This paper reports a woman diagnosed with citrullinemia type I (CTLNⅠ) in puerperium who was unfortunately died later. The 28-year-old patient (G1P1) delivered a live girl at 39 +2 gestational weeks and was transferred from a local hospital to Henan Provincial People's Hospital on January 11, 2020, due to "a 3-day paroxysmal confusion accompanied by dizziness 4 days after delivery". Intermittent confusion, elevated blood ammonia, and citrulline concentration, and encephaledema were presented 10 h after delivery, and the patient eventually died of cerebral hernia on the day of self-discharge. Two pathogenic mutations of the ASS1 gene were found by genetic testing, including c.422t>G (p.val141gl; HET) and c.431c>G (p.pro144arg; HET) and confirmed the diagnosis of CTLNⅠ. CTLNⅠ is a life-threatening disease that could be easily overlooked and misdiagnosed and was difficult to treat. It most often occurs in newborns and infants, whilst it is rare during pregnancy and postpartum. The possibility of this disease should be considered in patients with neurological system symptoms and elevated blood ammonia during pregnancy or puerperium.

Objective To observe the effect of mouse nerve growth factor (mNGF) on treating herpes zoster.Methods The 64 patients with herpes zoster were divided into treatment group and control group by random digits table with 32 cases each.The control group received only routine treatment,the treatment group based on routine treatment combined with mNGF 30 μ g,both groups were treated 14 days.Pain changes of two groups were observed in once every 5 days,a total of 1 month.Results The times of pain to lessen and the pain to vanish of treatment group were (4.36 ± 2.01) and (12.29 ± 1.98) d,those of control group were (7.23 ±3.57) and (20.36 ±2.24) d,there were significant differences (t =5.21 and 8.37,P ＜0.01).The effective rate of treatment group was significantly higher than that of control group [96.9％(31/32) vs.71.9％(23/32),P＜0.05].Conclusion mNGF combined with routine treatment can significantly shorten the course of nerve injury and improve the prognosis with few adverse reactions.

Objective:To discuss the application of antithrombotic drugs in myocardial infarction patients with thrombocytopenia. Methods:The therapy for one myocardial infarction patient with primary thrombocytopenia was discussed and summarized. Based on the related literatures, the characteristics of case, application status and adverse reactions of antithrombotic drugs and anticoagulant drugs were summarized. Results: The adjustment of antithrombotic drug treatment regimen for the patient was reasonable. Conclu-sion:Antithrombotic drugs applied in acute myocardial infarction patients with thrombocytopenia are safe. If patients complicate with other diseases, individualized antithrombotic therapy should be carried out according to particular case.

Objective To explore whether Cdc42 is an independent influence factor in regulating the migration of A549 cells by using quantitative measurement method,and to verify the effectiveness of an automatic measurement and calculation method for in vitro cell migration assay.Methods Cdc42 was overexpressed in human lung adenocarcinoma A549 cell line,and then in vitro scratch assay was applied to evaluate the migration of the cells.Different methods were used to measure the images acquired at different time points for quantitative analysis.Accuracy and repeatability of different measurement methods were analyzed.Results The results showed that overexpression of Cdc42 alone significantly advanced the migration of A549 cells (P＜0.05).The new method is efficient,accurate and reproducible as compared to manual measurement,and has significant advantages in target recognition and noise removal as compared to the existing measurement method in Image Pro Plus 6.0.Conclusions Over expression of Cdc42 significantly increased A549 cell migration ability in vitro.The new method can realize the automatic quantitative analysis of cell migration in vitro.

