Objective To explore the CT and MR imaging characteristics of intracranial melanomas. Methods CT and MRI characteristics in five patients admitted to our hospital from June 1993 to June 2000 and diagnosed as intracranial melanomas were retrospectively analyzed. Results There were two cases of primary melanoma and three cases of secondary melanoma. All the cases were examined by CT. The lesions presented as high density in 4 cases, and low density in only 1 case. Four cases were examined by MRI. Short T 1 and short T 2 signals were found in 3 cases, and slightly long T 1 and short T 2 signal was found in 1 case. Conclusion There are some special characteristics of melanomas on the MR imaging, which are helpful to ensure the diagnosis and distinguish the primary melanomas from secondary melanomas.

Objective To study the effects of quercetin(QUE) on proliferation of rat glioma C6 cell line in vitro.Methods The cells were divided into 5 treatment groups(10,25,50,75 and 100 ?mol?L~(-1) QUE),blank control and menstruum control group.The rat C6 cells were cultivated to 1?10~6?mL~(-1) in the RPMI 1640 medium,then added into 96 holes board with various doses of QUE by 3 holes per group,and MTT assay was used to observe the proliferation of the cells treated for 24,48 and 72 h.The change of cell cycle was also observed by flow cytometry(FCM) after the cells were treated with 50 and 100 ?mol?L~(-1) QUE for 48 h.The changes of the protein P53 and Bcl-2 of C6 cells treated with 50 ?mol?L~(-1) QUE for 48 h were detected by immunocytochemical methods.(Results With) the augmentation of QUE and the extension of the treated time,the C6 cell growth was inhibited,the A values decreased and the cell number in G_0/G_l phase was increased,the cell numbers in S and G_2/M phases were cut down,and the decreased expression of Bcl-2 protein and the increased expression of P53 protein were also observed after treatment with QUE.Conclusion Inhibitory effect of QUE on C6 cell line is proved to be dependent on the treated time of the drug and the dose of QUE,and the induced apoptosis of C6 cells is implemented by the means of up-regulation of P53 protein expression and down-regulation of Bcl-2 protein expression.

Objectives To provide prenatal diagnosis and genetic counseling for four athigh-risk pregnant women with a suspected family or personal history of fragile X syndrome (FXS) by genetic screening of fragile X mental retardation (FMR1) gene.Methods This study was conducted on four pregnant women (No.l to 4) who received outpatient treatment in Peking University First Hospital from August 2014 to June 2016.Genomic DNA was extracted from peripheral blood samples of the pregnant women and six of their family members,four of which were suspected or confirmed FXS and the other two were FMR1 gene carriers.Amplide X kits were used to detect CGG repeat size in FMR1 gene.Two amniocytes and one chorionic villi samples were collected from three pregnant women to extract DNAs for FMR1 gene and karyotyping analyses.Results There were patients diagnosed with FXS in all the families by detecting CGG repeat numbers in FMR1 gene.The pregnant woman No.1 was a permutation carrier;No.2 carried normal FMR1 alleles while her brother had a mutation with over 20 CGG repeats in FMRI gene at chromosome X.No.3 and 4 were full mutation carriers with over 200 CGG repeats in FMR1 gene.After genetic counseling,No.3 decided to terminate the pregnancy due to abnormal fetal karyotype (47,XY,+21) and full mutation of FMR1 alleles.No.1 and 4 continued to pregnancy as their fetuses were normal in FMR1 alleles and karyotype.No.2 continued to pregnancy as her fetus was free of FXS risk.Conclusions Prenatal diagnosis and genetic counseling should be conducted on women at highrisk for FXS to avoid birth defects.People with a family history of FXS should be tested for FMR1 gene carrier status.

