Foreign student education is an important task in medical colleges and universities.Clinical neurology teaching is very difficult because of its complex discipline.Neurologists in the First Affiliated Hospital of Chongqing Medical University summarized and analyzed the common problems including the training of teachers' ability to use language,teaching of basic subjects,clinical skills training,promotion of patients' compliance and implementation of regular tests so as to provide references for improving the quality of neurology teaching.

Objective To study the distribution and expression of Semaphorins-3A protein in brain of postnatal rats.Methods Semaphorins-3A positive cells were observed by immunohistochemistry in the cerebral cortex,hippocampus,dentate gyms and entorhinal cortex in postnatal 0d,7d,14d,21 d and 28d of Sprague Dawley rats.Results Semaphorins-3A positive cells widely distributed in the granule cell layer ( Ⅱ ),external pyramidal cell layer ( Ⅲ ),internal granular cell layer ( Ⅳ ),pyramidal cell layer ( Ⅴ ) and layer of polymorphous cells ( Ⅵ ),in addition to the molecular layer ( Ⅰ ) of the parietal,occipital,frontal,temporal,insular,cingulate cortex,piriform cortex and entorhinal cortex with postnatal 0d,7d,14d,21d and 28d rats.The amount of semaphorins-3A positive cells(IOD) in the entorhinal cortex was 84916.23 ± 3266.34 in P0d,77711.41 ± 2634.26 in P7d,74124.25 ± 3989.09 in P14d,65887.63 ± 3406.57 in P21d and 57705.96 ± 3136.35 in P28d,meanwhile the region of semaphorins-3A positive cells narrowed in the part level with Ⅱ -Ⅵ levels of cortex.Similarly semaphorins-3A positive cells distributed mainly in granule cell layer of dentate gyrus,CA1,CA3 region and only a few of semaphorins-3A positive cells scattered in the multi-line layer in hippocampus.The expression level of semaphorins-3Awas significant difference among postnatal 0d,7d,14d,21d and 28d rats (P＜0.01).Conclusion Semaphorins-3A positive cells widely distribute in the various cortex and hippocampus in developing rat brain,and the region of semaphorins-3A is reduced with age growth of rats.

ObjectiveTo observe Semaphorins-3A and synaptophysin P38 expression in hippocampus of developing rat induced by status epilepticus.Methods 320 SD rats were divided into four groups (P7,P14,P21 and P28) according to day -old after birth (7d,14d,21d and 28d).Rats in each group were randomly divided into model group (SE group) and saline control group (NS group).SE was induced by Pentylenetetrazol (PTZ).Semaphorins-3A and synaptophysin P38 expression were determined by immunohistochemical staining on 1d,7d,14d,21d and 28d after SE in hippocampal CA1 of rats.ResultsSemaphorins-3A-positive cells could be seen in the hippocampal granule cell layer in all rats.Semaphorins-3A expression tended to decrease with the increasing of day-age,especially in P7 group(91 552.68 ± 4664.69 ).No matter how day-age,Semaphorins-3A expression was similar to that in NS group and was obvious reduced in 7d after SE(56 938.84 ± 5688.47 ).Meanwhile P38 expression in P7-day-age rats had had been gradually increasing between 1 day and 14d (5413.18 ±48.77,6223.40±29.19,6902.94 ±78.51 ) and then stabilized gradually on 21d(7523.42 ± 62.94) after rats were tested.P38 expression in other day-age rat was relatively stable on the same level in physiological state.On the other hand P38 expression in the hippocampal CA1 region of P7,P14,P21 and P28 rats was significantly higher than that in normal rats between 1day and 28day after SE episode(P＜ 0.05 ),and reached a peak on 14 day(8408.35 ± 55.73 ).ConclusionSemaphorins-3A and synaptophysin P38 involved in hippocampal synaptic plasticity of rat in developing stage and epilepsy.

