BACKGROUND: Most cases of early-onset familial Alzheimer disease (AD) are associated with presenilin-1 mutation, which mainly occurs in the 5th and 8th exons. Except for the onset age and family history, sporadic AD is basically the same as early-onset familial AD regarding clinical manifestations and pathological characteristics. Is its pathogenesis also related to the mutation of presenilin-1 gene?OBJECTIVE: To probe into the relationship between sporadic AD and presenilin-1 mutation.DESIGN: Case control analysis based on clinical diagnosis.SETTING: Neurology Department of the First Hospital Affiliated to Sun Yat-sen University.PARTICIPANTS: Outpatients who came to the Memory Obstacle Clinic of the First Hospital Affiliated to Sun Yat-sen University between April 1998 and June 2000 but without familial history of AD were selected and divided into 3 groups: [1] AD group: There were 68 cases confirmed as probable having AD according to the clinical diagnostic standard of NINCDS-ADRDA. [2] Vascular dimentia (VaD) group: There were 25 cases confirmed as probable having vascular dimentia according to the clinical diagnostic standard of NINCDS-ADRDA. [3] Normal control group: There were 20 healthy elders (spouses of some patients in the above two groups)without dimentia.METHODS: The conventional phenol extraction method was used to withdraw DNA from peripheral blood, and polymerase chain reaction-single strand conformation polymorphism analysis (PCR-SCCP) was applied to detect the mutation of the 5th and 8th exons in presenilin-1 gene.RESULTS: All the 5th and 8th exons in presenilin-1 gene were proved to be composed of two single strands and a double strand by PCR-SCCP analysis.No abnormal electrophoresis was found, suggesting no that mutation occurred.CONCLUSION: Sporadic AD differs from familial AD in pathogenicity;mutation does not occur or seldom occurs in the 5th and 8th exons in presenilin-1 gene, thereby cannot be considered as an important causive factor for sporadic AD.

The construction plan of information service platform for biomedical industry groups was proposed, including expert intelligence database, special database, advanced information service platform and biomedical achievements transformation platform.The information ( including names, subject fields and research interests of experts) in expert intelligence database can be searched according to the subject fields and research interests of experts.The special database is consisted of database of special literature, genes, proteins, special drugs, achievements, patents and demands.The information service platform can provide literature retrieval service, literature novelty assessment service, data-mining service, information analysis service, decision-making support service, and competitive informa-tion service.The biomedical achievements transformation platform can provide service for transforming achievements and for solving difficulty demand problems.

Objective To explore the value of Ligasure and Ultracision in total laparoscopic hysterectomy (TLH). Methods From January 2002 to December 2006,totally 225 patients received total laparoscopic hysterectomy in our hospital. Among the cases,Ligasure was used in 152 patients,and Ultracision were employed in 72. The clinical data of the patients were reviewed. Results The mean operation time in the Ligasure group was significantly shorter than that in the Ultracision group [(104.9?29.2) min vs. (152.4?46.6) min,t=-9.329,P=0.000]. And the mean blood loss of the Ligasure group was significantly less than that in the other group [(32.9?14.9) ml vs. (126.4?12.1) ml,t=-46.710,P=0.000]. In both the groups,no patient was converted to open surgery or developed complications or surgical injuries. Conclusions Both Ligasure and Ultracision are safe and effective for total laparoscopic hysterectomy. Ligasure is superior in the management of uterine vessels,while the Ultracision is more effective in opening the vesicle and separating the cardinal ligament.

Objective To study the effects of different doses of insulin in diabetic ketoacidosisin children.Methods 44 patients with diabetic ketoacidosis in children who were treated with insulin in our hospital were selected as research object,and they were divided into group A(low dose group)22 cases and group B(high dose group)22 cases, and the blood glucose, blood calcium, serum potassium, acidosis corrected time and the levels of serum IL-6,IL-12,IL-18 and TNF-α and incidence of hypoglycemia of the two groups were compared and studied. Results The blood glucose, blood calcium,serum potassium, acidosis corrected time and the levels of serum IL-6, IL-12, IL-18 and TNF-α of the two groups had no differences, there were no significant difference(all P ＞ 0. 05), but the incidence of hypoglycemia of the group B was lower than that of group A,there was significant difference(P ＜0. 05). Conclusion The effects of low dose of insulin in diabetic ketoacidosis in children was better, blood glucose placidity decreases, and was worthy of further studying and popularization and application.

