Objective To quantitatively assess severity of movement disability by analyzing physical activities recorded by an actigraph monitor in patients with neurology disorders.Methods Eighty-one patients with Parkinson' s disease(PD)and 61 patients with acute cerebral infarction(ACI)accompanying impaired upper limb motor function were included in the study.PD patients and ACI patients were treated using the international PD and ACI treatment guidelines,respectively.The patients were asked to wear an Actigraph monitor for 6 days before the treatment in both PD and ACI patient groups and at 24-38 days post-treatment in PD patients or at 28 days post-treatment in ACI patients.The recorded data was analyzed by power-law exponent(PLE)and detrended fluctuation analysis(DFA).Clinically,before and after the treatments,PD patients were evaluated using the conventional Unified Parkinson Disease Rating Scale (UPDRS),and ACI patients were evaluated by assessing upper limb motor function using Fugl-Meyer Assessment(FMA)and Functional Independence Measure(FIM).The correlation of the UPDRS scores with PLE was analyzed in PD patients,and the correlation of FMA or FIM with DFA in ACI patients.Results Both the UPDRS scores and the PLE values in PD patients were improved after the drug administration(UPDRS total:32.8 ± 16.2 and 28.8 ± 14.7,Z =2.080,P =0.038; UPDRS Ⅲ:18.6 ± 8.2 and 15.7±6.8,Z=2.155,P=0.031; PLE:0.98 ±0.25 and 0.82 ±0.21,Z=2.212,P=0.027,before and after the treatment,respectively).There were a linear correlation coefficient of 0.699 between the improvements of total UPDRS scores and the PLE values,and of 0.823 between the UPDRS Ⅲ and the PLE values.FMA,FIM scores and DFA were improved significantly than before treatment(FMA:12.39 ± 8.21 and 30.28 ±7.29,Z=3.016,P =0.004; FIM:8.98 ±7.29 and 13.21 ±7.6,Z =2.282,P=0.038; DFA:0.86 ±0.31 and 0.98 ±0.27,Z =2.360,P =0.036,before and after the treatment,respectively).It also showed linear correlations between the improvements of FMA scores and DFA(r =0.638),and between FIM scores and DFA(r =0.712,both P ＜0.05).There was no correlation between UPDRS scores and DFA values in PD patients,nor between FIM scores or FMA scores and PLE values in ACI patients.Conclusions Actigraph device can be used to monitor patients activity in movement disorders.Analysis of its PLE can provide a quantitative evaluation in PD while its DFA may provide useful specific assessment of impaired upper limb motor function in ACI patients.It can also be used in quantitatively assessing new drug efficacy.

Objective To explore the value of shear wave elastrography (SWE) in diagnosis of prostate cancer.Methods SWE quantitative elastography was preformed in 55 patients with suspected prostate cancer,to obtain the elastic modulus (mean,maximum).Each patient underwent sonography-guided prostatic biopsy on the same day.With the pathologic results as reference,ROC curves were used to assess diagnostic performance.Results ①Pathological tests showed that 39 lesions were benign(hyperplasia) and 16 lesions were malignant.The mean elasticity value of benign lesions was (39.04 ± 8.22) kPa,and the maximum value was (54.10 ± 9.18)kPa,whereas of malignant ones were (53.31 ± 3.92)kPa and (68.71 ±2.57)kPa,respectively (P ＜0.05).② The area under the ROC curve (AZ) of the maximum and mean elasticity value was 0.951 and 0.944.Taking 48.07 kPa as the threshold of the mean elasticity value,the sensitivity was 91.8％ and the specificity was 89.7％.Then taking 65.50 kPa as the threshold of the maximum elasticity value,the sensitivity was 92.1％ and the specificity was 87.5％.Conclusions SWE is helpful to diagnose and differentiate prostate diseases by measuring elastic modulus.

