Allogeneic hematopoietic stem cell transplantation is an effective method for treating various hematological diseases. Membranous nephropathy is the second leading cause of novo glomerular disease after transplantation. Protocadherin FAT1 is a target antigen for diagnosing membranous nephropathy, primarily related to hematopoietic stem cell transplantation. Here we report a rare case of membranous nephropathy after hematopoietic stem cell transplantation. The target antigen of membranous nephropathy was confirmed to be FAT1 by pathology combined with mass spectrometry analysis. The nephrotic syndrome achieved partial remission after corticosteroid combined with cyclosporine treatment, and the patient's condition was stable during follow-up.

Objective To study the effects of Xihuang pills combined with sodium cantharidinate and vitamin B6 injection in the treatment of tumor-induced fever. Methods A total of 100 patients with tumor-induced fever in our hospital from March 2015 to January 2017 were enrolled in this study. The subjects were divided into the control group (n=50) and the treatment group (n=50) randomly. The control group were treated with aspirin-D L-Lysine injection, and the treatment group were treated with Xihuang pills combined with sodium cantharidinate and vitamin B6 injection. The two groups were treated for 2 periods. The clinical effects of the two groups after treatment were compared. The life quality of the two groups after treatment were compared. The serum TNF-α and IL-1β of the two groups before and after treatment were compared. The adverse reaction rates of the two groups during treatment were compared. Results The total efficacy rate of defervescence of the treatment group was 88.0％(44/50) significantly higher than 56.0％(28/50) of the control group (χ2=12.698, P=0.000). After treatment, the daily life score (1.10 ± 0.18 vs. 2.47 ± 0.21, t=35.025), social communication score (1.21 ± 0.13 vs. 2.53 ± 0.25, t=33.124), mental state score (1.08 ± 0.15 vs. 2.75 ± 0.21,t=45.758), appetite score (1.13 ± 0.16 vs. 2.56 ± 0.19, t=40.708), sleep score (1.22 ± 0.17 vs. 2.71 ± 0.20, t=40.139) of the treatment group were significantly lower than those of the control group (P<0.05). After treatment, the serum TNF-α (1.98 ± 0.07 μg/L vs. 2.86 ± 0.13 μg/L, t=42.144), IL-1β (9.20 ± 1.89 μg/L vs. 13.51 ± 2.36 μg/L, t=10.080) of the treatment group were significantly lower than those of the control group (P<0.05). There was no significantly differences of the adverse reaction rates of the two groups during treatment (χ2=0.211, P=0.646). Conclusions The Xihuang pills combined with sodium cantharidinate and vitamin B6 injection for patients with tumor-induced fever has a good efficacy and low incidence of adverse reactions, can improve the quality of life and reduce the serum levels of TNF-α and IL-1β.

Objective To explore the effect of measure accuracy of crevasse diameter of atrial septal defect (ASD) by transthoracic echocardiography (TTE) on radiation dose during interventional therapy.Methods 79 cases ASD with interventional therapy in our hospital were analyzed retrospectively,according to the times which we chosen occluder device on the basis of defect diameter by TTE,we divided those cases into three groups:group A,the occluder device chosen well,and it took only one time to block success (50 cases);group B,it took two times to block success (22 cases);group C,because of the measurement error,it needed three times to block success (7 cases).Following data were separately recorded:①measurement values of TTE,size of the occluder device and times of occluder device exchange;② radiation dose [cumulative radiation dose (AK,Gy),area dose product (DAP,Gy · cm2),fluoroscopic time (T,min)];③patient gender,age and body mass.Results All the cases were blocked success,the coincidence rate of TTE and occluder device were 62.67 ％,28 ％,9.33 ％,but there were significantly differences of AK,DAP and T in three groups (FAK=12.119,P=0.000;FDAp=8.241,P=0.001;FT =12.777,P=0.000).It showed that the radiation dose and T of group C were the largest and the longest,and group A were the least and the shortest,while the radiation dose and T of group B ranged between A and C groups.There was no statistically difference between radiation dose for different gender,age,body mass(P≥0.050).Conclusion The times of block and radiation dose is most influenced by the coincidence rate of TTE and occluder device.Increase of the coincidence rate may decrease the times of block and reduce the radiation dose for surgeon and patient.

