Objective To explore the clinical effect of double micro-catheter technique for detachable coil treatment of intracranial an-eurysms. Methods From January 2010 to April 2014,there were a total of 83 patients with cerebral aneurysms treated with double micro-catheters,and the ratio of neck/body was 1/3~1. The double micro-catheters were positioned within aneurysm. The detachable coils were in-troduced to satisfactory position by different ways. There was always one undetached coil to hold the stability of detached coils till aneurysm compactly embolized. Results 83 cases were instantly compactly embolized with double micro-catheter technique. No coils out of aneurysm. There were two cases of ischemic complication during clinical treatment,one of them was died. One case ruptured during operation. Conclu-sion The double micro-catheter technique may be an optional and safe method during embolization of some cerebral aneurysms.

Objective To investigate the influence of recombinant human augmenter of liver regeneration (hALR) on gelatinase A(MMP 2) gene expression in experimental liver fibrosis. Methods Two kinds of animal model of rat experimental liver fibrosis induced by CCl 4 and albumin were established and different dosage of hALR (10,50 ?g?kg -1 ?d -1 )was given during the process of model making. Total RNA of liver tissues was isolated and MMP 2 gene expression levels were measured by reverse transcription polymerase chain reaction (RT PCR). Results In both rat models of experimental liver fibrosis, MMP 2 gene expression levels in two hALR preventing group were significantly lower than those of model group in different periods of model forming. MMP 2 gene expression levels in high dose of hALR treating group were significanfly lower than those of low dose hALR treating group. Conclusion hALR may have an effect on inhibiting gene expression of MMP 2 in experimental liver fibrosis.

The blood-brain barrier(BBB) is formed by the brain capillary endothelium and excludes from the brain approximately 100% of large-molecule neurotherapeutics and more than 98% of all small-molecule drugs.There are three routines to increase drug transport into brain,ie,neurosurgical,pharmaceutical chemical,and physiological ways and the later is most hopeful.The receptor-mediated transcytosis system on the brain capillary endothelium could be used as multifunctional vectors for drug active transport into brain.This provides the platform for CNS drug delivery programs.

Objective To investigate the effect of different dose of dexmedetomidine for pre-venting the visceral traction reaction during caesarean section under spinal anesthesia.Methods Two hundred ASA physical status Ⅰ-Ⅱ patients,full-term primiparas scheduled for elective cesarean sec-tion were enrolled in this randomized,placebo-controlled study.Patients were randomly allocated to receive dexmedetomidine in four groups:group C (0.9% normal saline),group D1(dexmedetomidine 0.6 μg/kg),group D2(dexmedetomidine 0.8 μg/kg),group D3 (dexmedetomidine 1.0 μg/kg),50 cases in each group.Two minutes after cutting umbilical,groups D1,D2,D3 received an intravenous infusion single-dose of 0.6,0.8,1.0 μg/kg dexmedetomidine respectively for 10 minutes.Group C was injected the same dose of saline.Maternal blood pressure (BP),heart rate (HR),Ramsay scores,visceral traction reaction conditions were recorded at three points:before iv (T0 ),10 min af-ter iv (T1 )and abdominal exploration (T2 ).Results As for the inhibition of visceral traction pain, groups D2 and D3 were obviously better than groups D1 and C,and there was no statistically signifi-cant difference between groups D2 and D3 at T2 (P <0.05 ).The effects of slowing down heart rate and increasing blood pressure were weaker in group D2 than that in group D3 at T2 .Ramsay scores were higher in groups D2 and D3 than in groups D1 and C (P <0.05),and there was no significant difference between groups D2 and D3 at T2 .Conclusion Administration of dexmedetomidine 0.8 μg/kg could alleviate the visceral traction reaction and had little effect on maternal hemodynamics.

The intracellular trafficking and subcellular distribution of exogenous gene is very important for gene delivery. A successful gene vehicle should overcome various barriers including endosomal membrane barriers to delivery gene to the target organelle. Traditional nonviral vehicle is unable to avoid endosomal pathway efficiently, so the efficiency of gene delivery is low and the application of gene drugs is limited. In order to achieve efficient nonviral gene delivery, a lot of researches based on endosomal escape have been carried out and some agents with the function of endsomal escape have been found. These agents facilitate the endsomal escape via various mechanisms, such as fusion into the lipid bilayer of endosomes, pore formation in the endosomal membrane, proton sponge effect and photochemical methods to rupture the endosomal membrane. In this review, various reported strategies for endsomal escape are described according to the escape mechanisms, and their applications in intracellular gene delivery are also discussed.

Cultivation of laboratory physicians in accordance with the needs of discipline should be a priority of education on laboratory medicine in China. Unfortunately, the professional career of Chinese laboratory physicians is presently entrapped in a dilemma owing to unfavorable settings, in-cluding the late start of laboratory physician training in this country, unmatched installation between higher school faculty and curriculum, faulty programs of in-hospital training, disparity in management policies, low social esteem, uncertainty in personal intention of employment, and poor knowledge of position awareness. This paper puts forward a lot of measures such as the development trend of the university curriculum, which is in compliance with the subdivision and refinement of clinical medicine, the establishment of a medical degree for a professional laboratory physician, constantly improving the standardization of laboratory physician residency training and continuing education system for the in-spection of doctors , setting up physicians inspection posts and giving a clear mandate to examine physicians inside the hospital, while outside of the hospital continually improving awareness and accep-tance of the laboratory physicians, giving more educational resources to laboratory physicians, so as to improve the overall level of the laboratory medicine.

