Chronic cerebral hypoperfusion is a common pathological state. Cognitive impairment is its main manifestation in early stage, and it will eventually result in persistent or progressive cognitive impairment and neurological deficits. Chronic cerebral hypoperfusion caused neuronal damage, synapse abnormity, energy impairment and the function defects of central cholinergic system and monoaminergic system are its pathophysiological mechanisms resulting in cognitive impairment.

Gene therapy has emerged as an efficient modality to treat human diseases.This method is based on the transfer of genetic material to tissues to induce a curative effect.Gene therapy vectors are molecular constructs used to facilitate the penetration of genomic sequences inside the cells.Viral vectots have however several limitations when administered directly to the patient.They may cause significant toxicity by activating innate immunity or by eliciting an adaptive immune response against viral proteins.In addition,targeting the vector to the desired site is an issue when given systemically.The use of cells as vehicles for gene therapy vectors has many advantages.The combination of cell-viro-gene therapy has been thought as a new and promising strategy for therapy of cancer.The targeting vector to cancer stem cells will become a new direction in the field of gene therapy.In this article,we will introduce progressions,limitations and future directions of gene therapy of liver cancer.

ObjectiveTo explore the effect of guided learning in the eye optical applied optics teaching.Methods30 students of Grade 2013 were chosen as experimental group which was given guided learning teaching, and other 30 students of Grade 2013 were chosen as control group which was given used traditional teaching. In the guided learning teaching, self-study and practice students were re-quired to master the key and found the difficulties in the course firstly, answering questions after the group discussion. Then teachers focused on parsing the teaching materials. By the repeated communication and practice students mastered knowledge finally. The control group used the traditional teaching method which was based on the teacher's lecture. Through comparing the theory examination scores, practical as-sessment grades and questionnaire of the students self-assessment, teaching effect based on guided learn-ing was evaluated. Normal distribution measurement data was showed by standard deviation, T test was used in two independent sample measurement data; The count data was showed by rate, using Chi-squared test whichα=0.05.ResultsIn experiment group,the theoretical examination average score was(78.35±7.14) points, while in control group, the average score was(69.15±8.88)points. There were significance differ-ences between the two groups(t=-4.339,P=0.000). The experimental group practical assessment grades and the self-assessment score were superior to control group, and the difference has statistical sig-nificance (P<0.05).ConclusionGuided learning teaching can guide the students to obtain and master relevant knowledge independently, fully arouse their initiative of learning and improve their ability to analyze and solve problems, which can help reach a good teaching effect.

Objective To summarize the clinical experience of laparoacopic cholecystectomy(LC) for acute cholecystitis. Methods LC was performed in 68 cases of acute cholecystifis for 2004 to 2007. The operation was completed under CO2 pneumoperitoneum by using 4-port technique. Results The LC was successfuUy accomplished in 64 cases, while a conversion to open surgery was required in 4 cases. A drainage tube at the foramen of Winslow was placed in 1 cases. Conclusion Strict adhesion to surgical indications of LC, standard performance of the proce-dure, timely conversion to open surgery, and proper placement of drainage tube are key factors to ensure a successful operation.

Objective To discuss the influence of different doses budesonide aerosol inhalation on serum cytokines levels in children with severe asthma.Methods 96 children with severe asthma aged 4 to 14 years old in our hospital were chosen,and they were randomly divided into the observation group and the control group,48 cases in each group.All patients were given conventional treatment, and the control group was given 1mg/time budesonide treatment on the basis of conventional treatment (3 times a day),while the observation group was given 2mg/time budesonide treatment (3 times a day).Before and 1 week after treatment,the clinical symptoms of two groups were observed and compared,as well as the changes of IL-4,IFN-gamma,IL-10 and TNF-α.Results In the obser-vation group,wheezes,coughing,wheezy sound and rales disappearance time were (2.10 ±0.77)d,(5.45 ±1.20)d, (3.46 ±1.03)d,(5.55 ±1.35),which were significantly shorter than (2.98 ±1.02)d,(7.48 ±1.19)d,(5.43 ± 1.06)d,(7.56 ±1.67)d in the control group (t=4.77,8.32,9.23 and 8.32,all P<0.01).4 weeks after treat-ment,the total effective rate of the observation group was 89.6%,which was significantly higher than 72.9% of the control group (χ2 =4.376,P<0.05).After treatment,the IL-4,IL-10,TNF-alpha,IFN-gamma levels in the observation group were (4.06 ±1.77)pg/mL,(12.77 ±2.05)pg/mL,(4.15 ±1.11)ng/mL,(26.23 ±2.78)pg/mL, which had significant changes compared with (9.02 ±2.23)pg/mL,(10.21 ±1.30)ng/mL,(6.66 ±1.62)pg/mL, (17.33 ±2.31)pg/mL before treatment(t=12.07,24.56,16.20,17.25,all P<0.01).After treatment,the IL-4, IL-10,TNF-alpha,IFN-gamma levels in the control group were (9.11 ±2.05)pg/mL,(6.80 ±1.23)ng/mL, (9.88 ±2.20)pg/mL,(21.22 ±2.80)pg/mL,which had significant changes compared with (9.11 ±2.05)pg/mL, (10.38 ±1.37) ng/mL,(6.71 ±1.77) pg/mL,(17.30 ±2.05) pg/mL before treatment( t=5.36,13.47,7.77, 7.83,all P<0.01).But IL-4,TNF-alpha levels in the treatment group were significantly lower than those in the control group (t=7.32,11.08,all P<0.01),while IL-10 and IFN-gamma levels were significantly higher than those in the control group (t=6.65,8.80,all P<0.01).The incidence of adverse reactions of the two groups had no statistically significant difference (χ2 =0.771,P>0.771).Conclusion High doses of budesonide aerosol inhalation in the treatment of children with severe asthma has obvious clinical curative effects,which could significantly improve the patients'clinical symptoms,and also has low incidence of adverse reactions,which is worthy of clinical promotion.

