The rate of stroke has been rising year by year and become the world's major cause of mortality and disability. The high rate of disability did not only bring economical burden to society and family, but also induce psychological damage to patients. Post-stroke depression (PSD) is a most common mental complications of stroke. In recent years, More and more attentions have been paid to PSD. This article reviewed the cause and mechanism of PSD and the treatment with Chaihu Shugan Powder on it.

OBJECTIVETo investigate the salvage therapy for a child with refractory and ( or) repeatedly-relapsed Langerhans cell histiocytosis.

METHODData of a patient with Langerhans cell histiocytosis whose disease relapsed repeatedly treated with cladribine was collected and analyzed and the related literature was reviewed.

RESULTThe initial symptoms developed 3 months after his birth, multiple systems (skin, skeleton, lung, liver) were involved; he was sequentially treated with LCH-III-Group I, JLSG-96, DAL-HX90 chemotherapeutic regimens. The patient got relapses for more than 3 times, but the disease got completely controlled after being treated with cladribine when the patient was 6 years old. The dosage was 10 mg/(m2 · d) for 4 days, and one course lasted for 28 days, the third to fifth courses of treatment used Arac in combination, the whole treating time lasted for 5 months. The patient remained in persistent remission for 8 months since discontinuation of treatment. "Langerhans cell histiocytosis" "refractory" "cladribine" were used as the key words to search in the data bases CNKI, Wanfangdata and Pubmed, 11 articles were picked. According to the literature, the effective rate of cladribine in treatment of repeatedly relapsing Langerhans cell histiocytosis was 44%-100%, with a good response of 22%-86%, the dose was 5-13 mg/(m2 · d). The main side effects were hematological system damages and infection.

CONCLUSIONThe effect of commonly used chemotherapeutic regimens is limited for children with refractory and (or) repeatedly-relapsed Langerhans cell histiocytosis and cladribine can be used as an alternative therapeutic option of the salvage therapy.

Child ; Cladribine ; therapeutic use ; Histiocytosis, Langerhans-Cell ; drug therapy ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Recurrence ; Skin

Objective To detect the expression of osteopontin (OPN) in cervical local tissues of patients with chronic cervicitis, cervical intraepithelial neoplasia (CIN), cervical cancer. To investigate the possibility that OPN is used as tumor marker of cervical cancer. Methods The expression of OPN in 25 cases of chronic cervicitis, 18 cases of CIN and 21 cases of cervical cancer was detected by immuohistochemistry SP method. Results The positive expression rates of OPN in the chronic cervicitis, CIN and the cervical cancer had a rising trend (48 %, 77.78 % and 80.95 %, respectively) and their differences had statistical significant (P <0.05). The OPN expression level in cervical cancer had no statistical correlation with age, tumor size, clinical stage and other clinical pathological features (P >0.05). Although OPN expression level in cervical cancer wasn' t related with tumor clinical stage, positive expression rates of OPN had a gradually increased trend along with the clinical stage. Conclusion High expression of OPN is found in cervical cancer and may be related to the occurrence and development of cervical cancer.

Objective To study the changes of neuron-specific-enolase (NSE), S100B protein and neuropeptide Y (NPY) levels in serum and cerebrospinal fluid of children with viral encephalitis and their clinical significance. Methods The NSE, S100B protein and NPY levels in the serum and cerebrospinal fluid of 50 children with viral encephalitiswere were measured, and another 20 children without central nervous system infection were selected as controls. Results The NSE, S100B protein and NPY levels in the serum and cerebrospinal fluid of children with viral encephalitis[serum: (18.90 ± 5. 50)μg/L, (0. 57 ±0. 26) μg/L, (267. 3 ± 54. 7 ) μg/L; GSF: ( 10. 45 ± 4. 40) μg/L, (0. 93 ± 0. 53 ) μg/L, (347.2 ± 60. 6) μg/L] were higher than those in control group [serum: ( 10. 35 ± 2. 49 ) μg/L, ( 10 ± 0. 06 ) μg/L, ( 67. 8 ±22.5)μg/L;GSF:(3.96 ± 1.57)μg/L,(0. 29 ±0. 18)μg/L,(102.6 ±38.9) μg/L] ( P <0.01). The levels of serum and CSF NSE S100B protein and NPY in critical patient[serum: (21.93 ±5.39)μg/L,(0.71 ±0. 31)μg/L, (32. 5 ± 62. 8) μg/L;GSF: (13.05 ±4.41)μg/L, (1.23 ± 0. 66) μg/L, (407.3 ±68. 1 ) μg/L] were higher than ordinary patients [serum: ( 15.93 ± 4. 02 ) μg/L, ( 0. 42 ± 0. 14 ) μg/L,(234.7 ±51.2)μ.g/L;GSF:(8.05 ± 1.77) μg/L,(0. 63 ±0.26)μg/L, (320.2 ±59.5) μg/L] ( P <0. 01 ). Conclusion NSE, S100B protein and NPY can be used to evaluate encephalitis condition, brain damage degree and prognosis of viral encephalitis.

