Because of the lymphatic drainage of the neck area level-Ⅰb of nasopharyngeal carcinoma is particular,and skip metastasis in the cervical lymph node is rare,the involved region of level-Ⅰb lymph node metastasis rate is low in nasopharyngeal carcinoma.In the three-dimensional radiotherapy era of precision radiotherapy,there is no consensus on whether level-Ⅰb need to be prophylactic irradiated in the clinic.

AIM: To establish the HPLC fingprint spectrum of Radix Arnebiae as identification. METHODS: HPLC fingerprint spectrum of Radix Arnebiae collected from the seven production places and that of Radix Lithospermi from three production places were evaluated based on shikonin content. RESULTS: The major features of HPLC fingerprint of the seven production places were approximately similar to control sample there was no significant difference among the contents but Radix Lithospermi from three production places were not the same. CONCLUSION: The HPLC fingerprint spectrum of Radix Arnebiae can be used as an identification.It may provide the basis for quality control of Radix Arnebiae.

Objective To evaluate the effect of preoperative intramuscular injection of of dextromethorphan in three dosages on fentanyl consumption in postoperative PCA in order to optimize its pre-emptive analgesia dose. Methods 80 ASA Ⅰ-Ⅱ patients underwent spine operations under general anesthesia were randomly divided into four groups, who respectively received intramuscular dextromethorphan 10mg (DM10 group), 20mg (DM20 group), 40mg (DM40 group), or normal saline (CON group) respectively. The PCA fentanyl consumption as well as VAS pain scores were observed 4h, 24h, and 48h after the operation. Results Although there was no significant differences in pain VAS score between the four groups, the fentanyl consumption was significantly lower in groups DM20 and DM40 compared with group CON and DM10. However, there was no significant difference between group DM20 and group DM40. Conclusion Preoperative IM dextromethorphan shows a dose-dependant fentanyl spare effect on postoperative PCA, and a dose of 20mg seems to be optimal for preoperative use.

Objective To investigate the relationship between angiotensin Ⅱ ( AngⅡ) and transformation of vascular fibroblasts phenotype .Methods Eighteen rats were randomly assigned into the untreated group , mini-pump infusion of saline group and mini-pump infusion of AngⅡgroup which was used as the hypertension model .Their systolic pressure and vascular morphology were examined .The expression of catalase ( CAT ) and 4HNE was examined by immunohistochemistry .Western blotting was used to examine the expression of CAT of adventitial fibroblasts which were cultured by different incubation times and concentrations of Ang Ⅱ.Results Compared with untreated and mini-pump infusion of saline groups , the systolic pressure and carotid media thickness stained by HE of mini-pump infusion of AngⅡgroup were significantly higher (P<0.01).The results of immunohistochemistry showed that the expression of CAT ofAngⅡgroup was significantly lower than that of untreated group , however the expression of 4HNE of AngⅡgroupwas higher than that of untreated group (P<0.05).Furthermore, the results of Western blotting indicated that the effect of Ang Ⅱ on down-regulation of CAT function was in a dose and incubation time dependent manner .Conclusion AngⅡdown-regulates adventitial CAT expression and promotes fibroblasts phenotypic transformation which leads to pathological arterial vascular remodeling .

Objective To report specific clinico-radiological syndromes in neuropsychiatric systemic lupus erythematosus (NPSLE).Methods Ten patients with NPSLE in Peking Union Medical College Hospital from 2005 to 2011 were studied retrospectively with magnetic resonance imaging, computer tomography or positron emission tomography. Results Posterior reversible encephalopathy syndrome was diagnosed in 2 patients with radiological features,headache and tonic-clonic seizure;3 patients with bilateral diffuse leukoencephalopathy,cognitive disorder and acute confusional state; 1 Fahr' s disease patient,with cognitive disorder and psychiatric symptom,movement disorder; 2 Parkinsonism patients with tremor and cogwheel rigidity,and 2 chorea patients. Conclusions The emergence of diffuse brain calcinosis,leukoencephalopathy and edema may happen in lupus encephalopathy particularly.Autoantibody reaction and vascular disease may play an important role in movement disorder including Parkinsonism and chorea.

