Objective To investigate the therapeutic effect of ectopic pregnancy prescription,mifepristone and methotrexate in the treatment of refractory tubal pregnancy.Methods 100 cases of refractory tubal pregnancy from January 2015 to December 2016 in our hospital,according to randomly divided into Chinese and western medicine group(ectopic pregnancy treatment prescription+mifepristone+methotrexate)and western medicine group(mifepristone and methotrexate)50 cases,compared two methods of treatment effect.Results After treatment,the two groups of patients with β-HCG level,ectopic pregnancy mass diameter showed a significant decrease,beta-HCG,ectopic pregnancy mass of Chinese and western medicine group were lower than the diameter of the western medicine group in the treatment of 7,10,14 days,the difference was statistically significant(P<0.05); The success rate of Chinese and western medicine group was 92.00％,which was higher than that of western medicine group(84.00％),but the difference was not statistically significant,failure of conservative treatment of patients were transferred to open surgery.In Chinese and western medicine group,the β-HCG value of blood beta was completely recovered and the disappearance time of ectopic pregnancy was significantly lower than that of western medicine group,and the difference was statistically significant(P<0.05).Conclusion Ectopic pregnancy prescription combined with mifepristone and methotrexate in the treatment of refractory patients with tubal pregnancy can accelerate the β-HCG level,ectopic pregnancy mass diameter reduced,can significantly shorten the treatment time.

Objective To investigate the changes and clinical significance of QT dispersion of patients with acute myocardial infarction especially those after thrombolitic therapy. Methods QTd, QTcd, QTLcd of 56 patients with AMI and 54 healthy people were measure through computer ECG. Results (1) The indexes of QTd in AMI group were significantly longer than normal ( P

Objective To investigate the clinical and imaging features of cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy(CARASIL).Methods Clinical data of a Chinese Mongolian patient with CARASIL were analyzed retrospectively and pedigree investigation was carried out in the family.Results The proband's parents were cousin and her brother was a patient with CARASIL too.The patients had onset at 25 and 23 years old,respectively.Clinical manifestations included cerebral stroke,progressive motor and mental deterioration,seizures,alopecia,and ocular fundus arteriosclerosis.No common risk factors of cerebral stroke were found in the family.Brain MRI showed bilateral diffuse cerebral white matter lesion with multiple infarcts and O'Sullivan sign.Cervical vertebral MRI showed multiple protrusion of intervertebral disc and significant retrogression.Conclusions CARASIL is clinically characterized by young-age-onset cerebral stroke,cerebral arteriosclerosis,alopecia,cervical and lumbar spondylopathy.MRI shows multiple cerebral infarcts,leukoencephalopathy and retrogression of intervertebral disc.

BACKGROUND: There are some reports about the relationship between atherosclerotic cerebral infarction and apolipoprotein E and B, but the results are still controversial. The relationship between apolipoprotein E and B and young adult atherosclerotic cerebral infarction has not been reported yet in China.OBJECTIVE: To investigate the relationship between the polymorphism of apolipoprotein E and B gene and young adults atherosclerotic cerebral infarction (ACI).DESIGN: A controlled case analysis of young adult atherosclerotic cerebral infarction patients.SETTING: Department of Neurology, Shengjing Hospital of Chinese Medical University.PARTICIPANTS: This study was conducted in the Department of Neurology, Shengjing Hospital of Chinese Medical University from January of 1998 to December of 2000. Thirty-six young adult patients with atherosclerotic cerebral infarction, including 30 males and 6 females, with the meaage of (41.6±6.54) years, and 100 healthy young adults, including 66 males and 34 females, with the mea age of (36.16±6.12) years were included in this study.METHODS: 8 Ml venous blood was collected after fasting for 12 hours to assay serum lipid and apolipoprotein. The gene polymorphism of apolipoprotein E and B were detected with PCR method. Enzymic method was used to detect total cholesterol, total triglycerides and high density lipoprotein-cholesterol (HDL-C). Apolipoprotein AI.B was measured with immunoturbidimetry method and lipoprotein (a) with ELISA method.Lipids, lipoprotein and apolipoprotein of six control blood samples couldn't be measured because of hematolysis.MAIN OUTCOME MEASURES: ① The distribution characteristics of genotypic frequency of apolipoprtein E and B in the two groups. ② The relationship between gene polymorphism of aoplipoprotein E and B and the level of blood lipids, lipoprotein and apolipoprotein. ③ The correlation intensity between genotypes of apolipoprotein E and B and onset of young adult atherosclerotic infarction.RESULTS: ① In ACI group, ε3/4 counted for 36.1% and ε2/4 for 27.7%, but was 12% and 7% in control group respectively. The gene frequency of ε4 was 0.320. All these values were higher than that in control group 0.95 (P ＜ 0.05). ② The levels of TG, TC, and LP (a) in ACI group were higher than that in control group. The level of HDL-C was much lower than the control group's (P ＜ 0.05-0.01). ③ ε4 allele caused the increase of the content of TG, TC, and LP (a) so as to induce the relative risk rates of decrease of HDL-C which were 8.23, 4.85, 29.9,4.39 (P ＜ 0.01-0.001) respectively. ④ AI content of the gene frequency of ApoB XbaⅠ X+X- was (1.01±0.30) g/L in ACI group, which was lower than (1.33±0.15) g/L in X-X- subgroup (t=2.55, P ＜ 0.05). The level of ApoA I in X+X group (244.3 mg/L) was remarkably different from that (183.0 mg/L)in control group (t=4.50, P ＜ 0.01). ⑤ Three cases had both ε3 and X+X-in ACI group, 10 had both ε3 and X-X-, 2 had both ε4 and X+X-, and 19 had both ε4 and X-X-. The risk of ACI was 2.85 with the linkage of allele ε4 and allele X-X- in ACI patients (x2=1.52, P ＞ 0.05).CONCLUSION: Allele ε4 is a genetic facilitated factor of young adults ACI. Xba Ⅰ X+X- is another probable genetic symbol. The correlation between atherosclerotic cerebral infarction of young patients during the combination of apolipoprotein E and B should be researched further.

