Objective To introduce the clinical manifestations of REM sleep behavior disorder (RBD) which hasn't been reported in China ever before and to discuss the possible causes and mechanisms of the disease. Methods Ten cases of RBD verifted by polysomnography(PSG)were analyzed retrospectively. Results All patients were senile or in middle ages and most of them were male.The main clinical features included violent movements,shouting and other abnormal behaviors occuring in dreams when they fell asleep.Four cases were diagnosed as Parkinsonism,2 as multiple system atrophy and 1 as cerebral trauma.The causes of another 3 cases were unknown.all symptoms of them were relieved by using clonazepam administered prior to sleep.The PSG of all cases showed a loss of normal muscular atonia and an appearance of EMG activities during REM sleep. Conclusions RBD should be considered when patients showed abnormal especially violent behaviors in sleep.PSG should be essential for its correct diagnosis and the differentiation from partial complex epilepsy.Clonazepam given prior to sleep should be effective for treatment.

Objective To explore the effect of treating chronic pelvic inflammatory disease with the combination of retention enema,acupuncture and microwave physical therapy.Methods 80 patients were randomly assigned into two groups:a treatment group(50 cases) treated with combination of retention enema,acupuncture and microwave physical therapy,and a control group (30 cases) treated with Fuyankang capsule.The efficiency was observed after the treatment.Results The total effective rate in the treatment group was 92.0%,showing significant difference (P＜0.05) compared with the control group.Conclusion The triple-combined therapy of retention enema,acupuncture and microwave physical therapy has sound effect in treating chronic pelvic inflammatory disease.

Objective: To obtain the 12-mer phage clones displaying the Hantaan virus mimic epitopes.Methods: HFRSV-positive sera were used as selective molecules for biopanning.A 12-mer phage peptide library was bio-panned for 5 rounds,and the result was confirmed by sandwich ELISA,competition ELISA and DNA sequencing.Results: After 5 rounds of effective screening,the results detected by sandwich ELISA and competition ELISA showed that the majority of the selected clones could react to positive sera in a dose-dependent manner,but could not bind to BSA and the control sera.Sequencing and alignment analyses indicated that amino acid sequences of 45 positive clones fell into 8 groups,and 7 of them exhibited putative motifs: LVXKR,LTXR,IXKP,LXPA,VGA,KXIR and EKXP.Four of the putative motifs had a homologous region within the structural proteins of HFRSV.Conclusion: The peptides displayed by the phage can mimic the epitopes of HFRSV antigens,which provides the potential for preparing more effective epitope-based vaccines and specific diagnostic reagents.

Objective: To clone,identify and express the Shigalike toxin 2B(Stx2B) subunit gene of EHEC O157∶H7.Methods: A pair of primers were designed based on the Stx2B subunit gene sequence of EHEC O157∶H7.The Stx2B gene was amplified from the EHEC O157∶H7 chromosome by PCR and cloned into the pMD18-T vector.Thereafter,the gene was cut from the pMD18-T vector and cloned into the prokaryotic expression plasmid pET-28a vector.Then the recombinant plasmids were transformed into E. coli BL21(DE3) and the transformed host strain induced by IPTG.The expression protein was detected by SDS-PAGE and Western-blot analyses.Results: The Stx2B gene was successfully cloned into pMD18-T and pET-28a vectors,and the expressed protein identified by SDS-PAGE and Western blot.The molecular mass(Mr) of the expressed product was about 7 500,and the expression rate about 40%. Conclusion: The Stx2B gene was successfully cloned and effectively expressed in the prokaryotic expression system.

Objective To provide clinical evidence for the relationship between epithelial-mesenchymal transition (EMT) and colorectal cancer(CRC) by detecting the expression of TGF-β, Smad-3 and Smad-7 in serum from CRC patients. Methods We detected the expression levels of TGF-β1 , Smad-3 and Smad-7 by ELISA method. Results The expression levels of TGF-β1 , Smad-3 were significantly higher and the Smad-7 was significantly lower in CRC patients than those in control group(P<0. 01). The expression levels of TGF-β1 and Smad-3 were signifi-cantly higher in Dukes D than those in Dukes B,C. The Smad-7 was significantly lower in Dukes D than that in Dukes B,C(P<0. 01). Conclusion TGF-β1 and Smad-3 and Smad-7 may play an important role in the develop-ment of CRC.

Objective To investigate the morphological features,biological behavior ,and diagnosis and treatment of gastric hepatoid adenocarcinoma(GHA).MethodsTwenty GHA cases were evaluated. Of the 20 patients,14 underwent radical gastrectomy, 3 total gastrectomy,3 total gastrectomy and wedge excision of the liver metastasis.ResultsHistologically,hyaline globules and venous invasion were common features of GHA.Tumor cells were immunohistochemically positive for alpha fetoprotein(AFP), alpha antitrypsin(AAT), and alpha antichymotrypsin(ACT). Ultrastructurally,tumor cells were arranged toward the lumens with microvilli on the luminal surfaces.There were junctional complexes between the lateral plasma membranes of adjacent tumor cells.Patients were followed up for 1～5 years with 12 deaths, 11 died of metastasis and one died of intraabdominal tumor seeding. The 1, 3 year survival rate was 44%(8/18), and 17%(3/18), respectively. Conclusions GHA deriving from gastric mucosa is characterized both by the histologic structures of hepatoid differentiation and adenocarcinoma.The prognosis is usually poor due to frequent liver metastasis.

