With the indepth studies of molecular mechanisms of renal cell carcinoma ( RCC),people have made great progress in the targeted therapy drugs which targeted at vascular endothelial growth factor (VEGF) and their receptors,which dramatically improve the treatment outcome for patients with advanced or metastatic RCC.However,recent clinical trails show that the targeted therapy drugs may cause adverse events,such as hypertension,bone marrow toxicity,pneumonitis and so on.It is important to manage the adverse events promptly not only to improve the therapeutic efficacy but also to improve the quality of life for patients with RCC.

Objective:To synthesize analogues of 6-[4-(4-substituted acyl piperazinyl)phenyl]-4, 5-dihydro-3(2H)pyri-dazinones and 6-[4-(4-substituted acyl piperazinyl)phenyl]-5-methyl-4,5-dihydro-3(2H)pyridazinones in search for more potent and selective antithrombotic drugs. Methods:Many reactions such as Friedel-Crafts reaction,hydrolysis,cyclation, acyla-tion,substitution were used to synthesize the title compounds. Born method was applied for preliminary pharmacological test in vitro. Results : Twelve title compounds were synthesized, in which 10 compounds were firstly reported. Their structures were identified by element analysis and 1H-NMR. Conclusion:Results of preliminary pharmacological test show that all synthesized compounds are effective against platelet aggregation induced by ADP in vitro. The activity of compound (9) is the most potent. The activity of compound (6), (7), (10), (11), (12) are also better than that of CCI-17810.

Pirh2 (p53-induced protein with a Ring-H2 domain),one of the ubiquitin-protein E3 ligases,can promote p53 degradation via ubiquitin-proteasome pathway,and repress the biological functions of p53.Researchers have found that the Pirh2 is overexpressed in many cancers,which suggests Pirh2 is probably correlated with tumorigenesis and cancer development,and it may become a promising cancer therapeutic target.

Discoidin domain receptor 2 (DDR2) is a receptor tyrosine kinase (RTK) that can be activated by fibrillar collagens (Ⅰ-Ⅲ,X).Recently researchers show that the DDR2 is expressed differently in many cancers,which suggests DDR2 is probably correlated with tumorigenesis and cancer development,and it may become a promising cancer therapeutic target.

Objective To find an ideal operative method of i nteral fixation for supracondylar a nd in-tercondylar femur comminuted fractures.Methods 30cases with supracondylar and inte rcondylar femur frac-tures were treated percutaneously with retrograde femoral intramedullary nail(GSH)in condition of close reduction technique with assistance of endosc ope and fluroscope.Results The mean 115ml blood loss was seen in 30cases without grafting intraoperatively.Thigh edema recovery and over90?knee flexion motion were seen one week after the operation.All fractu res were united in 6months.Postoperative following-up for 18months revealed the mean 125?knee motion,normal gait in all cases,no varus or valgus defo rmities and no osteoarthotitis.Conclusion The percutaneous tech.of retrograd e nailing with assistance of endosco pe and fluroscope is an ideal surgery method to treat supracondylar and intercondylar femur factures.

Objective Introducing the job embedded scale to explore the dropout intention of medical workers at tertiary hospitals.Methods Correlation analysis, analysis of variance and regression analysis were used to analyze with a job embedded scale, the dropout intention of medical workers of a Beijing hospital.Results There was a significant negative correlation between job embedding and dropout intention of such people(r=-0.223).The predictive ability of on-the-job embeddedness is better than off-the-job embeddedness.Fit-organizational, sacrifice-organizational, fit-community and sacrifice-community were significantly negatively correlated with dropout intention.There are differences in the relationship between job embedding and dropout intention of medical workers of different individual attributes.Conclusion Job embedded scale can effectively predict the dropout intention of medical workers, offering a usable tool to predict the dropout of these people.

