Objective To investigate the clinical manifestation, pathological features and pathogenesis of Holmes-Adie syndrome (HAS). Methods The clinical data of one HAS patient with sweating abnormality and combined with literatures were analysed. Results The patient had the typical characteristics of HAS, including Adie pupil, areflexia of lower limb and the symptoms of autonomic nerve dysfunction. The characteristic pupil of HAS was proved by slit lamp of ophthalmology. Cranial MRI showed lacunar infarction. A partial or total loss of neurons of the ciliary ganglion was the main pathological characteristic of HAS. Conclusions The etiology of HAS remains unclear, and has characteristic pupil finding, which was associated with autonomic nerve dysfunction to a certain extent. HAS still need to differentiate from Ross syndrome and Harlequin syndrome.

Objective The relationship between XbaI polymorphism of ApoB gene and cerebral infarction(CI)among Chinese population was assessed by Meta-analysis.Methods All related case-control studies were collected from all publications,the relevant studies were identified after eliminating those poor-qualified studies.Meta-analysis was conducted for investigating heterogeneity among individual studies,and summarizing the effects across studies.Results The combined data statistics revealed the frequencies of the X-X+/X+X+ genotypes showed no statistically difference(Z=1.72,P=0.08).Through the subgroup analysis,it was obviously increase the risk of CI in Chinese northern population(OR=2.66,95%CI:1.67~4.24),but no statistically difference in Chinese southern population(OR=1.26,95%CI:0.90~1.77).Conclusions ApoB gene XbaI polymorphism may be significantly associated with susceptibility of CI in Chinese northern population,but not a definite risk for Chinese southern population.

Objective To explore the effect of TBL based on evidence-based medicine PICOS model in practice teaching of neurology. Methods Totally 47 medical undergraduates in our department were chosen and randomly divided into 2 groups during March 2016 to April 2016. 24 students in the trial group were taught with TBL based on PICOS, while other 23 students in the control group were only taught with conventional TBL method. After three times clinical practices, the test referring to disease pathogenesis, clinical manifestations, auxiliary examinations, diagnosis and treatments of related diseases was performed, and meanwhile, questionnaires were distributed to students in order to survey their satisfaction degree of teaching methods. All the evaluation results and scores of two groups were compared. Statistical data were analyzed by using t-test or Chi-square test with SPSS 17.0 software. Results The score of the theoretical test of trial group was significantly superior to the control group [(89.08±3.60) vs. (79.09±7.75), t=5.707, P=0.03 ]. Survey showed that in the experimental group , the number of students in the trial group who thought teaching method could help understand clinical thinking of neurology and could help integrate the theory into clinical practicewas significantly higher than that in the control group (P<0.05). Conclusion In the clinical teaching of neurology, the TBL based on PICOS model is more effective than conventional TBL method for medical undergraduates.

Objective To investigate the natural head position and cervical posture in the patients with different vertical facial patterns with skeletal class Ⅰ relationship,and to clarify the relationships between vertical facial patterns and natural head position, cervical posture in the patients with skeletal class Ⅰ relationship. Methods 94 patients aged 8- 15 years old with skeletal class Ⅰ relationship were selected as the subjects.The subjects were classified into high angle group,average angle group,and low angle group according to their mandibular plane angles.The cephalometric radiographs in natural head position were taken,and the variables representing craniofacial morphology,head position,and craniocervical posture were measured.The intergroup differences in variables were compared.Results The inclinations of mandible to the true vertical and cervical column (ML/VER,ML/OPT,ML/CVT)were smallest in high angle group,and they were largest in low angle group (P <0.01);other variables representing head posture and craniocervical posture (NSL/VER,FH/VER,NSL/OPT,NL/OPT,NSL/CVT,FH/CVT)were largest in high angle group,and they were smallest in low angle group (P <0.05).The inclinations of ramus to cervical column (RL/OPT,RL/CVT)were largest in high angle group and they were smallest in low angle group (P <0.01).There were no significant differences in the inclinations of cervical column and cervical lordosis (OPT/HOR,CVT/HOR,OPT/CVT)among three groups (P >0.05). Conclusion The significant differences exist in natural head position and cervical posture among the patients with skeletal class Ⅰ relationship with different vertical facial patterns (high angle,average angle,low angle);the subjects with high angle show extended head position and cervical posture,while the subjects with low angle exhibit the opposite tendency.

Objective:To explore the influence of the veneering porcelain thickness on the compressive strength of zirconia all-ceramic crown.Methods:25 zirconia basement crowns with the thickness of 0.5 mm were made by CAD-CAMsystem,and then were divided into 5 groups randomly with the veneering porcelain thickness of 0.5(A),1.0(B),1.5(C),2.0(D)and 2.5 mm(E)respectively. The compressive strength of the samples was measured by a testing machine.Statistical analysis was conducted by SPSS13.0 software. The microstructure of the fractured bonding interface of the specimens was observed by scanning electron microscope(SEM).Results:The compressive strength in group A,B,C,D and E were:(1 279.96 ±42.85)N,(2 235.44 ±50.14)N,(2 216.38 ±48.97)N, (2 169.22 ±60.40)N and (2 028.70 ±47.37)N respectively(A or E vs B,C or D,P <0.01;A vs E,P <0.01;B vs C or D,P >0.05;C vs D,P >0.05).SEMobservation found that in group A and E the bonding interface was uneven and loose,the cracks and spores in veneering porcelain appeared more and larger,and had a more intensive distribution.Conclusion:When the veneering porce-lain is too thick or too thin,the compressive strength of zirconia all-ceramic crown decreases,the thickness of the veneering porcelain should be controled in an appropriate range.

