Hirayama disease is benign and self-limited,characterized by atrophy of unilateral upper extremity.Misdiagnosis was common due to the restriction of diagnostic techniques in the past.In recent years,Hirayama disease is familiar to us because of the rapid development of electromyography and imageological examinations.X-ray and CT scan play an important role in evaluations on cervical curvature,segmental stability,degeneration of facet joints and posterior longitudinal ligament.Loss of attachment in neutral cervical MRI and anterior shift of dura mater in flexion cervical MRI are the most important signs.This review summarizes the imageological examinations and characteristic signs of Hirayama disease in detail,together with a brief introduction to clinical manifestations and electromyography features.

Virus infection can cause a variety of host immune response to prevent the spreading of virus.Innate immunity is the first line of defense to resist to virus infection in host.After the virus enters,the macrophage phagocytoses and process of virus antigen.On the other hand,it activates the innate antiviral immune response.The expression of interferon after EV71 infection may be associated with cell specific response.Most studies have shown that EV71 can inhibit the expression of interferon to achieve immune escape.Then antigen presenting cells present antigens to T/B lymphocytes,once specific T/B lymphocytes are activated by antigen,they will be activated,proliferated,diferentiated to immunologic effector cells,which secrete antibodies,cytokines,cell toxicity of medium,ultimately,develop immunological effect.Both humoral immunity and cellular immunity are activated in EV71 infection,and play an important role in mediating protection effect.Cellular immunity may be associated with the clinical outcome of EV71 infection.The EV71-specific neutralizing antibody generated by the humoral immunity plays a key role in protective immunity,but the antibody response level is not correlated with disease severity.In addition,virus infection can induce cell apoptosis to prevent the virus proliferation and the spreading of progeny virus.

Neoadjuvant chemoradiotherapy (nCRT)and subsequent radical resection have become the standard care of locally advanced rectal cancer (LARC).However,conventional radical surgery is associated with high intra-and postoperative morbidities,and a temporary or permanent stoma in some cases,impaired sexual and urinary function,and it eventually impair the quality of life.Rectum-preserving surgery is a novel concept in the era of nCRT,which will maximally benefit patients through the minimized injuries.This strategy has been increasingly utilized in LARC following nCRT.Nevertheless,it lacks high-level evidence of evidence-based medicine,and the long-term oncological safety remains to be determined by larger,multicenter,randomized clinical trials.The crucial aspect of rectum-preserving surgery is to accurately evaluate the status of primary tumor and metastatic lymph nodes,and thus to selective patients who could benefit from this strategy most.

The surgical management and the nutritional support in patients with AHNP were reported.We consider that the necrosis of the pancreas complicated with infection should be operated and that parenterally nutritional support could be helpful to patients with AHNP.

Objective To observe the effect of Tongqiaohuoxue decoction on cognitive impairment in rats with traumatic brain injury and explore the mechanisms. Methods 70 Sprague-Dawley rats were randomized into normal group (n=10), sham operated group (n=20), untreated group (n=20) and treatment group (n=20). Controlled cortical impact device was utilized to establish traumatic brain injury model. The treatment group received Tongqiaohuoxue decoction 5 ml/d, and other groups received distilled water. The cognitive function of rats was evaluated with Morris water maze 1, 2, 3, 4 weeks post operation. And the rats were sampled to test the expression of brain-derived neu-rotrophic factor (BDNF) and synaptophysin (Syn) I in hippocampus through immunohistochemistry. Results The escape latency was longer in the untreated group than in the normal group in all the time points (P<0.05), and was longer in the treatment group than in the normal group 1 and 2 weeks after injury (P<0.05), with no significant difference 3 and 4 weeks after injury (P>0.05). And it was shorter in the treat-ment group than in the untreated group 3 and 4 weeks after injury (P<0.05). The percentage of swimming time was lower in the untreated group than in the normal group in all the time points (P<0.05), and was lower in the treatment group than in the normal group 1, 2, and 3 weeks after injury (P<0.05), with no significant difference 4 weeks after injury (P>0.05). And it was higher in the treatment group than in the untreated group weeks after injury (P<0.05). The BDNF expression was lower in the untreated group than in the normal group 1 and 2 weeks after injury (P<0.05), with no significant difference 3 and 4 weeks after injury (P>0.05). It was higher in the treatment group than in the normal group 4 weeks after injury (P<0.01), and was higher in the treatment group than in the untreated group 2, 3 and 4 weeks after in-jury (P<0.05). The Syn I expression was lower in the untreated group than in the normal group in all the time points (P<0.001), and was low-er in the treatment group than in the normal group 1, 2 and 3 weeks after treatment (P<0.01). And it was higher in the treatment group than in the untreated group 3 and 4 weeks after injury (P<0.01). Conclusion Tongqiaohuoxue decoction could improve the cognitive function in rats with traumatic brain injury. The change in expression of BDNF and Syn I might be associated with the improvements.

