Objective In this article,we report and discuss the clinical presentation of antithyroid drug(ATD)-induced agranulocytosis.Methods We retrospectively studied 36 cases of ATD-induced agranulocytosis over the past 14 years in PUMC hospital.Results ATD-induced agranulocytosis patient's age ranged of 16-62 years old.88.9％ of ATD-induced agranulocytosis occured with a large ATD treatment.91.7％ patients occured in the first three month of drug therapy.A case occured agranulocytosis when 8 months duration.94.4％ patients occurs secondary infections.Conclusion This study showed that ATD-induced agranulocytosis considered to be dose dependent,not irrelevant to sex,age and the drug.

Objective:To analyze the correlation of single nucleotide polymorphisms ( SNP) of ATP binding cassette transporter A1 gene (ABCA1) and lower extremity atherosclerotic disease (LEAD). Methods: The clinical data and peripheral blood were col-lected from 630 participants (314 LEAD cases and 316 normal controls) in Han population of Minnan. The 9 SNP genotypes in the ABCA1 gene were detected by Sequenom MassArray. Results:Among the 9 SNP genotypes, rs2980083 was rejected because it wasn' t in accordance with Hardy-Weinberg equilibrium. Obvious linkage disequilibrium was found between rs2066714 and rs2066715, rs1800976 and rs2246293, rs2246293 and rs2980083, and rs1800976 and rs2980083(D′>0. 9,r2 >1/3). There were no significant differences (P>0. 05) in 6 haplotypes of ABCA1 gene groups between the LEAD cases and the normal controls. No significant differ-ences (P>0. 05) were found in frequency distribution between the LEAD cases and the normal controls in 8 SNP according to the re-sults of genotype statistics. There was no onset risk of LEAD according to the gene logistic regression analysis. Conclusion:The SNPs of rs10124755, rs2980083, rs1800976, rs4149341, rs2066714, rs2066715, rs2066716, rs2230808 and rs2246293 might not correlate with the susceptibility of LEAD in Han population of Minnan.

BACKGROUND:Topping-off technique can be used for fixation treatment through the combination of fusion and interspinous dynamic device, in order to prevent or slow down the adjacent lumbar segment degeneration.
OBJECTIVE:To obverse the protective effect of Topping-off technique (posterior lumbar interbody fusion
procedure combined with the fixation of dynamic interspinous device Coflex) for the degenerative intervertebral disc. METHODS:A total of 32 patients with degenerative lumbar diseases who had been treated with Topping-off technique were included in this study. The Oswestry disability index, the Japanese Orthopaedic Association scores, range of motion for Coflex implanted segment and during the relative signal intensity of the Coflex implanted segment in MRI image were recorded and calculated preoperatively and the entire fol ow-up period.
RESULTS AND CONCLUSION:Al patients were fol owed-up for 20.6 months averagely. Up to the last fol ow-up, the Oswestry disability index and Japanese Orthopaedic Association scores were significantly improved when compared with those before treatment (P<0.001). There was no significant difference in the range of motion for Coflex implanted segment before and after treatment (P=0.19). The relative signal intensity of the Coflex implanted segment was significantly improved when compared with that before treatment (P<0.01). The clinical application of the Topping-off technique showed a protective effect on the intervertebral disc.

BACKGROUND:Neurotrophin-3 is found in the repair of spinal cord injury in the role of the strongest neurotrophic factor.It can effectively promote axonal regeneration through the glial scar tissue in repairing spinal cord injury.OBJECTIVE:To construct recombinant lentiviral vectors for gene delivery of homo sapiens neurotrophin-3(hNT3),and to investigate the expression of hNT3 gene in Schwann cells after transfection.DESIGN,TIME AND SETTING:Observational experiment was performed from June 2007 to March 2008 at the Central Laboratory of Changhai Hospital.MATERIALS:Bilateral sciatic nerves were harvested from 3-day-old Sprague Dawley rats for culture and identification of Schwann cells.Three-plasmid lentivirus systems:pGC-E1-EGFP,pHelper 1.0 and pHelper 2.0 were gained from Shanghai Chemical Technology Co.,Ltd.METHODS:pGC-E1-hNT3-EGFP plasmid was constructed by double restriction enzyme digestion and ligation,and then the plasmid was transformed into E.coli DH5?.Purified pGC-E1-hNT3-EGFP plasmids from the positive clones was confirmed by PCR and sequencing.293T cells were cotransfected with lentiviral vector pGC-E1-hNT3-EGFP,pHelper 1.0 and pHelper 2.0 by Lipofectamine 2000 to produce lentivirus.2 mL recombinant virus complete culture solution was added according to multiplicity of infection=1,4,8,10,12.The titer of virus was tested according to the expression level of enhanced green fluorescent protein.The control groups were Schwann cells and Schwann cells transfected by no-loaded lentivirus.MAIN OUTCOME MEASURES:The lentiviruses were transduced to Schwann cells,and the transfection efficiency was examined by flow cytometry,the overexpression of hNT3 was determined by Real-time PCR and Western blotting.RESULTS:The exogenous gene sequence of the recombinant hNT3 was completely in accordance with that of its open reading frame in GeneBank.The titer of concentrated virus was 5?107 TU/L.After recombinant LV-hNT3 infection,Schwann cells gave off strikingly bright green fluorescence,and the transfection efficiency amounted to 85%(multiplicity of infection=10).Real-time RCR test showed that the hNT3 mRNA were highly expressed in hNT3-Schwann cells,while did not express in the control group.Western blotting showed the hNT3 expression in Schwann cells.CONCLUSION:Construction of hNT3 gene lentiviral vector can transfect Schwann cells leading to an efficient overexpression of hNT3.

