[Objective]To study cervical hollow threaded autograft cortical bone fixator with morselized bone for cervical anterior interbody fusion.[Method] Eighteen sheep were underwent cervical anterior discectomy and fusion with a hollow threaded and fenestrated tibial cortical hone fixator filled with morselized bone(diameter of 300～500 um) for C5、6 or autogenous iliac crest bone cylinder or C3、4 respectively.Cervical spines were radiographed immediately after surgery and 1,2,3 months later,the specimens of C5～6 and C3～4 were taken for histology investigation and biomechanical test respectively.[Result] Interbody fusion was achieved 3 months after surgery in experimental gronp and all but one in control group,with statisticdly significant difference was found between two groups in biomechanical compression and torsion tests of ante or post-fatigue test(P

ObjectiveTo investigate the effect of sivelestat sodium on the prognosis in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS).Methods Databases including PubMed, EBSCO, Springer, Ovid, Wanfang data, CNKI and China Biology Medicine (CBM) were searched to identify randomized controlled trials (RCTs) regarding sivelestat sodium treatment for ALI/ARDS published from 1985 to December 2014. The patients in treatment group received intravenous infusion of sivelestat sodium, and those in control group received normal saline. The items for analysis were 28-day mortality, duration of mechanical ventilation, length of intensive care unit (ICU) stay, and oxygenation index on day 3. According to the evaluation method of Cochrane system, data extraction and quality assessment from the literature were carried out. Meta-analysis was performed using RevMan 5.3. The publication bias was analyzed with funnel plot.Results Five RCTs with a total of 780 participants were included, with 389 patients in sivelestat sodium group, and 391 in control group. Meta analysis showed: compared with control group, sivelestat sodium could not lower the 28-day mortality [odds ratio (OR) = 0.91, 95% confidence interval (95%CI) =0.66-1.26,P = 0.58], or shorten the duration of mechanical ventilation or length of ICU stay [duration of mechanical ventilation: mean difference (MD) = -0.02, 95%CI = -0.29 to 0.24,P = 0.87; length of ICU stay:MD = -9.63, 95%CI =-23.34 to 4.08,P = 0.17], but it could improve oxygenation index on day 3 (MD = 0.88, 95%CI = 0.39 to 1.36, P = 0.000 4). Heterogeneity was not significant for the main analysis and no publication bias was shown on funnel plot. Conclusion Sivelestat sodium gave rise to a better oxygenation on day 3, but did not change the length of mechanical ventilation and ICU stay, and it did not improve 28-day mortality in ALI and ARDS.

Objective To evaluate the effects of rosiglitazone on ventilator-associated lung injury (VALI) in mice.Methods Twenty-four healthy male C57 mice,weighing 20-25 g,aged 6-8 weeks,were randomly divided into 3 groups (n =8 each) using a random number table:sham operation group (group S);group VALI;rosiglitazone group (group RGZ).The mice only underwent tracheotomy in group S.In group VALI,the mice were ventilated (respiratory rate 80 breaths/min,duration 4 h,tidal volume 40 ml/kg,fraction of inspired oxygen 21％,inspiratory/expiratory ratio 1:2,PEEP 0).In group RGZ,30 mg/kg rosiglitazone was given orally at 30 min before ventilation,and the other treatments were similar to those previously described in group VALI.At the end of ventilation,the mice were sacrificed,and the left lung was lavaged,and the broncho-alveolar lavage fluid (BALF) was collected for determination of neutrophil count.The pulmonary specimens were collected from the upper lobe of right lungs for microscopic examination of the pathological changes which were scored.The pulmonary specimens were obtained from the middle lobe of right lungs for measurement of the contents of interleukin-lbeta (IL-1β),tumor necrosis factor-alpha (TNF-α),high mobility group box-1 (HMGB-1) and receptor for advanced glycation end-products (RAGE) by enzyme-linked immunosorbent assay.Results Compared with group S,the neutrophil counts in BALF,contents of IL-1β,TNF-α,HMGB1 and RAGE,and lung injury score were significantly increased in VALI group (P＜0.01),and no significant change was found in the parameters mentioned above in group RGZ (P＞0.05).Compared with group VALI,the neutrophil counts in BALF,contents of IL-1β,TNF-α,HMGB1 and RAGE,and lung injury score were significantly decreased in group RGZ (P＜0.01).Conclusion Rosiglitazone can mitigate VALI in mice.

