Objective The aim of this study was to analyze the influence of combined therapy with L-carnitine and erythropoietin on renal anemia and nutritional status in patients treated with maintenance hemodialysis.Methods The combination of computer and manual searches were used.A Meta analysis was made regarding the effect of combined therapy with L-carnitine and erythropoietin on the improvement of renal anemia and nutritional status in patients treated with maintenance hemodialysis.The quality of the 9 studies was evaluated with the Jadad score.Statistical analysis was carried out by RevMan 5.0.Results A total of 428 patients in 9 reports were analyzed.Metaanalysis showed that there were significant improvement in hemoglobin (Hb) [WMD =9.21,95％ CI (7.69 ～10.73)] and hematocrit (Hct) [WMD =2.61,95％ CI (2.28 ～ 2.93)],albumin (ALB) [WMD =1.64,95％ CI (1.04 ～ 2.24)] and total protein (TP) [WMD =2.72,95 ％ CI (0.67 ～ 4.77)] in the treatment group compared with the control group.The level of erythropoietin dosage [WMD =-38.24,95％ CI (-76.87 ～ 0.39)] was decreased significantly.But there were no significant differences in triglyceride and serum phosphorus.Conclusion Combined therapy with L-carnitine and erythropoietin in patients treated with maintenance hemodialysis leads to significant improvement of renal anemia and nutritional status.

In this paper, the function of the iel gene from baculovirus Spodoptera exigua multiple nucleopolyhedrovirus (SeMNPV), belonging to group Ⅱ nucleopolyhedrovirus, was studied in mammalian cells.We amplified the SeMNPV ie1 gene and expressed it by fusing to the C terminal of enhanced GFP protein in HEK 293 cells. Confocal microscopy revealed that the IE1-GFP fusion protein was localized in the nucleus of the mammalian cells. The promoter sequences of AcMNPV gp64, SeMNPV F protein and Drosophila hsp70 were also analyzed, to further study the function of SeMNPV IE1. The results showed that, in the absence of the hr sequence, IE1 improved the expression of the F promoter but didn't influence the gp64 promoter significantly, but IE1 moderately stimulated the hsp70 promoter.

Objective To explore the safety, feasibility, and techniques of hand-assisted laparoscopic splenectomy (HSLS) for massive splenomegaly. Methods Between January 2005 and December 2006, 40 patients with massive splenomegaly owning to portal hypertension were treated with HSLS or open splenectomy (OS). The two groups were comparable in age, sex, hepatic function by Child classification, and size of the spleen. Results No serious complications occurred in both the groups. Compared with the OS group, patients in the HALS group had more blood loss [ (312?61) ml vs (235?105) ml, t=2.583, P=0.014], longer operation time [(95?20) min vs (73?16) min, t=3.832, P=0.000], earlier recovery of intestinal function [(48?1) h vs (98?1) h, t=-153.093, P=0.000], and shorter postoperative hospital stay [(6?2) d vs (10?2) d, t=-6.124, P=0.000]. Conclusions HSLS is feasible and safe for patients with massive splenomegaly. Despite a longer operation time, the procedure is superior in postoperative recovery.

Objective To investigate the interaction of human testis sperm-associated antigen 4 like(SPAG4L) protein containing Sad,UNC-84(SUN) domain with nuclear envelop spectrin repeat proteins 3 (Nesprin-3) containing Klarsicht,ANC-1 and Syne homology (KASH) domain.Methods SPAC-4L protein domains were analyzed with the bioinformatics method.After the SPAG4L plasmid was transfected into Ntera-2 cells,the subcellular localization of SPAG4L was observed.The interaction of SPAG4L with Nesprin-3 was determined by immunofluorescence,co-immunoprecipitation(co-IP) and bimolecular fluorescence complementation (BiFC) technology,respectively.Results Bioinformatics analysis results showed that there was a transmembrane structure in SPAG4L protein.Subcellular localization results demonstrated that SPAG4L protein located in the nuclear membrane and cytoplasm.Immunofluorescence,Co-IP,and BiFC results showed that there was an interaction between SPAG4L and Nesprin-3,and that a LINC(linkers of the nucleoskeleton to the cytoskeletan) complex was formed.Conclusion SPAG4L may interact with Nesprin-3 to form a LINC complex,which is important for understanding the function of SPAG4L protein in spermatogenesis.

Objective To explore clinical features and antimicrobial resistance of Klebsiella pneumoniae (K.pneumoniae) lower respiratory tract infection(LRTI) in children.Methods Clinical data of 107 children with K.pneumoniae LRTI confirmed by sputum culture from January to December 2015 were analyzed retrospectively.Results 62.62% of children with LRTI were aged less than 6 months and 64.49% episodes occurred in autumn and winter.All cases had cough and 39 had fever, the main complications were type I respiratory failure, type Ⅱ respiratory failure, cardiac insufficiency, and electrolyte disturbance, 39 cases(36.45%) had complications involving two systems, 5 cases(4.67%)had complications involving three systems,47 cases (43.93%) met the diagnostic criteria of severe pneumonia.43 cases (40.19%) had primary underlying diseases, the major were congenital heart disease, preterm and low birth weight, and malnutrition.Children with imipenem-resistant bacteria infection were more prone to develop extrapulmonary complications than those with non-resistant pathogenic infection.The resistance rate of K.pneumoniae to amikacin was the lowest(9.35%).90 cases were recovered and markedly effective, 11 cases were effective, 4 cases were not healed and voluntarily discharged from hospital, and 2 cases died.Conclusion Children aged less than 6 months and with underlying diseases are prone to develop LRTI, and complications are more.

