With the development and clinical use of the molecular targeted drugs and individualized treatment,cancer research has been focused on gene targeting diagnosis and treatment.Especially for the epidermal growth factor receptor (EGFR) signaling pathway-related genes,DNA replication-related genes,spindle apparatus format-related genes,cell metabolism-related genes and other molecular targeted detection and treatment,the polymorphism of targeting genes/molecules determines the clinical efficiency of the therapies.

Object To isolate and identify the artemisinin like impurities present in the mother liquor of synthetic dihydro artemisinin methyl ether, for the development of new drugs Methods Artemisinin like compounds in the synthetic mother liquor were isolated by chromatography Results 5 compounds were isolated and identified They were ? dihydroartemisinin methyl ether (Ⅰ); ?, 12 deoxy artemisinin 12 ol (Ⅱ); artemisinin (Ⅲ); octahydro 8 methoxy 4, 7 dimethyl furo benzopyran 10 yl acetate (Ⅳ) and 12 deoxy 11 en artemisinin (Ⅴ) Conclusion Compound Ⅴ was new

Objective To evaluate the effects of different depths of anesthesia with sevoflurane on cerebrovascular autoregulation in infants.Methods Twenty pediatric patients,of ASA physical status Ⅰ,aged 1-3 yr,undergoing elective hypospadias plasty surgery,were enrolled in the study.Single tube laryngeal mask was inserted after anesthesia was induced with 6％ sevoflurane inhalation.Caudal block was performed with 1 ml/kg of 0.2％ ropivacaine.Anesthesia was maintained with sevoflurane inhalation.The end-tidal sevoflurane concentration was adjusted to 1.8％,2.5％,3.3％ and 4.0％,and each concentration was maintained at this level for 15 min.The cerebral blood flow was collected from the middle cerebral artery immediately before adjusting the next concentration to record the Doppler spectrum and transient hyperemic response ratio (THRR) was measured.Results THRR at different depths of anesthesia with sevoflurane was larger than 1.09,and was within the normal range.THRR was significantly lower when the end-tidal concentration was 2.5％,3.3％ and 4.0％ than that obtained when end-tidal concentration was 1.8％.No significantdifference was detected in THRR between 2.5％ and 3.3 ％.THRR was significantly lower when the end-tidal concentration was 4.0 ％ than that obtained when the end-tidal concentration was 2.5％ and 3.3％.Conclusion Although the inhibitory effect on cerebrovascular autoregulation provided by sevoflurane anesthesia provides no obvious clinical significance,it shows statistical significance in infants.

Objective To explore the related factors with skin flap necrosis,we concluded the cases of patients with skin defects after free flap plantation.Methods From 2001 to 2016,188 cases about 20 influencing factors were analyzed (The characteristics of patients:age,sex,smoke,diabetes,high blood pressure;Preoperative factors:injured sections,injured causes,preoperative wound infection,preoperative wound osteomyelitis,the time from injury to operation;Intraoperative factors:operator,operation time,anesthesia time,intraoperative rehydration fluids,the way of vascular anastomosis,the number of venous anastomosis,the area of flap;Postoperative factors:flap hematoma,flap infection,vascular crisis) and multivariate logistic regression analysis was used to analyze the relationship between these risk factors and flap necrosis.Results All 188 cases were treated with free anterolateral thigh flap to repair soft tissue defect and it was revealed that the 174 cases were successful (92.55％) and 23 cases were occured vascular crisis (12.23％),8 cases were arterial crisis,11 cases were vein crisis,4 cases were ateriovenous crisis.After the treatment,the rescue was successful in 5 cases (38.46％).After the analysis we made the conclusion that the number of venous anastomoses,flap hematoma and vascular crisis were related with the skin flap necrosis.Conclusion The number of venous anastomose (≥2) will increase blood return to make the flap easier to survive.Intraoperative stanching and drainage tube placement work will reduce the skin flap hematoma as a result of reducing the skin flap necrosis.Artery and venous crisis handled in time,can enhance the survival rate of flap.

