Objective To impove the cognition of allergic bronchopulmonary aspergillosis by analyzing its clinical characteristics.Methods 22 patients diagnosed as having allergic bronchopulmonary aspergillosis in our hospital were studied in their clinical characteristics,imaging findings,laboratory inspections,pathologies,therapies and follow-up results.Results (1)The patients consisted of 13males and 9 femailes.Asthma was present in 16 patients,and absent in 6 cases,some of which had no wheezing heard in lung auscultation.(2)Central bronchiectasis was present in 19 cases,with the upper lobe bronchial mainly involved.(3)Simple glucocorticoid therapy was used in 2 cases,the joint anti-fungal therapy in 19 cases(one case improved combined with itraconazole therapy after recurrence and one case improved with the joint itraconazole treatment,followed by recurrence of the symptoms after discontinued antifungal therapy and by the combination therapy again).Conclusion Clinical asthma is the most common symptom of ABPA.However,there are one-third of cases without history of asthma.Central bronchiectasis with formation of mucus suppository is a characteristic feature of ABPA which can prompt diagnosis and help in the prognosis.The combination of antifungal treatment can lead to improvement and reduce or eliminate the need of glucocorticoid therapy.

[Objective]To observe the nerve regeneration and functional recovery in the adult rats.[Method]The sciatic nerves on the left side of 15 rats were exposed and 1.0 cm long segments of the nerves were removed from the mid-thigh level and replaced by rabbit nerve made acellular through chemical extraction.At 4 months after procedure,the nerve regeneration and function recovery were examined with HE staining,NF-160 immunohistochemical staining,electrophysiological tests and sciatic functional index(SFI).[Result]In the rats repaired by acellular nerves,regenerated axons re-entered into the acellular xeno-nerve segments without excessive sign of inflammation following implantation.As stimuling(1.5 mA,0.1 ms,1.0 Hz) to the proximal sciatic nerves,the implanted segment resulted in motor evoked potentials,which were recorded from posterior tibial muscles.SFI showed a partial recovery of locomotion of the limb with sciatic nerve defect.[Conclusion]Sciatic nerves defect can be repaired by chemical acellular xenogeneous nerves in rats.There was partial functional recovery,which revealed the grafting with chemical acellular xenogeneous nerves may be a promising mehod for nerve defect in clinical.

Objective To investigate the mechanism of Smad ubiquitination-related factor 2 (Smurf2)neddylation. Methods The Smurf2 protein level was tested by overexpression of Nedd8,while the method of immunoprecipitation(IP) and Western blotting were used to analyz Smurf2-Nedd8 modification.The GST-pulldown experiment was conducted to prove protein interactions.The protein was obtained by grinding mouse tissue and Western blotting was used to test the protein expression level.Results Over expression of Nedd8 could lead to the down regulation of the Smurf2′s protein level.Smurf1 and Smurf2 could interact in the GST-pulldown experiment. Smurf1 could enhance Smurf2-Nedd8 modification.The Smurf2′s protein level was up-regulated in mouse tissue of Smurf1 C426A.Conclusion There is some relationship and also difference between Smurf1 and Smurf2.Smurf1 can enhance Smurf2-Nedd8 modification.

From March 1982 through December 1083, free transplantation of the perichondrium was used to repair the cartilagenous surface of interphalangeal joints in 5 cases of traumatic comminuted fracture. Of these 5 cases, the injury involved proximal interphalangeal joint of index fingers in 2 cases, proximal interphalangeal joint of the middle finger in 2, and carpometacarpal joint of the thumb in 1. The perichondrium was harvested from the 8th or 9th costal synchondrosis.X-ray film showed growth of new smooth cartilage surface, and the movement of the joints ranging from 10 to 30 degrees was observed 3 months after operation. Points to be observed in operation are: (1) About 0.5 cm of the recipient site of the phalange should be bitten away to expose the cancellous bone, thus a surface with better blood supply was created to receive the perichondrial transplant; (2) The recipient surface was reshaped into an articular surface so that no dead space was left between the recipient surface and the graft: (3) The transplanted perichondrium should be anchored onto the bone under certain amount of tension to insure close contact with the bony surface; (4) Immobilization should be enforced for 3 weeks post-operatively.

