Volume 96  ·  Issue 25  ·  2016

Exercise plays a very important role in the healthy development of children and adolescents, but at the same time, unscientific exercise can also cause injury, affect the physical and mental development of children and adolescents, and even make life difficult for life. To guide the young people to exercise scientifically and reasonably and to avoid sports injuries, the state, schools, parents and sports medicine experts must attach great importance to it, and point out the direction for the development of sports for children and young people, and put forward the norms and guidelines of scientific exercise.

To investigate the MR image characteristics and clinical significance of focal periphyseal edema (FOPE) zone of the adolescent knee which was with or without trauma history, and provide the basis for the correct diagnosis and treatment.

A total of 12 patients (9 boys, age range 12-16 years, average age 14 years old, 3 girls, age range 12-15 years, average age 13 years )who had pain of the knee without the traumatic history and 16 patients (12 boys, age range 10-15 years, average age 14 years; 4 girls, age range 11-13 years, average age 12 years) who were painful in the knee after trauma were included in this study. The knee MR examinations were performed in all the patients. The characteristics of MRI between painful knee without trauma and painful knee after trauma were compared and analyzed, and the average vertical distances from the farthest of the edema area to the epiphyseal plate were measured. The vertical distances were measured respectively in sagittal view and coronal view in PD-FS and in sagittal view in T₁WI, and the average for the three were calculated. At last, the images with the results of operation or follow-up examinations were compared and confirmed by double blind method.

The MRI characteristics of FOPE zone in the 12 adolescent who complained painful knee but had no trauma showed low signal intensity in T₁WI and high signal intensity in PD-FS. The edema centered at the physis and extended into both the adjacent epiphysis and metaphysic.In addition, it shaped like patches and thread, and edema range(14.5±6.6)mm.The MRI findings of the 16 adolescent had pain of the knee after injury characterized by a wide range of low T₁WI signal intensity and increased PD-FS signal intensity involving the articular surface of the epiphysis.The range of edema was (26.2±8.8)mm.There was statistically significant difference between non-traumatic edema and the edema caused by trauma (t=4.346, P<0.05).

A FOPE zone of the adolescent knee is likely to be related to pain in the adolescent growth period and physiologic physeal fusion, and should not be mistaken for an abnormality, while the larger range of edema surrounding the epiphyseal plate may be associated with the trauma of the knee.

To investigate the characteristics of children male soccer players' ankle imaging features.

From October 2015 to February 2016, a total of 32 male children players of two soccer clubs in Guangzhou were enrolled in this study.The ages of all cases were from 10 to 14 years, average age was (11.3±0.9) years.A total of 15 male children in region ordinary primary and secondary school students were set as control group, ages were from 10 to 14 years, average age was (12.1±1.2) years. All objects' ankle were examined by X-ray for positive and lateral positions; routine CT scanning and then on the workstation restructuring for axial, coronal and sagittal slices; and examined by MR. MR scan was with special surface coil for ankle joint for horizontal axis T₂WI; coronal T₁WI; coronary proton density weighted imaging (PWI); sagittal T₂WI with fat suppression; sagittal PWI with isotropic and fat suppression sequence of fast field echo. The ankle bone morphological structures were observed on X-ray; the ankle bone mineral density, cortical bone thickness and sesamoid bone quantity was being observed and measured on CT; and the tenosynovitis, Achilles tendinitis, synovitis, and cancellous bone edema signal were observed on MR.

For study group, a total of 32 cases and 64 ankles joints were completed by X-ray, CT and MR examination.A total of 15 cases and 30 ankles joints were completed by X-ray in control group, 26 ankle joints were completed by CT scan and 22 ankle joints were completed by MR examination.X-ray examination showed there was no statistically significant difference between the two groups in ankle bone structure.CT showed that navicular bone CT value was (296±82) HU in research group and navicular bone CT value was (266±107) HU in control group, the difference was statistically significant (P=0.03). MR showed the incidence of diseases in research group that the tendon sheath peripheral inflammation was 92.2% (59/64), Achilles tendon lesions was 18.8%(12/64), edema of cancellous bone was 73.4% (47/64) , lateral malleous ligaments injuried was 43.8%(28/64), synovitis or effusion in posterior ankle was 87.5% (56/64). The incidence of diseases in control group was that tendon sheath peripheral inflammation was 31.8%(7/22), Achilles tendon lesions was 0/22, edema of cancellous bone was 0/22, lateral malleous ligaments injuried was 0/22, synovitis or effusion in posterior ankle was 54.5% (12/22). There was statistically significant difference between these two groups (all P<0.05).

