In clinical practice, muscular atrophy is a common sign in children. Because of relatively thick subcutaneous fat in children, muscular atrophy is not easy to be discovered. In order to confirm the diagnosis earlier, it is very important to take history in detail, to observe the motor function, cry, the posture of sitting and standing carefully, to do the physical examination thoroughly, and to use the assistant test reasonably.

Objective To observe the clinical effects of pemetrexed chemotherapy combined with radiotherapy in brain metastases of lung adenocarcinoma patients.Methods The data of lung adenocarcinoma patients with brain metastases were conducted retrospectively diagnostic analysis,and they were stratified randomized divided into the observation group (26 cases) and the control group (25 cases).The observation group was treated with pemetrexed chemotherapy combined with radiotherapy; the control group was treated with radiotherapy alone.Brain metastases,quality of life,short-term efficacy,adverse reactions,and patients' survival period were observed.Results The efficacy and quality of life of patients in the observation group were improved significantly than those of the control group,and adverse reactions were mild,the survival period was not significant between two groups.Conclusions Pemetrexed in combination with radiation therapy for the treatment of brain metastases from lung adenocarcinoma can effectively improve the short-term efficacy and quality of life of patients,and the adverse reactions are mild,it possess great application value in the treatment of brain metastases of lung adenocarcinoma.

To confirm a patient's muscular dystrophy is a motor neuron amyotrophy or not,we should take history in detail,physical examination completely,and assistant test reasonably.The history include the first onset symptom such as dysarthrosis,dysphagia,weakness and muscular dystrophy in the hand.We should pay attention to the fasciculation,insensibility,sphincter problem,the symptom progress,and family history.The lab tests include serum creating kinas,electromyogram,muscle biopsy,and gene(SOD1,SMA)analysis.It is important distinguish motor neuron amyotrophy from other muscular dystrophy with the cause of the spinal anterior horn cells damage clear.

Objective:To study p16 methylation of BEP-2D cells during its malignant transformation.Methods:Normal BEP-2D cells and BEP-2D cells treated by cigarette smoke condensate(CSC) for 15 weeks(W-15),25 weeks(W-25),38 weeks(W-38) and 43 weeks(W-43)respectively were chosen to study the p16 methylation status by Nested methylation specific PCR (Nested-MSP).Results:The p16 methylation was found in W-15,W-25,W-38 and W-43 BEP-2D cells,but not in the normal BEP-2D cell.Conclusion:The p16 methylation may be considered as a kind of biology-marker of the early diagnosis of lung cancer because the p16 methylation occurs in the earlier period of lung cancer.

0.05);There are significant differences between treatment group and control group in moderate and severe patients(P

Objective:To study the phamacokinetics of Nalmefene hydrochloride. Methods:30 healthy Chinese volunteers were assigned to 3 groups according to randomized design, and each group were given respectively a single intravenous administration dose of 0.5 mg, 1mg and 2mg of Nalmefene hydrochloride. The electrospray ionization positive selected reaction monitoring detections for Nalmefene hydrochloride and allyln-oroxymorphone (the internal standard) in the plasma and in the urine were used. The pharmaceutical parameters were calculated by 3P87 software. Results: The limit of the detection for Nalmefene hydrochloride was 0.0008 ng/ml in plasma and 0.0003 ng/ml in urine. There were good linear relationship range from 0.04 to 625ng/ml in plasma and 0.2 to 625 ng/ml in the urine. The variation coefficient in day and days, and the recoveries fitted the clinical pharmacokinetic study requirements. After a single intravenous administration of 0.5 mg,1mg, and 2mg of Na-lmefene hydrochloride, the obtained pharmacokinetic parameters were respectively as follows:Cmax were(1.74?0.48)?g/L,(4.17?1.08) ?g/L,(7.88?2.89) ?g/L;t1/2? were(12.83?3.98) h,(12.6?6.4) h, (10.58?3.74) h;V were (3.45?0.16) L/kg;(4.11?0.0716)L/kg、(4.25?0.56)L/kg;CL were (0.81?0.11) L/(h?kg), (0.85?0.15)L/(h?kg), (0.87?0.11) L/(h?kg);AUC0-∞ were (21.62?9.34) (ng/L)*h,(24.89?8.52) (ng/L)*h, (35?11.2) ng/L)*h;the urine accumulatived exc-retory rate were (78?21)%,(71?29)%,(78?19)%. Conclusion: The determination method for Nalmefene hydro-chloride in the plasma and in the urine by the electrosprayionization positive selected reaction monitoring detections is exclusive, accurate, sensitive and suitable. Pharmacokinetic characteristics in 3 groups of human treated with intravenous administration were described by a two-compartment model. The pharmaceutical characteristics of doxycycline hydrochloride in human body were linear in the range of 0.5~2.0 mg.

