Objective: To study the influence of inserting glycines(Gly) on biological properties of HIV Tat-(Gly)n-thymidine kinase (-TK) fusion proteins. Methods: Different fragments containing 0, 2, 4 or 6 Gly were inserted between the HIV Tat gene and TK using gene splicing by overlap extension (SOEing) PCR, and the products were cloned into PBK vector. The vectors were then transferred into E. coli after sequencing. After IPTG induction, bacilli were collected and destructed by ultrasound; the fusion protein was collected and identified by monoclonal antibody of HIV protein. HepG2 cells were incubated with DMEM supplemented with 1 μg/ml fusion protein containing 0, 2, 4 or 6 Gly for 24 h. HepG2 cells of different groups were detected by immunofluoreseence assay with HIV Tat monoclonal antibody; the apoptosis rate of HepG2 cells was determined by cell flow cytometry after they were incubated with gencilovir (10 μg/ml) for 3 d and the survival rate of cells was recorded by trypan blue in different groups. Results: The recombined genes containing 0, 2, 4 or 6 Gly were successfully constructed, inserted into PBK vectors, and expressed into E. coli. Their proteins were obtained and purified. The level of fluorescence in different groups was similiar, but the cell survival rate and apoptosis rate were different. The highest apoptosis rate was 14.77%, which was found in the group containing 4 Gly, followed by 12.69% in 2 Gly group, 8.31% in HIV Tat-TK group, 4.36% in 6 Gly group, and 1.0% in group containing no Gly. Significant differences were found between each 2 groups (P<0.05). Trypan blue showed similar results in the cell death rate of different groups: the highest cell death rate was 80.2%, which was found in the group containing 4 Gly, followed by 65.4% in 2 Gly group, 58.4% in HIV Tat-TK group, 56.7% in 6 Gly group, and 9.1% in the group containing no Gly. Conclusion: The number of Gly inserted into HIV Tat-TK protein does not alter the transcellular function of upstream Tat protein, but does substantially influence the TK protein-mediated cytoxic effects of gencilovir, and the influence is the smallest when 4 Gly are inserted.

One leading research target of modern tumor radiotherapy is to increase radiosensitization of tumor and improve curative effect of radiotherapy.Histone deacetylase inhibitors are epigenetic drugs that can play a part in radiosensitization through means of induction of apoptosis,inhibition of repair of DNA doublestrand breaks,cell cycle arrest,improvement of tumor cell hypoxia and increase of reactive oxygen species.There is an urgent need to develop biomarkers based on these pathways,which can promote clinically individualized treatment.

AIM: To study the effect of bioactive compounds from Entomogenous fungi (BCEF0083), on AVP content of hypothalamus, pituitary and expression of glucocorticoid receptor (GR) mRNA of hippocampus in chronic unpredictable stress model of depression in rats. METHODS: The depression animal model was induced by chronic unpredictable stress. The effect of BCEF0083 on AVP content in hypothalamus and pituitary was tested by radioimmunoassay. RT-PCR was used to test the expression of GR mRNA in hippocampus. RESULTS: BCEF0083 decreased the AVP content of hypothalamus and pituitary in chronic unpredictable stressed rats, and increased the expression of GR mRNA of hippocampus in chronic stressed rats. CONCLUSION: BCEF0083 exhibits antidepressant effect by attenuating the stimulated function of hypothalamus-pituitary-adrenal axis in chronic unpredictable stress model of depression in rats.

Objective To investigate of the radiological manifestations in congenital cystic adenomatoid malformation (CCAM) of lung in adult and to improve the diagnostic accuracy of CCAM of lung in adult.Methods Five cases with pathologically proved CCAM of lung in adult were retrospectively analyzed.Chest X-ray was available in 5 cases and chest CT was performed in 2 cases.Results On plain chest radiography,thin wall air cystic lesions with air-fluid level were detected in 3 cases.Honeycomb like small cystic lesion was detected in 1 case.Multiple round cystic lesions were found in 1 case.CT scan of the chest demonstrated a round thin wall air cystic lesion in the lateral segment of right lung's middle lobe,and a thin wall air cystic lesion with the wall merged into the shadow of chest wall in the left apicoposterior segment in one case.Small cystic lesions just like honeycomb were found in bilateral basal segments of the inferior lobes,with a 0.8—1.0 cm sized round mass revealed in the right lung′s inferior lobe basal segment, and the mass was spiculated in another case.Conclusion The imaging signs of CCAM of lung in adult is cyst or cyst-solid and at the risk of developing carcinoma.

