Objective To determine the clinical characteristics of neonatal asymmetric crying facies and to review the latest progress in clinical research of this condition. Methods Clinical and laboratory data of a case of neonatal asymmetric crying facies syndrome admitted to Peking Union Medical College Hospital in March, 2013 was reported. Clinical charateristics, chromosome abnormalities, treatment and prognosis of neonatal asymmetric crying facies reported in China were analyzed, and pertinent literatures in China Knowledge Resource Integrated Database and CQVIP Database were reviewed. Results Eighteen Chinese reports on this syndrome were retrieved and 48 patients, 31 males and 17 females including our patient, were analyzed. Twelve patients had neonatal asymmetric crying facies and 36 patients had neonatal asymmetric crying facies syndrome. Anomalies in these children included malformations of the heart (26 cases, 72.2%), ear (11 cases, 30.6%), gastrointestinal tract (4 cases, 11.1%), cleft palate (2 cases, 5.6%) and fingers (2 cases, 5.6%). Standard chromosome analysis in three studies was normal. In one case, chromosome 22q11.2 microdeletion was not found using flucrescence in situ hyloridization analysis. There were few studies with long-term follow-up in China. Conclusions Neonatal asymmetric crying facies are complicated with a high rate of other malformations. Identification of associated malformations and close follow-up are required, and intervention should be carried out earlier so as to ensure a good outcome.

Objective To investigate the effects of different fine particulate matter (PM2.5) components (water-soluble, organic, water-soluble+organic) in vivo on the NOS/NO system in the endothelial cells from rat thoracic aortas. Methods Three PM2.5 components were used to inject by vein in rat tail. ELISA and immunohistochemical technique were used to examine the change of NOS/NO system in the blood-serum and the endothelial cells from rat thoracic aorta. Results Compared with control group, three PM2.5 components increased NO level of rat blood-serum [control, (38.00±5.40) μmol/L; water-soluble group, (44.66±16.59) μmol/L, t =3.58, P< 0.05; organic groups, (58.28±12.30) μmol/L, t =12.85, P <0.01; mixtural component group, (84.02+19.24) μmol/L, t =31.39, P<0.01]; increased iNOS level of rat blood-serum [control, (17.47±5.33) U/ml; water-soluble group, (21.87±4.63) U/ml, t =4.92, P <0.05; organic groups, (25.27±6.58) U/ml, t = 6.22, P<0.05; Mixtural component group, (32.79±5.86) U/ml, t =32.84, P <0.01]. Mixtural component decreased eNOS level of rat blood-serum [(12.58±4.59) pg/ml vs (17.47±2.97) pg/ml, t =5.91, P <0.05], no significant difference on eNOS level of blood-serum among other component groups (P >0.05). Three components decreased the expression of eNOS protein in the endothelial cells from rat thoracic aorta(control, 164.68±4.80; water-soluble group, 185.43±5.63, t =4.26, P <0.05; organic groups, 194.07±9.77, t =5.26, P <0.05; Mixtural component group, 209.24±15.43, t =43.19, P <0.01), increased the expression of iNOS protein (control, 160.17±5.79; water-soluble group, 134.78±8.22, t =5.21, P <0.05; organic groups, 134.78±8.22, t =5.98, P <0.05; Mixtural component group, 81.62 ±10.59, t =34.98, P <0.01) in the endothelial cells from rat thoracic aortas.Conclusion Three components of PM2.5 induced the dysfunction of endothelial cells and disorder of NOS/NO system in the endothelial cells.

ObjectiveTo compare the real-time analgesic effects between two different groups of acupoints in treating primary dysmenorrhea, for providing objective evidences for optimizing the treatment protocol for primary dysmenorrhea.MethodSixty eligible patients with primary dysmenorrhea were randomized into 3 groups: group A received acupuncture at Sanyinjiao (SP6), group B received acupuncture at Sanyinjiao and Guanyuan (CV4), and group C as a blank control group, 20 cases in each group. Visual Analogue Scale (VAS) was observed prior to the acupuncture treatment, after the insertion of the needles, and after removal of the needles in the three groups.ResultThe VAS scores changed significantly in group A and B after intervention (P<0.05); there was no significant difference in comparing the VAS score between group A and B after intervention (P>0.05).Conclusion Acupuncture at Sanyinjiao alone and acupuncture at Sanyinjiao and Guanyuan both can produce analgesic effect at the attackof primary dysmenorrhea. However, for optimizing the treatment protocol, selecting Sanyinjiao alone will be enough.

