Dopa-responsive dystonia(DRD) is a clinical syndrome characterized by childhood dystonia and dramatic and sustained response to low-dose levodopa.The deficiency of any link in dopamine synthesis pathway can lead to DRD that is caused by TH gene mutation and is autosomal recessive, which results in the reduction of tyrosine hydroxylase(TH) synthesis and extensive deficiency of dopamine and catecholamine.However, DRD presents atypical clinical manifestations.Mild patients mainly present with dystonia.Some of them might progressively develop into spastic paraplegia and some may have parkinsonian features.Most of them display good response to levodopa.Severe patients present with progressively complex infantile encephalopathy, and badly response to levodopa and remnant intellectual development problems.Most of them manifest with declining homovanillic acid(HVA) in cerebrospinal fluid.However, due to the noncharacteristic clinical course and nonspecific laboratory tests of TH DRD, gene detection still is the only reliable criterion of diagnosis so far.Low-dose levodopa is effective to most mild patients and can improve symptoms to severe patients to some extent.

Objective To evaluate the clinical effect of acupuncture in the treatment of depression after stroke. Methods 90 patients with cerebral apoplexy were randomly divided into 2 groups according to the random number table, with 45 cases in each group. Patients in both groups were given routine western medicine treatment, and guided to carry out suitable limb function rehabilitation training. In addition, the control group was given traditional acupuncture treatment, while the treatment group was given the brain acupuncture treatment with tiaodu in addition to the traditional acupuncture treatment. Hamilton depression scale (HAMD) was used to assess the degree of depression, Chinese stroke scale (CSS) was used to evaluate the degree of neurological deficit, and barthel index (BI) was used to evaluate the activity of daily living (ADL). Results After treatment, the treatment group has a lower CSS score than that of the control group (11.38 ± 3.94 vs. 15.16 ± 4.52, t=4.229), and a lower HAMD score than that of the control group (6.25 ± 3.76 vs. 9.32 ± 5.06, t=3.267). Meanwhile, the treatment group has a higher BI score than that of the control group (69.22 ± 7.05 vs. 55.67 ± 6.21; t=9.675, P<0.01). Furthermore, the treatment group has statistically significant higher cure rate than that of the control group (62.2% vs. 33.3%;χ2=6.413, P=0.011). Conclusions Tiaodu brain acupuncture treatment of depression after stroke has obvious clinical curative effect, and is superior to other traditional acupuncture method.

Objective The aim of this study is to evaluate the effects of drug,electric cardiovertion,radiofrepuency ablation and implantable anti-atrial-fibrillation pacemaker on patients with persistent idiopathic atrial fibrillation.Methods 58 patients with persistent idiopathic atrial fibrillation were treated with drug or electric cardjovertion,radiofrequence ablation and anti-atrial-fibrillation pacemaker.Results There were 30 patients successfully converted to sinus rhythm by drug.The mean conversion time of drug was 8?5 days.22 patients were converted by electric cardioversion.10% of cases(6 of 58)failed to convert by both methods.In follow-up period,12 cases of patients were healed,19 cases got significant improvement,14 cases got moderate improvement,8 cases had no improvement.The total efficiency rate was 76%.18 cases in successful cardioversion patients were healed,5 cases got significant improvement,5 cases got moderate improvement,4 cases had no improvement.The total efficiency rate was 75%(14 of 18).2 cases got improvement by anti-atrial-fibrillation pacemaker.Conclusion Combined treatment of drug,electric cardioversion,radiofreqency ablation and anti-atrial-fibrillation pacemaker can imrove cure rate of persistent idiopathic atrial fibrillation.

For the treatment of primary dysmenorrhea, professor ZHAO Jiping focuses on meridian diagnosis and inspection, and uses pressing methods to locate the response points along the meridian, including acupoints and aishi points. During the stage of attack, it is essential to press along the spleen meridian, mainly Sanyinjiao (SP 6), Diji (SP 8) and Yinlingquan (SP 9); during the stage of remission, it is essential to press along the bladder meridian and stomach meridian, mainly Ganshu (BL 18), Pishu (BL 20), Weishu (BL 21), Shenshu (BL 23) and Zusanli (ST 36). The differences between deficiency syndrome and excess syndrome lead to the different feelings of doctors and patients. Combined with the results of meridian diagnosis and inspection, the aim of treatment can be achieved by different acupuncture methods. Professor ZHAO pays attention to the treatment of accompanied symptoms and timing of treatment, since the relief of accompanied syndromes and selection of timing are keys to relieving patient's pain.
Acupuncture Points ; Acupuncture Therapy ; Adult ; Diagnosis, Differential ; Dysmenorrhea ; diagnosis ; therapy ; Female ; Humans

OBJECTIVE： To study the pharmacokinetics of domestic carvedilol and relative bioavailability of carvedilol capsule in Chinese volunteer.METHODS： Eight volunteers orally took a single dose of 30mg test preparation and 25mg control preparation in a random crossover and self-control method.Samples were determined by RP-HPLC fluorescent method.RESULTS： Profiles of carvedilol in vivo could be described as open two-compartment model.The main pharmacokinetics parameters of test and control preparations were as follows： Cmax（98.89± 27.60） ng/ml、 （70.06± 27.29） ng/ml， Tmax（0.4 849± 0.2 635） h、 （0.6 037± 0.1 707） h， CL（0.1 621± 0.08 057） （mg· h） /（ng· ml） 、 （0.1 796± 0.09 198） （mg· h） /（ng· ml） ， V/F(c)（0.2 127± 0.1 260） mg/(ng· ml)、 （0.2 777± 0.1 860） mg/（ng· ml） ， T1/2β （2.011± 1.709） h、 （1.959± 1.156） h， AUC（233.1± 97.12） ng/（ml· h） 、 （168.0± 70.61） ng/（ml· h） ； Mean relative bioavailability in man was (111.3± 15.18)％ .CONCLUSION： The results can be used for design of therapeutic scheme.

