Hepatolenticular degeneration,namely Wilson's disease,an autosomal recessive disorder of copper metabolism.The author of this article gave a definition to toxin-pathogen,discussed the basic concept of collaterals disease briefly.And pointed out that hepatolenticular degeneration is a disease due to toxin-pathogen invading collaterals,which was caused by disorder of copper metabolism.This can result in toxin stagnating in collaterals and stagnation of blood stasis in collaterals in the initial stage,and collaterals injured at last.To improve QI-blood circulation and regulate the function of zang fu is important in order to accelerate elimination of toxin and prevent copper from stagnating. Specific therapy vary according to different clinical symptoms,such as promoting blood circulation for removing obstruction in collaterals and clearing toxin, clearing heat-fire and clearing toxin and dispersing stagnated liver-qi for promoting bile flow et al.

[Objective]To design a new kind of instrumentation specially to correct scoliosis and kyphoscoliosis.[Method]Through posterior transpedicular and vertebrae,wedged osteotomy was continually performed until anterior substantia compacta of vertebrae.[Result]More than(1 200) patients with scoliosis or kyphoscoliosis were treated with WVOI.The highest ostentomied vertebrae was thoracic 9 and 4 levels were performed for 1 case(mean 2 levels).The average time of osteotomy on one vertebrae was 30 min with 100 ml blood loss.No spine and spinal root injury was detected during the operating procedure.[Conclusion]Osteotomy with WVOI reduced operating time,blood loss,keep spine and spinal root safer during the operating procedure.It also made osteotomical plate fit well and prompted quick ossification.WVOI is an efficient instrumentation to correct kyphosis and kyphoscoliosis.

[Objective]To study the effect of improved universal pedicle screw systems which combined locking pedicle screws with sliding pedicle screws to correct the spinal deformities in growth period through posterior incision.[Method]From June 2000 to June 2006,209 spinal deformities in growth period were treated(106 males and 103 females),including 92 idiopathic scoliosis,72 congenital scoliosis,26 Scheuermanns diseases and 19 other kinds of spinal deformities.The age of patients ranged from 8 to 16 years(average 13.22 years).Locking pedicle screws were placed into pedicles of apical vertebra and the 3 to 5 adjacent vertebrae.Sliding pedicle screws were putted into pedicles of cephalic and caudal vertebrae.Double cross-links and rods were fixed and locked tightly.Sliding cross-links themselves could cannula prolonged to fit for the transverse development of vertebrae.[Result]Totally 209 cases with preoperative Cobbs angle 45 degree to 110 degree(average 68 degree)were instrumented with improved USS systems and 96 cases were followed up for 26～60 month.The length of spines were prolonged 4 cm to 15 cm with average 7 cm.With 26 months to 60 months follow-up,the whole spine growth was 230.4 cm with average 2.4 cm respectively.Rods broken were found in 6 patients and no other cmplication was detected.[Conclusion]Improved USS system which combined locking pedicle screws with sliding pedicle screws had the three dimensional power and intensity of traditional 3D instrumentations.Sliding pedicle screws and cross-links permitted longitudinal growth of the vertebrae and transverse development pedicles.

Objective To evaluate the value of high-frequency ultrasound for diagnosing Duchenne muscular dystrophy.Methods Eighty-one cases with Duchenne muscualr dystrophy were divided into four groups according to their age,age 3-7(13 cases),age 7-10 (30 cases), age 10-13 (30 cases),age 13-14 (8 cases). Twenty cases of healthy children, aged from 1 to 11 were chosed as controls. In all groups' buttock muscle,thigh and leg muscle were observed by high-frequency ultrasound longitudinally and horizontally.Results Gluteus atrophy and subcutaneous fat thickening were seen in age 3 patients,progressive subcutaneous fat thickening and progressive muscular atrophy of buttock,thigh and leg with age were proved.There were significantly differences among groups ( P

Objective To investigate the relation between serum asymmetric dimethylarginine (ADMA) level and endothelial function before and after living donor kidney transplantation in uremic patients.Methods A total of 38 renal transplant patients (21males and 17 females) and 36 healthy controls (20 males and 16 females) were enrolled. Plasma ADMA, symmetric dimethylarginine (SDMA), malondialdehyde (MDA), glutathione peroxidase (SeGSHPx), C-reactive protein (CRP) were mea-sured before transplantation and on Days 1, 3, 7, 14, and 28 posttransplantation. The brachial artery flow mediated dilatation (FMD) was studied before transplantation and on the 28th day after the transplantation. Results Serum levels of ADMA,SDMA,MDA and CRP were significantly increased, and the activities of nitric oxide (NO) and SeGSHPx were decreased in uremic patients compared with age matched healthy subjects (all P＜0.01). Serum levels of ADMA,SDMA,MDA and CRP decreased while the activities of NO and SeGSHPx increased significantly at the first day after the transplantation (all P＜0.01). The decrement of plasma SDMA normalized on the 28th day (P＞0.05). The FMD was lower in the patients than the control group (P＜0.01) and improved significantly on the 28th day of posttransplantation (P＜0.05). Serum levels of ADMA were positively correlated with MDA (r=0.412, P＜0.01;r=0.342,P＜0.01) and negatively correlated with the values of SeGSHPx (r=-0.345, P＜0.01;r=-0.315, P＜0.01) and FMD (r=-0.452,P＜0.01;r=-0.416,P＜0.01) both before and after kidney transplantation. Conclusion The level of serum ADMA is associated with endothelial function improvement in uremic patients both before and after kidney transplantation.

