BACKGROUND:The morbidity and mortality of lung infection after solid organ transplantation remains high, especial y the opportunistic aspergil osis infection. The early diagnosis of invasive pulmonary aspergil osis is difficult. OBJECTIVE:To summarize the CT manifestations of invasive pulmonary aspergil osis after solid organ transplantation. METHODS:The VIP database, CNKI database, Medline database, Highwire database and Foreign Journals Integration System were retrieved with the key words of“solid organ transplantation/renal transplantation/liver transplantation/lung transplantation/heart transplantation, aspergil osis, fungus, mold, pulmonary invasive, tomography computerized”in Chinese and English for the articles published from January 2001 to October 2012. The clinical reports related with the CT manifestations of invasive pulmonary aspergil osis among the reports of pulmonary aspergil osis infections and the fungus or mold lung infections were selected. Secondary manual retrieval of solid organ transplantation was performed, and the literatures on the CT manifestations of invasive pulmonary aspergil osis after solid organ transplantation were included. Reproductive research and atypical report were excluded. RESULTS AND CONCLUSlON:The typical chest CT manifestations of invasive pulmonary aspergil osis after solid organ transplantation included nodules, masses, consolidations and ground-glass opacities. With infection time prolonged, the halo sign, reversed halo sign, cavitis and air crescent sign appeared successively. Different incidences of these signs may be associated with the time interval between onset to a CT examination, fungus preventive treatment time and early antifungal treatment. Meaningful results are the relationship between invasive pulmonary aspergil osis signs and the prognosis of patients. No consolidations or masses and presence of smal cavitis may be related with a better prognosis. Greater nodules, multi-infarct consolidation, renal replacement therapy and persistent positive serum galactomannan is a 90-day independent predictor for mortality. Halo sign on behalf of bleeding has nothing to do with the 90-day mortality. Although the report is less, the CT pulmonary angiography is a promising diagnostic tool for the diagnosis of invasive fungal pneumonia, which can early detect the vascular occlusion used to reflect the invasive vascular involvement, and its sensitivity and specificity are better than the halo sign, and approximate to serum galactomannan test.

Objective To observe the mechanisms of bone marrow mesenchymal stem cells (BMSCs) transfected with neurotrophin-3 in treating nanoparticle repaired spinal cord ischemia-reperfusion (I/R) injury of adult rat. Methods BMSCs were transfected into NT-3 with nanoparticle carrier and transplanted into 80 adult rats on the spinal cord I/R injury model. Then the rats were divided into four groups: sham group, NS group, BMSCs and BMSCs+NT-3. The BBB scoring system, the neurons cell apoptosis, levels of malondialdehyde (MDA) and myeloperoxidase (MPO) were observed and compared between the four groups. Results The BBB score of the BMSCs+NT-3 group was significantly higher than those of BMSCs and NS group , but was lower obviously than the Sham group. TUNEL-apoptosis cells were significantly decreased in the BMSCs + NT-3 group compared to BMSCs and NS groups, but was more significantly lower than the Sham group. The contents of MDA and MPO of the NS group were significantly higher than the BMSCs group. The contents of the BMSCs + NT-3 group were lower than those of the BMSCs group, but lower significantly than the Sham group (P < 0.05). Conclusion BMSCs transfected with NT-3 with nanoparticle carrier could be induced each other. When transplanted into SCI , they can repair spinal cord by alleviating neuron cells apoptosis and inhibiting the lipid peroxidation of free radicals.

Based on the global governance prospective, this paper examines the linkage of global environment and health and the structural features in terms of the policy and institutions system level, the future challenges are al-so analyzed as well. From the institutional perspective, the linkage of global environmental and health is mainly re-flected in laws, norms, governance models, actors and institutions. The current global environment and health gov-ernance structure presents three characteristics: it experiences a rapid formation; it remains fragmented, loose and fragile, thus it has much room for future development;and it is held on dominating advantage in science, engineering and technology, funds, diplomatic skills and other aspects for the developed countries. There is also a potential con-flict between environment and health which may be from their different values or from different understanding of the relationship between them. Therefore, the future global environment and health governance faces challenges like po-liticization and national security considerations.

Objective: To evaluate the application value of large flat-panel multifunction digital machine in digestive system. Methods: Exam the gastrointestinal tract and biliary with dynamic detector, and then observe its advantages and disadvantages. Results: All the 13 gastrointestinal cancer lesions and 15 inflammatory lesions were shown clearly, including mucosa. Biliary tomography found two small stones, which were undetected by the general X-ray photography. The excellent rate of the photo was improved to 98%. Conclusion: The advantages of the flat panel detector include the wide range of display, clear image of digital pulse fluoroscopy spot film, the improvement of the diagnostic accuracy and the reduction in radiation dose. The disadvantage is that it is more inconvenient than the remote cradle gastrointestinal machine in rotating the position of the patient.

