Objective To investigate the development of the cervical cord in children by using diffusion tensor imaging.Methods Ninety healthy children were undergone with diffusion tensor imaging of the cervical cord by using single-shot spin-echo echo planar image sequence.The values of apparent diffusion coefficients (ADC), fractional anisotropy (FA), average length(Ltract) and volume of tracts(Vtract) were measured in the cervical regions.Results The measurements of each group were as follow:ADC value:0.9747 ±0.2777,0.8493 ±0.2236,0.8210 ±0.1432,0.9198 ± 0.1444,0.9048 ±0.1676;FA value:0.4117 ±0.0391,0.4712 ±0.0199,0.4944 ±0.0439,0.5608 ±0.0443,0.6169 ± 0.0551;Ltract:25.61 ±8.63,24.66 ±7.14,27.03 ±7.23,34.93 ±10.99,37.63 ±10.22;Vtract:3.07 ±1.49,3.00 ± 1.52,3.81 ±1.33,5.41 ±2.35,6.64 ±2.84.FA value, Ltract and Vtract showed significance in different age groups , while ADC value was found no difference ( P<0.001) .Post-Hoc test revealed that FA value was significantly different between age group I and Ⅱ.FA value, Ltractand Vtract presented significantly different between group ⅢandⅣ.FA value difference was also found between group Ⅳand V.FA value, Ltract and Vtract were all positively corelative with age (F=1.758, P=0.145 ) .Conclusion Development of the cervical cord shows periodicity with periodic features .Diffusion Tensor Imaging can be used as a tool to observe and evaluate development of the cervical cord in children .

Background and purpose:Colorectal carcinoma(CRC) is a major cause of cancer-related mortality. In the 1990s, several fi rst-line phase Ⅲ trails showed a signifi cant improvement in result with the addition of CPT-11(irinotecan, which is a specifi c inhibitor of topoisomerase Ⅰ) to FU-LV combination therapy(FOLFIRI).We observed the survival rate, effi cacy and adverse reaction of the combination chemotherapy of irinotecan plus folinic acid/continuous 5-? uorouracil bimonthly FOLFIRI regimen as second chemotherapy in treating advanced colorectal adenocarcinoma. Methods:Sixty patients with histologically proved advanced colorectal adenocarcinoma whose disease had progressed after treatment with first-line oxaliplatin or other chemotherapeutics agents were included to receive at least 2 cycles of chemotherapy with irinotecan 180 mg/m2 day 1 and folinic acid 200 mg/m2 iv,5-FU 400 mg/m2 iv bolus,days 1 and 2, 5-FU 600 mg/m2 iv infusion over 22 hours, days 1 and 2.Treatment was repeated every two weeks. Results:All patients were assessable for toxicity and 58 patients were evaluable for treatment response. The non-hematological toxicity was mild. Most was grade Ⅰ or Ⅱ. Only two patients experienced grade Ⅲ diarrhea and one patient experienced grade Ⅲ nausea and vomiting. There were no cases with grade Ⅳ toxicity. The most common hematological toxicity was neutropenia. Grade Ⅲ neutropenia were observed in fi ve patients. There was no case of febrile neutropenia. Based on intention to treat analysis, there were no complete responses (CR), 14(24.14%) partial response (PR), and 30 (51.72%) stable disease. the median time to disease progression was 6.09 months. The median overall survival was 9.65 months. Conclusions:Bimonthly irinotecan in combination with folinic acid and 5-fluorouracil was active with acceptable toxicities and a prolonged survival time in retreated colorectal cancer.

Objective To determine the mutations in exon 5 of the phenylalanine hydroxylase(PAH)gene in phenylketonuria(PKU)patients from Xinjiang.Methods The mutations in exon 5 and flanking sequence of PAH gene were detected by SSCP analysis and DNA sequencing.Results Four different mutations,including missence mutation F161S,splice mutation IVS4-1G→A,missence mutation R158Q and nonsence mutation Y166X were identified in 74 chromosomes from 37 PKU patients,with relative frequencies of 4.1%,1.4%,1.4% and 1.4%,respectively.The frequency of mutant alleles in exon 5 is 8.1%.Considering the previous reports and the present study,R158Q was the most prevalent form in PKU patients from European and Latin American countries,IVS4-1G→A was a common mutation inoriental PKU populations.However,F161S and Y166X are two characteristic forms in Chinese.Conclusion Characteristics of PAH gene mutations and their distribution were showed in Chinese PKU population from Xinjiang,where is a hinterland located between China and Europe.The results give a clue that Xinjiang might be an ideal genetic resource repertoire for studying diversity of gene mutations,heterogeneity of PAH gene,human genesis and migration.

