Objective To investigate the clinical manifestation, pathological features and pathogenesis of Holmes-Adie syndrome (HAS). Methods The clinical data of one HAS patient with sweating abnormality and combined with literatures were analysed. Results The patient had the typical characteristics of HAS, including Adie pupil, areflexia of lower limb and the symptoms of autonomic nerve dysfunction. The characteristic pupil of HAS was proved by slit lamp of ophthalmology. Cranial MRI showed lacunar infarction. A partial or total loss of neurons of the ciliary ganglion was the main pathological characteristic of HAS. Conclusions The etiology of HAS remains unclear, and has characteristic pupil finding, which was associated with autonomic nerve dysfunction to a certain extent. HAS still need to differentiate from Ross syndrome and Harlequin syndrome.

Four key attributes,position,rate,shape and force,are programs of pulse tracing put forward by ZHOU Xue-hai,a medical practitioner in late Qing dynasty.The essences of four key attributes are'images'of di erent levels.There are complex relationships between pulse tracing and position,rate,shape and force attributes,which include not only subordinate relationship and static-dynamic relationship between four attributes but double relationship between four attributes and pulse tracing.

Object To select the endophytic fungi which produce vincristine by isolating fungi from the leaves of Catharanthus roseus (L.) G. Don. Methods The endophytic fungi were isolated from the leaves of C. roseus and the zymotic extracts were analyzed by TLC and HPLC. Results An endophytic fungus which is Mycelia sterilia 97CY_3 can produce vincristine. The content of vincristine in the fungus was determined as 0.205 ?g/L by HPLC. Conclusion Some endophytic fungi isolated from C. roseus can produce the anticancer substance vincristine which is the same as that of host plant producing.

Objective To assess the effectiveness of balloon dilation and airway stenting performed under fluoroscopic guidance for the treatment of benign and malignant tracheal stenosis. Methods Under fluoroscopic guidance,balloon dilation and airway stenting were performed in 45 patients with tracheobronchial stricture. Of the 45 patients, malignant tracheal stenosis was seen in 37, including mediastinal nodal metastases (n = 14), esophageal carcinoma (n=13), lung carcinoma (n = 4), adenocarcinoma of bronchus (n = 3), lymphoma (n = 2) and laryngocarcinoma (n = 1), and benign tracheal stenosis was seen in 8, including endobronchial tuberculosis (n = 6), retrosternal thyroid adenoma (n = 1) and endotracheal intubation (n = 1). Airway stenting with serf-expandable metal stent was employed in 38 patients and balloon dilation in 7 patients. All the procedures were performed under fluoroscopic guidance. Results A total of 53 self-expandable metal stents was implanted in 38 patients. The clinical symptoms were immediately relived after the procedure in all patients except for one patient who died from choking of sputum. No stent migration was observed. Restenosis developed in 4 patients, which was successfully treated with repeated stenting and balloon dilation. Nineteen times of balloon dilation procedure were accomplished in 7 patients. Marked remission of clinical symptoms was seen in most cases. During a follow-up period (ranged from 0 to 124 months with a mean of 24.5 months) 31 patients died. Conclusion For both benign and malignant tracheal stenosis, balloon dilation with airway stenting performed under fluoroscopic guidance is a safe and efficient therapy with instant curative effect in relieving clinical symptoms.

e factors of elder age, abdominal surgeries and malignant tumor.

