attempt to develop reliable reference values of renal volume to estimate the renal sizes. Methods A total of 1572 Chinese Han children suffering from stomachache, cryptorchidism and neurogenic enuresis with no history of renal disease or pathological abnormalities that might affect measurements, aged 1month to 12years (mean, 5.64years) were examined bilateral kidneys by ultrasonography. The measurements of renal volume were determined using QLAB software in IU22 units (Philips Medical Systems, Holland). Anthropometric indices including sex, age, height and weight were collected for reviewed analysis. Results A total of 1683 children were included, and renal volume of 1572 cases (93.4%) was accepted. There was no significant difference between renal volumes of male and female separately in left and right kidneys ( P =0.844 and P =0.621, respectively), whereas there was a significant difference between mean left and right renal volumes ( P =0.000). Age, height and weight were all significant correlations with renal volume (R 2 , 0.885 and 0.913 for the left and right kidneys, respectively, both P =0.000), and age was the strongest correlation with renal volume (r, 0.472 and 0.399 for the left and right kidneys, respectively) among the anthropometric indices. We drew regression equations to estimate renal volume as follows: left renal volume (cm 3 )=0.441×age+0.156×height+0.398×weight+6.677 and right renal volume (cm 3 )=0.256×age+0.195×height+0.632×weight+1.788, and developed reference values of renal volume separately for the left and right kidneys in different age groups. Conclusions Regression equations have been developed, which define the renal volume from three-dimensional ultrasonography and may assist pediatricians in monitoring renal growth and detecting of unsuspected bilateral increases or decreases in renal size.

To investigate the significance of dynamic monitoring of procalcitonin (PCT) in guiding the use of antibiotics for treating patients with sepsis in intensive care unit (ICU).Eighty-two patients with sepsis from January 2012 to June 2013 hospitalized in ICU of First Hospital of Jilin University were enrolled, and they were randomly divided into regular antibiotic therapy group (RAT group, n=40) and PCT monitoring in guiding the use of antibiotics group (PCT group, n=42). Patients in RAT group were treated according to principle of antibiotics usage, while in PCT group patients' PCT value was observed everyday. When no active symptoms of infection were shown, and acute physiology and chronic health evaluation II (APACHEII) scores declined, PCT value decreased over 90% or PCT value lower than 0.25 μg/L time point were selected as drug withdrawal indication. The general status of the patient, antimicrobial drug use time, and prognosis were compared between the two groups, and Kaplan-Meier method was used for survival curve analysis. Variance analysis was used for repeating measurement to observe dynamic serum PCT level of the two groups of patients for survival and death during 7 days.Mann-Whitney U test or χ(2) test showed that there were no statistical significance in age, gender, APACHEII score, blood culture positive rate, sputum culture positive rate, cardiac insufficiency, renal failure, respiratory failure, and ventilator and hemofiltration usage (all P0.05). Log Rank test results showed that the time of antimicrobial drug usage was significantly reduced in PCT group than that in RAT group [days: 8.1±0.3, 95% confidence interval (95%CI 8.3-9.7) vs. 9.3±0.3 (95%CI 8.7-10.1), P=0.013]. Kaplan-Meier univariate survival curves showed that the speed of curve declination in PCT group was faster significantly than that in RAT group, suggesting that the time of using antimicrobial drug was shortened. There was no significant difference in length of hospital stay, ICU stay time, number of death in 28 days, number of cases of recurrence in 28 days and clinical cure rate between two groups (all P0.05). PCT level in non-survivors in both groups was significantly higher than that in the survivors, exceeding more than 10 μg/L in the early and late stages of treatment.Dynamic monitoring of PCT can effectively reduce antimicrobial drug use in ICU patients with sepsis, but there is no significant difference in patients' prognosis.

