Attention-deficit/hyperactivity disorder (ADHD)is one of the most common comorbidities of ASD.This article reviews the assessment tools and clinical research (prevalence,clinical characteristics and treat-ment)and fundamental research (iconography,genetics,neurophychology,electronerophysiology)of ASD with ADHD according to lately related articles.The findings suggested that there was lack of researches on treatment and iconography of ASD with ADHD and the conclusions were inconformity.Furthermore,most of the objects in these researches were children of normal intelligence.Thus future research should expand its objects to patients of adult and children with mental retardation and do further explore in iconography and treatment.

Objective To explore the features of clinicopathology,gastroscopy,endoscopic ultrasonography (EUS) and immunohistochemistry of esophageal mesenchymal tumors (EMT).Methods The clinical data of 98 cases of EMT patients who underwent endoscopic biopsy,endoscopic treatment or surgery and were diagnosed according to pathological and immunohistochemistry examination were collected.The clinicopathologic characteristics,endoscopy,EUS and immunohistochemistry of these cases were retrospectively analyzed,and differentiated from other submucosal tumor.Results Among the 98 cases of EMT,there were 77 leiomyomas (LM),15 gastrointestinal stromal tumors (GIST),four lipomas,one leiomyoblastoma and one schwannoma.The age of GIST group were older than that of LM group,and most were male patients predominated in these two groups.Dysphagia was the most common symptom of EMT.Gastrointestinal bleeding was rare,which was different from other gastrointestinal mesenchymal tumors.Under endoscopy,the appearances of EMT were similar,as submucosal protuberant lesions.One esophageal GIST was extraluminal lesion.Under EUS,LM,GIST and schwannoma showed low echo images originated from the muscularis propria or muscularis mucosa.Lipomas showed high echo images originated from submucosa.Pathological examination indicated that main cell type of LM and schwannoma was spindle cell,part of GIST was epitheloid cell type.The expressions of CD117 and CD34 were high in GIST,the expressions of SMA and Desmin were high in LM.S-100 was expressed in schwannoma.Other submucosal tumors,such as esophageal cyst,esophageal tuberculosis,esophageal carcinosarcoma,and some esophageal squamous carcinoma were easily misdiagnosed as EMT.Conclusions Esophageal LM is the most common EMT,followed by GIST.EUS is helpful in EMT diagnosis,however it can not accurately distinguish GIST,LM or schwannoma.

Objective To research the pathogeny and the electromyographic characteristics of myokymia.Methods The clinical features and electromyography of 42 elderly patients with myokymia were examined. Results Symptomatic myokymia (SM) in 27 cases was caused by low salt syndrome, thyrotoxemia, urinaemia, chronic wasting diseases (such as carcinoma of the stomach or liver), brachial plexus neuropathy, lead poisoning, chronic inflammatory demyelinating polyradiculoneuritis, succinylcholine narcosis, restless leg syndrome or Isaac's syndrome.Symptomatic facial myokymia was caused by neoplasm of the brain stem or in posterior cranial fossa, multiple sclerosis or other causes. Primary myokymia ( PM ) in 15 cases involved idiopathic generalized and benign myokymia.Compared with PM, SM was more constant and powerful. Myokymia potential appeared in the electromyograms of 42 of the patients. The majority of patients with SM had accompanying myotonic discharge. Conclusion The pathogeny and electromyographic characteristics of symptomatic myokymia are different from the primary stage.

Objective To study the endogenous glucocorticoid on rat femoral head microenvironment of 11 hydroxysteroid dehydrogenase expression ,and to discuss the influence of combined with femoral head pathological changes of the corresponding mechanism .Methods Sixty SD rats were divided into control group ,1‐month group ,3‐months group ,each 20 rats in group .1‐month group and 3‐months group inject cortisone acetate in the abdominal cavity intraperitoneal for 1‐month or 3‐months each .Im‐munohistochemical ,immunofluorescence ,Real‐time qPCR ,HE staining were employed in this study .Results From immunohisto‐chemical ,immunofluorescence ,Real‐time qPCR ,the 11 hydroxysteroid dehydrogenase content of 1‐month group and 3‐months group were higher than that of the control group(P<0 .05) .From HE staining we detected 1‐month group in the bone marrow cavity in‐creased in fat cells ,3‐months group subchondral trabecular bone density decreased ,compared with the control group(P< 0 .05) . Conclusion Supplement of corticosterone could promote rat femoral head microenvironment 11 hydroxysteroid dehydrogenase ex‐pression and subchondral trabecular bone density decrease .

