ObjectiveTo analyze the clinical features and pathogenesis mechanism of Isaacs syndrome.MethodsA case with Isaacs syndrome was reporttedResults and ConclusionIsaacs syndrome is characterized by the occurrence of spontaneous and continuous muscle fiber activity, associated with muscle cramps, pseudomyotonia and myokymia, stiffness and delayed relaxation of the muscle. The stiffness and myokymia are present at rest and during sleep. Isaacs syndrome has been recently suggested to be produced through an immune-mediated mechanism in which voltage-gated potassium channels may be targeted by auto-antibodies.

Clinical data and treatment of a patient with late-onset glutaric acidemia type Ⅱ who was admitted to the Department of Pediatric Intensive Care Unit (PICU) of Shenzhen Children′s Hospital were retrospectively analyzed.The patient is a female with the clinical manifestations of aggravated progressive proximal muscle weakness, accompanied by vomiting, abdominal pain and liver enlargement.A marked increase of transaminase, bilirubin and creatine kinase was detected, and hyperammonemia, hypoglycemia and metabolic acidosis were also observed in the patient.Blood amino acids and acylcarnitines spectra showed increased levels of various acylcarnitines.The muscle biopsy study suggested lipid storage myopathy (LSM), and the genetic test identified a homozygous mutation in the electron transfer flavoprotein dehydrogenase (ETFDH) gene.After treatment with Vitamin B 2, carnitine, coenzyme Q10 and plasma exchange, the motivate ability and biochemical parameters of the patient returned to normal.For patients with aggravated progressive proximal muscle weakness, hepatic dysfunction and increased serum creatine kinase levels, late-onset glutaric acidemia type Ⅱ should be considered.The key to early diagnosis and treatment of the disease is to improve the knowledge of it.

Objective To study the positive rates of oligoclonal bands(OCB)and the IgG index in patients with multiple sclerosis(MS)and in other nervous system disorders(OND).Methods Cerebrospinal fluid(CSF)and serum were collected from 54 patients with MS,271 patients with OND including 62 patients with infections of central nervous system and 209 patients with non-infections.The OCB and IgG index of CSF and serum were detected.Results The positive rate of OCB was 35.2% in MS,8.9% in OND(P<0.05),in which 24.2% in infections of central nervous system(P>0.05),4.5% in non-infections of central nervous system.The positive rate of IgG index was 83.3% in MS,78.2% in OND(P>0.05).Conclusion OCB is helpful to diagnose MS if infection diseases have be excluded,while IgG index can be referenced.

Objective To observe efficacy of percutaneous laser disc decompression (PLDD) and its correlation with plasma levels of β-endorphine and substance P in patients suffering from protrusion of lumbar intervertebral disc (PLIVD). Methods Seventy-eight patients with PLIVD were randomly divided into two groups, one group (40 patients) treated with PLDD and the other (38 patients) treated with lumbar spine traction and physical therapy as control. Their peripheral plasma levels of β-endorphine and substance P were measured before the procedure and one day, one week and four weeks after it, respectively.Meanwhile, the visual analogue scale (VAS)was applied to assess their pain index. Results Plasma level of substance P was (186±66) ng/L and (419±82) ng/L, and (127 +83) ng/L and (322 +47) ng/L,in treatment and control groups, one day and one week after the procedure, respectively, and that of β-endorphine was (313 ±27) mg/L and (187 ±56) mg/L, and (364 + 18) mg/L and (211 +39) mg/L,one day and one week after it, respectively ( all P ＜ 0. 01 ), with its clinical efficacy of 90% (36/40)and 66% (25/38) one week after it, respectively ( P ＜ 0. 01 ) . Four weeks after it, plasma level of substance P was (64 ±50) ng/L in treatment group as compare to that in controls (93 ±75) ng/L, and that of β-endorphine was (410 ± 21 ) mg/L and (317 ± 42 ) mg/L, respectively, with efficacy of 95% (38/40) and 84% (32/38), respectively. Conclusions Plasma level of substance P can be reduced and that of β-endorphine can be increased by PLDD in patients with PLIVD, thus relieving their pain.Measurements of substance P and β-endorphine can be used as objective indicators to evaluate clinical efficacy of PLDD.

