Objective To analyze the CT contrast enhanced features of the extra-organic primary tumors in pelvis and to evaluate anatomic bases of these imaging characteristics.Methods CT findings in 14 patients with pathologically proved extra-organic primary tumors in pelvis were reviewed retrospectively for tumor size,density,margins,contrast enhanced characteristics,location and relationship of the lesions with surrounding organs and tissues.Results There were benign tumors (n=3) and malignant tumors(n=11) in this study.There were 6 lesions in peritoneal cavity and 6 in retroperitoneal space of pelvis respectively,and two other masses were in both peritoneal cavity and retroperitoneal space of pelvis.CT scan revealed that there were 6 solid masses and 8 cystic-solid masses.The enhanced characteristics of lesions were homogeneous and heterogeneous in 3 and 11 patients respectively.The fatty space surrounding the lesion was invasive in 7 cases and all of them were malignant tumor.The fatty space surrounding lesion was clear in other 7 cases including 3 benign tumors and 4 malignant tumors.CT revealed calcification in 4 lesions including benign teratoma (n=2) , malignant teratoma (n=1), and carcinoid (n=1).Conclusion In the diagnosis of extra-organic primary tumors in pelvis,CT enhancement scan can reveal the anatomic location and relationships of the lesions with surrounding organs and tissues and can differentiate benign and malignant tumor to some degree.

Background & Objective: Sleep quality in neuromyelitis optica spectrum disorders (NMOSD) were investigated in two recent studies. However, factors affecting sleep quality have not been studied in NMOSD. This study aimed to investigate the prevalence of sleep disorders in Chinese outpatient clinics with NMOSD and its clinical correlates. Methods: We administered Chinese validated self-questionnaires on HRQOL (MSQOL-54), sleep (PSQI), pain (SF-MPQ-2), anxiety (HARS) and depression (HDRS) to 42 patients followed up in our outpatient department. We assessed the relationships between sleep quality with pain, anxiety, depression, gender, age, disability, disease duration, NMO-antibody status and explored the determinants of poor sleep quality. Results: Sixty four percent of NMOSD patients were poor sleepers. Significant correlations were found between duration, disability, pain, anxiety, depression and sleep quality. Disability, depression and the domain of affective descriptors of pain were the three main predictors of poor sleep in NMOSD. Conclusion: This study reveals that poor sleep in NMOSD is common and it decreases physical function of quality of life. It is worthwhile considering exploring adjuvant strategies aimed at controlling pain associated affect, and treatment of depression may help to improve sleep quality in NMOSD.
Neuromyelitis Optica

Objective To investigate the reproductive endocrine status of women with epilepsy at childbearing age and to systematically analyze the clinical features of reproductive endocrine disorders,especially polycystic ovarian syndrome (PCOS),to facilitate early detection and timely intervention.Methods In this study,scoring of anthropometry and physical signs,menstrul assessment,examination of sex hormone and pelvic ultrasound in women with epilepsy at childbearing age were performed,and the data such as overweight,central obesity,oligo/amenorrhea,luteinizing hormone (LH)/follicule-stimulating hormone (FSH),hyperandrogenism and polycystic ovary (PCO) were collected. The characteristics of their reproductive endocrine hormone disorders were analyzed statistically. Results The age of these patients was (22. 5 ± 7.0 ) years,and women younger than 30 years old and at their peak fertility accounted for 84. 89%. The prevalence rate of PCOS in women with epilepsy at childbearing age (12. 75% ) was significantly higher than that of ordinary women at childbearing age (7.2%) in China.Highly specific indicators for PCOS were hyperandrogenism (100%),LH/FSH ＞ 2 (93%) and oligo/amenorrhea (90%),whilst the highly sensitive indicators for PCOS were PCO (92%), oligo/amenorrhea (85%) and hyperandrogenism (54%). This study revealed statistically significant difference in LH,LH/FSH and testosterone (T) between PCOS group (LH: (10.24 ± 6.92) IU/L; LH/FSH;(2.20 ± 1.16);T: ( 1.07 ± 0. 35) ng/ml) and non-PCOS group ( LH: (4. 16 ± 2.62 ) IU/L; LH/FSH:( 0. 87 ± 0. 56 );T: (0. 46 ±0. 25) ng/ml,t = -3. 899,-4. 240 and -4. 918 respectively,all P ＜0. 01 ). Conclusions Hormone indices are objective indicators for the diagnosis of PCOS. In clinical practice,attention should be paid to height,weight,abodominal circumference,menstrul history and ultrasound examination of the ovary in women with epilepsy.When reproductive endocrine hormone disorders are suspected from clinical features,the sex hormones (T,LH,and FSH ) should be checked to allow timely detection and early interventions.

