Objective To compare the brainstem auditory evoked potential (BAEP) in patients with different kinds of brainstem disorders, so as to offer a significative electrophysiological means for diagnosis and differential diagnosis of different kinds of brainstem disorders. Methods BAEP was recorded from 80 cases of vertebrobasilar arterial insufficiency, 56 cases of acoustic neuroma and 47 cases of chronic cerebellar degeneration and compared with that from 50 healthy people. Results The abnormal rates of the three different case groups were 73.75%, 94.61%, 89.36%, respectively. Each group of patients demonstrated their own characteristics with regard to the BAEP. Conclusion Each of the three brainstem disorders has its own characteristics with BAEP.

The patients must lie down on the sickbed for a period after percutaneous coronary intervention (PCI). Most patients will feel uncomfortable such as lumbago, backache, abdominal distension, insomnia, dysuria and etc. Therefore measures including adjusting posture, starting exercise as early as possible and preventing bleeding should be taken.

Objective To study the relationship between the adult sternum multiple measurements and the body length in Chinese Han population for the purpose of body length estimation. Methods In this article, we had surveyed 135 samples(100 males and 35 females) .The total length of the sternum, the length of the sternal manubrium and the sternal body, the maximum and minimum breadth of the sternal manubrium, the Kleinste Breite des Ma-nubrium sterni, the maximum breadth of the sternal body, the Dicke des Manubrium sterni, the thickness of the sternal manubrium,the maximum thickness of the sternal manubrium and the sternal body in Chinese Han population was measured. Multiple linear regressions for estimating the body length were obtained by the stepwise regressive mathematics. Results Five multiple linear regressions (4 for different male age groups and 1 for female group ) for body length estimation were obtained. The multiple- relationship coefficient(R) was between 0.6237 and 0.7350, and the standard deviation was between 4.5720 and 7.0348. Conclusion The body length could be estimated by the sternum measurement data.However, its accurate was not as well as estimation by the long bone measurement. The male sternum multiple measurement data was significantly different from female. The body length can not be estimated only by the length of the sternal manubrium .

Cholangiocarcinoma (CCA) is a group of solid tumors with high malignant degree and poor prognosis. Surgical resection has still been the main therapy options. Targeting therapy and immunotherapy are the main anti-tumor methods that have been paid more and more attention in recent years, especially immunotherapy. The tumor microenvironment of CCA is complex, which encompasses not only interstitial and endothelial cells, but also a large number of immune cells. In addition, the innate and adaptive immune systems also play a role. This article summarizes the immune-related studies of cholangiocarcinoma and the latest clinical trials of immunotherapy.

Purpose Cortex is one of the frequently involved sites of multiple sclerosis (MS),and the cortex and corpus callosum lesions of MS are gradually concerned.The study aims to observe the changes of cerebral cortex and corpus callosum of MS in experimental autoimmune encephalomyelitis (EAE) model by using 7.0T MRI diffusion tensor imaging (DTI).Materials and Methods Twenty female C57BL/6 mice of 6-8 week old were enrolled in the study,10 of which were induced by MOG35-55 to make EAE models and the rest 10 of which were taken as control group.On the 20 days after model establishment,the head T2WI and DTI were performed on both control and EAE mice.DTI quantitative indicators such as fractional anisotropy (FA),mean diffusivity (MD),axial dispersion coefficient λ//,and radial dispersion coefficient λ ⊥ in region of interest including bilateral prefrontal cortex,bilateral cingulate cortex and corpus callosum were compared between the two groups.Results No obvious lesions were observed on the T2WI in both control and EAE groups.In the experimental group,the FA mapping suggested the integrity of the left side of the corpus callosum was destroyed.The FA,MD,λ// λ ⊥ of bilateral prefrontal cortex and corpus callosum showed significant difference between experimental group and control group (P＜0.05);the increase of λ ⊥ in bilateral cingulate was significantly different from that in the control group.Meanwhile,HE staining in the experimental group showed that inflammatory cells gathered around the cortical and subcortical vessels.The LFB staining in experimental group showed a bit paler than that in the control group,and the corpus callosum showed patchy demyelination.Conclusion The technique of 7.0T MRI DTI sequence can detect cortex and corpus callosum lesions which cannot be found by conventional MRI,so that it provides radiological evidence for the study of MS with cortex and corpus callosum lesions.

