Objective To disclose the variant rule of HIV-1 vertical transmission by studying the differences of genotypes and quasispecies in the individuals with HIV-1 vertical transmission. Methods RNA was extracted from the plasma of the individuals of vertical transmission and C2-V5 DNA segment of HIV-1 env gene was acquired by RT-PCR. Purified DNA segment was inserted into T vector and transformed into Top10 Escherichia coli. Positive clones were acquired by blue-white screening and used as models in PCR. PCR products were analyzed by conformation sensitive gel electrophoresis (CSGE). The clones of major and minor quasispecies were sequenced. Results HIV-1 quasispecies in the mother of the first group were less complex than her child, and their quasispecies nucleotide sequences were highly homologous and of HIV-1 of C subtype. HIV-1 quasispecies in the mother of the second group were more complex than her child, and their quasispecies nucleotide sequences were highly homologous and of HIV-1 of AE subtype. Conclusion HIV-1 genetic subtypes are generally not changed in vertical transmission, but HIV-1 quasispecies could be selected in vertical transmission and screened by the new environment of the new host which may both induce the changes of dominative and minor quasispecies. We also find that complexity of HIV-1 quasispecies is associated with immune status of host.

[Objective]To analyze the causes of complication following percutaneous vertebroplasty and to find out the methods on its prevention and treatment.[Method]Complications of 140 patients (233 vertebral bodies) performed percutaneous vertebroplasty from August 2002 to July 2006 and long-term complications and its correlative prognosis after followed-up 7-52 months (average 28.4 months were observed and analyzed.[Result]Sixty-one patients of 140 cases showed complications (43.6%).Forty-five of the 61 patients with complications revealed with leakage of bone cement,2 with transient low blood pressure or lethargy,3 with dyspneic respiration or slight cough or chest discomfort,1 with subcutaneous herniation.In 12 patients complicated with leakage of bone cement,10 complained aggravation of pain,1 of radiating pain of back and low limb,1 with incomplete paraplegia. The 11 patients complicated with various postoperative pain induced by bone-cement leakage were complete recovery after treatment with anti-imflamatory analgetics orally for 3-7 days.One patient with incomplete paraplagia caused by leakage of bone cement demonstrated satisfactory walking function recovery but still remained slight disability of lower limbs after 26 months by treatment of laminectomy decompression,with drawing of bone cement combined with anti-biotics,dehydration agent,hormone,nerve-nourisling agent and 3-month acupuncture. Two patients with transient low blood pressure or lethargy were treated and recovery after fluid infusion and 30-60 oxygen taking. Three patients with dypneic respiration or slight cough or chest discomfort but without abnormality on radiographs were convalesced after treatment of fluid infusion,taking oxygen and anti-biotics for 3-5 days.The subcutaneous homotoma of 1 patient was absorbed 7 days later.Ten patients complicated with new adjacent vertebral body fracture 1-12 months postoperatively were healed after conservative treatment of PVP operation.[Conclusion]Complications after percutaneous vertebroplasty are not uncommon(43.6%).Leakage of bone cement is most common complication. Strict pre-operation plan and improving operation skill are the most important preventive measures.

Objective: In order to observe the clinical effect of acupuncture plus moxibustion for insomnia. Methods: Seventy-six patients with insomnia were randomly divided into 38 cases in the treatment group and 38 cases into the control group. The main acupoints for the treatment group were Baihui (GV 20), Shenmen (HT 7), and Sanyinjiao (SP 6). The additional acupoints were Yintang (Ex-HN 3), Anmian (Ex-HN 22), Shenmai (BL 62), Zhaohai (KI 6), Neiguan (PC 6), Jueyinshu (BL 14), Xinshu (BL 15), Pishu (BL 20), Weishu (BL 21), Danshu (BL 19). The treatment was given by acupuncture plus moxibustion. Suspending moxibustion by moxa stick was used over the main acupoints. And the additional acupoints were punctured routinely. The main acupoints for the control group were Baihui (GV 20), Shenmen (HT 7), and Sanyinjiao (SP 6), Yintang (Ex-HN 3), Anmian (Ex-HN 22), Shenmai (BL 62), and Zhaohai (KI 6). The additional acupoints were Jueyinshu (BL 14), Xinshu (BL 15), Pishu (BL 20), Weishu (BL 21),Danshu (BL 19). The treatment was given by acupuncture routinely. The therapeutic effects were compared in the change of Pittsburgh Sleep Quality Index (PSQI), therapeutic effect and therapeutic courses. Results: The treatment group was better than the control group in PSQI change, therapeutic effect and therapeutic course (P＜0.05). There was no adverse reaction.Conclusion: Acupuncture plus moxibustion has a better therapeutic effect for insomnia.

