To explore the protective effect of adenovirus mediated IGF-Ⅰgene(Ad-IGF-Ⅰ)transfer on non-obese diabetic(NOD)mice. The results showed that the incidence of diabetes and degree of insulitis were significantly reduced in mice receiving Ad-IGF- Ⅰ . Treatment with Ad-IGF- Ⅰ significantly decreased apoptosis rate,expression of Fas and caspase-3, and increased expression of Bcl-xl. This study indicates the potential of IGF- Ⅰ gene therapy in protecting NOD mice from insulitis and apoptosis.

Objective To study the effect of cervical disc replacement in the treatment of cervical spondylotic myelopathy(CSM).Methods 21 patients with CSM(17 cases of spondylotic myelopathy,2 cases of radiculopathy and 2 cases of acute soft disc herniation)were treated by anterior decompression and replaced by the Bryan cervical disc prosthesis. Results All cases were: followed for 4～12 months, average 8 months. The pre-operative JOA score was 8.5 and post-operative score was 15.5 on average. There were no prosthesis, curve was good. Replaced segment achieved stability and restored partial of normal ROM. There was no subsidence of implant and no worsening of pre-operative symptoms, post-operative 21 cases remained flexion/extension movement at replaced segments at latest follow up. There was no neck stiffness and restriction of movement complained by the patients. Conclusion The Bryan cervical disc replacement for the treatment of CSM has offered an excellent early clinical outcome.

Objective To investigate whether low-protein diet has protective effect on the progression of renal interstitial fibrosis in rats with cyclosporine A (CsA)-induced nephropathy. Methods Eighteen male Sprague-Dawley rats were randomly divided into three groups (6 rats in each group). The rats in control group (C group) received common diet; in model group (M group) low-salt diet; in intervention group (Ⅰ group) low-salt and low-protein diet. After diet adaptation period of one week, the rats in C group received subcutaneous injection of olive oil 1 mg/kg daily for 5 weeks, while M group and Ⅰ group subcutaneous injection of CsA (diluted into 25 g/L with olive oil) 1 ml/kg for 5 weeks. All the rats were sacrificed at the end of the 5th week. The food-intake and body weight were measured daily. The creatinine clearance (Ccr) was examined before rats were sacrificed. The semi-quantitative pathological analysis on kidney sections was performed. The mRNA and protein expression of transforming growth factor-β1 (TGF-βI) and type Ⅰ collagen (Col Ⅰ) in kidney tissue was determined with real time PCR and immunohistochemical staining, respectively. Results The food-intake and body weight of rats in M and I groups were significantly lower than those in C group (P<0.05). Compared with C group, the Ccr levels in M and Ⅰ groups were significantly reduced [(0.65±0.15) ml/min, (0.40+0.13) ml/min vs (1.55±0.29) ml/min, P<0.05], the relative fibrosis areas of kidney interstitium in M and I groups were significantly increased (3.60%±0.46%, 3.26%±0.75% vs 0.44%±0.24%, P<0.05), the mRNA and protein expression of TGF-β1 in M and I group was significantly up-regulated (by 2.6 and 3.1 times in mRNA and by 1.5 and 1.6 times in protein, respectively, P<0.05), and the mRNA and protein expression of Col Ⅰ in M and I groups was also significantly up-regulated (by 3.0 and 3.5 times in mRNA and by 2.3 and 2.1 times in protein, respectively, P<0.05). There were no significant differences between M and I groups in every parameters above-mentioned except the rat body weight and Ccr. Both the body weight and Ccr in Ⅰ group were significantly lower than those in M group (P<0.05). Compared with C group, the urine osmotic pressure in M group and in I group were deceased (for M group, P>0.05; for I group, P<0.05). Compared with C group, the serum cholesterol levels in M and I groups were significantly increased (P<0.05), and the serum phosphorus level in I group was significantly decreased (P<0.05). The levels of serum albumin and serum calcium of all three groups had no statistical differences (P>0.05). Conclusion Low-protein diet has no renoprutective effects on the rat model of cyclosporin A nephropathy, on the contrary, may induce body weight loss.

