Objective To observe the clinical features and visual function of recurrent neuromyelitis optica (NMO).Methods Thirty-four patients with NMO were enrolled in this retrospective case series study.The patients included two males and 32 females.The average first onset age was (35.03± 14.56) years old and the average recurrent rate were (4.24±2.45) times.The recurrent rate of optic neuritis (ON) ranged from two to 12 times.The recurrent rate of ON was two times in 15 eyes of 10 patients,≥three times in 37 eyes of 24 patients.Vision acuity,direct ophthalmoscope,fundus pre-set lens examination,visual field and visual evoked potential (VEP) were evaluated.Clinical features were observed.The abnormal rate of optic nerve including optic edema and atrophy; abnormal rate of visual field including decreasing retinal sensitivity,central and paracentral scotoma,ring scotoma,half field defects,tunnel visual field,visual field centrality constriction; abnormal rate of VEP including Prolonged latent phase and/or decreasing amplitude of P100 wave from patients of first episode or recurrence was analyzed.Serum NMO-IgG was detected from 28 patients hy indirect immunofluorescence technique to observe its positive rate.Results All patients were characterized by repeated episodes of ON and myelitis.The main clinical feature of ON was visual loss,and the main clinical features of myelitis included sensory disability,dyskinesia and vesicorectal disorder.Blindness rate was 41.67％ after the first attack of ON,33.33％ after two relapses,and 64.86％ after ≥ three relapses.The difference of blindness rate between first attack and two episodes was not significant (x2=0.270,P=0.603).However,the blindness rate in patients having ≥ three episodes was significantly higher than those having two episodes (x2=4.300,P=0.038).With recurrence rate increasing,the abnormal rate of the optic nerve (x2 =6.750,P =0.034) and VEP(x2 =6.990,P =0.030)increased.But the abnormal rate of visual field did not increase along with recurrent rate (x2 =0.660,P=0.718).Seropositive rate of NMO-IgG did not differ significantly between patients with first attack ON and that with recurrent ON (x2 =1.510,P =0.470).But the seropositive patients had significantly higher bilateral blindness rate than seronegative patients (x2=5.063,P=0.027).Conclusions NMO are characterized by recurrent ON and myelitis.Visual loss,sensory disability,dyskinesia and vesicorectal disorder are the main clinical features.With recurrence rate increasing,the blindness rate,abnormalities the optic nerve and the abnormity rate of VEP increase.Seropositive recurrent NMO patients have higher bilateral blindness rate than seronegative patients.

Objective To investigate glucose metabolism , insulin secretion and serum lipid in patients of nonalcoholic fatty liver disease (NAFLD) with hypertension. Methods A total of 100 subjects including NAFLD with hypertension (n = 50) and NAFLD without hypertension (n = 50), in our hospital during Jul. 2010 to Jul. 2012, were enrolled in this study. Records the following information of the two groups: The clinical data , oral glucose tolerance and insulin releasing test , serum lipid , serum uric acid and ALT were recorded. Results Compared with the NAFLD without hypertension group, impaired glucose regulation was significantly increased in patients in the NAFLD with hypertension group(P < 0.05).The insulin releasing was significantly increased at 30 min and was increased at 180 min in patients in the NAFLD with hypertension group (P < 0.05).The insulin releasing during 30 min to 120 min was descend gradually in patients in the NAFLD with hypertension group,with no significant difference between these two groups. TG was markedly elevated in patients in the NAFLD with hypertension group (P < 0.05). Conclusion Prevalence of impaired glucose regulation was elevated obviously in NAFLD with hypertension group,and early-phase insulin secretion were reduced and delayed.