Objective To study the clinical,pathological and genetic features of myofibrillar myopathy caused by BAG3 gene mutation.Methods The clinical features and pathological findings of a patient with myofibrillar myopathy were analyzed.Genomic DNA of the patient was extracted from peripheral blood and the next generation sequencing was performed to explore the mutation of genes about myopathies.Results The patient presented with nine-year-old onset myopathy characterized by progressive difficulty for squatting,rigid spine and muscle atrophy in the limbs symmetrically.Peripheral neurogenic damages were found on electromyography.On muscle biopsy,myogenic and neurogenic damages with rimmed vacuoles appeared,and the deposited materials were positive for sarcoglycan,dystrophin-R and dystrophin-C.There was a reported heterozygous mutation in the exons of the BAG3 gene (c.626C ＞ T).Conclusion There is no specificity of clinical manifestation in myofibrillar myopathy,and the diagnosis of this disease mainly depends on muscle biopsy and genetic screening.

Objective To investigate the effect of Bcl-2 gene expression on the proliferation and apoptosis of human pancreatic cancer SW1990 cells.Methods Bcl-2 short guide RNA (Bcl-2-sgRNA) was designed and synthesized,and it was combined with CRISPR-Cas 9.After confirmation by gene sequencing,it was transfected into human pancreatic cancer cell line SW1990,then the cells with stable Bcl-2 gene knock-out were selected,and wild type SW1990 cells were used as control.The cell growth curve was determined by CCK-8 method.The number of clone formation was measured.Flow cytometry was used to measure cell cycle and apoptosis.Results Human pancreatic cancer cell line SW1990 with Bcl-2 gene knock-out was successful constructed.Compared with wild type SW1990 cells,the growth of SW1990 cells with Bcl-2 gene knock-out was inhibited,the number of clone formation was significantly decreased [(160.7 ± 10.0) vs (285.3 ± 14.2)],the proportion of G1 cells was significandy increased [(84.51 ± 0.97) ％ vs (57.49 ± 1.08) ％],the proportion of S phase cells significantly decreased [(12.82 ± 0.99) ％ vs (27.56 ± 1.65) ％],and apoptosis rate was remarkably increased [(12.67 ± 0.59) ％ vs (0.37 ± 0.35) ％],and the difference between the two groups was statistically significant (P ＜ 0.01).Conclusions Knock-out of Bcl-2 gene can inhibit the growth of human pancreatic cancer cell line SW1990,decrease the ability of clone formation,block the cell in G1 phase and greatly increase cell apoptosis rate.

Objective To determine the surgical approaches and evaluate the clinical efficacy of skin defects of the emergency thumb, finger reconstruction.Methods Emergency in 11 cases complicated skin defect of the thumb and the hand, fingers missing injured patients by using the method of combined of toenail flap of biped dorsalis pedis flap or the second toe.The implantation of thumbnail flap of dorsalis pedis flap combined with the second toenail flap was applied on 5 cases.3 cases had received the implantation of thumbnail flap of dorsalis pedis flap combined with the second toe and 3 cases with combined repair of the second toe of biped dorsal flap.Of all the cases, reconstruction of 3 fingers in 1 case, reconstruction of 2 fingers in 10 cases,5 cases with reconstruction by means of implantation of toenail flap of same pediele splitting flap or the second toe, 6 cases with repair of toenail flap of dorsalis pedis flap or second toe.Results Except for 1 necrosis occurred in 1 finger in 1 case of 3 fingers reconstruction, the rest of tissue flaps and fingers all survived.The primary healing was achieved postoperatively.The patients were followed up for 5-24 months.The functions such as grabbing, grasping, nipping were basically restored after the repair.The appearance of hand was also restored to a certain degree.Sensory recovery S2-S4 of reconstruction finger and flap was achieved.Healing was satisfying in the donor area, no obvious cicatricial contracture was seen, while the walk function was not affected.Conclusion The application of combined implantation of toenail flap of biped dorsalis pedis flap or the second toe in the repair of overall hand skin degloving injury could restore the function and appearance of the injured hands to a certain degree.It is proved to be an effective treatment method.

