The directed molecular evolution of enzyme in vitro can not only improve the efficiency of evolution, but also evolve enzyme according to the investigator's desire. This review summed up the feasible methods of this novel technique.

Objective To assess the value of intra-aortic balloon pump (IABP) support in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) undergoing percutaneous coronary intervention (PCI). Methods The clinical data of 41 patients with AMI complicated by CS receiving emergency PCI with IABP support were retrospectively reviewed, and 47 patients receiving emergency PCI without IABP support at the same time were included as the control group. Left ventricular function was evaluated in the 2 groups at 2 weeks and at 3 months after the operation respectively. The incidence of MACE was compared between the 2 groups at 30 days and also at 3 months after the operation. Results Patients receiving IABP support had greater improvement in left ventricular function at 2-week and 3-month after operation (43.8?8.2% vs 39.4?5.9%, 45.5?6.6 vs 40.6?4.6%, both P

BACKGROUND:Cuttlebone/racemic polylactic acid composite artificial bone has been prepared in the previous studies to improve the incomplete degradation of cuttlebone. OBJECTIVE:To observe the degradation and biocompatibility of cuttlebone/racemic polylactic acid composite artificial bone in animals. METHODS:Thirty healthy New Zealand white rabbits were randomly divided into four groups. Models of right radial defects were prepared in rabbits, and model rabbits were subjected to implantation of cuttlebone/racemic polylactic acid composite artificial bone into the defects and muscular sac between the radial lateralis muscle and rectus (experimental group), implantation of cuttlebone into the defects and muscular sac between the radial lateralis muscle and rectus (control group 1), implantation of racemic polylactic acid into the defects and muscular sac between the radial lateralis muscle and rectus (control group 2), or no treatment (blank control group), respectively. At 2, 4, 8 weeks after operation, X-ray and histological examinations were performed in the four groups. RESULTS AND CONCLUSION:(1) Compared with the other three groups, the bone mineral density of the experimental group was significantly higher at 4 and 8 weeks after material implantation into the defects (P < 0.05), and moreover, the bone mineral apposition rate of the experimental group was significantly higher at different time after operation (P< 0.05). At 8 weeks after operation, the bone tissues in the experimental group grew from the both ends to the center to form multiple bone island-like structures, with less residual materials, and the marrow cavity and implanting material were in a traffic manner; in the control group 1, there were many residual materials, and no intercommunication was found between the marrow cavity and implant material. (2) At 2 weeks after material implantation into the muscle capsule, there were more inflammatory cels, but the inflammation relieved at 4 weeks and disappeared basicaly at 8 weeks, and the material was degraded partialy. These findings indicate that the cuttlebone/racemic polylactic acid composite artificial bone is a kind of good bone substitute material that has good biocompatibility and degradability.

Adenoma ; Adult ; Ear Neoplasms ; Ear, Middle ; pathology ; Humans ; Male

AIM: To investigate the role of retinal pigment epithelium (RPE) in the growth of Müller cells using a co-culture system in vitro . METHODS: Müller cells were cocultured with RPE cells under both normoxic and hypoxic conditions in Transwell chamber culture system. Müller cell proliferation was evaluated by MTT assay. The number of cells which migrate through micropores and stay on the outer bottom side of insert systems were observed and counted. RESULTS: The activities of proliferation and migration of Müller cells when cocultured with RPE cells were significantly higher than those of the Müller cells when cultured alone at all time points under both normoxic and hypoxic conditions. However, for both the coculture and control groups, there is no significant difference between the measurements at 3 and 6 hours. CONCLUSION: Evidence suggests that RPE, when co-cultured with Müller cells, can stimulate migration and proliferation of Müller cells under both hypoxic and normoxic conditions in a time-dependent manner; how-ever, there is no evidence to support the synergetic interaction of RPE and Müller cells co-cultured under hypoxic conditions.

