[Objective]To discuss the indication and attentive affairs among single and combined surgical treatments for spastic cerebral palsy by analyzing the therapeutic efficacy of different operations,such as lengthening tendon,osteotomy and neurectomy,etc.[Method]Six hundred and forty-two patients(aged 10 months to 37 years)were treated with combined operations of different operations,including traditional operations on soft tissue release,osteotomy,selective posterior rhizotomy,selective rhizotomy and converse anastomosis,neurectomy,etc.The follow-up period ranged from 6 months to 4 years(mean 18 months).[Result]The traditional soft tissue release and lengthening was still the major surgical treatment to cerebral palsy.It resulted on rectifying fixed contracure and deformity,although could not decrease muscular tension.The decisive processes lied on neurectomy.Though the selective posterior rhizotomy and selective peripheral neurectomy reduced muscular strength partially in the early stage,the muscular tension was also reduced,therefore the range of motion of joints was enlarged and the functions of extremities were strengthened.[Conclusion]Classifying the types of cerebral palsy carefully,mastering the indications of all sorts of surgical treatment strictly,realizing the latent complications of different operations,combining different processes of surgical treatment can enhance therapeutic efficacy,reduce recurrence of convulsion and malformed,as well as avoiding serious complications during therapy.In addition,postoperative exercise is also the basic treatment to spastic cerebral palsy.

Objective: To study the biotransformation of Poria cocos by Ganoderma lucidum and the changes of total polysaccharide and total triterpenes contents of the biotransformation products. Method: The experiment uses the microwave method to extract and sulfuric acid-phenol method to measure total polysaccharide content. And the ultrasonic wave method was used to extract total triterpenes and the content was measured by vanillin-perchloric method. Result: After treatment by G. lucidum, the total polysaccharide and triterpenes content of the biotransformation products were significantly higher than the non-conversed P. cocos (P<0.01), showing that the original performance of P. cocos was changed by way of biotransformation of G. lucidum; P. cocos had a promotion effect on the growth of G. lucidum. Conclusion: Biotransformation of P. cocos for Increasing the total polysaccharide and triterpenes contents by using G. lucidum has advantages of simple, low cost and so on. This method has a certain application value in modernization of Chinese traditional medicine.

Objective To investigate the the treatment of class Ⅲ malocclusion by orthognathic surgery combined with postoperative orthodontics.Methods Nine patients with skeletal class Ⅲ malocclusion were treated by surgery-first approach without pre-surgical orthodontic from January 2012 to August 2014.The studied sample consisted of 7 women and 2 men (aged 15-28 years old, mean age 19.7 years), who had obvious mandibular protrusion.2 to 3 days after surgery, intermaxillary traction was used to made the maxilla and mandible together by board;we replaced a rubber band every 2 to 3 days and lasted for four weeks.We would dismantle board and performed conventional orthodontic treatment after patient's facial swelling subsided, and the positional relationship between the jaw stabilized.Results The face type of 9 patients were greatly improved after orthodontic treatment for 6.5 to 19.5 months.Patients and their family members felt satisfied, and their occlusal function returned to normal.At 3 to 32 months follow-up, the postoperative appearance and occlusion were becoming good without obvious signs of recurrence.Conclusions The surgery-first approach is an effective method to treat skeletal class Ⅲ malocclusion.

Objective To study the relationship between genotypes and phenotypes,geographical distribution,and the sites of infection of Trichophyton rubrum(T.rubrum).Methods The genotypes were determined by Southern blotting with a probe amplified from the small-subunit rDNA and adjacent internal transcribed spacer(ITS)regions.The phenotypes of T.rubrum were determined by conventional method.Results Twenty genotypes(DNA type A to T)and5phenotypes(villous,furrowed,granular,powdery,and woolly)were recognized among49strains of T.rubrum.Genotype A prevailed in all phenotypes except granu-lar type.Type B represented the most common genotype among the strains of villous type and furrowed type.Type A took the first place in powdery type and woolly type.All of the type A strains were from Dalian.Seven of9type B strains were from Nanjing.Six type C strains were all from Nanjing.The majority strains of21strains isolated from tinea unguium were type C,most of the16strains isolated from tinea cruris and tinea corporis were type A,8strains from tinea pedis were type B,and4strains from tinea capitis were type C.Conclusion There are certain possible relationships between genotypes and phenotypes,geographical distri-bution and sites of infection of T.rubrum.

