Objective To explore the effect of biliary stenting combined with ademetionine on malignant obstructive jaundice.Methods According to the digital table,60 patients of malignant obstructive jaundice were randomly divided into the control group and the observation group.The patients in the control group were treated with biliary stenting individually,and the observation group received biliary stenting and combined treatment with ademeotionine.The variety of liver function and C-reactive protein were observed.Results The liver function and index of Creactive protein of patients in the observation group were significantly superior to those in the control group (all P ＜0.01).Conclusion The treatment of malignant obstructive jaundice by biliary stenting combined with ademetionine is effective.The mechanism may be related to the effect of ademetionine on promoting cytothesis,glutathione synthesis and eliminating free-radicals.

Objective To evaluate regional and global left ventricular systolic function after coronary artery bypass grafting (CABG) by speckle tracking imaging (STI).Methods Transthoracic echocardiography (TTE) was performed in 32 patients with coronary heart disease (CHD) preoperative and 3 months after CABG.The two-dimensional data were obtained in apical 4-chamble,2-chamble and long axis view.Peak systolic longitudinal strain (SLs),global longitudinal systolic strain (GLS) and average global strain(GLS-Avg) were measured using STI.30 healthy volunteers were involved as controls.Results SLs in the control group increased from the basal to the apical ventricular.SLs in the control group and CHD group apical segment were significantly higher than the basal and middle segments.Compared to the control group,SLs,GLS in part of myocardial ischemic segments were lower in CHD group before CABG (P ＜0.05).SLs and GSL in the corresponding segments showed significantly improving 3 months after CABG in CHD group (P ＜ 0.05).There was good relationship between GSL-Avg and left ventricular ejection fraction.Conclusions STI technology can be used to objectively and quantitatively evaluate the change of regional and global left ventricular systolic function.Therefore,it provide a non-invasive means for evaluation of curative effect and prognosis judgement of CHD after CABG.

Objective To explore the relevance between fasting plasma glucose (FPG) level in early pregnancy and gestational diabetes mellitus (GDM). Methods Clinical data of 5299 singletonpregnant women accepted antenatal examination and delivered in the Department of Obstetrics and Gynecology, Peking University First Hospital from January 1, 2008 to December 31, 2009 were retrospectively analyzed. Results (1) The pregnant women were divided into 3 groups according to their FPG levels at early stage of gestation: Group A, FPG ＜5. 1 mmol/L (n= 4565); Group B,FPG≥5.1, but ＜5.8 mmol/L (n=701); Group C, FPG≥5.8 mmol/L, but ＜7.0 mmol/L(n=33). The incidence of GDM in Group A, B and C was 10. 69% (488/4565), 26. 11% (183/701)and 54. 55% (18/33). (2) The incidences of large for gestational age (LGA), cesarean section,premature birth, preeclampsia, neonatal hyperbilirubinemia, neonatal hypoglycemia, neonatal polycythemia, and neonatal infection were compared between Group A and B. The cesarean section rate [54. 63% (282/518)]and neonatal hypoglycemia rate [1.54% (8/518)]of those who were not diagnosed as GDM in middle and late term in Group B were higher than those of Group A [49.03%(1999/4077) and 0. 61% (25/4077)] (P＜0. 05); while there were no differences between the other six index of Group A and Group B (P＞0. 05). The prognosis of the GDM patients who did not accept gestational glucose management in two groups were similar (P＞0. 05), so did the prognosis of the GDM patients who accepted gestational glucose management in two groups. After combining the patients of the two groups who were not diagnosed as GDM as a new group, they were compared with those who did not accept gestational glucose management of the two groups (Group A2 and B2)respectively. The incidence of LGA rate of the new group was lower than that of Group A2 (12. 00%va 4. 94 %, x2=21. 4159, P＜0. 05) and Group B2 (18. 39 % vs 4. 94%, x2 = 28. 7189, P＜0. 05).Cesarean section rate of the new group was lower than that of Group A2 (57. 78% vs 49.64%,x2 =5. 6806,P＜0.05) and Group B2 (66. 67% vs 49.64%, x2 =9. 9003, P＜0. 05). And there were no differences between the other six index between the new group and the other two groups (P＞0. 05). Conclusions The diagnosis criteria of GDM set as FPG≥5.1 mmol/L at early stage of gestation, recommended by International Association of Diabetes and Pregnancy Study Group, is not applicable in China yet. Oral glucose tolerance test in middle and late term is still the most important diagnostic tool for GDM.

