The histological and biomechanical aspects of the osteogenesis in metaphysioto-my lengthening of the tibia were observed in 45 immature rabbits,which were divided into 3 groups as follows:(1)Group A:After metaphysiotomy,the periosteum and endosteum of the transected boneends were well-preserved.(2)Group B:After metaphysiotomy,the periosteum about 0.7 cm in width on the 2 bone ends was circumcised.Then the 2 bone ends were aligned without disturbing the endosteum.(3)Group C:After metaphysiotomy,a part of the bone marrow and endosteum in the 2 bone ends wwere removed.Then the 2 bone edns were well aligned and the periosteum was sutured up.In all the experimental animals,the tibia was lengthened by 1mm/day.It was found that in Group A,the formation and remodelling of the new bone in the lengthened area occurred quite early after metaphysiotomy and the new bone was good in its biomechanical quality;in Group B,the formation of new bone was retarded and the biomechanical quality of the new bone was not satisfactory;and in Group C,new bone formation was sluggish in the early stage after metaphysiotomy but it wwas active in the late stage,and the neww bone formed was similar to that of Group A in its histological morphology and biomechanical quality.The periosteum could grow synchronously with the slow traction without any tearing.In addition,osteotomy and mechanical traction could stimulate and accelerate periosteal osteogenesis.It is believed that an intact periosteal cuff is of significance in the osteogenesis of the lengthened area since it serves as a restriction framework for the adherent growing of the connection between the new bones of the 2 bone ends and periosteal osteogenesis plays a more important role than endosteal osteogenesis in the bony healing of the lengthened area.

OBJECTIVE:To provide policy recommendations for optimizing medicines distribution system reform in China.METHODS:Literature review and field investigation were used to mapping the medicines distribution system. Problems and influ-ential factors were analyzed and policy recommendations for optimizing the medicines distribution system reform were put forward. RESULTS & CONCLUSIONS:Medicines distribution system has been undergoing a rapid development and transformation under the overall health system reform. Most medicines distributors are still with small scale,low concentration,high cost,low profitabil-ity,lack of core competence, development of new form facing challenges. A large number of drug distributors still follow the tradi-tional business model,know little about modern drug supply chain management,and not understand their appropriate roles under the new social and economic development. Medical E-commerce face both opportunities and challenges in the process of develop-ing. Drug distribution industry needs vertical and horizontal integration, speeds up the socialization of the third party logistics and the healthy development of the medical electricity supplier, improves and perfects the drug distribution supervision system which is suitable for the healthy development of new form.

Objective Moyamoya disease is a progressive cerebrovascular occlusive disease. The etiology of the disease is unknown. most think that Moyamoya usually presents with cerebral ischemia in children and intracranial hemorrhage in adults. But we have some adults present with cerebral ischemia .This article will help us know better about moyamoya disease in adults present with cerebral ischemia. And will let us know better about treatment and prognosis of this disease.Methods We reviewed our experience 88 adults angiographically diagnosed patients with moyamoya. There are 49 patients with moyamoya disease initially present with cerebral ischemia. We report their clinical presentation, radiological findings, management, and clinical outcomes. Results The incidence of moyamoya disease presents with cerebral ischemia is 55.7% in adults .The mean age of patients at symptom onset was 32 years (range, 18~64 years). Ischemic strokes or transient ischemic attacks were the predominant initial presentations.7 cases present intracranial haemorrhage in follow-up period. There was no difference in clinical representation, image and cerebral infarction in this 7 case.Conclusions Moyamoya usually presents with cerebral ischemia in adults higher than we think. diagnosis and treatment of moyamoya disease in adults is essential to minimize residual mental and physiologic deficits. If we find patients 30-40 years old ,with cerebral infarction that can’t explain in conventional mode, we should pursuit these patients, in order to exclude Moyamoya disease .Structured multicenter randomized clinical trials are needed to further assess the best treatment modalities for patients with moyamoya.