The kidney stores essence,essence generates marrow is one of the important contents in zaag-xiang theory of traditional Chinese medicine (TCM).The kidney-marrow-brain,kidney-marrow-bone and other biological axis put forward by modern scholars took kidney-marrow system as their cores.Derived from this basis as well as under the guidance of TCM holism concept,the construction of TCM kidney-marrow system has been continuously improved;and the kidney-marrow correlation theory has been enriched.To better grasp and apply the kidney-marrow correlation theory can solve clinical problems of major diseases.However,doctors in past dynasties did not clearly define kidney-marrow system. It has not formed a complete theoretical system.Marrow in the kidney-marrow system contained brain,spinal cord and bone marrow.Marrow can generate blood,which nourishes bone together with the bone marrow.The bone marrow connects with the brain and spinal cord,which are all related to blood.Hence,the function of marrow generates blood occupied an important position in the kidney-marrow system. In this paper,the structure and function of the kidney-marrow system were preliminarily explained and constructed;and the kidney-marrow system related theories were further enriched.

There was preliminary understanding of the kidney-marrow correlation from the pre-Qin to Han dynasty.Until Wei-Jin and Sui-Tang dynasty,the close relationship between kidney-essence-marrow-bone-blood-brain was gradually realized in terms of the structure and physiological function.There was a new anatomical understanding of marrow in the Song,Jin and Yuan dynasty.The concept of spinal cord was put forward for the first time.There was also the etiology and pathogenesis on kidney marrow related diseases.In the Ming and Qing dynasty,there was in-depth understanding on the kidney-marrow correlation.However,the concept of kidney-marrow system was not clearly proposed.Modern scholars summarized traditional Chinese medicine (TCM) theories on kidney stores essence,essence generates marrow,marrow enriches brain,nourishes bone and transfers into blood. Then,the kidney-marrow systemhad begun to take form.It laid a theoretical foundation for the construction of kidney-marrow system..

Objective To compare the value of NBI with magnify endoscopy (NBI-ME) and Lugol chromoendoscopy (LCE) in preoperative assessment of early esophageal cancer, and assess whether the former can replace the latter. Methods 59 patients, sampled in the Second Hospital of Lanzhou University, the First Hospital of Lanzhou University and the Second Hospital of Lanzhou City from January 2014 to December 2015, were examined respectively by NBI-ME and Lugol chromoendoscopy not only to distinguish the lesion boundaries but also predict the pathological types as well for statistical analysis with the combination of the final postoperative pathological results. Results Only 64.4 % (38/59) of lesion boundaries can be well-distinguished by NBI-ME, which is significantly lower than that distinguished by Lugol chromoendoscopy (91.5 %, 54/59), with its kappa value 0.208< 0.4, P < 0.01 (0.006). It indicated that poor concordance existed in these two methods. The McNemar value which reflects concordance between pathological type predicted by NBI-ME and postoperative pathology was diagnosed to be 5.397, P > 0.05 (0.369), Kappa > 0.4 (0.429), P < 0.01 (0.000), suggesting the concordance can be acceptable. However, the McNemar number diagnosed by Lugol chromoendoscopy was only 4.533, P > 0.05 (0.475), Kappa <0.4 (0.286), P < 0.01 (0.001), showing the poor concordance instead. Conclusions To some extent, pathological type predicted by NBI-ME indeed had an concordance with postoperative pathology, which was also superior to the results examined by Lugol chromoendoscopy, while there was no denying that Lugol chromoendoscopy had an obvious advantage over NBI-ME in terms of distinguishing lesion boundaries, therefore, it can not be completely replaced with NBI-ME at present.

OBJECTIVETo investigate whether miR-492 is involved in the post-transcriptional regulation of OK blood group antigen expression on red blood cells.

METHODSTwo 3'-UTR fragments of the BSG gene were synthesized with a chemical method, which respectively encompassed the BSG rs8259 TT or BSG rs8259 AA sites. The fragments were added with Xho I and Not I restriction enzyme cutting sites at both ends and cloned into a pUC57 vector, which in turn was constructed into a psiCHECK-2 vector and verified by sequencing. K562 cells were transfected with various combinations of miR-492 mimic and constructed psiCHECK2-BSG-T or psiCHECK2-BSG-A recombinant plasmid. A blank control group was set up. Each transfection experiment was repeated three times. The activity of Renilla reniformis luciferase was determined and normalized with that of firefly luciferase, and detected with a dual-luciferase reporter assay system. The data were subjected to statistical analysis.

RESULTSThe sequencing results confirmed that the recombinant psiCHECK2 plasmids containing the BSG rs8259 TT or rs8259 AA sites were constructed successfully. The results of dual-luciferase report gene detection showed that the miR-492 mimic could significantly inhibit psiCHECK2-BSG-T at a concentration over 100 nmol/L. However, it could not inhibit psiCHECK-BSG-A.

CONCLUSIONmiR-492 may be involved in the regulation of OK antigen expression on red blood cells with the BSG rs8259 TT genotype.