Summary Purpose The recovery time of traumatic carotid-cavernous fistula-induced oculomotor nerve paresis (ONP) after endovascular embolization with detachable balloons has not yet been adequately evaluated. This study was performed to make a deep analysis of the factors, which affect the prognosis of ONP after endovascular treatment of traumatic carotid-cavernous fistula (TCCF). Materials and methods We retrospectively evaluated the clinical characteristics and the outcome of oculomotor nerve function in a series of 98 consecutive patients with ONP due to traumatic carotid-cavernous fistula which were endovascular treated with detachable balloons. Univariate analysis was applied to test the association between the time of ONP recovery and clinical variables. Results Ninety-eight consecutive patients (62 males, 36 females, mean age 34.2 ± 12.7 years) having presented with ONP underwent endovascular treatment with detachable balloons were enrolled in this study. ONP was complete in 22 (22.4%) patients and partial in 76 (77.6%) patients. Ninety (91.8%) patients were successfully occluded by single-session endovascular embolization. Retreatments by transarterial routes had to be performed in 8 (8.2%) patients because of recurrent fistula having occurred within 4 weeks after embolization. ONP was recovered completely in all the patients, among who 4 (4.1%) were treated with occlusion of internal carotid artery. Factors showing significant association with the recovery time of ONP were the location of the fistula (P = 0.007), the degree of preoperative ONP (P = 0.003), the number of detachable balloon used (P = 0.000) and the length of ONP before endovascular treatment (P = 0.000). Conclusion Endovascular treatment of traumatic carotid-cavernous fistula-induced ONP with detachable balloons is a safe and effective method. The length of ONP before endovascular treatment, the location of the fistula, the degree of preoperative ONP, the number of detachable balloons used were the statistically significant predictors of the length of ONP complete recovery.

To evaluate the efficacy of Kirschner wires and tension-band fixation through posterolateral minimal incision for the treatment of displaced supracondylar humeral fractures in children.From January 2005 to December 2010, there were 62 children (38 males and 24 females, ranging in age from 2 to 14 years, averaged 6.8 years) with Gartland type III supracondylar humeral fractures. All the injuries were caused by falling, and all the fractures were fresh injuries. The duration from injury to surgery ranged from 5 to 20 hours. All the children were treated with open reduction through a posterolateral minimal approach, Kirschnere wires and tension-band fixation were fixed with plaster at 90 degrees of elbow flexion, forearm supination, and palms facing upwards. The kirschner pins and wires were removed after fractures healing. The Flynn's criterion was used to evaluate therapeutic effects.The operation time ranged from 30 to 50 min (averaged 45 min). All the patients achieved solid union. Sixty patients were followed up, and the mean follow-up time was 15 months (ranged from 6 to 24 months). At the 6th month after operation, 48 patients got an excellent result, 9 good, 3 bad (light cubitus varus with varus angle about 6 degree, without infection on function) according to Flynn's criteria. There were no complications such as procedure-related pin tract infection, iatrogenic nerve and vascular injuries and myositis ossificans.The Kirschner wires and tension-band fixation through posterolateral minimal incision approach can obtain clearer surgical field, simple in operation, and few wound complications. Therefore, this modified treatment is an effective and reliable method for pediatric displaced Gartland type III supracondylar humeral fractures.

We have investigated the expression and role of the 58-kDa micro-spherule protein (MSP58) in hepatocellular carcinoma (HCC). Immunohistochemistry was performed in 252 samples from patients with HCC to detect the expression level of MSP58. Results indicated that the expression level of MSP58 in the cancer samples was significantly higher than that in adjacent normal tissues. The Wilcoxon–Mann–Whitney test showed significant difference in the expression of MSP58 in patients with serum AFP, tumor size, histological differentiation, and universal integrated circuit card (UICC) stage (P < 0.001, P = 0.004, P < 0.001, P < 0.001, respectively). A total of 252 HCC patients were followed up for five consecutive years, and Kaplan–Meier survival analysis demonstrated that the survival time of HCC patients with low expression of MSP58 was longer than those with high expression during the 5-year follow-up period (P < 0.001). Cox regression analysis indicated that high expression of MSP58 (++ or +++), serum AFP (≥25 μg/L), tumor size (≥3 cm), and UICC stage (III or IV) were the independent poor prognostic factors of HCC (P = 0.008, 0.0290, 0.001, 0.047, respectively). Furthermore, down-regulation of MSP58 was introduced to HCC cell lines (HepG2 and Huh7) by plasmid transfection. In vivo and in vitro studies indicated that MSP58si markedly reduced proliferation and promoted the apoptosis of HepG2 and Huh7 cells. In summary, our results demonstrated that MSP58 played an important role in the proliferation and apoptosis of HCC cells and the expression of MSP58 in HCC patients was closely related to the prognosis.

