Klein-Levin syndrome is a chronic recurrent sleep disorder characterized by periodic excessive sleep, which can be accompanied by cognitive dysfunction, eating disorders, behavioral disorders, sensory disorders and emotional disorders, etc. During interval, individual′s daily functions are completely normal. Most of the KLS cases are sporadic. At present, only 17 familial cases of KLS have been reported abroad, while domestic reports in China are rare. We analyzed the detailed medical history, laboratory examinations, differential diagnosis, and the disease prevalence amongst family members of a patient with familial KLS, in order to provide reference for the follow-up study of familial cases of KLS.

Klein-Levin syndrome is a chronic recurrent sleep disorder characterized by periodic excessive sleep, which can be accompanied by cognitive dysfunction, eating disorders, behavioral disorders, sensory disorders and emotional disorders, etc. During interval, individual′s daily functions are completely normal. Most of the KLS cases are sporadic. At present, only 17 familial cases of KLS have been reported abroad, while domestic reports in China are rare. We analyzed the detailed medical history, laboratory examinations, differential diagnosis, and the disease prevalence amongst family members of a patient with familial KLS, in order to provide reference for the follow-up study of familial cases of KLS.

Objective To investigate the MRI classifications and imaging findings of dysembryoplastic neuroepithelial tumor(DNET). Methods MR images of 34 patients with pathologic confirmed DNET of Beijing Sanbo Brain Hospital were retrospectively reviewed in this study. The classification was made according to the number of pseudocysts, scope of involvement, morphology and location. Results MRI appearances of DNET were divided into three subtypes: cystic‐like, polycystic‐like and diffuse type. Twelve cases had cystic cortical, including front lobe (5 cases), temporal lobe (5 cases), parietal lobe (2 cases). These cases presented quasi‐circular or oval shape, with hypointense on T1WI and strongly hyperintense on T2WI. T2‐FLAIR was observed hyperintense ring sign in the tumor periphery and the cystic content was close to CSF but having the largest difference to that of CSF, which signal was higher than CSF. Twenty cases were polycystic‐like, front lobe (7 cases), temporal lobe (7 cases), parietal lobe (5 cases), occipital lobe (1 case). In these 20 cases, they had slightly hypointense on T1WI and strongly hyperintense on T2WI. Located in the cortex and subcortical matter, with wedge shape, gyriform or triangle shape.On T2‐FLAIR, internal septation and hyperintense"ring sign"were observed. Two cases were diffuse type, bilateral (1 case), unilateral (1 case). In these 2 cases, diffuse lesions involving multiple areas with hyperintense ring and internal septation on FLAIR, including subcortical white matter, deep nucleus and periventricular area. Conclusions The MR appearances of DNET are variable. Understanding the MR imaging type of DNET might improve the MR diagnosis of DNET.

OBJECTIVE:To investigate the utilization and trend of endocrine therapeutic drugs after breast cancer surgery,and to provide reference for rational drug use in clinic. METHODS:In retrospective study,the data of endocrine therapeutic drugs use in outpatients after breast cancer in a Third Grade Class A Hospital during 2014-2016 was calculated,sorted and analyzed statistically. RESULTS:The age of outpatients receiving endocrine therapy after breast cancer ranged from ＞40 to 60. Among endocrine therapeutic drugs used within 3 years,3 kinds of them were aromatase inhibitor(AI),3 kinds were anti-estrogen and 2 kinds were gonadotropin releasing hormone(GnRH)analogues. The amount of Toremifene citrate tablets(imported)in prescription was much more than the others. The proportion of anti-estrogen drugs alone in prescription was the highest(81.11%). The AI and GnRH analogues were mostly used in drug combination prescription,and commonly combined with anti-osteoporosis drugs. The comsuption sum of endocrine therapeutic drugs was increased year by year,increasing by 52.48% in 2015,40.60% in 2016. The consumption sum of AI ranked the highest proportion among three categories of endocrine drugs(44.71%,48.62%,48.62%,each year respectively). The consumption sum of imported drugs was significantly higher than that of domestic drugs. The consumption sum of Toremifene citrate tablets(imported)increased continuously in 3 years,and took the first place in 2016. The consumption sum of Leuprorelin acetate microspheres for injection(imported)had the largest growth rate when applied to the clinic. Top types in the list of DDC were all imported types;Fulvestrant injection(imported)ranked top 1,and Tamoxifen citrate tablet(domestic) was the bottom of the list. DDDs of endocrine therapeutic drugs also increased year by year,among which Toremifene citrate tablets,Tamoxifen citrate tablets,Anastrozole tablets and Letrozol tablets ranked top 4 places during the 3 years,while Tamoxifen citrate tablets DDDs decreased year by year. B/A values of these drugs were between 0.25 and 9.00. B/A values of domestic varieties were basically more than or equal to 1,of which Tamoxifen citrate tablets was the largest;B/A values of the imported varieties were basically less than or equal to 1. CONCLUSIONS:The consumption sum of endocrine therapeutic drugs after breast cancer surgery increased year by year in 3 years,and DDDs is also increasing year by year. The imported drugs took up the dominant place. Toromiphene citrate tablets had replaced Tamoxifen citrate tablets as the first choice of endocrine therapeutic drugs in the hospital. The frequency of AI and GnRH analogues use had also increased. And the combination of 2 kinds of endocrine therapeutic drugs and endocrine therapeutic drugs combined with anti-osteoporosis drug had become a trend of clinical treatment. The choice of therapeutic drugs should take into account of effectiveness,safety,economics,cost and therapeutic efficacy,so as to guarantee the greatest benefit of the patient.

