Objective To investigate the clinical and neuroimaging features of adults with myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease at the first attack. Methods We retrospectively analyzed the clinical manifestations,radiological features,laboratory findings,and outcome of 14 adult patients with MOG antibody-associated disease at the first attack who were hospitalized in the departments of neurology of Jiangxi Provincial People's Hospital and Xinyu People's Hospital from January 2018 to January 2022. Results The 14 patients included six males and eight females,with a median age of 29.5 years. The most common initial symptoms were fever and headache (n=5),seizure (n=3),and dizziness (n=3). The supratentorial lesions were located in the thalamus (n=7),subcortical white matter (n=6),cortex (n=5),corpus callosum (n=2), and basal ganglia (n=2). The infratentorial lesions were frequently located in the brainstem:the pons (n=5),middle cerebellar peduncle (n=3),midbrain (n=2), and medulla (n=2). Three patients had spinal cord involvement,with one case of longitudinally extensive transverse myelitis. Thirteen patients had elevated cerebrospinal fluid cell counts,and seven had elevated cerebrospinal fluid protein levels. The serum MOG antibody titer ranged from 1∶3.2 to 1∶512. All the 14 patients received intravenous pulse glucocorticoid therapy. Only one patient had a relapse with optic neuritis. Conclusion In our study,MOG antibody-associated disease showed a slight female predominance and frequently presented as acute disseminated encephalomyelitis. The supratentorial lesions were often located in the thalamus and subcortical white matter,while the infratentorial lesions were frequently in the pons. Intravenous pulse steroid therapy was effecitve in the acute phase. The majority of the patients had a favorable outcome.

AIM To study the chemical constituents from twigs of Trigonostemon lutescens Y.T.Chang et J.Y.Liang.METHODS The ethyl acetate fraction of 95％ ethanol extract from T.lutescens twigs was isolated and purified by silica,Sephadex LH-20 and MCI column,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Ten compounds were isolated and elucidated as 3-O-acetyloleanolic acid (1),methyl 3-acetoxy-12-enly-oleanen-28-oate (2),taraxerone (3),spiciflorin (4),simiarenol (5),β-sitosterol palmitate (6),3,3',4-tri-O-methylellagic acid (7),β-sitosterol (8),stigamasterol (9),palmitic acid (10).CONCLUSION Compounds 1-6 are isolated from genus Trigonostemon for the first time,compounds 7 and 9 are first obtained from this plant.

Objective:To clone and express the full length cDNA of human CD38. Methods:The full length cDNA of the human CD38 antigen was amplified from total RNA of Daudi cell by RT-PCR, and it was inserted into pGEM-T. The validity on the sequences was confirmed by automatic DNA sequencing. Inserting the valid CD38 gene into pcDNA3.1(+) plasmid to obtain recombinant mammalian expression vector pcDNA3.1(+)/CD38Z; Using lipofectin gene transfer technique system, recombinant expression vector containing CD38 gene was transfected into COS7 cells. The expression of CD38 molecules on the surface of COS7 cells was detected by FACS and immunohistochemical technique. Results:DNA sequencing showed that the cloned full length cDNA sequence was identical with reported. The result of FACS and immunohistochemical technique indicated that CD38 molecules were expressed on the surface of COS7 cells. Conclusion:The full length cDNA of human CD38 is obtained, recombinant mammalian expression vector pcDNA3.1(+)/CD38Z is successfully constructed, and the CD38 molecules is expressed on the surface of COS7 cells,this may facilitate studies on the biochemistry and function of CD38 antigen.

Objective To investigate the prevalence of fecal incontinence (FI) among adult women in Beijing area, and to analysis risk factors associated with FI. Methods A stratified multiple-cluster systemic method was used to recruit women ≥ 20 years old in 6 districts of Beijing. A self-administrated questionnaire was used to collect information about Fl and possible risk factors. Results There were three thousand and 58 women participated in the survey, the average age was (48 ± 16 ) years (range 20 -79 years). The prevalence of FI was 1.28% ( 39/3058 ), which was related to age. There were five factors entered the logistic regress model, which were included age ≥40 years old ( OR = 3.3, 95% CI: 1.7 -6. 8), urinary incontinence ( OR = 3.0, 95% CI: 1.5 - 6. 1 ), vaginal delivery ( OR = 2.4, 95% CI:1.2 -4. 9), household per capita income ≤2000 RMB per month ( OR = 3. 3, 95 % CI: 1.6 - 6. 5 ), and feeling fatigue ( OR = 3.0, 95% CI: 1.5 - 5.8). Conclusion Prevalence of FI is low among adult women in Beijing area, while risk factors associated with Fl are complicated and further studies are necessary to be conducted.

