Juvenile Parkinson's disease caused by PRKN gene compound heterozygous mutation:A case report and literature review / 吉林大学学报(医学版)

Objective:To conduct the genetic analysis of a family with one patient suffering from juvenile Parkinson's disease(JP)and discuss the clinical manifestations,genetic mutation characteristics,and treatment plans prompted by PRKN gene compound heterozygous mutations,and to enhance the clinicians'awareness of this disease.Methods:The clinical data of one patient with JP caused by PRKN gene mutations was analyzed,the clinical manifestations and genetic mutation features of the patient were summarized,and the related literatures were reviewed.Results:The patient,a 16-year-old male,was admitted to the hospital due to unstable gait,trembling limbs with rigidity in both lower limbs for three years.The examination results revealed a panic gait,clear consciousness,fluent speech,normal muscle strength in limbs,increased"gear-like"muscle tone in both upper limbs,and"lead-pipe"rigidity in both lower limbs;the sensory functions and tendon reflexes were normal.The head,neck,and thoracic magnetic resonance imaging(MRI)results showed no abnormalities.18F-fluorodeoxyglucose(18F-FDG)positron emission tomography/computed tomography(PET/CT)results showed that the head size and shape were normal,the glucose metabolism in the left cerebellum and middle temporal gyrus was slightly decreased,and the glucose metabolism in bilateral thalami,right frontal lobe,parietotemporal lobe,and left medial frontal lobe was increased.The dopamine transporter(DAT)PET/CT results showed that there was no radioactive distribution in the brain cortex and the DAT distribution in the posterior part of both striata was decreased.The whole-exome sequencing results showed the patient had two PRKN gene mutations,such as codons c.8T>A and c.850G>C compound heterozygous mutations,and each mutation was from one parent;the patient's father carried the c.8T>A mutation,the patient's mother carried the c.850G>C mutation,and the patient's sister had the same genetic mutation site as the patient's father.Conclusion:PRKN gene compound heterozygous mutations may be the basis of the disease in this family.Identification of the mutation c.8T>A expands the mutation spectrum of the PRKN gene,and provides the valuable information for the research on the pathogenic genetic mutations of the JP patients.

Establishment of a genotyping method for the junior blood group and identification of a rare blood type with partial DVI.3 and Jr(a-) / 中华医学遗传学杂志

OBJECTIVE@#To develop a genotyping method for the Junior blood type and report on a rare blood type with Jr(a-).@*METHODS@#Healthy O-type RhD+ volunteer donors of the Shenzhen Blood Center from January to May 2021 (n = 1 568) and a pedigree with difficult cross-matching (n = 3) were selected as the study subjects. Serological methods were used for proband's blood type identification, unexpected antibody identification, and antibody titer determination. Polymerase chain reaction-sequence specific primer (PCR-SSP) method was used for typing the proband's RhD gene. ABCG2 gene coding region sequencing and a PCR-SSP genotyping method were established for determining the genotypes of the proband and his family members and screening of Jra antigen-negative rare blood type among the 1 568 blood donors.@*RESULTS@#The proband's ABO and RhD blood types were respectively determined as B and partial D (RHDDVI.3/RHD01N.01), Junior blood type Jra antigen was negative, and plasma had contained anti-D and anti-Jra. Sequencing of the ABCG2 gene revealed that the proband's genotype was ABGG201N.01/ABGG201N.01 [homozygous c.376C>T (p.Gln126X) variants], which is the most common Jr(a-) blood type allele in the Asian population. Screening of the voluntary blood donors has detected no Jr(a-) rare blood type. Statistical analysis of the heterozygotes suggested that the allelic frequency for ABCG2*01N.01 (c.376T) was 0.45%, and the frequency of Jr(a-) rare blood type with this molecular background was about 0.2‰.@*CONCLUSION@#A very rare case of partial DVI.3 type and Jr(a-) rare blood type has been identified. And a method for identifying the Junior blood type through sequencing the coding regions of the ABCG2 gene and PCR-SSP has been established.

