Objective To investigate the clinical and skeletal muscular pathological features of chronic progressive external ophthalmoplegia(CPEO).Methods The clinical and skeletal muscular pathological data of 6 patients with CPEO were analyzed retrospectively.Results All of the 6 patients onset were 4 to 18 years old.The first symptom was blepharoptosis.The clinical mainly manifestations were limited activity of eyeball,accompanied with limbs muscle fatigue,weakness and level elevatation of serum creatine kinase(CK).5 cases had myogenic changes in electromyography(EMG).The skeletal muscular pathological examination showed that the ragged red fibers(RRF)were scattered among the muscle fibers,and the deficient or absent of COX activity in many fibers.A few degenerating and necrotic fibers were observed in 4 cases.Lipid-drops were increased by oil red "O" stain in 3 cases.Electromicroscope showed that abnormal mitochondria increased in number and aggregated under sarcolemma or in cytoplasm.Crystalloid inclusion body could be observed.Conclusions The clinical mainly features of CPEO are external ophthalmoplegia and accompanied with limbs weakness.RRF and COX activity deficiency or absence according to skeletal muscle pathology can be suggest and support the diagnosis of CPEO.Gene sequencing based on skeletal muscle biopsy is necessary to make the final diagnosis of CPEO.

BACKGROUND:Presently used pulmonary vein antrum location methods mainly performed by three-dimensional electroanatomy combined with X-ray image or CT image fusion.These methods conducted vein antrum location and ablation by anatomy instructions.It is still poorly understood whether the ablation hit the key part of atrial fibrillation.OBJECTIVE:To explore the feasibility of catheter ablation guided by three-dimensional electroanatomic mapping system in conjunct with pulmonary vein antrum potential in patients with atrial fibrillation.DESIGN,TIME AND SETTING:The verification clinical study was performed at the Department of Cardiology of Jinan Fourth People's Hospital and Hebei People's Hospital from March 2007 to June 2009.PARTICIPANTS:Fifty-one patients with drugs refractory,paroxysmal atrial fibrillation were included.METHODS:All patients underwent circumferential pulmonary vein antrum ablation guided by three-dimensional electroanatomic mapping system (CARTO) in conjunct with pulmonary vein antrum potential with the endpoint of electrical isolation.Relevant parameters and ablation success rate were observed.MAIN OUTCOME MEASURES:Procedure-related parameters,such as procedure duration,fluoroscopy duration,cumulative success rate and complication were observed.RESULTS:Pulmonary veins were isolated in all 51 patients.The mean procedure duration,fluoroscopy time and radiofrequency ablation duration are respectively (207±36.7) minutes,(38.2±14.3) minutes,(56.4±15.7) minutes.After (17.5±3.8)-months follow-up,forty (78.4%) patients did not have recurrence of atrial fibrillation,atrial flutter or atrial tachycardia.No severe procedure-related complication had happened.CONCLUSION:Pulmonary vein antrum potential can be used as a landmark to define pulmonary vein antrum,that combined with CARTO system to guide pulmonary vein antrum ablation is effective,safety and feasible for catheter ablation of atrial fibrillation.

Objective To investigate the effect of ketamine on hippocampal uncoupling protein 2 (UCP 2) expression after forebrain ischemia-reperfusion (I/R) in rats and the mechanism of protective effect of ketamine on brain. Method Forty-five male Wistar rats weighing 250～300 g were randomly divided into 3 groups, with 15 animals in each group. Forebrain I/R was estabhshed by occlusion of bilaleral carotid artery combined with hy-potemion,EFG in a sustained low rate of 7 Hz, 30～40 μVθ rhythm was the success signs of forebrain I/R. Con-trol group (C) :sham operation was performed; I/R group (Ⅰ): bilateral common carotid arteries were clamped for lOmin combined with hypotension [MAP:(40±5) mmHg] induced by exsanguinations, then saline (1 mg/kg) was injected into the lateral cerebral ventricle using microsyringe; ketamine group (K):ketamine (1 mg/kg) was injected into the lateral cerebral ventricle using microsyringe after I/R. The animals were decapitated, the brain was immediately removed,and the hippocampal tissues were dissociated at 6 h after reperfusion. The cerebral I/R injury was observed with light microscope, the levels of UCP 2 mRNA expression in hippocampus were detected by using semi-quantitative RT-PCR technique (n=7), coronal sections including hippocampal tissue were obtained for detection of UCP 2 protein expression by immuno-histochemistry (IH) method (n=8). The RT-PCRR and IH data were expressed as the mean±SD, the statistical signiticance was determined by one-way ANOVA. Results The UCP 2 mRNA expression was (1.06±0.02) in group Ⅰ and (1.18±0.06)in group K increased significantly compared with that in group C(0.91±0.02) (P<0.05), there were more UCP2 mRNA expression in group K increased than that in group Ⅰ(P<0.05). The expression of UCP 2 protein was (31.56±4.01) in group Ⅰ and (44.61±4.96) in group K, increased significantly compared with that in group C (17.91±5.49) (P<0.05),there were more UCP 2 protein expression in group K than that in group Ⅰ (P<0.05). Conclusions Ketamine can attenuate the cerebral I/R injury in rats, the underlying mechanism may be related to the up-regulartion of the expression of hippocampal UCP 2 mRNA and UCP 2 protein.