AIM:To develop a new method to determine cucurbitacin B in Pedicellus Melo by capillary zone(electrophoresis(CZE).) METHODS:All the samples were analysed on a fused silica capillary(75 cm?75 ?m I.D.) by using 50 mmol/L sodium borate solution(containing 5% acetonitrile) as the background electrolyte with the running voltage at 12.0 kV and detection wavelength of 265 nm.And clorprenaline hydrochloride was applied as the internal standard. RESULTS:The results showed a good linear correlation between relative peak area of cucurbitacin B(y) and its concentration(x) over the range of 0.15～1.2 mg/mL.Regression equation was y=(0.003 4x)+0.058,r=0.999 7,and the average recovery for baicalin was 100.2% with the RSD at(2.11%). CONCLUSION:The method is rapid,simple,reproducible and produces low pollution.It serves as a novel way to determine cucurbitacin B.

Objective To explore the management of gliomas in pregnant women.Methods We retrospectively analyzed the clinical data in 11 pregnant women with gliomas treated at Xuanwu Hospital of Capital Medical University between January 1989 and December 2012.Results All the patients were first diagnosed with gliomas during pregnancy,including two cases during early pregnancy,four cases during midpregnancy,and five cases during late pregnancy.The main clinical manifestations were dizziness,headache,nausea and vomiting due to intracranial hypertension,accompanied by epilepsy and blurred vision,hearing and speech disorder and other neurological dysfunctions.Among the 11 patients,one received no obstetric treatment,five underwent cesarean section,three had metaphase induced labor,one had induced abortion,and one had spontaneous abortion.Five neonates appeared normal without malformation:four survived,and one with severe asphyxia died.Ten patients underwent neurosurgery,four of them were diagnosed with low-grade gliomas and six were diagnosed with high-grade glioma by pathology.Seven patients received craniotomy after termination of pregnancy,two underwent craniotomy before termination of pregnancy,and one received emergency craniotomy immediately after admission without obstetric treatment because of her critical conditions.Of the ten patients treated with craniotomy,one died after a coma for 50 days,one was lost to follow-up,six received radiotherapy plus chemotherapy,one received chemotherapy alone,and one received neither radiotherapy nor chemotherapy.Among the 11 patients,one patient who underwent cesarean section without craniotomy was lost to follow-up,one patient with low-grade glioma died 50 days after operation,one treated with craniotomy was lost to follow-up,and eight were followed up for four months to three years,among which four survived and four with high-grade glioma died within one year after operation.Conclusion The overall prognosis of glioma patients during pregnancy is poor.It is important to take into account the tumor status of the pregnant women,gestational age,fetal maturity and patient's desire for tocolysis,and weigh the pros and cons,and timely terminate pregnancy and perform neurosurgery.

Humans ; Monitoring, Intraoperative ; methods ; trends ; Perioperative Care ; methods ; trends

Objective To observe the mitochondrion and nucleus ultrastructural damage and caspase-3 expression in hippocampal CA_3 neurons during kainic acid(KA) induced status epilepticus(SE) in rats.Methods SE was induced for 2 h with KA in adult male Wistar rats.3,12 and 24 h later the rats were killed and the hippocampal CA_3 subareas were taken out to make brain sections.The neuronal damage on the whole with light microscope and the ultrastructure of mitochondrion and nucleus with electron microscope.Caspase-3 expression of the same area was examined with immunohistochemical staining.Results 24 h after SE,by the light microscope examination,the KA group showed that the neurons put scattered disorder and nucleus shrink firmly.3 h after SE,electron microscope examination showed swelling cristae and ruptured membrane of mitochondria.The change of nucleus were significant margination of chromatin 24 h after SE.Compared to normal control group,the caspase-3 expression increased 12 h after SE,the average number of positive cell and the gray scale were obviously higher(all(P

Objective To explore the correlation between the gene polymorphism of glucocorticoid receptor intron 4 G1666T (GR G1666T) and intracerebral hemorrhage(ICH ).Methods Frequencies of genotypes and alleles of GR G1666T in 48 pations with ICH(ICH group),48 ICH patients combining essential hypertension(EH) (ICH+EH group),46 EH patients (EH group) and 71 healthy people (NC group) were analyzed by a polymerase chain reaction for restriction fragment length polymorphism (PCR-RFLP).The gender,body mass index(BMI),blood pressure(BP),the levels of plasma angiotensinogen,renin,blood glucoseand and blood lipid were compared among the various genotype of GR G1666T in ICH patients.Results There was no obviously difference of G1666T genotype and allele frequencie among the 4 groups.However,the G allele frequence of females in groups ICH,ICH+EH and EH were significantly higher than that in NC group(all P