Atopic dermatitis-like lesions appearing after interleukin-17 antagonist therapy in 4 cases of psoriasis: case analysis and literature review / 中华皮肤科杂志

Objective:To summarize and analyze clinical characteristics and possible pathogenesis of atopic dermatitis (AD) -like lesions after treatment with interleukin-17 (IL-17) antagonists in patients with psoriasis, so as to improve the clinical management of these patients.Methods:Four patients with psoriasis, who developed AD-like lesions after the treatment with IL-17 antagonists, were reported. A comprehensive update-search was carried out to analyze and summarize clinical characteristics of and therapeutic strategies for other related cases reported in Chinese and international literature.Results:Among the 4 patients in this study, 2 were males and 2 were females, with a history of psoriasis ranging from 10 to 35 years; after 5-month to 2-year treatment with secukinumab, they developed pruritic erythema and papules with exudation on the trunk, limbs and/or face. All the 4 patients had a history of atopic diseases and elevated serum total IgE levels and/or eosinophil counts. AD-like lesions were controlled in 3 patients after treatment with systemic cyclosporine, glucocorticoids and/or antihistamines, as well as topical glucocorticoids and/or tacrolimus, and secukinumab continued to be administered simultaneously; 1 discontinued secukinumab due to repeated AD-like lesions. Totally, 12 articles in English containing 48 patients were included, and a total of 52 patients including the 4 patients in this study were analyzed. Among them, there were 30 males and 22 females, with the age being 50.1 ± 13.6 years; 37 cases were induced by secukinumab, 14 induced by ixekizumab, and 1 induced by brodalumab; the time from the initiation of biologic therapy to the onset of AD-like lesions ranged from 1 week to 2 years; the lesions manifested as pruritic erythema and papules, accompanied by scales or exudation; the skin lesions were mainly distributed on the limbs (41 cases, 78.8%), followed by the trunk (32 cases, 61.5%) and face (20 cases, 38.5%) ; a personal or family history of atopic diseases was reported in 57.7% patients; peripheral blood eosinophil counts increased in 5 cases, and serum total IgE levels were elevated in 17. Thirty-two (61.5%) patients discontinued IL-17 antagonists, and received single or combination therapies, including systemic treatment with cyclosporine, methotrexate, glucocorticoids, antihistamines, other biologic agents and small-molecule drugs, topical treatment with glucocorticoids and/or tacrolimus, and phototherapy; 20 (38.5%) patients continued the previous treatment with IL-17 antagonists, and additionally received topical treatment with or without oral antihistamines or cyclosporine; after the above treatment, the psoriatic and AD-like lesions were controlled in most patients.Conclusions:AD-like lesions after IL-17 antagonist therapy were not common in patients with psoriasis, and these patients developing AD-like lesions were more likely to have a personal or family history of atopic diseases and elevated levels of serum total IgE; based on the disease condition, the treatment with IL-17 antagonists may be considered to continue during the symptomatic treatment of AD-like lesions.

Correlations of melanin concentration hormone with sleep disorder, memory dysfunction and prognoses after cerebral ischemic stroke / 中华神经医学杂志

Objective:To investigate the correlations of melanin concentration hormone (MCH) in cerebrospinal fluid (CSF) and serum with sleep disorder, memory dysfunction and prognoses in patients with cerebral ischemic stroke (CIS).Methods:One hundred elderly CIS patients, admitted to Department of Neurology, He'nan Provincial People's Hospital from June 2021 to January 2022 were enrolled as CIS group, and 50 subjects collected from Physical Examination of the same hospital during the same period were enrolled as control group. MCH levels in the CSF and serum were detected by ELISA. Sleep quality was assessed by polysomnography and Pittsburgh Sleep Quality Index (PSQI). Memory function was assessed by Rivermead Behavioral Memory Test 2 nd Edition (BMT-II). Prognoses were assessed by modified Rankin Scale (mRS) 3 months after discharge. The clinical data and MCH levels of the two groups were compared; the differences in MCH levels among CIS patients with different degrees of sleep disorder, and different memory functions and prognoses were compared. Correlations of MCH level and sleep parameters with RBMT-II scores in these CIS patients were analyzed. Results:Compared with that in the control group, the proportion of patients with hypertension in CIS group was significantly higher ( P<0.05). Compared with the control group ([42.39±16.11] pg/mL), the serum MCH level in CIS group ([36.89±15.19] pg/mL) was statistically lower ( P<0.05). In CIS patients, patients with mild or severe sleep disorder had significantly decreased CSF MCH level compared with patients without sleep disorder ( P<0.05), patients with severe sleep disorder had significantly decreased CSF MCH level compared with patients with mild sleep disorder ( P<0.05); patients with severe sleep disorder had significantly decreased serum MCH level compared with patients without sleep disorder ( P<0.05); CSF MCH level was negatively correlated with PSQI scores, sleep latency and wake frequency ( P<0.05), and positively correlated with percentage of rapid eye movement ( P<0.05); serum MCH level in CIS patients was negatively correlated with PSQI scores and wake frequency ( P<0.05). In CIS patients, the CSF and serum MCH levels in patients with memory dysfunction was significantly lower compared with those with normal memory function ( P<0.05); a positive correlation was noted between RBMT-II scores and CSF MCH level ( P<0.05). In CIS patients, patients with poor prognosis had statistically lower CSF and serum MCH levels compared with those with good prognosis ( P<0.05). Conclusion:The serum MCH level in CIS patients is significantly decreased, which is closely related to the occurrence of sleep disorder and memory dysfunction after stroke; and they further affects the prognoses.

