Objective To investigate the relationship between plasma level of homocysteine (Hcy) and amyotrophic lateral sclerosis (ALS).Methods The differences of Hcy,Vitamin B12,and folate levels between 150 outpatients with ALS and 137 age and sex matched controls were compared in a cross-sectional study.Results Compared with the healthy controls,patients with ALS had a higher plasma Hcy level [ ( 18.47 ± 13.09) μmol/L vs ( 11.91 ± 5.37 ) μmol/L,P ＜ 0.001 ] and a lower folate level [ ( 8.39 ±4.45) ng/ml vs (10.38 ±5.01) ng/ml,P ＜0.001].In a logistic regression model using ALS as a dependent variable,plasma level of Hcy was significantly associated with ALS.A trend for higher Hcy levels in patients with shorter interval from symptom onset to diagnosis ( ODI ) was also found [ Hcy levels (20.73 ± 15.79 ) μmol/L with ODI ＜ 19 months vs ( 16.41 ± 9.73 ) μmol/L with ODI ≥ 19 months,P =0.035 ].Conclusions Plasma Hcy level is significantly increased in patients with ALS.The individuals with shorter time to diagnosis present higher Hcy level,suggesting that it may associate with the progression pace of ALS.

Objective To investigate the relationship between alterations in the corneal innervation observed by laser confocal microscopy and peripheral neuropathy severity in the patients with impaired glucose tolerance (IGT).Methods A total of 70 patients with IGT were consecutively enrolled into the study.Among them,30 patients were diagnosed as peripheral neuropathy (IGT-PN),40 patients without peripheral neuropathy (IGT-NPN).Fifty age-matched healthy subjects were also studied.Corneal subbasal nerves were investigated by laser confocal microscopy.Results Corneal nerve fiber length (17.1 ±4.9) vs (14.0±3.8) mm/mm2; t=13.484,P＜0.05),newe branch density ((53.1 ±18.8) vs (36.2±11.5) mm/mm2 ; t =9.369,P ＜ 0.01) and nerve fibre tortuosity ((2.07 ± 0.76) vs (0.88 ± 0.55) levels,t =12.957,P ＜0.05)were significantly increased in IGT-NPN group when compared with control group,but nerve fibre density had no difference.Nerve fiber length,nerve branch density and nerve fibre density were significantly decreased in IGT-PN group compared with control group and IGT-NPN group,while NFT was significantly increased in IGT-PN group.Conclusions Patients with impaired glucose metabolism show alterations in corneal innervations before diagnosed with diabetes mellitus or peripheral neuropathy.It indicates that corneal confocal microscopy can be used for early diagnosis of diabetic peripheral neuropathy.

Objective To explore the diagnostic value of corneal confocal microscopy in the early small fibre neuropathy (SFN).Methods A total of 45 patients with small fibre neuropathy and 50 age-matched healthy subjects undertook a neurological evaluation,neurological deficits score (NDS),sural nerve conduction velocity,contact heat evoked potential (CHEP) and corneal confocal microscopy (CCM) to quantify small nerve fibre pathology.Four parameters including nerve fiber length (NFL),nerve branch density (NBD),nerve fiber density (NFD) and nerve fibre tortuosity (NFT) were calculated from the observation of corneal confocal microscopy.Results Compared with the control group,significantly decreased NFD and NBD were found in the SFN group [(42.00 ±25.26)/mm2 vs (72.38 ± 14.09) /mm2 ;(31.93 ± 13.21)/mm2 vs (46.24 ± 11.48)/mm2 ; with all P ＜ 0.05],while NFT were significantly increased in the SFN group [(2.48 ±0.87) levels vs (0.88 ±0.56) levels,P ＜0.001].The neurological deficits score was correlated with NFT,NFD and NBD (r =0.782,-0.376,-0.504 ; with all P ＜ 0.001).Conclusion CCM is a new and sensitive noninvasive clinical technique that may be used to detect early small fibre nerve damage in patients with SFN.

