BACKGROUND:There are no available therapies for spinal cord ischemia-reperfusion injury, and stem cel transplantation is a focused topics. OBJECTIVE:To observe the therapeutic effect of hypoxia-inducible facotr-1α gene-modified umbilical cord blood mesenchymal stem cels (UC-MSCs) transplantedvia the infrarenal abdominal aorta on spinal cord ischemia-reperfusion injury in rats. METHODS:Thirty adult female Sprague-Dawley rats were randomly divided into three groups, with 10 rats in each group. The infrarenal abdominal aorta of rats was occluded surgicaly for 1 hour, and then the spinal cord reperfusion was restored. At 2 hours after reperfusion, 1 mL of 10% PBS, UC-MSCs suspension and hypoxia-inducible factor-1α-modified UC-MSCs suspension was injectedvia the infrarenal abdominal aorta, respectively, in the three groups. At 1, 6, 12 days after injection, Basso-Beattie-Bresnahan scores were recorded and western blot assay was used to detect hypoxia-inducible factor-1α protein expression in the spinal cord. The motor-evoked potential was determined at 12 days after injection. RESULTS AND CONCLUSION: Compared with the control group, the Basso-Beattie-Bresnahan scores were significantly higher (P < 0.05), the expression of hypoxia-inducible factor-1α protein in the spinal cord tissue was significantly increased (P < 0.05), the motor-evoked potential latency was shortened (P < 0.05) and the amplitude was increased (P< 0 .05) in the untransfected group and transfection group. Compared with the untransfected group, the Basso-Beattie-Bresnahan scores were significantly higher (P < 0.05), the expression of hypoxia-inducible factor-1α protein in the spinal cord tissue was significantly increased (P < 0.05), the motor-evoked potential latency was shortened (P < 0.05) and the amplitude was increased (P < 0 .05) in the transfection group. Above al, umbilical cord blood mesenchymal stem cel transplantation modified by hypoxia-inducible factor 1α has better effects on spinal cord ischemia-reperfusion injury.

28 patients with acute respiratory distress syndrome caused by 2009 H1N1 influenza were mechanically ventilated for 1 hour in the supine, lateral, semi-supine, lateral prone, and prone position respectively. Changes of heart rate, respiratory parameters and arterial partial pressure of oxygen ( PaO2 )were measured. There were no significant differences ( P ＞ 0. 05 ) of heart rate and mean arterial pressure among these postures. Lateral prone ( P ＜ 0. 05 ) and prone posture ( P ＜ 0. 01 ) , however, can both significantly improve tidal volume, mean airway pressure, PaO2, static lung compliance and oxygenation index. We concluded that mechanical ventilation delivered in the prone position can remarkably improve oxygenation in patients with H1N1 influenza-associated acute lung injury.

OBJECTIVE To investigate the generation of beta-lactamases from Klebsiella pneumoniae(KPN) which is only susceptible to imipenem.METHODS Sixteen kinds of beta-lactamase genes were detected in a KPN strain by PCR.The genes included TEM,SHV,LEN,OKP, CTX-M-1 group,CTX-M-2 group,CTX-M-9 group,OXA-1 group,OXA-2 group,OXA-10 group,PER,GES,VEB,CARB,DHA,and ACT-1.RESULTS The assay showed six positive genes including TEM,SHV,CTX-M-1 group,CTX-M-9 group,OXA-1 group,and DHA.CONCLUSIONS The KPN strain carries six kinds of beta-lactamase genes simultaneously.

Objective To analyze the clinical effect of anti-angina pectoris combined with anxiolytic-depressive drugs in patients with angina pectoris and anxiety and depression and its influence on psychological fluctuation .Methods 100 patients with coronary heart disease and angina pectoris who were treated with anxiety and depression were randomly divided into the observation group and the control group according to the digital table method.The control group were treated with conventional angina pectoris, and the control group were treated with anti-anxiety and depression medication.The left ventricular end-systolic volume ( LVESV ) , left ventricular ejection fraction ( LVEF ) , left ventricular end-diastolic volume (LVEDV), left ventricular end-diastolic volume (LVEDV) and left ventricular end-diastolic volume (LVEDV) and anxiety and depression scores were compared between the two groups before and after treatment.Results The total effective rate of the treatment group was significantly higher than that of the control group (P<0.05).There was no serious adverse reaction in the two groups.The treatment compliance rate in the observation group was significantly better than that in the control group (P<0.05), and the level of cardiac function after treatment in the observation group was significantly better than the control group (P<0.05); observation group before and after treatment anxiety and depression scores were statistically significant (P<0.05), while the control group before and after treatment anxiety and depression score was not statistically significant.Results The combination of anti-angina pectoris and anxiety-depression drugs had better clinical curative effect on patients with angina pectoris and anxiety and depressive patients, and could effectively control the onset of angina pectoris.Meanwhile, they had higher safety and could improve the compliance of patients with clinical treatment.Anxiety and depression, so as to improve the quality of life of patients.

A fair,just,and credible mediation institution is required to ensure the effective implementation of medical liability insurance,relieve physician-patient conflicts,and protect the legal rights of medical institutions,patients and insurance corporations as well.Medical disputes mediation institution,as the arbitrator of physician-patient conflicts,clarifies the rights and obligations on all parties,including doctors,patients,and the insurance corporations as well,safeguards the legal rights of all parties,standardizes and simplifies the settlement procedure of medical disputes,and provides an effective approach to relieving the conflicts between doctors and patients.

