AIM:To explore the diagnosis and treatment methods of radioaction-induced optic neuritis ( RION) through the clinical dates of 17 patients.
METHODS: It was a retrospective case series study. From August 2008 to October 2013, 17 cases (24 eyes) of Rion clinical dates from Chinese PLA General Hospital were studied. The diagnosis methods including visual acuity, pupil, fundus, visual field, fundus fluorescein angiography (FFA), visual electrophysiological testing, and head MRI. To analysis the clinical date of patients with diagnosis of RION by statistical description.
RESULTS: The deterioration degree of vision: 13 eyes were classified as Ⅳ, 9 eyes as Ⅲ, 2 eyes as II. Ten eyes RAPD ( + ) , visual electrophysiology is extinguished. The retina of 5 eyes showed flame hemorrhages and cotton wool spots exudation. Optic nerve head edema in one eye. T1 - weighted MRI enhanced in 19 eyes which showed optic nerve of the intracranial and intratubal segments abnormal changed, optic chiasm and pituitary stalk signal abnormalities and enhancement of the optic nerve. Tortuous optic nerves and rough edges were observed in 5 eyes. Treatment effect: 4 eyes of visual acuity improved, 1 eye from blindness to light perception,1 eye from 0. 08 to 0. 2, 1 eye from 0. 4 to 0. 6,1 eye from 0. 04 to 0. 15, the rest of the cases did not see any improvement.
CONCLUSION: The unique clinical manifestation of RION can provide objective basis for clinical diagnosis in time, but there have not been proven any effective treatments.

Objective To investigate drug resistance and genotypes of methicillin-resistant Staphylococcus aureus (MRSA) isolated from intensive care unit (ICU). Methods MRSA strains were isolated from patients, medical staff and environment of hospital ICUs. Disk diffusion (K-B method) was used for drug resistance testing; Staphylococcal cassette chromosome mec (SCCmec) and Staphylococcal protein A (spa) typing methods were used for genotyping and identifying the homology. Results There were 78 strains of Staphylococcus aureus isolated including 62 isolates of MRSA, which were mainly from the burn ICU (22, 35.48%). Among 62 MRSA strains, 50 were hospital acquired strains, in which 43 isolates were of SCCmec Ⅲ, 4 of SCCmec Ⅰ and 3 of SCCmec Ⅱ. Twelve isolates could not be typed. Twenty-eight out of 37 hospital acquired isolates were typed by spa typing as SCCmec Ⅲ-t030, which belonged to the same clone. Conclusion MRSA in ICU is multi-drug resistant and SCCmec Ⅲ-t030 is the most prevalent genotype, which indicates that clinical MRSA strains and environmental MRSA strains may be homologous.

Objective To investigate the diagnostic value of cervical metastatic lymph nodes by T1 perfusion-weighted imaging and analyse the effect of age on perfusion.Methods 18 cases of cervical lymph node metastasis (case group)and 30 healthy people (control group)were performed T1 perfusion-weighted imaging.The semi-quantitative parameters (including in maximum relative enhancement ratio,wash in rate,wash out rate and peak time)and time-intensity curve (TIC)were compared between case group and control group.Moreover,the effect of age on perfusion was investigated by the age of 40 years old.Results The inflow rate was statistically significant difference between the two groups (P<0.05)and that of 23 cases of metastatic lymph nodes was higher than 49 normal lymph nodes.However,the maximum relative enhancement ratio,outflow rate and peak time weren’t statistically signif-icant difference(P>0.05).The time-intensity curve in metastatic lymph nodes and normal lymph nodes were common in typeⅡ. The maximum relative enhancement ratio and wash in rate negatively correlated with the age and the maximum relative enhancement ratio and wash in rate below the age of 40 years old were higher than above the age 40.Conclusion The wash in rate is helpful to dif-ferentiate metastatic lymph nodes and normal lymph nodes.The effect of age on perfusion is considered.

