Objective To investigate the relation between CAG expansion length and clinical symptoms in hunting-ton′s disease ( HD) ,and to evaluate the value of CAG age product ( CAP score) in the clinical practice. Methods Two Han Chinese HD family members’ clinical data, including clinical symptoms and signs, the Cambridge cog-nitive examination-Chinese version ( CAMCOG-C) and Hamilton depression rating scale were collected, and these two families pedigree trees were drawn. Volunteers peripheral venous blood was extracted to pursue IT15 genetic test. CAP scores among members whose CAG repeat number was more than 35 were calculated. Results The pedi-gree trees indicated that HD was autosomal dominant inheritance. Among 6 participants who had pursued genetic test,1 was normal and 5 were carring expanded allele; according to fomal clinical diagnosis criteria,2 participants were in manifest period and 3 were in pre-manifest period. Individuals in manifest period had clinical triad,and in-divudals in premanifest period,though hadn’ t been clinically diagnoseded, were characterized by subtle motor,cog-nitive,behavioural or personality changes. Conclusion HD prior to clinical diagnosis may have mild clinical symptoms;the more CAG repeats indicate earlier onset, the heavier the symptoms. CAP score as a parameter, combined with the CAG repeat number and the age, is of great significance for predicting the onset age, clinical tri-al subjects grouping, and give a better understanding of the natural history of HD.

ObjectiveTo observe the effect of levamlodipine besylate combined with benazepril in treatment of primary hypertension with left ventricular hypertophy.MethodsNinety-eight primary hypertension with left ventricular hypertrophy patients were divided into two groups by random number table.Observation group(49 cases) was treated with levamlodipine besylate combined with benazepril,and control group (49 cases) was only treated with levamlodipine besylate.The clinical effect,the levels of systolic blood pressure (SBP),diastolic blood pressure (DBP),left ventricular posterior wall (LVPW),interventricular septal thickness (IVST),left ventricular end-diastolic dimension (LVEDD) and left ventricular mass index (LVMI) were compared between two groups.ResultsThe total effective rate in observation group was 93.9％ ( 46/49 ),which was significantly higher than that in control group (77.6％,38/49 ) ( x2 =5.333,P ＜0.05).Before treatment,the differences were not statistically significant in the levels of SBP and DBP (P ＞0.05).After treatment,the levels of SBP,DBP,LVPW,IVST,LVEDD and LVMI were significantly decreased in both groups (P＜0.05).Moreover,the levels of SBP,DBP,LVPW,IVST,LVEDD and LVMI in observation group after treatment were significantly lower than those in control group[ ( 121.27 ± 8.69 ) mmHg( 1 mm Hg =0.133 kPa) vs.( 131.54 ± 9.85 ) mm Hg,( 82.45 ± 4.69 ) mm Hg vs.( 88.49 ± 5.14 ) mmHg,(9.42 ± 1.58 ) mm vs.( 11.41 ± 1.92 ) mm,(9.56 ± 1.31 )mm vs.( 11.38 ± 1.85 ) mm,(47.86 ± 2.38 ) mm vs.(51.46 ±3.25) mm,(108.16 ±6.24) g/m2 vs.(119.21 ±7.68) g/m2] (P ＜0.05).Conclusion Levamlodipine besylate combined with benazepril in treatment of primary hypertension with left ventricular hypertrophy can improve the clinical effects and ease left ventricular hypertrophy status,which can be applied in clinic.

Objective To investigate the effect of arthroscopic arthroplasty on the short-term efficacy and stress factors in patients with primary osteoarthritis of the elbow and to guide the clinical application.Methods From February 2013 to February 2016,32 patients with primary primary osteoarthritis of the elbow underwent arthroscopic arthroplasty in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology.The levels of serum TNF-α,IL-6,IL-10,adrenocorticotrophic hormone(ACTH) and other stress factors were measured before and after the operation.The ROM,MEPS and VAS were used to evaluate the curative effect before,3 months and 6 months after operation.Results All patients were followed up successfully.The excellent rate was 96.9%(31/32) 1 year after the operation.Preoperative ROM,MEPS score,VAS score were (83.2±18.6) °,(63.2±14.5) points,(3.2±1.8) points;3 months,6 months postoperative ROM were (102.3±18.9) °,(124.3±15.4) °,and MEPS scores were (75.4±16.8) points and (89.5±14.3) points respectively,which were significantly higher than those before operation (ROM F value of 43.19,P<0.001;MEPS F value of 23.86,P<0.001).Three months,6 months postoperative VAS scores were (0.5±0.2) points and (0.3±0.1) points,which was significantly decreased(76.55,P<0.001);preoperative TNF-α,IL-6I,L-10,ACTH were respectively (12.5±2.5) μg/L,(5.4±2.3) ng/L,(10.5±4.0) ng/L,(22.4±6.3) ng/L,and were (38.4±8.6) μg/L,(25.6±8.4) ng/L,(23.1±4.8) μg/L,(58.6 ± 15.0) μg/L 1 day after surgery,which significantly increased compared with preoperative levels(P<0.05);1 week after patient TNF-α,IL-10 were respectively (9.4±1.2) μg/L,(7.5±3.5) ng/L,which decreased significantly(P<0.001).IL-6,ACTH were respectively (3.1±0.9) μg/L,(19.5±5.8) ng/L,which showed no significant difference(P>0.05).Conclusion For the modest primary osteoarthritis of the elbow,arthroscopy arthroplasty can achieve good therapeutic effect,improve the patient′s motor function and life quality,and minimally invasive surgical approach is conducive to relieve systemic stress.

