Objective To investipate the cerebral autosomal dominat arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) through the clinical features , pathology, neuroimage, and molecular genetics as well as the family tree of a case as to exploring the diagnostic method of the disease .Methods Systematic study on the clinical manifestations, genetic site, neurologic and muscular biopsy was performed. Results The main clinical features including poor memory and history of stroke were found. Neuroimaging examination showed multiinfarct lesions and leukoencephalopathy. Biopsy indicated the arteriolar hyalinosis,GOM and osmiophilic granule. A family history was confirmed. A mutation on the fourth exon of notch 3 gene was revealed. And no risk factors of hypertension and arteriosclerosis were found. All these features are in conformity with those of CADASIL.Conclusion CADAIL is not rare and is possible to be defined in vivo by way of dermal biopsy,examination of gene and neuroimage characteristics.

Objective To study the effects of formaldehyde on activities of enzymes in testes of male mice. Methods Male Kunming mice were used. Experimental groups had been exposed to formaldehyde with different doses by i.p. once per day for 7 consecutive days. The formaldehyde doses were 0.2, 2.0 and 20.0 mg/kg body weight. The mice were killed after 7 days of treatment and their testes were fetched out to be made into even slurry and the activities of LDH, G-6-PD and SDH in them were tested. Results The activities of G-6-PD and SDH were decreased with the increasing of doses of formaldehyde. Compared with the control group, the activities of SDH in each exposed group had significantly decreased (P

Objective To compare the clinical efficacy and safety between the improved ligation method and the traditional ligation method in the treatment of internal hemorrhoid. Methods Double blind and randomized study were made in 86 patients with internal hemorrhoid. The traditional method was performed by ligation of internal hemorrhoidal body, and the improved method was to ligate rectal mucous membrane above internal hemorrhoidal radicles. Results The improved method has better effect than the traditional method. The clinical symptoms of internal hemorrhoid such as bleeding,pain,constipation,edema,itching and erosion in the patients treated by the improved method were significantly improved compared with the patients treated by the traditional method(P

Objective To evaluate urgent selective arterial embolization to treat massive postpartum hemorrhage. Methods Twenty seven patients with ages of 21～53 years undengoing severe postpartunm hemorrhage, were due to centrol placenta previa, uterine atony, birth canal trauma, placenta accretio, cervical pregnancy etc. All of the patients had lost a volume of blood about 1 000ml to 5 000ml while the hemorrhage could not be controlled with vaginal packing and administration of uterotonic drugs. Urgent hemostatic embolization was performed for them. After angiography, super selective catheterization was performed for bilateal anterior division of internal iliac branch of uterine arteries and embolized with Gelfoam particles. Results Catheterization success rate was 96.3%. Angiography showed ectopic uterine artery in one case. Immediate block of hemorrhage took place in 22 cases and gradual hemostasis appeared in 4 cases, the efficacy rate was 96.3%. The one with ectopic uterine artery was operated upon to ablate the uterus. 11 patients with (bleeding) shock and 8 patients with DIC were all saved. Conclusions Urgent arterial embolization is an ideal method for treating life threatening postpartum hemorrhage. The procedure saves the maternal uterus and is also effective for postpartum DIC.

The General Rules of the Civil Law of the People′s Republic of China(hereinafter the General Rules)shall officially come into effect as of July 1 of 2017.In this consideration,the paper probed into the legal attributes of the doctor-patient relationship in China in view of the relationship management in line with the General Rules.Also analyzed are the basic principles to be observed by both parties as regulated by the General Rules and patient rights protection.These efforts aim at elevating China′s medical service,protecting legitimate rights of both parties,and encourage a healthy and harmonious doctor-patient relationship.

Objective To evaluate the application value of three‐dimensional ultrasonography OmniView technology in diagnosis of fetal cleft lip/palate . Methods Three‐dimensional volume data was acquired from 100 normal singleton fetuses and 18 cleft lip/palate fetuses ,and was analysed by OmniView technology . Two‐dimensional ultrasonography and three‐dimensional OmniView technology were compared in the displaying rate of different planes of the lip and palate and the diagnosis accordance rate of cleft lip/palate.Results ①ThedisplayingrateofthelipandpalateofOmniViewtechnologywashigherthanthatof two‐dimensional ultrasonography ( the displaying rates were 64% -88% and 30% -65% ,respectively , P <0 .05) . Further more ,the curved plane tiled imaging of palate was successfully reconstructed by OmniView technology ,displaying the nonplanar panorama of the palate . ② There was no significant difference in diagnosis accordance rate of fetal cleft lip/palate between two‐dimensional ultrasonography and OmniView technology( the accordance rate was 89% -94% and 78% -100% ,respectively , P >0 .05) . Conclusions Three‐dimentional ultrasonography OmniView technology can improve the displaying rate of the hard and soft palate .The application of this technology in the fetuses who has a high risk of cleft palate may be beneficial to the diagnosis of cleft palate .

