Objective: To find out who is more suitable to be screened by MMSE (mini-mental state examination) Method: A total of 4921 persons aged 55 or above were collected by stratification cluster sampling for urban and rural areas of Xi'an They were screened by MMSE According to different age and education levels, the tenth percentage, median, skewness and kurtosis, and the positive predict value were calculated Results: MMSE scores showed a negative and cliff distributions whether among groups of different education level, among different age groups or in the total sample Moreover, these features was more obvious in relatively younger people (less than 70 years) with higher education level (high school or college), while in those aged more than 70 years with poor education (primary school or illiterate), the distribution of MMSE score was close to normal Consequently, the rates screened out by MMSE was higher in older and poor educated people than in those younger with higher education Multiple regression showed that education level, age, sex, lose of hearing, activity in daily life were factors having influence on score of MMSE Conclusion: In screening dementia, MMSE is more suitable for poor educated older people (older than 70)

Objective To study the feasibility of composite of human fibrinous gel and transgeneic MSCs aiming at replicating adenoviruses-bone morphogenetic proteins-2 (Ad-BMP-2) in repair of segmental bone defects. Methods Bone defects for 10 mm were created on the bilateral radius of 14 Japanese big ear rabbits and treated with four kinds of implantations (seven radii per group), ie, composite of transgeneic MSCs and fibrinous gel (Group A), composite of MSCs and fibrinous gel (Group B),fibrinous gel alone (Group C) and nothing as control group. The defects were observed radiologically and histologically and examined by biomechanical test at the 12th week after operation. Results The defects treated in the Group A were repaired and regenerated much more new bone, bridged earlier and stronger than those in the Group B 12 weeks after operation. The defects treated in the Groups C and D could not attain osseous tissue healing. Conclusions The composite of transgeneic MSCs and fibrinous gel can be used to effectively repair segmental bone defects.

Objective To explore the effects of galantamine on function of learning and memory and cholinergic neurons in cortex and hippocampus in rat models of Alzheimer's disease (AD) so as to further investigate the mechanism of cholinesterase inhibitors in improving the cognitive ability of AD patients. Methods The AD rat models established by injecting amyloid-beta protein (A? 1-40) into the bilateral Meynert nucleus were intervened with galantamine, and their abilities of learning and memory were measured with a behavioral test. Meanwhile, the changes in choline acetyltransferase (ChAT) in the rats were examined with immunohistochemical technique. Results In the AD model rats administered with galantamine, the performances in the test were significantly improved and ChAT immunoreactive positive neurons were increased significantly in hippocampus and cortex fields. Conclusion Galantamine can significantly improve the function of learning and memory of the AD model rats, and enhancing the survival characteristics of cholinergic neurons may be one of the important mechanisms, indicating a new possible mechanism of cholinesterase inhibitors as a remedy for AD.

BACKGROUND: Long-term follow-up of the patients undergoing anterior cervical discectomy and fusion (ACDF) shows some incidence of degeneration at the segments adjacent to the fusion level. Cervical total disc replacement may resolve this problem. OBJECTIVE: To compare the effects of cervical total disc replacement versus ACDF on the biomechanics of the segment adjacent to the operation level. DESIGN, TIME AND SETTING: The randomized controlled trial was performed at biomechanical laboratory in Beijng Trauma and Orthopaedic Institute from August 2007 to February 2008. MATERIALS: Eighteen samples of fresh goat cervical spine; Bryan artificial cervical disk (Medtronic); CSLP-VA cervical plate (Synthes); coral bone (Beijing Yihuajian Science And Trade Co., Ltd.). METHODS: The goat spines were divided into 3 groups: control group with no specific treatment; total disc replacement group, in which C5/6 segment underwent Bryan artificial cervical disk replacement and fusion; internal fixation group, in which the C5/6 segment underwent cervical discectomy, coral bone implantation and internal fixation with CSLP-VA cervical plate. MAIN OUTCOME MEASURES: The adjacent intervertebral disk pressure (IDP) was measured in flexion, extension, rotation and lateral bending under certain loading, and the pressure changes were compared among three groups. RESULTS: At level C4/5, the IDP between total disk replacement group and the control group had no statistical significances in flexion (P 0.05) but internal fixation group was significantly higher than control group (P=0.014). There were no significant differences among the three groups in IDP in extension, rotation and lateral bending. CONCLUSION: Compared with ACDF, the total disk replacement can reduce the adjacent segment IDP and may avoid the degeneration in adjacent cervical segment.