Objective To explore the effect of apolipoprotein E (ApoE) gene polymorphism on brain volume in healthy young adults.Methods One hundred and ninety-three healthy young volunteers (age:20-40 years) were recruited in Shengjing Hospital of China Medical University between August 2013 and May 2014.Two milliliters of peripheral blood were collected for the determination of ApoE genotype using direct sequencing of polymerase chain reaction (PCR) products.Brain MRI scans were performed using three-dimensional T1-weighted turbo field echo imaging sequence.The diffcrences of brain morphometry between the ε4 carriers group (ε3/ε4 and ε4/ε4 genotype) and the ε4 non-carriers group (ε3/ε3 genotype) were analyzed using voxel based morphometry (VBM).Results The ε4 carriers accounted for 14.51％ (28/193) of the total population.Twenty of ε4 carriers and 45 of ε4 non-carriers were included in the final images analysis.VBM analysis showed that the ApoE ε4 carriers had 10 atrophic brain areas compared with the ε4 non-carriers (P ＜ 0.005,uncorrected,10 continuous voxels),which mainly located in the right anterior cingulate,the bilateral caudates,parietal lobes and lateral temporal lobes.Conclusions The influence of ApoE gene polymorphisms on brain volume has appeared in the youth.The ε4 gene is related to the reductions of the gray matter volume in multiple brain areas.

Objective To investigate the effect of PARP inhibitor 3?aminobenzamide(3?AB)on cortical neurons in streptozotocin?induced diabe?tes mellitus(DM)rats and the mechanism. Methods A total of 60 rats were divided into 3 groups randomly:sham?operated control group,DM group and DM+3?AB group,20 rats in each group. Morris maze was used to detect learning and memory abilities in each group. Spectrophotometer assay was used to detect the levels of superoxide dismutase(SOD),glutathione peroxidase(GSH?Px)and malondialdehyde(MDA)in cortex. West?ern blot was used to determine the expression of poly(ADP?ribose)polymerase 1(PARP1)in cortex. Immunohistochemical staining was used to de?termine the expression of caspase?3?immunoreactive neurons in cortex. Results DM rats showed significantly declined learning and memory abili?ties. Compared with the control group,the levels of SOD and GSH?Px were significantly reduced(P<0.01)and the level of MDA was significantly up?regulated(P<0.01)in the DM group. Compared with the DM group,the levels of SOD and GSH?Px were significantly higher(P<0.05)and the level of MDA was significantly lower in the DM+3?AB group(P<0.05). The expression level of PARP1 was significantly up?regulated in the DM group and was significantly decreased in the DM+3?AB group(P<0.01). The level of caspase?3 was significantly higher in the DM group than in the control group(P<0.01),and was significantly decreased in the DM+3?AB group(P<0.01). Conclusion 3?AB protected cortical neurons from apoptosis in DM rats by inhibition of PARP1 and alleviation of oxidative stress.

Objective Aiming at detecting Staphylococcus aureus、Pseudomonas aeruginosa and Klebsiella pneumoniae in laboratory animals,the paper provides a rapid,sensitive and simple test method.Methods According to Staphylococcus aureus nuc gene,Pseudomonas aeruginosa LasI gene,Klebsiella pneumonia PhoE gene and general 16S rRNA gene, designed specific primers;Through the optimization of multiplex PCR primer concentrations and annealing temperature, the specificity and sensitivity of detection, establishing multiplex PCR system.Application of the PCR system test specimens of artificial infections and experiment animal feces is compared with traditional test method.Results Multiplex PCR amplification of Staphylococcus aureus (153 bp), Pseudomonas aeruginosa (600 bp) with Klebsiella pneumoniae (368 bp) and general (520 bp).The multiplex sensitivity for the purpose of 10pg, specificity of detection was not detected from other pathogens.Application of establishing multiplex PCR system to detect the artificial positive samples, and detect 1 Pseudomonas aeruginosa positive case in 76 fecals.Conclusions This paper established the multiplex PCR method which has the advantages of specific,sensitive,simple and rapid, and provides a reliable way for rapid test in laboratory animals microbiology.

