Objective To investigate the characteristics of clinical manifestations,treatment and prognosis of patients with systemic lupus erythematosus (SLE) complicated with central nervous system (CNS) infoction.Methods The medical records of 30 patients with SLE complicated with CNS infeetion were retrospectively reviewed.Results In the cohort of 3039 SLE patients admitted during last 20-year8,30 patients (1%) were identified with CNS infection.The mean age of patients with CNS infection was (34±11) years.Twenty-seven (90%) out of the 30 patients were fomale.Patients could be divided into 3 groups based on the offending microorganisms:mycobacterium tuberculosis (TB),non-TB bacterial and fungal infection groups respectively.TB infection was identified in 11 patients (37%),non-TB bacterial infections could be confirmed in 11 (37%),and fungal infection in 8 (26%).The most common presentations of CNS infeetion were fever,headache,and conscious level changes.There was no difierence among the three groups in morta-lity rate.Conclusion The clinical presentations of SLE patients complicated with CNS are generally atypical.Tubereulosis meningitis is the most prevalent CNS infection in patients with SLE.CSF analysis should be done as soon as possible for establishing early diagnosis.A lOW sernm albumin level,low C3 level and a low intracranial pressure predicts for unfavorable outcomes.

Objective To explore the distinction between measles vaccine strain Shanghai-191 (S- 191) and wild-type strains in China at molecular level. Methods After having been amplified by RT-PCR, the nucleotides of S-191 was sequenced and analyzed with reference to the sequences obtained from Gen- Bank, which includes 24 whole genome sequences, 211 sequences of wild-type strains isolated from China and WHO reference strains. Results The sequence of S-191 strain had been submitted to GenBank. Phylo- genetic analysis of the COOH terminal 456 nucleotides coding for the nucleoprotein (N) indicated that most of the measles virus strains from China were members of clade H1. The genetic distances between the virus strains detected in a number of provinces and S-191 strain were 6.7% -8.2%. It is noteworthy that the muta- tion rate of non-coding regions was considerably higher than that of coding regions. The mutation rate of N gene was the highest among all of the coding regions. Conclusion This report shows that genotype H1 is widely distributed throughout the country. The circulation has no apparent geographic and temporal restric- tion. The evolution of measles virus should be closely followed.

Objective To investigate the laparoscopie resection of the adrenal tumor effects and clinical experience. Methods Among the 24 cases of Laparoscopic adrenalectomy tumors, there were 8 cases of adrenal adenoma, 7 cases of pheochromoeytoma and 9 eases primary aldosteronism. Results One ease was transit to open operation, the other 23 were successful,each surgerical time was 40～130 min with an average of 98 rain. Hemorrhage was 50～300 mL, 140 ml average, no blood transfusion. It was 1～2 d after sur- gery to remove drainage tubes, and could take some activities and have fresh flow in the second day. The pa- tients didn't appear complications and discharged after 5～7 d. Follow-up of 6～24 months, there was no recurrence and long-term complications. Conclusion Laparoscopic adrenalectomy has the advantages of minor trauma surgery, less bleeding, good demonstrating, convenient operation, fewer complications and quick recovery.

Objective To explore the effects of deoxynivalenol (DON) on apoptosis of human gastric carcinoma cell line SNU in vitro. Methods SNU cells were treated with DON at different concentrations (50, 100, 1000, 2000 μg/L) for 12 hours, and then cells were harvested for cell apoptosis by flow cytometric (FCM) DNA analysis and the expression of Bax, Bcl-2 and Caspase-3 at protein level with FCM and Western blotting. Results FCM results showed that the apoptosis rates of SNU cells in DON treatment groups were all higher than that in control, especially in DON 1000 μg/L and 2000 μg/L groups (P<0.05). In the concentration range from 50 to 2000 μg/L, a significant concentration-depended response correlation could be found between apoptosis rate and DON concentration (r =0.940, P <0.01). FCM and Western blotting showed Bax and Caspase-3 expression in often SNU cells DON treatment for 12 hours were up-regulated while that of Bcl-2 was down-regulated. Conclusion DON can induce apoptosis of SNU cells in vitro in dose-dependent manner, and possible mechanisms of apoptosis induction effects may be up-regulation of the expression of Bax and down-regulation of that of Bcl-2 and activation of the key enzyme of apoptosis Caspase-3.

目的通过循证和专家讨论研究法建立第一版针对脑卒中的一套综合ICF核心分类模板和与之相应的简明ICF核心分类模板。方法来自于不同国家和地区的国际专家从初步研究中搜集证据,结合这些证据进行正式的决策并最终达成共识。初步研究包括Delphi研究方法、对ICF分类的系统评价以及实证数据的收集。结果来自12个不同国家的39位专家出席会议并达成共识。专家初步研究决定在ICF分类的第二、第三和第四级水平上针对脑卒中确定一套448个类目的ICF核心分类摸板,其中193项类目属于身体功能,26项属于身体结构,165项属于活动和参与,64项属于环境因素。综合性ICF核心分类模板包括在ICF分类第二级水平上的130个类目,其中41项属于"身体功能",5项属于"身体结构",51项属于"活动和参与",33项属于"环境因素"。简明型ICF核心分类模板包括在ICF分类第二级水平上的18个类目,其中6项属于身体功能,2项属于身体结构,7项属于活动参与,以及3项属于环境因素。结论专家组通过整合研究过程中的证据,以及专家们基于ICF框架和分类的观点达成正式的共识,并确定针对"脑卒中"的ICF核心分类模板,同时界定综合型ICF核心分类模板和简要型ICF核心分类模板。

Objective To observe the microanatomy of the bridging veins emptying into the superior sagittal sinus (SSS) for preservation of the bridging veins in surgeries through the anterior transcallosal approach. Methods Blue latex was injected into the SSS and internal jugular veins in 20 cadaver heads (40 sides), in which the bridging veins of the frontal zone and central zone were dissociated and their positions relative to the body surface were determined. Such indexes of the lateral veins in each zone as the caliber, the number of bridging veins, and convergence angle were determined. The opposite hemisphere was manipulated in an identical manner to measure the indexes of the sagittal sinus. Results in an area posterior to the frontal region of the SSS, a "safe zone" was identified where no bridging veins drained into the SSS, covering the area 32.6 nun anterior and 7.5 mm posterior to the coronal suture. After complete dissociation of the bridging veins near the longitudinal fissure in the "safe zone", the fissure allowed an opening width of 4.48～10.86 mm. Conclusion Thorough knowledge of the venous anatomy can help avoid the bridging veins in the anterior transcallosal approach. Total dissociation of the sticking segment and arachnoid segment of the bridging veins can broaden the opening width of the longitudinal fissure without increasing the tension of the bridging veins to better preserve the bridging veins during surgery.