BACKGROUND: Methamphetamine (MA) has neurotoxic effects to central nervous system. However, as the 5-hydroxytryplamine reuptake enhancer, it is uncertain that if there are protective effects of tianeptine to the damages of 5-hydroxytryp-taminergic neurons caused by MA.OBJECTIVE: To investigate the neurotoxicity of MA and the neuroprotective effects of tianeptine as well as the acting mechanism.DESIGN: Randomized case control study based on animals.SETTING: Animal research room and pathology research room of a university.MATERIALS: The experiment was completed in the Experimental Animal Centre of Sichuan University and Molecular Pathology Laboratory of West China Hospital during June to August 2003. Totally 25 male Wistar rats were injected MA through abdominal cavity to build model. Methamphetamine was provided by National Institute for the Control of Pharmaceutical and Biological Products(NICPBP) while tianeptine was given by French Servier Company (Batch No. OE3086). The TUNEL testing kit was purchased from Boehringer Mannheim Company.INTERVENTIONS: There were one control group and four experimental groups(A, B, C, D). A group was used intraperitoneal injection of MA while B, C, D, groups were administered tianeptine 7 days, 4 days before and the same day of MA administration. Normal saline with same volume was injected into rats of control group. HE stain and silver stain were conducted after experiment to observe the morphologic changes of neurons. And TUNEL method was used to detect apoptotic cells.MAIN OUTCOME MEASURES: The HE stain and silver stain of brain tissue sections and counts of TUNEL positive neurons.RESULTS: MA could damage the axon and dendrite of neurons and the absorbance of silver positive cell was(50.74 ± 1.86) . It could also induce cell apoptosis while the apoptotic cell count every high power field was 29.26 ±4. 14. There were less apoptotic cells in the group with 7 days usage of tianeptine with the cell count of( 18.90 ± 1.60) per high power field.CONCLUSION: MA can cause neurotoxicity by inducing cell apoptosis.And giving tianeptine in advance can protect neurons.

Objective To review the three-dimensional characteristics and configuration of cranial base arteries of patients with intracranial berry aneurysms. Methods All the 70 patients with intracranial berry aneurysms (83 cases)were admitted from January to December in 2007. Their images of spiral computer angiography (CT) were presented and analyzed retrospectively. The site, size and figures of aneurysms were recorded, especially the variations of cranial base arteries were analyzed. Results Cerebral anterior communicating artery (ACoA) was the frequent site where aneurysms located. Incidence of ACoA aneurysms was 43.37%(36/83), that of posterior communicating artery (PCoA) was 28.92%(24/83), that of internal carotid artery was 9.64% (8/83), that of middle cerebral artery was 6.02% (5/83), that of A1-A3 was 3.61% (3/83), that of basilar artery was 3.61% (3/83), that of posterior cerebral artery was 2.41% (2/83), that of posterior inferior cerebellar artery was 1.20% (1/83),that of anterior choroidal artery was 1.20% (1/83).The shape of many berry aneurysms was regular. Mutational rate of cranial base arteries among aneurysms were 56.63% (47/83) and ACoA ancurysms with A1 dysplasia rate was 72.22% (26/36). Conclusions The solid shape and vascular variation of intracranial berry aneuryams can be optimally identified by spiral computer angiography. The occurrence of berry aneurysms might be associated with variation of cranial base arteries.

Fecal microbiota transplantation(FMT)is a therapeutic approach that targets intestinal microorganisms by transplanting fecal microorganisms from healthy individuals into the gastrointestinal tract of diseased individuals,thus restoring the recipient's disordered gastrointestinal microbiota by restructuring the intestinal flora.However,the mechanism of action and adverse effects of FMT in different diseases have not yet been clarified,thus limiting its wide clinical application.Its use still relies on in-depth preclinical studies;however,highly inconsistent or incomplete experimental details provided in current reports,coupled with a lack of authoritative standards and recommendations,seriously affect the interpretation of the study findings and replication of the experimental procedures,as well as hindering the clinical translation of the result.We therefore review and discuss the key steps of recipient selection and graft sample collection,storage,graft material preparation,and grafting route,with the aim of improving the utilization of experimental animals,consumables,and labor,and providing method ological recommendations and references to achieve replicability and standardization of preclinical FMT studies.

