Objective To observe the changes of retinal nerve fiber layer (RNFL) thickness and its correlation with visual field mean defects(MD)in Parkinson's disease (PD). Methods Fifteen eyes of 15 PD patients in early stage and 18 eyes of 18 normal controls undertook RNFL examination by Stratus OCT-3. Circular scans (diameter is 3. 46 mm) were taken around the optic nerve head including eight quadrants (superior, inferior, temporal, nasal, temporal-superior, temporal-inferior, nasal-superior and nasalinferior). The RNFL thickness in different quadrants in the two groups was analyzed. The visual field of PD patients was measured by central 30-2 program of Humphery750 visual field analyzer, and the MD was recorded. The correlation between RNFL thickness and MD was analyzed by linear correlation and regression analysis. Results RNFL thicknesses of superior, inferior, temporal, nasal, temporal-superior, temporal-inferior, nasal-superior, nasal-inferior and average RNFL thickness in the control group were (132.7±17.4), (141. 5±15. 3),(83. 2±17. 5), (83.7±22.3) ,(120.8±21.2), (117. 9±24.5) ,(109.6±20. 6),(110.2±27.7), and(109. 9±8. 5) μm respectively, while in the PD group they were (128.1±25.3),(128. 6±13. 2),(68. 7±13. 5),(76. 5±17. 8),(102. 6±23. 7), (103.3±14.1) ,(101.2±20.9),(96.6±15.0),(102.3±11.9) μm . Compared with each other, the differences of RNFL thickness of inferior, temporal, temporal-superior, temporal-inferior and average RNFL thickness were statistically significant (t = 2. 595, 2. 700, 2. 330, 2. 153,2. 131;P = 0. 014, 0. 011, 0. 026, 0. 040, 0. 041). There was a close negative relationship between average RNFL thickness and MD in PD patients (r= -0. 933, P<0. 0001). Conclusions RNFL thickness was significantly thinner in PD patients than that in the normal controls. There was a negative relationship between RNFL thickness and MD in PD patients.

Objective:To study the changes of serum IL 1?,IL 6,IL 8,TNF ? and sIL 2R and its relationship with disease activity in adult Still disease patients.Methods:Serum levels of IL 1?,IL 6,IL 8,TNF ? and sIL 2R were assessed by ELISA in 18 adult Still disease patients before and one month after treatment with prednisone.Results: Active adult Still disease patients had significant elevated erythrocyte sedimentation rate (ESR) and serum levels of C reactive protein (CRP),IL 1?,IL 6,IL 8,TNF ? and sIL 2R.After one month treatment with prednisone,ESR and serum levels of CRP,IL 6,TNF ? and sIL 2R significantly decreased.There was a significant correlation between ESR values and serum IL 6,TNF ? and sIL 2R levels,and between serum CRP levels and IL 6,TNF ? and sIL 2R levels.Serum IgG,IgA and IgM levels in active adult Still disease patients were similar to those in healthy controls.Conclusion: There are no changes in serum immunoglobulins but significant increases of serum IL 1?,IL 6,IL 8,TNF ? and sIL 2R levels in active adult Still disease.Serum levels of IL 6,TNF ? and sIL 2R are related to the activity of adult Still disease.

Background and purpose:Single drug of docetaxel and pemetrexed as second line treatment is standard treatment of advanced non-small cell lung cancer (NSCLC). Whether combined with platinum can increase the response and survival is still not elucidated. This study was designed to investigate the treatment response, overall survival (OS) and the safety of combined with oxaliplatin or cisplatin regimens as second line in treating NSCLC patients. Methods:Advanced NSCLC inpatients, failure of cisplatin or carboplatin in initial treatment, were divided into three groups at random in 3∶2∶1 rate. Control group:who received docetaxel, 75 mg/m2 (for all patients), d1 or pemetrexed 500 mg/m2 (for non-squamous carcinoma);Cisplatin group:who received cisplatin 25 mg/m2, d1-3 and docetaxel/pemetrexed; Oxaliplatin group: who received oxaliplatin 130 mg/m2 d1 and docetaxel/pemetrexed. Every 3 weeks were repeated as one cycle. The side effect was assessed every cycle and treatment efifcacy was investigated every two cycles. Follow-up examination was taken every 3 months after treatment. Results:There were no differences in treatment response, progress free survival (PFS), OS and toxicity among the three groups (P>0.05). Old patients (≥60 years) had a better PFS than that of patients less than 60 years (HR=0.56, 95%CI:0.35-0.90, P=0.015). Patients with performance score 0-1 had a better PFS and OS (HR=1.52, 95%CI:1.01-2.30, P=0.048;HR=1.90, 95%CI:1.17-3.09, P=0.009). Treatment response had relation to PFS and OS (HR=2.93, 95%CI:2.01-4.26, P=0.000;HR=2.03, 95%CI:1.37-3.01, P=0.000). Patients with anemia after treatment tended to have a worse PFS and OS (HR=1.59, 95%CI:0.97-2.61, P=0.066;HR=1.60, 95%CI:0.94-2.75, P=0.085). Patients with thrombocytopenia after therapy had a worse OS (HR=2.97, 95%CI:1.01-8.78, P=0.049). Patients with neural toxicity after chemotherapy tended to have a worse PFS (HR=3.36, 95%CI:0.92-12.25, P=0.066). Patients received post treatment after second line therapy had a better OS (HR=0.36, 95%CI:0.22-0.61, P=0.000). Conclusion:Combined with oxaliplatin or cisplatin as second line treatment can’t improve the response and survival in NSCLC patient. Treatment response and PS are prognostic factors to NSCLC patients’ PFS and OS. Patients with treatment related anemia might have a worse survival. Post therapy after failure to second line chemotherapy can prolong the survival.