Objective To investigate the efficacy of combined intravenous rt-PA and free-radical scavengen (edaravone) on Chinese patients with acute ischemic stroke. Methods Eighty-nine subjects with ultra-acute ischemic stroke were assigned to the group treated with intravenous rt-PA and another group treated with a combination of intravenous rt-PA and edaravone. The NIH Stroke Scale (NIHSS) and Barthel Index (BI) in 30 days and 90 days after thrombolysis were compared between two groups. Results There were statistically significant differences between the group of rt-PA thrombolysis and the group of combined with rt-PA and edaravon in the ratio of NIHSS 0-1 of 30 days after therapy (25.0% vs35.6%, χ2=8.259,P=0.041) and 90 days (27.3%vs 40.0%, χ2=9.158,P=0.027),as well as in the proportion of BI 95-100 of the same time points(30 days:20.5%vs33.3%,χ2=8.833,P=0.032;90 days:25.O%vs37.8%,χ2=8.221,P=0.042).The rates of hemorrhagic conversion and mortality in two groups were similar. Conclusion rt-PA combined with free radical scavenger edaravone safely and effectively decreases the loss of neurofunctions and reserves more self-dependence capability in patients with acute ischemic stroke 30 days and 90 days after treatments.

Objective To investigate the relationship between various clinicopatholngic factors and prognosis of early gastric cancer. Methods The clinical data of 459 patients with early gastric cancer who had undergone gastrectomy combined with extended (D2) lymphadenectomy at Zhongshan Hospital from January 2002 to October 2007 were retrospectively analyzed. Survival was calculated using the Kaplan-Meier method, and clinicopathologic factors such as age, sex, tumor size, gross morphology, tumor differentiation, depth of invasion, lymphatic vessels involvement and lymph node metastasis were analyzed using the Cox regression model. Univariate analysis was done by Log-rank test. Results Univariate analysis demonstrated that tumor size and differentiation, depth of invasion, lymphatic vessels involvement and lymph node metastasis significantly affected survival in patients with early gastric cancer (χ~2 = 8.476, 6.210, 4.014, 14. 197, 55.027, P < 0.05). The status of lymph node metastasis was an independent predictor of survival in patients with early gastric cancer, and the more metastatic lymph nodes detected, the greater the influence on the prognosis. Conclusions Lymph node metastasis is the most important factor influencing the prognosis of early gastric cancer. Appropriate lymph node dissection is necessary, especially for patients with risk factors associated with lymph node metastasis.

Objective To investigate the values of urine neutrophil gelatinase associated lipocalin (NGAL), kidney injury molecular-1 (KIM-1) and interleukin-18 (IL-18) in the diagnosis of acute kidney injury (AKI) in children after cardiopulmonary by-pass (CPB). Methods Sixty-seven patients who had undergone CPB were recruited from March to June 2013 and assigned to acute kidney injury group (AKI group) or non-acute kidney injury group (non-AKI group) according to the pediatric RIFLE (pRIFLE) cri-teria. Serum and urine samples were collected from each patient at 30 min, 2 h, 4 h, 24 h, 48 h and 72 h after CPB for serum and urine creatinine, urine NGAL, KIM-1 and IL-18. All the data were evaluated by receiver operator characteristic curve (ROC) analysis and area under curve (AUC) analysis. Results Twenty-three cases (34.3%) had AKI in 67 children after CPB. Among them 15 cases were risk-stage AKI, 4 cases injury-stage AKI, 3 cases failure-stage AKI and 1 cases loss-stage AKI. The levels of urine NGAL/Ucr were higher in AKI group than those in non-AKI group at 4h, 48h and 72h after CPB (P<0.05). The cut-off value of NGAL/Ucr was 1.200 at 4 h after CPB, the sensitivity and specificity for prediction of AKI were 0.864 and 0.561, and the AUC was 0.671 (95%CI:0.537-0.804). The levels of urine KIM-1/Ucr were higher in AKI group than those in non-AKI group at 48h and 72 h after CPB (P<0.05). The cut-off value of KIM-1/Ucr was 1.162 at 24h after CPB, the sensitivity and specificity for prediction of AKI were 0.773 and 0.512, and the AUC was 0.698 (95%CI:0.563-0.834). The levels of IL-18/Ucr were higher in AKI group than those in non-AKI group at 4 h after CPB (P<0.05). The cut-off value of IL-18/Ucr was 0.04 at 4 h after CPB, the sensitivity and specificity for predici-ton of AKI were 0.773 and 0.561, and the AUC was 0.655 (95%CI:0.510-0.800). Conclusions It is indicated that urine NGAL, KIM-1 and IL-18 may have important clinical values for early prediction of AKI.

