Objective To investigate the clinical and neuroimaging characteristics of patients with reversible posterior leukoencephalopathy syndrome (RPLS). Methods The etiology, clinical manifestations, neuroimaging features, treatment, and prognosis were retrospectively analyzed in 8 patients (5 males and 3 females) with RPLS. Results The causes of RPLS included systemic lupus erythematosus (2 cases) eclampsia (one case), primary hypertension (one case), fungal encephalitis (one case), multiple myeloma (one case), renal transplantation (one case), immunosuppressant (three cases), chemotherapy (one case) and antifungal agent (one case). The clinical manifestations of these patients included headaches, seizures, visual abnormalities, and consciousness or mental disorders. Magnetic resonance imaging (MRI) of the head mainly showed symmetrical abnormalities in the posterior regions of the brain, as evidenced by low or equal signal on T_1WI, and high signal on T_2WI and FLAIR images. After treatment with antihypertensive agents, dehydration therapy, and heteropathy for 2～3 weeks, the neurological deficits of the patients were almost resolved and the initial lesions disappeared completely or almost completely in all patients at the follow-up MRI. Conclusions RPLS is a clinical entity characterized by reversible white matter damage in posterior brain. Prompt diagnosis and treatment may result in reversible resolution of its clinical symptoms and neuroradiological lesions.

Objective To explore the relationship between chromosomal abnormalities and abnormal pregnancy .Methods Chro‐mosomal karyotypes were examined in 766 pairs of couples with adverse pregnancy history from 2011 January to December by pe‐riphery blood lymphocyte culture and carried out G banding .Results The detection of 86 cases of patients with abnormal chromo‐somes ,chromosome abnormality rate was 5 .61% ;Among them ,1 cases of abnormal autosomal chromosome number ,67 cases of ab‐normal structure;Sex chromosome abnormality in 5 cases ,13 cases of abnormal structure .Conclusion Description of chromosome abnormalities and abnormal pregnancy is closely related ,The carriers of the couple should have prenatal diagnosis to avoid chromo‐some patients is born .

Objective To establish a sensitive,valid and rapid high performance liquid chromatography-trap mass spectrometry (HPLC-MS) method for determining carbocisteine concentration in human plasma. Methods Plasma samples were pretreated by 100 mL/L perchloric acid to remove the interference protein. The supernatant was separated by reverse phase HPLC,electrospray MS was used to detect carbocisteine in plasma samples,and selective ion method of multiple reaction modes was used to determine the concentration of carbocisteine. Results The limit of detection was 0.01 ?g/mL and the linear range was 0.2-200.0 ?g/mL. The recovery rate was within the range of 89.2%-105.6%. Conclusion The proposed method could be used to determine carbocisteine in biological samples.

Objective To investigate the efficacy of sequential add-on of pegylated interferon α-2a (PEGIFN-α-2a) for 48 weeks in chronic hepatitis B (CHB) patients with low serum hepatitis B e antigen (HBeAg) titer after long term adefovir dipivoxil (ADV) monotherapy.Methods This was a randomized,open and prospective clinical trial.Patients who had been treated with ADV for 72 to 144 weeks,with undetectable serum hepatitis B virus (HBV) DNA level,low HBeAg titer (5 S/CO＜ HBeAg＜50 S/CO) and serum hepatitis B surface antigen (HBsAg) ＜5000 IU/mL were included.The patients were categorized into ADV monotherapy group and ADV plus PEGIFN-a-2a combination therapy group by random number table.Patients in ADV group continued ADV monotherapy and patients in combination therapy group added PEGIFN-α-2a to ADV for 48 weeks.After the treatment,efficacy of the two therapies were assessed by comparing the reduction of serum HBeAg reduction,HBeAg loss rate,HBeAg seroconversion rate,and reduction of intrahepatic HBV DNA and HBV covalently closed circular DNA (cccDNA).Pre-and post-treatment results were compared by paired samples t test.Comparison between groups was performed using indepedent samples t test.Comparison of rates between groups was performed using x2 test.Results The trial enrolled 55 CHB patients,and there were 27 patients in ADV monotherapy group,28 patients in combination therapy group.Baseline characteristics including age distribution,sex ratio,alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin (TBil),serum HBeAg and HBsAg,hepatic HBV DNA and HBV cccDNA were all comparable (all P＞0.05).Twenty-five patients in ADV monotherapy group and 26 patients in combination therapy group completed 48 weeks treatment.HBeAg loss rates and seroconversion rates of combination therapy group were higher than those of ADV monotherapy group (x2 =5.38 and 4.69,respectively,both P＜0.05).HBeAg titers of both groups were significantly lower than those of baseline (t=8.43 and 8.50,respectively,both P＜0.05).The HBeAg titer of combination therapy group was lower than that of monotherapy group (t=5.60,P＜ 0.01).HBV DNA and HBV cccDNA in liver tissue of combination therapy group was (6.934±0.52) lg IU/mg and (5.63±0.54) lg IU/mg post-treatment,respectively,which were both lower than baseline (t＝7.12.6.67,respectively,both P＜0.01).HBV DNA in liver tissue of monotherapy group was (7.09＝0.43) lg IU/mg post-treatment,which was lower than baseline (t=2.67,P=0.02).After treatment,HBV cccDNA in liver tissue of combination therapy group was lower than that of monotherapy group (t =2.87,P=0.00).Conclusions Compared with ADV monotherapy,sequential add-on of PEGIFN-a-2a in combination with ADV can achieve higher serum HBeAg loss rate and seroconversion rate and facilitate the clearance of hepatic HBV DNA and HBV cccDNA in CHB patients with low HBeAg titer after long-term ADV monotherapy.