[Objective]To explore the operating methods and rudimental clinical effects of reconstruction of anterior cruciate ligament(ACL) with the ligament advancement reinforcement system(LARS) artificial ligaments under arthroscope.[Method]Since June of 2006,15 patients(11 males and 4 females,with an average age of 26.8 years)with acute ACL rupture have been treated with the LARS artificial ligaments.The results of preoperative Arto-scan of all patients suggested discontinuation of ACL.The average score of Lysholm on knee joint was 50 points.The operations were completed under arthroscope.Bone tunnels of the femur were located at the central point of arc on the medial surface of ectocondyle of 140 degree.Bone tunnels of tibia were located between the medial and lateral condyle on the tibial plateau、2-4 mm to summit line of fossa intercondylica.The diameter of the bone tunnels was 7.5 mm while that of LARS ligament and hollow crushing screw were 8 mm.[Result]All 15 patients were available for follow-up with an average of 18 months.No postoperative complications such as infection,ligament rupture,ligament loosening occurred.The clinical results were graded as being excellent in 8 patients,good in 5 and fair in 2 according to the Lysholm's classification.The excellent and good rate was 86.6%.[Conclusion]The anatomical reconstruction and the stability of the knee joint can be obtained after ACL reconstruction with LARS artificial ligaments.The operation under arthroscope has advantages of less-injury,rapid recovery and satisfactory curative effect.

Objective To study the antibacterial substances produced by Musca domestica and heattreatment and electrophoresis isolation of the substances. Methods After the 3rd instar larval of Musca domestica being induced for 48 hours by pricking,the hemolymph was collected and bathed at 100 ℃ for 0,0.5,1,3,5 min. Antibacterial substances of Musca domestica was isolated by electrophoresis with acide polyacrylamide gel using 5,10,20,30 ?l doses. Results 20 ?l was the optimum dose both for bathed and non-bathed hemolymph. Water bath at 100 ℃ for 1 min was the optimum bath time for hemolymph. Comparing induced hemolymph with non-induced hemolymph,the protein of the induced hemolymph was increased in the number and content. After 100 ℃ bathed for 1 min,it showed that the bonds of hemolymph increased both in quantities and contents. Conclusion Optimum treatment is 100 ℃ bath for 1 min and 20 ?l of adding dose. Pricking inducing can produce new proteins in hemolymph, which are the new induced antibacterial substances.

OBJECTIVE:To systematically review the effects of long-term oral low-dose of azithromycin on pulmonary func-tion and clinical signs of patients with stable COPD. METHODS:Retrieved from PubMed,Medline,CJFD,VIP and Wanfang da-tabase,randomized controlled trials(RCTs)about long-term oral low-doses of azithromycin for stable COPD were collected. After quality evaluation according to modified Jadad scale,Meta-analysis was conducted by Rev Man 5.2 statistical software. RESULTS:A total of 13 RCTs were included,involving 1207 patients. Meta-analysis showed that,long-term oral low-doses of azithromycin could significantly improve FEV1[SMD=0.78,95%CI(0.62,0.93),P<0.001],FEV1%[SMD=0.81,95%CI(0.61,1.00),P<0.001],FEV1/FVC [SMD=3.91,95%CI(2.58,5.24),P<0.001] and 6MWD[SMD=23.74,95%CI(21.20,26.18),P<0.001] in sta-ble COPD patients,meanwhile significantly reduce dyspnea score [SMD=-1.15,95%CI(-1.60,-0.71),P<0.001],quality of life score [SMD=-1.82,95%CI(-2.74,-0.90),P<0.001] and 24 h sputum volume[SMD=-18.68,95%CI(-24.79,-12.56), P<0.001],with statistical significance. CONCLUSIONS:Long-term oral low-doses of azithromycin can improve pulmonary func-tion,dyspnea,activity tolerance and quality of life in acute exacerbation of COPD patients.

