One-and-a-half syndrome with facial diplegia, also referred to as the fifteen-and-a-half syndrome, is an extremely rare clinical entity caused by involvement of bilateral tegmentum of pons. Herein, we report a 52-year-old male who presented with one-and-a-half syndrome with left facial paralysis, which was consistent with the so-called eight-and-a-half syndrome. Brain magnetic resonance imaging showed pontine infarction. Five days after initiation of antiplatelet therapy, the patient developed right facial paralysis, a diagnosis of fifteen-and-a-half syndrome was made, repeat MR imaging revealed bilateral pontine tegmentum infarction. Fifteen-and-a-half syndrome is a newly proposed concept associated with pontine infarction. The clinicoradiological features of this specific disease are as yet unclear due to its extreme rarity. The current case would help advance the current understanding of the disease spectrum of pontine infarction.

Clinical oncology is becoming more and more important as the tumor incidence increases year by year. According to the need of clinical teaching, some important contents in teaching should be emphasized. And some ideas should be pard attention to such as chronic disease needing long-period and long period of treatment of chronic tumor diseases, necessary pathlolgical diagnosis, in despensible evidence-based medicine, multidisciplinary treatment combined with individualized treatment, caring psychological problems and pain in cancer patients, recognizing tumor research progresses by way of molecular targeted therapy. Finally, some teaching methods to raise study interest in a flexible way were put forward.

Objectives To analyze the clinical features, diagnosis and treatment of Lemierre syndrome. Methods The clinical data of one case of Lemierre syndrome were retrospectively analyzed. The relevant literatures were reviewed. Results The primary infection of the patient was oral infection, and jugular vein thrombosis and metastatic lung abscess were followed. The blood culture showed that Staphylococcus aureus was positive. Lemierre syndrome was diagnosed. After anticoagulation and anti-infection treatment, the symptoms were improved. Conclusion Lemierre syndrome should be considered in present of jugular vein thrombosis and pulmonary abscess caused by infection.

In order to evaluate the neuroprotective effect of Rosiglitazone Maleate (RSG) against brain ischemic injury, the effects of Rosiglitazone Maleate on the inflammation following cerebral ischemia/reperfusion were investigated. Focal cerebral ischemia was induced by the intraluminal thread for cerebral middle artery (MCA) occlusion. Rosiglitazone Maleate at concentrations of 0.5, 2 and 5 mg/kg was infused by intragastric gavage twice immediately and 2 h after MCA occlusion, respectively. The effects of Rosiglitazone Maleate on brain swelling, myeloperoxidase and interleukin-6 mRNA level in brain tissue after MCA occlusion and reperfusion were evaluated. The results showed that as compared with the model control group, RSG (0.5 mg/kg) had no significant influence on brain swelling (P>0.05), but 2 mg/kg and 5 mg/kg RSG could significantly alleviate brain swelling (P<0.05). All different doses of RSG could obviously reduce MPO activity in brain tissue after MCA occlusion and reperfusion in a dose-dependent manner. RSG (0.5 and 2 mg/kg) could decrease the expression levels of IL-6 mRNA in brain tissue after MCA occlusion and reperfusion to varying degrees (P<0.05) with the difference being significant between them. It was concluded that RSG could effectively ameliorate brain ischemic injury after 24 h MCA occlusion and inhibit the inflammatory response after ischemia-reperfusion in this model.

