Objective To analyze features of clinical manifestation, laboratory tests, electrophysiology and imagol?ogy of Heidenhain’s variant of Creutzfelt-Jakob disease (CJD). Methods Clinical data, laboratory and electrophysiologi?cal results as well as medical images were collected from 3 patients with Heidenhain variant of CJD. Results Three pa?tients presented with rapid visual impairment at onset and refractory pruritus. Whole gene sequencing indicated that one patient had point mutation at E200K whereas the other two did not the mutation. All the cases had positive 14-3-3 pro?tein in CSF. Patients had three phases sharp waves burst at posterior part of cerebral cortices with slow waves back?ground in EEG, no evoked P100 in visual evoked potential test,‘cortical ribbon sign’at bilateral occipital lobe in DWI sequence of head MRI and hypometabolism of glucose from occipital cortex spreading to extensive cerebral cortices in PET/CT. Conclusion Head MRI and EEG should be conducted in old patients with visual disturbance as the onset symptom, followed by rapid cognitive impairment, ataxia and extrapyramidal symptom to rule out Heidenhain variant of CJD. Refractory pruritus indicates a high likelihood of CJD.

It has been 4 years since Natural Health Products Regulations(NHPRs)was enforced by Health Canada in January of 2004.In the past time,how will it affect the marketed Traditional Chinese Medicines(TCM) in Canadian market? Recently,The two TCM products Carditionic Pill (Fufang Danshen Diwan)and Chaihu Pill from Tasly have been newly certificated by Health Canada recently.Taking them as examples,this article introduces the current status.opportunities and challenges for the regulation of TCM in Canada.and suggests that the domestic TCM corporations push the product registration as soon as possible.

AIM :To investigate the association of primary open-glaucoma (POAG), intraocular pressure (IOP) and systemic blood pressure in a rural population aged 50 years old or above in Shaanxi Province, China.METHODS: In the population-based, cross-sectional study, 1 775 (83.53%) residents, aged 50 years old or above, from 3 counties of Shaanxi Province, China, undertook an interview with a standard questionnaire and a detailed eye examination, including logarithm of the minimum angle of resolution visual acuity, slit-lamp biomicroscopy, applanation tonometry and dilated fundus examination. Two blood pressure reading in the sitting position were taken. Gonioscopy was performed if a narrower peripheral anterior chamber (less than one fourth of the corneal thickness) was indicated. Automated visual field testing was performed by participants assessed to have suspicion of glaucomatous disc damage or if IOP was 22mmHg or higher.RESULTS: IOP significantly correlated with systemic blood pressure, and both IOP and systolic blood pressure increased significantly with increasing age. No association between POAG and hypertension was found. The frequency of POAG increased significantly with lower diastolic perfusion pressure.CONCLUSION: Data in our study are accordance with those reported in other population-based studies, and confirm that lower diastolic perfusion pressure is a significant risk factor for primary open angle glaucoma.

AIM: To assess the prevalence and risk factors for age-related macular degeneration (AMD) in a rural population in Shaanxi Province of China.METHODS: A total of 2 835 (81.00%) people aged 40 years old or more, from Fuping county, Jingbian county and Yang county of Shaanxi Province, China, underwent a comprehensive interview and a relative eye examination. The present of AMD was classified into neovascular AMD (NV) and pure geographic atrophy (GA) by using direct ophthalmoscopy for fundus examination according to International Classification System.RESULTS: The prevalence (95% CI) of AMD was 3.00% (2.42, 3.71) in this population, of which NV accounted for 1.45% (1.05, 1.98) and 1.55% (1.14, 2.10)for GA. The prevalence of AMD increased significantly with increasing age (P ＜0.001). AMD was present in 0.47% of participants aged 40 to 49 years, rising to 11.90% of participants older than 80 years, of which the corresponding data increased from 0.28% to 4.76% for NV and from 0.19% to 7.14% for GA. No significant difference was found in the prevalence of NA and GA between genders in this population. With multiple logistic analyses, apart from advancing age, only smoking was found to have a strong association with any type of AMD.CONCLUSION: The prevalence of AMD in the rural population of Shaanxi Province of China is lower than that reported from other population-based studies in different provinces of China, less than that reported in whites, more than that reported in blacks. Except increasing age, smoking is also a significant well-known risk factor for AMD.