BACKGROUND:Insulin-like growth factor-1(IGF-1) is an important regulator in osteoblasts proliferation,differentiation and matrix synthesis,which participates in the process of fracture healing and repairing. OBJECTIVE:To investigate the potential bone regeneration effect of human bone marrow mesenchymal stem cells(MSCs) transfected into IGF-1 retroviruses vector on bone defects repairing. DESIGN,TIME AND SETTING:A controlled observation experiment was performed between March 2004 and May 2005 at the Laboratory Animal Center of Soochow University. MATERIALS:MSCs were transfected into IGF-1 retroviruses vector in vitro and combined with demineralized bone matrix(DBM) . METHODS:Fifteen BalB/C nude mice were prepared for 8 mm calvarial defects models and divided into 3 groups by number table method,with 5 animals in each group. DBM transfected with IGF-1 and DBM transfected with vector were implanted into the defect in MSCs cells transduced with IGF-1 and vector groups,respectively. There was no other intervention in the blank control group. The implants were harvested and evaluated by histological examination at 4 weeks after model preparation. MAIN OUTCOME MEASURES:①The mRNA expression of IGF-1 was analyzed by RT-PCR and Western Blot. ②The complexes of cells and DBM were analyzed by scanning electron microscope(SEM) at days 3 and 6 after co-culture. ③Gross observation of the calvarial defects models. ④Osteogenic activity of the implants was evaluated by hematoxylin-eosin staining at weeks 4 after model preparation. RESULTS:①There were mRNA and protein expression of IGF-1 in MSCs cells transduced with IGF-1 vector. ②SEM showed that there were plenty of cells adhered to surface of DBM,and grew into inner part at the 3 days after co-culture with IGF-1,which secreted much collagen fibers at days 6. The count of adherent cells and collagen fiber was smaller in the vector group at each time points. ③No obvious inflammatory reaction could be seen in each group at 4 weeks after model preparation. Compared with vector control,abundant new bone and blood vessel formation occurred in the calvarial defects treated with DBM/IGF-1,and no new bone formation in the blank control groups. ④Results of hematoxylin-eosin staining showed that grafts in the MSCs cells transduced with IGF-1 group was combined closely with calvarial defects,new bone and vessel could be found. There were few bone-like materials formation in vector group,and no defects in control group were repaired. CONCLUSION:The composites of IGF-1 transfected MSCs and DBM has good effect in repairing calvarial defects.

Objective Polyinosinic-polycytidylic acid (poly IC) plays an important role in the central nervous system damage and repair.This study was to investigate the effect of poly IC on inflammatory response after spinal cord ischemia-reperfusion injury (SCIRI) in rats.Methods A total of 72 healthy adult male SD rats were equally randomized into a sham-operation, an ischemia-reperfusion (IR), and a poly IC group.The abdominal cavities of the rats were cut open and closed again in the sham-operation group and SCIRI models were established in the IR and poly IC groups by clamping the abdominal aorta, followed by reperfusion 60 minutes later and intraperitoneal injection of saline (0.1 mL) and poly IC (1.25 μg/g), respectively.At 6, 24, and 48 hours after modeling, BBB scores were obtained and the contents of TNFα, IL-1β and IFN-β were measured by ELISA.At 48 hours, the expressions of NF-κB and IL-10 were determined by immunohistochemistry, the area of ischemic necrosis in the spinal cord tissue was calculated by TTC staining, and its morphological changes were observed under the optical microscope.Results At 48 hours after modeling, the BBB scores were significantly lower in the IR and poly IC groups than in the sham-operation group (3.80±0.75 and 9.40±0.49 vs 20.00±0.00, P<0.01), though higher in the poly IC than in the IR group (P<0.01).The rats of the IR group showed extensive degenerated neurons in the gray substance of the spinal cord, with scattered foci of bleeding and blood coagulation, while those of the poly IC group exhibited fewer necrotic neurons and basically normal nuclear morphology, though with a few swelling cells.The ischemic necrosis area of the spinal cord tissue was significantly reduced.The expression of NF-κB was decreased while that of IL-10 increased markedly.Compared with the IR group, the poly IC group showed a significant increase in the expression of IFNβ (117.23±6.06 vs 55.65±4.02, P<0.01) and a remarkably decrease in the expressions of TNFα (190.45±4.16 vs 201.82±2.18, P<0.01) and IL-1β (39.27±2.48 vs 50.59±1.47, P<0.01) at 48 hours.Conclusion Poly IC can protect the spinal cord and reduce inflammatory response after spinal cord ischemia-reperfusion injury.

Objective To investigate the key points of treating elder patients with hip fractures by hemiarthroplasty.Methods Clinical data of 138 elder patients with hip fractures undergone hemiarthroplasty between January 2008 and December 2010 were analyzed retrospectively.There were 43 males and 95 females at mean age of 82.8 years(range,75-103 years).Injury causes included fall from height(n=98),contusion(n=32)and sprain(n=8).There were 84 patients with femoral neck fractures(33 patients with Garden type Ⅲ,51 with type Ⅳ)and 54 patients with intertrochanteric fractures(three patients of Jensen-Evans type Ⅱ,six with type Ⅲ,25 with type Ⅳ,18 with type V,two with type R).Follow-up evaluation was performed using Harris scoring system.Results The ambulation period was average 4.5 days(range,3-12 days).Follow-up was average 24.4 months(range,10-45 months),which presented no loosening,subsidence or infection of prostheses.Due to additional trauma postoperatively,one patient suffered from prosthesis dislocation and two from fractures of distal prosthetic femoral shaft.Harris score at six months postoperatively was average 86.8 points(range,52-100 points),with excellent results in 42 patients,good in 59,fair in 19 and poor in five,with excellence rate of 80.8％.Conclusion With full accomplishment of peri-,intra-and post-operative measures,hemiarthroplasty is a suitable choice for treating hip fractures in the elderly patients.