Objective To identify the clinical and neurophysiological features of multiple system atrophy (MSA) and explore diagnostic values using various techniques in electro neurophysiology Methods Forty four subjects diagnosed as multiple system atrophy (MSA) during 1983 to 2001 in PUMC Hospital were studied retrospectively about their clinical features, routine electromyography (EMG), nerve conductive velocity (NCV), somatosensory evoked potential (SEP), motor evoked potential (MEP), brainstem auditory evoked potential (BAEP) and visual evoked potential (VEP) The clinical features and the electroneurophysiologic results were analyzed in different subgroups (probable MSA and possible MSA, OPCA and non OPCA, classified MSA and unclassified MSA) Results Most patients were found to be suffered from autonomic failure (88 6%) and cerebella dysfunction (88 6%) The pyramidal sign was seen in 72 7% of patients No remarkable statistical differences were found in all of the above three domains The incidence of Parkinsonism was 36 4% of all the patients, which showed significant differences between probable and possible MSA (54 5% vs 18 2%), non OPCA and OPCA (50% vs 7 1%), unclassified MSA and classified MSA (52% vs 15 8%) EMG was abnormal in 7 patients (38 1%), all of them were neurogenic impairments The rates of abnormal EMG were varied differently between probable and possible MSA (54 5% vs 22 2%), non OPCA and OPCA (53 8% vs 14 3%), unclassified MSA and classified MSA (58 3% vs 12 5%), but without statistical differences The abnormal rates in BAEP,SEP, VEP and MEP were 56 7%, 28%, 23 1% and 20 0%, respectively, and there were no significant differences between subgroups Conclusions It should be hard to divide MSA into groups only by the clinical manifestations All EPs were abnormal in some extent The most sensitive test is BAEP in current study, but there were no differences among the subgroups in the rates of abnormal EPs The difference of EMG and NCV between the groups showed that the technique might be helpful in the diagnosis of MSA

Immunological imbalance is the foundation for the development of liver damage or fibrosis.Therefore,the treatment of liver disea-ses not only relies on regenerative medicine for cellular replacement,but also depends on immunoregulation.The immunological basis of liver injury and repair,the immunological basis of multipotent stem cells for allograft,and the research advances in the immunoregulatory effect of stem cells in the treatment of liver diseases demonstrated that multipotent stem cells,especially mesenchymal stem cells,have low immuno-genicity and cause immunosuppression,with the immunological basis of allograft;in addition,they can improve the local immune microenvi-ronment of the liver by immunoregulation to reduce the liver injury caused by immune response.It is suggested that multipotent stem cells, which meet the requirements of cellular replacement and immunoregulation in the liver,will become an ideal treatment of liver diseases.

Acupuncture Therapy ; Female ; Humans ; Middle Aged ; Pain, Intractable ; therapy ; Trigeminal Neuralgia ; therapy