A series of cycloberberine derivatives were designed, synthesized and evaluated for their anti-cancer activities in vitro. Among these analogs, compounds 6c, 6e and 6g showed strong inhibition on human HepG2 cells. They afforded a potent effect against DOX-resistant MCF-7 breast cells as well. The primary mechanism showed that cell cycle was blocked at G2/M phase of HepG2 cells treated with 6g using flow cytometry assay. It significantly inhibited the activity of DNA Top I at the concentration of 0.1 mg mL-1. Our results provided a basis for the development of this kind of compounds as novel anti-cancer agents.

A series of novel N-(2-arylethyl) isoquinoline derivatives were designed, synthesized and evaluated for their anti-cancer activities. Among these analogs, compound 9a exhibited the potential anti-cancer activities on HepG2 and HCT116 cells with IC50 values of 2.52 and 1.99 microg x mL(-1), respectively. Cell cycle was blocked at S phase of HepG2 cells treated with 9a by flow cytometry detection. Our results provided a basis for the development of a new series of anti-cancer candidates.

Objective To evaluate cerebral parenchymal atrophy of patients with Alzheimer's disease(AD)through the compara-tive analysis of the volume and morphology of the brain ventricle between patients with AD and normal elderly.Methods 20 patients with AD and 20 normal elderly people were scanned at 3.0T MR,and lateral ventricle section images were achieved,and the lateral ventricle volume and the anterior horn,posterior horn and temporal horn of the lateral ventricle were calculated by analyzing the re-construction of section images with MIMICS software from Belgian.Results As compared with normal elderly group,the patients with AD exhibited significantly increased the volume of left ventricular volume(LV),right ventricular volume (RV)and total vol-ume (TV)(P<0.05).Angle of bilateral anterior horn and temporal horn but not posterior horn of the lateral ventricle in patients with AD were significantly higher than that in normal elderly (P<0.05).The volume of the left,right and total cerebral ventricle, the angle of the anterior horn of the left and right lateral ventricle and the angle of the temporal horn of the left and right lateral ven-tricle were negatively correlated with MMSE (P<0.05).Conclusion Patients with AD exhibites significantly greater volume and an-gle of the lateral ventricular than normal elderly people.These related data measured can predict brain parenchymal atrophy of pa-tients with AD more conveniently and accurately.

OBJECTIVETo determine the CARD11 expression and its prognostic value in diffuse large B cell lymphoma (DLBCL).

METHODSThis retrospective study included previously untreated patients diagnosed with DLBCL from January 2007 to December 2012. Formalin-fixed, paraffin-embedded blocks of these patients were collected. Tissue microarray was built and expression of CARD11 was examined immunohistochemically. Subtype of DLBCL was determined by Hans algorithm (CD10, BCL6, MUM1). The pattern of CARD11 was further studied and their correlation with outcome was analyzed.

RESULTS79 patients with DLBCL were enrolled and two reactive lymph nodes were used as control. The positive rate of high CARD11 expression in DLBCL was 65.33%, which showed no significant associations with patients' characteristics. Positive CARD11 expression was associated with an inferior event free survival (EFS)(2- year EFS: 52.03%vs 86.12%,P=0.036). Even in patients with a high international prognostic index (IPI, 3-5 points), this difference still remained significant (Median EFS not reached vs 557 days,P=0.033).

CONCLUSIONDLBCL patients with high CARD11 expression had a shorter EFS compared with low level of CARD11. This difference remained significant when patients were in high IPI (3-5 points), which might indicate the value of CARD11 in stratification of high-risk DLBCL patients.

CARD Signaling Adaptor Proteins ; genetics ; metabolism ; Disease-Free Survival ; Guanylate Cyclase ; genetics ; metabolism ; Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; genetics ; metabolism ; Prognosis ; Retrospective Studies

