0.05).The expression of survivin mRNA and BCRP mRNA was correlated with therapeutic effect of chemotherapy(P

Objective To objectively evaluate the endpoint ot transcatheter arterial chemoembolization (TACE) using two dimensional color-coded digital subtraction angiography (2D-ccDSA).Methods Retrospective analysis of twenty-four patients diagnosed with hepatocellular carcinoma (HCC),treated by TACE and evaluated by post-processed 2D-ccDSA.All patients were examined by DSA before and after TACE procedure,all these DSA series were converted into color-code images,the time density curve (TDC) was derived from the 2D-ccDSA imaging.Time-to-peak (TTP) was measured for the ostia of the catheter,the origin of the tumor feeding artery (TFA) and the embolized site of the TFA; maximal TDC enhancement was measured for selected spots of the tumor parenchyma.The tumor blood supply time (TBST) for pre and post-TACE was calculated accordingly.Data were interpreted with paired t test using SPSS.Results The TTP of the ostia of the catheter and the origin of the tumor feeding artery (TFA) before TACE were (3.47 ± 0.96) and (4.09 ± 1.09) s,after the TACE were (3.49 ± 1.02) and (3.78 ± 1.05) s,respectively.There was no statistical difference between the pre-and post-procedural TTP of the two landmarks (t values were 0.10 and 1.15,P values were 0.92 and 0.26).TTP at the embolized site of the main TFA were [(4.62± 1.16) and (5.59± 1.57)s]for pre and post-TACE,the tumor blood supply time (TBST) was greatly delayed compared with that after the TACE procedure [(1.82± 1.10)s and (0.52±0.41)s].The mean maximal TDC enhancements of the tumor parenchyma areas were (3.03±0.88)units before TACE and (1.10±0.67)units after TACE.The differences were all statistically significant (t values were 3.32,6.04 and 8.93,respectively,P＜0.01) Conclusion It is feasible to use 2D-ccDSA to objectively assess the endpoint of TACE procedures.

Objective To investigate the clinical efficacy,operative essentials and indications of hybrid spinal fusion surgery for cervical spondylotic myelopathy.Methods From August 2008 to December 2011,thirty-eight patients with cervical spondylotic myelopathy underwent hybrid spinal fusion surgery in our hospital.There were 27 males and 11 females,aged from 33 to 70 years (average,51 years).A total of 86 segments were treated (fusion 48 vs.non-fusion 38).Twenty-eight patients underwent a two-level surgery,and ten patients received a three-level surgery.The Japanese Orthopaedic Association (JOA) score and Visual analogue scale (VAS) were used to evaluate pre-and post-operative neurological function and pain,respectively.The pre-and post-operative range of motion of the cervical spine was measured according to Xrays.Moreover,the surgical complications were recorded and analyzed.Results Thirty-seven patients were followed up for 15 to 55 months (average,29.1 months).The improvement of neurological function was obtained in 36 patients.The JOA score was improved from preoperative 10.5±1.57 to 14.3±1.97 at final follow-up,with an improvement rate of 58.46％,and the results were excellent in 16 cases,fair in 20 cases and poor in 1 case.The VAS was improved from preoperative 7.3±1.04 to 3.2±1.41 at final follow-up.The Cobb angle changed from preoperative 25°±3.21°to 20°±2.56°at final follow-up.After operation,the neurological function was not restored in 1 case; hoarseness and bucking occurred in 2 cases; sore throat occurred in 22 cases; anterior displacement of prosthesis (PCM) occurred in 3 cases.Other patients had no complications,such as displacement,loosening and heterotopic ossification.Conclusion In hybrid spinal fusion surgery,the lesions segments are decompressed fully,the severely degenerative segments are fused,and the motion of the non-fusion segments is reserved.As a result,not only the stability of the cervical spine is achieved,but also an obvious improvement of symptoms and a satisfactory short-term efficacy can be obtained.Therefore,this method is an alternative procedure for cervical spondylosis myelopathy.

Objective To explore the relationship between airway responsiveness and bronchial asthma inhalation therapy .Meth-ods Select 50 asthmatic patients as research subjects ,Fluorine given inhaled salmeterol 50 mcg/fluticasone propionate 250 micro-grams ,1-2 times a day ,Respectively before treatment ,after treatment ,3 months ,6 months ,12 months ,conventional pulmonary function tests and bronchial provocation test ,Determination of peak expiratory flow (PEF) ,and a second forced expiratory volume (FEV1 ) ,maximum mid-expiratory flow (MMEF) and specific airway conductance decreased 35% or above to inhaled methacholine the concentration(PC35sGaw) .Results Three months after the majority of patients with clinical symptoms before treatment ,after treatment ,significant improvement ,PEF ,FEV1 increased significantly in all cases of bronchial provocation test is still positive ,six months after treatment ,more than 80% of patients with asthma ,complete control ,lung function returned to normal follow-up prov-ocation test positive cases of 38 cases ,up to 76% after 12 months of treatment ,more than 90% of patients with lung function re-turned to normal .29 cases(58% ) stimulation test positive .Conclusion Asthma clinical indicators have reached complete control to achieve the desired level of time earlier than the airway responsiveness ,airway responsiveness index value in the long-term follow-up of the combination therapy ,and adjust the treatment plan is superior to clinical symptoms and lung function ,is a serious assessment of asthmadegree of judgment and withdrawal of drug treatment of one of the indicators .

