The clinical data of 3 cases with myasthenia in Children′s Hospital of Fudan University were retrospectively analyzed.All the 3 patients were diagnosed with myasthenia gravis and given pyridostigmine bromide, but the treatment effect was unsatisfactory.One patient had left lower limb weakness and motor development impairment, and was diagnosed with centronuclear myopathy by gene testing.One patient had blepharoptosis, accompanied by developmental delay, facial deformity, and toe deformity.This patient was diagnosed with chromosome 18p syndrome by chromosome analysis.One patient had weakness of both legs, slight development retardation, and significantly high lactic acid levels.Basal nuclei lesions were observed under head magnetic resonance imaging (MRI). Whole exome sequencing (WES) and mitochondrial genome testing results revealed Leigh syndrome.Through summing up experience and lessons, strengthen and improve the clinical identification ability of clinicians for myasthenia gravis, and avoid misdiagnosis.

Acute ischemic stroke caused by posterior circulation occlusion is extremely dangerous, with a mortality rate of more than 90%.In recent years, mechanical thrombectomy had become an important method in the treatment of acute anterior circulation ischemic stroke, but whether it is effective and safe in the treatment of posterior circulation acute ischemic stroke is not clear.In this paper, the safety and effectiveness of intravascular treatment of acute ischemic stroke with posterior circulation occlusion were reviewed.

Reuse of waste oil in cooking has been the social concern for long time, but until now there is no reliable method to identify the gutter oil.In this work, based on the generation of long-chain aliphatic aldehydes in the refinement of gutter oil, gutter oil and adulterate cooking oil were identified by determining hexanal, heptanal, octanal, nonanal and decanal in oil sample with high perfomance liquid chromatography (HPLC) method using O-(3-(9H-carbazol-9-yl)propyl)hydroxylamine as the fluorescent derivative reagent.At first, 10 μL of oil sample was dissolved in 200 μL of isopropanol, then reacted with O-(3-(9H-carbazol-9-yl)propyl)hydroxylamine to form the stable derivatives, extracted with acetonitrile and injected into HPLC for analysis.The derivatives were separated on a C18 column within 15 min with ACN-H2O (90∶10, V/V) as mobile phase.The fluorescence detector was set at λex/λem=292 nm/348 nm.The linear range of 5 kinds of long-chain aliphatic aldehydes was 0.01-1.00 μmol/L with limit of detection (LOD, S/N=3) of 0.05-0.10 nmol/L, and the spiked recoveries were 95.6%-101.4%.The results showed that the edible oils obtained from supermarket almost had no hexanal, heptanal, octanal, nonanal, decanal, but these aldehydes increased significantly in gutter oil.Thus the 5 kinds of long-chain aldehydes could be used as the indictor of gutter oil.Taking the advantage of good specificity, higher sensitivity, good accuracy and simplicity, the method was suitable for the rapid identification of gutter oil.

A combination technique of LC/ESR, LC/MS and spin trapping was used to identify and characterize the carbon-centered free radicals formed from lipoxygenase-catalyzed peroxidation of dihomo-γ-linolenic acid(DGLA). The spin trap, α-[4-pyridyl-1-oxide]-N-tert-butyl nitrone(POBN), could react with short-lived carbon-centered radicals to form relatively stable adducts. Based on the same retention time of POBN radical adduct in LC/UV/ESR and LC/MS, molecular weight of adduct could be confirmed and the structure of adduct could be confirmed by their LC/MS2 fragment pattern. The results showed that free radicals formed in lipoxygenase-catalyzed peroxidation of DGLA, including ~·C_7H_(13)O_2, ~·C_(10)H_(17)O_2 and ~·C_5H_(11), all stemmed from β-scission of DGLA alkoxyl radicals(8-, 11-, 15-LO~·). The results were helpful for further study of biological activities of these radicals in vivo.

Objective To investigate the effects of soluble components derived from bone marrow mesenchymal stem cells (BMSCs) on the expression of vascular endothelial growth factor (VEGF) and liver regeneration caused by 70％ portal branch ligation (PBL) in rats.Methods Isolated and cultured BMSCs were lysed by sonication.PBL was performed in male SD rats followed by splenic injection of BMSCs or PBS as control.Animals were analyzed for liver regeneration index,hepatocytes proliferation,hepatic function,histopathological changes,and hepatic genes expression.Expression of VEGF was assessed by Western blot and immunohistochemistry.Results The liver regeneration index increased in the BMSCs group especially 2 and 5 days after PBL compared with the control group (P＜0.05) and reached (51.71±1.62)％ and (76.82±0.81)％ respectively.A 2-fold increase was showed in the PCNA labeling index of hepatocytes in rats treated with BMSCs compared with the control group (P＜0.05).Histopathological findings showed that vacuolar change and sinusoidal congestion were lower in the BMSCs group.Alanine transaminase (ALT) and Aspartate transferase (AST) showed no significant difference between the two groups (P＞0.05).On post operation day 2,hepatic interleukin-6 (IL6),tumor necrosis factor α (TNFα),hepatocyte growth factor (HGF),vascular endothelial growth factor A (VEGFA),and vascular endothelial growth factor 2 (VEGFR2) mRNAs tended to increase in the BMSCs group (P＜0.05) while transforming growth factor β1 (TGFβ1) mRNA decreased (P＜0.05).Western blot showed that the expression level of VEGF in the two groups were equal 2 and 5 days after surgery (P＞0.05).On day 2 post operation,positive VEGF immunoreactivity was present in both pericentral and periportal hepatocytes in the BMSCs group,while only in periportal hepatocytes in the control group.Conclusion These results demonstrate that BMSCs accelerated liver regeneration caused by PBL,which may result from hepatoprotection,enhanced hepatocyte proliferation,and VEGF-mediated angiogenesis early after the operation,potentially creating a new avenue for the study of hepatic regeneration.