OBJECTIVE:To study the influence of calcineurin gene polymorphism on the efficacy of cyclosporine A (CsA). METHODS:The blood samples of patients treated with CsA were collected. The trough blood concentration of CsA was detected by EMIT. The genotype of PPP3CA and PPP3CB was assayed by RFLP-PCR method. The expression of NFAT-regulated gene IL-2, IFN-γand GM-CSF were measured by RT-qPCR,which were used to define the index of indirect efficacy of CsA. The relationship of gene polymorphism with CsA efficacy was study by relationship analysis and multiple factor regression method,etc. RESULTS:A to-tal of 100 blood samples were collected. There was no significant correlation between the expression of CsA efficacy-related NFAT-reg-ulated gene GM-CSF and trough concentration of CsA(rGM-CSF=-0.04,P=0.238);the expression of IL-2 and IFN-γ were negatively correlated with trough concentration of CsA significantly(rIL-2=-0.384 3,P<0.001;rIFN-γ=-0.335 4,P<0.001). Using the average value of mRNA expression of IL-2 and IFN-γas indirect efficacy index,the polymorphism of PPP3CB rs3763679 site significantly in-fluenced the efficacy of CsA(P<0.05),but PPP3CA rs3804358 had no any effect on it(P>0.05). Stratified analysis showed that among patients with immune disease underwent renal transplantation,efficacy of patients with PPP3CB rs3763679 genovariation(TC+TT) were better than those with wild-type gene (CC)(P<0.05). After the efficacy was normalized by CsA trough concentration, multivariate analysis showed that normalized efficacy of CsA was negatively correlated with gender,PPP3CB rs3763679,lactate dehy-drogenase and creatinine significantly,but positively correlated with PPP3CA rs3804358,leucocyte count,usea nitrogen,glycerin trilaurate,etc. CONCLUSIONS:PPP3CB rs3763679 gene polymorphism influence the efficacy of CsA;among patients with immune disease underwent renal transplantation,efficacy of patients with PPP3CB rs3763679 TT+TC is better than that of CC type. At the same time,gender,PPP3CA rs3804358,leucocyte count,usea nitrogen,glycerin trilaurate and other factors all can influence the nor-malized efficacy of CsA to different extent. Multiple factors should be considered when using CsA.

Objective:To introduce recent progress on diagnosis and treatment of benign symmetric lipomatosis(BSL).Method:Detailed clinical data of 6 patients with BSL were reviewed and analyzed.We present a summary of the clinical symptoms,physical sign,diagnosis and therapeutic methods of BSL. And related literatures were discussed together.Result:All of 6 patients have excessive subcutaneous fat deposit predominantly around neck.One patients had upper extremity localizations. Six patients had the complication of left ventricular diastolic function changes,glucose intolerance or diabetes mellitus, chronic hepatopathy, hyperuricemia and sleep apnea syndrome in one or more. One patients with several symptoms occur simultaneously, another one female patient was accompanied by all symptoms but chronic hepatopathy. Five male patient were alcohol abusers. Tatal neck lipentomy and abstinence from alcohol were performed on 5 patients. One patient refused treatment.During a follow-up of 3 months to 4 years, one patients was relapsed again,and no recurrence was seen in another 4 patients. All pathological results were nonencapsulated fat. Conclusion:BSL is a lipodystrophy caused by diffuse fatty tissue, symmetry deposition in the neck and shoulder subcutaneous fascia space or deep fascial space .The highest incidence favors to middle-aged man who is alcoholist. Chronic alcohol addiction and typical clinical symptoms help to diagnosis BSL. Lipectomy represents a successful procedure in treating BSL.

Objective:To investigate the preventive effects of Pueraria on presbycusis in rats. Method:Thirty-two 24-26 month old Wistar rats were randomly divided into four groups, and were treated with different dosages of Pueraria (1,2,4,0 g·kg~(-1)·d~(-1)) seperately for 4 weeks. Auditory brainstem response (ABR) was used to de-tect the change of hearing threshold of rats. Hemorheological items of rats were checked in each group. Result: Compared with control group,the hearing threshold and hemorheological items of rats was significantly improved after treated with Pueraria(P<0. 05). In addition, 2 g/(kg·d) was found to be the best dosage of Pueraria for rats, which can achieve ideal effect with minimum side effect. Conclusion:Pueraria could improve tiny circulation, has good preventive effect on presbycusis of rats.