Objective To explore the feasibility of prediction of subacute infarct lesion volumes by processing ADC maps based on ADC cut-off values in patients with acute stroke.Methods MRI was performed in 20 patients with clinically diagnosed acute infarct less than 6 h after stroke onset.The MRI included a DWI and conventional MRI.The follow-up MR examinations of all the patients were carried out within 4-7 days after admission.The brain tissue, which showed abnormal high intensity both in DWI at the baseline and FLAIR at the reexamination , was regarded as the area of the initial ischemia core.Graphic-penumbra was regarded as the difference between initial DWI and follow-up FLAIR.The ADC values of the ischemia core, graphic-penumbra and the contralateral normal brain tissue , the relative ADC (rADC) were measured.The rADC value of the graphic-penumbra was defined as the ADC cut-off values.GE medical system based on ADC cut-off values was also tested in these patients to obtain ADC maps.The lesion volumes, the abnormal area seen on the DWI , ADC maps and follow-up FLAIR, were also measured.rADC values in different areas were analyzed by paired Student t test.Relationship between baseline DWI , ADC map and follow-up FLAIR was analyzed using Spearman rank-order correlation test , and Kruskal-Wallis H test was used to compare the volumes among three groups.Results Absolute ADC and rADC values gradually increased from the core to the periphery of the ischemic lesion.The absolute ADC values statistically differed from those on the contralateral side for both ischemia core and graphic-penumbra.The rADC values were significantly decreased in the ischemia core ( 0.620 ±0.116 ) compared with the graphic-penumbra values (0.809 ±0.097;t =8.083,P <0.01).The lesion volume of follow-up FLAIR [16.3 (4.7, 29.0) cm3 ] correlated highly with both volume predicted with the ADC map [13.5 (4.8, 25.4) cm3] (r=0.967, P<0.01) and baseline DWI volume [11.0 (4.4,30.4) cm3] (r=0.950, P<0.01).There was no difference between the volume of DWI , ADC map and follow-up FLAIR(H=0.168, P>0.05).Conclusions Data shows the high feasibility of prediction of subacute infarct lesion volumes by processing ADC maps based on ADC cut-off values in patients with acute stroke , without intravenous contrast material, and it provides a new method for outcome prediction.

Objective To evaluate the clinical value of Headway duo microcatheter combined with Onyx glue in embolization ofmeningiomas.Methods A retrospective analysis on clinical data of 12 patients with meningiomas,admitted to our hospital from December 2015 to March 2017,was performed.According to the blood supply typing ofManelfe meningiomas,5 were type Ⅰ,3 were type Ⅱ,2 were type Ⅲ,and 2 were type Ⅳ.The degrees of embolization were compared by DSA tumor staining before and after embolization;and complications of embolization were recorded.Results Cerebral angiography after embolization demonstrated complete embolization in 5 patients,subtotal embolization in 5,partial embolization in 2,and small amount of embolization in 0.Only 2 had head and face pain in the process of embolization,and these syndromes disappeared once the operation stopped.The mean average blood loss in the surgery was 685 mL and the mean surgical time was 4.45 h.Conclusion Headway duo microcatheter combined with Onyx glue in the embolization of intracranial meningiomas can play a good role in blocking blood flow,and results suggest that this method is safe and effective,worth of clinical promotion.

Objective To explore the therapeutic effect and prognosis of modified large craniectomy decompression in the treatment of patients with malignant middle cerebral artery infarction. Methods Forty malignant cerebral artery in-farction patients were treated with modified large craniectomy decompression from July 2010 to July 2013 in our hospi-tal , set as the treatment group; retrospective analyzed 40 cerebral infarction patients in our hospital from July 2006 to July 2009 which were adopted traditional operation bone flap decompression treatment as the control group. The recov-ery stage, the rapeutic effect and prognosis were compared between two group patients. Results The survival rate in the treatment group was 90%(36/40),and was significantly higher than 57.50%(23/40) in the control group, the differ-ence was statistically significant (P<0.05);Postoperative complications in treatment group were significantly lower than the control group,the differences were statistically significant(P<0.05). Conclusion Modified large craniectomy decom-pression in the treatment patients with malignant middle cerebral artery infarction ,can significantly improve the thera-peutic effect, and reduce postoperative complications, the safety is excellence,and is worth the clinical promotion.