Objective To investigate the expression of DNA damage and repair gene Apurinic/apyrimidinic endonuclease (APE1) protein in nasal NK/T cell lymphoma, and elucidate its clinical implication. Methods Expression of APE1 proteins was detected immunohistochemically in 10 normal lymph nodes and human nasal NK/T cells from lymphoma of 64 patients and their integral optical density was determined by means of image analytic system. The proliferation index and apoptosis index were determined by means of immunohistochemical staining and terminal dUTP nickend labeling (TUNEL) technique. Results 1. Nuclear, nucleus/cytoplasmic and cytoplasmic types of APE1 positive staining could be noted in nasal NK/T cell lymphoma. Expression of APE1 gene in nucleus was significantly strengthened compared to that in nucleus/cytoplasm and cytoplasm. In relapse or refractory group, no relapse or refractory group, and normal control group, the positive degree of cytoplasmic staining diminished significantly in the above order (P

Objective To evaluate the accuracy and reliability of 4D time-resolved MRA with keyhole (4D-TRAK) for the detection and characterization of cerebral aneurysms ( CAs),with a comparison of 3D time-of-flight MRA (3D-TOF-MRA).Methods3D-TOF-MRA,4D-TRAK and 3D-DSA were performed sequentially in 52 patients with suspected CAs.4D-TRAK was acquired using a combination of sensitivity encoding (SENSE) and contrast-enhanced (CE) timing robust angiography ( CENTRA ) k-space sampling techniques at a contrast dose of 10 ml at 3 T scanner. Accuracy,sensitivity,specificity of 4D-TRAK and 3D-TOF-MRA were calculated and compared for the detection of CAs on patient-based and aneurysm-based evaluation using 3D-DSA as a reference. Wilcoxon signed rank test were used. Results The overall image quality of 4D-TRAK was appropriate for the diagnostic purpose,but yet not comparable with that of 3D-TOF-MRA.In 52 patients with suspected GAs,58 CAs were confirmed on 3D-DSA finally.Fifty-one (with 2 false-positives and 9 false-negatives) and 58 (with 1 false-positive and 1 false-negative)CAs were visualized on 4D-TRAK and 3D-TOF-MRA,respectively.Accuracy,sensitivity and specificity on patient-based evaluation of 4D-TRAK and 3D-TOF-MRA were 92.31％ ( 48/52 ),93.33％ ( 42/45 ),85.71 ％ (6/7) and 98.08％ ( 51/52 ),100.00％ ( 45/45 ),85.71％ ( 6/7 ),respectively,and 74.07％(20/27),75.00％ ( 18/24),66.67％ (2/3) and 96.30％ (26/27),95.83％ (26/27),100.00％ (3/3)on aneurysm-based evaluation in patients with multiple CAs,respectively.Subgroup analysis revealed that for 19 very small CAs ( maximal diameter ＜3 mm,measured on 3D-DSA),9 were missed on 4D-TRAK and 1 on 3D-TOF-MRA( Z =- 2.464,P ＜ O.01 ). However,for 39 CAs with maximal diameter more than 3 mm,there was no significantly difference in the diagnostic accuracy (39 on 4D-TRAK vs.39 on 3D-TOFMRA) (Z =0.000,P ＞0.05).In 4 large CAs with maximal diameter more than 10 mm,4D-TRAK provided a better characterization of morphology than 3D-TOF-MRA.Conclusions 4D-TRAK with a combination of SENSE and CENTRA at 3 T shows potential value in the diagnosis of cerebral aneurysms.However,due to the compromise in spatial resolution and vascular edge artifacts,it does not yet have a diagnostic accuracy of CAs comparable with 3D-TOF-MRA.TRAK imaging can be of great help in patients with large-giant CAs to characterize the morphology of CAs and to diminish the risk of NSF in patients with renal impairment by using a lower-dose contrast.

Objective To explore the diagnostic value of the percentage of attenuation drop measured by diastolic phase coronary CTA (CCTA) in identifying significant dynamic compression of myocardial bridge (MB).Methods Totally 135 patients with MB confirmed by CCTA were enrolled.The CT value of MB segment and proximal MB segment was measureed respectively.Attenuation of mural coronary artery(％) =(CT value of proximal MB segment-CT value of MB segment)/CT value of MB segment × 100 ％.Systolic compression ≥50 ％ was considered significant.The percentage of attenuation drop of MB vessel,length and depth of MB were measured and correlated with the presence and degree of dynamic compression.Results Attenuation drop of mural coronary artery(％),length of MB in MB patients with significant systolic compression,slight systolic compression and without systolic compression had significant statistical differences (all P＜0.05).ROC curve showed the percentage of attenuation had the best accuracy of 73.3％ in diagnosis of MB with significant systolic compression with the cutoff value of 15％ and the area under the curve (AUC) of 0.75 (95％ CI [0.67,0.82],P＜0.01).Conclusion Attenuation drop of MB segment has relationship with the extent of dynamic compression of MB and it has value to identify significant dynamic compression of MB.

