According to the related requirements of medical technology clinical application management, the specific implementation approaches of surgery physicians surgery permission management were made, including establishing surgery classification project directory library, developing surgery classification management system and the surgery permission declared, and audit program, and investigating to determine the steps of surgery permission owned by surgery physicians currently, and finding problems and solution measures in implementation surgery permission management. To prevent surgical risk, improve the quality of operation, and evaluate surgical doctors scientifically, it provides management experience and references.

Aim To investigate the role of NO/cGMP in the cardioprotective effects of intrathecal morphine preconditioning against myocardial ischemia-reperfu-sion injury in rats. Method 54 Male Sprague-Dawley Rats were used to establish the model of intrathecal catheter placement. The rats were randomly assigned to
9 groups. SHAM (sham group), CON (control, sa-line) , ITMP ( intrathecal morphine preconditioning, 3μg·kg-1 ) , L-NAME+ITMP ( NO synthetase inhibi-tor,L-NAME ) , ODQ + ITMP ( guanylate cyclase in-hibitor, ODQ ) , KT5823 + ITMP ( PKG inhibitor, KT5823),L-NAME,ODQ,KT5823,6ratsineach
group. ITMP were produced by three cycles of 5 min intrathecal injection of morphine and 5 min intermis-sion before myocardial ischemia, CON were achieved by intrathecal injection of saline in the same way, L-NAME+ITMP, ODQ +ITMP, KT5823 +ITMP were prepared by intrathecally administering L-NAME ( 30 nmol), ODQ(11 nmol) and KT5823(20 pmol) 10 minutes prior to ITMP respectively, L-NAME, ODQ, KT5823 worked as the control of inhibitors themselves respectively without ITMP. Subsequently, all rats were subjected to 30 min of left coronary artery occlusion followed by 2 h of reperfusion except the SHAM group. Myocardial infarct size, as a percentage of the AAR,
was determined by 2 , 3 , 5-triphenyltetrazolium stai-ning. Results Compared with CON, the volumes of IS and IS/AAR were reduced in ITMP ( P <0.01 );the protective effects of ITMP were abolished by pre-treatment with L-NAME, ODQ and KT5823 ( P <0.01 );Conclusions NO/cGMP might be involved in the cardioprotective effect of intrathecal morphine pre-conditioning against myocardial ischemia and reperfu-sion injury in rats.

The present problems were analyzed in the education in the gynecology of traditional Chinese medicine. And then the discusion was underwent as fellowes: the reasonable allocation of teaching hours, enriching teaching methods, setting up the concept of combining traditional Chinese and western medicine, developing the another class, paying attention on teacher training and student feedback. In this way, we want to explore the effective methods to improve the quality of education in the gynecology of traditional Chinese medicine.

Objective We reported previously that single nucleotide polymorphisms SNP) + 11G ＞ A in intron 3 of the human urate transporter 1 (hURAT1) gene are associated with hyperuncaemia in Han Chinese.The aim of the present study was to evaluate the effect of the variants on hURAT1 function.Methods The wild-type,mutant-type hURAT1 and exon 5-null hURAT1 were constructed,and respectively microinjected into the zebrafish embryo yolks.The subcellular localization of different genotypes of hURAT1 was detected by confocal laser scanning microscope.Results Compared with wild type,the mutant recombinant plasmid transcribed two types of mRNA spliceosome,the wild type and the exon 5-null type.The hURAT1 wild type protein was prominent localized on cell membrane,while the mutant type and exon 5-null hURAT1 proteins were distributed uniform in the cytoplasm but not on the cell membrane.Conclusion The hURAT1 variant + 11 G ＞ A resulted in an alternative splicing of hURAT1 mRNA-exon 5-null type.Its protein product exhibited a different subcellular localization compared with that of wild type.

