Limb-shaking transient ischemic attack (TIA), a rare manifestation, is commonly caused by severe stenosis or occlusion of an extracranial internal carotid artery. Such patients are usually treated with surgical revascularization or anti-platelet therapy. We present a 56-year-old woman with 6 months’ episodic attacks starting with mouth skewed to the right and a sensation of ‘weakness’ involving predominantly her left arm, and at times, also involved the left leg. This was immediately followed by rhythmic jerky movements of the left arm and at times, also involved the left leg. Magnetic resonance angiography revealed severe stenosis of M1 segment of the right middle cerebral artery. The patient’s symptoms were signifi cantly improved by treatment with anti-platelet drugs and nimodipine.

Balantidiosis is a disease infected with Balantidium coli,and swine is the main infection source. The infection of B. coli may cause diarrhea,extra intestinal infection and co?infection with other pathogens and even intestinal necrosis. Strength?ening the manure management of both human and livestock,paying attention to personal hygiene and labor protection,and time?ly treatment of the patients are the main measures to control balantidiosis.

Background With the changes of diet and living style,the diabetes has become the major diseases affecting human health.Diabetic cataract is a common complication of diabetes. Objective The present study was to investigate the difference of lens proteomics between diabetic cataract and age related cataract using two dimensional electrophoresis (2-DE) and mass spectrometry in order to postpone happening of diabetic cataract and offer the effective approach to the prevention and therapy of diabetic cataract. Methods The lenses were obtained from 8 diabetic patients and 12 age-related cataract patients during the surgery to extract the protein by lysis and centrifugation.The lens proteins were separated using immobilized pH gradients 2-DE.Image analysis was carried out using PDQuest Advanced-8.0.1 software package.Significant difference of the crystallines was identified by matrixassisted laser adsorption/ionization time of-flight-mass spectrometry (MALDI-TOF-MS) and peptide mass fingerprint combined with protein database. Results The maps of 2-DE showed that lens proteins of diabetic cataract and age related cataract were in the section of pH 5-9 with the relative molecular weight 14000-97000;while relative molecular weight of more abundant crystalline was localized at 20000-31000.About 3 differential protein spots were detected by image analysis software.Two crystallines,αB and βB1 crystallin,were identified using MALDI-TOF-MS.Conclusions Proteomic analysis of lens can be accomplished and the proteins can be well separated,moreover,differential proteins can be analyzed using 2-DE and mass spectrometry between diabetic cataract and age related cataract.These results indicate that αB and βB1 crystallin proteins accelerate the development of diabetic cataract.This technique offers a new avenue for clarity of lens proteins of diabetic cataract other than age related cataract.

Objective To compare the effects of ureteroscopic lithotripsy (URL), minimally invasive percutaneous nephrolithotomy ( MPCNL) , retroperitoneal laparoscopic ureterolithotomy ( RLU) and open ureterolithotomy (UL) for the treatment of complex upper ureteral calculi. Methods The data of 281 patients with complex upper ureteral calculi from January 2005 to January 2013 were retrospectively reviewed. 48 patients of them received treatment of URL, 113 patients received MPCNL, 67 patients received RLU and other 53 patients received UL. Results Success rates of treatment at the first time were:URL 62.5% (30/48), MPCNL 92.9%(105/113),RLU 100%(67/67) and UL 100%(53/53) . The mean blood losses during the operation were:URL (9.2 ± 1.4) mL,MPCNL (72.5 ± 5.8) mL,RLU (43.1 ± 8.5) mL and UL (100.5 ± 9.2) mL. The average operation time of URL group was shorter than three other groups, and the difference was statistically significant (P< 0.05) . The average hospital stay of URL group was also shorter than three other groups ( < 0.05) . The difference was not statistically significant in complications among four groups after operation ( >0.05) . Conclusion Clinical characteristics of patients and individual require ment should be considered comprehensively before an individual treatment choice is made for the treatment of complex upper ureteral calculi.

As CD40 transduces activation signals involved in inflammatory and immune disorders, we explored the expression and response to CD40 engagement in human glioma cell lines in this study. The CD40 expression in BT-325 and U251 cells was flow cytometrically detected. The cells were incubated with srhCD40L for 72 h to assess its effects on cell growth in vitro. TNF-α expression was quantified by real-time PCR, and protein expression was analyzed by ELISA. The I-κb mRNA was detected by RT-PCR. I-κB expression decreased after stimulation with 1 μg/mL srhCD40L, but it was upregulated after the cells were pretreated with CD40 antibody. srhCD40L significantly inhibited the proliferation of the CD40+ human glioma cells. The stimulation of CD40+ glioma cells with soluble CD40L (CD154) up-regulated the expression of TNF-α at both mRNA and protein levels. We are led to conclude that CD40L/CD40 could inhibit human glioma cells through I-κb signaling pathway. Interferon-γ can augment CD40 expression and the inhibitory effect of CD40 ligand on cell growth in vitro. These results suggest that srhCD40L may benefit the therapy strategy of glioma.

