Objective: To construct a replication-competent adenovirus shuttle plasmids named pAd-delE1b55kD,which can transfect the cell of tumor targeted.Methods: delete the E1B55 region of pXC1 and retain a site for Bgl II by such technique of gene recombination as nested PCR;verify the correctness of pAd-delE1b55kD by gel image analysis and sequencing the gene order.Results: The 2279~3326 region of E1B in pXC1 was deleted.The 2024 basic radical C was mutated to T,the 2252 basic radical C to T and the 2261 basic radical G to T.Stop codon TGA?TAG and TAA were inserted.A site for Bgl II was retained in downstream of the stop codon.Conclusion: The replication-competent adenovirus shuttle plasmids named pAd-delE1b55kD is constructed,which provided a carrier for the gene therapy of tumor targeted.

Objective:To reseach the effects of focused ultrasound on the capability of proliferation that human hepatocarcinoma cell SMMC7721 have in vitro,and to determine the mechamism of this therapy initially.Methods:To irradiate the SMMC7721 cell which is in logarithmic growth time with ultrasound.The dosage of ultrasound was 0.8MHz 20W 25s,which make 70% of SMMC7721 cell that had been irradiated alive.The changes in cell morphology,biochemistry and gene expression were observed with immunohistochemistry and hybridization in situ.Results:The ultrastructure of SMMC7721 cell was changed by focused ultrasound,and the ultrasound could inhibit the expression of VEGF,PCNA,VEGF mRNA and PCNA mRNA( P

Objective To construct the conditionally replicating adenovirus vector Ad-delE1b55kD-shRNA/Survivin-EGFP that can transfects into HT-29 effectually and selectively and contains shRNA targeting to human Survivin gene.Methods EGFP geoe and shRNA gene were inserted into pAd-delE1b55kD,then pAd-delE1b55kD-shRNA/Survivin-EGFP was obtained.The plasmid and pBHGE3 were cotransfected into HEK-293 cell to obtain the conditionally replicating adenovirus vector Ad-delE1b55kD-shRNA/Survivin-EGFP.Then DNA of the adenovirus vector was extracted and identified.The transfection efficiency of the vector to HT-29 and LO2 was detected.The expression of Survivin mRNA and protein was detected by RT-PCR and Western blot.Results EGFP gene and shRNA gene targeting to human Survivin mRNA were inserted into conditionally replicating adenovirus vector successfully,proven by sequencing.The transfection efficiency to HT-29 of Ad-delE1b55kD-shRNA/Survivin-EGFP was significantly higher than replication defective adenovirus and liposome vector(P

Objective To find the best level of transducer when continuous invasive arterial blood pressure monitoring using evidence-based approach. Methods Searched in three databases (Cochrane, PubMed,sinoMED), meanwhile the website of related academic societies,supplemented with Citation Index. Results There were 11 articles after selected. The majority of evidences (9 articles) suggested leveling with the heart, one suggested leveling with the catheter tip,and the other one regarded the matter as nothing important. Conclusions Transducer should be leveled to align the heart rather than the tip of arterial catheter when continuous invasive arterial blood pressure monitoring, but it doesn't matter which surface landmark of the heart. It was suggested that changing the level of transducer when changing the patient position or head of bed.

The standard surgery intern orientation is very important. The surgery intern orien-tation is completed by surgery education division (SED) in the U.S.A. The orientation includes speech from director of surgery department. the interaction part presided by surgical teachers, topic groups for discussing. Then the faculties of SED will explain the core competences which are required by accred-itation council on graduate medical education (ACGME), educational activities of department, the re-view process for resident physicians. The orientation also includes occupation development plan for residents; manners, teamwork and communication to patients; surgical basic skills training, system management, feedback and evaluation etc. The expectation of this article is for the improvement of Chinese surgery intern orientation.

Objective To investigate the effect of RNAi-mediated survivin gene with conditionally replicating adenovirus Ad-de-lE1b55KD-shRNA/survivin-EGFP silencing on propagation and apoptosis of colon carcinoma cell lines HT-29 .Methods Ad-de-lE1b55KD-shRNA/survivin-EGFP was transfected to transplantation tumor on athymic mouse ,replication defective adenovirus and liposome vector which was contained the same shRNA as Ad-delE1b55KD-shRNA/survivin-EGFP were as control one .Then the change of transplantation tumor on athymic mouse was tested ,and TUNEL was used to assay the apoptosis rate of transplantation tumor cells .Results After transfection of Ad-delE1b55KD-shRNA/survivin-EGFP ,the quality of transplantation tumor on athymic mouse were reduced and the apoptosis rate of transplantation tumor cells were higher than replication defective adenovirus and lipo -some vector which was contained the same shRNA (P<0 .05) .Conclusion The effect of Ad-delE1b55KD-shRNA/survivin-EGFP to colon carcinoma cell on propagation and apoptosis were higher than replication defective adenovirus and liposome vector .

