Objective To explore the clinical characteristics of vestibular migraine in patients from the clinic and ward of the neurological department in comprehensive hospitals.Methods A total of 226 patients diagnosed as vestibular migraine were enrolled in the study.Clinical data were collected and analyzed,including the medical history,clinical symptoms and signs,as well as the result of diagnostic examinations.Results The mean age of the patients at the visit was 51.7 years old,with the male to female ratio of 1:1.48.The occurrence of vertigo and migraine varied in order,with 53.1％ (120/226) patients presented migraine several years before vertigo.The duration time of vertigo ranged from seconds to days,with 1.8％ (4/226) patients presented no headache during the whole course.Several punctate long T2 or high FLARE (fluid attented inversion recovery) signals scattered at the centrum ovale.Conclusions Vestibular migraine has complex mechanism and presents multiple clinical manifestations with certain regularities of the onset.Differential diagnosis should be made from the similar diseases.

To explore the clinical characteristics and imaging features of miliary tuberculomas in central nervous system (CNS).A total of 5 cases diagnosed with tuberculosis in CNS first diagnosed by neurologists in Navy General Hospital of PLA were enrolled in the study.All clinical and imaging data were collected and analyzed retrospectively.The main initial symptoms were fever and headache (4/5).Multiple diffused miliary lesions were shown by brain MRI,with maximum diameter ranged from 1-4 mm and ringshape or nodular enhancement after gadolinium injection.As mycobacterium tuberculosis could seldomly be found in serum and cerebrospinal fluid,contrast MRI remains the effective method for detecting miliary tuberculomas in CNS.

Objective To investigate the effect and the mechanism of the GITR-antibody(glucocorticoid-induced tumor necrosis factor receptor-ligand antibody) on the mouse leukemia model induced by L615.Methods The mouse leukemia models induced by L615 cells were divided into 4 groups: negative controls(peritoneal injection of normal saline,0.2 ml/d),GITR group(GITR,100,infused through caudal vein 2 d before leukemic lymphocytes inoculation,again at dose of 50 ?g/each mouse after inoculation),Cyclophosphamide group(200 mg?kg~(-1)?d~(-1),intraperitoneal injection from the 3~(rd) day after inoculation for 3 d),GITR+ Cyclophosphamide group(100 mg?kg~(-1)?d~(-1) Cyclophosphamide instead).The survival time,leukocyte counting in the peripheal blood,liver and spleen index were calculated and the pathological examination of liver,spleen were performed.Results GITR-ligand could prolong the survival time of mouse leukemia model,lead the necrosis and apoptosis of leukemic cells in bone marrow,decrease the liver and spleen index,decrease and relieve the leukocyte increase of peripheal blood and the irregular swelling of liver and spleen.Conclusion Through immunoregulation,GITR-antibody can inhibit the L615 leukemic cells effectively,therefore inhibit the progress of leukemia to some extent.

Objective To explore how the antibody of glucocorticoid-induced tumor necrosis factor receptor (GITR) exerts inhibitory effect on the L615 leukemia cells by strengthening the activation of the NK cells. Methods The 24 established L615 leukemia mice were equally and randomly divided into 4 experimental groups according to different drugs given intraperitoneally, groupⅠ (normal saline), Ⅱ (GITR), Ⅲ (cyclophosphamide), and Ⅳ (GITR +cyclophosphamide).Then the NK cells were extracted from the spleen of mice as effective cells, and L615 leukemia cells served as the target cells. The changes of the NK cells’killing activation was observed in vivo. The mRNA levels of 3 proteins tightly related to the NK cells’activation Perforin, IFN-? and Fas mRNAs were detected with RT-PCR. Results The GITR-antibody enhanced the killing activity of the NK cells obviously, with the expressions of the 3 proteins increasing obviously. Conclusion By regulation of the Treg cells, the GITR-antibody can inhibit the L615 leukemia cells through enhancing the NK cells' killing activity.

