Objective To explore diagnosis and treatment of hypokalemic paralysis in patients. MethodsIntegrated into our hospital,admitted 42 patients with hypokalemic paralysis of the clinical data. Results Of 42 pa-tients, 32 cases were diagnosed of periodic paralysis, eight cases of hyperthyroidism, distal renal tubular acidosis two cases. All patients in the supplementary potassium and causing symptoms disappeared after treatment. Serum potassi-um restored to normal level. Conclusion Of frequent seizures in hypokalemic paralysis should be taken to excludehypert hyroidism. For difficult to corrected hypokslemic paralysis should do more detailed checks.

Objective To investigate the siginicance of evaluation of chemotherapy the changes of serum concentration of CYFRA21-1 application in patients with advanced non-small cell lung cancer (NSCLC).Methods Enzyme linked immunosorbent assay ( ELISA) was used to analyze of 86 cases of advanced NSCLC in the serum of the patients after first-line chemotherapy(gemcitabine +cisplatin) difference between the changes of CYFRA21-1 con-centration in serum before and after chemotherapy ,and 42 cases of normal healthy control CYFRA 21-1 concentration in human serum were analyzed .Results Compared with healthy controls ,serum concentrations of CYFRA 21-1 in pa-tients with advanced NSCLC increased significantly [(1.98 ±1.17)μg/L vs (17.36 ±13.28)μg/L,t=12.56,P<0.05],and the concentration of CYFRA21-1 in serum of patients with lung squamous cell carcinoma was significantly higher than that in patients with lung adenocarcinoma [(25.47 ±15.31)μg/L vs (17.36 ±13.28)μg/L, t=5.84, P<0.05] .In addition to first-line chemotherapy in patients with NSCLC patients ,the serum concentration of CY-FRA21-1 significantly lower than before chemotherapy and after chemotherapy ,the first-line chemotherapy drug was invalid or CYFRA21-1 concentration in serum of patients with chemotherapy resistance in before and after the change is not obvious ,even there was a trend of rising .Conclusion Serum CYFRA21-1 can be used as the curative effect of chemotherapy in patients with advanced NSCLC effective evaluation index of early .

Objective To analyze clinical effects of microendoscopic discectomy in the treatment of lumbar disc herniation with or without lumbar spinal stenosis.Methods A total of 216 patients were included in the study.The patient was maintained in the prone position on an arch-like bed.Under C-arm fluoroscopic guidance,a thin pin was inserted down to the facet of the target level.A longitudinal incision was made approximately 1.7 cm at the level of the disease to introduce a series of dilators,over which a working channel was then established.Once extraneous soft tissues were removed,a curette was used to puncture the ligamentum flavum.And the local ligamentum flavum and part of inferior border of the adjacent lamina were removed with a gun-shaped rongeur.The disc space was incised and a discectomy was performed.The lateral recess was cleared of any bone stenosis.Results conversions to open traditional discectomy were conducted in 2 patients because of bleeding.The 216 patients were followed for 3 months ~ 4 years with an average of 2.5 years.According to the Nakai criteria,excellent outcomes were achieved in 210 patients,good in 2 patients,fair in 1,and poor in 3,the rate of excellent or good outcomes being 98.1%(212/216).Of the 3 patients with poor outcomes,2 patients were given a re-operation of traditional surgery 3 months after the microendoscopic discectomy and 1 patient had a missed diagnosis of spinal tuberculosis.Conclusions Microendoscopic discectomy in the treatment of lumbar disc herniation gives little influence to spinal stability and satisfactory clinical effects.

To evaluate the clinical efficacy of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis.
●METHODS:Totally 22 cases (22 eyes) with superficial fungal keratitis were referred to our hospital from April 2012 to October 2013. The patients with persistent cornea ulcer after treatment of local and systemic antifungal drugs underwent corneal lamellar debridement combined with sutureless amniotic membrane transplantation, and the recipient bed was covered with an amniotic membrane using fibrin sealant during the operation. All patients were still given topical antifungal therapy for 1 -2mo after operation. The followed- up time was 3mo or above. We observed the corneal healing and amniotic membrane adhesion by split lamp microscope, and investigated the transformation of amniotic membrane and fungal infection recurrence with confocal microscope.
●RESULTS: Corneal edema and anterior chamber reaction of 21 patients disappeared gradually, and no amniotic membrane graft dissolved and shed off within 1-2wk postoperatively. Two weeks after operation, the graft integrated into the corneal and the corneal wounds' thickness increased gradually, the corneal epithelium reconstructed and corneas became clear. Four weeks after operation, the corneal scarring developed gradually and fluorescence staining was negative. Nineteen cases' amniotic membranes that adhered with the cornea dissolved 4wk after operation. There were different degrees of corneal nebula or macula remained 3mo postoperatively. All patients' vision improved in varying degrees, except in 1 case with fungal keratitis who had been cured by lamellar keratoplasty.
●CONCLUSlON:Corneal lamellar debridement combined with sutureless amniotic membrane transplantation can effectively remove the foci of inflammation, improve the local efficacy, shorten the operation time, relieve the postoperative reaction, and promote cornea union, which is an effective way to treat superficial fungal keratitis.

