Objective To investigate the MRI features of intracranial lymphoplasmacyte-rich meningioma and the corelation between the MRI features and pathologic findings. Methods The MRI and pathologic data of 7 patients with lymphoplasmacyte-rich meningioma were reviewed retrospectively. All cases were proved by surgery and pathological examinations. Results All lesions were solitary. The tumors crawled along meninges in 6 cases and in 5 cases the tumors did not appear as mass lesions. In 2 cases, the tumors appeared as half-moon. The boundary of all of the tumors was unclear, accompanying heavy peritumoral brain edema. The brain invasion can be seen in 7 cases. The lesions showed hypo-isointense signal on T1 WI in 7 cases, hyper-isointense signal in 5 cases and hypo-isointense in 2 cases on T2 WI.Enhancement scan demonstrated marked enhancement in 7 cases. Extensive thickening of the meninges was observed in 6 cases. Pathological results showed that the cells were abundant and diversified, with a great quantity of lymphoplasmacytes, and there were typical meningeal epithelial cells area in the surgical specimen. Conclusion The MRI findings of lymphoplasmacyte-rich meningioma show some features different from other common meningiomas, which would be helpful to the diagnosis and differential diagnosis.

Objective To investigate the clinical manifestation,pathogenesis and imaging features of hemichorea associated with hyperglycemia in primary diabetes mellitus(DM).Methods Analyze the clinical manifestations,the neuroimaging features and the treatment of the three patients with hemichorea induced by hyperglycaemia in primary DM,and review the literatures about this disease.Results All of the three cases had a long history of uncontrolled diabetes,among whom,two were non-ketotic hyperglycemic patients and one was ketotic hyperglycemic patient.All of them had an acute onset hemichorea which was almost continuous during awakeness and ceased during sleep.The early CT findings in this disorder were high density in the caudate nucleus,putamen and/or globus pallidus on the side contralateral to the involved limbs,but showed decreased attenuation or completely resolved in about a month.T1-weighted MR images in all cases showed high-signal intensities without edema or mass effect in the diseased region which decreased after several months,while the T2-weighted images were more variable.Conclusion Hemichorea induced by hyperglycemia often happens in the patients with poorly controlled DM,and both of the non-ketotic hyperglycemic and the ketotic hyperglycemic state can be the cause.In the major affected region-corpora striata,CT shows hyperdense lesions,T1-weighted MR images show hyperintense lesions and T2-weighted images show variable lesions in the early time.

Objective:To explore the pharmaceutical care points in advanced lung cancer patients with brain metastases. Meth-ods:Clinical pharmacists participated in the drug treatment process of one case of small cell cancer patient with brain metastases. Pharmaceutical care was carried out from various aspects, including brain metastases treatment, chemotherapy, antiviral therapy and patient education. Results:Cerebral transfer symptoms and quality of life of the patient were effectively improved and adverse reactions were reduced by the pharmaceutical care. Conclusion:By the implementation of pharmaceutical care on the patient, clinical pharma-cists can not only improve their own knowledge base and exploit professional advantage, but also provide suggestions on rational drug use for health care professionals.

Toll-like receptors ( TLRs) are pattern recognition receptors, which exist in both cell membrane and cytoplasm, and participate in inflammatory reactions. Some studies have shown that TLR2/4-NF-κB signal pathways mediated by TLR2 and TLR4 could regulate the production of inflammatory factor IL-1β, which played an important role in the attack of gouty arthritis. The article focused on the pathogenesis of gouty arthritis, discussed the structure and distribution of TLRs, the ligands and its mediated signal pathways, the validity in the treatment of gouty arthritis using the signal pathways as the target points and the relationship between the signal pathways and gouty arthritis, and reviewed the research progress in Chinese medicines using the signal pathways as the guidance.

Objective To investigate the renal expression of stem cell factor (SCF) in lupus nephritis (LN) and its correlation with disease activity and renal injury parameters. Methods Histochemical stain was used to examine all renal specimens (LN group n=34, chronic glomerulonephritis n=16, control group n=8). Hyhridization in situ and immunohistochemistry were used to detect the expression of SCF and infiltration of mast cells, macrophages , α-SMA (+) cells in renal tissues of the two groups. SPS software was used for tissue of the control group. However, they increased markedly in lupus nephritis and CGN (t=6.03～14.25, P< 0.01). But there was no significant difference between LN and CGN in SCF and mast cells in renal interstitium. Positive correlation was observed among the expression of SCF and α-SMA and the number of mast cells and macrophages (r=0.47～0.84, P<0.01) at their corresponding locations. The expression of SCF and ot-SMA and the number of macruphages were positively correlated with renal pathological active index, chronic index, albuminuria and the injury of renal interstitium (r=0.34～0.93, P<0.05 or 0.01); meanwhile, it was negatively correlated with Ccr(r=-0.39～0.61, P<0.01). There was significant correlation between SCF, macrophages and anti-dsDNA antibody, complement C3 level, SLE disease activity index (SLEDAI). The number of mast cells in renal interstitium was positively correlated with chronic indexes and the injury of renal interstitium (r=-0.86, r=0.93, P<0.01) and negatively correlated with Ccr (r=-0.56, P<0.01), but not correlated with active index and albuminuria (r=0.27, r=0.23, P>0.05). Conclusion The expression of SCF is widespread in kidney, and it is markedly eorrelated with various kinds of inflammatory cells, renal inherent cells, renal function, and urine protein levels. SCF may be an critical participant in the initiation and progression of renal injuries in human lupus nephritis.