Objective To evaluate the surgical technique of titanium miniplates in reconstruction of laminar roof after a posterior approach in intraspinal tumor surgery. Methods From August, 2007 to March, 2009, 11patients underwent intraspinal tumor surgery with osteotomy and reconstruction of laminar roof, titanium miniplates were used for fixing in the re-implantation. There were 2 intramedullary tumors,9 extramedullary tumors. The target of surgery was the cervical spine in 2 cases, the cervicothoracic spine in 4 cases, the thoracic spine in 2 cases, the thoracolumbar spine in 2 cases, and the lumbar spine in 1 cases. The patitens were followed up for 6 months to 2years. Local pain,bony healing and spinal malformation were assessed. Results In the 11 patients, there was no case of dural, nerve root, or spinal cord injury due to laminar roof reconstruction. One patient complained of moderate to severe local pain during follow-up and 2 patients complained of occasional slight pain at the surgical site. No limitation of activity occurred. Bony healing was confirmed radiologically or CT scan in 9 patients. There were no patients demonstrated a new spinal malalignment, and no patients developed stenosis of the spinal canal. Conclusions The reconstruction of the laminar roof using titanium miniplates will benefit the recovery of normal structure of spine,and maintain the stability of spine,and avoid the occurrence of stenosis of the spinal canal.

Objective Through investigating the current situation of first national Standardized Medical Resident Training Bases construction in Xinjiang to provide the basis for the administrative department of public health to improve their resident training bases.Methods Selecting standardized training related personnel 133 people of 20 base hospital to conduct a questionnaire survey,and selecting the base hospit.al leaders,the management staff of functional departments,teachers and residents,a total of 254 people were given in-depth interviews.We conducted data collection mainly around the basic situation of the base hospitals and departments,to understand the basic situation,difficulties and problems of the standardized training of resident doctors in the base hospitals,and suggestions and opinions on the training work.We used x2 test,Wilcoxon rank test to make statistical analysis.Results Basic conditions of the hospital was not balanced,70％ of the base hospital library number was 10 thousand ～5 million,75％ of the base hospital computer had a volume of less than or equal to 30.There was statistical significance in the difference of the rate of operation between the cases and the skills in the southem/northeru region teaching/non professional teaching base hospital.Teacher level was not balanced,and only 5 hospital teacher training rate was greater than or equal to 80％,which met the national requirements.Enrollment of each department had a rising trend,including the department of pediatrics,psychiatry and other major shortage of profes-sional year by year,the increase in the proportion of 1 ～2 times.National financial aid was implemented,but lacked local financial input.Conclusion The balanced development of base construction,the continuous improvement of system construction and organization management,the improvement of the teachers' teaching and training quality,the improvement of the resident treatment and striving for more national and local financial allocation will be the focus of the construction and development of Xinjiang resident standardized training base.

Objective:To investigate the changes and clinical implications of serum procalcitonin in exacerbation of chronic obstructive pulmonary disease(COPD).Methods:We have evaluated PCT measurement in 45 patients with an exacerbation of COPD(group A) and 25 patients with stable COPD(group B),quantitative sputum culture was performed,too.PPMs were only regarded as significant if they reached a growth of ≥10~7cfu/mL,indicating the presence of bacterial infection.Results:In patients with an exacerbation,15 patients,sputum yielded a high(≥10~7cfu/mL) bacterial load(group A_1),30 patients,sputum yielded a low(0.05).Using a cut-off point of 0.155?g/L for PCT,the sensitivities and specificities for bacterial infection in patients with an exacerbation of COPD were 93.3% and 60% respectively.Conclusion: Serum procalcitonin measurements in patients of an exacerbation of chronic obstructive pulmonary disease play a role in the diagnosis of bacterial infection.

Hepatocellular carcinoma is one of the largest causes of cancer-related deaths worldwide for which there are very limited effective treatment options.The ubiquitin-proteasome pathway(UPP) has rapidly become acknowledged as both critical mechanism for cellular biological function and a latent target of regulation of cancer-related disease.This review focus on the role of ubiquitin-proteasome pathway in hepatocellular carcinoma and its correlation factors(HBV、P27、NF-?B,et al),in order to find novel therapeutic interventions against the genesis and development of hepatocellular carcinoma.

Objective To explore the etiology of lumbar degenerative spondylolisthesis(DS)by analyzing its CT manifestations.Methods The location,degree and angle of inclination of lumbar facet joints were measured in 125 cases with 131 spondylolisthesis.Results The angle of inclination of lumbar facet joints was