To investigate the scientificity of patient-reported outcome (PRO) scale for myasthenia gravis (MG), which was used to evaluate the clinical effects of traditional Chinese and Western medicine treatment on MG patients. Psychometric performance of the MG-PRO scale was also expected to be evaluated in this study.

Objective To evaluate the clinical effect of acupuncture as an adjuvant therapy for acute pancreatitis (AP).Methods We retrieved the databases ofCNKI,VIP,Wanfang,PubMed,EMBase,and Cochrane Library,selected the relevant randomized clinical trials (RCTs) of AP treated with routine western medicine as control group and treated with routine western medicine combined with acupuncture therapy as trial group.And then,the quality of the qualified RCTs was evaluated,and the end-point outcomes of the RCTs were analyzed by Meta-analysis.Results A total of 7 RCTs involving 371 AP patients were included into the analysis.The time for abdominal pain relief(WMD =-1.44;95％CI:-2.38,-0.50),time for abdominal distension relief (WMD =-2.50;5％CI:-4.07,-0.73),time for the restart of anal exhaust(WMD =-1.79;95％CI:-3.73,-0.14),time for defecation (WMD =-1.95;95％CI:-3.51,-0.39),time for the restart of bowel sound(WMD =-1.39;95％CI:-2.44,-0.34),time for blood amylase becoming normal(WMD =-2.09;95％CI:-3.22,-0.96),and hospitalization time (WMD =-3.70;95％CI:-6.04,-1.36) in the trial group were less than those in the control group,and the differences of the above indexes except for the time for the restart of anal exhaust were significant (P ＜ 0.05).Conclusion Acupuncture as an adjuvant therapy is effective for improving the gastrointestinal function of AP patients,and shortening time for blood amylase becoming normal and hospitalization time.However,due to the low methodological quality,more well-designed randomized controlled trials are needed to confirm the therapeutic effect of acupuncture therapy for AP.

To observe Antiarrhythmic effects of L-dicentrine．Methods using experimented model of arrhythmials．Results: L-dicentrine iv l0 mg/kg could convert BacRinduccd arrhythmia into sinus rhythm in rats,and could significantly increase the tolerant dose of aconine to produce Ventricular fibrillation (VF) and Cardiac ［rrest (ca) in rats． The drug could also decrease the incidence of VF and CP by cardiac rats and by chloroform in mice． L-dicelltrine had protective effects on ouabain ind uced　Arrhythmias in guined pigs and on adrenalice induced arrhythmias in rabbit s ． The drug might also inhibit the arrhymias induced by stimulation ofhypothaplu s． Conclusion: L-dicenirine have significant antiarrhythmic properties．

Objective To study the evaluative values of amplitude integrated electroencephalogram (aEEG) in screening neonatal seizures.Methods The aEEG and video electroencephalogram (VEEG) on 32 patients with seizures hospitalized in Peking University First Hospital was conducted on the same day.The parameters of aEEG including the integrated spectra band,background rhythm and primitive electro signal were analyzed and compared with VEEG.Results Seizures presented clinically by 12 cases were detected by VEEG,and their electric discharges were detected by aEEG.The sensitivity of aEEG was 100%.VEEG showed electric discharges during intermediate stage in twenty cases and thus the seventeen of this group were detected by aEEG with its sensitivity of 87% and 100% in the specificity.The positive and negative predictive values of aEEG were 80% and 100%,respectively.But aEEG could not discriminate the attack stage or intermediate stage electric discharges.The abnormal background activity was detected by VEEG in 13 cases and the sensitivity of aEEG was 100% and the specificity was 83%.The positive and negative predictive value by aEEG were 76% and 100% respectively.The electric discharges of 32 cases were detected by VEEG whenever they were in attack stage or intermediate stage.All electric discharges could be detected through primitive electro signal by aEEG.The electric discharges in 3 cases were not detected by integrated spectra band from aEEG,but were detected by primitive electro signal from aEEG.Conclusions The sensitivity and specificity in the screening of neonatal seizures by aEEG is useful and could be applied clinically as a simple and safe screening method for recognizing neonatal seizures.

