Extracranial carotid athcrosclcrosis is the major cause of ischcmic stroke.The intumescence of carotid atherosclerotic plaque in meries results in lumen stenosis or detachment of plaque organisms.causing the distal vascular embolization,and thus resulting in a reduced cerebral blood supply and cerebral ischemic event.The volume data acquisition of multislice spiral CT angiography can provide high-quality two-dimensional and three-dimensional images,its imaging technique has become a very effective detection tool for carotid atherosclerosis.This article reviews the diagnosis application of multislice spiral CT angiograohy of carotid atherosclerosis and its pitfalls.

Gastrointestinal stromal tumor( CIST) is the most common form of mesenchymal tumor of the gastrointestinal tract. Most GISTs characteristically harbor activating mutations of c-kit or PDCFRA( platelet derived growth factor receptor alpha, PDGFRA). All CISTs should be regarded having malignant potential. Tumor size and mitotic count, as two basic progonstic factors for primary CISTs, are largely site dependent. Most c-kit mutations have been found in exon 11,9,13,17 while PDGFRA mutations re found in exon 18,12,14.The sites and types of mutions are associated with the prognosis of CIST. Histopathology and immunohistochem-istry are another two factors predicting tumor outcome.

Natural killer group 2,member D (NKG2D) is a C-typelectin-like activating receptors on natural killer cells surface. NKG2D engaging with the ligands on tumor cells surface can eliminate tumor cells. However,there must exist immune escape mechanisms in tumor mice and cancer patients. Recently, molecular biological techniques are used to regulate the expression of the receptors and ligands to break the immune evasion.

Objective　To evaluate the effects of the excimer laser in situ keratomileusis (LASIK) for treatment of high myopia.Methods　LASIK was performed on 308 eyes of 186 patients who were followed up for one year. The patients were divided into two groups (group A and group B) according to preoperative diopters.Results　One year after surgery, in group A(-6.0～-10.0D) the uncorrected visual acuities of 0.5 and 1.0 were in 95.76% and 77.58% of the eyes, the mean residual refraction was -0.32D±0.46D. In group B(-10.25～-20.0D) the uncorrected visual acuities of 0.5 and 1.0 were in 62.24% and 37.06% of the eyes, the mean residual refraction was -0.92D±1.13D.Conclusion　It is an effective and safe refraction surgery to correct high myopia with LASIK.

Objective To observe the effect of omeprazole or famotidine combined with itopride in the treatment of reflux esophagitis.Methods 86 patients with reflux esophagitis were randomly divided into two groups,which group A with 43 eases was treated with omeprazole combined with itopride,and group B with 43 cases was treated with famotidine combined with itopride.The clinical effect and main symptoms were observed and compared.Results The total effective rate in group A was 91.3％,significantly higher than that of group B ( 71.4％ ) ( x2 =5.460,P ＜0.05 ).After treatment,the scores of heartburn,acid reflux and chest pain were significantly decreased ( all P ＜ 0.05 )in both two groups.Moreover,the scores of heartburn,acid reflux and chest pain in group A after treatment were significantly lower than those of group B ( all P ＜ 0.05 ).Conclusion Omeprazole combined with itopride in the treatment of reflux esophagitis is better than famotidine combined with itopride.

Small molecule antibodies are naturally existed and well functioned but not structurally related to the conventional antibodies. They are only composed of heavy protein chains or light chains, much smaller than common antibody. The first small molecule antibody, called Nanobody was engineered from heavy-chain antibodies found in camelids. Cartilaginous fishes also have heavy-chain antibodies (IgNAR, "immunoglobulin new antigen receptor"), from which single-domain antibodies called Vnar fragments can be obtained. In addition, free light chain (FLC) antibodies in human bodies are being developed as therapeutic and diagnostic agents. Comparing to intact antibodies, common advantages of small molecule antibodies are with better solubility, tissue penetration, stability towards heat and enzymes, and comparatively low production costs. This article reviews the structural characteristics and mechanism of action of the Nanobody, IgNAR and FLC.

Objective To investigate the causes and influencing factors of dead on arrival (DOA) in children.Methods The clinic data from 66 children with DOA admitted in the emergency department of Hunan Children's Hospital from Jan 2010 to Apr 2012 were analyzed retrospectively.Results All of the 66 cases had cardiac respiratory arrest when admission.Fourteen cases had arrest for 10 minutes,12 cases for 30 minutes to an hour,40 cases had no details.Forty-four (68.2％) cases were carried by parents,22(31.8％)cases were transferred by medical professionals.The main causes of DOA were severe pneumonia with respiratory failure and (or) heart failure,intracranial infection,neonatal diseases.All cases were taken to resuscitation room by triage immediately.Tracheal intubations were completed in 48 cases and intravenous access with injection of epinephrine and other resuscitative drugs were established in all cases,but all cases were dead due to breathing and heartbeat stopped for a long time.Conclusion DOA is one of the important reasons for pediatric high-risk.The key of reduction of DOA incidence and improvement of survival rate is to improve pediatric emergency medical service system,strengthen the health education for the parents,to carry out training and establish homogenization service in emergency ICU.

