Objective To analyze stenting and dual catheter technique in protection of posterior inferior cerebellar artery and its imaging and clinical follow-up results in the endovascular treatment of vertebral artery dissecting aneurysms. Methods From January 2012 to December 2014,the clinical data of 4 patients with vertebral artery dissecting aneurysm involving posterior inferior cerebellar artery treated with endovascular method and admitted to the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were enrolled retrospectively. The whole brain DSA examinations were performed at 6 months after procedure. The clinical follow-up period ranged from 12 to 24 months. Results Three of the 4 patients were treated with posterior inferior cerebellar artery-vertebral artery stenting,one patient was treated by using bidirectional dual catheter technique to protect posterior inferior cerebellar artery. The interventional therapy of 4 patients were all successful. Immediately after procedure,angiography revealed that the posterior inferior cerebellar arteries were patent,no ischemic symptoms were observed. The angiography at 6 months after procedure revealed no recurrence of aneurysms;the posterior inferior cerebellar arteries were patent without in-stent stenosis. No new symptoms of neurological deficit were observed during 12 to 24-month follow-up. Conclusion In the interventional treatment of vertebral artery dissecting aneurysms of posterior inferior cerebellar artery,using the posterior inferior cerebellar artery-vertebral artery stenting technique and bidirectional dual catheter technique may safely and effectively protect the posterior inferior cerebellar artery.

Objective To find the chemical elements whose contents are abnormal in the soil of the high prevalence areas of birth defects in Shanxi Province. Methods 131 soil samples were collected from the high and low prevalence areas of birth defects respectively in 2005, the contents of 16 elements were determined with inductively coupled plasma (ICP)machine. The data were analyzed with regression and nonparametric tests. Results The total content of elements in the soil of the high prevalence areas was significantly higher than that of the low prevalence area. Compared with the low prevalence area, in a high prevalence area, the content of Mo, As, Pb, Ni, V and Se in soil was abnormal, Mo, As, Ni and Pb showed a significant relationship to the prevalence rate of birth defects, in another high prevalence area, the content of Sn, Se, Mo, Zn, Sr, Pb, Ni, Fe, V, Ca, Cu, Al, Mg and Na was abnormal, Pb, Mg, Ca, Al and Zn showed a significant relationship to the prevalence rate of birth defects. Conclusion Maybe the abnormal content of Mo, As, Ni, Pb, Mg, Ca, Al and Zn in the soil is one of the risk factors for birth defects.

OBJECTIVE:To shorten outpatients'time spent on pricing,paying and delivery of drugs.METHODS:The time for outpatients spent on pricing,paying and drug delivery were measured by applying6?management method;the key processes and reasons resulting in long waiting time were analyzed;and corresponding measures were taken to improve the situation.The waiting time after improvement was compared with that before improvement.RESULTS:The time for out?patients spent in drug pricing,paying and drug delivery has been significantly shortened while the complaints and complaining letters have been reduced and their degree of satisfaction toward the hospital has been increased.CONCLUSION:Applying6?in hospital can facilitate a more scientific and fine management,thus promoting hospital pharmaceutical care.

Objective To understand the current situation of endoscope disinfection and sterilization quality of the medicalinstitutions in Guangzhou , and provide evidence for improvement of disinfection surveillance and nosocomial infection control management in the area .Methods The field survey and sampling examination were used to monitor the cleaning and disinfection effect of endoscopes in the medical institutions in 3 years.Results The cleaning and disinfection management of endoscopes in the medical institutions of Guangzhou was nearly eligible .In 3 years, a total of 106 samples were examined continually .The average eligible rate of cleaning and disinfection effect of endoscopes was 90.0%.The eligible rates in 2012-2014 were 95.6%, 85.2%, 85.3%respectively, and the difference was not significant (χ2 =2.960, P>0.05); Among the different types of endoscopes , the qualified rates of the disinfection of the enteroscopes and the gastroscopes lumen were 83.3%, 92.1%respectively.The difference between the two was not significant;Using integrated endoscopic wash -infec-tion center and the use of four or five channel slot method for cleaning disinfection , qualified rate difference has no statistical significance (P>0.05);Both the concrntration of the disinfectants and the hygienic puality were pualified .Conclusion We should strengthen the disinfection supervision and monitoring and give some technical advices for medical institutions to improve the ability to prevent and control hospital infection .

