Objective To evaluate the clinical effect of neuromatosis scoliosis treated by vascularized grafted rib Method The clinical date of 16 cases of neuromatosis scoliosis treated by surgical operation were analysed retrospectively Result Sixteen patients with scolisis caused by neurofibromatosis were treated by this technique The clinical result was satisfactory and solid fusion was observed in all patients within 6 months after operation Conclusion This operation is an effective method for the treatment of neuromatosis scoliosis

OBJECTIVE:To provide reference for the implementation of national essential drugs system. METHODS:Based on the experience on the implementation of national essential drugs system in the past year,relevant policies about essential drugs system were analyzed to probe into several issues on its implementation. RESULTS & CONCLUSION:The legal place of National essential drugs system should be further confirmed and qualification authentication of pharmaceutical enterprises involved in bidding for essential drugs list need to be standardized. Subject and proportion of essential drug use must be ensured as well as the supply of essential drugs to make sure the implementation of national essential drugs system.

Liver transplantation,as a new treatment for terminal-stage liver diseases,has made remarkable strides in the past decades.Animal models play an essential part in liver transplantation research,but differ from one another and have different limits to be used in imitating human clinical conditions.Therefore,it is the base for the development of liver transplantation to build and improve animal models by correctly selecting and utilizing different characteristics of different animals.

ObjectiveTo set up the porcine combined liver/small bowel orthotopic allotransplantation model.MethodThe donors including liver, about 2 to 3?m proximal jejunum, duodenum and a sma ll part of pancreas head were transplanted to the hybridized long-white recipie nt pigs after the resection of their livers and the majority of small bowels.ResultWithout using immunosuppressive drugs, the median survival time of the animals w as 92?h with the longest survival time being 196?h, and there was about 75?% of the animals lived for more than 24?h after operation.ConclusionThe successful establishment of the combined liver/small bowel transplantation m odel will do great favor to our future clinical practice and further study of th e combined liver/small bowel transplantation.

BACKGROUND: The glial scar formation after spinal cord injury in mammals is the physical and chemical barriers for neural regeneration, and relieving or delaying glial scar formation can provide benefit conditions for the regeneration of injured spinal cord.OBJECTIVE: To design and screen short hairpin RNA (shRNA) interfere molecular targeting the gene coding region of glial fibrillary acidic protein (GFAP) in rat, and reconstruct the eukaryotic vector of shRNA.DESIGN: An observational animal experiment.SETTING: Department of Spine Surgery, Shenzhen Hospital affiliated to Southern Medical University.MATERIALS: Twenty-five Wistar rats of clean degree, either male or female, weighing 20-25 g, were used. DMEM/F12,lipofectamine2000, Trizol RNA separating kits); fetal bovine serum (Hyclone); BamH Ⅰ, HindⅢ, Pstl, Sail and T4 ligases;Plasmid mini preparation kit and DNA gel extraction kit.METHODS: The experiments were carried out in the Shenzhen Hospital affiliated to Southern Medical University from October 2005 to June 2006. Three pairs of shRNA template which composed of 19 bp reverse repeated motif of GFAP target sequence with 9 bp spacer were designed and synthesized, then they were inserted directionally into plasmid Psilencer 2.1 respectively to generate small interfering RNA (siRNA) eukaryotic expression vector. ShRNA molecules were transfected by liposome via ex vivo expression repressive model of GFAP of rat spinal astrocytes. The effects of expressive suppression were detected with real-time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-PCR) and Western blot, and then the optimal shRNA eukaryotic vector of repressive expression of GFAP was screened.MAIN OUTCOME MEASURES: ① Interfering sequence specific shRNA template synthesis; ② Constructing specific recombinant plasmid eukaryotic expression vector. ③ Culturing rat spinal astrocytes in vitro; ④ Effects of expressive suppression on GFAP in primary astrocytes after RNA interference detected with real-time fluorescence quantitative RT-PCR and Western blot.RESULTS: Sequence analysis showed that GFAP-shRNA recombinant plasmid eukaryotic expression vector was successfully constructed, and optimal GFAP-shRNA eukaryotic vector was screened using real-time fluorescence quantitative RT-PCR and Western blot. The GFAP expressions were reduced by 81%, 63% and 56% at the levels of mRNA and protein respectively.CONCLUSION: GFAP-shRNA eukaryotic expression vectors were successfully constructed and screened. The gene expression GFAP of primitive rat astrocyte can be suppressed significantly by the GFAP-shRNA eukaryotic expression recombinant optimized via ex vivo cellular expression suppression model, which should pave the way for the following multiple targets of RNAi genetic manipulation in the treatment of suppression of glial scar formation after spinal cord injury.