BACKGROUND:Fibroblast growth factor can promote proliferation of mesenchymal stem cells (MSCs).grew along the wall.However,there are few reports on the differentiation of MSCs into hepatocytes following fibroblast growth factor induction.When mass concentration of hepatocyte growth factor was 1 μg/L,it can promote mitosis of hepatocytes,and is the strongest mitogenic agent for normal hepatocytes.OBJECTIVE:To explore the biological characteristics of human umbilical cord MSCs/n vitro and their differentiation ability to hepatocyte-like cells under the induction of chemical factors.DESIGN,TIME AND SETTING:The cytological in vitro study was conducted at the Institute of Blood,Jinan University from August 2008 to April 2009.MATERIALS:Umbilical cord was obtained from healthy full-term fetus,which was provided by the Guangzhou Huaqiao Hospital.The parturient signed informed consent.Hepatocyte growth factor and flbroblast growth factor were bought from Peprotech,USA.METHODS:The MSCs from human cord were isolated and cultured by type Ⅳ colagenase digestion+differential adherence.At the third passage,MSCs received cell surface antigen analysis and cell cycle determination to detect their ability to differentiate into adipocytes and osteoblasts.At the fifth passage,MSCs were adjusted into 5×10~9/L and assigned into 2 groups.BMSCs in the control group were incubated in DMEM/F12 containing 5% fetal bovine serum.BMSCs in the induction group were treated with above-mentioned medium supplemented with 20 μg/L hepatocyte growth factor and 10 μg/L flbroblast growth factor.MAIN OUTCOME MEASURES:The following parameters were measured:biological characteristics of human umbilical cord MSCs and differentiation of human umbilical cord MSCs into hepatocyte-like cells in vitro.RESULTS:At the third passage,MSCs derived from human cord expressed CD29,CD44,CD105,but not antigens of hematopoietic CD34,CD45,and 92.2% of them were in G_0/G_1 phase.Oil red O staining showed cytoplasm presented red granules.Alkaline phosphatase staining demonstrated that cytoplasm was black,with the differentiation ability into adipocytes and osteoblasts.Following 10 days of combined induction of hepstocyte growth factor and fibroblast growth factor,RT-PCR and Western blot results confirmed that cells expressed alpha fetoprotein and albumin.Negative expression was found in the control group.CONCLUSION:Human umbilical cord contained plenty of MSCs,with strong potential of multi-differentiation.Umbilical cord MSCs can differentiate into hepatocyte-like cells following combined induction of hepatocyte growth factor and fibroblast growth factor.

Alginate fiber is prepared by wet spinning method.The preparation process of alginate fiber is:dissolution,filtration,deaeration,figuration,stretching,washing,drying and convoluting.At present,one of thebiodegradable fibers studied the most is alginate fiber.The material,principle and producing technology of alginatefibers are introduced in this article and its application in wound dressings are underlined.

Objective To evaluate the efficacy of fusion with and without instrumentation in the treatment of chronic low back pain.Methods To search Medline(from 1966 to Deeember.2006).Embase (1984 to December,2006),Cochrane Central Register of Controlled Trial f4th Quarter 2006),Current Controlled Trials.The China Biological Medicine Database(1984 to December,2006).and hand searched several related journals.The quality of included trials was evaluated.Data were extracted by two reviewers independently with a designed extraction form RevMan 4.2.8 software was used for data analysis.Results Eight studies involving 656 patients were included.The results of meta-analysis indicated that statistically significant difierences were observed between the two operative procedures in the fusion rate(OR=2.26,95% CI 1.51-3.38,P=0.0001),clinical outcome(OR=1.54,95%CI 1.09-2.19,P=0.01),incidence of re-operation (OR=2.16.95% CI 1.08-4.33,P=0.002).There were no statistically significant difierences in back pain scores (WMD=-0.22,95% CI-0.81-0.36),leg pain scores(WMD=0.22,95%CI-0.50-0.93),complications(OR=1.68,95%CI 0.78-3.63),satisfaction of surgery by patients(OR=1.54,95%CI 0.93-2.55).Three studies described the mean surgical time,perioperative blood loss,days in hospital after surgery,which revealed that single fusion was superior to fusion with instrumentation.Three studies described the work status of patients post-operatively.Two studies indicated smoking could decrease the fusion rate.Conclusion To compare with single fusion,fusion with instrumentation can increase the fusion rate and improve clinical outcome slightly,but it also increases the incidence of re-operation.More high quality large-scale randomized controlled trims are required.