In the recent years, with the improvement of conditioning regimens, the prevalence of high-resolution HLA matching, as well as the application of high-intensity broad-spectrum antibiotics, unrelated donor transplantation for the treatment of severe aplastic anemia has been improved significantly, with lower incidences of graft failure, graft-versus-host disease, infectious complications, etc. Studies have already confirmed that transplantation from an unrelated donor should be recommended as an effective therapy for children and young adults who do not respond to the first course of immunosuppressive therapy.

OBJECTIVE:To discuss about the marketing strategy of a newly-developed drug,polysaccharide-iron cap?sule,before being listed.METHODS:To analyze the situation of marketing potential of antanemics and conditions of consumers and opponents,and to analyse the market enviroment of this enterprise with SWOT method.RESULTS&CONCLUSION:To give the valuable and feasible marketing strategy and emphasize the problems which should be paid attention in the proceeding.

Objective To investigate the value of ultrasound-guided core needle biopsy in diagnosing precancerous lesions of breast cancer.Methods Totally 605 cases were enrolled.Ultrasound characteristics were recorded.The pathological diagnosis on ultrasound-guided core needle biopsy was compared with the findings of the excisional biopsy and follow-up results.Results In all of the 605 cases,3 cases were failed on ultrasound-guided core needle biopsy because of less biopsied tissue.The accuracy of ultrasound-guided core needle biopsy was 97.84％ (589/602),the Kappa value was 0.96 (P=0.01).In biopsy,42 cases were precancerous lesions of breast cancer,and divided into according group (n=32) and upgrading group (n=10) according to surgical pathology or follow-up results.The rate of underestimation was 23.81 ％ (10/ 42).Compared to according group,microcalcification,acoustic attenuation,rich vascular and suspicious axillary lymph nodes had statistical difference in upgrading group (all P＜0.05).Conclusion Ultrasound-guided core needle biopsy is ac curate in the diagnosis of breast neoplasm,however,ultrasound-guided core needle biopsy diagnosis of precancerous lesions are partly underestimated.To some degree,ultrasound characteristics of precancerous lesions of breast cancer could predict the underestimation.

Th17 cells play an important role in the pathogenesis of various immune-mediated diseases,including psoriasis,rheumatoid arthritis,multiple sclerosis,inflammatory bowel disease,asthma,and so on.The discovery of Th17 cells has offered scientists a new insight into the etiology and treatment of a broad spectrum of diseases.This article presents an overview of the differentiation,cytokine expression and trafficking of Th17 cells.

Objective:To investigate the protective effect of rifampicin in a rat model of global cerebral ischemia /reperfusion ( GCIR) and discuss the influence of rifampicin on microglial activation.Methods:The GCIR rat model was induced via the bilateral occlusion of the common carotid arteries and systemic hypotension.Forty-two male SD (Sprague-Dawley) rats were randomly assigned to three groups:sham group ,I/R and I/R+FRP treated group.The rats in I/R+RFP group were treated with rifampicin 20 mg/kg by intra-peritoneal injection 30 min after reperfusion , while the other groups were treated with normal saline.Morris water maze test was performed for neurobehavioral test ,HE staining was detected for pathomorphology changes of neurons in CA 1 region.Microglia was im-munohistochemically stained in CA 1 region using ionized calcium adaptive molecular 1 ( IBA-1) as the marker.The protein levels of IL-1β,IL-6 and TNF-αin the hippocampal tissues of rats were also measured by enzyme-linked immunosorbent assay.Results:Rifampin improved the behavior ,shorten the escape latency of rats following GCIR obviously ( P<0.05 ) and reduced the neuron damage in hipp-ocampal CA1 region of rats after GCIR (P<0.05).Additionally,in I/R+FRP treated group the activation of microglia also showed a significantly inhibited compared with I/R group(P<0.05).Futhermore,we also found the expression of IL-1β,IL-6 and TNF-αin hipp-ocampal reduced obviously in I/R+FRP group ( P<0.05 ).Conclusion: Rifampin have obvious protective effect in the rat model of GCIR.The underlying mechanism may be associated with inhibition the activation of microglia ,reduction the expression of IL-1β,IL-6 and TNF-αand suppression the inflammatory response finally.

Objective To explore the role of humall papillomavims (HPV) type 16 E6 variants in the persistent infection and recurrence of the cervical high-grade squamous intraepithelial lesion (HSIL) after conization. Motheds During May to June 2012, 100 HSIL patients with HPV16 positive but negative at the margin after Loop electrosurgical excision procedure (LEEP) were selected from Shanghai People′s Hospital of Pudong District. The gene sequencing was done to the E6. The patients were followed up for 2 years. The E6 gene sequencing was done again to detect the HPV16 variants among those with persistent infections and recurrence. Results Among the 100 cases, E6 variants were detected, 81% of them HPV E6 variants Asian prototype, 14% European variant; 2% European prototype (EP) and 3% African variant 1. LEEP for Asian prototype was susceptible to the clearance of HPV16 (P < 0.001). The European variants of T350G, and A442C were correlated with persistent infection and recurrence (P < 0.001). Conclusion The HPV16 variant is closely related to the HSIL incidence. HSIL caused by HPV16 in Pudong New Area of Shanghai belong to the Asian type variant. The European variants of E6 , T350G/A442C were likely related to the recurrence of HPV16.

