Objective To observe the effective treatment of severe in peri-menopausal syndrome,and improve the quality of life of women in perimenopausall and postmenopausal women.Methods We review the different treatment methods in the 216 patients diagnosed with moderate to severe menopausal syndrome.Group A:simple hormone replacement therapy (HT) of 60 cases.Group B:simple treatment of traditional Chinese medicine of 90 cases.Group C:hormone replacement and comprehensive therapy of Chinese medicine of 66 cases.Follow up the improvement of symptoms and adverse reactions after the treatment one and three month respectively.Results The three groups after treatment in patients with clinical symptoms were improved after three month.Efficient comparisons among third group,the differences were statistically significant (90％ (54/60),82％ (76/90),100％ (66/66);x2 =13.160,P ＜ 0.01).Adverse reactions of 3 treatment group comparison difference had statistical significance (45％ (27/60,1％ (1/90),6％ (4/66);x2 =60.720,P ＜0.01).Compared with pure hormone treatment group,treatment group of Chinese medicine,comprehensive treatment group adverse reactions happen was less,the difference was statistically significant(P＜0.01).Chinese medicine treatment group and combined treatment group,there was no statistically significant difference (P ＞0.05).Conclusion Severe menopausal syndrome with hormone replacement therapy indications without contraindications suggestions take comprehensive treatment of traditional Chinese and Western medicine,The hormone supplement contraindications or unwilling to hormone replacement therapy,also has good effect of Chinese medicine treating.

Objective To explore the clinical value of serum CA125 and HE4 combined with transvaginal color Doppler(TVCD)examination in early screening of ovarian cancer among high-risk populations.Methods The included research subjects were divided into 3 groups:100 cases in the healthy group,80 cases in the high-risk group and 32 cases in the ovarian cancer group.The serum CA125 and HE4 levels and ultrasonic scores were compared among 3 groups.Results The HE4 and CA125 levels and ultrasound scores in the ovarian cancer group were significantly increased compared with the other two groups,the difference was statistically significant(P＜0.01);the positive detection rate of CA125 plus HE4 levels combined with ultrasonic examination in the high-risk group was higher than that of other detection method(P＜0.05);the sensitivity and specificity of CA125+HE4 combined with vaginal ultrasound screening were obviously higher than those of other screening method,the difference was statistically significant(P＜0.05);the specificity of HE4 was significantly higher than that of CA125,but its sensitivity was lower than that of CA125(P＜0.05).Conclusion CA125 and HE4 combined with TVCD is helpful for early screening of ovarian cancer in high-risk populations,easy to save medical cost and improves its detection rate.

Objective To analyze plasma vitamin E and CoQ10 levels in patients with autosomal recessive cerebellar ataxia for finding the evidence of the related pathogenesis research and therapeutic strategies.Methods The plasma vitamin E and CoQ10 levels were detected by high performance liquid chromatography (HPLC) with diode array detector in 123 probands of autosomal recessive cerebellar ataxia pedigrees.Quantitation was performed using vitamin E and CoQ10 external standard and two 5-point calibration curve;clinical manifestations were analyzed simuhaneously.Results Vitamin E and CoQ10 levels of healthy subjects in the plasma were (8.77 ± 2.28) μg/ml and (1.31 ± 0.38) μg/ml,respectively;the plasma vitamin E and CoQ10 levels of patients were (5.61 ± 2.04) μg/ml and (0.79 ± 0.26) μg/ml,respectively,which were significantly lower than those in healthy controls (t =11.87,13.15;all P＜ 0.01).Clinical manifestations were characterized by cerebellar symptoms,and gait instability was usually the first recognized abnormality.Most of early onset occurred before the age of 25 years (111/123);dysarthria and abnormal eye movement were observed,with cerebellar atrophy on MRI;concomitant symptoms were also present.Conclusions HPLC analysis shows that the plasma vitamin E and CoQ10 levels of patients with autosomal recessive cerebellar ataxia are generally lower than those in the healthy controls.Several patients with significant reductions in these two levels have genetic defects.The combination of clinical phenotypes,biochemical indexes and genetic analyses will be helpful for the establishment of diagnosis and specific treatment.

Objective To study the clinical and neuroimaging features of subtypes of multiple system atrophy (MSA) and their correlations. Methods One hundred and forty-three MSA cases fulfilled Gilman diagnostic criteria (1999) were recruited and their clinical subtypes and stages were classified. Using the staging methods of the pontine cross sign and putaminal slit proposed by Horimoto, 108 patients showed abnormalities in MRI and were further evaluated. The relationship between the subtypes of MSA, disease duration, and MRI abnormalities has been analyzed. Results Of 143 MSA patients, the male-to-female ratio is 1.3:1 ; 93 cases are diagnosed with MSA-C, 39 with MSA-P, and 11 with MSA-P + C; 90 cases with probable diagnosis, and 53 with possible diagnosis. Of the 76 MSA-C cases with MRI abnormalities, 36 (47%) show the pontine cross sign and 10 (13%) show the putaminal slit; of the 24 MSA-P cases with MRI abnormalities, 6 (25%) show the pontine cross sign and 6 (25%) show theputaminal slit. In addition, MSA-C cases with shorter disease duration demonstrate earlier stages of the pontine cross sign. Conclusions In this study, the number of MSA-C cases is more than MSA-P, which might be related to the ethnic background. In neuroimaging, both the pontine cross sign and the putaminal slit are the marked features of MSA. To some degree, the subtypes of MSA are related with the features of imaging, that is, MSA-C patients present the pontine cross sign more often than MSA-P, and the putaminal slit is a comparatively common feature among MSA-P cases.