Clinicopathological features and prognostic factors associated with metaplastic carcinoma of the breast / 中华普通外科杂志

Objective:To study the clinicopathological features of metaplastic breast cancer (MBC) , and its prognostic factors.Methods:Data of 49 MBC cases and 30 cases of invasive ductal carcinoma (IDC) during the same period as matched control were collected. The immunohistochemistry staining of CK5/6, CK, P63, ER, HER2, Ki67 was performed in all MBC samples.Results:In MBC cases, the median age was 55 years. Median tumor size was 2.5 cm (range, 0.6-19 cm). Fifteen cases were classified as metaplastic carcinoma with heterologous mesenchymal differentiation (8 as matrix-producing carcinoma), 12 as spindle cell carcinoma, 7 as squamous cell carcinoma, 2 as low-grade adenosquamous carcinoma, 2 as fibromatosis-like metaplastic carcinoma, and 11 as mixed metaplastic carcinoma. The 5-, 10-year overall survival rate was 50%, 41%, respectively, lower than those of IDC (76%,63%) (all P<0.05). Lymph node metastasis rate, and expression of ER, PR, HER2 in MBC were lower than those in IDC (all P<0.05). Triple-negative cases in MBC were more than those of IDC ( χ2=26.244, P=0.000). The proliferative index of Ki67 was statistically different between the two groups ( t=2.624, P=0.011). Conclusions:MBC is a rare and heterogenous breast cancer. Compared to IDC, MBCs are usually larger, lower in lymph nodes metastasis, higher in proliferative index of Ki67, more triple-negative, hence with a poorer prognosis.

Research progress in genetic susceptibility genes and related pathogenic factors and treatment of neoplastic calcinosis / 国际生物医学工程杂志

Tumor calcinosis(TC) has different clinical and biochemical patterns. The existence of chronic injury as well as calcium and phosphorus metabolism disorder has been gradually proved to be the important link in the occurrence of TC. In this paper, the related basic diseases with the pathophysiological mechanism of calcium and phosphorus metabolism disorder were reviewed, and the pathophysiological mechanism of phosphate metabolism disorder in various diseases was summarized.In addition, the phosphate homeostasis genes including GALNT-3, FGF-23 and α-KLOTHO were described. The relevant research results have showed that mutations in any of these three genes will lead to defects in the synthesis or action of FGF-23, which will increase the reabsorption of phosphate by renal tubules, resulting in hyperphosphatemia and severe ectopic calcification of soft tissue.At present, surgical resection is still the main treatment of TC. New technologies such as cinalcet peritoneal dialysis, ultrasound-guided aspiration of TC lesions and local injection of sodium thiosulfate (STS), as well as the successful application of lanthanum carbonate and other drugs, provide alternatives to TC treatment.In this paper, the research literatures on TC at home and abroad in recent years were introduced and the genetic susceptibility genes, related pathogenic factors and the latest treatment progress of TC were reviewed.

