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.

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.

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 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 investigate the effect of nerve growth factor on the levels of serum S100 protein and interleukin-6 (IL-6) in patients with acute brain injury.Methods 70 cases with acute craniocerebral injury from March 2013 to May 2015 in department of cerebral surgery of Tianjin port hospital were selected and divided into two groups according to random number method.The control group (35 cases) received conventional symptomatic treatment, the study group (35 cases) received conventional treatment on the basis of mouse nerve growth factor for injection, with a consecutive treatment of two weeks.On admission, one and two weeks after admission, the Glasgow coma scale ( GCS) score was recorded, serum S100 beta protein and IL-6 levels were measured by enzyme-linked immunosorbent assay ( ELISA ) and the clinical curative effect of cerebral edema eliminate was compared.Results After two weeks’ treatment, the total efficacy in control group was lower than that in study group (77.14% vs.94.29%) ( P<0.05).The GCS score of two weeks after admission in study group was lower than that in control group, serum levels of neuron-specific enolase (NSE), myelin basic protein ( MBP) , S100βprotein and IL-6 of one and two weeks after admission in study group were lower than those in control group ( P<0.05).Conclusion The nerve growth factor could decrease the levels of serum S100βand IL-6 and alleviate inflammation in patients with acute craniocerebral injury and the effect is obvious.

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 .

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.

Objective To investigate the correlation between ankle-brachial index (ABI) and early neurological deterioration (END) in patients with acute ischemic stroke. Methods Consecutive patients with acute ischemic stroke admitted to hospital within 7 d after onset from January 2014 to December 2014 were enroled. Bidirectional Doppler flow detector was used to detect ABI. END was defined as the increased National Institutes of Health Stroke Scale score ≥2 or the increased motor score ≥1. The demographic characteristics, vascular risk factors, laboratory parameters, and the incidence of END were identified and analyzed. Results A total of 210 patients with acute ischemic stroke were enroled, including 51 had END and 159 did not have END. Univariate analysis showed that the proportion of patient with ABI ≤0. 9 of the END group was significantly higher than that of the non-END group (43. 1% vs. 22. 0% ; χ2 = 8. 714, P =0. 003). Multivariable logistic regression analysis showed that ABI ≤0. 9 (odds ratio 2. 688, 95% confidence interval 1. 265 - 5. 052; P = 0. 009) was independently associated with END in patients with ischemic stroke after adjusting for the confounding factors, such as age, sex, baseline systolic blood pressure, and ischemic heart disease. Conclusion The low ABI was associated with the occurrence of END in patients with acute ischemic stroke.