Objective To explore clinic manifestations and laboratory investgation of virus encephalopathy.Methods The clinical course,cerebrospinal fluid(CSF),hepatic dysfunction,computerized tomography of 7 cases treated in our hospital from October 1999 to March 2005 were retrospectively reviewed.Results Seven cases of virus encephalopathy were typically associated with a suddent onset of high fever,severe convulsion,rapidly progressive coma,marked elevations of alanine aminotransferase(AST) and aspartate transaminase(ALT).Four cases died,3 cases had severe sequelae.Blood ammonemia was normal,brain CT scans revealed peripheral or basal nuclei low-density areas.Conclusion Children with a sudden onset of high fever,severe convulsions,rapidly progressive coma may have a poor prognosis.

Objective To explore the clinical features,diagnosis and treatment of serious pyogenic infection in deep neck. MethodsFrom January 2002 to April 2005,the clinical data of 22 patients hospitalized with serious pyogenic infection in deep neck were collected and retrospectively analysed. Results All the patients suffered unilaterally.Besides the symptoms of infection,dyspnea,pain in swallowing,limitation of mouth opening and progressive limitation of cervical activity were presented.Bacterial cultivation were performed in 14 patients and positive results were detected in six.Fourteen of all the 22 patients were cured with antibiotics,and abscess incision drainage was carried out in the other eight.Preoperative cervical PA-LAT X-ray photography and contrast-enhanced CT scanning were performed on one and seven patients,respectively,all of which indicated the formation of abscess.All the patients were cured except one who died of cerebral infarction and multiorgan dysfunction. Conclusion Imaging evaluation plays a significant role in the preoperative diagnosis and systemic treatment of serious pyogenic infection in deep neck.Bacterial cultivation provides reliable evidence for the etiopathogenisis and helps to make the effective treatment.

Objective：To study the toxicity mechanism(s) of ifosfamide(Ifo) in suspending cultured rat hepatocytes.Methods：Hepatocytes of adult rat were isolated using two-step perfusion method and cultured suspendingly. Cell viability,intracellular enzyme leakage, contents of sulfhydryl groups and MDA contents of hepatocytes were examined 3 hours after ifosfamide was administered at 5,10,20 mmol/L. Surface and ultrastructure of hepatocytes were also observed. Results：Cell viability and TSH,NPSH,PSH contents of hepatocytes significantly declined, and LDH,AST activities in media increased due to the leakage of intracellular enzymes. The decrease in PSH content was ascribed to depletion of TSH. The higher the dose was, the more serious these changes became. However, MDA contents of the hepatocytes were not found increased at any ifo dose groups. In pathological examination, “bulla" formation was found on the surface of the hepatocytes, deformation，swelling even vacuolation of mitochondria and dilation of rough，smooth endoplasmic reticulum were also observed. Conclusions：Ifo has toxic effect on suspending cultured rat hepatocytes. The decrease in sulfhydryl groups contributes to the hepatotoxicity induced by Ifo.

Objective To evaluate the therapeutic effect of segmental hepatectomy for intrahepatic bile duct stones.Methods In this study, 414 patients suffering from intrahepatic bile duct stones underwent hepatectomy from Jan 1981 to Dec 2001. Stones distribution, operation modality,postoperative complication and therapeutic effect were evaluated. Results Postoperative complications occurred in 72 cases(17.4%), mortality was 0.7%. A follow up of 2 to 22 years was achieved in 305 patients (73.7%), with excellent or good result in 88.9%, residual stone in 15.7%,and stone recurrence in 4.6%.Conclusion Appropriate use of hepatectomy is effective for the treatment of intrahepatic bile duct stones.

Objective To evaluate the diagnostic and therapeutic methods for hilar bile duct carcinoma. Methods The clinical data of 36 patients with hilar bile duct carcinoma from Jan 1998 to Jul 2003 were retrospectively analyzed. Results The misdiagnosis rate(39%) was high. All patients underwent a surgery. The median survival time of 16 patients treated by radical resection was 30 months. The 1,3,5-year survival rate was 93%,50% and 25% respectively. While the median survival time of the rest 20 patients treated by a variety of non-radical operation was 16 months with 1,3,5-year survival rate of 47%,8% and 0 respectively(t=2.585).Conclusions Early diagnosis and radical resection improves long-term survival of patients with hilar bile duct carcinoma.

