Obesity is a developing public health issue. As a core organ in energy storage and metabolic modulation, adipose tissue becomes an important target in body weight control. Total caloric intake limitation and /or macronutrient ratio regulation are commonly used in obesity therapy. The anti-obesity agents derived from adipocyte products may bring us new ways more suitable to physiological status in the future.

Objective To develop a new method to repair the defect after enlarged excision of dermatofibrosarcoma protuberans.Methods This study included 8 patients with dermatofibrosarcoma protuberans measuring 2.5 to 5.5 cm in diameter.All the patients underwent enlarged excision of the affected skin and subcutaneous tissue.The defect measured 12.5 to 17.5 cm in diameter.Sieve skin flaps secured with a vacuum-assisted closure device were used to repair the huge surface defects.Results All the patients experienced the survival of sieve skin flaps at stage Ⅰ after operation,with no infection,effusion or necrosis.No relapse was observed during the 3 to 40 months of follow up.A satisfactory recovery was achieved in skin appearance and function with the formation of a flat scar,and no obvious proliferation occurred.Conclusion The vacuum-assisted closure device offers a safe and simple method for securing skin grafts to the defect after enlarged excision of dermatofibrosarcoma protuberans.

Objective To explore the ultrasonographic, clinical and histopathological characteristics features of primary uterus lymphoma. Methods The clinical, sonographic and histopathological characteristics of nine patients who were pathologically comfirmed as primary uterus lymphoma were analyzed. Results Among the nine cases of primary uterus lymphoma, three lesions were found in the uterine bodys and 6 were found in the cervixes. Two patients with uterine body lymphoma had painless pelvic masses and six patients with cervix lymphoma had contact bleeding, including irregular vaginal bleeding in four patients. In sonograms, six lesions showed remarkable hypoechogenicity with homogeneous internal echogenicity;the margins of most lesions were circumcribed;all lesions had posterior enhancement. In color Doppler lfow imaging, abundant vascularities were detected in eight lesions. In the cases of uterine body lymphoma, all of the uterine bodys showed diffuse symmetrical enlargement without disruption of the endometria, while in ifve cases of cervix lymphoma, the tumors showed the shape of lobule. The pathological examination showed that all tumors were diffuse B-cell type non-Hodgkin lymphoma. Conclusions Primary uterus lymphoma has some clinical and ultrasonic features, including contact bleeding or irrgular vaginal bleeding, diffuse symmetrical enlargement of uterine body, complete endometria, remarkable hypoechogenicity, homogeneous echogenicity and posterior enhancement. Final diagnosis depends on the histopathology.

Objective To investigate the resistant status and to type the phenotype and plasmid profiles of prevalent gonococcal strains. Methods A total of 98 gonococcal strains isolated from 1998 to 1999 in Zhanjiang was identified systemically. The susceptibilities of 98 strains of gonococci to penicillin,tetracycline and ciprofloxacin were detected by agar dilution method. The β － lactamase production was tested by iodometric method. The plasmids were extracted by alkaline lysis technique. Results The prevalence of gonococcal strains resistant to penicillin, tetracycline and ciprofloxacin were 22.44％ ,45.94％ and 55.12％ ,respectively. There were 6 positive strains for β － lactamase, accounting for 6.12％ (6/98). The most common phenotypes were susceptiblePT、 CMRNGT、 CMRNGPT and TRNG, accounting for 43.86％ ,23.46％ ,10.20％ and 10.20％ ,respectively. The detection rate of plasmids were 91.84％ .Among them, the percentages of 42.5 kb,39.5 kb,7.4 kb and 4.2 kb plasmids accounted for 11.22％ ,41.82％ ,59.16％ and 67.32％ ,respectively.There were 12 types of plasmid profiles(PP), the predominant types were 7.4kb＋ 4.2kb and 39.5kb＋ 7.4kb＋ 4.2kb, accounting for 21.42％ and 17.34％ ,respectively. Conclusion The gonococcal strains resistant to ciprofloxacin are very high in Zhanjiang. The phenotype and plasmid profiles of the strains have characteristic distribution.

There is mounting evidence that vascular pathology plays a role in the initiation and/or progression of the major disease of joints: osteoarthritis(OA).Potential mechanisms are:episodically reduced blood flow through the small vessels in the subchondral bone at the ends of long bones,and related to this,reduced interstitial fluid flow in subchondral bone and compromised nutrient and gas exchange into the articular cartilage,a potential initiator of degradation changes in the cartilage.The second is apoptosis of osteocytes in regions of the subchondral bone,which would initiate osteoclastic resorption of that bone and at least temporarily reduce the bony support for the overlying cartilage.It may be important to recognize these potential aetiological factors in order to develop more effective treatments to inhibit the progression of OA.

