Transpedicular screw and rod internal fixation system is the common implants in spinal surgery. Multi-slice spiral CT and magnetic resonance imaging can generate section image, become routine imaging modality in the assessment of the postoperative spinal patients. Magnetic resonance imaging can evaluate the bone marrow and soft tissue, which is the first choice for examination. However, to the patients with metal implants, the existed metal artifacts can decrease the imaging quality. Therefore, multi-slice spiral CT is an important evaluation method for inserted material, os integumentale and anatomy. This article reviewed the production mechanism of metal-related artifacts, influencing factors and decreasing technique.

It puts forwards the hypothesis of disease curtailment efficacy,viewing that it may explain the TCM medication rule and the mechanism of TCM compatibility improving cure effect;taking gastric ulcer as pathological model,Lizhong Decoction as object,it makes split formula experiment to test its existence of disease curtailment effect,exposing the scientific and available hypothesis.

BACKGROUND:Bone marrow mesenchymal stem cel transplantation for myocardial infarction becomes popularized in recent years, but transplanted cels cannot survive and proliferate under early inflammatory reaction or local ischemia/hypoxia microenvironment, eventualy hampering the therapeutic outcomes.
OBJECTIVE:To investigate the therapeutic effect of PTEN-silenced bone marrow mesenchymal stem cels on acute myocardial infarction.
METHODS:(1) Bone marrow mesenchymal stem cels from Sprague-Dawley rats were randomly assigned to receive no treatment, NCsiRNA transfection using Lipofectamin2000orPTEN siRNA transfection using Lipofectamin2000. Cel growth curves were described using MTT method to detect cel cycle using flow cytometry. (2) Thirty Sprague-Dawley rats were selected to prepare myocardial infarction models that were randomized into three groups (n=10 per group): blank control, negative control and RNAi group. Six hours after modeling, bone marrow mesenchymal stem cels transfected with nothing, NCsiRNA and PTEN siRNA were respectively injected into the infarcted center of the left ventricular anterior wal in these three rat groups. After 4 weeks, al rats were subjected to cardiac function detection using echocardiography, and the survival and proliferation of bone marrow mesenchymal stem cels in the rats were observed by fluorescence microscopy.
RESULTS AND CONCLUSION:Compared with the other two groups, a significant increase in the absorbance values at different culture time, the proportion of cels in S+G2phase, and the number ofbone marrow mesenchymal stem cels in the myocardial tissue was found in the RNAi group (alP< 0.05). Additionaly, the left ventricular ejection fraction and left ventricular shortening fraction were significantly reduced in the RNAi group than the blank control and negative control groups at 4 weeks after cel transplantation (P< 0.05). Bothin vivoandin vitroexperimental findings showed that PTEN silencing could effectively improve cel survival and proliferation in the infarcted myocardium. Moreover, in thein vivoexperiment, an overt improvement in rat’s cardiac function was achieved.

OBJECTIVE:To control the drug varieties in our hospital. METHODS:According to Prescription Administrative Policy,the related meetings was hold by Drug Therapy and Pharmacy Administration Committee and monitoring procedure was set up to ensure drug elimination publicly,fair and clearly. Drugs of different specifications with same general name were limited strictly. RESULTS:After implementing drug elimination measure,drugs reserved were in line with national drug control standard. CONCLUSION:Drug elimination applied to control drug varieties can improve drug management in the hospital.

Objective To evaluate therapeutic effects of endovascular therapy for in-stent restenosis of superficial femoral artery,and the risk factors of restenosis of re-intervention therapy.Methods We retrospectively summarized the clinical data of 35 patients(38limbs)who suffered from in-stent restenosis of superficial femoral artery(SFA)stent from 2010 to 2012.Results 35 patients (38 limbs)were enrolled in this study,there were 24 males and 11 females.Mean age was (68 ±8)years.The success rate of endovascular therapy was 89.5％ (34/38),including in-stent angioplasty in 14 limbs,in-stent and beyond-stent angioplasty in 5 limbs,in-stent angioplasty and beyond-stent re-stenting in 15 cases.The primary patency and sencondary patency rate for 6,12 and 24 months was 65.2％,46.5％,46.5％,and 87.5％,80.2％,55.8％ respectively.The independent risk factors for re-obliteration were age ＞ 70 years (P ＜ 0.05) and diabetes mellitus (P ＜ 0.05).Conclusions Endovascular therapy is effective and safe in treatment in-stent restenosis of superficial femoral artery.The long-term in-stent patency is not satisfactory,with age ＞ 70 years and diabetes mellitus as independent risk factors.