· AIM: To assess the prevalence and related risk factors for primary angle-closure glaucoma in a rural population for 40 years of age or older in Shaanxi Province.· METHODS: By using a stratified, cluster-based, random sampling technique, 8 500 persons of all ages were selected randomly, including 3 500 those aged 40 years or more, from the North, the South and the Middle of Shaanxi Province in Western China from July to December in 2003. All participants had an interview with a standard questionnaire and those questions related to glaucoma of previous diagnosis and treatment, family history and outbreak history. Then a detailed and relative eye examination was performed, including logarithm of the minimum angle of resolution visual acuity, external eye examination with slit-lamp biomicroscopy and fundus examination. The intraocular pressure was measured with Perkins applanation tonometry to those persons aged 50 years old or more and those with suspected increased IOP. A further examination was performed to those persons with suspicious glaucoma, including repeated tonometric examination, gonioscopy, dark room test, automated visual field testing, et al.·RESULTS: 6 815 of the eligible 8 500 persons of all ages were interviewed and examined from July to December in 2003, a response rate of 80.18%, including 2835 of the eligible 3 500 persons of 40 years old or more with a response rate of 81.00%. According to Van Herick method, the percentage of shallow peripheral anterior chamber was 13.6%, of which 10.4% was in grade 2, 3.0% in grade 1, and 0.2% in grade 0. In this rural population for 40 years of age or older 31 participants were found to have primary angle-closure glaucoma, with the prevalence of 1.09%. With multiple logistic analyses, the prevalence increased significantly with age (P=0.008), whereas no significant difference (Pgender=0.180, Peducation=0.199) was found in the rate with gender and education, although women and illiteracy seemed to be at increased risk of the disease (OR: 1.77, 95%CI,0.77-4.10; OR: 1.71, 95%CT, 0.76-3.87). Of 31 participants, 21 persons (67.74%) had not been previously diagnosed and treated. Of 10 participants previously diagnosed, 6 (60%) had been received peripheral iridectomy; nevertheless, no any other treatments were performed. 48.39% participants suffered from visual impairment in various degrees, of which the percentage of blindness in either eye accounted for 29.03%. Of those with primary angle-closure glaucoma, 22 persons (70.97%) were classified as having chronic from of the disease.· CONCLUSION: In this rural population in Shaanxi Province of China, the rate of occludable angles is 13.6%, more common than that reported previously in other Chinese populations. The prevalence of primary angle-closure glaucoma is close to that from other Asian populations, increasing with age. A majority of glaucoma was undiagnosed and untreated previously.

· AIM: To assess the prevalence and related risk factors of primary open angle glaucoma (POAG) in a rural population in Shaanxi Province.· METHODS: By using a stratified, duster-based, random sampling technique, 8 500 persons of all ages were selected randomly, from the North, the South and the Middle of Shaanxi Province from July to December in 2003. All participants had an interview with a standard questionnaire and those questions related to glaucoma of previous diagnosis and treatment, family history and outbreak history. Then a detailed and relative eye examination was performed, including logarithm of the minimum angle of resolution visual acuity, external eye examination with slit-lamp biomicroscopy and fundus examination. The intraocular pressure was measured with Perkins applanation tonometry to those persons aged 50years old or more and those with suspected increased IOP. A further examination was performed to those persons with suspicious glaucoma, including repeated tonometric examination, gonioscopy, dark room test, automated visual field testing, et al.· RESULTS: 6 815 of the eligible 8 500 persons of all ages were interviewed and examined from July to December in 2003, a response rate of 80.18%. 9 participants were found to have POAG, with the prevalence of 0.13%, age ranging from 38 to 80 years (mean year:62.0). In those aged 30 years old or more, the prevalence of the disease was 0.23%, 0.28% and 0.39% for those more than 40 and 50 years old, respectively. The rate of suspicious POAG was 0.18% (12 cases) with age ranging from 35 to 77 years (mean year: 54.7). With multiple logistic analyses, the prevalence increased significantly with age (P=0.023). Other than increasing age, myopia was also a strong risk factor for POAG. Of 9participants with POAG, only 2 cases (22.22%) had been previously diagnosed. No one with POAG was received any treatment previously. 66.67% (6 cases) participants with POAG suffered from visual impairment in various degrees secondary to POAG. The percentage of blindness in either eye was 33.33%.· CONCLUSION: The prevalence of POAG is close to that from other Chinese populations, increasing with age. A majority of glaucoma was undiagnosed and untreated previously.

