Objective To investigate clinical and MRI features of the reversible posterior encephalopathy syndrome (RPES).Methods Clinical and MRI materials of 4 RPES cases confirmed by integrated clinical diagnosis were retrospectively analyzed.Results All the cases presented with a rise of blood pressure.The neural symptom include severe headache (2 cases),dysphoria (3 cases),blur of vision (2 cases),impairment of impermanent memory (1 case),seizure (2 cases).In MRI,the lesions mainly systematically located in posterior parietal lobe and occipital lobe in all cases,or randomly located in frontal lobe (2 cases).Lesions demonstrated high signal on T_2 weighed and water-suppressed sequences in MRI.The lesions dominantly located in cortex in 2 cases,in both cortex and subcortieal white matter in 1 case and in subcortical white matter in 1 case.Four cases resolved their lesions when re-examined. Conclusions RPES represents such characteristic MRI findings as symmetrical distribution of reversible lesions in posterior brain with involvement of cortex or subcortieal white matter.When combined with hypertension and neural symptoms caused by involvement of posterior brain structure,it is helpful for early differential diagnosis of this syndrome.

Objective To evaluate the method for vaginal treconstruction with muscle sparing verti-cle rectus abdominis myocutaneous flap(MS-VRAM flap). Methods From September 2006 to April 2008, MS-VRAM flaps were used for vaginal reconstruction in 9 patients (20 to 35 years old), ancl all ca-ses were congenital absence of vagina. Before operation, the inferior epigastrie arteries were detected by the Doppler and the flaps based on the perforators ranged from 6 cm×20 cm. MS-VRAM flaps were ele-vated and then transferred to reconstruct the vagina. Results All 9 cases of MS-VRAM flaps survived completely. No complications occurred at donor site of abdominal wall. With 2-12 months' follow-up, the patients were satisfied with the results. Conclusion Despite technical difficulties in elevating the MS-VRAM flap, the flap is a good choice for vaginal reconstruction.

Objective To explore the distribution of age,reasons for treatment,risk factors,and causes of vulvovaginitis in prepubertal girls.Methods A total of 4 214 prepubertal girls with vulvovaginitis who were admitted to the Girl's Sub-department,Zhongshan Boai Hospital from January 2010 to June 2013 was reviewed retrospectively.All clinical data were from medical records with files.Results Atotalof1 587 patients (37.7％) was0to1 years old,954 (22.6％) ＞ 1 to3 years old,1 289 (30.6％) ＞ 3 to 7 years old,and 384 (9.1％) ＞ 7 years old.Many risk factors were associated with vaginitis,including poor hygiene (2 924 girls; 69.4％),allergies and exposure to allergens (875 girls; 20.8％).Most common reason for treatment was a referral from physical examination accounting for 919 girls (21.8％),followed by vaginal secretions 812 girls (19.3％).The causes of vulvovaginitis of all patients were evaluated,1 771 of which (42.0％) were nonspecific vulvovaginitis,1 309 (31.1％) labial adhesions,375 (8.9％) bacterial vulvovaginitis,266 (6.3％) allergic vulvovaginitis,and 266 (6.3％) affective leg rubbing action.Conclusions Prepubertal vulvovaginitis occurred mainly in infancy and preschool.Floating population was common.They were caused by many risk factors including poor hygiene,allergies,poor urination habits,etc.The most common causes of vulvovaginitis were nonspecific vulvovaginitis and labia adhesion,yet allergies and affective leg rubbing action were the more common causes of recurrent vulvovaginitis.We propose that focusing on girls' reproductive health,timely treating allergic and crossing rub legs and other diseases would help reduce the prevalence of vulvovaginitis in the prepubertal girls.

