Objective To explore the correlation of β2-adrenergic receptor (β2-AR) polymorphisms (Arg16Gly) with early onset Myasthenia Gravis (MG). Methods Forty-eight with age less than 40 years at disease onset were divided into three groups:normal thymus (13 cases), thymic hyperplasia (22 cases) and thymoma (7 cases) groups according to the thymus histology. These patients were further divided into different subgroups including female (31 cases) and male groups (17 cases) based on the gender, OMG (29 cases) and GMG (19 cases) groups according to the symptom of disease onset and groups associated with (10 cases) or without (33cases) other autoimmune diseases Or with unknown causes (5 cases). The genotypes ofβ2-AR in 48 early onset MG were determined by gene sequencing. Results Arg/Arg was more common in early MG patient with normal thymus ( 53.8%)and thymic hyperplasia(54.6%)whereas Arg/Gly was more common in thymus group(71.4%). The difference in distribution of the genotypes between the three groups was not statis?tically significant (χ2=5.657,P=0.226). Arg/Arg was more common in early female MG patient (58.1%) and Arg/Gly was more common in male MG patients (58.8%). The difference in distribution of the genotypes between the two groups was
statistically significant (χ2=6.064,P=0.048). Arg/Arg was more common in early OMG patient (48.3%). Arg/Arg(42.1%) and Arg/Gly(47.4%) were equal common in GMG patients. The difference in distribution of the genotypes between the two groups was statistically significant ( χ2=1.623,P=0.444). Arg/Arg was more common in early MG patient associated with other autoimmune diseases (80.0%). Arg/Gly was more common in MG patients without other autoimmune diseases (39.4%). The difference in distribution of the genotypes between the three groups was statistically significant (χ2=6.394, P=0.041). Conclusionβ2-AR gene polymorphism in position 16 is associated with gender and other autoimmune diseas?es in patients with early onset of MG.

Objective To explore the correlation of β2-adrenergic receptor (β2-AR)polymorphisms (Arg16Gly) with the prognosis of myasthenia gravis (MG) complicated with other autoimmune diseases.Methods Among the 75 MG patients in analysis,17 cases were complicated with other autoimmune diseases (AIDMG),58 cases without other autoimmune diseases (NAIDMG).MG patients,AIDMG patients,NAIDMG patients were separately divided into recurrence groups and nonrecurrence groups according to the progression at 2 years after onset.The genotypes of β2-AR in 75 MG patients were determined by gene sequecing.Results The frequencies of three genotypes (Arg/Arg,Arg/Gly and Gly/Gly) in position 16 were 30.8％,50.0％,19.2％ in recurrence MG group and 42.9％,38.8％,18.3％ in non-recurrence MG group respectively.The difference in distribution of the genotypes between recurrence MG group and non-recurrence MG group was not statistically significant (x2 =1.150,P=0.563).The frequencies of Arg and Gly allele were 55.8％ and 44.2％ in recurrence MG group,and 62.2％ and 37.8％ in non-recurrence MG group.The difference in distribution of the alleles between the two groups was not statistically significant.The frequencies of 3 genotypes in position 16 were 27.3％,63.6％ and 9.1％ in recurrence AIDMG group and 100.0％,0,0 in non-recurrence AIDMG group,respectively.The frequencies of Arg and Gly allele were 59.1％,40.9％ in recurrence AIDMG group,and 100.0％,0 in non-recurrence AIDMG group.The difference in distribution of the genotypes between recurrence AIDMG group and non-recurrence AIDMG group was statistically significant (P =0.009).There also was significant difference in distribution of alleles between recurrence and non-recurrence AIDMG groups (x2 =6.676,P =0.010).The frequencies of 3 genotypes in position 16 were 33.3％,40.0％ and 26.7％in recurrence NAIDMG group and 34.9％,44.2％,20.9％ in non-recurrence NAIDMG group,respectively.The frequencies of Arg and Gly allele were 53.3％,46.7％ in recurrence NAIDMG group,and 57.0％,43.0％ in non-recurrence NAIDMG group.There was no significant difference in distribution of genotypes or alleles between recurrence and non-recurrence NAIDMG groups.Conclusion β2-AR gene polymorphism in position 16 may predict the prognosis of AIDMG,and there is no correlation between the polymorphism in position 16 of β2-AR and the prognosis of MG and NAIDMG.