Compared with the control group, children's male soccer players ankle bone structure, bone cortex thickness and bone mineral density there were no obvious difference. In the tenosynovitis, Achilles tendinitis, synovitis, bone marrow edema, lateral malleous ligaments injuried were significantly higher than the control group.

To accelerate the detection rate and accuracy of diagnosis in damage imaging of Lisfranc joint through research on the information of X-ray, CT, and MR imaging of tarsometatarsus joint (also called Lisfranc joint) damage.

A total of 153 cases of tarsometratisus damage or Lisfranc ligamentous injury patients were chosen during November 2012 to November 2015. Lisfranc injuries were classified according to the Myerson fracture displacements classification and Nunley-Vertullo low-grade injury classification. All the treatment data was performed using SPSS 17.0 software.

For Myerson fracture displacements, there were 16 cases in Myerson Ⅰ type (homolateral complete), 100 cases in Myerson Ⅱ type (homolateral incomplete), and 5 cases in Myerson Ⅲ type (divergent). For the low-grade injury, there were 7 cases, 24 cases, and 1 case in Nunley-Vertullo Ⅰ, Ⅱ, Ⅲ type respectively. The probability was 14.9% (18/121) for patients that the initial survey found negative by X-ray imaging diagnosis and was confirmed by subsequent CT or MRI. It was found that the distance between the base of first (M1) and second (M2) metatarsus which was larger than 2 mm was 69.4%(84/121)from the X-ray imaging; there were small chip fractures between the base of M1 and M2 was 47.1% (57/121), and 71.2% (37/52)of small chip fractures in the inside of base of M2 from CT. On MRI, ligament disruption showed the discontinue or normal signal disappearing, and there were 15 cases in the complete disruption condition.

It should be suggested to take a CT or MRI check for the patients who have highly suspicious Lisfranc injure and the X-ray imaging diagnosis was negative, since there is a certain rate of missed diagnosis for the Lisfranc injure using X-ray imaging. For children and teenagers, the sports injuries and joint strain are common style, such as the injuries caused by jump from higher platform, football/skateboarding injures, etc. If the distance between the base of M1 and M2 is larger than 2 mm or there are small chip fractures between the M1 and M2, the patients would be suspected bone fracture or Lisfranc ligament injure. Myerson Ⅱ type is the most common Lisfranc joint injury , and MRI is best for Lisfranc ligament injury.

To explore mutant superoxide dismutase (SOD)1 protein expression and mitochondrial function in amyotrophic lateral sclerosis (ALS) patients' fibroblasts carrying different SOD1 mutations.

SOD1 gene mutation was detected using PCR and direct sequencing. Skin fibroblasts of three familial ALS patients with mutations and age/gender matched controls obtained by a punch skin biopsy were cultured. We performed immunofluorescence staining and quantitative detection of SOD1 proteins and mitochondrial membrane potential. Also, we detected the intracellular ROS by flow cytometry.

We found that fibroblasts from familial ALS patients carried SOD1-V14M, SOD1-G16A, SOD1-C111Y mutation, respectively. The cytoplasm abnormal SOD1 protein aggregates appeared in ALS patients carrying SOD1 mutations. And the cytoplasmic/nuclear ratio of SOD1 aggregates increased 2.54, 2.80, 3.25-fold for each mutations, respectively, compared to the control group. Three SOD1 mutant groups showed loss of mitochondrial membrane potential and the ratio of red / green fluorescence intensity decreased by 36%, 124%, 142%, respectively, compared to the control group. The intracellular ROS levels also increased 3.33, 3.65, and 6.87-fold respectively.