Objective To investigate the indication and value of metallic stent in the management of patients with malignant obstructive jaundice(OJ). Method The clinical data of 15 patients with malignant OJ treated in our hospital were analysed retrospectively. All the 15 patients were treated with metallic stent including cholangiocarcinoma in 8 cases, carcinoma of gallbladder in 3 cases, pancreatic carcinoma in 2 cases, porta hepatis metastasis of gastric carcinoma after radical gastrectomy in 2 cases. Result All the patients' jaundice disappeared 11-38 days after the stent placement. No severe complications or death occurred in this series. One patient had cholimia 5 days after the stent placement, which was cured by non-operative method. All cases were followed up periodically, the survival time was 30-384 days(averag 180.5 days). Conclusions Installing stent of Titanium-Nickel metallic alloy for the patient with unresectable malignant OJ is an ideal palliative therapy which is simple and less discomfortable.and less complications.The effect of reducing jaundice is satisfactory. This method may offer a new alternative method in the management of malignant OJ.

Objective:To search the release in vitro of new MU-AN ophthalmic gel consist of ganciclovir instead of aciclovir is whether better than the Old. Methods:Using the content of ganciclovir and acyclovir as the index, taking the second oar method ( in Ch. P 2010), drug release in vitro test was investigated. Results:The character of drug release of new MU-AN ophthalmic gel was e-qual to the old, the rate of drug release was similar, The amount of drug release was the same. Both drugs met the requirements of clin-ical medication. The character corneal permeability of new MU-AN ophthalmic gel was better than the old. Gel matrix had no influ-ences on drug release, drug would be bring treatment effect after the way that it was released quickly then was dissolved in tear. Con-clusion:The drug release characteristics consistent with ophthalmic preparation requirements. The character of drug release of new MU-AN ophthalmic gel consist of ganciclovir instead of aciclovir is equal to the old, the time administer drug and interval time is gener-ally scientific, reasonable and feasible, providing the basis for the pharmacodynamics , toxicology and clinical study in the next step.

Objective To investigate the expression of glutamine synthetase ( GS ) in prostate cancer and the utility of 13 N?NH3 PET/CT in detecting prostate cancer. Methods The uptake ratio of 13 N?NH3 and the expression of GS in PC3 and DU145 cells were measured by Western blot and PCR methods. A total of 34 patients with suspected prostate cancer underwent 13 N?NH3 PET/CT imaging and prostate biopsy. Immunohistochemistry staining of GS was performed and Gleason scores of tumors were evaluated. One?way analysis of variance, the least significant difference?t test and Spearman correlation analysis were used to an?alyze data. Results The uptake of 13 N?ammonia in PC3 and DU145 cells elevated along with the decrease of glutamine in medium. The expression of GS mRNA and protein also increased when glutamine was de?creased. In biopsy samples, the mean GS expression scores of prostate cancer, benign prostatic hyperplasia (BPH) and prostatitis were 7.76±2.57, 3.98±2.60, 3.34±0.36, respectively (F=36.85, t1=7.97, t2=4?45, all P<0.05), which had a weak correlation with Gleason scores (rs=0.52, P<0.05). In 34 patients, the mean SUVmax of prostate cancer segments (1.56±0.58 and 1.14±0.22;F=5.966, t1=2.63, t2=2.65, all P<0.05). There was a weak correlation between GS expression scores and the uptake of 13 N?ammonia in prostate cancer (rs=0.47, P<0.05). Conclusions Up?regulated expression of GS is common in prostate cancer cells. GS is the main reason for the uptake of 13 N?ammonia, which is a useful tracer for prostate cancer imaging.

