Objective To analyze the causes of death in patients with uremia during maintenance hemodialysis and explore the countermeasures for improving life quality and decreasing mortality.Methods A retrospective analysis was made on the clinical and hemodialysis material fo 145 patients with MH to analysis the causes of death.Results The total number of deaths was 38;cerebral hemorrhage 6,heart failure 16,infection 5,the mean age in the deceased group was older than that in the survival group.The systolic blood pressure in the deceased group was higher than that in the survival group,but the levels of serum albumin,serum total cholesterol,serum creatinine,and urea nitrogen in the deceased group were much more lower than those in the survival group.The mean duration of hemodialysis in the deceased group was shorter than that in the survival group.Conclusion Cardiovascular disease and severe infections were the leading causes of death in patients with maintenance hemodialysis.Controlling the inter-dialysis weight gain and blood pressure,improving the anemia and main-nutrition were the significant management of prevention of cardiovascular complications.

Apolipoprotein E (ApoE) was purified from human serum and used as the antigen to immunize BALB/C mice. The splenic cells of the mice fused with NS-1 mouse myeloma cells. Three hybridoma cell lines(E3C3, E6C3 and E4C2)secreting anti-human ApoE McAb were established. The immunological property of the McAb was studied. The ascites fluids titer were 8?10~(-5)2?10~(-6). The McAbs did not cross react with the other apolipoprotins. ApoE was purified by immunoaffinity chromatography prepared by using the ApoE McAb. McAbs recognized two distinct respective epitopcs on ApoE. The subclass of immunoglabulin of three McAbs were IgG_1. A double McAb sandwich EL1SA was developed to evaluate ApoE levels in normal and hyperlipidemia human serum.

Amyotrophic lateral sclerosis (ALS) is a rare neurodegenerative disease characterized by progressive loss of upper and lower motor neuron. Insomnia is one of the widespread but underappreciated non-motor symptoms in ALS patients, which may not only seriously affect patients′ quality of life, but also reflect the lesions of central nervous system in ALS. This review summarizes the insomnia symptoms reported in current ALS studies, and summarizes the somatic factors and central nervous system changes associated with insomnia in ALS patients, so as to provide ideas for the development of effective intervention measures and future research.

Objectives To evaluate the application of systemic octreotide radioactive imaging in diagnosis and follow-up for children with neruoblastoma (NB). Methods Clinical data of 14 children with NB applied systemic octreotide radioac-tive imaging from April 2006 to March 2011 were collected and analyzed. For the ifrst-visit patients, they were applied with systemic octreotide radioactive imaging at the ifrst follow-up appointment after routine treatment. And for recurrent or sus-pected recurrent cases, systemic octreotide radioactive imaging was applied before the treatment and after 2-3 weeks chemo-therapy. Results Nine of 14 patients were male and 5 were female with a median age of 4.8 years (1-10 years). According to In-ternational Neuroblastoma Staging System (INSS), 4 cases were categorized as stage 3 and 10 cases were categorized as stage 4. The uptake rate of systemic octreotide radioactive imaging in primary site or metastasis sites of 8 cases were higher than nor-mal site with positive rate of 57.14%(8/14). One case was conifrmed as false positive by treatment and imaging examination. Six cases were negative in primary site or metastasis sites with negative rate of 42.86%(6/14). One case was conifrmed as false negative via treatment and imaging examination. Therefore, the sensitivity of systemic octreotide radioactive imaging reached 85.71%(12/14). Conclusion Systemic octreotide radioactive imaging could be one of the effective methods for NB in diagno-sis, follow-up and evaluation of prognosis.

Objective To investigate relationships between serum asymmetric dimethylarginine (ADMA) and transient ischemic attack (TIA).Methods Forty hcalthy controls and 40 patients with TIA were enrolled in the present study.ABCD2 score was used to evaluate risk for future stroke.Serum ADMA levels were measured with ELISA analysis.Results Serum level of ADMA was higher in TIA group than that in control group [(0.52 ± 0.06) mmol/L vs (0.23 ± 0.04) mmol/L,P ＜ 0.05].In TIA subgroup,19 cases(47.5％)developed cerebral infarction and 23 cases(57.5％)had no stroke history.There is positive correlation between serum ADMA levels and ABCD2 score in both cerebral infarction subjects (r =0.560,P =0.013),and no stroke history cases(r =0.602,P =0.002).TIA subjects were,then,divided in to two groups based on ABCD2 score as 0-3 group and ≥ 4 group.In general linear model analysis,ADMA level was associated with ABCD2 score (F =4.39,P =0.043) after adjusted for age and gender.This situation hold true for subjects within cerebral infarction group (F =7.327,P =0.017) or non-previous stroke group(F =12.300,P =0.002).No association could bc found between ADMA level and ABCD2 score grouping in subjects with non-infarct (F =0.523,P =0.675) or stroke history (F =0.274,P =0.609).Conclusions Elevated ADMA is associated with occurrence of TIA.Endothelial dysfunction may play an important role in the pathogenesis of TIA.

