Objective To investigate the clinical characteristics of general paresis of insane(GPI) and diagnostic value of laboratory and neuroimaging examinations.Methods The clinical data of 2 patients with GPI were analyzed retrospectively and the pertinent literatures were reviewed.Results The main clinical characteristics consisted of insidious onset,progressive dementia,mental disorder and epileptic seizure.These 2 patients were originally misdiagnosed.Both rapid plasma reagin test and treponema gelatin agglutination test in serum and cerebrospinal fluid were positive.Cranial MRI showed diffuse cerebral atrophy.Conclusions The clinical characteristics of GPI are varied and misdiagnosis rate is high at early stage of this disease.The diagnosis of GPI mainly depends on clinical characteristics,serum and cerebrospinal fluid examinations.

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 the importance of CT diagnosis and differential diagnosis in Wilms′ tumors of children.Methods　45 cases of Wilms′ tumors confirmed by clinical and pathology were retrospectively analyzed,CT characteristics of Wilms′ tumor,renal carcinoma(2 cases),renal rhabdomyosarcoma(1 case)in children were discussed.Results　Wilms' tumors appeared in solid masses in 34 cases (76%),cysticsolid masses in 9 cases(20%),cystic masses in 2 cases (4%),7 cases (15.6%)had thrombosis in renal vein or IVC.Renal carcinoma shared the same appearance with Wilms′ tumor in image.Rhabdoid tumor of kidney appeard as cystic-solid mass with lineal calcification and subcapsular fluid accumulation.Conclusion　Wilms′ tumor is the most popular malignant renal tumors in children.It is originate from renal parenchyma,and likely to invade renal pelvis.Hemorrhhage,necrosis or cystic formation in tumor is common.They are difficult to be distinguished from renal cell carcinomas in radiology.Rhabdoid tumor of kidney is rare and has characteristic features on CT.

OBJECTIVETo study the effects of Jing'an Oral Liquid (JOL) on the central neurotransmitters of multiple tics (MT) children.

METHODSSixty MT children patients were randomly assigned to the treatment group and the control group, 30 cases in each group. Another 30 healthy children were recruited as the health group. JOL and Tiapride Tablet (TT) was respectively given to patients in the treatment group and the control group. The treatment course was 2 months. The levels of central neurotransmitters [dopamine (DA), homovanillic acid (HVA), 5-hydroxytryptamine (5-HT), norepinephrine (NE), glutamic acid (GLU), aspartate (ASP), gamma-aminobutyric acid (GABA)] were measured using high performance liquid chromatography (HPLC) before and after treatment, and compared with the health group.

RESULTSCompared with the health group, the levels of 5-HT, HVA, GLU, and ASP significantly increased in the treatment group and the control group before treatment (P < 0.05), GABA significantly decreased (P < 0.05). Compared with before treatment in the same group, the levels 5-HT, HVA, and GLU significantly decreased in the treatment group (P < 0.05), while the levels of NE and GABA significantly increased (P < 0.05). The levels of DA, 5-HT, GLU, and ASP significantly decreased, while the levels of NE ang GABA significantly increased in the control group, showing statistical difference (P < 0.05). There was no statistical difference in each index between the treatment group and the control group before and after treatment (P > 0.05).

CONCLUSIONS(1) The imbalance of a variety of monoamines and amino acid neurotransmitters can lead to MT, especially in the changes of 5-HT, HVA, GLU, ASP, and GABA. (2) JOL can significantly reduce the levels of 5-HT, HVA, and GLU, and significantly increase the levels of NE and GABA, which might be its pharmacodynamic mechanisms for treating MT.

Child ; Dopamine ; blood ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Humans ; Male ; Neurotransmitter Agents ; blood ; Norepinephrine ; blood ; Phytotherapy ; Serotonin ; blood ; Tiapride Hydrochloride ; therapeutic use ; Tourette Syndrome ; blood ; drug therapy

Objective To analyze the causes for diffuse bone marrow uptake of 18F-FDG on PET/CT scans. Methods Sixty-six patients with diffuse bone marrow uptake on whole-body FDG-PET/CT imaging were enrolled for this study. Seventy-nine healthy subjects ( with no history of tumor or recent fever) were selected as normal control. The SUVmax and SUVmean were measured in bone marrow and mediastinum in both groups. The maximum (bone marrow SUVmax/ mediastinum SUVmax) and mean value ratios (bone marrow SUVmean/ mediastinum SUVmean) were calculated. Statistical analysis was performed by one-factor variance analysis. Results With diffuse bone marrow uptake pattern of 18F-FDG, 27 were caused by injection of hematopoietic growth factor, 21 by hematopathy and 18 due to fever. SUVmeanof those three causes were 3.076±1.955, 3.633±2.405 and 2.546±0.791 respectively, each was significantly different from that of the control group (1.026±0.190; F =34.465, P<0.001). Conclusion Diffuse bone marrow uptake on FDG-PET/CT are caused by both benign and malignant reasons.

