Objective To explore the correlation of electrophysiological features with clinical manifestation in patients with diabetic peripheral neuropathy (DPN).Methods The clinical data of 306 patients with DPN undergoing nerve conduction study (NCS) during May 2013 to June 2015 were retrospectively analyzed.Among 306 patients,304 were type 2,and 2 were type 1 diabetes with a mean age of 64.1 years and disease duration of 1 week-31 years.The relationship between the electrophysiological features and clinical manifestations was evaluated.Nerve conduction studies and F-wave and in sympathetic skin response were analyzed.Results ① NCS in lower limbs presented more abnormalities than that in upper limbs.There was the highest prevalence of not elicited sensory potential in Tibial nerve [56.9％(174/306),x2 =175.9] and the highest prevalence of not elicited motor potential in peroneal nerve [7.8％(24/306),x2 =1 103.1].Amplitude abnormality was more severe in sensory nerve than that in motor nerve[41.4％ (507/1 224) vs.10.8％ (132/1 224),x2 =559.2].The ratio of abnormal motor conduction velocity or distal latency was higher than that of amplitude decreased [22.9％ (280/1 224) vs.10.8％(132/1 224),x2 =1 077.4].② The abnormal ratios of the shortest F-wave latency was lower than that of the prolonged distal latency in median and tibial nerve [5.4％ (33/612) vs.20.6％ (126/612),x2 =607.6].③ The abnormal ratio of sympathetic skin response (SSR) in lower limbs were higher than that of upper limbs [40.2％ (246/612) vs.27.3％ (167/612),x2 =129.4,P ＜ 0.001],abnormal ratio of amplitude was higher than that of the prolonged latency [30.1％ (368/1 224) vs.4.7％ (58/1224),x2 =1040.5,P ＜0.001].Among the 99 cases presenting abnormal SSR in upper limbs,32 cases were normal in conventional NCS.Among the 127 cases presenting abnormal SSR in lower limbs,7 cases were normal in conventional NCS.④Disease course and glycosylated hemoglobin values were positively correlated with the distal motor latency,and negatively correlated with the nerve conduction velocity and amplitude.Conclusion Electrophysiological features of DPN is mainly shown in axon of the distal sensory nerve.Long duration and hyperglycemia may lead to more abnormalities in electrophysiological tests.

Objective To assess the irregular shape of hematoma with math methods,which is one of the risk factors of hematoma enlargement.Methods We reviewed images data of patients with spontaneous intracerebral hemorrhage treated nonsurgically who underwent initial computed tomography (CT) within 6 hours and repeated CT within 48 hours of onset.The area(s),the circumference(L),the greatest diameter(A)and the transverse diameter(B)of the greatest hemorrhage CT slice was measured.The formula X=L/S waft used to calculate the value.We calculated the area(S1)and the circumference (L1) of the ellipse with A as its long diameter and B as its short diameter.The formula X1=S1/L1 was used to calculate the value. We used formula R=X/X1 to assess the irregular hematoma shape.The relationships between hematoma enlargement and R was analyzed. Results Thirty-one patients(25.8%) showed enlarged hematomas after admission.The larger the value of R,the more irregular the shape of hematoma.When R≥1.3,the shape of the hematoma was significantly irregular.36.0% patients with R≥1.3 had hematoma enlarged.compared with only 18.6% those with R<1.3(χ2=4.62,P=0.032).Conclusions The irregular shape index R Can be used to assess the shape of a hematoma. A particularly high likelihood of hematoma enlargement is observed in patients with an irregularly shape index R≥1.3.

Objective To explore the strategy and response of medical emergency centers to unexpected disaster,such as snowstorm in 2008.Method The response of Wuxi Medical Emergency Center to the snowstorm in 2008 was retrospectivey analyzed.Results Because of the disaster response plan in advance,preparation for the ambulance,and effective integration of pre-hospital care,pre-hospital tasks were completed successfully.But there existed some unsatisfied points,such as anti-skid chains wasn't fully prepared,and affected the efficiency of emergency treatment.Conclusions The increase of government input,good preparation,emergency network construction,scientific and timely disaster response plans are key to disaster events,such as snowstorm.