Objective To study paraquat adsorbability of different field soils in Guangxi province of China. Methods HPLC method was adopted to measure the peak area of paraquat in three different media of four types of soils. Chromatographic column was Kromasil C18 column (4. 6 mm×200 mm, 5 μm); mobile phase was acetonitrile-water (including 0. 03 mol·L-1 sodium heptanesulfonate and 0. 24 mol·L-1 phosphoric acid) at a ratio of 397 (pH adjusted to 2. 0 by triethylamine). Detection wave length was 258 nm; column temperature was 25 ℃; the injection volume was 20 μL; flow rate was 0. 8 mL·min-1 . The peak areas of paraquat before and after being adsorbed were compared to calculate the adsorption rate of paraquat in different soils. Results All tested soil samples possessed the adsorption rate of paraquat over 99. 0%. Conclusion Four common field soils in Guangxi province can be used as temporary effective absorbents for the first-aid of paraquat poisoning.

BACKGROUND:Anterior cervical discectomy and fusion surgery is a good choice for repair of degenerative cervical disc herniation, but it is reported that fusion can affect the exercise of cervical neighboring stages. Artificial disc replacement can not only play a role in mitigation of cervical disease neurological symptoms and signs, but also maintain stability and semental activity of cervical spine, and reduce secondary adjacent segmental degeneration.
These two methods which applied in cervical degenerative intervertebral disc herniation stil remain controversial. OBJECTIVE:To investigate the short-term effect of artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single segmental cervical disc herniation. METHODS:Total y 48 patients with single segment radiculopathy or myelopathy cervical diseases induced by cervical disc herniation that required surgery and received a three-month fol ow-up were included and retrospectively analyzed. These patients were divided into replacement group (n=21) and fusion group (n=27) according to the different repair programs. Patients in the replacement group were subjected to Prestige LP cervical artificial disc replacement, and patients in the fusion group were subjected to disc fusion using interbody fusion cage of Johnson or al ogeneic fibularing. They were fol owed up at 1 week, 3, 6, 12, 24, 36 months after treatment. Complications were recorded during the fol ow-up. The pain of patients was evaluated using neck and upper limb pain visual analogue scale scores. The therapeutic effect was evaluated using Japanese Orthopaedic Association (JOA) score. The clinical symptoms improvement and daily functional status of patients after treatment were evaluated using cervical disability index. RESULTS AND CONCLUSION:During the final fol ow-up, the fusion rate in fusion group was 93%(25/27). Comparisons between groups:at the 1 week and final fol ow-up after treatment, the visual analog scale scores of neck and upper limbs and cervical dysfunction indexes were al lower than those before treatment;the Japanese Orthopaedic Association scores were higher than those before treatment (P<0.05). In the final fol ow-up, the visual analog scale scores of neck and upper limbs and cervical dysfunction index were al lower than those after one week of treatment, and the Japanese Orthopaedic Association scores were higher than those after one week of treatment (P<0.05). There were no significant differences in the above indicators at each time point between these two groups (P>0.05). The cervical activity and surgical segmental motion after cervical disc replacement were significantly higher than those in the fusion group;the difference was statistical y significant (P<0.05). There were no serious complications in these two groups. There was no significant difference in the incidence of complications between these two groups (P>0.05). These results suggest that the artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single cervical disc herniation have the same effect in terms of patients’ symptoms mitigation. With respect to fusion technique, artificial disc replacement surgery has the advantage of maintaining cervical stability and activities of replacement segments.