This work highlights that ALS alters SOD1 protein expression, mitochondrial function, and increases the ROS level even in peripheral tissues outside the central nervous system. Fibroblasts might therefore represent a powerful and minimally invasive tool to investigate ALS pathogenic mechanisms, which might translate into considerable advances in clinical management of the disease.

To assess the electrophysiological subtypes of Guillain-Barré syndrome (GBS) acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor axonal neuropathy (AMAN), and long-term prognosis in northeastern China.

One hundred and eighteen patients with GBS were recruited between 2010 and 2012 and retrospectively reviewed.

According to electrodiagnostic criteria, patients were classified as AMAN (49, 46.7%) or AIDP (39, 37.1%), or were unclassified (17, 16.2%). Between the AMAN and AIDP groups, age, sex, and clinical disability did not differ significantly, but the AMAN patients more frequently had preceding gastroenteritis. By 4 weeks after onset, 24.5% of the AMAN patients (12) and 33.3% of the AIDP patients (13) had regained the ability to walk; by 1 year, 77.6% of the AMAN patients (38) and 79.5% of the AIDP patients (31) could walk. Recovery was generally favorable in both subtypes. Immunotherapy was effective in patients with either AIDP or AMAN, and glucocorticoids and immunoglobulin treatment could achieve similar effect.

AMAN and AIDP are the main subtypes of GBS in northeastern China. The prognosis of patients with AMAN is similar to that of patients with AIDP. Different immunotherapies have similar effect on long term prognosis.

To evaluate the clinical and radiological outcomes of artificial cervical disc replacement (Prodisc-C), dynamic cervical implant and anterior cervical discectomy and fusion (ACDF) in the treatment of cervical spondylosis.

From May 2011 to May 2013, a total of 44 cervical spondylosis patients that received cervical disc arthroplasty (Prodisc-C), dynamic cervical implant (DCI) or ACDF were retrospectively reviewed in Orthopedics Department, Beijing Chaoyang Hospital, Capital Medical University.The patients were divided into three groups by surgical methods.Parameters as gender, age, the operation time, blood loss and average hospital stay of three groups were compared.The patients were followed 3 months, 6 months, 12 months and 24 months postoperatively.Neck disability index (NDI), Japanese Orthopaedic Association (JOA) Score and Visual Analogue Scale (VAS) were used to evaluate the clinical outcomes of the three groups.We also measured the cervical lordosis, range of motion of surgical segment and adjacent segment and height of disc at pre-op and post-op.

All the patients were got at least 24 months follow-up.The differences between postoperative JOA, NDI and VAS scores and preoperative scores were of statistical significance (P<0.05). There was no statistical difference in average hospital stay, JOA, NDI and VAS recovery rate (P>0.05) among three groups.But the operative time and intraoperative blood loss were statistically different (P<0.05). Compared the pre-and postoperative ROM of C_2-7, operative, upper and lower levels of each group respectively, the difference between pre-and postoperative ROM of ACDF group were of statistically significant [(16.6±3.6)°, (22.3±4.6)°, (18.1±3.1)°, P<0.05], while was no statistically significant of non-fusion group(P>0.05). There was no statistically significant difference between pre-and postoperative ROM of upper and lower levels among three groups (P>0.05), but had statistically difference in operative levels [(7.0±1.0) mm, (9.2±1.5) mm, (6.8±1.4) mm,P<0.05]. And there are no serious postoperative complications.

Two cervical non-fusion surgery and ACDF have received good clinical effects in the treatment of spondylotic myelopathy or radicular spondylosis.The artificial cervical disc replacement and dynamic cervical implant can not only recover cervical lordosis and keep the range of motion and stability of the surgical segment, but also reduce the incidence of compensatory motion at adjacent segments and will prevent from adjacent segment degeneration.