Objective To summarize the clinical experience in 58 cases of split liver transplantation (SLT).Methods A retrospective analysis was conducted on 58 cases of SLT during June 2006 to January 2011.There were 13 cases performed at the first phase (2006.6-2008.12),and 45 cases at the second phase (2009.1 2011.1). The survival rate of patients,recovery of liver function,re-transplantation rate,incidence of vascular complications and biliary complications were observed,and the causes of death were analyzed.Results The median follow-up time of all the patients was 11.4 months (0-48 months).The 1- and 2-year cumulative survival rate was 77.4％ and 68.3％ respectively,re-transplantation rate was 6.9％,the incidence of vessel complications was 13.8％,and biliary complication rate was 32.1％.Fifteen cases died,including 8 deaths which were related to surgical complications.Conclusion With the donor split technology improvements and refinements in partial liver transplantation, the survival rate of SLT recipients is significantly increased,but selection of recipients is still the key factor that impacts survival rate of recipients receiving SLT.SLT can expand the resource of liver donors,and adequate selection of recipients can obtain better results.

Objective To investigate the underlying mechanisms of Miller-Fisher syndrome (MFS) and Bickerstaff' s brainstem encephalitis (BBE) by studying their clinical and electrophysiological characteristics.Methods The clinical and electrophysiological characteristics of 13 MFS and 7 BBE cases in Peking Union Medical College Hospital between 2000 and 2011 were retrospectively analyzed.The electrophysiological parameters included sensory and motor nerve conduction,electromyography,F wave,sympathetic skin response and brainstem auditory evoked potential and blink reflex.Results MFS and BBE had similar clinical characteristics:respiratory symptoms were the most common infectious symptoms before disease onset; Ophthalmoplegia,facial palsy and bulbar symptoms were common; They both had cerebrospinal fluid albuminocytological dissociation and positive serum anti-GQ1b antibody.However,BBE had more central nervous system lesion signs clinically such as conscious disturbance,positive Babinski' s sign and central facial palsy.Electrophysiologically,MFS and BBE also had similar electrophysiological features:sensory nerve abnormality ratios were 6/13,2/7 respectively,with prominently reduced sensory nerve active potential amplitude,normal or slightly slowed sensory conduction velocity; Motor nerves abnormality ratios were 2/13,1/7 respectively,with slightly prolonged distal motor latency and normal compound muscle action potential; Electromyography abnormality ratios were 1/7,0/4 respectively; F wave frequency abnormality ratios were 3/13,5/7 respectively,and in some cases,F wave frequency would restore; Sympathetic skin response abnormality ratios were 1/2,1/3 respectively; Blink reflex abnormalityratios were 1/2,1/1 respectively,with central involvement in BBE; Brainstem auditory evoked potential abnormality ratios were 3/5,1/4 respectively,with wave Ⅰ latency or amplitude abnormality.Conclusion The similarities of clinical and electrophysiological features suggest that MFS and BBE have the same mechanism and they form a continuous spectrum with variable central nervous system and peripheral nervous system involvement.

Objective:To investigate the value of growth differentiation factor-15 (GDF-15) and extravascular lung water index (EVLWI) in severity grading and prognosis prediction of patients with acute respiratory distress syndrome (ARDS).Methods:Patients with ARDS aged 18-75 years admitted to the department of respiratory intensive care unit (RICU) of Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2019 to February 2020 were enrolled. All patients were treated with conventional therapies such as mechanical ventilation, anti-infection, stabilization of water, electrolytes and acid-base environment, blood purification and nutritional support according to their conditions. Besides, the pulse-indicated continuous cardiac output (PiCCO) was performed after admission to the department, and EVLWI before treatment and at 24, 48 and 72 hours of treatment were recorded. Serum GDF-15 level was measured by enzyme linked immunosorbent assay (ELISA) during the same period. Patients were classified as mild, moderate, and severe degree according to the 2012 Berlin Definition of ARDS, and EVLWI and GDF-15 levels in patients with different disease levels before and after treatment were compared. In addition, the length of intensive care unit (ICU) stay, ICU mortality, and 28-day mortality of patients with different GDF-15 or EVLWI levels were analyzed comparatively, with the GDF-15 3 458 ng/L and EVLWI 15 mL/kg as the cut point.Results:A total of 82 patients with ARDS were enrolled, including 22 patients with mild ARDS, 28 patients with moderate ARDS, and 32 patients with severe ARDS. The GDF-15 and EVLWI levels in patients with moderate and severe ARDS at each time point before and after treatment were higher than those in patients with mild ARDS. Both GDF-15 and EVLWI levels in patients with severe ARDS were higher than those in the patients with moderate ARDS. The differences were statistically significant at all the time points except for the difference of GDF-15 levels at 24 hours after treatment (ng/L: 3 900.41±546.43 vs. 3 695.66±604.73, P > 0.05). [GDF-15 (ng/L): 3 786.11±441.45 vs. 3 106.83±605.09 before treatment, 3 895.48±558.96 vs. 3 333.29±559.66 at 48 hours, 3 397.33±539.56 vs. 3 047.53±499.57 at 72 hours; EVLWI (mL/kg): 19.06±1.91 vs. 14.31±1.50 before treatment, 18.56±2.23 vs. 13.26±1.69 at 24 hours, 17.23±1.76 vs. 12.45±1.36 at 48 hours, 15.47±1.81 vs. 11.13±2.19 at 72 hours, all P < 0.05]. According to the cut-off value, there were 23 patients with GDF-15 ≥ 3 458 ng/L and GDF-15 < 3 458 ng/L respectively and there were 23 patients with EVLWI ≥ 15 mL/kg and EVLWI < 15 mL/kg respectively. The length of ICU stay and 28-day mortality in patients with high GDF-15 were significantly higher than those in patients with low GDF-15 [length of ICU stay (days): 21.22±2.69 vs. 15.37±3.14, 28-day mortality: 56.5% vs. 21.7%, both P < 0.05]. The length of ICU stay and 28-day mortality in patients with high EVLWI were also significantly higher than those in patients with low EVLWI [length of ICU stay (days): 18.45±2.61 vs. 14.98±2.75, 28-day mortality: 47.8% vs. 17.4%, both P < 0.05]. Conclusion:To some extent, GDF-15 and EVLWI levels reflect the severity of patients with ARDS, and high GDF-15 and EVLWI levels are significantly associated with poor prognosis in patients with ARDS.

