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.

Entrepreneurship of the students in TCM colleges can help alleviate the pressure of employment and take advantages of TCM to benefit the public, deepen medical reform, promote the heritage and develop the TCM culture. The influence of the environment could be throughout the whole process of entrepreneurship. The entrepreneurial environment of the students from TCM colleges were analyzed in the following three factors, such as family environment, school environment, and social environment. Only these three environment work together could help entrepreneurship go well. Thus, it is important to change the traditional concept, develop education system of entrepreneurship, and improve the entrepreneurial support system.

Objective To survey the semen quality of healthy adult men in the Liaoning area.Methods We included 400 male volunteers of different ages who underwent a premarital examination and reproductive health checkup in 2015 for semen sample collection.The inclusion criteria were as follows:men who underwent unified semen analysis,those who answered the questionnaire for analysis of overall semen quality,and those who were aged 18-25,26-30,and 31-40 years.Results Among the 400 male volunteers,the consistent standard rate only reached 40.5％ according to the World Health Organization-specified reference values for testicular volume,semen volume,semen concentration,total energy,forward movement,livability,normal appearance,pH,liquefaction time,DNA fragmentation index,and high DNA staining index.The differences between the three groups were statistically significant (P ＜ 0.05).The results of the 18-to 25-year age group were better than those of the other groups.Conclusion Healthy adults' semen quality in the Liaoning area has declined in recent years;therefore,male reproductive health education should be seriously considered.

Benign lymphoepithelial lesion(BLEL) is known as Mikulicz disease.The clinical manifestation of BLEL mainly includes diffuse painless enlargement of the eye or the monocular lachrymal gland.The etiology and pathogenesis of the disease proposed mainly concerns the sex hormone hypothesis,transforming growth factor-β involvement hypothesis,basal cell hyperplasia invasion hypothesis,and IgG4-related hypothesis,etc..The typical pathological changes are infiltration of lymphocytes in the gland,atrophy of the gland tissue,formation of myoepithelial islands within the duct hyperplasia in the gland caused by infiltration of the tubular expansion.There is no uniform diagnosis criterion for this disease up to now,but it needs to be differentiated from idiopathic orbital inflammatory pseudotumor and Sj(o)gren syndrome in clinical diagnosis.The application of glucocorticoid is the primary treating regimen for benign lymphoepithelial lesion.Local radiation therapy and/or surgery extraction are available to patients unsensitive to glucocorticoid therapy.

Objective To evaluate the diagnosis and surgical management of appandiceal mucoceles.Method The clinical data of 50 patients with appendiceal mucoceles surgically treated from January 2004 to January 2008 were reviewed retrospectively. Result The correct preoperative diagnosis rate was 8%.Eight patients were complicated with pseudomyxoma peritonei.The canceration rate was 4%.All the 50 patients recovered uneventfully after the surgery.There was no complications,no recurrence during the follow-up period,including the 2 patients with canceration. Conclusion It was difficult to make correct diagnosis of appendiceal mucoceles preoperatively.The diagnosis should always be in mind if the B-type ultrasonography indicated a cystoadenoma.Abdominal CT coupled with necessary digestive image examinations may improve the correct diagnosis rate.Some patients may be complicated with pseudomyxoma peritonei.Occasionally this abdominal mass was also associated with malignancy.Surgery is the management of choice,and the prognosis is good.

[Objective]To study the application and clinical results of the adjustable erternal fixation of ankle joint(AEFA) in orthopedic surgery.[Method]From January 1999 to May 2005,45 cases(55 feet)of equinovarus deformity were treated with orthopedic surgery.In order to preventent the deformity relapsion,the patients were assigned to two groups.The A group(26 cases,32 feet)patients were treated with the adjustable erternal fixation of ankle joint(AEFA).The B group(19 cases,23 feet)patients were treated with plaster immobilization.The orthopedic surgery effect and functions of ankle joint were studied and tested with independent sample t test and x~2 test.[Result]Thirty-eight cases were fellowed-up for 3 months to 9 years(averaged 19 months).There were significant difference between the two groups in the functions of ankle joint.[Conclusion]The new apparatus can effectively prevent the foot-drop deformity and enhance the function of ankle joint.

