Objective To discuss the clinical characteristics of patients withclinical features of patients with neuromyelytis opica and spectrum of neuromyelytis opica(NMOSD) and neuromyelitis optica (NMO).Methods With a retrospective study,From February 2013 to September 2016,a total of 72 NMO patients in Navy General Hospital for diagnosis and treatment were selected as the NMO the NMO group and the other 72 patients of NMOSD patients were selected as the NMOSD group.The results of two groups of patients with general demographic data,ocular symptoms,spinal cord and brain MRI,influence NMO-IgG were recorded.Results There were no significant differences in gender and age compared between the two groups (P ＞ 0.05).The clinical characteristics,frequency and duration in the NMOSD group compared to the NMO group were significantly different (P ＜ 0.05).In the NMOSD group,there were 8 patients who were decreased vision,4 patients were visual field defect,3 patients were discoloration,5 patients were diplopia.While in the NMO group,32 patients were decreased visual acuity,14 patients were visual field defect,12 patients were color vision,21 patients were diplopia.There were statistically significant difference between the two groups (P ＜ 0.05).In the NMOSD group,there were 8 patients were MRI of the spinal cord were normal,64 patients were abnormal and 32 patients of brain lesions in the head MRI.In the NMO group,MRI of the spinal cord were all abnormal,and there were 28 patients were brain lesions in the head MRI.The serum positive rate of NMO group was 41.7％,and the serum positive rate of NMOSD group was 59.7％.The sensitivity of AQP4-Ab antibody to NMO was 44.4％,the specificity was 75％,the sensitivity of AQP4-Ab was 61.1％,and the specificity of NMOSD was 75％.Conclusion The NMOSD is more with female patients,the first symptom is more with the spinal cord that the gray matter involvement in the spinal cord,and the performance of complex,NMO-IgG antibody can be used as a support for NMOSD diagnosis.

Objective To investigate the expression and clinical significance of UL16 binding protein 3 (ULBP3) in human esophageal squamous cell carcinoma (ESCC) and its correlation with nature killer (NK) cells.Methods The relative expression of ULBP3 in the ESCC tissues and corresponding carcinoma adjacent tissues of 40 patients was detected by realtime-poly merase chain reaction (PCR),immunohistochemical staining and Western blot methods.The percentage of NK cells in peripheral blood of same patients was examined by flow cytometry.The correlation between ULBP3 and the percentage of NK cells was analyzed with Pearson method.Results The expression of ULBP3 at mRNA level in the tumor tissues ([4.96 ±-6.11]×10-3) was significantly higher than that of corresponding carcinoma adjacent tissues ([1.64 ± 2.96]× 10-3,t =3.656,P＜ 0.01).The immunohistochemical staining results indicated that the positive rate of ULBP3 in the tumor tissues was 60％ (24/40),however that of corresponding carcinoma adjacent tissues was only 32.5％(13/40,t=3.921,P＜0.01).The Western blot results indicated that the expression of ULBP3 at protein level in the tumor tissues was significantly higher than that in the corresponding carcinoma adjacent tissues.The relative expresssion ULBP3 at mRNA level in carcinoma tissues of ESCC patients with lymph node metastasis and at TNM stage Ⅲ was higher than that of ESCC patients without metastasis and at TNM stage Ⅰand Ⅱ (t=4.839,4.192,P＜0.05).There was no significant correlation between the expression and ages,gender,location of tumors and the differentiation degree of tumor (P＞0.05).At early and mid stage of the tumor,the expression of ULBP3 at mRNA level was positively correlated with the percentage of NK cells in peripheral blood (r=0.5233,P＜0.05),however there was no correlation at advanced stage.Conclusion ULBP3 was highly expressed in ESCC and may be involved in the immune regulation of NK cells.