At present, the diagnostic criteria of congenital cholangiectasis are still vague.The aim of this study was to assess the diameter references of the common bile duct (CBD) in pediatric population in different age groups with ultrasound.The diameter of the common bile duct was measured with ultrasound in 343 Chinese Han children aged 1 day to 14 years (mean: 3.2 years, median: 2.8 years) who were all free of hepatic and biliary tract disease. The ultrasound records, gender, and age were collected for reviewed analysis.A total of 343 children were included, and the CBD was clearly detected in 322 cases (93.9%). The mean diameter of this population was 1.58 ± 0.70 mm. (ranging from 0.4 to 4.4mm). Spearman correlation analysis showed that the diameter of CBD was positively associated with age (r=0.573, P0.001). The percentile method demonstrated that the diameter references of CBD was as follows: ≤ 1 years: ≤ 2.26 mm; ≤ 4 years: ≤ 2.99 mm; ≤ 7 years: ≤ 3.03 mm; and ≤ 14 years: ≤ 4.10mm.There was a close correlation between CBD width and the age. The range of CBD widths in each age group will be helpful in the diagnosis of biliary dilatation in childhood.

Objective To investigate the clinical value of high-resolution ultrasonography (US) in the diagnosis of neonatal congenital esophageal atresia. Materials and Methods Longitudinal or oblique mediastinal and abdominal scans were performed using a high-frequency, linear array Philip IU22 probe of 5–13MHz to measure the length and diameter of the upper and lower esophageal pouches, as well as the gap length. Results Three neonates with esophageal atresia received surgical treatment. For each case, the length and diameter of the blind upper and/or lower esophageal pouches were measured by ultrasonography. The gaps in two of three cases were long (>3cm), and in one case, it was short ( Conclusions High-resolution ultrasonography can demonstrate clearly the upper and lower pouches, as well as wall features, and has a clear advantage in measuring the length of the lower esophageal pouch and the gap, which is impossible with plain radiography and esophagography. The drawback is that ultrasonography failed to clearly demonstrate the fistula between the esophagus and the trachea. Despite this, high-resolution ultrasonography is a promising modality in the clinical diagnosis of esophageal atresia.

This study investigates cross-talk of the related bioactivity mediators in silica-induced pulmonary inflammatory and fibrosis on rats, which contributes to the preventive and therapeutic effect of soluble TNF-α receptor. Wistar rats received saline or 50 mg of quartz by intratracheal instillation. Rats in drug-treated groups were given soluble tumor necrosis factor-α (TNF-α) receptor (500 μg) by hypodermic injection on days 1, 5 and 8 after operation. At 7 days or 14 days after instillation, rats were killed to observe the degree of injury and expression of the related bioactivity mediators including nuclear factor KB (NF-KB), nitric oxide, interleukin-1β, interleukin-10, transforming growth factor beta 1 (TGF-β1), TNF-α, interferon-Y (IFN-Y) and granulocyte macrophage colony-stimulating factor (GM-CSF). The area percentages of type I and III collagens in intervention group were lower than those in silica group. The expression of NF-κB, TGF-β1, and COL I were lower in intervention group than in silica group(p < 0.05) and GM-CSF was significantly higher (p < 0.05) at 7 days after instillation, however, NF-κB, TGF-β1, and COL I were identically lower in intervention group than in silica group, and TNF-α, IFN-γ, and GM-CSF were higher at 14 days after instillation. It may be concluded that soluble TNF-α receptor upregulating or downregulating the expression of the related bioactivity mediators results in decreasing lung injury induced by silica.

To compare the short-term clinical outcome of non-fusion techniques using interspinous implantation Coflex(TM) and Wallis treatment in patients with lumbar spine degenerative diseases.Forty-one cases of lumbar stenosis, 18 of lumbar disc herniation, and 34 of lumbar stenosis with lumbar disc herniation were evaluated. Among the 43 cases receiving Coflex(TM) implantation, 41 had operations in one segment and 2 in 2 segments. In the other 50 cases with Wallis implantation, 47 had fixation of 1 segment and 3 had 2 segments fixed. JOA Score, Oswestry Disable Index (ODI) and VAS were used to evaluate the short-term clinical results.The average operating time was 64.55 min in Coflex(TM) implantation with an average blood loss of 81.82 ml. The average operating time was 82.71 min in Wallis implantation, which caused an average blood loss of 89.66 ml. Significant improvements in the JOA Score, ODI and VAS were noted after the operations.The two interspinous non-fusion techniques, Coflex and Wallis, produce good short-term clinical outcome in the treatment of lumbar spine degenerative diseases.