BACKGROUND:A large number of studies have shown that adult stem cels derived from multiple tissues are available to differentiate towards nucleus pulposus-like celsin vitro. It is unclear whether mesenchymal stem cels derived from nucleus pulposus tissues have the ability to differentiate towards nucleus pulposus-like phenotypes induced by transforming growth factor-beta 1. Up to now, there are few reports on the difference between the differentiation ability of mesenchymal stem cels derived from nucleus pulposus tissues and adipose-derived mesenchymal stem cels. OBJECTIVE:To compare the ability of mesenchymal stem cels derived from nucleus pulposus tissues and adipose-derived mesenchymal stem cels differentiating into nucleus pulposus-like cels under induction of transforming growth factor-beta 1. METHODS:The groin fat tissue and the coccygeal spine of rats were taken respectively to isolate and culture mesenchymal stem cels derived from nucleus pulposus tissues and adipose-derived mesenchymal stem cels by mechanical enzyme digestion method. Flow cytometry was employed to detect the expression of CD105, CD90, CD29, CD45, CD44, CD34, and CD24 of both two kinds of stem cels. Mesenchymal stem cels derived from nucleus pulposus tissues and adipose-derived mesenchymal stem cels were divided into complete induction group (complete induction medium with transforming growth factor-beta 1), incomplete induction group (complete induction medium without transforming growth factor-beta 1) and control group(DMEM/F12 containing 10% fetal bovine serum and 100 mg/L penicilin/streptomycin), respectively. After 14 days of culture, real-time PCR was used to detect the expression of colagen type II, Aggrecan and SOX-9 in each group. RESULTS AND CONCLUSION:CD105, CD90, CD29 expressed positively and CD45, CD44, CD34, CD24 negatively in both two kinds of stem cels. After 14 days of induced differentiation, the expressions of colagen type II, Aggrecan and SOX-9 in the two kinds of cels were significantly higher in the complete induction groups than in the control groups (P < 0.05). Under the induction of transforming growth factor-beta 1, the expression of colagen type II, Aggrecan and SOX-9 in mesenchymal stem cels derived from nucleus pulposus tissues was significantly higher than that in adipose-derived mesenchymal stem cels (P < 0.05). These findings suggest that both two kinds of mesenchymal stem cels have the ability to differentiate towards nucleus pulposus-like cels induced by transforming growth factor-beta, and mesenchymal stem cels derived from nucleus pulposus tissues may be more suitable as seed cels for nucleus pulposus tissue engineering research.

Objective To observe the clinical efficacy of Xiezhuo Zhubi Decoction combined with Etoricoxib for the treatment of acute gout arthritis.Methods Seventy acute gout arthritis patients were randomly divided into treatment group and control group,35 cases in each group.Based on the fundamental treatment,the control group were given oral use of Etoricoxib and the treatment group was treated with Xiezhuo Zhubi Decoction combined with Etoricoxib.The treatment for both group lasted for 7 days.Before and after treatment,the changes of blood uric acid,C-reactive protein and erythrocyte sedimentation rate in both groups were observed.After treatment,the clinical efficacy was evaluated,and the toxic and adverse effects were also monitored.Results (1) In the treatment group,the total effective rate was 91.4％;in the control group,the total effective rate was 71.4％.There were significant differences between the two groups(P ＜ 0.05).(2) After treatment,blood uric acid,C-reactive protein and blood sedimentation rate were much improved in both groups (P ＜ 0.05 compared with those before treatment),and the treatment group had better effect on improving blood uric acid and C-reactive protein(P ＜ 0.05).(3) The control group had 3 cases of nausea,while no adverse reactions occurred in the treatment group.Conclusion Xiezhuo Zhubi Decoction combined with Etoricoxib is effective for the treatment of acute gout arthritis,and its effects on relieving clinical symptoms and decreasing blood uric acid and erythrocyte sedimentation rate are better than Etoricoxib alone.