AIM: To investigate the immunologic mechanism of CXC chemokine ligand 10(CXCL10) and its receptor CXC chemokine receptor 3 (CXCR3 ) involved in the process of endometriosis (EM). METHODS: Serum samples were collected from 3 groups; EM patients without operation (n = 76) , EM patients with operation (n = 10) and the normal control persons (n =76). CXCL10 and CA12S concentrations were detected by means of ELISA and chemilumino-metry. Cell surface antigens on the activated PBMC - CD3 and CXCR3, as well as CXCR3 subgene - CXCR3A and CX-CR3B were tested by flow cytometry (FC) and RT - PCR when PBMC was separated from women with EM ( n = 10) and without EM (n = 10), and then activated. RESULTS: Serum CXCL10 concentrations between three groups were signifi-canly different (P < 0.05). Compared to normal control group, although the supernatant CXCL10 concentration and CD3~+ /CXCR3~+ PBMC number in EM group has no significant difference (P >0.05) , highly expressed CXCR3B in EM group rather than CXCR3A was observed. CONCLUSION: CXCL10 in women with EM is low, indicating that it plays a vital role in the process of EM and immune system of the women with EM is defected and impaired. The immunoreactivity of PBMC from both EM patients and normal person is same to activated signal, but the productions are different: PBMC in EM group mainly express CXCR3B but PBMC in normal person mainly express CXCR3A after activation, which may be one of the immune mechanisms that EM escapes from immunological lethal effect of the infected host.

Based on the current status of allocation, demands and utilization of medical care resources and the needs for future development in Shanghai, the overall objectives, principles, key plans of allocation of medical care resources in the 12th Five-years Plan in Shanghai and the leading role of health bureaus at all levels were discussed.

Objective To investigate serum uric acid (UA) levels and related clinical characteristics of neuromyelitis optica (NMO). Methods The serum uric acid levels were measured in 65 patients with NMO, compared to control groups which were 76 cases with multiple sclerosis ( MS), 126 cases with cerebral vascular diseases (CVD) and 130 healthy controls(HC). The disability severity in NMO was assessed by the Expanded Disability Status Scale (EDSS). Magnetic resonance imaging ( MRI ) was performed to strengthen assessment the involved lesions. Serum AQP4 antibody was tested in a cell based immunofluorescence assay. Results In male groups, serum UA levels in NMO patients [ (298.90±74.14) μmol/L] were significantly lower than that in CVD [ (355.37 ±50. 30) μmol/L] and HC subjects [ (340.33 ± 58.23 ) μmol/L, P ＜ 0.05 ]. No difference was found between NMO and MS [ ( 292.36 ±92.95) μmol/L] groups. In female groups, serum UA levels in NMO patients [(198.21 ± 62.62)μmol/L] were significantly lower than that in CVD [(274.51 ± 70.66) μmol/L] and HC subjects [(243.26 ±60.65) μmol/L,P ＜0.05]. No difference was found between NMO and MS [(232.29 ±71.95 ) μmol/L ] groups. UA levels were significantly lower in females [ ( 198.21 ± 62. 62) μ mol/L] than in males [ (298.90 ±74.14) μmol/L]. UA levels were significantly lower in patients with EDSS≥5 [ ( 195.48 ± 83.70 )μmol/L] than EDSS ＜ 5 [ (241.00 ± 63.20)μmol/L] NMO patients. In our study UA levels were not correlated with longitude of spinal lesions, activity revealed by MRI and AQP4 antibody tires.Conclusion Lower serum UA levels were found in patients with NMO and related to more severe symptoms.

Objective To investigate the change of dynamic expression of t-PA and PAI-1 during early venous crisis after free perforator flap transplantation.Methods Thirty healthy New Zealand white rabbits weighed 2.5-3.0 kg were chosen and randomly divided into experimental group (n =15) and control group (n =15).Free transplantation of superficial epigastric artery perforator flap (SEAPF) was implemented in all rabbits firstly.Then the model of venous crisis was established by ligating the anastomosis vein in order to interrupt venous blood outflow in experimental group.The blood supply of all flaps was monitored by observing their color,swelling degree and the filling reaction of the capillaries after operation.Peripheral blood was drawn from femoral artery at different time point for measuring the concentration of t-PA and PAI-1 by Elisa.Partial flap tissue was harvested for pathological examination at corresponding time point.Data analysis was performed by using SPSS 17.0 statistical software.P ＜ 0.05 was considered statistically significant.Results One rabbit died of anesthesia,and the venous congestion was observed in 1 rabbit in control group.The models of free transplantation of SEAPF and venous crisis were established successfully in the remaining rabbits.No significant appearance change was observed within 1 h after the outflow vein being ligated,while typical appearance of venous crisis could be observed 2 hours after the outflow vein being ligated.Compared with the control group,the concentration of t-PA was lower,but the concentration of PAI-1 was higher in experimental group at 2 hours,4 hours,6 hours,8 hours after the outflow vein being ligated(P ＜ 0.05).However,there was no obvious differences between two groups at other time points (P ＞ 0.05).The pathological examination showed the red cells gradually got together and adhered to the venous wall,eventually the microcirculation had been blocked completely and theflap became necrosis after venous crisis being occurred.Conclusion t-PA and PAI-1 can't be used to diagnose early venous crisis of perforator flap transplantation.

