Objective To study the relationship between the renal cortical thickness and age,and to establish the range of the normal renal cortex thickness by using CT measurement in different age groups so as to obtain a best age-related and practicable method for clinical measurement. Methods (1) the accuracy of measuring renal cortical thickness by CT was evaluated; 18 kidneys resected due to renal neoplasm were studied and the cortical thickness of the normal part of these specimens was assessed. The difference between the renal cortical thickness of specimens and preoperative measurements of renal cortex of the same patient by contrast enhanced CT was analyzed statistically. (2) 120 patients without history of renal disease or long term usage of potentially renal toxic drugs or history of hypertention were examined by CT with indication(s) other than renal disease. All the patients were divided into 20-40, 41-60, and 61-80 year-old groups. The renal cortical and parenchymal thickness and renal size were measured in three CT sections. The difference of the measurements among the three groups and their relationship to age was analyzed statistically. Results There was no significant difference between the renal cortical thickness measured by enhanced spiral CT and measured in renal specimens(t =0. 80,P =0. 43). The renal cortical thickness in three groups was 0. 73 cm, 0. 65 cm, and 0. 53 cm, respectively, and the differences among the three groups were significant ( F = 93.430, P 0. 05). Conclusion The measurement of the renal cortical thickness with enhanced spiral CT was reliable and was a sensitive method in investigating the morphologic changes of the kidney. The renal cortical thickness of normal kidney diminishes with age, but the change of the ratio of thickness of renal cortex to renal parenchyma with age was not significant.

〔Abstract〕 Based on analyzing the background of generic drugs research and development, the paper elaborates the utilization meth-ods of drugs invalid patents, including information sources optimization and retrieval, invalid patents selection indexes and methods, in-fringement avoidance strategy.It takes the gastrointestinal stromal tumor drugs for example to find out drugs which can be imitated, pros-pects the future application of invalid patents information.

Research progress of somatic mutations and the response to the treatment of de novo myelodysplastic syndromes (MDS) patients in the 57th American Society of Hematology (ASH) annual meetings was reviewed. The optimal methods and therapy time for patients with high-risk de novo MDS remained an area of ongoing investigation. The clinical prognostic scoring system does not include the molecular genetic abnormalities and DNA metlylation of histone/nuclear chromatin modifications, which may predict the effect of hypomethylation (HMA). Treatment of HMA may change the expression of genes related with prognosis, and the response rate to the HMA treatment was significantly increased for TET2-mutated patients with high-variant allele frequencies. The overall grade of recommendation for choosing HMA therapy over induction chemotherapy in high-risk MDS based on molecular genetic mutations was 2C, according to less-associated toxicity and increased responses primarily in TET2-mutated disease. Further prospective studies are needed to evaluate the long-term effects of HMA therapy, particularly in TET2-mutated patients.

Progress of World Health Organization (WHO) reclassification of myelodysplastic syndromes (MDS) in the 57th American Society of Hematology annual meetings were reviewed. A revision to the 4th edition of the WHO classification of MDS will be enacted in mid-2016. Based on recommendations of the Clinical Advisory Committee, proposals for change included abandoning the routine names of 'refractory anemia/cytopenia', expressing the prognostic significance of gene mutations in MDS, revising the diagnostic criteria for MDS entities with ring sideroblasts based on the detection of SF3B1 mutations, modifying the cytogenetic criteria for MDS with isolated del (5q), reclassifying the erythroid/myeloid type of acute erythroleukemia, and recognizing the familial link in some cases of MDS.

New progress of treatment of low-risk myelodysplastic syndromes (MDS) reported in the 58th American Socienty of Hematology (ASH) Annual Meetings was reviewed. Anemia is a single common symptom of low-risk MDS, and erythropoietic-stimulating agents (ESA) may be effective. The dose and duration of erythropoietic-stimulating agents (ESA) are critical to determine efficacy. If the treatment of ESA failed, the available options may include lenalidomide (approved for del5q positive cases), hypomethylating agents and a rather large number of experimental agents. The choice for the second-line treatment must consider the biologic, cytogenetic and molecular-identified characteristics of individual patient, as well as frailty and comorbidities. Other cytopenias rarely appear alone. Thrombomimetic agents for thrombocytopenia has been proposed in clinical trials, but there were some safety issues. Although neutropenia is targeted symptomatically with growth factor supportive care, the immunosuppressive therapy is indicated mainly for pancytopenic and hypoplastic low-risk MDS. Finally, hematopoietic stem cell transplantion is the curative option also for low-risk MDS, but it should be carefully evaluated to balancing toxicity and the possibility of survival advantage.

Objective; To investigate the cytotoxicity of monocytes/macrophages against Tca8113 cells in hypoxic microenvironment in vitro. Methods; Peripheral blood mononuclear cells were extracted from healthy person^ blood and cultivated to transform into monocytes/macrophages. The monocytes/macrophages were cultured with Tca8113 cells in hypoxic microenvironment (O_2 < 1%) and in normal microenvironment (20% O_2). The cytotoxicity of monocytes/macrophages against Tca8113 cell was examined by MTT assay. Results;The cytotoxicity of monocyles/macrophages against Tca8113 cells in hypoxic microenvironment was lower than that in normal environment(P<0.05). Conclusion; In hypoxic microenvironment, the cytotoxicity of monocytes/macrophages against Tca8113 cells is decreased. Bui the mechanism of monocytes/macrophages' function in tumors need further research.