Objective To compare the therapeutic effects of minimally invasive percutaneous nephrolithotomy(MPCNL) and retroperitoneal laparoscopic ureterolithotomy(RLUL) in the management of impacted upper ureteral calculi.Methods A total of 72 patients with unilateral impacted upper ureteral calculi were treated with MPCNL(n=45) or RLUL(n=27).The operation time,clearance rate of the stone,and the incidence of postoperative hyperpyrexia were statistically analyzed.Results All the operations were completed.As compared to the RLUL group,the MPCNL group had a significant shorter operation time [(43?9) minutes vs(69?17) minutes,t=-11.564,P=0.000].On the day after the operation,both the groups showed a stone clearance rate of 100%.No significant difference was detected in the rate of postoperative hyperpyrexia between the two groups [13.3%(6/45) vs 11.1%(3/27),?2=0.000,P=1.000).The patients were followed up for 1 to 24 months(mean,8 months),none of them developed ureteral stricture or recurrent stones during the period.Conclusion Both MPCNL and RLUL are safe,effective,and feasible for impacted upper ureteral calculi.

Objective To evaluate the predictive value of serum presepsin (sCD14-ST) for septic myocardial depression (SMD) in patients with severe sepsis or septic shock.Methods This was a prospective cohort study.A total of 84 patients with severe sepsis or septic shock were monitored by pulse indicator continuous cardiac output (PiCCO) system and divided into myocardial depression group (cardiac function index [CFI]<4.1 L/min, n=37) and non-myocardial depression group (CFI≥4.1 L/min, n=47) according to cardiac function index (CFI).Left ventricular ejection fraction (LVEF) was measured by doppler echocardiography at admission.The patients were divided into survival group (n=40) and non-survival group (n=44) based on 28-day mortality.Serum sCD14-ST,B-type natriuretic peptide(BNP), tumor necrosis factor-α(TNF-α), cardiac troponin Ⅰ (cTnⅠ) levels and hemodynamic parameters were observed dynamically at day 1,3,5 after admission.Quantitative data with normal distribution were analyzed using t-test and abnormal distribution data were analyzed using Mann-Whitney U test.Categorical data were analyzed using χ2 test.Results The serum levels of cardiac index (CI), global ejection fraction (GEF) and left ventricular contractility index (dPmax) in myocardial depression group were all significantly lower than those in non-depression group at day 1 after admission (all P<0.01).The serum levels of sCD14-ST, TNF-α and BNP in myocardial depression group were all significantly higher than those in non-depression group (all P<0.01).Serum sCD14-ST levels in 84 septic patients were positively correlated with both BNP and TNF-α (r=0.204, P<0.05 and r=0.516, P<0.01, respectively).The area under the receiver operating characteristics curve (AUC) of sCD14-ST was 0.782 for myocardial depression in patients with sepsis, with a sensitivity of 89.2% and a specificity of 78.0% at the cut-off point of 988 mg/mL.The predictive value of sCD14-ST was inferior to BNP and TNF-α (both P<0.05).The combination of sCD14-ST, TNF-α and BNP could provide better prediction value in septic myocardial depression.Logistic regression analysis showed that serum sCD14-ST was not the in dependent predictor for septic myocardial depression (P>0.05).There were 24 cases died in myocardial depression group.The mortality of myocardial depression group was significantly higher than that of non-depression group (64.9% vs 42.6%, χ2=4.132, P =0.042).The serum levels of sCD14-ST at day 1 and day 3 in myocardial depression group were significantly higher than those in non-myocardial depression group (both P<0.01).sCD14-ST levels in both groups showed downtrend.The serum level of sCD14-ST in non-survival group was significantly higher than that in survival group (P<0.01).Conclusions Myocardial depression is common in patients with severe sepsis and septic shock.High serum level of sCD14-ST is correlated with myocardial depression to some extent, but not an independent predictor.The combination of sCD4-ST, BNP and TNF-α can improve the predictive value for myocardial depression.