Objective To report the clinical outcome of L3～L5 fractures treated with USS short segmental pedicel screw system. Methods From 1994 to 2004, 57 cases of lower lumbar fractures were treated, of which 21 cases were treated with USS pedicel screw system. There were 12 cases of L3 fracture, 8 cases of L4 fracture and 1 cases of L5 fracture. The intervertebral height and lumbar lordosis were evaluated both before and after operation, the spinal impingement of bone was evaluated on CT scan, the neurofunction was evaluated with Frankle system and the clinical outcomes were evaluated with Charles system. Results The operation time ranged from 90 min to 150 min, averaging 120 min. The bleeding volume ranged from 100 ml to 600 ml, averaging 350 ml. The Frankle scores increased from 3.7 to 4.5 after operation. The intervertebral height of the fractured vertebral body increased from preoperative 30%to 60%to postoperative 70%to 100%(averaging 87%). The lumbar lordosis angel increased from preoperative 35.2?8.3o to postoperative 38.3?10.2o. The mobilization time was 3d to 2w, and the time for resuming work was 3 to 6w. The 3 to 30 months follow ups (averaging 15m) showed that the clinical outcomes were excellent in 9 cases, good in 9 cases, fair in 2 in and poor in 1. Conclusion The advantages of treating the lower lumbar fractures with short segmental USS pedicel screw system are effective restoration of intervertebral body height, lumbar lordosis and spinal volume, prevention of long term lumbago and lumbar stenosis, as well as early mobilization and return to work.

Diabetes patients in China is large in number, low level of health literacy, and their self management mainly relies on community doctor's health propaganda and education, as a result, it is very important to train community healthcare professionals to improve their communication skills with patients.Guided by the Social Cognitive Theory (SCT), the researchers developed a literacy-addressing training model specifically through: 1) low literacy healthcare education materials written in plain language, simple text, maximal white space, and behavior-oriented images or pictograms;2) a standardized health communication curriculum to promote simple communication with decreased jargon usage, teach teach back, and enhance shared goal-setting;3) use of standardized patients to enhance doctor-patient communication training;and 4) MOOC and a series of videos demonstrating doctor-patient communication scenarios.The novel training model can be used in continuing medical education through traditional on-site classes or by E-learning platform.It is expected to improve the communication skills of community doctors and patients, improve the satisfaction of both doctors and patients, and the effect of patients' self-management.

Objective To qualitatively analyze the expressions of key marker genes involved in osteogenic differentiation of bone marrow stromal cells (BMSCs) of mice at defined stages in vitro using real-time RT-PCR. Methods The BMSCs of mice were cultured in vitro and induced to osteoblasts for 7, 14, and 21 days. The total RNA was extracted from the cultured cells and the gene expression levels of collagenⅠ, bone alkaline phosphatase (APL), osteopontin (OPN) and bone sialoprotein (BSP) in the osteoblasts at the defined stages were determined by real-time RT-PCR. Results The ColⅠmRNA levels in 14 and 21 days were (0. 75?0. 04) and (0. 34?0. 03) times respectively of that in 7 days. ALP, OPN and BSP mRNA levels in 21 days were (19. 70?2. 36), (150. 12?9. 31) and (7. 73?0. 58) times of those in 7 days respectively. Conclusions ColⅠexpression levels tend to gradually decline while ALP, OPN and BSP levels gradually increase along with the culture time. Real-time RT-PCR is a reliable method for investigation of gene expressions in BMSCs cultured in vitro.

Application of lymphatic tracer has greatly facilitated lymphadenectomy of tumor resection.As a novel lymphatic tracer,activated carbon nanoparticles suspension has high lymph taxis and can stain lymph nodes black as indicators.Thus,carbon nanoparticles can help to track tumor lymphadenectomy,modify the efficiency of lymphadenectomy and improve the prognosis of patients.Now it has been widely applied in the area of surgical treatment of tumors,such as gallbladder cancer,pancreatic cancer,liver cancer,etc.

[Objective] To discuss the prognostic factors for cervical OPLL treated by anterior decompression.[Method]A total of 48 patients with cervical OPLL,who underwent anterior decompression,were followed up for 1～4 years,with an average of 2.1 years.The patients were classified into a good-prognosis group and a poor-prognosis group according to the JOA neruologic scoring system.Age,sex,JOA score,duration of symptoms,diabetes mellitus,Pavolv ratio,occupying rate,type of ossification,CT double-layer sign,hyperintense areas,level of segments,and treatment of ossification were testified using multiple logistic regression analysis.[Result]Treatment of ossification was the only statistically significant factor predicting clinical results in this study.[Conclusion]It is the most important to resect the ossification and decompress the spinal cord thoroughly in the process of antarior decompression for cervical OPLL.

