Objective To study the diagnosis and trea tm ent of multiple endocrine neoplasia type 2b. Methods On e case of MEN2b was reported.The clinical features,the diagnosis and treatment o f MEN2b were reviewed and presented. Results The diagno sis was established on B-ultrasonography and CT scanning,and the patient was cu red by operation. Conclusions MEN2b has been rare.Endoc rine check up,imaging procedures,family investigation and DNA analysis are very important to early diagnosis.Surgical removal of the tumors is effective.

Objective To investigate the genotypes of extended spectrum β-lactamases (ESBLs) and their carrying modes in Escherichia coli (E.coli) isolates,and to analyze the mechanism of protein phosphorylation and ESBLs gene expression induced by β-lactam antibiotics or inhibited by histidine kinase inhibitors.Methods The predominant genotypes of ESBLs (KPC,TEM,SHV and CTX-M) and their carrying modes were identified by PCR and sequencing analysis.E-test and micro-tube dilution method were applied to measure minimal inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs).Immobilized metal ion affinity chromatography,bacterial protein phosphorylation detection kit and real-time fluorescent quantitation RT-PCR were performed to analyze the enhancing effects of 1/4 MIC penicillin or cefotaxime or the inhibitory effects of histidine kinase inhibitors (closantel,bromized or iodized methylimidazol) on protein phosphorylation and the expression of ESBLs at mRNA level in E.coli isolates.Results In 183 β-lactam antibiotics-resistant E.coli isolates,TEM and CTX-M genes (83.1％ and 77.1％) were highly expressed than other two ESBLs genes with a prevalent carrying mode of coexisting (65.0％) (P＜0.05).Penicillin or cefotaxime at 1/4 MIC induced the protein phosphorylation and promoted the expression of TEM,SHV and CTX-M at mRNA level (P＜0.05).Closantel (200 μmol),bromized methylimidazol (2 or 10 μmol) or iodized methylimidazol (20 or 50 μmol) could neither kill E.coli isolates nor inhibit their growth,but could inhibit the protein phosphorylation induced by above mentioned antibiotics and enhance the expression of ESBLs at mRNA level (P＜0.05).Moreover,the susceptibility of antibioticresistant E.coli strains to penicillin and cefotaxime were increased (P＜0.05).Conclusion TEM and CTX-M were the predominant genotypes of ESBLs carried by β-lactam antibiotics-resistant E.coli strains isolated from Zhejiang province,which were mostly found in a TEM plus CTX-M carrying mode.Sublethal dose of β-lactam antibiotics could up-regulate the expression of ESBLs genes in E.coli isolates via TCSS,but it could be inhibited by histidine kinase inhibitors.

Aim To investigate the effect of astragalus injection on the expression of JNK3(c-jun N terminal kinase)protein and JNK3 mRNA interrelated by apoptosis after hypoxia/hypoglycemia and reoxygenation in hippocampal neurons of rats.Methods The hippocampal neurons cultured for eight days were divided into four groups:normal control group,hypoxia/hypoglycemia and reoxygenation group,astragalus injection group and astragalus solution group.Hypoxia/hypoglycemia and reoxygenation group,astragalus injection group and astragalus solution group were treated with hypoglycemia and reoxygenation after being deprived of oxygen and glucose for 30 minutes.Methods of Western blot,ELISA and RT-PCR were used respectively to measure the expression of JNK3 mRNA after hypoxia/hypoglycemia and reoxygenation 0,0.5,2,6,24,72,120 h.Results Compared with normal control group,the mean optic density(MOD)of expression of JNK3 protein and activation of JNK3 protein in hippocampal neurons of rats every time points increased obviously in hypoxia/hypoglycemia and reoxygenation group except 120 h(P<0.05);compared with hypoxia/ hypoglycemia and reoxygenation group,MOD of expression of JNK3 mRNA and activation of JNK3 protein in hippocampal neurons of rats every time points decreased obviously except 120 h in astragalus injection group (P<0.05);compared with hypoxia/hypoglycemia and reoxygenation group,there was no difference in astragalus solution group.Compared with normal control group,MOD of expression of JNK3 mRNA in hippocampal neurons of rats every time points increased obviously in hypoxia/hypoglycemia and reoxygenation group(P<0.05);compared with hypoxia/ hypoglycemia and reoxygenation group,MOD of expression of JNK3 mRNA in hippocampal neurons of rats every time points decreased obviously in astragalus injection group except 120 h(P<0.05);compared with hypoxia/hypoglycemia and reoxygenation group,there was no difference in astragalus solution group.Conclusion Astragalus injection can inhibit the expression of JNK3 mRNA after hypoxia/hypoglycemia and reoxygenation,moreover,it can inhibit the expression of JNK3 protein and decrease the activation of JNK3 protein,accordingly it inhibits hippocampal neuronal apoptosis.