Objective To discuss the application of color-coded digital subtraction angiography (ccDSA) in quantitatively analyzing the instant perfusion changes of hepatic tumors during transcatheter arterial chemoembolization (TACE).Methods The clinical data of 35 patients with hepatocellular carcinoma (HCC) who underwent TACE were reviewed.Before and after TACE,two-dimensional DSA (2D-DSA) was performed by using the same parameters in all patients.The image sequences were post-processed with 2D-ccDSA.On ccDSA images the regions of interest (ROIs) were measured to obtain the time-contrast-intensity (CI[t]) curves as well as the perfusion parameters,including tumor blood supply time (TBST),area under the curve (AUC),contrast-intensity peak (C I-Peak) and maximum upslope (MS),which were used to evaluate the degree of the reduction in direct blood flow and in tumor staining.The relationship between the above parameters and subjective angiographic chemoembolization endpoint (SACE) was analyzed.Results After TACE,the perfusion parameters were significantly different from pre-TACE ones.AUC and CI-Peak values were dramatically decreased.After TACE,TBST slowed a significant delay.The reduction of perfusion about 30％-40％ was equal to SACE grade Ⅲ;the reduction of perfusion about 60％-70％ was equal to SACE grade Ⅳ.Conclusion 2D-ccDSA can be used to objectively and quantitatively evaluate the effect of TACE on the perfusion of hepatic tumors,providing useful indexes for making quantitative assessment of the degree of blood flow stagnation and the reduction of tumor staining.

Objective To understand the genetic characteristics of Enterovirus 71 ( EVT1 ) circu-lating strains of Guangdong province in 2008. Methods We isolated an EV71 strain from the fatal case of the hand, foot and mouth disease during an epidemic of Guangdong in 2008. Its complete genome was se-quenced and analyzed comparatively. Results The results showed that the full length of EV71 GDFS-3 ge-nome( not including poly A tail ) is 7405 bp. No insertion or deletion is detected in the coding region. There are several insertions and deletions in 5'and 3'UTR. Phylogenetic analysis of GDFS-3 and reference strains showed GDFS-3 strain shares the highest nueleotide homology with TW984 strain(96.0% ) but low homology with SIN5865, MS and BrCr( about 81.0% ). GDFS-3 strain also shares the highest amino acid homology with TW984 strain(99.0% ). It clustered with reference strains of CA subgenotype in the phylogenetie tree. The nucleotide identity with CA reference strains is 91.0% -95.0%. Conclusion The phylogenetic analysis based on the entire genome demonstrates that GDFS-3 strain has the nearest genetic relationship with TW984 strains ( isolated in 2004). GDFS-3 may belong to the same subgenogroup ( CA ) with Taiwan predominant strains. Otherwise,Some mutations in 5'UTR of EV71 may play the very important role in heightened viru-lence.

BACKGROUND:Endogenous stem cells have no repair effects on the process of disc degeneration. Authors assumed that this maybe associate with abnormal effects of related etiological factor, resulting in an inhibitory effect on the function of nucleus pulposus-derived mesenchymal stem cells. OBJECTIVE:To investigate the effects of inflammatory cytokine interleukin-1βon biological characteristics of nucleus pulposus-derived mesenchymal stem cells of rats. METHODS:Lumbar spinal nucleus pulposus was obtained from 3-month-old male Sprague-Dawley rats. Nucleus pulposus-derived mesenchymal stem cells were isolated and cultured with col agenase and sequential trypsin digestion. The expression of CD24, CD34, CD45, CD90 and CD105 was detected using flow cytometry. Stem cellgene SOX2 and Nanog expression was measured using RT-PCR. Adipogenic, osteogenic and chondrogenic abilities of nucleus pulposus-derived mesenchymal stem cells were observed. The apoptotic rate of interleukin-1β-treated nucleus pulposus-derived mesenchymal stem cells was detected using flow cytometry. Fluorescent quantitative PCR was used to measure the expression of SOX9, proteoglycan, type II col agenase and caspase-3 gene after nucleus pulposus-derived mesenchymal stem cells were treated with interleukin-1β.

Objective To differential the biologic characteristics and multiple differentiation potential of mesenchymal stem cells in nucleus pulposus in (NP-MSC) scoliosis patient and patient with degenerative interverthral disc.Methods The human nucleus pulposus-mesenchymal stem cells were isolated and cultured with enzyme digestion from 2 patients of scoliosis and 2 patient with degenerative intervertbral disc separately.Cellular proliferation was detected with MTT assay and trypan blue.The immunophenotype expression of NP-MSC was detected by flow cytometry in scoliosis and degenerative group.The multiple differentiation ability of cells was assessed respectively using alizarin red dye,Oil red O dye and immunohistochemical staining.Results The primary cell morphology of scoliosis NP-MSC was the shape of spindle,while the degenerative NP-MSC was inhomogeneous.However,both of them became spindle shape after passages.The scoliosis NP-MSC was stronger than degenerative one in metabolic activity and proliferation.The percentage of positive antigen expression of CD44,CD105 and CD29 was 97％-100％ in scoliosis NP-MSC group,but 88.7％-97％ in the degenerative group.The expression of mature cell marker CD24 was negative in both groups.Furthermore,the MSC i.isolated from both groups differentiated along the osteogenic,chondrogenic but not adipogenic lineages.Conclusion The scoliosis and degenerative NP contains mesenchymal stem cells.Moreover the scoliosis NP-MSC had stronger ability of cell metabolic activity and proliferation.These cells have multiple differentiation potential with the exception of their adipogenic differentiation ability.