To investigate the outcome of renal transplantation in the elderly patients,the sur-vival rate,postoperative complications,rejection incidences and causes of death after renal trans-plantation in the elderly patients were compared to those of the contemporary younger patientsduring a follow-up of 5 years.No significant difference was found in the patients/graft survivaljection incidence was only 16%6 months after renal transplantation.Infection was the most com-mon complication and the main cause of death.The findings suggest that the elderly patients aresuitable for the renal transplantation as younger ones.

Objective To investigate the clinical and imaging features of cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy(CARASIL).Methods Clinical data of a Chinese Mongolian patient with CARASIL were analyzed retrospectively and pedigree investigation was carried out in the family.Results The proband's parents were cousin and her brother was a patient with CARASIL too.The patients had onset at 25 and 23 years old,respectively.Clinical manifestations included cerebral stroke,progressive motor and mental deterioration,seizures,alopecia,and ocular fundus arteriosclerosis.No common risk factors of cerebral stroke were found in the family.Brain MRI showed bilateral diffuse cerebral white matter lesion with multiple infarcts and O'Sullivan sign.Cervical vertebral MRI showed multiple protrusion of intervertebral disc and significant retrogression.Conclusions CARASIL is clinically characterized by young-age-onset cerebral stroke,cerebral arteriosclerosis,alopecia,cervical and lumbar spondylopathy.MRI shows multiple cerebral infarcts,leukoencephalopathy and retrogression of intervertebral disc.

AIM:To investigate whether hypoxic preconditioning(HPC)protects cardiomyoblast H9c2 cells against oxidative injury,and to discuss whether calreticulin(CRT)contribute to this protection through p38 MAPK signaling pathway.METHODS:Cardiomyoblast H9c2 cells were randomly divided into eight groups as follows:hydrogen peroxide stress(H2O2);brief hypoxic exposure of 20 min to simulate hypoxic preconditioning(HPC);20 min of hypoxic exposure followed by 24 h of normoxic reoxygenation before hydrogen peroxide stress(HPC+H2O2),SB203580(the specific inhibitors of p38 MAPK)+HPC+H2O2,antisense oligonucleotides transfection of calreticulin(AS),AS+H2O2,AS+HPC+H2O2 and control.Morphological studies,estimation of lactate dehydrogenase(LDH)leakage and flow cytometry were employed to assess the cell apoptosis and necrosis.RT-PCR and Western blotting analysis was used to detect calreticulin expression and phosphorylation of p38 MAPK.RESULTS:The results obtained are as follows:(1)HPC relieved cell injury caused by H2O2.Compared with those in H2O2 group,apoptosis rate and LDH leakage in culture medium in HPC + H2O2 group decreased 13.4% and 44.0%,respectively(P

Objective To investigate the expression of spleen tyrosine kinase (Syk) in endometrial cancer ( EC ) and its relationship with the clinic and pathological factors , as well as the diagnostic value for EC . Methods Through real-time PCR and immunohistochemistry, the expression level of Sky mRNA and protein in normal endometrial tissues, atypical hyperplasia of endometrial tissues and endometrial cancer tissues were examined. Results The expression of Syk in EC were lower than that in endometrial atypical hyperplasia and normal endometrium (P < 0.05). The expression of Syk was related to histological grade, invasive depth, lymphatic metastasis and clinical stages (P<0.05). Conclusion Syk contributes to tumorigenesis and metastasis of EC. The detection of Syk can provide evidence to evaluate the malignancy grade of EC.

Objective To analyze the improvement of clinical symptoms,relapse and neurological functional recovery and the prognostic factors of anti-N-methyl-D-aspatate receptor (NMDAR) encephalitis.Methods Follow-up was conducted for 51 hospitalized patients with anti-NMDAR encephalitis at the Department of Neurology,Xuanwu Hospital,Capital Medical University from June 2012 to April 2015.The neurological functional recovery was evaluated through modified Ranking Scale (mRS),and the prognostic factors were analyzed.Results Among the 51 patients with anti-NMDAR encephalitis,89％ (45/51) were completely recovered or remained mild neurological dysfunction (mRS score ≤ 2).The prognosis of main clinical symptoms was as follows:78％ (35/44) of the mental and behavior disorders were fully recovered,94％ (32/34) of the seizures were controlled and 65％ (21/31) of the cognitive deficiency were completely recovered;25％ (13/51) of the patients relapsed.Comparison of clinical data of initial on-set among complete recovery patients group (mRS score =0),partial recovery patients group (mRS score =1 or 2) and poor prognosis patients group (mRS score ≥ 3) showed that initial clinical manifestation with memory deficiency (17,9,6 cases respectively;x2 =6.664,P=0.036),involuntary movements(19,4,5 cases respectively;x2 =7.976,P =0.019) and central hypoventilation (5,0,2 cases respectively;x2 =6.124,P =0.047) had statistically significant difference.Conclusions The majority of anti-NMDAR patients have favorable prognosis,but some of the patients may remain various degrees of neurological deficiency,including mental and behavior disorders,cognitive deficiency and seizures.Initial clinical manifestation with memory deficiency,involuntary movements and central hypoventilation may indicate a poorer prognosis.