Objective:Tiapride has been used effectively in the clinic for the treatment of dyskinesias and tic disorders including Tourette syndrome. The purpose of the retrospective study is to evaluate the effectiveness of tiapride with the horn of saiga tatarica in treatment of hemifacial spasm. Method:Twenty-eight patients with idio-pathic hemifacial spasm, who were previously treated with carbamazepine, or acupuncture, or botulinum toxin injection, but refused to continue the previous therapies, were treated with tiapride, at a dosage of 50 mg /time once to thrice per day, combined with the horn of saiga tatarica at a dosage of 0. 15 g to 0. 30 g/time once per day. The dosage of tiapride can been up to 100 mg/time once to thrice per day in some cases if necessary. The effectiveness of the therapy was evaluated from the time of three months after the beginning of the treatment. The main efficacy parameter was the degree of spasm reduction, that is, the classification of spasm before versus after the treatment. Result:The duration of following up is between 3 months and 12 months. Twenty-five cases out of 28 patients have demonstrated a significant reduction of spasm. Of which, eight cases were completely relieved, 12 cases marked relieved and 5 cases partially relieved. The effective rate is 89. 29%. Conclusion:Tiapride combined with the horn of saiga tatarica was effective and safe in reducing hemifacial spasm. However, further data from blinded trials and long-term following up are required before this treatment can be considered to be one of the main medical treatment options for hemifacial spasm.

Objective To investigate serum levels of β-human chorionic gonadotrophin (β-HCG) and progesterone (P) in early pregnant women,and their relation to luteal maintenance therapy for early pregnancy protection.Methods One hundred and thirty five infertility women treated in Department of Gynecology and Obstetrics of Beijing Chaoyang Hospital from January 2007 to December 2011.Total 150pregnancy cycles,including 84 with intrauterine insemination (IUI) and 66 with natural conception,were divided into two groups:normal intrauterine pregnancy group (group A,n =80) and early pregnancy loss group (group B,n =70).Medical history,ultrasonic findings,serum female hormone,P and β-HCG levels at early pregnancy stage were analyzed.Results The age of group A and group B was (30.0 ± 3.9) years and(30.7 ± 4.9) years,respectively (P ＞ 0.05).The follicle-stimulating hormone/luteinizing hormone in group A and group B was 1.57 ±0.96 and 1.56 ± 1.08 ; the estradiol levels in two groups were (152 ±66) pmol/L and (147 ± 69) pmol/L,respectively (both P ＞ 0.05).There were no differences in dominant follicles and endometrial thickness between groups A and B (P ＞ 0.05).Ovulation promotion and luteal support treatments were adopted in both groups:50％ (40/80) of cycles in group A received ovulation promotion,73％ (58/80) of cycles received luteal support,while 44％ (31/70) and 76％ (53/70) received in groups B,respectively.The levels of serum progesterone in group A during 14-21 d,22-27 d and ≥ 28 d after ovulation were higher than those in group B at each time points (P ＜ 0.0l).There were no significant differences in serum progesterone levels between women with luteal support treatment and those without luteal support treatment in both groups (P ＞ 0.05).Conclusion Dynamic monitoring of serum progesterone level in early pregnancy may be used as an auxiliary index for prediction of pregnancy outcome,but it may not be an indicator for luteal maintenance therapy.

Objective To investigate the clinical effect of basilic vein transposition arteriovenous fistula in hemodialysis patients.Methods NInety patients with maintenance hemodialysis received in the NO.180 Hospital of the Chinese People's Liberation Army from September 2011 to September 2012 were randomly divided into two groups,and each group of 45 cases.Patients in the observation were given brachial-basilica transposition arteriovenous fistula,while patients in the control group received artificial vascular graft arteriovenous fistula.The fistula maturation time,dialysis blood flow,urea removal index (Kt/V),patency rates and complications were respectively recorded.Results Compared with control group,fistula maturation time,dialysis blood flow,Kt/V and complications rates in observation group were significantly higher((14.4±3.2)weeks vs.(16.1±2.7) weeks,(291.5±33.9) ml/min vs.(252.6±29.8) ml/min,(1.6±0.2) vs.(1.3±0.3);t =4.538,3.984,4.016;P＜ 0.05).Complications (ipsilateral upper limb swelling,thrombosis,venous ectasia and arteriovenous fistula stenosis) incidence were significantly lower than those of control group (2.2％vs.13.3％,2.2％ vs.11.1％,6.6％ vs.17.8％,11.1％ vs.24.4％;x2=5.463,4.972,5.017,3.968;P ＜0.05).Patency rates of observation group in 3 months,6 months,1 year and 2 years were also significantly higher than those of control group (97.8％ vs.93.3％,91.1％ vs.84.4％,88.9％ vs.75.6％,84.4％ vs.68.9％,x2 =5.315,4.238,7.024,5.913;P＜0.05).Conclusion Basilic vein transposition arteriovenous fistula is reliable and effective for hemodialysis patients.It can achieve adequate dialysis and less complications and It is worth of clinical application.

Objective To study the effect of new dressing combined with ostomy appliances for treating intestinal fistula .Meth-ods 50 patients with intestinal fistula from September 2009 to September 2012 were taken as the experimental group and treated by the new dressing combined with ostomy appliances .Contemporaneous 29 cases of intestinal fistula as the control group were treated by traditional drainage method .The peristomal skin healthy state in the two groups′patients was evaluated by DET scoring before intervention ,on 5 ,10 ,15 d after intervention .The following indexes on 15 d after intervention were compared between the two groups ,including the infection rate of wound ,times of change dressings and costs of change dressings .Results The DET scores at each follow -up timepoint in the experimental group were significantly lower than those before intervention and those in the control group ,the difference had statistical significance (P<0 .05) .Compared with the control group ,,infection rate of wound were lower ,times of change dressings were fewer ,costs of change dressings was less in experimental group significantly (P<0 .05) at 15 days after treatment .Conclusion New dressing combined with ostomy appliances for treating intestinal fistula could get bet-ter clinical effect .