Objective: To develop a molecular screening test for genetic defects on hearing loss related genes has significant impacts on early identification of hereditary hearing loss and genetic susceptibility to aminoglycoside ototoxicity. Early identification of pre-lingual hearing loss is very important for patient's language development, academic achievement, and social skill. Two common mutations, the 235delC in GJB2 gene and the mutation A1555G in mitochondrial DNA, are included in the newly developed screening panel for Chinese population. Methods: A molecular genetic assay, based on fluorescent labeled multiplex PCR and automatic DNA fragment analyzing techniques, was developed to detect both mutations simultaneously. Results: This assay was able to detect both mutations from patient's samples, and pooled DNA tests, as well as suitable to detect mutation from the DNA extracted from dried blood spot and buccal swab. Conclusion: This assay could be a useful tool for newborn screening and carrier screening for the hereditary hearing loss for the Chinese population.

Objective To investigate the changes of androgen receptor (AR) and AR mRNA of the ventral lobe, lateral lobe part 1(LP1) and lateral lobe part 2 (LP2) in the Wistar rat prostate after androgen manipulation. Methods Healthy adult male Wistar rats were randomly divided into 3 groups: control group(N), castration group(C) and androgen replacement group (T). In castration group, orchiectomy was performed through the scrotum. In androgen replacement group, testosterone propionate (2 5 mg/d) was injected subcutaneously for 14 d after castration. Expressions of AR and AR mRNA in the separate lobes of the adult Wistar rat prostate after androgen ablation and replacement were determined by immunohistochemistry and semi quantitative PCR. Results Different autoregulation of AR protein and mRNA was observed in the ventral lobe, LP1 and LP2 of rat prostate after androgen manipulation. In the ventral lobe and LP1, immunoreactive nuclear AR markedly decreased in staining intensity in the glandular epithelium 2 d after castration compared to that in the intact rats. Epithelial immunostaining continued to decline and was absent at day 7 and returned to normal level 3 d after testosterone replacement. There was a transient increase in AR mRNA demonstrated by RT PCR within 3 d and returned to control level within 7 d after castration in the ventral lobe and LP1 of rat prostate. In contrast, in LP2, the epithelial cells showed continued expressions of both AR protein and mRNA 14 d following androgen withdrawal. Conclusion These results suggest that there might be a different regulation of AR mediated by androgen in ventral lobe, LP1 and LP2 of rat prostate.

Objective To establish three-dimensional (3D) simulation model of acetabular fracture based on Letournel-Judet classification and analyze its significance. Methods Pelvis of one healthy female volunteer was scanned with 16 slice spiral CT. Dicom format data were processed by software Mimics 10.01 to reconstruct 3D model of hip bone. Different fracture types were simulated based on Letournel-Judet classification of acetabular fracture. The fracture fragments were displayed with different color. Screen-captures of fracture model from different directions were saved and video mode of fracture model was exported. Five orthopedic doctors and 10 medical students were employed to compare 3D fracture model with two-dimensional planar schematic diagram and made preliminary evaluation. Results The 3D simulation model of acetabular fracture had realistic form and stereoscopic sense, with satisfactory visual effect. The fracture could be observed and charted from optional direction and angle. Fracture model could rotate for 360° in the corresponding video mode. Four orthopedic doctors and nine medical students considered that 3D simulation model of acetabular fracture was helpful for understanding fracture classification. Conclusion The 3D simulation model of acetabular fracture is intuitive, realistic and dynamic and is helpful for clinical work and medical teaching.

Objective: To investigate the vascular anatomy of the stomach, especially the right gastroepiploic artery for the reconstruc-tion of a gastric tube during esophagectomy. Methods: The vascular anatomy of the stomach was studiing in 28 embalmed human specimens provided by the Department of Anatomy, Shanghai Medical College, Fudan University, included 10 female and 18 male spec-imens. The length and diameter of gastric vessels were measured. The ratio of the length of the right gastroepiploic artery to the length of the greater curvature was calculated. Anastomosis between the left and right gastroepiploic arteries was also assessed. Re-sults: Twenty-five left gastric arteries were observed in the autopsies, with the mean diameter of 3.40 (2.10-6.40) mm. Twenty-one right gastric arteries were measured, with the mean diameter of 1.97 (0.68-3.56) mm. Twenty-six left gastroepiploic arteries were ob-served, with the mean diameter of 1.87 (0.80-2.96) mm. Twenty-eight right gastroepiploic arteries were measured, with the mean di-ameter of 2.82 (1.58-4.80) mm. The mean lengths of the 28 right gastroepiploic arteries and their greater curvatures were 216.71 (120-318) mm and 356.39 (248-487) mm, respectively. The ratio of the length of right gastroepiploic arteries and greater curvatures was 0.61 (0.45-0.82). The anastomosis between the left and right gastroepiploic arteries was observed in 60.7% (17/28) of the specimens. Conclusions: The length and diameter of gastric vessels were calculated. It was assumed that the right gastroepiploic artery provides an average of 61% of the blood supply for the great curvature. In addition, the anastomotic branch of the right and left gastroepiploic arteries was observed in 60.7% specimens. These anatomical data allow surgeons to estimate the blood supply and to choose an opti-mal method of gastric tube reconstruction during esophagectomy.