Objective:To explore the clinical application of NanoString fluorescent barcode technology in the molecular subtyping of diffuse large B-cell lymphoma (DLBCL), and to analyze the correlation between the cell-of-origin subtype and prognosis of patients.Methods:The tumor tissue samples of 12 patients with DLBCL at the Third People's Hospital of Datong of Shanxi Province and 8 patients with DLBCL at Peking University, Health Science Center between January 2014 and December 2019 were collected. According to Hans algorithm, all patients were divided into 1 case of germinal center-derived B-cell (GCB) type and 19 cases of non-GCB type. NanoString platform was used to analyze the expression level differences of 15 genes-related to Lymph2Cx molecular subtyping of all samples at mRNA level. Hierarchical clustering was used to subgroup 20 DLBCL cases and to contrast the prognosis in different subgroups according to the subtyping.Results:NanoString fluorescent barcode technology was used to detect samples of 20 DLBCL cases and hierarchical clustering analysis was performed, and then subtyping results showed that 11 cases were GCB-like type and 9 cases were activated B cell (ABC)-like type. Based on Hans algorithm, 10 GCB-like cases were non-GCB type. According to the survival analysis, GCB-like group had a better overall survival compared with that in ABC-like group ( P=0.019). Conclusion:NanoString fluorescent barcode technology can be successfully applied to the cell-of-origin subtyping of DLBCL, and the molecular subtyping strategy can effectively predict the prognosis of patients.

Objective To analyze the possibility of using TCR Vβsubfamily as the diagnostic in-dicators for major histocompatibility complex( MHC) deficiency-induced graft-versus-host disease( GVHD) . Methods The BALB/c mice were given 9.5 Gy (950 rad) of irradiation and transplanted with 106 of T-cell depleted (TCD) bone marrow cells from C57BL/6 and DBA/2 mice with MHC Ⅱ deficiency.Two control groups were set up accordingly by injection of TCD bone marrow cells from wild type ( WT) C57BL/6 and DBA/2 mice.Several parameters including the body weight, the GVHD clinical score and the survival time of the recipients were monitored.Flow cytometry analysis and mixed lymphocyte culture test were performed for the evaluation of autoimmune responses.Histological examination was used to analyze the severity of GVHD.Results The MHC deficiency-induced GVHD was successfully induced in the irradiated BALB/c mice receiving MHC mismatched allogeneic hematopoietic cell transplantation ( allo-HCT ) . The MHC matched DBA/2 mice with MHC deficiency could be used as the mice model of subclinical GVHD.Changes of the TCR Vβ6 were consistent with the results of histopathological examination.Conclusion Highly ex-pressed TCR Vβ6 could be used as indicators for the diagnosis of MHC deficiency-induced subclinical GVHD.

Objective To investigate serum uric acid (UA) levels and related clinical features in patients with high risk syndrome of neuromyelitis optica. Methods UA levels were measured in 51 patients with high risk syndrome of neuromyelitis optica including 34 with longitudinally extensive transverse myelitis (LETM) and 17 with optic neuritis (ON), 48 with neuromyelitis optica (NMO), 45 with other neurological diseases (OND) and 65 with healthy controls (HC). The disability severity was assessed by the expanded disability status scale (EDSS). Spinal lesions were viewed by MRI. Serum aquaporin-4(AQP4) antibody was tested in cell based immunofluorescence assay. Results Serum UA levels in LETM ( ( 189. 84 ±85. 65) μmol/L) and ON patients ( (222. 12 ±61.68) μmol/L) were significantly lower than that in OND ((315.90±71.36) μ mol/L) and HC ((291.05 ±76.64) μ mol/L) subjects (P＜0.01). No difference was found between LETM, ON and NMO groups. UA levels were significantly lower in females ( ( 158.24 ±55.92), (187.00±47.52), (198.21 ±62.62), (274.51 ±70.66)and (243.26±60.65) μmol/L)than in males ( ( 262. 09 ± 101.63 ), ( 262. 45 ± 62. 13 ), ( 298.90 ± 74. 14 ), ( 355.37 ± 50. 30 ) and (340. 34 ±58. 23) μmol/L) in all groups (t=3. 183, 2.578, 4.356, 4.365 and 6.579, all P＜0.05).UA levels in patients with high risk syndrome of NMO were not correlated with mono or relapse course,duration or status of serum AQP4 antibody. UA were negatively correlated with EDSS in patients with LETM (r= -0.714, P＜0.01). Conclusion Lower serum UA levels were found in patients with high risk syndrome of NMO and related to more severe symptoms in LETM group.