We have used continuous epidural anaethesia for 308 cases of orthopoedis operation of poliomyelitic sequel since 1983 to 1987. The satisfactory rate of anesthesia effect is 92%. However, as the disease caused by a special change of pathology, we have also found some ineffective cases. The causes of defect are multiple. The questions met during Anesthesia in our case series were discussed.

Objective To study the inhibitory effects of HLA-G1 expressed in ECV304 on the proliferation of allogeneic T cells.Methods The recombinant plasmid pcDNA3-HLA-G1 which contained a full-length cDNA of HLA-G1 was constructed, and the ECV304 cell was transfected with the pcDNA3-HLA-G1 by using the lipofectin transfection. The expressed HLA-G1 on the cell surface was checked by specific monoclonal antibody (G11E5) with indirect immunofluorescence assay and FCM. The HLA-G1 expressed in ECV304 was used as stimulator in co-culture with allogeneic T cells, to perform allogeneic T cell proliferation assay and to generate ECV304-specific alloreactive CTL. The proliferation of T cells and the CTL’s cytotoxicity against ECV304 were tested by the MTT method.Results The expression of HLA-G1 on the surface of the ECV304 was verified with the immunofluorescent staining of the pcDNA3-HLA-G1 transfected cells. The proliferation intensity of allogeneic T cells was significantly decreased after the HLA-G1 expressed in ECV304, as the stimulation index of co-culture of allogeneic T cells with plasmid pcDNA3 transfected ECV304 was 1.59?0.41, meanwhile it was 1.33?0.46 to pcDNA3-HLA-G1 transfected ECV304, with the difference being significant (P

Objective To study the protective effect of Duzhong Hongjingtian Capsule (DHC) on cerebral ischemia in rats. Methods Thrombotic ischemia and middle cerebral artery occlusion (MCAO) induced by FeCl3 in rats was used to observe the protective effect of DHC on ischemia stroke, and common carotid artery occlusion (CCAO) rats was used to analyze the effect of DHC on blood brain barrier (BBB) permeability. Results DHC could improve the abnormal behavior of MCAO rats and decrease the infarction area and water content in the brain of MCAO rats. DHC could also improve the cerebral blood flow on MCAO rats and significantly reduce the permeability for evans' blue (EB) of CCAO rats. Conclusions DHC can protect the brain ischemic injury.

HPV in remission CA,so the disease can be cured.

Objective To investigate the accuracy of the new trauma scoring method:Glasgow coma score (GCS),age and systolic pressure score (GAP),in diagnosing patients' traumatic condition and predicting fatality rate in department of emergency.Methods The chnical data of 27 706 traumatic patients in department of emergency were collected.The observation was categorized into three kinds:death within 24 h after reaching department of emergency (24 h death);death from 24 h after reaching department of emergency to 7 d (death after 24 h);survival.On the basis of the trauma mechanism,GCS,age and systolic pressure score (MGAP),the GAP method was used for judging traumatic condition and predicting fatality rate of traumatic patients in department of emergency.The accuracy of GAP in predicting fatality rate was compared with revised trauma score (RTS),trauma and injury severity score (TRISS) and MGAP.The C-statistics method was used to calculate the accuracy in predicted the fatality rate.Results The C values (0.936 and 0.961) of GAP in predicting fatality rate after 24 h and in 24 h were higher than RTS (0.917 and 0.958) and MGAP (0.920 and 0.950),but slightly lower than TRISS (0.950 and 0.970).The traumatic condition in GAP was defined in this way:severity 3-10 scores,moderation 11-18 scores,and slightness 19-24 scores.Conclusions The GAP is simple,practical and accurate in diagnosing patients' traumatic condition and predicting their fatality rate.It is helpful in physicians' decision of a proper treatment plan.

