Objective To describe the clinical and radiological characteristics, the etiology, clinical course and MRI findings and prognosis of reversible splenial lesion syndrome ( RESLES) are analyzed.Methods Clinical and MRI findings of adult patients who presented with RESLES were retrospectively reviewed.Corresponding to severity of disability using Modified Oxford Handicap Scale ( MOHS ) , patients were classified into favorable outcome group (MOHS≤2)and poor outcome group(MOHS≥3),clinical and neuroimaging features between two outcome groups were compared.Results Eight patients fulfilled the criteria were included, who suffered from a broad spectrum of disorders, including mild encephalitis/encephalopathy, Marchiafava-Bignami disease and antiepileptic drug withdrawal.MRI found a high signal lesion in the splenium with or without the other parts of corpus callosum and extracallosal involved.The hyperintensity disappeared or lapsed comfirmed by repeated MRI.There is an significant difference on symptoms of severe disturbance of consciousness during clinical course and MRI showed extracallosal lesions between two groups (P<0.05).Conclusions RESLES is a rare entity with wide clinicoradiological spectrum due to varied diseases and conditions.Although overall symptoms of patients with RESLES trend to relieve, the prognosis of patients with severe disturbance of consciousness and extracallosal lesions are unlikely to be favorable.

Objective To evaluate the relationship between cytotoxin-associated gene-A (CagA)seropositive of Helicobacter pylori (H .pylori )infection and risk of atherosclerotic cerebral infarction(ACI).Methods Related literatures were researched through literature retrieval ,literatures were obtained by uniformed criteria of inclusion and exclusion,and Meta analysis was performed with RevMan 4.2 software.Results A total of 10 literatures which met the inclusion criteria were retrieved,all were case-control study,case group included 907 studied subjects,and control group included 966 subjects;the included population were divided into Chinese subgroup and European Caucasian sub-group.Meta analysis of CagA seropositive of H .pylori infection and risk of ACI revealed that OR of the overall popula-tion,Chinese subgroup,and European Caucasian subgroup was 2.66(2.17-3.26),2.60(1.93-3.49),and 2.71(2.05-3.59)respectively;Meta analysis of CagA seronegative of H .pylori infection and risk of ACI revealed that OR of the overall population,Chinese subgroup,and European Caucasian subgroup was 0.74(0.49-1.10),0.81(0.45-1.48),and 0.64(0.37-1.09)respectively.The funnel plot and fail-safe number showed that there was no significant publication bias, the result was stable and reliable.Conclusion Chronic infection caused by CagA seropositive strains of H .pylori may be one of the risk factors of CAI,whether the eradication treatment of seropositive strains of H .pylori influences the process of atherosclerotic diseases like CAI needs to be further studied.

Objective:To evaluate the utilization of both parenteral nutrition and enteral nutrition drugs for the reference of clinical medication.Method:The statistics on nutrition drugs in a hospital from 2006 to 2008 were conducted by the defined daily dose method.Result:The cost ratio of the nutrition drugs to the total drug consumption increased annually.Glutamine was the leading nutrition drug according to the increase tendency of DDDs.The utilization ratio of enteral nutrition drugs to the whole nutrition drugs increased continuously,from 8.72%to 15.58%during 2006 to 2008.Conclusion:Nutritional support has attracted more and more clinical attention,and DDDs of the enteral nutrition increases rapidly.

Objective To compare the curative efficacy and safety of subcutaneous immunotherapy (SCIT) versus sublingual immunotherapy (SLIT) for allergic rhinitis.Methods A total of 127 cases of patients with allergic rhinitis in the outpatient department of our hospital from June 2009 to March 2016 were retrospectively analyzed,including 79 cases treated with SCIT and 48 cases treated with SLIT.The curative effects and adverse reactions were compared between the two groups.Results After 3-year treatment,the total effective rate in the SCIT group was 75.9%,which was higher than 72.9% in the SLIT group,but the difference was not statistically significant (χ2=0.15,P>0.05).The incidence rate of adverse reactions in the SCIT group was 26.6%,which was higher than 10.4% in the SLIT group,the difference between the two groups was statistically significant (χ2=4.79,P<0.05).Conclusion The two desensitization treatment methods all gain better effect,but SLIT has lower occurrence rate of adverse reactions.

Objective To investigate the risk factors of wound healing 30 days after treatment in patients with pressure ulcer. Methods Two hundred and forty-five hospitalized patients with pressure ulcer between January 2015 and October 2016 were selected. They were divided into the healed group and the unhealed group 30 days after the treatment. The influencing factors 13 indexes including age, gender, edema, the number of diseases, the number of pressure ulcer, the size of pressure ulcer, PUSH score (Pressure Ulcer Scale Healing), hemoglobin, serum albumin, low density lipoprotein cholesterol and blood homocysteine underwent single factor and Logistic regression analysis. Results Single factor analysis of 12 indicators of risk factors affecting healing were age, Hb, Alb, Hcy, area of ulcer and PUSH scores of the 6 indicators in the regression equation (Z=3.11-6.63, All P < 0.01), gender also entered the regression equation (χ2=0.19, P<0.01);further multivariate regression analysis showed that there were statistically significant differences in PUSH score index (χ2=10.47, P<0.01, OR=0.001, 95%confidence interval were 0.001-0.037). Conclusions Age, gender, Hb, Alb, Hcy and PU area were the risk factors of pressure ulcer healing.

