Objective To construct pcDNA3 1(+)GDNF recombinant eukaryotic expression plasmid and to investigate its expression in eukaryotic cells. Methods The coding sequence of GDNF was amplified from rat astrocytes by reverse transcription PCR (RT PCR) and cloned into pcDNA3 1(+) eukaryotic expression vector The recombinant pcDNA3 1(+)GDNF plasmid was then transfected into eukaryotic cells mediated by using Fu Gene 6 method Analysis by restricting enzyme digestion and DNA sequencing were carried out to demonstrate the sequence of the plasmid GDNF protein and its activity were then determined using pcDNA3 1(+)GDNF plasmid transfected eukaryotic cells Results RT PCR product is 640 bp specific segment Analysis by restricting enzyme digestion and DNA sequencing of pcDNA3 1(+)GDNF recombinant showed results from restricting enzyme were 640 bp and 300 bp segments respectively DNA sequencing revealed that GDNF cloning was successful The recombinant plasmid can express active GDNF protein in eukaryotic cells Conclusion The study on the role of both GDNF and gene therapy is significant in the treatment of Parkinson disease

Complaints of medical consumers are caused by a good many factors,which aim at distincting medical pur?pose further,asking for economic compensation and justice,and punishing complained individual or complained hospital.It’s a realistic proposition on howto treat,reduce and avoid complaints,and maintain a correct attitude by units which ac?cept the complaints.

Objective To compare the efficacy and safety of prourokinase,reteplase and urokinase on the patients with acute ST -segment elvation myocardial infarction.Methods According to random number table,the eligible patients with acute ST -segment elvation myocardial infarction were randomly divided into prourokinase group (50mg,n =34),reteplase group (36mg,n =42)and urokinase group (1 500 000IU,n =32).The patency of infarct related coronary artery was estimated by coronary angiography at 90min after administration of thrombolytic agents.The adverse reaction was also observed including bleeding and the major adverse cardiac events(MACEs).Results The patency of culprit vessel in the prourokinase group was 76.50% (≥TIMI 2 flow),which in the reteplase group was 83.30% (≥TIMI 2 flow),and which in the urokinase group was 53.10% (≥TIMI 2 flow),respctively.Both of prourokinase group and reteplase group were higher in the patency than theurokinase group(χ2 =8.27,P =0.004). The MACEs and bleeding adverse reaction(prourokinase group 17.65%,reteplase group 28.57%,urokinase group 42.19%)showed that security of prourokinase group was securer than reteplase group and urokinase group(χ2 =6.36,P =0.012).Conclusion Both of prourokinase and reteplase are effective for the patients with acute myocardial infarction with ST -segment elvation,and prourokinase is safer.

[Objective]To present the basis for qualitative control by analyzing the components of polyphenols in Phyllantuus urinaria L.[Method]Raw material was extracted by 50% ethanol,then purified by acetic ethyl.The extract was injected into LC/MS after filtering with micro-membrane.[Result]The polyphenols mainly consisted of rutin,phyllansusiin,ellagic acid,etc,but less free gallic acid.[Conclusion]The total content of these compounds should be used for qualitative control instead of gallic acid.

Objective A large number of traditional Chinese medicine(TCM)are widely used for the treatment of patients with cerebral hemorrhage in China. The aim of this study is to systematically review the existing clinical evidences on TCM treatment for cerebral hemorrhage. Methods Randomized controlled trails(RCTs) of TCM treatment of cerebral hemorrhage were identified, eligible studies were included, the methodological quality of inclusive trails was assessed by the modified Jadad scale. The Cochrane Collaberation’s Revman 5.20 was used for data analysis. Results 69 RCTs were available and included. Meta-analysis indicated that relative risk of overall effective rate of Sanqi, Ciwujia, Chuanxiongqin and Naoxueshu were significant difference; SMD(95% CI) of neural function defect score was SMD=-0.46, 95%CI(-0.56,-0.35)of Sanqi, Danshen, Qingkailing, Liangxuetongyufang;SMD(95%CI) of the reduce of cerebral hemorrhage was SMD = -0.98, 95% CI(-1.32, -0.63)of Danshen, Dahuang, Ciwujia, Qingkailing, Liangxue-Tongyufang. Conclusions The evidence currently available showed that the TCM which included do not increase the death rate and adverse reaction of the patients with cerebral hemorrhage, TCM could reduce neurological deficit and improve the absorption of hematoma.

Transanal total mesorectal excision (taTME) is a hot topic surgical approach in the field of colorectal surgery. However, the therapeutic effect of this surgical approach is controversial. Based on the accumulated experience and evidence, the domestic and international consensus and guidelines on taTME have been updated and improved. The importance of taTME registry study is emphasized again in the 'International expert consensus guidance on indications, implementation and quality measures for transanal total mesorectal excision' published in 2020. The implementation of prospective case registration is the fundamental premise to ensure the quality of data and the advancing data collection methods and online platform construction can further improve the quality of data. Based on the latest taTME international consensus, the authors discuss the importance of case registry study to improve the data quality of taTME registry study and provide reliable and timeliness evidence based medicine in the field of colorectal surgery.

In recent years, the Gut Microbiota-Brain Axis theory has pointed out that there is an interaction between gut microbiota and central nervous system diseases.A number of studies have shown that there is a link between gut microbiota and depression, Parkinson's disease, and Alzheimer's disease.The association between gut microbiota and stroke has also attracted wide attention.This article reviews the association between gut microbiota and stroke.