Objective To investigate the clinical efficacy of laparoscopy combined with cholangioscopic FREDDY laser lithotripsy for the treatment of difficult central type bile duct calculi.Methods Fifty-five patients with difficuh central type bile duct calculi undergoing laparoscopy combined with cholangioscopy were analyzed retrospectively.There were 31 patients in FREDDY laser lithotripsy group (FREDDY group) and 24 patients in routine instrunent group (routine group).Operative time,intraoperative blood loss,conversion rate,time to first flatus,incidence of postoperative complications (such as pancreatitis,hemobilia and biliary leak),postoperative hospital stay and first session bile duct clearance rate were compared.Results Operative time,intraoperative blood loss,time to first flatus,postoperative hospital stay in FREDDY group [( 106.2 ± 49.4) min,(37.7 ± 28.6) ml,(25.8 ± 19.3 ) h,(5.9 ± 3.3 ) d]were significantly lower than those in routine group[( 142.2 ± 64.8 ) min,(60.3 ± 32.1 ) ml,(37.2 ± 21.6 ) h,(8.4 ±4.9) d] (P＜ 0.05 or ＜0.01 ).There were no statistically significant differences in conversion rate,incidence of postoperative complications and first session bile duct clearance rate between the two groups (P ＞ 0.05).There were no dead in both groups.Seven patients with residual bile duct stones were cured by cholangioscopy through T-tube sinus 6 weeks after prior surgery.Forty-three patients were followed up 6 to 12 months with no recurrent bile duct stones and bile duct stenosis.Conclusions Laparoscopy combined with cholangioscopic FREDDY laser lithotripsy is recommendable to treating difficult central type bile duct calculi with good short-term results and has the advantages of minimal invasiveness,safety,efficiency and rare complications.

Candida shehatae xyl1 gene and Pichia stipitis xyl2 gene were amplified by PCR and the xyl1 and xyl2 were both placed under the promoter GAL of vector pYES2 to produce the recombinant expression vector pYES2-P12. Subsequently the pYES2-P12 vector was transformed into S. cerevisiae YS58 by LiAc to produce the recombinant yeast YSS8-12. It was indicate that the recombinant yeast YSS8-12 could converse xylose to ethanol with the xylose consumption rate of 81. 3%.

Objective To investigate the imaging features of primary clear cell carcinoma of liver and to assess the role of CT and MRI in the diagnosis of the disease. Methods Nineteen cases of primary liver clear cell carcinoma of liver were collected. All cases were confirmed by operation and pathology. Both pre-contrast and post-contrast scans with spiral CT were performed in 13 cases. MRI with T1WI, T2WI, and dynamic multi-phase contrast scanning were performed in 8 cases. Imaging findings in all cases were retrospectively reviewed. Results On pre-contrast CT scans, all 13 lesions appeared as hypodensity and among them irregular more hypodense region was found in 9 cases. On the arterial phase, all cases showed obvious enhancement, among which 9 cases were enhanced heterogeneously with central non-enhanced area.On the portal venous phase, 11 lesions were hypodense compared with normal live parenchyma and 2 lesions were isodense. The rim enhancement of tumor capsule was demonstrated in 3 cases. On MR T1WI, 5 of 8 were hypointense and 3 were slightly hyperintense. On MR T2WI, 5 of 8 cases were heterogeneously hyperintense, and 3 were iso-hypointense. On the MR arterial phase, marked enhancement was found in all 8 cases. On the portal venous phase and delayed phase, 7 of 8 cases were hypointense and 1 was isointense.The rim enhancement of tumor capsule was found in 2 cases. Conclusion CT and MRI can display the characteristic features of primary clear cell carcinoma of liver and can be helpful to improve the diagnostic accuracy.

Objective To investigate the predictive value of the 40 Hz auditory steady state response (40-Hz ASSR) in the short-term prognosis of patients with brainstem stroke.Methods The 40-Hz ASSR and brainstem auditory evoked potentials (BAEP) examinations were recorded and graded from 36 patients with brainstem stroke admitted in the Neurological Intensive Care Unit (NICU). Tue end point of short-term prognostic evaluation was at the time of leaving the NICU. Tue patients with brainstem stroke were divided into the survival group (n =21) and the death group (including brain death,n = 15). The correlation between the grade of the 40-Hz ASSR or BAEP and the short-term prognosis was analyzed. Results The grade of the 40-Hz ASSR (r=0.571,P =0.000) or BAEP (r =0.441,P =0.001 ) was significantly correlated with the short-term prognosis in patients with brainstem stroke. The sensitivity,specificity and accuracy of the 40-Hz ASSR were 60.00％,100％ and 83.33％,respectively,and those for BAEP were 66. 67％,71.43％ and 69. 44％,respectively. Conclusions Tue 40-Hz ASSR has a certain short-term prognostic value in patients with brainstem stroke. The higher the grade of 40-Hz ASSR is,the more serious the illness,and the worse the prognosis.

