with pyramidat tract and/or peripheral nerve symptoms.

Objective To explore the early diagnosis of germinoma originating from the basal ganglia (BG) and thalamus during juveniles. Methods Retrospective analysis was done with the clinical cases of germinomas in BG and thalamus from 2000 to 2009. The symptoms, signs, neuroimaging,cerebrospinal fluid (CSF) findings were analyzed and related literature were reviewed. Results Eight patents were collected. The main symptoms were hemiplegia, associated with aphasia and/or impaired cognition. Brain CT showed high density and calcification. Abnormal T1 and T2 signal were found in brain MRI frequently associated with ipsilateral hemisphere atrophy. MRS showed increased choline and decreased N-acetylaspartate level. Elevated CSF human chorionic gonadotrophin level were found in two of them.Conclusions Germinoma in BG and thalamus predominates in a boy. The neuroimaging features are very informative for early diagnosis.

In recent years,the basal and clinical research in gonadal dysgenesis has achieved great progress.Considerable literatures concerning the diagnosis and therapy of these diseases have been published.In this review,we analyzed and summarized some more instructive literatures for clinical practice,discussed the problems and defects in gonadal dysgenesis research in China,and proposed some suggestions.

Objective To improve the recognition of early diagnosis and pathogenesis of non-traumatic rhabdomyolysis and prevent the occurrence of rhabdomyolysis.Methods Seven cases of non-traumatic rhabdomyolysis were collected,whose clinical data and related review were analyzed.Results The clinical features included weakness of limbs,myalgias,myoglobinuria,and an elevated serum creatine kinase.pathogenesis of non-traumatic rhabdomyolysis include drug in three cases,diabetic ketoacidosis in one case and metabolic myopathy in one case.Conclusion Multiple diseases can cause non-traumatic rhabdomyolysis.The early diagnosis and investigation of causes of non-traumatic rhabdomyolysis are important.

Objective To investigate the difference of serum C-reactive protein (CRP) concentrations in subjects with various glucose tolerances and the change of serum CRP concentrations in cases of impaired glucose tolerance (IGT) treated with acarbose. Methods A total of 154 subjects participated in the study and according to oral 75 g glucose tolerance test (OGTT), among them there were 44 subjects with normal glucose tolerance (NGT), 89 cases with IGT and 21 cases with type 2 diabetes (DM). Sixty IGT subjects were recruited into randomized, double-blind, placebo-controlled study. The IGT subjects received either 150 mg acarbose daily or placebo for 16 weeks. The serum CRP concentration was detected with immunoscattering assay. Results (1) The serumCRPconcentration〔median(25%, 75%)〕 was 4.60(4.10-5.25)mg/L in NGT subjects, 5.25(4.50-6.00)mg/L in IGT subjects, 5.70(5.20-7.50)mg/L in type 2 DM patients (F=157.00, P0.05). Conclusion (1) The serum CRP concentration is gradually increased with the worsening of glucose tolerence; (2) The serum CRP concentration is positively correlated with OGTT 2 h blood glucose, HbA 1C , TC, TG; (3) The serum CRP concentration is decreased in IGT subjects treated with acarbose following the improvement of hyperglycemia.

Objective To explore causes and solutions of false estimates of elevated serum creatinine in patients with Walden‐strom′s macroglobulinemia throug wet chemical enzymatic method .Methods 5 cases of patients hospitalized in the Bethune Inter‐national Peace Hospital were enrolled as subjects from 2010 to 2012 .The large molecular proteins were removal from serum sam‐ples collected from patients with Waldenstrom′s macroglobulinemia by using centrifugal ultrafiltration tube .The serum creatinine levels were detected through using the wet chemical enzymatic method ,wet chemical picric acid method and dry chemical enzymatic method before and after ultrafiltration ,and data were compared .Results Before ultrafiltration ,the levels of serum creatinine of 2 cases of patients with Waldenstrom′s macroglobulinemia detected by using wet chemical enzymatic method differed with those de‐tected by using wet chemical picric acid method and dry chemical enzymatic method .While there were no obvious differences be‐tween levels of serum creatinine detected by wet chemical picric acid method and dry chemical enzymatic method .While ,after ultra‐filtration ,no obvious differences were founded in levels of serum creatinine detected by the thress methods .Conclusion The large molecular proteins should be eliminated when using the wet chemical enzymatic method in the detection of serum creatinine levels , in order to avoid abnormal increase .And the wet chemical picric acid method and dry chemical enzymatic method could also be uti‐lized to determine the accuracy ,and provide reliable determination results .

