A mutation is predominant in weak D individuals,and DⅥⅢ mutation in partial D individuals.

[Objective]To investigate the therapy of human enbryonic olfactory ensheathing cells(hOECs) transplantation on adult rats' transected spinal cord.[Method]Separated,cultured hOECS from abortus were obtained and percent age of P75 positive cells was calculated.Twenty-four Wistar rats were choosen and divided into experimental group and control group randomly.All rats of two goups were transected at the T_(10) segment of spinal cord.Nine to ten days later 5 ul(2.5?10~5) hOECs(labled by Hoechst 33342) were injected in the contusion area of lesion site in transplantation group.In control group same volume of DMEM-F12 were transplanted.1,2,4,6,8 and 10 weeks later all rats were estimated by system of the BBB locomotion score respectively.Then part of them were killed.The tissue section of spinal cords were separated and inspected by fluorescence microscope or the methods of immunohistochemical staining.Data were processed with statistical tools in double-blinded condition.[Result]Transplanted hOECs can survive for at least ten weeks and even migrated from the injuried area in spinal cord.From 4 weeks to 10 weeks the BBB locomotion scores of experimental group were improved significantly contrasting to that of control group(P

Objective To discuss the feasibility and long-term effect of free latissimus dorsi muscle flap in repair of severe lower extremity injury in children. Methods From July 1999 to June 2004, nine child patients (at age of 6-13 years) with severe lower extremity injury involving soft tissue defects a-round the calf and the foot associated with complex open fractures, bare dislocation, and injury of the nerve, tendon and artery were repaired with free latissimus donsi flap, with flap area ranging from 30 cm ×12 cm to 10 cm × 5 cm. Results All the latissimus dorsi flaps survived, with success rate of 100%. A follow-up for 4-9 years showed that the flap had sound shape and function and normal blood supply, without significant influence on donor area. Conclusion Latissimus dorsi flap has advantages of constant anatomical site, abundant blood supply, massive area, strong anti-infection ability and less in-fluence on donor area and hence is an ideal method for repairing severe lower extremity injury in children.

To analyze features of the rabies epidemic in China between 2007 and 2011,identify factors influencing the epidemic and to provide a scientific basis for further control and prevention of rabies,Descriptive epidemiological methods and statistical analysis was used on data collected from the National Disease Reporting Information System between 2007 to 2011 and the National Active Surveillance System between 2007 and 2010.Our analysis shows that while the number of human rabies cases decreased year by year,the number of districts reporting cases did not show significant change.The situations in Guangdong,Guangxi,Guizhou and Hunan provinces clearly improved over the period but they remain provinces with high-incidence,and consequently influence the epidemic situation of surrounding provinces and possibly the whole country.Summer and autumn were high-incidence seasons.Farmers,students and pre-school children represent the high-risk populations,and rates of cases in farmers increased,those for students decreased,and pre-school children remained unchanged.Provinces with active surveillance programs reported a total of 2346 individual cases,of which 88.53％ were associated with canines.Postexposure prophylaxis (PEP) of rabies cases was not significantly improved,whereas PEP in post-exposure population was good.In rural regions of China,canine density was reduced somewhat,and the immunization rate increased slightly.Finally we show that while the epidemic decreased 2007 to 2011 in China,cases continued to be diffused in certain regions.Lack of standardization of PEP on rabies cases was the main reason of morbidity.The high density and low immunization of dog in rural areas and the defective situation of PEP are still continuous occurrences in China and remain a cause for concern.

In recent years (2007 to 2011),although the overall number of rabies cases in China has decreased,there is evidence of emerging or re-emerging cases in regions without previous rabies cases or with low incidence of rabies.To investigate the origin and the factors affecting the spread of rabies in China,specimens were collected from 2007 to 2011 from provinces with emerging and re-emerging cases and tested for the presence of the rabies virus.Positive specimens were combined with sequences from GenBank to perform comparisons of homology and functional sites,and to carry out phylogenetic analyses.Out of these regions,five provinces had 9positive specimens from canine and cattle,and 34 canine or human specimens were obtained from previously high-incidence provinces.Complete sequences of G gene were obtained for these samples.Homology of the sequences of these 43 specimens was 87％-100％ at the nucleotide level and 93.7％ -100％ at the amino acid level.These G gene sequences were combined with reference sequence from GenBank and used to construct a phylogenetic tree.The results showed that 43 specimens were all assigned to China clade I and clade Ⅱ,with all specimens from emerging and re-emerging areas placed within clade I.Specimens isolated from Shanxi and Inner Mongolia in 2011 were distinct from previously-isolated local strains and had closer homology to strains from Hebei,Beijing and Tianjin whereas new isolates from Shanghai were tightly clustered with strains isolated in the 1990s.Finally,Shaanxi isolates were clustered with strains from adjacent Sichuan.Our results suggest that the rabies cases in emerging and re-emerging areas in China in the last 5 years are a consequence of the epidemic spreading from of neighboring provinces and regions experiencing a serious epidemic of rabies.

