Objective To report clinical features,diagnosis and treatment in a case of adult onset Still's disease (AOSD) accompanied by demyelinating encephalopathy.Methods We reported a case of Stills disease with signs of encephalopathy.We also reviewed and discussed the literature on the neurological manifestations in AOSD.Results The 35-year-old patient had recurrent fever and arthralgias for 3 years,headache for 1 month and transient loss of consciousness.Laboratory tests showed non-specific immunological activity.MRI showed tumor-like lesions at left parietal and occipital lobes surrounded by sleeve-like edema.The lesion had significant occupation effect.Biopsy proved the presence of demyelinating changes.The patient recovered favorably after administration of corticosteroids and immunoglobulin.The lesions had almost disappeared on follow-up MRI 4 months later.Conclusions Demyelinating encephalopathy may develop in patient with AOSD.MRI may show tumor-like damage,which is rarely reported in the literature.Diagnosis depends on history,clinical manifestation and neuroimaging.Biopsy provides important information in making diagnosis.Treatment with corticosteroids and intravenous immunoglobulin was found to achieve good recovery.

To exert the role of high quality resources of national experimental teaching demonstration center in teaching,we have promoted laboratory opening through research teaching.By the contest of university students’experiment designing and inviting public bidding for exploring experiment,we encourage students to conduct innovation research,blazed their orexis and enthusiasm to start scientific research.We also encourage teachers to explore new teaching methods and innovated experimental items.

Objective To explore the best way for clinical screening of primary aldosteronism (PA).Methods Three hundred and three suspected cases of PA were collected and divided into groups of primary aldosteronism group, essential hypertension group, and nonsecreting cortical adrenal tumor group.The plasma aldosterone concentration/plasma renin concentration ratio ( ARR) was used to draw the receiver operating characteristic ( ROC) curve and obtain the best cut-off point.Furthermore, the current screening schemes for PA were compared.Results Upright ARR yield had larger areas under the ROC curve than plasma aldosterone concentration or plasma renin concentration under all conditions of testing. The best cut-off point of upright ARR[(pg/ml)/(μIU/ml)] for the diagnosis of PA was 43.45.During the two postural stimulation tests,the two upright ARR exceeded 43.45 with the highest diagnostic sensitivity of PA reaching 0.94.During the two upright tests ARR was less than 43.45, with a sensitivity of 0.74, and a specificity of 0.94.Conclusion To screen for PA in high-risk populations, twice postural stimulation test is recommended.As long as the upright ARR is above 43.45, PA may be considered and further confirmation is needed to prevent misdiagnosis.

Objective To evaluate the predictive values of ABCD,ABCD2 ,SPI-Ⅱ and ESSEN score models for the patients with high-risk transient ischemic attack (TIA)to develop to cerebral infarction in short and long term. Methods The ABCD, ABCD2 , SPI-Ⅱ and ESSEN scores of 235 cases of TIA patients were retrospectively analyzed.The incidence of cerebral infarction was followed up for 7 d and 1 year, and the receiver operating characteristic curve (ROC)was drawn to calculate the area under curve (AUC)to assess the accuracy of the score models,and compared with the original model and the relative risk (RR)value was calculated.Results The 7 d-incidence and 1 year-incidence of cerebral infarction in the 235 TIA patients were 9.36 % and 20.43%.The AUC of ABCD,ABCD2 ,SPI-Ⅱ and ESSEN models for 7 d were 0.70,0.74,0.67,and 0.62.The AUC of 1 year were 0.62,0.62,0.64,and 0.65.Compared with the orginal models,the RRs for 7 d of ABCD score model of the TIA patients in low,middle,and high risk groups were 0.09,0.92,and 0.72;the RRs of ABCD2 score model were 0.49,0.59,and 0.65;the RRs of SPI-Ⅱ score model were 0.58,0.87,and 0.55;the RRs of ESSEN score model were 0.11,0.18,and 0.55.Conclusion ABCD,ABCD2 ,SPI-Ⅱ and ESSEN score models can be used to assess the risk of cerebral infarction after TIA in Chinese population.The ABCD2 score model is of great value for short-term risk prediction,and the ESSEN score model is more value for long-term risk prediction.

