Objective To study the clinical and neuroimaging features of subtypes of multiple system atrophy (MSA) and their correlations. Methods One hundred and forty-three MSA cases fulfilled Gilman diagnostic criteria (1999) were recruited and their clinical subtypes and stages were classified. Using the staging methods of the pontine cross sign and putaminal slit proposed by Horimoto, 108 patients showed abnormalities in MRI and were further evaluated. The relationship between the subtypes of MSA, disease duration, and MRI abnormalities has been analyzed. Results Of 143 MSA patients, the male-to-female ratio is 1.3:1 ; 93 cases are diagnosed with MSA-C, 39 with MSA-P, and 11 with MSA-P + C; 90 cases with probable diagnosis, and 53 with possible diagnosis. Of the 76 MSA-C cases with MRI abnormalities, 36 (47%) show the pontine cross sign and 10 (13%) show the putaminal slit; of the 24 MSA-P cases with MRI abnormalities, 6 (25%) show the pontine cross sign and 6 (25%) show theputaminal slit. In addition, MSA-C cases with shorter disease duration demonstrate earlier stages of the pontine cross sign. Conclusions In this study, the number of MSA-C cases is more than MSA-P, which might be related to the ethnic background. In neuroimaging, both the pontine cross sign and the putaminal slit are the marked features of MSA. To some degree, the subtypes of MSA are related with the features of imaging, that is, MSA-C patients present the pontine cross sign more often than MSA-P, and the putaminal slit is a comparatively common feature among MSA-P cases.

Objective To study the correlation between clinical rating scale and the duration of multiple system atrophy.Methods One hundred and twenty-two MSA cases fulfilling Gilman diagnostic criteria were recruited.Unified Multiple System Atrophy Rating Scale(UMSARS)was applied to assess the degree of the patients' disability.For analyzing the correlation between the UMSARS scores and the duration of the disease,the Spearman's rank correlation coefficients were calculated.Results Among 122 MSA cases,male:female ratio was 1.7:1;disease duration lasted(2.8±1.6)years:possible MSA accounted for 50 cases(41%),probable MSA 72 cases(59%);MSA-P 35 cases(29%);MSA-C 73 cases(60%).MSA-P+C 5 cases(4%),MSA-A 9 cases(7%).The scores of UMSARS,UMSARS-Ⅰ and UMSARS-Ⅱ were found positively correlating with the disease duration.The Spearman's rank correlation coefficients were 0.368,0.266 and 0.392 respectively,all P<0.01;the adjusted Spearman's rank correlation coefficients were 0.360,0.257 and 0.385 respectively.all P<0.01.Conclusions MSA has complex clinical manifestations.which should include MSA-P+C subtype.UMSARS is a reliable scale to mirror the progression of MSA.which is useful to study the clinical features and disease duration of MSA.

The clinical practice is a very important link for medical students to relate theory with practice and to be trained comprehensively.Stomatology is an applied science,so clinical practice is more outstanding and important during the stomatological education.This thesis discusses how to improve stomatological students' comprehensive skill in the clinical practice.

OBJECTIVE To investigate the effective treatment for secretory otitis media. METHODS 63 patients (78 ears)with secretory otitis media were randomly devided into two groups: The experimental group :Thirty-one patients (38 ears) were treated by eustachian tube insertion under nasal endoscope. Drugs were injected repeatedly through the pipe. The control group: 32 patients (40 ears) were treated by traditional method: the tympanic cavity pressure equalization tube. All patients were followed up for 6-9 months, the effectiveness was compared.RESULTS The experimental group: 16 ears (42.1 %) were cured, 18 ears (47.4 %) were straightened up, The total efficiency rate was 89.5 %. The control group: 8 ears (20.0 %) were cured, 21 ears (52.5 %) were straightened up, The total efficiency rate was 72.5 %. There were significant difference between the two groups after treatment (P