BACKGROUND:The mechanical index is an important method for the evaluation of the therapeutic efficiency of drug treatment for osteoporosis animal models. OBJECTIVE: To explore the effects of various drug treatments on osteoporosis through a mechanical performance test about the femoral compression of rats. METHODS: Thirty-six Wistar female rats were randomized into six groups: normal control group, model group, Dan Qiparticles group, alpha-D3 group, premarin group, ipriflavone group, with six rats in each group. Osteoporosis models were made in al groups except for the normal control group, and after modeling, the rats in different groups were treated withDan Qi particles, alpha-D3 group, premarin and ipriflavone, respectively. After 15 weeks, the rats were kiled by abdominal aortic bloodletting to take out the left and right femurs that were placed on a universal testing machine to perform a compressive test at a speed of 5 mm/min. RESULTS AND CONCLUSION:The maximum load, maximum stress, maximum displacement, maximum strain, and elastic modulus were significantly lower in the model group than the other four groups (P < 0.05). There was no difference in different mechanical parameters between alpha-D3 group and model group as wel as between Dan Qi particles group and normal control group (P> 0.05). These findings indicate that osteoporosis leads to the variation of compression mechanical properties of the femur. There are good compression mechanical properties of the femur after treatment with premarin and ipriflavone, andDan Qi particles has the best effect.

Objective To evaluate the effeciency and safety of the implantation of phakic iris-fixated intraocular lens for high myopia.Methods 12 cases(18 eyes)with the mean spherieal equivalent refraction was(-15.12?5.23)diopters of myopia,following up 3~6 months after surgery(averaging 5.1 months)were enrolled.Visual acuity,intraocular pressure,contrast sensitivity,glare sensitivity,corneal endothelium and the stable of intraocular lens and the turbid level of lens were observed.Results A postoperation uncorrected visual acuity of(0.73?0.21)was observed in 18 eyes at 6 months.There was significant difference as compared with preoperation corrected visual acuity of(0.52?0.17)(P

Objective To compare the similarities and differences of the five detection methods used in the detection of fungi in vaginal secretions,and find the most sensitive、the most specific、the fastest、the most cost effective and the simplest method used in the detection of fungi in vaginal secretions.Methods A total of 442 patients were selected from the Department of Gynecology of Shenzhen OCT Hospital from May 2016 to August 2016.The vaginal secretion of 442 specimens was detected by using the methods of fungi culture、saline and KOH suspension method,Gram stain,Wright''s stain and Vaginitis Multi Test Kit.In these five methods,Fungi culture were using as gold standard to evaluate the specificity,sensitivity,negative predictive value,positive predictive value and accuracy of the other four methods.Results Using the fungus culture method to detect 442 cases of vaginal secretion,we found the positive rate of mycotic infection was 34.8%(154/442).Compared with the fungi culture method,the Specificity of saline and KOH suspension method was 97.9%,the sensitivity was 64.9%,the negative predictive value was 83.9%,the positive predictive value was 94.3% and the accuracy was 86.4%;the Specificity of Gram stain was 96.5%,the Sensitivity was 83.1%,the negative predictive value was 91.4%,the positive predictive value was 92.7% and the accuracy was 91.8%;the Specificity of Vaginitis Multi Test Kit was 84.7%,the Sensitivity was 46.8%,the negative predictive value was 74.8%,the positive predictive value was 62.0% and the accuracy was 71.5%;the Specificity of Wright''s stain was 96.9%,the Sensitivity was 78.6%,the negative predictive value was 89.4%,the positive predictive value was 93.1% and the accuracy was 90.5%.Conclusion Gram stain could be the most sensitive and specific method in the four methods,with highest accuracy,and the the fastest,the most cost effective and the simplest method for the detection of fungi in vaginal secretions.The accuracy of detecting fungi in vaginal secretions could be improved by the combination of Gram stain method in clinical work.