Objective To study the clinical value of heat shock protein (HSP)70 in the diagnosis of neonatal asphyxia and the correlation of HSP70 and Neonatal Behavioral Neurological Assessment (NBNA)score.Methods From January 2014 to June 2016,full-term neonates born in our hospital were enrolled in the study and assigned into mild and severe asphyxia groups.Normally delivered full-term infants were assigned to the control group.Blood from umbilical artery were extracted immediately after birth and HSP70 levels were detected using ELISA.The NBNA scores were recorded at the 7th,14th and 28th-day after birth.Results HSP70levels in both mild (n =46 )and severe (n =35 )asphyxia groups were significantly higher than the control group(n =50)[(14.4 ±2.7)ng/ml、(17.7 ±4.5)ng/ml than(11 .9 ± 2.3)ng/ml,P <0.05].The severe asphyxia group had even higher HSP70 levels than the mild asphyxia group (P <0.05).The NBNA scores of both asphyxia groups were significantly lower than the control group (P <0.05).The umbilical pH values of both two asphyxia groups were also significantly lower than the control group(P <0.05).Correlation analysis showed that HSP70 level was negative correlated with NBNA score (7th,14th,28th-day)(r =-0.574、-0.493、-0.208,P <0.05).The HSP70 level was negatively correlated with umbilical pH (r =-0.576,P <0.05).The area under curve(AUC)for HSP70 levels to predict asphyxia was 0.798(95%CI 0.722 ~0.874,P <0.05).Conclusions HSP70 level in umbilical cord blood can be used as an indicator for neonatal asphyxia.The more severe the asphyxia,the higher the HSP70 levels and the lower NBNA score and umbilical pH.

Objective To compare the clinical effect of penehyclidine hydrochloride and atropine in the treatment of acute organophosphorus pesticide poisoning.Methods 86 patients with organophosphorus pesticide poisoning were selected and randomly assigned to the observation group and the control group according to the digital table,43 cases in each group.The two groups were given conventional treatment,while the control group was treated with atropine,the observation group was given penehyclidine hydrochloride.The disappearance time of main symptoms, rescue success rate and adverse reactions of the two groups were observed.Results After salvage treatment, the rescue success rate of the observation group was 97.8%,which of the control group was 88.4%,the difference was statistically significant (x2=1.433,P<0.05).The disappear time of M like symptoms,N like symptoms and central nervous system symptoms in the observation group was significantly shorter compared with the control group (all P<0.05).The number of drugs,dosage,cholinesterase recovery time and hospitalization time between the two groups had statistically significant differences (P<0.05).The incidence rates of blurred vision,restlessness,heart rate and urinary retention in the control group were significantly higher than those in the observation group (all P<0.05).Conclusion Penehyclidine hydrochloride for acute organophosphorus pesticide poisoning can significantly reduce the incidence of symptoms,shorten the disappearance time of symptoms,reduce hospitalization time,improve the efficacy of rescue,reduce the incidence of adverse reactions, it is safe,effective and has great clinical significance.

Tumor metastasis and recurrence had become a key to curative effect and long-term survival,and it's hotspot of current clinical oncology research.Differential expression of proteomics between cancer and normal tissue can be used for discovering new tumor markers.Clinical detection of liver cancer-related protein molecules was useful to monitor and assess early diagnosis,recurrence and prognosis of hepatocellular carcinoma.Herein,this article reviewed the research progression of protein molecules in hepatocellular carcinoma.

Asialogycoprotein receptor (ASGPR) is a specific receptor of mammalian hepatocytes,exclusively up-take the glycoprotein in the blood.The number of ASGPR correlates significantly with liver function,and the reduction of the number of ASGPR suggest liver dysfunction.Decreased ASGPR in patients with liver cirrhosis or portal hypertension or hepatocellar carcinoma,lead to varying degrees of liver dysfunction,which made it more susceptible to post operative complications.liver ASGPR scintigraphy with Technetium-99 m DTPA-galactosyl human serum albumin (99m Tc-GSA),combinating with single photon emission computed tomography (SPECT) technology can assess the functional reserve of remnant liver and predict incidence of postoperative complications,then assist to evaluate the use fulness for clinically surgical decisions.Current situation and progress of 99mTc-GSA SPECT imaging in hepatic surgery were reviewed in the paper.

Objective To assess the effect of bladder neck sling in combination with pelvic floor suspension for management of urinary incontinence due to neurogenic sphincter incompetence in children. Methods From March 1998 to October 2000,23 patients (age:5 14 years) with neurogenic urinary incontinence resulting from congenital myelodysplasia underwent bladder neck sling with pyramidalis muscle in combination with pelvic floor suspension with iliopsoas,of whom 14 patients underwent bladder augmentation concomitantly with the procedure. Results All patients were followed up for 5 to 32 months (mean 18 months).Thirteen cases achieved continence,7 cases were improved,and 3 failed to gain effect.The overall effective rate was 87%.Pre operatively,the maximum bladder volume were (151.5?72.8)ml,leak point pressure were (32.3?6.5)cm H 2O(1 cm H 2O=0.098 kPa),maximum urethral pressure were ( 38.4 ? 13.7 )cm H 2O,maximum closing pressure were (22.8?13.2)cm H 2O and functional urethral length were (3.9?1.8)cm respectively.Post operatively,they were (211.6?63.3)ml,(49.8?16.4)cm H 2O,( 50.8 ?12.3)cm H 2O,(32.9?12.5)cm H 2O,(5.6?2.0)cm correspondingly.The differences were significant ( P