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.

Objective To evaluate the association of Smad2/3,Smad4 and P-Smad3 protein expressions in tissue with liver fibrosis in patients with chronic HBV infections.Methods Liver biopsy was performed to determine the liver fibrosis grades in 131 cases of chronic HBV infections.Immunohistochemistry and semiquantitative analysis were applied to detect the expression of Smad2/3,Smad4 and P-Smad3 proteins in liver tissues.Results Smad2/3,Smad4 and P-Smad3 were detected mainly in fibrous septum,portal areas,myofibroblasts,sinus and cytoplasm in the liver tissue.The expression of Smad2/3,Smad4 and P-Smad3 was increased with the development of fibrosis ( r =0.81,0.58and 0.68,P =0.000),and a strong positive correlation was observed among three proteins (r =0.75,0.87and 0.84,P =0.000).Conclusion The expression of Smad2/3,Smad4 and P-Smad3 is correlated with liver fibrosis in chronic HBV infection,which suggests that the up-regulation of Smad proteins may be involved in the progression of liver fibrosis.

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.

Objective To investigate the application value of transvaginal three-dimensional ultrasound combined with tomographic ultrasound imaging (TUI) in the diagnosis of early ectopic pregnancy. Methods One hundred and twenty patients with 4 to 6 weeks menopause were collected. All of the cases were clinical suspected of ectopic pregnancy and the surgical pathology and clinical follow-up results of each case were obtained. Both transvaginal two dimensional ultrasound imaging and three-dimensional ultrasound imaging combined with TUI technique were applied in order to make a diagnosis based on ultrasonographic characteristics for each of the case;surgical pathology and clinical follow-up results were compared with the ultrasonographic diagnosis so as to analysis and conclude the ultrasonographic imaging characteristics of cases misdiagnosed or missed diagnosed by transvaginal two-dimensional ultrasound imaging and three-dimensional ultrasound imaging joint TUI technique. Results One hundred and two cases were confirmed as ectopic pregnancy by surgical pathology and clinical follow-up results among 120 patients and eighteenth cases were confirmed as intrauterine pregnancy. Comparing surgical pathology and clinical follow-up results with the ultrasonographic diagnosis showed:(1) Ninety-two cases of tubal pregnancy:80 cases were correctly diagnosed by transvaginal two-dimensional ultrasound imaging (86.9%, 80/92) while 84 cases by three-dimensional combined with TUI technique (91.3%, 84/92); 8 cases were missed diagnosed by both two methods;4 cases were misdiagnosed by transvaginal two-dimensional ultrasound imaging while zero case by three-dimensional combined with TUI technique. Ultrasonographic imaging characteristics:adnexal masses presented as“Donut”sign which was similar to gestational-sac or masses with irregular boundary. The majority of the masses presented as clear boundaries and internal structure and had obvious margins with fallopian tube. A total 36 cases of unruptured tubal pregnancy were correctly diagnosed by the two methods while 43 cases of abortion type and 5 cases of ruptured type were correctly diagnosed. (2) Ten cases of uterine cornual pregnancy:6 cases were correctly diagnosed by transvaginal two-dimensional ultrasound imaging (60.0%, 6/10) while 9 cases by three-dimensional ultrasound imaging joint TUI technique (90.0%, 9/10);4 cases were misdiagnosd by transvaginal two-dimensional ultrasound imaging and 1 case by three-dimensional ultrasound imaging joint TUI technique. Ultrasonographic imaging characteristics:the gestational-sac was located in the uterine horn, 6 cases of gestational-sac was not connected with endometrium showed by transvaginal two-dimensional ultrasound imaging while 9 cases were clearly showed by three-dimensional ultrasound imaging joint TUI technique that the gestational-sac was connected with endometrium, especially in the coronal-section. The surrounding decidua circumvoluted the gestational-sac was unclear in 4 cases by transvaginal two-dimensional ultrasound imaging and in 9 cases by three-dimensional ultrasound imaging joint TUI technique. And‘interstitial line’ sign appeared in 4 cases showed by transvaginal two-dimensional ultrasound imagingwhile 6 cases by three-dimensional ultrasound imaging joint TUI technique. (3) Cases missed diagnosed and misdiagnosed:8 cases of early ectopic pregnancy were missed diagnosed both by transvaginal two-dimensional ultrasound imaging and three-dimensional ultrasound imaging joint TUI. The reasons we concluded were as follow:‘false gestational-sac’ located in the uterine cavity;the location of the gestational-sac was so closed to uterine cavity. Four cases of tubal pregnancy and 4 cases of uterine cornual pregnancy were misdiagnosed by transvaginal two-dimensional ultrasound imaging. The location of the ectopic pregnancy mass and the gestational-sac of 7 cases of uterine cornual pregnancy were clearly showed by three-dimensional ultrasound imaging joint TUI and only 1 case was misdiagnosed. Conclusions Transvaginal three-dimensional ultrasound imaging combined with TUI technique can provide more detailed ultrasound diagnostic information and reduced missed diagnosis and misdiagnosis of the early ectopic pregnancy. The clinical application value of transvaginal three-dimensional ultrasound imaging combined with TUI technique in the diagnosis of early ectopic pregnancy was good.

