Nowadays, AIDS becomes the serious public health and social pr ob lem. Discovering new anti-HIV active natural products from natural resources i s an important approach for new drug research and development. The paper review s the anti-HIV active natural products derived from marine microorganisms and m arine algae,and the anti-HIV active natural products' screening methods and ac tive targets.

With increasing demands and recognition, emergency medicine has advanced rapidly in China in recent decades. The education and training of professionals in this field are important for the further development of emergency medicine. With an attempt to investigate the way to strengthen residency training system in emergency medicine, this article reviews its potential development direction, training modes, learning materials, and quality control.
China ; Emergency Medicine ; education ; organization & administration ; Internship and Residency ; methods ; standards ; trends

AIM: To isolate peptides targeted binding and internalizing into glioblastoma cell line SWO-38. METHODS: Tumor cells were screened five rounds of whole cell screen through the Ph.D.-12 phage display library. The monoclone specific binding efficiency to the tumor cell was analyzed, and the DNA of phages were extracted, sequenced and translated to the sequences of amino acid. RESULTS: In the phage library after five rounds of screen , 10 of 13 monoclones had highly selective binding to SWO-38 cells. We found two repeated peptide sequences. CONCLUSION: Whole cell screening against tumor cells through random phage peptide library can obtain phage peptides with highly specific binding and internalizing ability. The peptides could be used as a therapy vector for tumor targeted delivery.

[Objective]To study the effect of semi-constrained total elbow arthroplasty in rheumatoid elbow arthritis.[Method]Eighteen semi-constrained total elbow replacements were performed on 22 rheumatoid patients with 28 elbows(Morrey Stage:6 of Ⅲ Stage,17 of Ⅳ Stage,5 of Ⅴ Stage).The elbows were reviewed retrospectively after a followup of mean 26 months(range12~44 months).Mayo Elbow Performance was used to evalue the function of preoperative and postoperative elbow.The curative effect and complications were observed.The statistically significant differences were analyzed.[Result]Elbow arthroplasty was successful in 22 rheumatoid patients with 28 elbows.After 6 weeks function exercise the Mayo Elbow Performance was improved from(31.6?29.2)to(82.1?24.3)with a statistically significant difference(P

[Objective]To study the means and curative effect of the total hip replacement for ankylosed hip joint with severely flexinal abnormality.[Method]Retrospective analysis of the operative effect and related problems of the total hip replacement for ankylosed hip joint with severely flexinal abnormality.[Result]Through follow up for 6 to 44 months(22 months averaged),the average range of motion of hip joint and of flexion was 220.5? and 103?,respectively.The postoperative Harrris Score was 84.4 versus the preoperative Harrris Score of 14.2.The pain of the hip was disappeared almost completely and pain of lower waist and knee was relieved obviously.Patient got their gait right and could care themselves approximately.[Conclusion]The total hip replacement can eliminate the pain of the joint effectively and meliorate the function of the joint rapidly for ankylosed hip joint with severely flexinal abnormality,but surgeons must grasp the indication and technique of the operation and postoperative functional exercise.

Hospital TQM system is designed to fit China′s specifics,based on the Total Quality Management (TQM)theory and integrating the system theory concepts, comprising two structural modules of perceived quality and non-perceived quality.The former is a trinity framework made up of patient satisfaction,employee commitment and social reputation,while the latter is a management system featuring“Six pillars and six columns”,constituting a three-dimensional management for integrated operation and integration of the hospital.

Objective To evaluate the accuracy of 3D-CT navigation in guiding pedicle screw fixation in the thoracic spine.Methods Thoracic pedicle screw placement guided by 3D-CT navigation was performed on 24 cases,including 14 patients with thoracic spine fractures,6 thoracic tumors,and 4 scoliosis.CT data was input into the navigation system,and point-matching test was chosen.The optimal position,diameter,and length of the screw were set up using navigation stick after true-up.Then,the screw was placed dynamically in a stereo way according to navigation plan.After the operation,the position of the pedicle screw was assessed with CT using the Rampersaud grading system.Results Under the guidance of 3D-CT navigation,a total of 144 screws were successfully fixed into the 24 patients.According to the Rampersaud grading system,136 of the screws were at grade A(94.4%),6 at grade B,1 grade C,and 1 grade D.No postoperative injury of the nerve or spinal cord was observed.Of the patients,22 were followed up for a mean of 8 months(range,6-14 months).During the follow-up,no loose or breakage of the screw was detected by X-ray and CT.No delayed spinal cord injury was found.Conclusions The thoracic pedicle screw placement can be accurately guided by 3D-CT navigation.