Objective To explore the changes of brain functional network in insomnia disorder (ID) during resting-state with voxel-based degree centrality (DC).Methods Forty-five subjects underwent resting-state fMRI scans,including 22 patients with ID (ID group) and 23 sex-,age-,and education-matched healthy volunteers (control group).The subjects' sleep quality and emotion state were assessed with Pittsburgh sleep quality index (PSQI),Hamilton anxiety scale and Hamilton depression scale.The resting-state fMRI data were analyzed with voxel-based DC.The intra-and inter-groups parameters were compared using t-test.Correlation analysis was performed between DC values of ID group and clinical parameters.Results Compared with control group,DC values increased in left parahippocampal gyrus,left hippocampus and bilateral precuneus (all P＜0.05),while decreased in left middle occipital lobe,left precuneus,left inferior frontal gyrus and left middle frontal gyrus in ID group (all P＜0.05).DC values of the left hippocampus in ID patients showed significantly negative correlation with the score of Pittsburgh sleep quality index (r=-0.46,P=0.047).Conclusion ID patients have abnormal DC distribution of brain functional network,therefore providing basis for understanding pathophysiological mechanisms of ID.

Objective To investigate radiation dose diffent type of anesthesia affected radiation dose when we do interventional therapy for child patent ductus arteriosus (PDA).Methods From 201 1 to 2014,we collected 50 children(3-6 years old)with PDA which received interventional therapy were included in the study.They were divided into two groups:group A (25 cases,male/fe-male=7/18,mean weight=1 5.32 kg±2.41 5 kg)underwent interventional therapy of PDA under general anesthesia,and group B (25 cases,male/female=13/12,mean weight=1 6.40 kg±2.056 kg)using local anesthesia.The surgery were operated by the same doctor,we used DSA children cardiovascular film AE mode (ped CARD)to monitor the surgery,image frames 1 5-30 f/s,used the non-ionic contrast agent (Iodixanol 320 mg I/mL)and recorded the child cumulative incidence of skin surface dose (AK),dose area product(DAP),and time of fluoroscopy,and do statistical analysis.Results All 50 cases were performed the surgery successfully. There were no significant difference of age,weight and gender between groups (age:t=1.924,P =0.06;weight:t =1.703,P =0.095;gender:χ2 =3.00,P =0.083).The cumulative incidence of skin surface dose (AK),dose area product (DAP)and time of fluoroscopy were (0.061±0.025)Gy,(5.08±2.19)Gy·cm2 and (3.15±1.16)min in A group,and (0.094±0.046)Gy,(8.41±3.587)Gy·cm2 , (6.86±3.27)min in B group.The sequence and image number of two groups were same.There were significantly differences of cumulative incidence of skin surface dose (AK),dose area product (DAP)and time of fluoroscopy between two groups (AK:t =3.152,P =0.003;DAP:t =3.957,P =0.000;time of fluoroscopy:t =5.346,P =0.000).The radiation doses of A group significantly lower than B group,compared with B group,the radiation dose were 40 percent [(1-5.08/8.41)%]lower in A group,the 1.1 7 times discrepancy of time of fluoroscopy between two group [(3.1 5-6.86)/3.1 5].Conclusion Radiation dose is associated with type of anesthesia. Compared with local anesthesia,radiation dose reduced 40% using general anesthesia during interventional therapy for PDA.

Purpose The study aimed to explore gender differences of brain activation in healthy volunteers under the stimulation of emotional pictures.Materials and Methods The cerebral functional imaging data of twenty healthy volunteers at Henan Medical College from Nov.2014 to Dec.2014 were prospectively studied (12 males and 8 females).Emotional pictures (30 positive,30 negative and 30 neutral pictures) from Chinese Affective Picture System (CAPS) were used randomly as visual stimuli for both males and females.Functional MRI was performed while each subject was stimulated by emotional pictures.The fMRI data were processed and the statistical analysis was performed to obtain the activated brain regions of males and females and to compare the gender differences.Results Under the stimuli of negative emotional pictures,bilateral temporal lobe,bilateral cuneus in men and bilateral cuneus in women were activated under the stimuli of positive emotional pictures (P＜0.05).Compared with men,increased activation of left amygdala,bilateral prefrontal gyrus,bilateral precuneus and right insula were observed in women under the stimuli of negative pictures.The differences were statistically significant (P＜0.05).Compared with women,no cerebral region was more activated in men under the stimuli of negative pictures.Under the stimuli of positive emotional pictures,the left prefrontal gyrus in women was more activated than that in men whilst the left temporal lobe in men was more activated than that in women.The differences were statistically significant (P＜0.05).Conclusion Gender differences of activated cerebral regions under stimuli of emotional pictures do exist in healthy volunteers.In particular,more cerebral regions and increased activation were observed in women compare to men,which demonstrates that women response stronger to negative emotion.

