BACKGROUND:Induced pluripotent stem cells research has become a hot topic nowadays, because it can avoid the immune rejection and ethical issues in stem cellresearch and have characteristics is similar to the embryonic stem cells.
OBJECTIVE:To review prospect and progress of induced pluripotent stem cells, and to find out some problems about the induced pluripotent stem cells in inducing method, efficiency, safety and application which need to be solved.
METHODS:Kjmed database was searched by the first author using key words of“induced pluripotent stem cells, efficiency, disease model, clinical application”in English to retrieve relevant articles published from January 2003 to June 2013. Literatures addressing induced pluripotent stem cells were included, and the repetitive researches were excluded.
RESULTS AND CONCLUSION:A total of 112 documents were retieved, and final y 32 articles were retained after deleting unrelated and repetitive ones. Induced pluripotent stem cells have very high application value and prospects in the somatic celltransplantation, tissue engineering, drug screening and establishment in vitro of disease models. But this technology is stil in the stage of research and exploration, and there are many technical problems that need to be solved.

Objective To explore the clinical efficacy and safety of cyclosporin A combined with glucocorti-costeroid in the treatment of juvenile uveitis.Methods 66 juvenile uveitis patients(93 eyes)were selected.Accord-ing to the conditions,the patients were treated by oral administration of cyclosporin A,2-5mg·kg -1 ·d -1 ,twice per day,combined with prednisone,0.5-1mg·kg -1 ·d -1 ,taken in the morning.After 4-6 months treatment,the inflam-mation control and visual acuity improvement were observed,and before and after treatment liver and kidney function, blood glucose,blood pressure,white blood cell counts were checked.Adverse reactions in patients were recorded with regular follow-up.Results After 4-6 months treatment,heal inflammation 78 eyes,accounted for 83.87%;improved 9 eyes,accounted for 9.68%;no respond in 6 eyes,accounted for 6.45%;the total effective rate was 93.55%.Visual acuity was obviously improved in 50 eyes,improved in 27 eyes and no response in 16 eyes;the total effective rate was 82.79%;56 eyes were removed from residual standard.In the stage of therapy,6 patients had liver and kidney dys-function,6 patients had blood abnormalities,and 3 patients had low blood sugar,all were controlled by symptomatic treatment in the normal range,and no systemic progression.Conclusion Cyclosporin A combined with glucocortico-steroid applied in juvenile uveitis improved the results with obvious clinical effect and fewer systemic side effect.

Users' cognition and information retrieval are faced with great challenges in ubiquitous knowledge environ-ment. The influence of cognitive factors such as personality traits, cognitive style and ability, knowledge structure and ascribed methods on users' information retrieval behaviors was thus analyzed. It was pointed out that different cognitive factors could influence the retrieval, judgment and absorption of its results,users' satisfaction and continuous use in ubiquitous knowledge environment,with suggestions put forward from the aspects of information retrieval education, information service and information users for improving the users ' knowledge system in knowledge assimilating process by working out effective retrieval strategies using the advantages of cognition.

Objective Three-dimensional(3D) automated ultrasonic volume measurement is becoming favorable in clinical application and turns to be an important direction .The article was to evaluate the consistency of two-dimensional (2D) and three-di-mensional ultrasonography in the diameter measurement of single follicle . Methods 438 single folliculars were respectively meas-ured by the same sonographer in 2D and 3D ultrasonic measurement.2D diameter, 3D mean diameter and 3D virtual ball diameter of every single follicle were recorded , and Bland-Altman method were used to evaluate the consistency of the results by these two meth-ods. Results In the consistency analysis on the diameter measurement of single follicle by 2D and 3D mean diameter measurment methods, d equaled -1.06 mm, and 95% LoA range covered the range of -4.82 mm to 2.70 mm.95% CI of 95% LoA range,-5.21 mm to 3.08 mm, was beyond the settings of clinical acceptable error limit range , -3.56 mm to 1.44 mm, showing poor consis-tency.Likewise, in the research of the consistency in the measurement of 2D diameter and 3D virtual ball diameter in the diameter measurement of single follicle , d equaled -0.07 mm , and 95%LoA range covered the range of -3.11 mm to 2.98 mm.95%CI of 95%LoA range, -3.43 mm to 3.29 mm, was beyond the settings of clinical acceptable error limit range , -2.57 mm to 2.43 mm, showing poor consistency . Conclusion 2D and 3D ultrasound measurements in the diameter measurement of single follicle are not consistent.However, considering the objectivity and accuracy of the results , 3D ultrasonography still has an advantage over 2D ultra-sonography , which can provide more acurate aid for assisted reproductive technology .