Objective To investigate the clinical efficacy of the self-retaining laryngeal microsurgical operation in the treatment of Reinke ’ s edema of vocal cords . Methods There were 24 cases of Reinke ’ s edema who were treated with self-retaining laryngoscope mucosal stripping surgery of vocal cords from January 2004 to December 2009 ( traditional group ) , while another group of 32 cases of Reinke ’ s edema were treated with self-retaining laryngoscopic microsurgery lateral submucosal incision micro-flap operation of vocal cords from January 2010 to December 2015 ( laryngeal microsurgery group ) .The two groups were executed with electronic laryngoscopy and subjective voice evaluation GRBAS ( The Speech and Language Institute of Japanese in 1979, G: Grade, R:Roughness, B:Breathness, A:Asthenia, S:Strain) in pre-operation and post-operation (1 week, 3 weeks, 8 weeks).The wound healing time of vocal cords , hoarseness improved time and voice improvement were retrospectively compared between the two groups . Results The patients in laryngeal microsurgery group had earlier voice hoarse improvement and more rapid mucosal epithelial of vocal cords recovery time in post-operation as compared with the patients in the traditional group [voice improving time, (7.3 ±1.9) d vs. (11.3 ±2.7) d, t=-6.481, P=0.000;mucosal epithelial of vocal cords recovery time , (12.2 ±3.1) d vs.(20.1 ±3.4) d, t=-9.062, P=0.000].The results of pre-operative voice evaluation with GRBAS showed no significant differences between the two groups, but the results of post-operative evaluation of each session (1 week, 3 weeks, 8 weeks) showed that the main data were statistically different.The GRBAS score of laryngeal microsurgery group was lower than that of traditional group in post -operation, especially after 8 weeks (8 weeks after post-operation, G:1.0 ±0.8 vs.1.6 ±0.2, t=-3.584, P=0.000; R:1.0 ±0.9 vs. 1.5 ±0.4, t=-2.536, P=0.014;B:1.0 ±0.6 vs.1.4 ±0.5, t=-2.647, P=0.011).In laryngeal microsurgery group, 24 cases were cured , 5 cases were effective and 3 cases were invalid , contrasting in the traditional group with 11 cases of cured , 7 cases of effective and 6 cases of invalid respectively, with a significant difference (Z=-2.239, P=0.025).No significant difference in effective rate between the two groups [90.6%(29/32) vs.75.0%(18/24),χ2 =1.459, P=0.227]. Conclusion The clinical efficacy of self-retaining laryngoscope microsurgery in the treatment of Reinke ’ s edema of vocal cords is faster and better comparing traditional operation , with a more significant pronunciation quality improvement .

ObjectiveTo explore the application of new tec hn iques: pulmonary surfactant(PS), nasal continuous positive airway pressure (NCPA P) and the neonatal transportation on the morbidity and mortality of ventilated very low birth weight infant (VLBWI).MethodsSeventy three VL BWI ventilated because of respiratory failure ,recurrent apnea and cardiopulmo nary resuscitation were enrolled in this study. They were divided into two group s according to the use of new techniques, before and after. There were 32 cases during 1995～1998 in group A and 41cases during1999～2002 in group B. In group B, PS was used in 10 cases (24%); NCPAP in 12 cases (29%) after extubation, and transportation in 11 cases (27%).ResultsThe survival rate in group B were significantly improved (71% vs 39%, P

Objective It is to study the influence of atorvatatin on serum C-reactive protein(CRP)level in acute cer- ebral infarction patients and to analyze its clinical significance.Methods 62 patients with acute cerebral infarction di- agnosed by CT or MRI were chosen and divided into two groups randomly.Both the groups were treated with normal method and the treatment group was given atorvastatin 20mg per day.Serum CRP levels in the two groups were measured by immunnturbidimetry within24h after final diagnosis and at two weeks the level decreased obviously in treatment.Re- slllts Serum CRP levels all increased in the patients.After treatment for two weeks the level decreased obviously in treatment group.The difference was significant compared with control group.Conclusion Atorvastatin can markedly reduce the serum CRP level in acute cerebral infarction patients and has important significance for the pathogenetic condi- tion change and prognosis of cerebral infarction.

Objective To explore the influential factors of hospital management teaching and to apply new plans to improve quality of teaching. Methods Questionnaire survey was conducted among 94 students majored in health management in Xuzhou Medical College to investigate student' learning behavior as well as contents, applying value, procedures, and teaching effects of the course. Data was put in by Epidata 3.02, described and analyzed by SPSS 18.0. Continous variables were ana-lyzed by t test and classified variables were analyzed by X2 test. Results 25.6%(24/94) students were not interested in this course. 61.7%(58/94) students thought that the course was highly correlated with profession. 56.4%(53/94) students thought that the course was valuable. 35.1%(33/94) students thought that the course was not good in combining theory with practice in teaching. 19.1%(18/94) stu-dents thought that the course was deficient in interactive teaching and teaching methods. 62.8%(59/94) students were satisfied with the teaching effect. Conclusions Main influential factors of hospital man-agement teaching are learning interest, curriculum evaluation and teaching evaluation. To improve quality of hospital management teaching, it is necessary to communicate the importance of the course and to apply new teaching plans to arouse the interests of students.