Objective To explore the clinical diagnosis and treatment of cyclic vomiting syndrome in children.Methods Thirty children proved with cyclic vomiting syndrome admitted from January,1998 to January,2003 were analyzed retrospectively.Results Cyclic vomiting syndrome was most likely to occur in 3-12 years old.The male to female ratio was 3∶2.The clinical manifestations were recurrent vomiting.Twenty-one cases had inducements,while 9 cases had not inducements.It was safe and efficient that curing cyclic vomiting syndrome with cyprohetadine and amitriptyline.Conclusions If these children with cyclic vomiting syndrome are inefficient to treatment,excluding metabolizable diseases,gastrointestinal,neurological diseases,they may be diagnosed cyclic vomiting syndrome,and cured with cyprohetadine and amitriptyline.

Objective To investigate the difference of the protein expression in serum of rats with acute edematous pancreatitis (AEP) and acute necrotizing pancreatitis (ANP),and to investigate serum marker for acute pancreatitis severity.Methods The model of AEP and ANP was induced by retrograde injection of 4％ or 5％ sodium taurocholate into the biliopancreatic duct.Weak cation exchange (WCX2) and surface enhanced laser desorption/ionization time of flight mass spectrometry ( SELDI TOF MS) was used to investigate the difference of the protein expression in serum of rats with AEP and ANP.Results Thirty-eight spectral peak clusters which had significantly different signal intensities between AEP and ANP sera at mass charge ratio between 1000-50 000(P ＜0.05) were detected.The peak clusters at 9500 and 9700 in the sera of AEP were higher than that in ANP rata.Conclusions Serum analysis with SELDI-TOF MS can detect the difference of the protein expression in rats with AEP and ANP.The decreased expression of the protein of molecular weight of 9500 and 9700 may be a signal of AEP transition into ANP.

Objective To investigate the effect of carbon dioxide (CO2) pneumoperitoneum with different duration periods on renal function.Methods Eighty-nine patients undergoing laparoscopic operations from October 2009 to December 2011 were divided into 3 groups according to operative time.The patients whose operative time was less than 1 hour belonged to group T1,between 1 hour and 2 hours belonged to group T2,and more than 2 hours belonged to group T3.The levels of serum creatinine,urinary creatinine,urinary microalbumin were detected at preoperation as well as 10 minutes,1 hour,24 hours after operation.Results There was no significant difference regarding of the endogenous creatinine clearance rate(Ccr) postoperatively between group T1 and T2 (P ＞ 0.05).The Ccr levels at 10 minutes after operation in group T3 was significant lower than at preoperation(P ＜0.05),and increased gradually at 1 h and 24 h after operation.The ratio of urinary microalbumin to urinary creatinine (A/C) increased at post-operation compared with at pre-operation in all 3 groups (P ＜ 0.05),but there was no significant difference between the 3 groups after operation (P ＞ 0.05).The renal function post-operation of patients over 60 years old was as same as that of patients less 60 years old in group T1 (P ＞ 0.05).However,the Ccr level in patients over 60 years old at post-operation was lower than that of patients less 60 years old in group T2 and T3 (P ＜ 0.05).Conclusion Long CO2 pneumoperitoneum could lead to the acute and obvious injury on renal function,especially in the patients over 60 years old.Fortunately,the renal function recovered to be normal gradually in a short time.

Objective To evaluate the relationship between varicocele (VC) and the prostativenouplexuby coloDoppleflow imaging(CDFI) and to explore the etiology of varicocele .MethodThe innediameterand the hemorrheologiparameterof spermativein and prostativenouplexuwere observed in 135 patientwith lefvaricocele(lefVgroup) ,51 patientwith bilat-eral V(bilateral Vgroup) and the control group(100 cases) by CDFI .The diameteof the prostativenouplexus(PVD) ,peak velocity of reflux flow (RFV) in the Valsalvtesand the peak velocity of antegrade flow (AFV) aresin 3 groupwere statistical-ly analyzed .ResultPVD and RFV in the bilateral Vgroup were greatethan those in the lefVgroup and the control group (P＜0 .01) .PVD and RFV in the lefVgroup had no statistical differencecompared with the control group (P＞0 .05) .AFV had no statistical difference among 3 group(P>0 .05) .PVD ,RFV and AFV in 30 caseof Vhad no statistical differencebe-tween before and afteoperation (P>0 .05) .Conclusion Bilateral Vmay be accompanied with potential systematic vascular abnormalities.

Objective To analyze recent 30 years’ regularities in point selection for acupuncture treatment of Parkinson disease and provide reference for its treatment. Methods Parkinson disease, parkinsonism and acupuncture were used as key words. Recent 30 years’ Chinese literature was searched using Wanfang, CNKI, VIP and Chinese biomedical literature database. Selection of main acupoints and scalp acupuncture points, syndrome differentiation-based point selection and meridian tropism of main acupoints were metrologically studied. Results The Du meridian, the large intestine meridian and the gallbladder meridian were mainly selected for acupuncture treatment of Parkinson disease. Taichong(LR3), Baihui(GV20), Hegu(LI4) and Fengchi(GB20) were used as main points. Chorea-tremor control area, motor area and parietotemporal anterior oblique line were often selected as main scalp acupuncture points. Fenglong (ST40), Qihai(CV6), Sanyinjiao(SP6), Yinlingquan(SP9) and Zusanli(ST36) were often used according to syndrome differentiation-based point selection. Conclusion Modern acupuncture doctors select Taichong(LR3), Baihui(GV20), Hegu(LI4) and Fengchi(GB20) as main points, often use scalp acupuncture points and combine points mainly from the Du meridian according to syndrome differentiation in the treatment of Parkinson disease.