Objective To investigate the application and clinical significance of the medial plantar flap on repairing the medial ankle and foot soft tissue defects. Methods A total of 13 patients with the medial ankle and foot soft tissue defects were repaired by the local transferred medial plantar flap alone or in combination with sural neurovascular flap transplantation in the Yuebei People's Hospital Affiliated to the Medical College of the Shantou University from Jun. 2006 to Dec. 2012. Results All patients were followed-up of 4-21 weeks,and the average follow-up periods were 6. 3 weeks. All of the skin and soft tissue defects of the medial ankle and foot were repaired,and there were 2 cases of partial necrosis of flap were repaired after tow times skin grafting operation,and all cases without complications of wound infection or iatrogenic nerve injury. Conclusion The medial plantar flap on treating ipsilateral medial malleolus and foot skin and soft tissue defects is useful and effective with less complications,satisfactory effects,intact the ankle flexor and extensor device,allowing early functional exercise,good functional recovery.

BACKGROUND:Ideal models of spinal cord injury should simulate human spinal cord injury, exclude confounding factors affecting effects, and have extensive repeatability. Spinal cord transection model is an ideal choice at present. Nevertheless, the operation is diverse, so therapeutic effects have great differences, and the research results lack of comparability. OBJECTIVE:To compare and analyze behavioral changes and pathological features of rat hindlimb after spinal cord transection by establishing standardized model of transected spinal cord in rats. METHODS:A total of 60 adult female Sprague-Dawley rats were randomly divided into sham surgery group (n=12), conventional spinal cord transection group (n=24) and microscopic spinal cord transection group (n=24). Each group was randomly assigned to 7-day, 14-day and 28-day groups according to time points after model establishment. T9 vertebrae were considered as a center. Sham surgery group underwent laminectomy. Other groups underwent spinal cord transection. Thus, models of acute spinal cord injury were induced. Models in the conventional spinal cord transection group were established by conventional surgical methods. Models in the microscopic spinal cord transection group were established by standardization micromanipulation technique. At 7, 14 and 28 days after model establishment, motor function of hindlimb was evaluated using Basso, Beattie and Bresnahan (BBB) scoring system. Histopathology of transected spinal cord was observed. The thickness of the glial scar, the longitudinal distance between the two stumps, the transverse diameter of the spinal cord cavity and cerebrospinal fluid cyst formation were measured at the transected site of the spinal cord. RESULTS AND CONCLUSION:In the sham surgery group, preoperative and postoperative BBB scores and pathology of the spinal cord did not clearly change. In the conventional spinal cord transection group and microscopic spinal cord transection group, complete paralysis of hindlimb was detected after model establishment. Hindlimb function did not recover in the conventional spinal cord transection group. At 1 to 2 weeks after model induction, spontaneous recovery of hindlimb function was visible in rats of the microscopic spinal cord transection group. Spinal pathology index value was significantly lower in the microscopic spinal cord transection group than in the conventional spinal cord transection group (P<0.01). Pathological observations were not correlated with BBB scores in each group. These data indicated that standardized spinal cord transection method helps to eliminate individual differences and to quantitatively analyze and to compare studies addressing therapeutic effects.

