Objective To analyze the relationship between hyperhomocystinemia (HHcy) and occurrence of Alzheimer disease (AD) .Methods A total of 100 cases of elderly patients with dementia were collected ,from April 2010 to May 2013 ,and divided in‐to AD group and vascular dementia (VD) group according to patients′condition .Other 50 cases of healthy elderly individuals were collected in the control group .Levels of homocysteine (Hcy) were detected ,and the relationship between level of Hcy and occur‐rence of AD was analysed .Results Levels of Hcy in the AD group and VD group were higher than that in the control group ,and were decreased after treatment ,there were statistically significant differences(P<0 .05) .After treatment ,the scores of mini‐mental state examination(MMSE) in the AD group and VD group both were increased ,and the score of activity of daily living scale(ADL) was decreased in the AD group ,there were statistically significant differences (P<0 .05) .The level of Hcy in mild AD patients was lower than that in severe AD patients ,the difference was statistically significant (P<0 .05) .The AD odds ratio(OR) was 4 .7 ,and 95% confidence interval(CI) was 1 .76 -7 .09 .The level of Hcy in patients with AD was significantly negatively correlated with score of MMSE ,the coefficient value(r) was -0 .32 ,-0 .40 and -0 .27 in mild ,moderate and severe AD(P<0 .05) .Conclusion HHcy is an independent risk factor for the onset of AD ,so attention should be paid on high Hcy level ,in order to prevent AD .

Objective To explore rapamycin's inhibitory effect on proliferation of H_(22) hepatic cancer in mice. Methods In vitro study: H_(22) hepatic cancer cell lines were cultured with rapamycin, CsA, FK506, and proliferation was determined through MTT. The influences of different agents on the H_(22) hepatic cancer cell cycle were observed by flow cytometry. The vascular endothelial growth factor (VEGF) concentration of the supernatant fluid of the cultured H_(22) hepatic cancer cell was detected by ELISA. In vivo study: C57BL/6 to Balb/c mice allogenic skin transplant was established, and the H_(22) hepatic cancer cell was implanted under skin. Rapamycin, CsA, FK506 and 5-FU were fed to the mice, respectively. The effect of different immunosuppressors on the survival of skin graft was observed while the proliferation of the transplant tumor was investigated. VEGF concentration of treated mice serum was examined by ELISA. The microvessel density of the transplanted tumor was observed through immunohistochemistry staining of CD34. Results The proliferation of the H_(22) hepatic cancer cells was inhibited by rapamycin at the concentration different dose of rapamycin, the VEGF concentration of the supernatant fluid decreased significantly (P<0.05). The number of S phase cells decreased significantly compared to that of other agents (P<0.05). When rapamycin, the lengthened survival time of the skin grafts was similar to that in CsA and FK506 groups. But the tumor volume was smaller than that in CsA and FK506 groups (P<0.05). Compared to that in the control group, the VEGF concentration of mice serum decreased in rapamycin group (P<0.05), and the microvessel density of the transplant tumor was reduced greatly (P<0.05). Conclusion Rapamycin, as an immunosuppressor, significantly resists immunologic rejection and inhibits the proliferation of H_(22) hepatic cancer, thus having its advantage in treating malignant hepatic cancer with liver transplantation.

Objective To analyze the features of pelvic arteriography in postpartum hemorrhage.Methods The pelvic arteriographic results of postdelivery hemorrhage caused by differeut cause in 10 patients whom were treated with artery embolization were analysed and compared with the clinical data.Results The arteriographic features included irrgeular nodose or diffuse outflow of contrast medium in bilateral upper branches of uterine artery in 5 cases with atonic uterus streaky or cloudy contrast medium in the site of uterine incision in 2 cases after caesarean.In two cases with incomplete laceration in the lower portion of soft puerperant tract,there was distinct outflow of contrast medium in one side or bilateral down branches of uterine artery but its bilateral upper branches was displayed clearly.On angiography in one case with uterine vascular malformation displayed one of upper uterine branch was enlarged and the constrast medium flowed into utrine cavity directly.Conclusion Pelvic arteriography in postpartum hemorrhage with different causes has its special findings.Arteriography in combination with the clinical data can afford more direct and accurate informations for analysing the causes of postpartum hemorrhage causes.