OBJECTIVE:To provide reference for the safe and rational drug use for children. METHODS:Information manage-ment system was used to investigate the use of essential medicines system variety in stock in 2015 and analyze the medication infor-mation for children in the drug instructionsin our hospital in 2015. RESULTS:Only 201 kinds of medicines belonged to children’s medicines in all the 685 kinds of medicines in our hospital. And 89 kinds (44.28%) of medicines belonged to essential medicine system among the 201 kinds of children’s medicines,in which,78 (87.60%) showed complete medication information for chil-dren;112 kinds(55.72%)of medicines belonged to non-essential medicine system,in which,38(33.93%)showed complete medi-cation information for children. The proportions of showing complete medication information for children in the essential medicines and in its chemicals,biological products,injections and oral preparations were higher than non-essential medicines,the differences were statistically significant(P<0.05). Only 41 kinds of medicines belonged to child-specific medicines among the 201 children’s medicines;62 showed complete medication information for children in the 73 kinds of essential medicines among the non-child-spe-cific medicines;only 13 showed complete medication information for children in the 87 kinds of non-essential medicines,the pro-portion of showing complete medication information for children in essential medicines among the non-child-specific medicines was higher than non-essential medicines,the difference was statistically significant(P<0.05). CONCLUSIONS:The use proportion of essential medicine system variety for children’s medicines is high in our hospital;but there are lacking of child-specific medicines and the medication information for children is insufficient. However,compared with non-essential medicines for children,the essen-tial medicines show better medication information for children in aspects of types,dosage form distribution and non-child-specific medicines,and it is suitable for children.

Objective To explore the characteristic of memory impairment and its relationship with Nmethyl-D-aspartate receptor 2B (NR2B) expression in alcohol dependence patients,in order to provide an unprecedented view of alcohol-associated memory impairment therapy.Methods Participants (n=67) included 35 alcohol dependence patients and 32 matched healthy controls.Wechsler memory scale (WMS) was used to access the memory.The expression levels of NR2B were detected with quantitative reverse transcription-polymerase chain reaction (qRT-PCR).Results Compared with the memory quotient(MQ) of controls(69.45±8.96),that of alcohol dependence patients(50.59±8.64) significantly decreased (t=-6.08,P＜0.01).Compared with the NR2B expression level of controls (1.00-0.00),that of alcohol dependence patients (3.52 ± 1.17) significantly increased (t =9.67,P＜0.01).MQ was negatively correlated with the levels of NR2B expression (r=-0.44,P＜0.05).Conclusion Alcohol dependence patients suffer memory impairment detected by WMS,and modulate NR2B expression may improve the memory.

Objective To determine MR manifestations and pathologic types of benign meningiomas and their relationship with tumor recurrence.Methods There were 218 patients (160 females,58 males; age range 4-79 years) with benign meningiomas in the study,including 31 recurrent meningiomas (recurrence group)and 187 primary meningiomas (primary group).All patients were proved by postoperative pathology.Differences of pathological types and MRI manifestations between the recurrence group and the primary group were evaluated by using x2 test and rank sum test.Logistic regression analysis was performed by taking tumor recurrence as the dependent variable,and age,gender,vital structures involvement and pathologic types as independent variables.The recurrent time intervals were compared by rank sum test.Results There were 30 patients with intracranial vital structures involvement or extreintracranial communication tumors in the recurrent group,which was obviously higher than that of the primary group (61 patients).The difference was statistically significant (x2 =57.672,P =0.001).The tumors located in the skull-base and juxtasinus in the recurrent group were obviously more than those in the primary group,and difference was statistically significant (x2 =10.990,P =0.001).Multi-logistic regression analysis showed that the recurrent risk of benign meningiomas was elevated significantly only with vital structure involvement or extre-intracranial communication tumors (wald x2 =31.863,OR =3.820,P =0.001).The recurrent risk of dural sinus involvement was 3.820 times of cerebral artery trunk and cranial nerves involvement,and the risk of the latter was 3.820 times of the non-involved.There was no statistical difference between the two groups in pathology type,location,peritumoral edema,tumor morphology and tumor size.The relapse time of dural sinus involvement and cerebral artery trunk involvement in the recurrent group was 24(13 to 180) and 126(12 to 187) months,respectively.There was significant difference (Z =2.197,P =0.028).Conclusions It is more common that the recurrent benign meningiomas located in the skull base and juxtasinus.The recurrent risk significantly increases when benign meningiomas with vital intracranial structure involved or with extra-intracranial communication tumor.The relapse time of dural sinus involvement is possibly shorter than that of cerebral artery trunk involvement.MRI plays an important role in predicting tumor recurrence and prognosis of benign meningiomas.