Infertility has become a global problem affecting human reproductive health.As an important treatment for infertility, assisted reproductive technology has made great progress over the past few decades.Rapid development has also taken place in medical devices for human assisted reproductive technology.It is imperative to establish the risk management and safety evaluation system of these products.In 2016, the industry standard YY/T 1434-2016 Human in vitro Assisted Reproductive Technology With Medical Equipment in vitro Mouse Embryo Test was officially released.In this paper, the key notes and elements of this in vitro mouse embryo test are briefly reviewed.

Liver transplantation is the best treatment for end-stage liver disease.Because of the severe shortage of donor sources,most of the patients died while waiting for liver grafts.Artificial liver support system can improve the liver function in a short time,and help patients to pass the waiting periods.Artificial liver support system takes place of composition,detoxification and metabolism function of liver,stabilizes the physiological and biochemical index of liver,relieves the burden of liver and helps patients to prepare for the liver transplantation.With the wide application of artificial liver support system,new types of the artificial liver support systems gradually conquered the defects of the old types,but they still have their own defects.This review concludes the merits and demerits of artificial liver systems,its clinical application and the problems so as to help the treatment of end-stage liver disease.

Objective To measure the changes of total factor productivity (TFP)of Zhejiang medical facilities for decision makers to promote their service efficiency.Methods Collecting the panel data of 2005-2010(four input indexes and five output indexes)from medical facilities in Zhejiang province and measuring with Malmquist index of DEA programs of DEAP2.1.Results The average annual TFP growth rate in the period is 2.0％.A further decomposition found that the average annual growth rate of technology progress is 1.8 ％,while that of technical efficiency and pure technical efficiency is only 0.2％respectively.In the meantime,no scale efficiency growth was found.Conclusion The average annual growth of total factor productivity of Zhejiang medical institutions is substantially low in the period,with technology recession found as well.To maximize productivity of the medical sector,the allocation and internal management should be strengthened to stimulate technical efficiency and scale efficiency while encouraging technology innovation.

Immunological rejection is the major barrier to successful transplantation.The immune response to an allograft is an ongoing dialogue between the innate and adaptive immune system that will lead to the rejection of allograft.Activation of elements of the innate immune system,triggered as a consequence of tissue injury sustained during cell isolation or organ retrieval and ischemia reperfusion,will initiate and amplify the adaptive response.Identifying the molecular pathways that trigger tissue injury,signal transduction and rejection facilitates the identification of targets for the development of immunosuppressants.

BACKGROUND:Renal tubular-interstitial lesion and fibrosis induced by peritubular capil ary reduction is a common pathway for various chronic kidney diseases which eventual y develop into end-stage renal failure. How to increase the density of peritubular capil ary network is the key to resolving renal interstitial fibrosis. Netrin-1, as a potent mitogen of vascular endothelial cel s, can promote the migration and proliferation of vascular endothelial cel s and induce angiogenesis. OBJECTIVE:To observe the protective effects of naked netrin-1 plasmid transfer on the remnant renal function of 5/6 nephrectomized rats and the effects of naked netrin-1 plasmid transfer on peritubular capil ary network, and to further discuss the possible mechanism. METHODS:Thirty Sprague-Dawley rats were randomly divided into sham, model and treatment groups. Upper and lower one-third of the rat left kidney was resected in the model and treatment groups, and then the right kidney was resected after 1 week to prepare remnant kidney models in rats. IRES2-EGFP and pCMV6-XL5-Netrin-1-IRES2-EGFP pGenesil-NPs plasmids were intravenously injected into the left renal vein while resecting the right kidney of rats in the model and treatment groups, respectively. RESULTS AND CONCLUSION:Compared with model group, the levels of blood urea nitrogen and serum creatinine decreased, the degree of renal interstitial fibrosis al eviated, the density of peritubular capil aries increased, and the netrin-1 protein expression in renal tubular cytoplasm increased in the treatment group. These findings suggest that the naked netrin-1 plasmid transfer can significantly improve the renal function of the 5/6 nephrectomized rats, reduce the pathological lesion and renal interstitial fibrosis of the remnant kidney, increase the density of peritubular capil aries, and decrease the expression of hypoxia-inducible factor 1α, thereby improving the anoxic condition of renal interstitial tubules.

Objective To analyse the levels of estrogen in women patients with Alzheimer's disease(AD),and the relationship of estrogen level,menarche age,age of menopause,pregnancy times with severity of AD.Methods A 1:1 matched case-control study was conducted.The study subjects were given neuropsychological test face to face in questionnaire,including MMSE,ADL,POD,FOM,WISE and HMT depression scale.All the women subjects accepted another questionnaire concerning menarche age,age of menopause and pregnancy times.Radioimmunoassay was used to measure the sex hormone level of all the subjects.Results The level of estrogen in serum was obviously lower in AD group than in the control group(P