Objective To evaluate the value of two-dimensional strain imaging in assessing right ventricular function of recipient fetus in TTTS pregnancies.Methods Sixteen TTTS pregnancies and 19 normal monochorionic diamniotic pregnancies(controls) were included.Doppler studies of the umbilical artery,umbilical vein,ductus venosus,middle cerebral artery,atrioventricular valve and semilunar value were recorded in both fetus,and myocardial performance index of both ventricles was calculated.Longitudinal peak systolic strain of right ventricular were calculated and compared between recipient fetus and other fetus.Results Cardiothoracic ratio and myocardial performance index of right ventricular showed significant differences between recipient fetus and controls.Right ventricular strain was decreased in recipient fetus compared with controls.Conclusions Two-dimensional strain imaging can be used to evaluate right ventricular myocardial function in the recipient fetus of TTTS.

Objective To make a Meta-analysis of the effectiveness and safety of Shenling Baizhu Powder (SBP) for the treatment of ulcerative colitis(UC),thus to provide evidence for the clinical treatment of ulcerative colitis.Methods Randomized controlled trials (RCTs) of SBP combined with western medicine vs western medicine in treating ulcerative colitis were included.The quality of RCTs was assessed by the Cochrane scale.A Meta-analysis was performed for the clinical efficacy,improvement of disease activity index (DAI) levels of the included trials.Results A total of 19 RCTs were included,involving 1498 cases.The results of Metaanalysis showed that compared with the western medicine group,the combined risk ratio(RR) of clinical efficacy in the SBP combined group was 1.55,95％ confidence interval (CI) being (1.39,1.72).The subgroup analysis based on control medicine showed that the combined RR of combined use of sulfasalazine or mesalazine/Olsalazine was 1.46,1.59 [95％CI (1.19,1.77) vs 95％CI (1.40,1.80)].The subgroup analysis based on different treatment courses showed that the combined RR of 1-30 days,31-60 days,61-90 days was 1.42,1.69,1.47 [95％CI (1.18,1.70) vs 95％CI (1.44,1.97) vs 95％CI (1.15,1.88)] respectively.The differences were significant (P ＜ 0.05).(2) The differences of the two groups on the improvement of DAI and inflammatory factors levels of interlekin-17(IL-17),IL-23,tumor necrosis factor alpha(TNF-α),C-reactive protein(CRP) were statistically significant(P ＜ 0.05).(3)The sensitivity analysis of the primary outcomes showed a higher homogeneity in the literatures and the funnel plot analysis showed no evidence of publication bias.Conclusion Compared with western medicine,SBP combined with western medicine has better clinical efficacy for the treatment of UC,and the combined use of mesalazine/Olsalazine medicated for 30-60 days is more effective on improving DAI and inflammatory factors levels.However,for the low quality of the included literatures and insufficient experimental design,the conclusion needs more evidence from large sample-size randomized double-blind controlled trials.

ObjectiveTo explore the clinical value of ultrasound and MRI in diagnosis of simple fetal indirect hernia.MethodsA total of 671 558 fetuses were examined in maternal and child healthcare hospital of Hubei from February 2003 to February 2015. Once inguinal hernia or testicular tumors was suspected, MRI examination was performed after prenatal ultrasound. Final diagnosis was confirmed by postnatal follow-up. The ultrasonographic characteristics of fetal indirect hernia were compared with prenatal MR image characteristics and postnatal follow-up results.ResultsThree cases were conifrmed after birth. The simple fetal indirect hernia was uncommon clinical entity which occurred during 3rd trimester. The ultrasonic characteristics in prenatal period were: (1) Right enlarged scrotum was iflled with heterogeneous lesion; intestinal peristalsis within the scrotum was found in real-time ultrasonography. (2) The contralateral testis in left scrotum and penis could be found. MRI could display the characteristicsof indirecthernia contents and its extension from abdominal cavity intoinguinalregion, which may help diagnose fetal simple indirect hernia. One case of fetal indirect hernia was misdiagnosed as testicular tumors, which was correctly diagnosed by MRI.ConclusionsThe simple fetal indirect hernia can be prenatally diagnosed by characteristic ultrasonic features, which can present with abnormal mass ininguinalregion. Prenatal ultrasound is the primary screening method of fetal indirect hernia. MRI can serve as a supplement approach. The combination of US and MRI can further improve the diagnostic accuracy of fetal indirect hernia.

