Objective To evaluate the effect of percutaneous device closure guided by transesophageal echo-cardiography (TEE)on atrial septal defect(ASD)via right internal jugular vein(RIJV)in children.Methods A total of 8 cases with secundum ASD were recruited as candidates to receive percutaneous device closure via RIJV between July 22 and November 5,201 5 in Heart Center,Dalian Children′s Hospital.In this group,5 boys and 3 girls who were 5 months to 1 0 years old were included.The youngest patient was a 30 weeks premature infant of 5 months old,with 3 -month correction gestational age.All patients were clearly diagnosed as ASD by transthoracic echocardiography(TTE) before operation.Five patients had single central type ASD which were 5 -8 mm in diameter,and 3 patients had multi-ple(1 biforate and 2 cribriform)ASD which were 1 0 -1 2 mm in shunt range.New type Fustar curve adjustable sheath was delivered after RIJV accessed.By passing through the ASD by adjusting the depth and bending of the tips of sheath,then the device was delivered and released to close the ASD.The procedures were always guided and monitored by TEE.After the devices were released,the position of device,residual shunt,and the effect of valves were assessed by TEE or TTE.Results All patients were tested with TEE and TTE after procedure,devices were stable and well shaped,and the defects were closured well without any residual shunt.All the patients were followed up more than 6 months.No hydropericardium,thrombogenesis,tachyarrhythmia,complete atrioventricular block or other complications were found.Conclusions To close ASD with new type curve adjustable sheaths via RIJV may have wide indications, short operation path,well curative effect,minimal invasion and fast recovery in pediatrics,especially fit for the small age children with a big ASD who are difficult to treat via femoral vein.

BACKGROUND:Smal-needle-knife therapy for knee osteoarthritis has no uniform location, operation and mechanisms of action. Studies have proved that exercise therapy can enhance muscle strength, increase stability of the knee, improve joint range of motion, and effectively relieve pain.
OBJECTIVE:To observe the clinical effect of smal-needle-knife therapy combined with exercise therapy for treatment of knee osteoarthritisvia a randomized controled clinical trial.
METHODS:122 patients were randomly divided into treatment group (n=61; smal-needle-knife therapy combined with exercise therapy) and control group (n=61; low-frequency therapy combined with exercise therapy). Then, clinical efficacy in the two groups were assessed by statistical analysis of visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), sweling degree of the knee joint, quadriceps circumference, flexion and extension of the knee joint before and after treatment. Meanwhile, adverse reactions in patients were recorded for safety evaluation.
RESULTS AND CONCLUSION:(1) The visual analog scale and WOMAC scores in the two groups were both significantly improved at 2 weeks after treatment (P < 0.05). Moreover, these scores in the treatment group were significantly lower than those in the control group (P < 0.05). (2) At 12 weeks after treatment, the WOMAC score in the treatment group was better than that in the control group (P< 0.05), and the range of motion of the knee joint was also better in the treatment group than the control group (P< 0.05). (3) According to the full analysis set and per protocol set, the total efficiency rats in the treatment group were both superior to those in the control group (P< 0.001). (4) In the treatment group, there were four cases of surgery, four cases lost to folow-up, and two cases of mild adverse reactions; in the control group, there were six cases of surgery, three cases lost to folow-up, and no adverse reaction. Taken together, smal-needle-knife therapy and physiotherapy both have certain clinical effects on knee osteoarthritis. Smal-needle-knife therapy combined with exercise therapy is superior to physiotherapy combined with exercise therapy in the total efficiency. Folow-up results of 3 months have been confirmed, but long-term effects need further exploration.

