The pathogenesis of multiple sclerosis ( MS) involves alterations to multiple pathways and processes, which represent a significant challenge for developing more-effective therapies.In MS, abnormalities have been identified in several cytokine-signaling pathways, as well as those of other immune receptors.Among the downstream molecules implicated are Jak/Stat, NF-κb, ERK1/2, p38 or Jun/Fos, current MS drugs target some of these pathways.This article will with the aid of the latest research results of systems biology approaches that study pathway dysregulation in the process of MS development, targeting these relevant MS-signaling pathways, offers the opportunity to accelerate the development of novel individual or combination therapies for the future of new drug research.

OBJECTIVETo investigate the epidemiological characteristics, clinical manifestations, diagnosis, and treatment of Brucella orchitis, so as to provide reliable evidence for the prevention and treatment of the disease.

METHODSWe conducted retrospective statistical analyses on the medical records of 48 outpatients and 21 inpatients with Brucella orchitis.

RESULTSBrucella orchitis was diagnosed in 6.67% of the male patients with brucellosis (69/1 034). The disease exhibited typical epidemiological features, with a higher incidence rate among those in frequent contact with sheep and elderly people, in the period from April to July, and in the areas with sheep husbandry. All the Brucella orchitis patients had such local symptoms as testicular pain and swelling, more frequently involving both testes, and other most common symptoms included fever, chills, sweating, and painful joints. Based on IIEF-5, 45 of the patients suffered from severe erectile dysfunction, with their reproductive function temporarily affected in the course of the disease. Misdiagnosis easily occurred in the early stage of the disease. Therapeutic options mainly included doxycycline hydrochloride and rifampicin, administered orally or intravenously, which could effect a cure, though relapse might occur in some cases.

CONCLUSIONBru- cella orchitis has distinct epidemiological characteristics, with clinical manifestations of testicular pain and swelling. Though a transient disease, it affects the reproductive function of the patient before cured. It can be treated by combined oral and intravenous medication, with painkillers or ice bags for testicular pain and swelling.

Animals ; Brucella ; pathogenicity ; Brucellosis ; complications ; diagnosis ; therapy ; Humans ; Male ; Orchitis ; diagnosis ; microbiology ; therapy ; Retrospective Studies ; Sheep

Objective To compare the efficiency of oscillation with sonication in preparing nano-scale microbubbles (NBs).Methods Nano-scale microbubbles were prepared using oscillation and sonication respectively,and then compared the NBs' size,size distribution,concentrations and time-consumption of the two methods.Results The sizes of nanobubbles prepared by sonication and oscillation were (373.88 ±18.43)nm and (360.74 ± 14.39)nm,respectively.There was no significant difference in size between the two methods (P =0.523).The polidispersity was larger in sonication before centrifugation,there was significant difference between the two methods (P ＜0.001).The concentration of nanobubbles prepared by oscillation was (1.48 ± 0.15) × 1010,which was higher than that by oscillation [(8.07 ± 0.62) × 108],there was significant difference between the two methods (P ＜ 0.001).The consuming time was shorter in oscillation,the difference was significant when compared with sonication (P ＜0.001).Conclusions Both two methods can successfully prepare NBs.Compared with sonication,oscillation can effectively produce NBs with smaller polidispersity,higher concentration and shorter time-consumption.