Objective To explore the predictive value of early electroenphalography (EEG) for a malignant course in patients with large middle cerebral artery infarction (LMCAI).Methods Thirty-seven patients (20 patients with a malignant and 17 with a benign course) with stroke of >50% of the middle cerebral artery territory in early CT/MRI scan were included;Glasgow-Pittsberg Coma Scale (24 ±1 vs. 30 ±4, P =0. 003) and National Institutes of Health Stroke Scale (23 ±3 vs. 16 ±4, P =0.000) in the group with a malign course were higher than those in the group with a benign course. Early EEG was recorded within 24 h after ischemic stroke. The correlation between the change characteristics of EEG and a malignant course in patients with LMCAI was analyzed. Results The contralateral occipital background frequencies < 8 Hz (17/20 vs. 3/20, P =0.000), β frequency within the focus ≤20 Hz (19/26 vs. 7/26, P= 0-001), EEG non-reaction to stimuli (11/12 vs. 1/12, P= 0.002),slowing affecting the whole hemisphere in the lesion (17/24 vs. 7/24, P = 0. 008) and focal slowing contralateral to the lesion (16/19 vs. 3/19, P =0. 000) were significantly related with a malignant course. Whereas the contralateral occipital background frequencies ≥8 Hz (14/17 vs. 3/17, P =0. 000),β frequency >20 Hz within the focus (10/11 vs. 1/11, P =0. 001) were related with a benign course. Conclusions Early EEG has a certain predictive value for a malignant course in patients with LMCAI, and it may be used as one of the bedside monitoring approaches of LMCAI.

Objective:To illuminate the influence of InsB15-23 H-2Kd dtSCT to the morbidity of type 1 diabetes mellitus in NOD mice.Methods:An eukaryotic plasmid encoded membrane-expressed InsB15-23 H-2Kd dtSCT was inoculated into 3 weeks old female NOD mice subcutaneously and the blood sugar and morbidity of type 1 diabetes mellitus were monitored once a week.To illuminate the cellular mechanism of immunologic intervention of membrane-expressed InsB15-23 H-2Kd dtSCT to the course of type 1 diabetes mellitus in NOD mice,the mononuclear cell infiltration of islets was detected by tissue slice and the frequency of IGRP206 2-14 specific CTLs in PBMC was analyzed by FACs.Results: As compared with pcDNA3.1 (-) control ( 60%) and untreated NOD mice ( 80%) , mice immunized with InsB15-23 H-2Kd dtSCT exhibited low level of islet infiltration and low morbidity in 30 weeks old ( 9%) .But the frequency of IGRP206-214 specific CTLs in PBMC of 16 and 40 weeks old mice showed no difference.Conclusion:Membrane-expressed InsB15-23 H-2Kd dtSCT can protect NOD mice from type 1 diabetes mellitus in IGRP206-214 independent pattern.

Objective To illustrate and analyze the clinical feature and treatment of botulism introduced by illegal injection of botulinum neurotoxins (BoNT),in order to provide some evidence for early diagnosis and treatment strategy.Methods Retrospective analysis of 13 botulism patients was performed in this article.All of the patients were suffered from illegal injection of botulinum neurotox in products.Support treatments were carried out according to their severe grade,and the courses of disease and the curative effects were observed.Results A new category was first identified as injection induced botulism to describe such a situation of cosmetic injection out of the hospital with neither the prescribed botulinum toxin product nor a doctor.One in 13 patients graded mild botulism,the other 12 patients graded middle level.The processes of the new botulism had 4 stages:preclinical stage (4 days),progressive stage (9.8 days),apical stage (9.1 days) and restoration stage (5.2 months).The relationships of a positive correlation in injection dose and the length of progressive stage were identified,while a negative correlation with the length of preclinical stage was revealed.Conclusions The earlier2-3 weeks after illegal injection are crucial for intense care because of the acceleration in this period.Absolute rest and active treatments as well as antitoxinum are benefit for the recovery of patients.