To retrospectively investigate the clinical manifestation of patients with spinal stenosis in the upper thoracic and cervical spine by posterior decompression in different ways.

From January 2010 to December 2015, 18 patients of that complicated phenomenon were studied in Department of Orthopaedic Surgery, China-Japan Union Hospital, Jilin University.Ten patients received one-stage combined decompression (group A); while the other 8 received multi-stage posterior decompression(group B). The Visual analogue scale (JOA), thoracic Cobb and range of motion(ROM) were compared.

No statistically significant inter-group difference existed in preoperative JOA score[(9.1±2.6)vs (9.1±2.2)]and postoperative JOA score[(15.4±1.2)vs(13.8±4.5)], but the mean recovery rate of nerve function of group A(79%±15%)is better than that of group B(69%±34%).

All the approaches are effective for the treatment of patients with spinal stenosis in the upper thoracic and cervical spine, while one-staged combined decompression was better than double-staged operation.

To study the expression of CD36 mRNA in granulosa cells (GCs) of patients with polycystic ovary syndrome (PCOS) and the impact of testosterone, insulin and PPARγ agonist rosiglitazone on GCs.

The expression of CD36 mRNA inGCs of patients with PCOS and normal controls were assayed byreal-time PCR.The level of CD36 mRNA after treatment with testosterone, insulin, and rosiglitazone in GCs ofnormal controls were also tested by real-time PCR.

(1) The expression of CD36mRNA in the GCs of PCOS was significantly higher than that of the controls (P<0.05). (2) When testosterone concentration was 1 nmol/L, CD36 mRNA increased in the GCs, but there was no significantdifference compared to the blank control, (P>0.05). When testosterone concentration was 10 nmol/L, the expression of CD36 mRNA in the GCs was higher than that in the blank control with significant difference (P<0.05). When insulin concentration was 10 nmol/L, the expression of CD36 mRNA increased but the difference was not statistically significant (P>0.05). When insulin concentration was 100 nmol/L, the expression of CD36mRNA in the GCswas higher than that in the blank control (P=0.05). When rosiglitazone concentration was 1nmol/L, the expression of PPARγ mRNA in GCs were significantly increased compared with the blank control (P<0.05). The expression of CD36 mRNA atrosiglitazone concentrationof 10 nmol/Lwere significantly increased compared to the concentration of 1 nmol/L (P<0.05).

High testosterone and insulin induced the expression of CD36 mRNA.Rosiglitazone increased CD36 mRNA in a dose-related manner in GCs.Increased CD36 mRNA in the GCs of PCOS may be related to the clinical characteristics of PCOS.

To study the distribution characteristics of lactobacillus in the vaginal mucosa of patients with HPV infection.

The planting density of lactobacillus in vaginal secretions of 95 cases with HPV16/18 infection and 90 cases of normal women of childbearing age were observed by oil microscope. And the strains of vaginal lactobacilli in two groups were analyzed using species-specific polymerase chain reaction (Species-specific PCR) and the distribution of vaginal lactobacilli in patients with HPV16/18 infection were investigated.

In HPV16/18 infective groups, the planting density of lactobacillus in the vaginal mucosa was 104 (68-186)/HP. It was significantly lower than that of the normal group (234 (161-326)/HP, P<0.05). Compared with the normal group, the positive rates oflactobacillus iners, lactobacillus crispatus, and lactobacillus gasseri were significantly lower in HPV16/18 infection group (P<0.05).

The HPV16/18 infection is associated with the decreased number of lactobacillus and the imbalance of vaginal flora; Lactobacillus iners, lactobacillus crispatus, and lactobacillus gasseri may play a key role in maintaining the vaginal micro ecological environment.

To investigate the causes and strategies for intraoperative rupture during clipping the anterior circulation aneurysms.

Nineteen patients with anterior circulation aneurysms ruptured during clipping, who admitted to the Department of Neurosurgery, Henan Provincial People's Hospital from November 2012 to February 2014, were enrolled. Their clinical data were analyzed retrospectively to summarize the causes and strategies for intraoperative rupture.