Objective To explore clinical outcomes of using improved 2D computer-assisted fluoroscopic navigation of inu'tation 3D vertebra image to guide the pedicle screws in lumbar disease. Methods The anterio posterior, lateral and oblique radiographic materials were got in 43 lumbar disease patients performed neck of vertebra internal fixation, and used the method of improved computer-assisted fluoroscopic navigation to imitate anterio posterior, lateral spinal and axial pedicle virtual image to guide the pedicle screws implantation. Results One hundred and eighty-eight lumbar pedicle screws were implanted, deviation mean position 1.5 mm and mean angle deviation 0.8° in match navigation virtual path with real pedicle screws image. Postoperative CT showed all pedicle screws contained within the pedich, without invasion to lateral and inner bone cortical of the pediele. Deviation mean 1.0° by measured pedicle screws with longitudinal axis vertebra compared with preoperational predict implant screws sagttial angle. Conclusions Improved 2D computer-assisted fluoroscopic navigation is simple and convenient, use anterio posterior,lateral and oblique radiographic materials to imitate anterio posterior,lateral spinal and axial pediele virtual image can precisely guide the pedicle screws implantation.

Objective To explore the efficacy of computer-assisted fluoroscopic navigation to guide the treatment of thoracolumbar burst fractures. Methods 18 patients with thoracolumbar unstable fractures were treated with short-segment vertebral pedicle screw fixation guided by computer-assisted fluoroscopic navigation, and fractures were reinforced with CPC cement vertebroplasty. Postimplantatively, the implants' images-error between virtual image of fluoroscopy and X-ray image was measured. Results The implant's location was excellent. All patients were allowed sitting-up or bearing body weight one week after operation. The vertebral height restored 40% postoperatively. 12 months after operation the vertebral height only changed 0.15%. Dynamic X-ray films showed no abnormal segment instability and no instrument breaking. Conclusion Using computer-assisted fluoroscopic navigation to guide the treatment of thoracolumbar burst fractures with CPC vertebroplasty and short-segment pedicle srew fixation could determine the internal fixation approach and let implants to the precise position by one time of X-ray image. It increases the security of pedicle screw fixation and vertebroplasty.

AIM To study the chemical constituents from the stems of Clausena lansium (Lour.) Skeels.METHODS The n-butanol fraction of Clausena lansium stems' 95％ ethanol extract and herb residue's 50％ ethanol extract were isolated and purified by silica,RP-MPLC and PHPLC column,then the structures of obtained compounds were identified by spectral data.RESULTS Eight compounds were isolated and identified as marmesinin (1),nodakenin (2),decuroside Ⅳ (3),3,4-dimethoxyphenyl-β-D-glucopyranoside (4),glucosyringic acid (5),2-(3-methoxy-4-hydroxyphenyl)-ethanol-1-O-β-D-glucopyranoside (6),4-hydroxy-2-methoxy-phenyl-β-D-glucopyranoside (7),4-hydroxy-2,6-dimethoxyphenyl-β-D-glucopyranoside (8).CONCLUSION Compounds 4-6 and 8 are isolated from genus Clausena for the first time.

Aim The goal is to make a further comprehension of the pathogenesis of Parkinsons disease (PD) and hence add further knowledge for PD diagnosis by observing the functions of nitric oxide (NO) in striatum (STR). Method Microelectrodes were used to observe the effects of sodium nitroprusside (SNP), L-glutamic acid (GLU) and ?-aminobutyric acid (GABA) on STR neurons' spontaneous firing rates, and at the same time, we observed the effects of NO on GLU and GABA. Results 77% (51/66) of the tested neurons were excited by SNP, NO synthase inhibitor L-NAME antagonized the excitatory effect of SNP. Duringthe periods of microelectrophoresis GLU and GABA, SNP amplified the excitatory effect of GLU and weakened the inhibitory effect of GABA. L-NAME antagonized the excitatory effect of GLU.Conclusion These results demonstrated clearly that NO, GLU and GABA functions might converge in the same STR neurons. NO and GLU functions are excitatory whereas GABA function is inhibitory on the firing activities in STR neurons.