BACKGROUND:Pulmonary aspergilosis is a disease caused by pulmonary fungal infection. Its diagnosis and treatment is usualy delayed because of nonspecific clinical symptoms, physicial sign and imaging changes as wel as uncertainties of histological and bacterial findings. Therefore, it is necessary to establish mouse models of invasive pulmonary aspergilosis to investigate the underlying pathological mechanism and novel therapeutic methods. OBJECTIVE: To establish mouse models of invasive pulmonary aspergilosis, detect the expression ofγ-interferon, Tol-like receptor 2 and Tol-like receptor 4, and discuss the mechanism of action underlying invasive pulmonary aspergilosis. METHODS:Seventy-five female BALB/c mice of clean grade, aged 6-8 weeks, were randomly and evenly divided into five groups: blank control group (group A), immunosuppressive model group treated with high concentrations of Aspergilus fumigatus spore suspension (group B), normal infection group treated with high concentration of Aspergilus fumigatus spore suspension (group C), immunosuppressive model group treated with low concentration of Aspergilus fumigatus spore suspension (group D), normal infection group treated with low concentration of Aspergilus fumigatus spore suspension (group E). First, mice in the groups B and D were intraperitonealy injected with cyclophosphamide to establish immunosuppressive models. The mice in the groups D, E (108 cfu/mL) and groups B, C (109 cfu/mL) were treated with 12 mL Aspergilus fumigatus spore suspension through the use of nebulizer. Mice in the group A were treated identicaly with sterile PBS. At 1, 3, 5 days of infection, the pathological change of lung tissue was observed, the mass concentration of γ-interferon in bronchoalveolar lavage fluid and the expression levels of γ-interferon mRNA and Tol-like receptor 2 and Tol-like receptor 4 mRNA and protein in the lung tissue were determined. RESULTS AND CONCLUSION:Abscess, spores and very severe bleeding and congestion, widenened alveolar septum and tracheal epithelial cel shedding and necrosis were observed in the mouse lung tissue in the group B. At 5 days of infection, the mass concentration of γ-interferon in bronchoalveolar lavage fluid and the expression ofγ-interferon mRNA in the lung tissue in the group B were significantly decreased compared with the group A (P < 0.05). Tol-like receptor 2 expression was strongly positive in the group B. Tol-like receptor 2 expression in the group C was significantly lower than that in the group B (P< 0.05). Tol-like receptor 4 expression was positive in the groups B and C, and its expression in the group C was significantly greater than in the group B (P < 0.05). The expression of Tol-like receptor 2, 4 mRNA in the mouse lung tissue of group B was significantly increased at 1, 3, 5 days of infection (P < 0.05). These results suggest that atomizing high concentration of aspergilus fumigatus spore suspension to immunosuppressive mice can establish stable invasive pulmonary aspergilosis models with typical pathological features. The infection of aspergilus fumigatus can activate tol-like receptor 2, 4 at the same time, and the pathological mechanism is closely related to organism’s immune defense function.

OBJECTIVE Explore the waysof cochlear implantation(CI)surgery technique for bilateral profound sensorineural hearing loss patients with otitis media and mastoiditis. METHODS CI was performed in 29 patients with different of otitis media and mastioditis,26 of them underwent a single-stage operation,and 3 had a two-stage operation,according to the degree and extent of lesion. For patients with mild inflammation,cochlear implantation was performed after complete eradication of inflammation at the same protocol the patients with severe inflammation underwent an intact canal wall tympanomastoidectomy or reconstructed it initially,cochlear implantation was performed after the initial procedures. RESULTS One- stage or tow-stage operations of CI were carried out for 29 patients with otitis media and mastoiditis. All electrodes were implanted successfully,in which the CI went normally and electrode array were protected well. None of the cases showed recurrence of infection during an average follow-up period of 2-8 years. CONCLUSION The CI could be performed in otits media and mastoiditis patients after reversionary surgery . Individual management based on the degree and extent of the local lesion was emphasized.

Objective Carbonic anhydrase 1 (CA1) not only enhances the hydration reaction but also promotes the formation of CaCO3,which is an essential step for new bone formation in vitro.However,there is no direct evidence to demonstrate the involvement of CA1 in bio-mineralization in cells and tissues.This study is aimed to evaluate the important role of CA1 in bio-mineralization and ossification in cultured cells.Methods Calcification in Saos-2 cells was induced using osteogenic medium (OM) and the calcification was determined by Alizarin Red-S staining.The expressions of ossification protein marker Runt-related transcription factor-2 (Runx2),osterix (OSX),alkaline phosphatase (ALP),osteocalcin (OCN) and bone sialoprotein (BSP) were detected in the process of bone formation by real-time PCR.The expression of CA 1 in the calcified cells were measured using real-time PCR and Western blotting.We also detected calcification in Saos-2 cells in the presence of acetazolamide,an anti-carbonic anhydrase drug to CA1,to determine the role of CA1 in biomineralization in culture cells.T test analysis was used to compare the two groups,M-ANOVA of repeated measurs was conducted for different time point.Results Following the stimulation of OM,Saos-2 cells produced a great amount of calcium-rich deposits [0.68±0.03 vs 2.76±0.13,P＜0.01].Increased transcriptions of ossification protein markers were also detected in these stimulated Saos-2 cells,indicating that the OM launched the process of bone formation in the cells.CA1 had a significantly increased expression during this process [0.25±0.03 vs 0.94±0.06,P＜0.01].Following treatment with acetazolamide,the expression of CA1 evidently declined [1.09±0.05 vs 0.55±0.07,P＜0.05],and the mineralized nodule formation was declined [2.76±0.13 vs 2.19±0.07,P＜0.01].Conclusion These findings indicate that CA1 participates in the biomineralization and ossification,and may play an important roles in bone formation.

