Objective:To compare the clinical and imaging characteristics between central nervous system vasculitis(CNSV)and mitochondrial encephalomyopathy(ME),so as to analyze the differential diagnosis of the two disorders.Methods:Clinical data on seven patients with CNSV and five with ME were retrospectively analyzed.The clinical manifestations,laboratory parameters,imaging features and histological characteristics were compared to screen for the evidence of their differential diagnosis.Results:The MRI results of both CNSV patients and ME patients(MELAS type)showed a multi-lesion pattern.The symptoms of CNSV patients included headache,limbs weakness,and erythrocyte sedimentation rate(ESR)increase.The symptoms of MELAS patients included epilepsy and increased serum lactic acid.The electroencephalographic manifestations of both diseases were abnormal:CNSV patients mainly had diffused lesions accompanied with limited alterations;ME patients had evidence of epileptic discharge,which was consistent with the clinical symptoms.Conclusion:Clinical manifestations of CNSV and ME patients are more valuable than imaging findings in the diagnosis of the two diseases.CNSV is characterized by vascular disorders and inflammatory reactions;ME is characterized by abnormal energy metabolism and severe damage of gray matter.The final diagnosis should depend on laboratory and histological examinations.

BACKGROUND: Clinical experiments indicates that Yufeng capsule (composed of milkvetch root, angelica, szechwan lovage rhizome, senega and salvia miltiorrhiza) is effective for benefiting vital energy, circulating blood flow,dispelling gores and killing inflammation. The mechanism may be associated with the function of platelet aggregation, changes of contents of thromboxane B (TXB) and 6-Ketoprostaglandin F1 alpha (6-keto-PGF1 α) in plasma.OBJECTIVE: To observe the influence of Yufeng capsule on the platelet aggregation and its mechanism.DESIGN: Randomized controlled animal trial.SETTING: Department of Pathology, Daqing Branch of Harbin Medical University.MATERIALS: The experiment was performed at the Laboratory of Pharmacology, Daqing Branch of Harbin Medical University from May 2000 to July 2004. A total of 40 Wistar male gerontic rats with mean age of (8-10) weeks and mean body mass of (550±150) g and 8 Wistar male young rats with mean age of 4-6 weeks and mean body mass of (230±120) g were selected.METHODS: The 8 Wistar male youth rats were selected as youth control group. The 40 Wistar male gerontic rats were selected as the blood stasis model, and according to the numeration table method they were classified into 5 groups: aspirin group, low-dose Yufeng capsule group, the middle-dose Yufeng capsule group, high-dose Yufeng capsule group and gerontic model group, with 8 rats in each group. The Yufeng capsule was constituted by milkvetch root, angelica, szechwan lovage rhizome, senega and salvia miltiorrhiza, and provided by the Preparation Office, Second Affiliated Hospital,Heilongjiang University of Chinese Medicine. Respectively the rats were injected with aspirin solution (5.5 g/kg), Yufeng capsule (0.33 g/kg, 0.66 g/kg and 1.32 g/kg), successively for 22 days by gastric perfusion, twice a day.Those in the gerontic group and youth control group were not treated with any drug One hour after last time administration, function of platelet aggregation(PAG), contents of thromboxane B2 (TXB2) and 6-Ketoprostaglandin F1 alpha (6-keto-PGF1 α) in plasma were examined with platelet aggregation method and radioimmunoassay.MAIN OUTCOME MEASURES: Function of platelet aggregation; contents of TXB2 and 6-keto-PGF1 α as well as ratio of TXB2 to 6-keto-PGF1α.RESULTS: Totally 48 animals were involved in the result analysis. ①The PAG was higher in the gerontic model group than other groups (P ＜ 0.01).②One minute platelet aggregation rate (PAG1), five minutes platelet aggregation rate (PAG5)and the maximal platelet aggregation rate (PAGM) in the high-dose Yufeng capsule group were lower than those in the aspirin group[(7.96±2.17), (6.38±1.66), (14.33±2.87) ng/L and (31.95±3.94),(35.29±6.54), (38.68±7.46) ng/L, respectively(P ＜ 0.01 )]. PAG5 in the middle-dose group was lower than that in the aspirin group [(13.96±1.66),(35.29±6.54) ng/L, (P ＜ 0.01 )]. ③TXB2 content in the low-dose Yufengcapsule group, middle-dose Yufeng capsule group, high-dose Yufeng capsule group, aspirin group and youth control group was lower than that in the gerontic model group (P ＜ 0.01). ④The TXB2 content in the high-dose Yufeng capsule group was lower than that in the low-dose Yufeng capsule group [( 100.13±8.90), (127.00±20.99) ng/L, (P ＜ 0.01 )]. ⑤TXB2/6-ke-to-PGF1 α in the high-dose Yufeng capsule group, middle-dose Yufeng capsule group and youth control group was lower than that in the gerontic model group [0.62±0.17,0.69±0.14,1.75±0.17,1.11±1.12, (P ＜ 0.05 )].CONCLUSION: High-dose and middle-dose Yufeng capsule is able to decrease the content of TXB2 and increase the content of 6-keto-PGF1 α, and improve their ratio. It is important to enhance the balance of TXB2 and 6-keto-PGF1 α. The effect in the low-dose Yufeng capsule group is lower as compared with that in the high-dose and middle-dose Yufeng capsule groups. It is thought that the low-dose Yufeng capsule has preventive effect.

