Objective To explore the clinical and MRI features of spontaneous osteonecrosis of the knee(SONK).Methods 15 patients with SONK diagnosed by clinic and imaging were collected.All of cases were examined by MRI,of them 5 cases underwent CT scan and 3 cases underwent radiographic examinations.Results The subchondral lesions were seen in all cases on MRI and the lesions located in the femoral condyle weight-bearing zone in 14 cases.The subchondral "fracture cleft"sign was found in 2 cases;the subchondral long T1 and short T2 linear abnormal signal intensity surrounding with bone marrow edema were shown by MRI in 3 cases of them.The subchondral focal lesions were slight long T1 and long T2 signal intensity in 10 cases.The subchondral lesion were showed clearly only in 2 cases of 5 cases with CT scan,and only 1 case of 3 cases with plain X-ray examinations.Conclusion MRI is more sensitive than CT and radiography in showing the lesions of SONK.The SONK can be diagnosed based on the clinical and MRI features.

OBJECTIVE: To study the compatibility stability of aztreonam after mixing with fructose injection, calorose injection and xylital injection. METHODS: The content of solution, quantity of particles, pH value and physical changes were observed after aztreonam mixing with 3 kinds of injections for 6 hours at room temperature. RESULTS: The content of solution, quantity of particles, pH value and physical changes were up to the standard. CONCLUSION: Aztreonam mixed with fructose injection, calorose injection or xylital injection is keeping stable.

Objective To prospectively compare cadmium-zinc-telluride (CZT) SPECT gated myocardial perfusion imaging (GMPI),conventional SPECT MPI and cardiac MRI for the assessment of left ventricular volume and ejection fraction in patients with heart failure.Methods From July 2016 to October 2016,a total of 35 patients (27 males,8 females,average age:(52.7±14.9) years) with heart failure were consecutively included.All patients underwent CZT SPECT GMPI,conventional SPECT GMPI and cardiac MRI within 7 d.LVEDV,LVESV and LVEF of three imaging modalities were calculated.One-way analysis of variance,Pearson correlation analysis and Bland-Altman analysis were used.Results CZT SPECT showed excellent correlation with conventional SPECT for LVEDV,LVESV and LVEF (r values:0.983,0.986 and 0.910,respectively;all P＜0.001).Bland-Altman analysis revealed good agreement between CZT SPECT and conventional SPECT for LVEDV,LVESV and LVEF.The correlation between CZT SPECT and cardiac MRI for LVEDV,LVESV and LVEF were all significant (r values:0.864,0.896 and 0.836,respectively;all P＜0.001).Compared with cardiac MRI,CZT SPECT showed systemic underestimation of LVEDV and LVESV and good agreement of LVEF by Bland-Altman analysis.Conclusions CZT SPECT has high clinical value for patients with heart failure.Despite underestimating LVEDV and LVESV,it correlated well with cardiac MRI.It also has a good agreement with conventional SPECT on left ventricular volume and LVEF.

OBJECTIVETo determine the structures and contents of the volatile components of flowers of Fritillaria thunbergii, and investigate the effects of operation modes on its volatile components.

METHODThe volatile oils were first obtained by the hydrodistillation assay and then submitted to gas chromatography-time-of flight mass spectrometry (GC-TOF-MS) analysis.

RESULTMore than 60 peaks were resolved, and 39 of which were identified quantitatively and qualitatively based on high-resolution spectra and compounds library screening. Among these identified components, the octadecatrienoic acid methyl esters were major components in the unprocessed flowers, while some aromatic aldehydes and ketones, such as benzeneacetaldehyde and 1-(2-hydroxy-5-methylphenyl)-ethanone, were prominent components in the flowers both dried in the fluidized bed and in shadow. In addition, the flowers dried in the fluidized bed were more fragrant than other flowers.

CONCLUSIONThe component and contents closely related to their processing mode, and the fluided bed drying may be a best choice to process the flowers of F. thunbergii.