The aneurysms ruptured during predissection in 2 cases (10.5%), during dissection in 11 cases (57.9%) and during clip application in 6 cases (31.6%). There was no residual aneurysm confirmed by postoperative CTA in 17 patients. One case with posterior communicating artery aneurysm cannot be clipped because of the serious avulsion of the aneurysm neck during clipping. The aneurysm was trapped and the patient paralysed on one side after operation. One case died postoperative 8 days because of severe cerebral edema, whose aneurysm ruptured during predissection. The Glasgow Outcome Scale (GOS) of three months after operation showed good recovery in 11, moderate recovery in 5, severe disability in 2, and death in 1 cases, respectively.

Adequate preoperative evaluation for the risk factors of intraoperative rupture and excellent microsurgical techniques can prevent intraoperative rupture of intracranial aneurysms. Controlling the bleeding quickly and dissecting and clipping the aneurysm after definitely know the anatomy of the aneurysm and surrounding vasculature could be the keys to deal with intraoperative aneurysm rupture.

To investigate whether inhibitory effect of chrysin on sphere formation of ovarian cancer stem-like cells(spheroids derived from human ovarian cancer SKOV3 cell line ) is involved in the down-regulating of the protein expression of casein kinase CK2α.

SKOV3-derived ovarian cancer stem-like cells obtained by suspension culture in stem cell-condition medium using ultra-low adhesion plate were treated with various concentrations (5.0, 10.0 and 20.0 μmol/L) of chrysin. Sphere formation assay was used to determine the sphere forming rate of SKOV3-derived ovarian cancer stem-like cells. Western blot was used to analyze the protein expressions of CK2α and cancer stem cell markers CD133 and CD44. Silence of CK2α by siRNA and ectopic expression of CK2α by transfection with pcDNA3.1-CK2α plasmid were used to explore the mechanism underlying the effect of chrysin on sphere formation of SKOV3-derived ovarian cancer stem-like cells.

Chrysin (5.0, 10.0 and 20.0 μmol/L) significantly reduced the sphere forming rate of SKOV3-derived ovarian cancer stem-like cells, in a concentration-dependent manner (22.3%±2.5% vs 14.7%±2.1%, 8.6%± 1.7% and 3.8% ± 1.1% respectively; P<0.05). In addition, chrysin (5.0, 10.0 and 20.0 μmol/L) obviously down-regulated the protein expressions of CK2α, CD133 and CD44 in SKOV3-derived ovarian cancer stem-like cells. In combination with CK2α siRNA transfection and chrysin synergistically decreased sphere formation (P<0.05) and the protein expressions of CK2α, CD133 and CD44 in SKOV3-derived ovarian cancer stem-like cells. However, transfection with pcDNA3.1-CK2α plasmid attenuated inhibitory effects of chrysin on sphere formation capability and the expressions of CK2α, CD133 and CD44 of SKOV3-derived ovarian cancer stem-like cells.

Down-regulation of CK2α protein expression is involved in the inhibition effect of chrysin on the sphere formation capability of SKOV3-derived ovarian cancer stem-like cells.

To investigate the role of follistatin-like protein 1 (FSTL1) on bone marrow mesenchymal stem cells (BM-MSCs)-mediated cardioprotection during myocardial ischemia/reperfusion injury.

Rat bone marrow mesenchymal stem cells were isolated by whole bone marrow adherence method in vitro. A total of 60 Wistar rats were randomly divided into 4 groups: control group, ischemic /reperfusion injury (IRI) group, ischemia/reperfusion injury group treated with natural BM-MSCs (IRI+ MSC group), ischemia/reperfusion injury group treated with BM-MSCs which did not contain FSTL1 (IRI+ MSC FSTL1 siRNA group). Survival analysis was used to analyze survival time of rats, besides, expression of FSTL1 was detected by Western blotting. Myocardial pathological changes were detected by Hematoxylin and Eosin (HE) staining. Terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) and enzyme-linked immunosorbent assay (ELISA) were used to determine the associated biomarkers and apoptosis 7 days after operation.