Objective To analyze CT characteristics of metastatic liver leiomyosarcoma(MLL),and to improve the diagnostic accuracy of MLL.Methods CT manifestations and clinical characteristics of 5 patients with pathological-proved MLL were retrospectively analyzed.Plain and contrast-enhanced triphase(including arterial,portal phase in all cases and delayed phase in a part of cases) scans were performed.Results On plain scan,all lesions were hypo-dense."Bull-eye-sign" was found in two cases on contrast-enhanced scan,which is the typical metastatic feature.During arterial phase,the smaller lesions showed marked peripheral enhancement and central necrosis.The larger MLL presented as solid-cystic lesions,the parenchyma of tumor was rich in blood supply.Some cases presented mild hypo-dense or iso-dense comparing with the parenchyma of the liver on delayed phase.One case was misdiagnosed as hepatic hemangioma or focal nodular hyperplasia(FNH).Metastases were found out of the liver.Tumor thrombus of portal vein was not found in all of the cases.Conclusion MLL should be considered in the patients with history of extra-hepatic leiomyosarcoma,no marker expressions,no history of hepatitis,no tumor thrombus of portal vein and the special CT findings.

Objective To report one case with congenital ichthyosiform eruption, neurosensory deafness and vascularizing keratitis. Methods The overall clinical and laboratory examinations were conducted to confirm the diagnosis of keratitis, ichthyosis and deafness (KID) syndrome. Results The case presented with the typical hypotrichosis features of the eye lashes and eyebrows, alopecia of the scalp, and ophtalmological lesions. The keratotic plaques over the face, nose, ears, and the extremities were characterstic, and the skin of the trunk was leather-like, dry and hyperkeratotic. Dysplasia of cerebellum, and cystic enlargement of the fourth ventricle of cerebrum, and Dandy Walker syndrome were observed on MRI scanning. Treatment with oral acitretin for 3 weeks cleared the hyperkeratotic ichthyotic lesions on her posterior scalp and also improved other lesions on the extremities and the trunk. Conclusion Acitretin seems to be promising in the treatment of keratotic skin lesions in KID syndrome.

To investigate the N-glycosylation characteristics of recombinant human erythropoietin (rhEPO) produced by an industrial Chinese hamster ovary (CHO) cell line that is currently used in a large scale manufacturing process, we cultured this cell strain in static mode. The produced rhEPO in the culture supernatant was analyzed using isoelectric focusing (IEF) and Ricinus communis agglutinin-I (RCA-I) lectin precipitation. The lactate dehydrogenase (LDH) and sialidase activity in the serum-free supernatant were assayed as well. The analyses revealed that this cell strain could produce rhEPO with high sialic acid content, but during prolonged culture, cell viability decreased with time whilst the activity of sialidase present in the supernatant increased. The loss in rhEPO quality was due to a decrease in terminal sialic acid on the N-glycans, caused by sialidase degradation. The methods and findings in this paper serve as basis for further investigation of industrial production process.
Animals ; CHO Cells ; metabolism ; Cell Culture Techniques ; methods ; Cricetinae ; Cricetulus ; Erythropoietin ; biosynthesis ; genetics ; metabolism ; Genetic Engineering ; Humans ; N-Acetylneuraminic Acid ; metabolism ; Neuraminidase ; metabolism ; Proteolysis ; Recombinant Proteins ; biosynthesis ; genetics ; metabolism

Objective The relationship between toll like receptor 4 (TLR4) the single nucleotide polymor-phisms of gene (SNP) and ischemic stroke reperfusion injury was evaluated by meta-analysis ,which was de-signed to provide evidence-based medicine for the prevention of ischemic stroke reperfusion injury . Methods In Medline ,PubMed ,EMBASE ,Cochrane ,CBM ,Chinese Journal Net ,academic conference materials and dissertations ,we searched for comprehensive information on the relationship between TLR4 gene SNP (rs10759932 ,rs11536891 ,rs11536879) in ischemic stroke Cohort study and case-control literature to determine whether the gene SNP (rs10759932 ,rs11536891 ,rs11536879) was associated with ischemic stroke reperfusion injury by genotype comparison .The heterogeneity test was performed by Stata11 .0 .The heterogeneity test was used to calculate the OR value .The heterogeneity between different studies was analyzed quantitatively . The fixed effect model was used and the percentage I2 was calculated .Results Meta analysis showed that 1943 cases of ischemia-reperfusion injury and 5043 cases of control group were analyzed ,TLR4 gene SNP (rs10759932 ,rs11536891 ,rs11536879) was associated with the risk of ischemic stroke reperfusion injury ,the dominant fixed effect models were (OR=1 .653 ,95％ CI:1 .416 -1 .930 ;OR=1 .653 ,95％ CI:1 .416 -1 .930 ;OR=1 .653 ,95％ CI:1 .416-1 .930 ;);a co-dominant fixed effect model (OR=1 .525 ,95％ CI:1 .350 -1 .723 ;OR= 1 .653 ,95％ CI:1 .416 -1 .930 ;OR= 1 .653 ,95％ CI:1 .416 -1 .930) .Conclusion TLR4 gene SNP (rs10759932 ,rs11536891 ,rs11536879) was associated with the occurrence of ischemic stroke reperfusion inju-ry by Meta-analysis .