Objective To analyse the etiology and clinical characteristics of 26 critically ill children with severe hand foot and mouth disease (HFMD) of Shanxi province in 2010.Methods We retrospectively analysed the clinical data of 26 children with severe HFMD from Mar to Sep 2010.Nucleic acid of enterovirus 71 ( EV71 ) and Coxsackie virus A 16 ( CoxA16) were detected in 20 out of 26 children with HFMD by reversed real time polymerase chain reaction (rRT-PCR),and the whole VP1 gene of EV71 deriving from 6 different areas of Shanxi province was amplified,sequenced,and compared with strains from other areas in china.Results EV71 nucleic acid were positive in 18 out of 20 children,while the other two were negative for EV71 and CoxAl6.Among all the critical cases,20 cases (76.9％) occurred in Weinan area,four in Xianyang area,and two in Xi'an urban area.Compared with those of Fuyang Anhui,Hong Kong China,Guangzhou,Shenzhen,Shandong,Beijing,the homology of the whole VP1 gene sequence from 6 strains of Shanxi area was 96％ ～ 100％.Most of the critical children were under 3-year-old,and the incidence rate of male children was higher than that of female children.All affected children had persisted fever,poor energy,hyperarousal,hypersomnia,and limb shaking.Meanwhile their peripheral blood leukocytes,C-reactive protein and blood glucose were markedly increased,but renal injuries were rare.Eighteen children clinically recovered on discharge,among which 2 cases had sequelae of limb activity obstacle,and 8 cases died.Conclusion Weinan is the area with the highest incidence rate of critical HFMD cases in Shanxi Province,and the major etiological organism is EV71,which is highly homologous to EV71 found in other regions of mainland China.As many cases are in dangerous condition,thus early identification and intervention could inhibit the disease progression,and play a key role in reducing the mortality.

Objective To investigate clinical characteristics of smear- or culture-positive pulmonary tuberculosis (TB) in patients hospitalized at a general hospital to improve its diagnosis. Methods Clinical data of smear- or culture-positive pulmonary TB diagnosed in 50 patients hospitalized at Peking Union Medical College Hospital, Beijing during 2006 to 2009 were analyzed retrospectively. Results Seventeen (34%) of 50 cases of smear- or culture-positive pulmonary TB aged more than 60 years, with 30 males (32%), 16 retirees and nine farmers (18%). Their main symptoms included fever (80%), cough (94%) and sputum expectoration (92%), with elevated erythrocyte sedimentation rate (ESR) in 38 of 45 patients (84%). Chest X-ray examinations showed that lesions located mostly in the upper lobes or in both of the lungs diffusedly, with patchy infiltrations, nodular opacities and cavities. Acid-fast bacilli were demonstrated on sputum smear in 41 ( 82% ) and in specimens of six ( 12% ) cases obtained through bronchoscopy with brush or bronchoalveolar lavage fluid ( BALF), and M. Tuberculosis was cultured from sputum specimens in three (6%). Mean time interval between admission and diagnoses averaged 14 days.Conclusions Basic knowledge about prevention and control of pulmonary tuberculosis should be publicized comprehensively in general hospital keeping alert in its diagnosis with acid-fast staining for sputum smear as a routine test for patients with respiratory symptoms, and in some cases, bronchoscopy procedures ( brush or BALF) are reasonable options to improve its detection.