Compared with IRI group, rats in IRI+ MSC group had a higher survival rate and lived longer. Meanwhile, IRI+ MSC group had higher FSTL1 expression in blood and myocardial tissues than IRI group. Control group showed significantly lower apoptosis rate of myocardial cells[(1.4±0.1)% vs (29.8±4.5)%, P<0.05], less histological changes and infarction areas (0 vs 24.48±4.27,P<0.05) than IRI group. Compared with IRI group, IRI+ MSC group had an improvement of apoptosis rate[(4.2±0.3)% vs (29.8±4.5)%,P<0.05], less histological injury and infarction areas (15.12±3.82 vs 24.48±4.27,P<0.01). IRI+ MSC group had lower expression of LDH, MDA, CK and higher expression of SOD than IRI group (P<0.05). However, IRI+ MSC FSTL1 siRNA group showed weaker protection of myocardial cells than IRI+ MSC group after knockdown of FSTL1 (P<0.05).

FSTL1, which was secreted by BM-MSCs, plays a protective role in myocardial IRI.

To prepare a novel folate-targeted magnetic nanocomposites loaded with tissue facor pathway inhibitor 2 (TFPI-2) and cisplatin (CDDP) and to investigate its targeting ability and anti-tumor effect on nasopharyngeal carcinoma HNE-1 cells in vitro.

The copolymer folic acid-polyethylene glycol-polyethyleneimine (FA-PEG-PEI) was synthesized through amidation reaction, and then FA-PEG-PEI/ magnetic nanoparticles-CDDP/TFPI-2 (MNP-CDDP/TFPI-2) nanocomposites was obtained by electrostatic adsorption between TFPI-2 plasmid and magnetic nanoparticles loaded with CDDP (MNP-CDDP) with vortex FA-PEG-PEI. ¹H Nuclear Magnetic Resonance (¹H NMR ) was used to determine if FA-PEG-PEI was synthesized. The particle size, zeta potential and morphology were detected by dynamic light scattering (DLS) and transmission electron microscope (TEM). The content of Fe and CDDP was measured by phenanthroline and o-phenylenediamine (OPDA) colourimetry. Agarose gel electrophoresis was used to analyze the binding ability of FA-PEG-PEI/MNP-CDDP to TFPI-2 plasmid. Molecular targeted uptake of FA-PEG-PEI/ MNP-CDDP/TFPI-2 coupling with green fluorescent protein (GFP) in NPC cells were observed by Prussian-blue iron staining and fluorescence microscope. The levels of TFPI-2 protein expression after transfection were evaluated by Western blot. The effects of nanocomposites on HNE-1 cells proliferation and apoptosis were measured with Cell Counting Kit-8(CCK-8) and flow cytometry.

Special peak value of FA, PEG and PEI were showed on ¹H NMR spectrogram. The mean size and zeta potential of FA-PEG-PEI/MNP-CDDP/TFPI-2 were 141.1 nm and 21.5 mV. The nanocomposites showed a good monodispersity and an insufficient size uniformity under TEM. The content of Fe and CDDP were 116.2 μg/ml and 92.88 μg/ml, respectively. Agarose gel electrophoresis showed TFPI-2 could be encapsulated completely and protected from digestion of DNA enzyme as the mass ratio of FA-PEG-PEI/ MNP-CDDP and TFPI-2 plasmid was equal or higher than 1∶1. More blue-stained magnetic granulars and green fluorescence were seen in folate receptor (FR)-positive HNE-1 cells than in FR-negative CNE-2 ( P<0.05) under microscope and fluorescence microscope. The level of TFPI-2 protein expression in HNE-1cells increased significantly after transfection by FA-PEG-PEI/ MNP-CDDP/TFPI-2, compared with other control groups (FA-PEG-PEI/MNP-CDDP group and TFPI-2 group), allP<0.05. The nanocomposites inhibitory effect on HNE-1 including cell growth inhibition rate (64.00%) and apoptosis rate (49.61%) were significantly higher than that in FA-PEG-PEI/MNP group (8.19%, 9.26%), FA-PEG-PEI/TFPI-2 group (40.35%, 19.85%) and FA-PEG-PEI/MNP-CDDP group(56.15%, 36.46%)(P<0.05).