Background and purpose:Early evaluating the therapeutic efficacy of transcatheter arterial chemoembolization (TACE) in patients with hepatic cancer is still a diffcult clinical problem. The purpose of this study was to evaluate the ability of the apparent diffusion coeffcient (ADC) to help predict early disease progression after TACE.Methods:Institutional review board approval was obtained, and all patients signed informed consent. Magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) (b=50, 500, 1 000 mm2/s) were performed before and 1 month after initiating TACE for 23 patients with hepatic cancer (14 were male, 9 were female; mean age: 53.3 years;range: 21-85 years). Contrast-enhanced MRI was performed 3 months after initiating TACE. Patients were classiifed as either progressing or non-progressing according to RECIST 1.1. The preoperative ADC values of tumor and the ADC values of tumor 1 month after TACE were analyzed by pairedt-test in both progressing and non-progressing group. Unpairedt-test was used to compare ADC parameters between progressing and non-progressing group. In all the 23 hepatic cancer patients, receiver operating characteristic (ROC) curve analysis was performed to determine a threshold ADC ratio (ADC%) to differentiate progressing from non-progressing patients.Results:Thirteen progressing and 9 non-progressing patients were evaluated. Increase in ADCs of tumor was observed in non-progressing patients at 1 month after TACE compared with preoperative ADCs. There was a signiifcant difference between the 2 groups (P=0.01). In progressing group, preoperative ADCs of tumor were similar to those at 1 month after TACE (P=0.221). There was no significant difference in preoperative ADCs of tumor and ADC% between the progressing and non-progressing groups. In patients with hepatic cancer, 1 month ADC ratio in non-progressing patients were signiifcantly higher than those of progressing patients (P=0.029). Using ROC to evaluate the ability of ADC% could predict early disease pro-gression after TACE. Using -6.455% as the threshold, the area under the ROC curve was 0.867 (95%CI: 0.643-1.000). The sensitivity was 100%, and the speciifcity was 66.7%.Conclusion:One month after TACE, the increases in ADCs of tumor were observed only in the non-progressing group; and the ADC ratio seems to be a promising tool for helping predict the early disease progression after TACE in patients with hepatic cancer.

Objective To discuss clinical significance on early diagnosis of brain injury in premature infants with multiple sequence joint inspection of magnetic resonance imaging (MRI).Methods The brain MRI findings of 160 premature infants treated by Neonatal Intensive Care Unit were analyzed retrospectively.Results In 160 premature infants,brain injury occurred in 76 cases,the incidence of brain injury was 47.5％.Ischemic lesions were seen more in brain injury in premature infants,cerebral white matter injury was the most common,especially periventricular leukomalacia.Ischemic brain injury performed patchy or large sheet increased signal intensity on T1-weighted images(T1 WI),decreased signal intensity on T2-weighted images (T2WI) and obviously increased signal intensity on diffusion weighted imaging (DWI) in half egg circle center and around the lateral ventricle.Periventricular leukomalacia performed patchy decreased signal intensity on T1WI,increased signal intensity on T2WI and decreased signal intensity on DWI.Periventricular-intraventricular hemorrhage was seen more in hemorrhagic lesions.Hemorrhage stove was performed different signal because of different bleeding time.MRI performance in acute phase was iso-signal or slightly decreased signal intensity on T1WI,increased signal intensity on T2WI,increased signal intensity on T1WI,slightly decreased signal intensity on T2WI in early subacute,increased signal intensity on T1 WI and T2WI in late subacute and obviously decreased signal intensity on magnetic sensitive weighted imaging.The detection rate of ischemic lesions by DWI was higher than the conventional MRI,and DWI could show cerebral white matter damage of premature infants much earlier than the conventional MRI.The detection rate of hemorrhage stove by susceptibility weighted imagingc (SWI) was higher than the conventional MRI (x2 =23.78,P ＜ 0.05),and SWI could show hemorrhagic lesions much earlier than conventional MRI (x2 =27.02,P ＜ 0.05).Conclusions MRI,especially combined multiple sequence checking,could provide accurate imaging evidence for the early diagnosis of brain injury in premature infants.

Objective To explore the diagnosis and treatment of tumor associated gastrocolic fistula (GCF).Methods The records of the 4 patients with GCF between August 2008 to February 2014 were retrospectively analyzed.Three female and one male patients,those whose average age were 61 years,have been pathologically diagnosed postoperatively as gastrocolic fistula caused by malignant diseases.The main clinical symptoms were diarrhea (3 cases),fecal vomitus (3 cases),weight loss (4 cases),and abdominal pain (4 cases).Positive diagnostic tests for GCF included gastroscope (3 cases),colonoscope (1 case),barium enema (1 case),upper gastrointestinal contrast (2 cases).Results En-bloc resection of the involved gastrocolic region have been performed for all,2 patients underwent radical gastrectomy and colon resection and 2 patients were taken on palliative procedure.Pathology indicated adenocarcinoma all,Immunohistochemical detection for CK20,CDX-2 were applied for identifying the originations of tumors.Delayed gastric emptying and DIC occurred in one patient who died in 3 months after the operation,anastomotic leakages were found in 2 cases.The survival patients were all discharged and taken capecitabine combined with Oxaliplatin for chemotherapy.Conclusions Endaoscopy and gastrointestinal imaging are main evidences for diagnosis of GCF.En-bloc resection of the involved gastrocolic region were recommended,enterostomy was safer than entero-anastomosis in one stage procedure.The originations of tumors may be identifying according to the pathological characteristic and CDX-2,CK20 staining.Adjuvant chemotherapy should be applied.