Objective: To summarize our experience on 164 cases of retroperitoneoscopic nephrectomy and to analyze the clinical outcomes of retroperitoneoscopic nephrectomies. Methods: From October 1998 to July 2006, a total of 164 patients (91 males and 73 females; age range 2-80 years, mean age [49.5±25.7] years) have undergone retroperitoneoscopic nephrectomies in our department, with 95 undergoing radical renal cancer resection and 69 undergoing simple nephrectomies. Fifteen renal cancer patients visited doctors due to painless hernaturia and the rest 80 were detected during physical examination. The tumors were averagely (4.3 ± 1.2) cm (range 1.0-8.0 cm) in diameter, with 40 at T1N0M0 stage, 47 at T2N0M0 stage, and 8 at T3aN0M0 stage. Among the 69 simple nephrectomy cases, 3 were kidney atrophy, 46 were kidney dropsy, 3 were kidney maldevelopment, and 7 were kidney tuberculosis. All the kidneys were confirmed to have no function by radiological renal pictures. Results: The operative time was 25-180 min (mean, [53.5 ± 27.2] min) and the blood loss was 20-1 500 ml (mean, [150 ± 66] ml). Three cases were converted to open operations. The average hospital stay was (8.0 ± 4.4) days. Three renal cancer patients died of metastasis during a follow-up of 1-90 months and all the other patients survived. Conclusion: Retro entoneoscopic nephrectomy, with shorter operative time and quicker postoperative recovery, is a practical surgical procedure.

Objective: To investigate the influence of sirolimus on the disease progression of a rat model of autosomal dominant polycystic kidney disease (ADPKD) - Han : SPRD with chronic renal insufficiency. Methods: Twenty 6-month-old male ADPKD heterozygous (Cy/+) rats with chronic renal insufficiency were divided into 2 groups at random (n=10). Rats in experimental group received intragastric administration of sirolimus (0.2 mg · kg-1 · d-1) for 45 days and those in control group were bred routinely. The general state and renal function of rats were monitored throughout the treatment. The rats were sacrificed 45 days later and both kidneys were harvested, weighed; and the 2-kidney/ total body weight (2K/TBW) ratio was determined. Then the kidneys were subjected to immunohistochemistry examination and the numbers of cells positive of proliferating cell nuclear antigen (PCNA) were counted. Results: There was no death in the 2 groups and all rats gained weights, with no significant difference between the 2 groups, Blood urea nitrogen (BUN) increased progressively in both groups, with the increase in experimental group lower than that in the control group by 12.5 % on 45 days after administration (P<0.05). The 2-kidney-weight and 2K/TBW ratio in experimental group was lower by 11.8 % (P<0.05) and 7.1 % (P<0.01) than those in the control group, respectively. Renal enlargement and cystogenesis were inhibited by sirolimus, with the number of PCNA-positive cells per cyst being 0.23±0.11 in experimental group and 0.47±0.24 in the control group (P<0.05). Conclusion: Sirolimus can slow down the disease progression in Han: SPRD rats with ADPKD, even though they had been in a condition of renal insufficiency.

Objective: To investigate the differential expression of matrix metalloproteinases-1/tissue inhibitor of metalloproteinase-1 (MMP-1/ TIMP-1) between normal kidney, kidneys of patients with autosomal dominant polycystic kidney disease (ADPKD), and the original kidneys after renal transplantation (OKRT). Methods: DNA microarray technique was used to analyze the differential gene expression in the above 3 tissues. Semi-quantitive RT-PCR was performed to verify the differentially expressed genes. Results: There were 463 differentially expressed genes between normal kidney and ADPKD tissues and 130 differentially expressed genes between ADPKD and the OKRT tissues. Expression of MMPI/TIMP1 in the ADPKD and the OKRT tissues were significantly higher than that in the normal kidney tissue (P<0.05), with no significant difference found between the former 2 groups. Results of RT-PCR were consistent with the microarray findings. Conclusion: The pathogenesis of ADPKD may be related with the high expression of MMPs/TIMPs and the inhibitor of MMPs may have therapeutic effect on ADPKD.

? Intraoperative floppy iris syndrome is a particular symptom in phacoemulsification, and it is often occurred in patients with the history of using alpha-1 adrenergic antagonist before cataract surgery. Although the pupil be fully mydriatic before the operation, the progressive constricting of the pupil, the relaxing of iris even the iridoptosis and the unstable anterior chamber still can be found during the phacoemulsification. If treated inappropriately, severe complications and terrible outcomes may happen, which would influenced the surgery effectives. This paper reviewed the epidemiological characteristics, pathogenesis, risk factors, clinical manifestations, complications, and coping strategies of the intraoperative floppy iris syndrome.