Objective To analyze the HEV genetic structure and nucleotide homology isolated from sporadic acute hepatitis E in Changchun.Methods HEV RNA was detected with reverse transcription nested polymerase(RT-nPCR) and sequenced by automatic sequenator.Results The length of acquisitive HEV-CCC220 was 7193 bp coding 2397 amino acid.The gene of HEV-CCC220 was composed of 5'-UTR(nt 1-9),3'UTR(nt 7152-7193) and three open reading frames(ORFs).Its homology with HEV IV was obviously higher than that with HEV(I-III.) The whole genome sequence nucleotide homology was 83.2%-85.0%,85.0%-93.9% and 80.6%-86.7% as compared with 300nt and 98nt partial nucleotide sequence of ORF2.The homology comparison of various areas and various lengths of nucleotide was different.Conclusion The HEV-ccc220,which sporadically happened in Changchun,is the subtype IV of HEV.The 300nt of ORF2 can replace the whole gene order to perform genotype analysis of HEV.

Objective To investigate the main risk factors and protective factors of malignant tumors in Taian City. Methods Esophagus, lung, stomach, liver Malignancies in Taian City, 1:1 matched case-control study, application conditions of the relevant factors, logistic regression univariate and multivariate analysis were done. Results For esophageal and gastric cancer, the common risk factors were eating hot, dry,hard, deep fried foods, and also animal food, heavy drinking, family history of cancer, the staple food pancake with esophageal cancer-related. For lung cancer, heavy smokers, living in and around the sources of pollution,may increase the probability of illness, hepatitis B virus infection, chronic liver disease history, unstable emotion, eating and drinking are the major risk factors for liver cancer. Tea on the four kinds of malignant tumors often have a protective effect. Raw garlic, fruits and vegetables, dairy soy foods can prevent esophageal cancer and gastric cancer. Conclusion To promote proper exercise, stop and smoking alcohol drinking,psychological balance, good dietary habits, can effectively prevent the occurrence of malignant tumors.

Objective:To investigate the role of MicroRNA-9-1 in inducing epidermal stem cells(ESCs) differentiation into neurons.Methods:The lentiviral of MicroRNA-9-1 was constructed and transfected into rats epidermal stem cells.The experiment was divided into transfected group,non-transfected group and the negative control group.The β-mercaptoethanol was as an inducer for triggering the ESCs to differentiate into neurons.The GFP fluorescence expression of epidermal stem cells after transfection was observed under inverted fluorescence microscope.The protein and mRNA expression level of microtuble-associated protein 2 (MAP-2) was detected by immunocytochemical method and RT-PCR,respectively.Results:The result of Positive clone PCR confirmed successful construction of MicroRNA-9-1 in rats.Transfection after 48 h,the expressing of GFP fluorescence at peak in transfected group,and transfection efficiency reached (85.6+1.9)％.Most ESCs differentiated into neurons in transfected group after β-mercaptoethanol induction 7 h,and the effect was significantly better than non-transfected group and the negative control group.The protein ((87.3± 0.6)％) and mRNA (about twice over) expression levels of MAP-2 in transfected group was higher than those in non-transfected group and the negative control group (P＜0.05).Conclusion:The lentiviral of MicroRNA-9-1 has high transfection efficiency in rats ESCs,and could promoted ESCs differentiate into neurons under β-mercaptoethanol induced.

Objective To compare and analyze the curative effects of mediopatellar plica syndrome under different therapies. Methods 147 patients with mediopatellar plica syndrome were enrolled in the study from January 2011 to January 2015 and divided into three groups refer to treatment: Group A, B and C. Each group was also divided in the youth group and the mid-age group. Different treatments were used in the three groups. Group A: drug therapy and physicotherapeutics; Group B: intraarticular injection regularly; Group C: arthroscopic surgical treatment. All patient conditions were assessed with Lysholm score. Results All patients received an average of 11 (9 ~ 13) months follow-up. No blood-vessel and nerve injured and infection occurred. Before receiving treatment, difference in Lysholm score of the three groups showed no statistical difference (F = 0.08, P = 0.926); after treatment, difference revealed significant difference (F = 15.48, P = 0.001). Compared with those before operation and after operation among the three groups, the Lysholm score was improved (tA = 3.43, tB = 6.74, tC = 7.99, P = 0.001). In the rangeability of Lysholm score, the Group C > B > A (F = 66.43, tAB = 5.97, tAC = 11.52, tBC = 5.55, P = 0.001);The general youth group > the general mid-age (t = 7.91, P = 0.001). Conclusion The best therapeutic method for mediopatellar plica syndrome is the arthroscopy. As for mid-age patients, it is necessary to inform them of possibility that prognosis is not well in preoperative planning.