BACKGROUND: Several studies have demonstrated that bone marrow mcscnchymal stem cells (MSCs) can differentiate into osteoblasts after induction of bone morphogenetic protein (BMP).OBJECTIVE: This study was designed to compare the osteogenetic effects between MSCs, bBMP, and fibrin gel alone and their composite.DESIGN: A controlled observation experiment.SETTING: Second People's Hospital of Guangdong Province and Second Hospital Affiliated to Sun Yat-sen University.MATERIALS: This study was performed at the Second Hospital Affiliated to Sun Yat-sen University between January 2004 and June 2006. Healthy New Zealand rabbits were provided by the Laboratory Animal Center, Sun Yat-sen University.METHODS: Bone marrow was taken from the lilac bone. By density gradient centrifugation, autologous MSCs were in vitro cultured and amplified. A composite was made of fibrin gel and bovine bone morphogenetic protein (bBMP). After adding MSCs, another composite was made. Twelve rabbits underwent lumbar L3/4, LA/5, and LS/6 discectomy and interbody fusion via an anterior retroperitoneal approach. Three fusion sites in each animal were randomly assigned into three of four treatments: composite of MSCs and hBMP and fibrin gel (group A), composite of MSCs and fibrin gel (group B), composite of bBMP and fibrin gel (group C) and fibrin gel alone (group D). The interbodies were observed radiologically and histologically 3 months after surgery.MAIN OUTCOME MEASURES: Bone formation in the spinal interveRebral space of rabbits.RESULTS: Twelve weeks after surgery, bone formation was appasenfly greater in the Group A than in the other groups.Histological findings revealed continuous bone formation. The groups B and C showed equivalent radiological and histological changes. Bone formation was intermittent. Group D had fibrous union, but no bone formation. No residual fibrin gel was found in all groups, but a small amount of residual nucleus gelatinosus with a little cartilaginous tissue was visible in the intervertebral disc.X-ray examination results did not reveal vertebral posterior hyperplasia or spinal stenosis. There was significant difference in range of lumbar motion between the group B and the groups C and D (P ＜ 0.05). No pronounced difference in vertebral posterior height loss existed among the groups.CONCLUSION: The composite of MSCs, fibrin gel and bBMP can promote bone regeneration and achieve osseous spinal fusion.

OBJECTIVE To study the antitumor activity and underlying mechanisms of Xiaoaiping injection(Xap)combined with gefitinib(Gef)in nude mice bearing resistant non-small cell lung cancer (NSCLC) cells H460 or H975. METHODS BALB/c nude mice were inoculated with human NSLCL cells H460 or H1975 and the drug treatment did not start until the tumor volume reached 50-100 mm3. The tumor bearing mice were divided into four groups:control group,Xap group(5 g · kg-1,ip),Gef group (50 mg · kg-1,ig),and Xap plus Gef group. All the administration lasted for 21 d continuous. Tumor volumes were measured two or three times per week,and the body weight of animals was re-corded. At the end of the test,tumors were weighed after the sacrifice of mice. Tumor inhibition rate and relative tumor proliferation rate were calculated based on tumor weight and tumor volume. The related biomarkers and proteins in tumor tissues were detected by immunohistochemistry and Western blot assay, respectively. RESULTS Compared with the control group,no significant effect was observed on the growth of H460 and H1975 xenografts in groups of Xap or Gef alone in nude mice. However,the two-drug combination significantly suppressed tumor volume,with (1103 ± 340) versus (3020 ± 450) mm3 for H460 and(487 ± 153)versus(1269 ± 161)mm3 for H1975,respectively(P<0.05). The combined Xap and Gef application also significantly reduced the tumor weight,with(1.20±0.52)versus(2.78± 0.93)g for H460 and(0.52 ± 0.32)versus(0.92 ± 0.42)g for H1975,respectively(P<0.05). The relative tumor proliferation rate and inhibition rate in the combination group was 42.1%and 43.5%for H460(P<0.01),43.0%and 52.5% for H1975(P<0.01). Compared with Xap and Gef drug alone,their combination showed significant difference in reducing tumor weight,suppressing tumor proliferation rate and increasing tumor inhibition rate(P<0.05). Immunohistochemistry results showed that each drug alone had no effect on tumor angiogenesis markers of vascular endothelial growth factor(VEGF)and CD105 expression,or on drug resistance related proteins of p-ERK,p-Akt and p-mTOR,whereas the combination of Xap and Gef obviously reduced the expression of these biomarkers in H460 and H1975 tumor tissues. The decreased drug resistance related proteins of p-PI3K and its downstream molecules p-Akt,p-ERK and p-mTOR by the two-drug combination were also confirmed by Western blot results(P<0.01,compared with control), and showed significant difference compared with each single treatment(P<0.05). CONCLUSION The addition of Xap significantly improves the antitumor activity of Gef in H460 and H1975 xenografts,and this synergistic effect may be ascribed to the inhibition of tumor angiogenesis,the down-regulation of PI3K and its downstream signaling molecules which are associated with drug resistance.