OBJECTIVETo determine the influence of Helicobacter pylori (H. pylori) on gastric cancer-related antigen MG7 expression.

METHODSThe H. pylori infection and the expression level of antigen MG7 in gastric mucosa were determined by HE stain, PCR, ELISA and immunohistochemistry in 291 patients with H. pylori-related conditions, among whom 34 were followed-up.

RESULTSNo significant difference was found between H. pylori-negative and H. pylori-positive intestinal metaplasia, atrophic gastritis and dysplasia of gastric epithelium in positive rate of antigen MG7 expression. There was significant difference between H. pylori-negative and H. pylori-positive superficial gastritis in the positive rate of MG7 expression (P < 0.05). During follow-up, one of 3 H. pylori-negative cases turned to be H. pylori-positive, and its MG7 expression turned to be higher at the same time. Three of 31 H. pylori-positive patients were discovered as having early gastric cancer, among whom one with antigen MG7 expression (+ + +) was found to have a reduced Mg7 expression accompanied with H. pylori eliminutied after operation.

CONCLUSIONThere is correlationship between H. pylori infection and MG7 expression in superficial gastritis. Although the MG7-positive lesions with H. pylori infection shows a benign nature in morphology, they also have the potential risk of developing into gastric cancer. Therefore, they should be followed up, during which special attention should be paid to patients with increased MG7 expression.

Antibodies, Bacterial ; blood ; Antigens, Neoplasm ; biosynthesis ; DNA, Bacterial ; genetics ; Enzyme-Linked Immunosorbent Assay ; Gastric Mucosa ; metabolism ; microbiology ; pathology ; Gastritis ; metabolism ; microbiology ; Helicobacter Infections ; metabolism ; microbiology ; Helicobacter pylori ; genetics ; growth & development ; immunology ; Humans ; Immunohistochemistry ; Polymerase Chain Reaction ; Stomach Diseases ; metabolism ; microbiology ; Stomach Ulcer ; metabolism ; microbiology

Objective To observe neural stem cells proliferation,migration and differentiation in hippocampus in developing rats with status epileptictus.Methods 320 healthy SD rats at age 7,14,21,28 d (P7,P14,P21,P28) were randomly divided into status epilepticus (SE) and normal control group.In each group those rats at the same age were further randomly divided into 1,7,14,21,28 d five time points after PTZ-induced SE (n =8).New cell proliferation and migration were observed by immunohistochemistry studies in the dentate gyms.Double labeling with Brdu/NeuN and Brdu/GFAP was performed in the P14 rats.Results Nestin positive cells appeared in the dentate gyms on 1 d after SE in P7,P14,P21,P28 rats.The number of nestin positive cells gradually increased on 7 d and reached a peak on 14 d,then gradually reduced on 21 d,finally fell to a minimum on 28 d after SE.The numbers of nestin positive cells on 7 d(177.00 ± 3.22,t =16.033) and 14 d (195.00 ± 3.41,t =28.840) were significantly higher in the SE group than the NS group (147.50 ± 2.08,136.50 ± 2.65,both P ＜ 0.05).The smaller age of rats with SE onset,the greater the nestin intensity.But the number of nestin positive cells in the dentate gyrus of normal rats were gradually decreased with increasing age.Nestin positive cells were distributed in subgranular zone of dentate gyrus on 1 d and 7 d after SE,then gradually migrated to the granule cell layer on 14 d with morphological changes.Small part of nestin positive cells were ectopically migrated to the hilus of dentate gyrus in P14,P21,P28 age rats,and were also seen in the CA1,CA3 of hippocampus and cortex with various cell morphology.For differentiation of newly generated cells,most of Brdu positive cells coexpressed NeuN and about 4％-5％ cells co-expressed GFAP.Conclusions SE could induce neurogenesis in the hippocampal dentate gyrus area in developing rats which has age-related characteristics.Most new cells migrate from the subgranular zone to the granule cell layer of the dentate gyrus,and a small number of newly generated cells ectopically migrated to the hilus of dentate.The majority of newly generated cells differentiate into neurons,and the others differentiate into glial.

