延髓性麻痹临床罕见，治愈更少见。2010年9月6日，本科收治1例延髓性麻痹患者，经过针康法的治疗，成功拔除鼻饲并实现正常饮食，康复期间未出现并发症，最终成功回归社会。

Objective To determine the efficacy of glucose-loweringtreatment by proton magnetic resonance spectroscopy (1H-MRS).Methods Bilateral frontal lobes of 45 male patients with type 2 diabetes mellitus (T2DM) underwent 1 H-MRS separately bythe time it was first diagnosed.Among them,30 were treated with insulin,15 were rejected.The bilateral frontal lobes of all patients were re-examined with 1 H-MRS after 6 months.The ratios of metabolites in the frontal lobe were recorded and compared,and observing whether the lactate(Lac) peak appeared or not.Results Significantly higher values of the N-acetylaspartate (NAA)/creatine (Cr)ratio and NAA/choline (Cho) ratio after 6 months (2.414 2± 0.206 6 and 2.244 2±0.341 5) were found in bilateral frontal lobes compared with pre-therapy (1.905 3±0.135 7 and 1.906 0±0.322 1)(P＜0.05).Significantly lower values of the NAA/Cr ratio and NAA/Cho ratio in the refuse treatment group(1.504 2 ± 0.262 4 and 1.510 0± 0.220 8) were found in bilateral frontal lobes compared with pre therapy (1.960 0±0.175 0 and 1.880 8±0.297 0)(P＜0.05).Lac peak was not detected in the all experiments.Conclusion 1 H-MRS provides valuable information in the assessment and evaluation of clinical efficacy and prognosis of T2DM by detecting the changes of brain metabolism.

Objective To explore the value of multivoxel 1H-MRS in the differential diagnosis of corpus callosum lesions.Methods 17 patients with corpus callosum lesions confirmed by clinical or pathological method underwent MRS examination.These patients included 2 cases of lymphoma,4 cases of Marchiafava-Bignami disease,3 cases of glioma, 7 cases of infarction,and 1 case of multiple sclerosis.MRS features of lesions were analyzed.Results 2 cases with corpus callosum lymphoma revealed significantly increased Cho peak, decreased Cr and NAA peak,towering Lip peak.Among 4 cases with Marchiafava-Bignami diseases, 2 cases revealed increased Cho/Cr and decreased NAA/Cr,1 case showed normal,1 case revealed inverted Lac peak.For 3 cases with corpus callosum glioma,NAA peak decreased or disappeared,and Cho peak increased in varying degrees.7 cases with corpus callosum infarction revealed significant inverted Lac peak, and NAA peak decreased in varying degrees.1 case of multiple sclerosis revealed increased Cho peak,decreased NAA peak,and inverted Lac peak during acute period with enhancement,while these features returned normal during inactive period.Conclusion Multivoxel 1H-MRS plays an important role in the differential diagnosis of corpus callosum lesions.

Objective To evaluate the effect of non-linear blending function for dual-energy CT on image of pulmonary angiogra-phy.Methods 27 patients underwent dual energy CT pulmonary angiography(CTPA).Data obtained with 100 kVp,140kVp,and non-linear blending were divided into group A,B,and C respectively.CT value of emboli were measured.Corresponding signal to noise ratio(SNR )and contrast to noise ratio(CNR)were calculated.One-way Anova analysis and Friedman test were used to ana-lyze statistical significance among these values.Results On quantitative analysis of 27 patients,there was no statistical difference for CT value of CTPA among the three groups(P >0.05).For the noise,CNR and SNR,there were statistically significant among the three groups(P <0.05).Conclusion The non-linear blending function has certain advantages in improved image signal-to-noise ratio and it can be used in CT pulmonary angiography examination for patients suspected pulmonary embolism clinically .

The article explores the teaching content in immunology according to "three modules and one line" and tamps the knowledge points of the basic module ,forms the point-into-line methods of the core module and emphasizes the application of extending module to expand the teachin "gspaces" between the theachers and students.

The design and the teaching of immulogical experiment should be helpful to training the students'ability both in clinical practising and scientific thinking.The key links may include nailing down the target,optimizing the contents,improving the teaching method,valuing the design item,and standardizing the report so as to enhance the students' comprehensive skills and scientific thinking by means of "operating" and "braining".

Objective To investigate the current status of treatment on traumatic ruptured spleen in a regional medical center in Tianjin,China.Method Logistic analysis of 16 impact ffactors of treatment decision on 147 patients with traumatic ruptured spleen.Results The type of trauma,pulse rate at admission,result of abdominal puncture and CT grade were related to treatment decision making.Splenectomy was carried out in 89 patients (60.54％) which accounted for 89.90％ of all surgical procedures.Splenectomy was carried out in 50.85％ of patients with CT grade 1 or 2 (or 85.71％ of grade 1 and 2 surgery),and 100％ of CT grade 3 or 4.Spleen preservation surgery was carried out in 7 patients with CT grade 1 or 2.Conclusion Splenectomy was carried out in most cases in this study.It is necessary to investigate the treatment of splenic trauma in regional medical centers,and to develop more reliable surgical techniques to carry out more spleen-preservation surgery ffor CT grade 1 or 2 ruptured spleen.