BACKGROUND:Many foreign studies confirm that recombinant human growth hormone (rhGH) is a safe and effective agent for treatment of idiopathic short stature (iSS), but there are no long-period and systematical researches reported in China.OBJECTIVE: To observe the promoting effect of rhGH on the growth of children with ISS.DESIGN: Case-control observation.SETTING: Department of Pediatrics, the Affiliated Hospital of Medical College of Qingdao University.PARTICIPANTS: Ninety-eight children with ISS who were treated in the Department of Pediatrics, the Affiliated Hospital of Medical College of Qingdao University during December 2004 to March 2006 were involved in this study.Informed consents were obtained from the guardians of these children with ISS. According to the etiological factors, the children were assigned into 2 groups: ISS group (n =30) and growth hormone deficiency (GHD) group (n =68).METHODS : The children in ISS group and GHD group received subcutaneous administration of home-made rhGH (Jinsai Pharmaceutical Co.,Ltd., Changchun at 0.15 IU/(kg ·d) and 0.1 IU/(kg ·d) respectively before sleeping within 6 months.The body height, body mass and bone age were measured before, 3 and 6 months after treatment. The local region of injection was observed and the growth rate was calculated. Bone age was calculated by graphic atlas method and body height was predicated by BP method.MAIN OUTCOME MEASURES: Body height, body mass, bone age and growth rate of children in two groups before, 3 and 6 months after treatment.RESULTS: All the 98 children wereinvolved in the result analysis, without deletion. ①Intragroup comparison: The body height, growth rate of children in two groups 3 and 6 months after treatment were significantly superior to those before treatment [ISS group: body height:(126.5±9.4), (129.1±8.6), (121.1 ±11.0) cm (P ＜ 0.01), growth rate: (7.3±2.9), (7.5±2.7),(3.5±2.1) cm/year (P＜ 0.01); GHD group: body height: (111.0±13.0),(114.0±13.0),(108.0±12.0) cm(P＜ 0.01),growth rate: (13.2±3.5), (13.5±3.6), (4.0±2.9) cm/year(P ＜ 0.01)]. Six months after treatment, body height was increased in 27 of 30 children in ISS groups, and in all the 68 children in GHD group. ② Intergroup comparison: The growth rate of children in GHD group was concurrently higher than that in ISS group 3 and 6 months after treatment. ③Adverse reaction and side effect: During the treatment, hypothyroidism was observed in 2 children within 1 to 3 months of treatment,but there was no influence on growth rate after oral administration of thyroxin tablets. Local red swelling of skin was observed in another patient, which stopped automatically after one week duration, but the injection continued.CONCLUSION: Home-made rhGH is a safe and effective reagent for treatment of ISS. It can obviously enhance the body height and growth rate of children. Whereas the inhomogeneity of treatment effect does exist, what's more, therapeutic effect in ISS children is inferior to that in GHD children.

BACKGROUND: The oxidation of low density lipoprotein (LDL) is a key influencing factor in the occurrence and development process of atherosclerosis. How is the merit of the method for the detection of the level of anti-serum oxidized LDL (ox-LDL) antibody on the evaluation of atherosclerotic plaque?OBJECTIVE: To study the method for the detection of serum anti-ox-LDL antibody in mice with apolipoprotein E (Apo-E) genetic defect to analyze the merits of serous level of anti-ox-LDL antibody on the evaluation of the area of atherosclerotic plaque in mice with Apo-E genetic defect.DESIGN: Single factor analysis of variance (a case-controlled study)SETTING: Laboratory of nutrition and metabolism diseases in a university.PARTICIPANTS: Mice with Apo-E genetic defect were grouped into positive group (series: C57B L/6J, n = 15), while normal mice were grouped into control group (series: C57BL/6J, n = 15).INTERVENTIONS: Mice of two groups were fed in separate cage on laminar flow shelf for free drinking and eating. The venous blood was drawn from the orbit of mice after 16 weeks for the separation of mice serum. The level of anti-ox-LDL antibody was detected by enzyme-linked immunosorbent assay (ELISA) in the separated serum from either mice with Apo-E genetic defect or normal mice. The area of atherosclerotic plaque was measured by image analysis after oil red O staining.MAIN OUTCOME MEASURES: ox-LDL level and atherosclerotic plaque area in mice with Apo-E genetic defect or normal mice.RESULTS: Anti-ox-LDL antibody level of mice with Apo-E genetic defect was[ (0. 079 ±0. 028)% ], which was significantly higher than [(0. 012± 0.001 )% ] of normal mice ( F= 10. 666, P ＜ 0.01 ). The area of atherosclerotic plaque of mice with Apo-E genetic defect was (26. 25 ± 9.20) %, which was also significantly higher than 0% of normal mice, and moreover, there was a significant correlation between these two factors ( r =0. 638, P ＜ 0.01).CONCLUSION: Serum level of anti-ox-LDL antibody in mice with Apo-E genetic defect is closely correlated with the area of atherosclerotic plaque,which is an important indicator for the generation of atherosclerosis in mice with Apo-E genetic defect.

Objective To compare the operative cooperation of da Vinci robotic surgery and traditional laparoscopic surgery, so as to provide evidence to qualify the operative cooperation of minimally invasive operation. Methods Comparison of the operative cooperation with related experiences and literature was made between the two kinds of surgeries. Results More requirements were put forward during the da Vinci robotic surgery on nurses′ service quality and training methods, ethics & law knowledge and humanistic care, equipment installation and preparation, complicated nursing performance content, system error handling and postoperative management, etc.. Conclusions It is suggested that the operative cooperation of the precise minimally invasive operation should be improved as follows:strengthen the nurses′ special training and continuing education; establish related operation process and management standards;do patients′explanation work and surgical team cooperation.