Objective To compare the perinipple round-block technique with the conventional periareolar round-block technique in areolar reduction operations.Methods A total of 37 patients who underwent areolar reduction operations in our department were randomly allocated into two groups:Group A (19 patients) received a conventional periareolar round-block technique,while group B (18 patients) through a new perinipple round-block technique.In the latter approach,an intraareolar donut of pigmented skin was deepithelialized,and the exposed areolar dermis was then telescoped inward and stretch-anchored to an imaginary circular line situated beneath the breast skin areola junction.The roundblock technique was then utilized to approximate the skin edges,resulting in a minimal scar,totally inconspicuous,confined to the immediate perinipple area.The operative time,perioperative complications,scars,absorption time of the skin folds,the sensation of the nipple-areolar complex and the patients' satisfaction were compared between the two groups.Results The mean operative time of group A and group B was 40.5 min and 45.8 min,respectively (P＜0.05).No perioperative complications were found in these two groups.No patient had experienced permanent nipple sensory changes.The skin folds absorption time of group A was 4.34 months,while the time of group B was 8.78 months (P＜0.01).The perinipple round-block technique produced a more inconspicuous scar with a better aesthetic results.Conclusions The traditional periareolar round-block technique leaves a sharply demarcated areola by a circular scar which has a totally unnatural and artificial look.As for the perinipple round-block technique,the incision as well as any residual cutaneous wrinkling or puckering is well concealed by the dome of the nipple and the areolar,but it needs a longer skin folds absorption time.

Objective To investigate the epidemiological characteristics and mortality risk factors of severe sepsis patients admitted into intensive care unit (ICU).Methods The clinical data of 419 severe sepsis patients admitted to an adult ICU of Beijing Friendship Hospital from January 2009 to December 2012 were retrospectively analyzed and evaluated.Logistic regression analysis was employed to identify independent risk factors for the death of patients with severe sepsis during ICU stay.Results Overall ICU mortality was 43.9％ (184/419),and the respiratory tract was the most common site of infection (50.8％),followed by infection of the gastrointestinal tract and abdominal cavity (27.8％),and hematogenous infection (4.3％).Gram-negative bacteria were the most common pathogens [46.0％ (214/465)].Iatrogenic infections accounted for 53.7％ (225/419) of the enrolled patients.Logistic regression analysis showed that age [odds ratio (OR)=0.003,95％ confidence interval (95％CI) 1.015-1.056,P=0.O00],vasoactive drug application (OR=3.251,95％CI 1.562-6.768,P=0.002),failure of 3 or more organs (OR=2.452,95％ CI 1.015-5.924,P=0.046),and iatrogenic infection (OR =1.775,95％ CI 0.981-3.221,P=0.046) were independent risk factors for ICU mortality.Conclusions Severe sepsis is a common cause of ICU admission.Patients with risk factors for high mortality should be carefully monitored,and aggressive treatment should be administered.

Objective To investigate the expression of FSCN1 mRNA in breast carcinoma and benign breast diseases and its relationship to clinicopathological characteristics of breast cancer. Methods Sixty-three cases of breast cancer and thirty cases of benign breast diseases were analyzed by in situ hybridization. Results The expression rates of FSCN1 mRNA in breast cancer tissue and benign breast lesions were 65.1% and 90.0% , respectively (P < 0.05). No relation was found between the expression of FSCN1 mRNA and histopathologic grading, ER, PR, karyokinesis figure, patients′ age, tumor size, lymph node metastasis, TNM stage and c-erbB-2 expression in breast cancer. Survival rates of breast cancer patients with carcinoma expressing FSCN1 mRNA were 92.3% , while those patients with tumors which was negative for FSCN1 mRNA were 82.2%, but there was no significance difference. A significant correlation was observed between FSCN1 mRNA and its protein expression (rs = 0.315, P < 0.05). Conclusion FSCN1 is downregulated in breast carcinoma which may be associated with breast carcinogenesis.

Objective To explore the clinical effect of the modified rhytidectomy technique with hidden temporal and buccal incision.Methods 26 cases of aging face were collected.The operation was performed with modified preauricular incision which was the leading edge of the cartilage of helix and hair line.Preauricular remporal fascia was modified as suspended vertically and SMAS superficial to parotic gland was suspended vertically to nasolabial sulcus.Results All the patients reported fine rejuvenescent effects,the satisfaction rate was 100％ without any severe complications,such as scar,hair loss on temperal incision.Conclusions This surgical technique may maintain natural configuration of preauricular area,result in invisable incision scar with no obvious baldness,and avoid important nerves or vessel injury.

