Objective To disuss the clinic characteristics,the etiologies and the misdiagnosis cause of hyperthyroidism featuring in vomit mainly.Methods The clinic data of 35 hyperthyroids featuring in vomit mainly were reviewed and analyzed.Results The hyperthyroids in this group were middle-aged female mainly whose symptoms showd that they vomit frequently with abdominal distention,thin,inappetence,chest congestion,palpitation;tachycardia;hypohepatia and electrolyte disturbance.Furthermore,their thyroid gland function assay is in concordance with the hyperthyroidism diagnosis.Treatment for antihyperthyroidism can get remarkable effects.Conclusion The patient showing vomit of unknown origin may be taken into account as hyperthyroid.The key points to prevent misdiagnosis are to detect thyroid gland function in time and to improve the understanding for un-typical hyperthyroidism.

The Sindbis-like virus was first discovered in China in 1986. Its complete genomic sequence consists of more than 11 000 bp encoding more than 3 700 amino acids. It contains a 5' non-transcriptional region (5'-NTR) in a non-structural region, four non-structural proteins (nsP1, nsP2, nsP3, nsP4) regions, capsids in conserved and non-conserved regions and structural E1, E2, E3, 6K regions and a 3' non-transcriptional region (3'-NTR). The Sindbis-IMB was isolated from the blood of a patient suspected to have encephalitis, and was followed by identification and passage. The virus RNA was extracted from virus supernatant in infected cells and the whole genome was divided into 12 fragments; RT-PCR was then performed to amplify the 12 fragments for complete sequencing. The results showed that the whole genomic sequence of Sindbis-IMB consists of 11 717 bp encoding 3 773 amino acids. Homology comparison with other Sindbis-like isolates demonstrated the highest similarity was the YN87448 with a variation of 1% strain isolated in Yunnan Province and the second highest to the SAAR86 strain with a variation of～1.2%.The nucleotide sequence variations were present in non-structural regions, resulting in amino acids K, E, N, R, H, and L in protein sequences in positions 230, 231, 443,781, 1 582, and 1746 in the new isolation respectively. Furthermore, three additional amino acids--glutamic acid, serine and alanine--were noted in nsp4 terminus as compared to the YN87448 isolate.

Objective To analyze the clinical features, diagnosis, treatment and prognosis of neurosyphilis. Methods Clinical data on and laboratory findings in 18 cases with neurosyphilis collected in the Affiliated Provincial Hospital, Anhui Medical University from 2006 to 2008 were retrospectively studied.Results Among the 18 patients, 3 sufferred from asymptomatic neurosyphilis, 1 from meningeal syphilis, 7 from meningovascular syphilis, 5 from paralytic dementia, and 2 from intracranial space-occupation. Toluidine red unheated serum reagin test (TRUST) and Treponema pallidum particle agglutination test (TPPA) of sera were positive in all the patients; cerebrospinal fluid (CSF) TRUST was positive in 16 patients, and CSF TPPA in all patients. An increase was observed in CSF leukocyte count in 7 patients and in CSF protein in 13 patients.The findings on cerebral magnetic resonance imaging (MRI) mainly included demyelination, brain atrophy,cerebral infarction, etc. All the patients, except 2 with a TRUST titer of 1:4, experienced a 4-fold decrease in TRUST titer within a 3-month follow up. Clinical symptoms of neurosyphilis improved in all patients except 1 with paralytic dementia. Conclusions The diversity of clinical manifestations usually leads to the misdiagnosis of neurosyphilis, which should be diagnosed based on comprehensive analysis of clinical characteristics as well as laboratory and imaging findings. Early diagnosis and treatment are beneficial to its prognosis.

Objective To study the effect of endovenous laser ablation combined with subfascial endoscopy therapy for venous ulcer of the lower limbs.Methods Clinical data of 112 patients undergoing endovenous laser ablation combined with subfascial endoscopy therapy for venous ulcer of the lower limbs from Oct 2011 to Feb 2016 was retrospectively evaluated.Results Patients had average 2-6 perforating veins in their affected lower limbs.Procedures were successful in all the patients,all the superficial varicose veins disappeared after 1 month and 1 year of ultrasound follow-up,perforating veins closed,ulcer healed,and chromatosis alleviated.Conclusion Endovenous laser ablation combined with subfascial endoscopy therapy for venous ulcer of the lower limbs is effective,safe and quick recovery.

Objective To evaluate clinical efficacy of lung transplantation for lung chronic graft-versus-host disease (cGVHD) after hematopoietic stem cell transplantation (HSCT). Methods Clinical data of 12 patients undergoing lung transplantation for lung cGVHD were retrospectively analyzed. Preoperative clinical manifestations and involved organs of patients were analyzed. The lung function before and after lung transplantation was compared, and the survival of patients after lung transplantation was analyzed. Results Eleven patients underwent HSCT due to primary hematological malignancies, including 9 cases of leukemia, 1 case of myelodysplastic syndrome, 1 case of lymphoma. And 1 case underwent HSCT for systemic lupus erythematosus. Among 12 cGVHD patients, skin involvement was found in 8 cases, oral cavity involvement in 5 cases, gastrointestinal tract involvement in 4 cases and liver involvement in 3 cases. All 12 patients developed severe respiratory failure caused by cGVHD before lung transplantation, including 9 cases of typeⅡ respiratory failure and 3 cases of type Ⅰ respiratory failure. Two patients underwent right lung transplantation, 2 cases of left lung transplantation and 8 cases of bilateral lung transplantation. The interval from HSCT to lung transplantation was 75 (19-187) months. Upon the date of submission, postoperative follow-up time was 18 (7-74) months. Ten patients survived, 1 died from severe hepatitis at postoperative 22 months, and 1 died from gastrointestinal bleeding at postoperative 6 months. No recurrence of primary diseases was reported in surviving patients. Conclusions Lung transplantation is an efficacious treatment for lung cGVHD after HSCT, which may prolong the survival time and improve the quality of life of the recipients.