ObjectiveTo detect the mutations of GJB3 and GJB4 genes in two sporadic cases of erythrokeratodermia variabilis(EKV).MethodsGenomic DNA was extracted from two sporadic patients with EKV,their family members,and 100 normal human controls.All the exons and adjacent splice sites of GJB3 and GJB4 genes were amplified by PCR.Mutation scanning was carried out via direct bidirectional DNA sequencing.ResultsA G134C mutation was found at the GJB3 gene in patient 1,which caused a substitution of glycine by alanine at codon 45 (G45A).No mutation was found in the GJB4 gene in case 1 or GJB3 and GJB4 genes in case 2.ConclusionA missence mutation G45A in GJB3 gene is found in a patient with EKV.

Objective To study the clinical significance of intercostobrachial nerve ( ICBN) reservation in radical resection of breast cancer .Methods 42 cases with breast cancer at stageⅠ,ⅡorⅢa were randomly divided into experimental group(n=28) and control group(n=14).In the experimental group,the ICBN were preserved in the axillary lymph node dissection operation ,while in the control group ,the ICBN were resected in the operation .After the operation,both two groups were treated as breast cancer and the patients were followed up .The operation time,the number of ALND , local tumor recurrence and distant metastasis rates after operation , survival rate were compared between the two groups.Results Postoperative 14 days,3 months and 6 months,the incidence rates of the sensory disorder in the internal upper arms in the control group were 85.7%,64.3% and 50.0% respectively,those in the experimental group were 10.7%,3.5% and 0.0%.The differences were statistically significant between the two groups(P<0.05).The average operation time,average number of lymph node dissection between control group and experimental group had no significant difference [(80.0 ±12.9) min vs (88.0 ±15.6) min,(16.4 ±5.4) vs (14.8 ±6.1)](P >0.05).In the control group,the local recurrence rate,distant metastasis rate and survival rate were 0.0%,7.0%and 0.0%,those in the experimental group were 0.0%,0.0% and 0.0%.There were no statistically significant differences between the two groups .Conclusion It is feasible to preserve the ICBN in radical resection of breast cancer ,which reserves the skin sensory function of the internal upper arm and axilla ,and enhance the patients'quality of life.

Objective To explore the effect of endovenous laser treatment ( EVLT) for varicose great saphe-nous veins complicated with ulcers .Methods 40 cases ( 46 limbs ) of varicose great saphenous veins complicated with ulcers underwent EVLT .The abnormal vein branches of the base of ulcers and adjacent ulcers were burned and closed.Results Except a case suffered the secondary transplantation for skin flap necrosis ,no infection,skin necro-sis,deep vein thrombosis complications occurred in other 39 cases.All the ulcers healed ,and postoperative lower limb varicose veins were disappeared .The operation time was (65 ±11.6) min.All the ulcers healed and the hospitalization time was (21 ±4.6)d.All the patients were followed up for 6-36 months,and no recurrence was found.Conclusion EVLT for varicos e great saphenous veins complicated with ulcers has the advantages of good effect ,minimal incision , and quick recovery .

Objective:To investigate the correlation between the iliac cortical density line and pelvic tilt (PT) in X-ray films of patients with kyphosis.Methods:The imaging data of 67 patients with kyphosis treated in Tianjin Beichen Hopsital from August 2016 to December 2019 were analyzed retrospectively. PT and iliac tilt (IT) were measured on lateral X-ray of the spine. IT was defined as the angle between the density line of the iliac cortex and vertical direction. The correlation between PT and IT was analyzed, and a linear regression model was established.Results:PT and IT can be determined by X-ray lateral films of spine in 67 patients. Pearson correlation analysis results showed that PT was significantly correlated with IT( r=0.852, P<0.05). Subgroups analysis was conducted by gender. The linear regression formulas for females and males were PT=IT-12.9° and PT=IT-16.7°, respectively. Conclusions:When it is difficult to identify the femoral head on X-ray film, IT can be measured conveniently and directly through the density line of the iliac cortex, and then PT can be reliably evaluated through IT.