Objective To study the changes of oxidative stress and caspase-3 in swine with traumatic hemorrhagic shock in dry-heat environment of desert.Methods A total of 48 Landrace small swine were randomly(random number)divided into 2 groups(n=24 in each group), and then the traumatic hemorrhagic shock was established in room temperature environment and in dry-heat environmentin swine.Dry-heat environment traumatic hemorrhagic shock group (DHS), which was made in an artificial experiment cabin mimic the reality included swine exposed in the dry-heat environment of desert for 3 h (T0, n=6), T1 (50 min after shock modeling, n=6), T2 (100 min after shock modeling, n=6), T3 (150 min after shock modeling, n=6).At each interval, blood sample was collected to detect urea nitrogen (BUN) and creatinine, urine sample was collected to detect neutrophil gelatinase-associated lipoprotein (NGAL), kidney tissue samples were collected to evaluate renal morphological and tubular scores, as well as to detect catalase (CAT), superoxide dismutase (SOD) and malondialdehyde (MDA).Western blot was used to detect the level of caspase-3.Traumatic hemorrhagic shock group of room temperature environment (RTS) was established and variety of assays were carried out as same as those deteced in the dry-heat environment group.Results Compared with the room temperature environment exposed group,kidney damage index, antioxidant and caspase-3 were increased in desert dry-heat environment exposed for 3 h group, but there were no statistically significant difference(P> 0.05).And from T1 then on, the levels of NGAL, CAT and SOD in DHS groups were increased which were significant different from those in RTS group (P<0.05 or P<0.01).There were significant differences in BUN and creatinine at T2 between two groups(P<0.05).At T3, caspase-3 protein content in DHS group was significantly different from that in RTS group (P<0.01).Correlation analysis showed that the NGAL level was correlated with the levels to MDA (rRTS=0.935, rDHS =0.858, P<0.01) in RTS group and DHS group.Compared with RTS group, renal tissue under light microscope showed that Bowman appeared dilated with degeneration and exfoliated epithelial cells, proximal tubule epithelial shedding, and interstitial edema in DHS group.Electron microscope showed that mitochondria became pleomorphic, endoplasmic reticulum with fold broadening.Conclusions When traumatic hemorrhagic shock happened in the desert dry-heat environment, desert dry-heat environment can aggravate kidney damage, possibly by reducing the renal tissue antioxidant enzyme content and increase renal tissue caspase-3 activity to promote renal tissue apoptosis.Antioxidant stress and apoptosis may be an important role in the prevention of the secondary kidney injury induced by traumatic hemorrhagic shock in dry-heat environment.

Objective To explore the associations of depressive symptoms with functional status and frailty in elderly outpatients.Methods A total of 297 geriatric outpatients(aged 65 years and over) from Zhejiang Hospital were recruited in the cross-sectional study from January 2014 to December 2015.We gathered general information,and evaluated depressive symptoms by Geriatric Depression Scale-15 (GDS-15),cognitive function by mini-mental state examination(M MSE),frailty by clinical frailty scale(CFS),activities of daily living (ADL)by Barthel index,instrumental activities of daily living (IADL),balance,POMA and gait by Tinetti-performance oriented mobility assessment (Tinetti-POMA),grip strength and 4m gait speed by 4-meter walk gait speed test.According to the GDS-15 scores,297 geriatric outpatients were divided into a depression symptom group(n=35,GDS-15 ≥6)and a nomdepressive symptom group(n=262,GDS-15＜6).The frailty and functional status were compared between two groups by SPSS 23.0.Results As compared with non-depressive symptoms,the depressive symptoms group had higher clinical frailty scale(CFS),lower body mass index(BMI),lower cognitive function and poorer grip strength and balance(all P＜0.05).There were significantly negative correlations of Geriatric Depression Scale-15 (GDS-15) with ADL,IADL,gait,balance,POMA and grip strength(r=-0.165、-0.154、-0.216、-0.291、-0.305、-0.314,All P＜ 0.05),while there were significantly positive correlations with CFS score,gait speed(r=0.256、0.198,both P＜0.05).The more severe the frailty was,the higher the risk of depressive symptoms was(OR=3.650,95％ CI 1.611-8.271).Conclusions The cognitive and physical functions in the elderly with depression symptoms are poorer as compared with the elderly without depression symptoms.Elderly outpatients with more severe frailty have a higher risk for depressive symptoms.

Objective To observe the expression levels of kidney injury molecule-1(KIM-1) in renal tissues of ischemia-reperfusion rats,and to explore the value in the diagnosis of acute kidney injury.Methods Rats were randomly divided into two groups,control(CON) group (n=64) and acute kidney ischemia reperfusion injury (AIKI) group (n=64).Rats were sacrificed following reperfusion 2h,6h,24h,48h,72h,1 week (w),2 w,and 4 w.The changes of morphology were checked on HE staining sections under light microscope.The extent of tubulointerstitial injury was determined by Sayhan classification.The distribution and expression of KIM-1 in renal tissue were observed by immunohistochemistry and Western blotting.Serum samples were collected and serum creatinine measurement was performed at different reperfusion time points.Results (1) Compared with the CON group,the renal tubulointerstitial injury scores of AIKI group were significantly higher at all times after reperfusion (P<0.01).(2) The expression of KIM-1 was consistent with the tubulointerstitial injury.The positive correlation between KIM-1 and the tubulointerstitial injury scores was significant(r=0.887,P=0.003).(3) Compared with the CON group,serum creatinine in AIKI group was significant higher at 2h,6h,24h,48h,72h after reperfusion (P<0.05).Serum creatinine had no correlation with the damage of renal tubulointerstitial.Conclusion The expression of KIM-1 increases significantly in renal ischemia reperfusion injury,and it is consistent with the tubulointerstitial injury.Compared with serum creatinine,KIM-1 may be a more accurate biomarker of renal damage.