Objective To evaluate diffusion weighted imaging (DWI) sequence and apparent diffusion coefficient (ADC) in dif-ferentiation of various solid focal liver lesions (SFLL )commonly encountered .Methods 142 cases with 158 SFLLs underwent breath-hold diffusion weighted imaging (DWI)(b = 500 s/mm2 ) using a 1 .5 Tesla MR scanner .The cases included 7 cases of imma-tured abscesses ,12 cases of FNHs ,74 cases of hepatic cell cancer ,26 cases of cholangiocarcinomaes and 39 cases of metastasises . The signal intensity on DWI ,ADC value and the difference for each type of SFLLs were measured and analyzed .Results 24 cases of SFLLs were manifested as high signal intensity ,132 cases of SFLLs manifested as slightly high signal intensity and only 2 cases of SFLLs manifested as iso-signal intensity on DWI sequence .The mean ADC value ( × 10 - 3 mm2 /s)for immatured abscesses , FNHs ,HCCs ,cholangiocarcinomaes ,metastasises were (1 .48 ± 0 .23) ,(1 .75 ± 0 .26) ,(1 .23 ± 0 .43) ,(1 .47 ± 0 .35) ,(1 .36 ± 0 .33) ,respectively .The difference in ADC values between FNH patients and other SFLLs patients showed statistically significant (P< 0 .01) ,while HCCs immatured abscesses and malignant SFLLs showed no statistical significance (P> 0 .05) .Conclusion The signal intensity on DWI and ADC values may be helpful for diagnosing solid focal liver lesions .

OBJECTIVETo evaluate the clinical effects of iliolumbar fixation for the sacrum fractures of Denis type II.

METHODSThe clinical data of 86 patients with sacrum fracture of Denis type II treated by iliolumbar fixation from January 2008 to January 2012 were retrospectively analyzed. There were 55 males and 31 females, aged from 17 to 55 years old with an average of 39.1 years. Among them, 73 cases complicated with pelvis fracture and 13 cases with acetabular fracture; 37 cases with sacral neurological symptoms and 49 cases without sacral neurological symptoms. Fracture healing time, nerve function, clinical function and complications were observed in the patients.

RESULTSIn 86 cases, 6 cases were out of followed-up and 80 cases were followed up from 24 to 71 months with an average of 36 months. The mean fracture healing time was 13 weeks (ranged, 10 to 38 weeks). According to Gibbons scoring to evaluate the neurological function, preoperative nerve rehabilitation, lower limbs feeling, lower limbs activity,bladder and rectum function,total score respectively were 0.62 +/- 0.04, 1.54 +/- 0.35, 1.12 +/- 0.18, 0.23 +/- 0.01, 3.46 +/- 0.47 and postoperative respectively were 0.82 +/- 0.12, 0.36 +/- 0.04, 0.05 +/- 0.01, 0.03 +/- 0.01, 1.25 +/- 0.22, there were statistically significant differences between preoperative and postoperative (P < 0.05). According to Majeed scoring to evaluate the clinical function, postoperative pain, standing, sitting, sexual life, work ability, total score respectively were 22.54 +/- 4.02, 27.93 +/- 5.46, 8.47 +/- 3.61, 2.54 +/- 1.33, 16.46 +/- 4.34, 81.32 +/- 8.73, 60 cases got excellent results, 17 good, 3 fair. The main complications including fracture nonunion of 5 cases,deep incision infection of 1 case, and screw prominence resulting uncomfortable of 8 cases.

CONCLUSIONIliolumbar fixation has the advantages of stable fixation, satisfactory functional rehabilitation, less complications, and is a good method in treating sacrum fracture of Denis type II.