Objective To explore the clinical significance of combination detection of serum squamous cell carcinoma antigen (SCC-Ag) and carcino-embryonic antigen (CEA) for the diagnosis,effect evaluation,monitoring and prognosis in cervical carcinoma.Methods Four hundred and twenty-four cases of cervical carcinoma patients diagnosed by pathology and 400 binign gynaecology patients were selected to detect levels of SCC-Ag and CEA by ELISA.Besides,the pelvic color ultrasound results of cervical carcinoma patients were collected and analyzed.Results The positive rates of serum SCC-Ag,CEA and combined detection of cervical carcinoma patients were 55.9 ％(237/424),26.4 ％(112/424),61.8 ％(262/424),which were higher than those of binign gynaecology patients [12.0 ％(48/400),12.5 ％(50/400),14.5 ％(58/400)],and the differences were statistical significance (all P＜ 0.05).The sensitivity of combined detection of SCC-Ag and CEA for diagnosing cervical carcinoma (61.8 ％) was better than that of detection of alone SCC-Ag or CEA (55.9 ％,26.4 ％),and the difference was statistical significance (P ＜ 0.05).The differences of pretreatment serum SCC-Ag and CEA levels in the cervical carcinoma patients who were dependent on clinical stage,pathological type,depth of invasion,lymph node metastasis were statistically significant (all P ＜ 0.05).The combined detection of SCC-Ag and CEA in patients with stage Ⅰ and Ⅱ had higher positive rates [45.5 ％ (71/156),73.2 ％(139/190)] than those of the ultrasound examination [33.3 ％(52/156),51.1％(97/150)] (P＜ 0.05).After surgery or concurrent chemoradiotherapy or surgery combined radiation and chemotherapy,SCCAg levels of patients in post-treatment (median 0.34,0.51,0.33 ng/ml) were much lower than those of pretreatment (median 0.48,3.44,1.29 ng/ml),and CEA levels of post-treatment (median 0.75,0.81,0.71 ng/ml)were also lower than those of pre-treatment (median 1.22,1.53,1.50 ng/ml) (P ＜ 0.05).After treatment,cervical cancer patients with the raised or not decreased to the normal range levels of SCC-Ag and CEA had recurrences or metastasis rates of 33.3 ％(6/18),56.5 ％(13/23) and 46.1％(35/76).Survival rate of the patients with positive SCC-Ag was significantly lower than that of patients with negative (P ＜ 0.05),while the survival rate of patients with positive or negative CEA had no difference (P ＞ 0.05).Conclusions Combined detection of SCC-Ag and CEA can be used as an important indicator to estimate clinical stage,pathological type,depth of invasion,lymph node metastasis,curative effect and prognosis of cervical carcinoma.Combined detection of SCC-Ag and CEA had higher positive rates than pelvic color ultrasound examination for cervical carcinoma patients in stage Ⅰ and Ⅱ.

OBJECTIVE:To systematically review the efficacy of ursodeoxycholic acid(UDCA)in the prevention ofulcerative colitisassociated colorectal cancer (UC-CRC) and dysplasia (UC-Dys),and provide evidence-based reference for clinic. METH-ODS:Retrieved from Cochrane Library,EMBase,PubMed,CJFD,CBM,VIP and Wanfang Database,randomized controlled tri-als(RCT)or cohort studies about UDCA(test group)versus placebo(control group)in the prevention of UC-CRC and UC-Dys were collected. Meta-analysis was performed by using Rev Man 5.3 software after quality evaluation and data extraction by Co-chrane Manual 5.1.0. RESULTS:Totally 7 studies(3 randomized controlled trials and 4 cohort studies)were included in the analy-sis,involving 672 patients. Results of Meta-analysis of 3 RCT showed that there was no significant difference in the incidence of UC-CRC and UC-Dys between 2 groups [OR=0.95,95%CI(0.17,5.12),P=0.95];results of Meta-analysis of 4 cohort studiess-howed that there was no significant difference in the incidence of UC-CRC and UC-Dys between 2 groups[OR=0.74,95%CI(0.30, 1.84),P=0.52]. Results of subgroup analysis showed,the incidence of UC-CRC and UC-Dys in test group with low-dose UDCA (<15 mg/kg) was significantly lower than control group,the difference was statistically significant [OR=0.19,95%CI(0.08, 0.49),P<0.001];there were no signifficant diferences in the incidence of UC-CRC and UC-Dys in high-dose UDCA group[OR=1.97,95%Cl(0.53,7.25),P=0.31](≥15 mg/kg). There was no significant difference in the incidence of adverse reactions(P>0.05). CONCLUSIONS:UDCA can not decease the incidence of UC-CRC and UC-Dys,it only prompts a possible trend toward decreased UC-CRC and UC-Dys risk in low-doseUDCA.