This study aims to evaluate ultrasound findings that are predictive of the need for surgical management in pediatric patients with small bowel intussusceptions (SBIs). A retrospective review of pediatric patients with SBIs treated from 2004 to 2009 was conducted. Patients were divided into surgical and non-surgical groups. Demographic data, ultrasound findings, treatments, and outcomes were collected and analyzed. There were 56 cases of SBIs in 31 males and 25 females ranging in age from 4 months to 9 years; 39 patients were managed conservatively and 17 patients underwent surgery. The mean length and diameter of the intussusception in the surgical group were 6.53 and 2.78 cm, respectively, and 3.21 and 1.81 cm, respectively in the non-surgical group (both, P

To evaluate the short-term clinical results of a new approach of lumbar-pelvic fixation for lumbosacral reconstruction after resection of sacral tumors.Fifteen patients with sacral tumors underwent lumbar-pelvic fixation using TSRH-3D, CDH-M8 or ISOLA with iliac screws. The lumbosacral stability was evaluated according to the X-ray result to assess the feasibility and therapeutic effect of this approach.X-ray showed that high lumbosacral stability was achieved in all the 15 cases after the operation, and satisfactory therapeutic effect was obtained.Lumbar-pelvic fixation with iliac screw is feasible for lumbosacral reconstruction after resection of the sacral tumors, which provides strong internal fixation and produce good clinical outcomes.

To study the efficacy of combined application of deproteinised calf serum injection (DCSI) and acupuncture in treating cerebral ischemia (CI) in rats.Ninety Wistar rats were randomly divided into control, CI model, Acupunct (acupuncture), DCSI, Acupunct + DCSI groups, with 18 cases in each group. CI model was duplicated by middle cerebral artery occlusion (MCAO). DCSI (80 mg/kg) was given via the rat's tail vein, once daily for 7 days. Acupuncture was applied to "Baihui" (GV 20), "Shuigou" (GV 26), "Neiguan" (PC 6), "Hegu" (LI 4), "Taichong" (LR 3) and "Zusanli" (ST 36), once daily for 7 days. The neurological deficit score (NDS), cerebral infarct volume (CIV), water and lactic acid (LA) contents in cerebral tissues were measured.In comparison with control group, NDS, CIV, cerebral water content and LA in model group increased significantly (P0.05); while compared with model group, NDS, CIV, cerebral water content and LA in Acupunct, DCSI and Acupunct + DCSI groups decreased significantly (P0.05). Comparison among DCSI group, Acupunct group and DCSI + Acupunct group showed that NDS, CIV, cerebral water and LA contents of Acupunct + DCSI group were significantly lower than those of the former two groups (P0.05). No significant differences were found between DCSI and Acupunct groups in the above-mentioned 4 indexes (P0.05).Combined application of DCSI and acupuncture has a definite effect in improving cerebral ischemia and is superior to that of simple acupuncture or DCSI alone.

To observe acupuncture at Jiquan (HT 1) with different manipulations for improvement of abnormal sensation of the upper limb induced by cervical spondylosis of nerve root type.One hundred and seven cases were randomly divided into 3 groups. The lifting-thrusting group (n = 37) were treated with acupuncture at Jiquan (HT 1) with lifting-thrusting manipulation, the twirling group (n = 36) with acupuncture at Jiquan (HT 1) with twirling manipulation and the routine needling group (n = 34) with acupuncture at C4 - T1 Jiaji (EX-B 2), Quchi (LI 11).The total effective rate of 91.9% in the lifting-thrusting group was significantly better than 58.3% in the twirling group (P0.005) and 76.5% in the routine needling group (P0.05), and the therapeutic effect of the twirling group was similar to that in the routine needling group CP0.05).Acupuncture at Jiquan (HT 1) with lifting-thrusting manipulation can obviously improve abnormal sensation of the upper limb induced by cervical spondylosis of nerve root type.

To investigate the effect of secondary mutations on Leber's hereditary optic neuropathy (LHON).Three primary and 24 secondary mutations were identified in 4 Chinese families which included male offspring.All of the four pedigrees carried classic LHON mutations at nucleotide (nt) 11778, and did not carry any point of 24 secondary mutations. Nevertheless many polymorphic points were found in the nearby fragments of these pedigrees, such as 5178, 5108, 3705, 3721, 13734, etc.Male offspring sequences should be analyzed in pedigrees with LHON to avoid the influence of familial inheritance characteristic which mitochondrial DNA polymorphism carried. Existence of the "repair genes" may affect the development of LHON.

