Objective To investigate the MRI features of intracranial lymphoplasmacyte-rich meningioma and the corelation between the MRI features and pathologic findings. Methods The MRI and pathologic data of 7 patients with lymphoplasmacyte-rich meningioma were reviewed retrospectively. All cases were proved by surgery and pathological examinations. Results All lesions were solitary. The tumors crawled along meninges in 6 cases and in 5 cases the tumors did not appear as mass lesions. In 2 cases, the tumors appeared as half-moon. The boundary of all of the tumors was unclear, accompanying heavy peritumoral brain edema. The brain invasion can be seen in 7 cases. The lesions showed hypo-isointense signal on T1 WI in 7 cases, hyper-isointense signal in 5 cases and hypo-isointense in 2 cases on T2 WI.Enhancement scan demonstrated marked enhancement in 7 cases. Extensive thickening of the meninges was observed in 6 cases. Pathological results showed that the cells were abundant and diversified, with a great quantity of lymphoplasmacytes, and there were typical meningeal epithelial cells area in the surgical specimen. Conclusion The MRI findings of lymphoplasmacyte-rich meningioma show some features different from other common meningiomas, which would be helpful to the diagnosis and differential diagnosis.

Toll-like receptors ( TLRs) are pattern recognition receptors, which exist in both cell membrane and cytoplasm, and participate in inflammatory reactions. Some studies have shown that TLR2/4-NF-κB signal pathways mediated by TLR2 and TLR4 could regulate the production of inflammatory factor IL-1β, which played an important role in the attack of gouty arthritis. The article focused on the pathogenesis of gouty arthritis, discussed the structure and distribution of TLRs, the ligands and its mediated signal pathways, the validity in the treatment of gouty arthritis using the signal pathways as the target points and the relationship between the signal pathways and gouty arthritis, and reviewed the research progress in Chinese medicines using the signal pathways as the guidance.

Objective:To explore the pharmaceutical care points in advanced lung cancer patients with brain metastases. Meth-ods:Clinical pharmacists participated in the drug treatment process of one case of small cell cancer patient with brain metastases. Pharmaceutical care was carried out from various aspects, including brain metastases treatment, chemotherapy, antiviral therapy and patient education. Results:Cerebral transfer symptoms and quality of life of the patient were effectively improved and adverse reactions were reduced by the pharmaceutical care. Conclusion:By the implementation of pharmaceutical care on the patient, clinical pharma-cists can not only improve their own knowledge base and exploit professional advantage, but also provide suggestions on rational drug use for health care professionals.

Objective To investigate the clinical manifestation,pathogenesis and imaging features of hemichorea associated with hyperglycemia in primary diabetes mellitus(DM).Methods Analyze the clinical manifestations,the neuroimaging features and the treatment of the three patients with hemichorea induced by hyperglycaemia in primary DM,and review the literatures about this disease.Results All of the three cases had a long history of uncontrolled diabetes,among whom,two were non-ketotic hyperglycemic patients and one was ketotic hyperglycemic patient.All of them had an acute onset hemichorea which was almost continuous during awakeness and ceased during sleep.The early CT findings in this disorder were high density in the caudate nucleus,putamen and/or globus pallidus on the side contralateral to the involved limbs,but showed decreased attenuation or completely resolved in about a month.T1-weighted MR images in all cases showed high-signal intensities without edema or mass effect in the diseased region which decreased after several months,while the T2-weighted images were more variable.Conclusion Hemichorea induced by hyperglycemia often happens in the patients with poorly controlled DM,and both of the non-ketotic hyperglycemic and the ketotic hyperglycemic state can be the cause.In the major affected region-corpora striata,CT shows hyperdense lesions,T1-weighted MR images show hyperintense lesions and T2-weighted images show variable lesions in the early time.

Objective To investigate the renal expression of stem cell factor (SCF) in lupus nephritis (LN) and its correlation with disease activity and renal injury parameters. Methods Histochemical stain was used to examine all renal specimens (LN group n=34, chronic glomerulonephritis n=16, control group n=8). Hyhridization in situ and immunohistochemistry were used to detect the expression of SCF and infiltration of mast cells, macrophages , α-SMA (+) cells in renal tissues of the two groups. SPS software was used for tissue of the control group. However, they increased markedly in lupus nephritis and CGN (t=6.03～14.25, P< 0.01). But there was no significant difference between LN and CGN in SCF and mast cells in renal interstitium. Positive correlation was observed among the expression of SCF and α-SMA and the number of mast cells and macrophages (r=0.47～0.84, P<0.01) at their corresponding locations. The expression of SCF and ot-SMA and the number of macruphages were positively correlated with renal pathological active index, chronic index, albuminuria and the injury of renal interstitium (r=0.34～0.93, P<0.05 or 0.01); meanwhile, it was negatively correlated with Ccr(r=-0.39～0.61, P<0.01). There was significant correlation between SCF, macrophages and anti-dsDNA antibody, complement C3 level, SLE disease activity index (SLEDAI). The number of mast cells in renal interstitium was positively correlated with chronic indexes and the injury of renal interstitium (r=-0.86, r=0.93, P<0.01) and negatively correlated with Ccr (r=-0.56, P<0.01), but not correlated with active index and albuminuria (r=0.27, r=0.23, P>0.05). Conclusion The expression of SCF is widespread in kidney, and it is markedly eorrelated with various kinds of inflammatory cells, renal inherent cells, renal function, and urine protein levels. SCF may be an critical participant in the initiation and progression of renal injuries in human lupus nephritis.

