Objectives To compare the difference of ERG11 partial promoter sequence(-440 ～ -1)between yeast-form and hypha-form of Candida albicans, and the relation between the mutation of ERG11 promoter and the susceptibility of C. albicans to fluconazole. Methods Yeast-form and hypha-form of C. albicans genome DNA were extracted from 4 substrains C. albicans, which were isolated from a single HIV-sero-positive patient. Partial ERG11 promoters of yeast-form and hypha-form of these 4 substrains were amplified by polymerase chain reaction (PCR) and the PCR products were sequenced. Results There was no sequence difference between the yeast-form and the hypha-form of C. albicans in this region. Heterogeneities at position -365, -353, -328, -310, -308, -299, -295, -293, -292, 290, -289 and a single base deletion (-284 delT) were found on one allele of ERG11 promoter region of fluconazole-susceptible substrains. No heterogeneities were observed in dose-dependent fluconazole-susceptible and fluconazole-resistant substrains. Conclusions There is no difference of ERG11 partial promoter sequence between the yeast-form and the hypha-form C. albicans. The mutation of ERG11 promoter may be associated with the resistance of C. albicans to fluconazole.

Objective To introduce the clinical application and method of endoscopic harvesting the sural nerve in the carbon dioxide gas cavity. Methods 7 cases with peripheral nerve defect were involved, including 5 men and 2 women. The length of nerve defects ranged from 5 to 8 cm, all the nerve defects were repaired by autogenous sural nerve grafting. The sural nerve were removed from 9 calves in 7 cases. Along the course of the sural nerve in the proximal calf, a transverse 1.0 to 1.5 cm incision was done for endoscope approach, another transverse 0.5 to 1.0 cm incision was done lateral to the sural nerve for operation approach. Using abdominoscope system, the sural nerves were cut and removed smoothly in the cavities which were maintained the gas pressure 10 to 15 mm Hg with carbon dioxide insufflation. All the peripheral nerve defects of 7 cases were repaired as cable graft with harvested sural nerve. Results The length of nerve graft harvested from 30 to 42 cm in 9 calves. It took about 30 minutes to harvest the nerve in each side. There was no abvious injuries found by pathologic inspection. No carbonemia and air embolism occurred on patients during operating time, no complications of hypodermic pneumatosis and hematoma occurred on all cases. All patients followed up from 6 to 10 months, the function recovery of the nerves was good. The muscle power was obtained 2 to 4 grade, the sensation was obtained S3 to S4 grade. The function recovered as fast as the traditional operation of sural nerve transfer. Conclusion The method of endoscopic harvesting the sural nerve in the carbon dioxide gas cavity with minimal incision is easy to perform. Compared with the long longitudinal incision and multiple stair-step incision, the method can get less invasive and traumatic, and good aesthetic results. This technique deserves the doctor application in clinical work.

[Objective]To investigate the differentiation of acute from chronic osteoporotic vertebral fractures.[Method]The clinical presentation,X-ray,CT and MRI of patients with osteoporotic vertebral fractures were evaluated in the study.[Result]In 36 cases,64% were identified as acute and 36% with chronic osteoporotic vertebral fractures.The decreased anterior vertebral height was a most important criterium for the diagnosis of osteoporotic vertebral fractures.Degenerative changes on the X-ray film were usually found in chronic fractures.A high intense signal in a specific T2 under eliminating fat tissue was always observed in acute fracture.[Conclusion]The local back pain located at the level of the fractured vertebral body suggests an acute vertebral fracture.Degenerative changes occurred in the edged vertebra is indicative of a chronic fracture.The finding of a specific T2 high intense signal under eliminating fat tissue on MRI is a gold standard for the diagnosis of an acute vertebral fracture.

Objective To study the methods of repairing the sole defects and reconstruction of the sensory function. Methods Twenty- nine cases of sole defect were repaired with flaps and full- thickness grafting according to the weight- bearing area and non- weight- bearing area. Sixteen cases had reconstruction of the sensory nerves. Results Twenty- nine cases were followed up for 1－ 9 years. One case failed. One case required thinning the flap. Twenty- eight cases have gained normal weight bearing ambulation. Ulcer occurred in one case, giving an ulcer rate of 3.4％ . The sensation have recovered to S2－ S3 in 16 cases repaired with reconstruction of cutaneous sensory nerves. Thirteen cases repaired with non- innervated flaps and full- thickness grafting showed deep pain sensation, and over the 1－ 2 cm area coverage around the flaps there was light touch sensation. No significant difference was found in the ulcer rate between reinnervated and non- innervated flaps. Conclusion Defects of the weight- bearing area in sole must be repaired with flaps. The medial foot island flap, medial pedal island flap, toe arterial flap and anterolateral thigh flap are the appropriate options. Defects of the non- weight- bearing area could be repaired with full- thickness grafting. The transplantation of non- sensory skin flaps can re- establish the sensory function, so the reconstruction of sensory nerve is of minor importance.

