0.05).Conclusion The V allele in exon24 of A2M might be one of the susceptible factors in PD in Shanghai Hans.

[Objective]To investigated the clinical result of transpedicle fixation combined with injectable calcium sulfate vertebroplasty in patients with thoracolumbar fractures.[Method]From April 2005 to June 2007,43 patients with thoracolumbar fractures were treated with vertebroplasty reinforced by calcium sulfate injection and short-segment pedicle screw fixation.The symptom improvement was observed.Plain X-rays were taken at pre-operation and post-operation and final follow-up to determine the improvement of the injured vertebral height and Cobb′s angle.[Result]All the patients underwent surgery uneventfully.Thirty-eight patients were followed up for an average of 22 months.After operation Frankel Grading System improved to Grade E.The loss rates of anterior,mid and posterior height were 51.4%,41.5%,3.5% before operation but 11.7%,14.3%,1.7% after operation.The Cobb′s angles were improved from 16.3?preoperatively to 0.8?postoperatively.The loss rates of vertebral height between pre-operation and post-operation were significantly different(P0.05).There was no breakage of pedicle screw or loosening of instrument.Pain score by visual analog scale(VAS) reduced from 8.5 to 1.0.[Conclusion]The surgery of transpedicle fixation combined with injectable calcium sulfate vertebroplasty is a mini-invasive and effective method for the treatment of patients with thoracolumbar fracture.It can achieve and maintain kyphosis correction,decrease the instrument failure rate,and provide better postoperative outcomes.

Identifying the similarity and differences of malpractice,medical negligence and medical error has realistic meaning to deal with medical disputes efficiently.They are all subjective negligence and belong to the category of medical behavior.This paper mainly discussed the criteria and civil liability of their differences.

ObjectiveTo analyze the perioperative risk factors of right heart failure (RHF) in human heart transplantation, and to summarize the efficacy of targeted agent especially on pulmonary hypertension.Methods Patients underwent heart transplantation were selected by exclusion criteria : (1) acute heart or other organ failure, or supported by mechanical assist device ; (2) the difference between the body weight of donor and recipient was ＞ 20％ ; (3) the ischemic time of donor was＞ 6 h; (4) acute rejection episode after transplantation; (5) perioperative death.The clinical data of 96 patients were collected, including gender, age, body weight, protopathy, history of heart failure, preoperative systolic pulmonary arterial pressure (SPAP), left ventricle end diastolic diameter (LVEDD), preoperative ejection fraction(LVEF), preoperative blood creatinine, donor ischemic time and preoperative application of 5-PDEs.The diagnosis standard of RHF was established.The risk factors were analyzed through Logistic Regression.Patients were divided into two groups according to the systolic pulmonary arterial pressure (SPAP).In group A, SPAP was ＜40 mm Hg, and in group B with SPAP≥40 mm Hg.The correlation between two groups was tested byχ2 test.ResultsIn the multivariable analysis, age, history of valve disease, length of heart failure,and preoperative SPAP were the risk factors of RHF with the coefficient of 1.051, 1.351, 1.712 and 6.725, respectively.SPAP seems to be the most important risk factor.Coronary artery disease and preoperative application of 5-PDEs-I were the favorable factors with the coefficient of 0.056 and 0.034, respectively.Parameters regarding age, history of valve disease, length of heart failure between the two groups were significantly different.There were no significant differences in gender, body weight, diagnosed as dilated cardiomyopathy or coronary artery disease and other etiologies, preoperative LVEDD, preoperative EF, preoperative blood creatinine, isehemic time and RHF, though the incidence of RHF in group B was higher than in group A (67.6％ vs 45.8％).There was also no statistic difference in using of ECMO and the mortality rate between two groups.ConclusionPreoperative PAP was the main risk factor of the RHF after heart transplantation.Although there was no statistic difference, the incidence of RHF in patients with SPAP≥40 mm Hg was higher than in patients with SPAP ＜40 mm Hg .The application of targeted agent therapy and ECMO may be helpful in treating RHF after heart transplantation.

The management of national defence science and technology reports was described from their compila-tion, submission, review, communication and use, taking The Scientific Research and Training Center of China Astronauts as an example. The problems in the management of national defence science and technology reports were pointed out, with measures and suggestions put forward for strengthening their management.

After the development of different medical social media in China was summarized , the advantages and trend of social media in medical field of China were analyzed , the challenges facing medical social media were pointed out and their countermeasures were proposed .