BACKGROUND:Lipoic acid, with a closed circle structure composed by sulphur and carbon atoms, exerts strong anti-oxidation, and has been extensively applied in the prevention and treatment of oxidative stress, diabetic cataract, diabetic neuropathy and cardiovascular diseases. OBJECTIVE:To investigate the protective effect of lipoic acid on peripheral nerve function during peripheral nerve ischemia/reperfusion injury. METHODS:Models of peripheral nerve ischemia/reperfusion injury were established in rabbits, and then rabbit models were then allotted to treatment and non-treatment groups. The treatment group was subdivided into experimental (injection of lippoic acid) and control groups according to the use of lipoic acid at 1, 3 and 6 hours after ischemia and before reperfusion. The ultrastructural changes of the sciatic nerve were observed under electron microscope, and the electrophysiological changes of the sciatic nerve were detected using evoked potential instrument. RESULTS AND CONCLUSION:With the ischemic time increasing, the number of vacuoles in the axon increased gradually, accompanied by axonal atrophy, and Waller's degeneration in the aggregated microfilaments. The myelin sheath thickening and dissolving were visible. All above phenomena became severest at 6 hours after ischemia. Compared with the control groups, lipoic acid reduced the number of the vacuoles in the axon and all eviated axonal atrophy, Waller's degeneration and demyelination. As the ischemic time increasing, the latency of sciatic nerve was significantly increased, and peaked at 6 hours of ischemia;while the amplitude was significantly decreased, and reached a minimum at 6 hours of ischemia. Compared with the control groups, in the experimental groups, the latency of sciatic nerve was significantly decreased, but the amplitude was significantly increased. These results suggest that lipoic acid provides neuroprotection against peripheral nerve ischemia/reperfusion injury.

Objective To investigate the alteration of chaperone hsp40 and its effects on the dealyed neuron death in the CAI neurons after transient cerebral ischemia.Method Twenty-minute transient global ischemia rat model was used.Following different repeffusion period,all the 28 wistar rats were divided into sham-operation group ,4-hour recovery group,24-honr recovery group and 72-hour recovery gronp,7 ratsin in each group,Immunochemistry and laser scanning confocal microscopy were used to observe the distributional alteration of hsp40 in the neurons.Differential centrifuge and westemblot analysis were used to analyze the quantitative alteration of hsp40 and its redistribution in the neurons.Results lnanunechemistry and laser scanning confocal microscopy showedthe reduction of hsp40 first in cytosol,then in the nucleus until all the neurons in the CAI region died.Differential centrifuge and westemblot analysis showed the quantity of hsp40 decreased from (1.00_+0.21) to (0.23±0.13)(P<0.01) after 24-hour repeffusion;the quantity of hsp40 in the protein aggregates increased from (1.00±0.18) to(8.61±1.89)(P<0.01) after24-hour reperfusion.Conclusions The reduction of hsp40 in the neurons of hippocampus CA1 region is an important factor resulting in protein aggregates formation.

Objective To summarize the clinical features of 22 probands diagnosed with congenital muscular dystrophy (CMD),and to provide genetic counseling and prenatal diagnosis for 23 fetuses of these pedigrees.Methods Data of 22 CMD patients who were treated in the Pediatric Department of Peking University First Hospital during October 2006 to March 2016 were analyzed.Informed written consents for participation in this study were obtained from the parents or guardians.Prenatal diagnosis was performed using DNA samples extracted from fetal villus cells of 12 cases at 11-13 gestational weeks and amniotic fluid of 11 cases at 18-22 gestational weeks.Direct DNA sequencing by polymerase chain reaction (PCR) and multiplex ligation-dependent probe amplification (MLPA) were used to detect CMD-related gene mutations.Linkage analysis of short tandem repeats (STRs) was used to identify maternal blood contamination and biological parents.Results Thirteen out of the 22 probands with CMD were diagnosed with congenital muscular dystrophy type 1 A (MDC1A),and all of them carried compound heterozygous mutations in LAMA2 gene.Prenatal diagnosis of 13 fetuses from these pedigrees found that four fetuses were wild-type,seven were heterozygotes and two carried the same mutations as their proband.Three probands with LMNA-related congenital muscular dystrophy (L-CMD) carried de novo mutations in LMNA gene.In these pedigrees,two fetuses were wild-type and one whose mother was mosaicism carried the same mutations as the proband.One proband with Ullrich congenital muscular dystrophy carried compound heterozygous mutations in COL6A2 gene and the fetus of the same pedigree was wild-type.Five probands were diagnosed with α-dystroglycanopathies.And among them,two cases of muscle-eye-brain disease (MEB) carried compound heterozygous mutations in POMGnT1 gene and the fetuses of the two peidgrees were heterozygotes;one case of congenital muscular dystrophy type 1C (MDC1C) had compound heterozygous mutations in FKRP gene and the fetus carried the same mutations;one patient diagnosed with POMGnT1-related congenital muscular dystrophy with mental retardation (CMD-MR) carried compound heterozygous mutations in POMGnT1 gene,and the fetus was positive for the same mutations;one proband with POMT1-related CMD-MR was positive for compound heterozygous mutations in POMT1 gene and the results of prenatal diagnosis for two fetuses of this pedigree showed that the first fetus had the same mutations as the proband,while the second was heterozygote.Conclusions No effective therapeutic method is available for CMD.Therefore,accurate genetic counseling and prenatal diagnosis are necessary to prevent CMD child from birth.

