Objective To evaluate the efficacy of Chinese botulinum toxin A(CBTX-A)injection in the treatment of motor tics in patients with tic disorder.Methods Twenty-five patients(20 male,5 female)were treated with CBTX-A in the sites of their most problematic motor tics.Before treatment the data of Yale Global Tic Severityb Scale(YGTSS)was collected.All patients were assessed at least 3 times after 1 week,4 weeks and within 12-month period.At each visit the following data were collected:YGTSS,Jankovic clinical rating scale,time to response,duration of response,global impression of changes by patients,presence of premonitory sensory tic component and side effects.Results Total number of treatment sessions was 29.The mean response time was 5.0 days.The mean duration of response was 4.6 months.The mean peak effect response in Jankovic clinical rating scale was 3.4.Based on YGTSS,62.1% (18/29)was rated as marked improvement,34.5%(10/29)as moderate improvement and only 3.4% (1/29)as no effect.85.7%(18/21)patients had less premonitory sensation symptoms(mean benefit 72.4%(20%-100%)).Weakness in the site of injection and rash were the main side effect. Conclusion CBTX-A is an effective and safe treatment for motor tics associated with tic disorder.

OBJECTIVE To discuss the quality management of the recycled medical instrument.METHODS We executed the routine of recycled instrument seriously during our daily work,and gave strict measures during quality management such as callback,washing,classification,packaging,sterilization,handout,and inspection.RESULTS The recycled medical instrument had been used and managed for more than one year and the clinical work was ensured in progress smoothly and achieved satisfied results.CONCLUSIONS Actualizing the measure of quality control,perfecting the method of management and improving quality control could assure the safe and efficient use of recycled medical instrument and reach the standard of controlling hospital infection,and advancing medical nursing level.

Objective To present the distinction on clinical features,laboratory features,treatment schemes between the patients with and without brucellar epididymo-orchitis,and to provide a theoretical basis for clinical diagnosis and treatment.Methods A retrospective analysis of 223 male patients with brucellosis in the First Hospital of Jilin University from June 2010 to November 2016 was carried out.A comparative analysis of the clinical and laboratory features of 22 patients with epididymo-orchitis and 201 cases without epididymo-orchitis was done.The SPSS 23.0 software was used to analyze the statistical results,P ＜ 0.05 was defined as statistically significant.Results Epididymo-orchitis occurred in 9.87％ (22/223) of all male patients with brucellosis.The median ages of patients with and without epididymo-orchitis were 35.5 and 42.0 years old,respectively,the difference was not statistically significant (Z =1.323,P ＞ 0.05).Cases with and without epididymo-orchitis of brucellosis with fever [90.9％ (20/22) vs 69.2％ (139/201)],chills [54.4％ (12/22) vs 28.9％ (58/201)],hepatomegaly [22.7％ (5/22) vs 3.5％ (7/201)],abdominal symptoms [59.1％ (13/22) vs 17.4％ (35/201)],and urinary tract infection symptoms [31.8％ (7/22) vs 3.5％ (7/201)],the differences were statistically significant (x2 =4.586,6.076,14.424,20.392,27.059,all P ＜ 0.05).The medians of white blood cell (WBC) count (7.9 × 109/L),erythrocyte sedimentation value (ESR,38.0 mm/h),and aspartate aminotransferase (AST,110.0 U/L) in brucellosis with epididymo-orchitis were higher than those without epididymo-orchitis (5.1 × 109/L, 30.0 mm/h,73.8 U/L),the differences were statistically significant (Z =2.239,2.064,2.762,all P ＜ 0.05).All brucellosis patients with epididymis-orchitis were treated with antibiotics for 8 weeks.The defervescence time was 4.5 days,the time of pain relief was 3.9 days,21 patients were cured,and only Ⅰ patient relapsed.Conclusions Epididymo-orchitis is a common complication of brucellosis.Brucellar epididymo-orchitis is usually characterized with a severe acute clinical presentation,which needs timely diagnosis.Combination of antibiotics treatment for 8 weeks in brucellosis patients with epididymis-orchitis is effective.