Objective To compare the efficacy difference of Green Forsythiae Fructus and Ripe Forsythiae Fructusby using Lianqiao powder and Yinqiao powder in the classic formula; To provide experimental evidence for the guidance of one for dual-use of the Forsythiae Fructus. Methods The guinea pig sore model was made with Staphylococcus aureus. 40 guinea pigs were randomly divided into blank group, model group, Lianqiao powder Green Forsythiae Fructus group and Lianqiao powder Ripe Forsythiae Fructus group. The blank group and the model group were fed with normal saline, while Lianqiao powder Green Forsythiae Fructus group and Lianqiao powder Ripe Forsythiae Fructus group were treated with 1.2 g raw medicine/kg liquid Lianqiao powder Green Forsythiae Fructus and Lianqiao powder Ripe Forsythiae Fructus for 7 d. The symptom score, blood and pathological changes of guinea pig soreness were observed. The model of acute lung injury was induced by 10% LPS aerosol inhalation. 40 rats were randomly divided into blank group, model group, Yinqiao powder Green Forsythiae Fructus group and Yinqiao powder Ripe Forsythiae Fructus group. The blank group and the model group were fed with normal saline, while Yinqiao powder Green Forsythiae Fructus group and Yinqiao powder Ripe Forsythiae Fructus group were treated with 4 g raw medicine/kg liquid Yinqiao powder Green Forsythiae Fructus and Yinqiao powder Ripe Forsythiae Fructus for 10 d. The levels of IL-6, TNF-α and IL-1β in the lung lavage fluid were detected. Results The effect of Lianqiao powder Green Forsythiae Fructus on the wound healing of guinea pig sore wound was faster than that of Lianqiao powder Ripe Forsythiae Fructus, but there was no significant difference between Lianqiao powder Green Forsythiae Fructus group and Lianqiao powder Ripe Forsythiae Fructus group in inhibiting the secretion and pathological changes of guinea pig sore wound. The levels of IL-6, TNF-α and IL-1β in Yinqiao powder Green Forsythiae Fructus group was lower than that in Yinqiao powder Green Forsythiae Fructus group, without statistical significance. Conclusion It is verified that there is efficacy differences between Green Forsythiae Fructus and Ripe Forsythiae Fructus in the different Chinese herbal compound.

Objective To detect the correlation of immunophenotyping of DLBCL with Choi's and Han' s classification to the prognos is. Methods Ninty-nine cases of DLBCL were studied using immunohistochemistry EnVision method for bcl-6, CD10, FOXP1, GCET1, MUM1 in Shanxi cancer hospital. The follow-up was included. All cases they were classified according to Hans' s and Choi' s algorithm. Fluorescence in situ hybridization (FISH) for bcl-6 gene expression (located on chromosome 3q27) was performed on paraffin-embedded tissues of 35 cases. Results In Hans classification, 21 cases were GCB and 78 were nonGCB subtype. In Choi's classification, 23 cases were GCB and 76 cases were nonGCB subtype. According to the both classification, the prognosis in GCB group was much better than that in nonGCB's (P = 0.000). The expression of FOXP1 was inverse proportion to the prognosis (P =0.011), on the contrary GCET1 expression was in proportion to the prognosis (P =0.027). Among all of 35 DLBCL cases, bcl-6 rearrangement was more frequently encountered in the nonGCB type, bcl-6 gene rearrangement was no correlated to bcl-6 protein expression. Conclusion On the basis of classification, GCB group had a better clinical outcome than that of nonGCB group. FOXP1, GCET1, bcl-6 protein expression is associated with different outcome in DLBCL. Both of Choi's and Hans's algorithm play an important role in the immunophenotyping and prognosis.