Objective To investigate the point mutation features of exon 11 and 12 in phenylalanine hydroxylase(PAH)gene of the patients with phenylketonuria(PKU)in Xinjiang.Methods PCR/SSCP and gene sequencing were used in present study.Results Five mutations were identified from 74 chromosomes of 37 patients.Among them two mutations were detected from exon 11 including nonsense mutation Y356X and splice site mutation V399V,and three mutations were detected from exon 12 including R413P,R408W and A434D,all which were missense mutation.The frequency of the five mutations were 5.4%,5.4%,4.1%,1.4%,1.4% and 1.4%,respectively.The allelomorphic frequency of exon 11 and 12 were 10.8% and 6.8%,respectively.Among the five mutations,R413P is common in Japan,Y356X and V399V are centered in north China,and R408W is the most often mutation in Europe and America.Conclusion Xinjiang Uygur Autonomous Region is situated on northwest China,contiguous to other countries of central Asia,and is such an area differed from other areas of China,and distributed special PAH gene mutation in PKU patients.

It started with the legitimacy of commercial insurance agencies undertaking claiming services for basic medical insurances.Experiences and warnings from the international world in this area were examined and causes behind it were scrutinized,under a context of the contracting-out of public services.The domestic picture was also drew and arguments were given.A three-step strategy was suggested for China's contracting-out of claiming services for basic medical insurances.

Objective To investigate the efficacy of intracoronary tirofiban during percutaneous coronary intervention(PCI)for patients with acute myocardial infarction(AMI).Methods Seventy-six consecutive AMI patients,treated with primary coronary angioplasty in 12 hours were enrolled.They were randomly divided into two groups:tirofiban group(39 cases)and control group(37 cases).Tirofiban group was treated with intracoronary timfiban during PCI and after the operation for 48 hours.Both of them were given heparin in PCI and aspirin,clopidogrel before PCI.At the end of PCI procedure,angiographic features such as TIMI flow grade and TIMI myocardial perfusion grade(TMPG)were analyzed.The difference of two groups in complication and major adverse cardiac events(MACE) was investigated.Results The myocardial reperfusion of tirofiban group was better than that of control group[TIMI grade 3 flow 94.9%(37/39) vs 78.4%(29/37),P<0.05;TMPG 3 grade 89.7%(35/39)vs 67.6%(25/37),P<0.05].There was no significant difference between two groups in bleeding complication.The occurrence of MACE in tirofiban group was less than that in control group[7.7%(3/39)vs 18.9%(7/37),P<0.05].Conclusion Intracoronary tirofiban dunng primary PCI in patients with AMI can improve coronary flow and myocardial perfusion,and has no more bleeding and less MACE occurrence.

HRP-anti-HRP complex was injected into BALB/c mice through the tail vein. 24 hours later, the spleens of mice were removed, fixed and cut into slices. After incubation in DAB/H_2O_2 the follicular dendritic cell (FDC) distribution area could be defined at a certain part of lymph nodule. Light microscopic and stereologic analysis study on the lymphocytes at intra- and extra- FDC distribution area were carried out. The results revealed that lymphocytes at intra- and extra- FDC distribution area were composed of various lymphocytes populations of different sizes. The cell populations at intra-FDC distribution area were mainly composed of large and medium sized lymphocytes, while the populations at extra-FDC distribution area were mainly medium sized and small lymphocytes. As a result, FDC always exists on the location where lymphoblastic phenomenon appears. This indicates that FDC has certain relation with the lymphoblastic phenomenon.

