Background and objectives: Radiation treatment in nasopharyngeal carcinoma (NPC) is known to be associated with increased prevalence of carotid stenosis. The objectives of the study was to determine the prevalence of radiation-induced extracranial carotid stenosis, plaque, carotid intima thickness (CIMT) in NPC patients; to explore whether the stenosis is due to direct effect of radiation rather than general tendency to atherosclerosis. Methods: This was a cross-sectional study conducted in the University Malaya Medical Centre from July 2011 to February 2012. The study subjects consisted of 47 NPC patients who were treated with radiation, and 47 healthy control. The patients and control had carotid duplex ultrasound and transcranial Doppler (TCD). Results: The mean age of the patients was 55.1 years, the time lapse from radiation was 76.7 ± 95.3 months. Internal carotid artery (ICA) and common carotid artery (CCA) stenosis of ≥50% was seen in 17.0% of patients vs 2.1 % of controls (p = 0.031), with 61.7% of patients and 19.1% of controls having plaque in ICA and CCA (p=0.004). CIMT was increased in 70.2% of patients and 44.7% of controls (p =0.022). Both the patient group and control had similar rate of intracranial stenosis of 12.8% in TCD. Conclusion: Extracranial internal carotid artery is the most common site of stenosis following radiotherapy in NPC. This suggests that local trauma from irradiation is the most important factor in predisposition to atherosclerosis following radiation therapy.

Objective To develop a teaching and examination system based on Delphi for the obstetric nurse. Methods The teaching materials were collected for the obstetric nurse, the teaching and examination mode was analyzed, and Delphi was used for programming and MySQL database was applied to teaching and examination data. Results The system had easy operation, high stability and rapid response to the database, and could meet the requirements for the teaching and examination of the trainee nurse. Conclusion The system realizes informatization and high expansibility of obstetric teaching and examination, and thus is worthy promoting practically.

Objective To explore the nutritional status of hemodialysis patients with different ages, and analyze the reasons of differences of nutritional status. Methods 109 hemodialysis patients were divided into the young-age group (n=26), the middle-age group (n=49) and the old-age group (n=34). The body indices, blood biochemical parameters, dietary assessment, handgrip strength and subjective global assessment were measured. The nutritional indices and relationship were compared among patients in the three groups. Results Leg circumstance, prealbumin, creatinine, handgrip strength and SGA scores were different among the three groups (P<0.05 or P<0.01). And those five factors were all statistically associated with age (P<0.05). Conclusions With the increase of age, the hemodialysis patients' nutritional status has a descending trend. It's necessary for nursing staff to timely monitor and intervene the nutrition of elderly patients so as to prevent the incidence of malnutrition.

Primary angiitis of the central nervous system (PACNS) is a rare vasculitis restricted to the central nervous system without systemic involvement. Delay in diagnosis and treatment is common due to its non-specific symptoms and lack of non-invasive diagnostic tests. Myelopathy can occur in PACNS, during the clinical course of the illness, with or without cerebral symptoms. We describe here a 51 year-old ethnic Chinese woman who presented initially with paraparesis without cerebral symptoms. The diagnosis of PACNS was eventually made from brain biopsy when she subsequently developed cerebral involvement. Despite aggressive treatment, the patient developed progressive neurological deterioration and died. This patient demonstrates the rare occurrence of myelopathy as the sole initial presentation of PACNS.
Central Nervous System ; Spinal Cord Diseases

Glioblastoma multiforme (GBM) is the commonest primary cerebral malignancy consisting of 12- 20% of intracranial brain tumours.1 We report here a patient with GBM with very unusual marked and widespread leptomeningeal GBM.

Hyponatraemia with rapid correction of serum sodium may cause an osmotic demyelination syndrome (ODS) with damage to pontine and/or extrapontine areas of the brain. The prognosis of ODS can range from complete recovery to death; at present, our ability to predict clinical outcome is very limited. We describe here a patient with ODS and increased signal intensity in the striatum on diffusion-weighted MRI, with corresponding low apparent diffusion coeffi cient values (indicating restricted water diffusion). This case provides a further example of the typical MRI appearance of extrapontine ODS and suggests the potential value of diffusion-weighted MRI in predicting prognosis in ODS.

Background and objective: Deep tendon reflexes are important physical signs in neurological examination. Despite being an established technique clinically, there is lack of normality data in the healthy population, especially among the elderly. This study aims to determine the range of normality in deep tendon reflexes among the adults. Methods: The study subjects consisted of 176 healthy volunteers. They were examined by trained assessors using standardized protocol. Results: Among the commonly elicited deep tendon reflexes, isolated absent reflexes were found in up to 34.4% (supinator) in the older group, and 12.5% (triceps) in the young adults, significantly higher in the older group. Symmetrical absent reflexes was seen in up to 26.3% of supinator in the older group. Absent reflexes of the entire limbs both sides were however, much less common particularly among young adults, with 6.3% of the older group having absent reflexes in the entire lower limbs, and 2.5% in the entire upper limbs. Isolated asymmetry in reflex was present in up to 17.0% (triceps). However, only 6.3% had asymmetrical reflexes in the contiguous anatomical region. Conclusion: Isolated absent or asymmetry deep tendon reflexes were common particularly in the elderly.

