Objective To observe clinical efficacy of external bath of modified Huangqi Guizhi Wuwu Decoction in relieving peripheral neurotoxicity induced by oxaliplatin.Methods Sixty patients were randomly divided into control group and treatment group (30 cases in each group). Both groups received intramuscular injection of mecobalamine (0.5 mg/d, three times a week). At the same time, the treatment group received external bath of modifiedHuangqi Guizhi Wuwu Decoction. All the courses of treatment lasted for 14 days. Clinical efficacy and adverse reactions of the two groups were observed.Results The total effective rate of treatment group was 73.3% (22/30), which was superior to that of 40.0% (12/30) in the control group, with statistical significance (P<0.05), without any adverse reaction.Conclusion External bath of modifiedHuangqi Guizhi Wuwu Decoction is effective as supportive care for alleviating chronic peripheral neurotoxicity induced by oxaliplatin.

Objective To discuss the relationship between the substype of peripheral blood CD8 lymphocyte in patients with chronic hepatitis virus B and clinic condition and the replication of HBV. Methods CD45RO, CD45RA and CD28 of peripheral blood CD8 lymphocyte were detected by flow cytometry with multicolor fluorescence technology in 107 patients with chronic hepatitis virus B and 20 healthy volunteers. Results The total quantity of CD8 lymphocyte in patientswith chronic hepatitis virus B was not different from that in controls. The percent of CD3+ CD8+/CD45R0+ cells in patients with chronic active hepatitis was significantly higher than that of the control (15.7?3. 35)% vs( 8. 56?1. 12)% , P

Objective To investigate CT and MRI features of extragonadal primary seminoma and improve its diagnostic accuracy.Methods The clinical and imaging features of 8 patients with extragonadal primary seminoma proved by histopathology were analyzed retrospectively.Results In 8 cases,4 cases were located in intracranial regions,4 cases in the abdominal and pelvic cavity.Detailedly,roundlike solid and cystic tumors were seen in the basal ganglia and thalamus in 2 cases.The mass density and signal were inhomogeneous in the necrotic area with slight peritumoral edema and heterogeneous enhancement,and hemorrhage and metastasis of the third ventricle were occurred inone case.Shallow lobulated tumor was occurred in the pineal region forone case,which MRI features included slightly low signal on T1 WI,equal or higher signal on T2 WI,with obvious enhancement and peripheral cystic change.There was one case in the sella area with slight high density on CT routine scan,and on MRI,slight equal signal on T1 WI,equal or higher signal on T2 WI.The pituitary stalk was involved with thickening.Tumor in suprasellar region was obviously enhanced,with a small uniformity enhancement nodule in the mouth of corpus callosum.4 cases were occurred in the abdominal and pelvic cavity,shallow lobulated tumors with varying degrees of necrosis were found on CT with infiltrating growth and slight to moderate enhancement,and swollen lymph nodes were found in retroperitoneal and mesenteric root areas.Conclusion Extragonadal primary seminoma is rare,there are some characteristic imaging findings,which contributes to improve diagnosis accuracy when combining with clinical data.

Objective To compare and observe the clinical effects of microscopic evacuation of intraeranial hematoma and small bone flap approach mierosurgical operation in treatment of hypertensive cerebral hemorrhage.Methods From June 2008 to June 2010,116 cases of patients with hypertensive cerebral hemorrhage were classified into two groups with 58 cases in each by random digits table.Group A was treated with microscopic evacuation of intracranial hematoma and group B was treated with small bone flap approach microsurgical operation.The clinical efficacy and neurological impairment Scores were observed and compared between the two groups.Results The total effective rate in group A[87.9%(51/58)]was significantly higher than that in group B[72.4%(42,58)](P<0.05).After treatment 14 d and 28 d,the neurological impairment scores in group A were (22.1±6.2).(12.6±3.3)scores and in group B were (23.5±6.7),(18.6±5.1)scores.Compared with pre-treatment[group A:(41.9±8.1)scores;group B (41.7±7.9)scores],after treatment l4 d and 28 d,the neurological impairment scores in two groups were significantly decreased(P<0.05).Moreover,After treatment28 d,the neurological impairment scores in group A were significantly lower than those in group B(P<0.05).Conclusion Both microscopic evacuation of intracranial hematoma and small bone flap approach microsurgical operation are effective methods in hypertensive cerebral hemorrhage,but microscopic evacuation of intracranial hematoma can enhance the effect and improve the neurological function.