Objective:To investigate the effects of IL-12p35 small interference RNA on immune functions of Dendritic cells in rats.Methods:DCs were generated by culturing bone marrow progenitor cells of rats with GM-CSF, IL-4 and LPS in vitro. The IL-12p35 siRNA was synthesized and transfected into DCs. The expressions of CD80 and MHCⅡwere examined by flow cytometry. Reverse transcriptase PCR analysis was used to detect IL-12p35 mRNA transcription and ELISA was used to detect IL-12 and IL-10 protein levels, respectively. The antigen presenting by DCs was evaluated by mixed lymphocyte responses.Results:IL-12p35 siRNA silenced DCs expressed lower IL-12, higher IL-10,and exhibited weak activity in stimulating the proliferation of allogenic T cells, but no changes on CD80 and MHCⅡexpressions.Conclusion:IL-12p35 siRNA interference exerts no effects on maturation of DC, but negative effect on immume function of DCs.

Objective To explore a 3D printing model of fracture restoration which can be used in preoperative planning and design for distal tibiofibular fractures.Methods A retrospective analysis was performed of the 35 patients with distal tibiofibular fracture who had been treated from October 2015 to September 2016 at our department.Bilateral tibiofibular CT scan was performed in all the cases to obtain Dicom data.Using Mimics 15.0 software,cross sections were created at 5 cm,10 cm and 15 cm above the knee joint at the bilateral upper tibiae and marked as PT5,PT10 and PT15.The long and short axles on the left and right sides were measured and compared (LL vs.RL;LS vs.RS).After the STL files for 3D models were generated using Mimics 15.0 software,a real-sized 3D model of the distal tibiofibular fracture and a mirror model of the contralateral tibiofibula were printed.The fracture lines were drawn and preoperative manoeuvre was performed on the mirror 3D printed model.The real operation used the implants preoperatively designed;the actual screw lengths were measured and compared radiographically with those designed in the preoperative manoeuvre.Results All the data were collected of the long and short axles on the 3 cross-sections (PT5,PT10 and PT15) of the left and right sides of the proximal tibia.The samples were paired into 6 groups.The correlation coefficients of paired samples were greater than 0.95,showing an extremely strong correlation.The differences between the left and right sides showed no statistically significance in paired samples of LR-RL and LS-RS groups on PT5,PT10 and PT15 cross-sections (P ＞ 0.05).All the 35 cases received surgical operation.The postoperative X-ray review showed fine agreement between actual surgery and preoperative design in terms of screw length and accuracy.The deviations were in an allowable range,leading to satisfactory internal fixation.Conclusions A mirror 3D model of the healthy side is of clinical value to some extent because it can serve as one for an anatomically reduced fracture which can be used for preoperative manoeuvre and preparation of implants.The contrasts between the long and short axles on the 3 cross-sections may simplify and facilitate comparisons of bilateral similarity,avoid the blindness in direct application of the health side mirror model for preoperative planning.

Objective To discuss the surgical method and efficacy of adult Dandy-Walker syndrome ( DWS) through retrospective anal-ysis and literature review .Methods There were 3 cases of adult DWS in our hospital from August 2010 to August 2011.One case of them was given posterior cranial fossa cyst peritoneal shunt , and the surgery adopted ordinary high voltage shunt .Case 2 was given left side of the lateral ventricle peritoneal shunt , and the surgery adopted ordinary high voltage shunt .Case 3 was given posterior cranial fossa cyst peritoneal shunt combined with left side of the lateral ventricle peritoneal shunt , and the surgery adopted double-end high voltage shunt .The two ends of the shunt were respectively linked with the diverter valve and abdominal cavity drainage tube through T -branch pipe .Results Among the 3 patients, there was 1 case failed to ease the headache symptoms , and it was relieved one month later .The preoperative symptoms of the oth-er 2 cases disappeared immediately after the surgery .During the 4 years of follow-up,preoperative symptoms of the 3 patients disappeared , and there was no positive signs .Conclusion For adult patients with symptomatic DWS ,shunt surgery can eliminate symptoms ,relieve the tension of the posterior fossa cyst ,achieve good curative effect , and there was no surgical complication .

Objective To analyze and summarize the risk factors of failed internal fixation for intertrochanteric fracture.Methods From April 2008 to April 2011,267 patients with intertrochanteric fractures in 4 hospitals were treated with internal fixation.The relationship between the failure of internal failure and possible factors as age,gender,hypertension,diabetes,the abuse of alcohol and tobacco,use of glucocorticoid,the degree of osteoporosis and fractures type were studied.According to the surgical risk assessment table,the patients were divided into low-risk,mid-risk,and high-risk group.The rate of internal fixation failure was compared in the 3 groups.Results We found 42 cases which showed radiographic failures.The internal fixation failure directly related with advanced age,diabetes,severe osteoporosis,unstable type fracture,but not gender,hypertension,the abuse of alcohol and tobacco,use of glucocorticoid.Risk factors of internal fixation failure included diabetes,osteoporosis degree,and fracture stability.Failed intertrochanteric fracture fixation mainly occurred in the mid-risk and high-risk groups.Conclusion Severe osteoporosis,unstable fracture,diabetes are risk factors of failure of intertrochanteric fracture fixation.These factors will affect the quality of surgery.For the patient with intertrochanteric fractures in the low-risk groups,internal fixation should be the first choice for treatment.For the patients in the mid-risk and high-risk group,internal fixation should be applied cautiously.For the aged patients in high-risk groups,hip arthroplasty is a wise option.