0.05), and both groups got ideal clinical effect. Conclusions MGHSV is an ideal operation for various types of duodenal ulcer, which with a preferable long-term effect. It is worth to be widely applied in clinical practice.

ObjectiveTo investigate the clinical phenotypes of familial hypercholesterolemia (FH) caused by exon 13 A606T mutation in low deusity lipoprotein receptor.MethodsClinical data of the suffered family were collected and analyzed,as well as measurement of perivascular intima-medial thickness and follow-mediated-dilation function by ultrasonography.ResultsThere were totally 11 sufferers including 4 males and 9 females,aged 8-90 years,with 2 homozygotes and 9 heterozygotes.Among them, one homozygote showed angina pectoris and hematuria,both homozygotes had skin xanthomata.TC,TG,LDL-C and HDL-C were(7.39 ± 1.30) mmol/L,(0.93 ± 0.36) mmol/L,( 11.76 ± 1.10) mmol/L and ( 1.22 ±0.17) mmol/L,respectively.The left/right sided intima-medial thickness of the common,internal,external and bulb carotid artery were ( 1.15 ±0.45) mm/( 1.30 ±0.60) mm,(0.82 ±0.30) mm/( 1.00 -0.66)mm,(0.77 ±0.28) mm/(0.78 ±0.30) mm and ( 1.40 ±0.59) mm/( 1.46 ±0.71 ) mm respectively.The brachial artery flow mediated dilation rate was (4.85 ±4.80)％.Echocardiography revealed 2 patients with cardiac valvular disease and 3 with atrium septum aneurysm. ConclusionFH patients show a variety of phenotypes incuding extraordinary hypercholesterolemia,subcutaneous xanthomata and premature coronary heart disease.

Objective To analyze the prognostic factors and trerapy strategy of lung cancer in the patients aged 80 years and over.Methods Totally 107 patients aged ≥ 80 years with lung cancer were retrospectively reviewed.Patients' clinical characteristics and treatment were analyzed.Results Median survival time of the patients was 6.9 months.92.9％ (13/14) of small cell lung cancer patients and 34.4％ (31/90) of non small cell lung cancer patients were treated.Life cycle of patients who accepted effective treatments and supportive treatments were 16.5 months and 8.7 months,respectively (P=0.008).In the early stage of tumors,survival time of patients undergoing surgery was 36.7 months,15.5 months in patients without surgery (P=0.023),while in the late stage,survival time of patients receiving combined chemotherapy was 13.4 months,4.6 months in patients receiving single agent chemotherapy(P=0.002).In small cell lung cancer,survival time of patients who received radiotherapy was 12.8 months,6.4 months in patients who did not receive radiotherapy (P=0.049).Performance status (PS),clinical stage,early surgery,late chemotherapy and radiotherapy(x2=38.236,18.831,5.187,9.827,4.186,P＜0.05),but not sex and pathology type affected the prognosis.PS score (P=0.003)and clinical stage(P=0.046) were the independent influencing factors.Conclusions Performance status and clinical stage are the independent influencing factors of lung cancer in the patients aged over 80 years.Patients may improve survival if receiving surgery,chemotherapy and/or radiotherapy when they have good PS,otherwise patients may choose best supportive care.

Objectives To explore the perceived stigma among family members of people with schizophrenia and to identify the influential factors related to perceived stigma in socio-demographic characters of family members and patient characters.Methods Total 127 family members of people with schizophrenia in a psychiatric hospital in Beijing were surveyed by the Perceived Devaluation-Discrimination Scale developed by Link.Results The mean score of the perceived devaluation-discrimination scale is 2.60±0.44.It was significantly higher than the 2.5 midpoint(t=2.53,P<0.05).Family member's perceived stigma was significantly different between different groups of residence area,education level,occupation and family income (P<0.05).Perceived stigma were not affected by patient characters (P>0.05).Family members'education level was the influencing factors of stigma,and the R~2 Square is 0.213.Conclusions The family members of people with schizophrenia suffered from high stigma.Education level of family member may be one of the influential factors.