Amyotrophic lateral sclerosis(ALS)is a progressive neurodegenerative disorder.Mutations in the Cu,Zn-superoxide dismutase(SOD1)gene cause ALS by an unknown gain-of-function mechanism.Current researches show that diminishing SOD1 mutation enzymatic activity does not account for motor neuron lose in ALS,while direct toxicity of variant SOD1 protein or aggregation of SOD1 protein may impart cell function and cause motor neuron death.Though motor neuron death is selective,other cells also participate in this course.The author reviewed recent advances in the relationship between mutant SOD1 and Amyotrophic Lateral Sclerosis.

[Abstrct] More and more laboratory indicators including serum creatinine , serum cystatin C , urinary microalbumin, N-acetyl-beta-D-Glucosaminidase (NAG), kidney injury molecule 1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), interleukin 18 (IL-18) and L type fatty acid binding protein (L-FABP) are used to diagnose and monitor acute kidney injury (AKI).However, the clinical applicability and limitations of these indicators , as well as the detection effect factors and biological variation on the diagnosis and monitoring of AKI are very important , especially how to combine the detection effect factors and biological variation to interpret test result is attached great importance by the laboratory personnel .

The paper expounds the practical significance of the humanistic quality of medical staff,and probes into the cultivation path according to the problems existing in the humanistic quality of medical staff,aimed at promoting the new health care reform orientation,in order to better practice the modern biological-psychological-social medical model,and to provide a useful reference for constructing harmonious doctor-patient relationship.

Chimeric antigen receptor natural killer cell (CAR-NK) is a new promising immunotherapy. NK cell can derive from peripheral blood cells, cord blood cells, NK-92 cell line and iPSC cells. CAR-NK cells can recognize target antigens non-specifically and are not restricted by human leukocyte antigens. Allogeneic infusion of CAR-NK cells does not cause graft-versus-host disease. It has a strong effect on primary cells of leukemia, lymphoma and multiple myeloma, thus making animal models have strong anti-tumor effect. Therefore, as a "off-the-shelf" product, CAR-NK cells have a wide range of clinical applications. In this paper, the construction of CAR-NK vector and its preliminary clinical application in hematological tumors and the challenges were reviewed.

[Objective]This paper aimed at discussing the application of pulse in the clinical through the analysis of medical cases by Wang Mengying. [Methods]Revisited the theory and practice of pulse in the medical cases of Wang Mengying and discussed Wang's experience in the clinical application of pulse in the diagnosis and treatment of diseases such as protration syndrome and cholera.[Results]The pulse is better than the other three in the diagnosis of patients with etiology and pathogenesis.Pulse can reflect the situation of patients ’etiology and pathogenesis.The process of disease can be plumbed through pulse diagnosis. [Conclusion] Ancient doctor attached great importance to the pulse,it can guide our clinical practice better through the study of pulse in modern clinical work.

Objective To observe the effect of community rehabilitation on the motor function and activities of daily living(ADL)of stroke patients.Methods 155 stroke patients were randomly divided into the exercises group(n=76)and control group(n=79)and evaluated with simple Fugl-Meyer Assessment(FMA),Modified Barthel Index(MBI)and Functional Comprehensive Assessment(FCA)before treatment and 1 and 3 months after treatment.Results The evaluations of FMA,MBI and FCA were not different between two groups before treatment.One month later,the scores of MBI and FCA of the exercises group improved significantly(P<0.01),but simple FMA not improved even to 3 months after treatment(P>0.05).In the control group,the simple FMA score not improved(P>0.05),the scores of MBI and FCA had a declined tendency with disease course prolong.Conclusion The effect of community rehabilitation on the motor function of stroke patients during convalescence is not significant,but community rehabilitation may improve ADL and the quality of life.

The term complication is defined as a secondary disease, an accident, or a negative reaction occurring during the course of an illness and usually aggravating the illness. It usually takes two forms: a secondary illness of a disease; or a complication resulting from medical treatments.Characteristic of being risky, predictable, uncertain, and relatively avoidable, complications are affected by a variety of factors. In the course of identifying medical malpractice, identification of complications should be achieved according to how complications occur and evolve in the entire course of treatment and care, whether staffs have followed standards and regulations for treatment and care, whether staff are well aware of their obligations to take precautions to avoid risks, and provide medical care once complications take place, whether malpractice exists in the practice of medical staff, whether a cause -effect relationship exists between complications in patients and harms caused to families and medical malpractice.

Objective To evaluate the technique of Kirschner with a hole and tensile developed from the Kirschner tensile band wire.Methods Forty-two cases with fracture of patella and 23 cases with fracture of ulna olecranon were successfully operated with this apparatus.Average age was 42 years old(range,24～78 years),including 38 male patients and 27 females totally.Results Fracture healing rate was 100%,the rate of excellent and good result was 95% after 9 months to 3 years follow-up.No tenderness,skin penetrating caused by the bolt ends,and loosen fixations were found.Conclusion This apparatus can be considered as a rigid,safe and effective method and can meet the biomechanics principle of the Kirschner tensile band wire,complication of the Kirschner tensile band wire could be avoided by using this technique.

Objective To investigate the curative effect and the feasibility of treating femoral neck fractures with cannulated screw fixation.Methods Twenty-three patients with femoral neck fractures were treated with cannulated screw fixation,their average age was 51 years old(range,12～86 years),including 7 male patients and 16 females totally.Garden Ⅱ 2 cases,Garden Ⅱ 6 cases,Garden Ⅲ 12 cases,Garden Ⅳ 3 cases.A patient who suffered from fractures displacement needed traction for 3～7 days before surgical operation and the opening reduction was necessary if reduction was not satisfactory.Results During the follow-up 11～33 months the rate of nonunion was 9%(2 cases) and the rate of avascular necrosis was 13%(3 cases).Conclusion Trectin femoral neck fracture with cannulated screw fixating is very simple and the trauma is small.This may improve the cure rate of the femoral neck fractures and it is easy to be spreaded across the basic-level hospital.

0.10). However, for patients with positive cervical lymph nodes, neck dissection plus radiotherapy resulted in a better local control rate than radiotherapy alone (P