Objective To observe histologic changes of human cytomegalovirus(hCMV)-infected explants of first trimester human placenta and expression of hCMV gene in the hCMV-infected explants, and investigate the mechanism of intrauterine transmission of hCMV from mother to fetus.Methods The first trimester placenta explants cultures were carried out, and they were infected with hCMV for 10 days. The expression of hCMV immediate early protein(IEP) 72-IEP86 were determined using indirect-immuno fluorescent assay, and in situ hybridization method was used to examine the hCMV late gene (LG)mRNA. For histologic evaluation of morphological changes in villi, transmission electron microscope was used.Results (1) Typical hCMV-induced lesions bearing hCMV IEP72-IEP86 were consistently localized in the trophoblast of covering placenta villi, interstitial cell and vascular endothelia cell 12 hours after infection, and were predominant in cytotrophoblast. (2) Replication of hCMV in placenta explants culture occurred from 12 hours to 24 hours and disappeared since 48 hours after infection with different concentrations of hCMV when examined by in situ hybridization. (3) Tissue integrity and viability of first trimester placenta explants were obtained in culture for 10 days and then explants were infected with different concentrations of hCMV 100 tissue culture infectious doses(TCID_ 50 ),200 TCID_ 50 and 300 TCID_ 50 , the progression of the infection was observed in the tissue that maintained its normal cellular organization under light microscope. But typical inflammation of cellular organization was observed under transmission electron microscope. Conclusions (1) A flash replication of hCMV in placental explants culture occurs; IEP72-IEP86 may be in intrauterine infection of hCMV for a long time. (2) There are pathological ultrastructure changes in hCMV-infected explants.

Objective: To study clinical application value of 320-slice spiral computed tomography (SCTCA) for diagnosing coronary artery disease. Methods: A total of 85 patients underwent 320-slice spiral CT and selective coronary angiography (CAG). With CAG as gold standard for diagnosing coronary heart disease (CHD), sensitivity, specificity, positive predictive value, negative predictive value and accuracy were compared between 320- SCTCA and CAG. Results: Sensitivity was 95.65%, specificity was 74.36%, positive predictive value was 81.48%, negative predictive value was 93.55% and accuracy was 85.9% diagnosing coronary artery disease by 320-slice spiral CT. Conclusion: 320-slice spiral computed tomography is a simple, safe, reliable non-invasive measurement, may be used for screening coronary heart disease and reviewing after operation.

To develop a medication reminder based on Android platform, which can be used to set up personalized reminders quickly and record the patient' s medication time-stamp and related information. In addition, the effect of using the reminder on medication compliance was studied. 14 subjects participated in the evaluation of medica-tion compliance. The differences of dosage and medication rate between the group using and without using reminder were investigated. The dosage and medication rate were got by the pill counting. The Wilcoxon matched -pairs signed rank test showed that the dosage and the medication rate of the group using reminder were higher than that without using reminder significantly(Z= -2. 93, P =0. 003 ). The results demonstrated that the use of the re-minder can improve the medication dose and rate significantly,indicate that the reminder might be a new technical support for clinical research on medication compliance, and also might reduce the workload for medical staff and patients.

[Objective]To investigate the efficacy of early Chinese biotype total hip arthroplasty(THA) in clinical application.[Methods]From October 1997 to March 2004,THA was done in 46 patients(49 hips) with early Chinese biotype.The efficacy was evaluated according to the clinical score and X-ray photographs.[Results]Forty-six patients were followed up for 5~11.5 years(average 8.5 year).The mean Harris hip score improved from 38(35~50) points preoperatively to 82(70~90) points at final follow-up.The imaging observation showed that prothesis loosening occurred in 9 cases.There were hip dislocation in 3 cases.One dislocation occurred on the way to the ward after operation,and the other 4 events occurred after the patients were discharged.Close reduction was all successful.There was 1 case of ectopic ossification,Brooker classification was GradeⅠ.One patient had hip pain and limping.The X-ray photographs showed that there was obvious osteoporosis,but no prothesis loosening occurred.No infection was found.The total good to excellent result was 73.9%.[Conclusion]The early Chinese biotype total hip arthroplasty can relieve the pain.However,the design and the moding parts of the domestic prosthesis need to be modified in order to improve the prosthetic efficacy.

