Objective To describe the clinical characteristics of 4 patients with concomitant amyotrophic lateral sclerosis (ALS) and Sj(o)gren' s syndrome.Methods The clinical features,laboratory findings,and electrophysioiogical manifestations etc.of these patients were analyzed.Results Four female patients all developed progressively aggregated weakness in their limb/limbs at the fifth to sixth decades of their lives.According to their neurologic findings,3 met the criteria of clinical probable ALS,while the other was diagnosed with probable laboratory-supported ALS.All these patients showed diffused patterns of neurogenic changes in electromyography tests.Motor symptoms of 2 patients transiently improved after immunomodulation treatments.Conclusion Careful screening of the Sj(o)gren' s syndrome symptoms in patients with ALS is necessary so as to deal with the treatable concomitant disease in time.

Objective To explore the emergent measures for hematomyelia during microendoscopic discectomy (MED). Methods Different measures, such as electrocoagulation, compression, irrigation, or hemostatic administration, were directed against different types of hematomyelia during MED. Results No conversions to open surgery for hematomyelia were required in all the 287 cases in the study. A follow-up for 4~30 months (mean, 17 months) was carried out. According to the MacNab criteria, excellent results were achieved in 219 cases, good results in 59 cases, fair in 7, and poor in 2. Conclusions Measures for hematomyelia during MED include the decrease of abdominal pressure, strict hemostatic performance, keeping off varicose veins when the protruded intervertebral disc is resected, compression by using gelfoam or styptic cotton, and intravenous administration of thrombin. These measures can effectively improve the surgical safety and the curative effect.

BACKGROUND:Spine is relatively complex in structure, shape, material properties, and load bearing. The traditional biomechanical method cannot solve these problems. OBJECTIVE:To investigate the stress distribution of intervertebral disc, zygapophysial joints and vertebral body of degenerative scoliosis, and to provide accordance to the biomechanical mechanism of degenerative scoliosis occurrence and development. METHODS:Based on the successive CT images of spinal column from T12 to superior segment of S1 of degenerative scoliosis patients, the special material properties were attributed to the model to form the integrated and effective three-dimensional finite element model of degenerative scoliosis. The model was loaded on the anteflexion, extension, left lateral bending, right lateral bending, left rotation and right rotation conditons. Then the spinal activity and the stress distribution of intervertebral disc, vertebral body and articular cartilage of zygapophysial joints were calculated and analyzed. RESULTS AND CONCLUSION:The spinal activities of degenerative scoliosis finite element model were less than those of common lumbar spine. The stress distribution of intervertebral disc was inclined to the verge of it and the greatest stress was appeared on the extension motion. The apex of scoliosis was the place of stress concentration and the obvious stress concentration of articular cartilage of zygapophysial joints was appeared on the rotation motion, then fol owed by the extension motion, especial y that of articular cartilage of zygapophysial joints on the apex of scoliosis. Stress concentration is easily appeared on the apex of scoliosis, and the extension and rotation motion can aggravate the development of degenerative scoliosis.

Objective: To investigate the effects of different extracts of Smilax china L on the activity of ovarian cancer cells. Methods:Solvent extraction method was used to extract the active ingredients of Smilax china L. , and CCK-8 assay method was ap-plied to detect the influence of different Smilax china L. extracts (0, 50, 100, 150 and 200μg·ml-1 ) on the survival rate of ovarian cancer cells including low invasiveness A2780 cells and high invasiveness HO-8910PM cells. At the same time, the status of the two kinds of ovarian cancer cells at different time points (24, 48 and 72 h) was observed. Results:The IC50 of N-butanol extracts (SCR-B) on HO-8910 and A2780 ovarian cancer cells was 47. 5 μg· ml-1 and 69. 2 μg· ml-1 , respectively, and that of ethyl acetate ex-tracts (SCR-E) on A2780 and HO-8910 cells was 147. 9 μg· ml-1 and 166. 0 μg· ml-1, respectively. Smilax china L. extracts had the inhibition against both A278 and HO-8910PM ovarian cells in a dose-and time-dependent manner. Conclusion:The inhibitory activity of SCR-B against ovarian cancer cells is stronger than that of SCR-E, and SCR-B has stronger inhibition against A2780 cells than against HO-8910 cells. SCR-B has better inhibition against ovarian cancer cells.

