Delirium is defined as an acute imbalance state in the higher nervous center.It is more of ten been an accompanied syndrome,or may be a complication associated with the diagnosis and treatment of cancer.Delirium occurs frequently in cancer patients,especially in terminal patients.No more attention was paid on it yet.Its clinical feature,diagnosis and treatment were described.

Objective To report the first case of cutaneous type adult T-cell leukemia/lymphoma(cATLL) in China. Methods The skin lesion was examined by histopathology and direct immunofluorescence (DIF), and the immunophenotype was also studied. ELISA and Western blot were used to test the serum antibodies to HTLV-Ⅰ, and HTLV-Ⅰproviral DNA of lymphoid cells was detected by PCR. Results The patient had polymorphic skin lesions including papules, plaques, and bullae with tense or flaccid walls. Histopathogical examination showed subepidermal bullae, and there were small-to-medium-sized atypical lymphoid cell infiltrations in the dermal papilla in the bottom, and border of the bulla. CD45+ and CD45RO+ staining, and negative DIF were observed in the atypical lymphoid cells. The serum antibodies to HTLV-Ⅰ, and proviral DNA of HTLV-Ⅰin the blood lymphoid cells were detected. The patient died with a disease course of one year and ten months. Conclusion ATLL is not extremely rare in China, and cATLL may also exist.

Objective To optimize the concentrate process ofDanshen injection.Methods The concentration changes of Salvianic acid A sodium, Protocatechuic aldehyde and Salvianolic acid B were selected as indexes to compare mospheric concentrate, vacuum concentrate, nanofiltration concentrate and nanofiltration-vacuum coupling concentrate methods with HPLC. Results Phenolic acid composition changed when atmospheric and vacuum concentrate method were used. Retention rate of three phenolic acids were over 93% after nanofiltration concentration, but the concentration efficiency was limited by solution viscosity. Nanofiltration-vacuum coupling concentrate methods could solve the above problems, meanwhile, retention rate of three phenolic acids were over 91%.Conclusions Nanofiltration technology takes advantage in medicine extraction concentrate with heat sensitive ingredients, and its application prospect in traditional Chinese medicine pharmaceutical industry would be broad.

Objective To observe the value of non-invasive positive pressure ventilation for the overlap syndrome complicated with pulmonary encephalopathyt.Methods Fifty-six patients with the overlap syndrome complicated with pulmonary encephalopathy were divided into the experinental group and the controlled group.The experimental group was treated with non-invasive positive pressure ventilation and conventional clinical therapy (drugs and oxygen).The controlled group was treated with conventional clinical therapy.Results The experimental group was better than tche Controlled group in blood gas analysis (PH、PaCO2) in the second hour and the twentyfourth hour after treatment (P ＜ 0.05).The experimental group was more than the controlled group in the improvement of consciousness disorder (P ＜ 0.05).The experimental group was less than the controlled group in tracheal intubation (P ＜ 0.05).Conclusion Non-invasive positive pressure ventilation could improve consciousness disorder of the overlap syndrome complicated with pulmonary encephalopathy,and reduce tracheal intubation.

[ABSTRACT]OBJECTIVETo compare the difference of serum Leptin between obstructive sleep apnea hypopnea syndrome (OSAHS) patients and the control group, to analyze the genotype distribution and allele frequency of Leptin receptor gene Gln223Arg in OSAHS patients. To discuss the relationship between the gene polymorphism and OSAHS susceptibility.METHODSOSAHS group(221 cases) and control group (213 cases) were divided into obese OSAHS group (107 cases), non-obese OSAHS group (114 cases), obese control group (110 patients) and normal control group (103 cases). All participants were tested the level of serum Leptin after monitoring by polysomnography (PSG). The genomic DNA of Leptin receptor gene was extracted and the genotype was analyzed.RESULTSThe level of serum Leptin in non-obese OSAHS patients was 13.59±5.01μg/L and (13.10±1.87)μg/L in obese control patients. They were higher than that in normal control group, but there were no significant difference among them. The level of Leptin in obese OSAHS group was(19.01±3.43)μg/L, that was significantly higher than that in other three groups. Leptin receptor gene Gln223Arg genotype and allele frequency had no significant difference among the 4 groups. But neck circumference of GG genotype patients was greater than that of AA/AG patients.CONCLUSIONThe level of serum Leptin in obese OSAHS patients is significantly higher than that in control group. There is no relations between the gene polymorphism of two sites in Leptin receptor gene Gln223Arg and the onset of OSAHS. But Gln223Arg variation may be involved in regulating the OSAHS patients' neck fat distribution.