Objective To investigate the association of glucocorticoid receptor (GR) polymorphisms (BclI)with the prognosis of myasthenia gravis (MG).Methods We totally enrolled 74 patients diagnosed as MG from the Department of Neurology,Beijing Shijitan Hospital between 2002 and 2014.Of them,54 patients started with ocular MG and 20 patients started with general MG.MG patients were divided into recurrence group and non-recurrence group according to the progression at two years after onset.Patients with simple ocular symptom at disease onset were further divided into generalized MG (GMG) group and single ocular MG (OMG) group according to disease progression or not.The GMG group was divided into two groups (≤6 months,7-24 months) according to the progression time of generalization.The GMG group was further divided into three groups (limbs,throat,both limbs and throat) according to the first symptom of generalization.The genotypes of GR were determined by polymerase chain reaction and nucleotide sequence determination.Results The frequencies of three genotypes (GG,CG,CC) in BclI were 57.7％,34.6％,7.7％ in recurrence MG and 64.6％,31.3％,4.1％ in non-recurrence MG respectively.The difference in distribution of the genotypes between the two groups was not statistically significant (x2 =0.570,P =0.750).The frequencies of G and C allele were 75.0％ and 25.0％ in recurrence MG,and 80.2％ and 19.8％ in non-recurrence MG.The difference in distribution of the alleles between the two groups was not statistically significant (x2 =0.540,P =0.462).The frequencies of three genotypes GG,GC and CC were 55.9％,35.3％,8.8％ in GMG and 2/6,4/6,0/6 in OMG respectively.The frequencies of G and C allele were 73.5％ and 26.5 ％ in GMG,and 8/12,4/12 in OMG.The difference in distribution of the genotypes and alleles between the two groups was not statistically significant (x2 =2.278,P =0.320;x2 =0.241,P =0.624).The frequencies of three genotypes GG,GC,CC were respectively 61.9％,28.6％,9.5％ and 3/6,3/6,0/6 in ≤6 months,7-24 months of GMG group.The frequencies of G and C allele were 76.2％,23.8％ and 9/12,3/12 in the two groups.The difference in distribution of the genotypes and alleles between two of the three groups was not statistically significant (x2 =1.326,P =0.515;x2 =0.007,P =0.932).The frequencies of three genotypes GG,GC and CC were respectively 2/8,4/8,2/8;11/13,2/13,0/13 and 3/6,3/6,0/6 in limbs,throat,both limbs and throat of GMG group.The frequencies of G and C alleles were 8/16,8/16;92.3％,7.7％ and 9/12,3/12 in the three groups.The difference in distribution of the genotypes and alleles between two of the three groups was statistically significant (x2 =8.813,P =0.028;x2 =9.706,P =0.008).The genotype frequencies in every group were all in Hardy-Weinberg equilibrium.Conclusions BclI polymorphism may predict the first generalized symptom of OMG.BclI polymorphisms of GR might have no relationship with the recurrence of MG,generalization and generalized time of OMG during the first two years after MG onset.

OBJECTIVEThe effect of Kou Yan Qing Ke Li on the prevention and treatment of radiation-induced oral mucositis was investigated in patients with nasopharyngeal carcinoma.

METHODSSixty patients with nasopharyngeal carcinoma to be treated with radiotherapy were randomized into two groups: the experimental and control groups. The experimental group (30 patients) was treated with Kou Yan Qing Ke Li during the full course of radiotherapy. The control group (30 patients) rinsed their mouths in the same way with mouth washes containing 0.9% sodium chloride injection, lidocaine, dexamethasone, vitamin B2 and B2 gargle liquid mixture, when grade 2 and above radiation-induced oral mucositis appeared in the process of radiation. Radiation-induced oral mucositis was assessed according to the radiation therapy oncology group criteria. The time of occurrence and degree of pain grade were compared between the two groups.