Objective To evaluate the role of breast MRI in detecting the primary malignancy in patients presenting solely with axillary lymph node metastases. Methods Thirty-three patients with axillary lynph node metastases but negative findings on either physical examination or mammography underwent breast MRI to identify occult breast carcinoma. MRI of the breast was assessed according to BI-RADS criteria. The pathologic diagnosis was made according to the standard criteria by the WHO Classification of Tumor. Results Among 33 patients presenting solely with axillary metastases, 30 patients underwent modified radical mastectomy. Primary breast carcinoma was proven in 17 patients. MRI detected lesions in 16 patients, including 10 masses and 6 non-mass lesions. Size of the masses ranged from 0. 5 to 2. 6 cm (mean 1.5 cm). Six lesions were smaller than 1.5 cm in size. Non-mass lesions showed ductal enhancement in 4 cases and segmental enhancement in 2 cases. One patient with tumor detected by histopathology showed no abnormal enhancement on MRI. No tumor was found at mastectomy in the other 13 womeu, and negative MR findings were revealed in 9. Four cases with suspicious enhancement on MRI had no corresponding primary foci on pathology. Three patients didn't undergo surgical procedure. The sensitivity, specificity, and accuracy of MRI in the diagnosis of the primary malignancy were 94. 1%,69. 2%, and 83.3%, respectively. Conclusions Small size of mass and ductal or segmental enhancement of non-mass lesion were common MR features of occult malignancy. MRI showed high sensitivity and accuracy in diagnosing occult breast carcinoma. Breast MRI should be taken in search of occult malignancy in patients with axillary metastases.

Objective To investigate the clinical features and the therapeutic effects in patients with vestibu-lar paroxysmia(VP) .Methods A total of 32 patients with VP were analyzed retrospectively through pure -tone au-diometry (PTA) ,auditory brainstem response(ABR) ,magnetic resonance imaging (MRI) ,and vestibular function . The effects were assessed after 3 months treatment of carbamazepine (CBZ) or oxcarbazepine (OXA) .Results The main clinical symptom of 32 patients was a brief spell of vertigo ,and 75% of patient's attacks were regularly precipi-tated by certain head positions or position changes .The most common accompanying symptom was unsteadiness of stance or gait (75 .00% ) .The PTA thresholds were elevated in 11 patients (34 .38% ) .MRI in all patients showed neurovascular cross -compression(NVCC) .Among 30 patients who performed ABR tests ,24 (80 .00% ) were ab-normal and 19 patients (63 .33% )were found that the interpeak latency (IPL) of wave I-III( IPL I-III) prolonged more than 2 .2 ms .The course of the patients with IPL I -III prolonged was relatively longer (P=0 .231) ,but there was no significantly difference .All patients received carbamazepine (CBZ) or oxcarbazepine (OXA) for one month .One case was lost to follow -up ,4 had no symptom improvement and 27 had a significant reduction in the attack frequency and intensity respectively after treatment of one month ,two months ,three months and 6 months of the drug withdrawal ,compared with the previous (P<0 .05) .The level of vertigo was significantly improved(P<0 .05) .Conclusion Episodic spells of vertigo are the main clinical symptom of VP ,regularly caused by certain head positions or position changes .The NVCC can be found by MRI in all patients .The IPL I -III in ABR was pro-longed in most patients ,some of them have hearing loss .CBZ and OXA are effective with VP and also significant in the experimental treatment of diagnosis .

Objective To compare the oil yield of celery seeds and the contents of 3-n-butylphthalide and the total phthalocyanine lactones of celery seed oil extracted by different methods. Methods Three routine extraction methods involving organic solvent extraction, Soxhlet extraction, steam distillation extraction, as well as subcritical extraction method and supercritical fluid extraction method were used to extract the celery seed oil. The contents of 3-n-butylphthalide and total phthalocyanine lactones were respectively detected by high performance liquid chromatography(HPLC) and ultraviolet visible spectrophotometry. Results The ranges of oil yield and the contents of 3-n-butylphthalide and total phthalocyanine lactones of celery seed oil extracted by different methods were 0.30%-20.02%, 1.40%-10.13%, 4.74%-17.65%, respectively, indicating obvious differences. Conclusion With R134a and butane as the solvents, the subcritical extraction method is better than other extraction methods for the extraction of 3-n-butylphthalide. With dimethyl ether as the solvent, the subcritical extraction method is the best for the extraction of total phthalocyanine lactones.

Objective To investigate the relationship between Hepatitis B patients with different viral loads and immunoglob-ulin A,G,M and complement C3,C4.Methods Firstly,followed by real-time fluorescence quantitative PCR detection 210 cases of hepatitis B patients with HBV-DNA levels,according to 10n copies/ml different viral load detection results,it was divided into 102 ~108 copies/ml of the experimental groups.Then the experimental groups and control group were simulta-neously detected in immunoglobulin A,G,M and complement C3,C4.Analysed the correlation between HBV loads and im-munoglobulin A,G,M and complement C3,C4.Results When the viral loads of hepatitis B patients were 105 ~108 copies/ml,the testing results of IgA,IgG and IgM were both increasing (U =12.43,10.96,6.42,P <0.01),while C3 and C4 were both decreasing (U =8.37,6.0,P <0.01).When the viral loads of hepatitis B patients were 102 ~ 104 copies/ml,only IgA and IgM were increasing (U =2.36,2.04,P <0.05),the other testing results had no statistical significance.Between the test of 7 experimental groups compared with each other,only 104 group and 105 group had significantly changed (IgA and IgM were increasing,C4 was decreasing,U =2.39,2.46,2.09,P <0.05,IgG was increasing,U = 3.25,P <0.01),but between other low viral loads or high viral loads were not significantly differences.Conclusion The different viral loads of hepatitis B patients could cause the different changes of immunoglobulin A,G,M and complement C3,C4,especially in the 4 groups from 105 to 108 copies/ml.Followed by increasing in viral loads,there were immunoglobulin A,G,M increasing and comple-ment C3,C4 decreasing,and also serious impaction on the immune function of organism.There was a positive correlation be-tween viral loads in vivo and immune damages,correlation coefficient (γ =0.967,P <0.01).When the viral loads from 104 to 105 copies/ml,the testing results had changed significantly.It suggest that should control viral loads under 104 copies/ml in the hepatitis B antiviral treatment,so the effect of immune function damage will be the minimum.