Adolescent ; Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sacrum ; injuries ; surgery ; Spinal Fractures ; surgery ; Treatment Outcome ; Young Adult

Objective:To analyze the correlation between preoperative parametres and positive surgical margin after robot-assisted laparoscopic radical prostatectomy.Method:From October 2014 to January 2019, the clinical data of 310 patients who underwent robot-assisted laparoscopic radical prostatectomy(RARP) by single surgeon were collected retrospectively. The median age, PSA, f/t PSA and PSAD was 68(62-72)years, 26(13-63) ng/ ml, 0.12 (0.07-0.18) and 0.36(0.20-0.75) ng/ml 2, respectively. There were 115 cases with clinical T 1, 100 with clinical T 2, 41 with clinical T 3, and 15 with clinical T 4. Based on the MRI or ultrasound examination, the median value for the transverse diameter, anteroposterior diameter, vertical diameter, and volume of the prostate is 44(35-50)mm, 45(40-51)mm, 41(36-50)mm, and 76(54-118)ml, respectively. In this study, 84(27%)cases were diagnosed pathologically by transurethral resection of the prostate, and 226(73%)cases by prostate biopsy. The biopsy technique was transrectal ultrasound-guided systematic 12-point biopsy, and additional 1-5 needles were performed in regions with abnormal ultrasound echoes. The median for total number of puncture needles, number and percentages of positive needles were 12(12-13), 9(4-12)and 85%(35%-100%), respectively. Of all the patients, there were 61 cases with Gleason score≤6, 95 with Gleason score=7 and 84 with Gleason score≥8. There were 237(76%)patients undergoing neoadjuvant endocrine therapy. The patients were divided into the negative surgical margin group and positive surgical margin group. The correlation between positive surgical margin and general clinical data, PSA derivates, prostate size (transversal diameter, anteroposterior diameter, vertical diameter, and prostate volume), percentage of positive biopsy cores, Gleason score, method of pathological diagnosis, and endocrine therapy were analyzed. Results:Of all the 310 enrolled patients, the overall positive surgical margin rate was 34.2%(106/310). Univariate analysis showed that tPSA(41.3 ng/ml vs.24.8ng/ml, P=0.029), f/tPSA(0.14 vs.0.10, P=0.004), transversal diameter of prostate(46 mm vs.38mm, P=0.049), percentage of positive biopsy cores(100% vs.58%, P=0.001), and biopsy Gleason score(Gleason score≤6, =7 and ≥8: 14, 31 and 32 cases vs. 47, 64 and 42 cases, P<0.05)exhibited significant correlation with postoperative positive surgical margin. Multivariate analysis showed that transversal diameter of prostate( P=0.026) and percentage of positive biopsy cores( P=0.048) were independent risk factors for positive surgical margin. Conclusions:Transversal diameter of prostate and percentage of positive biopsy cores were independent risk factors, which help to predict the occurrence of postoperative positive surgical margin.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Diarrhea ; virology ; Female ; Humans ; Male ; Middle Aged ; Oligonucleotide Array Sequence Analysis ; methods ; Young Adult

Objective To find out prevelence of thyroid goiter on school-aged children in excessive iodine region of Shandong Province.Methods By employing B-ultrasonography and palpation method,the thyroid volume were investigated and the thyroid goiter rate were calculated among 6415 children aged 8～10 years old in execssire iodine region.Results By employing B-ultrasonography method.The volumes of thyroid in goiter children aged 8,9,10 years were(5.67±1.49),(6.07±1.24),(7.30±2.01)ml,respectively.The goiter rates were 28.84%(683/2368),20.89%(448/2144),11.82%(225/1903).The volumes of thyroid in non-goiter children aged 8,9,10 years were(3.36±0.67),(3.64±0.77),(4.02±0.94)ml.When the normal value of thyroid volume in 8 and 9 year-groups lowered 0.5 ml,the goiter rate would be changed to 18.20%(430/2368)and 12.92%(277/2144) respectively.The thyroid volumes of boys and girls were(4.20±1.38),(4.18±1.73)ml,respectively.The goiter rates of boys and girls were 21.92%(732/3340)and 20.29%(624/3075)respectively.The rates of goiter detected by palpation in 8,9 and 10 year-groups were 10.05%(238/2368),10.31%(221/2144)and 14.45%(275/1903) respectively.Conclusions Along with the increasing age,the volume of thyroid in children aged 8～10 is increasing in excessive iodine region of Shandong Province.But the goiter rate is decreasing ahmg the increasing age.This phenomena may be caused by improper normal value of thyroid volume.Therefore,the normal value of thyroid volume should be revised urgently.