Objective To explore the role of the autoantibodies against angiotensinⅡ type 1 receptor (ATR-1) in the pathogenesis of preeclampsia. Methods Forty normotensive and 46 pregnant women with preeclampsia were recruited in this study. Synthesized ATR-1 polypeptide fragment was used as antigens to screen the autoantibodies against ATR-1 by ELISA. The level of angiotensinⅡ was also examined. Results The positive rate of the ATR-1 antibodies and plasma level of angiotensin Ⅱ in patients with preeclampsia [63.0%(29/46) and (92.54?37.22) pmol/L] were significantly higher than those in normotensives [7.5% (3/40) and (25.75?12.33) pmol/L, P

Objective To establish a CLCN3/MMTV-PyMT double transgenic mouse model of spontaneous breast tumor with simultaneously overexpressing ClC-3.Method CLCN3 transgenic mice were crossed with MMTV-PyMT spon-taneous mammary tumor model mice.The genotype was determined by PCR.The expression of ClC-3 in tissues was detec-ted by immunofluorescence and Western blot.Results CLCN3 and MMTV-PyMT transgenic mice were bred and CLCN3/MMTV-PyMT hybrid mouse model was successfully established.The ClC-3 expression in CLCN3/MMTV-PyMT hybrid mice was higher than that in the MMTV-PyMT mice, assessed by immunofluorescence and Western blot analysis.Conclu-sions Transgenic mouse models of spontaneous breast cancer with simultaneously overexpressing ClC-3 are successfully es-tablished.The double transgenic mice provide a good animal model for further research of ClC-3 in tumor growth and metas-tasis.

Objective To investigate the role of expression in the differential diagnosis of thyroid follicular carcinoma and follicular variant of papillary carcinoma. Methods Seventy cases of thyroid lesions (including 15 cases of follicular adenomas, 15 cases of adinomatous goiters, 30 cases of papillary carcinomas and 10 cases of follicular carcinomas) were collected, and CD10 expression was detected by means of immunohistochemistry in above thyroid lesions. Results Seven of 9 cases of follicular variant of papillary carcinoma were CD10 positive (77.8), and 8 of 10 cases of follicular carcinoma were CD10 positive (80.0). However, CD10 was negative in all cases of non-follicular variant of papillary carcinoma, follicular adenoma, adinomatous goiter and normal thyroid tissue. Conclusion The detection of CD10 expression is useful to the differential diagnosis of thyroid follicular carcinoma and follicular variant of papillary carcinoma.

Objective To investigate the knowledge, attitude and behavior related to stroke and rehabilitation in the stroke patients and their relatives. Methods Questionnaires were performed in 60 stroke patients and 100 relatives. Results 71.7% patients knew "what is stroke". 40% knew "hypertension is the most risk factors of stroke". 45% patients and 41% relatives knew that the risk factors for stroke were hypertension, diabetes, hyperlipidemia, smoking and drinking. 35% patients and 29% relatives learned that the prevention of stroke should start being young. 50% patients did not understand post-stroke rehabilitation. Patients learned some to limit their smoking, alcohol, salt intake and alter their personality. More than 80% relatives wished to help the patients abstain smoking, limit fat and salt. 55% patients agreed to control the blood pressure. About 40% patients or their families did not know it was necessary to monitor the blood pressure and lipid, 70% relatives would help the patient exercise. Less than 50% patients began to treat their hypertension, heart disease and diabetes. 40% accepted low-fat diet and regular exercise. 35% measured their blood pressure and lipid regularly, or go to the hospital for the medical examination. Conclusion At present, the knowledge, attitude and behavior related to stroke and rehabilitation in stroke patients and their relatives need to be improved.

To study the effects of rCBF and brain function in the patients with cerebral infarction byearly rehabilitation training. 89 cases were randomized into rehabilitation and control groups and were ex-amined rCBF by 133Xe inhalation method and BEAM. Total effect rate was 93.9%in rehabilitationgroup,to the control 77.5%(X2=3. 95,P<0.05). The rCBF rised up in two groups,but it was higher inthe foriner,to the contro1,t=4. 99,P<0. 01. BEAM improve rate was 95.9%,to the control,77.5%(X2=5. 30,P<0. 05). So we confirmed that early rehabilitation training may promote rCBF and improve brainfunction of patients with cerebral infarction.