Objective:The therapeutical effects of salpingocatheterism and the states of tubal function were studied after different middle ear operations and within different middle ear pathological changes.Method:Total 71 patients with tubal occlusion, 18 of myringoplasty, 20 of reconstruction of ossicolar chain followed tympanoplasty, 14 of combined approach tympanoplasty, 10 of radical mastoidectomy followed tympanoplasty, 9 of re-radical mastoidectomy followed tympanoplasty were implemented salpingocatheterism. The patients were followed up for evaluation of the postoperative therapeutical effects and the state of tubal function. Result:The causes of operation failure in different middle ear operations or different middle ear pathological changes had no significantly difference. The major cause for postoperative tympanic membrane perforation and tubal occlusion was the pathogenic damage being not cleared up thoroughly and/or there being nasal cavity or pharyngeal cavity pathogenic changes accompanied.Conclusion:Salpingocatheterism is effective for preventing eustachian tube postoperative adhesion.

ObjectiveTo investigate the correlation of Skp2,p27kiP1 and p21WAF1 expression with the clinicopathological features of ovarian serous cystadenocarcinomas.Methods Expressions of Skp2 ,p27kiP1 and p21WAF1 were examined by immunohistochemical staining in 124 epithelial ovarian tumors (25 serous cystadenomas, 19 borderline serous cystadenomas, and 80 serous cystadenocarcinomas) Results(1) The expression of Skp2 in serous cystadenocarcinomas (47.5％)was significantly higher than that in borderline serous cystadenomas (0％)and serous cystadenomas (0％)(P ＜ 0.001) .The p27kiP1 expression in serous cystadenocarcinomas (35.0％) was significantly lower than that in borderline serous cystadenomas(73.7％)and serous cystadenomas (80.0％) .The p21WAF1 staining frequency in serous cystadenocarcinomas (38.8％)was significantly lower than in borderline serous cystadenomas (73.7％)and serous cystadenomas (80.0％) .(2) The Skp2 protein expression in serous cystadenocarcinomas was positively correlated with clinicopathological stage,histological differentiation degree and lymph node metastasis of the tumors.The p27kiP1, p21WAF1 protein expression in serous cystadenocarcinomas was reversely correlated with clinicopathological stage and histological differentiation degree of the tumors(Ps ＜ 0.05) .(3) The Skp2 protein expression in serous cystadenocarcinomas was reversely correlated with that of p27kiP1 , p21WAF1.Conclusion The Skp2 protein expression in serous cystadenocarcinomas was increased and positively correlated with the clinicopathological features of ovarian serous cystadenocarcinomas.Skp2 protein expression was reversely correlated with p27kip1 ,p21WAF1.Skp2 protein expression may play an important role in the development and progression of serous cystadenocarcinomas.