Cancer stem cells are a new field with the gradual deep understanding of the stem cell research. Although its history is not long, the rapid development showed a good potential prospect. The existence of cancer stem cells and its use as tumor formation, growth and metastasis-based approach has been widely recognized. In theory, cancer stem cells derived from normal stem cells can transform. Cancer-causing factors can also be derived-from the dedifferentiation induced cells. Because it contains all-round, multi-and single stem cell, with the proliferation and differentiation potential of different directions, it is possible to explain the heterogeneity of tumor cells, and reasons for hypoxic environment, anti-cancer drugs and radiation resilience. In this area, it has been made a lot of progress in recent years. However, there are still some problems to be solved. Such as the identification of cancer stem cells, biological function and mechanism.

OBJECTIVE To explore the gene gyrA mutation in nalidixic acid-resistant Salmonella paratyphi A(SPA) in Shaoxing area.METHODS Fifty-two strains of SPA gene were assessed by amplification and purification and the PCR products were detected by two directional sequencing methods.The sequences of DNA gyrase A were compared and analyzed with the OMIGA2.0 software,and the gene gyrA mutation was identified.RESULTS The mutation in nalidixic acid-resistant SPA was discovered in No.83 or No.87 animo acid site of gyrA quinolones resistant determinate region(QRDR),and the mutation of 51 strains occurred in No.83 site,1 strain occurred in No.87 site.The simultaneous mutation of two sites was not discovered,No mutations were found in other sites of gyrA QRDR.CONCLUSIONS No.83 site mutations of gene gyrA has a direct relation to nalidixic acid-resistant SPA.No.87 site mutation of gene gyrA might also cause nalidixic acid-resistantce.The nalidixic acid-resistant SPA is mainly mutated in No.83 site by TCC→TTC(Ser→Phe) in Shaoxing area.

Cancer stem cells are a new field with the gradual deep understanding of the stem cell research.Although its history is not long,the rapid development showed a good potential prospect.The existence of cancer stem cells and its use as tumor formation,growth and metastasis-based approach has been widely recognized.In theory,cancer stem cells derived from normal stem cells can transform.Cancer-causing factors can also be derived from the dedifferentiation induced cells.Because it contains all-round,multi-and single stem cell,with the proliferation and differentiation potential of different directions,it is possible to explain the heterogeneity of tumor cells,and reasons for hypoxic environment,anti-cancer drugs and radiation resilience.In this area,it has been made a lot of progress in recent years.However,there are still some problems to be solved.Such as the identification of cancer stem cells,biological function and mechanism.

Objective To analyze the corneal flap thickness in laser in situ keratomileusis(LASIK) using Moria M2 microkeratome and to identify the related factors. Methods Sixty patients with LASIK were divided into two groups: M2 90 group,using the Moria M2 90 microkeratome,n=30;M2 110 group,using the Moria M2 110 microkeratome,n=30.All were performed on both eyes with the right one treated first.Subtraction pachymetry was used to measure corneal flap thickness which was analyzed statistically with the data including age,preoperative corneal diameter,curvature,corneal thickness and refraction. Results In the 30 patients of M2 90 group,the mean corneal flap thickness of right eye and left eyes were(128.03?12.03)?m(105~156 ?m) and(123.40?12.38) ?m(92~147 ?m),respectively,and the corneal flap thickness were statistically different between the right and left eyes(P

OBJECTIVE:To provide reference for setting reasonable medicines insurance payment price in China.METHODS:We retrieved and analyzed academic articles formally published at home and abroad,official websites and government documents,summarized.medicines insurance payment pricing mechanism as well as fair solutions to high-cost medicines,so as to put forward the suggestions to formulate reasonable medicines pricing policy in China.RESULTS&CONCLUSIONS:The international medicines payment prices are usually determined by internal reference pricing method,incremental cost-effectiveness evaluation method and external reference pricing method.The sustainable and fair accessibility of high-cost medicines are promoted by fair medicines pricing program,medicines patent pool,open source medicines discovery znitiative and so on.After the goal of universal health care has been achieved in china,reasonable medical insurance payment price should be explored and formulated.It is necessary to adopt,intemal reference pricing method to determine the payment standard of completitive eneric products,external reference pricing method or incremental cost-effectiveness evaluation method to determine the reference price for price negotiation of the innovative patented medicines;the concept of fair pricing for high-cost medicines.

BACKGROUND:General y considered bone marrow cells obtained by adherent method are mesenchymal stem cells, and they can differentiate into osteoblasts, adipocytes and chondrocytes.
OBJECTIVE:To explore the differentiation capacity of bone marrow adherent cells into osteoclasts.
METHODS:Primary mouse mesenchymal stem cells were obtained using adherent method, and bone marrow cells were obtained through adherence 1-5 days. Both of them were cultured with normal medium and inducing medium containing m-csf and RANKL. After 9 days, cells were stained by alkaline phosphatase and tartrate-resistant acid phosphatase. The passage 2 mesenchymal stem cells were divided into four groups, which were induced by mock, m-csf, RANKL and m-csf+RANKL, respectively. After 9 days of culture, the cells were stained by alkaline phosphatase and tartrate-resistant acid phosphatase.
RESULTS AND CONCLUSION:Primary culture of adhered cells was uniform. Alkaline phosphatase and tartrate-resistant acid phosphatase staining of primary and passaged bone marrow adherent cells induced with m-csf+RANKL were positive. This result showed that there were cells that could be induced into osteoclasts in the primary and passaged bone marrow adherent cells. Alkaline phosphatase and tartrate-resistant acid phosphatase staining showed differences of adherent cells at different times after the induction, indicating that adherent cells at different times had different differentiation capacity.

Since the oral rehydration salts solution(ORS) has been used to treat acute diarrhea of children, there are different kinds of ORS in order to satisfy the need of clinical work. They are the initial WHO-ORS, other substances-supplemented ORS and the reduced osmolarity ORS, each of which has their own efficiency and advantage.