Objective To explore the relationship between the HLA-G 14 bp insertion/deletion polymorphism and the infection of Epstein-Barr virus(EBV) for children.Methods The study genotyped HLA-G 14 bp insertion/deletion polymorphism of 102 infectious mononucleosis children and 165 normal controls by PCR-PAGE,detected the plasma sHLA-G level of 51 infectious mononucleosis children and 146 normal controls by ELISA.Results A significant difference was observed for the frequencies of the HLA-G 14 bp genotype between the two groups( x2 =6.742,P=0.034 ),and a significant difference was also observed for the 14 bp allele frequencies between the two groups( x2 =6.672,P=0.01 ).The plasma sHLA-G levels in the infectious mononucleosis children were dramatically higher than that in normal controls,and a significant difference was observed between the two groups( Z=-9.472,P＜0.01 ).Among the infectious mononucleosis children,levels of sHLA-G was find a significant difference between the three genotypes of HLA-G 14 bp insertion/deletion polymorphism( H=6.09,P =0.048 ),and the level of s HLA-G with 14 bp+/+ genotype was markedly lower than that of the two other genotypes (Z=-2.376,P=0.01 8).Conclusion There was a relationship between the HLA-G 14 bp insertion/deletion polymorphism and the susceptibility to the infectious mononucleosis for children.Children who carried the 14 bp-/- genotype or deleted the 14 bp allele may have a significantly increased risk of the infection of EBV.The plasma sHLA-G might be considered as an index for auxiliary diagnosis infectious mononucleosis.

Objective To study the incidence and clinical significance of the herniation pits of the femoral neck.Methods 600 cases(299 men,301 women,18～82 years)were collected.The incidence,radiologic finding and clinical significance of the herniation pit of the femoral neck were analysed.Results Of 1200 hip joints in 600 cases,there was 58 cases(64 sides)(5.3%)with herniation pits of the femoral neck,including 39 men(68.7%)and 19 women(31.3%),the lesions localized in the left joint in 25 eases(39.1%),in the right joint in 27 cases(42.2%)and in bilateral joints in 6 cases(18.7%).There were a obvious significant differences on both sexes,and no significant differences on age groups.On X-ray film,the lesions appeared as a round radiolucency with thin clear sclerotic rim.Conclusion The incidence of the herniation pit of the femoral neck is 5.3%,which has a typical X-ray feature,and may indicate the femoroacetabular impingement.

Objective To explore the effect of hospital-community integration follow-up pattern on medication compliance in patients with mental disorder. Methods From January 2016 to January 2017, 96 patients were treated effectively with systemic therapy in psychosomatic department and TCM WM department, and 96 discharged mental disorder patients were treated with brief psychiatric rating scale (BPRS) ≤ 28. The patients were randomly divided into 48 cases in the intervention group and the control group; both groups were standardized medication; control group received an outpatient referral, intervention group combined with medical doctors in our hospital and community doctors for one year follow-up intervention. Observed the condition of illness and medication compliance after six months and one year intervention between two groups, compared the patient recurrence rate of one year after discharge. Results BPRS score of intervention group was significantly lower than control group (P＜0. 01), the difference was statistically significant, while intervention group had higher compliance than control group (P＜0. 01), and the difference was statistically significant. Recurrence rate (20. 83％) of intervention group was significantly lower than control group (38. 78％) ( 2 = 4. 03, P＜0. 05), the difference was statistically significant. Conclusion Hospital-community integration follow-up has positive effect on stabilizing patients with mental disorder and improving compliance and decreasing relapse rate.