ObjectiveTo investigate the effect of primary duct closure and T-tube drainage after laparoscopic common bile duct exploration, as well as the criteria for clinical application of primary duct closure. Methods A retrospective analysis was performed for the clinical data of patients with common bile duct stones who were treated in The First Hospital of Jilin University from July 2014 to July 2015, and 51 patients who met the inclusion criteria were enrolled. Among these patients, 26 underwent primary closure of the common bile duct and 25 underwent T-tube drainage. The change in total bilirubin after surgery, time to recovery of gastrointestinal function, volume of peritoneal drainage at 1 day after surgery, time of removal of peritoneal drainage tube, complications, length of postoperative hospital stay, and total hospital fee were analyzed and compared between the two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThe length of postoperative hospital stay and total hospital fee showed significant differences between the two groups (t=-7.067, P＜0.001; t=-3.126, P=0.003). One patient in each group experienced a complication and was cured after treatment. ConclusionOn the basis of strict control of surgical indications, the primary closure of common bile duct after laparoscopic common bile duct exploration has the advantages of a short length of hospital stay, low hospital fee, and high quality of life, and is safe and feasible. Therefore, it holds promise for clinical application.

Objective To explore the feasibility and effectiveness of peer-assisted learning (PAL) in the clinical probation teaching of orthopaedics in excellent doctors classes. Methods Forty students in the 2014 excellent doctors class in Inner Mongolia Medical University were selected and randomly divided into the experimental group and the control group. The experimental group adopted the PAL teaching mode, and the control group received the ordinary teaching mode . At the end of the internship , theoretical knowledge and practical skills tests were conducted, and self-evaluation and course evaluation were completed in the form of questionnaires. Results The scores of the experimental group in theoretical knowledge and practical skills were higher than those of the control group, and the differences are statistically significant [theoretical scores (97.2±0.7) vs. (90.2±1.3); practical operation scores (98.5±2.4) vs. (89.2±1.5); case analysis (98.1 ±0.8) vs. (92.3 ±2.8), P<0.05]. Students in the experimental group were generally satisfied with their mastering of the basic theoretical knowledges and clinical practice skills of orthopaedics. Conclusion The application of the PAL model in clinical probation teaching not only stimulates students' enthusiasm for learning, but also enhances their eagerness in self-learning;it helps students master the basic theoretical knowledge and clinical skills better in clinical probation.

Objective To investigate the effect of exogenous taurine (TAU) on amino acid content in the brains of rats suffered hypoxic-ischemic brain injury (HIBD).Methods The 7-day-old SD rats were randomly divided into sham-operated group, control group and TAU treatment group.HIBD models in the later two groups were established following Rice-Vannucci method.On the basis of breastfeeding, TAU at 300 mg/(kg ·d) via tube feeding to the TAU treatment group and an equal volume saline solution to the sham-operated group and control group were given.The aspartic acid (ASP), glutamic acid (GLY), glycine (GLY), TAU and γ-aminobutyric acid (GABA) contents in the rat brains were measured by high-performance liquid chromatography at 48 h and 14 d after HIBD.Results At 48 h after HIBD, the TAU, ASP and GLU contents in the TAU treatment group were significantly increased as compared with those in the control group (P＜0.05);the GLU/TAU ratio in the TAU treatment group was significantly decreased as compared with that in the control group (P＜0.05).Fourteen d after HIBD, the TAU, GABA and GLY contents were significantly increased, the GLU content was significantly decreased, and the ASP/GLY, GLU/GLY and GLU/TAU ratios were significantly deceased in the TAU treatment group as compared with those in the control group (P＜0.05).Conclusion Exogenous TAU addition during lactation of rats suffered HIBD may improve contents of inhibitory amino acids as TAU, GABA and GLY, and modulate the ratio of main excitatory/inhibitory amino acids neurotransmitters.