Objective To explore the clinical and radiological features of bilateral thalamus venous infarction.Methods The cases definitely diagnosed as thalamus venous infarction were collected and the corresponding clinical and radiological data were retrospectively analyzed.Results Four cases confirmed as thalamus venous infarction by digital substraction angiography (DSA) were collected.Bilateral thalamus lesions were detected in all cases by brain MRI scans which mainly presented as thalamus edema with high T1 and T2 signals with partial enhancement.Mild hemorrage was also shown in one case.Acute or subacute onset with clinical manifestations of headache,hypomnesia and hypersomnia were reported in all cases.The neurological examination showed conscious disturbance,memory impairment and positive Babinski sign.The venous thrombi were formed mainly in the transverse and the straight sinuses in 3 cases with the deep cerebral venous involved in 2 cases.All patients were improved after the anticoagulation therapy.Dural arteriovenous fistula was found in the other case drained by the Rosenthal's vein,and the symptoms were ameliorated after the embolotherapy.Conclusions As the thalamus is drained by the thalamostriate vein and the lateral thalamic vein towards the internal cerebral vein with the caudate portion drained particularly by the Rosenthal's vein,venous thrombosis or fistula drainage into these veins would probably disturb the normal drainage of the thalamus and result in further edema and infarction.Thus,the venous infarction should be taken into consideration whenever bilateral thalamus lesions are encountered in clinical practice and DSA is necessary to confirm the diagnosis.