To observe the clinical effect of argon laser photocoagulation on diabetic retinopathy (DR) in different stages.A total of 263 eyes in 170 patients with DR in different stages were photocoagulated using argon laser machine 2000. Thirty eyes in non-proliferative stage received focal photocoagulation, 156 pre-proliferative eyes received subtotal panretina photocoagulation, and 77 proliferative eyes were treated with panretinal photocoagulation. Additional focal or grid treatment was given for the eyes with localized or diffused macular edema. The visual acuity, eye fundus examination and retinal fluorescein angiography were carried out 3 months after the treatment and the results compared with the preoperative findings.Improvement of visual acuity by at least one row on the visual chart was achieved in 92 eyes (35%), 144 eyes (55%) exhibited no changes, and 27 eyes (10%) deteriorated. Microaneurysm, retinal edema, exudates and fluorescence leakage were reduced in 89% of the eyes, with the rest eyes requiring additional treatment in the non-proliferative and pre-proliferative stages. For the retina in proliferative stage, neovascularization on the disc resolved completely in 67% eyes, whereas partially in 33% eyes which needed additional photocoagulation. The eyes with partial and complete resolution of macular edema accounted for 91% of the total eyes. Postoperative pre-retinal hemorrhage and vitreous hemorrhage occurred at the rates of 8% and 1%, respectively.Argon laser therapy is effective for the eyes with DR in different stages, but produces better efficacy in non- and pre-proliferative stages than in proliferative stage. Follow-up and additional photocoagulation are necessary for the eyes in proliferative stage to ensure better outcome.

To evaluate the clinical effect of argon laser photocoagulation for central serous chorioretinopthy.This study included 102 consecutive cases of central serous chorioretinopathy (102 eyes) with fluorescein dye leakage located 500 microm away from the central fovea of the macula lutea as defined by fundus fluorescein angiography (FFA). Argon laser photocoagulation of the leakage spots was performed once (98 eyes) or twice (4 eyes) with the spot diameter for exposure ranging from 100 to 200 microm and exposure time of 0.2 s that delivered energy of 80 to 150 mW.The visual acuity was improved in 95 cases by one row on the standard vision chart within 2 or 3 d after the laser treatment, while in the other 7 cases, the visual acuity remained unchanged. The symptoms of micropsia, metamorphopsia and blurred vision disappeared in 87 cases. Serous detachment of the sensory retina and the fovea light reflex recovered in 80 cases within two weeks after the treatment and no fovea injuries due to photocoagulation were recorded. During the follow-up lasting for 6 to 12 months no recurrence or long-term complications in relation with photocoagulation treatment were observed in these cases.Argon laser photocoagulation is effective for central serous choiroretinopathy, and strict control of the photocoagulation conditions is crucial for preventing complications in relation to laser coagulation.

Background Sex determining region Y (SRY)-related high mobility groupbox 9 (SOX9) is an important transcription factor required for development, which regulates the expression of target genes in the associated pathway. The aim of this study was to describe the expression of SOX9 in human non-small cell lung cancer (NSCLC) and to investigate the association between SOX9 expression and progression of NSCLC. Methods SOX9 protein and mRNA expression in normal human pneumonocytes, lung cancer cell lines, and eight pairs of matched lung cancer tissues and their adjacent normal lung tissues were detected by Western blotting and real-time reverse transcription-polymerase chain reaction (RT-PCR). Immunohistochemistry was used to determine SOX9 protein expression in 142 cases of histologically characterized NSCLC. Statistical analyses were applied to test for prognostic and diagnostic associations. Results SOX9 in lung cancer cell lines was upregulated at both mRNA and protein levels, and SOX9 mRNA and protein were also elevated in NSCLC tissues compared with levels in corresponding adjacent non-cancerous lung tissues. Immunohistochemical analysis demonstrated a high expression of SOX9 in 74/142 (52.1%) paraffin-embedded archival lung cancer biopsies. Statistical analysis indicated that upregulation of SOX9 was significantly correlated with the histological stage of NSCLC (P = 0.017) and that patients with a high SOX9 level exhibited a shorter survival time (P < 0.001). Multivariate analysis illustrated that SOX9 upregulation might be an independent prognostic indicator for the survival of patients with NSCLC. Conclusions This work shows that SOX9 may serve as a novel and prognostic marker for NSCLC, and play a role during the development and progression of the disease.