OBJECTIVETo explore clinical results of open reduction and internal fixation (ORIF) for posterior Pilon fracture through posterolateral approach.

METHODSSeventeen patients with posterior Pilon fracture were treated through posterolateral approach from February 2010 to April 2013. Among them,including 11 males and 6 females aged from 29 to 59 with an average of 43.4 years old. All fractures were associated with more than 20% of articular surface of distal tibial. The causes of injury included falling down (11 cases), traffic accident (4 cases) and sports injury(6 cases). Fracture classification was based on posterior pilon fracture by YU Guang-rong, including type I (6 cases), type II (2 cases) and type III (6 cases). Fracture healing time, fracture reduction and postoperative complications were observed, AOFAS score were applied to evaluate clinical efficacy.

RESULTSAll patients were followed up from 13 to 24 months with an average of 20.5 months. All incisions were healed at stage I, and fractures obtained healing,the time of fracture healing ranged from 12 to 21 weeks with an average of 15.2 weeks. No incision infection, neurovascular injury, bone ununion and fracture deformity were found after operation. Postoperative AOFAS score was 92.0 ± 10.2, and 14 cases got excellent results, 2 good and 1 moderate.

CONCLUSIONPosterior pilon fracture through posterolateral approach could obtain effective reduction, stable fixation. It is a safe, simple and effective operation for treating posterior Pilon fracture, and it is worth popularizing.

Adult ; Ankle Fractures ; surgery ; Ankle Joint ; surgery ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

AIM: The purpose of this study is to investigate the mechanisms related to oxidized low-density lipoprotein(ox-LDL) and dendritic cells(DCs) in the process of atherosclerosis.METHODS: Human DCs were prepared from human CD14~+ peripheral blood monocytes using rhGM-CSF((100 ?g/L)) and rhIL-4(40 ?g/L).Cells were incubated with(100 mg/L) native or oxidized LDL for 72 h.The formation of foam cells was investigated by electron microscopy and oil red O staining.Phenotypic and immune functional assays were used with FACS,FITC-dextran phagocytosis,allogeneic mixed T lymphocytes reaction and secretion of Th1/Th2(IL-12/IL-2) cytokines were also conduced.RESULTS: DCs treated with ox-LDL,but not native LDL were induced into foam cells after cultured for 72 h.Compared with native LDL,ox-LDL-treated DCs were less potent in FITC-dextran phagocytosis.ox-LDL promoted allogeneic T cells proliferation.Moreover,ox-LDL upregulated CD80(72.4? 9.6 vs 89.5?10.1,P

Objective To investigate clinical and radiological characteristics of reversible posterior leukoencephalopathy syndromes(RPLS) in preeclampsia/eclampsia and to summarize prognosis of patients and fetus in order to provide the basis for early diagnosis and early treatment.Methods Clinical and radiological characteristics, and treatments and outcomes of 33 pregnant women with RPLS in preeclampsia/eclampsia were analyzed retrospectively.All patients were treated in Guangzhou Medical Center for Critical Pregnant Women during January 2013 and July 2015.Results Clinical symptoms :23 of 33 patients were with headache, 19 cases with visual changes, 15 with seizures, and 12 cases with conscious or mental disorder besides 3 cases with nausea and vomiting, and 4 cases with chest tightness and shortness of breath symptoms.Imaging features: 33 cases were all checked with radiological examination in acute period, which suggests edema of white matter.It involved the most common parts of occipital lobe(24 cases), 13 cases in the parietal lobe,9 cases in temporal lobe and basal ganglia,and 6 cases in frontal lobe.Moreover, the common parts involving the brain stem occurred in 4 cases, and 2 cases of cerebellum.Clinical outcomes: 33 cases of pregnant women in prenatal emergency termination of pregnancy include 31 cases of cesarean section, and 1 case of natural delivery.After active treatment, the prognosis was good, except 1 case complicated with systemic lupus erythematosus (SLE) died, the rest were good.Fetal prognosis : stillbirths occurred in 8 cases, the rest were good.Conclusions The clinical presentations of RPLS in patients with eclampsia or preeclampsia are typical, including headache, epileptic seizures, visual changes, conscious, or mental disorder.The imaging features which involved the most common parts are occipital lobe and parietal lobe.The early diagnosis and timely intervention lead to a sound prognosis.