Study on the effect of N-acetylserotonin on the expression of tumor necrosis factor-α in retina of rats with retinal ischemia-reperfusion injury / 中华眼底病杂志

Objective:To dynamically observe the effect of N-acetylserotonin (NAS) on the expression of tumor necrosis factor-α (TNF-α) protein in retina of retinal ischemia reperfusion injury (RIRI) rats, and to explore the mechanism.Methods:By using random number table method, 90 healthy male Sprague-Dawley rats were divided into sham operation group ( n=10), RIRI group ( n=40), and NAS group ( n=40). The right eye was as the experimental eye. In the RIRI group and NAS group, the anterior chamber high intraocular pressure method was used to establish the RIRI model. In the NAS group, 10 mg/kg NAS was injected intraperitoneally before modeling and 30 minutes after modeling. At 6, 12, 24, 72 h after modeling, hematoxylin-eosin staining was used to observe the pathological changes of the retina, and the retinal ganglion cells (RGC) were counted. Each group was detected by immunohistochemical staining and Western blot about the relative expression of TNF-α, nuclear factor E2-related factor 2 (Nrf2), and heme oxygenase-1 (HO-1) protein in the rat retina. Oneway analysis of variance was used for differences between groups. The general linear regression method was used to analyze the correlation between the relative expression changes of TNF-α protein and the changes of Nrf2 and HO-1 protein expression after NAS intervention. Results:Optical microscope observation revealed that the retinal edema of rats in the RIRI group was observed at 6, 12, and 24 h after modeling; the thickness of the retina in the NAS group was significantly thinner than that in the RIRI group, and the difference was statistically significant ( F=9.645, 477.150, 2.432; P<0.01). At 6, 12, 24, and 72 h after modeling, the retinal RGC counts in the NAS group were significantly higher than those in the RIRI group, and the difference was statistically significant ( F=12.225, 12.848, 117.655, 306.394; P<0.05). The results of immunohistochemical staining and Western blot showed that 6 h after modeling, the relative expression of TNF-α protein in the retina of the RIRI group increased significantly compared with that in the sham operation group, reaching a higher level at 12 h, and decreased at 24 and 72 h. But all were significantly higher than the sham operation group, the difference was statistically significant (immunohistochemical staining: F=105.893, 1 356.076, 434.026, 337.351; P<0.01; Western blot: F=92.906, 534.948, 327.600, 385.324; P<0.01). At different time points after modeling, the relative expression of TNF-α protein in the retina of the NAS group was significantly lower than that of the RIRI group (immunohistochemical staining: F=15.408, 570.482, 21.070, 13.767; P<0.05; Western blot: F=12.618, 115.735, 13.176, 111.108; P<0.05), but still higher than the sham operation group (immunohistochemical staining: F=40.709, 151.032, 156.321, 216.035; P<0.01; Western blot: F=33.943, 79.729, 74.057, 64.488; P<0.01), the difference was statistically significant; 12 h after modeling, Nrf2 in the retina of the NAS group (immunohistochemical staining: F=51.122, P<0.05; Western blot: F=33.972, P<0.05), HO-1 (immunohistochemical staining: F=30.750, P<0.05; Western blot: F=18.283, P<0.05) protein relative expression was significantly higher than that of RIRI group, and the differences were statistically significant. The results of linear regression analysis showed that the difference in the number of TNF-α + cells in the RIRI group and the NAS group was negatively correlated with the difference in the number of Nrf2 + and HO-1 + cells ( r 2=0.923, 0.936; P<0.01). Conclusions:NAS can inhibit the expression of TNF-α protein in the retina of RIRI rats and reduce RIRI. The mechanism may be related to the Nrf2/HO-1 pathway.

Solutions to cross-matching incompatibility in clinical: retrospective study of 1 770 cases in Shenzhen / 中国输血杂志