Flowers ; chemistry ; Fritillaria ; chemistry ; Gas Chromatography-Mass Spectrometry ; methods ; Oils, Volatile ; analysis ; isolation & purification ; Plant Extracts ; analysis ; isolation & purification

Background and purpose:In recent years, epigenetics research has become a new direction of cancer research. A large number of results have shown that the abnormal changes of epigenetic modifications have close connection with cancer. Genome-wide epigenetic modifications have become new markers for cancer. This study aimed to investigate the methylation of the promoter ofDBC1 gene in cervical cancer tissues of Uyghur women in Xinjiang, to explore the correlation between the gene methylation and the infection of HPV, and to evaluate whether it can be used as a tool with high sensitivity and specificity for cervical cancer screening.Methods:This study detected the infection of HPV16, 18 in 43 normal cervical tissues, 35 cervical intraepithelial neoplasia tissues and 54 cervical cancer tissues using the polymerase chain reaction (PCR) method. The methylation of the promoter ofDBC1 gene in above-mentioned tissues was detected by the methylation-specific PCR method. The expression ofDBC1 at mRNA level was measured by real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR) in 10 methylation-negative normal cervical tissues and 10 methylation-positive cervical cancer tissues.Results:In normal cervical tissues, CIN tissues and cervical cancer tissues, the infection ratios of HPV16 were 18.6%, 34.3% and 68.5%, respectively; the infection ratios of HPV18 were 2.3%, 8.6% and 16.7%, respectively; and the methylation ratios ofDBC1 gene were 23.3%, 40.0%, 87.0%, respectively. In 79 high-grade squamous intraepithelial lesions (CINⅡ and Ⅲ) and cervical cancer tissues, 50 of 79 were infected with HPV16/18, while 29 of 79 were negative. The methylation ratio ofDBC1 gene was 88.0% in HPV16/18 infection positive group while the methylation ratio was 55.2% in negative group (P<0.05). The expression ofDBC1 gene at mRNA level in 10 methy- lation-positive cervical cancer tissues was significantly lower than that in the 10 methylation-negative normal cervical tissues (P<0.05).Conclusion:The methylation ofDBC1 gene may become a molecular marker to detect cervical cancer of Uyghur women in Xinjiang.DBC1 gene methylation combined with HPV16/18 infection test can be used to aid diagnosis of cervical cancer.

Objective To investigate the epidemiological characteristics of outpatients exposed to rabies and to analyze the post-exposure prophylaxis in Weinan City in 2017 in order to provide a scientific basis for the prevention of rabies. Methods Clinical data of all outpatients with exposure to rabies in Wei-nan were collected. Ecxcel 2007 was used for data entry and SPSS13. 0 for Chi-square test. Results A total of 32 094 cases were reported with an annual exposure rate of 625. 64/100 000 in Weinan in 2017. Animal bites mainly occurred in spring and summer,accounting for 47. 47% of the total cases in 2017. There were statistically differences in exposure rate among different age groups (χ2=15. 858,P=0. 003). Farmers ac-counted for the largest proportion of the outpatients exposed to rabies (52. 34% ). Among 31 435 outpatients, 28 181(89. 65% ) received wound care and rabies vaccination. The vaccination rate of rabies immunoglobu-lin for patients with gradeⅢ exposure was 46. 93%. Conclusion Comprehensive measures with focuses on compulsory vaccination for domestic dogs and adoption of stray dogs should be implemented to prevent human rabies. Meanwhile,health education rabieson prevention and control should also be strengthened.