Objective To study the effect of euthyrox on blood lipids in patients with hypothyroidism throngh the meta analysis.Methods Patients with clinical hypothyroidism theated by euthyrox on blood lipid effect of randomized controlled trials were retried by Pubmed(2000/2014-07),EMbase (2000/2014-07),the Cochrane library(2014,7),the Chinese biomedical literature database(2000/2014-07),retrieved the time limit from January 2000 to July 2014.The paper were objective evaluated of the quality,Meta analysis with Rev Man 5.3 software system applicated by Cochrane collaboration.Results Euthyrox could significantly reduce cholesterol levels of hypothyroidism patients ,it was statistically significant difference(OR=0.63,95%CI:0.71 ~0.55,P<0.001);Euthyrox could significantly reduce triglyceride levels of hypothyroidism patients,difference was statistically significant(OR =0.29,95%CI:0.34 ~0.25,P <0.001 );Euthyrox could significantly reduce low-density lipoprotein cholesterol levels of hypothyroidism patients,it was statistically significant difference(OR=0.22,95%CI:0.30 ~0.14,P<0.001);euthyrox could obviously increase high-density lipoprotein cholesterol levels, it was statistically significant difference (OR =0.21, 95% CI:0.17 ~0.26, P <0.001 ). Conclusion Euthyrox could significantly reduce total cholesterol,triglyceride,low-density lipoprotein cholesterol(hdl-c)of hypothyroidism patients,and promote the synthesis of high-density lipoprotein cholesterol(hdl-c),could effectively promote the lipid metabolism,reduce blood fat level,prevent the happening of the disease of heart head blood-vessel hypothyroidism patients,have the guide meaning to clinical treatment.

Objective:To evaluate the application value of diffusion tensor imaging (DTI) in guiding the postoperative radiothera-py plan of the gliomas adjacent to the corticospinal tract (CST). Methods:Thirty patients with gliomas adjacent to the CST underwent routine magnetic resonance imaging (MRI) contrast-enhanced scanning and DTI after radiotherapy. Tractography data sets were ac-quired and were fused with the images of corresponding anatomical MRI and computed tomography. The acquired data sets of radio-therapy planning system were imported to assist with the delineation of the target volume, organs at risk, and CST. Two sets of radio-therapy plan, which considered or did not consider the dose protective effect of the CST, were formulated and compared using the treat-ment technique of intensity modulated radiotherapy. Results:The protective radiotherapy and unprotected plans both achieved the thera-peutic dose to the target volume and the protection of the routine organs at risk. In the protective dose (with an optimization program that considered the dose reduction of CST), the maximum and mean radiation doses suffered by the patients' ipsilateral and contra-later-al CSTs were lower compared with the unprotected plan (P<0.05). Conclusion:DTI can identify the location and shape of CSTs, and their relationship with the postoperative radiotherapy target of gliomas. These findings contribute to the formulation of a protective ra-diotherapeutic regimen to keep the CST from the maximum and the mean radiation doses to the largest extent, thereby decreasing the possibility of nerve damage after radiotherapy.

Objective To investigate the diagnostic value of susceptibility weighted imaging (SWI)semiquantitative assessment of pathological vascularity in grading cerebral gliomas.Methods Images of thirty-six patients with gliomas(1 5 low-grade and 21 high-grade gliomas)were obtained before therapy.Standard clinical MR imaging and SWI were performed at GE 3.0T scanner.All SWI postprocessed images were reviewed independently by two neuroradiologists and the number of vessels in tumor region were scored. Tumor were graded according to the World Health Organization classification.Results In 1 5 cases of low-grade glioma,semiquanti-tative assessment of pathological vascularity scored 0 in 6 cases,1 in 9 cases.In 21 cases of high-grade gliomas,semiquantitative as-sessment of pathological vascularity scored 2 in 18 cases,3 in 2 cases,1 in 1 case.There was a statistical significance between low-grade and high-grade gliomas(Z =-5.327,P <0.05).The grade of intratumoral pathological vascularity detected on SWI was asso-ciated with tumor grade.Conclusion It is usefull that SWI semiquantitative assessment of pathlogical vascularity in grading cerebral gliomas between low-grade and high-grade.

It′s reported that RNA-binding proteins ( RBP) play key roles in post-transcriptional regulation of eukaryotic genes.The aberrations of RBP are associated with a large number of human disorders , particularly autoimmune and neuro-logic diseases .The interaction between RNA and proteins has been widely explored since the development of the method known as RNA immunoprecipitation with differential display or microarray analysis (RIP-ChIP) around the year of 2000. Since then, diverse derivatives of the RIP-ChIP, such as ultraviolet crosslinking and immunoprecipitation ( CLIP), high-throughput sequencing of CLIP cDNA library (HITS-CLIP), photoactivatable -ribonucleoside-enhanced crosslinking and immunoprecipitation ( PAR-CLIP) , and individual nucleotide resolution CLIP ( iCLIP ) have been developed .All these methods have some advantages over the original RIP-ChIP and greatly facilitate the study of RBP-RNA interactions .Addi-tionally , aided by the next-generation sequencing , transcriptome-wide identification of RBP target sites has become possible and the RNA-binding site resolution of RBP has also improved to some degree .We introduced the basic principles and processes of the interactions between proteins and RNA , focusing on the advantages , disadvantages and prospect of the present genome-wide version of CLIP .