Objective Method discussion of measuring curvature of cervical endplate based on reverse engineering software.Methods The CT scan images data (From C2 to C7) of 8 normal males were selected and inputted into Mimics 10.0 software for 3D reconstruction and separation (cervical spine is divided into C1-C7 isolated reconstructed 3D images).Another software NX Imageware 13.2 is used for further curvature measuring in lines named left,middle,right,anterior,middle,posterior which are derived from each superior and inferior endplate.In each line,15 different points which can perfectly show morphologic characters of the endplate are selected for statistic comparing between different points in the same endplate,different lines in the same endplate,different endplates in the same individual and the same endplate in different individuals.In addition,the correlation between the concavity and the width and depth of endplate is also analyzed.Results From inferior endplate of C2 to that of C6,except superior endplate of C7,there is significant difference between different points in the same line (P＜0.05),while it is opposite in the compare between lines in the same endplate,different endplates in the same individual and the same endplate (except inferior endplate of C4) in different individuals (P＞0.05).It showed significant correlation between the concavity and the width and depth of endplate.Conclusion Reverse engineering software is feasible to be used in evaluate morphologic characters of normal cervical endplate as a new method for measuring the detail parameters of them,it also explore the laws of the curvatures of cervical endplate initially and both of them will be of great use for cervical interbody cage design.

One hundred patients with type 2 diabetic neuropathy were divided into L-carnitine group and control group with 50 eases in each group. Data showed significant improvements in clinical symptoms scores, visual analogue scale and quantitative sense test after 16-week L-earnitine treatment (all P < 0.05). The study demonstrates that L-earnitine has affirmative effect on patients with diabetic neuropathy, especially in alleviating pain.

Objective To observe the characteristics of midbrain hyperechogenicity of amyotrophic lateral sclerosis (ALS) patients by transcranial sonography (TCS).Methods A total of 107 ALS patients,enrolled from January to July 2015 in Beijing University Third Hospital,with the diagnosis of possible or definite ALS according to revised E1 Escorial criteria were examined by transcrinal B-mode sonography.The area of midbrain and substantia nigra and the area ratio of hyper-substantia nigra/midbrain (S/M) were measured and compared between ALS and 40 age-and gender-matched controls.Results There were 29.0％ (31/107) of ALS patients and 7.5％ (3/40) of controls who displayed abnormal midbrain hyperechogenic areas for groups comparison (x2 =22.708,P ＜ 0.01).The hyperechogenic substantia nigra area and S/M were (0.40 ± 0.14) cm2 and 9.5％ (6.0％,13.0％) in ALS group,whereas (0.20 ± 0.06) cm2 and 5.0％ (2％,6.0％) in control group respectively,the difference between the two groups being statistically significant (t =12.727,Z =16.545,both P ＜0.01).No correlations of hyperechogenic area sizes in ALS patients were found in regard to age,gender,ALS duration or ALS Functional Rating Scale score (r=0.043,-0.088,0.018,0.202;P=0.251,0.512,0.894,0.190).However,there was significant correlation between TCS severity and ALS subtype (bulbar vs spinal form,r =0.386,P ＜ 0.01).Conclusion Hyperechogenicity of the substantia nigra was found in patients with sporadic ALS with a frequency higher than in controls.

0.05).CONCLUSION:Pure red cell aplastic anemia appears after allogeneic hematopoietic stem cell transplantation in major ABO incompatibility between donor and recipient,which may lead to prolonged destruction of donor-derived erythrocytes and prolonged transfusion requirements.However,myeloid and megakaryocyte hematopoietic recovery,incidence of complications and survival rate are not influenced by ABO incompatibility.

