Motor neuron disease(MND)is a kind of degenerating disease which involves the upper and lower motor neurons.Irreversible muscle weakness,muscle atrophy and pyramidal sign are its main clinical manifestations.Diagnosis of MND should be made with caution because no effective treatment can change the unceasing course.This article specifies the diseases which mimic MND:cervical spondylosis,Hirayama disease,multifocal motor neuropathy,monoclonal gammopathy with motor neuropathy,paraneoplastic motor neuron syndrome,post-polio syndrome,spinal muscular atrophy,Kennedy syndrome and diabetic amyotrophy.Wish it do some favor to clinical doctors.

Objective To investigate the relationship between body mass index(BMI) and the outcomes of liver function of patients with hepatocarcinoma after surgery. Methods We divided the patients into three groups: normal, overweight and obese groups based on BMI, then we recorded their preoperative and the postoperative liver functions: albumin, total bilirubin, alanine aminotrasferase(ALT), aspertate aminotransferase (AST), alkaline phosphatase(ALP), γ-glutamyltranoferase(γ-GGT), triglycerides(TG), total cholesterol (TC), high density lipoprotein(HDL) and low density lipoprotein(LDL). Results The mean values of ALT change between the preoperative and the postoperative were (14.9 ± 1.98) U/L, (15.4 ± 2.27) U/L,(22.2±1.32) U/L; Mean values of γ-GGT change were(16.2 ± 1.33) U/L, (18.7 ±0. 97) U/L,(22.3 ± 1.27) U/L; mean values of TG change were (0. 18 ± 0. 44) mg/dL, (0. 21 ± 0.08) mg/dL,(0.25 ± 0.03) mg/dL. Compared with the results of control groups, there were no significant differences of recovery of liver functions between normal and overweight groups(P ＞ 0. 05), but the obese group' s recovery of liver functions did lag behind the normal group (P ＜ 0.05). It is showed that the obese group' s shared same recovery of albumin, total bilirubin, AST, ALP, TC, HDL and LDL. The difference was significant between the normal and obese groups in terms of recovery of ALT, γ-GGT, TG(P ＜ 0. 05). Conclusion BMI is associated with the recovery of liver function of patients with hepatocarcinoma, the obese patients have poor prognosis of recovery of liver function.

PurposeTo study the characteristics of contingent negative variation (CNV) in vascular dementia.MethodsCNV was tested and compared in 24 vascular dementia (VD) patients and 22 normal aged persons. Results The data showed that in compare with normal controls the latencies of early component and late component of CNV in VD were greatly prolonged and closely correlated to the extent of dementia. The amplitude of early component was greatly reduced. The reactive time (RT) was prolonged prominently and also correlated with the extent of dementia. The occurrence of postimperative negative variation (PINV) increased. Conclusions The value of CNV can be used to reflect the extent of dementia. Test the CNV in series may help to evaluate the cognitive impairment in VD.

Objective To test the efficacy and safety of nicergoline in treatment of vascular dementia patients with mild or moderate cognitive impairment. Methods A multicenter,double blind,randomized,efficient drug controlled clinical trial was carried out All the subjects met the DSM-Ⅲ criteria for vascular dementia We used MMSE and WMS as main assessing items and ADL,CGI as secondary assessing items. Results 103 subjects were assessed MMSE were raised in both groups after the treatment and more obvious in nicergoline group than in anecetan group (1 62?2 33 and 2 88?2 85 respectively) WMS raised in nicergoline group (5 04?10 61),but not in anecetan group (1 98?9 49) ADL and CGI (SI) showed decreased scores in both groups Total efficiency of nicergoline was 80 0% and of anecetan was 56 6%. Conclusions Nicergoline was an effective drug in treatment of vascular dementia and more effective than anecetan Using nicergoline 60 mg per day was safe

Objective To explore the current status of non-operative management strategy for blunt hepatic trauma. Methods The clinical data of patients with blunt hepatic trauma admitted to our hospital during the past 15 years were retrospectively analyzed, and the new standpoints in the selection of therapeutic strategy for blunt hepatic trauma were elucidated with referance to recent litereture, especially regarding the different opinions in non-operative management in the treatment of blunt hepatic trauma between the developed countries and China. Results The concept in the selection of therapeutic strategy for blunt hepatic trauma in China lagged relatively behind the advanced countries. Compared with that in the developed countries, the percentage of non-operative management was significantly lower in China (10%-30% vs 50%-80%), and the fewer CT scanning was carried out in the patients with stable hemodynamics. Conclusion Non-operative management is becoming one of the most important strategies in the treatment of blunt hepatic trauma nowadays. Non-operative management is widely acknowledged as the first choice for blunt hepatic trauma, especially for those with stable hemodynamics. This new trend should be more emphasized in China. Besides, CT scanning as a diagnostic tool should be carried out as frequently as possible in those patients with stable hemodynamics.