Objective To compare intraindividual higher-order aberrations(HOA)after implantation of aspherical and spherical intraocular lenses(IOL).Design Prospective,case-controlled study.Participants 33 patients(66 eyes)were between 50 and 76 years of ages.The patients with bilateral senile cataracts were operated with phacoemulsification and IOL implantation.All the patients had no other ocular pathologies and no previous ophthalmic surgery.Patients with keratometric astigmatism higher than-2.0 diopters(D)were excluded from the study.Methods Wavefront aberration measurements of 33 patients(66 eyes)after implantation of a spherical IOL(Canon Staar KS-3)in one eye and an aspherical IOL(Cannon Staar KS-3Ai)in the contralateral eye were analyzed.The eyes were randomly assigned to groups of the spherical IOL or the aspherical IOL.Third-order,4th-order,5th-order,total HOA root-mean-squares(RMS),and 4th-order spherical aberrations(Z40)were compared 3 months after surgery.Main Outcome Measures Visual acuity(VA),the best corrected visual acuity(BCVA),the centrality of IOL,refraction data,diameter of pupil size,3rd-order,4th-order,5th-order and total HOA RMS,and 4th-order spherical aberration(Z40)RMS were measured.Results Fourth-order aberration RMS(0.193?0.098?m),Z40 RMS(0.037?0.099?m),total HOA RMS(0.498?0.072?m)in the aspherical IOL group were lower than those with the spherical IOL(0.403?0.155?m,0.381?0.142?m,0.737?0.164?m,respectively)at 6mm pupil diameter.For 3rd-and 5th-order RMS at 6mm pupil diameter,total HOA RMS(at 5mm pupil diameter),no significant difference was found in both IOLs.Under mesopic conditions,ten patients(30%)with an aspheric IOL had better contrast sensitivity.The average myopic shift were(-0.29?0.09)D and(-0.87?0.16)D in the aspherical and spherical IOL groups at 6mm pupil diameter(P

OBJECTIVE: To explore the expression levels of three T-type calcium channel receptors (α1G; α1H; α1I) in the cochlea and spiral ganglion neurons of C57BL/6J mice with different ages. METHOD: Thirty cases of C57BL/6J mice were divided into three groups (6-8 W, 24-26 W, 42-44 W) according to the age. The expressions of three T-type calcium channel receptors were quantified by RT-PCR after hearing thresholds measured by ABR. RESULT: Three receptors were detected in the cochlea and spiral ganglion neurons of 6-8 W C57BL/6J mice. The quantitative results showed that the expression levels of α1H and α1I were highest among three receptors in spiral ganglion neurons and in the cochlea respectively. The expression levels of three receptors significantly decreased with age,especially at the age of 4244 W. CONCLUSION The expression of T-type calcium channel receptors reduced with age in the inner ear of C57BL/6J mice.
Animals ; Calcium Channels ; Calcium Channels, T-Type ; biosynthesis ; Cochlea ; metabolism ; Ear, Inner ; Mice ; Mice, Inbred C57BL ; Neurons ; Receptors, Calcium-Sensing ; Spiral Ganglion ; metabolism

Objective To report a case of lymphomatoid papulosis(LyP)followed by mycosis fun-goides(MF)during his27years course and determine whether these diseases are clonally related.Methods Characteristics of clinicopathology and immunophenotype of skin tissues of different phases of the patients were compared.Simultaneously,clonal T-cell receptor gene rearrangement of skin lesion tissues and blood specimens were detected by means of polymerase chain reaction and Southern blot analysis.Results A dis-tinct clinical and pathological feature was shown in this case of LyP followed by MF.The proliferating lym-phocytes in LyP and MF were mature T helper lymphocytes,and with same T-cell clone.Conclusion LyP followed by MF displays a same T-cell clone.The clonal T-cell is irrelevant to the biological behavior of these diseases.