BACKGROUND: Polymethylmethacrylate (PMMA) can ameliorate the condition between vertebral pedicle screws and peripheral bone-matrix interfaces and notably enhance the strength of screw fixation. However, there are several disadvantages during and after operation such as polymerized thermal damaging effect, toxicity and unabsorbable etc. Calcium phosphate cement (CPC) is biocompatible and biodegradable with good biosafty and produce no heat of polymerization, which is a perfect substitute for PMMA.OBJECTIVE: To evaluate the reinforcing effect of CPC on vertebral pedicle screw fixation at biomechanical aspect.DESIGN: Randomized control and repetitive observed measurement.SETTING: Department of Orthopaedics, Second Affiliated Hospital of Nanjing Medical University.MATERIALS: The experiment was conducted in Tongji Medical College of Huazhong University of Science and Technology from August of 2002 to February 2003. ①Two fresh spines from male bodies respectively aged of 52 and 50 years were provided by the Anatomic Department of Tongji Medical College. Ten vertebrae in each spine were obtained (T8-12, L1-5) and taken as 52-year group and 50-year group. Radiographs of these vertebrae were taken to exclude congenital abnormality, fracture, tumor or other pathological changes. Vertebrae in both groups were osteoporoses of grade I and in accordance with experimental requirement.②Main components of solid phase of CPC were micropowder of tricalcium phosphate and tetracalcium phosphate (TTCP) and its main ingredients of liquid phase was citrate solution, which was prepared with solid phase in the ratio of 1g vs 1 mL.Primarily setting-time was 15 minutes and the final setting-time was 12hours with the maximum compressive strength between 45 Mpa and 57 Mpa. ③Diameter of self-made pedicle screws was 5 mm; Length of screw thread segment was 34 mm; Pitch was 2 mm; Depth of screw thread was 0.8 mm.METHODS: ①Biomechanical test of pedicle screw fixation at final solid time of CPC: Vertebrae of 50-year group were taken as testing subjects.Control lateral: vertebral pedicle screws were implanted directly in screw path; Strengthening lateral: vertebral pedicle screws were inserted after fillingwith CPC. After that, specimens were deposited in a thermostated container for twelve hours at 37 ℃. Maximum axial pull-out strength of vertebral pedicle screw was determinated. ②Biomachanical test of vertebra pedicle screw fixation when CPC primarily hardened: specimens in 52-year group were taken as testing subjects. In the same way, vertebral pedicle screw was implanted in the control lateral of vertebral pedicle,while that in the strengthen lateral was implanted after filling of cement,which were placed in the thermostated container for 15 minutes at 37 ℃,the maximum axial pull-out strength of vertebral pedicle in primary setting time were determinated. ③Biomechanical test of CPC in the reinforcement of loose vertebral pedicle screw fixation: vertebrae in 50-year group were selected. Loosened vertebral pedicle screws were re-fixed with CPC for 12 hours. Maximum axial pull-out strength of bilateral screws was tested.MAIN OUTCOME MEASURES: ①Biomechanical testing results of pedicle screw fixation at final solid time of CPC. ②Biomechanical testing results of vertebral pedicle screw fixation when CPC primarily hardened.③Biomechanical testing results of CPC in the reinforcement of loose vertebral pedicle screw fixation.RESULTS: ①Medians of maximum axial pull-out strength of vertebral pedicle screws in control and strengthening laterals in the 50-year group were 620 N and 1 136 N respectively. Compared with control lateral, that in the strengthening lateral increased by 83 % (P ＜ 0.01). Median of anti-cutting stress increased from 1.16 N/mm2 to 2.13 N/mm2 after being strengthened. ②The medians of those in the 52-year group were 554.5 N and 859.5 N respectively and that in the strengthening lateral increased by 55 % in comparison with that in the control lateral (P ＜ 0.01).The median of anti-cutting stress of reinforced bone-screw interface increased from 1.03 N/mm2 to 1.61 N/mm2. ③Maximum axial pull-out strength of vertebral pedicle screws in control and strengthening laterals in the 50-year group of 12 hours after re-fixation were 517 N and 876 N, which respectively increased by 63.6% or 54.2% (P ＜ 0.01) in comparison with median of that of loose screw in the same lateral.CONCLUSION: CPC can enhance vertebral pedicle screw fixation in primary and final setting time, with which loosened screws can be re-fixed.Vertebral pedicle screw in control lateral and strengthening lateral strips from bone-screw interface without peripheral bone and vertebral pedicle being destroyed seriously, which are beneficial to the second insertion of screw.