Objective To evaluate the correlation between the types of vertebral artery occlusion and their compensatory hemodynamic changes and posterior circulation ischemia using color Doppler flow imaging combined with transcranial color-coded sonography.Methods From June 2015 to June 2016,A total of 108 patients with vertebral artery occlusion confirmed by vascular sonography,digital subtraction angiography (DSA) or CT angiography (CTA) were enrolled retrospectively.According to the magnetic resonance imaging (MRI)-diffusion weighted imaging (DWI) findings,they were divided into posterior circulation infarction (n=78 in infarction group) and non-posterior circulation infarction (n=30 in TIA group).Color Doppler flow imaging and transcranial color Doppler ultrasonography were used to examine the contralateral vertebral artery extracranial diameter, peak systolic velocity(PSV) and end diastolic velocity(EDV) of bilateral extracranial and intracranial vertebral arteries.The differences of the vertebral artery occlusion types,establishment of collateral circulation and hemodynamic changes of the contralateral vertebral artery were compared between the two groups.Results The patients with single vertebral artery occlusion in the infarction group and TIA group were 69 (88.5%) and 26 (86.7%) respectively;those with bilateral vertebral artery occlusion were 9 (11.5%) and 4 (13.3%) respectively.There was no significant difference in the number of vertebral artery occlusion between the two groups (χ2=0.000,P=1.000).The proportion of patients with vertebral artery occlusion in intracranial segment in the infarction group was higher than that in the TIA group (70.5% [55/78] vs.36.7% (11/30);χ2=10.444,P=0.001).The proportion of patients with the establishment of collateral circulation in the infarction group was lower than that in the TIA group (14.1% [11/78] vs.43.3% (13/30);χ2=10.711,P=0.001).The peak systolic velocity (PSV) and the end diastolic velocity (EDV) of contralateral extracranial vertebral artery in patients with single vertebral artery occlusion in the TIA group were higher than those in the infarction group (65±21 cm/s vs.57±15 cm/s,25±8 cm/s vs.20±7 cm/s,t=2.043 and 2.606 respectively,all P<0.05).Conclusion The establishment of collateral circulation and hemodynamic compensation of the contralateral vertebral artery after vertebral artery occlusion were closely associated with the occurrence of posterior circulation ischemia.

Objective To investigate the effect of transplantation of allogeneic bone marrow hematopoietic cells(HCs)and mesenchymal stem cells(MSCs)on experimental colitis(EC)in rats.Methods The HCs and MSCs obtained from SD male rats were cultured and expanded in vitro.In experiment 1 and 2 groups,HCs were labeled with bromodeoxyuridine(BrdU)and MSCs were obtained using the tube wall attach technique,respectively.Seventy-two female rats were infused with trinitrobenzene sulfonic acid(TNBS)to induce EC models.After 24 hours,HC or MSC suspensions were injected into the rats in experimental 1(n=18)and 2(n=18)groups via caudal veins,respectively.Control animals were injected with isotonic saline.The whole colon was removed on day 7,14 and 21 after transplantation and examined histopathologically.BrdU labeled HCs were tested with immunohistochemical staining and MSCs were detected for sex-determining gene(sry)by PCR.Results EC models were successfully established.The HCs or MSCs grew rapidly in the culture suspension.On day 7,14 and 21 after transplantation,the BrdU immunoreactive cells were detected in the colon(6/6),and the positive expression of the sry gene was found in 1/6,2/6 and 3/6,respectively.No positive labeled cell was found in controls.There was no significant improvement in histopathological scores on the colon in two experimental groups compared with the controls.Conclusions Allogeneic HCs and MSCs may localize in the colon of EC models.The ability of localization is higher in HCs than MSCs.The transplantation of HCs and MSCs can not obviously improve histopathologically.

ObjectiveTo explore the value of expanded radical resection for gallbladder cancer located respectively at body and bottom of the gallbladder and at the neck.MethodsIn this study,91 cases of gallbladder cancer were macropathologically divided into two groups, one with the lesion at the body and bottom of the gallbladder and the other at the neck, survival analysis was made accordingly. Three different kinds of resection were performed: the expanded radical resection, the standard radical resection and palliative operation.ResultsThe overall median survival rate of patients undergoing expanded radical operation was significantly longer than that of the cases doing other two procedures, that was 27. 1 ± 2. 4,10. 7 ±2. 2,4. 7 ±2.2 (months) respectively for body and bottom cancer, and 8.5 ±2. 1,6. 7 ± 1.9,3.1 ± 1.1 (months) respectively for neck cancer. For cancer at the body and bottom RO was achieved by expanded radical resection in 16/18(88％ ) cases and by standard radical resection in 7/12(58％ ) cases, while for cancer at the neck it was in 6/16(38％ ) cases, and in 3/13 (23％)cases only.ConclusionsThe median survival time is longer and RO resection rate is higher in patients with the cancer at the body and bottom than these at the neck of the gallbladder.