Objective: To evaluate the feasibility and strategy of the lesser omentum approach for laparoscopic pancreatic enucleation. Methods: Between June 2011 and October 2013, 6 laparoscopic pancreatic enucleations were performed by lesser omentum approach.The average age was 42 years, including 1 male and 5 female.The preoperation diagnosis of 6 cases were pancreatic islet cell tumors determined by abdominal CT/MRI, ultrasound and digital subtraction angiography.The tumors of 3 cases located in pancreatic neck, 2 tumors located in neck and body of pancreas, and 1 tumor located in pancreatic body.Their biggest tumor diameter were 0.8-2.5 cm. Results: Among the 6 cases, all laparoscopic pancreatic enucleations were successfully performed.None of the patients were converted to open operation.Eestimated blood loss was (26.7±18.6)ml, operating time was (82.5±19.4)minutes, and postoperative length of stay was (5.17±1.17)days.Additionally, postoperative complication included grade A pancreatic fistula in 1 case.After 36-64 months followed-up, there was no tumor recurrence and clinical symptom disappeared. Conclusion For the islet cell tumors located in pancreatic neck and body, the lesser omentumapproach may contribute to good surgical view and operative space, which can make pancreatectomy safer and easier for clinical application.

Objective To analyze the clinical presentation , the mutation of the pathogenic genes and imaging features in a Chinese Han early-onset Alzheimer's disease pedigree.Methods A pedigree of Alzheimer's disease was collected.The DNA sequence of presenilin 1 (PSEN1), presenilin 2, micro-tubule associated protein tau ,β-amyloid precursor protein gene was analyzed , the clinical presentation , results of accessory examination , neuropsychological evaluation of the proband were investigated and the point mutations of some members of the family , 50 sporadic Alzheimer's disease patients , 50 normal controls were verified.Results The proband of the family appeared as language impairment , memory loss, personality change, repeated language, visuospatial impairment, mental and behavior disorder.The gene detection showed p.L226R mutation in the condon 226 in the exon 7 of PSEN1 gene of the proband and five other family members (Ⅲ1 ,Ⅲ2 ,Ⅲ4 ,Ⅲ6 ,Ⅲ7 ).The mother of the proband had the suspicious symptoms , and the sister and the brother of the proband had the similiar symptoms with the proband , all of whom died.Fifty sporadic Alzheimer'disease patients and 50 unrelated normal subjects did not have the mutation .The computed tomographic angiography showed that the brain blood vessels were normal and 18 F-fludeoxyglucose positron emission tomography (18F-FDG-PET) showed brain atrophy and hypometabolism in frontotemporal regions, parietal regions, hippocampal areas, however, the MRI, MRA and 18F-FDG-PET of the two mutation carriers (Ⅲ6 ,Ⅲ7 ) were all normal.Conclusion We reported a novel mutation in an early-onset Alzheimer's disease family presented as language impairment in the early stage of the disease , the p.L226R mutation of PSEN1, which may be a pathogenic mutation to cause the family's dementia.

Objective To explore the clinical features,auxiliary examinations,therapies and prognoses of patients with antibodies against contactin-associated protein-like 2 (CASPR2).Methods The clinical data of 11 anti-CASPR2 encephalitis patients who were admited to the People's Hospital of Zhengzhou University from March 2015 to April 2018 were retrospectively analyzed.Results The age of these 11 cases was (35.6± 19.4) years (ranged 20-74 years),and eight cases were females.There were seven cases with limbic encephalitis which included six cases of epilepsy,four cases of memory impairment,two cases of mental and behavioral abnormalities.Four cases had peripheral nerve hyperexcitability.Four cases had neuropathic pain.There were six cases with autonomic dysfunction including five cases of constipation,three cases of tachycardia,two cases of hyperhidrosis,two cases of urinary disorder.Seven cases had sleep disorder.Four cases had weight loss.Two cases showed cerebellar symptoms and two cases had hyponatremia.Magnetic resonance imaging scan of the brain showed abnormal signal in two cases,mainly involved medial temporal lobe and the hippocampus.Six cases underwent 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) examination,and three cases showed abnormalities,including two with temporal hypermetabolism and one with cortical hypermetabolism.Chest enhanced CT and PET-CT showed thymoma in one case.All cases received immunotherapy,and after treatment their symptoms were improved.Long-term follow-up was performed in nine cases,and three cases relapsed.Conclusions The major clinical manifestations of anti-CASPR2 encephalitis were limbic encephalitis,peripheral nerve hyperexcitability,neuropathic pain,autonomic dysfunction,insomnia and so on.Immunotherapy was effective and some patients may have recurrence.