Objective To study the correlation between clinical rating scale and the duration of multiple system atrophy.Methods One hundred and twenty-two MSA cases fulfilling Gilman diagnostic criteria were recruited.Unified Multiple System Atrophy Rating Scale(UMSARS)was applied to assess the degree of the patients' disability.For analyzing the correlation between the UMSARS scores and the duration of the disease,the Spearman's rank correlation coefficients were calculated.Results Among 122 MSA cases,male:female ratio was 1.7:1;disease duration lasted(2.8±1.6)years:possible MSA accounted for 50 cases(41%),probable MSA 72 cases(59%);MSA-P 35 cases(29%);MSA-C 73 cases(60%).MSA-P+C 5 cases(4%),MSA-A 9 cases(7%).The scores of UMSARS,UMSARS-Ⅰ and UMSARS-Ⅱ were found positively correlating with the disease duration.The Spearman's rank correlation coefficients were 0.368,0.266 and 0.392 respectively,all P<0.01;the adjusted Spearman's rank correlation coefficients were 0.360,0.257 and 0.385 respectively.all P<0.01.Conclusions MSA has complex clinical manifestations.which should include MSA-P+C subtype.UMSARS is a reliable scale to mirror the progression of MSA.which is useful to study the clinical features and disease duration of MSA.

Objective To investigate the inheritance principle of the expanded GAG repeat allele and the clinical features of spinocerebellar ataxias 3 (SCA3) in a consanguinity family with first cousin marriage.Methods The CAG repeats of SCA3 gene were amplified by means of polymerase chain reaction.Fragment analysis with laser-induced fluorescence in capillary electrophoresis were performed for the positive samples detected by agarose gel electrophoresis.Furthermore,the clinical features were analyzed carefully.Results Fragment analysis revealed that the proband carried 2 alleles with 56 and 72 CAG repeats separately.The proband' s father carried 28 and 66,and the expanded CAG repeat allele inherited from his grandfather.The proband' s mother carried 33 and 56,and the expanded CAG repeat allele inherited from his grandmother.The proband' s son carried 27 and 85 and presented with dystonia besides ataxia.Conclusions The proband' s parents have the common ancestors.Their alleles with expanded CAG repeats probably come from the same allele of their ancestor.The GAG repeat is more unstable in the paternal inheritance than in the maternal inheritance.The 71-year-old asymptomatic family member carry the allele with 56 CAG repeats,which indicates the 56 CAG repeats may be not associated with the disease.The patients within this family have variable clinical features,especially the juvenile-onset case presents with apparent dystonia.

Objective To identify the pathogenic gene for a Chinese Han consanguineous marriage family with autosomal recessive cerebellar ataxia by homozygosity mapping and mutation analysis.Methods Six members of the family were enrolled in this study,including 3 patients,the unaffected sibling and their parents of first cousin marriage.After excluding GAA repeats mutation of FXN gene,whole-genome single nucleotide polymorphism (SNP) microarray scanning and homozygosity mapping were performed to localize the candidate gene.The coding regions and intronic flanking sequences of the candidate genes were analyzed.Results Four candidate regions were identified,including 2p25.3,9q22.2-34.3,13q12.3-14.3 and 17p13.The SETX gene localizing in 9q22.2-34.3 that is responsible for ataxia with oculomotor apraxia 2 was analyzed at first.There were 4 mutations in exon 10,including three missense mutations (c.3576T ＞ G,p.D1192E ; c.3754G ＞ A,p.G1252R; c.4156A ＞ G,p.I1386V) and a deletion mutation (c.5084_5087delAGTC,p.Q1695_S1696del).Three patients were homozygous of the 4 mutations,an unaffected sibling was normal,and their parents were heterozygous of 4 mutations.Conclusions The pathogenic haplotype comprising four mutations of the SETX gene was identified in the consanguinity family.c.5084_5087delAGTC (p.Q1695_S1696del) is a novel mutation.The affected individuals of this family were characterized by mild phenotype and slow progress without oculomotor apraxia,indicating the clinical variability of the disease.

ObjectiveTo investigate the psychology of the children with lip and palate cleft and their social environment.Methods700 patients with lip and palate cleft of 0～24 years old were investigated to the harmonization with their parents and their social environment using questionnaire, so as their psychology using Symptom Checklist 90 (SCL-90) in the follow-up after operation.ResultsThe score of SCL-90 was higher in the patients above 6 in some dimension compared with the normal. Their parents seemed to exclude them, and they felt uncomfortable to the others around them.ConclusionThere were a lot of problem of the psychology in patients with lip and palate cleft above 6, and they get poor support from their social environment.

With the increasingly strengthening of economic globalization and higher education internationalization,medical imageology as an important intersecting science in life sciences has more and more international communion and cooperation.In China many hospitals and medical colleges require large quantities of medical imageology professionals,and it is very necessary and important to develop the bilingual education in medical imageology,though a series of problems appear in the process.