Remarkable progress has been achieved in the transplantation of mesenchymal stem cells (MSCs)for the treatment of liver injury and hepatic failure.However,there are obstacles such as low engraftment capacity,tumorigenesis,and a fibrogenic potential that all hamper the use of MSCs in clinical trials.Therefore,it is worthwhile to talk about the alternatives that will increase the safety and efficacy of MSCs therapy.To date,applications of MSCs-derived hepatocytes,genetically modified MSCs,or MSC-conditioned medium for promoting liver regeneration have shown encouraging results.This review summarizes the current applications of MSCs in the study of hepatic regeneration.

Objective To study the value of zoledronic acid combined with psychological intervention in osteoporotic vertebral compression fractures in percutaneous balloon kyphoplasty (PKP). Methods 72 patients with osteoporotic vertebral fractures underwent PKP operation from August 2013 to August 2015 were randomly divided into observation group and control group,with 36 cases,in each group. The patients in the control group were given salmon calcitonin after operation. The patients in the observation group were given zoledronic acid after operation. Both patients were given psychological care. The total effective rate of clinical treatment and the incidence of secondary osteoporotic vertebral compression fractures,Visual analogue pain scale before and after treatment (VAS), Oswestry dysfunction index questionnaire (ODI) score, bone mineral density T value changes were compared between the two groups. Results The total effective rate was 94.44% in the observation group and 77.78% in the control group (P<0.05). The recurrence fracture rate was significantly lower than that of the control group (P<0.05). After treatment, the scores of VAS and ODI in the observation group were significantly lower than those in the control group (P<0.05). The T value of bone mineral density was significantly higher than that of the control group (P<0.05). Conclusion Zoledronic acid combined with psychological intervention can effectively improve the effective rate of PKP after osteoporotic vertebral compression fractures, increase bone density and reduce the incidence of fracture, which is worthy of clinical application.

In current study,by means of analysis of client and administrator needs,we constructed "internal medical resource database" based on internet,which has 5 modules including database itself,communication on line,resource searching,recent updating and resource statistic.We hope the establishment of "internal medical resource database" can do a favor for the similar resource database.

BACKGROUNDTo evaluate the significance of progastrin-releasing peptide (ProGRP) as a new tumor marker for small cell lung cancer (SCLC)..

METHODSFifty-five patients with pathologically proved SCLC were initially treated and retrospectively studied, in which the level of serum ProGRP was tesed in various situations and its relationship with tumor stage and therapeutic effects was observed.

RESULTSThe diagnostic sensitivity and specificity of ProGRP to SCLC were 80.0% and 97.0% respectively. The average ProGRP level in extensive disease of SCLC patients was 820.00 ng/L, significantly higher than 205.86 ng/L in limited disease of SCLC patients (P=0.000 3). In chemotherapy sensitive cases, the ProGRP level had a significant decrease after treatment, while there was no change in failure cases.

CONCLUSIONSProGRP is a new SCLC tumor marker with high specificity and sensitivity. It has a close relationship with SCLC stage and can be used as a predictor of SCLC to chemotherapy response.

Objective To investigate the relationship between hypoxia and insulin resistance in males with metabolic syndrome ( MS ). Methods Parameters at physical, hematological, glucose metabolism, lipid metabolism, and insulin resistance were measured in 295 middle-aged men who took health examination. The trends of laboratory indexes grouped by hemoglobin quartile and MS components were compared. The correlation between hypoxia and insulin resistance was analyzed. Results With the increase of hemoglobin, the occurrence rates of MS, TG, INS, and HOMA-IR were also significantly increased ( P < 0. 05 ), while HDL-C and HOMA-IS reduced remarkably(P<0. 05). With the increase of MS components, hematological parameters(RBC, Hb, Hct), INS, and HOMA-IR were significantly increased( P<0. 05) while HOMA-IS were significantly decreased( P<0. 05). Blood lactate and HIF-1αwere significantly increased with the increase of hemoglobin as well as MS components(P<0. 05);Hematological parameters were positively correlated with blood lactate and HIF-1α, and Hypoxia related indicators including hematological parameters, Lac, HIF-1α showed a positive correlation with HOMA-IR and a negative correlation with HOMA-IS( P < 0. 05). Conclusion Chronic hypoxia does exist in metabolic syndrome, and the degree of hypoxia is associated with insulin resistance. Hematological parameters are also significantly correlated with insulin resistance which could be as a result of chronic hypoxia.