Objective To discuss the application of Apofix interlaminar clamp for the treatment of atlantoaxial instability. Methods From April 2000 to July 2004, 30 patients with atlantoaxial instability were treated with posterior atlantoaxial fusion and Apofix fixation. There were 24 males and 6 females. The mean age of the patients was 41 years (range, 19 to 67 years). The patients included 5 with atlantoaxial dislocation, 25 with odontoid fracture (including fresh fracture for 21, old fracture and nonunion for 4; Anderson Ⅱ for 23 and Anderson Ⅲ for 2). After reducted by skull traction, atlanto-occipital space, arcus posterior atlantis and axial laminar were exposed during operation, upper and lower hooks were inserted. The iliac bone graft was inserted into the space of C1 and C2, the connecting rod of the clamp was compressed and fixed. Results The follow-up of all cases ranged from 8 months to 3 years and 10 months (with the mean of 27 months). There were 28 cases with complete reduction of fracture and dislocation, 2 cases in incomplete reduction. The operation time was 70 to 150 minutes, and the average blood loss was 65 ml. Patients could sit up 3 days (2 to 6 days) after surgery with soft collar. The mean off-bed time was 7 days (2 to 10 days) after operation in the patients without or less spinal cord injury. All cases obtained solid bony fusion 3 months postoperatively. No severe complications such as injuries of vertebral artery, nerve root and spinal cord or aggravation of spinal cord injury occurred. Conclusion Apofix interlaminar clamp has advantages of convenience in operation, provided reliable and safe stability for atlatoaxial segment. The results suggested that this technique is an efficient, reliable segmental posterior fixation.

OBJECTIVE:To analyze the rationality of the preventive use of antibiotics in Chinese ophthalmologic patients with type Ⅰ incision.METHODS:By means of retrospective study,a total of 1 273 ophthalmologic cases from 113 hospitals of 2006～2007 from National Monitoring Network of Ministry of Health for Clinical Application of Antibiotic with type Ⅰ incision involving preventive administration of antibiotics via different routes were analyzed.RESULTS:The local administration (eye drops and local injection) was rational on the whole,but the systemic administration (intravenous or oral administration) was irrational to some degree in which the drug grade was on the high side,the antibacterial spectrum was inappropriate,and the medication time was delayed.CONCLUSION:Preoperative local administration and rational use of dosage forms should be emphasized in the preventive use of antibiotics for patients undergoing ophthalmologic surgery.

Objective To discuss the value of CT prognosis on the Masaoka staging system of thymic epithelial tumors(TET) before surgical resection.Methods The CT images of 102 patients with TET proved by surgery and pathology were reviewed retrospectively.The TET were reclassified according to Masaoka stage system.The size,homogeneity,sharp,contour,infiltration of surrounding tissue,and metastasis on CT were analyzed with Logistic analysis.The diagnostic value was also evaluated with a ROC curve.Results Masaoka pathologic stages were stage Ⅰ for 36 (35.3 ％),stage Ⅱ for 27 (26.5 ％),stage Ⅲ for 30 (29.4 ％),and stage Ⅳ for 9 (8.8 ％).A multivariable Logistic regression model showed that TET with larger size of tumor (20/35,P =0.0371,OR =4.539),irregular or lobulated tumor contour (26/42,P =0.0230,OR =4.870),heterogeneous (21/33,P =0.0154,OR =6.020),infiltration of surrounding fat (25/32,P =0.0019,OR =14.005),and pleural seeding (11/11,P =0.0032,OR =36.153)were more likely to have stage Ⅲ or Ⅳ disease.The area under ROC curve was 0.940.Conclusions The tumor CT imaging features can differentiate between stage Ⅰ,Ⅱ and stage Ⅲ,Ⅳ disease.This helps identified patients more likely to benefit from neoadjuvant therapy.

There are a large amount of neural stem cells in the olfactory system which have an active proliferation, ongoing and direc-tional differentiation and migration in order to adapt to the changing environment. The clinical findings showed that the early stages of some neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease all presented dysosmia. In recent years, the relationship be-tween air pollution and dysosmia attracts public concerns. This article introduced some research progresses in this field.

The application of fetal echocardiography in clinical is increasing , more and more patients need de-tailed consulting services .The following suggestions are made:Echocardiographic doctors should set up the consulting service consciousness , provide consulting with patience , popularity and carefulness; the doctors should understand the patients and their family′s emotions and also pay attention to the psychological care;environmental requirements for patients′echocardiographic examination and counseling service;encouraging multidisciplinary join the participa-tion of consulting services .

Objective To analyze the changing process and development trend of deaths (mortality)in patients with viral hepatitis after the use of the Internet-based National Notifiable Infectious Disease Reporting System.Methods Descriptive statistical and moving average methods were employed to analyze the infectious disease reports released by the Chinese government during 1992-2013,and the changing process and development trend of deaths (mortality)in patients with viral hepatitis in China over the past 10 years were investigated.Re-sults The annual deaths (mortality)in patients with viral hepatitis showed a decreasing trend.The deaths (mortality)from hepatitis B showed a slight declining trend,accounting for a great proportion (over 70%)of the deaths (mortality)from viral hepatitis;the deaths (mortality)from hepatitis C had shown a slight downward trend since 2007;the deaths (mortality)from hepatitis A and unclassified hepati-tis decreased to different extents;the deaths (mortality)from hepatitis E remained at a relatively low level.Conclusion The treatment of viral hepatitis has been gradually improved in China and the public awareness of viral hepatitis keeps increasing.However,much attention still needs to be given to the prevention and treatment of viral hepatitis,especially hepatitis B and C,by the government.