Objective To investigated the efficacy of celecoxib for postoperative analgesia after endoscopic nasal surgery. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients of both sexes aged 18-64 yr were randomly assigned to one of three groups ( n = 40 each): control group ( group C); celecoxib 200 group ( group CEL1 ) and celecoxib 400 group ( group CEL2 ). The patients took celecoxib 200 and 400 mg by mouth at 1 h before induction of anesthesia in group CEL1 and CEL2 respectively. Anesthesia was induced with midazolam,propofol, remifentanil and rocuronium and maintained with iv propofol and remifentanil infusion. VAS was used to assess postoperative pain (0 = no pain, 10 = worst pain). In PACU when VAS score ≥3, the patients were given fentany125 μg iv every 5-10 min until the VAS score ＜ 3. After being discharged from PACU, the patients received celecoxib 200 mg every 12 h for 5 days in the 2 celecoxib groups. Oxycodone 5 mg was used as rescue analgesic when VAS score ≥ 4 until the VAS score ＜ 4. The number of patients who needed fentanyl for analgesia in PACU, the number of patients who needed oxycodone within 6 h, 6-24 h and day 2-5 after operation and side effects after operation were recorded. Analgesic efficacy was assessed at day 5 after operation and the satisfactory rate of patients calculated. Blood samples were obtained at 0, 6 and 48 h after operation for determination of PGE2,6-k-PGF1α and TXB2 concentrations. TXB2/6-k-PGF1α was calculated. Results The number of patients who needed fentanyl in PACU and the number of patients who needed oxycodone within 6 h and 6-24 h after operation were less, the satisfactory rate was significantly higher, and PGE2 concentrations in blood were significantly lower at 48 h after operation in the 2 celecoxib groups than in group C ( P ＜ 0.05 or 0.01 ). There was no significant difference in each index between the 2 celecoxib groups ( P ＞ 0.05 ). There was no significant difference in TXB2/6-k-PGF1α at each time point among the three groups. Nausea and vomiting occurred in one patient after operation in group C, but side effects were not observed in the 2 celecoxib groups. Conclusion Celecoxib given before and after operation can effectively relieve postoperative pain after endoscopic nasal operation by reducing PGE2 concentrations in blood.