FA-PEG-PEI/MNP-CDDP/TFPI-2 nanocomposites was successfully synthesized using amidation and electrostatic adsorption technology and has a good molecular targeting and inhibitory effect on FR-positive HNE-1cells in vitro.

To investigate the effect of astaxanthin (AST) on vascular smooth muscle cells (VSMCs) proliferation in vitro induced by platelet derived growth factor-BB (PDGF-BB), and to explore its possible mechanism.

There were 4 groups in this experiment: blank control group, PDGF-BB group, PDGF-BB+ AST group, AST group. After the cells received different intervention for the indicated time, the cell growth was determined by Trypan blue staining; cell proliferation was demonstrated using CCK-8 kit; the cell cycle progression was analyzed by flow cytometry, and the mRNA expression of cyclin D1, cyclin E, CDK6, CDK4, cyclin kinase inhibitor protein P21 was determined by real-time PCR; reactive oxygen species (ROS) generation was detected using a Microplate reader; the total and phosphorylated forms of ERK1/2, p38 MAPK, JNK was observed in AST pretreated VSMCs in 5, 10 and 15 min after PDGF-BB treatment by Western blot analysis.

(1) Cell viability: AST and/or PDGF-BB did not induce VSMCs necrosis with the different concentration compared with untreated cells (P>0.05). (2) Cell proliferation: PDGF-BB induced VSMCs proliferation (2.5±0.3 vs 1,P<0.01), while AST reversed the effect in a concentration-dependent manner when co-treated with PDGF-BB (allP<0.01); Cell cycle: Flow cytometry analysis showed that AST at a dose of 25 μmol/L reduced the percentages of cells in S phase and increased the G0/G1 populations in PDGF-BB-stimulated VSMCs; mRNA expression of the check-point proteins: Real Time PCR results demonstrated that, compared with the control group, the mRNA expression of CDK6, CDK4, cyclin D1, cyclin E in the PDGF-BB group was higher (4.20±0.30, 2.90±0.18, 3.50±0.30, 2.70±0.11 vs 1, allP<0.01), while p21 mRNA expression was lower (0.52±0.03 vs 1,P<0.01), while AST reversed these effects when co-treated with PDGF-BB. (3) ROS expression: compared with the control group, ROS level was significantly higher in the PDGF-BB group (2.10±0.09 vs 1,P<0.01), while AST reversed the effect in a concentration-dependent manner when co-treated with PDGF-BB (allP<0.01). (4) Signaling pathway: AST blocking the proliferation of VSMCs induced by PDGF-BB was related to suppress ERK1/2, p-p38 MAPK signaling pathway, but little effect to JNK.

These results demonstrate that AST can block the proliferation and migration of VSMCs through G0/G1 to S phase of the cell cycle arrest. Further study indicates that AST suppress PDGF-BB-induced VSMCs proliferation is associated with an inhibition of ROS generation and ERK1/2, p-p38 MAPK signal pathways.

Decision modeling method-Graph with results and activities interrelated (GRAI) is a method to describe and analyze the decision model in manufacturing system engineering proposed by the University of Bordeaux I in the mid-1970s. It modeled the decision process of an enterprise from the decision-making activities of an enterprise. It consists of GRAI lattice and GRAI network. GRAI lattice is used to describe the whole system, and GRAI network further refines each decision center in GRAI lattice. Because GRAI method is applied to manufacturing system decision modeling, some adjustments are needed when it is applied to building decision system modeling in operating room. Although hospitals cannot be regarded as ordinary enterprises, they have great similarities with enterprises. Doctors and nurses, medical devices and drugs can be regarded as various resources in management, and the allocation and management of each resource is the work of hospital managers, that is, the decision-making and resource allocation in GRAI model.