Objective To review the diagnosis and treatment of adrenal myelolipoma(ML).Methods The medical records of 21 patients with adrenal myelolipoma were reviewed.All patients were examined by B-ultrasound,CT and endocrine tests while some were also examined by MRI and 131I-MIBG.Results All patients had undergone resection of adrenal ML.The mean diameter of tumors was 6.7 cm(4.5 cm～12 cm).Pathological examination of all tumors confirmed the diagnosis of adrenal ML.No recurrence was recorded during the follow-up period(1～15years).Conclusion Adrenal ML is a kind of rare,benign tumor and is often incidentally discovered.Its prognosis is generally good.

Objective To investigate the diagnosis and treatment of renal neoplasm with calcification .Methods Retrospectively summarized the clinical data of the 2 patients with calcific renal neoplasm admitted in our hospital from the May to July in 2014, then analyzed and discussed the clinical manifestations , diagnosis and treatment com-bined with the literatures .Results The two cases were both suspected of renal malignant tumor preoperatively .The case 1 was a 32-year-old male , laparoscopic partial resection of the left kidney was performed , and the postoperative pathology was clear cell carcinoma (Fuhrman levelⅠ).The case 2 was a 18-year-old male, partial resection of the right kidney was performed because of the tumor size , and the postoperative pathology was adult nephroblastoma . Conclusions The calcific renal neoplasm is a rare disease , the property determination depends on postoperative pa-thology, and as to the choice of surgical method , the patients'age, the tumor size and the tumor location should be taken into consideration , and intraoperative frozen should be performed when necessary .

Objective This paper studies on feasibility of low dose CT scanning in lung cancer patients simulated localisation.Methods 62 patients cases of lung cancer are selected.Scan parameter:scan twice by 20/100 mA,the other parameter remain unchanged as voltage of 120 kV,thickness of 5 mm,pitch of 1:1 and scan time of 1 s.After scan,picture quality was evaluated according to excellent,good,bad under different condition.Volume of target was determined by treatment planning system.Data such as dose index value of single helical scan,z-axis scan range,dose length product value and etc.are recorded in order to evaluate radiation dose of patients.Picture quality and the difference of radiation dose were statistically analyzed using Fisher's and pair t-test.Results Picture quality of low dose scanning was a little bit lower than that of normal dose,however,picture quality difference of difference dose scanning was statistically meaningless (number of patients according to excellent,good,bad were 46,13,3 and 50,11,1,P =0.541).There is no obvious difference of target volume under different dose scanning in the same (36.78 cm3,40.35 cm3,t =2.57,P =0.189).Radiation dose of low dose scanning group is far less than that of high dose scanning group and the difference is obvious (133.05 mGy,941.25 mGy,t =-41.24,P =0.000).Conclusions Low dose scanning of 20 mA current during CT simulated localisation tremendously reduces harm that may happen to patients during CT scan,while tumor target delineation and scanned picture quality is guaranteed.

An statistical analysis of aorta-septal angle(AS angle) between anterior wall of aorta and ventricular septum was taken,AS angle was measured fromthe right ventricle with long-axis, two-dimensional echocardiongram of the left ventricle in 227 consecutive cases of patients with cardiovascular diseases and 80 healthy adults since 1985. It was found that AS angle for normal adults at the end of systoie(ES) and the end of diastole(ED) being 118.50?? 7.70? and 110.60??8.23?; the difference between ES and ED was 7.89??4.51?. In patients with overburdening of left ventricular volume and resistance of coronary artery disease, car-diomycpathy and hypertension , AS angles were amaller,and in patients with overburdening of right ventricular pressure of rheumatic mitral stenosis, AS angles were larger than healthy adults. The difference between ES and ED was smaller than normal for all patients. It was also found that in patients with heartdisease AS angle tends to be smaller or larger before the appearance of abnormality of the left ventricular cavity. Our data suggested that AS angle variance might afford some clinical significance of diagnosis

Objective To investigate the blood glucose changes in critically ill patients taken continuous renal replacement therapy(CRRT)before treatment and at different time points after treatment. Methods Sixtyseven critically ill patients were enrolled in the study,of whom 13 cases were treated conventionally and assigned as pre-treatment control group,while the other 54 cases undertook CRRT were assigned as CRRT group. The CRRT group were further sub-divided into four groups according to CRRT time((CRRT time ＜6 h group(n = 18),CRRT time of 6 - 12 h group(n = 18),CRRT time ＞ 12 h group(n = 18);or sub-divided into two groups according to circulating blood temperature(≤ 36. 5 ℃ group(n =27)and ＞ 36. 5 ℃ group(n =27));or sub-divided into two groups by sugar substitute fluid replacement solution as the formula group(the standard level of sugar content was 6. 9 mmol/L(n = 27)and sugar-free replacement fluid group(n = 27);or sub-divided into two groups according to the Glasgow Coma score(GCS)(GCS ≤ 8 points group(n = 24)and GCS ＞ 8 group(n = 30). Blood glucose level at different time points were measured. Results The longer CRRT cycle time,lower temperature,sugar substitute fluid replacement fluid worse GCS score corresponded to more dramatic blood glucose fluctuation at different time points in CRRT group,and it took longer time for them to recover to normal blood sugar level Conclusions During the CRRT process insulin secretion was suppressed and led to increase of blood sugar. In most cases the blood glucose returns to normal after CRRT treatment over time,but a small number of cases require clinical intervention.