Objective To identify a locus at chromosome coding for hereditary palmoplantar keratoderma of three Chinese pedigrees.Methods The genome scan was conducted with microsatellite markers on chromosome 12(D12S85、D12S368、D12S83、D12S345)and 17(D17S1868、D17S787、D17S1857、D17S798、D17S944、D17S949)respectively on the ABI 3100 Genetic Analyzer(Applied Biosystems).Two-point LOD score was calculated.Results The maximum two-point LOD score 6.59 and 5.96 at ?=0.1 were obtained at D17S1868 and D17S787 on chromosome 17q12～q21.It is an evidence of linkage between this disease and KRT9 which has been mapped within the region.Conclusion There is a locus responsible for this disease on chromosome 17q12～q21.

Objective To compare the efficacy of KumaFix posterior spinal screw/rod system (KumaFix system) and posterior U-shape screw/rod system for treatment of thoracolumbar vertebral body fractures.Methods A total of 131 patients with thoracolumbar vertebral body fractures treated from January 2011 to July 2011 were prospectively analyzed.All patients showed thoracolumbar injury classification and severity score (TLICS) more than 5 points and spinal load-sharing classification (LSC) score of 4-6.The patients were assigned to two groups according to the coin toss method:group A (n =72,treated with reduction and fixation with KumaFix system in combination with transpedicular bone grafting of fractured vertebrae) and group B (n =59,submitted to posterior reduction and fixation with U-shaped screw/rod system in combination with transpedicular bone grafting of fractured vertebrae).In group A,there were 41 male and 31 female patients at age of (41.2 ± 4.9) years (range,20-53 years).In group B,there were 33 male and 26 female patients at age of(40.6 ± 4.5)years (range,21-51 years).The two groups were analyzed and compared in aspects of operation time,blood loss,anterior vertebral height ratio,middle vertebral height ratio,posterior vertebral height ratio,kyphosis angle,Oswestry disability index (ODI) and incidence of adjacent segment degeneration.Results All patients were followed up for mean 5.3 years (range,5.1-5.8 years).Operation time and blood loss were (72.5 ±21.8)rain and (320.6 ±90.0)ml in group A,less than (104.3 ±20.7)min and (421.0 ± 84.5) ml in group B (P ＜ 0.05).Both groups achieved obvious improvements in anterior vertebral height ratio,middle vertebral height ratio,posterior vertebral height ratio and kyphosis angle after operation(P ＜ 0.05).At the last follow-up,the middle vertebral height ratio was (92.0 ± 2.8) ％ in group A,better than (84.1 ± 5.1) ％ in group B (P ＜ 0.05).Both groups showed improvement in ODI after operation (P ＜ 0.05).At the last follow-up,ODI and incidence of adjacent segment degeneration were 11.9 ± 7.1 and 0 in group A,decreased compared to 20.9 ± 6.7 and 12％ in group B (P ＜ 0.05).Conclusions For thoracolumbar vertebral body fractures,the KumaFix system has better reduction effect than U-shape screw/rod system.Meanwhile,the KumaFix system can avoid negative effect.

Objective To compare the biochemical and immunological parameters and histopathological characteristics in the patients with autoimmune hepatitis (AIH),biliary cirrhosis (PBC)and AIH/PBC overlap syndrome,and to provide basis for working out the reference standard of clinical diagnosis and reasonable treatment.Methods 135 cases of autoimmune liver disease patients were selected,including 49 cases of AIH patients,43 cases of PBC patients, and 43 cases of AIH/PBC overlap syndrome patients. The biochemical, immunological parameters and histopathological changes of the patients were detected. The patients with AIH/PBC overlap syndrome were treated with different therapy methods including ursodesoxycholic acid (UDCA ) treatment,prednisone treatment and combination treatment with UDCA and prednisone,and the effectiveness of different treatment programs were evaluated.Results The activities of GGT and ALP and IgM level of the patients in the AIH/PBC group were significantly higher than those in AIH group,there were significant differences (P<0.05);the activities of ALT and AST and IgG level of the patients in AIH/PBC group was significantly higher than those in PBC group,there were significant differences (P<0.05).The detection rates of AMA and AMA M2 of the patients in AIH/PBC group were higher than those in AIH group, there were significant differences (P<0.05);the detection rates of ANA and SMA of the patients in AIH/PBC group were higher than those in PBC group,there were significant differences (P<0.05).There were high incidence of piecemeal necrosis (100.0%), liver cell rosette-like changes (83.72%)and bile duct lesions (69.77%)of the patients in AIH/PBC group.The effective percentage in combination therapy group was 85.7% which was significantly higher than those in various drug alone groups (P< 0.05 ). Conclusion The changes of biochemical and immunological indicators and pathological features of the patients with AIH/PBC overlap syndrome are in combination with the particular indicators of AIH and PBC which would provide the diagnostic basis for AIH/PBC overlap syndrome. The combined therapy for AIH/PBC overlap syndrome is effective and should be popularized.