Objective To investigate the immune tolerance in animal models of primary biliary cirrhosis (PBC) by determining the cell proliferation and activation induced cell death (AICD).Methods C57BL/6 mice were injected with 5 mg/kg of polyI:C to develope PBC models. The lymphocytes and CD4~+ T cells were separated from spleens and livers 16 weeks later and were stimulated by M2, conA and anti-CD3 for cell proliferation and AICD. Expression of apoptosis related genes and proteins were detected by real time polymerase chain reaction (PCR) and Western blotting, respectively. Results ① The lymphocyte proliferation was 0.1988 ± 0.0111 in blank controls and 0. 2068±0. 0115 in PBS treated mice with no significant difference (P>0.05). However, an abundant lymphocyte proliferation was found in PBC mice (0. 358 ± 0. 022), which was higher than that in controls and PBS treated mice. The proliferation of lymphocyte from liver was greater than that from spleen in PBC mice (P<0.01). ② The apoptotic rate in blank controls (74.70%±4.58%) and PBS treated mice (74.20%±4.44%) was higher than that in PBC mice (44.85%±6.47%,P<0.01),but no difference was found between blank controls and PBS treated mice (P>0.05). Furthermore, the apoptosis rate of T cells from livers were significantly lower than that from spleens in PBC mice (P<0.01). ③ The expressions of FasL and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) in PBC mice were lower than those in PBS treated mice (P<0. 01), but there was no change in expression of Fas was found. ④ The expression of Fas-associated death domain-like interleukin-1-β-converting enzyme-inhibitory protein (FLIP_L) in PBC mice was higher than that in blank controls. Moreover, the expression of FLIP_L in livers was higher than that in spleens in PBC mice (P<0. 01). Conclusios The elevated expression of FLIP_L may inhibit AICD. Besides, the decreased expressions of FasL and TRAIL may also help in the enhancement of the anti-apoptotic ability in lymphocytes and in the aggravation of portal area inflammation.

Objective:To summarize the clinical features and pathological changes of peripheral tissues from patients with neuronal intranuclear inclusion disease (NIID) diagnosed by genetic tests.Methods:Repeat-primed polymerase chain reaction was used to confirm the GGC repeated expansion in the 5′ untranslated region of the NOTCH2NLC gene in patients with suspected NIID who had visited the Department of Neurology of Peking University First Hospital from January 2018 to February 2020. The clinical data and pathological changes of peripheral tissues from patients with genetically diagnosed NIID were collected retrospectively and analysed. Immunostaining with anti-p62 and anti-ubiquitin antibody was performed on peripheral biopsy specimens.Results:Totally nine patients with NIID who had GGC repeated expansion in the NOTCH2NLC gene were found. Five patients were familial (from three faimilies), and four patients were sporadic. The age of onset was 36-61(51.33±7.12) years. The most common symptoms in this NIID group were episodic emotion and personality change (8/9), paroxysmal disturbance of consciousness (6/9) and intermitant head discomfort (6/9). Other symptoms included cognitive dysfunction, limb weakness, limb sensory disturbance, bladder dysfunction, ataxia, seizures and psychiatric symptoms. Brain magnetic resonance imaging showed high signals along the corticomedullary junction on diffusion-weighted image in eight out of nine patients. Skin biopsied samples from nine patients demonstrated the presence of eosinophilic intranuclear inclusions (IIs), appearing in the nucleus of fibroblasts, fat cells and ductal epithelial cells of sweat glands on hematoxylin-eosin staining. IIs were positive on anti-p62 and anti-ubiquitin immunostaining. Electron microscopy indicated the IIs were composed of a pile of filament materials without membrane. Muscle biopsies from two patients showed no obvious neurogenic or myogenic pathologic changes, except in one patient several rimmed vacuoles fibers were found. In one patient sural nerve biopsy showed severe demyelinating pathological changes. No IIs were found in the muscles and peripheral nerve tissue either by histological examination or by immunohistochemical staining with anti-p62 or anti-ubiquitin, while IIs were found by immunofluorescence staining with both anti-p62 and anti-ubiquitin in three patient′s tissue. Conclusions:The phenotype of this NIID patient group is adult-onset NIID, with episodic encephalopathy as the main clinical manifestation. Skin biopsy has high pathological diagnostic value for NIID. The immunofluorescence staining with anti-p62 and anti-ubiquitin is easier to detect the presence of IIs than histological staining and immumohistochemical staining.