Objective To investigate the effects of comprehensive psychological intervention on psychological and biochemical indexes of servicemen in three degree combat readiness. Methods 189 servicemen in three degree combat readiness were randomly divided into the study group and the control group by squad. Beyond the same exercise and education as the control group, the study group received the comprehensive psychological intervention in the course. They were all assessed with Self-rating Depression Scale (SDS) ,self-rating anxiety scale (SAS) ,and simplified coping style questionnaire (SCSQ) at the day entering three degree combat readiness (prereadiness) and the next day after the mission (post-readiness). The serum concentrations of superoxide dismutase ( SOD), malondialdehyde ( MDA), cortisol ( COR), and aldosterone (ALD) were determined to evaluate biochemical indexes at the same time. Results Compared with the control group after the combat readiness, the total scores of SDS( (42.1 ± 9.3 ) vs (49.2 ± 10.3 ) ) and SAS( (43.8 ± 7.2) vs (50.6 ± 10.2), P＜ 0. 01 ) were lower, the score of the positive coping style ( ( 21.2 ± 6.4) vs ( 18.2 ± 5.4), P ＜ 0. 05 ) was higher in the study group.Meanwhile,the levels of MDA( (2.6 ±0.51 ) μmol/L) ,COR( (252.5 ±52.4) ng/ml) ,and ALD ( (97.5 ±24.4) pg/ml) were lower ( P ＜ 0. 01 ), the activity of SOD ( ( 1551 ± 354 ) U/gHb) was higher ( P ＜ 0. 01 ) after the combat readiness. In the control group post-readiness, the total scores of SDS (49.2 ± 10.3) and SAS (50.6± 10.2) ,the levels of MDA ( (2.9 ±0.35 ) μmol/L) ,COR( (333.8 ±62.6) ng/ml) ,and ALD( ( 123.8 ±29.6)pg/ml ) increased significantly (P＜0.01), the score of the positive coping style ( 18.2 ± 5.4) and the activity of SOD ( 1302 ± 352 ) U/gHb decreased significantly ( P ＜ 0. 01 ). The total scores of SDS, SAS were negatively related to the level of SOD ( r= -0. 142, -0. 119, P＜0. 0lor 0.05) ,and positively related to COR ( r=0. 156,0. 159, P＜0. 01 ) and ALD ( r=0.151,0.156, P＜0. 01 ). The score of positive coping style was positively related to the level of SOD ( r=0. 141, P＜0. 01 ) ,and negatively related to COR and ALD ( r= -0. 152, -0. 155, P＜ 0. 01 ). Conclusion Comprehensive psychological intervention could effectively improve the psychological and biochemical indexes,reduce the stress level of servicemen in three degree combat readiness.

Objective To explore the cultivated methods of dendritic cells (DC) and the killing effect of DC stimulated by CpG ODN1826 on gastritic cancer cells MKN45 in vitro. Methods DC was induced from peripheral blood monocytes stimulated by A group ( GM- CSF + IL-4 ), B group ( GM- CSF + IL-4 + TNF- α), C group(nonCpG ODN) and D group( CpG ODN 1826). The surface markers of DC was analyzed via flow cytometry, and the abilities to stimulate proliferation of allogenic lymphocyte by DC and antitumor experiment were detected by MTT assay. Results On day 10, a majority of cells showed typical morphology of DC in D group and B group with visible branching-like and pseudopod-like structures under microscope. The results of flow cytometry showed that there are significantly high expressed co-stimulated molecules such as CD40, CD1a,CD80, CD86 and MHC- Ⅱ in D group compared to other experimental groups ( P ＜ 0.05 ), which dramatically stimulate the proliferation of allogenic lymphocytes and enhance the killing activity of DC on gastric cancer cells. Conclusion This method can acquire relatively high purified DC, and CpG ODN can significantly induce the differentiation and maturation of DC isolated from peripheral blood and enhance the killing activity of DC on MKN45 by stimulating PBMC in vitro.

Objective To investigate the characteristics of PMP22 duplication mutation and the clinical variability of Charcot-Marie-Tooth disease type 1A (CMT1A) patients. Methods PMP22 duplication mutation analysis were performed in 45 cases diagnosed probably CMT by combination of improved allele-specific PCR-restriction enzyme digestion and short tandem repeat (STR) analysis based on laser-induced fluorescence detection in capillary electrophoresis. The clinical features of the positive cases were precisely analyzed. Results With the combined use of two methods, PMP22 duplication was detected in 21 cases, i.e. 10 CMT1 cases with typical presentations including weakness and atrophy in the distal limbs, and 11 atypical cases with special phenotypes including 1 case with mild dizziness, 1 case with hearing loss, 2 cases with recurrent limbs weakness, 2 cases with postural tremor in the upper limbs, 4 cases with cerebellar ataxia and 1 case with epilepsy. Conclusions The improved allele-specific PCR-restriction enzyme digestion provides the accurate, reliable and feasible method to detect PMP22 duplication, which is the most common cause of CMT. Comprehensive analysis of clinical, electrophysiological and pathological features of the CMT1A patients with positive PMP22 duplication indicate the high clinical variability of this disease.