Objective To investigate the application of whole-body diffusion-weighted imaging (WB-DWI),and to detect bone metastasis in malignant tumor patients.Methods A total of 118 malignant tumor patients prospectively underwent WB-DWI,standard MRI/CT in suspicious bone metastases parts within one week after inspection.Final diagnosis of the bone metastases in each patient was determined on the basis of results of all radiologic and follow-up examinations.The differential diagnosis value of apparent diffusion coefficient (ADC) in benign and malignant bone metastases was compared with the variance analysis.Results Area under ROC curve value of WB-DWI with standard MRI/CT (0.999) was larger than that of WB-DWI (0.944) and standard MRI/CT (0.983),and the specificity,accuracy and positive predictive value were also the highest(100.0 ％,97.4 ％,100.0 ％).The ADC values of malignant bone metastases were significantly lower than those of benign lesions[(0.71±0.15)×10-3 mmTs vs (1.50±0.23)×10-3 mm2/s] with a statistically significant difference(F =261.587,P ＜ 0.001).Conclusion WB-DWI is the beneficial supplements of standard MRI/CT.Which can be used for assessment and differential diagnosis of bone metastases in malignant tumor patients combined with ADC value.

Objective To prospectively and directly compare the capability of whole-body DWI,MRI and/or CT (MRI-CT),and whole-body DWI with MRI-CT for assessment of lymphatic metastases in non-small cell lung cancer (NSCLC) patients.Methods The institutional review board approved this study; informed consent was obtained from patients.A total of 56 NSCLC patients underwent whole-body DWI and thoracic CT scan prospectively.Conventional MRI was performed in suspicious lymphatic metastases parts within one week after inspection.Final diagnosis of the lymphatic metastases in each patient was determined on the basis of results of all radiologic and follow-up examinations.Two chest radiologists independently assessed all examination results and used a five-point visual scoring system to evaluate the probability of metastases.Final diagnosis based on each of the methods was made by consensus of two readers.Receiver operating characteristic (ROC) analysis was used to compare the capability for lymphatic metastases assessment among whole-body DWI,MRI-CT and whole-body DWI with MRI-CT.The detection abilities of lymph nodes with different size were compared with x2 test.Value of apparent diffusion coefficient (ADC) in the differential diagnosis of benign and malignant lymph nodes was compared with the variance analysis.Results (1) Lymph nodes metastases were divided into 3 groups according to the length diameter (＜ 2,2-3,＞ 3 cm).A statistically significant difference (x2 =13.819,P ＜ 0.01) was found in detection of lymph nodes (＜ 2 cm) among whole-body DWI,MRI-CT and whole-body DWI with MRI-CT(within the 123 lymph nodes,109,98 and 117 were detected respectively),whole-body DWI with MRI-CT was superior to conventional MRI-CT(x2 =13.324,P＜0.01).There were no statistically significant difference between the other 2 groups (in the length diameter 2-3 cm group,43,40 and 45 of all 46 lymph nodes were detected respectively by whole-body DWI,MRI-CT and whole-body DWI with MRI-CT,x2 =3.816,P ＞ 0.05,while in the length diameter ＞ 3 cm group,all of the 27 lymph nodes were detected by each of them.(2) Conventional MRI-CT was superior to whole-body DWI in the diagnosis of lymph node metastasis in NSCLC.The area under ROC curve value of whole-body DWI with MRI-CT(Az =0.978),the sensitivity,specificity,accuracy (97.4％ 、88.9％ 、86.3％ respectively) were significantly higher than conventional MRI-CT or whole-body DWI.(3)The ADC value of malignant lymph nodes were significantly lower than those of benign [(0.79 ± 0.15) × 10-3 mm2/s vs (1.59--0.15) × 10-3 mm2/s,F =332.813,P ＜ 0.01].The sensitivity,specificity,accuracy were 100％ with the cut-off value of 1.06 × 10-3mm2/s.Conclusions Whole-body DWI is the beneficial supplements of MRI-CT and can be used as a earlier clinical technique in patients with suspected NSCLC lymph node metastasis.Combined with ADC value,it can be used for assessment and differential diagnosis of lymphatic metastases in NSCLC patients.

Objective To assess the therapeutic effect and opportune time of surgical treatment of hepaticolithiasis . Methods The clinical data of 92 patients with hepaticolithiasis who underwent surgical treatment were analyzed retrospectively. Results (1) The incidence of postoperative complications was 14.1% (13/92 cases), in choledochoscopy group it was 9.3%(4/43 cases) and in the non choledochoscopy group 18.4%(9/49 cases) ; in the emergency operation group it was 36%(9/25 cases) and in selective operation group 5.97%(4/67 cases) . (2) The incidence of residual stones was 22.9%(21/92 cases); in choledochoscopy group it was 13.9%(6/43 cases) and the non choledochoscopy group 30.6%(15/49 cases); in emergency surgery group it was 36%(9/25 cases) and in selective operation group 17.9%(12/67 cases).(3)One pationt died from ACST two days after operation . All of the patients were followed up for 4-10 years; there were 80 cases (86.9%) who had a good therapeutic outcome. Conclusions Logical surgical procedure associated with choledochoscopy and appropriate timing of surgical intervention can markedly improve the effect of surgical treatment of hepaticolithiasis and reduce the incidence of postoperative complications.