Objective To obtain the effective characteristic information for the standardization of diagnosis of traditional Chinese medical(TCM) syndrome in rheumatoid arthritis(RA).Methods Fifty-four items of symptoms and signs in RA patients were input into the computer,and Mahalanobis distance discriminant analysis(DDA) was used for the selection of effective indexes.Results According to the weight value and the result of T test,17 items from 54 had the highest rate of discrimination accuracy,up to 96.5%.Conclusion The results of computerized pattern recognition for the syndrome diagnosis of RA are consistent with the clinical diagnosis,which indicates that computerized pattern recognition can be used for the standardization of syndrome diagnosis of RA.

Objective To investigate microvascular injury-related factors post-percutaneous coronary intervention (PCI). Methods Seventy-two elderly patients with stable angina , who underwent PCI from February 2009 to February 2014, were enrolled in this study. The index of microvascular resistance (IMR) was assessed and the clinical data were collected. The correlation between general clinical data and the IMR value before and after PCI were analyzed, and regression analysis was conducted on the relevant factors with postoperative microcirculation after PCI. Results After PCI, FFR, CFR, CK-MB, troponin were higher than those before PCI, with significant differences (P < 0.05). Linear regression analysis result showed that glycated hemoglobin, the degree of stenosis after PCI were positively correlated with IMR, but ejection fraction and CFR before PCI were negatively correlated with IMR. Conclusion Clinically, diabetes, severe vascular stenosis, low ejection fraction, low CFR before PCI in patients with unstable angina may likely occur microcirculation after PCI.

Objective To explore the related risk factors for bypass graft occlusion in patients within 1 year after coronary artery bypass grafting,in order to provide the basis for the prevention of postoperative bypass graft occlusion.Methods Clinical data of 197 cases treated with coronary artery bypass grafting were collected,and the incidence rate of bypass graft occlusion and its related risk factors were analyzed.Results Graft occlusion occurred in 28 (14.2％) of 197 patients.The incidence rate of bypass graft occlusion were much higher in patients with BMI ≥24 kg/m2,smoking,hypertension,hyperlipemia,diabetes,peripheral vascular diseases and cerebrovascular disease than in patients with BMI ＜24 kg/m2,non-smoking,patients without hypertension,hyperlipemia,diabetes,peripheral vascular diseases or cerebrovascular disease (20.0％ vs.9.8％,22.4％ vs.10.8％,21.2％ vs.3.8％,31.1％ vs.9.2％,23.4％ vs.9.8％,25.5％ vs.10.7％,26.3％ vs.11.3％,x2 =4.106,4.534,11.735,13.658,6.615,6.486,5.656,respectively,P=0.043,0.033,0.001,＜0.001,0.010,0.011,0.017).Smoking,diabetes,hyperlipidemia,peripheral vascular diseases and cerebrovascular disease were the independent risk factors for bypass graft occlusion.Conclusions Many risk factors are related with short-term postoperative bypass graft occlusion in patients with coronary artery bypass grafting.The corresponding control measures should be conducted to decrease the risk of postoperative bypass graft occlusion,aiming directly at the risk factors,especially the independent risk factors.

Objective To evaluate the effect of single CVVH and HDF on endothelial system. Methods Group CVVH:20 patients with multiple organ dysfunction syndrome ( MODS) underwent CVVH for 12h.Vascular access was through two-lumen catheter in femoral vein;Group HDF:Twenty patients with end stage renal disease (ESRD) on maintenance hemodialysis underwent HDF for 4h.Vascular access was through internal arteriovenous fistula.Group control:Healthy people were examined at our hospital.The se-rum levels of sVCAM-1, sICAM-1, vWF and MMP-9 were measured by enzyme-linked immunosorbent assay ( ELISA) after centrifugation in treatment group before and after treatment.Four cytokines were also meas-ured in fasting healthy subjects in the morning.Results The levels of serum sVCAM-1, sICAM-1, vWF, MMP-9 were significantly higher in Group CVVH and HDF than control group before and after treatment( P<0.05).Group CVVH:The serum levels of sICAM-1 and sVCAM-1 were significantly lower in post-treat-ment than pre-treatment, But the serum levels of vWF and MMP-9 showed no obvious changes after CVVH;Group HDF:the levels of four cytokines showed no obvious changes after single HDF.Conclusions Endo-thelium becomes impaired in MODS and ESRD patients, Endothelium may be protected by CVVH through the partial removal of cytokines harmful to endothelium in MODS patients.Single HDF therapy does not pro-tect endothelial function obviously in MHD patients.