Objective To modify the techniques for establishment of an abdominal working heart transplantation model in rats and to sum up the key factors to success.Methods A total of 180 12-week old Brown Norway rats ( donor) and Lewis rats ( recipient) were used in this study:50 BN rats and 50 Lewis rats for pilot experiment, and 40 BN rats and 50 Lewis rats for the formal experiment.The rat model of working heart heterotopic transplantation was adopted and estab-lished by Wiedemann’ s mode.We transplanted the heart from BN rats to Lewis rats and analyzed the survival rate, causes of death and histological changes of the heart ( HE staining) in this experiment.Results After exercise and modification, the survival rate was increased to 77.5%, and the mean total duration of operation was 71 ±11 min, and the mean ische-mic time of the donor hearts was 34 ±5 min.Histological examination ( HE staining) of the cardiac allograft showed a mild inflammatory cell infiltration in the graft at 24 h after transplantation, indicating that the model was reliable.Conclusions A variety of factors may affect the final operation success rate in the establishment of this heart transplantation model.A-mong them, the major affecting factors include: healthy animals, donor heart protection, rapid and effective vascular su-ture, and postoperative animal management.

Atherosclerosis is a chronic inflammatory disease,with both the innate and adaptive immune systems responding to many endogenous and exogenous antigens.Subsequent investigations have revealed that an immunomodulatory strategy via active immunization against atherosclerotic plaque antigen(s) could potentially alleviate atherosclerosis.Substantial data from clinical investigations support the key role of immune system in atherosclerosis.So,it may be promising to develop immunotherapy against atherosclerosis.The paper reviews current status of immunization studies and possible associated immunemediated inflammatory mechanisms in atherosclerosis.

Objective To analyze the feasibility of low dose temporal bone CT scans in children.Methods We obtained an optimized low-dose protocol in pre-experiment.The optimized protocol was used to examine 27 consecutive children.And then we retrospectively analyzed 27 examinations underwent a standard temporal bone CT scan acquired with 120 kV and 250 mAs.The interobserveragreement (Kappa value) for the 2 reviewers was calculated.The children were then divided into 4 subgroups according to age-specific effective dose conversion coefficient.The effective dose and image quality between the two protocols at the same age were compared by t test.Results The result of pre-experiment showed that radiation dose was significantly reduced when the parameters were 100 kV and 70 mAs.The interobserver agreement(Kappa value)was high (0.784).The interobserver agreement for both low-dose (0.641) and high-dose (0.815) groups were high.The effective doses of low-dose group were (0.707 5±0.029 1)(0,1.0 year old),(0.431 6±0.051 3)(1.1 to 5.0 years old); (0.309 5±0.138 4) mSv (5.1 to 10.0 years old) respectively.The effective doses of high-dose group were (3.166 2±0.462 5),(2.048 6±0.224 7),(1.492 0±0.422 1) mSv respectively.The difference between low and high dose groupswas significant in all of the subgroups (t=-10.612,-26.22,-79.84,P＜0.05).The image quality of low-dose group was75.5±0.6,75.6±3.5,75.4± 2.4 respectively.The image quality of high-dose group was78.8± 1.0,79.8± 2.2,79.5± 1.0 respectively.The effective dose for the forth subgroup (10.1 to 18.0 years old) wasl.194 9 and 0.228 1 mSv respectively.Though the image quality of low-dose group was significantly lower than that of high-dose group (t=-3.667,-26.220,-6.315,P＜0.05).All the images of low-dose scan were diagnostic.The image quality of both groups was 80.The radiation dose was 5 to 6 times lower thanstandard protocol used in daily work.The effective dose for infants is higher than the older children underwent the same protocol.Conclusion Low-dose temporal bone CT scan allows an accurate evaluation of middle and inner ear structures and is feasible in children.

Objective To evaluate the optimum ratio of medicine dosage for dexmedetomidine mixed with sufentanil used for patient?controlled intravenous analgesia ( PCIA) after Nuss procedure in pedi?atric patients with pectus excavatum. Methods Sixty pediatric patients diagnosed with pectus excavatum, aged 5-12 yr, weighing 18-50 kg, of ASA physical statusⅠorⅡ, scheduled for elective Nuss procedure under general anesthesia, were randomly divided into 3 equal groups using a random number table:different ratios of medicine dosage while dexmedetomidine was added to sufentanil groups ( SD1-3 groups) . Postopera?tive analgesia was as follows: group SD1 received sufentanil 1 μg∕kg + dexmedetomidine 2 μg∕kg; group SD2 received sufentanil 1 μg∕kg + dexmedetomidine 3 μg∕kg; group SD3 received sufentanil 1 μg∕kg +dexmedetomidine 4 μg∕kg. A mixture of tropisetron 0?1 mg∕kg and dexamethasone 0?1 mg∕kg ( in 100 ml of normal saline) was added in each group. The PCA pump was programmed to deliver 0?5 ml with a lockout interval of 15 min and background infusion at 2 ml∕h. The PCA pump was connected immediately after the end of operation, and sufentanil with a dosage of 0?1μg∕kg was used as a rescue analgesic within 48 h post?operatively. The VAS score was maintained below 4. The requirement for rescue analgesics was recorded. The Ramsay sedation scores was recorded at 4, 8, 12, 24 and 48 h postoperatively, and the occurrence of adverse reactions such as nausea and vomiting, bradycardia, over?sedation, respiratory depression, agitation and shivering was recorded within 48 h after surgery. Results No pediatric patients developed nausea and vomiting, respiratory depression, bradycardia, over?sedation, and shivering. No pediatric patients required rescue analgesics in SD2 and SD3 groups. Compared with group SD1 , the requirement for rescue analgesics and incidence of agitation were significantly decreased, and Ramsay sedation scores were increased at 4 and 8 h after operation in SD2 and SD3 groups. Ramsay sedation scores were significantly higher at 4 h after oper?ation in SD3 group than in SD2 group. Conclusion Dexmedetomidine 3 μg∕kg mixed with sufentanil 1μg∕kg is the optimum ratio of medicine dosage when used for PCIA after Nuss procedure in pediatric patients with pectus excavatum.