Objective To construct a recombinant lentiviral expression vector containing NIS and EGFP gene,and to explore the feasibility of NIS gene for monitoring the bone marrow derived mesenchymal stem cells (BMSCs) migration to the intracranial glioma.Methods The NIS and EGFP gene fragments were subcloned into lentiviral vector pLVX-puro,then packaged and amplified in HEK293T cells to obtain recombinant lentivirus pLVX-CMV-NIS-EGFP.pLVX-CMV-0-EGFP was constructed as control.BMSCs were isolated,cultured,and transfected by lentivirus.The antibiotic-resistant transfected BMSCs (BMSCs-NIS-EGFP and BMSCs-EGFP) were selected.The expression of NIS gene was examined by Western blot.Functional NIS activity was confirmed by the uptake of 125I and the inhibition effect of NaClO4.The nude mice intracranial glioma models were established.MicroSPECT was performed at 24 h post BMSCs-NIS-EGFP injection via the tail vein.Results pLVX-CMV-NIS-EGFP and pLVX-CMV-0-EGFP were successfully constructed and packaged.BMSCs were successfully isolated and cultured.Stable cell lines BMSCs-NIS-EGFP and BMSCs-EGFP were constructed after lentivirus transfection and puromycin selection.The expression of NIS gene was detected by Western blot in BMSCs-NIS-EGFP,but not in BMSCs-EGFP.BMSCs-NIS-EGFP showed significantly more uptake of 125I (nearly 10 times than the uptake in BMSCs-EGFP) and the uptake could be significantly inhibited by NaClO4.The nude mice intracranial glioma models were successfully established and the BMSCs-NIS-EGFP in glioma foci could be visualized by microSPECT imaging at 24 h post injection.Conclusions A recombinant lentivirus containing NIS gene could be successfully constructed for monitoring BMSCs migration towards intracranial glioma.It might provide evidence on the research of BMSCs and NIS gene mediated therapy for glioma.

Objective:To compare the titanium-porcelain bonding strength between CAD/CAM and cast pure titanium.Methods:Pure titanium samples were prepaired by CAD/CAMand casting respectively and fused with porcelain.The bond strength between tita-nium and porcelain of the samples was measured with three-point test.The titanium-porcelain interface was investigated under scanning electronic microscope(SEM).Results:The bond strength of CAD/CAMpure titanium to porcelain was (35.95 ±3.74)MPa and cast pure titanium to porcelain was (28.37 ±1 .98)MPa(P <0.05).SEMobservation showed that there was thin transition layer between titanium substrate and ceramic in CAD/CAM bond interface,titanium and porcelain combined closely,no obvious pores.However, there was thicker transition layer and small pore in cast pure titanium to porcelain bonding interface.Conclusion:The bonding strength of porcelain to CAD/CAMpure titanium is greater than that of porcelain to casting pure titanium.

Objective To discuss the clinicopathologic and imaging features of multilocular cystic renal eell carcinoma(MCRCC). Methods The data of 8 cases(5 men and 3 women)MCRCC classified according to 2004 WHO criteria were reviewed retrospectively.The tumor was incidentally found in 5 out of 8 cases.Renal ultrasound and CT scans were available in all 8 cases.CT or enhanced CT scans showed a well-defined cystid mass with irregular thickening wall or septa in 7 cases,without visible nodules found.For treatment,open or laparoscopic radical and partial nephrectomy was done in those cases. Results Postoperative pathological findings confirmed the diagnosis of MCRCC.The mean greatest diameter of the tumors was 5.6 cm.Microscopically,the wall and septa lined by one or several layers of clear cells were observed in all cases.The TNM stage of all 8 cases was T1 N0 M0.For pathologic grade,7 cases were G1 and 1 case was G2.Seven patients were followed up and remained tumor free during the average time of 8 months. Conclusions MCRCC is an uncommon subtype of RCC,it has a lower malignant potential and a better prognosis compared with other types of RCC according to the literature.Nephron-sparing surgery may be an appropriate treatment option for MCRCC.

Objective To investigate in evaluation of various capacity requirement of probationer nurs-ing students by nurses in operation room in order to improve clinical teaching work. Methods A self-de-signed questionnaire was applied, 191 qualified teaching nurses from nine grade three A general hospitals in Beijing were invited to fdl the questionaires. The results underwent subsequent analysis. Results The teach-ers had high expectations for various capacity of the probationer nursing students. Conclusions Clinical teachers should establish feasible teaching scheme according to the existing teaching syllabus in order to in-crease teaching quality, make students gain new insights through reviewing old materials, so that they can mas-ter various technique in operation room in short time.

BACKGROUND: With the rapid development of surgical techniques, unicompartmental knee arthroplasty has become an issue of concern in the treatment of osteoarthritis, which has achieved significant progress inreducing trauma and rapid rehabilitation.OBJECTIVE: To summarize the development history, curative effect of unicompartmental knee arthroplasty, and the research progress of lateral unicompartmental knee arthroplasty aided with computer navigation or robot system, thus providing reference for further study on unicompartmental knee arthroplasty.METHODS: Web of Science, and PubMed databases were searched for the literatures published from January 1955 to April 2017 with the keywords of unicompartmental knee arthroplasty, osteoarthritis, unilateral compartment, lateral knee arthroplasty.RESULTS AND CONCLUSION: A total of 562 articles were retrieved, and finally 75 English literatures were enrolled according to the inclusion and exclusion criteria. With the continuous improvement of unicompartmental knee arthroplasty, it can retain the cruciate ligament and more bone mass. Notably, strict indications and reasonable postoperative functional exercise are essential for obtaining optimal effectiveness. At the same time, the development of computer navigation and robot-assisted technology has opened up a new horizon for the treatment of osteoarthritis,which makes the operation more accurate and minimally invasive. But the application still needs to be studied in depth.