Objective:To analyze the clinical effect and influencing factors of closed reduction and percutaneous cannulated screw fixation in the treatment of femoral neck fracture in the adolescents, and to provide evidence for surgical treatment of femoral neck fracture in the adolescents. Methods:The clinical effect and influencing factors of 36 cases of femoral neck fracture treated by closed reduction and percutaneous cannulated screw fixation were analyzed. The time of operation, the time of fracture healing evaluated with X-ray image, the evaluation on the function after operation by Harris score of hip joint,and the occurrence of complications of the patients were observed.Results:All the cases were followed up for 6-24 months, average 16 months. One case of all patients had avascular necrosis of the femoral head, and accounted for 2.78% of all the patients;2 cases of all fractures were nonunion, and 5.56%.The remaining 33 cases were completely healed.The HHS-harris hip score results showed that 26 were excellent, 6 cases were good, and 2 cases were poor;the excellent and good rate was 88.89%.Conclusion:Closed reduction and percutaneous cannulated screw fixation in the treatment of adolescent femoral neck fracture is an effective program of operation;timing of operation, good reduction, and rigid internal fixation can decrease the femoral head necrosis and the incidence of complications.

With the development of higher medical education,the traditional academic year system can no longer meet the development of the times.This paper analyzes the advantages of the Credit System and the difficulties met by Medical Colleges and Universities that apply Credit System Management Mode,and make some proposals to the measures of the credit system management.

Objective To predict as well as bioinforrmatically analyze the target genes of has-miR-451.Methods miRBase, miRanda, TargetScan and PicTar were used to predict the target genes of hsa-miRNA-451.The functions of the target genes were demonstrated by Gene Ontology and pathway enrichment analysis.P＜0.05 was set as statistically significant.Results 18 target spots of hsa-miRNA-451 were predicted by 3 databases or prediction software at least.The functions of the target genes were enriched in proliferation and development of epithelial cells and regulation of kinase activity (P＜ 0.05).Pathway analysis showed that transforming growth factor-beta signaling pathway, mitogen-activated protein kinase signaling pathway, epidermal growth factor signaling pathway, Wnt signaling pathway and mammalian target of rapamycin signaling pathway were significantly enriched (P＜0.05).Conclusion hsa-miRNA-451 might be involved in various signaling pathways related to proliferation and development of epithelial cells.

BACKGROUND:Tumor necrosis factor-α(TNF-α), a main cytokine inducing chondrocyte apoptosis of osteoarthritis, plays a regulatory role in the process of osteoarthritis. OBJECTIVE:To compare the rat models of chondrocyte apoptosis induced by different mass concentrations of TNF-α, thus providing theoretical basis for further study on the regulation of drugs on chondrocyte apoptosis. METHODS:Chondrocytes were isolated from the knee cartilage of 4-week-old Sprague-Dawley rats of clean grade by mechanical l col agenase digestion and were then incubated with different mass concentrations of TNF-αto induce apoptosis. The morphology of chondrocytes was observed under inverted phase contrast microscope, cel s were identified using immunohistochemical staining of type II col agen, as wel as the cel viability and apoptosis were detected by MTT and DAPI, respectively. RESULTS AND CONCLUSION:(1) In vitro, the cytoplasm of chondrocytes was stained brown-yel ow by using immunohistochemical staining of type II col agen. (2) At 48 hours, the apoptosis rate of chondrocytes induced by 10, 20 and 30μg/L TNF-αwas significantly higher than that of the 0μg/L TNF-α(P<0.01), and the apoptosis rate of chondrocytes induced by 40μg/L TNF-αwas significantly higher than that of the 10μg/L TNF-α(P<0.01). (3) The viability of chondrocytes induced by 10, 20 and 40μg/L TNF-αwas significantly lower than that of the 0μg/L TNF-α(P<0.01). In detail, the viability of chondrocytes induced by 20μg/L TNF-αwas lower than that of the 10μg/L TNF-α(P<0.05);the viability of chondrocytes induced by 40μg/L TNF-αwas significantly lower than that of the 10 and 20μg/L TNF-α(P<0.01, P<0.05). (4) These results suggest that 20μg/L TNF-αcan successful y induce the chondrocyte apoptosis model.

Objective To analyze the aetiological characteristics and bacterial susceptibility in chronic obstructive pulmonary disease (COPD) complicated with ventilator-associated pneumonia (VAP) after mechanical ventilation. Methods To review the clinical characteristics, aetiological flora and bacterial susceptibility in 28 patients complicated with VAP in the ICU in recent years. Results The incidence rate of VAP was 66.7％. 91 clinical bacteria and 10 mycete isolates were collected, 64 (80.3％) were Gram-negative bacteria (GNB) and 27(29.7％) Gram- positive bacteria (GPC). The dominant bacteria was Xanthomonas maltophilia in COPD complicated VAP. Conclusion The main kind of bacteria in COPD complicated VAP after mechanical ventilation was GNB, and all kinds of the bacteria showed high tolerance. More attention should be paid to the cultivate aetiological bacteria and bacterial susceptibility and select the most suitable antibiotics in the treatment of VAP.