Now the in-service staff have been permitted to apply for master's degree with the same educational level aspostgraduates. This is a signal reforming policy in postgraduate education and degrees management area in China. Manyhigher professionals are trained for our socialist modernization construction by this education technology. Although therelatively perfect system to manage this project was established in China, there are still some problems demandingprompt solution on the management thoughts, management process as well as management methods in some authorizedunits.

Objective:To analyze the levels of immune cytokine in peripheral blood(PB) and the expressions of immune related transcription factors in placenta cytotrophoblast,which in patients with pregnancy-induced hypertension(PIH).And to explore the effect of fetal-maternal immune tolerance on pregnancy-induced hypertension.Methods:50 cases patients with PIH were selected as the observation group,and 40 healthy people were chosen as the control group.Enzyme-linked immunoassay(ELISA) was performed to detect the levels of IFN-γ,IL-4,IL-17 and TGF-β in peripheral blood.Quantitative Real-time PCR(RT-qPCR) and Western blot were used to analyze the mRNA expressions and protein levels of T-bet,GATA-3,RORC and Foxp3 in placenta cytotrophoblast,respectively.Results:①Compared with the control group,the IFN-γ and IL-17 levels in peripheral blood in the observation group were obviously higher and the TGF-β level was greatly lower(P<0.05).There was no significant difference of IL-4 level between the two groups(P>0.05),but the ratios of IFN-γ/ IL-4 and IL-17/TGF-β in the observation group were larger than that in the control group(P<0.05).②Compared with the control group,the mRNA expressios and protein levels of T-bet and RORC in the observation group were increased significantly(P<0.05),but that of GATA-3 and Foxp3 were decreased greatly(P<0.05).Thus,the ratios of T-bet/GATA-3 and RORC/Foxp3 in the observation group were significantly larger than that in the control group(P<0.05).Conclusion:PIH is occurred with the imbalance of Th1/Th2 and Th17/Treg,and it might be associated with the mechanism of fetal-maternal immune tolerance disorder that induced by Th cells.

Objective To explore the CT and MRI manifestations and diagnosis of primary small intestinal lymphoma( PSIL) .Methods The CT or MRI in 28 cases of PSIL confirmed by surgical pathology were retrospectively analyzed.Results 28 PSIL patients were confirmed to be non-hodgkin's lymphoma,17 cases were found in terminal ileum or ileocecal junction,11 cases were found in jejunum,near and the middle ileum.All had different degree of bowel wall thickening;CT scan displayed soft tissue density,contrast enhanced CT images demonstrated mild-to-moderate enhancement,uniform enhancement;PSIL was manifested as thick intestinal wall or a mass with slightly hypointensity signal on T1 weighted image,hyperintensity on T2 weighted images,hyperintensity on DWI images and mild to moderate homogeneous enhancement on contrast enhanced T1 weighted images.12 cases of aneurismal dilatation;manifestations were irregular round thickening of intestinal wall with infiltration with expansive;10 cases of infiltrating type,mainly for bowel wall thickening;6 cases of polypoid mass type,density of soft tissue mass,stenosis lumen.Conclusion CT and MRI has obvious advantages in the diagnosis of PSIL, plays an important role in the diagnosis and differential diagnosis.