Objective To investigate the effect of acupuncture on the inflammatory changes of α7 nicotinic acetylcholine receptors(α7 nicotinic acetylcholine receptors,α7nAChRs)in rats with chronic migraine(CM).Methods Adult male SD rats were randomly divided into control group(VEH group),model group(NTG group),acupuncture group(TA group),α7nAChRs antagonist group(MLA group)and α7nAChRs agonist group(TA group)according to basic pain threshold.The rat model of CM was established by repeated subcutaneous injection of nitroglycerin(NTG)at the neck and back every other day.TA group and MLA group received acupuncture treatment one hour before NTG injection,20 minutes every day for 9 consecutive days.The MLA group was intraperitoneally injected with α7nAChRs antagonist MLA half an hours before acupuncture,and the PNU group was intraperitoneally injected with α7nAChRs agonist PNU-282987 half an hours before NTG injection,both groups were injected continuously for 9 days.The changes of paw withdrawal mechanical threshold(Paw Withdrawal Mechanical Threshold,PWMT)and tail-flick latency(Tail-Flick Latency,TFL)were detected by Von Frey and thermal radiation pain meter.The contents of inflammatory factors IL-1β,TNF-α and TGF-β in TNC and serum were determined by ELISA.The relative fluorescence intensity and co-expression of GFAP and α7nAChRs in TNC were detected by immunofluorescence dual labeling method.Results Compared with VEH group,PWMT and TFL in NTG group were significantly decreased(P<0.05 or P<0.01),the contents of IL-1β(P<0.01)and TNF-α(P<0.01,P<0.05)in serum and TNC were significantly increased;and in TNC,the astrocytes were activated significantly(P<0.01),while the relative fluorescence intensity of α7nAChRs and the co-expression of GFAP and α7nAChRs were significantly decreased(P<0.05,P<0.01).Compared with NTG group,PWMT and TFL in TA group were increased(P<0.05 or P<0.01),the contents of IL-1β(P<0.01)and TNF-α(P<0.01,P<0.05)in serum and TNC were increased;and in TNC,the relative fluorescence intensity of GFAP was significantly decreased(P<0.01),however the relative fluorescence intensity of α7nAChRs and the co-expression of GFAP and α7nAChRs were significantly increased(P<0.01).Compared with MLA group,PWMT and TFL in TA groups and PNU groups were significantly increased(P<0.05 or P<0.01).The contents of IL-1β(P<0.05)and TNF-α(P<0.01)in serum and TNC of TA group were increased,while the contents of TGF-β(P<0.05)were decreased.The contents of IL-1β in serum and TNC of PNU group were decreased(P<0.01,P<0.05),while the contents of TGF-β(P<0.01)were significantly increased.Conclusions Acupuncture can effectively relieve CM inflammatory response and hypersensitivity to pain,and its anti-inflammatory and analgesic effects may be related to the up-regulation of α7nAChRs expression.