This paper reviewed and analyzed the management and performance of 43 key clinical pmjeets in recent ten years in Fudan University(the clinical part of original Shanghai Medical University).It was found that hardware equipments of clinic,the ability of disease prevention,diagnosis and treatment obviously improved,the talent training and personnel structure received outstanding outcome,the academic level of basic researches got obvious promotion,the preponderant disciplines established gradually and consolidated,and the center radiation effect showed preliminary success under the aid of key project fund.Constructing the key clinical projects should boost actively amalgamation of medicine and sciences and pay a great attention to develop the medicine auxiliary discipline to further enlarge the clinical research achievements and fully display the guidance function for the development of our country~clinical medicine discipline under the new situation.

To study the role of a novel MDR-related gene MGr1-Ag in the multidrug resistant (MDR) gastric cancer. The whole length MGr1-Ag gene was cloned, and eukaryotic vectors carrying the full length of MGr1-Ag cDNA and its antisense expression vector were constructed. The sense vector and anti-sense were then transfected into MGC803 cells and SGC7901/VCR cells respectively by lipofectamine. The result showed that a 1.0kb fragment was successfully amplified by RT-PCR and cloned into pUCm-T vector. DNA sequencing suggested that the fragment was the properly encoded MGr1-Ag gene. Recombinant eukaryotic plasmids harboring MGr1-Ag and its antisense expression vector were also obtained by subcloning the gene into pCDNA3.1/V5-His, which was confirmed by endonuclease digestion. As confirmed by Western blot, stable cell strains with up and down-regulated MGr1-Ag expression were constructed. Those cell strains provided the basis for further study on the MGr1-Ag in MDR of gastric cancer.

0.05). Conclusion 1. Exogenous glutamate application via scala tympani can result in a rapid excitotoxic damage of cochlear typeⅠspiral ganglion cells of guinea pigs. 2. NT-3 can protect typeⅠspiral ganglion cell from glutamate neurotoxicity even applied 60 minutes after the occurrence of glutamate induced cochlear impairment. The result indicates that NT-3 may be an ideal candidate for the treatment of a series of acute neural hearing loss.It may lead to a better outcome when NT-3 gene therapy is actilized.

The State Key Specialized Scientific Projects bring the unprecedented opportunity for the development of variety disciplines and provide the critical timing for the improvement of science and technology of university. Meanwhile, it presents new challenges to develop the frontier of sciences and to promote cooperation and cross of different disciplines. Through the process of the programs, we will expect to train and find team leaders and outstanding scientists. This paper presented the brief outline how the researchers from the Departments of Infectious Disease and School of Pharmacy in Fudan University collaborated in a cross-discipline manner and integrated the research resources based on the objectives of the research programs. During the application, they reorganized research teams, combined the overlapping research fields to focus the direction of research fields according to the national and research needs. In the process of their application, they finally promoted the capacities for their competition and innovation which were undoubted to help us to establish headship/main forces in the fields of infectious disease precaution and devolvement of new clinical medicine in the future.

Objective To introduce our experience in embolizing cerebral ruptured-aneurysms of elderly patients in our hospital. Methods Totally 76 elderly patients were referred to our hospital due to ruptured-aneurysms.81 aneurysms were confirmed by DSA,all of them were sac aneurysms,among which 75 cases (body/neck≥ 1) were treated with balloon-assisted coiling,29 narrow-necked (body/neck≥2) aneurysms and 30 wide-necked (1 ≤ body/neck＜ 2) aneurysms were treated with balloon-assisted coiling successfully,but 6 narrow-necked (body/neck≥2) were treated with balloonassisted coiling in emergency,followed by a stent-assisted coiling in secondary embolization,4 cases with body/neck＜1 were treated with stent-assisted coiling technique in emergency,2 non ruptured aneurysms could not be treated.The times of balloon dilation were (2.1 ± 1.3),single expansion of filling was (33.4±14.1)s. Results The arterial thrombosis happened in two patients (2.7 ％),two aneurysms ruptured (5.3％) during the procedure. No stent-related thrombosis happened. 86were elevated as good,8 as serious according to the Glasgow outcome scale,neither died after operation or delayed thrombosis or infarction lesion during following up. Conclusions Balloonassisted coiling is a safe and effective method in elderly patients during acute stage of rupturedaneurysms.

