Kennedy disease,a motor neuron disease,is an adult onset form of spinal and bulbar amyotrophy characterized by the damage of low motor neuron and uncompleted androgen insensitivity syndrome.So far,there is no effective treatment.This article is intended to provide neurologist with information about Kennedy disease in epidemiology,etiology,pathogenesis,clinical feature,treatment and so on.

Objective: To observe and analyze clinical characteristics of patients with coronary myocardial bridge (CMB) and explore its therapeutic methods. Methods: To retrospectively analyze clinical data of 340 patients undergoing selective coronary angiography (CAG) in our hospital from Jan 2011 to Jan 2013. Results: A total of 33 CMB cases (9.7%) were found in 340 patients undergoing CAG, including 29 cases（87.9%）with isolated myocardial bridge and four patients with coronary atherosclerosis-like changes. There were 31 cases (93.9%) located in left anterior descending branch (LAD), one case (3.03%) in the first diagonal branch (D1) and one case (3.03%) in left circumflex artery (LCX). According to Noble classification of stenosis, 19 cases (57.6%) were class 1, 12 cases (36.4%) were class 2 and two cases (6.06%) were class 3. A total of 16 cases (48.5%) had typical symptoms of angina pectoris, 15 cases (45.5%) had chest tightness and two cases (6.06%) had palpitations. In electrocardiogram and/or dynamic electrocardiogram, ST-T or T wave changes were found in 19 cases (57.6%). All patients received β-receptor blocker and/or non-dyhydropyridine calcium channel blocker, and 29 patients (87.7%) with symptoms improved. Conclusion: Clinical symptoms and manifestations of myocardial bridge is diverse, β-receptor blocker and non-dyhydropyridine calcium channel blocker can relieve most clinical symptoms caused by myocardial bridge.

Objective To explore the effects and mechanisms of urokinase-type plasminogen activator (uPA) on high glucose-induced rat mesangial cells proliferation and phenotype transformation. Methods Rat mesangial cells were cultured and incubated in media containing either 5 mmol/L D-glucose or 30 mmol/L D-glucose with or without addition of wortmannin, or uPA (105 U/L) for different time periods. At the end of the incubation period, mesangial cells proliferation was assessed by MTT assay and flow cytometric analysis. Cyclin-dependent kinase 2 (CDK2) and p27kip1 expression and activation of Akt were evaluated by Western blotting and Akt kinase assay respectively. Furthermore, the expression and distribution of α-SMA were detected with laser confocal microscopy. Results MTT assay and flow cytometric analysis demonstrated that high glucose induced mesangial cells proliferation (P＜0.05) and an incresed proportion of cells in G2/M+S stage after 24 h incubation (P＜0.01), which were attenuated by uPA or wortmannin (P＜0.01). High glucose induced the enhance of Akt activity after 3 h (P＜0.05), and the effect was inhibited by wortmannin or uPA (P＜0.01). High glucose did not alter CDK2 expression (P＞0.05),but significantly inhibited p27kip1 expression (P＜0.05), which was attenuated by wortmannin or uPA (P＜0.01). High glucose induced the up-regulation of α-SMA expression and perinucleus location in mesangial cells after 24 h (P＜0.01), which were alleviated by wortmannin or uPA (P＜0.01). Conclusion uPA up-regulates p27kip1 expression and counteracts high glucose-induced mesangial cells proliferation and phenotype transformation via blocking PI3K-Akt signaling pathway.

Abstract?AIM:To evaluate the efficacy of photocoagulation alone or combined with intravitreal Bevacizumab for radiation retinopathy ( RR) .?METHODS: There were 43 patients ( 43 eyes ) with RR were collected at the Fifth Affiliated Hospital Sun Yet-Sen University between Jan.2009 and Jan.2014.Twenty-one patients received the photocoagulation treatment combined with intravitreal bevacizumab and 22 patients received the treatment of photocoagulation alone.All the patients would complete ophthalmologic examinations, including best -corrected visual acuity ( BCVA ) , intraocular pressure, optical coherence tomography, fundus fluorescein angiography before and after the treatment.?RESULTS:BCVA:In monotherapy group, there were no statistically difference about BCVA before and after treatment ( P>0.05).In combined therapy group, the BCVA had been increasing gradually in 2wk, 1, 3, 6mo after treatment ( P <0.05 ). There was no significant difference about BCVA before and 1a after treatment ( P>0.05).In the comparison of BCVA in these two groups in 2wk, 1, 3, 6mo after treatment, the combined therapy group were better than monotherapy group in each time point (P<0.05), but no statistically significant difference was observed in these two groups at 1a after treatment (P>0.05).Central macular thickness (CMT):in monotherapy group, the CMT had been decreasing gradually in 2wk, 1, 3, 6mo after treatment ( P <0.05 ). There was no significant difference about CMT before and after 1a treatment ( P>0.05).In combined therapy group, the CMT had been decreasing gradually in 2wk, 1, 3, 6mo after treatment ( P<0.05 ). There was no significant difference about CMT before and 1a after treatment ( P>0.05).In the comparison of CMT between these two groups in the 2wk, 1, 3, 6mo after treatment, those of combined therapy group were thinner and difference were statistically significant ( P <0.05 ), but no statistically significant difference was observed in two groups at 1a after treatment (P>0.05).? CONCLUSION: Photocoagulation combined with intravitreal bevacizumab for the treatment of radiation retinopathy both have an effect on reducing the macular edema in a short time (6mo).But the long-term efficacy is poor.

