Objective To explore the clinical characteristics and treatment of methylmalonic acidemia(MMA) in order to improve our understanding of it.Methods We analyzed the clinical manifestations,laboratory examinations and treatments of 26 cases of methylmalonic acidemia in children.Results Twenty-four cases were involved in nervous system.Nine patients were involved in renal system.Eight cases of hematological involved.Liver enzyme elevated in 2 cases as well as the cardiac system were involved in 3 cases.One case was with pneumonia onset.The laboratory findings showed metabolic acidosis in 12 cases,hyperhomocysteinemia in 8 cases and remarkable elevation of urinary methylmalonic acid concentration in all cases.Some abnormalities in globus pallidus and cerebral white matter as well as diffuse cerebral atrophy were noted by the brain CT and MRI in 15 cases.Sixteen children have received therapy of vitamin B12,and supplementation of L-carnitine with restricted-protein diet.The follow-up for a period ranging from 3 months to 1.5 years( mean 8.5 months) of 15 cases with medical therapy showed a favorable outcome of nervous system improvement in 12 cases,however,2 patients died from severe metabolic acidosis.8 patients with renal involvement were normal in urine routine and renal function.Conclusion Methylmalonic acidemia has different clinical features,so early urine organic acids analysis by GC/MS method is essential Long-term and reasonable treatment after diagnosis is an effective way to improve the prognosis.

Intrauterine infection is an important risk factor for neonatal brain damage and neurological dysfunction. Viruses, bacteria, and protozoa can cause intrauterine infection which results in neonatal brain damage. The inlfammatory response is an important pathogenic factor for neonatal brain damage caused by intrauterine infection. Intrauterine infection in different periods of pregnancy might cause different types of brain damage in neonates. Clinicians should pay attention to the prevention of intrauterine infection during pregnancy. It is necessary to further strengthen the clinical and basic research to explore effective interventions for neonatal brain damage caused by intrauterine infection.

Objective To investigate the clinical curative effect of titanium microplate to repair and fix obsolete cracky orbital fracture.Methods According to the diagnosis of CT scanning and three-dimensional imaging, 20 cases of obsolete orbital fractures were repaired and fixed by using titanium microplate along fracture lines. The microplates were placed according to the part nad shape of fractures. For the part of comminuted fractures, the two ends of fractures were fixed like a bridge. Results After the repair and fixation of titanium microplate, facial deformity became recuperative completely, eye-ball-movement and mastication function were recovered. During 6~12 months follow-up period, no reject reaction or cracking or dropping of microplate occured.Conclusions The titanium microplate can make orbital fractures rigid and internal fixed, and the procedure is simple and easy mastered. Therefore, it is one of the most effective materials in the repair and fixation of orbital and facial fractures.

ObjectiveTo investigate the effects of ginsenoside Rg1 on apoptosis in spinal dorsal horn in development of morphine tolerance in rats with arthritis.MethodsTwenty-four healthy male SD rats weighing 280-320 g in which intrathecal(IT) catheters were succcessfully implanted without complication were randomized into 4 groups ( n =6 each):group normal saline ( group C) ; group morphine ( group M ) ; group ginsenoside Rg1 (group G) and group morphine + ginsenoside Rg1 (group MG).Arthritis was induced with complete Freund adjuivant injected into the ankle joint of right hind limb according to the method described by Butler et al in all 24 animals.Chronic morphine tolerance was induced by IT morphine 10 μg twice a day for 7 consecutive days in groups M and MG.Ginsenoside Rg1 100 μg was given IT once a day for 7 consecutive days in groups G and MG.Paw withdrawal threshold to mechanical stimulation with yon Frey filaments (MWT) was measured before induction of arthritis (T1,baseline),and IT drug administration (T2) and at day 1,3,5,7 (T3-6) after IT administration.The rats were sacrificed after last MWT measurement and their lumbar segments of the spinal cord ( L3-5 ) were removed for detection of apoptosis in the spinal dorsal horn by TUNEL.ResultsMWT was significantly decreased after induction of arthritis at T2-6 compared with the baseline value before arthritis at T1 in all 4 groups.In group M IT morphine significantly increased MWT at T3.4 compared with the baseline at T2 but the MWT was decreasing at T5.6 indicative of development of morphine tolerance.In group MG,addition of ginsenoside Rgl to IT morphine significantly attenuate the decrease in MWT at T5.6.The number of apoptotic cells in spinal dorsal horn was significantly higher in groups M and MG than in group C,but was significantly lower in group MG than in group M.Concluson Ginsenoside Rg1 can prevent the development of morphine tolerance in rats with arthritis by inhibiting apoptosis in spinal dorsal horn.