AIM: To investigate the ameliorative effect of water extract of propolis (WEP) preconditioning on mesenteric microcirculation of rats subjected to small intestinal ischemia reperfusion (I/R). METHODS: Thirty-two male Wistar rats were randomly divided into sham, I/R and WEP (100, 200 mg/kg) preconditioning groups. Model of small intestinal I/R injury was made by clamping super mesenteric artery for 45 min followed by 120 min of reperfusion in rats. Mesenteric microcirculation was detected at the end of reperfusion. The degree of small intestinal injury was The content of soluble intercellular adhesion molecule-1 (sICAM-1) in plasma and myeloperoxidase (MPO) activity in intestinal tissue were detected using enzyme linked-immuno-sorbent assay (ELISA) and spectrophotometer, respectively. RESULTS: (1) WEP preconditioning alleviated significantly the pathologic lesion in small intestine, and wet/dry ratio, compared to those in I/R group (P<0.01). (2) The disturbance of the blood flow in microvessel induced by I/R was improved significantly by WEP. In addition, WEP preconditioning alleviated significantly the decrease in diameters of microvessels and microcirculatory blood velocity (P<0.05 vs I/R group) and inhibited the adherence of leukocytes to venule (P<0.01 vs I/R group) in a dose-dependent manner. SICAM-1 content in plasma and MPO activity in intestinal tissue were decreased in WEP preconditioning group, compared to those in I/R group (P<0.05 or P<0.01). CONCLUSION: WEP preconditioning ameliorates mesenteric microcirculation of rats subjected to small intestinal I/R through suppressing the activation of polymorphonuclear neutrophils mediated by ICAM-1.

Objective To explore the correlation between HLA-A, B alleles polymorphism and hemorrhagic fever with renal syndrome (HFRS) among Han nationality in Zunyi area. Methods Using group study, HLA-A, B genotypes were conducted in 100 HFRS cases and 100 controls among Han nationality in Zunyi area with polymerase chain reaction-sequence specific primer (PCR-SSP), gene frequency (GF) and relative risk (RR) were compared and calculated. Results The frequencies of HLA-A * 31 and HLA-B * 58 alleles in HFRS cases (GF=4%,12.5%) were strikingly higher than that in the healthy controls (X2=6.380, 7.792, P<0.05;RR=18.47,2.91). The frequencies of HLA-B * 40 alleles in HFRS cases (GF=11%) were strikingly higher than that in the healthy controls (X2=6.095,P<0.01, RR=O.47). Conclusion HLA-A * 31, B * 58 genes are positively related to HFRS of Han nationality in Zunyi area, HLA-B * 40 gene is negatively related to HFRS of Han nationality in Zunyi area.

Objective Explore the clinical application values of Golgi Protein 73 ( GP73 ) , AFP variants (AFP-L3) , Alpha fetoprotein ( AFP) and α-l-Fucosidase ( AFU) detection in the diagnosis of hepatocellular carcinoma ( HCC) .Methods From January of 2013 to June of 2014, 84 case of HCC Patients( HCC group ) who presented at interventional department; 64 case of cirrhotic patients ( liver cirrhosis group ) , 86 case of chronic hepatitis patients ( chronic hepatitis group ) and 120 healthy people ( normal control group) were selected from Shanghai Tongren Hospital.GP73 was detected by the enzyme-linked immunosorbent assay (ELISA), AFP-L3 was isolated with ACSC, AFP and AFP-L3 were detected with ECLIA and calculated the percentage content of AFP-L3 ( AFP-L3%) , AFU was detected with enzyme kinetic method.Adopted the SPSS 19.0 statistical software for data analysis.The rank sum test was used in the multi group comparison;the chi square test was used in the comparison group.Results Serum levels of GP73, AFP-L3, AFP and AFU in HCC group were 202.1 μg/L, 9.5%, 68.3 μg/L, 33.2 μg/L respectively.Their difference from those of the normal control group(69.0 μg/L,2.5%,4.5 μg/L,24.2μg/L) was of statistical significance (U was 1126.59, 204.67,1247.68,564.08,respectively,all P <0.05).GP73 and AFP in the hepatic carcinoma group was significantly higher than that in the cirrhosis group(151.1 μg/L、18.5 μg/L) (U was 463.47, 368.56,respectively, P<0.05).GP73, AFP-L3 and AFP in the hepatic carcinoma group was significantly higher than that in the chronic hepatitis group(93.6μg/L,3.5%,5.7μg/L) (U was 1 116.52,213.42,1 166.52, respectively, all P<0.05).The content of AFU in HCC group (33.2 μg/L), normal control group and chronic hepatitis group were compared (24.2μg/L,24.1 μg/L), respectively ,no significance was found(U was 564.08,487.24,P>0.05) Sensitivity of GP73 and AFP in individual inspection was 95.24%, significantly higher than that of AFU, AFP-L3. Specificity of AFP-L3 was 94.81%respectively, with an accuracy of 85.88% respectively.Specificity and accuracy of the allied detection of GP73, AFP-L3, AFP and AFU for HCC diagnosis were 98.52% and 84.75% respectively.Conclusions The allied combination of serum GP73, AFP-L3, AFP and AFU makes up for the insufficient clinical applications of individual serum markers. It is of great clinical significance to improve the diagnosis of HCC.