Objective To comprehend spatial characteristics of the cavity created by a working space market.Methods 40 patients were successively operated according to the surgJical mode of minimally invasive video-assisted thyroidectomy from Jan.2010 to Aug.2010.Instead of hand-retraction.a mechanical arm-working space marker type I(WSM-I(R)，MIEO Medinstr Co.Ltd，China)，was applied to establish a working space.After the pathway making，a cavity above the gland was created and adjusted properly by the space maker，and then，endoscopic view was built and manipulation in the cavity was progressed throughout the later process.Geometric measurement of the cavity were performed at abasic space positionjust after the initial cavitation，and parameters such as length，width and height of the cavity were measured with a specifically scale-marked puncture needle(MC1820，Bard4(R)Max·Cor(R)Instrument)through mini-holes lay in the lifting hook(φ4mm，middle point and distant point).Results13 cases received a lobectomy and isthmectomy.The other 27 cases received a partial thyroidectomy.Dimensional parameters were calculated as below.①The basic length of cavity button was(4.35±0.39)cm.The basic width of cavity button(distance at central point)was(4.66±0.53)cm.The basic central height of cavity was( 1.36±0.34)cm.The maximal central height archived by readjusting was(1.66±0.32)cm and a height increase of0.3 cm can be achieved(22.1％).②The basic peripheral height was(0.98±0.29)cm.The maximal peripheral height archived by readjusting directionally was(1.33±0.14)cm and a height increase of 0.35 cm can be achieved(35.7％).③Statistic analysis yielded a negative correlation between the cavity volume and the size of the nodule.Conclusions The working space created by WSM-I appears to be an laigh and irregular trapezoid stock with oblique roof formed by lifting hook.Although vertical height，especially the peripheral height，is a major restrictive dimension，the cavity can still be usable and enough for factual observation and manipulation，due tocompensating effectof endoscope，finite space requirement of harmonica anddirectional volume shiftingof WSM.

Hyperparathyroidism is an important complication of thyroid surgery.Identification is the premise of intraoperative pretection.At present,identification of the parathyroid gland relies on personal experience of surgeons.Amplifying display of endoscope or surgical magnifying glass,the use of dyeing agent such as methylene blue,nanocarbon,5-ALA or BB5-G1,the use of radionuclide imaging and contact endoscope,and biopsy like intraoperative frozen pathological examination and FNA are all important trials.This article is going to make a review of the methods.

objective To determine a proper fiducial photography distance setting for ideal amptitied endoscopic imaging of parathyroid gland by high definition endoscopy system.Methods 30 patients were operated with MIVAT mode (modified Miccoli's approach) for treatment of thyroid carcinoma from Apr.2013 to Mar.2014.High definition imaging was established by Image 1 Endoscopy System(Karl Storz Co.) to observe parathyroid gland and related fine anatomical structures during surgery.5 fiducial photography distances (1.0/1.5/2.0/2.5/3.0 cm) were separately tested during surgery.Maximally amplified parathyroid gland images of each setting were obtained by the approaching-amplifying photographic method,and then the size of the real parathyroid glands as well as their screen images were measured and recorded to calculate the magnification.A proper fiducial photography distance setting was determined postoperatively by comparison of the magnification times,as well as clarity,stability of the imaging and surgical maneuverability.Results ①90 parathyroid glands were successfully observed and measured.②At the longest fiducial photography distance (3.0 cm),the parathyroid gland could be stably magnified by 14.26±3.06(long trail)/12.62±2.88 (wide trail)times,but their contour and color not clear.③At the intermediate distance (2.5 cm),the parathyroid gland could be magnified by 16.74±3.15 (long trail)/14.81± 3.47(wide trail)times with the graphics stable,and the color and contour more clear,but the vascular pedicle and the tiny vessels under the capsule still blurred.④At the shortest distance (1.0 cm),the parathyroid gland could be magnified by 27.72±6.45 (long trail)/26.33±7.22(wide trail)times,not only the color and contour,but also the vascular pedicle and the tiny vessels under the capsule of the gland became further clearer,unfortunately the graphics was shimmy and unstable.Conclusions ①2.5 cm can be a proper fiducial photography distance for searching,identifying and preserving parathyroid gland in MIVAT,while 1.0 cm can be a special fiducial photography distance for further confirming parathyroid gland when necessary.② Current high definition endoscopy system can be applied to identify the parathyroid gland if fiducial photography distance was properly set and approachingamplifying photographic method was used.Along with the magnification of the imaging,the features of the parathyroid gland may become clearer,including its yellow-brown color and oval contour,as well as the detail structures such as the tiny vessels under the capsule and the vascular pedicle.