Objective To compare 18F-FDG、11C-MET and 11C-CHO PET/CT in rat C6 glioma and inflammation models and observe their correlations with HIF-1α and VEGF expressions.Methods Thirtytwo male Wistar rats were included to bear both C6 glioma and turpentine oil-induced acute inflammation (AI).18F-FDG,11C-MET and 11C-CHO PET/CT were performed on rats.The SUVmax ratios of tumor-tomuscle (T/M),AI-to-muscle (AI/M) and tumor selectivity index (SI) were calculated.One-way analysis of variance and two-sample t test were used for statistical analyses.HIF-1α and VEGF expression was detected by immunohistochemical staining.Spearman correlation analysis was performed to evaluate the relationship between T/M ratios and the expressions of HIF-1α or VEGF.Results T/M ratios of 18F-FDG,11 C-MET and 11C-CHO in C6 glioma were 6.89±2.53,2.75±0.87,2.73±1.01,and the AI/M were 4.77±2.21,1.75±0.66,2.23±0.90 respectively.The 18F-FDG and 11C-MET uptake between C6 glioma and AI were significantly different(tFDG =2.133,tMET =3.267,both P＜0.05).The SIMET was significantly higher than SIFDG(t =2.600,P＜0.05).The 11C-CHO uptake between tumor and inflammation showed no significant difference(t=1.537,P＞0.05).T/M ratios of 18F-FDG and 11C-MET were positively related to HIF-1α and VEGF expressions(rs =0.725,0.637,0.621,0.764,all P＜0.05).The T/M ratio of 11C-CHO related only to VEGF (rs =0.682,P＜0.05).Conclusions 18F-FDG and 11 C-MET PET/CT may differentiate C6 glioma from AI,and 11 C-MET PET/CT seems more tumor-selective.11C-CHO PET is less valuable for the differential diagnosis.The 18F-FDG and 11 C-MET uptake of C6 glioma may be related to tumor hypoxia.All the three tracers could reflect tumor angiogenesis,but with different sensitiveness.

Objective To evaluate the efficacy andtolerability of continuous low-dose cyclophosphamide and prednisone treatment of relapsed and refractory multiple myeloma. Methods84 relapsed and refractory multiple myeloma patients were enrolled, including 46 males and 38 females, the assess patients of 81 cases with average age of 69.7 (45-91)years. They were treated continuous with oral cyclophosphamide (50 mg/d) and prednisone (15 mg/d) and monthly follow-up.ResultsAverage follow-up time were 23.5(1-71)months.The assessed patients were 81 cases,with 52 cases (64.2 ％) responded.There were 2 cases(2.5 ％)CR,21 cases(25.9 ％) of PR,29 cases(35.8 ％)MR,19 cases(23.5 ％)NC and 10 cases (12.3 ％)PD.The median time to response was 2 months.In the patients who responded to the treatment,the median progression-free survival(PFS)and overall survival (OS) were 18(95 ％CI 12.8-23.2),29(95 ％CI 24.1-33.9)months.In the non-responding patients,the PFS and OS were 4(95 ％ CI 2.2-5.8) and 6(95 ％ CI 4.9-7.1)months.Two groups were statistically significant(P＜0.05).The most common toxicities included fatigue,nausea, neutropenia, hyperglycemia and lung infection. No patient withdrew from the study because of toxicity. Conclusions Continuous low-dose cyclophosphamide combined prednisone is a treatment options for relapsed and refractory MM patients.