Objective To study the mechanisms involved in the regulation of endogenous β-glucuronidase expression and to explore the more effective methods to prevent recurrence of hepatolithiasis formation.Methods The expression levels of c-myc and endogenous β-glucuronidase in the liver specimens of hepatolithiasis were examined by immunohistochemical staining.The expressions of c-myc and endogenous β-glucuronidase in the human intrahepatic biliary epithelial cell line (HiBEpiC),and normal liver cell line (L02) treated with different concentrations of lipopolysaccharide (LPS) were studied using western blot.The c-myc siRNA transfection was utilized to detect the role of c-myc in the regulation of the expression of endogenous β-glucuronidase.Results Compared with normal liver samples,the expressions of endogenous β-glucuronidase and c-myc in the liver specimens of hepatolithiasis were significantly increased,and they were positively correlated with each other.LPS induced increased expressions of endogenous β-glucuronidase and c-myc in a dose-dependent manner.C-myc siRNA transfection effectively inhibited the increased expression of endogenous β-glucuronidase as induced by LPS.Conclusion LPS played a crucial role in the formation of hepatolithiasis by stimulating the endogenous expression of β-glucuronidase in liver and biliary epithelial cells via c-myc.

Presented in the paper are the necessity,general ideas and principles of building a teaching center for virtual simulation experiment on disaster medicine,covering the teaching modules, capability objectives and education resources deployment among other basics of such a center.The authors propose to build a comprehensive platform for teaching by experimentation,integrating basic clinical skills training to trainings targeted to disaster rescue in view of actual needs in experiments and teaching.This way resources can be shared between the experiment center website and virtual simulation teaching software,promoting a regular,standardized and scientific development of disaster medicine in China.

ObjectiveTo systematically review the efficacy and safety of endoscopic papillary large balloon dilation (EPLBD) versus endoscopic sphincterotomy combined with large balloon dilation (ESBD) in the treatment of large common bile duct stones (≥10 mm). MethodsPubmed, Embase, Cochrane Library, CNKI, Wanfang Data, and VIP were searched for related articles published up to March 2020. Two reviewers independently performed article screening, data extraction, and quality assessment, and RevMan 5.3 software was used for statistical analysis. ResultsA total of 11 studies (6 randomized controlled trials and 5 non-randomized controlled trials) were included, with 1282 patients in total. The meta-analysis showed that in the 6 randomized controlled trials, there were no significant differences between the EPLBD group and the ESBD group in initial stone clearance rate (odds ratio ［OR］=0.71, 95% confidence interval ［CI］: 0.45-1.12, P=0.14), overall stone clearance rate (OR=1.39, 95%CI: 0.65-2.96, P=0.39), rate of use of mechanical lithotripsy (OR=1.19, 95%CI: 0.75-1.89, P=0.46), and incidence rate of early complications (OR=1.10, 95%CI: 0.60-2.03, P=075); in the 5 non-randomized controlled trials, there were no significant differences between the EPLBD group and the ESBD group in initial stone clearance rate (OR=0.64, 95%CI: 0.35-1.15, P=0.13), overall stone clearance rate (OR=0.46, 95%CI: 0.19-112, P=009), and incidence rate of early complications (OR=1.20, 95%CI: 0.65-2.21, P=0.56), but the EPLBD group had a significantly higher rate of use of mechanical lithotripsy than the ESBD group (OR=1.96, 95%CI: 1.26-3.05, P=0.003). ConclusionEPLBD and ESBD have similar efficacy and safety in the treatment of large common bile duct stones, while EPLBD may increase the risk of the use of mechanical lithotripsy. More high-quality randomized controlled trials are needed to confirm this conclusion.