Objective To evaluate the diagnostic accuracy of GenoType? M TBDRsl for the resistance to fluoroquinolones anti‐tuberculosis drugs .Methods Systematic and comprehensive literature was searched in PubMed ,Embase ,Web of Science ,CBM , CNKI ,VIP and Wanfang database .The relative studies of GenoType? MTBDRsl to fluoroquinolones anti‐tuberculosis drugs were included .After quality assessment ,Meta‐Disc1 .4 software was used to analyze the data .Results A total of 16 trials ,involving 1 766 participants ,were included .The results of Meta‐analysis showed that the weighted sensitivity ,specificity ,positive likelihood ra‐tio ,negative likelihood ratio ,diagnostic odds ratio ,and the area under summary receiver operation curve were 0 .83 ,0 .96 ,17 .50 , 0 .20 ,108 .46 and 0 .934 9 ,respectively .Conclusion GenoType? M TBDRsl assay for the resistance to fluoroquinolones anti‐tuber‐culosis drugs might be with high sensitivity and specificity ,which could be recommended as efficacy diagnostic tool .

Objective To quantitatively estimate upper motor neuron (UMN) lesion with the triple stimulation technique (TST) in amyotrophic lateral sclerosis (ALS). Methods Fifty ALS patients and 22 normal controls were enrolled in the study. Patients were examined clinically with conventional transcranial magnetic stimulation (TMS) and TST at abductor digiti minimi. Central motor conduction time (CMCT),motor evoked potential ( MEP), resting motor threshold ( RMT), compound muscle action potential ( CMAP), modified ashworth scale ( MAS), Medical Research Council scale and modified ALS scale were assessed and their correlation to disease progress was analyzed. Results The TST amplitude ratio was significantly decreased in ALS patients with UMN signs(28 cases 62. 0% (40. 7%, 75.9% ) ), compared with controls ( 96. 9% ± 2. 6% ) and ALS patients without UMN signs ( 22 cases 95.6% ( 85.4%,100. 0% ) ;Z = -4. 827, -5.435, both P =0. 000). The abnormal rates of the TST amplitude in ALS with UMN signs, ALS without UMN signs and controls were 89. 3%, 27.3% ,9. 1% respectively. The abnormal rates of the TST amplitude, the latency of MEP, CMCT, RMT in detecting UMN lesions were 89. 3%,64. 3%, 53.6%, 64. 3% , 78. 6%, respectively. The TST amplitude was significantly correlated to tendon reflex in right arm ( r = 0. 690, P = 0. 000), with modified ashworth scale ( MAS, r = - 0. 772,P = 0. 000),with diagnostic degree ( r = 0. 483, P = 0. 000), with RMT ( r = - 0. 774,P = 0. 000), the latency of MEP (r = - 0. 444, P = 0. 005 ), motor evoked potential/compound muscle action potential of erb' s ( MEP/ CMAPerb, r = 0. 685, P = 0. 000 ), MEP/CMAPerb in facilitation ( r = 0. 770, P = 0. 000). Conclusions TST appears to be a more accurate and sensitive measure of detecting and quantifying UMN abnormality in ALS patients than the other parameters. TST may reveal the subclinical UMN impairment in ALS and provide an accurate diagnosis assessment for UMN loss in ALS and an objective scale for monitoring the progression of disease.