Objective Mikulicz's disease (MD) was considered to be a subtype of Sj(o)gren's syndrome (SS) due to the clinical and histological similarities between them.Evidence had shown that there were differences between MD and typical SS.The purpose of this study was to investigate the correlation between MD and SS,by means of analyzing the expression of IgG4 in salivary glands and the clinical characteristics of patients who were previously considered as SS.Methods The paraffin sections of salivary glands from SS patients were stained with monoclonal antibodies to IgG4 and CD38.Patients were divided into two groups based on the pathological results.Analysis of the symptoms,the signs and the laboratory results were carried out in these patients.The difference in laboratory parameters and histopathological gradings in the two groups was analyzed.Normal and abnormal distributed data comparison was conducted using random independent samples t-test and rank sum test respectively.Two-sample rates were compared with Chi-square test.Results Based on immunohistochemistry of IgG4 distribution,the 58 patients with SS were divided into two groups:IgG4 related (9 cases) and non-IgG4 related (49 cases).Histopat-hologically,IgG4 related cases showed IgG4+ plasma cells/IgG+ plasma cells infiltration and there were more IgG4 related monoclonal antibody expressed when compared to IgG4 unrelated cases.In addition,there were also significant differences in clinical features between the two groups.IgG4 related disease was associated with male gender,higher level of plateletconnt,lymphocytes [(2.4±0.8)×109/L vs (1.4±0.7) ×109/L] count and CRP [(52±60) mg/L vs (15±17) mg/L] levels and lower titer of IgM [(1.2±0.7) g/L vs (1.8±0.8) g/L],antinuclear antibody (56％ vs 87％) and anti-SSB antibodies (13％ vs 54％) (P＜0.05),when compared with IgG4-unrelated cases.There was no significant difference in other indicators (P＞0.05).Conclusion The present study has demonstrated that some of the MD patients misdiagnosed as SS.Some of the laboratory tests such as the level of platelet and lymphocyte count,serum level of CRP,IgM,antinuclear antibody,anti-SSB antibodies,the serum levels of IgG4 and the histopathological presentations in the salivary gland are different between these two disorders.Because of good response to steroid in MD,so laboratory tests and pathological examinations for IgG4 can help to avoid misdiagnosis.

The medical records of all 12 patients diagnosed as chronic active Epstein-Barr virus (CAEBV) infection at our hospital were analyzed retrospectively.There were 7 males and 5 females with a median onset age of 28 years.CAEBV was characterized by fever,splenomegaly,hepatomegaly and lymphadenopathy,etc.The abnormalities of laboratory examination included liver dysfunction,thrombocytopenia,anemia and leucopenia.EBV-DNA detected by real-time polymerase chain reaction was (1.7 × 103-3.5 × 107) copies/μg DNA in peripheral blood mononuclear cell.Among them,the outcomes were death (n =5),lost to follow-up (n =2) and T cell lymphoma (n =1).It is necessary to improve our awareness of CAEBV infection because of its poor prognosis and high mortality.

Purpose To retrospectively analyze and summarize the image features of rare ovarian clear cell carcinoma (OCCC), and to provide basis for clinical diagnosis. Materials and Methods CT and MRI features of 30 cases of OCCC confirmed by pathology were retrospectively analyzed. Sixteen of all the patients underwent pre- and post-contrast CT scan. And 14 patients underwent pre- and post-contrast MRI scans. Results ① CT features: unilateral mass was revealed in 15 cases and bilateral mass was in 1 case. The maximum diameter of the mass ranged from 8 to 23.7 cm, mean (12.86±3.96) cm. One mass was irregular, 4 masses revealed incomplete capsule, and 4 masses had septa in the mass. CT value of cystic part of the mass was 20-30 HU, and which of solid part was 28-53 HU. On post-contrast CT images, the septa and solid component of the mass showed marked enhancement and delay enhancement, while the cystic component showed no enhancement. ② MRI features: Unilateral mass was revealed in 13 cases and bilateral mass was in 1 case. The maximum diameter of the mass ranged from 9.2 to 30.0 cm, mean (14.03±4.72) cm. One mass was irregular, 2 masses revealed incomplete capsule, and 2 masses had septa in the mass. The cystic component showed heterogenous signal intensity on T1WI, and high signal intensity on T2WI. There was no enhancement on post-contrast images. The solid component showed iso-intensity on T1WI, high signal intensity on T2WI, and diffused restricted on diffusion-weighted images. There was markedly enhancement on post-contrast images. ③ Blood supply of the tumor: In 8 cases, the branch of enlarged ipsilateral ovarian artery fed the tumors. In other 16 cases, the masses were surrounded by enlarged ipsilateral ovarian vein. Conclusion The characteristic CT and MRI features of OCCC include: a cystic solid mass with complete capsule; the solid component projects into the cavity, which could be hypervascular and marked enhanced.