Luminal breast cancer is the most common subtype of breast cancer, representing more than 60% of all breast cancers. Endocrine resistance and late recurrence are two challenges in the treatment of luminal breast cancer. To overcome endocrine resistance in multiple levels, high-dose-fulvestrant can inhibit estrogen-receptor (ER)-dependent pathways, while targeted drugs can block ER-independent pathways.To reduce the risk of late recurrence in luminal breast cancer, recurrence prediction model should be formed. For patients with high risk of late recurrence, extended endocrine therapy, combination of ovarian function suppression (OFS) or vascular endothelial growth factor (VEGF) inhibitor could be utilized. Based on the challenges of the treatment, scientific research achievements can be used in clinical practice, and finally optimize the clinical treatment strategy.

Luminal breast cancer is the most common subtype of breast cancer, representing more than 60% of all breast cancers. Endocrine resistance and late recurrence are two challenges in the treatment of luminal breast cancer. To overcome endocrine resistance in multiple levels, high-dose-fulvestrant can inhibit estrogen-receptor (ER)-dependent pathways, while targeted drugs can block ER-independent pathways.To reduce the risk of late recurrence in luminal breast cancer, recurrence prediction model should be formed. For patients with high risk of late recurrence, extended endocrine therapy, combination of ovarian function suppression (OFS) or vascular endothelial growth factor (VEGF) inhibitor could be utilized. Based on the challenges of the treatment, scientific research achievements can be used in clinical practice, and finally optimize the clinical treatment strategy.

Coronary heart disease is the main cause of death,and harmful to the health of the elderly,affecting the quality of life of the elderly.Coronary stent treatment with its safety,minimally invasive,simplistic characteristics in the past 40 years has become the focus of coronary therapy development.At present,the bioresorbable scaffolds made of biodegradable materials have been developed,and magnesium alloy scaffolds have been developed rapidly as one of the representative materials.This article reviewed the progress of clinical research on bioresorbable magnesium alloy coronary stents in recent years,summarized stent development process,and thought about the future development of intervention and treatment of the future.

Objective To investigate the clinical characteristics of coronary heart disease risk fac tors,and explore the relationship of severity of coronary artery lesions in patients with coronary heart disease and coronary heart disease risk factors.Methods In our hospital for treatment of coronary artery disease patients during April 2013 to August 2014,230 cases of hospitalized patients were divided into two groups after coronary angiography diagnosis,including 170 cases of patients with coronary heart disease as the observation group,and 60 patients with coronary atherosclerosis as the control group with the degree of stenosis less than 50％.The clinical data of two groups were used to study the risk factors for coronary heart disease.The relationship was analyzed between severity of coronary artery pathological changes and coronary heart disease risk factors.Results For the observation group,type 2 diabetes,smoking,and men were associated with coronary heart disease (CHD),with the corresponding OR (95％ CI) of 17.489 (11.013-30.017),48.632 (20.379-117.178),and 18.976 (13.105-28.331),respectively.Smoking and type 2 diabetes were associated with coronary artery stenosis degree (P ＜ 0.05),with OR 95％ (CI) of 10.15 (2.012-2.584),and of 7.23 (1.613-2.176).The results found there was no relationship among hypertension,dyslipidemia,coronary heart disease (CHD),and age.There was a link between the body mass index (BMI) and the severity of the disease.For observation group,left ventricular ejection function,high-sensitivity C-reactive protein (hs-CRP),and Ccr were related to the severity of coronary lesions,and the patients existed lower Ccr,left ventricular ejection function abate,and increased hs-CRP levels increase,P＜0.05,and the OR (95％ CI) were 1.986 (5.204-17.627),1.103 (1.012-1.027),and 2.131 (1.901-2.369).Conclusions Type 2 diabetes,smoking,male patients with coronary heart disease risk factors had a close relationship,and the severity of coronary artery lesions included the reduced re nal function in patients and the increased hs-CRP level.

