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 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 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 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.

Objective To study the clinical characteristics of primary Sj(o)gren's syndrome (pSS) patients with dry eyes.Methods Ninety-six pSS patients with dry eyes admitted to the Department of Rheumatology and Immunology,the Affiliated Hospital of Guilin Medical College from August 2009 to August 2011 were retrospectively analyzed.Results In all 96 patients,89 patients had symptoms,23 of whom had two or more symptoms.The tear-film break-up time (BUT) of 154 eyes were Less than 5 seconds,18 were between 5-10 second,and twenty were more than 10 seconds,with the average of 3.7±1.9 seconds.The length of tear flow of 154 eyes'width of tear mocus was less than 3 millimetres (mm),with the average of (0.21±0.10) mm.The average score of corneal fluorescein staining score was 5.2±2.4.The wet lengths of filter paper of 192 eyes were all less than 10 mm/5 min,with the average of (4.6±1.8) mm.The average score of meibomian gland function was 1.5±0.9.Conclusion In patients with pSS,the width of tear meniscus and the wet lengths of filter paper are reduced,which implies less tear secretion.At the same time,BUTs are short,and the Meibomian gland dysfunction are observed.Dry eyes of pSS are mixed in type,not only aqueous tear deficiency.

Objective To explore the possible mechanism of SchA ,which decreases MPP+induce SH-SY5Y cell damage .Meth-ods Cultured cells were divided into 5 groups ,one as control group ,cultured by free-blood serum media;the other 4 groups were treated with different concentrations of SchA(1 ,3 ,5 μmol/L) and MPP+ (1 mmol/L) for 48 h named model group ,1 ,3 ,5 μmol/L SchA group respetivly .The content of nitric oxide(NO) were measured by NO kit ;The expression levels of total Akt and p-Akt proteins were detected by Western blot .Results Compared with the control group ,the content of NO in group significantly in-creased after MPP+stimulating(P<0 .05);compared to the control group ,the content of NO in 5μmol/L SchA group significantly decreased(P<0 .05) .The expression levels of total Akt in all groups had no significant difference(P>0 .05) .The expression levels of p-Akt in model group significantly lowered ,while SchA(1、3、5 μmol/L) significantly increased the expression levels of p-Akt in comparision with cells in model group .Conclusion Decreasing MPP+ induced SH-SY5Y cell damage of SchA may be related to the content of NO and p-Akt expression .

Objective To investigate effect of sorafenib on serum hepatoma marker in patients with advanced hepatocellular carcinoma. Methods 101 patients with advanced hepatocellular carcinoma were selected, and divided into two groups.50 cases in control group were treated with routine clinical treatment, and 51 cases in experimental group were treated with sorafenib on the basis of control group.The survival time, adverse reactions, VEGF, CTGF, HIF-1 and OPN levels were compared after the treatment.Results The survival time of experimental group was higher than control group (P<0.05).Compared with control group, the serum levels of VEGF、CTGF,HIF-1, OPN,AFP, CEA, and CA199 in experiment group were lower (P<0.05,P <0.01).There were no significant differences of total adverse reactions between experimental group and control group. Conclusion Sorafenib can effectively prolong survival time of patients with advanced hepatocellular carcinoma, reduce serum VEGF, CTGF, HIF-1 alpha and OPN levels.

Objective To analyze the related immune parameters in liver transplantation recipients to help guide adjusting future immunosuppressants.Methods Fifty-three tolerant recipients after liver transplantation were included in this study.They had normal liver functions and took only one immunosuppressive drug.They were divided into the 3 ～5 years tolerance group (3Y group,n =21) (including 5 years) after transplantation,and the 5 ～ 11 years tolerance group (5Y group,n =32).Another 15 liver transplantation recipients who had twice or more recurrent acute rejections were enrolled as the RJ group and 32 age-matched healthy donors served as the HC group.The natural killer (NK) cells,B cells,memory T cells,regulatory T cells (Tregs) and the subsets were detected by flow cytometry.The plasma TGF-β level was evaluated using ELISA.Results The percentages of NK cells (3Y group 19.00 ± 0.09,5Y group 20.00 ±0.09,HC group 14.00 ±0.07,RJ group 9.00 ±0.03) and total Tregs within the CD4+ cells (3Y group 6.26 ±2.33,5Y group 4.80 ±2.21,HC group 3.04 ± 1.25,RJ group 1.09 ±0.81) in the 3Y,5Y and HC groups were significantly higher than those in the RJ group (P ＜ 0.05).The proportions of resting Tregs (3Y group 0.23 ±0.07,5Y group 0.16 ±0.02,HC group 0.07 ±0.02,RJ group 0.05 ±0.01),active Tregs (3Y group 0.56 ± 0.11,5Y group 0.42 ± 0.15,HC group 0.08 ± 0.02,RJ group 0.05 ± 0.01) and non-suppressive Tregs (3Y group 3.51 ±0.80,5Y group 3.71 ±0.41,HC group 1.44 ±0.14,RJ group 2.15 ± 0.62) increased significantly in the tolerant recipients after liver transplantation when compared with those in the HC and RJ groups (all P ＜ 0.05).No significant differences on B cells,memory T cells and TGF-β level were detected among in four groups.Conclusions The NK cells,total Tregs,resting Tregs,active Tregs and non-suppressive Tregs increased significantly in the tolerant recipients after liver transplantation.These might serve as potential biomarkers for immune tolerance.