A large number of starring biomedical industry clusters are emerged in recent years with the develop-ment of biomedical industry. The information access approaches of users in biomedical industry clusters consisting of higher education institutions, scientific research institutions and enterprises, the types of biomedical information they need, the transformation ways of their achievements, and the major barriers of information access were thus in-vestigated in this paper with questionnaires. The different information behaviors were compared between the users of scientific research group and enterprise group. The characteristics of information need of users in biomedical indus-try clusters were summarized, and following suggestions were put forward, namely establishing information service platform, perfecting institution-oriented information service model, and improving information service system for bi-omedical industry clusters.

Objective To evaluate the effect of early-phase insulin secretion and insulin resistance in the pathogenesis of type 2 diabetes, and to analysis the risk factors of glucose tolerance deterioration. Methods Oral glucose tolerance test (OGTT) was performed in subjects over 30 years old coming from 78 families with type 2 diabetes. A total of 118 subjects with normal glucose tolerance (NGT) [fasting plasma glucose (FPG)<6.1 mmol/L and 2h postprandial glucose (2hPG)<7.8 mmol/L] were enrolled. Another OGTT was performed in them to define the glucose tolerance status at the end of the 4-7 years follow-up. AINS30/APG30, the ratio of the increment of insulin to that of plasma glucose at 30 min after the glucose load, was used to assess the early phase insulin secretion. HOMA-IR and HOMA-β were calculated to assess the insulin resistance and β-cell function respectively. Results After 4-7 years follow-up, 66 of 118 subjects still remained NGT, while 52 became either diabetic (n=11)or pre-diabetic (n=41). Using the median of HOMA-IR and AINS30/APG30 as the cutoff points, all subjects were divided into four groups: subjects with good early phase insulin secretion and no insulin resistance, subjects with good early insulin secretion but relative insulin resistance, subjects with impaired early phase insulin secretion but no insulin resistance, subjects with impaired early phase insulin secretion and also relative insulin resistance. The incidences of abnormal glucose tolerance among these four groups were 23.1%, 36.4%, 45.5% and 73.1% respectively. There was a statistical difference between the former three groups and the last one (P<0.05). Log/st/c regression analysis showed that only the early phase insulin secretion was the risk factor of glucose tolerance deterioration, while age, gender, insulin resistance or β-cell function were not. Conclusion Impaired early phase insulin secretion is a major risk factor for the disturbance of glucose metabolism in the population with NGT.

Objective To investigate the value of perfusion CT in the evaluation of neoadjuvant chemotherapy in locally advanced squamous cell carcinoma.Methods Sixty-seven patients with Ib2-IIb squamous cell carcinoma of the cervix underwent CT perfusion imaging before neoadjuvant chemotherapy to measure blood flow (BF),blood volume (BV),peak time (MTT),permeability sur-face (PMB),perfusion time to peak (TTP)and MIP(HU);and underwent routine enhancement CT after the two course of neoadju-vant chemotherapy treatment to measure tumor size,and evaluate the therapeutic effect.Results Among 67 patients,48 patents were effective (2 completely remission and 46 partial remission),and 1 9 patients were ineffective (1 5 stable and 4 progressed),with the overall response rate of 71.6%.The differences of PMB and BV value between effective and ineffective group were statistically significant before neoadjuvant chemotherapy (P <0.001).The BF,MTT,TTP value were no significant difference between effec-tive and ineffective group before neoadjuvant chemotherapy (P >0.05).The BV and PMB value were relatively higher in the patients with effective chemotherapy.Conclusion CT perfusion imaging could measure the BV and PMB value of the tumor before neoadju-vant chemotherapy to provide the basis for treatment selection.