Objective To investigate effect of trepibutone tablet combined with ursodeoxycholic acid in treatment of patients with gallstone. Methods 200 cases with gallstone were diagnosed and randomly divided into observation group and control group from February 2013 to February 2014.100 cases in control group were given ursodeoxycholic acid treatment 50 mg/(kg? d),two times per day for six month.On the basis of control group observation group were treated with trepibutone one tablet per day,three times per day,4 weeks for 1 course, 2 weeks of treatment interval between 4 courses, totally for four courses.After treatment, patients were followed up and recorded gallbladder wall thickness, gallbladder functional status. Results After 6 months of treatment in patients with gallbladder wall thickness of observation group ( 2.77 ±0.38 ) mm was superior to control group (3.24 ±0.36)mm(P<0.05).After 6 months of treatment in patients with gallbladder function score of observation group (58.75 ±4.79) was better than control group (53.11 ±5.02) ( P<0.05).Recurrence rate of observation group was 9% better than that of control group 18%(χ2 =3.468,P<0.05)after treatment for 6 months.Conclusion Effect of trepibutone tablet combined with ursodeoxycholic acid in treatment of patients with gallstone is well.There is no obvious side effects during the treatment.

Objective To analyze the feasibility of incorporation of tracking visual pathway fiber bundles by diffusion tensor imaging ( DTI) in computed tomography ( CT) simulation to develop a protective radiotherapy regimen for cerebral gliomas.Methods A total of 31 patients with cerebral gliomas who were admitted to our hospital from 2013 to 2015 and planed to receive postoperative radiotherapy were enrolled as subjects.All patients underwent CT simulation, conventional or contrast-enhanced magnetic resonance imaging, and DTI.The obtained DTI images of visual pathway fiber bundles were fused with 3DT1 anatomical scans and then imported into the treatment planning system.A protective treatment plan ( setting the entire visual pathway fiber bundles as organs at risk (OARs)) and a conventional treatment plan were made for intensity-modulated radiotherapy ( IMRT) .Comparison of treatment outcomes was made by paired t test.Results There were no significant differences in the conformity index and heterogeneity index of the planning target volume between the two treatment plans ( P=0.875,0.597), both of which had sufficient radiation doses to the target volume and conventional OARs protected.For the patients undergoing the protective treatment plan, the Dmax and Dmean values were reduced to 9.01%and 9.05%, respectively, in the ipsilateral optic tract and to 17.96%and 15.52%, respectively, in the contralateral optic tract;the Dmax and Dmean values were reduced to 5.37%and 5.48%(P=0.000), respectively, in the ipsilateral optic radiation tract and to 12.89%and 11.21%( P=0.000) , respectively, in the contralateral optic radiation tract.Conclusions The protective treatment plan based on CT simulation combined with the display of visual pathway fiber bundles by DTI can reduce the radiation dose to the entire visual pathway fiber bundles, which keeps the risk of visual dysfunction after radiotherapy as low as possible.

Objective To design and construct a new non-fusion soluble expression vector pTIG-mSUMO(small ubiq-uitin-related modifier) using the widely used solubility promoting protein SUMO and based on the translational coupling phenomenon in order to enable the non-fusion soluble expression of the broad-spectrum antiviral protein RA in Escherichia coli by pTIG-mSUMO.Methods The smt3 gene coding for SUMO protein was cloned from yeast genome DNA by PCR. After directed-site silent mutation to eliminate the EcoRⅠsite, the mutant mSUMO was inserted into pET-22b to obtain the translational coupling expression vector pTIG-mSUMO.The RA was subject to PCR amplification and cloned into the pTIG-mSUMO to obtain the expression plasmid pTIG-mSUMO/RA which was supposed to direct the soluble expression of RA by the translational coupling with mSUMO.Results A translational coupling expression vector pTIG-mSUMO which could di-rect/drive the SUMO and heterogonous protein non-fusion expression simultaneously was designed and constructed.The Western blotting result indicated that pTIG-mSUMO could direct the high-level expression of RA, around 40%of which was soluble.Conclusion A translational coupling expression vector pTIG-mSUMO is obtained.After coupling with SUMO, RA is highly expressed in E.coli and both the expression level and solubility are greatly improved.pTIG-mSUMO might contrib-ute to soluble expression of other proteins.