Objective To explore the relationship between operation scores and the expression of caveolin-1 ( Cav-1 ) protein in the cortex of mice.Methods Male Kunming mice were used and divided into two groups (excellent group and bad group) according to the training scores after 4 days' Y-maze learning training.The expression of cav-1 protein in cortex and hippocampus of the mice with different scores were measured through Western blot technology.Results Cav-1 protein expression of excellent group( Cav-1/β-actin was 5.71 + 1.11 ) in the cortex was significantly higher than that of the bad group ( Cav-1/β-actin was 1.69 + 0.20) (P ＜ 0.01 ).While there was no significant difference in the two groups in the expression of Cav-1 protein in hippocampus(P ＞ 0.05 ).Conclusion The operation scores have distinct correlation with the expression of Cav-1 protein in the cortex of mice.

Objective To determine the influence of schizophrenia patients with diabetes on cognitive function.Methods Altogether 78 schizophrenia patients with diabetes and 118 patients with schizophrenia were enrolled and Negative and Positive Syndrome Scale,Wechsler Memory Scale-Revised Visual Reproduction Test,Wechsler Adult Intelligence Scale-Revised Digit Symbol Test,Computerized Wisconsin Card Sorting Test,Trail Making Tests,Part A and B,and Wechsler Adult Intelligence Scale-Revised Digit Span Test were used to assess the clinical syndrome and to test the cognitive function.ResultsImpairment of Processing Speed,Attention/Working Memory,Executive Functioning and Visual Memory in schizophrenia patients with diabetes was significantly poorer than that of the schizophrenia patients ( all P ＜ 0.05 ).WAIS-R Digit Symbol Test score and Trail Making Test A and B scores were associated with diabetes duration and age at diabetes onset (P ＜0.01 ).Conclusion The impairment of cognitive function in schizophrenia patients with diabetes is severer than schizophrenia patients,suggesting that the prevention and management of diabetes may improve cognitive outcome in schizophrenia patients.

Objective To evaluate the efficacy of unilateral atlanto-axial transpedicle screw fixation plus iliac bone graft for treatment of unstable atlas fractures combined with unilateral pedicle dysplasia or comminuted fractures.Methods A retrospective case control study was made on 44 patients with unstable atlas fractures surgically treated between January 2012 to June 2016.Unilateral atlanto-axial transpedicle screw fixation combined with iliac bone graft was performed for 22 patients combined with unilateral pedicle dysplasia or comminuted fractures in Group A[15 males,seven females;(37.5 ± 13.4)years],and bilateral atlanto-axial transpedicle screw fixation combined with iliac bone graft was performed for 22 patients without unilateral pedicle dysplasia or comminuted fractures in Group B [14 males,eight females;(38.1 ± 13.3)years].Between-group differences were compared concerning operation time,intraoperative blood loss,length of hospital stay,success rate of screw placement,postoperative atlantoaxial stability,surgery-related complications,visual analog scale (VAS),Japanese orthopedic association score (JOA) and bone fusion.Results Mean duration of follow-up was 28.4 months (range,14-48 months).In Group A,operation time was (123.4 ± 18.2) min,blood loss was (218.5 ± 80.2) ml,hospital stay was (7.1 ± 1.0)d,success rate of screw placement was 100％,postoperative atlanto-axial stability of all patients was obtained,and no complications occurred.In Group B,operation time was (173.4 ± 12.4) min,blood loss was (318.2 ± 61.7) ml,hospital stay was (7.2 ± 0.8) d,success rate of screw placement was 100％,postoperative atlanto-axial stability of all patients was obtained,and no complications occurred.There were significant differences in operation time and blood loss between the two groups (P ＜0.01),while not in hospital stay,success rate,postoperative atlant-oaxial stability,complication incidence,VAS and JOA (P ＞ 0.05).Conclusion Both treatments are effective,but unilateral atlanto-axial transpedicle screw fixation combined with iliac bone graft is associated with relatively shorter operation time and less blood loss and hence is considered as a better choice for treatment of unstable atlas fractures.

