Objective To study the expression of prepro-orexin mRNA in circadian rhythms and sleep-deprived rats.Methods Sleep was deprived with “rotation cylinder” in rats. RT-PCR was used to determine the change of prepro-orexin mRNA expression in cortex and hypothalamus of circadian rhythms and sleep-deprived rats.Results There was a significant changes of prepro-orexin mRNA expression with circadian rhythms in hypothalamus of rats. But there was no significant change in cortex. More prepro-orexin mRNA expression was found in hypothalamus than in cortex of rats. The expression of prepro-orexin mRNA in hypothalamus and in cortex of rats was not effected by short times of sleep deprivation. However the expression was raised by a 8-hour sleep deprivation.Conclusions There should be a close relationship between orexin and sleep. The control of sleep may be dependent on regulation of orexin in hypothalamus.

Objective To study the clinical features and treatment of horizontal canal benign paroxysmal positional vertigo (HC-BPPV).Methods The clinical features of 27 patients with HC-BPPV and the treatment results with otolith repositioning maneuver of Barbecue rotation were analyzed retrospectively.Results All the patients with HC-BPPV had vertigo attack and this kind of vertigo attack presented with some characters such as brief, positioning, latency and no fatigability. Geotropic nystagmus was seen in 21 patients and apogeotropic nystagmus was seen in 6 patients when head was turned to either side in supine position. After Barbecue rotation, all symptoms disappeared in patients with geotropic nystagmus and did not change in patients with apogeotropic nystagmus.Conclusions The diagnosis of HC-BPPV is based on typical clinical features and test of turning head to either side in supine position. Geotropic nystagmus is associated with canalithiasis and apogeotropic nystagmus is associated with cupulolithiasis, and the therapy of Barbecue rotation is very effective to HC-BPPV patients with geotropic nystagmus.

Objective To evaluate the clinical features and treatment of posterior semicircular canal benign paroxysmal positional vertigo(PC-BPPV).Methods To retrospectively analyse the clinical features and therapy results of 120 patients with PC-BPPV from January 2003 to November 2004 in the Chang Zheng Hospital of the Second Military Medical University.Results Vertigo attack of PC-BPPV had such characters as brief period,positioning,latency and fatigability.Geotropic rotatory nystagmus occurred in 108 patients and apogeotropic rotatory nystagmus in 12 patients in the test of Dix-Hallpike,and the former received the repositioning maneuver therapy of Epley and the later received the therapy of Semont maneuver.The symptoms disappeared completely in 88 patients after a single session and 12 patients after twice、6 patients after triple sessions of Epley repositioning maneuver therapy in the former,no effectiveness in 2 patients;the symptoms remitted in 8 patients after once,2 patients after twice and 1 patient after triple sessions therapy of Semont repositioning maneuver in the later,no change in 1 patient.The total success rate was 97.5%(117/120).Fifteen patients had relapse during follow-up and the recurrence rate was 12.5%(15/120).They also responded to repositioning maneuver therapy.Conclusion The diagnosis of PC-BPPV is based on the typical clinical features and the test of Dix-Hallpike.The repositioning maneuver therapy is safe and effective for PC-BPPV and should be used for all patients when the diagnosis is clearly made.

Objective To set up rodent ankylosing spondylitis model. Methods Recombinant natively folded versican G1 domain(VG1) and FCA were injected into BALB/c mice to induce spondylitis and sacroiliitis. Spondylitis and sacroiliitis were determined by pathological examination. Results It was shown that immunity to recombinant VG1 resulted in spondylitis in the lumbar spine and sacroiliitis in 35 0% and 12 5% mice respectively. Accumulation of mononuclear cells was observed in spinal ligaments adjacent to the intervertebral disc, the intervertebral disc and the sacroiliac joints. No clinical peripheral arthritis was observed. Conclusion These observations suggest that immunity to human VG1 is involved in the induction of experimental spondylitis and sacroiliitis in BALB/c mice, which will do some help to probe the pathogenesis of human ankylosing spondylitis

Objective To study the role of transforming growth factor-?1(TGF-?1) and bone morphogenetic protein 2 (BMP2) in the ankylosing spondylitis, and to evaluate whether synovial levels of TGF-?1/ BMP2 mRNA and TGF-?1/BMP2 protein expression correlate with disease activity and macroscopic observation during arthroscopy. Metheds TGF-?1/BMP2 mRNA and protein were detected by in situ hybridization and immunohistochemistry.The vascular morphology of synovial membrane was assessed for vascular morphology, tortuous vessels, straight vessels, vascular density, synovial hypertrophy, by 2 blinded observers and Reece's method using a validated VAS methods. They were significantly higher in AS than that in RA in different synovial regions. Results TGF-?1 mRNA and TGF-?1 expression were significantly higher in early AS than that in early RA in perivascular region and sublining interstitial tissue. BMP2 mRNA and BMP2 expression were significantly higher in AS than that in RA in different synovial regions.No significant relation was found between TGF-?1/BMP2 expression and CRP/ESR/platelet count in early AS. A positive relation was found between the TGF-?1 and synovial hypertrophy in synovium lining layer region, and between TGF-?1 and straight vessels,vascular density in perivascular region, and between BMP2 and synovial hypertrophy in sublining region in early AS. Conclusion Expression of TGF-?1 mRNA and TGF-?1 protein is higher in AS synovial tissue than that in RA. BMP2 mRNA and BMP2 expression are significantly higher in AS than that in RA.