Objective To explore the inhibitory effects of Zibu Piyin Recipe(ZBPYR)serum on neuron apoptosis induced by tunieamyein(Tm,5 μg/ml)and its mechamsm in vitro by using sero-pharmacological method.Method Totally 12 healthy adult male SD rats(220～250 g)(SPF)were divided randomly into control group and ZBPYR group,6 in each group,then the blank and ZBPYR serum were prepared.The mouse.neuroblastoma cell line Neum2a cells were treated with Tunicamycin(Tin,an inhibitor of N-glycoslytion)to establish the endoplasmic reticulum(ER)stress model.The cells treated by ZBPYR aerum of different concentrations were interventional groups,and the cells treated by blank serum were control group.The viability of Neuro2a cells was meusurcdd by MTT assay.Flow cytometry wus applied to observe the apoptosis of Neuro2a cells.Western blotting was utilized to detect the protein expressions of two molecules,ER molecular chaperone-ucose regulated protein 78(CRP78)and transcriptional factor CCAAT/enhancer-binding protein-homologous protein(CHOP).The results were analyzed by sNK-q test.Results Compared to Tm group(cell viability 0.1673±0.0213,apoptotic rate 62.7050±1.4056),The cell viability of interventional groups(5%0.5295±0.0373,10%0.5843±0.0428,15%0.6274±0.0324)increased significantly(P<0.05);and the apoptotic rate(5%47.8733±2.8166,10%46.3366±1.2748,15%39.8833±1.0524)reduced significantly(P<0.05).The protein expressions of GRP 78(5%2.1228±0.2251,10%1.3293±0.9443,15%;15%0.0931±0.1168)and CHOP(5%1.1776±0.2927,10%0.7290±0.1708,15%0.6577±0.1883)of interventional groups reduced significantly compared with Tm group(GRP78 2.9149±0.5355;CHOP 1.6611±0.2913)P<0.05.Condusions ZBPYR serurn could increase the cell viability of Neuro2a cells treated with Tm and inhibit cell apoptosis.Thereby it may have neuroprotective effects,and the mechanism may be associated with the inhibition of ER stress and apoptosis pathway.

Objective To explore characteristics and treatment of the clinical crises myasthenia sufferer.Methods Retrospective analysis 32 patients with clinical data of MG crises,intravenous immunoglobulin all.Results Treating group,recovered in 1 case,the basic recovery in 4 cases,markedly effective in 6 cases,improved in 3 cases,Ineffective in 2 cases;the total effective 31.25%.Conclusion Group,recovered in 0 case,the basic recovery in 1 cases,markedly effective in 2 cases,improved in 3 cases,Ineffective in 10 cases; efficient 37.50%.Two groups of efficient comparative greup(X2 = 4.54 ,P <0.05) conclusion:Improved the patients's clinical symptoms after intravenous injection of gamma globulin,and the titer of patients with blood AchRAb significantly lower than that before treatment.

Objecive To evaluate and compare the efficacy of injecting tissue glue and lauromacrogol in modified sandwich method combined with synchronous ligation for patients with esophageal and gastric variceal.Methods 42 cases of patients with esophageal and gastric variceal were randomly divided into synchronous treatment group (22 cases) and sequential treatment group (20 cases). Both group received modiifed sandwich method for gastric varices (lauromacrogol-tissue adhesive-lauromacrogol). Synchronous treatment group meanwhile received synchronization ligation for esophageal varices, but sequential treatment group received sequential ligation after one week. The hemostasis rate, effective rate of varices, rebleeding and complications rate were analyzed.Results There were no signiifcant difference in hemostasis rate, effective rate and rebleeding rate between two groups. The incidence of complications, such as chest and abdominal pain, fever, transient bacteremia were equal between these two groups. No patients had ectopic embolism. The number of ligation device in synchronous treatment group was more than sequential treatment group (8.19 ± 2.01 vs 7.81 ± 1.78,P > 0.05), and the rate of esophageal varices disappearance was inferior to sequential treatment group (59.09% vs 70.00%), however, there were no statistical difference (P > 0.05).Conclusion Endoscopic injection of tissue glue and lauromacrogol synchronization ligation is safe and effective for esophageal and gastric variceal with low complication rates. This method could reduce gastroscopy times and medical expenses, and is worthy of further investigating.