AIM: To explore the effect of L-carnitine on nuclear factor of activated T-cells, cytoplasmic 3 (NFATc3) in cardiomyocytes under H2O2 stimulation.METHODS: Primary cultured neonatal rat myocardial cells were stimulated by H2 O2 at concentration of 200μmol/L for 12 h to induce oxidative stress injury.In treatment group, L-carni-tine and cyclosporin A ( CsA) , a specific inhibitor of calcineurin ( CaN) , were administered 30 min prior to H2 O2 stimula-tion.After treatment, total, cytoplasmic and nuclear NFATc3 protein levels were determined by Western blotting.The method of immunofluoresence was used to evaluate the distribution of NFATc3.RESULTS: H2 O2 treatment produced no effect on the expression of total NFATc3, but caused its translocation from the cytosolic to nuclear compartment, which was greatly blunted by L-carnitine pretreatment.CONCLUSION:L-carnitine antagonized oxidative stress injury via alleviating NFATc3 nuclear translocation.

Objective To explore the differences and similarities of clinical characteristics,pathological features, treatment and prognosis between primary gastric lymphoma(PGL)and primary intestinal lymphoma (PIL). Methods The clinical characteristics, pathological features, therapeutic results, the detection of Helicobacter pylori (Hp) and prognosis of 48 PGL cases and 15 PIL cases were retrospectively analyzed. Results There was no statistical significance in age, gender, abdominal pain, gastrointestinal bleeding, B symptoms, clinical stage, mortality between PGL and PIL groups (P>0. 05). However, there were significant differences in the pathological type, acute abdomen emergency surgery between these two groups (P<0. 05). There was 12 Hp positive cases in mucosalassociated lymphoid tissue (MALT) lymphoma of PGL group (12/19), and 5 Hp positive cases in diffuse large B-cell lymphoma (DLBCL) (5/20). There was significant difference in Hp detection rate of these two pathological types. Hp was not found in PIL group. The Cox multivariate analysis indicated that stage Ⅲ-Ⅳ was the independent adverse factors affecting PGL prognosis (P<0. 05).Conclusions Mainly histological types are DLBCL and MALT lymphoma in PGL, and DLBCL in PIL.PIL predispose to T-cell lymphoma compared with PGL. MALT lymphoma is rare in PIL group. The mainly clinical stage is Ⅲ-Ⅳ both in PGL group and PIL group. Emergency surgery is often needed in PIL because of intussusception or perforation. The prognosis of PGL is correlated with the stage and the prognosis of PIL are correlated with the stage, B symptoms and T cell phenotype.

Objective To compare the effect of difierent combinatio of mannitol, furesemide and albumin in reducing intracranial pressure in 451 patients with severe traumatic brain injury (sTBI). Methods A total of 451 patients with an admissiou Glasgow Coma Scale of or less from 5 medical centers were randomly divided into 5 groups, ie, Group A(250 ml 20% mannitol each time as control), Group B(125 ml 20% mannitol each time), Group C(alternate use of 250 ml 20% mannitol each time or 40 mg furosemide), Group D(alternate use of 125 ml 20% mannitol each time and 20 mg furosemide)and Group E(alternate use of 125 ml 20% mannitol and moderate or large dose of albumin). We monitored intracraniai pressure continuously and observed the changes of intracranial pressure, electrolytes, hemato-crit and renal function after use of 5 combinations of mannitol. Furosemide and albumin. Results Man-nitol and furosemide could independently reduce intracranial pressure after 1-3 hours (P<0. 05). Semis mannitol plus furosemide or albumin could more signifieantly reduce intracranial pressure, with statistical difference compared with full dose of mannitol. Semis mannitol and alternate use of mannitol and furose-mide in aspect of intracranial pressure reduction and persistence time(P<0. 05). Alternate use of man-nitol and furosemide begot higher incidence rate of electrolyte abnormality, compared with the other com-binations (P<0. 05). Rebound rate of intracranial pressure was higher in full dose of mannitol than other combinations (P<0. 05). Incidence of renal function abnormality was higher in combination involved al-bumin than alternative use of mannitol and furosemide as well as combination of semis mannitol and furo-semide (P<0. 05). Abnormality of electrolyte and renal function wag reversible. Conclusion The use of 125 ml 20% mannitol each time plus 20 mg furesemide is more reasonable than other combina-tions. Meanwhile, semis mannitol combined with moderate or large dose of albumin has certain advantages too.