Objective:To analyze the clinical features and genetic factors of neonatal 17β-hydroxysteroid dehydrogenase type10 (HSD10) deficiency.Methods:The clinical characteristics and genetic test results of a child with HSD10 deficiency coming from Children′s Hospital of Nanjing Medical University in April 2019 were retrospectively analyzed.The keywords" 17β-hydroxysteroid dehydrogenase type 10 deficiency" or " 2-Methyl3-Hydroxybutyryl-CoA dehydrogenase deficiency" or " HSD10" , etc.were searched in various databases, including CNKI, Wanfang, Weipu, Embase and PubMed to review the cases collected from all published data until May 31, 2020.Results:The patient was a newborn male who developed symptoms on the first day after birth.The main signs were metabolic acidosis, increased blood ammonia and lactate, and hypotonia.Trio whole exom sequencing in the patient and his parents identified hemizygous NM001037811: c.650G>A, p.R217Q in the HSD17B10 gene that is inherited from the mother.Since the child died on the third day after birth, no further central nervous system examination was performed.The mother of the child has intellectual disability, the sibling sister is normal and the HSD17B10 locus is wild type.By lite-rature reviewing, 5 newborn cases with clear medical records and genetic test results were listed.All patients were male, and had onset of HSD10 deficiency within 1 week after birth.The main phenotypes include metabolic acidosis (increased blood ammonia and lactate), hypoglycemia, hypotonia, and convulsions.All 6 children died in early infancy.The corresponsive HSD17B10 variants were c. 740A>G/p.N247S, c.677G>A/p.R226Q, c.257A>G/p.D86G and c. 650G>A/p.R217Q, which did not indicate the hot spots of mutation. Conclusions:HSD10 deficiency in the neonatal period is relatively rare.The clinical diagnosis is difficult due to the serious condition and short course of the disease.Severe metabolic acidosis, hypotonia, and convulsions in neonatal patients are the main reasons for the poor prognosis, which can be attributed to the hemizygous variation and heterogeneity of the mutation site in male patients.c.650G>A may be closely associated with severe neonatal HSD10 deficiency, but the molecular biological mechanism needs to be further clarified.HSD10 deficiency has a poor prognosis and lacks effective treatment.

Student evaluation is an important part of the teaching process.The Children's Hos-pital of Chongqing Medical University focused on the characteristics of individual child's growth and overall development according to the own condition and integrated formative assessment and summa-tive evaluation in the classroom teaching and clinical internship process. All the measures mentioned above not only help promote students' learning interests,master of knowledge and clinical skills but also exert positive effect on the improvement of teaching level.

Objective To explore the clinical effect of anteromedial thigh perforator flap for repairing soft tissue defect in lower extremity.Methods From January 2009 to December 2012,12 patients with soft tissue defect of lower extremity were treated with free anteromedial thigh perforator flap.Among them,there were 5 cases of wound in front of tibia,4 cases of dorsal foot wound,3 cases of heel wound;the wound size was 3.0 cm ×3.5 cm-7.0 cm × 9.5 cm;3 cases were repaired with free perforator flap of descending genicular artery,2 cases with free anteromedial thigh perforator flap,and 7 cases with medial vastus muscle perforator flap.Results All the transplants survived.Among them,1 case of anteromedial thigh perforator flap and 1 case of descending genicular artery perforator flap appeared vascular crisis postoperative.After anticoagulation and antispasmodic treatment aggressively,the flaps survived.One case of descending genicular artery perforator flap necrosis in edge,and then were cured by changing dressing.Twelve cases were followed up 6-12 months after operation (average 8.6 months),and the texture of flaps were good,the appearance appropriate ;7 sensation of 5 free flaps after nerve anastomosis came back to S; the donor sites in all cases were sutured directly and healed,leaving only the linear scar,and no effect on function.Conclusion The anatomy of anteromedial thigh perforator flap is constant,and the operation is convenient.The clinical result of repairing soft tissue defect of lower extremity is satisfying.