Objective To investigate the stress changes of intervertebral disk of degenerative scoliosis (DS) after treatment with short-segment internal fixation and fusion.Methods Based on the DS patient's CT images of the successive spinal column from T12 to superior segment of S1,assigning special material attributes to the model and forming the integrated and effective three dimensional finite element model of DS.Treated with the short-segment (one-segment and two-segment) spinal canal decompression +intervertebral bone fusion+pedicle screw internal fixation.Loading the model on the following postures:anteflexion,postextension,left lateral inclination,right lateral incliniation,left rotation and right rotation.Calculating and analyzing the stress distribution of intervertebral disk and comparing to that of the preoperative normal DS model.Results The stress of intervertebral disk after the short-segment internal fixation and fusion was increased than that of preoperation.The rotation motion affected greater to the upper intervertebral disk of fixation segment and the extension motion affected greater to the inferior intervertebral disk of fixation segment.The increase of stress of upper and inferior intervertebral disk of fixation segment treated with one-segment fixation and fusion(average was 6.03,4.58 MPa,separately) was greater than that of the two-segment fixation and fusion (average was 5.24,4.47 MPa,separately),but there was no statisticdifference (P ＞ 0.05).Conclusions The short-segment intemal fixation can increase the intervertebral disk stress of adjacent segment fixation of DS.The effect on the stress of upper and inferior intervertebral disk of fixation segment of one-segment fixation and fusion is greater than that of two-segment fixation and fusion.And the patient should avoid the rotation and extension movements after treated with the short-segment internal fixation and fusion.

OBJECTIVE To evaluate the effect of antiviral agents in treating of severe acute respiratory syndrome(SARS). METHODS Based on the particular data (including medical history,examiuations and treatments) of 1702 patients of with SARS which were offered by the Health Bureau of Guangdong Province,the inpact factors of death and the course of diseases of SARS were retrospectively analyzed with unifactorial and multifactors statistic analysis methods. RESULTS It did not show any signs that the death rate could be decreased by the six antiviral agents in common use,but vidarabine could help to shorten the course of disease(OR=1.399,P=0.025),while oseltamivir might be prolonged the course of disease(OR=0.708,P=0.000). CONCLUSIONS The data showed that the effect of the six antiviral agents for curing SARS is limited,and a new antiviral treatment for SARS should be explored further.

Objective To investigate the growth inhibition and DNA damage of energized fusion protein anti-CD20(Fab)-LDM on B JAB cells in vitro.Methods The binding activity of fusion protein anti-CD20 (Fab)-LDP to B JAB cells was studied by flow cytometry and confocal laser scanning microscopy.MTT assay was used to study the energized fusion protein anti-CD20(Fab)-LDM on cell growth of B JAB cells.Comet assay was employed to detect DNA damage in B JAB cells.The cell growth cycle of BJAB was analyzed by FACS.Results The recombinant fusion protein anti-CD20 (Fab)-LDP possessed an significant target affinity towarded BJAB cells.The energized fusion protein anti-CD20(Fab)-LDM showed obvious inhibition on proliferation,as well as induced potent DNA damage in B JAB cells in vitro compared with lidamycin.B JAB cells treated with energized fusion protein anti-CD20 (Fab)-LDM showed S phase cell cycle.Conclusion The energized fusion protein anti-CD20 (Fab)-LDM could target binding to BJAB cells and significantly inhibit the proliferation of B JAB cells by inducing DNA damage and S phase arrest.

Objective:To introduce the application and practice of information technology in the pharmacy management of our hos-pital in order to provide reference for fine hospital management. Methods: The difficulties and application experience of information technology in the practice of hospital storeroom, pharmacy and medication management were summarized and analyzed. Results: The introduction of information and automation technology was beneficial to the improvement of work efficiency, prevention of medication er-rors, reduction of the incidence of clinical irrational drug use and improvement of patient treatment service quality. Conclusion:Imple-menting information-based pharmacy management is not only a new idea and method in hospital pharmacy development, but also the in-evitable tendency of the times.