Objective To analyze results of atopy patch test (APT) with dust mite allergens at different concentrations in patients with atopic dermatitis (AD),and to evaluate the diagnostic value of APT.Methods Totally,85 patients with AD were enrolled into this study.All the patients underwent APT with 5 concentrations (3 000,5 000,7 000,10 000 and 12 000 pnu/g) of dust mite allergens,as well as skin prick test (SPT) with dust mite allergens.Dust mite allergens were obtained from two different manufacturers (group 1 and 2).Enzyme-linked immunosorbent assay (ELISA) was performed to detect allergen-specific immunoglobulin E (SIgE) in sera from these patients.The sensitivity,specificity and positive predictive value of APT,SPT and SIgE assay were compared,and the results of APT were compared among different concentrations of allergens and between allergens from different manufacturers.Results When SIgE assay served as the gold standard,the sensitivity,specificity and positive predictive value in the diagnosis of dust mite allergy were 79.41％,76.12％,and 64.29％ respectively for APT,73.53％,80.95％ and 67.57％ respectively for SPT with group 1 dust mite allergens,and 81.53％,77.78％ and 65.09％ respectively for APT,76.02％,79.85％ and 66.07％ respectively for SPT with group 2 allergens.When SPT was regarded as the gold standard,the sensitivity,specificity and positive predictive value in the diagnosis of dust mite allergy were 78.38％,77.42％,67.44％ respectively for APT,67.57％,84.21％,73.53％ respectively for SIgE assay with group 1 dust mite allergens,79.25％,80.63％ and 69.55％ respectively for APT,61.07％,82.54％ and 77.21％ respectively for SIgE assay with group 2 allergens.There were no significant differences in the sensitivity,specificity or positive predictive value of APT or SPT between the two groups of allergens.The positive rate of APT was 8.24％,22.35％,29.41％,44.71％ and 41.18％ respectively with group 1 allergens at 3 000,5 000,7 000,10 000 and 12 000 pnu/g,and 3.53％,23.53％,31.76％,34.12％ and 35.29％ respectively with group 2 allergens.No significant differences were observed in the positive rate of APT between group 1 and 2 allergens at same concentrations (all P ＞ 0.05),but a significant difference was observed in that between different concentrations of group 1 or 2 allergens (both P＜ 0.05).The positive rate of APT increased with the increase of allergen concentrations,but stopped rising when the concentrations of group 1 and 2 allergens reached 7 000 pnu/g and 5 000 pnu/g respectively.Conclusions The sensitivity of APT is relatively high for the diagnosis of dust mite allergy.The positive rate of APT increased with the increase in allergen concentrations,but stopped rising when the concentrations reached a certain level.

Objective To investigate the risk factors and anticoagulation parameters in patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with deep venous thrombosis (DVT). Methods All of 110 AECOPD patients were divided into two groups according to Doppler examination of lower extremities: DVT group and non-DVT group. The risk factors and anticoagulation parameters were compared. Results Twelve cases (10.9%) were in DVT group,of whom 2 cases (1.8%)had pulmonary embolism. The rate of lying in bed > 3 d, smoke, mechanical ventilation, hospital stays and the levels of PaCO2 were significantly higher in DVT group than those in non-DVT group (P < 0.01 or <0.05 ). In DVT group, the activity of antithrombin Ⅲ and the level of protein S decreased (P < 0.05 ), and the level of D-Dimer increased (P < 0.05). Conclusions Long-term bed, smoke and mechanical ventilation requirement are the main risk factors of DVT in patients with AECOPD. Respiratory failure (type Ⅱ ) is easier to combine with DVT. Abnormality of coagulation and fibrinolytic system exists in AECOPD with DVT.

Objective:To investigate the correlation between IL-10 and I1-17 expression levels in Mycoplasma pneumoniae pneumonia (MPP) and lung function.Methods:70 patients were included in this study.According to wheezing or not,they were divided into wheezing group and non-wheezing group.Another 30 healthy children were taken as a control group.After taking fasting blood 5ml,the serum IL-10 and IL-17 expression levels were detected by ELISA.The forced expiratory volume in one second (PEV1),peak expiratory flow (PEF) and forced vital capacity (FEV1 / FVC) of all subjects were detected.Results:The IL-10 expression level of the wheezing group were significantly different with that of the control group (P＜0.05) and that of the non-wheezing group (P＜0.05).The 1L-17 expression level of the wheezing group also had significant difference (P＜0.05) with that of the control group and non-wheezing group (P＜0.05).The IL-10 expression levels of wheezing and non-wheezing group all were lower than that of the control group.Whereas the IL-17 expression levels of wheezing and non-wheezing group all were higher than that in the control group.In addition,patients in wheezing group had higher PEV1,PEF,PVE1/FVC values than those in non-wheezing group,with significant difference (P＜0.05).The serum level of IL-10 expression of Mycoplasma pneumonia patients was positively correlated with PEV1,PEF and PVE1/FVC,while the serum level of IL-17 expression of Mycoplasma pneumonia patients was negatively correlated with PEV1,PEF and PVE1/FVC.Conclusion:The serum levels of IL-17 and IL-10 expression of Mycoplasma pneumonia children had close correlation with their pulmonary function.