The content and thought on gradually exploratory experiment teaching of pharmacology was introduced to research the cultivation of innovative talents and good experiment concept.

From April.1993 to Jan.1994,transcatheter maxillary arterial chemoem- bolization using Cisplatin microspheres(DDP-ms)in combination with PBF(DDP,BLM,5- Fu)had been used in 14 cases with regional relapsed nasopharngeal carcinoma and 3 cases of untreated locally advanced nasopharngeal carcinoma got positive response.The result showed 2 patients with Cr,13 PR,1MR and 1 NC advanced cases with PR.The total suc- cessful rate(CR+PR)was 88 24%(15/17),In addition,the main toxicity and coplicaton had been discussed.

Objective: To observe the effect of bortezomib (Btzmb) on the differentiation and function of osteoclasts from patients with multiple myeloma (MM) during their maturation in vitro and investigate the influence of Btzmb on the expression of tumor necrosis factor receptor-associated factor (TRAF6), one of the key signaling molecules on the upstream of osteoclasts differentiation. Methods: Osteoclast precursor mononuclear cells were isolated from peripheral blood of MM patients and cultured with receptor activator of NF-κB ligand (RANKL) and macrophage colony stimulating factor (M-CSF) and different concentrations of Btzmb. The number of tartrateresistan acid phosphatase (TRAP)-positive osteoclasts was counted. The TRAP activity in the supernatant was tested. The extent of the ivory slice resorption was observed. The effects of Btzmb on the mRNA and protein expressions of TRAF6 were determined by RT-PCR and Western blotting, respectively. Results: After Btzmb 2.5 and 5 nmol/L treatment, the number of osteoclasts were reduced compared with the control group [(157 ±21) and (98 ± 15) vs (307 ± 25), P < 0.05]. The number of the ivory slice resorption decreased [(53 ± 24)% and(29 ± 7)% of the control, P < 0.05]. The TRAP activity in the supernatant was inhibited [(86 ± 24)% and(60 ± 25)% of the control, P < 0.05]. The activity of TRAF6 protein gradually declined and the levels of TRAF6 mRNA also decreased at 24 h after Btzmb treatment. Conclusion: Btzmb can inhibite the differentiation and function of osteoclasts. The action of Btzmb may be related with TRAF6.

目的观察肌电图导引下应用A型肉毒毒素治疗脑卒中偏瘫患者肢体痉挛的临床疗效。方法65例脑卒中痉挛性偏瘫患者按FMA量表评定分为3组,应用肌电图纪录痉挛肢体在功能位时的运动单元电位数,确定治疗肌肉,每一部位注射5U,0.2ml国产A型肉毒毒素,治疗3天后由康复训练师亲自或指导家属进行肢体功能训练。采用改良AshWorth分度评分评定痉挛状态,FMA量表评定日常生活能力(上下肢分别统计)。结果治疗后,中、轻度运动障碍者恢复至基本正常;严重运动障碍者恢复至明显运动障碍;严重运动障碍合并挛缩者可改善其生存质量;所有患者增高的肌张力均有明显改善。结论在肌电图导引下,A型肉毒毒素作为缓解痉挛药物使用安全、有效,对肢体功能的恢复有显著的辅助作用。

Brain ; pathology ; Central Nervous System Diseases ; congenital ; diagnosis ; pathology ; physiopathology ; Diagnosis, Differential ; Humans ; Infant, Newborn ; Magnetic Resonance Imaging ; Male ; Mobius Syndrome ; diagnosis ; pathology ; physiopathology

Humans ; Tinnitus ; diagnosis ; therapy