【Objective】 To analyze the blood samples sent by hospitals in Shenzhen to solve ABO cross-match incompatibility during 2011 to 2020, so as to find corresponding solutions to improve the efficacy of blood transfusion. 【Methods】 The clinical data of 1 770 cases of cross-match incompatibility in our laboratory from January 2011 to December 2020 were collected and reviewed. The causes of cross-match incompatibility were analyzed, the types of unexpected antibodies were determined. The overall incidence of antibodies was evaluated by statistical method of classified variables. The safety of blood transfusion was safeguarded by ABO homotype plus cross-matching compatibility. 【Results】 1) The 1 770 samples, presenting cross-matching incompatibility, involved 956 patients. The average number of cross-matching per patient from 2011 to 2015 was 1.32(307/232), which increased from 1.27(103/81) in 2016 to 2.23(286/128) in 2018, and remained stable in 2019 and 2020. 2) Among 956 patients, auto-and/or allo-antibody in plasma were yielded in 90.38%(864/956), including auto-antibody plus alloantibody in 42.26%(404/956), solo auto-antibody in 20.71%(198/956) and solo allo-antibody in 27.41%(262/956). Up to 20 kinds of specific allo-antibodies were detected, belonging to 8 blood groups. Among them, 70.82%(551/778) were Rh blood group, such as anti-E(37.15%)>anti-c(20.95%)>anti-C(5.27%)=anti-e(5.27%)>anti-D(2.19%), followed by MNS [11.40%(112/778)], Kidd [5.66%(44/778)], Leiws [3.21%(25/778)], Duffy [1.80%(14/778)], Diego [1.03%(8/778)], P1 [0.39%(3/778)] and H [0.26%(2/778)]. 3) 86%(37/43) of multiple transfusion recipients, aged below 20 years old, were thalassemia, and 1-4 kinds of allo- and/or auto-antibody were yielded. 【Conclusion】 The cross-matching incompatibility were mainly caused by allo- and/or auto-antibodies, which may be induced by blood transfusion, pregnancy or autoimmune diseases such as autoimmune hemolytic anemia.Those suspicious blood samples in clinical should be sent to blood group reference laboratory for further determination, in order to ensure the safety and efficacy of blood transfusion.

Dynamic observation of the effect on coagulation function of arsenic trioxide in children with acute promyelocytic leukemia / 国际儿科学杂志

Objective:Patients with acute promyelocytic leukemia(APL)treated with arsenic trioxide(ATO)have significant coagulation disorders both in pretherapy and post-treatment, and severe cases can progress quickly to the disseminated intravascular coagulation(DIC). This article aims to investigate the risk factors of DIC and observe dynamically the effect of ATO on coagulation function in APL children.Methods:We collected basic characteristics, laboratory characteristics and coagulation index at various time points on admission of 28 children who were first diagnosed APL and treated with ATO at department of pediatric hematology in Shengjing Hospital from January 2012 to January 2018. We retrospectively analyzed the correlation between these factors and the occurrence of DIC, and the trend of dynamic changes in coagulation index in different treatment time.Results:Of the 28 patients, 24(85.7%)were diagnosed as DIC. No relation has been found between the occurrence of DIC and the age, gender, blood routine at initial diagnosis, fibrinogen level, lactate dehydrogenase level in APL children( P>0.05). Different indicators of plasma prothrombin time, fibrinogen at different time point showed significantly difference. In the high-risk group, PT was higher significantly before treatment[(17.58±2.99)s] than those of the 3-4 days after therapy[(15.3±1.86)s], 7-10 days after therapy[(13.81±1.18)s], 14-16 days after therapy[(14.13±0.62)s], 22-26 days after therapy[(14.2±1.59)s]( P=0.016). In the group which PLT was greater than or equal to 20×10 9/L, PT was higher significantly before treatment[(15.02±2.83)s]and the 3-4 days after therapy[(14.59±2.19)s] than those of the 7-10 days after therapy[(13.25±2.01)s], 14-16 days after therapy[(13.31±1.51)s], 22-26 days after therapy[(13.47±1.64)s]( P<0.01). Conclusion:No relation has been found between the occurrence of DIC and the age, gender, blood routine at initial diagnosis, fibrinogen level, lactate dehydrogenase level in APL children. The time points of significantly abnormal of coagulation function occurred in the newly diagnosed APL children were before the ATO induction treatment and the 3-4 days after therapy.

Current situation of clinical research of buccal mucosa squamous cell carcinoma / 中华放射肿瘤学杂志

Treatment approaches for buccal mucosa carcinoma include surgery, radiotherapy, chemotherapy, targeted therapy, immunotherapy and various combinations of these modalities, whereas the clinical efficacy is not satisfactory. In this article, literature review was conducted to summarize the current situation of the diagnosis, lymph node metastasis, treatments of buccal mucosa carcinoma, aiming to provide reference for clinical practice.