Objective: To evaluate the impact of bleomycin/etoposide/cisplatin (BEP) and paclitaxel/carboplatin (PC) chemotherapy regimens on the fertility and prognostic outcomes in malignant ovarian germ cell tumor (MOGCT) patients who underwent fertility-sparing surgery (FSS). Methods: A propensity score matching algorithm was performed between the BEP and PC groups. The χ2 test and the Kaplan-Meier method were used to compare the fertility outcome, disease-free survival (DFS) and overall survival (OS). The Cox proportional hazards regression analysis was used to identify risk factor of DFS. Results: We included 213 patients, 185 (86.9%) underwent BEP chemotherapy, and 28 (13.1%) underwent PC chemotherapy. The median age was 22 years (range, 8–44 years), and the median follow-up period was 63 months (range, 2–191 months). Fifty-one (29.3%) patients had a pregnancy plan, and 35 (85.4%) delivered successfully. In the before and after propensity score matching cohorts, there were no significant differences in spontaneous abortion, selective termination of pregnancy, during-pregnancy status, and live birth between the BEP and PC groups (p>0.05). Fourteen (6.6%) patients experienced recurrence, including 11 (5.9%) in the BEP group and 3 (10.7%) in the PC group. Four (1.9%) patients in the BEP group died. Kaplan-Meier analysis revealed no significant differences in DFS (p=0.328) and OS (p=0.446) between the BEP and PC groups, and the same survival results were observed in the after matching cohort. Conclusion The PC regimen is as safe as the BEP regimen for MOGCT patients with fertility preservation treatment, and no differences were observed in fertility and clinical prognosis.

ObjectiveTo investigate the effects of Guizhi Fulingwan on oxidative stress and renal fibrosis in diabetic mice based on the nuclear factor E₂-associated factor 2/antioxidant response element （Nrf2/ARE） pathway， and to explore its mechanism of action. MethodA diabetic mouse model was established by feeding high-fat diet combined with intraperitoneal injection of streptozotocin. The diabetic mice were divided into a model group， a metformin group （250 mg·kg^-1）， and Guizhi Fulingwan low， medium， and high dose groups （400.4， 800.8， 1 601.6 mg·kg^-1）， with 10 mice in each group. Another 10 mice were included in a normal group. The treatment was conducted continuously for 8 weeks. Body mass and blood glucose were recorded， and the renal index was calculated. Triglyceride （TG）， total cholesterol （TC）， urea nitrogen （BUN）， serum creatinine （SCr）， superoxide dismutase （SOD）， and malondialdehyde （MDA） levels were measured. Pathological changes in renal tissues were observed using Hematoxylin-eosin， periodate-Schiff， and Masson staining. The protein levels of α-smooth muscle actin （α-SMA）， fibronectin （FN）， and transforming growth factor-β₁ （TGF-β₁） were detected by immunohistochemistry. The protein levels of Nrf2， Kelch-like ECH-associated protein 1 （Keap1）， SOD1， NAD（P）H single-nucleotide oxidase 1 （NQO1）， and heme oxygenase-1 （HO-1） were detected by Western blot. ResultCompared with the normal group， the model group showed elevated glucose， renal index， TG， TC， BUN， and SCr levels， thickened glomerular basement membrane， increased collagen fibers in renal tissues， decreased SOD activity， elevated MDA content， increased protein levels of FN， TGF-β₁， α-SMA， and Keap1， and decreased protein levels of Nrf2， SOD1， NQO1， and HO-1 （P<0.01）. Compared with the model group， the Guizhi Fulingwan and metformin groups showed reduced blood glucose， renal index， TG， TC， BUN， and SCr levels， improved renal histopathological injury， significantly increased SOD activity， significantly reduced MDA content， reduced protein levels of FN， TGF-β₁， α-SMA， and Keap1， and increased protein levels of Nrf2， SOD1， NQO1， and HO-1 （P<0.05， P<0.01）. ConclusionGuizhi Fulingwan can improve oxidative stress and inhibit renal fibrosis， and its mechanism may be related to the activation of the Nrf2/ARE signaling pathway.