Objective To explore the therapeutic strategy for intracranial ischemia due to extraand intracranial artery stenosis using endovascular stent angioplasty.Methods Totally 109 patients with extra-and/or intracranial artery stenosis were treated by endovascular stent in our hospital from March 2008 to September 2011.There were 93 cases with single stenostic lesion,16 cases with multiple stenosis and 5 cases with distal unruptured aneurysm.All patients received endovascular stentings and 94 cases were followed up for 3 20 months.Results All of the patients underwent endovascular stenting placement successfully.The average stenosises were(79.2 ± 13.4)％ before operation and(18.1 ± 9.20)％ after operation.During follow-up for(10.8 ± 4.2)months,mild restenosis occurred in 9 stenosises(7.0％)among 129 lesions and no serious stroke event was found.Conclusions Endovascular stent is safe and effective in treating extra and intracranial stenosis.It is important to investigate adequately cerebral blood flow in the multiple stenosis or in complicating other kind of vascular diseases before proper treatments.

Objective To investigate the relationship between brachial-ankle pulse wave velocity (baPWV)and different stage of cardiac dysfunction.Methods 253 consecutive patients with coronary atherosclerotic heart disease were enrolled from August 2006 to February 2007.Patients were grouped according to the functional classification of New York Heart Association(NYHA).The baPWV was measured non-invasively with a VP1000 automated PWV/ABI analyzer(PWV/ABI,Colin CO.Ltd.,Komaki.Japan).At the sanle time,BNP,EF,LAEDV and LVESV were measured in all the patients.Results Brachial-ankle PWV was significantly correlated with cardiac function classification of NYHA(r=0.444.P＜O.001),BNP(r=0.394,P＜0.001)and left ventriculat end diastolic volume(r=-0.130,P＜0.05),The under area of receiver operating charachateistic(ROC)curve was 73.9%.The ROC curve demonstrated that when the value of brachial-ankle PWV was equal to or larger than 1717 cm/s(≥1717 cm/s),the sensitivity of diagnosing mild cardiac dysfunction was 72.9%and specifity 61.8%.When its value was equal to or larger than 1900 cm/s(≥1900 cm/s),the sensitivity and specificity were 61.5%and 81.9% respectively.Conclusion Brachial-ankle PWV is significantly correlated to the NYHA classification of heart failure and it may be a prospective index to diagnose early stage of cardiac dysfunction.

Objective To investigate the current situation and influencing factors of overweight and obesity in the elderly from Changsha city.Methods Using stratified sampling,2500 elderly in Changsha were included for the investigation by questionnaire and physical examination.The influencing factors were analyzed with univariate analysis and two-level models.Results Among 2500 persons,the valid questionnaires were 2254,the effective rate was 90.16％.About 39.71％ (895/2254) of Changsha's elderly were in overweight and obesity (BMI≥ 24 kg/m2).Univariate analysis showed that there were significant differences in BMI among different area,education degree,income,marital status,drinking wine,drinking tea,physical exercises and occupation (x2＝ 304.17,18.39,19.35,12.93,13.29,11.77,12.87,12.84,all P＜0.05).The results of two-level models indicated that the independent influencing factors were income,physical exercises,drinking wine,age and occupation.Conclusions It is necessary to take interventional measures against elderly obesity and to encourage the elderly taking physical exercises and keeping reasonable diets.

Objective To identify PRKAR1A mutations in a pedigree with Carney's complex through clinical investigation and molecular biology research,and to summarize the genetic law,characteristics,and clinical features of this family disease.Methods The family members received a detailed medical examination and related biochemical tests.The hereditary history and clinical features were recorded.DNAs of 12 family members were extracted from blood and 9 exons and adjacent introns of PRKAR1A were sequenced.Results PRKAR1A mutation intron4 c.440+4 delG was identified in 7 family members,including the proband's patient,who presented special signs of pigmentation on the lips,buccal mucosa,and fingertips.Conclusions The deletion mutation (c.440+4del G) in intron 4 of the PRKAR1A gene was found in this family,which is possibly associated with the phenotype skin pigmentation.

Objective To explore the effect of core stability training (CST) on motor of upper limbs after stroke. Methods 60 patients with stroke were divided into observation group (n=30) and control group (n=30). Both groups accepted routine medicine and motor relearning program, and the observation group accepted CST before training. They were assessed with Simple Test for Evaluating Hand Function (STEF), modified Barthel index (MBI), and the Trunk Control Test (TCT) before and 4 weeks after treatment. Results The scores of STEF,MBI, and TCT improved after treatment in both groups (P<0.01), and improved more in the observation group than in the control group (P<0.01). Conclusion CST may facilitate the motor recovery of upper limbs after stroke.