Objective To investigate the effect of remote ischemic postconditioning on brain injury after asphyxial cardiac arrest-resuscitation in rats.Methods Sixty-nine male Sprague-Dawley rats were randomly divided into 3 groups (n =23 each) using a random number table:sham operation group (group S),asphyxial cardiac arrest-resuscitation group (group CA-CPR),and remote ischemic postconditioning group (group RIPost).The animals were anesthetized with intraperitoneal 1％ pentobarbital 40 mg/kg,intubated and mechanically ventilated.Asphyxia was induced by occlusion of the tracheal tube and resuscitation was started 8 min later.In RIPost group,RIPost was produced by 3 cycles of 15 min occlusion of the right hind femoral artery-15 min release of the right hind femoral artery after restoration of spontaneous circulation (ROSC).Neurological deficits were evaluated and scored at 24 h,72 h and 7 days after ROSC.Neuron specific enolase (NSE) concentration in serum was assessed at 48 h after ROSC by ELISA.At 3 days after ROSC,the number of viable neurons in hippocampal CA1 region was recorded (by N issl's staining).Morris water maze test was used to quantify spatial learning and memory deficits after ROSC.Results Compared with group S,the neurological deficit score at each time point and the number of viable neurons in hippocampal CA1 region were significantly decreased,the NSE concentration in serum was increased,the escape lantency was prolonged,and the target quadrant residence time percentage and distance percentage were decreased in CA-CPR and RIPost groups.Compared with group CA-CPR,the neurological deficit score at each time point and the number of viable neurons in hippocampal CA1 region were significantly increased,the NSE concentration in serum was decreased,the escape lantency was shortoned,and the target quadrant residence time percentage and distance percentage were increased in group RIPost.The damage to neurons in hippocampal CA1 region was significantly mitigated in group RIPost as compared with group CA-CPR.Conclusion Remote ischemic postconditioning can reduce brain injury after asphyxial cardiac arrest-resuscitation in rats.

Objective To investigate the distribution relationship of microglia and neuron in rat medullary visceral zone(MVZ) after stomatic nociception. Methods After 2ml formalin(2.5%)injection in rat stomach by tiny plastic tube,Anti-Fos protein(labeling neuron)and anti-OX 42(labeling microglia)single and double immunohistochemical ABC method staining on model medulla oblongata sections in different time point(0.5h,1h,2h and 3h) were used. Results 1.After wakefulness,the animal models appear restlessness and agitation in 1-2h.2.We found hemorrhage and exfoliation in model's gastric mucosa.3.Fos positive neurons and OX 42 positive microglias were observed in MVZ,whose distribution was congruous and appeared clearly character of locations.4.The results of immunochemical diplex staining indicate that many Fos positive neurons were surrounded by intensive OX 42positive microglias.5.OX 42 positive microglia showed a tendency,which increased in 0.5-2h and decreased in 3h.Conclusion Neurons and microglia in MVZ may be involved in visceral nociception transfer and adjustment function.

OBJECTIVE To compare and analyze the drug resistance of Chryseobacterium meningosepticum which producing metallo-?-lactamase(MBL) and extended-spectrum-?-lactamases(ESBLs) from ICU patients′ and non ICU patients′ specimens of sputa so as to guide the rational application of antibiotics.METHODS Identified the strains with VITEK 32,MBL and ESBLs were also screened by double disk synergy;the antimicrobial sensitivity of clinical isolates was tested by VITEK GNS143 and the antimicrobial sensitivity was added and tested by K-B method.RESULTS As a result the rate of producing MBL of C.meningosepticum was 49.0% from ICU patients′ specimens of sputa which was higher than the rate of 13.8% from non ICU patients′;the rate of producing ESBLs of C.meningosepticum was 37.2% from ICU patients′ specimens of sputa which was higher than the rate of 30.6% from non ICU patients′;the rate of drug resistance to AMP/SUB,TZP,CEP,CIP,and LEV from ICU patients′ was higher than that from non ICU patients.CONCLUSIONS Why the high resistance rate of C.mengingosepticum in ICU patients′ specimens of sputa might be due to the high producing ?-lactamases(MBL and ESBLs).

Objective To explore the management of perioperative period on the effect of alimentary tract fistulas after gastric cancer operation.Methods The clinical data of 25 patients with alimentary tract fistulas after gastric cancer operation were reviewed.The location and time of alimentary tract fistulas,and perioperative period of patients were analyzed.Results Of the 25 patients,13 cases(52.0％) were anastomotic fistulas,1 case(4.0％) was bile fistula,2 cases (8.0％) were pancreatic fistulas,4 cases (16.0％) were small intestinal fistulas,and 3 case (12.0％) were duodenal stump fistulas,1 case (4.0％) was anastomotic and duodenal stump fistula,1 case (4.0％) was small intestinal and duodenal stump fistula.The alimentary tract fistulas generally occurred within the first or second week after gastric cancer operation.The incidence rate of gastrointestinal leakage was 64.0％ in gastric cancer with diabetes patients,56.0％ in gastric cancer with elderly patients,40.0％ in gastric cancer with anemia patients,36.0％ in gastric cancer with hypoproteinemia patients,16.0％ in gastric cancer with multivisceral excisions.21 cases of gastrointestinal leakage were healed after conservative treatment.2 cases with gastrointestinal leakage by operation treatment were healed.2 patients died,one died of intra-abdominal hemorrhage,one case died of MODF.Conclusion Strengthening the management of patients with alimentary tract fistulas after gastric cancer operation can promote the healing of fistula in perioperative period.