Objective To describe the distributions of FCGR polymorphisms in human immunodeficiency virus (HIV)-uninfected patients with cryptococcosis,and to investigate the association of FCGR polymorphisms with the susceptibility to cryptococcosis.Methods The distributions of the four functional polymorphisms,including FCGR2A 131H/R,FCGR3A 158F/V,FCGR3B NA1/NA2,and FCGR2B 232I/T were compared between 198 cryptococcosis patients and 190 healthy controls.The polymorphisms distribution patterns were also compared between patients with central nervous system (CNS) infection and those without CNS infection.Genotyping of eight single nucleotide polymorphism (SNP) in FCGR were performed by multiplex SNaPshot technology using DNA extracted from blood samples.The comparison between patients and controls was performed by chi square test or Fisher exact test.Results Compared to healthy controls,the frequency of FCGR2B 232I/I increased (65％ vs 53％,x2 =4.27,P=0.039,OR=1.652,95％CI:1.02-2.67) and that of FCGR2B 232I/T decreased (27％ vs 40％,x2 =5.77,P=0.016.OR=0.542,95％CI:0.33-0.90) in patients with cryptococcal meningitis.Among immunocompetent patients,the frequency of FCGR2B 232I/I was also over-presented (69％ vs 53％,x2=4.53,P =0.033,OR=1.958,95％CI:1.05-3.66) and the FCGR2B 232I/T genotype was also less frequently observed (24％ vs 40％,x2=5.14,P=0.023,OR=0.467,95％CI:0.24-0.91) compared to healthy controls.There were 117 cases with CNS infection and 81 non-CNS infection cases.The genotype of FCGR2A 131R/Rwas over-presented (19％ vs 6％,x2 =6.48,P=0.011,OR=3.52,95％CI:1.27-9.73) and the FCGR2B 232I/T genotype was under-presented (27 ％ vs 46 ％,x2 =7.56,P =0.006,OR=0.431,95％CI:0.24-0.79) in patients with CNS infection compared with those without CNS infection.Furthermore,the frequency of FCGR2B 232I/I genotypes increased (69％ vs47％,x2 =5.47,P=0.019,OR=2.479,95％CI:1.15-5.34) and the frequency of FCGR2B 232I/T decreased (24％ vs 51％,x2 =8.66,P=0.003,OR=0.307,95％CI:0.14-0.68) in immunocompetent patients with CNS infection compared with those without CNS infection.Conclusions FCGR2A 131H/R and FCGR2B 232I/T are associated with the susceptibility to cryptococcal CNS infection,which suggests that FcγRⅡA and FcγRⅡB may contribute to the pathogenesis of cryptococcosis.

Objective To investigate the implication of C-reactive protein in development and prognosis of acute lower limb deep venous thrombosis (DVT) complicated by malignant tumor.Methods34patients with acute lower limb DVT complicated by malignant tumor(observation group),34 patients with acute lower limb DVT complicated by operation or wound(case control group)and 34 normal volunteers (normal control group) were included in this study.The observation group and case control group were treated with conventional therapy such as thrombolysis and anticoagulation.The serum concentrations of CRP before treatment and 14 days after treatment were detected. Recanalization of lower limb DVT and therapeutic efficacy were compared between observation group and case control group.ResultsThe serum concentrations of CRP in observation group before treatment were significantly higher than those in case control group and normal control group [(47.72±29.88) mg/L vs (30.04±15.84) mg/L and (6.19±2.99) mg/L,F =38.444,P ＜ 0.01].At the 14th day of post-treatment,the serum CRP concentrations in observation group and case control group were significantly lower than those before treatment (P ＜0.05).At the 14th day of post-treatment,the CRP concentrations of observation group and case control groups were significantly decreased,although those of observation group were still significantly higher than those of case control group and normal control [(32.77±19.68) mg/L vs (7.76±7.52) mg/L and (6.19±2.99) mg/L,F =50.087,P ＜ 0.01].However,there was no significant difference between case control group and normal control group on the 14th day of post-treatment (F =1.277,P =0.263).The recanalization rate of observation group at the 14th day of post-treatruent were significantly lower than those in case control group(x2 =7.731,P =0.021).The therapeutic effect rate of observation group at the 14th day of post-treatment were also significantly lower than those in case control group (x2 =6.969,P =0.031).ConclusionCRP may play important roles in occurrence,development and therapeutic effect of acute lower limb DVT complicated by malignant tumor.

Objective To observe the changes of N-methyl-D-aspartate (NMDA) receptor 2B subunit (NR2B) expression in the striatum of chronic alcohol exposured rats at different withdrawal time.Methods 72 male Wistar rats were randomly divided into withdrawal 2h group,withdrawal 6h group,withdrawal 12h group,withdrawal 1d group,withdrawal 3d group and control group,and 12 rats in each group.In the 5 withdrawal groups,ethanol was administered in drinking water at the concentration of 6％ (V/V) for 16 weeks,and rats in control group were maintained with water.After 16 weeks ethanol was removed and ethanol withdrawal syndromes were evaluated.The expression of NR2B protein in the striatum was measured by immunofluorescence and western blot and the expression of NR2B mRNA in the striatum was measured by realtime PCR.Results Compared with withdrawal scores of control group((1.50±0.80)),scores of withdrawal 2h,6h,12h,1d,3d groups ((10.42±2.50),(15.42± 1.93),(9.25±2.01),(7.67± 1.92),(2.25±0.87) respectively) were higher,and the withdrawal scores of withdrawal 6h group were the highest.Compared with the expression of NR2B fluorescence intensity (2210.00± 178.20),the expression of NR2B protein(0.150±0.009) and the expression of NR2B mRNA(0.006±0.001) in the striatum of control group,the expression of NR2B fluorescence intensity (2710.56 ± 194.21),(5035.16 ± 234.41),(3326.23 ± 378.16),(2570.64 ±177.88),the expression of NR2B protein (0.192±0.008),(1.649±0.205),(0.783±0.109),(0.180±0.009) and the expression of NR2B mRNA (0.026±0.002),(0.351±0.034),(0.248± 0.023),(0.024±0.003) of withdrawal 2h,6h,12h,ld groups were significantly higher (P＜0.05),and with the extension of the withdrawal time,the expression was gradually increased.The expression of withdrawal 6h group was the highest,then began to decline,and returned to baseline levels at withdrawal 3 d(P＞0.05).Withdrawal scores were positively correlated with the expression of NR2B protein(r=0.719,P＜0.01),the expression of NR2B protein was positively correlated with the expression of NR2B mRNA(r=0.937,P＜0.01),and the expression of NR2B mRNA was positively correlated with withdrawal scores(r=0.673,P＜0.01).Conclusion The expression of NR2B was up-regulated in the striatum of chronic alcohol exposured rats at different withdrawl time.NR2B protein and NR2B mRNA expression is positively correlated with the withdrawal scores,suggesting that regulating the expression of NR2B may be a new target for the treatment of ethanol withdrawal symptoms.