Acute promyelocytic leukemia (APL) is characterized by the generation of the prototypic promyelocytic leukemia-retinoicacid receptor alpha (PML-RARα), an oncogenic fusion protein due to chromosomal translocation. In a human myeloid cell line,PML-RARα is cleaved by neutrophil elastase (NE) to produce the mutational PML [nuclear localization signal (NLS) deletion andRARα (NLS-RARα, containing NLS of PML), both of which may play an important role in APL pathogenesis. The yeast two-hybridtechnique was used to screen the intracellular proteins interacting with NLS-RARα, which may be involved in NLS-RARα signaling. The NLS-RARα coding sequence was amplified by polymerase chain reaction method and was cloned into the bait plasmid pGBKT7vector, which, after the confirmation by sequencing, was transformed into yeast AH109 and the subsequent expression of bait plasmidwas proved by Western-blot. The transformed yeast AH109 was mated with yeast Y187 (containing leukemia cDNA library plasmidspACT2) in medium. Diploid yeast was plated on synthetic dropout nutrient medium containing X-α-gal for screening. After beingreintroduced into yeast AH109 and sequenced to verify the expression of ORF, eight positive colonies were obtained, among whichonecontaining JTV-1 was cloned. The interaction between NLS-RARα and JTV-1 was further supported by indirect immunofluorescence,GST pull-down and co-immunoprecipitation, respectively. These findings brought some new clues for the further exploration ofNLS-RARα signaling to APL.

Objective: To investigate the relationship between expression of programmed cell death ligand-1(PD-L1) in the tissue of neuroblastoma (NB) and patient's clinical characteristics and prognosis. Methods: Clinical data and surgical tissue paraffin blocks of 100 newly diagnosed NB children at Sun Yat-sen University Cancer Center between January 2000 and December 2015 were collected and the expression level of PD-L1 and its' relationship with pathological parameters and survival rate were analyzed retrospectively. The ratio between groups was compared by chi-square test. Kaplan-Meier method was used for survival analysis and COX regression model was used for multivariate analysis. Results: Among 100 cases, 71 were males and 29 females; there were 5 cases of stageⅠ, 4 cases of stageⅡ, 19 cases of stage Ⅲ, 65 cases of stage Ⅳ and 7 cases of stage Ⅳs. Ten out of 62 cases (16%) were N-MYC amplified; 15 cases were in low-risk group, 18 were in medium-risk group and 67 were in high-risk group. The positive rate of PD-L1 in NB tumor tissue was 57% (57/100), of which 55 were weakly positive, 1 was moderately positive and 1 was strongly positive. The positive rates of PD-L1 expression in tumor tissues without bone metastasis were higher than those with bone metastasis(66%(39/59)vs.44%(18/41), χ²=4.864, P=0.027), the positive rates of PD-L1 expression in tumor tissues pathologically diagnosed as neuroblastoma were higher than those pathologically diagnosed as ganglioneuroblastoma (61%(53/87) vs.31%(4/13), χ²=4.195, P=0.041), the positive rates of PD-L1 expression in tumor tissues originated from abdominal cavity were higher than those originated from other places (61% (51/83)vs.35%(6/17), χ²=3.937,P=0.047).The 4-year event-free survival (EFS) rates of patients with PD-L1 negative and positive were 40% and 33% (χ²=0.009, P=0.923), respectively. The 4-year overall survival (OS) rates of patients with PD-L1 negative and positive were 62% and 58% (χ²=0.294, P=0.587). Among 33 non-high-risk patients, the 4-year EFS rates of patients with PD-L1 negative and positive were 89% and 78% (χ²=0.001, P=0.965), the 4-year OS rates of patients with PD-L1 negative and positive were 100% and 96% (χ²=0.500, P=0.480). Among 67 high-risk patients, the 4-year EFS rates of patients with PD-L1 negative and positive were 24% and 11% (χ²=1.154, P=0.282), the 4-year OS rates of patients with PD-L1 negative and positive were 48% and 41% (χ²=0.692, P=0.405). Multivariate analysis showed that N-MYC gene amplification was an independent adverse prognostic factor for OS and EFS rates of NB patients (RR: 1.726,95%CI:1.209-2.466; RR:1.326,95%CI:1.014-1.736) and advanced clinical stage was an independent adverse prognostic factor for EFS rates of NB patients (RR: 26.498, 95%CI:3.518-199.614). Conclusions The expression of PD-L1 in NB tumor tissues was correlated with the clinical characteristics of children. However, there were no significant differences in the prognosis of patients with or without PD-L1 expression.