Objective To discuss the unique biological,histological and clinical features of pediatric renal cell carcinoma (RCC).Methods A retrospective review and biological analysis of all RCC cases presenting to our hospital from January 1973 to March 2012 was undertaken.Results Twenty-nine RCC pediatric patients (16 boys,13 girls) with mean age of 9.6 (range 2.5-16.0) years were identified.The presentations included hematuria in 17 (58.6％) cases with 3 who developed hematuria after trauma,abdominal mass with hematuria in 3 (10.3％),abdominal mass in 3,abdominal pain in 2,abdominal pain with hematuria in 1,and incidentally finding in 3.The diameter of tumor was from 2.5 cm to 25.0 cm,mean 6.8 cm.According to TNM stage grouping system,16 cases were stage Ⅰ,10 stage Ⅲ,and 3 stage Ⅳ.Xp1 1.2 translocation RCC was identified in 21 patients,clear cell RCC 6,papillary RCC 2.Of the 29 cases,3 patients with the tumor less than 7-cm had nephron-sparing surgery.A 15-cm tumor was incompletely removed in 1 patient and another patient with a 25 cm× 18 cm×15 cm tumor had gross residual.Nephrectomy was performed for the affected kidney in the remaining 24 patients.Twenty-one patients (Xp1 1.2 translocation RCC 13 patients,clear cell RCC 6,papillary RCC only 2) were followed up from 1.5 to 34.0 years,18 were living well (T1N0M0 in 11 cases,T1N1M0 in 2,T2N1M0 in 3,T3N1M0 in 1 and T4N1M1 in 1) and 3 died of recurrence.Conclusions Although RCC is rare in children,pediatric RCC behaves in a distinct fashion compared with adult forms of RCC.Hematuria is the main symptom in pediatric RCC.Xp11.2 translocation RCC is the predominant form,associated with an advanced stage at diagnosis.Nephrectomy is the common treatment for RCC and nephron sparing surgery could be a reasonable option for patients with tumor smaller than 7 cm.For localized RCC (T1-2 N0-1 M0),simple kidney removal surgery is sufficient for treatment without lymph node dissection and postoperative adjuvant treatment.

BACKGROUND:Femoral offset reconstruction is significant for recovering strength of abductor and the balance of soft tissue tension surrounding hip joint, maintaining joint stabilization, restoring joint function, reducing limping after replacement, decreasing prosthetic abrasion, and the incidence of joint prosthesis dislocation.
OBJECTIVE:To discuss effect of femoral offset reconstruction on hip joint function in total hip arthroplasty.
METHODS:We comparatively analyzed 20 patients (20 hips) undergoing the modular prosthesis (S-ROM) total hip arthroplasty and 19 patients (20 hips) undergoing the one modular prosthesis (Corail) total hip arthroplasty at the same time. According to Harris hip score and radiography results, hip joint function and femoral offset reconstruction rate were comparatively studied in both groups.
RESULTS AND CONCLUSION:No infection, fracture, dislocation, deep venous thrombosis or neurovascular injury occurred in either group. Clinical fol ow-up results:In the modular prosthesis and one modular prosthesis groups, there was no significant difference in preoperative Harris hip score between the femoral offset reconstruction and non-reconstruction groups (P>0.05). At 12 months and the latest fol ow-up, the Harris hip score was higher in the patients with femoral offset reconstruction than those with femoral offset non-reconstruction (P<0.05). The range of abduction of hip joint was larger in patients with femoral offset reconstruction than those with femoral offset non-reconstruction (P<0.05). Radiographic fol ow-up results:significant differences in the rate of femoral offset reconstruction were detected between the modular prosthesis and one modular prosthesis groups (χ2=3.956, P<0.05). 39 (98%) femoral stems were in neutral position and one (2.5%) was in mild valgus. There was no significant difference in the abduction angle and the anteversion angle between patients with and without femoral offset reconstruction (P>0.05). These results indicated that functional recovery and the range of abduction were better in patients with femoral offset reconstruction than those without femoral offset reconstruction. Modular prosthesis has a high rate of femoral offset reconstruction.