Objective To investigate the management of pseudomyxoma peritonei originated in the appendix.Methods The clinical data of 51 patients with pseudomyxoma peritonei originated in the appendix who were admitted to the Beijing Hospital from 1970 to 2010 were retrospectively analyzed.The results of operation,reoperation,adjuvant treatment and follow-up were analyzed.The time from pseudomyxoma peritonei recurrence to the reoperation between patients who did or did not receive chemotherapy was compared by two tailed t test.Results Of the 51 patients,48 received operation,and the operation time was (135 ± 72 )minutes.Tumor recurrence was observed in 34 patients,and 16 of them received cytoreduction procedure,and 33 cytoreduction procedures were performed in total.The median time of follow-up was 49.7 months (range,3-132 months).The disease-specific survival was observed in 25 patients and disease-free survival in 16 patients.Four patients died of tumor recurrence or progression.The results of postoperative pathological examination confirmed that 19 patients were with benign disseminated peritoneal adenomucinosis (DPAM),26 were with malignant peritoneal mucinous carcinomatosis (PMCA) and 6 were with intermediate subtype (PMCA-1).The 3-,5- and 10-year survival rates were 75％ (38/51),55％ (28/51) and 22％ ( 11/51 ),respectively.The survival time and reoperation time interval for patients who received postoperative chemotherapy were ( 21 ± 4) months and ( 10 ± 6 ) months,which were longer than (19 ±7 )months and (7 ±4)months of those who did not receive postoperative chemotherapy (t =1.027,0.361,P ＞ 0.05).The median survival time of patients with benign DPAM,PMCA-1 and malignant PMCA were 96,63,23 months,respectively.The tumor recurrence interval for patients with benign DPAM and those with malignant PMCA were ( 15 ± 5 ) months and (7 ± 4) months,with significant difference ( t =2.193,P ＜ 0.05 ).Conclusions An active cytoreduction surgery is feasible for patients with pseudomyxoma peritonei originated in the appendix in improving survival.Repeated cytoreduction is a treatment of strategy to prolong the recurrence time and improve the prognosis of selected patients.

Objectives: To investigate the current state of pension security for rural doctors in 12 provinces those have not introduced related policies. Methods:Two counties were chosen in each province. Data was analyzed in terms of coverage, types and intention of pension security for rural doctors in these areas. Results:The study found that the proportion of rural doctors with pension security was 81. 4% in these areas. 57. 1% of rural doctors with pen-sion security had urban and rural pension insurance. Differences exist among these areas. The safeguard level is too low, and the willingness of rural doctors to attend to pension security is not strong enough. Results:The mechanism of pension security for rural doctors must be improved. These areas should implement classified guidance and syn-chronize various models to solve the problem of pension security for rural doctors.

BACKGROUND: Phenylketonuria is caused by gene mutation of phenylalanine hydroxylasel (PAH), which is mainly induced by permutation, short segments and insertion of base.OBJECTIVE: To evaluate the gene mutation of phenylalanine hydroxylasel in phenylketonuria in Hui nationality.DESIGN: Open study.SETTING: Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA; Capital Pediatrics Institute.PARTICIPANTS: A boy of Hui nationality in China and aged 3.1 years was selected in this study. The boy had intellect hysteresis in his one year and received medical treatment in his three years, while he was diagnosed as cerebral paralysis. After repeatedly inefficient treatment, he was hospitalized in our hospital on December 13, 2004. Iron sesquichloride in urine was strongly positive and concentration of serum phenylalanine was 1 680 μmol/L; therefore, he was diagnosed as the typical phenylketonuria.METHODS: 5 mL venous blood was selected from the boy and his parents, respectively, and anticoagulated with EDTA-Na2. DNA in gene group was extracted by using typical phenol/chloroform method. In addition, polymerase chain reaction (PCR) primer sequence of extron 7, 6, 11, 3, 12 and 5 of PAH gene was designed based on references. And then, PCR products were detected with 2% agarose gel electrophoresis. 5 μL PCR products were mixed with the same volume of degenerated buffer solution, degenerated at 97 ℃ for 5 minutes, put in iced bath and performed with 80 g/Lnon-degenerated polyacrylamide gel electrophoresis. After that, the products were dealt with sliver staining routinely, and single strand DNA banding patterns were analyzed and recorded. ABI377 automatic sequenator (PE Company) was used to detect PCR sequence and purify PCR product in Shanghai Boya Biotechnology Company.MAIN OUTCOME MEASURES: Iron sesquichloride in urine, concentration of serum phenylalanine and mutant gene types of phenylalanine hydroxylase.RESULTS: Extron 7, 6, 11, 3, 12 and 5 of PAH gene were analyzed in the boy and his parents. The results demonstrated that SSCP electrophoresis in extron 6 was different from that in the normal control group. Site of electrophoresis strip of his father was coincident with that of his mother, but different from that of the boy. Sequencing results indicated that point mutation (cytosine replaced by thymine), which was a R176X mutant heterozygote, occurred at the 526th site of cDNA of phenylalanine hydroxylase gene in his parents; however, two chromosomes of the boy had mutation at the same site, which was R176X mutant homozygote.CONCLUSION: Mutation of R176X homozygote of phenylketonurea is firstly reported in Hui nationality in China.