Objective To investigate whether the offspring of chronic ethanol exposured Wistar rats inherited the changes of histone modification.To explore the epigenetic mechanism of the effect of chronic ethanol exposured Wistar rats on the ethanol-seeking behavior of their offspring.Methods Twenty-four male and 24 female adult Wistar rats were randomly injected ethanol and saline for 15 days and experienced withdrawal for 15 days,then coupled into 4 groups.The offspring of the 4 groups were divided into two groups,48 rats without ethanol exposure and 48 rats with ethanol exposure.Conditioned place preference (CPP) was used to evaluate the ethanol-seeking behavior.Using reverse transcription-polymerase chain reaction (RT-PCR) and chromatin immunoprecipitation (ChIP) assays,the levels of htr3a mRNA and specific histone modifications in htr3a promoter region of prefrontal cortex (PFC) were determined respectively.Results (1) In the offspring without ethanol exposure,the htr3a mRNA expression level and the H3K9 acetylation in htr3a promoter region were significantly increased in ones with parental ethanol exposured than ones with parental saline exposured (F =31.496,P ＜ 0.001 ; F =10.333,P ＜ 0.001).(2) In the offspring with ethanol exposure,the CPP score was significantly higher in ones with parental ethanol exposured than ones with parental saline exposured (F =11.436,P ＜ 0.001).The htr3a mRNA expression level and the H3K9 acetylation in htr3a promoter region were significantly higher in offspring of saline exposured rats than ones of ethanol exposured rats (F =26.105,P ＜ 0.001 ; F =3.740,P ＜ 0.05).Conclusion Chronic ethanol exposure could induce H3K9 acetylation in htr3a promoter region and be inherited between generations.Parental exposure to ethanol may enhance the ethanol-seeking behavior through mechanisms involving H3K9 acetylation in htr3a promoter region.

Objective To investigate whether the offspring of chronic ethanol exposured Wistar rats inherited the changes of histone modification.To explore the epigenetic mechanism of the effect of chronic ethanol exposured Wistar rats on the ethanol-seeking behavior of their offspring.Methods Twenty-four male and 24 female adult Wistar rats were randomly injected ethanol and saline for 15 days and experienced withdrawal for 15 days,then coupled into 4 groups.The offspring of the 4 groups were divided into two groups,48 rats without ethanol exposure and 48 rats with ethanol exposure.Conditioned place preference (CPP) was used to evaluate the ethanol-seeking behavior.Using reverse transcription-polymerase chain reaction (RT-PCR) and chromatin immunoprecipitation (ChIP) assays,the levels of htr3a mRNA and specific histone modifications in htr3a promoter region of prefrontal cortex (PFC) were determined respectively.Results (1) In the offspring without ethanol exposure,the htr3a mRNA expression level and the H3K9 acetylation in htr3a promoter region were significantly increased in ones with parental ethanol exposured than ones with parental saline exposured (F =31.496,P ＜ 0.001 ; F =10.333,P ＜ 0.001).(2) In the offspring with ethanol exposure,the CPP score was significantly higher in ones with parental ethanol exposured than ones with parental saline exposured (F =11.436,P ＜ 0.001).The htr3a mRNA expression level and the H3K9 acetylation in htr3a promoter region were significantly higher in offspring of saline exposured rats than ones of ethanol exposured rats (F =26.105,P ＜ 0.001 ; F =3.740,P ＜ 0.05).Conclusion Chronic ethanol exposure could induce H3K9 acetylation in htr3a promoter region and be inherited between generations.Parental exposure to ethanol may enhance the ethanol-seeking behavior through mechanisms involving H3K9 acetylation in htr3a promoter region.

ObjectiveTo describe the MR features of Rasmussen encephalitis (RE).Methods The MRI of 10 pathologic confirmed patients (7 male,3 female,mean age 11 ± 4 years) with RE were retrospectively analyzed in this study.Routine axial,sagittal and coronal (perpendicular to the oblique long axis of the hippocampus) scans were obtained for T1WI,T2WI and fluid-attenuated inversion recovery (FLAIR)images. The location and degree of cerebral atrophy,gray matter signal changes,and the evolution of these findings were evaluated. Results Brain atrophy included the enlargement of lateral ventricle(8/10),temporal horn (9/10)and lateral fissure (9/10); widened sulci and small gyri in the isolateral hemisphere (7/10) ; atrophy in caudate and putamen nucleus (6/10).The cortical atrophy was extensive at late stage of the RE,and usually was hemispheric or involved more than two lobes.The signal changes included hyperintensity involving extensive cortical and/or subcortical regions (9/10). The follow-up MR study demonstrated the progression of brain atrophy and extensive signal changes.Conclusions RE usually presents in pediatric patients. The imaging findings included progressive unilateral brain atrophy,enlargement of lateral ventricle,lateral fissure and sulci,and small gyri with or without cortical T2hyperintensity.Deep nucleus atrophy may be involved in RE.