BACKGROUND:In recent years, with the continuously improving of the fixation systems and technology, conducting anterior cervical decompression bone graft accompanying with anterior plate fixation have been accepted by most scholars, however, the complications related to this also appeared constantly. In view of this, the zero notch interbody fusion plate (Zero-P) has been approved for the clinical treatment of cervical degenerative disease. OBJECTIVE:To discuss the early application effect of Zero-p on anterior cervical decompression and fusion. METHODS:The study enrol ed 22 patients who underwent anterior cervical decompression and fusion with Zero-P between February and December 2014. The number of Zero-P implanted in the C3-4, C4-5, C5-6 was 1, 3 and 18 respectively. Pain and neurological improvement were evaluated using Visual Analog Scales score and Japanese Orthopaedic Association (JOA) score for al the patients after operation. The X-ray plain of lateral and flexion-extension lateral of cervical vertebra were shot. The degradation degree was judged based on the measurement results from the cervical lateral X-ray films about the ratio of cephalad and caudal adjacent intervertebral space to vertebral body height, and adjacent segments osteoarthritis situation. The abnormal activity at the surgical spaces was observed by the extension and flexion lateral X-ray plain. RESULTS AND CONCLUSION:Twenty-two patients obtained fol ow up for 10-28 months. 2 patients had dysphagia on the fourth day and the fifth day after operation (extremely mild). The symptom disappeared within 2 weeks after treatment. The Visual Analog Scales score was significantly lower compared with preoperation (P<0.05), the JOA score was significantly higher than that before operation (P<0.05) , the cervical Cobb angle was significantly higher than that before operation (P<0.05). There were no significant differences statistical y in comparison of the Visual Analog Scales score, JOA score and cervical Cobb angle at different time points after operation (P>0.05). In cephalad adjacent intervertebral space, 3 cases had developed hyperosteogeny (first level). In caudal adjacent intervertebral space, 1 had developed hyperosteogeny (first level). There was no significant difference in the hyperosteogeny between cephalad adjacent intervertebral space and caudal adjacent intervertebral space (P>0.05). There was no significant difference in the R value in cephalad adjacent intervertebral space and caudal adjacent intervertebral space between preoperation and postoperation (P>0.05). During the fol ow-up, no abnormal activity at the surgical spaces and implant displacement was observed. These results suggest that using Zero-p in the treatment of monosegmental disc disease has significant effect, can effectively improve the cervical curvature and establish good cervical stability. The incidence of postoperative dysphagia is low. The degeneration of adjacent segments after treatment was not increased in early stage.

Objective To investigate low density lipoprotein receptor (LDLR)gene mutation in familial hypercholesterolemia (FH) patients. Methods The proband was given clinical diagnosis of homozygous FH based on marked features and blood lipid tests results. After apoB100R3500Q mutation was excluded, the promoter region and all of the 18 exons of LDLR gene were amplified by touch-downpolymerase chain reaction (PCR). The PCR products were analyzed by single-strand conformationalpolymorphism (SSCP). The PCR products with abnormal single strands were sequenced directly. Thesecondary structures of the mutational and wild type proteins were analyzed and compared byANTHEPROT5.0, and then the tertiary structures of the mutant and wild type LDLR were predicted atSWISS MODEL homepage online. Results A homozygous mutation A606T at exon 13 of the patients wasfound by SSCP and confirmed by DNA sequencing. GOR Ⅰ method in ANTHEPROT5.0 indicates that therandom coils and turns would replace some helixes at the mutation site. The online prediction from theSWISS MODEL homepage indicates the backbone structure of the mutant LDLR has no difference from thewild type one. Conclusion The results suggest the A606T mutation of LDLR gene is the cause of the FH inthis pedigree.

Objective By analyzing the mortality of patients with hypertension and cerebral infarction in different blood lipid stratification,the significance of blood lipid stratification management in the treatment of hypertension was clarified.Methods 604 patients with hypertension combined with cerebral infarction were divided into middle risk group (198 cases),high risk group (n=198) and extremely high risk group (n=208) and each group of different stratification according to the serum lipid HCY level,divided into H type hypertension group (HCY=10 μmol/L) and hypertension group ((HCY＜10 μmol/L group) and comparison of the 10 year mortality in each group.Results Comparison of mortality between H type hypertension group and simple hypertension group,among them,the difference between the two groups in middle risk group was statistically significant (x2 =5.095,P =0.024 205).The difference between the two groups in extremely high risk group was statistically significant (x2 =7.859,P=0.005 056).The difference between the two groups in high risk group was statistically significant (x2 =9.961,P=0.001 599).There was a significant difference in mortality between the groups with different blood lipids in simple hypertension group.Among the high-risk group and the middle risk group,the difference was statistically significant (x2=6.575,P=0.010 343),and there was significant difference between high risk group and high risk group (x2 =6.868,P=0.008 774).Comparison of mortality between different lipid levels in H type hypertension group,the difference was statistically significant.There was significant difference between the extremely high risk group and the high risk group (x2 =4.745,P=0.029 388) and there was significant difference between the high risk group and the middle risk group (x2 =11.668,P=0.000 636).Conclusion Hyperlipidemia,especially high LDL and high HCY are the main causes of death in patients with hypertension complicated with cerebral infarction,the clinical use of blood lipid levels can reduce the level of LDL and reduce the mortality of patients by strengthening the control of HCY level.Improve the survival rate of patients.