Objective To study the pathologic and molecular genetic characteristics of Chinese patients with oculopharyngeal muscular dystrophy(OPMD).Methods The ultrastructural muscle biopsies in 6 patients were carried out by using transmission electron microscopy.The DNA was obtained through blood samples from patients(n=11) and the at-risk individuals(n=16).Amplification of the PABPN1 gene mutation region was performed by polymerase chain reaction(PCR).The sequences were obtained and compared with the genomic sequence of the human PABPN1 gene.Results Intranuclear inclusions(INIs) were found by electron microscopy in 4 patients,and the rate of appearance was 18%,20%,34% and 40%.Sequence analysis of exon 1 of PABPN1 gene showed abnormal expansions of the GCG-repeat—(GCG)_8 and(GCG)_(10) in 9 patients.Conclusions INIs might be found by electron microscopy in muscle biopsies of OPMD patients.The rate of appearance of INIs should have positive relationship with the amount of the GCG-repeat.PABPN1 gene mutations might be present among Chinese patients with OPMD,and should have a negative relationship with the age of onset.

Objective To study the clinical,image and pathological features of cerebral gliomatosis.Methods 2 cases with cerebral gliomatosis underwent routine MRI scan, contrast enhance MRI scan and pathologic examination of the lesions. Their clinical manifestations were observed during the past 2 years.Results Main clinic features of the 2 patients were headache, dizziness, nausea, vomit, diplopia, hemiplegia, hemianesthesia and ataxia. Cranial MRI scan showed long T 2 signals in the bitemporal lobes, biparietal lobes, corpus collosum, thalamus, caudate nucleus and putamen. Brain stem and cerebellum were also involved in 1 patient. The borders of the lesions were unclear and no mass-effect phenomenons were found. Contrast enhancement occurred only in 1 patient after Gd-DTPA injection. The biopsies in the 2 patients showed diffuse infiltrative growth of most astroglioma cells. The shape of nucleus was round or ellipse and the staining of nucleus was comparatively deep. Cleavage of nucleus was seldom. The 2 patients died in 4 to 6 months after the onset of the disease.Conclusions MRI scan and pathologic examination are essential diagnostic methods for cerebral gliomatosis. The prognosis of cerebral gliomatosis is poor.

Objective To evaluate the effectiveness of outreach service.Methods Questionnaires on the satisfaction of the disabled to outreach service were performed in Changning Street of Shanghai.Results Most of the disabled were satisfied with such form of community-based rehabilitation; however, they also reflected that the services were too simple and at low-level.Conclusion Following works should be done that include making scientific researches on community-based rehabilitation technic, training professional staff, and propagandizing knowledge on community-based rehabilitation.

Objective To evaluate the clinical value of three-dimensional reconstruction and virtual hepatectomy for laparoscopic precise liver resection of right liver tumor.Methods 31 cases of right liver tumor from June 2012 to October 2015 at Department of Hepatobiliary Surgery in Affiliated Hospital of Nantong University,were analyzed retrospectively.Patients were divided into three dimensional reconstruction group (n =15) and control group (n =16),Operation time,bleeding volume during operation,postoperative complications and days of hospitalization after operation in two groups were observed.Results All operation was successfully performed with pure laparoscopic right liver tumor resection in three dimensional reconstruction group.In control group,1 case was completed by hand-assisted laparoscopic liver resection,1 case was converted to open operation,the remaining 14 cases underwent total laparoscopic right liver tumor resection.Operation time in 3-dimensional reconstruction group was (141 ± 36)min vs.(207 ± 66)min in control group,bleeding volume was (274 ±88)ml vs.(418 ± 189)ml,hospitalization after operation was (9 ± 3)days vs.(13 ±6)days (all P ＜0.05).Conclusions Preoperative three-dimensional reconstruction and virtual hepatectomy can ensure the localization of parenchyma tumor during the laparoscopic precise liver resection,clarifing the relationship between tumor operation section and peritumoral vascular or biliary ducts,fulfilling the idea of precise liver resection.

