SUMMARY To demonstrate the clinical manifestation, diagnosis and treatment of myoclonus epilepsy with ragged-red-fibers ( MERRF) , a case of MERRF was presented with review of the literature. A 4-year-7-month-old girl was diagnosed with MERRF. She had tremor, fatigue and developmental delay for more than 2 years. Laboratory tests showed that the serum and urine lactic acid and pyruvic acid increased significantly. Electroencephalogram showed diffuse and focal spike slow wave and slow wave in right central and parietal regions. Electromyogram showed neurological damage. Gene mutational analysis showed mtDNA 8344 A>G mutation. The mutational rate was 78%. Mitochondrial disease MERRF syndrome was diagnosed. Cocktails therapy with vitamins B1, B6, B12, L-carnitine, and coenzyme Q10 was administra-ted to the patient. MERRF is a rare disease. The diagnosis can be made by gene mutational analysis. Cocktail therapy may slow down the deterioration of the disease. Gene therapy is still experimental.

Purpose:To summarize the experences of treating malignant obstructive jaun- dice by percutaneous transhepatic drainage of the bile duct,as well as discussing its clinical effect and practical value.Materials and Methods:Among the 39 patients who were all unsuitable for sur- gical operations,5 were benign,34 were malignant.All patients underwent percutaneous transhep- atic puncture of bile duct.38 cases who were successfully aspirated continued to undergone canal- ization of the obstructive parts 28 be finally successful.Among these patients,metallic stents were placed in 17 cases,balloon dilation in 2 cases,canalization with multi-side-hole catheter in 9 patients.Only external biliary drainage were performed in 10 patients.Results:All of there canal- ization method effected well in verious degrees,but the best result was obtained in the metallic stents group.Conclusion:(1)There is less injury and complication in percutaneous transhepatic drainage,either external or antegrade biliary drainage,and it ts also easy to operate,Interventional treatment is the first choice for patients who suffered from benign or malignant obstructive jaundice unahe undergone surgical operation(2)All the methods amend with each other,but the placement of metallic stent is the best one.

AIM: To amplify and analyze the differential DNA fragment between pathogenic leptospira serovar lai and nonpathagenic leptospira serovar patoc I. METHODS: The previously subtractive DNA fragment only existing in leptospira serovar Lai was amplified by cassette ligation and semi-nested PCR.The obtained gene was sequenced and searched homologically. In addition, the deduced amino acid was analyzed and the secondary stracture of protein was predicted. RESULTS: The 580 bp DNA fragment, which deposited in GenBank (AF495587), was cloned, and four overlapping open reading frames (ORF) was contained. The high homology with conserved hypothetical protein streptococcus pyogenes was found. CONCLUSION: This study lays foundation for deeply exploring biological actions of new gene and pathogenic mechanism of leptospira serovar lai.

AIM: To optimize the spray-drying process of Qingxiang Tablets. METHODS: Excipients were selected in terms of hygroscopicity and yield rate of dried powders with several excipients added;then,the process parameters,such as the relative density of fluid extracts,intake temperature,and the input speed of liquid feedstock were optimized by orthogonal experiment,in which the transfer rate of peoniflorin,a constituent in the formulation,and dried powder yield rate were set up as the evaluation index. RESULTS: The optimal processing conditions were obtained and validated as follows: relative density of liquid feedstock was 1.12 mg/mL(containing 6%?-CD),the input speed was 10 mL/min and intake temperature was at 190 ?C. CONCLUSION: The optimal process is stable and the experimental results provide the basis of industrial production.

The gerbil model in this study was induced by 30 min of bilateral carotid occlusion and 120 min of reperfusion. Verapamil ( 0.5 mg/kg)was given intravenously 10 min before ischemia, or 5 min after bilateral carotid occlusion. Local cerebral blood flow was determined by the hydrogen clearance teachnique. Brain water content was detected by the wet and dry methods. We conclude that verapamil used in this model may improve post-ischemic hypo-perfusion, increase local cerebral blood flow in ischemic region (P

As social views on disability changed,how to support intellectual disabled adult so they can be involved in ordinary social life is not only the hot topic of special education and rehabilitation service system,but also the concern of psychologists.For the improvement of social inclusion,psychologists should provide assessment,intervention and support for intellectual disabled adults at personal and social supportive levels,and relative policy advices for the government should be included.

Objective To establish the training objective systems for undergraduates in mili-tary clinical medicine in order to promote the educational reform of military medicine, and to improve the quality of talents training in military medical universities. Methods Literature analysis was made to determine the initial military clinical medical undergraduate training objectives, and a questionnaire was given to experts, on-the-job military doctors, medical graduates to know the real requirements of military doctors' position. A total of 455 valid questionnaires were collected. Then the questionnaire results were discussed and summarized by the method of expert discussion. Finally,. Delphi method was used to determine the ultimate training objective system. Results The ultimate training objective system of military undergraduate clinical medicine contains two aspects, eight fields and sixty-one standards objective systems. Conclusion Organically fusing military medical knowledge, ability and professional quality requirement into two levels and eight modules and clearly understanding the standards and requirements of each module are significantly systematic, advanced and operable, which has important reference value and guiding significance to both the military medical colleges and uni-versities and the local universities.