Objective To compare the safety and clinical efficacy between paclitaxel liposomes and paclitaxel in patients with advanced esophageal cancer .Methods A total of 90 patients with advanced esophageal cancer were enrolled into this study and were randomly divided into paclitaxel liposomes treatment group(treatment group) and paclitaxel treatment group(control group) . The patients of each group were treated with paclitaxel liposomes or paclitaxel 80 mg/m2 intravenously on day 1 and 8 ,and nedapla‐tin 75 mg/m2 intravenously on day 1 ,respectively .After two cycles of chemotherapy ,three weeks per period ,we evaluated the short term efficacy and adverse reactions according to the WHO standard .Results The short term efficacy between control group and treatment group showed no significance statistically (P>0 .05) .However ,the incidence of allergic reactions in the treatment group was significantly lower than control group (P<0 .05) .Conclusion Paclitaxel liposomal or paclitaxel combine with nedaplatin was effective equivalently in the treatment of patients with advanced esophageal cancer .But the allergic reactions of paclitaxel liposomal were lower than paclitaxel .It is worthy of clinical promotion .

Objective To analyze the mutation of HBV X region nucleotide sequence in patients with HBV reinfection after liver transplantation. Methods In this study 320 patients received liver transplantation due to HBV-related end stage hver diseases between June 2002 and Dec 2003.Postoperatively polymerase chsin reaction was used to aInplify their serum HBV DNA fragments for direct sequence analysis.Patients that were followed-up for 1.5～3 years were enlisted for analysis.Results All the 11 reinfection recipients showed nucleotide mutations in X region mng4ng from 5 to 39 sites after transplantation.An A to T mutation at nt1762 and G to A mutation at nt1764 were found in 6 cases.The mutations at nucleotide fnt)1636～1741 were found in all 11 cases.Condusions The results indicated that mutations of nt 1762 and nt 1764 are very common and immunosuppressants cannot change the mutations in patients with HBV reinfection after liver transplantation.

Objective:To investigate the relationship between preoperative high-sensitivity C-reactive protein (Hs-CRP) levels and clinical outcomes of patients undergoing off-pump coronary artery bypass graft (OPCABG) surgery.Methods:We prospectively selected 123 patients who received OPCABG at Beijing Anzhen Hospital from January 2019 to October 2019, and collected relevant preoperative and postoperative data. Patients were divided into a normal Hs-CRP group(78 cases) and an elevated Hs-CRP group(45 cases)according to the cutoff value (2 mg/L) of Hs-CRP level. The data of the two groups were compared, and regression analysis was performed on the postoperative data with differences to define independent factors.Results:The leukocyte count in the Hs-CRP group was significantly higher than that in the normal Hs-CRP group[(6.5±1.6)×10 9/ml vs. (7.4±2.1) ×10 9/ml, t=-2.839, P=0.005]. In the elevated Hs-CRP group, proportion of patients with atrial post-CABG atrial fibrillation (38% vs. 19%, χ2=5.100, P=0.024), duration of hospitalization[(21.2±7.1)days vs.(16.0±4.6)days, t=-4.469, P=0.000], hospital costs[(143.1±30.7)×10 3 yuan vs. (123.7±21.8)×10 3 yuan, t=-4.090, P=0.000]were significantly higher than those in the normal Hs-CRP level group. Smoking ( OR=1.660, 95% CI: 1.186-1.993, P=0.031) and Hs-CRP ( OR=1.170, 95% CI: 1.050-1.294, P=0.007) were independent risk factors for post-CABG atrial fibrillation. Hs-CRP ( B=0.436, 95% CI: 0.197-0.675, P=0.000) and left ventricular ejection fraction (LVEF, B=-0.180, 95% CI: -0.289--0.071, P=0.001) were independent influencing factors of duration of hospitalization. Hypertension ( B=-11.256, 95% CI: -20.670--1.842, P=0.020), Hs-CRP( B=1.235, 95% CI: 0.217-2.254, P=0.018) and LVEF ( B=-1.168, 95% CI: -1.634--0.702, P=0.000) were independent influencing factors of hospital costs. Conclusion:The preoperative Hs-CRP level of OPCABG is an independent influencing factor of post-CABG atrial fibrillation, duration of hospitalization and hospital costs. This finding lays the foundation for Hs-CRP combined with other indicators to accurately predict the prognosis of OPCABG and screen high-risk patients.