Objective To develop a lower limbs rehabilitative apparatus and explore its effects. Methods From January to September, 2016, 28 children with spastic cerebral palsy were divided into control group (n=14) and observation group (n=14) randomly. The control group received routine rehabilitation, while the observation group received self-made lower limbs rehabilitative apparatus training addition-ally. They were assessed with Gross Motor Function Measure (GMFM)-88 and Berg Balance Scale (BBS) before and three months after treatment. Results There was no significant difference in the scores of GMFM-88 and BBS between two groups before treatment (P>0.05), while they increased after treatment (t>6.124, P<0.001), and were higher in the observation group than in the control group (t>2.329, P<0.05). Conclusion Self-made lower limbs rehabilitative apparatus could help to improve the gross motor function and balance function in children with spastic cerebral palsy.

The acceptance assessment is an important part of research project management.By analyzing the content,methods,process and model of the current acceptance assessment of medical research projects in China,we summarized and elaborated the main problems in the medical research management.By referring to the mature practices of some other countries,we proposed the solutions to improve the quality of acceptance assessment in China,i.e.,balancing the qualitative and quantitative assessment,improving the quality of peer-review,constructing information platform,introducing independent third party assessment and construing the overall process evaluation system.Our study may provide important reference for constructing the high-quality evaluation system of medical research projects in China.

Spinal cord injury (SCI), especially the complete SCI, usually results in complete paralysis below the level of the injury and seriously affects the patient's quality of life. SCI repair is still a worldwide medical problem. In the last twenty years, Professor DAI Jianwu and his team pioneered complete SCI model by removing spinal tissue with varied lengths in rodents, canine, and non-human primates to verify therapeutic effect of different repair strategies. Moreover, they also started the first clinical study of functional collagen scaffold on patients with acute complete SCI on January 16th, 2015. This review mainly focusses on the possible mechanisms responsible for complete SCI. In common, recovery of some sensory and motor functions post complete SCI include the following three contributing reasons. ① Regeneration of long ascending and descending axons throughout the lesion site to re-connect the original targets; ② New neural circuits formed in the lesion site by newly generated neurons post injury, which effectively re-connect the transected stumps; ③ The combined effect of ① and ②. The numerous studies have confirmed that neural circuits rebuilt across the injury site by newborn neurons might be the main mechanisms for functional recovery of animals from rodents to dogs. In many SCI model, especially the complete spinal cord transection model, many studies have convincingly demonstrated that the quantity and length of regenerated long descending axons, particularly like CST fibers, are too few to across the lesion site that is millimeters in length to realize motor functional recovery. Hence, it is more feasible in guiding neuronal relays formation by bio-scaffolds implantation than directing long motor axons regeneration in improving motor function of animals with complete spinal cord transection. However, some other issues such as promoting more neuronal relays formation, debugging wrong connections, and maintaining adequate neural circuits for functional recovery are urgent problems to be addressed.

OBJECTIVE To investigate the profile of pathogen of infection in kidney disease patients. METHODS Pathogen of infection in kidney disease patients in our hospital from Jan 2004 to Feb 2006 was retrospectively investigated. RESULTS A total of 240 pathogen strains were isolated from 223 cases.Of the 240 isolated strains the rate of strains of Gram-negative bacilli was 55.4%,that of the Gram-positive cocci was 26.3%,the rate of fungi was 10.0% and that of the Gram-positive bacilli was 8.3%.The positive rate of Escherichia coli was the highest followed by Haemophilus influenzae.54.2% Of isolates were from urine,21.3% from sputum.The isolated pathogens resisted at different degrees to antibiotics which were used frequently in clinic.The rate of polyinfection was not high. CONCLUSIONS Pathogen of infection in kidney disease patients is mainly Enterobacteriaceae.The isolates mainly are E.coli which is multi-resistant.It mainly causes the urinary infections.