BACKGROUND: A large amount of in vivo and in vitro experiments have confirmed that, basic fibroblast growth factor (bFGF) has been widely utilized in various tissues and cells, it can facilitate the wound healing.OBJECTIVE: To observe the efficacy and feasibility of gene gun-mediate delivery of human bFGF on the healing of deep partial thickness bum wounds.DESIGN, TIME AND SETTING: Randomized design,an observational trial was performed at the Military Central Laboratory of Changhai Hospital in the Second Military Medical University of Chinese PLA between December 2007 and October 2008.MATERIALS: SD rats of clean grade, weighing 200-250 g, irrespective of genders, ware involved in this study.METHODS: Natural human bFGF gene was recombined and optimized, then eukaryotic expression vector pCI-neo-bFGF was constructed taking pCI-neo as a vector, and transfeoted with human embryonic kidney cells 293 T cells. Dot blot and Western blot methods were utilized to determine the bFGF expression. Rat model of deep partial thickness burn wounds was processed into transgene process using gene gun technique, pCI-neo-bFGF-transfected ones served as experiment group while pCI-neo-transfected ones served as controls.MAIN OUTCOME MEASURES:Wound healing time was recorded and the efficacy was evaluated. The contents of hydroxyproline and collaganase Ⅰ in burn wound tissues were determined at 24 hours, 48 hours, 96 hours, 7 days, 10 days and 14 days following transgene process.RESULTS: the recombinant pCI-neo-bFGF was transfected with human embryonic kidney 293T cells. Dot blot and Western blot analysis have showed that, the constructed pCI-neo-bFGF expression vector could express human bFGF, and the expression of synthesized gene was remarkably higher than that of natural gene under fluorescence microscope; gene gun-mediated transgene experiment have showed that, the wound healing time was (13.00+1.31) days in the experiment group and (14.75±1.28) days in the control group, with significant differences (P＜0.05). The contents of hydroxyproline and collagenase Ⅰ reached a peak at 5 days after the injury, that is 48 hours after transfection, and then gradually decreased and maintained at a certain level. The experiment group had higher hydroxyproline levels compared with control group at different time points (P＜0.05, P＜0.01); the collagenase Ⅰ in the experiment group was notably higher than that in the control group at 48 hours and 96 hours after transfection (P＜0.01).CONCLUSION: Gene gun-mediated delivery of human bFGF can short the time of wound healing, increase the contents of hydroxyproline and collagenase Ⅰ during the healing period, accelerate the healing of deep partial thickness burn wounds.

Objective To report experience of endovascular aneurysm repair (EVAR) with Endurant stent-graft for abdominal aortic aneyrysm. Methods Between May,2010 and May,2011,19 patients underwent EVAR with Endurant stent-graft at Department of Vascular Surgery,Peking Union Medical College Hospital. Clinical and morphological characteristics, operative result, peri-operative complications and follow-up data were reported. Results Procedures were successful in all these 19 cases,among those 9 were with complicated anatomical alterations.There were no type Ⅰ,Ⅲ and Ⅳ endoleak found immediately after procedure,while 4 cases were found with type Ⅱ endoleak. Major adverse event during the 30-days after operation included:consumption coagulopathy,myocardial infarction combined with heart failure,wound infection or hematoma.All cases were followed-up from 1 to 12 months. No death occurred.Eight cases had at least one CT angiography.Five cases showed aneurysm shrink,the remaining 3 cases showed aneurysm diameter did not change.One case suffered from occlusion of unilateral iliac limb artery obliteration,and was treated by fem-fem graft bypass.One case had secondary type Ⅰ B endoleak,without increase of aneurysm diameter. Conclusions EVAR with Endurant stent-graft is safe and effective.Some complicated anatomic cases could be treated successfully with Endurant stent-graft.