Objective To evaluate the efficacy and safety of recombinant adenovirus-p53(rAdp53) injection combined with radiotherapy and hyperthermia in the treatment of unresectable advanced soft tissue sarcoma.Methods In this retrospective study, we evaluated 76 patients with unresectable advanced primary or recurrent soft tissue sarcoma treated in our hospital from November 2005 to November 2012.These patients received radiotherapy and hyperthermia with rAdp53(p53 group, n=41) or without rAdp53(control group, n=35).rAdp53((1-2)×1012viral particles each time, once a week, 8 times on average) was injected into the tumor or infused into the pelvic cavity.Radiotherapy (2 Gy each time, 5 times a week) was performed for the planning target volume at 56.3±5.3 Gy in the p53 group and 58.1±4.2 Gy in the control group, with no significant difference between the two groups (P>0.05).Superficial or deep thermotherapy was employed 8 times on average (twice a week).Clinical features, response rate, time to progression (TTP), overall survival (OS), and adverse events were compared between the two groups (P>0.05).The Kaplan-Meier method was used to calculate OS;the log-rank test was used for survival difference analysis and univariate prognostic analysis;the chi-square test was used for comparison of categorical data.Results At 2 months after treatment, the p53 group had significantly increased response rate (partial response+ complete response+ stable disease)(85% vs.54%, P=0.003) and local control rate (49% vs.23%, P=0.020) as well as prolonged TTP (12 months vs.5 months, P=0.010) and OS (48 months vs.31 months, P=0.049), as compared with the control group.No adverse events caused by radiotherapy and hyperthermia except transient fever were seen in the two groups.Conclusions Concurrent radiotherapy and hyperthermia combined with rAdp53 injection is effective and safe for patients with advanced soft tissue sarcoma.

Objective To analyze the clinical presentation and genotype of a Chinese pedigree with early-onset familial Alzheimer's disease.Methods A pedigree with early-onset familial Alzheimer's disease was recruited.The clinical data of the proband who admitted to Shengjing Hospital in March 2018 and the family members were collected.The DNA sequences of 53 dementia related genes were screened using next-generation sequencing technology in the blood sample of the proband.The point mutation discovered in the proband was also investigated in some family members.Results There were five members with Alzheimer's disease in the pedigree,including the proband,a 42 years old female.The onset age of a pedigree member was 33 years and that of the proband was 37 years.A point mutation from T to C at position 698 (M233T) in the exon 7 of presenilin 1 (PS1) gene was found in the proband and two other family members who were clinically normal.Conclusions The M233T mutation of PS1 gene can lead to early-onset familial Alzheimer's disease.This family is the first pedigree with M233T mutation of PS1 gene in China,which deserves clinical attention.

Background: and Purpose The electrophysiologic characteristics of peripheral neuropathy secondary to nitrous oxide (N2O) abuse remain unclear. The paper therefore aimed to summarize the electrophysiologic characteristics of N2O-associated peripheral neuropathy and identify the risk factors of severe nerve injury. Methods: The electrophysiologic results and clinical data of patients with peripheral neuropathy secondary to N2O abuse at our hospital between 2018 and 2020 were analyzed retrospectively, and their electrophysiologic changes were summarized. Results: Most patients exhibited decreased sensory and motor nerve conduction velocities (75% and 76%), decreased sensory nerve and compound motor action potentials (57% and 59%), and prolonged distal motor latency (59%), while a response was absent in 36%. These findings indicate that N2O abuse can result in generalized injury to sensory and motor nerves. Electrophysiologic results indicated axonal neuropathy in 37 cases (49%), demyelinating peripheral neuropathy in 4 (5%), and mixed neuropathy in 12 (16%). Peripheral nerve injury was more common in the lower limbs (72%) than in the upper limbs (42%, p<0.0001). The upper and lower limbs were primarily affected by sensory nerve demyelination (35%) and motor axonal injury (67%), respectively. Subgroup analysis indicated that longer N2O exposure and longer disease course were associated with more-severe motor axonal injury in the lower limbs. Conclusions N2O-associated peripheral neuropathy can lead to sensory and motor nerve injury, with axonal injury being the most common. Injuries were more severe in the lower limbs. Prolonged N2O exposure and disease course increased the severity of motor axonal injury in the lower limbs.