Background Limbal stem cells (LSCs) play an important role on the stability of corneal epithelium and corneal transparency.Rho-associated coiled-coil containing protein kinase (ROCK) inhibitor can promote cell proliferation and reduce apoptosis,such as human embryonic stem cells and karatin epithelial cells.Objective This study was to investigate the improving effect of Y-27632,a ROCK inhibitor,on the activity of rabbit LSCs in corneal preservation medium.Methods Corneal preservation solution was prepared by adding 12.5％ chondroitin sulfate,10.0％ low molecular dextran,20.0 mg/L dexamethasone,100 mg/L tobramycin sulfate,9.5 g/L Hepes and 0.375 mg/L L-glutamine in MEM.The corneas of New Zealand white rabbits were collected and preserved in the corneal preservation solution with or without Y-27632 for 4,7,14 days,and the density and morphology of corneal endothelial cells were examined by using 0.25％ trypan blue staining and 0.2％ alizarin red staining.Isolated corneal epithelial cells were seeded on 3T3 feeder layer and cultured for 7-10 days until colonies formation.Colony shape of LSCs was observed under the light microscope,and colony-formation efficiency was analyzed after Giemsa staining by Image J software.Results The morphology and density of corneal endothelial cells were normal in the corneal preservation solution with and without Y-27632 for 4 days.In the seventh day after preservation,the cells remained the regular hexagon in shape in the preservation solution with Y-27632,however,the cellular membrane was slightly shrinking with the positive staining for alizarin red in the preservation solution without Y-27632.The density of corneal endothelial cells in the corneal preservation solution without Y-27632 was (2 262-± 75) cells /mm2,while in the preservation solution with Y-27632 was (2 425 ±95) cells/mm2(P＜0.001).The cloning spheres of LSCs were similar in preservation solution both with and without Y-27632 in the freshly isolated cornea or preserved corneas and exhibited more cells inside.But in 7 days and 14 days after preservation,the cloning spheres were much smaller in the preservation solution without Y-27632 group than those in the preservation with Y-27632 group.No significant differences were found in the cloning-formation rate and survival rate of corneal epithelial cells in corneas freshly isolated or preserved for 4 days in both groups (all at P＞0.05).In 7 days and 14 days after preservation,the active rates of corneal epitheli.al cells were (73.00±2.12)％ and (56.00±0.71)％ in the preservation solution with Y27632,which were significantly higher than (66.00 ± 4.00) ％ and (49.00 ± 0.71) ％ in the preservation solution without Y-27632,showing statistically significant differences between them (t =3.098,P =0.018;t =9.798,P =0.000).In addition,the cloning-formation rates of LSCs were (11.05±0.21)％ and (3.10±1.97)％ in the preservation solution with Y-27632 in 7 days and 14 days after preservation,revealing significantly elevation in comparison with (2.05 ± 1.20) ％ and (0.40 ±0.14) ％ in the preservation solution without Y-27632 (t =18.107,P =0.000;t=3.184,P=0.017).Conclusions Y-27632 promotes the vitality and cloning-formation ability of LSCs in corneal preservation medium,suggesting its potential use during storage of cornea.

To explore the molecular characteristics of Streptococcus suis serotype 2(ss2) isolated in Zhejiang province by deciding the variation loci and its variation frequency of Cps2J gene.The total DNA of 9 strains of ss2 isolated in Zhejiang province were extracted and amplifed by PCR. Then,the Cps2J fragments were cloned into plasmid carrier and completely sequenced after purification.Finally,the sequence results of all 9 ss2 isolates were compared with those obtained by other studies around the world.It was found that the open reading fragments of Cps2J in 9 SS2 isolates encoding 333 amino acids were 999 bp in length.Comparisons of this region among ss2 isolates revealed a similarity of between 98.8% and 99.9%, while the homology to ss1 strains varied between 56.8% and 57.0%.Our study shows the sequences of complete Cps2J segment are fairly stable and all these 9 ss2 strains of different sources possibly have the same evolutionary origin.

Objective To evaluate the effect of recombinant human tumor necrosis factor receptor type Ⅱ:IgG Fc fusion protein (rhTNFR:Fc,trade name Etanercept) combined with methotrexate on levels of interleukin-17A (IL-17A) and tumor necrosis factor-α (TNF-α) in the serum and mononuclear cells of patients with moderate to severe plaque psoriasis.Methods A total of 30 patients with moderate to severe plaque psoriasis were enrolled from Department of Dermatology of Tenth People's Hospital of Tongji University between August 2014 and February 2016,and then were randomly and equally divided into Etanercept group and Etanercept + methotrexate group.The treatment lasted 24 weeks.Fifteen healthy blood donors served as healthy control group.Enzyme-linked immunosorbent assay (ELISA) and real-time quantitative PCR were performed to measure the serum levels and mRNA expression of IL-17A and TNF-α,respectively,in the patients of the above two groups before and after the treatment.Results Before the treatment,the serum levels of IL-17A and TNF-ct,as well as the mRNA expression of IL-17A and TNF-α in peripheral blood mononuclear cells (PBMCs),were all significantly higher in all the patients than in the healthy controls (all P ＜ 0.05).After the treatment,compared with the Etanercept group,the Etanercept + methotrexate group showed significantly lower serum levels of IL-17A (142.67 ± 14.82 vs.163.54 ± 23.18,P ＜ 0.05) and TNF-α (70.07 ± 25.02 vs.91.98 ± 14.62,P ＜ 0.05),as well as lower mRNA expression of IL-17A (1.12 ± 0.33 vs.1.56 ± 0.77,P ＜ 0.05) and TNF-α in PBMCs (2.50 ± 1.04 vs.3.61 ± 2.14,P ＜ 0.05).Conclusion Etanercept combined with methotrexate is superior to Etanercept alone in the treatment of psoriasis,and can reduce treatment duration and improve therapeutic effect,likely by down-regulating the expression of IL-17A and TNF-α.