恶性肿瘤居中国各类疾病死因之首，发病率与病死率呈逐年上升趋势。近几年来靶向治疗已广泛应用于临床，显示 出良好的抗肿瘤效果，新靶点的探索和鉴定在靶向药物研发过程中起着重要作用。E3泛素连接酶斑点型锌指结构蛋白（speckletype POZ protein，SPOP）作为治疗选择的潜在靶点，能特异性识别底物，使底物发生泛素化降解，广泛参与机体内多种生理、病理 过程。研究发现SPOP基因突变或表达水平改变，通过调控AR/ERG、Akt-mTORC1、Hedgehog/Gli2等多种信号通路影响恶性肿 瘤的发生发展，并与前列腺癌、肾癌、结直肠癌等多种恶性肿瘤细胞增殖及远处转移密切相关。目前，SPOP影响恶性肿瘤发生发 展的相关研究为靶向治疗恶性肿瘤奠定了基础，综述SPOP在恶性肿瘤的最新进展对抗肿瘤研究具有重要的意义。

Objective To explore the methods of the hemorrhage prevention and the measures of hemostasis by CT guided after renal cancer cryoablation.Methods Retrospective analysis of 8 patients of renal cell carcinoma patienthave been done,all the patients were underwent cryoablation.The basic model included 10 min frozen,3 min thawed and 1 cycle were repeated.Before the cryoprobe puncture,a CT scan was taken to observe the blood supply of the tumor and the relationship between the border of the tumor and renal cortex,renal pelvis.Besides,the path of reducing the injury of normal renal cortex and renal pelvis was chosen,and the decreased number of probes was adopted by taking conformal cryoablation to reduce the damage to the renal capsule,in theensurance of the treatment efficacy.Intraoperative CT scan was performed discontinuously,to observe the covering status of the range of ice ball on the lesion and to monitor the perirenal bleeding.Postoperative ECG and blood pressure changes was observed 24 h after operation.Besides,CT scan or blood routine examination is necessary to monitor whether active bleeding happened.Results According enhanced CT image positioning puncture path,the path of probes were selected in the shortest path between the tumor margins and the renal cortical which avoid the renal pelvis.Probes were CT-guided conformal puncture into the lesion successfully for 8 patients,according to freezing basic mode to complete cryoablation.Timely intraoperative CT scan can clearly observe that a low-density ice ball wrapped lesion completely without involving the renal pelvis and normal tissue surrounding the kidney.There was no bleeding in the procedure of cryoablation.After the probe was pulled,CT scan showed:3 of the 8 patients didn't show any sign of henorrhage,in which 1 patient had heavily bleeding,about 150 ml due to the biopsy after cryoablation.The bleeding was stopped by interventional embolization.A little hemorrhage was found in two patients,about 10 ml outside renal capsule.Medium hemorrhage took place in two patients,30 nl in one patient which underwent several cycles of thawing and 60 ml in another.The patients of mild and medium hemorrhage was treated with intravenous injection of Reptilase and strict bed rest.There was a great hemorrhage in one patient,about 200 ml.The bleeding was stopped by interventional embolization.A small and moderate bleeding,it necessary to execute intravenous infusion 2 IU reptilase and strict bed rest.There was no significant active bleeding from the CT scan after 24 h operation and no change in the blood routine examination of blood hemoglobin and red blood cell count.Conclusions Before the puncture,it is necessary to perform an enhanced CT scan to understand the position,which can determine the path of the puncture.It can reduce the damage of renal cortex,renal capsule and surrounding tissue and prevent and reduce the risk of bleeding.For larger amounts of intraoperative and postoperative bleeding subjects,the embolization should be given immediately,as for the small or moderate amount of bleeding,the conservative treatment may be given firstly.