Objective To explore the effect of Xiao Ban Xu, a compound Chinese traditional medicinal prescription, on the expression of collagenⅠand Ⅲ of keloid fibroblasts in vitro. Methods Six samples of keloid fibroblasts (KFB) and 6 samples of normal fibroblasts (NFB) entered the study as experimental and control groups, respectively. With the application of Xiao Ban Xu (10?g/ml), the fibroblast culture system and the ABC immunocytochemical staining method were used to investigate the expression of collagenⅠand Ⅲ of KFB and NFB. Results The density of the staining of collagenⅠand Ⅲ in the experimental group was much higher than that in the control group, with (7675 4?825 5 vs 2305 2?320 4 and 10595 2?1311 5 vs 2434 8?356 9; t =13 37 and 12 66, P =0 00004 and 0 00005) or without (11113 1?1304 9 vs 3519 6?236 0 and 11157 7?1300 3 vs 2626 5?426 3; t =14 42 and 13 47, P =0 00003 and 0 00004) the addition of Xiao Ban Xu. Compared with blank control group, the density of the staining of collagenⅠand Ⅲ was degenerated greatly in the experimental group after 48 hours of application of Xiao Ban Xu (7675 4?825 5 vs 11113 1?1304 9 and 10595 2?1311 5 vs 11157 7?1300 3; t =10 31 and 4 68, P =0 0001 and 0 0054). Furthermore, the inhibition ratios of collagenⅠwas 30 7%, and the one of collagen Ⅲ 5 1%, in the experimental group. Conclusions The expression of collagenⅠand Ⅲ of keloid fibroblasts in vitro may be significantly more intensive than the one of normal skin fibroblasts. It seems that the expression of collagenⅠand Ⅲ, especially collagenⅠ, in keloid fibroblasts and normal skin fibroblasts in vitro may be suppressed greatly by the application of Xiao Ban Xu.

Objective To study the effect of atorvastatin on serum cystatin C and urinary microprotein in patients with early diabetic nephropathy (DN).Methods Sixty-eight cases of early DN were divided into control group and observation group with 34 cases each by random digits table,the control group was treated with the conventional treatment,the observation group was treated with atorvastatin on the basis of conventional treatment,then blood lipids,serum cystatin C,urinary albumin excretion rate (UAER),microalbuminuria( MAU ),α1-microglobulin(MG),β 2-MG between the two groups were compared.Results After intervention,the levels of total cholesterol (TC),triacylglycerol (TG),serum cystatin C,UAER,MAU,αt 1-MG,β 2-MG were significantly decreased compared with those before treatment in the observation group [ (4.32 ± 1.26) mmol/L vs.(5.65 ± 1.38 ) mmol/L,( 1.67 ± 0.64) mmol/L vs.(2.53 ± 0.96 ) mmol/L,( 1.29 ± 0.38 ) mg/L vs.( 1.74 ± 0.51 ) mg/L,(61.09 ± 18.45 ) μ g/min vs.( 86.42 ± 21.34) μ g/min,( 5.73 ±4.81) mg/L vs.(23.16 ±9.73) mg/L,(1.41 ± 1.21) mg/L vs.(4.76 ± 1.24) mg/L,(1.21 ±0.13) mg/L vs.(2.58 ± 0.26) mg/L ] (P ＜ 0.01 or ＜ 0.05 ).In the control group,the levels of TC,TG,serum cystatin C were lower than those before treatment,but there were no significant differences (P＞0.05),but the levels of UAER,MAU,α 1-MG,β 2-MG had significant differences compared with those before treatment (P ＜ 0.01or ＜ 0.05 ) and the same time of the observation group (P ＜ 0.05 or ＜ 0.01 ).Conclusion Atorvastatin can significantly reduce serum cystatin C and urinary micro-protein levels in patients with early DN,which plays an important role in kidney protection.

Objective To study the expression of interleukin-18(IL-18)during the progression of renal interstitial fibrosis in rat kidney after unilateral ureteral obstruction(UUO)and the effect of Shenfu injection.Methods The obstructive nephropathy model was established by unilateral ureteral obstruction(UUO).Fifty。Six rats were randomly assigned into shame operation group,operation group(UUOgroup)and treatment group(UUO+Shenfu).After 7 and 14 days,the renal function and histopathological changes were evaluated.Immunohistochemistry was used to examine the expression of IL-18 in renal tissue.Results In comparison with the shame opeartion group,the operation group showed obvious renal interstitial fibrosis.And the expression of IL-18 increased signifieantly(P<0.05).Compared with the operation group,the degree of interstitial fibrosis was obviously ameliorated in the treatment group,and the expression of IL-18 decreased significandy after treatment for 7 days(P<0.05),and decreased more after treatment for 14 days(P<0.05).Conclusions Shenfu injection may protect renal function by decreasing the expression of IL-18 in the progression of renal interstitial fibrosis.