Objective To explore the characteristic of memory impairment and its relationship with Nmethyl-D-aspartate receptor 2B (NR2B) expression in alcohol dependence patients,in order to provide an unprecedented view of alcohol-associated memory impairment therapy.Methods Participants (n=67) included 35 alcohol dependence patients and 32 matched healthy controls.Wechsler memory scale (WMS) was used to access the memory.The expression levels of NR2B were detected with quantitative reverse transcription-polymerase chain reaction (qRT-PCR).Results Compared with the memory quotient(MQ) of controls(69.45±8.96),that of alcohol dependence patients(50.59±8.64) significantly decreased (t=-6.08,P＜0.01).Compared with the NR2B expression level of controls (1.00-0.00),that of alcohol dependence patients (3.52 ± 1.17) significantly increased (t =9.67,P＜0.01).MQ was negatively correlated with the levels of NR2B expression (r=-0.44,P＜0.05).Conclusion Alcohol dependence patients suffer memory impairment detected by WMS,and modulate NR2B expression may improve the memory.

Objective To learn the recent development and regional distribution of clinics in China.Methods Based on statistics and a nationwide survey of clinics in the country,a simple linear regression was made to find factors determining clinics regional distribution.Results Clinics in China were found to have grown sizably from 134 000 in 2008 to 155 000 in 2014;medical technology workers to 2.31 per clinic in 2014;and the total revenue of these clinics accounted for only 0.724% of all medical institutions,while there are more clinics in the east than the west regions in China.Conclusions The role of clinics in attracting high quality medical resources to primary care should be further enhanced for development of the hierarchical medical system in China.

ObjectiveTo investigate the effects of nicotine exposure and ethanol-preferring behavior on mRNA expression of some nAChR subunits in the rat ventral tegmental area(VTA) and to explore possible mechanisms of dependence on tobacco and alcohol.Methods39 male Wistar rats,35-day-old,were randomly divided into an experimental group (group N,n=20) and a control group (group C,n=19).Rats in group N were treated with nicotine ( 1.0 mg · kg -1 · d -1 ) by subcutaneous injection while in group C with saline both for 10 days,after which 6 rats (respectively group NE,n =6,group CE,n =6 )were drawn randomly from each group and killed by cutting off the head.mRNA was extracted from the VTA tissue,and the expression of nAChR subunits,including α4,α5,α7 and β2,were examined by Real Time-PCR.Other rats both in groups N and C ( respectively group NA,n=14,group CA,n=13) were induced for 69 days to establish two-bottle free choice alcohol-preferring behavior model by Samson sucrose fading program from 60-day-old on.The same indexes mentioned above were detected by the same methods in the VTA tissue.Results① The factor analysis showed that both the two factors,nicotine and alcohol-preferring behavior,showed regulating effects on the expression of nAChR subunits α4 and α5 ( respectively F was 6.13,5.407,5.186,7.132,P ＜ 0.05 ),and the factor,alcohol-preferring behavior,on subunit β2 (F =5.896,P＜0.05) ; the two factors exhibited strong interaction on the expression of subunit α7 (F=13.894,P＜0.001 ),and some interaction on subunits α5 and β2 (respectively F was 6.149,4.222,P＜0.05 ).② The mRNA expression of nAChR subunits α4,α5,α7,and β2 were significantly up-regulated by different degrees in group NA compared to group CA ( respectively Fwas 7.941,13.517,17.438,9.272,respectively P ＜ 0.05,P ＜ 0.05,P ＜ 0.01,P ＜ 0.01 ),the expression level of subunits α4,α5,α7 and β2 were significantly higher in different degrees in group NA than in group NE( respectively F was 5.293,8.500,6.149,4.837,P ＜0.05) ; while subunit α7 was significantly down-regulated in group CA compared to group CE (F =12.750,P ＜0.01 ).ConclusionNicotine and ethanol co-affect on the nAChR subtype comprised of subunits α4,α5,α7 and β2.