Objective To evaluate if the enteral nutrition have effect on the immune function and in- flammatory reaction after operating about gastric carcinoma.Methods 58 postoperative patients suffering from stomach cancer and colon cancer were randomly divided into the EN group and the TPN group.On the first postoperative day,nutrition fibre were given via nasal intestinal tube,increasing the capacity and drop- ping speed day by day until patients can eat liquid diet.While patients in the TPN group didn't eat anything until enterokinesia completely recovered.Observing on preoperative day 1 and on postoperative day 3 and day 8 respectively to check IgA,IgG,IgM,C3,C4,CRP,LYM,LYM%,TP,ALB,PA.Results The results showed that on the postoperative day 8,the target ascension extent was higher than that in the PN group.The statistical significance was very obvious(P

Objective To evaluate the efficiency and toxicities of Gemcitabine combined with S -1 cap-sule in the treatment of advanced esophageal cancer .Methods Twenty-nine patients with advanced esophageal cancer were treated with S-1 capsule 80 mg/m2 ,twice daily for 14 days and Gemcitabine (1 000 mg/m2 ) was in-travenously administrated on day 1 and 8.The chemotherapy was repeated every 21 days.After two consecutive treatment circles ,the short term efficacy ,adverse effects and follow -up condition were evaluated .Results One case showed complete remission (CR),11cases showed partial remission (PR),9 cases showed stable disease (SD),8 cases showed progressive disease(PD).The responsive rate(CR+PR)was 41.4%;the illness control rate(CR+PR+SD)was 72.4%.The major adverse events were myelosuppression ranging from grade Ⅰto Ⅲ, hand-foot syndrome,disgusting and the damage of liver function .Some patients displayed the damage of liver function.The median time to progress ( mTTP) was 6.9 months.The median 1-year survival rate was 64.3%. Conclusion The combination of Gemcitabine and S -1 capsule is an effective and well -tolerated method for the patients with advanced esophageal cancer .

Purpose To evaluate the role of 18F-FDG PET/CT tumor metabolic imaging in the detection of lung cancer lesions,using receiver operating characteristic (ROC) curves analysis and investigate the diagnostic value of TNR and TLR in lung lesions.Materials and Methods A total of 82 patients who were confirmed with lung space-occupying lesionsby 18F-FDG PET/CT tumor metabolic imaging were retrospectively analyzed.Based on the pathological gold standard,evaluate the diagnostic value of 18F-FDG PET/CT tumor metabolic imaging in lung space-occupying lesions by t-test and ROC curve.Results There was a significant difference of TNR and TLR between benign and malignant lesion (P＜0.01).The AUC on ROC curve of TLR ratio was 0.943 in the lung lesions while the TNR was 0.927.The sensitivity,specificity and the accuracy were 86.36％,62.50％ and 81.71％,respectively with the TNR cutoff of 6.87.The sensitivity,specificity and the accuracy were 90.91％,68.75％ and 86.58％,respectively with the TLR cutoff of 2.86.Conclusion 18F-FDG PET/CT tumor metabolic imaging is useful for differentiating lung space-occupying lesions.But for cases of atypical 18F-FDG uptake,it is suggested to combine with clinical information.

