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.

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

Objective:To analyze the metastasis rule of abdominal lymph node from thoracic esophagus carcinoma. Methods:The abdominal lymph node data on 164 patients who had undergone resection of thoracic esophageal carcinoma were analyzed retro-spectively. Grouping was based on the upper, middle, and lower thoracic esophagus. Differences in tumor infiltration depth, differentiat-ed degree, pathological type, pathological stage, and metastasis rate of the abdominal lymph node among the three groups were com-pared. The metastasis rates of the abdominal lymph nodes among the different tumor infiltration depths, differentiated degrees, and path-ological types were also compared. Results:The base condition of tumor infiltration depth, differentiated degree, pathological type, and pathological stage has no statistical significance among the upper, middle, and lower thoracic esophagus. The metastasis rate of the ab-dominal lymph node also has no statistical significance among the three groups (upper, 6.9%;middle, 27.4%;and lower, 39.6%). More-over, the metastasis rate of the abdominal lymph node has no statistical significance among the different tumor infiltration depths, differ-entiated degrees, and pathological types. Conclusion:A special bound lymph node metastasis was present in the esophageal carcinoma. If the tumor in the upper thoracic esophagus infiltrated the submucosa, then it could bound metastasize down to the abdominal lymph node by the lymphatic capillary net. The majority of the esophageal carcinoma was more than T1b period when diagnosed. The tumor has infiltrated the submucosa. Thus, early stage, well-differentiated, and upper thoracic esophageal carcinoma does not indicate mini-mal metastasis of the abdominal lymph node. Routine abdominal lymph node dissection through radical surgery for esophageal carcino-ma was necessary.

Cell transplantation has great potentials in repairing damaged tissue.If we want to use the cell transplants to treat diseases that respond poorly to the conventional treatment,or provide better treatments,in vivo dynamic tracking is particularly important.The application of superparamagnetic iron oxide (SPIO) improves a common inconvenience of the current invasive tests including immunohistochemical study or transmission electron microscopy (TEM) study and so on.Researchers has established a variety of preparation methods of the particles,groped the optimal condition of cell marking.SPIO were proved to be feasible and superior in cell tracking in vivo through animal experiments.The results provide the reliable means of using SPIO to track cell in clinical treatments.This review gives a summary of the related study.

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.

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 evaluate the feasibility and safety of ultrasound-localized percutaneous thrombin injection (ULTI) for the treatment of iatrogenic femoral pseudoaneurysm. Methods From January 2000 through October 2001, 5 patients (3 males, 2 females, age range 38～72 years) were found to have a pseudoaneurysm confirmed by ultrasound between 1 and 3 days following femoral arterial puncture. Two patients were associated with diagnostic arteriography and 3 with stent implantation. ULTI was our first choice for the treatment of ablating femoral pseudoaneurysm. All patients following ULTI were restudied within 24 hours. Results All 5 patients were initially treated with ULTI. Thrombin was injected directly into the pseudoaneurysm with a dose of 500 units over several seconds, successful ablation was visualized immediately in 4 patients, the remaining 1 patient needed ultrasound-guided compression treatment of five minutes. Follow-up at the 24th hour showed no recurrent pseudoaneurysm after initial successful ablation in any case. No distal embolization or allergic reaction occurred. Conclusion ULTI is a safe, rapid, well-tolerated, inexpensive and effective noninvasive method for the treatment of iatrogenic femoral pseudoaneurysm and should be considered as first-line therapy.

Objective The relationship between XbaI polymorphism of ApoB gene and cerebral infarction(CI)among Chinese population was assessed by Meta-analysis.Methods All related case-control studies were collected from all publications,the relevant studies were identified after eliminating those poor-qualified studies.Meta-analysis was conducted for investigating heterogeneity among individual studies,and summarizing the effects across studies.Results The combined data statistics revealed the frequencies of the X-X+/X+X+ genotypes showed no statistically difference(Z=1.72,P=0.08).Through the subgroup analysis,it was obviously increase the risk of CI in Chinese northern population(OR=2.66,95%CI:1.67~4.24),but no statistically difference in Chinese southern population(OR=1.26,95%CI:0.90~1.77).Conclusions ApoB gene XbaI polymorphism may be significantly associated with susceptibility of CI in Chinese northern population,but not a definite risk for Chinese southern population.