Objective:To observe the body fluid and cellular immune function of children with cerebral palsy (CP) in the plateau area, as well as the exchanges of these factors during the comprehensive rehabilitation treatment.Methods:A total number of 144 children admitted to Xining Hospital of Traditional Chinese Medicine from June 2018 to October 2019 were selected as the CP group for comprehensive rehabilitation treatment (consecutive courses). The peripheral blood immunoglobulin/complement (IgA, IgG, lgM, C3, C4) level, T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) and neuron-specific enolase (NSE) content was examined in the clinical specimens before and after treatment by using the immunoturbidimetry, flow cytometry, electrochemiluminescence analysis according to the Gross Motor Function Classification System (GMFCS) and Gross Motor Function Test Scale (GMFM-88). Children were divided as the different degrees to evaluate the rehabilitation efficacy. A total number of 50 healthy children taken a health check/physical examinations during the same period were considered as the control group. For statistical Analysis, the χ2 test and independent sample t test were performed. Results:The levels of humoral immune IgG, IgA, IgM, C3 and C4 in CP Group [(6.42±1.05), (0.64±0.13), (0.89±0.13), (0.80±0.08), (0.17±0.03) g/L, respectively] in CP groups′ children were lower than those in the control group [(10.25±0.62), (1.04±0.06), (1.06±0.17), (1.04±0.04), (0.27±0.04) g/L, respectively]. The humoral immune IgG and IgA levels [severe (5.40±0.69) and (0.55±0.09)g/L, moderate (6.63±0.30) and (0.66±0.14)g/L, mild (7.57±0.63) and (0.74±0.09)g/L, P<0.05] were also related to the children with CP of different GMFCS grades. Moreover, the level of T lymphocyte subsets (CD3+,CD4+,CD8+,CD4+/CD8+) in the CP group were not statistically different to that in the control groups children. Receiving the rehabilitation treatment, the levels of serum humoral IgG and IgA in CP Group (7.69±1.14) and (0.79±0.17) g/L were significantly enhanced; whereas the serum NSE (12.82±2.49) μg/L was lower than that before treatment (18.57±3.08) μg/L, and the total score of GMFM-88 (121.35±26.51) was higher than that before treatment (101.04±27.62). The differences were statistically significant ( P<0.05). IgM, C3, C4 and T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) had no significant difference compared with those before treatment ( P>0.05). Conclusions:Children with CP at high altitude have abnormal humoral immune function. IgG and IgA may be related to the severity of CP and neuronal damage. Comprehensive rehabilitation can not only improve the motor function of children with CP, relieve neuronal damage, but also enhance their humoral immunity status.

Objective To evaluate the effect of anticoagulant therapy by pulmonary ventilation/perfusion (V/Q) imaging in chronic thromboembolic pulmonary hypertension (CTEPH) patients.Methods Thirtysix CTEPH patients (16 males,20 females,average age:(53.8±13.8) years) diagnosed by pulmonary angiography from January 2013 to December 2015 were included in this retrospective study.All patients received anticoagulant therapy for more than 6 months.They underwent pulmonary V/Q imaging before and 6 months after anticoagulant therapy.The numbers of pulmonary segments with perfusion defect,percentage of perfusion defect score (PPDs) and pulmonary arterial systolic pressure (PASP) before and after anticoagulant therapy were measured by echocardiography.Pair t test was used for data analysis.Results Before anticoagulant therapy,there were 319 pulmonary segments with perfusion defect in 36 CTEPH patients,8.9± 3.4 on average,and reduced to 8.4+3.6 after anticoagulant therapy (t =3.101,P＜0.01).The PPDs before and after anticoagulant therapy were (43.3±19.7)％ and (40.8±+20.5)％ (t=2.364,P＜0.05).In the subgroup of 9 patients with improved pulmonary perfusion,the PASP significantly decreased from (68.7±27.3)to (56.1 +±34.8) mmHg (1 mm Hg =0.133 kPa;t =2.465,P＜ 0.05) after anticoagulant therapy.In contrast,in the subgroup of 27 patients with no improved pulmonary perfusion,the PASP before and after anticoagulant therapy were (71.3±26.9) and (76.7±35.0) mmHg respectively (t=-1.511,P＞0.05).Conclusion Pulmonary V/Q imaging is a reliable method for evaluating the changes of pulmonary perfusion before and after anticoagulant therapy,and it is valuable for assessing the effect of anticoagulant therapy in CTEPH patients.

