[ ABSTRACT] AIM:To evaluate the clinical application of single nucleotide polymorphism array ( SNP array) in prenatal diagnosis for screening the abnormality of women with Down’ s syndrome ( DS) .METHODS:The amniotic fluid samples ( n=312) collected by amniocentesis for the DS screening abnormality women were tested by karyotyping and SNP array analysis, respectively.The findings of karyotyping and SNP array analysis were compared.RESULTS:Two cases of trisomy 21 were identified by karyotyping and SNP array analysis, but SNP array analysis failed to identify 6 cases of chro-mosome balanced structural rearrangement.SNP detected 176 cases copy number variants ( CNVs) in 303 cases normal karyotype were detected by SNP, including 106 benign CNVs, 61 variants of unknown significance (VOUS), 9 de novo CNVs, and none of them was pathogenic.The distribution difference of CNVs in DS screening positive group and DS screening positive plus advanced maternal age group was not statistically significant ( P>0.05) .Furthermore, we reported 14 kinds of CNVs for the first time in population.CONCLUSION:SNP array can further assure chromosome microdupli-cation/microdeletion.In normal karyotype fetus of prenatal diagnosis, SNP can detect some clinical significant CNVs.

Purpose To analyze the image quality of brain CT with 256-slice wide detector axial scanning mode,routine axial scanning mode and spiral scanning mode,and to provide a more effective brain CT examination method for patients.Materials and Methods The prospective study was conducted on 90 patients accepting routine brain CT examination,and they were randomly divided into three groups.CT examination with 160 mm axial scanning mode,40 mm axial scanning mode and 40 mm spiral scanning mode were respectively conducted using GE Revolution CT.The scanning condition was adjusted to remain constant radiation dose,and then the image quality was analyzed.CT attenuation of gray and white matter,contrast-to-noise ratio (CNR) of white-gray matter and image noise of the three scanning modes were compared.Subjective scoring on image quality of the three scanning modes was also performed.Results On body lateral cerebral ventricle level,there were no significant difference in CT attenuation of gray and white matter and CNR (P＞0.05).On centrum semiovale level,the CT attenuation of gray matter [(31.71 ± 1.82) HU],white matter [(22.97± 1.50) HU] and CNR 2.05±0.42 of 160 mm axial scanning mode was significantly different from the other two scanning modes (F=26.74,47.16 and 3.85,P＜0.05).On centmm semiovale level,image noise of 160 mm axial scanning mode was lower than the other two kinds of scanning methods (F=6.31,P＜0.05),in the basal ganglia and posterior fossa there were no statistically significant differences in the image noise between the three scanning modes (P＞0.05).The subjective score of the three scanning modes all met the diagnostic requirements,and there was no significant difference (P＞0.05).The effective dose and scanning time of 160 mm axial scanning mode was lower than those of the other two scanning modes,and the X-ray utilization was higher.Conclusion 160 mm wide detector axial scanning mode is more suitable for brain CT scan,and it can be used as the preferred scanning mode in the emergency and among non-cooperative patients.

ObjectiveTo study tear film functions of diabetes mellitus with pterygium before and after surgery.MethodsNinety patients with single side pterygium were divided into 3 groups with 30 cases each:simple pterygium (treatment group A ),pterygium combination with type 1 diabetes mellitus (treatment group B) and pterygium combination with type 2 diabetes mellitus(treatment group C).Ninety patients without pterygium were divided into 3 groups with 30 cases each:normal (control group A),type 1 diabetes mellitus (control group B) and type 2 diabetes mellitus (control group C ).Tear film functions were compared in each group before surgery,while tear film functions in treatment group B and C were compared between before and after surgery.ResultsBefore surgery,there was no significant difference among each group in lacrimal secretion test.Every group's tear film break-up time(BUT) was abnormal except control group A.Cornea fluorescein staining (CFS) score in treatment group B compared with control group B,and treatment group C compared with control group C were significant differences [ (9.08 ± 0.48 ) scores vs.(3.43 ± 0.51 )scores and (10.31 ±0.94) scores vs. (7.91 ±0.51 ) scores,P＜0.05].There was significant difference in mucus fern test(MFT) between treatment group B and control group B (P＜0.05).Tear clearance rate (TCR) were all abnormal except control group A.Before surgery compared with after surgery between treatment group B and treatment group C,there was no significant difference in lacrimal secretion test (P＞0.05 ),but there were significant differences in BUT,CFS score and MFT,the TCR were normal.Conclusion Diabetes mellitus with pterygium will aggravate damage in tear film functions,and these damaged functions could be recovered through pterygium surgery with conjunctival limbal autograft.