Objective To analyze the epidemiological characteristics of mycoplasma pneumoniae (MP) infection among the out-patients and inpatients children in Shenzhen area during 2010-2012 and to explore the significance of the results of the laboratory routine tests in the diagnosis of MP infection .Methods The children patients with respiratory tract infection from 2010 to 2012 were selected and the MP infection and the non-MP infection were screened out .The epidemiological characteristics of gender ,age , etc .,among the children patients with MP infection during these 3 years were analyzed .The differences in the laboratory routine tests and high sensitivity C reactive protein (hsCRP) were compared between the MP infection and the non-MP infection .Results The positive detection rate of MP-DNA in males was slightly higher than that in females ,the difference had no statistical signifi-cance (P>0 .05);MP infection occurred in different age groups ,the positive detection rate of MP-DNA was lowest in the children patients aged <1 year old and highest in the children patients aged 3 - < 6 years (P< 0 .05);the routine laboratory tests and hsCRP level had no specificity in the diagnosis of MP infection .Conclusion The MP molecular epidemiology in Shenzhen area shows that MP infection has the seasonality ,the laboratory routine tests and hsCRP level can not be used as the basis of the MP la-boratory diagnosis .

Objective To perform a risk factor analysis of central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO),and compare the difference in risk factors between CRVO and BRVO.Methods Retrospective observational casecontrol study included 46 CRVO patients,33 BRVO patients and 79 control subjects with senile cataract or refractive error,the risk factors and blood lipid spectrum analysis were performed and compared.Results Multivariate linear regression analysis showed that higher serum levels of homocysteine (P ＜ 0.000 1),total cholesterol (P =0.003 0),lipoprotein (a) (P =0.027 0),hypertension (P =0.022 0) and shorter axial length (P ＜0.000 1) were significantly correlated with CRVO.BRVO was associated with higher serum levels of homocysteine (P ＜0.000 1),total cholesterol (P =0.008 0),hypertension (P =0.002 0),body mass index (P =0.004 0) and shorter axial length (P =0.001 0).There was no significant difference in risk factors between CRVO and BRVO patients on multivariate analysis.Conclusion Multiple systemic (hyperlipidemia,hypertension and hyperhomocystinemia) and ocular (shorter axial length) risk factors are associated with both CRVO and BRVO,but these risk factors are not different between CRVO and BRVO.

Objective To investigate and compare the level of food specific IgG antibody between children with chronic diarrhea and healthy children,analyze the correlation between chronic persistent diarrhea and food intolerance.Methods The research objective of 105 cases was obtained from in-patient children in Shenzhen children′s hospital diagnosed as chronic persistent diarrhea and 94 cases diagnosed not diarrhea as control group in the year of 2015.The level of fourteen food allergen specific IgG in serum was detected using enzyme-linked immunosorbent (ELISA) in 199 cases.Results Chronic persistent diarrhea was more observed in 0-1 years old of infants.The positive rate of 14 food allergen specific IgG in 105 cases of children with chronic persistent diarrhea in turn from high to low was milk,eggs,tomatoes,rice,wheat,cod,corn,beef,soybeans,chicken,pork,mushrooms,shrimp and crab;14 food allergen specific IgG in 94 cases of children not with diarrhea in turn from high to low was arranged as follows:milk,eggs,tomatoes,rice,wheat,soybeans,cod,corn,beef,crab,chicken,mushroom,shrimp and pork.Among them the level of milk,beef and soybeans in the comparison of the two groups was significantly different(P<0.05).Conclusion Food intolerance was one of the important factors caused chronic persistent diarrhea in children.Reasonable diet for children may be the effective treatment of chronic persistent diarrhea.