Objective To investigate the CT manifestations and differential diagnosis of benignity and malignancy of appendiceal mucocele.Methods The clinical and imaging data of 31 pathologically confirmed appendiceal mucocele were analyzed retrospectively,in which simple mucocele and mucinous cystadenoma were devided into benign group;low grade appendiceal mucinous neoplasm(LAMN) was devided into borderline group;mucinous cystadenocarcinoma was devided into malignant group.The CT manifestations were analyzed and compared statisticallyl in size(long diameter and short diameter), cyst wall(thickness, evenness, smoothness), intra-cystic contents(mural nodules, septum, calcification, intra-cystic fliud density), periappendiceal fat stranding, intraperitoneal free fluid and pseudomyxoma peritonei.Sensitivity and specificity values were calculated if single or multiple CT manifestations were used.Results Of the 31 cases of mucocele of the appendix, 11 of them were in benign group (including 8 cases of simple mucocele and 3 cases of mucinous cystadenoma);14 cases in borderline group (LAMN) and 6 cases in malignant group (mucinous cystadenocarcinoma).CT findings including evenness and smoothness of cyst wall, mural nodule, intraperitoneal free fluid and pseudomyxoma peritonei showed statistically significant difference among three groups (P<0.05).When combined with any four of the five signs, the sensitivity and specificity for diagnosing malignant mucocele were 83% and 88% respectively.But no significantly difference were found among the three groups(P>0.05) in long diameter and short diameter of mucocele, attenuation of intraluminal contents, maximal wall thickness, calcifications, internal septa and periappendiceal fat stranding.

Objective To clarify protective effect of the application of Ginkgo-damole in elderly patients with hypertension in total hip arthroplasty.Methods From January 2012 to December 2013,67 elderly patients with hypertension which should take total hip arthroplasty were divided into observation group and control group.Ginkgo-damole were only used in observation group during the operation.The anesthetic effect and the change of systolic blood pressure(SBP)diastolic blood pressure(DBP),heart rate(HR)and mean arterial pressure(MAP)were observed,postoperative recovery time of consciousness were recorded. Results The level of SBP,DBP,MAP and HR in both group were significantly difference when compared with before anesthesia(P<0.05 ).At the T2-4 time point,the level of SBP,DBP,MAP in observation group were significantly higher than that of control group,the level of HR was significantly lower than the control group,there had significant difference(P<0.05).At the T5 time point,the level of SBP, DBP,MAP and HR in observation group were significantly lower than of control group,there had significant difference between two groups(P<0.05 ).The postoperative recovery time in observation group was(10.41 ±2.35)min,which was lower than that in control group(15.63 ±2.42)min,there had significant difference between two groups(P<0.05 ).Conclusion Ginkgo-damole can effectively relieve the stress reactions caused by anesthesia and total hip arthroplasty,it has good protective effect on elderly patients with hypertension.

Objective To investigate the role of stem cell factor (SCF) and mast cells (MC) in the pathogenesis and progression of dermal lesions caused by chronic renal failure.Methods Thirty-six Wistar rats were randomly divided into model group (adenine lavage at a dose of 150 mg·kg-1·d-1) and control group (physiological saline lavage at equal volume).Six rats from each group were sacrificed respectively at week 4,8 and 12.The intensity of MC infiltration was examined by toluidine blue staining. The expression of SCF was detected by immunohistochemistry and real-time fluorescence quantitative PCR. Results Compared with control group,the intensity of MC and the expression of SCF were significantly higher in dermal tissue of model group (P＜0.O1,respectively),and they were increased with time.In the model group,the number of MC infiltration was positively correlated with both the protein expression of SCF (r=0.81,P＜O.01) and the level of SCF mRNA (r=0.65,P＜0.01). Conclusion The increased SCF and MC may participate in the pathogenesis and progression of dermal lesions caused by chronic renal failure.