Objective To assess the contribution of transrectal realtime tissue elastography (TRTE) on the differential diagnosis of prostatic diseases. Methods A total of 88 prostatic disease patients with 95 lesions proved by pathology from May 2012 to January 2013 in the Afifliated Drum Tower Hospital of Medical College of Nanjing University were included. The elasticity grade and strain ratio were calculated by using TRTE. According to the gold standard of pathological results, the sensitivity, speciifcity, accuracy rate were calculated to evaluate the effectiveness of elasticity grade and strain ratio in distinguishing benign and malignant prostatic diseases;and the receiver operating characteristic (ROC) curves were made respectively. The accuracy of elasticity grade and strain ratio in diagnosing prostatic diseases was also compared using chi-square test. Results Forty-seven benign lesions were found in the 95 prostatic lesions and the other 48 lesions were malignant. The elasticity grades of the 95 prostatic lesions were as follows:GradeⅠ26, GradeⅡ19, GradeⅢ16, GradeⅣ21, and GradeⅤ13. Elasticity grade ≤Ⅱwas considered to be benign, while grade ≥Ⅲwas malignant. The sensitivity, speciifcity, accuracy rate of elasticity grade in diagnosis of prostatic malignant lesions was 79.17%(38/48), 74.47%(35/47) and 76.84%(73/95), respectively. According the ROC curve analysis, the cutoff point of strain ratio was 4.67, and Youden′s index was 0.622. The sensitivity, speciifcity, accuracy rate of strain ratio was 83.33%, 78.72%and 81.05%, respectively. The area under ROC curves of strain ratio was superior to that of elasticity grade. But the diagnosis accuracy of the two approaches was almost the same in statistics (χ2=0.51, P>0.05). Conclusions TRTE is valuable in the differential diagnosis of the prostatic benign and malignant lesions. Both strain ratio and elasticity grade are useful approaches, and have similar diagnostic accuracy.

ObjectiveTo study the relationship between plasma riboflavin levels and esophageal squamous cell carcinoma.Methods We detected and compared plasma concentrations of riboflavin in patients with esophageal squamous cell carcinoma (ESCC) and immigrants of Linzhou living in Changzhi.Plasma riboflavin levels were quantified in 445 ESCC patients,689 healthy control subjects and 347 immigrants of Linzhou living in Changzhi by using enzyme-linked immunosorbent assay.ResultsThe plasma riboflavin levels in patients with ESCC were significantly lower than those in the healthy controls and immigrants of Linzhou living in Changzhi [ (731.69 ± 330.67 ) μg/L vs ( 1090.43 ± 445.08 ) μg/L,(731.69 ± 330.67) μg/L vs ( 897.58 ± 177.78) μg/L,respectively,all P ＜ 0.05 ],and the plasma riboflavin levels of the healthy controls were higher than those in the immigrants of Linzhou living in Changzhi (P ＜ 0.05).ConclusionPatients with ESCC have decreased plasma riboflavin levels as compared with the healthy controls and immigrants of Linzhou living in Changzhi,there exists a lack of riboflavin in ESCC patients,but the specific mechanism needs further study.

Objective To evaluate the therapeutic effeet of one stage posterior pedicle screw fixation combined with transpedicle intervertebrae titanic mesh autograft versus traditional posterior and anterior approach surgery in the treatment of severe thoracolumbar fractures.Methods A retrospective case-control study was done on 40 cases of type C thoracolumbar fractures admitted from January 2012 to December 2015.There were 28 males and 12 females,with age range of 20-48 years (mean,30.6 years).The fractures were located at T11 in 4 cases,at T12 in 16,at L1 in 14,and at L2 in 6.All cases were divided into two groups (with 20 cases per group) according to treatment method difference.The cases in posterior group had one stage posterior pedicle screw fixation combined with transpedicle intervertebrae titanic mesh autograft,and the others in posterior and anterior group were treated by traditional posterior and anterior approach surgery.The operation duration,volume of blood loss,hospital stay,kyphosis correction rate,visual analogue scale (VAS) and Oswestry disability index (ODI) were compared between the two groups.Results All patients were followed up for 10-46 months (mean,28.6 months).In posterior group,the average operation time was 154 minutes,the average blood loss was 564 ml,the postoperative suction drainage was 180.5 ml,the time period between surgery and recovery of walking ability was 5.9 days,and the hospital stay was 10.6 days.While in posterior and anterior group,the average operation time was 248.5 minutes,with the average blood loss of 960.8 ml,the postoperative suction drainage of 359.2 ml,the time duration between surgery and recovery of walking ability of 8.4 days,and the hospital stay of 14.5 days (P ＜ 0.05).At one week and six months postoperatively,the height ratio of anterior edge,Cobb angle,VAS and ODI in both groups were improved compared to the preoperative status (P ＜ 0.05).But there was no significant difference of these indicators between two groups (P ＞ 0.05) except for lumbar back pain one week after operation (P ＞ 0.05).Conclusions Through single pathway of posterior approach,one stage posterior pedicle screw fixation combined with transpedicle intervertebrae titanic mesh autograft can complete reduction of fractured vertebral body,spinal cord decompression,and anterior-middle column stability reconstruction.Compared with traditional combined posterior and anterior approach surgery,this technique has many advantages including simpler manipulation,less invasion,shorter rehabilitation time and equal bony fusion and hence is an ideal option for type C thoracolumbar fractures.