Objective To study curative effects of infrared fluoroscopic navigation guided percutaneous vertebroplasty for osteoporotic vertebral compression fractures. Methods A total of 28 cases of osteoporotic vetebral compression fractures(41 vertebrae) underwent infrared fluoroscopic navigation guided percutaneous vertebroplasty.The fracture was located at T_6～L_4 segment,including 16 thoracic vertebrae and 25 lumbar vertebrae.Fluoroscopic images of the spine were obtained,calibrated,and saved after the reference shelf was fixed on the spinous process of fractured vertebrae.The trajectory,a virtual tool corresponding to the tracked tool,was overlaid onto the saved fluoroscopic views in real time.Postoperative X-ray and CT examinations were performed to observe the vertebral body diaplasis as well as the distribution and leakage of bone cement.The vertebral body volume was measured with CT volumetry preoperatively and postoperatively.The visual analogue scale(VAS) scores were compared before and after operation. Results The bone cement was successfully injected in all the 41 vertebrae.Percutaneous vertebroplasty was performed in 13 vertebrae,while percutaneous kyphoplasty was conducted in 28 vertebrae(including balloon expansion in 12 vertebrae and "sky" expansion in 16 vertebrae).Vertebral body injection was performed via unilateral pedicle in 26 vertebrae and via bilateral pedicle in 15 vertebrae.Of the 28 cases,cement injection was carried out in one vertebral body in 17 cases,in two vertebral bodies in 9 cases,and in three bodies in 2 cases.No intraoperative deaths,nerve root or spinal cord injuries,or pulmonary embolism and cardiovascular or cerebrovascular emergencies occurred.The operative time for each vertebra was 7.7～20.7 min(14.2?3.3 min) in percutaneous vertebroplasty and 11.2～32.4 min(21.8?5.4 min) in percutaneous kyphoplasty.The X-ray exposure dose for each vertebra was 5.4～19.6 dGy(12.5?3.6 dGy).The amount of injected cement for each vertebra was 2.2 ～6.8 ml(4.6?1.2 ml).The vertebral volume was elevated from preoperative 21.4?4.6 cm3 to postoperative 25.8?5.4 cm3(t=5.623,P=0.000).The VAS scores decreased from preoperative 7.6?1.2 to postoperative 2.9?0.7(t=12.946,P=0.000).No serious complications or vertebral collapses were found during follow-up examinations for 3~14 months(mean,8 months) in the 28 cases. Conclusions Use of infrared fluoroscopic navigation for guiding percutaneous vertebroplasty is feasible.

Objective To investigate the corrective effect of modified Brisson technique to treat concealed penis in children.Methods From July 2014 to July 2016,selected 12 patients (3-10 years old,mean 7.2 years old) with concealed penis were surgically treated with the modified Brisson technique in the Second Affiliated Hospital of Nanjing Medical University.Their clinical manifestations included the penis buried below the surface of prepubic skin which can be palpated and visualized through pushing the skin around the penis to the pubis and the short foreskin which was not attached to the penile corpus cavernosum.Patients with other conditions such as obesity and penial agenesis that caused buried penis were excluded from the study.The modified Brisson technique consisted of 4 steps.Ventral incision was used to gradually slit the narrow ring of the prepuce and to expose the glans followed by circumfe-rential inner foreskin incision made below the coronary sulcus of penis then the foreskin stripping released the corpus cavernosum.Finally the skin coverage was accomplished by posthioplasty.The operation time,blood loss,complications,postoperative treatments and followed-ups were retrospectively analyzed.Results For all the 12 patients,the operations were successful,lasting 40 to 60 minutes.The bleeding was about 5 to 10 mL and there was no operation-related complications like bleeding and infection of incision.Satisfactory cosmetic outcomes were obtained without retraction and the scars were similar to those of circumcision.All patients had penile lymphedema postoperatively which disappeared within 6 months after operation.Follow-up ranged from 6 months to 1 year,and there were no complications like skin necrosis and contracture or voiding difficulty.Conclusions The modified Brisson technique for concealed penis repair is technically easy and safe.In addition,it provides a good cosmetic appearance,functional outcomes and excellent postoperative satisfaction grades.

Objective To study the method and clinical results of Infrared Fluoroscopic Navigation Guiding system guided percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures.Methods Twenty-two cases with 32 osteoporotic vertebral compression fractures underwent percutaneous vertebroplasty guided by Infrared Fluoroscopic Navigation Guiding system.The fracture segment was within T6-L 4(14 thoracical vertebrae,18 lumbarver vertebrae).The compression ratio was from 20% to 90% in which 5 vertebral bodies were 75%.12 vertebral bodies underwent PVP,and 20 vertebral bodies underwent PKP in which balloon expansion were used in 12 vertebral bodies and sky expansion were used in 8 vertebral bodies.Single vertebral body injection were in 14 cases,two vertebral body injection were in 6 cases,three vertebral body injection were in 2 cases including 18 vertebral bodies injection via unilateral pedicle of vertebral arch and 14 vertebral bodies injection via bilateral pedicle of vertebral arch.Restoration of vertebra height and cement leakage was observed by postoperative X-ray and CT scan.Changes of preoperative and postoperative vertebral body volume measured by CT volumetry was compared.Preoperative and postoperative Vasual analogue scale(VAS)score was compared.Results PVP was successful in 22 cases with 32 vertebral bodies.No nerve and spinal cord damage,lung embolism and heart and brain vessel acute reaction occurred.Operative time was(18.4?4.5)mins per vertebral body.X-ray dosage was(12.2?3.4)dGy per vertebrae.The amount of bone cement was(4.4?2.5)ml per vertebrae.The vertebral body volume was improved from preoperative(22.2?8.6)cm3 to postoperative(24.8?6.9)cm3 with a significant differences(P