Objective: To summarize the clinical and genetic characteristics of children with mitochondrial epilepsy. Methods: Clinical data of 62 children who were clinically and genetically diagnosed with mitochondrial epilepsy by the Department of Neurology, Beijing Children′s Hospital from October 2011 to December 2018 were analyzed retrospectively, and the control of epilepsy was followed up. T test or χ² test were used to analyze the related factors affecting the prognosis of epilepsy between the effective group and the ineffective group. Results: Of the 62 patients, 33 were male and 29 were female. The age of onset was 3.38 (0-12.00) years; for the type of seizures, 68% (42/62) of the patients had focal seizures, generalized or secondary generalized tonic-clonic seizures were seen in 32% (20/62), myoclonic seizures in 23% (14/62), spastic seizures in 7 cases, tonic seizures in 4 cases, absence seizure, atonic seizure and clonic seizure in 1 case each; 16 cases (26%) had status epilepticus, of whom 6 cases had epilepsia partialis continua; 52% (32/62) had 2 or more types of seizures. The clinical phenotypes were mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) in 29 cases, Leigh syndrome (LS) in 11 cases, combined oxidative phosphorylation deficiency in 6 cases, myoclonus epilepsy with ragged-red fibers in 5 cases, Alpers syndrome in 4 cases, pontocerebellar hypoplasia type 6 and mitochondrial DNA depletion syndrome 9 in 2 cases each, mitochondrial complex Ⅰ deficiency nuclear type 20, progressive cavitating leukoencephalopathy, and biotinidase deficiency in 1 case each. Of the 62 cases, 40 cases (65%) had mitochondrial DNA (mtDNA) variations, of which 26 cases had m.3243A>G variants, 6 cases had m.8344A>G variants, and 3 cases had m.8993T>G/C variants, m.3271T>C, m.3481G>A, m.3946G>A, m.13094T>C, m.14487T>C variant was in 1 case each; nuclear DNA (nDNA) variations were identified in 22 cases (35%), of which 7 cases carrying variations in mitochondrial ammonia acyl tRNA synthetase coding gene, mutations in POLG and the gene encoding complex Ⅰ were in 4 cases each, variations in SUCLG1 and SDHA genes were in 2 cases each, and variations in PDHA1, BTD and TRIT1 genes were in 1 case each. Forty-three patients were followed up, and the follow-up time was 20 (3-84) months. According to the follow-up results, the anti-epilepsy treatment was effective in 19 cases (44%) and ineffective in other 24 cases (56%). The onset age of the effective group was 3.42 (0-11.50) years and that of the ineffective group was 0.92 (0-9.50) years. The onset duration of the effective group was 0 (0-7.00) years and that of the ineffective group was 0 (0-4.83) years. There was no significant difference between the effective group and the ineffective group (t=1.662, 0.860; P=0.104, 0.395). In the effective group and the ineffective group, 12 cases and 9 cases used less than 2 kinds of antiepileptic drugs, 7 cases and 15 cases used more than or equal to 2 kinds of antiepileptic drugs, 13 and 15 cases had first epilepsy, 6 and 9 cases had non-first epilepsy, 14 and 11 cases had mtDNA variation, 5 and 13 cases had nDNA variation, respectively. There was no significant difference between the two groups (χ²=2.794, 0.164, 3.380; P=0.095, 0.686, 0.066). Conclusions The types of seizures with mitochondrial epilepsy in children varied, with focal motor seizures being the most common, followed by generalized or secondary generalized tonic-clonic seizures. Most children have more than two types of seizures. MELAS is the most common clinical phenotype, followed by LS; mtDNA variation is the dominant gene variation, of which m.3243A>G variation is the most common hotspot variation, followed by gene variation encoding mitochondrial aminoacyl tRNA synthase.