Objective To discuss the distance training for medical staff of children's rehabilitation. Methods 15 lessions were carried out using computer software from April, 2013 to November, 2014 in our centre. 7 cooperative hospitals participated the trainings. The implemen-tation effect was surveyed after training. Results 2693 person-times attended the trainings, including 2109 person-times with living distance training and 584 person-times with video distance training. In the following sampling survey, 92.8%staff thought that the distance training was helpful to their work. 98.6%staff thought that the living distance training was better than the video distance training and 88.6%staff thought their rehabilitation level improved after the distance training. Conclusion The distance training of children's rehabilitation has the advantages of economy, convenience and celerity. It has a wide developmental prospect.

Objective To observed the impact of selenium supplementation therapy on the thyroid perioxidase antibody(TPO-Ab) levels and serum oxidative stress[malondialdehyde(MDA, glutathione peroxidase(GPx), and superoxide dismutase(SOD)] in patients with Hashimoto′s thyroiditis. Methods 79 patients with Hashimoto′s thyroiditis were randomly divided into trial group(n=44) and placebo group(n=35) .The double-blind treatment was for 24 weeks. The thyroid hormone levels, serum TPO-Ab levels, and oxidative stress indexes(MDA, GPx, and SOD) of both groups were detected before and after treatment. Results (1)There was no change of thyroid hormone levels either before or after treatments of both groups(P>0.05). (2)TPO-Ab of the trial group decreased significantly after the treatment(P<0.05). While the placebo group has little change. Group with TPO-Ab≤200 IU/ml and the course≤1 year manifested the most obvious declines by 29.98% and 26.63% respectively. (3)The oxidative stress level of trial group significantly decreased after 24 weeks. There was significantly positive correlation between the oxidative stress indexes and TPO-Ab. However the placebo group was with little change. Conclusion Selenium supplementation may reduce the level of TPO-Ab titers and oxidative stress in patients with Hashimoto′s thyroiditis, especially for those with lower antibody titers and short course.

Objective To study the correlation between human leucocyte antigen-G (HLA-G) 14 bp insertion/deletion (I/D) polymorphism and susceptibility to non-small cell lung cancer (NSCLC) as well as poor prognosis in NSCLC.Methods A total of 113 patients with NSCLC and 150 age-and sex-matched healthy subjects were genotyped by PCR to analyze the HLA-G 14 bp insertion/deletion polymorphism in them.Epidermal growth factor receptor (EGFR) gene mutation in patients with NSCLC was detected by using amplification refractory mutation system (AMRS).Expression of HLA-G in NSCLC tissues was detected with immunohistochemistry.All patients with NSCLS were followed up to collect survival data, which were further analyzed with Kaplan-Meier method.Results The frequency of HLA-G 14 bp D/D genotype was significantly higher in the patients with NSCLC than that in the healthy subjects (x2=3.907, P=0.048, OR=1.66).Among the patients with NSCLC, HLA-G 14 bp I/I genotype carriers had a shorter overall survival time as compared with that of HLA-G 14 bp I/D or HLA-G 14 bp D/D genotype carriers (P=0.005).Patients who received chemotherapy or radiation had significantly shorter survival time than those received EGFR-targeted therapy (P=0.001).Among patients who were positive for EGFR mutation, HLA-G 14 bp D/D genotype carriers had longer survival time than those carrying HLA-G 14 bp I/I or HLA-G 14 bp I/D genotype (P=0.041).The expression of HLA-G was closely correlated with HLA-G 14 bp polymorphism in patients with NSCLC (P=0.001).Conclusion These data, reported for the first time, indicates that HLA-G 14 bp polymorphism might be a genetic factor related to the susceptibility to NSCLC and associated with survival in patient with NSCLC after excluding the interference of molecular targeted agents.

Objective To develop a kind of rapid decompression equipment replacing the toughened glass simulating the state of aircraft cabin glass bursting on the fly.Methods The metallic membrane was used to isolate both chambers with different air pressures.The areas of decompression membrane and path were determined by calculating on the basis of aircraft decompression altitude,cabin pressure differential and decompression time.The structural strength was determined according to enduring force of the metallic membrane.The membrane was ejected by high pressure air using the ejection launch technology of aircraft missile.The result of simulating aircraft cabin glass bursting on the fly was achieved.Results The rapid decompression equipment ejected by air pressure in low-pressure chamber could achieve the state of simulating aircraft cabin glass bursting on the fly,and the best decompression time was 0.16 s.Conclusion The rapid decompression equipment ejected by air pressure accomplishes the decompression preparative in short time with easy operation,and can satisfy the desired requirements for the performance and precision.

Objective Combined with susceptibility weighted imaging (SWI) and proton magnetic resonance spectroscopy (1H-MRS) to study the hippocampus in the first-episode depression patients for exploring the causal relationship.Methods 20 first-episode depression patients and 20 healthy volunteers underwent SWI scanning and hippocampal 1H-MRS image,analysis and comparison the changes between the venous system and metabolism of two groups.Results Proton spectroscopy analysis showed that compared with the control group,bilateral hippocampal NAA/Cr(left hippocampus:depression group 0.95±0.77,control group 1.78±0.82; right hippocampus:depression group 1.12±0.74,control group 1.91 ± 0.80) and Cho/Cr (left hippocampus:depression group 1.08±0.83,control group 1.75±0.73 ; right hippocampus:depression group 0.91±0.68,control group 1.95 ±0.74) in the depression group was significantly lower,the difference was significant(NAA/Cr:t value in left and right were -3.14,-3.49,P＜0.05; Cho/Cr:t value in left and right were-3.25,-3.19,P＜0.05),however MI/Cr had no obvious changes (t value in left and right were 1.24,-1.27,P＞0.05).Magnetic sensitive scan showed depression group compared with the control group was significantly reduced in lateral vein diameter,length and branches (t value were 3.23,4.56,2.66,P＜0.05).Conclusion The SWI sequence and 1H-MRS imaging methods can become a new research idea about the central nucleus,and this idea may explain the causal relationship between the hippocampus in depression patients of vascular abnormalities and hippocampal neuronal metabolic abnormalities.