OBJECTIVE To discuss a highly effective method to immobilize probe on the surfaces of piezoelectric DNA sensors.METHODS Pseudomonas aeruginosa probe was immobilized on the gold surface of gene sensor(array) with routine self-assembly method(SAM)(non-reduction method) and SAM with deoxidized probe((reduction) method),respectively.The changes in frequency and time-cost were compared in reactions with(different) concentrations of probe.RESULTS Reduction method had the advantage of more probe immobilization;less time consumed in testing and higher changes in frequency during the reaction than non-reduction method.CONCLUSIONS Reduction method has a better ability to immobilize probe on the surfaces of piezoelectric DNA sensors.

Objective To evaluate the clinical results of self-designed double-pivot extracorporeal reduction device in internal fixation with percutaneous pedicle screws for thoracolumbar fractures.Methods From January 2014 to May 2015,a total of 41 patients with thoracolumbar fracture without neurological symptoms underwent minimally invasive fixation with percutaneous pedicle screws.Of them,22 were treated with our self-designed double-pivot extracorporeal reduction device and the other 20 with common single-pivot extracorporeal reduction device.The 2 groups were compared in terms of pre-and postoperative kyphotic angles,correction rates and anterior,middle and posterior heights of injured vertebrae to evaluate the therapeutic effects of the self-designed double-pivot extracorporeal reduction device.Results The patients were followed up for 6 to 18 months (average,12.3 months).No iatrogenic impairment of nerve root,postoperative infection,or implant failure happened.Compared with preoperation,significant improvements were observed in all the patients regarding cobb's angle,anterior,middle and posterior heights of the fractured vertebral body (P ＜ 0.05).Compared with the single-pivot group,the double-pivot group were significantly superior in the kyphotic angle,correction rate,and anterior and middle heights of the injured vertebrae(P ＜ 0.05),but there was no significant difference between the 2 groups in the recovery of posterior height of the fractured vertebral body (P ＞ 0.05).Conclusion Compared with the single-pivot reduction device,the self-designed double-pivot reduction device may be preferable in percutaneous pedicle screw fixation for thoracolumbar fractures.

BACKGROUND:Monoaxial pedicle screws are not conducive to the instal ation during percutaneous pedicle screw technique, but it has better mechanical conductivity and stability than polyaxial pedicle screws. How to select and use these two kinds of screws in the clinic to exert their advantages and to further elevate efficacy has become a subject worthy of reflection. OBJECTIVE:To compare the clinical efficacy of percutaneous pedicle screw placement for thoracolumbar fracture using monoaxial and polyaxial pedicle screws at different placement selections. METHODS:A total of 46 cases of thoracolumbar fracture without neurological symptoms underwent minimal y invasive percutaneous pedicle screw fixation. 25 patients (monoaxial screw group) were treated with monoaxial pedicle screws and the other 21 ones (polyaxial screw group) with polyaxial pedicle screws. Kyphotic angle, correction rate, correction loss rate and height of injury vertebrae were compared before and after fixation in both groups. The therapeutic effects of monoaxial and polyaxial percutaneous pedicle screw fixation in the treatment of thoracolumbar fractures were evaluated. RESULTS AND CONCLUSION:(1) Fixation time, blood loss, complication and hospital stay were not significantly different in both groups (P>0.05). (2) Kyphotic angle and height of the fractured vertebra body were significantly different between the two groups (P<0.05). (3) The restoration of anterior height of injured vertebrae, kyphotic angle and correction rate were better in the monoaxial screw group than in the polyaxial screw group after treatment (P<0.05). The correction loss rate was significantly better in the monoaxial screw group than in the polyaxial screw group during last fol ow-up (P<0.05). However, there was no significant difference in the posterior height of injured vertebraeafter fixation (P>0.05). (4) These findings indicate that compared with the polyaxial percutaneous pedicle screw fixation, the monoaxial pedicle screw may be preferable in percutaneous pedicle screw fixation for thoracolumbar fractures, has more satisfactory fracture distraction reduction, and has less postoperative correction loss rate.