Progress in the treatment of disseminated intravascular coagulation in patients with acute promyelocytic leukemia / 国际儿科学杂志

Acute promyelocytic leukemia(APL)is identified as the M3 subtype of acute myelocytic leukemia(AML). One of its clinical features is severe coagulation dysfunction.Most patients could develop disseminated intravascular coagulation(DIC)resulting vital viscera hemorrhage, which is one of the significant causes of early death in APL patients.Early diagnosis and inductive therapy, dynamic monitoring patients′ coagulation index and correcting the abnormal coagulation could prevent the occurrence or progress of DIC, and then improving the early-term survival rate of APL patients.At present, APL is mainly treated from the treatment of primary disease, anticoagulant antifibrinolytic therapy, and alternative therapy.

Clinical efficacy of percutaneous tibial nerve stimulation in the treatment of chronic pelvic pain syndrome / 中国医师进修杂志

Objective@#To evaluate the clinical efficacy of percutaneous tibial nerve electrical stimulation in the treatment of chronic pelvic pain syndrome.@*Methods@#The clinical data of 28 patients with chronic pelvic pain syndrome from January to November 2018 in Dalian Third People′s Hospital were retrospectively analyzed. The patients were treated with percutaneous tibial nerve stimulation. The number of urination in 24 h, number of nocturnal urination, urine volume per urination, quality of life (QOL) score and digital pain intensity score before treatment and after treatment were compared; the patients were followed up for 3 months, and the recurrence and adverse reaction were observed.@*Results@#Compared with those before treatment, the number of urination in 24 h and number of nocturnal urination after treatment were significantly lower: (11.6 ± 6.4) times vs. (20.6 ± 7.8) times and (2.5 ± 1.2) times vs. (5.2 ± 2.6) times, and the urine volume per urination increased significantly: (181.2 ± 65.6) ml vs. (125.4 ± 58.2) ml, the QOL score and digital pain intensity score decreased significantly: (2.6 ± 1.4) scores vs. (5.1 ± 0.8) scores and (2.9 ± 1.3) scores vs. (6.9 ± 1.4) scores, and there were statistical differences (P<0.05). During the follow-up period, none of the patients had recurrent symptoms and obvious adverse reaction.@*Conclusions@#Percutaneous tibial nerve stimulation is an effective way to treat chronic pelvic pain syndrome.

Progress in the treatment of disseminated intravascular coagulation in patients with acute promyelocytic leukemia / 国际儿科学杂志

Acute promyelocytic leukemia ( APL) is identified as the M3 subtype of acute myelo-cytic leukemia ( AML) . One of its clinical features is severe coagulation dysfunction. Most patients could de-velop disseminated intravascular coagulation ( DIC) resulting vital viscera hemorrhage, which is one of the significant causes of early death in APL patients. Early diagnosis and inductive therapy, dynamic monitoring pa-tients' coagulation index and correcting the abnormal coagulation could prevent the occurrence or progress of DIC, and then improving the early-term survival rate of APL patients. At present, APL is mainly treated from the treatment of primary disease, anticoagulant antifibrinolytic therapy, and alternative therapy.

Analysis of Hospitalization Expenses about 7 Cancers in a West Northern County in 2014 / 现代医院

Objective To analyze the influencing factors of hospitalization costs for cancer patients in a county in Northwestern China, and to provide a theoretical basis for the health department to optimize the allocation of medical resources and improve the diagnosis and treatment of cancer in primary hospitals. Methods Using the data of the tumor registration report of a county hospital in northwestern China, the data of 7 common cancer patients in a county in northwestern China in2014 were collected. Use the R3. 3. 1 statistical software to perform t-tests and logistic regression analysis on the factors that influence the average hospitalization costs. Results The 7 common cancers in a county in northwestern China in 2014 were gastric cancer, lung cancer, liver cancer, esophageal cancer, cervical cancer, breast cancer, and colorectal cancer. The average hospitalization costs for the 7 cancers were 28 270 yuan, 29 630 yuan, and 28 990 respectively. Yuan, 43 950 yuan, 48 810 yuan, 45 620 yuan, 41 340 yuan; The main influencing factors for the average cost of hospitalization for the 7 types of cancer were: hospitalization day, patient age, and location of the patient for medical treatment. Conclusion Accelerating the improvement of the cancer prevention and control system in primary hospitals so that cancer patients can be effectively treated in primary hospitals to reduce personal and socioeconomic burdens.