BACKGROUND:Wnt5a is able to inhibit canonical Wnt signaling and activate non-canonical Wnt signaling pathway. In recent years, it has been found that non-classical Wnt5a/PCP signaling pathway mediated by Wnt5a plays an important role in the process of bone marrow mesenchymal stem cel proliferation and differentiation, but the underlying mechanism is unclear.
OBJECTIVE:To summarize the progress in downstream effector molecules related to Wnt5a/PCP signaling pathway, and its roles in the chondrogenic and osteogenic differentiation of bone marrow mesenchymal stem cel s.
METHODS:A computer-based online search of CqVip, CNKI and PubMed databases between January 2000 and February 2016 was performed using the Chinese keywords of“BMSCs, Wnt signaling pathways, chondrogenic differentiation, osteogenic differentiation”and English keywords of“BMSCs, chondrogenic differentiation, osteogenic differentiation, Wnt, Fzd, Ror2, RhoA, ROCK, JNK”, respectively. Literatures related to bone marrow mesenchymal stem cel chondrogenic and osteogenic differentiation were selected. Final y, 43 eligible articles were included for analysis through excluding the old and repeated research.
RESULTS AND CONCLUSION:Wnt5a, a representative protein in non-canonical Wnt signaling pathway, paticipates in the cytoskeleton, cel migration and cel polarization and other activities by mediating its downstream signaling molecules such as Fzd, Ror, RhoA, ROCK, JNK, thereby regulating its proliferation and differentiation. But it is unclear how Wnt5a/PCP participates in the bone marrow mesenchymal stem cel chondrogenic and osteogenic differentiation and how the downstream effector molecules interact or function independently, which requires further studies.

Background Researches showed that the content of nitric oxide (NO) and nitric oxide synthetase (NOS) increases in blood,aqueous humor and tear of cataract patient.But the function of NO and NOS in cataract formation is still elusive.Objective The aim of this study was to explore the prevention and treatment effect of NOS inhibitor,1-nitro-arginine methyl ester (L-NAME),on galactose cataract.Methods Sixty clean three-week-old Wistar rats were equally and randomly divided into 3 groups.0.9％ Normal saline solution (30 ml/kg) was subcutaneously injected every day for 30 days in the rats of the control group,and 50％ of D-galactose solution (30 ml/kg) was used in the rats of the model and L-NAME group at the same way.L-NAME eye drops was simultaneously administered in the L-NAME group 3 times per day for 30 days.The eyes of the rats were examined under the slit lamp in 10,20 and 30 days,and the degree of lens opacification was scored.Lenses of the rats were obtained at the end of this experiment for the detect of NO,NOS contents.Flow cytometry was used to assay the caspase-3 level of rat lens.Repeated measurement two factor analysis of variance was used to analyze the difference of lens opacification scores in different groups and different time points,and one-way ANOVA was used to analyze the differences of NO,NOS and caspase-3 contents in lens among the groups.Results Lens opacification appeared in 10 days after injection of 50％ D-galactose solution in the rats of the model group and L-NAME group.Lens opacification score was higher among the different groups and different time points (Ftime =435.251,P =0.000 ;Fgroup =395.120,P=0.000).NO content in the lens was (0.45±0.15) μmol/g,(2.67 ± 0.47) μmol/g and (1.68±0.34) μmol/g in the control group,model group and L-NAME group,showing a significant difference (F=58.872,P=0.000).The NOS contents in the lens was (0.0160±0.0020) U/ml,(0.0370±0.0040) U/ml and (0.0270±0.0010) U/ml in the control group,model group and L-NAME group,showing a significant difference (F =66.174,P=0.000).Caspase-3 contents in the lens was (339.4 ± 37.9),(697.7 ± 46.5) and (650.7 ± 53.1),Showing a significant difference among them (F =100.005,P =0.000).Conclusions The increase of NO,NOS and caspase3 levels are associated with lens opacification.Topical administration of L-NAME eye drops can down-regulate NOS content in lens,reduce the NO formation and inhibit the apoptosis of lens epithelial cells.