Objective To identify the factors related to amyotrophic lateral sclerosis (ALS) prognosis in a retrospective study.Methods One hundred and six patients were evaluated with ALS enrolled in our hospital from January 1994 to December 2004.The patients were monitored with a standard evaluation form,which recorded clinical features,function rating scale (FRS) and forced vital capacity (FVC) every 3 or 6 months from visit to death or having tracheostomy.Results Mean age at onset was (52.1±10.5) years.According to revised El Escorial diagnostic criteria (EEDC),52 patients had definite ALS,37 probable ALS,17 possible ALS.The median survival time from symptom onset was 35 months (95% CI 30-40 months).In the univariate analysis,survival was significantly related to lesion site,lag time from onset to diagnosis and predicted FVC at diagnosis (Log rank 6.84,43.30,4.78,all P < 0.05).In the Cox multivariate model,lag time from onset to diagnosis was significantly related to survival (Wald 20.221,hazard ratio 0.351,P<0.05).Age,sex,EEDC classification,FRS at diagnosis were not related to survival.Conclusion Lag time from onset to diagnosis is a strong predictor of survival,which suggests that progression rate is highly related to survival and further study is needed.

Objective To evaluate the subject's absorbed dose,equivalent dose and effective dose.Methods The CBCT unit was Implagraphy and three scan projections were selected such as mandible,maxilla and temporamandibular joint (TMJ).Thermoluminescent dosimeter tubes were used to record the absorbed dose at special positions in the head and neck region of an adult skull and tissue-equivalent phantom.16 interested organs included pituitary,lens,parotid glands,submandibular glands,sublingual glands、diploe,spongy bone of the chin and cervical vertebra,skins of cheeks and nuchal region,thyroid and esophagus.The absorbed dose was measured in these organs,and then the effective dose(E1990,E2007)were calculated according to different ICRP tissue weighting factors.Results The absorbed dose of mandible,maxilla and TMJ scan varied from (0.99 ±0.09) to (12.85 ±0.09)mGy,(0.93 ±0.01) to (13.07 ±0.02) mGy and (0.68 ±0.01) to (10.18 ± 0.04)mGy.There was significant difference among the three scan projections (F =19.61-30992.27,p ＜ 0.05).The equivalent doses of lens and skin were (1.11± 0.07)-(5.76 ± 0.06) mSv and (6.96 ± 0.06)-(10.64 ± 0.07) mSv.There was significant difference among the three scan projections(F =4473.02,9385.50,P ＜0.05).The effective dose(E1990,E2oo7) was [(191.35±1.53),(325.17 ±2.58) μSv] for mandible scan,[(106.62 ±2.17),(226.28 ±2.81)μSv] for maxilla scan,[(104.21 ± 1.02),(142.36 ± 1.90) μSv]for TMJ scan,respectively.Conclusions The valid measurement should be taken to reduce the subject' s dose such as a careful history and clinical examination before the performance of CBCT,the latest risk/benefit assessment,precise scan position,the shielding of thyroid as well as brain and the smaller volume size as well.

ObjectiveTo investigate the characteristics of three vaginal bacteria inspection methods of Amsel method,gram staining Nugent score method and bacterial vaginosis (BV) Blue methodMethods The leucorrhea specimen of 99 vaginal fluid abnormal patients were examined by Amsel method,gram staining Nugent score method and BV Blue method,then compared and analyzedResultsThe positive rate was 28.28％ (28/99) in Amsel method,47.47％(47/99) in gram staining Nugent score method and 16.16％ (16/99) in BV Blue method.There were significant differences among three methods(P＜ 0.01 ).The specificity and sensitivity of gram staining Nugent score method was higher.ConclusionThe three vaginal bacteria inspection methods have advantage and shortcoming individually,suspecting patients should be followed up to detect and diagnose in chnic,or detected by many methods.The specificity and sensitivity of gram staining Nugent score method is higher,but BV Blue method is simple,faster,which has higher value in detection and diagnosis in BV.

Objective To investigate the progression rate and prognosis of spinal decompression surgery after the onset of symptoms of amyotrophic lateral sclerosis(ALS).Methods A total of 329consecutive patients with deftnite or probable ALS were enrolled in the study.The patients were recorded with clinical features,history of spinal surgery,etc. Some of the patients were monitored every 3 months from visit to death or tracheostomy.Results Of 329 typical sporadic ALS,we found cervical spondylosis in 156(47.4%)patients,among whom 19(5.8%)underwent decompressive spinal surgery.No differences were noted regarding age at symptom onset,Sex and ALSFRS-R at time of diagnosis between ALS patients who underwent spinal surgery and other ALS patients.But the time from symptom onset to diagnosis was significantly longer in patients with spinal surgery((23.0±6.5)months vs(13.7±7.9)months,t=4.800,P=0.000).In the folow-up study,there were no differences in the rate of disease progression and survival between 2 groups.Conclusions All patients have inevitably progressed after spinal surgery.Although the surgery does not obviously fasten disease progression rate and shorten survival,it prolongs the time from disease onset to diagnosis,therefore should be handled with caution in patients with concurrent ALS and cervical spondylotic myelopathy.

[Objective]To evaluate the accuracy of computer-assisted cervical pedicle screw installation and discuss the reasons of screw malposition.[Method]Totally 144 cervical pedicle screws were installed by computer-assisted navigation in 25 patients with lower cervical spinal disease.All the patients were examined by X-rays and CT after operation.Screw position and direction were measured on the sagittal and transsection image of intraoperative navigation and post-operative CT.The result was analyzed statistically.[Result]Two screws perforated the upper pedicle wall,3 deviated from the lateral pedicle wal1.There was no statistical difference in screw position or direction between navigation and CT image.Navigational images were based on the principle of rigid tissue.[Conclusion]Computer-assisted navigation can improve the accuracy of cervical pedicle screw installation.Screw malposition is responsible for the excursion phenomenon.