Objective We conducted a case-control study to verify the association of rs2070045 SOLR1 polymorphism with PD in the northern Han Chinese population from mainland China.Methods A total of 215 unrelated Han Chinese healthy people and 377 PD patients were included in the study.According to the onset age,the PD patients were divided into 2 groups:early onset PD group (onset age ≤ 50 years old) and late onset PD group (＞50 years old).Clinical data was collected and peripheral blood genomic DNA was extracted using MALDI-TOF-PEX technology.The correlation of rs2070045 SOLR1 with Parkinson's disease was analyzed.Results Genotypic frequencies of rs2070045 SNP were investigated through the data from a total of 592 subjects including 377 PD patients and 215 control participants.Genotypes of TT,TG and GG were found in 52,182 and 143 PD patients respectively and in 31,13 and 71 Healthy controls.No significant differences were found in the genotype and allele frequency for rs2070045 between PD group and healthy control (HC) groups.The genotype for rs2070045 in the early-onset PD group was significantly different from that in the HC group (P=0.036).There were no significant differences in genotype and allele frequency between late-onset PD and HC groups.Moreover,carriers of the G-allele (genotype GG/ TG) of rs2070045 showed a significantly decreased risk of early-onset PD compared to non-carriers according to the Logistic regression analysis.Onset age of carriers (genotype GG/ TG) in late-onset PD group was lower compared to non-carries (P=0.001).Other clinical features such as gender,Hoehn-Yahr stage and disease duration had no statistical difference between carriers and non-carriers of PD patients.Conclusion We have found that rs2070045 SNP of SORL1 was associated with early-onset Parkinson's disease in the northern Han Chinese population.G-allele of rs2070045 SNP decrease the risk for early-onset PD,suggesting G-allele might be a protecting factor of early-onset PD.The influence of SORL1 gene polymorphism on Parkinson's disease warrants further investigation.

Background Hypoxia is the main factor of retinal neovascularization and is closely associated with retinal ganglial cells (RGCs) degeneration.However, the study of retinal neural tissue lesions is rare.Objective This study was to investigate the influence of hypoxia environment on the expression of annexin A2 (ANXA2) in mouse RGC-5 cells and explore the mechanism of RGCs damage induced by hypoxia.Methods Immortalized mouse RGC-5 cells were cultured in high glucose DMEM with 10％ fetal bovine serum.The cells were identified by detecting the expression of Thy-1 ,a specific biomarker of RGCs.CoCl2 was added into the medium at the final concentrations of 50,100,200 and 300 μmol/L, and the cells without CoCl2 served as the control group.Cell viability (absorbance) was assayed by cell counting kit-8 (CCK-8) method in 12,24 and 48 hours after addition of CoCl2.The hypoxic cell models were established in DMEM with 100 μmol/L CoCl2 and divided into the hypoxic 3-hour group, hypoxic 6-hour group, hypoxic 12-hour group and hypoxic 24-hour group,with the normal cultured cells as the normal control group.Apoptotic cells were determined by using hoechst 33342 stain.The expression levels of ANXA2 mRNA and protein in the cells were detected by real-time quantification PCR and Western blot,respectively.The expression and location of ANXA2 in the cells were examined by using immunofluorescence technique.Results The cultured cells grew well and showed the fusiform and polygonal shape,with positive expression of Thy-1 protein.Compared with the normal control group, the viabilities of the cells were insignificantly changed in the 50 μ mol/L CoCl2 group and 100 μmol/L CoCl2 group (all at P＞0.05) ,but the cell viabilities were significantly reduced in the 200 μμmol/L CoCl2 group and 300 μmol/L CoCl2 group in various time points (all at P＜0.05).Hoechst 33342 staining showed that the apoptotic cells with nuclear condensation and high green fluorescence intensity were obtained in the hypoxia groups.The relative expression levels of ANXA2 mRNA were significantly lower in the hypoxic groups than those in the normal control group (all at P ＜ 0.05).The relative expression levels of ANXA2 protein were significantly lower in the hypoxia 3-,6-, 12-and 24-hour group than those in the normal control group (all at P＜ 0.05).Apoptotic cells were seen in the hypoxic 3-hour group, hypoxic 6-hour group, hypoxic 12-hour group and hypoxic 24-hour group compared with the normal control group, showing the bright blue fluorescence in cellular nucleus for hoechst 33342.The relative expressing levels of ANXA2 mRNA in the cells were 0.80±0.14,0.67±0.33, 0.49±0.17 and 0.39±0.02 in the hypoxic 3-hour group,hypoxic 6-hour group, hypoxic 12-hour group and hypoxic 24-hour group, which were significantly declined in comparison with the normal control group, with a statistically difference among the groups (F=434.354, P =0.000).The relative expression values of ANXA2 protein were 0.552 6±0.012 3,0.425 9± 0.033 4,0.344 9 ± 0.017 8 and 0.382 7 ± 0.022 1 in the hypoxic 3-hour group, hypoxic 6-hour group, hypoxic 12-hour group and hypoxic 24-hour group,which were remarkably lower than 0.602 1 ±0.001 4 in the normal control group, showing considerably difference among the groups (F =3.057, P =0.000).ANXA2 proteins were highly expressed in the cellular nucleus and less expressed in the cell membrane and cytoplasm in the normal cells.Compared with the normal control group, the ANXA2 protein showed weak expression in the hypoxia group and primarily in the cytoplasm.Conclusions The expression of ANXA2 down-regulates in hypoxic mouse RGC-5 cells,which may participate in the apoptosis process of RGCs in high glucose environment.