Based on clinical features of refractory diseases and clinical practice experience for many years,the author expounded the therapeutic strategies from establishing individualized system of differentiation treatment,treatment strategies of refractory diseases,and the key for medication,and emphasized individual concerned therapy,separating primary and secondary treatment and grasping the physiological state to treat pathological changes.Thus complicated and changeable diseases can be treated clinically.

Objective To explore the diagnosis and treatment for the incision cesarean section scar pregnancy(CSP).Methods The clinical data of 34 patients with CSP admitted were retrospectively analyzed,and analyzed the methods of diagnosis and treatment of CSP.Results Our results showed that 9 cases after treatment with mifepristone combined with suction palace obtained success,2 cases of bleeding assisted with balloon compression;8 cases after mifepristone combined hysteroscopy under suction palace treatment obtained success,1 case was failed and transfer to laparotomy.Mifepristone combined with transvaginal lesion resection of scar pregnancy was succeed in 9 cases,2 cases were failed,of which 1 case was bleeding more and transfer to laparotomy,1 case was confirmed remaining during a review after half a month open.7 cases were succeed in the transabdominal lesion resection of pregnancy (3 cases of transit);without hysterectomy;3 cases were turn to the superior hospital for treatment of intervention.The statistical results showed that no statistical significant difference was obtained among the scores of different age, length of hospital stay, hospital expenses and rescue of shock in different teams of surgery.For the haemorrhage amount, the bleeding was at least in hysteroscopy group, and was at most in abdominal resection of lesions group (rescue of shock was on the high side).Conclusion Uterine scar pregnancy is a relatively rare and dangerous clinical special type of ectopic pregnancy, early diagnosis and appropriate therapeutic strategy are important.The mifepristone combined with suction palace and resection of the pregnancy lesions are safe and effective method for treatment.

Objective:To study the expression of apoptosis related gene FLIP and FADD in 56 cases of human laryngeal squamous cell carcinoma.Methods:Immunohistochemical method(SP) was used to detect the expressions of FLIP and FADD in larynx carcinoma.PCNA was detected to evaluate the proliferation of carcinoma cell.Results:FLIP expression showed a positive correlation with the proliferation of larynx carcinoma cells.FADD displayed a reverse results.No associations were observed in the expressions of FLIP and FADD.The expressions of FLIP and FADD were related to tumor's clinical stage,pathological grade,but not to age,sex of patients and lymphatic metastasis.Conclusions:The abnormal expressions of FLIP and FADD may play an important role in the development of larynx carcinoma.

The prevalence of osteoporosis has increased during recent years. The activation in the function of osteo?clast is the main reason of osteoporosis. Cathepsin is expressed by osteoclast and involved in the degradation of collagen of bone,and causes osteoporosis. Cathepsin K is a kind of most important enzyme in the family of cathepsin. Odanacatib(ODN) is the inhibitor of cathepsin K, and it may be used to anti-osteoporosis thought inhibiting the degradation of bone collagen. It was found that the cortical thickness and bone minerals of cancellous increased after taking ODN in the studies, and then the density and the strength of bone increased. This study reviewed the pharmacological profile of ODN and the progresses of ani?mal study and clinical trials about ODN.

Pacinian corpuscles from cat mesentery were fixed in Carnoy's fixative, paraffinsectioned and stained in Feulgen reagent and methyl green-pyronin. Controlled sectionswere hydrolyzed in 20% perchloric acid at 70℃ and 10% perchloric acid at 1-4℃. Itwas found that the so-called nuclei in the lamellae were Feulgen positive and stainedbluish purple after the methyl green-pyronin method. They disappeared after perchloric acidhydrolysis in 70℃ and showed no change after cold treatment. Their histochemicalreactions, stainability and detailed structures were similar to the nuclei of the connectivecells next to the corpuscle. It was therefore concluded the nuclear like bodies in the Paciniancorpuscles studied were true nuclei as mentioned in histological textbooks and not merely thecondensation of fibrils as W. Schwarz recently claimed after electron microscopic observation.These nuclei were located in between the fibrils of the lamellae.