Objective To explore the mechanism of severe intermittent hypoxia on oognitive function by evaluatig the effect of chronic intermittent hypoxia on cognitive function,neurons structure,damage,p38MAPK protein expression and neuronal apoptosis in rats hippocampal CA1.Methods Ninety-six mature and male Wistar rats were randomly divided into two groups:control group (UC) and 5％ chronic intermittent hypoxia group (5％CIH).Rats in IH groups were suffered 8 hours intermittent hypoxia everyday,and the duration of experiment was respectively 2,4,6 and 8 weeks.After exposed for 2,4,6,and 8 weeks,the cognitive function of rats was assessed with the Morris water maze (MWM) ; the changes in the morphology of nerve cells in hippocampus CA1 region were observed; the expression of phosphorylated p38MAPK protein in hippocampus was detected by the methods of immunohistochemistry and western blot; the apoptosis of nerve cells was detected by the method of TUNEL.Results Compared with control group,with prolonged hypoxia,the time of escape latency obviously prolonged and the time of across the target quadrant shortened significantly in rats of 5％ CIH group.The time of escape latency at the 8th week was the longest ((71.71 ± 5.49)s,P＜ 0.05) in 5％ CIH group,and the time of across the target quadrant at the 8th week was the shortest ((26.82 ± 4.30) s,P ＜ 0.05) in 5％ CIH group.There appeared neuronal degeneration and necrosis in hippocampus CA1 in 5％ CIH group.Compared with the control group,the density of the nerve cells survival in the region of hippocampal CA1 reduced dramatically at the 2nd,4th,6th and 8th week and was the lowest at the 8th week(14.16 ± 2.07,P ＜ 0.05).By Immunohistochemical method,the expression of phosphorylated p38 MAPK of 5％ CIH group in hippocampal CA1 was more than UC group at the 2nd,4th,6th and 8th week.By western blot,the expression of phosphorylated p38MAPK of 5％ CIH group was more than UC group at the 2nd,4th,6th and 8th week and was the most at the 6th week (2.45 ± 0.14,P＜ 0.05) ;the index of neuronal apoptosis in hippocampal CA1 was increased significantly at the 2nd,4th,6th and 8th week than UC group and reached to the peak at the 6th week (0.608 ± 0.069,P ＜ 0.05) in the 5 ％ CIH group.Conclusion Chronic intermittent hypoxia could cause the activation of p38MAPK/pathway of neuronal apoptosis and was important mechanism of cognitive dysfunction at the early and middle stage.

Objective The study was to investigate the feasibility of using an intravascular Loopless Monopole Antenna (ILMA) for 3.0 T MR imaging of water bath and deep-seated arterial walls of experimental animal.Methods A novel intravascular loopless monopole antenna (ILMA) was developed,including a non-shield loach guide-wire and a matching circuit.The non-shield loach guide-wire is used as a receive antenna,with the diameter of 0.019 in( 1 in =2.54 cm) and length of 23.11 in.During the MR scanning,the ILMA was used as a receive-only probe,while body coil was used to transmit the RF pulses.Utilizing the coil in water bath and in-vivo animal experiment,we measured signal-to-noise ratio (SNR) and contrast-to-noise ratio(CNR) of artery wall using the same scanning parameter compared with phased-array coil.Results In the study,the developed novel ILMA conduced to improved SNR of imaging and much higher space resolution( 313 μm).First,the feasibility of acquiring the wall images was demonstrated on phantoms.The SNRs map generated by the matlab software showed that in comparison with the phased-array coil,ILMA generated higher SNR of the phantom wall when using the same sequences,parameters,and slices (86.8 ±0.8 vs.9.9 ±0.1,P ＜0.01 ).When imaging the aorta wall with the ILMA and phased-array coil,the SNRs of the arterial wall with the ILMA is 60.4 ±20.9,61.3 ±22.5,59.8 ±20.4,32.3 ±22.6 (T1WI),51.2 ±21.6,49.8 ± 15.5,50.4 ± 17.2,22.4 ± 18.3 (T2WI),the CNRs of the aorta wall with theILMA is 19.8±8.1,18.9±9.2,19.6±11.8,20.7 ± 13.3(T1WI),17.7±6.4,18.6±6.9,17.2 ± 6.4,17.2 ± 6.4 ( T2 WI),compared with phased-array coil,t values SNR:6.36,3.84,3.51,6.92(T1 WI),3.47,4.89,6.35,4.21 (T2WI),CNR:3.56,3.97,-0.71,4.74 (T1WI),3.99,3.01,4.27,5.03(T2 WI,P ＜ 0.05 ),respectively.Conclusion The study demonstrates the capability of using an MR ILMA to generate 3.0 T MR in-vivo experiments,the developed novel ILMA conduces to increased SNR compared with the conventional phased-array coil.