Objective To survey the scientific research integrity situation of community health care organizations in Yangpu district in Shanghai,meanwhile,provide a reference for scientific research integrity management in any community health care organization.Methods Using the convenience sampling method,we sampled 200 health staff from 4 community health service centers.They were surveyed with uniform questionnaires.Results No dramatically relationship existed in health staff's knowledge about scientific research integrity breach and their age.However,education background,their academic titles,how many times they have learned relative information,publicity about science research integrity would impact their awareness on research integrity.Conclusions There is dramatically discrepancy on the scientific research integrity among these community health staff.

Objective:To investigate the current situation of junior medical students'cognition on the relationship between doctors and patients,and to provide reference for medical students'medical education and medical education reform,Methods:Self-made questionnaire was adopted to investigate the cognitive status of doctor-patient relationship among junior medical students from three medical universities in Guangzhou.Results:Totally 41.04％ of junior medical students had a basic understanding of doctor-patient relationship,and the degree of understanding of doctor-patient relationship is not different between junior and senior medical students (P ＞ 0.05);76.62％ of medical students got acquainted with the status of doctor-patient relationship mainly through the media;86.57％ of junior medical students thought that the doctor-patient relationship was tense.The cognition of doctor-patient relationship between male and female students was similar (P ＞ 0.05),and so wasit between freshmen and sophomores (P ＞ 0.05).Male and female students had the same opinion on the future trend of doctor-patient relationship (P ＞ 0.05).Many junior medical students were optimistic about the future doctor-patient relationship.Compared with freshmen,sophomore medical students were less optimistic about the future doctor-patient relationship (P ＜ 0.05).Medical students mostly agreed on the causes of medical disputes (P ＞ 0.05),believing that the main reason was the medical system.Conclusions:The cognition of the doctor-patient relationship profoundly affects the junior medical students as well as their choices of future employment and communication styles between patients and them,which may have important significance for avoiding medical disputes.Society,schools and the media should actively create a good atmosphere for the doctor-patient relationship.

BACKGROUND: Injured nerve can regenerate through end-to-side anastomosis and obtain partial physiological function in animal experiment. As an immuno-suppressivedrug, FK506, which is characterized by promoting neural growth and functional recovery, is paid widely attention to.OBJECTIVE: To investigate the effect of FK506 on functional recovery of peripheral nerve after end-to-side anastomosis.DESIGN: Randomized controlled animal study.SETTING: Department of Operation Surgery, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology.MATERIALS: The experiment was completed in the Department of Operation Surgery, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology in March 2005. Totally 26female Wistar rats were selected and divided into experimental group and control group with 13 in each group.METHODS: Peroneal nerve was transacted on the right side of all the animals, the proximal end of peronieal nerve was turned back and ligated, and the distal end was sutured to the side of tibial nerve with perineurial window. No operation was done on the left side. FK506 was injected in the right tibial muscle (2 mg/kg· d), once a day within two weeks in the experimental group, and saline was used in another group as contrast.MAIN OUTCOME MEASURES: Three months afteroperation, the bilateral common peroneal nerve and the tibial muscle were taken for electrophysiological and histological examination, and the number of common peroneal nerve fiber, area of tibialis anterior muscle fiber of transverse section and muscle wet weight of tibialis anterior muscle were measured. The results were expressed with the ratio between right side and left side (i.e.recovery rate).RESULTS: Totally 26 rats entered the final analysis. ① Results of histological examination: Both ratio of number of nerve fiber and ratio of area of muscle fiber in the experimental group were higher than those in the control group (0.734±0.143, 0.412±0.119; 0.628±0.125, 0.432±0.135; P ＜ 0.01,0.05). ② Results of electrophysiological examination: Recovery rate of action potential, recovery rate of single muscular contractility and recovery rate of tetanus contractility in the experimental group were higher that those in the control group (P ＜ 0.05). ③ Ratio of wet weight in the experimental group was higher than that in the control group (0.765±0.101,0.513±0.116, P ＜ 0.05).CONCLUSION: FK506 injected into targeted muscle can promote growth and functional recovery of peripheral nerve in end-to-side anastomosis.