Poria cocos,Cortex Poriae,Polyporusumbellatusand Alisma orientalisare common tra-ditionaI Chinese diuretic medicines. According to reported Iiterature,P.cocostriterpenes and poIysaccha-rides,steroids and tetracycIic triterpenes are the main chemicaI components of P.cocos,its epidermis, Pol.umbellatusand A.orientalis,respectiveIy. most of these diuretic drugs contain tetracycIic triterpenes and steroids,which have a simiIar structure to aIdosterone nucIeus structure. Therefore,this characteris-tic may reveaI their diuretic mechanisms. The tetracycIic triterpenes and steroids may exert diuretic effect through competitive inhibition of aIdosterone receptors in different parts of tubuIar reabsorption to increase urine output. The present articIe reviewed the chemicaI components of these diuretic Chinese medicines. Furthermore,their bioactive components and action mechanisms were aIso anaIyzed and discussed.

OBJECTlVE To investigate the effect of Guiyuan tablets on the analgesic effect of morphine and morphine-induced tolerance and hyperalgesia. METHODS ① The model of morphine-induced acute tolerance Mice were ig treated with Guiyuan tablets 200, 400 and 800 mg·kg-1 and 15 min later were sc treated with morphine 10 mg·kg-1 every hour for consecutive 9 h. At 24 and 48 h, they were sc treated with morphine 10 mg·kg-1 alone, respectively.②The model of morphine-induced chronic tolerance Mice were ig treated with Guiyuan tablets 200, 400 and 800 mg·kg-1 and 15 min later were sc treated with morphine 10 mg·kg-1 every day for consecutive 8 d. On d 9, the mice were sc treated with morphine 10 mg·kg-1 alone. ③ The model of morphine-induced established tolerance. Mice were sc treated with morphine 10 mg·kg-1 every day for consecutive 8 d. On d 1, d 4 or d 7, the mice began to be ig co-administered with Guiyuan 200 mg·kg-1 . On d 9, they were sc treated with morphine 10 mg·kg-1 alone. The hot-plate test was used to detect the values of the baseline latency ( T0 ) and the post-treatment latency ( T1 ) before the percentage of maximal possible analgesic effect (%MPAE) was calculated. Spec-trophotometry was used to detect the nitric oxide synthase ( NOS) activity and the nitric oxide ( NO) con-tent in the tissue of the spinal cord. RESULTS The ED50 of the analgesic effect of Guiyuan tablets was 523.5 mg·kg-1 in the hot-plate test. Guiyuan tablets 200 and 400 mg·kg-1 prolonged the duration of mor-phine anti-nociception and deceased its ED50 from 4.67 to 3.14 and 0.65 mg·kg-1, respectively. ln the models of both acute and chronic tolerance, Guiyuan tablets prevented the decrease of the%MPAE and the baseline latencies ( P<0. 05 ) . ln the model of morphine-induced established tolerance, Guiyuan tablets rapidly reversed the decrease of%MPAE( P<0.05) , and this compound preparation which began to be co-administered with morphine from d 1 could significantly inhibit the increase of the NOS activity and NO content induced by morphine in the spinal cord ( P<0.01) . CONCLUSlON Guiyuan tablets are capable of enhancing the analgesic effect of morphine, prolonging the duration of morphine anti-nocicep-tion, preventing the development of morphine-induced tolerance and hyperalgesia, and might have neuroprotective effect.

Objective:To analyze the characteristics of health financing at the provincial level according to the total health expenditure since China health system reform began in 2009 and provide evidence for improving health fi-nancing policy. Methods:20 provinces were chosen and vertical and horizontal Comparative approach was used to an-alyze the data. Results:Total health expenditure increased for all regions, of which the biggest rate was Anhui prov-ince, about 82. 97%, while the largest increasing for government health care expenditure was Ningxia province, a-bout 108 . 71%. In 2012 , the provinces with social health expenditure share of total above 40% were allocated in the east region, and the number of provinces with out-of pocket payment share of total above 40% reduces to 5. Conclu-sion:Total health expenditure grew in all regions, but there were differences in the degree that this spending matched the economic level;The financing structure was optimized, but the characteristic of regional financing was different. Some provinces were under huge pressure to reduce out-of pocket payments. Suggestions: Under the premise of im-proving the funding level, financing structure adjustment must be focused, and public funding should play a bigger role and out-of pocket payments should be reduced.