Objective To explore the distribution and drug resistance of extended-spectrum beta-lactamase (ESBLs)producing Klebsiella pneumoniae in elderly and young and middle-aged patients,and provide reference for rational use of antibiotics for clinicians.Methods Specimens of elderly (≥ 60 years old) and young and middle-aged (18-59 years old) patients who with various clinical infection in Shengjing Hospital of China Medical University from January 2016 to December 2016 were collected as the research object.ESBLs-producing Klebsiella pneumoniae was isolated from 125 patients (60 elderly patients and 65 young and middle-aged patients).The preliminary screening and phenotypic confirmatory test of ESBLs were carried according to the method which was recommended by American Clinical and Laboratory Standards Institute.The drug resistance of ESBLs-producing Klebsiella pneumoniae was analysed and the resuh of the two groups were compared.Results The specimens of ESBLs-producing Klebsiella pneumoniae strains of elderly patients were mainly from urine (36.67％),sputum (33.33％) and whole blood (11.67％);the specimens of young and middle-aged patients were also mainly from urine (24.62％),sputum(24.62％) and whole blood (15.38％).There was statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the specimens secretions between the elderly patients and the young and middle-aged patients(P ＜0.05).There was no statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the specimens of urine,sputum,whole blood,bile,pus,drain,cerebrospinal fluid,ascitic fluid and catheter between the elderly patients and the young and middle-aged patients (P ＞ 0.05).ESBLs-producing Klebsiella pneumoniae strains of elderly patients were mainly isolated from department of respiration (20.00％,12/60) and department of urinary surgery (18.33％,11/60);the ESBLs-producing Klebsiella pneumoniae strains of young and middle-aged patients were mainly isolated from department of intensive care (16.92％,11/65) and department of neurosurgery (16.92％,11/65).There was statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the department of respiration and obstetrics and gynecology between elderly patients and young and middle-aged patients(P ＜ 0.05);there was no statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the department of urinary surgery,general surgery,intensive care,neurosurgery,rheumatoid immunology,invasive technology,oncology,digestion,infection,kidney,orthopaedics,rehabilitation,hematology,neurology and other department between elderly patients and young and middle-aged patients(P ＞ 0.05).The drug resistance rates of ESBLs-producing Klebsiella pneumoniae to beta-lactam antibiotic in elderly and young and middle-aged patients were more than 90.00％;the drug resistance rates of ESBLs-producing Klebsiella pneumoniae to carbapenems were nearly 0.00％ in elderly and young and middle-aged patients.There was significant difference in the drug resistance rates of ESBLs-producing Klebsiella pneumoniae to ceftazidime and gentamicin between elderly patients and young and middle-aged patients(P ＜ 0.05);there was no significant difference in the drug resistance rate of ESBLs-producing Klebsiella pneumoniae to another antibiotic between elderly patients and young and middle-aged patients (P ＞ 0.05).Conclusion Both elderly and the young and middle-aged patients can be infected with ESBLs-producing Klebsiella pneumoniae.There was no significant difference in the distribution of ESBLs-producing Klebsiella pneumoniae in most clinical departments (except respiratory and obstetrics and gynecology).The most effective antimicrobial drugs at present for the treatment of ESBLs-producing Klebsiella pneumoniae was carbapenems.There is no significant difference in the drug resistance rates of ESBLs-producing Klebsiella pneumoniae to common antibiotics between elderly patients and young and middle-aged patients.Clinicians should rationally use antibiotics according to the results of susceptibility tests.

Objective To expore CT diagnostic values for hyaline-vascular type of giant lymph node hyperplasia(GLNH).Methods CT findings in 4 patients with hyaline-vascular type of GLNH confirmed by surgery and pathology were respectively analyzed and relevant literatures were reviewed.CT examination included plain and enhanced scan with contrast medium bolus injection.Results Lesions were located 2 at the posterior mediastinum,1 at the restroperitonum and 1 at the neck.The characteristic CT appearances were a large soft tissue mass round or oval in shape with homogenous density,well and regular margin.The masses were all markedly enhanced after contrast,their attenuation were similar to but slightly lower than the larger arteries in the same section.Conclusion GLNH is an uncommon disease and it′s clinical diagnosis is difficult.But CT scanning could showed some features.When CT found a mass with benign characters locating in lymph node regions,especially marked enhancement,Hyaline-vascular type of GLNH should be considered.

Objective To study the expressive changes of RAR-β gene in cervical carcinogenesis and analyze the relation between this differentiated expression and methylation, and discuss the clinical significance of this differentiated expression.Methods RT-PCR method was used to detect the expression of RAR-β in 4 cervical eancer cell lines,38 eases of cevical invasive carcinomatous tissues,30 cases of cevical intraepithelial neoplasia,and 10 cases of normal cervical tissues.Using Western Blot method to detect the expression of RAR-β protein quantificationally, analyze the RAR-β gene expressive difference in protein level.Using the methylation-*specific PCR methods to analyze the RAR-β methylation state in cell lines and tissues.Meanwhile analyze the relationship between the RAR-β gene expression and the clinical pathological parameters.Resuits The expression of RAR-β gene was deleted or deereaseed in cervieal cancer celllines,cevical intraepithelial neoplasia and cevical carcinoma,which was significantly difierent from normal tissues(P＜0.05).The same results was found in the protein expression.The methylation in RAR-β gene first exon was detected in 3 types of cell lines,11 cases of carcinoma,1 case of CIN Ⅰ and 5 cases of CIN Ⅱ～Ⅲ.while the RAR-β gene expression was decreased in those cell lines and tissues.There was significant differenee of RAR-β gene methylation in different pathological grades (P=0.037).There was no statistical significant difference of clinical stages(P≈1.000)and the metastasis of lymph node(P≈1.000).Conclusion The defective expression of RAR-β gene plays an important role in the carcinogenesis of cervical cancer.The abnormal methylation of promoter region was the main cause of defective expression of RAR-β gene.