Background Small incision cataract surgery combined with intraocular lens (IOL) implantation remains a popular way for cataract.However,some factors affect the postsurgical visual outcomes and lower the patients' satisfaction,including intraoperative and postoperative complications as well as corneal refractive and thickness changes.Objective This study was to evaluate the influence of corneal refractive and thickness changes on visual fluctuation after 2.6 mm temporal incision surgery for cataract.Methods A series cases-observational study was designed.Twenty-nine eyes of 25 age-related cataract patients received 2.6 mm temporal transparent incision phacoemulsification and IOL implantation from November,2011 through April,2012 in Eye & ENT Hospital of Fudan University under the informed consent.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),automatic and subjective refraction were examined,and the central corneal thickness (CCT) and corneal vector astigmatism were measured using Pentacam analysis system before and after operation.The examination outcomes were compared among different time points,and the influencing factors of UCVA or BCVA were analyzed.Results The mean UCVA (LogMAR) was 0.52±0.06 in 1 day and 0.64±0.07 in 2 months after surgery,with a significant difference between them (t=-3.051,P＜0.05).The mean BCVA (LogMAR) was 0.24±0.04 and 0.13± 0.04 in postoperative 1 day and 2 months,showing a significant difference between them (t =-3.031,P＜0.05).Spherical equivalents (SE) were (-1.74±0.28) D,(-1.99±0.27) D and (-1.69±0.24) D in postoperative 1 day,14 days and 60 days,respectively,with a significant difference among the 3 time points (F =3.562,P =0.039),and significant difference also was found between postoperative 1 day and 14 days (t =2.515,P＜0.05) or between postoperative 14 days and 60 days (t =-2.987,P ＜ 0.05).The preoperative J0 value was (0.06 ± 0.06) D,and postoperative J0 value was (0.29±0.08) D on the first day,which was significant higher than that in preoperation (t =-4.625,P＜0.01).In addition,J0 value showed a significant difference between postoperative 1 day and 14 days (t=-7.858,P＜0.01) as well as between postoperative 14 days and 2 months ([0.38±0.07] D versus [0.27±0.07] D,t=-5.649,P＜0.01).The mean CCT was (547.1±25.3) μm,(599.4±56.9) μm,(557.0±27.1) μm and (551.0 ± 25.9) μm before and 1 day,14 and 60 days after operation,with significant differences among the various time points (F =9.792,P ＜ 0.001),and significant differences also were seen in the CCT between preoperation and postoperative 1 day (t =-5.116,P＜0.01),between postoperative 1 day and 14 days (t =4.135,P＜ 0.01),between postoperative 14 days and 60 days (t=2.082,P＜0.05).UCVA=0.513-1.183×C J45(F=16.724;t=-4.089,P=0.026) and BCVA=-1.314+0.003×CCT (F=22.322;t=4.725,P=0.018).Conclusions The UCVA remains a downward trend,and BCVA sustains upward trend after 2.6 mm temporal transparent incision phacoemulsification combined with IOL implantation surgery.Postoperative UCVA is affected by corneal astigmatism change,while BCVA is influenced by CCT change.

The red cell deformability (RCD) has been taken as a diagnostic aid in recent years. The dilute red cell suspension passes through the silicon microch annels under constant suction pressure. Such three parameters of RCD are measure d as IF (filtration index), and The results show that the above-mentioned parameters can reflect the changes of cell rheological characteristics from dif ferent aspects. With the observation of the flow passage, the rehological charac teristics can be evaluated accurately and comprehensively.