ObjectiveTo investigate the prevalence of chronic kidney diseases (CKD) from inpatients with cerebrovascular diseases in Shanghai district. MethodsInpatients with cerebrovascular diseases from neurology department of five hospitals in Shanghai from Jun. 2007 to Feb. 2008 were recruited . All the patients were respectively diagnosed by brain CT, CTA, MRI, MRA and TCD. Laboratory data included urinary microalbumin-to-creatinine ratio (ACR), routine urinalysis, fasting plasma glucose, 2-hour-postprandial plasma glucose, Scr, uric acid, etc. All the serum creatinine samples were uniformly tested in central laboratory of Shanghai Ruijin Hospital.Glomendar filtration rate (GFR) was estimated by complicated MDRD equation and CKD stage was classified according to K/DOQI guidelines. ResultsA total of 1014 hospitalized patients with cerebrovascular diseases were enrolled during the observation period, with M/F ratio of 559/455 and mean age of (68.56±12.17) years. Cerebrovascular diseases included ischemic stroke (708 cases), hemorrhagic stroke (197 cases) and transient cerebral ischemie attack (TIA) (109 cases). Microalbuminuria (MAU) was detected in 11.2%, while 24.8% patients had proteinuria. The prevalence of CKD was 47.7%. The percentage of these inpatients in CKD stage 1 to 5 was approximately 6.90%, 14.69%, 21.60%, 2.56% and 1.97% respectively. The Logistic regression model showed that the risk factors of short-term (<30 days) prognosis were albuminuria, hyperglycemia (fast glucose) and anemia. ConclusionsThe prevalence of CKD in inpatients with cerebrovascular diseases was 47.7% in Shanghai. It is significant to evaluate CKD among patients with cerebrovascular diseases, especially to use the screening of ACR in the early stage.

Objective To explore the value of monitoring in vertebral and spinal cord operation by the real-time monitoring of the spinal cord in the process of operation.Methods Nineteen cases were included by the real-time monitoring of spinal cord in the process of operation.Japanese Orthopaedic Association(JOA) score was used to evaluate the clinical efficacy during following-up before and discharge after operation,6 months and 12 months after operation.Results Intraoperative ultrasound monitoring in the 19 patients had no symptom of spinal cord injury and other complications within the plant without loosening fracture occurred were bony fusion; the average JOA scores in the patients before operation,discharge after operation,6 months and 12 months after operation were 8.80±1.60,14.00±1.57,14.60±1.61 and 14.80±1.58,respectively.The improvement rate of JOA score for discharge after operation,6 months and 12 months after operation were individually 51.6%,61.3%,and 64.5%.The JOA score after operation was obviously higher than that before operation.The significant difference between the two groups was observed in the experiment (P<0.05).The cervical spinal canal sagittal diameter significantly increased after operation (mean sagittal diameter of the expansion of 6.6 mm),compared with that before the trial (P<0.05).Conclusion The real-time monitoring with ultrasonography during operation can identify the change of spinal cord and provide the image evidence of operative efficiency to avoid the injury in vertebral and spinal cord operation.