Objective To explore the inhibition role of 1 ,25 dihydroxyvitamin D3 on laryngeal cancer Hep‐2 cell proliferation and its influence on mTOR signal pathway .Methods Hep‐2 cells were treated with different concentrations of 1 ,25 dihydroxyvitamin D3 (10-8 ,10-7 ,10-6mol/L) for 24 ,48 ,72 h respectively .The proliferation situation of Hep‐2 cells was detected by the MTT meth‐od and the inhibition rate was calculated .The effect of 1 ,25 dihydroxyvitamin D3 on Hep‐2 cell cycle distribution was analyzed by flow cytometry .The influence of 1 ,25 dihydroxyvitamin D3 on mTOR signaling pathway was detected by Western blot .Results Different concentrations of 1 ,25 dihydroxyvitamin D3 could inhibit the proliferation of Hep‐2 cells ,changed the cell cycle distribu‐tion and increased the proportion of Hep‐2 cells in G0/G1 phase .The expressions of TSC1 and TSC2 protein after 1 ,25 dihydroxyvi‐tamin D3 intervention were increased compared with the control group (P<0 .01) ,while the Rheb protein expression was signifi‐cantly decreased(P<0 .01):mTOR protein and phosphorylation level were significantly decreased compared with the control group (P<0 .01) ,the decrease of mTOR protein phosphorylation was especially obvious (P<0 .01);4EBP‐1 protein expression was in‐creased compared with the control group (P<0 .01) .Conclusion 1 ,25‐dihydroxyvitamin D3 alters the Hep‐2 cell cycle distribution , affects the protein expression of mTOR signaling pathway ,thus inhibits the cell proliferation .

OBJECTIVE:To study the preventive and therapeutic actions of L-arginine on pulmonary hypertension induced by high pulmonary blood flow volume.METHODS:Male SD rats were randomly divided into control group(n=6),shunt group (n=7) and shunt+L-arginine group(n=8).Abdominal aorta-inferior vena cava shunt was performed to make the blood flow from left to right,11 weeks later,mPAP was detected with right cardiac catheter;the structure of pulmonary vessels and expression of PCNA of smooth muscle cells were observed.RESULTS:The mPAP of shunt group was obviously higher than that of control(P

Skillful in the treatment of gouty arthritis (GA) by integrated therapies of Chinese and Western medicine,chief physician Zhang Tang-fa proposes to ‘deal with the exterior with the needles,and attack the interior with the drugs,by integrated application of acupuncture and herbal medicine',in combination with comprehensive intervention of dietetic therapy and health education.In the treatment of GA,he adopts the syndrome differentiation based upon the pathogenic factors,in combination of syndrome differentiation based upon the six meridians,to reinforce and benefit the spleen and kidney,clear away heat and remove dampness as the therapeutic principle.By acupuncture mainly at the acupoints of the Spleen and Liver Meridians,he also proposes to select the acupoints by the theory of Na Zi Fa (earthly branch method) of Zi Wu Liu Zhu (midnight-noon ebb-flow),and to puncture the surrounding area of the involved joints shallowly by multiple needles as the major needling method,simultaneously with the reinforcing and reducing manipulations based upon the respiration.In the treatment,acupuncture and acupoint-injection are often used.In diet,low purine diet is often suggested.In health education,the patients are often instructed to understand the disease correctly,eliminate fears and cooperate with doctor's treatment positively.

Objective To estimate the consistency between the diagnostic criteria for dermatomyositis (DM) and polymyositis (PM) developed by Bohan and Peter criteria (B/P criteria) and ENMC criteria.Methods The clinical,laboratory and pathological data from 86 patients who were initially diagnosed with idiopathic inflammatory myopathy were collected retrospectively.These patients were diagnosed according to B/P criteria and ENMC criteria,and the similarities and differences between these two criteria were compared.The data were analyzed with Mann Whitney U test and Kappa test by SPSS 13.0 software.Results Thirtyseven DM and 49 PM were diagnosed using B/P criteria.Forty-six DM and 14 PM were diagnosed using ENMC criteria,and 1 was diagnosed as eosinophilic myositis,9 were diagnosed as sporadic inclusion body myositis (sIBM),11 cases were diagnosed as limb-girdle muscular dystrophy type 2B,and the diagnosis of 5 patients could not be clarified.Agreement for DM between these two sets of criteria was very good by Kappa test (κ=0.79),but the corresponding between the two tests for PM was poor (κ=0.26).Conclusion Our study has demonstrated that B/P criteria may cause over-diagnosis and misdiagnosing for PM.ENMC criteria involves immunohistochemical pathology,stratified clinical and pathological exclusion criteria.The diagnostic accuracy of ENMC criteria is much improved.