Objective To investigate the effect of vitamin D combined with iron succinate on children with premature anemia .Methods 66 patients with premature anemia from November 2013 to June 2015 in our hospital were selected and randomly divided into the control group and the experiment group, with 33 cases in each group.The patients in the both groups were give regular treatment, the experimental group was given the protein succinate oral solution (phenipril) 1.5 mL/kg on the basis of conventional treatment, Vitamin D drops ,one times a day.Two groups were treated continuously for 60 days.The hemoglobin, serum iron, ferritin, liver and kidney function and adverse reactions were compared before and after treatment.Results The hemoglobin, serum iron and ferritin levels in two groups were higher after treatment(P<0.05),compared with the control group,the hemoglobin, serum iron and ferritin levels in the experimental group were higher(P<0.05).Compared with before treatment ,the levels of serum ALT, AST, Cr and BUN in the two groups were not statistically significant.There was no significant difference in adverse reactions between two groups.Conclusion Vitamin D and iron proteinsuccinylate combined treatment of anemia in premature infants clinical curative effect, improve the body hemoglobin, serum iron and ferritin levels, without causing damage to liver and kidney function, drug safety.

Objective To analyze the clinical characteristics of leucine-rich glioma-inactivated protein 1 antibody-associated encephalitis.Methods Fourteen patients diagnosed as leucine-rich gliomainactivated protein 1 antibody-associated encephalitis in Capital Medical University Xuanwu Hospital from January 2012 to January 2015 were recruited.The clinical manifestation,brain magnetic resonance imaging,cerebrospinal fluid findings and biochemical examination of these patients were analyzed.Results The case series of 14 patients had an average age of (48.93 ± 15.60) years (range 27-67 years) with a male to female ratio of 2.5∶ 1.All patients presented with short-term memory loss.Nine patients experienced dementia.Additionally,among the 14 patients,12 experienced seizures,8 experienced faciobrachial dystonic seizures,10 had psychiatric symptoms,and 8 showed sleep dysfunction.Two patients were transferred into intensive care unit because of deteriorating symptoms and were provided operated mechanical ventilation.Thirteen of 14 patients exhibited abnormalities in their brain magnetic resonance imaging,with lesions in temporal lobe and hippocampus.Six patients had abnormal cerebrospinal fluid findings,8 patients showed hyponatremia (serum Na+ ＜ 135 mmol/L),while 5 patients co-existed with other autoantibodies.Screening for malignant tumors revealed normal findings.During 2 years follow-up,3 patients relapsed.Conclusions Leucine-rich glioma-inactivated protein 1 antibody-associated encephalitis is an autoimmune encephalitis characterized by short-term memory loss,faciobrachial dystonic seizures and hyponatremia.Lesions in brain MRI always involve in temporal lobe and hippocampus.This disease can relapse and is seldom associated with tumor.

With the widespread adoption of screening mammography, the incidence of ductal carcinoma in situ (DCIS) has been dramatically increased. The spectrum of local treatment advances from mastectomy to breast conservation surgery plus whole breast irradiation (WBI), and hypofractionated WBI or accelerated partial breast irradiation. Although the efficacy of WBI on reducing local recurrence is clear, such benefit in the low-risk DCIS is still controversial. Further studies are required to establish a more precise local recurrence risk stratification system for better tailoring local treatment in patients with DCIS. In this review, the latest advances and controversies in surgery, radiation therapy and local recurrence risk stratification system for patients with DCIS were summarized.

Objective To research the functional role of thyroidal motilin and the effects of electric excitation of the paraventricular nuclei(PVN) on gastric motility and the levels of motilin in thyroid and plasma.Methods The expression of motilin in rat and human thyroid was detected by immunofluorescence staining.A phase Ⅲ-like contraction was recorded before and after thyroidectomy and after PVN excitation.The changes in concentrations of plasma FT3,FT4 and motilin were determined via radioimmunoassay (RIA).c-Fos expression of PVN after thyroidectomy and motilin expression in thyroid after PVN excitation were observed by immunohistochemical staining.Results There were motilin immunoreactive cells in rat and human thyroid.The phase Ⅲ-like contraction and concentration of motilin in plasma decreased significantly when measured on the second and fourth days after thyroidectomy(2d,P＜0.01 ;4d,P＜0.05).The expression of c-Fos in PVN after thyroidectomy was significantly increased(P＜0.05).An electric excitation of PVN could increase the concentration of motilin in plasma and thyroid and increase corresponding gastric motility in rats (P ＜0.05).The increased phase Ⅲ-like contraction by PVN excitation could be partially inhibited by administration of motilin receptor antagonist,GM-109 (P＜0.05).Excitation of PVN in thyroidectomized rats resulted in lower plasma motilin and less intense phase Ⅲ-like contraction of stomach,as compared with the sham operated control group(P＜0.05).Conclusion Motilin from the thyroid may be secreted into the peripheral plasma to affect gastric motility and PVN may modulate gastric motility and motilin expression in the thyroid.

ObjectiveTo observe the morphology and structure of the urogenital hiatus in late pregnancy women using transperineal three-dimensional (3D) pelvic floor ultrasonography.Methods Twenty five nulliparas and fifty late pregnancy women were examined by transperineal 3D pelvic floor ultrasonography.The images of urogenital hiatus were obtained and compared to study their differences between nulliparas and late pregnancy women.Results Compared to nulliparas,urogenital hiatus in late pregnancy women tended to be circular and with an offset position.The puborectalis were bended and could be avulsed.Pelvic floor connective tissue could be loose.The morphology of vaginal might be abnormal and pelvic organ might prolapsed slightly.ConclusionsThe morphology and structure of urogenital hiatus in late pregnancy women are different to those in nulliparas,the hiatus tend to be slackness.3D pelvic floor ultrasonography is an effective imaging method to observe the morphology and structure of urogenital hiatus in pregnancy women.