Pancreatic neuroendocrine tumor is a common pancreatic tumor with high heterogeneity and multiple management modalities. A standard and practical staging system for pancreatic neuroendocrine tumors will be beneficial to clinical management and research. At present, there are two staging systems (ENETS and AJCC). Both of them have shortcomings which limit their clinical application. In addition, the coexistence of two staging systems is confusing to clinicians. We proposed a modified ENETS staging system by keeping the ENETS TNM definition and adopting the AJCC staging definition. The modified staging system can successfully distinguish patients with different prognosis and is helpful in establishing clinical standard. This study has been published in Journal of Clinical Oncology (JCO) and was selected as 2017 Best of JCO: Gastrointestinal edition. This paper was aimed to interpret the modified staging system in clinical practice.

Objective To investigate the alterations of regional spontaneous activity in patients with classical trigeminal neuralgia (CTN) during resting state.Methods Twenty-seven patients with CTN (CTN group) and 27 healthy subjects (control group) were recruited and underwent a rest-state functional MRI.The regional homogeneity (ReHo) analysis was used to compare the differences of regional synchronization of spontaneous brain activity.And correlation tests were performed between ReHo values in the abnormal brain areas and clinical metrics (visual analogue scale and disease duration) of the disease.Results Compared with control group (P＜0.05,Gaussian random field correction),ReHo increased in bilateral primary somatosensory cortex (S1) and primary motor cortex (M1),right supplementary motor area (SMA),inferotemporal cortex and cerebellum,left thalamus,limbic lobe,parahippocampa gyrus,middle and superior temporal gyrus in CTN group;ReHo decreased in bilateral insula,prefrontal cortex and orbitofrontal cortex,right frontal medial cortex and superior temporal gyrus,left anterior cingulate area,supramarginal gyrus and cerebellum in CTN group.ReHo values in right frontal medial cortex was negatively correlated with the course of disease (r=-0.45,P=0.03).The ReHo values of left primary sensorimotor cortex were positively correlated with the visual analogue scale scores (r=0.46,P=0.02).Conclusion CTN patients has abnormal functional homogeneity of spontaneous brain activity in regions involved in the pain processing,which can help understanding mechanism of CTN.

Objective To assess the altered regional homogeneity (ReHo) of local intrinsic cerebral activity within sensorimotor network(SMN) in patients with cervical spondylotic myelopathy (CSM) before or after spinal cord decompression using functional MRI (fMRI). Methods Twenty-one CSM patients who would decompress spinal canal, and 21 healthy volunteers (age, gender and level of education matched) were enrolled from June 2013 to April 2014. All the patients underwent rs-fMRI examination before and 3 months after spinal cord decompression. ReHo measurement was performed statistically within a SMN mask. A second-level random-effect 2-tailed Student's t test was applied to compare the ReHo results between pre-and post-operation CSM patients and healthy volunteers. A second-level paired 2-tailed Student's t test was applied to compare the ReHo results between pre-and post-operation CSM patients. Pearson correlation analysis was performed to assess the correlations between the altered ReHo and clinical evaluation. Results Compared with healthy volunteers, pre-operation patients showed significantly lower ReHo in the left postcentral gyrus/precentral gyrus, together with enhanced ReHo in the right superior parietal lobule (GRF correction, P<0.05). Post-operation CSM patients showed significantly lower ReHo in the right superior parietal lobule comparing with healthy volunteers, as well as enhanced ReHo in the left postcentral gyrus/precentral gyrus comparing with pre-operation (GRF correction, P<0.05). Abnormal ReHo areas in CSM patients demonstrated no significant correlation with clinical measurements (P>0.05) between pre-operation and post-operation. Conclusions Myelopathy in cervical cord may affect intrinsic cerebral activity, as patients with CSM show disrupted regional homogeneity within sensorimotor network. The change of ReHo following decompression suggests that central plasticity may influence functional recovery.