Objective To analyze the clinical characteristics of Hashimoto's disease(HD) accompanying with thyroid cancer,and to explore the experience of diagnosis and treatment.Methods Clinical data of 41 cases of HD accompanying with thyroid cancer were retrospectively analyzed.The patients were diagnosed by postoperative paraffin pathological examination from Jan.2002 to July 2011.Results 10 cases of HD,37cases of thyroid cancer,and 8 cases HD accompanying with thyroid cancer were diagnosed before operation.The rate of preoperative diagnosis was only 19.51％.All patients underwent surgical treatment,including 22 cases total thyroidectomy,14 cases subtotal thyroidectomy,and 5 cases lesion side lobe resection.24 cases underwent ipsilateral neck dissection,and 4 cases underwent bilateral neck dissection (ipsilateral radical resection,contralateral selective resection).Postoperative paraffin pathological examination proved that there were 39 cases of HD accompanying with thyroid cancer,1 case of focal cancer and 1 case of B-cell lymphoma of mucosa-associated thyroid.All patients were followed up.Conclusions The preoperative diagnosis rate of HD accompanying with thyroid cancer is low and great attention should be paid to its diagnosis.For HD patients,if carcinoma can not be excluded,surgical exploration is recommended.Appropriate surgical method should be chosen according to intraoperative frozen section results.Postoperative thyroid hormone treatment is usually taken.

Polydopamine (PDA) nanoparticles were prepared as a carrier, and bavachinin (BVA) was efficiently loaded by physical adsorption.The erythrocyte membrane was further utilized to modify and construct the erythrocyte membrane biomimetic nanoparticles (RBC-BP), the residence time in the body was extended and the in vivo analytical method was established to investigate their pharmacokinetics in mice.Polydopamine nanoparticles loaded with BVA (BP) were prepared by solvent replacement method, and the influencing factors of PDA loaded with BVA were investigated with the adsorption rate as the evaluation index.The erythrocyte membrane was extracted and separated, and RBC-BP was prepared by incubation coextrusion method. The effects of pH value on membrane coating and the extrusion times on the particle size and uniformity of RBC-BP were investigated.The particle size, potential, morphology, and cumulative release rate of RBC-BP were systematically characterized, and their pharmacokinetics in mice were preliminarily explored.The results showed that the adsorption rate of BP was as high as (92.08 ± 0.17) % and the drug loading rate was (42.05 ± 2.95) % at the PDA to BVA ratio of 1∶0.5, the solution pH value of 7, the incubation time of 6 h, and the incubation temperature of 20 °C, and that the erythrocyte membrane could be successfully oriented and coated on the surface of BP by the action of electric charge at the pH value of 4. The in vitro studies showed that RBC-BP has the apparent core-shell structure with the particle size of (308.63 ± 6.56) nm and good stability, and in vivo pharmacokinetic studies showed that RBC-BP can significantly extend the circulation time of nanoparticles in vivo.

Objective Autophagy serves a role in the pathogenesis of chronic inflammatory diseases. The aim of the present study was to compare the autophagy levels of the peripheral blood mononuclear cells (PBMCs) in patients with chronic obstructive pulmonary disease (COPD) and healthy individuals and to assess the association between autophagy and the clinical parameters of COPD. Methods Samples of peripheral blood from 20 patients with stable COPD and 20 healthy controls were collected. PBMCs were harvested using Ficoll density gradient centrifugation. Levels of the autophagy-associated proteins ubiquitin-binding protein P62 (P62), microtubule-associated proteins 1A/1B light chain 3A (LC3 I/Ⅱ) and beclin-1 in PBMCs were detected by western blotting. Enzyme-linked immunosorbent assay kits were used to detect the serum concentrations of interleukin (IL)-6, IL-8 and tumor necrosis factor (TNF)-α. Results Western blotting demonstrated that the protein expression of P62 decreased (P62/GAPDH = 0.212 ± 0.089 vs. 0.378 ± 0.176,P = 0.001 1), but LC3 I/Ⅱ(4.94 ± 1.85 vs. 3.85 ± 1.06, P = 0.024 9) and beclin-1 (Beclin-1/GAPDH = 0.578 ± 0.126 vs. 0.149 ± 0.035, P<0.01) levels increased in patients with COPD compared with healthy controls. Serum levels of IL-6 [(11.96 ± 3.46) ng/L vs. (2.70 ± 1.72) ng/L, P < 0.01], IL-8[(20.38 ± 18.44) ng/L vs. (6.00 ± 4.08) ng/L, P=0.001 6] and TNF-α (29.50 ± 28.18 vs. 11.08 ± 12.07, P=0.010 6) increased in patients with COPD. The extent of PBMC autophagy was negatively correlated with FEV1% predicted, but positively correlated with levels of proinflammatory cytokines. The levels of autophagy in PBMCs in patients with COPD increased and were negatively correlated with FEV1% predicted and positively correlated with circulating levels of pro-inflammatory cytokines. Conclusions Autophagy may serve a role as a biomarker of the severity of COPD or as a therapeutic target for treatment of COPD.