Objective To explore the clinical effect of atomoxetine on children with attention deficit hyperactivity disorder(ADHD)comorbid tic disorder.Methods The children who met the criteria of Mental Disorders Diagnostic and Statistical Manual diagnostic criteria for ADHD and tic symptoms were given systematic atomoxetine titration reaching the optimum dose.ADHD and tic symptoms were evaluated with ADHD rating scale-Ⅳ(ADHD-RS-Ⅳ)for parents Yale Global Tic Severity Scale(YGTSS),respectively.Results Twenty children with ADHD comorbid tic disorder [17 male,3 female;age range 7.58-17.0 years,mean age(10.55?2.58)years] completing systemic titration was enrolled in the study,including 10 subjects with ADHD-inattentive type,9 mixed type,and 1 hyperactive/impulsive type.The mean optimal dose was(1.19?0.21)mg/(kg?d).The total score(12.65?9.08)scores,inattention score(7.45?4.75)scores and hyperactivity/impulsivity score(3.0)of ADHD-RS-Ⅳ decreased significantly post-treatment compared with pro-treatment(31.10?8.52,17.60?3.09,and 13.0 scores,respectively,P

Objective To explore the effect of TBL based on evidence-based medicine PICOS model in practice teaching of neurology. Methods Totally 47 medical undergraduates in our department were chosen and randomly divided into 2 groups during March 2016 to April 2016. 24 students in the trial group were taught with TBL based on PICOS, while other 23 students in the control group were only taught with conventional TBL method. After three times clinical practices, the test referring to disease pathogenesis, clinical manifestations, auxiliary examinations, diagnosis and treatments of related diseases was performed, and meanwhile, questionnaires were distributed to students in order to survey their satisfaction degree of teaching methods. All the evaluation results and scores of two groups were compared. Statistical data were analyzed by using t-test or Chi-square test with SPSS 17.0 software. Results The score of the theoretical test of trial group was significantly superior to the control group [(89.08±3.60) vs. (79.09±7.75), t=5.707, P=0.03 ]. Survey showed that in the experimental group , the number of students in the trial group who thought teaching method could help understand clinical thinking of neurology and could help integrate the theory into clinical practicewas significantly higher than that in the control group (P<0.05). Conclusion In the clinical teaching of neurology, the TBL based on PICOS model is more effective than conventional TBL method for medical undergraduates.

OBJECTIVE: To investigate the level of H2-Ab1 in the nasal mucosa of mice with allergic rhinitis. METHOD: Twenty-four female 129/sv mice were divided into 2 groups: ovalbumin (OVA) group and control. The allergic rhinitis models were induced by classical method with OVA. After the last challenge, the pathological differences between the two groups were surveyed. The levels of H2-AB1 were measured by ELISA and quantitative real time PCR. RESULT: The expression of H2-Ab1 is higher in subjects with AR than that in controls (P < 0.05). CONCLUSION The levels of H2-Ab1 were highly increased in allergic rhinitis group, which might be associated with the pathogenesis of allergic rhinitis.
Animals ; Female ; Gene Expression ; Histocompatibility Antigens Class II ; genetics ; metabolism ; Mice ; Nasal Mucosa ; metabolism ; Rhinitis, Allergic ; metabolism

Objective The purpose of our research was to quantitative study the degeneration of lumbar intervertebral discs by using T2 mapping technology at 3.0T MR and research the correlation of biomechanics and lumbar disc degeneration.Methods 34 patients with low back pain or sciatica were enrolled.The correlation of T2 values of lumbar intervertebral discs and Pfirrmann grading,disc location,patient ages were analyzed.T2 values before and after loading were also analyzed.Results T2 values of nucleus pulposus were correlation with Pfirrmann scoring,disc location and,patient ages.Conclusion (1 )T2 mapping provides a non-invasive and quantitative way to diagnose lumbar discs degeneration.(2)The change of external pressure load can affect the T2 values of the intervertebral disc.

Objective To evaluate the patient-controlled paravertebral block (PCPB) in optimizing the cellular immune function when used after radical resection of pulmonary carcinoma performed via video-assisted thoracoscope in patients.Methods Forty-one ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 50-64 yr,with body mass index of 20-25 kg/m2,of TNM staging Ⅰ or Ⅱ,undergoing radical resection of pulmonary carcinoma performed via video-assisted thoracoscope,were randomly divided into 2 groups using a random number table:PCIA group (n =21) and PCPB group (n =20).PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline.The PCIA pump was set up to deliver a 2 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.In PCPB group,the patients received paravertebral injection of 0.2％ ropivocaine 5 ml at T5 level on the affected side under ultrasound guidance at the end of operation,and then received PCPB.PCPB solution contained 0.75％ ropivacaine 67 ml in 250 ml of normal saline,and the pump was set up to deliver a 5 ml bolus dose,with a 15-min lockout interval and background infusion at 5 ml/h.VAS score was maintained ≤ 3,and analgesia lasted until 50 h after operation.Before induction of anesthesia (baseline),at end of operation,and at 1,3 and 5 days after operation,peripheral venous blood samples were collected to determine the levels of regulatory T cells,natural killer cells and natural killer T cells (by flow cytometry) and plasma concentrations of interleukin-10 and transforming growth factor-β (by ELISA).Results Compared with group PCIA,the level of regulatory T cells was significantly decreased,the levels of natural killer cells and natural killer T cells were increased,and the plasma concentrations of interleukin-10 and transforming growth factor-β were decreased at 1 and 3 days after operation,and no significant change was found in the rate of cellular immune function decline after operation in group PCPB.Conclusion PCPB provides no significant difference clinically in optimizing the cellular immune function when used after radical resection of pulmonary carcinoma performed via video-assisted thoracoscope in the patients.