Objective To improve the understanding of severe anaphylactic reactions to infliximab retreatment. Methods Delayed hypersensitivity to infliximab in two patients with ankylosing spondylitis who had previously received infliximab and resumed after discontinuation over 4 years were reported and the related literatures were reviewed. Results Two patients ( 1 male, 1 female ) who were diagnosised with ankylosing spondylitis for more than 10 years, both individuals had received infliximab treatment during a clinical trial approximately 4-5 years prior to further therapy. On day 6 after subsequent infusion, one patient had pruritic skin rash covering her whole body, followed by flustered, dyspnea, hypotension and anaphylactic shock, she was successfully treated with epinephrine and glucocorticoid. Another patient experienced a skin rash and itching 9 days after reinfusion, he was successfully treated with antihistaminics.Conclusion A distant infliximab retreatment is associated with high rates of reinfusion reactions, including fever, urticaria, myalgia, arthralgia,even hypotension, dyspnea, laryngeal edema and anaphylactic shock.We recommend careful monitoring of those patients who receive infliximab retreatment, particularly after a lengthy interval.

OBJECTIVE Apolyclonalantibody-basedhomogeneouschemiluminescenceimmunoas-say was developed and optimized using AlphaLISA technology for the quantitative detection of microcys-tin-LR(MC-LR)inwatersamples.METHODS Thismethodwasbasedonacompetitivemodelin which an immune complex was formed from the ingegral binding of artificial MC-LR antigen-coated lumi-nescene beads,free MC-LR standards or sa mples,antibody and biotinylated second antibody.Next sensor bead were added that approached the i mmune co mplex through biotin-streptavidin interaction. With the exciting light,the energy was passed from the sensor luminescer before a special emission light could be observed.To opti mize the reaction conditions,working dilutions of polyclonal antibody and bioti-nylated second antibody were assayed while the effect of buffer syste ms and ti me of each reaction were evaluated.RESULTS Maininfluencingfactorsoftheassaywerediscussedasworkingdilutionsofpoly-clonal antibody and biotinylated goat anti rabbit IgG,assay buffer and reacting ti me.After opti mization of reaction conditions,MC-LR AlphaLISA could be finished in 40 min,with a sensitivity of 0.006 μg·L-1 and a dynamic range of 0.006 -5 μg·L-1 .The coefficient of variation was below 10% and average recovery was 1 07.7%.Moreover,the cross reactivity rates of MC-RR and MC-RY to MC-LR were 13.2%and0.91%,respectively.CONCLUSION Thismethodishighlysensitiveandspecific,time-saving and quite suitable for high throughput determination of MC-LR water samples.

Objective To investigate thickness of the hilar periportal space and caudate-right lobe ratio in the patients with chro-nic hepatitis B and liver cirrhosis after hepatitis B .Methods Eighty-four patients who were clinically and histologically diagnosed with chronic hepatitis B or cirrhosis and 18 healthy subjects without history of liver disease underwent abdominal MRI .The rela-tionship among liver fibrosis degree ,hilar periportal space and caudate-right lobe ratio were observed .Results There was signifi-cant correlation between the hilar periportal space and hepatic fibrosis for chronic hepatitis and cirrhosis (rs = 0 .546 ,P< 0 .01) . There was significant difference between S2 and S3 for thicknesses of the hilar periportal space(P<0 .01) ,and no significant differ-ence among S3 ,S4 and cirrhosis(P=0 .188) .A cutoff value of 9 mm for the hilar periportal space had a sensitivity of 85 .37% and a specificity of 76 .79% for a diagnosis of hepatic fibrosis with S3 or higher .There was no significant correlation between the caudate-right lobe ratio and hepatic fibrosis(rs = -0 .155 ,P=0 .119) .Conclusion Thicknesses of the hilar periportal space increase gradu-ally with hepatic fibrosis in patients with chronic hepatitis B and cirrhosis ,with a high sensitivity and specificity for a diagnosis of hepatic fibrosis with S3 or higher .

Objective To study the application of the combined detection of Golgi glycoprotein 73(GP-73),phosphatidylinositol proteoglycan 3(GPC3 )and percentage of AFP heteroplasmon(AFP-L3%)in the diagnosis of primary hepatocellular carcinoma (PHC).Methods The concentrations of GP-73,GPC3 and AFP-L3 were detected by enzyme-linked immunosorbent assay(ELISA) in 154 patients with PHC(PHC group),78 patients with cirrhosis(cirrhosis group)and 56 healthy subjects(control group).Then the detection results were statistically analyzed.Results The levels of GP-73,GPC3 and AFP-L3% in the PHC group were signifi-cantly higher than those in the liver cirrhosis group and the control group(P <0.05).The positive rates of GP-73,GPC3 and AFP-L3% in the PHC group were 66.2%,72.1% and 53.2% respectively.The positive rate in the combined detection of these three in-dices could reach 97.9%,which was higher than the sensitivity and accuracy in any single index detection and the combination de-tection.In the PHC group,the comparison between different levels of GP-73 and AFP-L3% with the AFP levels showed the statis-tically significant difference(P <0.05 ).Conclusion The combination detection of GP-73,GPC3 and AFP-L3% can improve the sensitivity and accuracy for diagnosing PHC and has reference significance in the differential diagnosis of early PHC.

Objective To analyze the ability of rheumatologistto read the magnetic resonance imag of sacroiliac joint of spondyloarthritis patients.Methods The questionnaire survey were conducted among rheumatologists and the answers of the questionnaires were analyzed by quantitative analysis.Results 66.9％ (75/112) rheumatologist did not known how to choose the sequence of magnetic resonance imaging,and 55.4％(62/112) rheumatologist thought that bone marrow edema was very important for the diagnosis of spondyloarthritis,but only less than 10％ rheumatologists thought that erosion and fat infiltration could also h elp to make the diagnosis of spondy-loarthritis.Conclusion It is very important for rheumatologists to receive training on the reading of magnetic resonance images of sacroiliac joint of spondyloarthritis patients.