Objective To quantitative analyze the injury degree of cervical cord in cervical spondylotic myelopathy (CSM) patients using fractional anisotropy (FA) entropy of diffusion tensor imaging (DTI).Methods Twenty-four CSM patients and well-match healthy volunteers underwent cervical cord DTI scanning.FA value was measured at each segment of spinal cord (including grey matter and white matter) of spinal cord level and intervertebral disc level.Further Shannon entropy of FA value was calculated in each segment to observe the disorder degree of cervical cord structure in CSM patients.After the analysis of homogeneity of variance,two samples t test analysis was used to identify FC's differences of FA and Shannon entropy of FA value between the two groups.Result In CSM group,the average FA value of whole cervical cord was 0.644 ± 0.056,while it was 0.672 ± 0.035 in the healthy control group.There was significant difference of FA values between the two groups (t=-2.049,P=0.046).The FA entropy of CSM patients' cervical cord was 0.687±0.043,while it was 0.854±0.027 in the healthy control group.The FA entropy of CSM patients' cervical cord was lower than that of control group.There was significant difference of FA entropy between the two groups (t=-12.100,P＜0.001).The significant difference between the two groups was only found at C6 level for each level's FA value.The FA entropy of CSM patients' cervical cord was significantly lower than that of control group for every level.Conclusion This decreased FA entropy of cervical cord in CSM patients indicates that FA entropy can be used to detect the disorder of cervical cord structure in CSM patients.

Objective To analyze the genetic characterization of VP1 region of Coxsackie virus A10(CVA10)isolated from clinical specimens of hand, foot and mouth disease(HFMD) patients in Shandong Province. Methods Clinical specimens were collected from some of HFMD patients from 2008 to 2009. The virus was isolated by cell culture. Total RNA was extracted, and the VP1 genes of the isolates were amplified by reverse transcription-polymerase chain reaction (RT-PCR) and sequenced. The genotypes were identified by molecular typing method and bioinformatics analysis.Homologous comparison and phylogenetic analysis of representative CVA10 strains were performed.Homologous comparison between the Shandong isolates and strains obtained from GenBank were performed and phylogenetic analysis of some representative CVA10 strains were performed. Results Three hundred and thirty viruses strains were isolated from 760 clinical specimens collected from HFMD patients, and 17 of them were identified as CVA10. The homologies of nucleotide and amino acid of the 17 CVA10 strains were 82.3%-100.0% and 94.2%-100.0%, respectively. Compared with the prototype strain of CVA10 (Kowalik/USA/2003), the homologies of nucleotide and amino acid were 75.6%-76.8% and 90.2%-93.2%, respectively. Interestingly, Shandong CVA10 strains were clustered into two distinct subgroups in the phylogenetic tree. Conclusions CVA10 is one of the causative agents of HFMD. Two independently circulating subgroups of CVA10 exist in Shandong province.

Objective To investigate the effects of octanol,a gap junction blocker,on the levels of pro-inflammatory cytokines after cerebral ischemia-reperfusion in rats.Methods Seventy-two male SD rats were randomly divided into sham operation group,saline control group,vehicle group,and octanol intervention group (n =18 in each group).The model of transient middle cerebral artery occlusion was induced by the modified suture method.The octanol intervention group was intraperitoneally injected with octanol solution at 5 mmol/kg body weight 30 min before ischemia.The saline control group and the vehicle group were intraperitoneally injected with the same amount of physiological saline and 5％ dimethyl sulfoxide solution 30 min before procedure.The neurological deficit score,brain water content,and cerebral infarction volume in each group were detected after ischemia for 2 h and reperfusion for 24 h.Enzyme-linked immunosorbent assay was used to detect the serum interleukin (IL)-1β,IL-6,and tumor necrosis factor-α (TNF-α) levels.Results Compared with the saline control group and the vehicle group,the neurological deficit score of the octanol intervention group was significantly lower (all P ＜0.05),the brain tissue water content was significantly decreased (P ＜ 0.05),the cerebral infarction volume was significantly reduced (P ＜0.05),and the expression levels of IL-1β,IL-6,and TNF-α were significantly decreased (all P ＜0.05).There were no significant differences in neurological deficit score,brain water content,cerebral infarction volume and serum IL-1 [β,IL-6 and TNF-α levels between the saline control group and the vehicle group.Conclusion Gap junction blocker octanol can reduce cerebral ischemic-reperfusion injury.Its mechanism may be related to the alleviation of inflammatory response.