Objective To investigate the relationship between expressions of mismatch repair gene (MSH2) and osteoprotegerin (OPG) as well as their biologic behaviors in gastric carcinoma. Methods The samples obtained from 220 patients with gastric cancer were prepared for tissue chip. Then, the expression of MSH2 and OPG in gastric cancer tissues were detected by in situ hybridization and immunohistochemistry. Results The positive rate was 57.3% in MSH2 mRNA, 56.4% in OPG mRNA, 59.6% in MSH2 protein and 55.9% in OPG protein. The expressions of MSH2 and OPG were positively associated with TNM stage, invasive depth, vessel invasion, lymph node and distant metastasis, however, they were negatively associated with degree of differentiation. The positive relationship between MSH2 and OPG expressions was found in gastric cancer. The average survival time and 5-year survival time in patients with positive expression of MSH2 or OPG were shorter than those in patients with negative expressions. Conclusions In gastric carcinoma, the expressions of MSH2 and OPG are up-regulated and there is a positive correlation between two genes. Furthermore, the expressions of MSH2 and OPG are related with clinicopathologic fetures. The combination of MSH2 and OPG is useful for examining and predicting outcome of gastric cancer.

Purpose To investigate the role of PTEN in podocyte injury in patients with diabetic nephropathy ( DN) . Methods Uri-nary samples from 30 patients with DN and 10 healthy volunteers were collected to detect the level of PCX by ELISA. Renal biopsies were reviewed to observe the morphological changes. All patients with DN were divided into three groups by glomerular lesion. The ex-pression of p-Akt and PTEN in glomeruli was detected by immunohistochemistry. Results The levels of PCX in the urine were signifi-cantly higher in patients with DN compared with those in healthy volunteers, and gradually increased along with glomerular lesion aggra-vating. The expression of p-Akt and PTEN increased in patients with DN compared with healthy volunteers. Although the expression of p-Akt and PTEN decreased with the aggravation of glomerular lesion, they were still higher than that in volunteers. There were obvious-ly positive correlation between the level of PCX and 24-h urinary protein and negative correlation between the level of PCX and the ex-pression level of p-Akt and PTEN. Conclusion PTEN down-regulation may be associated with podocyte injury in DN, which may be associated with the phosphorylation of Akt.

Objective To investigate the interconnection of the executive control network in major depressive disorder when they recognized the sad facial stimuli,and to discuss the aberrant mechanism of emotion processing.Methods Twenty major depressive patients and 20 well-matched healthy volunteers participated in the experiment.The brain actions of all subjects were recorded by the magnetoencephalography (MEG) when they were required to distinguish the emotion face.Based on prior knowledge,the interested brain area consisted of the primary visual cortex (V1),the orbitofrontal cortex(OFC),the dorsolateral prefrontal cortex (DLPFC),the anterior cingulated cortex (ACC).Then constructing three competing models to select an optimal model by the method of dynamic causal model(DCM),finally the differences of the effective connections of the optimal model between the depressed patients and healthy controls were analyzed.Results According to the results of Bayesian model selection (BMS),model 1 had the most exceedance probability of 0.80 with the features that there were bidirectional modulatory connections between the OFC,ACC and DLPFC.Given the best model,the parameters of effective connectivity of the optimal model were extracted,and then two-sample t-test over the model 1 was adopted.The modulatory effective connectivity from the OFC to the DLPFC in both hemisphere(t=-2.73,P=0.0096;t=-3.01,P=0.0046) and the OFC to the ACC (t=-2.93,P=0.0057) in the left hemisphere were significantly reduced in MDD.Conclusion There exists abnormal function of executive control network in depressed patients,the decreased effective connections between the OFC and the DLPFC,as well as the OFC and the ACC,may have correlation with the negative