Chimeric antigen receptor-T cell (CAR-T) therapy is one of the effective novel immunotherapy for malignancies, and it has a great effect on leukemia and lymphoma. More researches are needed to improve the understanding of CAR-T therapy and promote the development of this technology in order to treat hematological malignancies from a novel perspective.

ObjectiveTo observe the curative effect of Xiangshaliujunzi decoction on critically ill patients with gastrointestinal dysfunction accompanied by spleen deficiency syndrome of traditional Chinese medicine (TCM) and its influence on tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6).Methods Forty-eight critically ill patients admitted to Department of Emergency Intensive Care Unit (EICU) in Zhejiang Provincal Hospital of Traditional Chinese Medicine Xiasha Campus from February to December 2015 were enrolled, and they were randomly divided into observation group (26 cases) and control group (22 cases) by random number table method. The patients in both groups were given routine emergency western therapy, and in the observation group, additionally, Xiangshaliujunzi decoction (ingredients: codonopsis pilosula 20 g, atractylodes macrocephala koidz 12 g, poria cocos 12 g, radix glycyrrhizae preparata 4 g, rhizoma pinelliae preparatum 6 g, pericarpium citri reticulatae 5 g, fructus amomi villosi 5 g, radix aucklandiae 4 g, rhizoma zingiberis recens 3 pieces) 80 mL was prepared and divided into two parts for nasal feeding, once 40 mL, twice a day, while the patients in the control group received the nasal feeding with the same amount of warm boiled water. Before treatment and 3 days and 5 days after treatment, the gastrointestinal function scores were assessed, and the changes of the levels of plasma TNF-α, IL-6 were recorded.Results There were no statistical significant differences in gastrointestinal function scores, the levels of TNF-α and IL-6 between the two groups before treatment and 3 days after treatment (allP ﹥ 0.05). But 5 days after the treatment, the gastrointestinal function scores, the levels of TNF-α and IL-6 were obviously decreased in two groups, and the degree of decrease in observation group was more significant [gastrointestinal function score: 0.92±0.85 vs. 2.27±0.77, TNF-α (ng/L): 17.7±2.4 vs. 25.0±4.2, IL-6 (ng/L): 16.9±2.4 vs. 25.0±3.4, allP < 0.01].Conclusion Xiangshaliujunzi decoction has therapeutic effect on critically ill patients with gastrointestinal dysfunction and accompanied by spleen deficiency in TCM, the mechanism may be related to decreasing the levels of TNF-α and IL-6, thereby depressing the inflammation.

Objective To explore the splenic macrophages phenotype and secretory function of mice with periodontitis, so as to explore effects of periodontitis on macrophages. Methods 22 mice were randomly divided into periodental ligation group (group P10d ) and pseudo periodental ligation control group (group C), with 11 mice in each group. The experimental periodental ligation on mice lasted for 10 days before they were sacrificed. Flow cytometry was applied to detect the expression of M1 and M2 in mononuclear macrophages. Real-time PCR was applied to detect the relative expression of pro-inflammatory cytokines IL-1β and anti inflammatory cytokines IL-10. Results Compared with the control group C, the proportion of M1 macrophages in the periodontitis group decreased, and the ratio of M1/M2 was also decreased significantly, and IL-1β mRNA also down-regulated. Conclusions Chronic periodontal infection could down regulate the proportion of M1 macrophages , decrease ratio of M1/M2 and the expression of inflammatory cytokines IL-1βmRNA.

Objective To study the differences in the inclination of lower incisors among the female patients with beautiful profiles in different vertical skeletal types so as to provide the clinical treatment design for a certain guiding. Methods 137 cephalometric films of female patients with beautiful profiles were selected and divided into three groups based on the vertical facial types(∠SNMP):small degree(n = 31),average degree(n = 89) and larger degree groups(n=17). The angles of∠L1/MP and∠L1/A-Pog were measured and treated with covari-ance analysis for detecting the differences between the groups. Results The index of L1-MP(°)was the smallest in the larger degree group,the largest in the small degree group and average in the average group,with significant differences between the three groups(F = 17.38,P < 0.001). There was no significant differences in ∠L1/A-Pog (°)(F=2.61,P>0.05). Conclusion Lower incisors have compensatory inclined lingually in the group of higher mandible angle,but labially in the group of lower mandible angle.