Objective: To analyze the diagnostic value of skeletal muscle biopsy in patients with rhabdomyolysis. Methods: Clinical and pathological data of 26 patients with rhabdomyolysis from January 2002 to December 2018 undergoing muscle biopsy were collected. Results: Eighteen males and 8 females were finally recruited with median age of 6-73 (37.3±19.6) years. The average time from onset to biopsy was 44 days (median course was 30 days). All patients had acute manifestations with muscle pain and/or weakness. Serum creatine kinase was between 1 648-92 660 U/L. Muscle biopsies showed nonspecific changes in 12 cases (a few with type 2 muscle fiber atrophy, slight deposition of lipid droplets), 10 cases with necrotizing myopathy (muscle fiber necrosis and regeneration). Toxic neurogenic damages were seen in 2 cases (type 1 and type 2 angular atrophic muscle fibers with group change), lipid storage disease in 1 case (lipid droplets deposit significantly) and idiopathic inflammatory myopathy in 1 case (muscle fiber necrosis and regeneration, with lymphocyte infiltration). The etiology of non-specific pathological changes included short-term strenuous exercise in 6 patients, poisoning in two, chronic kidney disease in one, viral infection in one, hypothyroidism in one and unknown reason in one. As to patients with necrotizing myopathy, seven were poisoning or drug-related, one with hyperthyroidism, two with unknown reason. Conclusions Among the numerous causes of rhabdomyolysis, exercise usually links nonspecific skeletal muscle changes and poisoning or drug-related disorders are commonly associated with necrotic myopathy. Rhabdomyolysis induced by primary myopathy is rare.

OBJECTIVE: To explore the genetic basis of a child with holoprosencephaly. METHODS: Genomic DNA of the child was extracted and subjected to whole exome sequencing. Suspected variant was verified by Sanger sequencing of her family members. RESULTS: Cranial MRI suggested lobulated holoprosencephaly with partial absence of corpus callosum. Genetic testing revealed that she has carried a heterozygous c.517C>G (p.His173Asp) variant of the SIX3 gene, for which both of her parents were of wild type. Based on the American College of Medical Genetics and Genomics guidelines, the c.517C>G variant of SIX3 gene was predicted to be pathogenic (PS2+PM1+PM2+PM5+PP3). CONCLUSION The SIX3 gene c.517C>G variant probably underlay the multiple malformations in this child. Above finding has enabled her definite diagnosis.
Child ; Family ; Female ; Heterozygote ; Holoprosencephaly/genetics* ; Humans ; Mutation ; Whole Exome Sequencing

Objective To analyze the magnetic resonance imaging (MRI) images of patients with adult Japanese encephalitis (JE),and to investigate the diagnostic value of MRI for the disease.Methods Thirty-two adult JE patients who underwent cranial MRI at General Hospital of Ningxia Medical University between August 2016 and September 2018 were enrolled.All patients had disease onset between August and September and they aged 17 to 83 years old.The clinical data,laboratory results,MRI signal characteristics of each scanning sequence and the distribution of the brain lesions were retrospectively analyzed.Results Of the 32 adult JE patients,29 (90.6％)cases had acute onset,28 (87.5％) cases had unconsciousness and cognitive impairment,26 (81.2％) cases had intracranial hypertension,3 (9.4％) cases had meningeal irritation,3 (9.4％) cases had Parkinson-like symptoms,10 (31.2％) cases had epilepsy,and 15 (46.9％) cases had decreased muscle strength.Twenty patients were positive for JE virus-specific IgM antibodies.Twenty-eight patients underwent cerebrospinal fluid examination,15 (53.6％) cases showed intracranial pressure ≥180 mmH2O (1 mmH2O =0.009 8 kPa),7 (25％) cases developed lymphocyte reaction,and 16 (57.1％) cases showed mixed cell reaction.Twenty-three cases (71.9％) showed lesions of brain on MRI,including thalamus (17 cases,73.9％),hippocampus (13 cases,56.5％),cerebral peduncle (6 cases,26.1％),cortical and subcortical (4 cases,17.4％),basal ganglia (2 cases,8.7％),brainstem (1 case,4.3％) and splenium of corpus callosum (1 case,4.3％).Positive T1 weight image (T1WI) and T2 weight image (T2WI) results were found in 21 patients,respectively,23 patients had positive T2-fluid attenuated inversion recovery (FLAIR) images,and 20 patients had positive diffusion weighted imaging (DWI) images.Among them,T2-FLAIR and DWI images showed more lesions,wider range of lesions and clearer boundary of cortical involvement range than T1WI and T2WI images.Conclusions Bilateral thalamus and hippocampus are often involved in adult JE.T2-FLAIR and DWI sequences are more sensitive to detect lesions.Combining MRI images with epidemiological characteristics,clinical manifestations,and laboratory tests is of great assistance for early diagnosis of JE.