Objective To observe the therapeutic effect of curculioside on rats with ulcerative colitis(UC),and to explore its regulatory effect on the protein extracellular regulated kinases(PERK)/activated transcription factor 4(ATF4)/enhancer-binding protein(C/EBP)homologous protein(CHOP)pathway.Methods Sixty-one SD rats were induced by trinitrobenzene sulfonic acid(TNBS)to establish UC model.According to the random number table,they were divided into low,medium and high dose curculioside groups(25,50 and 100 mg/kg citronelioside dissolved in normal saline),mesalazine group(500 mg/kg mesalazine dissolved in normal saline),PERK inhibitor group(GSK2606414 1.0 mg/kg dissolved in normal saline),and model group(normal saline),and another 10 healthy SD rats were recorded as the normal group(normal saline),and the volume of normal saline was 1ml/100g the body weight of rats,gavaged once a day for 10 consecutive days.On the day after the end of administration,disease activity index(DAI)was evaluated.The ratio of lactulose(L)to mannitol(M)excretion rate(L/M)in the 5-hour urine of two groups of rats was determined by Gas chromatography(GC).Double antibody sandwich method was used to measure serum glucocorticoid concentration,and enzyme-linked immunosorbent assay was used to detect serum interleukin-6(IL-6),interferon-γ(IFN-γ),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)levels.Hematoxylin eosin(HE)staining was used to observe the pathological changes of the intestinal mucosa.Real time reverse transcription fluorescence quantitative polymerase chain reaction(RT-qPCR)was used to detect the expression of PERK,ATF4,CHOP,Bcl2 associated X protein(Bax),B lymphoblastoma 2(Bcl-2)messenger RNA(mRNA)in intestinal mucosa.Immunoblotting(WB)was used to detect the expression of PERK,ATF4,CHOP,Bax,and Bcl-2 proteins in intestinal mucosal tissue,as well as the levels of phosphorylated PERK(p-PERK).Results Visual and HE staining observations confirmed successful modeling.Compared with the normal group,the model group had L/M,DAI and intestinal mucosal pathological score,serum glucocorticoid concentration,and serum IL-6,IFN-γ,IL-8 and TNF-α levels,mRNA and protein expressions of PERK,ATF4,CHOP,Bax,and p-PERK increased(P＜0.05),while the mRNA and protein expressions of Bcl-2 decreased(P＜0.05).Compared with the model group,the L/M,DAI and intestinal mucosal pathological scores,serum glucocorticoid concentration,and serum IL-6,IFN-γ,IL-8 and TNF-αlevels,mRNA and protein expressions of PERK,ATF4,CHOP,Bax,and p-PERK of the three dose curculioside groups,mesalazine group,and PERK inhibitor group decreased(P＜0.05),while the mRNA and protein expressions of Bcl-2 increased(P＜0.05).There were no significant differences in glucocorticoid concentration,PERK,ATF4,CHOP,Bax,Bcl-2 mRNA and protein expressions,p-PERK levels between the low dose curculioside group and the mesalazine group,between the medium dose curculioside group and the PERK inhibitor group(P＞0.05),and there were significant differences between each other two groups(P＜0.05).The pathological changes of colonic mucosa in the model group were serious.The low dose curculioside group was relieved,the medium dose curculioside group,the Mesalazine group and the PERK inhibitor group were significantly relieved,and the high-dose group of citronelloside was significantly relieved.Conclusion Curculioside can improve intestinal mucosal barrier function,control disease activity,and alleviate pathological changes in UC rats,which is speculated to be related to the inhibition of the PERK/ATF4/CHOP pathway.

Wnt signaling is implicated in the control of cell growth and differentiation during neural stem cell(CNS) development.Wnt3a, one of wnt gene family members, has effect on regeneration neurospheres and differentiation into neurons.Wnt3a inhibits regeneration of neurospheres, and promotes its differentiation. In vitro neurosphere was cultured in a serum-free defined medium DMEM/F12 supplemented with bFGF and EGF. Dissociated cells were plated onto poly-d-lysine-coated coverslips and propagated in medium containing recombined Wnt3a-adenovirus. Plenty of Nurr1 were detected by RT-PCR after 3 days. Wnt3a combined AA would improve NSC differentiation into dopaminergic (DA) neuron. The quantity of DA neuron is obviously more than the AA alone group's. Moreover, the expression of TH mRNA is 1.86 fold in Wnt3a combined AA group. Induced cells were immunostained for TH and DAT. The proportion of TH-positive was (37.42 ? 2.54) % (P

Objective:To analyze the correlation between serum lipid levels and diabetic nephropathy in patients with type 2 di-abetic mellitus.Methods:A total of 240 patients with type 2 diabetic mellitus from Jun 2011 to Jul 2013 were enrolled.There were 100 patients with diabetic nephropathy and 140 patients without any complication.Gender,age,duration of diabetes, baseline fasting glucose,glycosylated hemoglobin and serum lipid were compared between the two groups.The odds ratio(OR) and 95% confidence interval(CI)of correlation between these factors and diabetic nephropathy were calculated and analyzed with Logistic regression model.Results:The differences of age,duration of diabetes,systolic pressure between the two groups were statistically significant(P <0.01).Adjusted Logistic regression model showed that age> 70(OR= 2.92,95% CI:1.31-6.51),duration of diabetes>10 years(OR=3.33,95%CI:1.79-6.16),diastolic pressure>90 mmHg(OR=2.23,95%CI:1.06-4.69),and low density lipoprotein>3.64 mmol/L(OR=2.85,95%CI:1.16-7.03)were independent risk factors for type 2 Dia-betic Mellitus complicated by diabetic nephropathy(P <0.01 and 0.05).Conclusions:Low density lipoprotein has the potential to be a predictive,prophylactic and therapeutic target for diabetic nephropathy.