Objective To explore the efficacy of Xipayigingiva consolidation gargle for root canal flushing. Methods 543 teeth in 543 patients with acute or chronic pulpitis or apical periodontitis who needed root canal treatmentwere divided into three groups by completely randomized design. The three groups wereXipayigingiva consolidation gargle group, hydrogen peroxide group, and sodium hypochlorite group. Conventional pulp chamber incision, pulpectomy and root canals preparation were used for the affected teeth. Three different rinsing solutions were applied to flush root canal. One week later , signs and symptoms were observed , and success rate was assessed in patients by comparing among the three groups. Results Regardless of duration of disease course and patients′ oral health situation, the success rate did not differ significantly among the three groups (P > 0.05). Conclusions Xipayi gingiva consolidation gargle has the same effect as sodium hypochlorite and hydrogen peroxide. It can be used as an alternative for flushing root canal.

Objective To observe the therapeutic efficiency of naoxintong capsule on the patients with moderate obstructive sleep apnea hypopnea syndrom ( OSAHS ) of cognitive dysfunction. Methods Sixty pa?tients of moderate OSAHS were randomly divided into treatment group and control group, 30 cases in each group. Patients in the treatment group were given naoxintong capsule,three goals,three times a day,at the same time,with double level positive pressure ventilation therapy for 3 months. Patients in the control group accepted double level positive pressure ventilation therapy for 3 months. The questionnaires of Montreal Cognitive Assess? ment( MoCA) were administered to assess cognitive in all the patients before and after treatment. Results There was no statistically significant difference in term of MoCA score between the two groups before treatment( t=0. 14,P>0. 05). After treatment,the MoCA score of the treatment group was (25. 83+1. 70),of control group was (22. 70+2. 51),the difference was statistically significant(t=5. 62,P<0. 05). The visual space and execu?tive function,naming,attention,language,abstract,delayed recall and directional score in the treatment group af?ter treatment were (5. 03±0. 81) points,(2. 90±0. 31) points,(4. 73±0. 58) points,(2. 63±0. 49) points, (1. 97±0. 18) points,(3. 93±0. 98) points,(5. 03±0. 56) points respectively,compared with before treatment ((4.07±0.79) points,(2.17±0.59) points,(3.40±0.50) points,(2.03±0.49) points,(1.80±0.41) points,(2. 87±0. 73) points,(4. 03±0. 77) points),the differences were statistically significant (t=6. 55, 6. 89,13. 36,5. 29,2. 41,4. 87,6. 60;P<0. 05) . The naming,attention,language,abstract,delayed recall and di?rectional score in the control group after treatment were ( 2. 77 ± 0. 43 ) points, ( 4. 07 ± 0. 75 ) points, ( 2. 20 ±0. 55) points,(1. 87±0. 35) points,(3. 10±0. 66) points,(4. 67±0. 71) points respectively,ompared with be?fore treatment((2. 30±0. 65) points,(3. 43±0. 68) points,(2. 00±0. 70) points,(1. 73±0. 45) points,(2. 93 ±0. 58) points,(3. 93±0. 69) points),the differences were statistically significant(t=5. 04,4. 34,2. 26,2. 11, 2. 41,6. 28;P<0. 05) . MoCA score in treatment group than the control group have improved significantly in visu?al space and executive function,attention,language and delayed recall,directional ( t=4. 51,3. 80,3. 22,3. 86, 2. 23,P<0. 05) . Conclusion Naoxintong capsule can improve cognitive dysfunction in patients with moderate OSAHS.

Objective: To investigate whether the plasmid ?1neo-hgp100 could be expressed and presented in vitro and could protect the immunized mice from B16F10 challenge in vivo. Methods: ?1neo-hgp100 plasmid was constructed in which the DNA sequence encoding hgp100 CTL epitope inserted into CDR3 of ?1-neo vector. The expression of anti-bodized antigen and IFN-? in supernatant was measured by ELISA respectively after transfection J558L with ?1neo-hgp100 and further co-culture of J588L transfacted with ?1 neo-hgp100 and pmel TCR transgenic T cell. After introspleenic inoculation of ?1neo-hgp100, the protective efficacy of the gene vaccine was observed by means of measuring the tumor area every two days. Results: ?1neo-hgp100 could be expressed and presented in vitro, the immunogenecity of CTL epitope of hgp100 was strong enough and could activate gp100 specific T cell, the mice immunized with the gene vaccine could resist the tumor challenging in vivo. The mean survival time was prolonged to 36 days, compared to control group (P