Objective Clinically, the anterior cruciate ligament ( ACL) can be reconstructed by either ligament advanced reinforcement system ( LARS) artificial ligament or hamstring tendon autograft ( HTAG) . This study aims to compare the early clinical outcomes of LARS versus HTAG in the treatment of ACL. Methods This study included 38 cases of ACL injury treated in our de-partment from March 2012 to August 2014, 18 by LARS artificial ligament and the other 20 by HTAG. Before and at 18 months after surgery, we evaluated the clinical outcomes of the tow strategies using the Lysholm knee scoring scale and International Knee Documen-tation Committee ( IKDC) scoring systems, and conducted statistical analysis on the follow-up findings. Results Statistically signifi-cant differences were not observed preoperatively between the LARS and HTAG groups either in the Lyshrolm scores (46.78±1.52 vs 46.80 ±1.89, P>0.05) or in the IKDC scores (42.83±1.47 vs 42.20±1.61, P>0.05), nor at 18 months postoperatively in the Lyshrolm scores (93.52±3.19 vs 94.10±1.37, P>0.05) or the IKDC scores (92.11± 1.45 vs 93.15±1.76, P>0.05). However, both the LARS and HTAG groups showed significant differences in the Lyshrolm and IKDC scores at the baseline as compared with those at 18 months after oper-ation ( P<0.05) . Conclusion Both LARS artificial ligament ham-string tendon autograft can achieve good early clinical outcomes in ACL reconstruction.

Objective To investigate the internal fixation for distal humeral fractures and its outcome .Methods A total of 74 patients with distal humeral fractures were performed surgical operation between Jan 2006 and Jun 2009 .According to AO/ASIF classification ,the factures were classified as type A (n=26) ,B(n=34)and C(n=14) .Internal fixation was applied to the patients , who did functional exercises after operation ,on the basis of classification .The healing of the fractures and the function the joints was examined via follow-up and X-ray films 1 ,3 and 6 months after operation .Results According to the Jupiter elbow score ,40 ca-ses were excellent ,22 cases were good ,12 cases were fair and 0 case was poor ,and the good rate was 83% .Conclusion Internal fix-ation with double plate ,is an effective therapeutic approach to distal humeral fractures in adults .Influencing factors of the efficacy include severity of the initial trauma ,operative scheme ,and post-operation functional recover .

OBJECTIVETo explore the auricular point specificity of the electric determination in stroke so as to provide the evidence for the objective study on the auricular point diagnosis in stroke.

METHODSThirty patients of stroke were selected in an observation group; 30 patients of non-stroke internal medicine disorder were in a control group A; 30 persons of healthy examination were in a control group B. In the observation group.and the control group A, beside the conventional treatment, acupuncture was applied to all the cases. In the observation group, Jianyu (LI 15), Quchi (LI 11), Shousanili (LI 10), Hegu (LI 4), Waiguan (TE 5), Liangqiu (ST 34), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) were selected on the affected side. In the control group A, Yin-tang (GV 29), Baihui (GV 20), Sishencong (EX-HN 1), Fengfu (GV 16), Dazhui (GV 14), Fengchi (GB 20), Tianzhu (BL 10), Jiaji (EX-B 2) C4-C7 were selected. Acupuncture was given once a day in the two groups. The; treatment of one week made one session, and continuously 2 sessions were required. In the control group B, the convention physical examination was provided without any medication and acupuncture involved. The CLRH-A auricular point detector was used to detect the entire auricular point area in the subjects and the positive reaction sites of auricular points in the subjects of each group before and after treatment separately. The auricular point positive detecting score and positive point frequency were observed in the subjects.

RESULTSBefore treatment, the auricular points detecting score in the observation group was obviously higher than that in the control group A and control group B (both P<0. 05). The difference in the score between the control groups was not significant in' comparison (P>0. 05). In two weeks of treatment, the auricular points detecting score in the observation group was reduced apparently (P<0. 05). The difference was not significant before and after treatment in either the control grolip A or the control group B (both P>0.05). In the observation group, the first 15 points with high frequencies of positive reaction were naogan (AT3,4i), pizhixia (AT4), e (AT1), xin (CO15), gan (CO12), nie (AT2), zhen (AT3), shen (CO10), jiaogan (AH6a), pi (CO13) shenmen (TF4), wei (CO4), neifenmi (CO18), shenshangxian (TG2p) and erjian (HX6,7i). The differences were significant in the frequencies of positive reaction at 9 auricular points as compared with the control group A and the control group B respectively, named naogan (AT3,4i), pizhixia (AT4), e (AT1), xin (CO15), gan (CO12), nie (AT2), zhen (AT3), shen (CO10) and jiaogan (AH6a) (all P <0. 05).

CONCLUSIONThe pathological degree of positive reaction about auricular points in stroke patients is higher than those in the patients of non-stroke internal medicine disease and the healthy people. It is verified that the auricular diagnostic method is specific in stroke. naogan (AT3,4i), pizhixia (AT4), e (AT1), xin (C15), gan (GO12), nie (AT2), zhen (AT3), shen (CO10) and jiaogan (AH6a) are correlative with stroke.

Acupuncture Points ; Acupuncture, Ear ; Adult ; Aged ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Stroke ; therapy ; Treatment Outcome