Object To observe the effect of gypenosides (GP) on the DNA and RNA in cerebral cortex and hippocampus in vascular dementia rat. Methods Modified Pulsinelli 4 vessel occlusion (4 VO) method was used to establish the models of vascular dementia rat. The acridine orange (AO) method was applied to study the protective effect of GP on the DNA and RNA of cerebral cortex and hippocampus in vascular dementia rat. Results The fluorescent intensity from the DNA and RNA in cerebral cortex and hippocampus of vascular dementia rat is abated as compared with the normal control group. The fluorescent intensity from DNA and RNA of the treatment group administrated GP (200 mg/kg, ig) significantly intensified, as compared with that of non treatment group, and is similar to that of normal group. Conclusion The injury to the DNA and RNA in cerebral cortex and hippocampus in vascular dementia rat was obviously decreased by GP.

Objective To explore the imaging manifestations of low-grade central osteosarcoma (LGCOS) and discuss their pathological features.Methods Twelve patients of LGCOS proved by surgery and pathology were analyzed retrospectively and a review of related literature was performed.All twelve patients had plain X-ray,1 1 patients CT examination,and 10 patients contrast-enhanced MR scan.Imaging features of the LGCOS were summarized,their clinical and pathological manifestations were discussed for differential diagnosis.Their prognosis was evaluated with followed up examination.Results Of the 12patients with LGCOS,six tumors were located in the distal femur,3 in the proximal tibia,2 in the proximal femur and 1 in the talus.The radiographic features of LGCOS were variable.There were 7 patients with predominantly osteolytic destruction,3 patients with mixed sclerotic and lyric changes,with well-defined margins,2 patients with Osteogenic changes on X-ray.On CT,9 patients showed a clear cortical breach,5 patients with soft tissue involvement,6 patients with peripheral incompletely sclerotic zone,2 patients with periosteal reaction.On MRI,there were 10 patients with abnormal signal in medullary cavity,8 patients with soft tissue masses,and all 10 patients exhibited contrast enhancement.The microscopic features of LGCOS were characteristically bland,comprising spindle cells arranged in interlacing fascicles in a heavily collagenous background with variable bone or osteoid production.There were mild nuclear atypia and rare mitoses.In four patients,misdiagnoses were made by biopsy or surgical pathology as fibrous dysplasia or fibrous histiocytoma and other benign lesions,all four patients had postoperative recurrence.Conclusions LGCOS should be differentiated form fibrous dysplasia,non-ossifying fibroma,and other benign lesions.An accurate diagnosis can be made in most cases by careful pathological and radiological correlation.

Objective To evaluate the effect of salicylic acid on skin barrier function and the efficacy of salicylic acid combined with flumetasone ointment for the treatment of atopic dermatitis (AD).Methods Sixtyfour patients with AD (including 31 males and 33 females) aged 18 to 58 years were recruited into the present study.Four lesional areas of similar size and severity were selected at the similar body sites of both sides of each patient,and randomly classified into four groups to be topically treated with compound flumetasone ointment (containing 0.02％ flumetasone and 3％ salicylic acid,compound flumetasone group),flumetasone 0.02％ ointment (flumetasone group),salicylic acid 3％ ointment (salicylic acid group) and vehicle (control group),respectively;two normal skin areas were chosen from apparently normal skin on the similar body sites of both sides of each patient and topically treated with salicylic acid 3％ ointment (salicylic acid group) and vehicle (control group) respectively.All of these preparations were applied twice a day for 3 weeks.Transepidermal water loss (TEWL) was measured by a Tewameter MPA580 (Courage & Khazaka,Germany) at the baseline as well as on week 1,2 and 3 after initiation of treatment.Symptom and sign scores were evaluated before and after the treatment.Meanwhile,two normal skin areas were selected on bilateral forearm of 30 healthy controls and treated with 3％ salicylic acid ointment (salicylic acid group) and vehicle (control group) respectively twice a day for 3 weeks,and TEWL was measured before treatment as well as on week 1 and 3 after initiation of treatment.Results In the healthy controls,TEWL value showed no significant difference between the salicylic acid group and control group at any of these time points.As far as the lesional skin was concerned,no statistical difference was observed in TEWL value at the baseline between the four groups ((34.26 ± 20.82) vs.(33.02 ±16.71) vs.(34.16 ± 18.03) vs.(33.81 ± 17.11) g· m-2· h-1,P ＞ 0.05),but significant difference was noted after treatment (repeated measurement data analysis of variance,F =39.57,P ＜0.01),with the TEWL value being (22.38 ± 16.16),(17.04 ± 12.74),and (15.34 ± 13.13) g·m-2·h-1 respectively in the compound flumetasone group on week 1,2 and 3,(24.63 ± 17.08),(20.37 ± 9.53),(19.06 ± 9.17) g·m-2·h-1 respectively in the flumetasone group,(26.49 ± 8.59),(21.91 ± 8.46),(21.20 ± 9.38) g·m-2·h-1 respectively in the salicylic acid group,and (29.80 ± 12.48),(26.16 ± 8.31),(25.52 ± 6.05) g·m-2·h-1 respectively in the control group.In detail,the decrease in TEWL value was stronger in the compound flumetasone group than in the flumetasone group on week 1,2,and 3 (all P ＜0.05),in the salicylic acid group than in the control group (P ＜0.05 or 0.01),but similar between the flumetasone group and salicylic acid group.In non-lesional skin,the salicylic acid group showed a more intense decrease in TEWL value compared with the control group on week 2 and 3 (both P ＜0.05).Both the cure rate and response rate were significantly higher in the compound flumetasone group than in the flumetasone group (53.1％ vs.34.4％,x2 =4.57,P＜0.05;83.1％ vs.64.1％,x2 =6.90,P＜0.01).Conclusions The salicylic acid 3％ ointment shows a reparative effect on skin barrier in patients with AD,and the compound flumetasone ointment is superior to the flumetasone ointment in the treatment of AD.