OBJECTIVE:To provide reference for guarantee the supply of short-landed drugs.METHODS:A questionnaire survey was conducted to investigate the drug shortage in 40 medical institutions in China.Based on the survey data,the econometric model was built to analyze the reasons for drug shortage in medical institutions.RESULTS:40 questionnaires were issued and 26 valid questionnaires were collected with effective recovery rate of 65.0％.The institutions surveyed received 87 samples of short-landed drugs,involving 33 drugs;82.8％ of short-landed drug samples were in short supply for more than 3 months,and even 21.8％ short-landed drug samples were in short supply for more than 12 months.The common reasons for drug shortage mainly included:not entering the provincial bidding directory;adopting the government pricing method;being redistribution system;not establishing provincial normal reserve mechanism.In addition to common reasons,there were some personality reasons for drug shortage based on the necessity of clinical needs,drug attributes and drug price.CONCLUSIONS:There are many reasons for the shortage of drugs in medical institutions.There are both common causes and personality reasons.It is necessary to solve many problems of drug shortage from the source,and it needs many policies and systems to cooperate with them.

Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease characterized by excessive fat accumulation in the liver. More and more evidence suggests that NAFLD is a multisystem disease that affects multiple extra-hepatic organs. Recent studies have shown that NAFLD may be associated with the risk, severity, and outcome of ischemic stroke. The article provides a summary of these aspects.

Objective To analyze the prognostic value of serum microRNA(miRNA)-21-5p and miRNA-5189-5p expression levels in elderly patients with prostate cancer after laparoscopic radical prostatectomy(LRP).Methods A total of 213 elderly prostate cancer patients treated with LRP from January 2014 to Sep-tember 2018 in the First Affiliated Hospital of Hainan Medical College were retrospectively selected as the study objects.According to the 5-year follow-up outcome,the patients were divided into good prognosis group(87 cases)and poor prognosis group(126 cases).The preoperative clinical baseline data and the expression levels of serum miRNA-21-5p and miRNA-5189-5p were collected.Logistic regression analysis was used to screen the factors affecting the prognosis of patients.The prognostic prediction model was constructed with independent risk factors,and the predictive value was analyzed by drawing receiver operating characteristic(ROC)curve.Results Multivariate Logistic regression analysis showed that serum prostate specific antigen(PSA)level,positive incisal margin,and expression levels of miRNA-21-5p and miRNA-5189-5p were inde-pendent risk factors for the prognosis of elderly prostate cancer patients receiving LRP(P＜0.05).The com-bined prediction model was established based on independent risk factors,and the area under the curve of each factor alone predicting prognosis of elderly prostate cancer patients receiving LRP was less than that of four combined prediction(P＜0.05).Conclusion The expression levels of serum miRNA-21-5p and miRNA-5189-5p are of high value in predicting the prognosis of elderly prostate cancer patients after LRP.

Purpose: The prognosis of patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) is extremely poor, and systemic therapy is currently the mainstream treatment. This study aimed to assess the efficacy and safety of lenvatinib combined with anti–programmed cell death-1 antibodies and transcatheter arterial chemoembolization (triple therapy) in patients with HCC and PVTT. Materials and Methods: This retrospective multicenter study included patients with HCC and PVTT who received triple therapy, were aged between 18 and 75 years, classified as Child-Pugh class A or B, and had at least one measurable lesion. The overall survival (OS), progression-free survival (PFS), objective response rates, and disease control rates were analyzed to assess efficacy. Treatment-related adverse events were analyzed to assess safety profiles. Results: During a median follow-up of 11.23 months (range, 3.07 to 34.37 months), the median OS was greater than 24 months, and median PFS was 12.53 months. The 2-year OS rate was 54.9%. The objective response rate and disease control rate were 69.8% (74/106) and 84.0% (89/106), respectively; 20.8% (22/106) of the patients experienced grade 3/4 treatment-related adverse events and no treatment-related deaths occurred. The conversion rate to liver resection was 31.1% (33/106), with manageable postoperative complications. The median OS was not reached in the surgery group, but was 19.08 months in the non-surgery group. The median PFS in the surgery and non-surgery groups were 20.50 and 9.00 months, respectively. Conclusion Triple therapy showed promising survival benefits and high response rates in patients with HCC and PVTT, with manageable adverse effects.