Bone cement leakage is the most common complication in the treatment of thoracolumbar osteoporotic fractures by percutaneous vertebroplasty.The incidence rates of the literatures are different,with the range from 5％ to 80％.There are several different classifications of cement leakage;however there is no uniform classification standard.The classification criteria' s are based on anatomical location and leakage way.The independent risk factors of cement leakage are fracture semiquantitative severity grade and the viscosity of bone cement.The incidence rate of cement leakage increases with high fracture semiquantitative severity grade and low bone cement viscosity.For cortical leakage,the presence of cortical disruption and intravertebral cleft on MRI were identified as additional strong risk factors.The majority of bone cement leakage does not produce clinical symptoms.But some of the patients suffered from new adjacent osteoporotic vertebral compression fractures,neurologic deficits,pulmonary cement emboli,cardiac perforation,and even death.Therefore,we should strictly grasp the indications,select appropriate filling materials,and improve surgical techniques to avoid the occurrence of bone cement leakage.

Objective To evaluate the reliability and reproducibility of the thoracolumbar osteoporotic vertebral compression fracture (OVCF) severity score system (TLOFS),so as to provide basis for clinical decision-making.Methods A total of 320 cases of thoracolumbar OVCF hospitalized between January 2014 and June 2015 were scored by TLOFS.There were 107 male and 213 female patients,aged 52-90 years (mean,63.78 years).All cases presented with a chief complaint of low back pain.Thirty-nine cases (TLOFS ≤3 in 21 cases,TLOFS =4 in 17 cases) were treated non-operatively,while 259 cases (TLOFS =4 in 23 cases,TLOFS ≥ 5 in 259 cases) were treated surgically.Pain was evaluated by the visual analogue scale (VAS).Reliability,reproducibility and content validity of the TLOFS were analyzed.Results Cronbach' sα coefficients of all TLOFS subgroups including evaluation of morphological changes,MRI,bone mineral density,clinical situation and therapy recommendation and total score evaluation were within the range of higher to high reliability (0.76-0.94).Kappa coefficients of all TLOFS subgroups were within the range of higher to high reproducibility (0.84-0.95).Mean content validity of all TLOFS subgroups was 0.916.VAS improved from preoperative(7.8 ± 2.1) to (1.3 ±0.7) at the final follow-up.Rates of correct diagnosis,sensitivity and specificity were 95.7％,87.6％ and 96.5％ respectively.Conclusion TLOFS exhibits good reliability and reproducibility,easy operation,and accurate and comprehensive evaluation,which is effective in guiding the clinical decision making in treatment of thoracolumbar OVCF.

Objective To retrospectively evaluate the safety and efficacy of osteotomy for progressive congenital scoliosis combined with split spinal cord malformation (SSCM).Methods Data of 31 patients,who had undergone osteotomy for progressive congenital scoliosis combined with SSCM from May 2008 to May 2011 in our hospital,were retrospectively analyzed.Twenty-nine patients were followed up successfully,including 11 males and 18 females,aged from 6 to 26 years (average,13 years).Seven patients had tethered cord syndrome (TCS) with progressive neurologic deterioration.Hemivertebrae resection was performed in 7 patients,pedicle subtraction osteotomy (PSO) in 16,and vertebral column resection (VCR) in 6; posterior fusion surgery was performed in all patients after the correction was obtained.Results Twenty-nine patients were followed up for 8 to 24 months (average,18 months).The coronal Cobb angle ranged from 15° to 40°(average,24.4°±18.6°) immediately after operation,with an average correction rate of 63.3％.The coronal apical vertebral translation ranged from 0 to 50 mm (average,21.1±19.2 mm) immediately after operation,with an average correction rate of 59.5％.The coronal thoracic trunk shift ranged from 0 to 28 mm (average,5.5±10.5 mm) immediately after operation,with an average correction rate of 55.0％.There were significant differences between pre-and post-operative coronal Cobb angle,coronal apical vertebral translation and coronal thoracic trunk shift.There was no permanent neurological deterioration in all patients.Pedicle screw break occurred in 4 patients,without permanent neurological compromise.Among 7 patients with TCS,muscle strength was improved in 3 patients,and urination control was improved in 1 patient.Conclusion The osteotomy for congenital scoliosis combined with SSCM is a satisfactory method,which can effectively improve the spinal deformity without significant complications.For patients with TCS,this method also can improve the restoration of neurosurgical function.However,additional large multicenter studies are necessary to further assess the safety and efficacy.