Objective To comparethe effects of four different emergency fixation methods for the open tibiofibular fractures on the treatment and prognosis of the multiple trauma patients. Methods A comparative study was carried out on the effect offour different early fixation methods on the fracture and the multiple trauma in aspects of the short-term indicators including mortality rate,acute respiratory distress syndrome(ARDS),fat embolism syndrome(FES),multiple organ dysfunction syndrome (MODS),ICU stay and the long-term indicators including wound healing time,fracture healing time,rate of joint function recovery and fracture complications in 43 multiple trauma patients. Results The locked intramedullary nail wag better than the other fLxation methods including the calcaneal traction,the gypsum external fixation and the internal fixation with steel plate and extemal fixation support in most indexes(P<0.05,0.01). Conclusion The locked intramedullary nail can significantly decrease the incidence rate of complications and obtain sound fracture healing for the patients with multiple trauma combined with open tibiofibular fractures(types Gnstilo Ⅰ,Ⅱ and Ⅲa).

Objective To explore the change of serum HER2/neu concentration during neoadjuvant chemotherapy for HER2-overexpressed breast cancer and its correlation with the response to the neoadjuvant chemotherapy.Methods The concentration of the serum HER2/neu in 78 cases of HER2-overexpressed advanced breast cancer treated with neoadjuvant chemotherapy were detected with enzyme-linked immunosordent assay(ELISA).The relationship between the serum HER2/neu concentration and the response of neoadjuvant chemotherapy was analyzed.Results The serum HER2/neu concentration of befor and after neoadjuvant chemotherapy was 18.6 ± 10.0ng/ml,11.6 ± 6.lng/ml respectively.The serum HER2/neu concentration decreased significantly(P ＜ 0.001).The response of neoadjuvant chemotherapy was correlated with the change of the serum HER2/neu concentration.The pathologic complete response was correlated with the serum HER2/neu concentration of prechemotherapy and the change of the serum HER2/neu concentration.Conclusion The change of serum HER2/neu concentration may serve as a marker predicting the response of neoadjuvant chemotherapy in HER2-overexpressed breast cancer.

Objective To observe the therapeutic effect of Tianwang Buxin Decoction for delirium after hip joint replacement in senile femoral neck fracture patients. Methods A total of 57 senile patients with femoral neck fracture induced by falling were enrolled from the department of arthropathy of Zhongshan Hospital of Traditional Chinese Medicine admitted from September of 2009 to February of 2014. The patents were aged over 65 years, and had delirium after hip joint replacement. Random number method was used to divide the patients into Chinese medicine group ( 29 cases) and western medicine group ( 28 cases) , which were given oral use of Tianwang Buxin Decoction and Olanzapine separetely. Before and after treatment, we observed the scores of Delirium Rating Scale (DRS), time for delirium disappearing, and incidence of indifferent mind and somnolence.Results (1) After treatment, DRS scores were obviously decreased in both groups (P<0.01 compared with those before treatment), but the difference was insignificant between the two groups (P>0.05). (2) The difference of time for delirium disappearing was insignificant between the two groups after treatment ( P>0.05). ( 3) After treatment, 7 cases of the control group had indifferent mind or somnolence, accounting for 25%. No case of the treatment group had indifferent mind or somnolence. The difference between the two groups was significant ( P<0.01). Conclusion Oral use of Tianwang Buxin Decoction has the same effect as Olanzapine for the treatment of delirium after hip joint replacement in falling-induced senile femoral neck fracture patients, and has the advantages of having no adverse reaction of indifferent mind or somnolence, and can realize comprehensive treatment by modification of the recipe according to the symptoms.

Objective To investigate the composite of chitosan(CS) and polyvinyl alcohol (PVA) as scaffold carrier for rabbit chondrocytes nurture and growth.Methods The third passage of chondrocytes were seeded in CS/PVA gel scaffold and 24,48 and 72 h after which cytoactive and toxicity were determined by MTT respectively.After one,two and three weeks,the growing status and morphology of chondrocytes in CS/PVA gel were observed with scaning electron microscope (SEM) and laser confocal scanning fluorescence microscope (LCSM).Results The third passage of chondrocytes in CS/PVA gel scaffold remained high proliferation ability.MTT measuring cell activity and virulence,the result showed that the number of cells obviously increased with the time,with statistical significance of difference between each groups (P＜0.05),without side effect to cells by the material.Observation of scaning electron microscope and confocal laser scanning fluorescence microscope showed that chondrocytes grew well with the scaffold of CS/PVA gel.Conclusion CS/PVA mixed gel material can be used as scaffold for rabbit chondrocytes growing for repairing cartilages defect in tissue engineering.