Objective To investigate the significance of Dezocine combining Fentanyl used for postoperative PCIA in breast cancer patients.Methods One hundred and twenty six patients with ASA Ⅰ-Ⅲ entered the study.All patients were scheduled for breast cancer operation under intravenous analgesia with tube insertion and treated with PCIA after the operation.They were randomly divided into Fentanyl group (n =63) and Dezocine combining Fentanyl group(n =63).VAS,Ramsay,BCS in two groups were compared al 12 h,24 h,48 h after operation.Side effect was also detected.The changes of T cell subset and IL-2 were analyzed in the patients respectively at the first day before operation,at the first day after operation,at the seventh day after operation.Results At every time point,VAS in research group was significantly lower than that in control group(P ＜ 0.05).However,Ramsay in research group was obviously higher than that in control group(P ＜0,05).There were no significant differences in BCS between two groups (P ＞ 0.05).And no difference was found in the incidence of side effect between two groups (P ＞ 0.05).Compared with control group,the changes of T cell subset,IL-2 had no significant differences in research group at the first day after operation and at the first day before operation (P ＞ 0.05).At the seventh day after operation,the levels of CD4 +,CD4 +/CD8 +,IL-2 in research group were obviously higher than those in control group (P ＜ 0.05).However,the percentage of CD8 + T cells in research group was significantly lower than that in control group (P ＜ 0.05).Conclusions Dezocine combining Fentanyl in PCIA can increase analgesia effect with less side effect.It is positive to improve immunologic function for breast carcinoma patients after operation.

To give the considerations on the syndrome differentiation and acupuncture treatment of diabetic peripheral neuropathy, generalize its pathogenesis and summarize treatment rules, this paper reviews and analyzed 52 articles on acupuncture treatment in recent years. It is believed that diabetic peripheral neuropathy is rooted from qi-yin deficiency and presented with blood stasis and collateral obstruction; many organs are affected, the liver, kidney,spleen and stomach in particular; the treatment principle concentrates on unblocking collaterals and regulating organs; treatment centers on limb acupoints, Back-Shu point and Front-Mu point;acupuncture treatment should be adopted early as possible and its clinical efficacy is rather good.

Objective To evaluate the efficacy and safety of InVance bulbourethral sling for stress urinary incontinence after radical prostatectomy.Methods Six male patients with stress urinary incontinence after radical prostatectomy were treated with perineal sling (InVance) from March 2005 to March 2011,and the clinical data were analyzed.Results The operation time was 80-120 min and intra-operative blood loss was 20-50 ml.The catheter was removed at the second day after surgery.In a follow-up of 12 to 29 months,4 patients were dry,1 patient was improved,and 1 patient suffered treatment failure.There were 2 patients transient acute urinary retention and 1 patient short-term perineal pain in the main post-operative complication.In six months after the operation,urodynamic examination showed (15.9 ± 7.7) ml/s at Qmax and 0-20 ml/s at postvoid residual.Conclusion InVance bulbourethral sling for the treatment of stress urinary incontinence after radical prostatectomy appears to be safe,simple in the procedure and good effect to mild and middle incontinence.

Administration, Inhalation ; Adrenergic beta-Agonists ; adverse effects ; Child ; Extremities ; Humans ; Male ; Paralysis ; chemically induced ; Terbutaline ; administration & dosage ; adverse effects

Objective To study the diagnostic value of double-balloon endoscopy (DBE) and capsule endoscopy (CE) for small intestinal bleeding. Methods Overall detection rates of small intestinal bleeding with DBE, CE and the whole alimentary tract barium meal were compared. Positive rates of bleeding detection with DBE and CE were compared within the same patients. Influence of CE on one-procedure rate of DBE was analyzed. Results In 105 cases of small intestine bleeding, DBE detected 24 cases of Crohn's disease, 15 adenocarcinoma, 12 chronic nonspecific inflammation, 10 small intestinal ulcer of unknown reason, 8 entero-mesenchymoma, 8 polypus, 6 vascular deformation hemorrhage, 5 ancylostomiasis, 5 Mechel's diverticula ( including multiple diverticula), 3 lymphoma and 9 of no evident abnormalities. The positive detection rate of DBE is 91.4% (96/105). Disease detection rates of CE and whole alimentary tract barium meal were 75.0% (30/40) and 33.3% (25/75), respectively. The one-procedure rate of DBE is 90% (36/40) based on CE results, but it was only 69. 2% (45/65) according to clinic features and the whole alimentary tract barium meal. Conclusion The main causes of small intestinal bleeding are benign ulcers (including Crohn's disease) and tumor, as well as chronic inflammation. Polyps, vascular deformation, parasitosis, Mechel's diverticulum and lymphoma are the secondary causes.DBE is superior to CE in diagnosis of small intestine bleeding, but CE can increase the one-procedure rate of DBE.