Invasion of glioma is a complex process with multiple steps and multiple factors,including the inhibition of tumor cell adhesion,the degradation of extracellular matrix,the promotion of tumor cells migration and angiogenesis.The abnormal activation of Wnt/β-catenin signaling pathway is closely related to the invasion of glioma.The study of Wnt/β-catenin pathway affecting invasion mechanism of glioma will provide new ideas and targets for the treatment of glioma.

Objective To explore the mechanism of hepatic autophagy inhibition induced by ischemia-reperfusion injury in the aging liver.Methods The healthy male Lewis rats aged 3 months (3M) and 24 months (24M) were selected,and then were randomly divided into 3M IRI group,3M sham operation group,24M IRI group,24M sham operation group.In the experimental group,noninvasive vascular clamp was used to clamp the left and middle hepatic lobes (about 70o％ hepatic ischemia).The liver was subjected to ischemia at 37 0.5℃ for 30min and reperfusion for 6h.The hepatic duodenal ligament was dissected only by sham operation.The serum levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured at 6 h after operation.Liver tissues of each group were examined by liver pathology and the number of autophagosome of LC3B in liver tissue of each group was observed under confocal microscopy.The changes of autophagyrelated protein were analyzed by Western blotting.Results The levels of serum ALT and AST in 24M IRI group were significantly higher than those in 3M IRI group,the difference was statistically significant (P＜0.05).Pathological analysis showed that 3M IRI group showed spotty necrosis,the 24M IRI group showed massive necrosis and the infiltration of the inflammatory cells;Confocal microscopy showed that the number of autophagosome in the liver tissue of the 24M sham group was slightly lower than that of the 3M sham operation group and the number of autophagosome in the 24M IRI group was significantly lower than that in the 3M IRI group (P＜0.05).The levels of autophagyrelated proteins (Beclin1 and ATG4B protein) in 24M IRI group were significantly down-regulated compare to 3M IRI group (P＜0.05).Conclusion The ischemia-reperfusion injury of liver in aged rats inhibits autophagy,and its mechanism may be related to the decrease of autophagy-related protein level in hepatic ischemia-reperfusion injury.

Objective To explore the antibacterial active components of Flos Caryophylii. Methods The components were distilled by extraction and big - hole colophony. The minimum antibacterial concentration of components was detected. Results and conclusion The and - staphylococcus aureus active components of of Flos Caryophylii. include fat - soluble ingredients and water - soluble ingredients.

Objective To describe the clinical characteristics and etiology diagnosis of an outbreak of acute respiratory tract infection in a military camp. Methods Two hundred and twenty-five cases were investigated using unified epidemiological questionnaires to describe the epidemiological characteristics. The etiological tests of 30 pharynx swab specimen were performed. The serum neutralized antibodies of 52 patients in acute and convalescence phases were detected by neutralization test. The patients and their close contacts were isolated. Air, stuffs and ground were all disinfected. Results Two hundred and twenty-five cases were distributed all the camp with obvious dormitory aggregation and the aggregation rate was 44. 9%. Among the 225 cases, all cases had fever and 161 (71.6%) had cough, 111 (49.3%) had pharyngalgia, 102 (45.3%) had headache, 31 (13.8%) had chest stuffy and 4(1. 8%) had dyspnea. Twenty (66. 7%) phargnxswab specimens turned to be adenorirus gene positive by polymerase chain reaction. Pharynx swab specimens were cultured in HepG2, Hela, RD and Vero cells, and 16 (53. 3%) presented with cytopathic changes. IgM antibody screening demonstrated that 24 cases were infected with Adenovirus, and neutralization test showed that antibodies increased ≥4 folds in paired sera from 28 cases. During 10 days after patient isolation and general disinfection, there was no new case of Adenovirus infection. Conclusions This outbreak of acute respiratory tract infection in a military camp was caused by Adenovirus, Timely andreasonable preventing measures can control the epidemic quickly.