AIM:Toobservetheeffectsofmicroparticlesderivedfrombonemarrowmesenchymalstemcells ( MSC-MPs) on angiogenesis and cardiac function in a rat myocardial infarction model .METHODS:MSCs were obtained from Sprague-Dawley rats.MSCs were treated under serum-free condition in hypoxia for 72 h, and the microparticles were isolated from the supernatants .The phenotypic profile of MSC-MPs was determined by bead-based flow cytometry and the morphology was observed under a transmission electron microscope .The rat myocardial infarction model was established . The cardiac function was evaluated by echocardiography after the intramyocardial injection of MSC -MPs.The myocardial in-farct size was observed by Masson staining .The blood vessel density in the peri-infarcted area was measured using immuno-histochemical staining for von Willebrand factor and α-smooth muscle actin.The expression of vascular endothelial growth factor ( VEGF) was analyzed by real-time PCR.RESULTS: Apoptotic MSCs released a large quantity of microparticles which were phenotypically similar to the parent MSCs and 100~1 000 nm in diameter.The cardiac functions of myocardial infarction rat model were improved at 7 d and 28 d after intramyocardial injection of MSC-MPs compared with control group . The myocardial infarct size was reduced and angiogenesis was promoted significantly in the infarcted heart injected with MSC-MPs 28 d after treatment .MSC-MPs treatment also increased the expression level of VEGF within 7 d.CONCLU-SION:MSC-MPs protect cardiac tissue from ischemic injury and improve cardiac function by promoting angiogenesis after myocardial infarction .

Objective To investigate potential problems and solutions within the data of national surveillance of Keshan disease(KSD), to improve the quality of surveillance data and the reliability of the results. Methods Four key variables (name, sex, age, and KSD diagnosis) in the national surveillance data of KSD in 2009 were cleaned by SPSS 15.0. Cleaning contents included duplicate records, missing values, outliers and logic errors. Name, sex, age, currently residing in townships and currently residing in villages and other variables were combined into different filters to find duplicate records by the command of Identify Duplicate Cases , then the duplicate records were returned to the data reporting agencies, and finally delete or merge. Data with missing values, outliers, or logical errors were found by commands of Frequencies, Descriptives and Select if, then the duplicate records were returned to the data reporting agencies. Data were revised based on not only the feedback , but also by using the relationship between variables, and by consulting KSD clinical experts. Results Four hundred and sixty-four cases of duplicate records were found and cleaned. The number of missing values was 2 047 (specifically, name 0, sex 3, age 32 and KSD diagnosis 2 012). The number of outliers was 1 988 (specifically, name 6, sex 3, age 10 and KSD diagnosis 1 969). The records of 5 kinds of logic errors of KSD diagnosis were 105 in all. Conclusion There are duplicate records, missing values, outliers and logic errors in the national surveillance data of KSD, cleaning work could improve the quality of surveillance data, ensure the authenticity and rliability of the monitoring data.

The study aims to investigate the associations of SUMO4 polymorphisms with tacrolimus concentrations in Chinese renal transplant recipients. Blood samples and clinical data were collected from 132 renal transplant recipients with tacrolimus treatment. CYP3A5*3 genotypes were detected by PCR-RFLP, and SUMO4 (rs237024, rs237025) genotypes were detected by Sequenom® MassARRAY system. SUMO4 rs237024 and rs237025 genotypes were in complete linkage disequilibrium (D' = 1). The dose-adjusted concentration of tacrolimus in SUMO4 rs237024A-rs237025A (GA-GA +AA-AA) carriers was considerably higher than that in GG-GG carriers (P < 0.05). After stratification by CYP3A5*3 genotypes, SUMO4 rs237024A-rs237025A carriers (GA-GA+AA-AA) had a higher dose-adjusted tacrolimus concentration than that in GG carriers in CYP3A5 expresser (P < 0.05). The results illustrated that SUMO4 rs237024 and rs237025 polymorphisms were associated with tacrolimus concentrations, and the test of these genotypes may be useful for individualized medicine of tacrolimus.