Objective To investigate the clinical data of Mycoplasma pneumoniae pneumonia(MPP)compli-cated with embolism in children,and to improve the understanding of the clinical features,diagnosis and treatment of the disease.Methods Six cases of MPP complicated with embolization,who were treated at Nanjing Children′s Hospital Affiliated to Nanjing Medical University from January 201 0 to June 201 5,were analyzed retrospectively.Results The ages of 6 cases ranged from 3 years and 3 months old to 1 3 years and 1 0 months old,and 3 cases were boys,3 cases were girls.All of 6 patients had high fever,positive anti -Mycoplasma IgM antibody (≥1 160)and sputum fluores-cence quantitative -Mycoplasma pneumonia (FQ -MP DNA),and all the chest imaging was consistent with pneumonia. Among 6 patients,4 cases complicated with liver function damage,4 cases had D -dimer rise,5 cases of erythrocyte sedi-mentation rate increased at different degree,while pleural effusion or pleuritis was found in 5 cases.The region of embo-lism in the cases included left renal artery in 1 case,the left popliteal artery in 1 case,the right middle cerebral artery em-bolism combined with cerebral infarction in 1 case,the right subclavian vein embolism combined with right upper extremi-ty embolism in 1 case,the basilar artery and bilateral posterior cerebral artery embolism combined with cerebral infarction in 1 case,and the other case involved the right pulmonary embolism.One case received thrombus dislodgment operation, and all of 6 cases were given the treatment including anti -infection,anticoagulation and low dose of glucocorticoid the-rapy,among whom 1 case died of cerebral hernia,and the other 5 cases improved.Conclusions MPP is often complicated with hypercoagulative state and potentialized to thrombosis,and thrombus may occur in vessels of whole body organs,and cerebral infarction had poor prognosis.Consequently,doctors should be aware of the potential risk factors for thrombosis. Early diagnosis and prompt anticoagulation and thrombolytic therapy could reduce mortality and disability rate.

Objective:To study the correlation between the degree of rh eumatoid arthritis(RA) and periodontal bone loss. Methods:70 cas es of RA were included. Periodontal bone loss was examined by clinical attachmen t loss(CAL) test and radiography. The degree of RA was determined by the measure ments of morning stiffness time (MST),erythrocyte sedimentation rate(ESR)and C -reactive protein(CRP).Results:MST,ESR and CRP were positivel y related to the levels of bone loss(P

Objective To report a newly designed method of cervical subtotal corpectomy with the posterior vertebral wall retention. Methods 89 cases of cervical spondylotic myelopathy(CSM) or cervical injury were treated with subtotal corpectomy with the posterior vertebral wall retention from March 2001 to March 2004. 61 males and 28 females, aged from 25 to 76 years(mean, 47 years) were included, which involved 62 cases of multiple level in CSM with or without radiculopathy, 14 fractures of cervical vertebral body with or without cervical dislocation, 13 cervical instability with or without cervical disc disease. Subtotal corpectomy with 2 mm retention in posterior wall of the vertebral body were performed, in which 23 cases' level were C4,55 C5 and 11 C6. Extensive decompression through intervertebral body space was performed and bone fusion with autogenous iliac bone graft or titanium mesh supplemented with anterior locking plates were used, the bone graft or mesh were impacted into the decompression slot between the upper to lower endplate as well as the preserved lateral and posterior wall stably. Bone fusion were assessed with roentgenogram during the 3rd, 6th, 12th month follow-up and neurological function was recorded. Results The average operation time is 100 min, ranged from 55-130 min, the blood loss were 120 ml, ranged from 30 to 300 ml. Neither plate or screw migration, nor bone graft loosening or subsidence were found in 77 patients with over 6 months follow-up. Bone fusion happened in all patients, and Frankel score improved 1.0 level averagely after operation. 3 patients with hoarseness recovered 2 weeks later. Conclusion Subtotal corpectomy with posterior wall of vertebrae retention was a feasible anterior decompression procedure with advantage of safety, completely decompression and reliable bone fusion. This method included double level of CSM, and cervical fracture as well as two level of local ossification of posterior longitudinal ligament.