Homogeneous management of multi-campus medical care is an effective way to promote the expansion of high-quality medical resources, improve medical quality, and ensure medical safety. The Second Affiliated Hospital Zhejiang University School of Medicine actively explored an integrated and high-quality management mode to effectively improve medical service capacity, ensure medical technology and quality, and enhance hospital influence and social benefits from three dimensions: unified establishment, implementation of core elements, and unified quality and safety evaluation and monitoring. These practices had achieved good results and could provide reference for the multi-campus construction of other large public hospitals.

OBJECTIVE:To establish a reasonable return level for Chinese pharmaceutical industry and to study the return level of the domestic pharmaceutical industry from 2000 to 2005.METHODS:In view of the financial data of Chinese pharmaceutical industry in the statistical yearbook from 2001 to 2006,the return level for Chinese pharmaceutical industry was established based on its risk level using the principle of "risk-return equilibrium",and the rationality of the return level of Chinese pharmaceutical industry over the 6 years was validated as well.RESULTS:Over the 6 years,the average lowest anticipating rate of return for the Chinese medicine industry was 7.72% and the actually average assets income rate stood at 8.53%,i.e.the average abnormal return rate over the 6 years was 0.81%.CONCLUSION:The return rate of Chinese pharmaceutical industry corresponds to the risk level as well as the reasonable return level.

OBJECTIVE:To probe into the profits level and profits-gaining capability of Chinese pharmaceutical industry.METHODS:Based on the data recorded in yearbooks between 2001 and 2006,the profits levels were compared between Chinese pharmaceutical industry and China social average assets,other industries in China and overseas pharmaceutical industry.RESULTS:Between 2000～ 2005,the profits level of Chinese pharmaceutical industry was lower than that of Chinese social average assets,i.e.the profit-gaining capability of Chinese pharmaceutical industry was lower than that of China social average assets.Between 2002～ 2004,the profits level of Chinese pharmaceutical industry ranked at the first 10 places among the 39 industries,but dropped far behind in 2005,meanwhile the number of pharmaceutical enterprises who suffered loss increased greatly.CONCLUSION:The prospect for the development of Chinese pharmaceutical industry and the industry environment they confronted are far from optimistic.

Objective To summarize the therapeutic effects of living related donor liver transplantation for Crigler-Najjar syndrome type Ⅰ (CNS type Ⅰ). Methods A 3-month-old male infant had appeared a progressive xanthochromia of the skin and sclera 4 d after birth without obvious cause. Other causative factors were eliminated after relevant tests were completed, and identified as CNS type Ⅰ by genetic testing. Living related donor liver transplantation was performed with his mother as the donor. An immunosuppression regimen was routinely applied postoperatively and tacrolimus doses were adjusted according to biochemical indicators and cytochrome P450 (CYP) 3A5 genotype of the recipient. Results The liver enzymes of the recipient returned to normal at 7 d postoperatively, and bilirubin decreased daily and fell to the normal range at 22 d postoperatively. Followed up to the submission date, the recipient's xanthochromia of skin and scleral faded with normal bilirubin and stable liver enzymes. The condition of the recipient was generally good with high quality of life. Conclusions Living donor liver transplantation can treat unconjugated hyperbilirubinemia and other diseases caused by CNS type Ⅰ, which greatly improve the quality of life of patients.