Objective To investigate the clinical effect of transplantation of the free anterolateral thigh flap and iliotibial band for the repair of soft tissue defects at foot and ankle and functional reconstruction.Methods From January,2008 to January,2013,25 pediatric patients with soft tissue defects at foot and ankle were transplantation of the free anterolateral thigh flap and iliotibial band.Of the 25 cases,there were 12 cases at heel,8 cases at dorsum of foot,3 cases at medial malleolus and 2 cases at external malleolus.All the cases were accompanied with different degree of fracture or dislocation,and with soft tissue defect such as achilles tendon,extensor tendon of dorsal,collateral ligament of ankle.The length of soft tissue defect which were reconstructed with iliotibial band were 3 cm to 16 cm.The causes of injury:19 cases were crushed by motorcycle or bicycle,4 cases were crushed machines,2 cases were injuryed in traffic accidents.The areas of free anterolateral thigh flaps were 8 cm × 5 cm to 18 cm × 12 cm.All the patients begined to early rehabilitative exercise under the protection of orthosis after 2 weeks of the operation.Results All cases were followed up from 6 to 24 months,averaged of 14 months.All the flaps survived,and only 2 cases with necrosis of small area in distal,and which were healed by dressing.The healing time were 12 to 24 days,and the average of 15.1 days; The surgery function were assessed according to Thermann's scale,and the results was 14 cases for excellent,9 cases was good,the general was 2 cases,and the excellent and good rate was 92％.Conclusion The transplantation of the free anterolateral thigh flap and iliotibial band for the repair of soft tissue defect at foot and ankle and functional reconstruction is a safe and effective strategy,and it has the advantages such as covering the wound at foot and ankle approvingly,reconstruction of power device once,the flap and iliotibial band were in the same wound,the trauma of doner site is small invasive,early recovery functional exercise,shorten the treatment cycle,and relieve the suffering of children.

A comprehensive physician authorization management system has been established at Renmin Hospital of Wuhan University in its effort of promoting the clinical standardization.This system covers authorization of prescription,disposition,surgery,and medical report among others,adhering to the principle of clear,complete quantitative competence-based,authorization.The training and assessment of physicians in parallel canimprove physicians' competence and quality of care.

Objective To explore the efficacy of fast-track surgery (FTS) combined with standard rehabilitation program (HSS) in elderly patients undergoing total hip arthroplasty (THA).Methods Ninety elderly patients with femoral neck fracture were randomly assigned to receive either FZS plus HSS Tehabilitation program (experimental group,n =45) or HSS rehabilitation program (control group,n =45) after THA from December 2013 to December 2014 in our hospital.The experimental group had 23 men and 22 women,with an average age of 68.2 ± 3.7 years.The control group had 22 men and 23 women,with an average age of 70.6 ± 4.1 years.Harris score and visual analogue scale (VAS) were used to assess the hip joint function before operation,4,8 and 14 weeks after operation.The complications were compared between the 2 groups at 14 weeks after operation.Results All the patients completed a 14-week follow-up.There were no significant differences in Harris and VAS scores at pre-operation between the 2 groups (P ＞ 0.05).At 4,8 and 14 weeks after operation,the Harris scores in the experimental group (67.2 ±3.5,88.3 ±2.5and 92.5±3.3) were significantly higher than those in the control group (52.5±7.8,65.8±4.9 and 72.2±4.9) and the VAS scores in the experimental group (3.4±0.8,2.2±0.8 and 1.3±0.5) were significantly lower than those in the control group (5.6 ±0.9,4.2 ±0.8 and 2.9 ±0.8) (P ＞ 0.05).There were no complications in the experiment group while there were 14 complications (31.1％) in the control group,showing a significant difference (P ＜ 0.05).Conclusion FTS combined with HSS standardized rehabilitation can effectively reduce the incidence of complications and accelerate the functional recovery of hip joint in elderly patients after THA.