OBJECTIVE: To set up a natural degeneration model of chondrocytes derived from endplate of intervertebral discs of rats in order to offer an appropriate carrier for the study on mechanism of intervertebral disc degeneration. METHODS: The method of enzyme digestion combined with natural subculture was used to set up the in vitro natural degeneration model of chondrocytes derived from the endplate of intervertebral disc of rats. The morphological appearances and microstructures of the chondrocytes of different generations were observed. The expression of collagen II in chondrocytes was detected by immunocytochemical method. RESULTS: The chondrocytes derived from the endplate of intervertebral disc expressed collagen II. After 13 days of culture, the chondrocytes of generation III showed that the ability of cell division descended, the nucleoli became unclear, the cells deformed obviously, fusiform shape with weak optical activity appeared, and the intercellular space was enlarged. There were vacuoles and lipid droplets in cytoplasm. The synthesis of collagen II, as well as the cell proliferation rate, descended notably. All results showed the natural degeneration process of the chondrocytes. CONCLUSION: The in vitro natural degeneration model of chondrocytes derived from endplate of intervertebral discs of rats was successfully established. This can offer the cytological basis for study on the mechanism of intervertebral disc degeneration.

Objective: To assess the health risk associated with drinking water in Hangzhou from 2016 to 2017,and to provide evidence for the safety of drinking water . Methods: The monitoring data of 5 genetic toxic substances（arsenic,hexavalent chromium,cadmium,chloroform,tetrachloromethane）and 13 body toxic substances（lead,mercury,selenium,cyanide,fluoride,nitrate,iron,ammonia nitrogen,manganese,copper,zinc,aluminum,volatile phenol）from 36 source water samples,36 finished water samples and 288 tap water samples in the main urban areas of Hangzhou were collected from 2016 to 2017. The health risk of drinking water containing the chemical pollutants mentioned above were assessed based on the evaluation models recommended by United States Environmental Protection Agency . Results: The concentrations of 5 genetic toxic substances and 13 body toxic substances in source water,finished water and tap water were all within the reference limits issued by Standards for Drinking Water Quality（GB 5749—2006）. The carcinogenic risk,non-carcinogenic risk and total health risk caused by the chemical pollutants in the source water were 2.18×10-5/a,7.75×10-9/a and 2.18×10-5/a. The carcinogenic risk,non-carcinogenic risk and the total health risk caused by the chemical pollutants in the finished water were 1.08×10-5/a,3.70×10-9/a and 1.08×10-5/a. The carcinogenic risk,non-carcinogenic risk and total health risk caused by the chemical pollutants in the tap water were 1.96×10-5/a,3.61×10-9/a and 1.96×10-5/a. The carcinogenic risk and total health risk caused by chemical pollutants ranged from high to low in the source water,tap water and finished water. The non-carcinogenic risks ranged from high to low in the source water,finished water and tap water . Conclusion The health risks of 18 chemical pollutants in drinking water in Hangzhou were at a low level,with the greater carcinogenic risk than the non-carcinogenic risk. Hexavalent chromium had the highest carcinogenic risk,while fluoride and aluminum had the highest non-carcinogenic risk.

OBJECTIVETo develop an HPLC method for determination of the four effective components (genistin; rutin; quercetin; genistein) in Huaijiao pill.

METHODThe chromatographic separation was performed on a Shim-packODS (4.6 mm x 150 mm, 5.0 microm) eluted with a mobile phase of MeOH-H2O-HAc (40:60:0.25). The detection wavelength was set at 256 nm and column temperature was set at 30 degrees C .

RESULTNice linear relation between the peak area and injected amount exists when the amount is within 0.059-0.352 microg for genistin, within 0.435-2.610 microg for rutin, within 0.020-0.121 microg for quercetin and within 0.053-0.319 microg for genistein. The correlation coefficient of each component is 0.999 6, 0.998 2, 0.998 9 and 0.999 9 respectively. The average recoveries of the four components are from 98.7% to 100.2%. The RSD of each group are 1.21%, 1.36%, 0.47% and 1.54% (n = 5).

CONCLUSIONThe method was accurate, repeatable and suitable to determine four effective components in Huaijiao pill. It can be use for quality control of Huaijiao pill.

Chromatography, High Pressure Liquid ; methods ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Genistein ; analysis ; Isoflavones ; analysis ; Plants, Medicinal ; chemistry ; Quercetin ; analysis ; Reproducibility of Results ; Rutin ; analysis ; Sophora ; chemistry