Objective To explore the influence of intubation-surfactant-extubation (InSurE)therapy combined with bilevel positive airway pressure (BiPAP)in the use time of mechanical ventilation,and to clarify the value of BiPAP in the treatment of respiratory distress syndrome in the preterm infants.Methods Toral 95 preterm infants with respiratory distress syndrome were treated with InSurE therapy during January 2011 to October 2014. Among them,the preterm infants before January 2013 were selected as control group who were treated with InSurE and nasal continuous positive airway pressure (nCPAP).After January 2013, 60 preterm infants were treated with BiPAP,as BiPAP group.The rates of InSurE failure,the need for mechanical ventilation (MV)on the 7th day after InSurE failure, total non-invasive ventilation time, total mechanical ventilation time, atmospheric oxygen therapy time and incidence of clinical complications were compared between two groups.Results ① There were no significant differences in the clinical data of the preterm infants between two groups, such as gender and age.② Although there was no significant difference in the failure rate of InSurE,but the rate of repeated mechanical ventilation during 1 week in BiPAP group was lower than that in control group (P <0.01).③ The Rank sum test result showed that the total time of non invasive ventilation in BiPAP group was longer than that in control group (P <0.01).The total time of invasive mechanical ventilation and oxygen therapy in BiPAP group was lower than that in control group (P < 0.05).④ The incidence of retinopathy of prematurity (ROP)and bronchopulmonary dysplasia (BPD)in BiPAP group was lower than that in control group.Conclusion BiPAP can significantly reduce the use of invasive mechanical ventilation after the failure of InSurE,thereby decreases the oxygen toxicity and barotrauma hazards.

Objective Cervical reserve cells are the maternal cells of cervical neoplasia. It's proliferation and origin were studied. Methods The pathological morphology of cervical reserve cell proliferating was observed by light microscopy in 238 cases of cervical benign diseases; Immunohistochemical technology of CD44v5 was used to inspect the expression of cervical reserve cells in 54 cases. Results and Conclusion 1.Reserve cell proliferation was common in most cases of cervical benign diseases and it was originated from stroma; 2 The proliferating reserve cells were composed of four types:large cells, small cells, clear cells and spindle cells; 3The expression of CD44v5 in reserve cells showed 100% strongly positive. The cells proliferation was common in begin diseases of cervix; Reserve cells possibly were originated from stroma.

Objective To evaluate the levels of serum TAM and Cyfra21-1 in diagnosis and chemotherapeutic efficacy assess-ment of patients with esophageal cancer.Methods The serum TAM and Cyfra21-1 levels were measured in 92 patients with initially diagnosed esophageal cancer or postoperative recurrence of esophageal cancer from September 2012 to September 2013 and 50 cases of healthy people in the same periods as control.The sensitivity and specificity of TAM and Cyfra21-1 were analyzed.Moreover,60 patients with high TAM and Cyfra21-1 levels before chemotherapy from September 2012 to A-pril 2014 were detected TAM and Cyfra21-1 levels after two cycles of chemotherapy.Relation between changes of TAM or Cyfra21-1 and chemotherapeutic efficacy were investigated.Results The diagnostic sensitivity of TAM for esophageal canc-er was 71.7%,which was higher than that of Cyfra21-1 (51.1%,P = 0.004).The diagnostic specificity of TAM and Cy-fra21-1 for esophageal cancer was 94.0% and 92.0% respectively.There were no significantly different between TAM and Cyfra21-1 (P =0.695).Of patients undergoing chemotherapy,the overall response was 25 cases,progress was 11 cases. There was no statistically significant difference in the coincidence rate of TAM and Cyfra21-1 (77.8% vs 75.0%,P =0.781).Conclusion Detection of serum TAM and CYFRA21-1 was valuable in the diagnosis and assessment of the thera-peutic efficacy of chemotherapy in patients with esophageal carcinoma.TAM was better than Cyfra21-1 in the diagnosis of e-sophageal carcinoma.