Objective To survey a prevalence of osteoporosis and prevalence of osteoporosis combined with hyponatremia in elderly hospitalized patients,and their risk factors.Methods We enrolled 2496 elderly hospitalized patients with detected plasma levels of sodium,calcium,25 (OH) D3,PTH,plasma PINP,and β-CTX.At the same time,sex,age,height,weight,smoking history,drinking history and BMI(kg/m2) in form of a questionnaire were recorded and calculated.The risk factors for osteoporosis were analyzed using multivariate Logistic regression method.Results The osteoporosis prevalence was 12.2％ (305/2496 inpatients)with 31.5 ％ (96/305)in male,68.5％ (209/305)in female(x2 =4.651,P=0.031).The prevalence of osteoporosis with hyponatremia was 27.5 ％ (84/305),with 24.8 ％ (21/84) in male and 75.2 ％ (63/84) in female(x2 =9.251,P=0.025).As compared with three groups of non-osteoporosis,normal serum Na+ with and without osteoporosis,the osteoporosis patients with hyponatremia were more aged,in a higher proportion of women and smokers,in lower BMI,and in low levels of serum sodium,BMD 25(OH)D3 (F=13.783,0.861,7.146,24.520,0.548,x2 =15.113、4.472;P =0.001,0.000,0.021,0.015,0.003,0.021,0.005).Multivariate Logistic regression analysis showed that aging,female,low BMI,smoking history,drinking history,low plasma 25(OH)D3 level,low plasma PINP level,and high plasma β-CTX level were the risk factors for osteoporosis(OR 4.215,2.271,3.176,2.013,1.237,3.987,1.843,1.972;all P＜0.05).Conclusions The osteoporosis prevalence is high in elderly patients,especially in old women.The risk factors for osteoporosis are diverse,and clinical conditions of osteoporosis patients with hyponatremia are much more severe than the others.More efforts should be given to them and need to be focused on the complications of osteoporosis.

Objective:To investigate the effects of endoplasmic reticulum(ER)stress on the stability of atherosclerotic plaques in mice by examining the action of lipopolysaccharide(LPS)-induced Toll-like receptor 4(TLR4)on the protein expression levels in the ER stress pathway in atherosclerotic plaques of polipoprotein E gene knockout (ApoE -/-) mice. Methods:From October 2015 to February 2016, 24 ApoE -/-mice were randomly divided into the control group, the LPS group and the TAK group after 10 weeks of high-fat feeding(n=8, each group). After 10 weeks of intervention, peripheral blood was extracted by removing the eyeballs for the measurement of total cholesterol(TC), triglycerides(TG)and oxidized low density lipoprotein(ox-LDL). Then mice were sacrificed to obtain carotid and aortic specimens.Immunohistochemistry was used to detect the expression of carotid plaque macrophages(MOMA-2), smooth muscle actin(α-actin), TLR4, interleukin-1β(IL-1β), interleukin-6(IL-6), tumor necrosis factor-α(TNFα)and nuclear factor-κ-gene binding(NFκB). Western blotting was used to determine the expression of PKR-like eukaryotic initiation factor 2αkinase(PERK), C/EBP-homologous protein(CHOP)and glucose-regulated protein 78(GRP78). Results:The levels of TC, TG and ox-LDL were elevated in the LPS group, compared with the control and TAK groups[(25.0±2.3) mmol/L vs. (20.2±1.6) mmol/L and (20.8±2.6) mmol/L, (1.3±0.1) mmol/L vs.(1.3±0.1) mmol/L and (1.0±0.1) mmol/L, (17.4±1.3) mmol/L vs.(15.8±1.6) mmol/L and (12.1±1.1) mmol/L, P<0.05]. The comparison of plaque morphology and pathology showed that the LPS group had a wider range of atherosclerotic plaques, more macrophages and fewer vascular smooth muscle cells than the control and TAK groups( P<0.05). The expression of TLR4, IL-1β, IL-6, TNFα, NFκB, PERK, CHOP and GRP78 was higher in the LPS group than in the control and TAK groups( P<0.05). Compared with the control group, the expression of PERK, CHOP and GRP78 was lower in the TAK group( P<0.05). The expression of TLR4, PERK, CHOP and GRP78 was higher in the LPS group. Conclusions:LPS-induced TLR4 can up-regulate the expression of proteins in the ER stress pathway, increase the secretion of inflammatory cytokines downstream of the ER stress pathway, aggravate lipid metabolism disorders and increase the instability of atherosclerotic plaques.