Objective To investigate the diagnostic value of improved pleural biopsy combined with biomarker and cytology detection in pleural effusion of unknown origin.Methods The clinical data in 216 cases of pleural effusion were respectively analyzed including 106 cases of tuberculous pleural effusion(tuberculosis group) and 110 cases of malignant pleural effusion(malignant group).All cases were performed the improved pleural biopsy,cytology examination and detection of pleural effusion ADA,CEA and LDH,and serum CEA.The pleural biopsy diagnosis rate was performed the statistics,and pleural effusion ADA,CEA and LDH,serum CEA,and pleural effusion CEA/serum CEA were compared between the two groups.Results Among 216 cases,241 times of pleural biopsy puncture were conducted,the first time puncture success rate was 94.9 ％ (205/216).Having the diagnostic value among pathological results of pleural biopsy materials in first puncture success accounted for 58.8％ (127/216),and the overall diagnosis rate was 65.3 ％ (141/216).The incidence rate of adverse reactions was 5.8 ％ (14/241).In the tuberculosis group,no case showed cytology tumor cell positive,while the cytology tumor cell positive rate in the malignant group was 54.5％ (60/110);pleural effusion CEA and LDH,serum CEA and pleural effusion CEA / serum CEA levels and positive rates in the malignant group were significantly higher than those in the tuberculosis group,while the pleural effusion ADA level and positive rate were significantly lower than those in the tuberculosis group the difference was statistically significant(P＜0.01).Conclusion Improved pleural biopsy,pleural effusion cytology,pleural effusion biomarkers have a certain limitation in alone auxiliary diagnosis of pleural effusion.The various indicators can be combined to determine the etiology of pleural effusion in clinic for guiding treatment.

Objective To observe the safety and efficacy of enteral nutrition (EN) in patients with hepatic dysfunction in early postoperative period. Methods A total of 52 patients with hepatic dysfunction were divided randomly into EN ( n =26) and PN ( n =26) groups. Patients in the two groups received EN and PN at 6 h after operation, respectively. The changes of hepatic function and conditions of nutrition were measured. The complications and the changes of gastrointestinal function were observed. The time of hospitalization after operation and cost of nutrition were also recorded. Results The level of bilirubin descended faster in EN than that in PN. Both EN and PN could improve the nitrogen balance. The recovery of gastrointestinal function in EN was much earlier than that in PN ( P

Myasthenia gravis (MG) is an immune-mediated disorder of the neuromuscular junction that is characterized by fluctuating muscle weakness.Acetylcholine receptor antibody (AchR-Ab) is the first MG specific antibody being elucidated,however,the discovery of many other MG specific or related antibodies enriches its immunopathogenesis greatly.The detection of antibodies is very important for the diagnosis and classification of MG.It can be used to guide the clinical management and evaluate the response to treatment as well.With the development of laboratory medicine,the methods of antibody detection are also being optimized.In this paper,we will review the serum antibodies closely associated with MG and their mechanisms,detection methods and clinical significance.

Objective To investigate the percentage of Th17 cells and regulatory T cells in patients with myasthenia gravis (MG) and observe the effects of methylprednisolone infusion on these cells.Methods The circulating Th17 cells and CD4+ CD25highT cells of 66 MG patients and 35 healthy controls were detected using four colour cytometry. The relationship between these cells and MGFA score in 18 MG patients and in 8 MG patients after methylprednisolone was infusion were also analyzed in this study. Results There was significant difference in the percentage of circulating Th17 cells between MG patients (2. 61% ±0. 28% ) and the healthy controls (0. 94% ± 0. 12%, Z = 4. 059, P = 0. 0001 ). Methylprednisolone therapy significantly reduced the percentage of circulating Th17 cells from 4. 72% ± 1.21% to 1.81% ± 0. 69%(Z = 1. 995,P = 0. 0460). In addition, the percentage of Th17 cells showed a positive correlation with MGFA score(r =0. 5359, P =0. 0219). Conclusions Circulating Th17 cells are elevated in MG patients.Methylprednisolone therapy can reduce such elevation, and this may be important in mediating symptomatic improvement in MG patients.

Objective Through studying the apoptosis induced by stichopus japonicus acid mucopoly saccharide in the hepatocellular carcinoma cell line HepG2 in vitro, analysing the expression of Bcl-2 and nm-23in HepG2, to provide the theory foundation and its feasibility on whether it can be used for the chemotherapy of hepetocellular carcinoma. Methods The cells of HepG2 were cultured in vitro and treated with SJAMP at different doses(0.25,0. 5,1.0,2.0,4.0 g/L). MTT was used to observe the inhibitory effects of SJAMP on cell growth, Western blotting was used to detect apoptosis, and the apoptosis related change of expression of protein Bcl-2 and nm23-H1. Results (1) MTT identified that SJAMP produced an obvious time-and-dose-dependent inhibitory effect on the HlepG2 cells. (2) Western blot showed that SJAMP could induce the apoptosis of HepG2 cells through changing the expression of the protein of Bcl-2 and nn23-H1 (P<0.05). Conclusion (1)SJAMP produced obvious inhibitory effects on HepG2 cells and induce HepG2 apoptosis. (2)SJAMP can enduce the anti-tumor function in the method of changing the expression of protein Bcl-2 and nm23-H1.