Objective To observe the alterations in brain gray matter volume(GMV)in idiopathic generalized epilepsy(IGE)patients with typical absence seizure. Methods Nine IGE patients with typical absence seizure and 16 healthy volunteers were prospectively recruited from People's Hospital of Zhengzhou University from September 2012 to January 2014. By using a 3. 0T magnetic resonance imaging(MRI)and voxel - based morphometry(VBM)method, their whole brain structures and their brain GMV were scanned and analyzed,respectively,then the changes in GMV were observed. Results Compared with healthy control group,brain GMV extensively decreased in IGE patients with typical absence seizure. Thirteen regions with significant differences were as follows:the right rectal gyrus(t = 3. 13,P ﹤0. 01),the left rectal gyrus(t = 4. 82,P ﹤ 0. 01),the right calcarine/ cuneus/ gyrus lingualis/ occipital gyrus/ inferior oc-cipital gyrus(t = 6. 86,P ﹤ 0. 01),right gyrus lingualis(t = 4. 01,P ﹤ 0. 01),the left gyrus lingualis/ inferior occipital gyrus(t = 3. 73,P ﹤ 0. 01),the left inferior occipital gyrus/ gyrus lingualis(t = 5. 42,P ﹤ 0. 01),the left middle occipi-tal gyrus(t = 3. 76,P ﹤ 0. 01),the right middle occipital gyrus/ superior occipital gyrus/ middle temporal gyrus( t =3. 85,P ﹤ 0. 01),left middle temporal gyrus/ superior temporal gyrus(t = 5. 06,P ﹤ 0. 01),the right precuneus/ cuneus (t = 3. 33,P ﹤ 0. 01),and the right superior parietal lo-bule(t = 3. 66,P ﹤ 0. 01),right precentral gyrus(t = 3. 44,P ﹤0. 01),right superior frontal gyrus/ paracentral lobule/ supplementary motor area(t = 3. 50,P ﹤ 0. 01). However,GMV increase was not found. Conclusions Brain GMV extensively decreased in 13 brain regions of IGE patients with typical absence seizure,and among them occipital lobe is the most significant.

Objective To investigate the value of dynamic contrast?enhanced MRI (DCE?MRI) in the differential diagnosis of glioblastoma and brain metastases. Methods Twenty patients with high grade gliomas and 20 cases patients with brain metastases proved by surgery and pathology were collected, and patients were examined with conventional MRI and DCE?MRI preoperatively. The ROIs were manually placed in solid parts of the tumors and their surrounding tissues to calculate Ktrans, Kep and Ve values. The Ktrans, Kep and Ve values differences for the solid part and surrounding tissues of the two brain tumors were compared by two independent sample t test. The correlation between Ktrans of the solid parts of the two brain tumors and Ktrans, Kep and Ve values of their surrounding tissues were studied by Pearson correlation analysis. Results The Ktrans, Kep and Ve values of glioblastoma were(0.258 ± 0.063)min-1,(0.398 ± 0.082)min-1, 0.632±0.084, the Ktrans, Kep and Ve values of brain metastases were(0.233±0.053)min-1,(0.357±0.042)min-1, 0.672±0.113. There were no significant differences between the glioblastoma and brain metastases for Ktrans, Kep and Ve values(t=-1.354,-1.982, 1.276, all P>0.05). The Ktrans, Kep and Ve values of surrounding tissues of glioblastoma were(0.093±0.032)min-1,(0.411±0.089)min-1, 0.107±0.021, the Ktrans, Kep and Ve values of surrounding tissues of brain metastases were(0.033±0.010)min-1,(0.204±0.045)min-1, 0.069±0.017. The Ktrans, Kep and Ve values of surrounding tissues between glioblastoma and brain metastases had significant difference (t=-7.978,-9.303,-6.203, all P<0.05). The Ktrans of glioblastoma were correlated with Ktrans, Kep and Ve values of their surrounding tissues (r=0.759, 0.464, 0.651, all P<0.05); The Ktrans values of brain metastases had no relationship with Ktrans, Kep and Ve values of their surrounding tissues (P>0.05). Conclusion The DCE?MRI can quantitatively display the microvascular permeability and accurately evaluate the damage of blood?brain barrier of glioblastoma and brain metastases, which has an important value in studying biological characteristics and differential diagnosis of the two brain tumors.