Flail leg syndrome: a case report and literature review / 中华老年医学杂志

Objective To review the clinical characteristics,diagnosis and treatment of flail leg syndrome and to promote awareness among clinicians of this disease.Methods We presented the clinical data,neural electrophysiological examination results,and cervical/lumbar MRI and follow-up results of an inpatient vith flail leg syndrome at China-Japan Union Hospital and then reviewed relevant cases reported in literature.Results The patient with flail leg syndrome had a slow and asymmetric onset of atrophy of the distal muscles and weakness in the lower limbs,gradually progressing to the proximal lower limbs while the brain stem was moderately involved.Electrophysiology displayed not only motor nerve conduction amplitudes falling more than 48％ or even disappearing in both lower limbs,but also extensive neurogenic damage in the brain stem,cervical,thoracic and lumbosacral areas.Laboratory tests showed abnormally high creatinc kinase levels.Conclusions Flail leg syndrome has been inadequately studied so far and can be easily misdiagnosed.Reviewing its characteristics should be helpful for clinicians to make the right diagnosis and prognosis.

Atherosclerosis Related Risk Factor Analysis in Middle and Old Age Patients With Newly Diagnosed Type 2 Diabetes Mellitus / 中国循环杂志

Objective: To study the relationship between serum levels of insulin-like growth factor-1 (IGF-1), cystation-C (Cys-C), interleukin-6 (IL-6) and atherosclerosis in middle and old age patient with newly diagnosed type 2 diabetes mellitus (T2DM). Methods: A total of 206 patients with newly diagnosed T2DM at the age of (67.3±10.4) years were enrolled. Based on color Doppler ultrasound examination, the patients were divided into 2 groups: Control group, the patient without carotid plaque or increased intima thickening, n=105 and Experiment group, patient with carotid plaque or increased intima thickening, n=101. The general information, fasting blood glucose, 2h postprandial blood glucose, glycosylated hemoglobin, LDL-C, HDL-C, TG, TC and IGF-1, Cys-C, IL-6, hs-CRP were recorded and compared between 2 groups, BMI was calculated in all patients. Results: Compared with Control group, Experiment group had increased carotid intima-media thickness (CIMT), elevated serum levels of Cys-C, IL-6, hs-CRP and reduced IGF-1, allP<0.05. Multiple Logistic regression analysis showed that CIMT was negatively related to IGF-1 (r=-0.493,P<0.01), positively related to Cys-C, IL-6 and hs-CRP (r=0.464,r=0.219 andr=0.618, allP<0.01). Conclusion: Serum levels of Cys-C and IL-6 might be the independent risk factors for atherosclerosis occurrence in meddle and old patients with T2DM; combined detection of IGF-1, Cys-C and IL-6 could help clinical diagnosis in relevant patients.

Drug-drug interation prediction between ketoconazole and anti-liver cancer drug Gomisin G.

BACKGROUND: Gomisin G, isolated from herb Schisandra chinensis, exhibits anti-tumor activities. Therefore, Gomisin G is a drug candidate for anti-liver cancer therapy. AIMS: To predict the metabolic behavior and metabolism-based drug-drug interaction of gomisin G. METHODS: Molecular docking method was used. The crystal structure of CYP3A4 with the ligand ketoconazole was chosen from protein data bank (http://www.rcsb.org/pdb). Chemdraw software was used to draw the two-dimensional structure of gomisin G with standard bond lengths and angles. RESULTS: Gomisin G can be well docked into the activity site of CYP3A4, and distance between gomisin G the heme active site was 2.75 Å. To evaluate whether the inhibitors of CYP3A4 can affect the metabolism of gomisin G, co-docking of gomisin G and ketoconazole was further performed. The distance between ketoconazole and activity center (2.10 Å) is closer than the distance between gomisin G and activity center of CYP3A4, indicating the easy influence of CYP3A4's strong inhibitor towards the metabolism of gomisin G. CONCLUSION: Gomisin G is a good substrate of CYP3A4, and CYP3A4 inhibitors easily affect the metabolism of Gomisin G.