Objective To summarize and explore the clinical value of selective partial neurotomy of muscular branch of triceps in the treatment of spastic talipes equines.Methods Forty-two cases were included in our study from Aug.2000 to Des.2007,all these cases accepted the operation of selective partial neurotomy muscular branch of triceps.In this study,29 cases were male,13 cases were female.Muscle force of legs,muscular tension,pathologic reflex,gesture and function of legs after operation were compared with that of before operation.Results The mean fallow-up was 18 months.During the fallow-up of this study,muscular tension degraded,the function of ankle joints and the gesture of extremitas inferior were improved obviously.The effective power was about 90% after 12 months follow-up.Conclusions Selective partial neurotomy of muscular branch of triceps is a effective method for the treatment of spastic talipes equines.The operation procedure is simple and effective,and could be generalized in the primary level hospital.

OBJECTIVE:To investigate the utilization of aspirin in patients with type 2 diabetes mellitus.METHODS:The utilization of aspirin in 510 inpatients with type 2 diabetes mellitus in the department of Endocrinology in our hospital from April 2004 to April 2007 was analyzed retrospectively.RESULTS:Of the total 510 cases,68.2% received aspirin,with daily dose reached 50～100mg.Aspirin was more often used in patients complicated with coronary heart disease and hypertension(P

Objectives: To establish an effective method to isolate germinal vesicle frommammalian oocyte and make the isolated germinal vesicle undergo meiotic resumptionin vitro. Methods: The germinal vesicles were isolated from oocytes directly througha physical method by drawing oocyte in and out of fine-bore pipette.The isolatedgerminal vesicles were cultured in cell-free system which was prepared from the celllysate of synchronized HeLa cells.DNA fluorescence dye Hoechest 33342 was used tomonitor the condensation of chromatin during germinal vesicle breakdown. Results:The cell lysate of metaphase HeLa cell induced chromatin condensation while the cellextract of early G2 phase could not. Conclusions: The germinal vesicle can beisolated successfully in such a physical method and it can undergo chromatincondensation in vitro just as the oocyte does in vivo. Natl J Androl,2001,7(2):79～83

Objective:To systematically review the characteristics of sleep patterns in the elderly with subjective cognitive decline (SCD) and the relationship between subjective cognitive decline and sleep disorders.Methods:Observational studies on sleep patterns in the elderly with SCD were retrieved by computer in Chinese and English databases such as PubMed, Embase, Web of Science, ScienceDirect, China National Knowledge Infrastructure (CNKI) , WanFang Data and VIP, and the retrieval time was from the establishment of the database to March 31, 2020. Two researchers independently conducted article screening, data extraction and quality evaluation according to the standard. The random-effects model was used for Meta-synthesis of studies with data that could be pooled, and descriptive analysis for studies that could not be pooled.Results:A total of 12 articles were included, with a total sample size of 67 474 cases. The prevalence of SCD in the elderly was 25.9% (95% CI: 6.4%-52.5%) . The sleep patterns of the elderly with SCD were characterized by decreased total sleep time, prolonged wake-time after sleep onset, and frequent awakenings at night. Compared with the normal elderly, the elderly with SCD had a higher risk of poor sleep quality, insomnia and excessive daytime sleepiness ( OR=2.1, 1.15, 2.6) , and excessive daytime sleepiness (ESD) increased the risk of SCD in the elderly ( OR=6.06) . Conclusions:Compared with the normal elderly, the overall sleep quality of the elderly with SCD is poor, and sleep disorders can increase the risk of SCD in the elderly. Existing studies have differences in the diagnostic criteria of SCD, and future studies need to further confirm the causal relationship between SCD and sleep disorders in the elderly.