BACKGROUND:Early-onset scoliosis is a kind of disease that seriously affects the growth of children’s spine and development of cardiorespiratory function. The treatment of the disease has always been the focus of many clinical researchers.OBJECTIVE:To analyze the therapy for early-onset scoliosis and explore the spinal fusion, spinal non-fusion, conventional growth rod technology and magnetic control ed growth rod technology of early-onset scoliosis. METHODS:We retrieved PubMed, CENTRAL, EMbase, the ISI Web of Knowledge Databases, VIP, CNKI, CBM and Wanfang Database for related studies published from inception of the database to March 2016. The key words were“scoliosis, growing rod, complications”. The included 54 studies were analyzed and discussed. RESULTS AND CONCLUSION:For these children of early-onset scoliosis, we should not only maintain the correction of spine deformities, but also protect the ability of spine growth, keeping the normal cardiopulmonary function. In addition to conventional (non-surgical) treatment, there are surgical treatment (such as spinal fusion and growing rod technique) and magnetical y control ed growing rod, a new technology for the treatment of early-onset scoliosis. A comprehensive understanding of the effect of surgical treatment on the spine growth and cardiopulmonary function of children with early-onset scoliosis wil help to prevent the occurrence of related complications, so as to obtain a better therapeutic effect.

Objective To analyze retrospectively the death pattern, risk factors, and death time of 253 patients at the Respiratory Care Unit of General Hospital of PLA in order to improve care quality and reduce mortality.Methods The information of patients was extracted from the hospital information system ( HIS) , and then classified and calculated accord-ing to different time points.Results Between November and next March,the mortality rate was higher than in other months (P<0.05), accounting for 19.5%.Mortality of those admitted between 8∶01 and 9∶00 or between 23∶01 and 24∶00 was higher than at other times(P<0.05), accounting for 41.7%and 50.0%, respectively.There was statistically significant difference(P<0.01) in mortality between days of the week,with the highest on Saturday, accounting for 43.1%.Mortality on non-work days was higher than on workday(P<0.01), accounting for 38.3% and 13.2%, respectively.Mortality at off-hour was higher than at office time(8∶00-11∶30 and 14∶30-18∶00 on workday) (P<0.01), accounting for 31.3%and 5.2%, respectively.Logistic regression analysis showed that age, month of admission, and the hour of discharge were associated with the outcome.Conclusion The high mortality between November and next March may be related to the higher incidence of respiratory diseases in winter, air pollution and cold weather.High mortality is also significantly associ-ated with the care quality of the medical staff.

Objective To investigate the effect of overexpression of P2X4 gene on cell apoptosis in 6-OHDA (6-hydroxydopamine, 6-OHDA) induced PD rat model. Methods One hundred twenty male Wistar rats were randomly divided into 6 groups: 6-OHDA group, control group, objective RNA-P2X4 + 6-OHDA group, target gene RNA-P2X4 group, P2X4-NC + 6-OHDA group and negative virus P2X4-NC only group. Lentivirus or negative virus carrying the target gene and or 6-OHDA or the same amount of physiological saline were injected into the left substantia nigra of rats according to the groups. The number of dopaminergic neurons in substantia nigra was measured by immunofluorescence method.The expression levels of P2X4R,caspase-1 and NLRP3 in substantia nigra were detected by Western blot assay. Results Compared with P2X4-NC + 6-OHDA group, the expression of protein P2X4R (1.099 ± 0.05569 vs. 0.7821 ± 0.02008, P=0.0003 ), NLRP3 (0.9875 ± 0.01932 vs. 0.6645 ± 0.01747. P<0.0001), caspase-1 (0.9948 ± 0.01788 vs. 0.8276 ± 0.04543, P<0.0001) increased significantly in RNA-P2X4+6-OHDA group. Conclusion overexpression of P2X4 gene can increase the expression of NLPR3 and caspase-1 protein and promote apoptosis in PD rats.