BACKGROUNDThe molecular mechanisms underlying the endometriosis are still not completely understood. In order to test the hypothesis that the approaches in phosphoproteomics might contribute to the identification of key biomarkers to assess disease pathogenesis and drug targets, we carried out a phosphoproteomics analysis of human endometrium.

METHODSA large-scale differential phosphoproteome analysis, using peptide enrichment of titanium dioxide purify and sequential elution from immobilized metal affinity chromatography with linear trap quadrupole-tandem mass spectrometry, was performed in endometrium tissues from 8 women with or without endometriosis.

RESULTSThe phosphorylation profiling of endometrium from endometriosis patients had been obtained, and found that identified 516 proteins were modified at phosphorylation level during endometriosis. Gene ontology annotation analysis showed that these proteins were enriched in cellular processes of binding and catalytic activity. Further pathway analysis showed that ribosome pathway and focal adhesion pathway were the top two pathways, which might be deregulated during the development of endometriosis.

CONCLUSIONSThat large-scale phosphoproteome quantification has been successfully identified in endometrium tissues of women with or without endometriosis will provide new insights to understand the molecular mechanisms of the development of endometriosis.

Adolescent ; Adult ; Chromatography, Affinity ; Endometriosis ; metabolism ; Endometrium ; metabolism ; Female ; Humans ; Phosphoproteins ; analysis ; Phosphorylation ; Proteomics ; methods ; Tandem Mass Spectrometry ; Young Adult

To prepare Fe(3)O(4)-magnetic nanoparticles loaded with adriamycin and investigate the reversal role of drug-loaded nanoparticles in K562 and resistant cell line K562/A02, the drug-loaded nanoparticles were prepared by using mechanical absorption polymerization at different conditions of 4 degrees C or 37 degrees C for 24 or 48 hours. The survival of cells cultured with drug-loaded nanoparticles for 48 hours was detected by MTT assay, then the growth inhibition efficacy of cells was calculated. The results showed that the growth inhibition efficacy of both two cell lines was enhanced with increasing concentration of Fe(3)O(4)-magnetic nanoparticles. The inhibitory ratio of two cell lines obtained at 4 degrees C and for 48 hours was significantly better than that at 37 degrees C and 24 hours. In conclusion, Fe(3)O(4)-magnetic nanoparticles can load adriamycin by using mechanical absorption polymerization, but depended on proper temperature and time. Furthermore, drug-loaded nanoparticles showed an ability reversing multidrug resistance.
Doxorubicin ; chemistry ; pharmacology ; Drug Carriers ; chemistry ; Drug Resistance, Multiple ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Ferric Compounds ; pharmacology ; Humans ; K562 Cells ; Magnetics ; Nanoparticles ; chemistry ; Particle Size

Background: Tuberculous meningitis is a life-threatening manifestation resulting from infection by Mycobacterium tuberculosis, especially in the developing countries. The molecular aspects of pathogenesis of tuberculous meningitis remain poorly understood. We evaluated the correlation of cerebrospinal fluid (CSF) and serum cytokine levels with the clinical outcome of 15 HIV-negative patients with tuberculous meningitis. We also assessed the association of CSF and serum cytokines with neuroimaging of brain findings in the patients. Methods: The prospective longitudinal study was conducted at the University Malaya Medical Centre between 2012 and 2014. Neuroimaging of the brain was performed and the findings of leptomeningeal enhancement, hydrocephalus, tuberculoma, infarcts and vasculopathy were recorded. The CSF and serum specimens were analyzed for IL-1ß, IL-8, IL-10, IL-18, IP-10, IFN-γ, MCP-1, TGF-ß, VEGF, TNF- α, IL-18BPa and MMP-9. The clinical outcome was graded at 3 months based on Modified Rankin scale (mRS). Results: On admission and at one month of anti-tuberculosis treatment, the CSF levels of IL-8, IL-1β, IP-10, IFN-γ and VEGF were elevated in all of the patients. Serum IP-10, MCP-1, IL-1β and IL-8 levels were increased on admission and at one month of anti-tuberculosis treatment. There were statistically significant differences between good and poor outcome (mRS at 3 months) for CSF IFN-γ (p=0.033), CSF IL-10 (p=0.033) and serum VEGF (p=0.033) at one month of treatment. None of the patients showed any association between CSF and serum cytokines on admission and at one month of anti-tuberculosis treatment with neuro-radiological findings. Conclusion: The CSF cytokine levels were not related to TBM disease severity on admission, and changes on MRI/CT scans. CSF levels of IFN-γ and IL-10 at one month of anti-tuberculosis treatment were associated with clinical outcome at 3 months. CSF cytokine levels on admission were not associated with the clinical outcome.
Tuberculosis, Meningeal