ObjectiveTo explore the clinical characteristics of reversible posterior leukoencephalopathy syndrome ( RPLS ),in order to deepen the awareness of the disease.MethodsThe clinical data of 11 patients with RPLS in our hospital were retrospectively analyzed.ResultsIn the 11 cases with RPLS,there were two cases of pregnancy induced hypertension,preeclampsia(38 weeks pregnant),four eases of chronic renal insufficiency,four cases of malignant hypertension,and one case of lung cancer after chemotherapy.The main clinical presentations were headache,abnormality of visual perception,mental and behavioral abnormalities,ataxia,epileptic seizure and so on.The neuroimaging performances were extensive white matter abnormalities of the rear of the bilateral cerebral hemispheres,such as the parietal-occipital temporal lobe lesions,also involving the brain stem,cerebellum,thalamus and other parts.ConclusionThe clinical characteristics and neuroimaging performances of RPLS has certain characteristics,the majority of lesions were reversible,if the early diagnosis and treatment,the prognosis is usually good.

Objective To investigate the long-term protective effects of the waistband onto lumbar spins.Based on the practical situation,to search for some effective and convenient methods,such as wearing waistband and mutual massage,to prevent from lumbago for the army drivers worked in plateau.Methods 372 army drivers,young males,healthy and all worked in plateau,ware involved as the treatment group in the present study.Another 545 army drivers with the similar physical qualities,also worked in plateau,were selected as the control group.For the treatment group,a kind of special waistband was employed for the drivers,and mutual massage on hack of each other was performed among them;while in control group the army drivers were given no measures for lumbar protection and lumbago pre- vention.All the drivers in the both groups ware in normal driving conditions.The therapeutic effects of the waistband and the lumbago symptoms were investigated by epidemiologic survey 16 months later,Results The epidemiologic survey results showed that the incidence of lumbago in the drivers of control group(72.8%)was significantly higher than that in the treatment group(30.9%,P

[Objective]To retrospectively analyze the results of plasma-mediated coblation in treating cervical disc herniation.[Method]From January 2003 to April 2006,127 symptomatic cases(197 disc levels)with cervical contained disc herniation were treated with plasma-mediated coblation technology,including 81 males and 46 females,their average age was 49 years,the treated disc levels were 17 in C3、4,61 in C4、5,90 in C5、6 and 29 in C6、7 ,respectively.All patients were reported to have persistent cervical or unilateral arm pain for a minimum of three months and failed previous conservative treatment.MRI showed herniated cervical disc causing focal compression of the nerve root.An average percentage of symptom relief(VAS score)and subjective satisfaction were administered to measure symptoms at all visits.[Result]In the immediate post-operative period,124 patients reported significant amelioration of symptoms,3 patients complained of arm numbness did not change clinical status,one week after operation,percentage of symptom relief was 64%,perfect rate of subjective satisfaction was 91%.Patients were followed up for average 18 months(range 6～31 months)postoperatively.Percentage of symptom relief was 47%,perfect rate of subjective satisfaction was 62%.In the last follow-up,7 patients were observed a stabilization of clinical status over 2 years and in 15 patients the status was similar to preoperation.The other patients referred some residual symptoms and were still under follow-up.There were no complications observed such as hemorrhages,infections and nerve root injurys due to the procedure.[Conclusion]Our data indicate coblation procedure appearing to be less injury,safety,is a promising treatment option for patients with contained cervical disc herniation who have failed conservative therapies and are not considered candidates for open surgery,also supplementary therapy perioperatively in patients treated with cervical open surgery.

20% . In both groups CH was induced with infusion of 0.01% sodium nitroprusside (NTP) to maintain MAP at 55-65 mm Hg. MAP, HR, CVP cardiac output were continuously monitored. Arterial blood samples were taken before (T0 ) and after AHH (T1 ) , 30 min after CH was induced (T2 ) and 30 min after tennination of CH (T3 ) for blood gas analysis and determination of plasma levels of electrolytes and ?2-microglobulin.Results The two groups were comparable with respect to the demographic data including age, body weight and height. In group Ⅰ pH was significantly decreased after AHH and CH (T1-3) compared to the baseline (T0 ) and was significantly lower than that in group Ⅱ . There was no significant difference in plasma K+ , Na+ , Ca2+ , Cl- and BE between the two groups. Plasma?2- MG decreased significantly after AHH (at T1 ) compared to the baseline value before AHH (T0) in group Ⅰ and was significantly lower than that ingroup Ⅱ at T1-3 . Conclusion Glomerular filtration rate decreases during controlled hypotension as shown by increased plasma?2-MG. AHH combined with CH can improve glomerular filtration rate while exerts no significant effects on blood gases and electrolytes.

Objective To study the relationship between common photoallergens and melasma.Methods Twenty allergens were selected according to the National Diagnostic Criteria for Photosensitive Dermatitis induced by cosmetics,National Diagnostic Criteria for Contact Dermatitis induced by cosmetics and National Diagnostic Criteria for Occupational Skin Diseases.Based on the standard procedures for photopatch test recommended by the British Photodermatology Group (BPG),photopatch test was performed on 50 patients with melasma and 30 normal controls.Results The positivity rate of photopatch test was 48.0%(24/50)in patients suffering from melasma,significantly higher than in the controls[23.33%(7/30),P<0.05].Conclusion Patients with melasma appear more likely to have positive photopatch test than normal controls.