In this research, Casuarina eguisetifolia Linn was used to verify the broadly suitability of DNA bar-codes in identification of Li-medicine plants and systematic development of species. The genomic DNA of 22 samples collected C. eguisetifolia and its adulterants were amplified by 4 pairs of primers respectively (ITS (inter-nal transcribed spacer), ITS2 (internal transcribed spacer 2), trnH-psbA , rbcL) and sequenced bi-directionally. Obtained sequences were assembled using CodonCode Aligner. The dates were analysised using MEGA5.1 in ac-cordance with the kimura 2-parameter (K2P) model. The neighbor-joining (NJ) phylogenetic trees were construct-ed. Our study demonstrated the efficacy of ITS/ITS2 to distinguish between C. eguisetifolia and other adulterants species at the molecular level. Comparative to the primer of trnH-psbA and rbcL, there was a obviously DNA gap. The NJ trees showed that the several species of Casuarina can be classified to same types to show a obvi-ously monophyly, which the nearest family was Guttiferae. Therefore, ITS/ITS2 regions can accurately distinguish the original plant of Li-medicine. The systematic evolution of Casuarina can be verified in the molecular level.

Health appropriate technologies are applied nationwide in our country and have produced good results. But the informatization of health appropriate technologies lags behind and is still at a preliminary stage.As the network of Zhejiang basic health appropriate technologies has been estabished,this paper discusses some issues related with the informatization of health appropriate technologies.

Objective To study the sensitivity and reliability of rat skin anaphylactoid test method, detect and evaluate the anaphylactoid reaction of traditional Chinese medecine injection. Methods The condition of rat skin anaphylactoid test was optimized by studying the influencing factors of sensitivity and reliability of test with C48/80 as a tool drug, Tween80, endotoxin, China cobra toxin, trichosanthin injection, Tanreqing injection and Xuesaitong injection were investigated. Results The best conditions of rat skin anaphylactoid test was as follows:intrademal inject the drug with insulin syringe, 50-100μL per point, immediately inject 0.5%Evans blue dye 1 mL though caudal vein, 15 min later, kill the rat by carotid artery bleeding, clip dorsal skin to do the test. With this method, Tween80, endotoxin, China cobra toxin and trichosanthin injection all can induce blue stain in rat skin. Tanreqing injection showed no blue stain at the clinical dose. Xuesaitong injection although can induce blue stain in rat skin at the clinical dose, but the results cannot exclude the interference of its pharmacological function. Conclusion The method is simple with short test cycle, less dose of test drug, high detection sensitivity and good reproducibility, but some drug can show false positive result due to its own property.

Objective To study the mechanism of miR?200c in regulating RMP7?induced increases of blood?tumor barrier(BTB)permeability by targeting Ras homolog gene family member A(RhoA). Methods Endogenous expression of miR?200c was detected by real?time PCR in hu?man cerebral microvascular endothelial cell line hCMEC/D3(ECs)after RMP7 treatment. miR?200c mimic and miR?200c inhibitor were transfect?ed into GECs(ECs with U87 glioma cells co?culturing),respectively. Transfection efficiency of miR?200c mimic and miR?200c inhibitor were de?termined by real?time PCR. HRP flux and TEER assays revealed BTB permeability. The protein expression level of RhoA was assessed by West?ern blotting. The distribution of RhoA was assessed by immunofluorescence microscopy. RhoA luciferase assays were performed using the Dual?Lucif?erase reporter assay system. Results RMP7 significantly induced a decrease in miR?200c expression in GECs of BTB. miR?200c mimic and miR?200c inhibitor were successfully transfected into GECs. Overexpression of miR?200c inhibited endothelial leakage and restored normal transendo?thelial electric resistance values. Simultaneously ,overexpression of miR?200c significantly reduced the protein expression level of RhoA. In addi?tion,immunofluorescence analysis revealed that the distribution of RhoA in the cytoplasm and nuclei of GECs were decreased in miR?200c mimic group. RhoA was one of the direct targets of miR?200c with the specific binding site being located at the seed sequence. The results of miR?200c si?lencing were opposite to that of the miR?200c overexpression group. Conclusion miRNA?200c regulated RMP7?induced increases in BTB perme?ability by targeting RhoA.