BACKGROUND:With the social and economic development and aging, coronary heart disease has become the primary cause of death endangering human life and health, while cardiovascular intervention (especial y stenting) in the treatment of cardiovascular disease is at a growing status. OBJECTIVE:To describe the development, research progress and latest clinical application of heart interventional materials as wel as advantages and disadvantages of biodegradable stents, and meanwhile to prospect for its future development and improvement. METHODS:A computer-based online search was conducted in PubMed for English language publications from January 1999 to April 2014 using the key words of“stent, scaffold, bioabsorbable, bioresorbable, biodegradable, biocompatibility, material properties”in English. RESULTS AND CONCLUSION:The new ful y biodegradable stents are considered as another major progress in the cardiac intervention, which brings a new gospel for patients with coronary heart disease. In the initial stage of implantation, biodegradable stents exhibit the same mechanical support as bare metal stents;after implantation, anti-proliferative drugs are released to prevent thrombosis and restenosis, and the stent is completely degraded within a specified period, which significantly reduces the late-stage and very late-stage thrombosis and the risk of in-stent restenosis. However, long-term safety and efficacy of biodegradable stents need further studies. Innovation of stent design and materials science is the key to overcome the current shortcomings of biodegradable stents.

Objective To analyze the data of Human Immunodeficiency Virus (HIV ) screening in Qinnan District of Qinzhou from 2013 to 2015 ,and to provide scientific evidences for the prevention and control of Acquired Immune Deficiency Syndrome (AIDS) .Methods HIV antibody data which was collected from the AIDS laboratory between 2013 and 2015 in Qinnan District of Qinzhou were analyzed .Results Of 3 955 cases of the HIV antibody detecting in the AIDS laboratory from 2013 to 2015 ,200 cases were HIV antibody positive ,and the positive rate was 5 .06% which was decreased compared with previously .The HIV antibody positive rate of man was 9 .26% ,which was higher than women .Among the HIV positive people ,the rate of the ages older than 50 was 25 .36% which was the highest compared to the other age groups .The positive rate of farmers was 30 .83% and the rate of di‐vorced or widowed was 30 .86% and the rate of the illiterate was 16 .08% .Conclusion Man ,farmers ,the age older than 50 years old ,the divorced or widowed and the low degree of education groups are the focus groups of health education and prevention of AIDS .If we can find HIV infectors earlier ,we can control the epidemic of AIDS and formulate the prevention and control strategies better .

Over the last decade, chronic critically ill (CCI) has emerged as an epidemic in intensive care unit (ICU) survivors worldwide. Advances in ICU technology and implementation of care bundles has significantly decreased early deaths of critically ill patients, and have allowed them to survive previously lethal multiple organ failure (MOF). However, more and more survivors leave persistent low grade organ dysfunctions, depend on continues organ support, need to stay in ICU, and become CCI patients. These patients experience a persistent immune dysregulation with persistent inflammation, immunosuppression, and catabolic syndrome. Therefore, malnutrition is an important feature of patients with CCI, and nutritional support is a crucial part of their treatment. The main strategies of nutritional support are as follows: providing sufficient calories and proteins with appropriate anabolic agents to promote anabolic metabolism, using immunomodulators to improve immune suppression and inflammatory responses, and supplementing micronutrients to enhance metabolic support. In this review, the nutritional assessment, calorie assessment, protein assessment and other nutrient supplementation (such as β blocker, testosterone and oxandrolone, immunonutrition, vitamins) of CCI patients were reviewed, so as to provide reference for the treatment of CCI.