Objective To compare the effects of different doses of FTY720 on inhibiting expression of Caspase-3 and neural apoptosisin rats with acute spinal cord injury (SCI), and find out the suitable dose. Methods 200 female SD rats were randomly divided into 5 groupswith 40 in each group. Group A (laminectomy but not contusion) were administered 0.3 ml normal saline by gavage. SCI model was establishedby Allen's WD method at the T9 level of spinal cord in other groups. Group B were administered 0.3 ml normal saline after modeling.Groups C, D and E were administered 0.3 ml FTY720- saline solution of 1, 3 and 5 mg/kg respectively. All the groups were sacrificed at 6 h,12 h, 24 h, 48 h, 72 h (n=8, per each time-point). Caspase-3 expression was detected with streptavidin-peroxidase immunohistochemistry,and neural apoptosis was detected with the TUNEL method. Results Positive Caspase-3 expression and neural apoptosis were not observedin Group A at 6 h. In Groups B、C、D and E, the number of apoptotic cells increased with increased time of acute SCI, peaked at 24 h afterinjury, and then gradually reduced. Caspase-3 expression was at equal pace with neural apoptosis. The difference of the number of apoptoticand Caspase-3 expression cells among all groups were significant, with the order Group B>Group C>Group D>Group A (P<0.05). However,there was no significant difference between Group D and Group E (P>0.05). The number of apoptotic and Caspase-3 expression cells negativelycorrelated with the dose of FTY720 when the dose was less than 3 mg/kg (P<0.05), and there was no relationship when the dose wasmore than 3 mg/kg (P>0.05). Conclusion FTY720 significantly reduces Caspase-3 expression and neural apoptosis in rats with acute SCI.There is a dose-effect relationship between the dose of FTY720 and the Caspase-3 expression and neural apoptosis. It's indicated that 3 mg/kg is the most appropriate dosage.

Objective To investigate the effect of multidisciplinary diagnosis and treatment including ex-utero intrapartum treatment (EXIT) procedure to improve the prenatal survival rate of fetus with neck mass.Methods Multidisciplinary diagnosis and treatment model were carried out in four pregnancy women with fetal neck mass from September 2007 to February 2010.The model included prenatal assessment and monitoring,EXIT procedure during cesarean section,neonatal reassessment and surgical treatment by the cooperation of obstetricians,neonatologists,children surgeons,sonographers and anesthetists.Results All patients underwent cesarean section after 37gestational weeks.Mean delivery time was 37+4 weeks (37-38+3 weeks); mean birth weight was 2972 g (2600-3250 g); mean operation time was 4 min (2-7 min).The gestational age of primary diagnosis of fetal neck mass was 24-34 gestational weeks.After delivery,the size of neck mass was from 3.0 cm × 2.0 cm × 1.0 cm to 6.2 cm× 5.8 cm × 6.8 cm.The tracheal compression and displacement were found by color doppler ultrasound scan and magnetic resonance imaging in all cases.Two of them were completed with polyhydramnios and the others with normal volume of amniotic fluid.EXIT procedure was successfully carried out during cesarean section.Neonatal reassessment showed the trachea of three infants were obviously compressed and lapsed by enhanced CT; the infants relied on mechanical ventilation after birth and underwent operation on day 6 to 8.Tracheal impression was not presented in one infant and trachea cannula was removed on the second day,operation was not performed.All of those infants had good outcomes.Conclusions The multidisciplinary diagnosis and treatment model,including EXIT procedure,is a safe,efficient and feasible strategy,which is necessary for fetus with neck mass.