Standardized training of residents is a necessary way for clinical medical personnel train-ing. Residents graduating from medical colleges and universities should accept the standardized, scientific, strict pre-service training, in order to realize role conversion from medical students to hospital physicians. This paper summarizes and analyzes the pre-service training, focusing on the training object, course design, organization implementation, evaluation, questionnaire survey, and puts forward some thoughts and sugges-tions on strengthening and improving pre-service training form, expanding the content of training, and quan-tifying the evaluation of training effect.

Objective:To observe the clinical effects of extraoral manual reposition approach in the treatment of acute anterior disloca-tion of temporomandibular joint. Methods:98 patients with acute anterior dislocation of temporomandibular joint were divided into 2 groups(n=49) by random digit table and treated by manual reposition through intraoral and extraoral approach respectively. The suc-cess rate, success time, patient pain during treatment, SBP, DBP, HR and patient satisfaction were evaluated respectively. Results:The success rate(95. 92%) and the patient satisfaction rate(76%) of extraoral method group were higher than those of the intraoral method group (81. 63% and 66%);success time(3. 91 ± 0. 55)s and patient pain during treatment(3. 51 ± 0. 25) in extraoral method group were less than those in the intraoral method group[(5. 57 ± 0. 51) s and (6. 6 ± 0. 21)]. The degree of changes of SBP, DBP and HR in extraoral method group were less than those in the intraoral method group(P<0. 05). Conclusion:Extraoral manual reposi-tion approach is more effective than intraoral approach in the treatment of acute anterior dislocation of temporomandibular joint.

ObjectiveToinvestigatetheeffectsofcaveolin1(Cav1)onexpressionsofproinflammatory cytokine interleukin (IL)-1βand IL-6 in the ischemic cortex after permanent middle cerebral artery occlusion in mice. Methods The Cav-1 knockout mice (n=40) and wild-type mice (n=40) were randomly divided into ischemia groups and sham operation groups (n=20 in each group). They w ere also redivided into ischemia or sham operation at 3, 7, 10 and 14 d time points ( n=5 in each time point). A permanent middle cerebral artery occlusion model w as induced by the suture method. Immunohistochemical method w as used to detect the expressions of IL-1βand IL-6 in the ischemic cortex. Results The expression levels of IL-1βand IL-6 in the ischemic cortex at each time point in the ischemia group in Cav1 knockout mice w ere significantly higher than those in the ischemia group in the w ild-type mice ( al P< 0.05 ). Conclusions The upregulations of proinflammatory cytokines IL-1βand IL-6 in the ischemic cortex in Cav1 knockout mice suggests that Cav1 plays an important role in aleviating inflammation after cerebral ischemia.

Objective To identify novel mutations in the GATA6 gene associated with congenital atrial septal defects (ASD).Methods This was a case-control study.A cohort of 220 unrelated Han-race patients with congenital ASD and 200 unrelated ethnically matched healthy individuals used as controls,who were admitted to Tongji University Affiliated Tongji Hospital from January,2007 to October,2011,were recruited.The peripheral venous blood samples from the participants were prepared.All the coding exons and their flanking sequences of the GATA6 gene were amplified by polymerase chain reaction and sequenced using the di-deoxynucleotide chain termination technique.The acquired sequences were aligned with the sequences derived from GenBank by BLAST to identify the sequence variations.The software ClustalW was used to analyze the conservation of the altered amino acids.Results Three novel heterozygous missense GATA6 mutations,c.250G ＞A (p.A84T),c.649G ＞C (p.G217R) and c.1270A ＞C (p.S424R),were identified in 3 of 220 ASD patients,respectively.None of the three mutations was detected in 200 healthy control individuals.A cross-species alignment of GATA6 encoded protein sequences showed that the mutated amino acids were relatively conserved evolutionarily.Conclusion The identification of novel GATA6 mutations associated with ASD contributes to the reveal of the mechanism involved in the pathogenesis of ASD.

Objective To introduce our experience of performing posterior or anterior renal lip incision for partial nephrectomy in the treatment of renal hilum endophytic renal cell carcinoma.Methods From Jan.2010 to Jan.2014,five female patients with renal hilum tumors were treated in our institute.The median age was 54 (51-72) years.The median tumor diameter was 4.0 (2.8-4.8) cm.The median preoperative creatinine was 53.9 (52.6-75.4) μmol/L.One of them was solitary kidney with absolute indication; three cases had basic disease with relative indication; one was with selective indication.The patients were put in supine or lateral position.After general anesthesia,we preformed partial nephrectomy by cutting posterior renal lip in 3 cases and the anterior lip in 2 cases.We clamped the renal artery,opened the renal posterior or anterior lip,then dissected the tumor beside the pseudo-capsule.After removing the tumor,we used 3-0 absorption suture to control bleeding and repair the opened collecting system.Finally,we used 2-0 absorption suture to close the renal defect.Results The median operation time was 195 (155-215) min; the median renal warm ischemia time was 35 (15-70) min; the median postoperative hospital stay was 8 (7-9) d.There was no secondary bleeding and urine leakage happened.The pathological results showed that 3 cases with clear cell carcinoma,1 with papillary carcinoma and 1 with renal medullary interstitial cell tumor.All patients showed normal kidney shape.The median postoperative creatinine was 63.0 (59.4-75.4) μmol/L.After a median follow up of 24.2 mon,all patients survive without tumor recurrence.Conclusions The short-term result of posterior or anterior renal lip incision partial nephrectomy in treating endophytic renal hilum endophytic renal cell carcinoma is safe and feasible.