ObjectiveTo estimate the value of serum soluble scavenger receptor CD163 (sCD163) to the prognosis of patients with stroke associated pneumonia (SAP).Methods A prospective study was conducted. The clinically suspected SAP patients admitted to Department of Intensive Care Unit (ICU) and Emergency ICU (EICU) in Zhejiang Province Zhuji City Chinese Medicine Hospital from February 2014 to January 2015 were all enrolled. According to clinical pneumonia severity index (PSI), they were divided into SAP group and non SAP group according to the presence or absence of SAP, the patients of SAP group were subdivided into mild SAP group (PSI grade Ⅰ-Ⅲgrade) and severe SAP groups (PSI grade Ⅳ-Ⅴ grade) and according to the 28-day prognosis, the patients were subdivided into hospitalized death group and survival group. The clinical data were collected, including gender, age, history of stroke presence or absence, present stroke pattern, National Institutes of Health Stroke Scale score (NIHSS) on the day of stroke suspect diagnosis, Glasgow coma scale (GCS) score, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score, clinical pulmonary infection score (CPIS), PSI score, body temperature, result of chest X-ray film, oxygenation index (PaO2/FiO2), result of sputum culture, serum levels of white blood cell (WBC) and C-reactive protein (CRP) in a period of 7 days after the suspected diagnosis, PCT, sCDl63 levels on days 1, 3, 5, 7 days, length of stay in ICU, the total time of hospitalization and 28-day survival situation, etc. The ability of each index to evaluate the prognosis of SAP was analyzed by the receiver operating characteristic curve (ROC curve). The risk factors influencing the prognosis of SAP patients were analyzed by multivariate logistic regression analysis.Results ① Seventy-eight patients were finally enrolled in the study, 44 patients were diagnosed as SAP, 34 were non SAP. In 44 patients with SAP, there were 28 cases of severe SAP and 16 cases of mild SAP. On the first day of the suspected diagnosis, the NIHSS score [13 (7, 22) vs. 8 (4, 17), the CPIS score [6 (4, 9) vs. 4 (3, 5), sCD163 [mg/L: 0.80 (0.59, 1.32) vs. 0.33 (0.22, 0.46)], CRP [mg/L: 84.2 (50.8, 114.9) vs. 51.4 (26.2, 79.9)] and 28-day mortality [38.6% (17/44) vs. 11.8% (4/34)] in SAP group were significantly higher than those in non SAP group (allP < 0.05), and other basic indexes between the two groups were all of no statistical significant differences (allP > 0.05). ② The levels of sCD163 reached the peak value on the third day after the suspected diagnosis among SAP group and non SAP group, mild SAP group and severe SAP group, survival group and death group and then began to fall; the levels of sCD163, WBC, CRP, PCT within 7 days in SAP, severe SAP and death groups were higher than those in non SAP, mild SAP and survival groups (allP < 0.05). ③ROC curve analysis indicated: sCDl63 showed a better capacity for evaluating the 28-day prognosis of SAP [ROC curve (AUC) =0.673, 95% confidence interval (95%CI) = 0.515-0.807, sensitivity and specificity were 41.2% and 96.3% respectively and the cut-off was 2.65 mg/L]. However, the levels of other inflammatory indexes and scores on the first day after the suspected diagnosis had no value for early prognosis of SAP. The multiple logistic regression analysis showed that the level of sCD163 on the first day after the suspected diagnosis was the independent risk factor of death in hospital of SAP patients [dominance ratio (OR = 1.27, 95%CI = 1.06-1.52,P < 0.05]. Age (OR = 1.04, 95%CI = 1.01-1.06,P = 0.015), NIHSS score (OR = 2.86, 95%CI = 1.64-4.92,P = 0.010), CPIS score (OR = 1.52,95%CI = 1.28-1.90,P < 0.001) and APACHEⅡ score (OR = 2.06, 95%CI = 1.53-3.07,P < 0.001) were also the risk factors of influencing the death of patients with SAP.Conclusions Early sCD163 level is an independent risk factor in predicting the 28-day mortality of patients with SAP, and it has a certain value for the prognosis of SAP.

Objective The mutation of the ABCB6 gene is involved in a variety of diseases , including dyschromatosis univer-salis hereditaria (DUH).This study aimed to construct the expression vectors for the ABCB 6-DsRed fusion proteins, pDsRed-wt-AB-CB6 and pDsRed-L356P-ABCB6, detect its cellular localization in A375 cells, and thus facilitate future studies on the pathogenesis of ABCB6-related diseases . Methods The recombinant plasmids pDsRed-wt/L356 P-ABCB6 were constructed based on the previously constructed pIRES2-ZsGreen1-ABCB6 vector and then transfected into A 375 cells.At 48 hours after transfection , the expression of AB-CB6 was detected by Western blot and the cellular localization of ABCB 6 determined under the laser scanning confocal microscope . Results The expression vectors pDsRed-wt/L356P-ABCB6 were verified by colony PCR, enzyme digestion, and DNA sequencing. The expression of ABCB 6 was significantly increased in the A 375 cells after transfected with the recombinant plasmids .Confocal mi-croscopy showed the localization of both wild-type and mutant ABCB6 in the cytoplasm. Conclusion The expression vectors for wild-type and mutant ABCB6-DsRed fusion protein were successfully constructed and the localization of ABCB 6 in A375 cells was de-termined, which may serve as a basis for further studies of ABCB 6 and the pathogenesis of ABCB 6-related diseases .

Infectious disease has replaced methodology with the development of subject. Special topic combined with case teaching method is introduced into infectious disease. Practice has showed that,compared with traditional teaching method, special topic combined with case teaching method can arouse students' leaning interest, improve comprehensive analytical ability and innovate clinical performing skills.It is an effective clinical teaching method.

Objective To observe biological effect of cardiotrophin-1(Adv-CT1)gene transfection mediated by adnovims on traumatic brain iniuries(TBI)in-vivo and discuss the role and mechanism of Adv-CT1 on TBI. Metheds A rat TBI model was established bv Allen method.After Adv-CT1 was transfefred into the iniured brain by adnovims,the effect of CT-1 on apoptosis and survival of neurons after TBI was determined by means of Nissl staining,TUNEL and flow cytometry apoptosis assay. Resuits Apoptotic cells were increased but the survived cells decreased in the injured cortical brain and hippocampus from 12 hours to 14 days after TBI in the control group.As compared with control group,Adv-CT1 treatment reversed this situation to some degrees. Conclusion CT-1 has neuropmtective effect on neurons after TBI by reducing apoptosis of neurons.