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.

AIM: To observe the changes of interleukin-6(IL-6), IL-8 and tumor necrosis factor-?(TNF-?) in serum and lung at different time, and the effects of anisodamine (654-2) treatment in rats with oleic acid-induced ARDS. METHODS: The ARDS model induced by intravenous injection of oleic acid in the rat was used and levels of IL-6, IL-8, TNF-? in serum and lung tissue supernatant were measured using enzyme linked immunosorbent assay (ELISA). RESULTS: Levels of serum and lung tissue IL-6, IL-8, TNF-? in oleic acid type ARDS 4 h group were increased significantly. These cytokines in oleic acid type ARDS 8 h group were lower than that of ARDS 4 h group, but serum IL-6, TNF-? and lung tissue IL-6 were still higher than that of control group . In oleic acid type ARDS 16 h group, serum IL-6, TNF-? were lower than that of the ARDS 8 h group and serum TNF-? and lung tissue IL-6 were higher than that of control group. After 654-2 treatment, the levels of serum and lung tissue IL-6, TNF-? were decreased significantly. CONCLUSION: IL-6, IL-8 and TNF-? might play important roles in the oleic acid-induced ARDS in the rat. 654-2 might alleviate ARDS by inhibiting excess production of IL-6 and TNF-?.

Objective To analyze the expression of serum anti M phospholipase A2 receptor (PLA2R)antibody in idiopathic membranous nephropathy (IMN),and to investigate its value in the diagnosis and evaluation of idiopathic membranous ne-phropathy.Methods One hundred and eighteen patients with biopsy-proved glomerular diseases were involved in this study, including 97 cases with IMN,21 cases with IgA nephropathy (IgAN)and 19 healthy people.ELISA was used to detect ser-um anti-PLA2R antibodies.Correlations of anti-PLA2R antibody level with laboratory parameters,including serum albumin, 24-hour urine protein of IMN patients were evaluated.Results The median of anti PLA2R antibody in IMN group,IgAN group and healthy group was 45.2(3.6~705.9)RU/ml,5.9(2.3~10.6)RU/ml and 1.2(0.6~9.3)RU/ml.The levels of serum anti PLA2R antibody in IMN group were higher than those in IgA nephropathy group and healthy control group.The difference was statistically significant (t=-5.027,-3.077;P=0.05).Among 97 cases with IMN,76 cases showed posi-tive anti-PLA2R antibodies (positive rate 78.35%).There was none patient showed positive anti-PLA2R antibody respec-tively in IgAN and healthy people.Furthermore,anti-PLA2R antibody level was negatively correlated with serum albumin (r=-0.453,P=0.000)and positively correlated with CREA,TC,ESR,24 hour urine protein (r=0.233,0.234,0.363, 0.586;P=0.004,0.217,0.021,0.000)in IMN patients.Conclusion Serum anti PLA2R antibody may be used as a IMN specific marker for the diagnosis of IMN,and it has important reference value for evaluating the severity of IMN.