Objective To investigate the clinical effect and safety of alpha lipoic acid injection combined mecobalamin and prostaglandin E on type 2 diabetic patients complicated with diabetic peripheral neuropathy(DPN).Methods One hundred and sixty type 2 diabetic patients complicated with DPN in the General Hospital of Benxi Iron and Steel Group Corporation from Jan.2011 to Dec.2012 were randomly divided into the treatment group(n =80) and the control group (n =80).Three cases of the treatment group and 5 cases of the control group discharged early from the study because of their own reasons.There were 77 cases in the treatment group and 75 cases in the control group.On the basis of controlling blood glucose,patients in the two groups were given 500 μg mecobalamin combined with intramuscular injection once two days,as well as prostaglandinE 10 μg injection once a day.Patients in treatment group were added with 600 mg alpha lipoic acid for intravenous injection once a day for 10-14 days.Total symptom score (TSS),nerve conduction velocity,satisfaction and adverse reactions were evaluated before and after treatment.Results TSS score,tingling score,burning sensation score and hypoesthesia score,numb score in treatment group were (3.5 ± 2.5),(1.1 ± 0.4),(0.9 ± 0.7),(1.3 ± 0.4),(1.3 ± 0.9),significantly lower than those in control group (4.3 ± 2.1,t =2.11,P ＜0.05;1.5 ±0.5,t =1.86,P＜0.05;1.3 ±0.5,t =1.83,P ＜0.05;1.7 ±0.5,t =1.87,P ＜0.05; 1.9 ± 0.4,t =1.91,P ＜ 0.05).The median nerve conduction velocity,peroneal nerve motor conduction velocity,median nerve sensory conduction velocity,common peroneal nerve sensory conduction velocity of patients in treatment group were (53.6 ± 1.4) m/s,(49.6 ± 1.1) m/s,(47.3 ± 1.1) m/s,(48.2 ± 1.9) m/s,lower than those in control group((48.5 ±2.7) m/s,t =-4.94,P ＜0.05;(43.9 ±2.1) m/s,t =-5.36,P ＜0.05; (41.6 ± 1.8) m/s,t =-5.09,P ＜0.05;(43.2 ±2.5) m/s,t =-4.27,P ＜ 0.05,P ＜0.05).In the treatment group,97.4％ (75/77) physicians and 92.2％ (71/77) patients were satisfied with treatment effect,while in the control group,84.0％ (63/75) physicians and 78.7％ (59/75) patients were satisfied with treatment effect.During the study periods,there were 3 cases with facial flushing and 1 cases of dizziness in the treatment group,and 2 cases of facial flushing and 1 cases of dizziness in the control group.All adverse reactions were spontaneous remission without any special treatment.Conclusion Alpha lipoic acid intravenous drip is effective in term of treating type 2 diabetic peripheral neuropathy,and with high safety.

Objective To study the clinical applied value of computed tomography perfusion imaging(CTPI) in early stage of ischemic stroke.Methods Routine CT scan and CTPI were performed in 45 patients with early stage of ischemic stroke(onset within 24 hours).CTPI yields a set of perfusion related parameters of relatine cerebral blood flow(rCBF), cerebral blood volume(rCBV),mean transmit time(rMTT),time to peak(rTTP) and positive enhancement integral (rPE).Results In all 45 patients,21 cases showed concerning lesions in the 29 cases with cerebral ischemia results of routine CT scan.16 cases presented normal results. 24 cases were not showed concerning lesions.The sensitivity of diagnose for early stage of ischemic stroke by CT was 46.67% (21/45).The specificity was 72.41% (21/29).44 cases of CTPI with abnormal perfusion changes were all showed concerning lesions. Only one case of CTPI presented negative result,which was acute brainstem infarction confirmed by follow-up magnetic resonance imaging (MRI).The sensitivity of diagnose for early stage of ischemic stroke by CTPI was 97.78% (44/45).The specificity was 100% (44/44).There was significant difference between CTPI and routine CT scan(P

Objective To study congenital transmission of Trichinella spiralis in mice and observe the protection of anti-Trichinella antibodies from the infected dams to challenge infection. Methods According to the gestation (fertilization), the Kunming mice were divided into two groups: the infected group after gestation and the gestated group after infection. New-born mice were cut into small pieces to separate the larvae within 1 day after birth. One-day-old offspring born to normal dams were nursed by the infected dams, slaughtered after 21 days and examined for the larvae. Serum anti-Trichinella antibody level in offspring born to the infected dams was assayed by ELISA at different time after birth, and its immune protection against challenge infection was studied. Results Out of 6 offspring born to the dams infected at 7 days after fertilization, two were found to be infected. Among other female mice which were first infected with T. spiralis and then gestated, only the offspring born to the dams fertilized at 8 and 22 days after infection were found to be infected, the infection rate of offspring was 20% (2/10) and 25%(2/8) respectively. All larvae recovered from the young were non-encapsulated. The cross-fostering experiment showed that none of 30 offspring born to normal dams were found to be infected. The serum antibody positive rate in 27 offspring born to the infected dams at 1, 7, 24, and 40 days after birth was 100%, 100%, 77.8% and 14.8%, respectively. The worm reduction rate in the offspring 40 days after birth was 62.0% after challenge infection. The worm reduction rate in mice in which sera from the offspring born to the infected dams were passively transferred was 55.7%, there was a significant difference (P