Objective: To analyze the diagnostic value of skeletal muscle biopsy in patients with rhabdomyolysis. Methods: Clinical and pathological data of 26 patients with rhabdomyolysis from January 2002 to December 2018 undergoing muscle biopsy were collected. Results: Eighteen males and 8 females were finally recruited with median age of 6-73 (37.3±19.6) years. The average time from onset to biopsy was 44 days (median course was 30 days). All patients had acute manifestations with muscle pain and/or weakness. Serum creatine kinase was between 1 648-92 660 U/L. Muscle biopsies showed nonspecific changes in 12 cases (a few with type 2 muscle fiber atrophy, slight deposition of lipid droplets), 10 cases with necrotizing myopathy (muscle fiber necrosis and regeneration). Toxic neurogenic damages were seen in 2 cases (type 1 and type 2 angular atrophic muscle fibers with group change), lipid storage disease in 1 case (lipid droplets deposit significantly) and idiopathic inflammatory myopathy in 1 case (muscle fiber necrosis and regeneration, with lymphocyte infiltration). The etiology of non-specific pathological changes included short-term strenuous exercise in 6 patients, poisoning in two, chronic kidney disease in one, viral infection in one, hypothyroidism in one and unknown reason in one. As to patients with necrotizing myopathy, seven were poisoning or drug-related, one with hyperthyroidism, two with unknown reason. Conclusions Among the numerous causes of rhabdomyolysis, exercise usually links nonspecific skeletal muscle changes and poisoning or drug-related disorders are commonly associated with necrotic myopathy. Rhabdomyolysis induced by primary myopathy is rare.

There are few reports on laparoscopic repair of traumatic atresia of bladder neck. In this study, three patients with traumatic atresia of bladder neck were repaired by laparoscopic surgery, and the surgery was successfully completed. During postoperative follow-up, the patients had smooth urination, no urinary incontinence and sexual function damage, and laparoscopic surgery was effective in repairing traumatic atresia of bladder neck.

Objective:To analyze the clinical characteristics, imaging, myopathology and outcomes of patients with COVID-19 related autoimmune myopathy.Methods:The clinical features, serum creatine kinase (CK), myositis antibodies, muscle magnetic resonance imaging, myopathology and therapy of 5 patients with COVID-19 related autoimmune myopathy diagnosed in Peking University First Hospital from December 2022 to April 2023 were collected. The effects of the therapy after a short term follow up were analyzed.Results:Among the 5 patients, there were 3 males and 2 females, with onset age of 42-86 years. All patients presented with proximal muscle weakness in the recovery term of COVID-19. Myalgia was noted in 3 cases, dysphagia in 1, skin damage in 2, interstitial lung disease in 1. The serum CK of the 5 patients was 1 663-16 000 IU/L, 1 patient had anti-3-hydroxy-3-methylglutaryl-CoA reductase autoantibodies and 1 patient had anti-signal recognition particle autoantibodies. The electromyography showed myogenic lesions in all patients. Muscle magnetic resonance imaging showed diffuse muscle edema in all patients, myofascial edema in 3 and subcutaneous-tissue edema in 3. The muscle biopsies in 4 patients revealed necrotic myopathy,with high P62 expression in muscle fibers. The electromicroscopy of 2 patients revealed vacuolated mitochondria and intranuclear tubulofilamentous inclusions in muscle fibers. Four patients were treated with glucocorticoids, of whom 2 patients combined with intravenous immunoglobulin, tacrolimus or cyclophosphamide. One case had close monitoring without drug therapy. They showed significant improvement, but the CK was still abnormal in 4 patients.Conclusions:COVID-19 leads to immune mediated myopathy. The manifestation of patients is characterized by proximal predominant weakness and high creatine kinase level. Muscle magnetic resonance imaging shows diffuse muscle edema. The muscle biopsies reveal necrotic myopathy. The effectiveness of immunosuppression needs to be further studied.