Objective To evaluate the diagnostic performance of Xpert MTB/RIF for the diagnosis of tuberculous meningitis (TBM).Methods This was a prospective, single center clinical trial.A total of 116 consecutive patients with suspected meningitis who were admitted to Xijing Hospital from October 2013 to June 2015 were recruited.Mycobacterium tuberculosis ( MTB) and rifampicin ( RIF) resistance mutations in 1 ml cerebrospinal fluid ( CSF) were detected with Xpert MTB/RIF and the remaining sample was tested by Ziehl-Neelsen staining , MGIT960 liquid culture and other laboratory tests .And the enrolled patients were grouped according to the 2010 South African expert consensus .The diagnostic performance of Xpert MTB/RIF was evaluated by comparing against clinical score >5 points and MGIT960 liquid culture as reference standards respectively .The comparison was performed using a χ2 test or Fisher′s exact test for categorical variables and a nonparametric rank sum test for continuous variables .Results Among the enrolled 116 subjects, 23 subjects were diagnosed as definite-TBM by MGIT960 liquid culture, 16 subjects were classified as probable TBM , 27 subjects were classified as possible TBM , and 50 subjects were classified as non-TBM.When clinical score >5 points was used as a reference standard , the sensitivity of Xpert MTB/RIF (39.4%) was comparable with that of MGIT960 liquid culture (34.8%) (χ2 =0.292, P=0.589), and significantly better than that of Ziehl-Neelsen staining (9.9%) (χ2 =16.500, 12.771, P<0.001). No significant differences were found among the specificities of Xpert MTB /RIF, MGIT960 liquid culture and Ziehl-Neelsen staining ( 98.0%, 100.0% vs 98.0%, χ2 =1.014, P=0.602 ) .When tested against MGIT960 liquid culture as a reference standard , the sensitivity of Xpert MTB/RIF was 91.3%. Conclusions Xpert MTB/RIF is a rapid and specific method to detect MTB and RIF resistance in CSF .It exhibits a good rule in value for the diagnosis of TBM and a comparable sensitivity with MGIT 960 liquid culture, thus it can be used as the initial method for the diagnosis of tuberculous meningitis .

Objective: To evaluate the feasibility and strategy of the lesser omentum approach for laparoscopic pancreatic enucleation. Methods: Between June 2011 and October 2013, 6 laparoscopic pancreatic enucleations were performed by lesser omentum approach.The average age was 42 years, including 1 male and 5 female.The preoperation diagnosis of 6 cases were pancreatic islet cell tumors determined by abdominal CT/MRI, ultrasound and digital subtraction angiography.The tumors of 3 cases located in pancreatic neck, 2 tumors located in neck and body of pancreas, and 1 tumor located in pancreatic body.Their biggest tumor diameter were 0.8-2.5 cm. Results: Among the 6 cases, all laparoscopic pancreatic enucleations were successfully performed.None of the patients were converted to open operation.Eestimated blood loss was (26.7±18.6)ml, operating time was (82.5±19.4)minutes, and postoperative length of stay was (5.17±1.17)days.Additionally, postoperative complication included grade A pancreatic fistula in 1 case.After 36-64 months followed-up, there was no tumor recurrence and clinical symptom disappeared. Conclusion For the islet cell tumors located in pancreatic neck and body, the lesser omentumapproach may contribute to good surgical view and operative space, which can make pancreatectomy safer and easier for clinical application.

Abstract： Objective　To elucidate the antigenic antibody reaction of recombinant expression of non-structural protein 1 (NS1) of Japanese encephalitis (JE) virus with various mosquito-borne flaviviruses, including JE virus, and the antigenic antibody reaction of serum samples of patients infected with JE virus in acute stage. Methods　In this study, Escherichia coli prokaryotic expression vector (pET) system was used to recombinant express Japanese encephalitis virus NS1 gene. Western Blot assay was performed to detect the antibody responses of the recombinantly expressed protein against a variety of mosquito-transmitted flaviviruses, including JE virus, as well as antigen-antibody reactions of serum from patients with acute JE virus infection. Results　The NS1 gene expression product of JE virus (P3 strain) was in the form of an inclusion body, and the denatured and renatured expression product was displayed as a single band in the denatured gel (polyacrylamide gel electrophoresis, PAGE), with a molecular weight of about 45 000. The results of further antigen-antibody analysis showed that the antigen/antibody hybridization reaction of the expression product with polyclonal or monoclonal antibody of JE virus (mosquito isolates, encephalitis isolates) and serum samples of patients with acute JE virus infection could be completely consistent. The recombinant product showed negative antigen/antibody hybridization reactions with mosquito-transmitted flaviviruses, such as dengue virus and yellow fever virus polyclonal antibodies, but positive reactions with polyclonal antibodies to West Nile virus and Murray Valley encephalitis virus. Conclusions　In this study, the recombinant expression of the NS1 protein of JE virus was successfully obtained, and the antigen/antibody reaction between the recombinant protein and samples of patients infected with mosquito-borne flavivirus and JE virus was analyzed. The study results provide important basic data for elucidating the antigen-antibody reaction between the NS1 protein of JE virus and mosquito-borne flavivirus. The recombinant expression protein obtained in this study provides an important material basis for further research on the function of JE virus NS1 protein.