Objective To explore the ways to decrease the postoperative complications of pancreaticoduodenectomy. Methods Thirty-four patients who underwent pancreaticoduodenectomy between January 1998 and December 2004 were reviewed retrospectively. A duct-to-mucosa pancreaticojejunostomy was performed mostly for patients, and an end-to-end pancreaticojejunal invagination for 5-patients with a soft pancreas and a small pancreatic duct. The end-to-side hepaticojejunostomy and the Roux-en-Y reconstruction of gastrointestinal continuity were performed for all patients. Results The hospital mortality was zero. The postoperative complications occurred in the form of wound infection was 4(12%), delayed gastric emptying was 1(3%), pneumonia was 1(3%), intra-abdominal collections was 1(3%) and pancreaticojejunostomy leak was 1(3%). In 1 patient with pancreaticojejunostomy leak, the closure was achieved with the conservative treatment. Intra-abdominal bleeding, intra-abdominal abscess and other anastomotic leakage were not seen in any of patients. The median follow-up was 21 months (ranging from 6 months to 5 years), none of patients had clinical evidence of steatorrhea, bile reflux gastric disease, anastomotic ulcer, retrograde cholangitis and dumping syndrome, there was no new case of diabetes. Conclusions Proper method of reconstruction produces encouraging results in decreasing the complications after pancreaticoduodenectomy.

Objective To evaluate the injury of pulmonary function of children with idiopathic pulmonary hemosiderosis(IPH) and the changes after treatment,and to provide some guidance for the diagnosis and treatment of IPH.Methods Twenty-one children with IPH who were admiued at Children's Hospital of Fudan University between June 2012 and May 2016 were selected.The pulmonary function and clinical data of them were analyzed.Results The general pulmonary function of 21 children with IPH before treatment with glucocorticoid was reported that 4 cases (19.05％) were normal and 17 cases (80.95％) were abnormal,including 11 cases (52.38％) with restrictive ventilatory disorder,4 cases (19.05％) with mixed ventilatory disorder,1 case (4.76％) with obstructive ventilatory disorder,and 1 case (4.76％) with small airway dysfunction.Pulmonary function test was performed on 15 cases after 1-2 months of treatment with glucocorticoid.The results showed that maximal vital capacity (VCmax％) vs.the expected value was (77.91 ± 18.86)％ vs.(60.43 ± 23.70)％,forced vital capacity (FVC％) vs.the expected value was (78.96 ±19.24)％ vs.(61.03 ±24.62)％ and forced expiratory volume in one second (FEV1％) vs.the expected value was (86.03 ± 21.69) ％ vs.(65.17 ± 26.89) ％,which were significantly higher than those before treatment,and the differences were statistically significant (t =-4.13,-4.01,-4.54,all P ＜ 0.05).Three cases were followed up for 18 to 40 months by detecting pulmonary function and the results of dynamic monitoring of pulmonary function showed a fluctuation in FVC％ [case 1:(69.6-84.2) ％;case 2:(56.1-73.7) ％;case 3:(40.4-70.2) ％].Conclusion The characteristic pulmonary function changes in children with IPH are restrictive ventilatory disorder.Pulmonary function test play a significant role in diagnosis,treatment and prognosis of IPH.

BACKGROUND: At present, there is no consensus on the timing of post space preparation in the clinical medical treatment. But it can be inferred from some studies that post space preparation may affect coronal microleakage using different fil ing materials. OBJECTIVE: To compare the effects of immediate post space preparation and delayed post space preparation restoration on coronal microleakage using different fil ing materials. METHODS: Forty-eight extracted and single-rooted premolars were randomly divided into six groups (n=8 per group): premolars were fil ed with AH-plus paste and gutta-percha with the immediate post space preparation as group A1; premolars fil ed with mineral trioxide aggregate paste and gutta-percha with the immediate post space preparation as group A2; premolars fil ed with AH-plus paste and gutta-percha with the delayed post space preparation 1 week later as group B1; premolars fil ed with mineral trioxide aggregate paste and gutta-percha with the delayed post space preparation after 1 week later as group B2;premolars fil ed with AH-plus paste and gutta-percha as negative control group; premolars fil ed with gutta-percha as positive control group. Afterwards, al specimens were soaked for 4 weeks under simulated oral environment to measure the length of coronal microleakage by pressurized dye penetration method. RESULTS AND CONCLUSION: No coronal microleakage was found in the negative control group, but serious coronal microleakage occurred in the positive control group involving the entire root canal. And there was no significant difference in the length of coronal microleakage between group A2 and B2, as wel as between group A1 and A2 (P > 0.05); but the length of coronal microleakage in the group A1 and B2 was significantly less than that in the group B1 (P < 0.05). These results show that the delayed post space preparation has overt effect on the coronal microleakage of root canal fil ed with AH-plus paste.