Objective To investigate balanced steady-state free precession with flow-sensitive dephasing magnetization preparation (FSD-bSSFP) in the assessment of arteries of foot in diabetic patients.Methods The lower-extremity peripheral arteries of 43 diabetic patients were evaluated by FSD-bSSFP no contrast MRA and contrast-enhanced MRA (CE-MRA)in. Two experienced observers assessed the image quality, degree of venous contaminated and visibility of pedal artery branches by FSD-bSSFP and CE-MRA respectively in consensus. The signal intensity( SI), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the source images of both groups were measured and Wilcoxon and t tests were performed. Results The image score of FSD-bSSFP group was 2.7 ± 1.1 and CE-MRA was 2.6 ± 0.8, there was no statistical difference ( Z = 0. 134, P ＞ 0. 05 ). The image score of demonstration of the pedal artery branches and degree of venous contamination on FSD-bSSFP were 3.2 ± 0. 9 and 1.8 ± 0. 4 respectively which were superior to that of CE-MRA (2.5 ± 0.9 and 2.1 ± 0.8 respectively). Significant statistical difference existed between the two groups in demonstration of pedal artery branches ( Z = 5.246, P ＜ 0.05 ) and degree of venous contamination (Z =2.541 ,P ＜0.05). SNR of FSD-bSSFP was 148.6 ±26.7, CNR was 88.3 ± 19.0. SNR of CE-MRA was 148.5 ± 45.6, CNR was 121.0 ± 41.0. No statistical difference existed between SNR between two methods (t = 0.013, P ＞ 0.05 ). But CNR of CE-MRA was superior to that of FSD-bSSFP and significant statistical difference existed between these two methods ( t = 5.113, P ＜ 0.01 ). Conclusion FSD-bSSFP without contrast could be used in the evaluation of foot arteries in patients of renal dysfunction and diabetes.