Objective To study the effect of glutamate on the expression of vascular endothelial growth factor (VEGF) mRNA and protein in cultured rat astrocytes. Methods Cultured rat astrocytes were randomly divided into 6 groups: control group (C), glutamate group (G), QA group (Q), DCG-IV group (D), L-AP4 group (L) and glutanmte-FMCPG gronp (G+M). Cells were cultured under nomoxic condition (95% air, 5% CO2). RT-PCR and ELISA methods were used to detect the expression of VEGF mRNA and protein in cultured astrocytes, respectively. G+ M group was preincubated with lmM MCPG for 30 min prior to the stimulation with glutamate. There were 7 time points at 0,4,8,12,16,24 and 48 h in each group except G+M group. Results The expression of VEGF mRNA and protein did not differ significantly among D group, L group and C group. Different from that in C group, the expression of VEGF mRNA and protein could be enhanced both in a dose-dependent and time-dependent manner in G group and Q group. Meanwhile, the enhanced expression of VEGF mRNA and protein in G group was completely suppressed by MCPG after 24 h. Conclusion Glutamate can increase the expression of VEGF mRNA and protein in cultured astrocytes, which may be due to the activation of group I metabotropic glutamate receptors in astrocytes.

Objective To analyze and summarize clinical manifestations of inflammatory bowel disease (IBD) in neonates.Methods From 2007 to 2013,three neonates were diagnosed with IBD in Peking University First Hospital.Data on these three cases with neonatal IBD were analyzed.The coding region of the interleukin 10 receptor A (IL10RA) gene was detected using direct Sanger sequencing in one of the patients.The literature was reviewed.Results The three newborns were 4-12 days old,all had symptoms of diarrhca,mucosanguineous feces and oral ulcers,accompanied by hypoalbuminemia and a family history.Two of these infants had perianal lesions,and one had liver damage and scizures.All three patients had elevated white blood cells and were anti-proteinase 3 positive.Two had elevated C-reactive protein and erythrocyte sedimentation rate,and one had positive antinuclcar antibodies and double stranded DNA antibodies.Colonoscopy showed multiple ulcers affecting the ileocecum and colon.The infants received treatment including antibiotics,switching formula feeding and 5-aminosalicylic acid.After treatment,one infant was cured,one died although glucocorticoids and azathioprine were used,and the other with a IL10RA gene mutation recovered,this infant had a compound heterozygous mutation with c.301C ＞ T (p.Arg101Trp),c.421G ＞ A (p.Gly141Arg) and whose parents were carriers.The literature review showed that fever and abnorrnal defecation were the main clinical features,and examination of serum antibodies showed a lower positive rate.The patients had a poor response to medications and most required surgery.IL10RA gene mutations were detected in some patients.Conclusions Neonates with diarrhea and a family history may have IBD and should undergo colonoscopy as early as possible.

Objective To study the neurological prognosis of neonates with ventriculomegaly and its influencing factors.Method A retrospective study was conducted among neonates with ventriculomegaly in Peking University First Hospital from January 2013 to December 2015.A series of cranial ultrasonography were performed after birth and the Gesell development scale was conpleted after six months.x2 test and two-independent-sample t test were used for statistical analysis.Result Among 103 cases of ventriculomegaly,95 cases (92.2％) had mildly enlarged lateral ventricles and 8 cases (7.8％) significantly enlarged.83 cases received serial cranial ultrasound examinations after birth.The lateral ventricles of 9 patients (10.8％) bacame wider and 74 (89.2％) not.The Gesell development scales were completed in 65 cases 6 months after birth.Among them,8 patients with widening lateral ventricles got poor prognosis (100％).Among 57 patients without progressively widening lateral ventricles,6 (10.5％) had poor prognosis.The difference was statistically significant (P ＜ 0.001).No correlation was found between the severity of the lateral ventricle widening and the neurological outcome (P =1.000).There were 2 cases with other abnormalities,and 1 case got poor prognosis on follow-up.Conclusion Most neonatal ventriculomegaly patients have mild and isolated lateral ventricle enlargement.Most of them remain stable or gradually return to normal.The patients with progressively widening lateral ventricles are likely to have adverse neurological prognosis.