The adenosine triphosphate-binding cassette subfamily member 4 (ABCB4) gene encodes multidrug resistance rotein 3 (MDR3),which is expressed on the cannalicular membranes of hepatocytes and translocates major phospholipids from the inner to the outer leaflet.Phospholipids are the major carrier and solvent of cholesterol,and in combination with bile salts form mixed micelles.Defects in ABCB4 function cause a low phospholipid content in bile,resulting in cholesterol supersaturation and crystal formation.Low phospholipid-associated cholelithiasis (LPAC) is characterized by the association of ABCB4 mutations and a low biliary phospholipid concentration,resulting in symptomatic gallstones starting before age 40 years,a high serum gamma glutamyl transferase (γ-GT) activity,intrahepatic microlithiasis,and recurrent biliary symptoms despite cholecystectomy.LPAC is an autosomal recessive condition caused by a rare single-gene mutation,commonly occurring in ABCB4,and can include homozygous and heterozygous point mutations in introns,coding exons,and 5 UTR regions.

Medical oxygen generator has been popularized in hospitals for its easy-and automatic operation and constant oxygen concentration output. This paper introduces the principle and usual faults of PTSI medical oxygen generator with the block diagram.

Objective: To investigate the effect of plastic calcaneus plate in the treatment of intra-articuIar fractures of calcaneus.Methods: 16 cases with intra-articuIar fractures of calcaneus were treated with open reduction and internal fixation with plastic calcaneus plate,all of which underwent Allogeneic bone grafting. Results: 16 cases were followed up for 10～25 months.According to Maryland foot score system,the results were excellent in 11 cases,good in 4 and fair 1 in. Conclusions:It can provide rigid fixation and less complication,which is beneficial for early functional exercises in the treatment of intra-articuIar fractures of calcaneus with plastic calcaneus plate.

Objective:To analyze the effect of clavicular hook plate in treating complete acromioclavicular joint dislocation.Methods:31 cases with complete acromioclavicular joint dislocation were treated using CHP and its effect evaluated.All patients were followed up for 6 to 18 months with average 12months.Results:According to Karlsson grading system,22 cases were excellent,9 cases were good and no case was poor.There were no such complications as infection,breakage or loosing of the clavicle hook plate.The X-ray showed good reduction in all patients.No subluxation occurred after removal of implants.Conclusions:Clavicle hook plate,which can provide reliable fixation and allow early functional exercise,is a sound way for complete acromioclavicular joint dislocation.

Metabolic rearrangement is a typical hallmark of cancer cells ,especially the disorders in glucose metabolism. Normal cells rely on the steps of oxidative phosphorylation within the mitochondria to metabolize glucose and yield energy upon enough oxygen ,yet turning to glycolysis in the absence of oxygen . Nevertheless ,tumor cells exhibit high levels of glycolytic flux in different environments ,due to the requirement of malignant proliferation. This phenomenon was named as the Warburg effect ,the initiation of which is driven by multiple mechanisms ,including the influence of tumor microenvironment ,the activa?tion of tumor-promoting signaling pathways ,and the aberrant levels of metabolic enzymes. Moreover ,our recent findings sug?gest that inhibition of gluconeogenesis ,the general reversal of glycolysis ,would further promote the Warburg effect and tumor progression.

Objective:To improve the hospital degree of attention to SPECT quality control. Methods: To introduction the basic principle and test methods of the Brightview produced by Philips company, and to analyze some common troubles.Results: According to understanding the working principle, parameter testing, maintenance and troubleshooting, to master quality control method.Conclusion: The quality control of the SPECT is the demand of UM workers. To master the test methods, improve the quality of medical imaging, minimize unnecessary exposure and serve the patients better.

Objective To explore the clinical efficacy and safety of pituitrin and phentolamine in the treatment of senile bronchiectasis with massive hemoptysis,thus to provide guidance for the clinical.Methods 80 elderly patients were selected as the subjects of this experiment,and the patients were randomly divided into two groups using the envelope random grouping method.40 patients in the control group used phentolamine.40 cases in the observation group were treated with pituitrin and phentolamine.The clinical curative effect,bleeding time,bleeding volume and the incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 92.50％,which was significantly higher than 70.00％ of the control group (x2 =6.646,P ＜ 0.05).The bleeding time,total amount of bleeding of the observation group were significantly less than those of the control group (tbleeding time =5.069,tbleeding volurne =5.447,all P ＜ 0.05).The incidence rate of adverse reaction in the observation group was 7.50％,which was significantly lower than 27.50％ of the control group (x2 =5.541,P ＜ 0.05).Conclusion Phentolamine combined with pituitrin in the treatment of senile bronchiectasis with massive hemoptysis can significantly relieve symptoms,shorten the bleeding time,reduce the total amount of bleeding,reduce the probability of adverse reactions in patients.

Objective To explore the clinical effect of precise radiotherapy combined with gefitinib in the treatment of elderly patients with locally advanced non -small cell lung cancer. Methods 88 cases with locally advanced non small cell lung cancer patients treated from December 2014 to January 2016 in Shanxi Cancer hospital were randomly divided into control group and study group (n=44) by random number table method, the control group received radiotherapy, the study group on precise radiotherapy given gefitinib oral treatment, clinical intervention for 3 months evaluation of clinical efficacy of the two groups, the levels of serum tumor markers (CEA, CA125, CA242) in the two groups were compared before and after the intervention, and the incidence of adverse drug reactions was observed and compared. Results The control rate of the study group and the control group were 90.91％ and 72.72％ respectively, the difference was statistically significant (P<0.05). After treatment, the levels of CEA, CA125 and CA242 in the two groups were significantly lower than those in the control group (P<0.05). The level of CEA, CA125 and CA242 in the study group was significantly lower than that in the control group (P<0.05), after treatment the study group decreased more significant than the control group (P<0.05). The study group and the control group had adverse adverse reaction rates were 34.14％ and 27.27％, and rank sum test the research group VS control group (Z=0.657, P=0.511), there was no significant difference between the two groups. Conclusion Precise radiotherapy combined with gefitinib in the elderly patients with locally advanced NSCLC treatment is a safe treatment method, can effectively improve the clinical efficacy, improve the level of serum tumor markers, it is worthy of clinical application.

Primary hepatic carcinoma is one of the most common cancer in China.There is no accurate and reliable serological diagnostic method could be used for the early diagnosis and prognosis evaluation of primary hepatic carcinoma at present.The detection of autoantibody for tumor associated antigens has high sensitivity and specificity to diagnose cancer.Thus,measurement of autoantibodies of primary hepatic carcinoma is expected to achieve early diagnosis and prognosis evaluation.The research situation and application prospect of these biomarkers are summarized.

Objective To introduce the relationship between the apoptosis hepatocyte and its genic mediation and the ischemia of portal vein. Methods The combination of related literatures and our research findings were made.Results Portal vein ischemia may induced hepatocyte apoptosis, p53 and bcl-2 gene alternatively adjust hepatocyte apoptosis. Expression of p53 gene is enhanced in hepatic tissue when hepatocyte apoptosis is not obvious, but after 24-72 h of portal vein ischemia, when hepatocyte apoptosis is obvious, enhanced expression of p53 gene or reduced expression of bcl-2 gene occur. There exists close relationship between portal vein ischemia and hepatocyte apoptosis. Conclusion Apoptosis hepatocyte is involved in organic atrophy after ischemia of portal vein, and p53 and bcl-2 gene alternatively adjust hepatocyte apoptosis. At present, the mechanism of apoptosis of hepatocyte induced by ischemia of portal vein is not clear, which needs further study.