Glaucoma is one of the main causes of blindness in the world,resulting from a slow and progressive loss of retinal ganglion cells (RGCs) and their axons.So far,intraocular pressure reduction is the main treatment modality to control disease progression.However,not all the patients benefit from this therapy,and the pathophysiology of glaucoma is not always associated with an elevated intraocular pressure.These limitations,together with the multifactorial etiology of glaucoma,urge the pressing medical need for novel and alternative treatment strategies.Such new therapies should focus on not only preventing or retarding RGCs death,but also repairing the injured axons.Glaucoma optic nerve protection therapy is becoming a hot spot of current research,especially Rho associated kinase (ROCK) inhibitors as a new drug for the glaucomatic neuroprotection,which can reduce intraocular pressure,inhibit scar formation after anti-glaucoma surgery,improve blood circulation,prevent RGCs death and axonal degeneration and induce axon regeneration.In this review,we focused on the research status and progress of the classical signal pathway of ROCK inhibitor in glaucoma optic nerve protection.

Objective To express and purify the human renin(REN)and mature renin(REN-340)in prokaryotic cells,and detect the concentration. Methods According to the human REN gene sequence(5972)registered in NCBI,REN and REN-340 gene fragments were artificially synthesized and cloned into vector p ET-28a(+)after E.coli codon optimization,and the recombinant expression plasmids 6 × His-REN-p ET and 6 × His-REN-340-p ET were constructed. The recombinant plasmids were transformed into competent E.coli BL21(DE3)and induced at different induction temperatures(20,25,30and 37 ℃)and different final concentrations(0. 1,0. 2,0. 4 and 0. 5 mmol/L)of IPTG. Recombinant REN and REN-340were induced under the optimal induction conditions,and the concentrations were detected by ELISA after nickel ion affinity chromatography with Ni-NTA. Results The recombinant expression plasmids 6 × His-REN-p ET and 6 × His-REN-340-p ET were constructed correctly as identified by restriction analysis and sequencing. The optimum induction temperature of recombinant REN and REN-340 was 37 ℃ and 20 ℃,and the best final concentration of IPTG was 0. 1 and 0. 2 mmol/L,respectively. The concentrations of purified recombinant REN and REN-340 were 9 148. 21 and 15 115. 31 m IU/m L,respectively. Conclusion The prepared recombinant REN and REN-340 proteins have high concentration with short production cycle,which are expected to be used as candidate quality control products and standard substances for external quality assessment(EQA).

Anti-Bacterial Agents ; therapeutic use ; Emergencies ; Enterocolitis, Necrotizing ; diagnosis ; epidemiology ; etiology ; prevention & control ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; diagnosis ; epidemiology ; etiology ; prevention & control ; Infant, Very Low Birth Weight ; Infection Control ; Intensive Care Units, Neonatal ; Premature Birth ; prevention & control ; Risk Factors

Axis, Cervical Vertebra ; injuries ; Cervical Atlas ; injuries ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Odontoid Process ; injuries ; Spinal Fractures ; diagnosis ; surgery ; Spinal Fusion

Objective To investigate the risk factors and microbial causes related to the pathogenesis of ventilator-associated pneumonia(VAP).Methods Totaly 138 intubated newborn infants for longer than 48 hours in Ningbo Women and Children's Hospital were studied,who were divided into VAP group (56 cases)and non VAP group(82 cases).Microbial causes of VAP were analyzed.Results Malnutrition,repeated tracheal intubation,repeated endotracheal suctioning,indwelling tube,posture,hyaline membrane disease,gestational age,birth weight,duration of intubation,duration of hospitalization were independent risk factors for ventilator-associated pneumonia(P<0.05).Klebsiella pneumoniae,pseudomonas aeruginosa,acinetobacter species and enterobacter cloacae were the main pathogenic bacteria of VAP.Conclusion Shortening of mechanical ventilation duration,avoiding repeated tracheal intubation and indwelling tube usage,semi-fowler positioning can lower the incidence of VAP.Pathogenic bacteria control is essential for VAP.