Objective To analyze the clinical features,treatment and prognosis of children with post-stroke epilepsy.Methods Sixty-nine children with epilepsy after cerebral stroke who were admitted to Guangdong General Hospital from Jan.2009 to Mar.2013 were retrospectively reviewed,including etiology,clinical features,laboratory examinations,treatment and prognosis.Results Among 260 stroke patients,69 of them (26.5 ％) developed epilepsy,but there was no significant difference between boys and girls(x2 =0.725,P =0.394).The incidence of post-stroke epilepsy differed significantly among different types (x2 =12.000,P =0.02),highest in the children with subarachnoid hemorrhage(47.8％,11/23 cases),followed by those with cerebral hemorrhage (34.6％,27/78 cases),and lastly,those with cerebral ischemia (19.5％,31/159 cases).Among them,53 patients developed seizures in the early stage (76.8％,53/69 cases),others in the late stage(23.2％,16/69 cases),early-onset epilepsy was more common in hemorrhagic stroke and late-onset epilepsy was more common in ischemic stroke,which differed significantly(x2 ＝ 4.778,P =0.029).The electroencephalogram background generally showed slow-wave in the early-onset epilepsy.The composition of seizure types differed significantly among different types of stroke (x2 =8.461,P =0.015).Forty-five of 58 patients (77.6％) suffered from cortical lesions and 13 of 58 patients (22.4％) suffered from subcortical lesions.Those children with post-stroke epilepsy who regularly use of antiepileptic drugs were followed up for 6 months to 4 years,81.2％ (56/69 cases)of clinical seizures were controlled.Conclusions The incidence of epilepsy after stroke is higher in children than in adults,cerebral stroke seizure occurs more commonly in cases with hemorrhagic stroke,especially with subarachnoid hemorrhage.Conventional antiepileptic treatment is effective.

Objective To investigate the epidemiological characteristics and therapeutic strategies of patients infected with hepatitis C virus (HCV)genotype 6 in Guangxi area.Methods Serum samples were collected from 150 patients with serologic HCV RNA positive in Guangxi, China. Reverse transcription nested polymerase chain reaction (PCR)was employed to amplify HCV NS5B fragments and the DNA products were sequenced.The sequences obtained were compared with the sequences deposited in GenBank to construct a phylogenetic tree.Among the patients who accomplished 48-week treatment of interferon plus ribavirin and 24-week follow-up after stopping medication,10 cases were infected with genotype 6a and 28 cases with genotype 1 HCV.The virological responses were evaluated at week 4,week 12,week 24 of treatment and week 24 after the end of the treatment.Results Among all recruited 150 cases,21 (14.0%)cases were HCV genotype 6 including two subtypes 6a (n = 20 )and 6d (n = 1 ). Genotype 6 HCV mainly affected intravenous drug users, especially with age of ≤ 40 years old. Phylogenetic tree showed that there was very close evolutionary distance between HCV 6 strains of Guangxi and Hongkong,China strains (Y12083,DQ 480515)and Vietnam strain (EU246930).All of 10 HCV genotype 6a patients who completed 48 weeks of antiviral therapy achieved sustained virological response (SVR).The rate of SVR was higher than that of genotype 1 patients,but without statistically different significance (10/10 vs 75 .0%,P >0.05).Conclusion HCV genotype 6 in Guangxi area mainly affects young intravenous drug users with age of ≤ 40 years old,which has high homology with Hongkong,China and Vietnam standard strains.Patients with HCV 6 genotype infection treated with interferon plus ribavirin for 48 weeks usually achieve favorable SVR.

BACKGROUND:Due to the higher modulus of elasticity, titanium cages are prone to have the folowing shortcomings: adjacent vertebral sinking and delayed fusion resulting from stress shielding; therefore, in recent years, it has been gradualy replaced by polyetheretherketone cages. OBJECTIVE:To compare the clinical and radiographic outcomes of patients undergoing posterior lumbar interbody fusion with pedicle screw fixation in which either a polyetheretherketone cage or a titanium cage was implanted. METHODS: The pre- and postoperative data of 104 patients who underwent single-level posterior lumbar interbody fusion were colected and analyzed, including 57 males and 47 females, aged (41.2±10.5) years. The 58 of 104 patients received the titanium cage and the remaining 52 patients received the polyetheretherketone cage. Visual analog scale scores and Japanese Orthopaedic Association Scores of the lumbar and lower limbs were recorded at 24 hours of postoperative folow-up; CT scan was used to detect bone fusion and cage subsidence. RESULTS AND CONCLUSION:After 12 and 24 months of folow-up, the visual analog scale scores and Japanese Orthopaedic Association Scores of the lumbar and lower limbs were al improved in the two groups compared with the previous (P < 0.05), but there was no difference between the two groups. At 12 and 24 months of folow-up, the fusion rates were 94% and 100% in the titanium cage group as wel as 74% and 84% in the polyetheretherketone cage group, respectively, and a significant difference was found between the two groups (P=0.012 andP=0.016). At 24 months of folow-up, the subsidence rate was 36% in the titanium cage group and 30% in the polyetheretherketone cage group, and there was no difference between the two groups. These findings indicate that the superiority of polyetheretherketone cages over titanium cages has not been demonstrated.

Advanced studying doctors play important roles in the clinical services, and how to train them to improve training quality is worth investigating. We classified them into three types such as the clinical skills-improved, the special skills-trained and clinical knowledge eextensively-spread, then employed the individual teaching methods and emphasized the medical ethics during the training, which is not only beneficial to us, but also of great importance and necessity to advanced studying doctors themselves.