Objective:To explore the association between Toll-like receptor (TLR) gene polymorphism and susceptibility to non-human immunodeficiency virus (HIV)-related cryptococcal meningitis in patients from Fujian Province.Methods:A total of 101 non-HIV patients with cryptococcal meningitis and 270 healthy controls in Huashan Hospital, Fudan University and Cangshan Hospital District, The 900th Hospital of the Joint Logistics Support Force from Fujian Province were prospectively enrolled in this case-control study. Genomic DNA was extracted. Genotyping was performed by multiplex SNaPshot technology on eight TLR single nucleotide polymorphism (SNP) which were reported to be related to cryptococcal meningitis but still lacking validations. The differences of gene polymorphism distributions were compared between all patients and healthy controls, and between patients without predisposing factors and healthy controls. Data were analyzed by chi-square test or Fisher exact test.Results:Except for TLR1 rs5743563, the distributions of allele frequency in seven tested TLR SNPs (TLR1 rs5743604, TLR2 rs3804099, TLR4 rs1927907, TLR6 rs3796508, TLR6 rs5743794, TLR9 rs164637 and TLR9 rs352140) were in Hardy-Weinberg equilibrium. Comparisons between cases and controls found that TLR2 rs3804099 T/T genotype (52.5%(53/101) vs 40.4%(109/270), odds ratio ( OR)=1.63, χ2=4.378, P=0.036) and TLR6 rs5743794 G/G genotype (44.6%(45/101) vs 32.2%(87/270), OR=1.69, χ2=4.877, P=0.027) were correlated with high risks of cryptococcal meningitis, while TLR6 rs3796508 G/G genotype ((83.2%(84/101) vs 92.6%(250/270), OR=0.40, χ2=7.271, P=0.007) and TLR9 rs164637 C/C genotype (96.0%(97/101) vs 100.0%(270/270), Fisher exact test , P=0.005) were found to be protective factors. Seventy out of 101 patients had no predisposing factors. Comparison between patients without predisposing factors and healthy controls also found similar results. TLR6 rs5743794 G/G genotype (52.9%(37/70) vs 32.2%(87/270), OR=2.36, χ2=10.216, P=0.001) was risk factor, while TLR6 rs3796508 G/G genotype (81.4%(57/70) vs 92.6%(250/270), OR=0.35, χ2=7.906, P=0.005) and TLR9 rs164637 C/C genotype (97.1%(68/70) vs 100.0%(270/270), Fisher exact test, P=0.042) were protective factors. Conclusion:TLR gene polymorphism is significantly associated with non-HIV-related cryptococcal meningitis, which indicates that TLR might play an important role in the pathogenesis of cryptococcal meningitis.

OBJECTIVE:To study invalid medical order warned by Prescription automatic screening system (PASS),and to improve rational drug use monitoring. METHODS:The infusion medical order warned with black light,red light and orange light by PASS were extracted from Pharmacy intravenous admixture services(PIVAS)of our hospital during Oct. to Dec. 2014. Invalid warning items were analyzed statistically in respect of warning level,problem types and reasons. RESULTS & CONCLUSIONS:There are 3 392 warnings items,468 were invalid (13.80%) which include 10 items by black light,219 items by red light and 239 items by orange light;by problem types,there are 218 items of overdose and 136 items of repeated treatment,etc. The main causes of invalid warning include 191 items caused by wrong system prompt,126 items by incomplete system information,143 items by insufficient auditing standards,etc. There are still some defects of invalid warning in practical application of PASS. It is suggested that user and developer add the function of self-defined drug list or user-defined system data by,and unify auditing stan-dards of rational drug use,etc.,so as to timely update the system information,and improve the accuracy of software system moni-toring and warning function.

Objective To observe the effect of electro-acupuncture therapy (ET) on the expression of sodium channel Na(v) 1.1 in rats after acute cerebral ischemia and the mechanism of any protective function of ET.Methods A model of focal acute cerebral ischemia was established by occluding the right middle cerebral artery.One hundred and eighty healthy SD rats were randomly divided into a sham operation control (SC) group, an ischemia control (IC) group, a real ET group and a false ET group, with 45 in each group. Immunohistochemistry and real-time polymerase chain reaction (PGR) methods were used to detect Na(v)1. 1 expression. 2,3,5-triphenyl tetrazolium chloride (TTC) staining was used to detect infarct volume. Neurological examination and grading was carried out at 6 hours and then 1, 2, 3 and 7 days after inducing ischemia. Results The gradings and infarction volume ratios of the rats in the IC group were the most serious, while in the real ET group the severity was much less at each time point. Compared with the SC group, the expression of Na(v) 1.1 was significantly up-regulated in the IC group. The expression of Na(v) 1.1 was increased at the 6th hour, then down-regulated to the lowest level at day 1,then from the 2nd to the 7th day was up-regulated again. The expression of Na(v) 1.1 in the real ET group was significantly lower than in the IC group. Although the expression of Na(v)1.1 in the false ET group was low compared with the IC group, the difference was not significant. The difference between the real ET group and the false ET group was significant, however. Conclusions ET can reduce damage from cerebral ischemia and benefit the recovery of neural function. ET can also could regulate the expression of Na(v)1.1 after acute cerebral ischemia, which may be an important mechanism for neural function recovery.