Objective To investigate the effect of exogenous apelin-13 on oxidative stress, myocardial inflammatory cytokines and apoptosis in diabetic model rats.Methods A total of 40 male Wistar rats were randomly divided into 2 groups: normal control group (NC, n=8) and experimental group (EX, n=32).Diabetes was induced by feeding with high-sugary and high-fat diet for 8 weeks and a single intraperitoneal injection of streptozotocin (STZ) (30 mg/kg).The wellestablished 28 diabetic model rats were then randomly divided into 2 subgroups: model group (DM, n =14) and apelin-13 administration group (AP, n =14).The rats in AP group were given intraperitoneal administration of apelin-13 at a single dose of 0.1 μtmol · kg-1 · d-1 for 10 weeks, while NC group and DM group were given 0.9％ NaCl in the same way.All rats were sacrificed at the end of the week 10.Blood hydrogen peroxide (H2O2), nitric oxide (NO) and malonaldehyde (MDA) were measured by colorimetry, and superoxide dismutase (SOD) was measured by enzyme-linked immunosorbent assay (ELISA).The expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in rat myocardium were detected by immunohistochemistry.Masson staining was used to observe the myocardial fibrosis in rats of different groups.Cardiomyocyte apoptosis was determined by TUNEL.Results (1) Compared with NC groups, DM group showed that MDA, H2O2 and NO were significantly increased, while SOD was significantly decreased (F=22.400, 6.230, 4.267 and 8.901, all P＜0.0167).There was a statistically significant difference in the levels of MDA, H2O2,SOD between DM group and AP group.(2) The expression of TNF-α and IL-6 was significantly higher inDMgroup than inNCgroup (0.0599±0.0208 vs.0.0076±0.0031, F=35.139;0.0503±0.0243 vs.0.0071± 0.0024, F=15.946, both P＜0.0167).After 10 weeks of apelin-13 administration, the levels of inflammatory cytokines were significantly decreased in AP group than in DM group.(3) The myocardial apoptosis and fibrosis were significantly increased in DM group than in NCgroup [0.0293±0.0061 vs.0.0030-t-0.0013 and 0.0708±0.0420 vs.0.0013±0.0003, F=84.930 and 19.420, both P＜0.0167].The myocardial apoptosis and fibrosis were significantly decreased in AP group than in DM group (both P＜0.0167).Conclusions To some extent, apelin13 reduces the levels of oxidative stress and myocardial inflammation reaction in type 2 diabetes.Moreover, it may play a vital role in the improvement of myocardial apoptosis and fibrosis.

PNS (Panax notoginseng saponins) is the main medical bioactive component in Panax notoginseng. The medical value of PNS cannot be extended because of its low production. With the deep study of saponins biosynthetic pathway, the control of PNS biosynthesis through metabolic engineering has gradually become possible. In this study, the Squalene synthase (SS) over-expression vector was established. By the way of agrobacterium-mediated method, the vector was transfered and integrated into the Panax notoginseng genome. The result of the PCR detection and the saponin content detection shows that over-expression SS is able to produce high level of Panax notoginseng saponins, and confirms the regulatory function of SS in the biosynthesis of ginsenosides in Panax notoginseng. It provides a theoretical basis and technical basis for the construction of PNS homologous or heterologous efficient expression system in the future.

Objective To investigate the clinical characteristics and mutations of guanosine triphosphate eyclohydrolase (GCH) Ⅰ gene in patients with dopa-responsive dystonia (DRD). Methods Five families with 18 affected family members and 17 patients with sporadic DRD were examined. Patients were allocated into 3 groups according to onset time, either in childhood, or in adolescence or adult. Interview, physical examination, psychologic testings and CT/MR scan were performed. Mutation screening was performed on 26 patients and 1 normal family nember. Thirty-five healthy control subjects were matched for age and sex. Statistical analysis were conducted with the use of SPSS 13.0 computer software. Results(1)Most of patients started with dystonia. The main clinical manifestation was dystonia too. There was no difference among 3 groups.(2) There were significant differences in diurnal fluctuation among 3 groups(15/15,6/6,7/14, χ2=13.125,P=0.001). Diurnal fluctuation negatively correlated with age (r=-0.720, P<0.01).(3)The differences in postural tremor were also found among 3 groups (7/15,5/6,1/14, χ2=8.073, P=0.018). Postural tremor positively correlated with age (r=0.399, P=0.018).(4)There were differences in exaggeration of tendon among three groups(11/15,1/6,4/14, χ2=8.309, P=0.016). Exaggeration of tendon reflexes negatively correlated with age (r=-0.429, P=0.010).(5)The scores of Hamilton Depression Scale and Hamilton Anxiety Scale in patients were higher than those in controls.(6)DNA sequencing revealed a heterozygous A224G missense mutation(Tyr75Cys)located within exon 1 in one autosomal dominant inheritance family. Conclusions The manifestations of DRD varies. The clinical course is closely correlated with age. A missense mutation(A224G)in coding region of the GCH 1 gene probablyleads to the occurrence of DRD.

Aged ; Female ; Humans ; Solitary Fibrous Tumor, Pleural ; surgery