RESULTSThe first onset of oral mucositis in the experimental group (12.40 d ± 2.74 d) was later than that in the control group (9.46 d ± 1.39 d) (t = 5.241, P < 0.001), whereas the grade of pain and acute radiation mucositis was lower in the experimental group than that in the control group. The difference was statistically significant.

CONCLUSIONKou Yan Qing Ke Li could delay the time of occurrence of radiation-induced oral mucositis, reduce the severity of radiation stomatitis, alleviate the pain of patients, improve the clinical symptoms of patients, and effectively prevent and treat radiation-induced oral mucositis in patients with nasopharyngeal carcinoma.

Objective:To observe the general status, the effect of resisting to the aggression of FBL-3 cells and protective immunity of the mice by using leukemia vaccine during the immune reconstitution.Methods:The immune deficiency C57BL/6 mice induced by total body irradiation were reconstituted immunity with homologous splenic lympocytes.The mice were immunized by injecting FBL-3 cells subcutaneously,and then attacked by using FBL-3 cells 7days thereafter.The activities of mice,the percentage of carcinoma formation and the growth status of tumor were observed.The amount of IFN-? in peripheral blood was determined by ELISA to evaluate the magnitude of cell immunity.The condition of cell infiltration in tumor central region and its periphery region was explored by patologic-section.Results:Immune reconstitution could obviously elevate protective immunity on the basis of using vaccine,and the amount of IFN-? was obviously higher.The FBL-3 tumors inoculated thereafter grwe slowly,and significant infiltration of mononuclear cells peri-tumor as well as necrosis of tumor cells were observed.Also,the life time of the mice was prolonged.Conclusion:Immune reconstitution and vaccine can significantly elevate protective immunity

Aim To investigate the role of phospho-lipase C epsilon 1 ( PLCE1 ) in modulating the apoptot-ic mechanism in esophageal cancer ( Eca ) cells. Methods Eca cell lines, OE33 and CP-C cells were cultured to assess the expression of PLCE1 . siRNA suppress expression of PLCE1 . The expression of PLCE1 and p53 was evaluated by quantitative real time PCR and Western blot. Methylation analyses of p53 were performed by bisulfite conversion of genomic DNA. Apoptosis was assessed by flow cytometry. Results OE33 and CP-C cells expressed high levels of PLCE1 . Knockdown of PLCE1 markedly increased the expression and hypomethylation of p53 , and in-creased the frequency of apoptosis. Conclusion PLCE1 suppresses apoptosis of Eca cells via promoting p53 promoter methylation and inhibiting expression of p53 .

Objective To observe the intervene effects of montmorillonite powder and mannitol on rat with acute paraquat poi-soning by intragastric administration .Methods 40 male SD rats were divided into four groups randomly ,control group(C) ,pa-raquat group(P) ,PT1 groups were treated with montmorillonite powder and mannitol gavage after paraquat exposure one hour ,PT2 group was treated after paraquat exposure four hours .P ,PT1 ,and PT2 groups were exposed to paraquat 50 mg/kg .one and four hour later ,PT1 and PT2 group rats were given 7 g/kg montmorillonite-mannitol solution respectively ,C group and P group with sa-line instead .then to observe general state in rats .Give rats run training before and after intragastric administration ,comparison the fall times from the treadmill among groups before and 5 ,10 ,15 days after administration ,rats were killed in 15 th days exposed pa-raquat ,collect their lung tissue ,hydroxyproline content were measured in lung tissue of rat by alkaline hydrolysis ,observe the path-ological changes by HE staining in rat lungs .Results the general condition were poor in P ,PT1 and PT2 group rats .And those mean food intakes were significantly lower than the control group (P<0 .01) .there are no significant of the weight gain and the fall times from the treadmill before and 5 th ,10 th after administration among four groups(P>0 .05) ,but P group′s fall times increased significantly than the others group′s at 15 th day after exposed(P< 0 .05) .the all group rat lung tissue hydroxyproline overall difference significant(P<0 .01) ,from the two-two compared results ,three paraquat exposed groups higher than control group ,and P group also higher than PT1 and PT2 group(P<0 .05) .From the lung tissue slices ,P ,PT1 and PT2 group showed significant pul-monary fibrosis than C group ,and the P group′s was the most severe .Conclusion Pulmonary interstitial fibrosis may be alleviated by early use of montmorillonite powder and mannitol on paraquat poisoning rats .