BACKGROUND:. Until now modern science cannot explain clearly aboutthe mechanism of acute alcoholic liver injury. Besides such methods as givingup drinking, or symptomatic treatment, there is no specific therapy and remedy. Traditional Chinese Medicine (TCM) has obvious advantages for this: Itcannot only improve the clinical symptoms, but also adjust organism immunefunction, and has very good development future. OBJECTIVE: To study the effects of radix bupleuri and radix scutellariae incompatibility with the ratio of different dosage (2:1, 1:1, 1:2) on acute alcoholicliver injury by regulating the system of endocrine-immunity network in rats. DESIGN: Groups are divided randomly and experiments are made underblank conditions. SETTING: TCM Clinical Laboratory of Pharmaceutical School, Henan University of TCM. MATERIALS: From September to November 2002 in TCM Clinical Laboratory of Pharmaceutical School, Henan University of TCM, the general condi tion of the animals were as follows: 96 healthy Wistar rats were divided into 8groups: blank group, model group, radix bupleuri group, radix scutellariaegroup, xiao-chaihu group, radix bupleuri-radix scutellariae 2:1 group, radix bupleuri-radix scutellariae 1:1 group, radix bupleuri-radix scutellariae 1:2 group. METHODS: ① According to the ratio of 2:1, 1:1, 1:2, radix bupleuri andradix scutellariae were taken respectively (480 g, 240 g; 360 g, 360 g; 240 g, 480 g) to produce the water decocting nedicine. Except the blank group(duplicated by saline of the same volume through consecutive gastric infusion), the other groups are duplicated through consecutive gastric infusionby 56 degrees of Er-Guotou White Spirit (7 mL/kg) two times a day for tendays until the model-making is finished. From the first day, the medicine wasgiven two times a day. The blank group and the model group were given thedistilled water of the same volume. The other groups were given the properwater decocting medicine. The dosage in xiao-chaihu group was 10 g/kg andin the other was all 12 g/kg. ② 16 hours later after the last time when thewhite spirit was given, blood was taken from stomach aorta to produceserum. Liver, spleen, chest gland, adrenal gland were quickly removed. Thecalculating formula of an organ index: An organ index= The weight of an organ (g)/The weight of a body (g) ×100%. The calculating formula of vitamin C content in adrenal gland (mg/g): Content of vitamin C= [(The Avalue of the testing tube-The A value of the blank tube)/ (The A value ofthe standard tube-The A value of the blank tube)] ×density of the standardtube (6 mg/L)×dilution times of the sample before tested/protein content(g/L). ③ Comparison between the groups was shown by using variancesimilar test and single-factor variance analysis.MAIN OUTCOME MEASURES: Index of rats' liver, spleen, chest gland, and adrenal gland (on the right side); the determination of vitamin C content in rats' right adrenal gland.RESULTS: During the experiment, 3 rats in the model group died. Tworats died in radix scutellariae group and radix bupleuri-radix scutellariae group respectively, In each of the other groups only one rat died. The condition of the number of the rats which were used for analyzing results:There were 12 in blank group; 9 in model group; 10 in radix bupleuri group, radix bupleuri-radix scutellariae 1:1 group respectively; 11 in each of the other groups. ① Comparison of index of rats in liver, spleen, chest gland, adrenal gland (right side) between different groups: There was no significant difference between the indexes of rats' liver in different groups.The index of spleen, chest gland, adrenal gland in the model group were all greatly less than in blank group (P ＜ 0.05-0.01). The index of spleen in the radix bupleuri group wcre greatly higher than in the model group, it could make the reduced spleen index return to normal (P ＜ 0.05); The index of chest in radix scutellariae group, radix bupleuri-radix scutellariae 1:1 group, radix bupleuri-radix scutellariae 1:2 group and xiao-chaihu group were greatly higher than in model group (P ＜ 0.05); The index of adrenal gland in radix bupleuri-radix scutellariae 1:2 group and xiao-chaihu group were greatly higher than in model group (P ＜ 0.05). ② Comparison of vitamin C content in rats' right adrenal gland between the groups: Compared with blank group, the vitamin C content of adrenal gland in the model group had no significant difference. While that of radix bupleuri group, xiao-chaihu group, radix bupleuri-radix scutellariae groups were greatly less than that of model group (P ＜ 0.05-0.01), especially radix bupleuri-radix scutellariae 1:1 group had the most significant influence (P ＜ 0.01).CONCLUSION: Interfering functional injuries of liver, spleen and suprarenal gland is one of the mechanisms of acute alcoholic liver injury.Generally speaking, bupleuri-radix scutellariae 1:2 group has the greatest effect on the testing index.

Objective To discuss the diagnostic paradigm of non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement.Methods Clinical features of one patient with non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement,manifesting fever of undetermined origin and refractory hyponatremia,were analyzed retrospectively.The related literature was reviewed,and experience in diagnosis of non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement was summarized.Results Clinical manifestations of the patient was nonspecific,and there was definite evidence to support the diagnosis of infectious and autoimmune diseases.However,the abnormal elevation of serum lactate dehydrogenase(LDH)and ?2 microglobulin,which were suggestive of the diagnosis of lymphoma.The diagnosis of non-Hodgkin lymphoma with bilateral adrenal gland involvement was finally established by adrenal gland biopsy under CT.On the other hand,the endocrine evaluation indicated there was pituitarism even though the lesion was not obvious on the MRI image.However,18F fluorodeoxyglucose-positron emission tomography-computed tomography(18F-FDG PET-CT)clearly showed lesions in pituitary,liver and lymph node of neck.With supplementation of hydrocortisone,sodium the serum level gradually elevated to above the normal range,and the lesions in pituitary and adrenal glands disappeared after three courses of CHOP chemotherapy.The functions of pituitary and adrenal gland recovered 3 months later.Conclusions Non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement is a rare disease.Early diagnosis relies on the logical clinical evaluation and 18F-FDG PET-CT image.