Background Diabetes mellitus (DM) can provoke the apoptosis of retinal cells and downregulate the expression of calcitonin gene related peptide (CGRP) in the retina.Capsaicin promotes the release of CGRP and elicits protective effects on human organs.However,whether CGRP protects retinal cells in diabetic retinopathy (DR) is still unclear.Objective The study was designed to examine the effect of capsaicin on the apoptosis of retinal cells in diabetic rats and its relationship with CGRP.Methods Forty clean healthy adult male Sprague-Dawey rats were randomly divided into the diabetes group,capsaicin pretreated group,streptozocin (STZ)control group,capsaicin control group and plain control group,with 8 rats per group.The diabetic model was established by the intraperitoneal injection of 60 mg/kg in all rats except those of the plain control group.0.4 mL of a 1％ capsaicin injected at 20 mg/kg was subcutaneously injected for 3 consecutive days prior to model establishment in the capsaicin pretreated group,after which 1.2 mL of STZ was intraperitoneally injected on the fourth day.Rats from the STZ control group were administered intraperitoneally 1.2 mL of 0.1 mol/L,pH 4.5,citrate buffer.The capsaicin control group received subcutaneous injections of 0.4 mL of 1％ capsaicin at 20 mg/kg for 3 consecutive days,after which 1.2 mL of 0.1 mol/L,pH 4.5,citrate buffer was administered intraperitoneally.The rats were sacrificed at the tenth week after model establishment and retinal specimens were prepared for the apoptosis assay by TUNEL staining and the quantitative analysis of caspase-3 activity.Expression of CGRP in the retina and serum was detected using ELISA.The use of experimental animals followed the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results Retinal cell apoptosis was mainly localized to the retinal ganglion cell (RGC) layer.The apoptosis rate of RGCs was (43.4±5.0)％ in the DR model group and (30.0±5.1)％ in the capsaicin pretreated group,showing a significant difference (t =5.930,P＜0.01).Compared with the DR model group and capsaicin pretreated group,the apoptosis rates of the DR control group (12.4±9.9) ％ and the capsaicin control group (17.6-±6.1) ％ were significantly lower (t =8.800,t =4.925,P＜0.01).The apoptosis rate of the plain control group was (16.2±6.9)％,exhibiting significant differences in comparison with the DR control group and capsaicin control group (t =-0.989,t =0.951,P＞0.05).The specific activity of caspase-3 was (2.19±0.86) in the DR model group and (1.96±0.56) in the capsaicin pretreated group,presenting a significant difference (t =-0.515,P＜0.05).Those of the DR control group and capsaicin control group were (1.47±0.14) and (0.74±0.27),respectively,with considerable decline in comparison with the DR model group and capsaicin pretreated group (t=2.142,t=2.797,P＜0.05).The retinal and serum CGRP levels were (424.4±44.2)and (148.8±39.1) ng/L,respectively,displaying significantly lower levels than (543.2±74.4) and (237.5±78.7) ng/L (t =3.070,2.359,P＜0.05) from the capsaicin pretreated group.Conclusions Apoptosis of retinal ganglion cells occurs in the STZ-induced diabetic rats.Pretreatment of capsaicin reduces retinal cell apoptosis,which may be associated with an increase of CGRP in the retina.

Objective To study the influence of colon hydrotherapy on premature infants with jaundice.Methods Based on intravenously infusing yinzhihuang and albumin and enzyme inducer,the warmed normal saline was poured into colon by 10 mL/kg per 8 hours in 40 preterm infants,and compared with 44 cases of control group.Serum bilirubin of all patients were measured at 24,72,120,168,216 hours,respectively.The days of meconiumbeing eliminated completely were recorded.Results The bilirubinemia level in trial group were lower in trial group than that in control group at every time and the rate of hyperbilirubinemia of the test group was lower(?~2=4.073 P

Objective To compare the curative effects between radiofrequency coblation and CO2 Laser in treat-ment of vocal leukoplakia. Methods Clinical data of 29 patients with vocal leukoplakia were retrospectively ana-lyzed. 14 of them were using radiofrequency ablation, the other 15 were using CO2 laser as treatment. Then compare the postoperative pain, postoperative wound healing, the first operation control rate of local recurrence between the two groups. Results Postoperative pain between the two groups has no statistically significance. The mucosal recov-ery of radiofrequency group in 1 month after surgery was better than CO2 laser group. In radiofrequency group, 5 cases suffered recurrence, the recurrence rate was 35.71%; In CO2 laser group, only 1 case suffered recurrence, the recurrence rate was 6.67%. Conclusions Laser and radiofrequency ablation were minimally invasive treatment for vocal cord leukoplakia, while CO2 laser as treatment has lower recurrence rate.

Objective To evaluate the diagnostic value of DCE-MRI and breast MR reporting and data system(BI-RADS-MR)in differentiation of breast lesions. Methods Seventy-five patients with 75 pathological-confirmed breast lesions underwent DCE-MRI before treatment and DCE-MRI quantitative analysis. Two senior doc-tors assessed the imaging features blindly by BI-RADS-MR. The pathology results were set as a gold standard. The receiver operating characteristic curve(ROC)interpretation of two physician′s curve analysis was used to evaluate the sensitivity,specificity of BI-RADS classification. Results According to the BI-RADS MR score,38 breast cancer patients were rated as 1 case in grade Ⅰ,0 case in grade Ⅱ,4 cases in gradeⅢ,13 cases in gradeⅣ,20 cases in grade V;37 breast benign tumors were rated as 17 cases in grade Ⅰ,5 cases in grade Ⅱ,12 cases in gradeⅢ,3 cases in gradeⅣandⅤ0 cases. The statistical difference of Tpeak,S max,K1 between benign and malig-nant breast tumors were significant(P<0.05). On ROC,the area under the curve was 0.940,95%confidence in-terval was from 0.887 to 0.994. The sensitivity of BI-RADS in the diagnosis of breast cancer was 94.59%and speci-ficity was 92.11%. Conclusion DCE-MRI combined with BI-RADS-MR classification in diagnosis of benign and malignant breast tumors has an important value and can improve diagnosis and differential diagnosis level.

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.