Objective To explore the clinical causes and preventive measures of complicating ascites of mini-percutaneous nephrolithotripsy (MPCNL).Methods Retrospective analysis of 285 patients with MPCNL for upper urinary tract calculus,which were divided into ascites group and no-ascites group.Results All the procedures were successful.Ascites group of 21 cases,no-ascites group of 264 cases.Univariate analysis showed that the diameter and number of calculus,perfusion pressure,perfusion time,pressure volume of irrigation fluid,preoperative upper urinary tract infection,history of treatment associated with complicating ascites (P＜ 0.05),with age,gender,body mass index no correlation (P＞ 0.05).Logistic regression analysis showed that perfusion pressure,perfusion time,pressure volume of irrigation fluid was independent risk factors after MPCNL concurrent ascites (P ＜ 0.05).Conclusions MPCNL concurrent ascites are closely related to the large perfusion volume,the long operative perfusion time,the high perfusion pressure of irrigation fluid.On the premise of keeping the operative visual field clear,as far as possible to reduce the perfusion pressure,control irrigation fluid-flow rate,reduce the large peffusion volume.These could decrease the coincidence of the ascites.

Neurodegenerative disease is characterized by progressive loss of neurons in specific brain regions that results in neuronal dysfunction of the central nervous system. Although the pathological mechanism is not fully established, the activation of glial cells mediated neuroinflammation appears to be involved. Heat shock protein 70 (HSP70) is originally described as intracellular chaperone, which plays an important role in protein quality control in cells. However, recent study showed that up-regulation of HSP70 had anti-inflammatory effects in the brain. HSP70 protected neurons from damage and improved neurological function by decreasing inflammatory response as indicated by inactivation of glial cells and inhibition of pro-inflammatory cytokine release. So it is of great significance to find new compounds targeting at HSP70 as neuroprotective agents to delay the progress of neurodegenerative disease. This review will focus on the role of HSP70 in neuroinflammation and the recent advances in using HSP70 as a target for the treatment of neurodegenerative disease.

Objective:To investigate whether elderly patients over 70 years of age with gastric stump carcinoma should be treated with operation and which surgical approaches should be selected.Methods:A retrospective analysis was performed on 36 patients with gastric stump carcinoma without any significant surgical contraindications hospitalized in lanzhou general hospital of lanzhou military area from January 2001 to January 2013.All these patients were over 70 years of age,with an active score of 0-3.The patients were divided into surgical and non-surgical treatment groups,and the surgical treatment group was further subdivided into radical surgery group and palliative surgery group.The treatment modalities,complications and survival of each group were analyzed.Results:A one-year and a three-year survival rate of surgical treatment group was 45.5％ and 22.7％,respectively,whereas the one-year and three-year survival rate of non-surgical treatment group was only 18.2％ and 0％,the difference was statistically significant (P ＜ 0.05).In the surgical treatment group,the radical surgery subgroup had a better survival rate than palliative surgery subgroup,with a one-year and a three-year survival rate of 58.3％ and 33.3％ respectively for the former,and 30％ and 10％ for the latter.The incidence of complications of radical surgery group and palliative surgery group was of no significant difference (P ＞ 0.05).Conclusions:Elderly patients over 70 years of age with gastric stump carcinoma can still benefit from radical surgery;while palliative surgery does not improve the survival rate of the patients,radical surgery is appropriate for elderly patients with gastric stump carcinoma.

Objective To investigate the effectiveness and safety of ultrasound-guided percutaneous microwave ablation in the treatment of benign thyroid nodules.Methods A total 456 patients (912 nodules) underwent microwave ablation in our department.Microwave ablation was carried out using microwave antenna under local anesthesia.Nodule volume,thyroid function and clinical symptoms were evaluated before treatment and at 1 ,3,6 and 12 months after the treatment to monitor changes in the volume,adverse effect and complications.Results 912 nodules were all studied with contrast-enhanced ultrasound immediately after the ablation,and all results showed “black hole”sign.The mean follow-up period after microwave ablation was (9±6)months (range,3-24 months).At 6-month follow-up,the mean volume reduction ratio of the solid nodules,mixed nodules and the cystic nodules was (61 ± 50 )%,(81 ± 33 )%,(89 ± 46 )%, respectively.The treatment was well tolerated and no major complications were observed except pain and transient voice changes (2.4%).Conclusions Microwave ablation is a safe and effective technique for the treatment of benign thyroid nodules.

Objective To evaluate the feasibility and efficacy of ultrasound-guided percutaneous microwave ablation combined with hormone suppression therapy for solitary papillary thyroid microcarcinoma.Methods A total of 25 patients with 25 nodules pathologically proven solitary papillary carcinoma 3.7 to 10.0 mm in diameter without clinically apparent lymph node,or distant metastasis were treated with microwave ablation equipement.Microwaves were emitted at 40 W for 200 -400 seconds and prolonged as necessary to attain confluent ablation zones.All patients were treated with both extended ablation therapy and levothyroxine that maintain TSH levels below 0.1 mU/L.Thyroid function test,nodule volume and clinical symptom were evaluated before ablation and during 1 ,3,6,9 and 12 months after treatment according to changes in tumor size,adverse reactions,complications and metastatic tumors.Three out of 25 patients received surgical treatment and the other 22 patients were followed up with routine ultrasound and contrast enhanced ultrasound.Results All 25 tumors were completely ablated by using mutiple plane fixed melting method and no serious or permanent complications occurred.No recurrence at the treatment site or distant metastase were detected,with a mean follow-up of 1 8 months.Histological examination showed no evidence of a tumor in the treated lesions in the 3 surgery patients.Conclusions Ultrasound-guided percutaneous microwave ablation appears to be a safe and effective technique for the therapy of solitary papillary thyroid microcarcinoma.