Objective To evaluate the clinical efficacy and toxicity of rituximab combined with CHOP (R-CHOP) in the treatment of relapsed or refractory diffuse large B cell lymphoma (DLBCL).Methods 30 patients were enrolled.All patients,pathologically confirmed to be CD20 positive DLBCL (all in stages Ⅲ-Ⅳ ), were relapsed or refractory after received 2-6 cycles of chemotherapy. Then all of them received R-CHOP schedule for 4 to 6 cycles, each cycle was 21 days. Clinical data before and after R-CHOP were collected.A retrospective analysis of the R-CHOP therapy,either compared to the literature or self-control was performed to evaluate the efficacy and toxicity. Results All the 30 patients were evaluable, induding 15 cases were complete remission (CR), 10 cases were partial remission (PR), 3 cases were stable disease (SD),and 2 cases were progressed disease (PD).The CR rate was 50.0 ％ (15/30),the total response rate (RR) was 83.3 ％ (25/30).All patients were well tolerated to the therapy.Only 3 cases were Ⅱ degree neutropenia,1 case was Ⅰ degree thrombocytopenia, and 2 cases suffered nausea and other mild gastrointestinal discomfort. Conclusions R-CHOP regimen could also achieve good response for relapsed or refractory DLBCL significantly.The common adverse effects of rituximab were mild.All the patients were well tolerated.

Objective To investigate the effect of telmisartan and irbesartan on PPARα transcriptional activity, and to clarify their molecular mechanisms in improving glucose and lipid metabolism. Methods The structural expression vectors, including pCMV-PPARα, pGL3-PPRE and the internal control vector pRL-TK, were transiently eo-transfected into COS-7 cells using SuperFect, the cells were eontinously cultured with various concentrations of telmisartan and irbesartan, and then the PPRE controlled luciferase activity was determined by using a dual-luciferase reporter gene assay system. PPARα mRNA and protein expression levels were detected by RT-PCR and Western blot after 3T3-L1 adipoeytes were treated with various concentrations of telmisartan or irbesartan. Results (1) Both telmisartan and irbesartan stimulated PPARα transcriptional activity in concentration-and time-dependent manners in cultured COS-7 cells with the maximal effect at 60 h, with the results increased by 3.8 and 2.6 folds respectively at the concentration of 100 μmol/L compared with control group (both P<0.01). (2) The PPARγ antagonist GW9662 did not inhibit fenofibrate, telmisartan and irbesartan-stimulated PPARα transcriptional activities. (3) Both telmisartan and irbesartan increased PPARα mRNA and protein expression levels in a dose-dependent manner in 3T3-L1 adipocytes. Conclusion Angiotensin type 1 receptor blockers, telmisartan and irbesartan, can both increase PPARα transcriptional activity, which may contribute to their metabolic effects.

OBJECTIVE: To observe the effect of Shenqi Recipe on the proliferation of glomerular mesangial cells (MC) and interstitial fibroblasts (FC) in rats. METHODS: The effect of serum containing prepared drugs from normal and chronic renal failure rats treated by Shenqi Recipe on glomerular mesangial cells and intersititial fibroblasts in vitro was observed by MTT colorimetric assay and serophrmacology. RESULTS: Compared with the blank sample normal rats, serum containing Shenqi Recipe inhibited the proliferation of MC and FC (P<0.001), and the serum containing Shenqi Recipe of CRF rats had significantly inhibited the proliferation of MC and FC compared with the model group(P<0.001). Conclusion Shenqi Recipe can postpone CRF progress by this mechanism.

Objective To observe the effect of angiotensin Ⅱ receptor blockers(ARBs)on peroxisome proliferator-activated receptor gamma(PPAR-γ)and to explore its mechanism for improving glucose and lipids metabolism.Methods Dual-luciferase gene reporting system was used to reflect PPAR-γ promoter activation by irbesartan and telmisartan.RT-PCR was used to reflect PPAR-γ mRNA by activation of irbesartan and telmisartan.Results Irbesartan and telmisartan may increase COS-7 cells PPAR-γ promoter expression and increase 3T3-L1 cells PPAR-γ mRNA expression in dose and time-dependent manners.Conclusions ARB may activate PPARs system to play a role in improving the glucose and lipids metabolism

Objective: To investigate whether antipsychotic agent-induced type 2 diabetes was associated with leptin gene -2548G/A functional polymorphism in schizophrenia patients who had treated by antipsychotics chronically. Methods: Fasting plasma glucose, 2-hour post meal plasma glucose, fasting plasma leptin and fasting plasma insulin were measured in 110 patients with chronic schizophrenia whose natural courses of the disorder were more than 5 years. According to the level of plasma glucose, these patients were divided into three groups, diabetes mellitus group, abnormal regulating glucose group and normal glucose group. The polymorphisms in the leptin promoter region (-2548 G/A) were determined with PCR-RFLP in the patients. Results: The patients in DM group were more likely to be homozygous for the -2548AA genotype. As compared with the patients with -2548AG/GG combined genotype, the patients with -2548AA genotype had significant increase in the level of plasma leptin(P=0.019). Conclusion: The -2548G/A polymorphism in promoter region of leptin gene may be associated with type 2 diabetes in schizophrenic patients treated by antipsychotics chronically. -2548A allele of leptin gene may be a genetic risk factor for the development of type 2 diabetes during antipsychotic treatment.