Objective To compare 2 approaches with different culture media which induce hyphal form of Candida albicans.Methods Induction of hyphal form was conducted for 16 C.albicans strains with either RPMI 1640 medium or DMEM medium,at 37 ℃ for 24 h,respectively.The hyphal and yeast forms were counted separately and the ratio of hyphal form to total cells was calculated.Results The ratio of hyphal form to total cells was higher in RPMI 1640 medium than that in DMEM medium at the same incubation time for the majority of strains.The ratio was above 99% for all strains after 7-day incubation with 12 times of passages in RPMI 1640 medium at 37 ℃.Moreover the ratio of hyphal form was significantly higher for fluconazole-susceptible strains than that for fluconazole dose-dependent susceptible and resistant strains in incubation with DMEM medium at 37 ℃.Conclusion Incubation with RPMI 1640 medium at 37 ℃ for 7 days seems a favorable condition to induce hyphal form of C.albicans.

This paper reported the history of avian flu outbreaks in China from 1996 to 2006, directed the characteristics of avian influenza outbreaks in recent years. China is one of the biggest poultry producers in the world and many migratory birds go through China, China faces high risk of pandemic bird flu. The continuing occurrence of sporadic human cases indicates that the virus is continuing to circulate in birds in some parts of the country. In the fighting again avian flu virus, China has developed some possible practice on precautionary and control measure. China enhances international cooperation and scientific involvement in the prevention and control of the avian flu. The State Council and Ministry of Agriculture issued the laws and regulations on avian flu. Wild birds may have played a role in getting domestic fowl and human beings infected with bird flu. Poultry manure is considered to be another key source of the spread routes of H5N1 virus, but the bio - security processing in free range poultry farming and waste products is very poor disposition in China. Epidemic control at grassroots level still needs to be strengthened.

Objective To investigate the effects of short-segment pedicle screws system on type A thoracic and lumbar spine fracture with or without pedicle screws on the fractured level. Methods 23 patients with type A thoracic and lumbar spine fracture were included, in which 11 cases received traditional short-segment pedicle screws system without pedicle screws on the fractured level (group A), and other 12 cases with pedicle screws on the fractured level (group B). The anterior vertebral height, posterior vertebral height and local kyphosis an-gle were measured before and after operation. Results All pedicle screws were successfully implanted with good location and stability. The vertebral height and kyphosis angle significantly improved after operation in both groups (P<0.05), and the improvement of kyphosis angle was more in group B than in group A (P<0.05). Conclusion Short-segment pedicle screws system with pedicle screws on the fractured level may fine correct the kyphosis angle in short term.

ObjectiveTo evaluate the early rehabilitation outcome of the spinal cord stab injury (SCSI).MethodsThe materials of 40 SCSI patients and 50 contusion spinal cord injury (CSCI) patients from 1992 to 2004 were analyzed retrospectively. The curative effects were evaluated with ASIA scale (modified in 2000) and FIM scale.ResultsAfter comprehensive rehabilitation treatment, scores of ASIA and FIM scales of SCSI patients increased and significantly higher than that of CSCI patients (P<0.05～0.01).ConclusionThe SCSI patients shall be treated with comprehensive rehabilitation in early stage and their prognosis will be better than CSCI.

With the development of the medical imageology, the lumbar pain resulted from vertebral compression of the anterior column can be treated through percutaneous vertebroplasty (PV). PV has some advantages, such as short operative time, definite pain release, less complications and better security. However, there are some indications and contraindications in PV. PV can reach the prospective effect after handling these indications and contraindications. The authors reviewed the predominance, anatomy, indications, contraindications, assessment before the operation, operative methods, complications of PV in this article.

ObjectiveTo investigate the concurrent and predictive validity of ASIA2000 motor scale.MethodsConsecutive observation was done to the 42 patients who were admitted in CRRC from September 2003 to September 2004.ASIA motor score and conventional motor score were recorded respectively 1 month and 3 months after injury.ResultsPearson correlation coefficient between the MDP of the two systems was 0.945,while that of the MRP was 0.897.ConclusionThe ASIA2000 motor score has good validity.