Objective To investigate the clinical effect of paclitaxel coated balloon in the treatment of symptomatic lower extremity arteriosclerosis obliterans.Methods From January 2016 to April 2017,64 patients with symptomatic lower limb arteriosclerosis obliterans ( ASO ) of femoral and popliteal artery stenosis admitted to Chongming Branch Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine were selected as the research subjects.According to the principle of randomization, they were divided into two groups, 32 cases in each group.In the drug?coated group, ordinary balloon was pre?expanded,and then paclitaxel drug?coated balloon was used to expand.If there were still retraction and stenosis of diseased vessels, which affected the blood flow of lower limbs, remedial stents were implanted.Bare stent group used a slightly smaller balloon to pre?expand superficial femoral artery and then release the stent.After one year follow?up, the changes of ankle?brachial index ( ABI), restenosis rate of target lesion vessels, Rutherford grading changes, clinical drive target vessel revascularization rate, perioperative period,death rate of patients during follow?up period, amputation rate and complication rate were observed.Results There were no amputations or deaths in the whole group during the perioperative period and follow?up.The incidence of complications in the drug?coated group was 3.1%( 1／32 ), significantly lower than that in the bare stent group 18.8%( 6／32) ( χ2 ＝4.010, P＝ 0.045).Before treatment,the ABI of patients in drug?coated group and bare stent group at 6 months and 12 months after treatment were significantly different ( Finter?group ＝ 7.028, Pinter?group ＝ 0.024, Fintra?group ＝ 219.028, Pintra?group＝0.000,Finteraction＝350.028,Pinteraction＝0.000),and ABI of the two groups at 12 months after treatment were (0.73± 0.11) and ( 0.68 ± 0.09),respectively, the difference was statistically significant ( t＝1.990, P＝0.025).Six months after operation, the restenosis rates of target lesions in the two groups were 9.4%(3／32) and 15.6%(5／32), respectively, with no significant difference ( χ2 ＝0.571, P＝0.450); The restenosis rate of bare stent group was 37.5%(12／32) 12 months after operation,which was significantly higher than that of drug?coated group by 15.6%(5／32) (χ2＝3.925,P＝0.048).Clinical observation results showed that 12 months after operation,the target?lesion revascularization (TLR) of the drug?coated group was 3.1%(1／32) and that of the bare stent group was 9.4%(3／32),with no significant difference.Rutherford grading was improved in both groups(χ2＝1.067,P＞0.05). Conclusion Paclitaxel drug?coated balloon is safe and effective in the treatment of symptomatic lower limb arteriosclerosis obliterans,which is worthy of clinical application.

Objective To evaluate the effect of weight-bearing alignment training (WBAT) in correcting anterior pelvic tilt in children with cerebral palsy.Methods Twenty-seven children with cerebral palsy and anterior pelvic tilt were recruited and randonly assigned to a WBAT group,a strengthening group and a standing group,each of 9.In addition to routine medication and rehabilitation training,the 3 groups received WBAT,strengthening training or standing training respectively for 20 minutes a day,5 times a week for 4 weeks.Before and immediately after the treatment,the subjects' anterior superior iliac spine-posterior superior iliac spine angles (ASIS-PSIS angles) were assessed along with their anterior-posterior angles (A-P angles) and distances in a 1-minute walk test.Results The WBAT group showed significant improvement in their average ASIS-PSIS angle (to 18.61 ± 3.13°),A-P angle (to 23.31±3.81°) and the distance in the 1-minute walk test after the treatment.The standing group had significant progress in improving their A-P angles (to 24.48±4.33°),and the strengthening group had significant improvement in the distance walked in the 1-minute walk test.The average improvements in the ASIS-PSIS angle and walk distance in the WBAT group were significantly better than in the other 2 groups.Conclusion WBAT is superior to strengthening and standing training in improving the ASIS-PSIS angle,A-P angle and walking ability of children with cerebral palsy and anterior pelvic tilt.

The dynamic changes of cognitive function has been paid more and more attention by foreign scholars.Dynamic assessment based on ecological momentary assessment(EMA)can capture subtle changes in cognitive function and provide more comprehensive information for early identification and timely intervention of people with cognitive impairment, which is an effective supplement to traditional cognitive assessment.This paper reviewed the concept of ecological momentary assessment, its advantages in cognitive assessment, its feasibility and effectiveness, and its application status in the evaluation of cognitive function in the elderly, so as to provide a reference for making ecological assessment of the cognitive function for older adults that is in line with China's national conditions.