Actins ; metabolism ; Adult ; Desmin ; metabolism ; Diagnosis, Differential ; Histiocytoma, Malignant Fibrous ; pathology ; Humans ; Immunohistochemistry ; Leiomyoma ; pathology ; Leiomyosarcoma ; metabolism ; pathology ; surgery ; Male ; Mediastinal Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Fatigue ; etiology ; therapy ; Humans ; Neoplasms ; complications

Objective: To investigate the diagnostic value of 64 multislice spiral CT (64-MSCT) and 1.5T MRI in nurseling with congenital vascular rings.
Methods:We retrospectively studied the diagnostic records of 64-MSCT and 1.5T MRI in 48 nurseling with congenital vascular rings. There were 42 cases received CTA, 12 received MRA and 6 received both CTA and MRA. We classiifed the types of vascular rings by Edwards sketch map of aortic arch embryonic development and trachea wrapping conditions. The diagnostic values of 64-MSCT and 1.5T MRI on vascular rings were compared.
Results: There were 25 patients with complete vascular rings including 3 of double aortic arch, 12 right aortic arch with left subclavian artery and patent ductus arteriosus (PDA), 9 combining with arterial ligament, 1 neck right aortic arch with left subclavian artery combining left PDA;and 23 patients with in-complete vascular rings including 2 pulmonary artery sling, 9 left aortic arch with right subclavian artery combining left PDA, 10 combining with arterial ligament, 1 right aortic arch with left subclavian artery combining right PDA, 1 with innominate artery compressed trachea. There were 32/48 patients combined with cardiac malformations, both 64-MSCT and 1.5T MRI may well reveal the composition and special relationship of vessel rings. The minimum intensity projection (MinIP) and air volume rendering (VR) of 64-MSCT may clearly display the morphology and development of trachea, image fusion technique could directly show the special relationships among vascular rings, trachea and esophagus. While 1.5T MRI was relatively poor to present tracheal image.
Conclusion: 64-MSCT could accurately and comprehensively display the special relationships among the vessels rings, trachea and esophagus;which was the best method for diagnosing the nurseling with vessel rings in clinical practice.

Purpose To explore the value of direct CT venography (CTV) for the diagnosis of varicose veins of lower limb. Materials and methods Forty patients diagnosed as varicose veins of lower limbs were enrolled. 40 patients with 56 involved limbs underwent direct CTV examination, and their images were stratified and evaluated according to the severity and the scope of the disease. Main assessment:definition and scope of CT axial scans combined with volume rendering (VR) and maximum intensity projection for the display of the varicose veins; situation for the display of perforating veins, deep veins and iliac veins;diagnostic compliance between CTV and DSA. Results All of the 56 involved limbs underwent laser intra-cavity occlusion surgery, among them 7 cases with 11 limbs underwent venous angiography under DSA at the same time. In the evaluation of the VR, excellent proportion was 92.86%(52/56), moderate proportion was 7.14%(4/56). Among the deep veins, ratio of the imaging that was able to meet the diagnostic standard was 94.34%, 88.46%and 27.27%, respectively for calf vein, femoral vein and external iliac vein. The total demonstration rate of perforating veins was 98.21%(55/56). Diagnostic compliance between CTV and DSA was 100.00%. Conclusion Lower extremity direct CTV imaging is convenient and noninvasive for patients with varicose veins, with high compliance with DSA results, thus is significantly valuable for the guide of clinical treatment.

Objective To investigate the treatment of elderly dialysis patients with refractory hypertension.Methods Sixty-six patients were randomly divided into two groups of A group and B group,with 33 cases in each group.Patients in A group were treated by routine hemodialysis 3 times per week and hemoperfusion 1 time every 2 weeks.Patients in B group were treated by routine hemodialysis 2 times per week and hemodiafiltration 1 time per week plus hemoperfusion 1 time every 2 weeks.The levels of blood pressure,plasma endothelin (ET),angiotensin-Ⅱ (AT Ⅱ),renin (RA),parathyroid hormone (PTH) in two groups before and after treatment were compared.Results Before and after treatment,the levels of blood pressure,ET,AT Ⅱ,RA and PTH in A group were (183.42 ± 16.20)/(109.15 ± 7.69) and (151.45 ± 3.31)/(88.71 ±4.95) mmHg(1 mmHg =0.133 kPa),(173.45 ±41.25) and (160.38 ±25.31) ng/L,(69.21 ± 18.47)and(57.25 ± 23.34) ng/L,(1.21 ± 0.15) and (0.87 ± 0.14) μ g/L,(530.27 ± 43.28) and (272.43 ± 34.19) ng/Lrespectively.Before and after treatment,the levels of blood pressure,ET,AT Ⅱ,RA and PTH in B group were (185.34 ± 12.26)/ (112.38 ± 6.24) and (141.59 ± 4.15)/ (80.39 ± 2.73) mmHg,(178.21 ± 34.35) and (149.12 ±21.34) ng/L,(68.38 ±23.57) and (47.17 ± 15.61) ng/L,(1.19 ±0.29) and (0.69 ±0.41) μg/L,(528.62 ± 42.53) and (253.15 ± 31.62) ng/L respectively.The levels of blood pressure,ET,AT Ⅱ,RA and PTH in two groups after treatment were significantly decreased compared with those before treatment (P ＜0.05),and there were significant differences between two groups (P ＜ 0.05).Conclusion Combined with hemoperfusion in the treatment of elderly hemodialysis patients with refractory hypertension,the effect of combined hemodiafiltration is significant,and it is worthy of promotion.