Objective To investigate the variation of middle cerebral arteries of rats in depression model by using 3D-TOF sequence on 3.0T MR.Methods Forty SD rats were randomly divided into control group and depressive group with 20 in each.Compared with control group,depressive group were handled according to the demand of rat depression model.Rats were scanned by 3.0T MR on 0th,4th,6th,8th week respectively.Using Mimics software,the variation of middle cerebral arteries were described and analysed.Results Compared with the control group,the middle cerebral arteries of depressive group rats changed along with the increase of time.On the 4th week,the diameter of the middle cerebral arteries of rats decreased significantly (the diameter of left middle cerebral arteries:control group (0.31 ±0.05) mm,depressive group (0.28±0.04) mm,t=2.76,P＜0.05 ; the diameter of right middle cerebral arteries:control group (0.30 ± 0.05) mm,depressive group (0.27± 0.03) mm,t =2.61,P＜ 0.05).On the 6th week,the length of the middle cerebral arteries of rats decreased significantly (the length of left middle cerebral arteries:control group (5.6± 0.77) mm,depressive group (4.9 ± 0.73) mm,t =2.84,P＜ 0.05 ; the length of right middle cerebral arteries:control group(5.5±0.76) mm,depressive group(4.8±0.72) mm,t=3.11,P ＜0.05).On the 8th week,the diameter and length of the middle cerebral arteries of rats decreased more significantly (the diameter of left middle cerebral arteries:control group (0.31 ±0.05) mm,depressive group (0.22±0.02) mm,t =5.50,P＜ 0.01 ; the diameter of right middle cerebral arteries:control group (0.30 ± 0.04) mm,depressive group (0.21 ±0.02) mm,t=5.57,P＜0.01 ; the length of left middle cerebral arteries:control group (5.6±0.78) mm,depressive group (4.3±0.70)mm,t=5.49,P＜0.01 ;the length of right middle cerebral arteries:control group (5.5 ± 0.79) mm,depressive group (4.2±0.71)mm,t=5.45,P＜0.01).Conclusion The variation of middle cerebral arteries of depressive rats reveals the relationship between brain vessels and depression in a certain extent.

Objective To explore the sensibility of the encephalic region affected by the inflammatory factor of cerebrospinal fluid(CSF) and the role of the inflammatory factor in the development of the depression.Methods Based on the evaluation of ethology,forty SD rats were randomly and equally divided into control group and model group which was exposed to chronic unpredictable mild stress for 4 weeks.Using analyzing technology 1 H-MRS to detect prefrontal cortex and hippocampus of each group and detecting the levels of interlukin 6(IL-6),interlukin 2 (IL-2),interlukin 10 (IL-10) in CSF at the beginning and 4 weeks later,and the correlation was analyzed between them.Results Compared with the control group,the values of Glx/ Cr and NAA/ Cr in bilateral prefrontal cortex were reduced which did not reach statistically significance (P ＞ 0.05),and the value of Cho/ Cr had no significant difference.The values of Glx/Cr and NAA/Cr in left hippocampus reduced significantly(Glx/Cr:(1.16 ±0.07),t =2.50,P＜0.05 ;NAA/Cr:(1.30 ±0.09),t=5.94,P＜0.01),and the value of Cho/Cr was increased which did not reach statistically significance(P＞ 0.05).The values of Glx/Cr and NAA/Cr were reduced and the value of Cho/Cr was increased in right hippocampus which did not reach statistical significance(P＞0.05).The depressive group had the significantly higher levels of IL-6,IL-2 in CSF(IL-6:(32.41 ± 3.52),t =11.46,P ＜ 0.01 ; IL-2:(18.89 ± 2.56),t =7.42,P ＜ 0.01),but no significant difference was found in the IL-10 level in CSF.The Glx/Cr of left hippocampus level was negatively correlated to the IL-6 and IL-2 level in CSF (IL-6:r =-0.555,P＜ 0.05 ; IL-2:r=-0.582,P＜ 0.05) ; the NAA/Cr of left hippocampus level was negatively correlated to the IL-6 and IL-2 level in CSF(IL-6:r=-0.582,P＜0.05;IL-2:r=-0.607,P＜0.05).Conclusion The development of inchoate depression has a correlation with the high sensibility of the left hippocampus affected by the inflammatory factor levels.The metabolism of never cells has changed,which maybe constitutes the physiopathology basis of the depression.