Objective To study the curative effects and adverse effects of the thalidomide combined with COMP chemotherapy in treating multiple myeloma(MM).Methods 42 patients were initially diagnosed as MM and 27 patients were refractory and relapsed MM.The small dose of thalidomide combined with COMP management and COMP management alone were used.The effective rate and adverse effects were analyzed.Changes of M-protein in serum,percentage of plasma cells in bone marrow and the level of hemoglobin were also analyzed in both pre-treatment and post-treatment periods.Results In 42 patients who were initially diagnosed as MM,the effective rate was 40.9% for 22 patients treated by chemotherapy alone and 70.0% for 20 patients treated by the thalidomide combined with chemotherapy.Statistic difference was observed between those two group.As to the 27 patients who were refractory and relapsed MM,the effective rate was 42.9% for 13 patients treated by chemotherapy alone and 84.6% for 14 patients treated by the thalidomide combined with chemotherapy.Statistic significance was present between them.Adverse effects were less and tolerated.Conclusion Treatment of small dose of thalidomide combined with COMP chemotherapy could significantly improve the effective rate with less adverse effects.

To report the clinical, radiological and neuropathological findings of a patient with rheuma-toid meningitis. The patient was a 71-year-old Chinese man with a two-year history of rheumatoid arthritisand no other significant medical history, who presented to our hospital recurrent weakness of his left ex-tremities, dysarthria and a continuous bilateral hand tremor. Cerebrospinal fluid (CSF) and serumexam-inations were normal apart from a mildly raised serum perinuclear antineutrophil cytoplasmic autoantibody(p-ANCA). Brain magnetic resonance imaging (MRI) showed leptomeningeal enhancementin both fron-tal and parietal lobes, in addition to several old white matter infarcts. Meningeal biopsy showed numerousinfiltrating macrophages and lymphocytes within the leptomeninges. The patient responded clinically andradiologically to corticosteroid and cyclophosphamide therapy. The patient subsequently developed herpeszoster over his left chest as a complication of his immunosuppressive treatment. His cyclophosphamidewas ceased and intravenous immunoglobulin (IVIG) therapy was commenced, with good clinical responseto both the herpes zoster and meningitis. According to the result of the biopsy, aseptic meningitis wasconsidered the MRI results and the patient’s clinical history were given, and a diagnosis of rheumatoidmeningitis was made. The patientwas p-ANCApositive. Although there was no evidence for cerebral vas-culitis on biopsy, it remains a possibility that the patient’s recurrent minor cerebral infarcts visible onMRI were vasculitic in nature.

Objective To study the chemical constituents of Epimedium brevicornum.Methods Compounds were isolated with various chromatographic techniques,their structures were elucidated by physicochemical methods and spectral analysis.Results Ten compounds were obtained and identified as p-nitroethylphenol(Ⅰ),salidroside(Ⅱ),5,7,4'-trihydroxy-8,3'-diprenylflavone(Ⅲ),kaempferol-3-O-?-L-dirhamnoside(Ⅳ),baohuoside-Ⅰ(Ⅴ),sagittatoside B(Ⅵ),2″-O-rhamnosylicariside Ⅱ(Ⅶ),7,3',4',5'-tetrahydroxyflavanol(Ⅷ),desmethylicaritin(Ⅸ),and 1-O-?-glucopyransosyl-1,4-dihydroxy-2-(3'-hydroxy-3'-methylbutyl)benzene(Ⅹ).Conclusion Compounds Ⅰ,Ⅱ,Ⅳ,and Ⅹ are isolated and identified from the plants of Epimedium L.for the first time and compound Ⅵ is isolated from the title plant for the first time.