Objective:To explore the relationship between vesicular monoamine transporter 2(VMAT2) density in the striatum and the non-motor symptoms(NMSs) in patients with Parkinson′s disease(PD).Methods:From December 2018 to December 2019, 29 normal controls (16 males, 13 females, age: (48.8±14.2) years), 31 patients with PD at the Hoehn-Yahr (mH-Y) Ⅱ stage (16 males, 15 females, age: (53.4±8.5) years) and 36 patients with PD at mH-Y Ⅲ stage (19 males, 17 females, age: (63.1±8.2) years) in the First Affiliated Hospital of Sun Yat-sen University were prospectively enrolled in this study. All subjects underwent 18F-fluoropropyl-(+ )-dihydrotetrabenazine( 18F-FP-(+ )-DTBZ, 18F-AV133) PET/CT imaging, then the specific uptake ratios (SURs) of striatal subregions were measured with the occipital cortex as the reference background region. The clinical data, laboratory data and imaging results were collected. The NMSs of each patient were evaluated with Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), Parkinson′s Disease Sleep Scale (PDSS), Montreal Cognitive Assessment (MoCA), Parkinson′s Disease Quality of Life Questionnaire (PDQL) and Non-Motor Symptoms Scale (NMSS). The independent-sample t test and one-way analysis of variance (the least significant difference t test) were used to compare data differences. Finally, the association of the striatal SURs with the clinical symptom scores were evaluated with Pearson correlation analysis and multivariable stepwise regression analysis. Results:Significant differences were found in depression (3.51±1.34 vs 11.36±3.87), anxiety (2.35±1.45 vs 6.00±3.32), sleep disorder (132.90±12.26 vs 110.34±19.69) and life quality (7.58±3.37 vs 24.01±10.15) scores between the mH-Y stage Ⅱ and the stage Ⅲ patients ( t values: from -10.573 to 5.439, all P<0.05), while cognitive scores did not differ significantly between the 2 PD groups ( t=1.067, P>0.05). Compared with healthy control group (1.28±0.22), the PD groups displayed a more marked decrease of SURs in the bilateral putamen and in the caudate nucleus (0.65±0.16 and 0.31±0.14; F=83.11, P<0.05), and the SURs of patients at stage Ⅱ were higher than those of the patients at stage Ⅲ ( t=9.116, P<0.05). NMSs scores of PD patients, with the exception of cognition scores, were correlated with striatal SURs ( r values: from -0.647 to -0.426, all P<0.05). Regression analysis showed that total striatum SURs was the best predictor of PDSS and NMSS scores ( R2 values: 0.234, 0.378, both P<0.001), while contralateral caudate nucleus SURs were best predictor of HAMD scores ( R2=0.402, P<0.001). The SURs of contralateral putamen were best variables for predicting HAMA scores ( R2=0.204, P<0.001). Conclusion:The correlation between the decreased striatal VMAT2 and a broad spectrum of NMSs in patients with PD is established, suggesting that the defect in dopamine supply may be an early abnormality promoting mechanisms leading to the development of NMSs in PD.

Abstract: Objective　To investigate the pollution of paralytic shellfish poisons (PSP) in shellfish sold in Hainan Province from 2018 to 2021. Methods　From 2018 to 2021, the content of 10 paralytic shellfish poisons including saxitoxin (STX), neosaxitoxin (neoSTX), gonyautoxins 1 (GTX1), gonyautoxins 2 (GTX2), gonyautoxins 3 (GTX3), gonyautoxins 4 (GTX4), gonyautoxins 5 (GTX5), decarbamoylsaxitoxin (dcSTX), decarbamoylgonyau toxins 2 (dcGTX2) and decarbamoylgonyau toxins 3 (dcGTX3) in 7 kinds of shellfish commonly sold in 13 cities and counties in Hainan province was analyzed. Results　The detection rate of PSP in 360 shellfish samples was 10.3%. Among them, the highest detection rate of STX was 5.83%, followed by GTX2 detection rate of 4.17%; the detection rate of neoSTX and GTX3 were both 1.67%; the detection rate of GTX1 was 1.39%. None of the five PSP, GTX4, GTX5, dcSTX, dcGTX2 and dcGTX3, were detected. Four types of PSP were detected in fanscallops, two were detected in oysters, mussels and Scapharca subcrenata, only one was detected in scallops, and no toxin contamination was detected in clams and razor clams. A single sample of fanscallops detected a maximum of 4 PSP, and a single sample of oysters, scallops, mussels and Scapharca subcrenata detected a maximum of 1 PSP. The equivalence of PSP in all samples was ND-155.6 μg/kg.The annual detection rate of PSP from high to low was: 20.0% in 2020, 15.6% in 2019, 5.3% in 2018, and 2.0% in 2021, and none of the samples tested exceeded the standard. Continuously detectable STX in 2018-2020, all PSP that could be detected in 2018 were STX. In 2019, in addition to STX detected in scallops and Scapharca subcrenata, neoSTX was also detected in oysters, mussels and Scapharca subcrenata. In 2020, PSP was only detected from scallops, and GTX2 could be detected in all positive specimens, while 5 STX, 5 GTX1 and 6 GTX3 were detected. Only GTX2 detected from scallops in 2021. STX was detected in shellfish sold in 12 cities and counties, GTX2 can be detected in 10 cities and counties, neoSTX can be detected in 5 cities and counties, GTX1 and GTX2 were detected in 4 cities and counties respectively. Shellfish sold in Wenchang and Lingshui markets can detect 5 types of PSP. Conclusion　Some types of shellfish on the market in Hainan are contaminated with some kind of PSP pollution risks, and it is necessary to strengthen the supervision of PSP in marketed shellfish.