AIM: To observe the effect of Baoxin capsules on hemodynamics of ischemic myocardium of dogs. METHODS: Fed Baoxin capsule for continuous three days, left anterior descending branch of the coronary artery of the dogs were ligated to observe the change of cardiac output, blood pressure and ?dp/dt max in different time of myocardial ischemia. RESULTS: Baoxin capsules increased the blood flow obviously, and increased left ventricular function simultaneously, the difference with ischemic group is significant (P

for the detection of their virulent abilities simultaneously.

Objective To analysis the risk factors in ventilator-associated pneumonia (VAP) in mechanically ventilated patients.Methods Seventy-eight adult inpatients on mechanical ventilation (MV) through oral endotracheal intubation were studied prospectively by observation between June,2007 and May,2010.Clinical associated factors including patients'predisposition related,medical personnel or device related and nutritional state related factors,etc.were recorded and analyzed.Results In 78 ventilated patients,the incidence of VAP was 23.1％,the fatality rate was 22.2％.Preventive antibiotic treatment (OR=6.038; 95％ CI:1.319-27.641; P =0.021),applying glucocorticoid (OR =5.385; 95％ CI:1.191-24.346; P =0.029) and prealbumin (PA) ≤ 69.7 mg/L (OR =0.975; 95％ CI:0.956-0.995 ; P =0.013) were risk factors in VAP.Conclusions The risk factors in VAP were PA ≤ 69.7mg/L,preventive antibiotic treatment and employment of glucocorticoid.

OBJECTIVE:To study improvement effect of modified mahuang chanyi decoction on allergic rhinitis(AR)model guinea pigs and its mechanism. METHODS:32 guinea pigs were randomly divided into normal group (0.9% Sodium chloride in-jection),model group (0.9% Sodium chloride injection),experimental [Modified mahuang chanyi decoction,5.18 g (medicinal materials)/kg] group and control [Fluticasone propionate nasal spray,50 μg/(guinea pig·d)] group. Except for normal group,other groups received ovalbumin 30 mg and calmogastrin 30 mg intraperitoneally to induce AR model. Except for control group,other groups were given relevant medicine intragastrically,twice a day for consecutive 15 d. Nasal symptoms of guinea pigs were ob-served and recorded,and then analyzed and scored. The protein expression of nasal mucosa SHP-1 was detected by immunohisto-chemistry,the serum contents of IL-4 and IFN-γ were determined by enzyme-linked immunosorbent assay. RESULTS:Compared with normal group,model group suffered from AR symptom,and nasal symptoms score was increased;and the protein expression of nasal mucosa SHP-1 and the serum content of IL-4 increased,while the content of IFN-γ decreased(P<0.05). Compared with model group,AR symptom of experimental group and control group were improved;nasal symptoms score,the protein expression of nasal mucosa SHP-1 and the serum content of IL-4 decreased while the content of IFN-γ increased(P<0.05). CONCLUSIONS:Modified mahuang chanyi decoction shows certain improvement effect on AR,and its mechanism is associated the decrease of IL-4 content and the increase of IFN-γcontent in serum.

OBJECTIVE: To study the effects of electroacupuncture and diet adjusting on insulin resistance in rats with nutrition obesity, and the role of electroacupuncture and diet adjusting in the treatment of obesity. METHODS: Obesity was induced in rats by high-fat diet. Rats with nutrition obesity were randomly divided into high-fat diet (HD) group, high-fat diet plus electroacupuncture (HA) group, normal diet (ND) group and normal diet plus electroacupuncture (NA) group, with another group of SD rats as normal control (NC). After 15 days, all the rats' body weight and length were measured, the Lee's index was calculated, and the levels of total cholesterol (TC), triglycerides (TG), free fatty acid (FFA), fasting plasma glucose (FPG), fasting insulin (FINS) and tumor necrosis factor-alpha (TNF-alpha) were detected. RESULTS: Compared with the HD group, food intake, body weight and viscera fat weight of the rats with nutrition obesity in the HA group and the NA group were markedly reduced (P<0.05). The levels of blood serum TC, FFA and IR index in the NA group were obviously lower than those in the HD group (P<0.01). The levels of TNF-alpha and FINS in the NA group were lower than those in the HD group (P<0.05). CONCLUSION: Electroacupuncture plus diet adjusting can decrease the levels of serum TNF-alpha and FINS of the obesity rats, and improve the state of insulin resistance.