Objective To investigate the changes of CD4 +CD25highFoxp3 +regulatory T (Treg) cells and their significance in immune escape of childhood B-cell acute lymphocytic leukemia ( B-ALL ) . Methods Forty-two children with B-ALL and twenty-eight age-matched healthy children were enrolled in this study.Flow cytometry analysis was performed to evaluate the proportion of CD 4 +CD25high Foxp3 +Treg cells as well as CD4 +CD25high ICOS+Foxp3 +and CD4 +CD25high ICOS-Foxp3 +subsets in peripheral blood samples.The expression of associated molecules including IL-10, TGF-β, IL-35, TGF-βRII, ICOS and CD28 at protein level were also measured by flow cytometry analysis .The transcription level of Smad3/4, TIEG1 and Itch by CD4 +T cells were determined by quantitative real-time PCR.The concentration of TGF-βin plasma was detected by enzyme-linked immunosorbent assay.Results (1)The proportion of CD4 +CD25highFoxp3 +Treg cells in children with B-ALL were significantly higher than those of health subjects (P<0.05).The proportion of both ICOS +Foxp3 +and ICOS -Foxp3 +subsets were increased in comparison with those of control group (P<0.05), while the ratio of ICOS +Foxp3 +to ICOS-Foxp3 +was decreased (0.73 ±0.21 vs 1.87 ±0.59, P<0.05).(2) The expression of Foxp3, TGF-β, IL-10 and IL-35 by ICOS+Foxp3 +Treg cells and the expression of membrane bound TGF-βby ICOS -Foxp3 +Treg cells were significantly increased in children with B-ALL (P<0.05).However, the expression of Foxp3 by ICOS -Foxp3 +Treg cells showed no significant difference between the two groups (P>0.05).(3)The concentra-tion of TGF-βin plasma from children with B-ALL were higher than those from control group [ ( 25 .83 ± 12.65) ng/ml vs (8.59 ±5.73) ng/ml, P<0.05].The expression of TGF-βRII and its associated mole-cules (Smad3/4, TIEG1 and Itch) by CD4 +T cells were significantly up-regulated.Moreover, an increased expression of ICOS and CD28 by CD4 +CD25highFoxp3 +Treg cells were also observed in children with B-ALL (P<0.05).Conclusion The hyper-activity of TGF-β, ICOS and CD28 signaling might be closely associ-ated with the increased proportion of CD4 +CD25high Foxp3 +Treg cells and the imbalance of its subsets in children with B-ALL.

Objective To analyze the follow-up results and clinical characteristics of one case of highly sensitized recipient after combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation.Methods This patient was diagnosed as having chronic renal insufficiency in the uremia period 10 years ago,subjected to kidney transplantation 9 years ago,and got renal allograft loss 8 years ago.The recipient was positive for PRA (for class Ⅰ,31％,and for class Ⅱ,63％).Under the general anesthesia,the patient was given combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation.The ATG was used for immune induction.Rituximab and plasma exchange were applied to prevent acute rejection.Regular follow-up was done after discharge.Results On the postoperative day (POD) one,ALT was 256 IU/L,AST was 342 IU/L and serum creatinine was 502 μmol/L.On the POD 6,ALT and AST levels were normal and serum creatinine was 141 μmol/L.Serum creatinine increased to 202 μmol/L and the volume of urine reduced on the POD 7.The ultrasound displayed graft size increased slightly,substantial echogenicity enhanced,artery blood flow RI increased to 0.8,suggesting the occurrence of acute rejection.A single dose of Rituximab,intravenous IG,and plasma exchange were given.On the POD 60,serum creatinine was reduced to 131 μmol/L.During a follow-up period of 28 months,imrnunosuppresants were given:Tac + MMF + Pred.FK506 valley concentration was maintained at 6-8 μg/L.The function of the transplanted kidney and liver was normal,and the general conditions were good.Conclusion Combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation is safe.Individualized medication and regular follow-up are the important factors for long-term survival of recipients.