Standardized training of residents is a necessary way for clinical medical personnel train-ing. Residents graduating from medical colleges and universities should accept the standardized, scientific, strict pre-service training, in order to realize role conversion from medical students to hospital physicians. This paper summarizes and analyzes the pre-service training, focusing on the training object, course design, organization implementation, evaluation, questionnaire survey, and puts forward some thoughts and sugges-tions on strengthening and improving pre-service training form, expanding the content of training, and quan-tifying the evaluation of training effect.

Objective To analyze the MRI features of Ewing sarcoma/peripheral primitive neuroectodermal tumors(pPNETs) arising from the meninges.Methods The MRI imaging of 9 patients with Ewing sarcoma/pPNET were reviewed retrospectively,and imaging features and pathological characteristics were analyzed.Results The age of most patients ranged from 10 to 20 years.Magnetic resonance revealed a spindle-like lesion with a wide base in 8 cases.The lesions showed heterogenous iso-or hypo-intense signal on T1 WI in 7 cases,heterogenous hypo-iso-intense signal on T1 WI in 2 case,and iso-or mildly hypderisointense on T2WI in all cases.The solid part of the tumor was heterogeneously enhanced after injection of gadolinium with cyst degeneration or necrosis.The dural tail sign could be seen in 3 cases.The adjacent skull erosion could be seen in 6 cases.The breakthrough of the plate of cranium and soft-tissue invasion was present in 2 cases.The right eye proptosis was present in 1 case.The distant metastasis was found in 3 cases.Pathology showed that the lesions had high cell density.Hemorrhage and necrosis could be observed.The cells were like lymphocytes and spindle cells with transparent cytoplasm.CD99 and Vimentin were expressed in all tumor cells.Conclusion The imaging findings of the meningeal pPNET are different from meningiomas,which could be useful for the diagnosis and differential diagnosis.

Objective:The paper provided the basis of morphology to treat severe obstructive sleep apneasyndrome (OSAS) by applying hard palate short uvulopalato-pharyngoplasty (HPS-UPPP) in clinic.Methods:The curve length of hard palate and soft palate,the distance between the greater palatine foramenwere measured with vernier caliper and the position relation of the nerve and vessels passing throughgreater palatine foramen was observed in 100 oranium and 50 cadaver. Results:The curve length of hardpalate was 49.3± 0. 28 mm;the curve length of soft palate was 26.1±0. 30 mm;the distance between thegreater palatine foramen was 27.3±0. 24 mm. Conclusion:The results have the guiding significance in re-moval of length of hard palate and soft palate ,and the way of operation.

Objective To identify novel mutations in the GATA6 gene associated with congenital atrial septal defects (ASD).Methods This was a case-control study.A cohort of 220 unrelated Han-race patients with congenital ASD and 200 unrelated ethnically matched healthy individuals used as controls,who were admitted to Tongji University Affiliated Tongji Hospital from January,2007 to October,2011,were recruited.The peripheral venous blood samples from the participants were prepared.All the coding exons and their flanking sequences of the GATA6 gene were amplified by polymerase chain reaction and sequenced using the di-deoxynucleotide chain termination technique.The acquired sequences were aligned with the sequences derived from GenBank by BLAST to identify the sequence variations.The software ClustalW was used to analyze the conservation of the altered amino acids.Results Three novel heterozygous missense GATA6 mutations,c.250G ＞A (p.A84T),c.649G ＞C (p.G217R) and c.1270A ＞C (p.S424R),were identified in 3 of 220 ASD patients,respectively.None of the three mutations was detected in 200 healthy control individuals.A cross-species alignment of GATA6 encoded protein sequences showed that the mutated amino acids were relatively conserved evolutionarily.Conclusion The identification of novel GATA6 mutations associated with ASD contributes to the reveal of the mechanism involved in the pathogenesis of ASD.

Objective To detect Porphyromonas gingivalis and clinical index in subgingival specimens after removal of orthodontic appliances and to evaluate clinical index and P.gingivalis factors associated with orthodontic appliances during an episode of gingival inflammation and the impact of appliance removal on periodontal health.Methods Choose 20 patients prepare to removal of orthodontic appliances.Plaque index(PLI),sulcus bleeding index(SBI) and probing depth(PD) of observed teeth were examined and subgingival plaques were collected at prior to appliance removal(baseline) and 1,3 and 6 months after appliance removal.The numbers of P.gingivalis,total bacteria,the proportion of P.gingivalis and the prevalence of P.gingivalis in the samples were detected with the TaqMan real-time PCR.Results The prevalence of P.gingivalis decreased from baseline to the 6th month after fixed appliance removal in two groups,and significant change was found in 6th month(P ＜ 0.05); The numbers of P.gingivalis significantly reduced from baseline to the 6th month(P ＜ 0.05); The proportion of P.gingivalis in subgingival plaque decreased from baseline to the 6th month(P ＜0.05).PLI,SBI and PD significantly decreased from baseline to the 6th month after fixed appliance removal.Conclusion After fixed appliance removal,most of patients can recover periodontal tissue health in good oral hygiene.The percentage of P.gingivalis are closely associated with periodontal status.TaqMan real-time polymerase chain reaction has a high sensitivity and specificity.It was demonstrated the broad potential of application on detection of oral microbes.