OBJECTIVE： To provide reference for the development and sustainable utilization of TCM industry with regional characteristics. METHODS： Taking Shicheng county of Jiangxi province as an example， field investigation was carried out on Paeoniaceae suffruticosa planting base in the county， a few representative P. suffruticosa planting bases in the county were selected as sample points， and GPS was used to locate and record the location information of sample points. The remote sensing image was automatically extracted by computer， the artificial visual interpretation method was used to get P. suffruticosa planting area image. Then combined with the field inspection verification， P. suffruticosa planting area was obtained， and the investigation results were analyzed. RESULTS： Through remote sensing interpretation of the planting area of P. suffruticosa in Shicheng county， it was obtained that the total planting area of P. suffruticosa in Shicheng county was 42 597 951.505 square meters （63 864.995 mu） in 2018， accounting for about 33％ of the cultivated land area， which was 42.12％ higher than the conventional planting area of 44 936 mu in 2013. The distribution of P. suffruticosa planting in Shicheng county was mainly concentrated in Xiaosong town and Fengshan town in the north， and Daqu town and Pingshan town in the south. CONCLUSIONS： Remote sensing technology has the advantages of fast data acquisition， large amount of information， high accuracy and strong timeliness， which greatly avoids the complexity of work， saves a lot of manpower and material resources. The technology can provide technology support for obtaining the regional planting area and distribution information of TCM such as P. suffruticosa， dynamic monitoring， scientific warning of the market status of TCM， and guiding the large-scale， standardized and intensive development of TCM cultivation.

OBJECTIVE： To establish a method to determine the contents of rhynchophylline and isorhynchophylline in Uncaria rhynchophylla. METHODS： The separation degree of ionic liquid 1-butyl-3-methylimidazolium chloride （C4mimCl） as mobile phase additive was compared with that of mobile phase without additives and with traditional additive triethylamine （which damaged the chromatographic column）. The optimum concentration of C4mimCl was screened and the contents of rhynchophylline and isorhynchophylline in U. rhynchophylla from 4 habitats in Jiangxi province were determined by the newly established method. The determination was performed on Dikmatech Diamonsil Plus C18 column， the mobil phase was acetonitrile-buffer （0.1％ phosphoric acid+3.0 mmol/L C4mimCl）， gradient elution. UV detection wavelength was set at 245 nm and the flow rate was 1    mL/min. Sample size was 10 μL. RESULTS： When mobile phase had no additives or 3.0 mmol/L triethylamine and 3.0 mmol/L C4mimCl were added as additives， the separation of rhynchophylline from the front peak was 1.02， 1.23 and 1.72， and the separation from the back peak was 1.06， 6.00 and 4.25， respectively. The symmetry factors were 0.81， 0.86 and 1.13， respectively. The separation of isorhynchophylline from the front peak was 0.96， 3.89 and 4.05， and the separation from the back peak was 1.02， 2.34 and 2.36， respectively. The symmetry factors were 0.88， 0.81 and 0.96， respectively. The linear range of rhynchophylline and isorhynchophylline were 4.93-157.76 （r＝0.999 9） and 4.98-159.50 μg/mL （r＝1.000）， respectively. The quantitative limits were 0.486 4， 0.793 6 μg/mL， respectively. RSDs of precision， repeatability， stability and durability tests were all less than 5％ （n＝6）. The recovery rates were 102.9％-107.8％ （RSD＝1.7％，n＝6） and 95.4％-106.3％ （RSD＝3.9％，n＝6）， respectively. The content of rhynchophylline and isorhynchophylline in U. rhynchophylla from 4 habitats were 0.758-1.343         and 1.511-1.823 mg/g， respectively. CONCLUSIONS： Addition of C4mimCl into mobile phase can enhance its separation. Established HPLC method is rapid， accurate and reproducible， which can be used for content determination of rhynchophylline and isorhynchophylline in U. rhynchophylla.

【Objective】 To investigate the risk factors and predictive effectiveness of prostate imaging reporting and data system (PI-RADS) score for patients with clinically significant prostate cancer (CsPCa) whose PI-RADS score was 3, so as to provide evidence for the diagnosis and treatment. 【Methods】 The clinical and multi-parameter magnetic resonance imaging (mpMRI) data of 153 CsPCa patients treated during Jan.2017 and Dec.2021 whose PI-RADS score was 3 were retrospectively analyzed. With PI-RADS score of 3 as the independent risk factor for CsPCa, the other relevant independent risk factors in predicting CsPCa were evaluated. 【Results】 Univariate and multivariate analyses showed that prostate-specific antigen (PSA) density and apparent dispersion coefficient (ADC) were independent risk factors for the diagnosis of CsPCa (P<0.05). Analysis of receiver operating characteristic (ROC) curve showed that combined PSA density and ADC were more effective than PSA density and ADC alone (P<0.05). 【Conclusion】 The combination of PSA density and ADC can guide clinicians to identify high-risk CsPCa patients from patients with PI-RADS score of 3 points.