Objective:To observe the differences in clinical efficacy of Jieyu Anshen Decoction combined with auricular points and oral tibolone in the treatment of patients with perimenopausal sleep disorders, and provide effective treatment for patients with contraindications to hormone supplement therapy in clinicalMethods:Using a randomized trial design, from July 2018 to August 2020,102 perimenopausal insomnia patients in International Peace Maternity and Child Health Hospital of China Welfare Institutewith kidney deficiency and liver depression who met the inclusion criteria were randomly divided into a treatment group and a control group with 51 cases each. The treatment group took Jieyu Anshen Recipe. At the same time, unilateral auricular point pressing treatment was given, and the opposite ear was changed in 5 d. The control group was treated with tiburon for a period of 3 months. The changes in the scores of each scale were observed in the two groups after 1 month and 3 months treatment. The scale included Pittsburgh sleep quality index (PSQI), modified Kupperman score (KMI), Generalized Anxiety Disorder Scale (GAD-7) and Patient Health Questionnaire Depression Screening Scale (PHQ-9). Its effectiveness and differences were evaluated and analyzed comprehensively through the above scale.Results:PSQI, KMI, GAD-7, PHQ-9 scores decreased significantly in the control and treatment groups after 1 month and 3 months of treatment, and the difference were statistically significant: PSQI: (8.58 ± 1.94) and (5.81 ± 1.93) scores vs. (13.10 ± 2.53), (9.15 ± 2.59) and (6.33 ± 1.98) scores vs.(13.52 ± 2.27) scores; KMI: (19.92 ± 2.16) and (14.67 ± 4.11) scores vs. (28.54 ± 7.65) scores, (19.02 ± 5.92) and(14.10 ± 4.37) scores vs. (27.42 ± 7.34) scores; GAD-7: (4.54 ± 2.03) and (3.81 ± 1.63) scores vs. (5.69 ± 2.95) scores, (3.71 ± 2.48) and (3.32 ± 1.73) scores vs. (4.90 ± 3.17) scores; PHQ-9:(6.90 ± 2.52) and (4.98 ± 1.96) scores vs. (9.83 ± 3.71) scores, (6.15 ± 2.62) and (4.44 ± 1.81) scores vs. (9.02 ± 3.73) scores ( P<0.01). PSQI, KMI, PHQ-9, and GAD-7 scores declined between the two groups, but there were no significant differences between the two groups ( P>0.05). After 1 month and 3 months of treatment, using PSQI scale and KMI score, the total efficiency of patients in the control group was slightly higher than that of the treatment group, but the difference was not statistically significant ( P>0.05); after 1 month and 3 months of treatment, using PHQ-9 score and GAD-7 score, the total efficiency of patients in the treatment group was slightly higher than that of the control group, but the difference was not statistically significant ( P>0.05). Conclusions:Traditional Chinese medicine combined with ear acupoint pressing has similar effects to tibolone in treating perimenopausal insomnia with kidney deficiency and liver depression. It can significantly improve the quality of sleep and quality of life of patients, and has good safety. For patients who are not suitable for hormone, Chinese medicine can be used as an alternative. The therapies are worthy of clinical application.

Objective To analyze composition principles of prescriptions for the treatment of diarrhoea caused by deficiency of spleen. Methods The prescriptions for diarrhoea caused by deficiency of spleen in the Prescriptions of Traditional Chinese Medicine Dictionary were collected, sorted and entered into the TCM Inheritance Support System (V1.3) to analyze the composition principles through the methods of entropy clustering and apriori. Results Based on the analysis of 1185 prescriptions and 815 medications, there were 33 medications with more than 50 frequencies. Composition principles were obtained through apriori method:50 herbal pairs were used with more than 50 frequencies, and 29 core combinations with more than 40 frequencies. Association principle rule were used for the analysis of those medications in the prescriptions (support≥20%, confidence≥0.9). Principles were obtained through entropy clustering:there were 19 core combinations which composed the new prescriptions, and 19 new prescriptions were found through hierarchical clustering method. There were 17 prescriptions matching with Sijunzi decoction (semblance=0.5). Conclusion Diarrhoea caused by deficiency of spleen should be treated with strengthening spleen and benefiting qi primarily, assisting with warming yang, excreting dampness and checking diarrhoea.

Herpes simplex virus type 1 (HSV-1) is a commonly occurring human pathogen worldwide. There is an urgent need to discover and develop new alternative agents for the management of HSV-1 infection. Tripterygium hypoglaucum (level) Hutch (Celastraceae) is a traditional Chinese medicine plant with many pharmacological activities such as anti-inflammation, anti-tumor and antifertility. The usual medicinal part is the roots which contain about a 1% yield of alkaloids. A crude total alkaloids extract was prepared from the roots of T. hypoglaucum amd its antiviral activity against HSV-1 in Vero cells was evaluated by cytopathic effect (CPE) assay, plaque reduction assay and by RT-PCR analysis. The alkaloids extract presented low cytotoxicity (CC_(50) = 46.6 μg/mL) and potent CPE inhibition activity, the 50% inhibitory concentration (IC_(50)) was 6.5 μg/mL, noticeably lower than that of Acyclovir (15.4 μg /mL). Plaque formation was significantly reduced by the alkaloids extract at concentrations of 6.25 μg/mL to 12.5 μg/mL, the plaque reduction ratio reached 55% to 75% which was 35% higher than that of Acyclovir at the same concentration. RT-PCR analysis showed that, the transcription of two important delayed early genes UL30 and UL39, and a late gene US6 of HSV-1 genome all were suppressed by the alkaloids extract, the expression inhibiting efficacy compared to the control was 74.6% (UL30), 70.9% (UL39) and 62.6% (US6) respectively at the working concentration of 12.5μg/mL. The above results suggest a potent anti-HSV-1 activity of the alkaloids extract in vitro.