Objective To observe stimulation and regulation of T lymphocyte subtypes by wild-type and mutant A?40 and A?42 conjugated with different adjuvants and to investigate possible ways to lower the toxicity of A? immune response. Methods Forty BALB/c mice were randomized into five groups:Al adjuvant group,A?42+CFA group,A?42+Al group,A?40+Al group and A?40(E22A)+Al group. After an initial immunization and booster immunization,antibody was titrated. Their splenocytes were stimulated by respective antigen. After 48 h,the quantities of IFN-?,IL-2,TNF-? and IL-4 were tested. After 72 h of culture,the proliferative response of splenocytes was detected by CCK-8 assay.Results Experimental groups generated specific anti-A? antibodies with proliferative response of spleen lymphocytes. Cytokine detection in culture supernatant showed that A?42+CFA group had the highest secretion of Th1-type cytokines IFN-?,IL-2,TNF-? when A?40(E22A)+Al group had the lowest(P

Objective To investigate the effects of serum from rats with burn injury on the differentiation of bone marrow mesenchymal stem cells(MSCs). Methods Bone marrow was extracted from sacrificed Wistar rats and MSCs were then incubated in F-12 medium in the presence of fetal calf serum (FCS) (group F),normal rat serum (group N),or serum harvested from rats with burn injury(group B). Cells of the fifth passage were harvested to investigate the expression of CK and FⅧ by immunohistochemistry and flow cytometry. Results With immunohistochemical staining,both CK and FⅧ were positive in MSCs of group B and negative in the cells of the other two groups. The flow cytometry analysis showed that the positive rates of CK and FⅧ staining MSCs of group B were higher than that of the other two groups ( P 0.05). Conclusions The serum obtained from rats with burn injury could induce differentiation of MSCs to both epithelial cells and vascular endothelial cells,implying that serum after barm injury might promote the MSCs to participate in the process of wound repair.

Objective To estimate the risk factors of fall happening in the old inpatient of the department of psychiatry and make up preventing measures.Methods 128 old inpatient(36 male cases and 92 female cases,whose age were older than 60) were surveyed.All of the patients were evaluated for risk factors and were interfered by safe nursing and follow-up in duration of hospital stay and in one year post-discharge in order to prevent the occurrence of accident fall.Results Of the 128 investigation patients there were 49 patients(38.3%) who had fall history in the past year.And the female falling patients were 39,while the male falling patients were 10.There were no significant statistical difference between the male and female cases(P>0.05).Of the 128 investigation patients there were 2 fall patients(1.6%) after 1 year safe nursing interference(P<0.001).The risk factors found by Logistic analysis were non-cooperation,poor action ability,blurred vision and taking antipsychotic drug.Conclusion The risk ratio of old inpatient of the psychiatric department is high.The accident of fall should be prevented efficiently.

Major breakthrough and challenge that encountered by modern western medicine were described in this article. Some standpoints about the necessity of innovative revolution for the development of traditional Chinese medicine, together with the key points should be bring to the attention during ideological emancipation have been put forward here. Chinese scientists agreed that it is the most appropriate timing for us to establish a new medicine system, which we named Holistic Systems Medicine (HSM). The concept and research contents of Holistic Systems Medicine were also introduced in this article. Finally, a proposal for setting up“China Holistic Systems Medicine development project” was proposed.

Objective To explore the value of the histogram of ultrasound in diagnosing and grading of fatty liver. Methods Ninety subjects were enrolled in normal group, light or moderate to severe fatty liver group (each n=30), respectively. All the subjects underwent histogram of ultrasound of the liver, kidney, spleen and right hepatic vein (RHV), and the ratio of histogram M value of different area were analyzed. Results Statistical differences of the ratio of histogram M value of anterior hepatic tissue of kidney and kidney (AntK) between normal group and two fatty liver groups were detected (P<0.05). The ratio of histogram M value of anterior hepatic tissue of RHV and RHV (AntV) between the normal group and moderate to severe fatty liver group, as well as the light and moderate to severe fatty liver group had statistical differences (P<0.05). When 0.97, 0.78 were used respectively as the critical value of the ratio of histogram M value in diagnosing and grading of fatty liver at AntK and AntV, the sensitivity was all 80.00% and 80.00%, specificity was 85.00% and 70.00%, respectively. Conclusion The ratio of histogram M value of AntK, AntV can be used as the referent index in diagnosing and grading of fatty liver.