Basigin ; genetics ; Blood Group Antigens ; genetics ; Erythrocytes ; immunology ; Gene Expression Regulation ; Genotype ; Humans ; MicroRNAs ; physiology

Objective To demonstrate the value of eombined application of prenatal ultrasonography with fetal magnetic resonance imaging(MRI) in the diagnosis of monochorionic muhifetal realformations. Methods Fourteen cases of muhifetal malformations,detected by prenatal ultrasonography,received MRI within 48 h afterwards.All diagnosis were confirmed after delivery or mid-term termination.All imaging results of the 14 cases were retrospectively reviewed. Results Among the 14 cases,there were 7 acardias,5 Conjoined twins and 2 demise of multifetuses.Comparing ultrasound with MRI,we found that:(1)In cases with acardia and demise of multifetusea,ultrasound could diagnose correctly and be an important tool for follow-up,while MRI could demonstrate organs and structures of the acardiac recipient more clearly and detect the secondary changes of brain in the donor and survived fetus.(2)In Conjoined twins,ultrasound was superior to MRI in demonstrating the structure and function of cardiovascular system : and equivalent to MRI in identifying stomach,kidney,bladder and limbs;but inferior to MRI in identifying esophagus,lung,liver and intestinal,especially in the brain. And MRI could demonstrate two fetuses and the relationship between them in COnjoined twins simultaneously. Conclusions Prenatal ultrasonography and MRI have their own advantages and disadvantages in diagnosing monochorionic multifetal malformations.But the combination of prenatal ultrasonography and fetal MRI may be more valuable.

Through reviewing and summarizing classical literatures of traditional Chinese medicine (TCM) and modern medical research results,TCM kidney-marrow system was presented and initially explained.The kidney marrow system is inseparable in structure,interdependent in physiology and mutually influential in pathology.The kidney-marrow system can be applied to the treatment of major diseases in TCM,which included metabolic bone diseases,brain and neurological disorders,haematological diseases and etc.,with significant clinical effects.The in-depth study on TCM kidney marrow system will improve the clinical curative effect of major TCM clinical diseases and achieve the precision treatment in traditional medicine.It displays unique advantages of TCM holism concept and achieves new breakthrough in TCM clinical diseases.

Objective To investigate the prevalence and clinical significance of different subtypes (IgG,IgM and IgA) of anticardiolipin antibodies (aCL) and anti-β2-glycoprotein Ⅰ antibodies (aβ 2GP1),as well as lupus anticoagulant (LA) in systemic lupus erythematosus (SLE).Methods IgG/IgM/IgA,IgG,IgM,IgA aCL and anti-β2GP1 were tested by enzyme-linked immunosorbent assay (ELISA) in 100 patients with SLE (42 patients were diagnosed as secondary antiphospholipid syndrome),44 healthy controls and 32 patients with other connective tissue diseases excluding SLE and antiphospholipid syndrome (APS).Meanwhile,LA was tested by modified Dilute Russell's viper venom time (dRVVT).The correlation between antiphospholipid antibodies and clinical manifestation was analyzed by Spearman correlation analysis.The postiverate of antiphospholipid antibodies in SLE patients,health controls and patients with other connective tissue diseases were compared by chi square test.The concentrations of antiphospholipid antibodies in different groups were compared using independent sample Kruskal Wallis test.The diagnostic efficacy of antiphospholipid antibodies in SLE patients was analyzed by crosstable using clinical diagnosis of APS as gold standard.P ＜ 0.05 was considered statistically significant.Results The prevalence of IgG aCL (x2 =15.031,P ＜ 0.001),IgA/G/M (x2 =11.678,P =0.003) and IgA (x2 =6.17,P =0.036) antiβ2GP1 were significantly higher in patients with SLE than in the other two groups.IgA/G/M (r =0.207,P=0.039),IgG (r=0.230,P=0.021) and IgA (r=0.217,P=0.030) aCL,IgA/G/M (r=0.218,P=0.029) and IgA (r =0.255,P =0.01) anti-β2GP1,as well as LA (r =0.233,P =0.02) were associated with thrombotic events.IgA/G/M anti-β2GP1 (r =0.22,P =0.029) and LA (r =0.254,P =0.011) were associated with pathological pregnancy.23.1％ (6/26) aCL positive SLE patients were IgM and/or IgA aCL positive.53.6％ (15/28) anti-β2GP1 positive SLE patients were IgM and/or IgA antiβ2GP1 positive.In SLE patients,the specificity and sensitivity of IgA/G/M aCL for APS were 98.3％ and 26.2％,respectively.The specificity and sensitivity of IgA/G/M anti-β2GP1 were 84.5％ and 40.5％,respectively.The specificity of at least two isotypes positive for APS (both aCL and anti-β2GP1 were 98.3％),was higher than IgG aCL (94.8％) or anti-β2GP1 (93.1％).The sensitivity of at least one isotype of aCL (47.6％) or anti-β2GP1 (42.9％) positive for APS were higher than IgG aCL (40.5％)and anti-β2GP1 (21.4％).Conclusions IgG and IgM aCL together would be better than IgA/G/M aCL for APS screening.IgA/G/M anti-β2GP1 would be better for APS screen due to higher sensitivity and strong association with thromboembolic events and pathologic pregnance.IgA aCL or anti-β2GP1 was associated with thromboembolic events.IgA aCL or anti-β2GP1 would be useful for APS diagnosis in IgG and IgM aCL or anti-β2GPl negative patients.