Neuroprotective effect of sulfated pachymaran on the MPTP-induced Parkinson mice / 中国药理学通报

Aim To determine the neuroprotective effect of sulfated pachymaran (SP)on MPTP-induced mouse model.Method ICR mice were randomly di-vided into control group,MPTP group and SP treatment group (50,1 00,1 50 mg·kg -1 ,ip).After 1 7 days, the activities of endogenous antioxidants (SOD,GSH-Px,CAT),antisuperoxide anion,hydrogen peroxide and MDA content in the midbrain and cortex were as-sayed.Results The results proved that SP significant-ly reduced the content of MDA and H2 O2 ,regulated the activities of antioxidant enzyme and increased the activity of antisuperoxide anion.Conclusion All these effects indicate that SP is a potential neuroprotective a-gent and its neuroprotective effects are achieved in the MPTP mouse model.

p16 and PR immunoreactivity and human papillomavirus infection in endocervical adenocarcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The aim of this study was to investigate the characteristics of p16 and PR immunoreactivity and HPV infection in endocervical adenocarcinoma.</p><p><b>METHODS</b>Paraffin blocks of 62 patients with endocervical adnocarcinoma treated in the Cancer Institute and Hospital, Chinese Academy of Medical Sciences from year 2005 to year 2010 were collected. p16 and PR immunostaining and HPV detecting by SPF-10 PCR were conducted on all cases.</p><p><b>RESULTS</b>HPV infection rate of the 62 endocervical adnocarcinoma cases was 74.2% with four cases combined with CIN3. Among the 46 HPV-positive cases, there were 22 cases of HPV18 infection (47.8%), 14 cases of HPV16 infection (30.4%), one case of HPV59 infection (2.2%). and nine multiple HPV infection cases (19.6%). The mean age of the 16 HPV-negative cases was (49.6 ± 10.5)year, while the mean age of the 46 HPV-positive cases was (42.8 ± 9.7)year, showing a significant difference between the two subgroups (P = 0.022). The positive rate of p16 infection was 80.6%. Association analysis showed that the results of p16 and HPV test were independent to each other (P = 0.077). The positive rate of PR was 3.2%. Among the 62 cases, there were 24 cases containing normal cervical glands, with 19 cases PR-positive in the normal cervical glands and the positive rate was 79.2%. The difference of PR positivity between neoplastic glands and normal glands was statistically significant by Chi-square test (P < 0.01) .</p><p><b>CONCLUSIONS</b>The HPV infection rate of endocervical adnocarcinoma is 74.2%, and the major subtypes were HPV16 and HPV18 infection. p16 immunoreactivity in endocervical adenocarcinoma maybe not the proof of high-risk HPV-related neoplasm. PR staining can be used as a reference designator to differentiate between neoplastic and normal cervical glands.</p>

Construction of calcium sulfate/bone marrow mesenchymal stem cells tissue-engineered bone for spinal fusion / 中国组织工程研究

BACKGROUND:Calcium sulfate has good biocompatibility and biodegradability, which is a safe and effective bone graft substitute. OBJECTIVE:To investigate the osteogenesis ability of calcium sulfate combined with bone marrow mesenchymal stem cells. METHODS:After L4/5 posterior lumbar discectomy, 36 rabbits were randomized into three groups:rabbits in autologous bone group were implanted with autologous iliac bone via the intervertebral space;animals in al ogenic bone group were implanted with decalcified bovine bone;rabbits in tissue-engineered bone group were implanted with calcium sulfate combined with bone marrow mesenchymal stem cells. Bone formation and molding were observed by gross observation, anteroposterior and lateral X-ray, histology and biomechanics at 4, 8 and 16 weeks. Cal us specimens were employed for histological observation of interbody fusion. Biomechanical analysis of spinal fusion site was conducted at 16 weeks. RESULTS AND CONCLUSION:Sixteen weeks later, interbody fusion was complete in the autologous bone group, the trabecular bone bridged continuously and a large amount of woven bone was merged into pieces;in the al ogenic bone group, incomplete bony fusion was found between the intervertebral space, most of cartilage tissues differentiated into bone, but fibrous tissue was also ful of the central part;in the tissue-engineered bone group, interbody fusion was complete, and a large amount of woven bone was fused into pieces, while the artificial bone was absorbed and ossified with smal residual. Failure strength and stiffness in the autologous bone and tissue-engineered bone groups were superior to those in the al ogenic bone group. These findings indicate that the calcium sulfate/bone marrow mesenchymal stem cells tissue-engineered bone has excellent osteogenic and osteoinductive capacity that can exert a good function of promoting spinal interbody fusion.