Objective To discuss influence and curative effect observation of sodium hyaluronate on serum matrix metalloproteinase-9,12 and 13 (MMP-9, 12 and 13) levels of patients with knee osteoarthritis (OA). Methods Selected 70 cases of patients with knee OA, and divided into observation group (n=35 cases) and control group (n=35 cases) in accordance at random. The patients in two groups were given oral 75 mg diclofenac sodium enteric capsules , once a day for 5 weeks. The patients in observation group were additionally given 2 mL sodium hyaluronate , injected into in-tra-articular, once a week, for 5 weeks. Excepted for sodium hyaluronate injection fluid, the patients in control group were given the same medical treatment as that in observation group. The changes of serum MMP-9 , 12 and 13 levels between the two groups before and after medical treatment were observed , and the clinical curative effect and untoward effect was compared as well. Results After 5 weeks’ treatment, the serum MMP-9, 12 and 13 levels of patients in two groups were declined more significantly than before with different degrees (P<0.05 or P<0.01), and the declining rate of patients in observation group was much higher than that in control group (P<0.05). The clinical good and excellent rate with in observation group(85.71%) was much higher than that in control group (62.86%)(χ2=4.79,P<0.05). 9 and 11 cases of untoward effect were appeared between control group and observation group respectively with light symp-tom, and after comparing the occurrence rates of untoward effect of patients in two groups, with no statistical differ-ences (χ2=0.28,P>0.05). Conclusion Sodium hyaluronate has favorable curative effect on patients with knee OA, whose mechanism of action has close effect on reducing serum MMP-9 ,12 and 13 levels.

BACKGROUND:A large number of studies have confirmed that anterior approach and posterior approach for multilevel cervical spondylotic myelopathy were effective, but there is stil no conclusion in which one is better.
OBJECTIVE:To systematical y assess the clinical effectiveness and safety of anterior approach versus posterior approach for multilevel cervical spondylotic myelopathy.
METHODS:The databases such as The Cochrane Library (Issue 3, 2013), PubMed (from 1966 to March 2013), OVID (from 1950 to March 2013), EMbase (from 1966 to March 2013), Chinese Biomedical Literature Database (from 1978 to March 2013), WanFang Database (from 1998 to March 2013), China National Knowledge Infrastructure (from 1999 to March 2013) were electronical y searched and five relevant journals were searched by hand to col ect the randomized control ed trials or non-randomized control ed trials about the clinical effectiveness and safety of anterior approach versus posterior approach for multilevel cervical spondylotic myelopathy. Two reviewers independently screened the literature according to the inclusive and exclusive criteria, extracted the data, and assessed the methodological quality of included studies. Then the meta-analysis was performed by using RevMan5.2 software.
RESULTS AND CONCLUSION:A total of 11 control ed trials involving 814 patients were included. Meta-analysis results showed that, compared with posterior approach, postoperative Japanese Orthopaedic Association scores were better (P<0.000 01), improvement rate of neurological function was higher (P=0.000 3), the incidence of C5 root palsy was lower (P=0.007), but operation time was longer (P<0.000 01), amount of intraoperative bleedin g was larger (P=0.000 7), incidence of adjacent segments degeneration was higher (P=0.01), incidence of postoperative complications was higher (P<0.000 01) and the rate of secondary surgical procedures was higher (P=0.003) after anterior approach. Additional y, there were no differences between the two groups in the cervical range of motion (P=0.56). For quantity limitation and low methodological quality of included studies, this conclusion stil needs to be further proved by performing more high-quality and large-scale randomized control ed trials.