MELAS mitochondrial myopathy: report of two cases and literature review / 中华全科医师杂志

Two male patients aged 33 and 38 years with mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS)admitted in our hospital in 2016 and 2017 were reported.The main symptoms included abdominal pain and distension,numbness and weakness of the limbs.MRI showed mild ventriculomegaly with deepened sulcus and widened cerebral fissure,deepened bilateral cerebellar sulcus and the widened cleavage,atrophy of cerebellum and brainstem,and manifestations of acute cerebral infarction.Gene analysis showed mutation of mitochondrial DNA(mtDNA) A3243G.After definite diagnosis was made,patients reveived coenzyme Q10,ATP and vitamin supplements for improving circulation,and neurotrophic drugs for symptomatic treatment.The symptoms were slightly improved after treatment and two cases were followed-up as outpatients.

Clinicopathological characteristics of papillary thyroid microcarcinoma and risk factors for central lymph node metastasis / 中华耳鼻咽喉头颈外科杂志

Objective@#To analyze the clinicopathological characteristics of papillary thyroid microcarcinoma (PTMC) and risk factors for central lymph node metastasis(CLNM) in PTMC.@*Methods@#The data of 900 patients with PTMC initially treated in our hospital from January 2004 to December 2015 were retrospectively analyzed. Chi-square test and Logistic regression analysis were performed to determine the risk factors for CLNM.@*Results@#CLNM affected 162 (22.9%) of 707 patients treated with central lymph node dissection. Age, maximum tumor size, multifocality, bilaterality, and extracapsular spread (ECS) were significantly correlated with CLNM (all P<0.01). Age<45 years, maximum tumor size>5 mm, multifocality, bilaterality, and extracapsular spread were independently correlated with CLNM.@*Conclusion@#A prophylactic central lymph node dissection should be considered in PTMC patients with age<45 years, maximum tumor size>5 mm, multifocality, bilaterality, and extracapsular spread.

Interleukin 17 and vascular endothelial growth factor expression and correlation analysis in nasal polyp tissues / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo explore the occurrence and development of nasal polyps by studying the interleukin 17 and vascular endothelial growth factor expression level in nasal polyp tissues.METHODSNasal polyps in 30 patients with chronic sinusitis (with polyps), ethmoid sinus mucosa in 30 patients with chronic sinusitis (without polyps), inferior turbinate mucosa in 10 patients with nasal septum deviation were collected intraoperatively. IL-17 and VEGF expression were detected using immunohistochemistry SP testing, and correlation between them was analysed. RESULTS1. The expression of IL-17 and VEGF in nasal polyps group is significantly higher than that of the other two groups.There was significant difference between each two groups statistically (P<0.01). 2. The expression of IL-17 was positively correlated with VEGF expression in nasal polyps.CONCLUSION1. The expression of IL-17 and VEGF increased in nasal polyp tissues. 2. The expression of IL-17 and VEGFwas positively correlated in nasal polyps , and both of them take part in the occurrence and development of nasal polyps.

Research progress in spatial structure and modulators ofγ-secretase / 中国药理学与毒理学杂志

γ-Secretase is aⅠtransmembrane protease associated with Alzheimer disease(AD), and including four subunits:presenilin,presenilin enhancer-2,anterior-pharynx-defective1 and nicastrin. In recent studies,the ultra-high-resolution cryo-electron microscope has been used for the first time, revealing the humanγ-secretase″horseshoe″,the three-dimensional structure and the arrangement of the subunits. This technique has shed light on the regulation of the enzyme pathway and mechanism. In addition,the γ-secretase modulators,including non-steroidal anti-inflammatory drugs,have been shown in vitro to inhibit γ-secretase activity and selectively reduce the level of Aβ42 against AD. They have provided an effective approach,with broad prospects for development. Studies in this area have become a hot topic in recent years. Here we summarized the γ-secretase subunits regulatory pathways, humanγ-secretase fine three-dimensional structure andγ-secretase modulators .

Significance of Ligustrazine on acute cerebral infarction rat model and its changes on hydrogen sulfide, plasma bilirubin and oxidized low density lipoprotein level / 中国生化药物杂志

Objective To explore significance of Ligustrazine on acute cerebral infarction rat model and its effects on hydrogen sulfide, plasma bilirubin and oxidized low density lipoprotein level.Methods 100 healthy SD rats, ( 250 ±30 ) g, male or female, were divided into five groups ( control group, sham operation group, model group, western medicine group, and Ligustrazine group) ,each had 20.Experimental groups prepared focal cerebral ischemia model with suture method.Normal group, model group and the sham group once daily intravenous injected sterile saline 10 mL, Ligustrazine intravenous injection group injected Ligustrazine 10 mL/(kg? d), the WM group intravenous injected atorvastatin 10 mL/(kg? d).Half of the rats were sacrificed at 10 days of the experiment to detect the relevant indicators, at 20 days, the remaining rats in each group were sacrificed.Blood hydrogen sulfide, plasma bilirubin and oxidized LDL levels were detected, and brain pathology change were observed.Results Compared with control group and sham group, in Ligustrazine group and western medicine group,hydrogen sulfide and plasma bilirubin levels increased significantly, and the difference was statistically significant (P<0.05);after 20 days of treatment, compared with western medicine group Ligustrazine group hydrogen sulfide and plasma bilirubin levels rose more significant (P<0.05).Compared with control group and sham group, in Ligustrazine group and western medicine group, OxLDL levels decreased significantly, the difference was statistically significant (P<0.05); after 20 days of treatment, compared with western medicine group, OxLDL levels in Ligustrazine group decreased more significant ( P<0.05 ) .The rats brain histopathology examination showed that, Ligustrazine group:few nerve cell death, cytoplasm loose and swelling reduced significantly;WM group:condensation nuclei rare, brain edema relieve;model rats: brain tissue surrounding the nerve yuan swelling and the emergence of shrinkage, nuclear condensation within the infarct cells and vascular necrosis of normal tissue disappeared, fuzzy structure, interstitial edema; the control group and the sham-operated rats: normal cell morphology, distribution, no cortical Ministry pale infarction.Conclusion Ligustrazine can increase acute hydrogen sulfide, plasma bilirubin levels in rats with cerebral infarction, elevate level of oxidized low-density lipoprotein, has clinical significance.

Thrombolytic treatment of cardiogenic cerebral embolism：comparison study between different thrombolytic methods / 介入放射学杂志

Objective To evaluate the effect and safety of intravenous (IV) thrombolysis, intra-arterial (IA) thrombolysis and mechanical adjuvant intra- arterial thrombolysis (IA + MA) in treating cardiogenic cerebral embolism. Methods A total of 66 patients with cardiogenic cerebral embolism were randomly divided into IV group (n = 25), IA group (n = 18), IA + MA group (n = 23). The artery recanalization rate, NIHSS score, GCS score, BI excellent rate, symptomatic intracranial hemorrhage rate and mortality after different thrombolytic therapies were determined. The results were compared between each other among the three groups. Results In all three groups both the post-treatment NIHSS score and GCS score were significantly improved when compared with pre-treatment ones (P < 0.05). In IA + MA group the artery recanalization rate was 78.3%(18/23) and the BI excellent rate was 40%(10/25), which were significantly higher than those in IV group (P < 0.05). The symptomatic intracranial hemorrhage rate in IA group was 5.6%(1/18), which was strikingly lower than that in IV group (32%, 8/25). Analysis of the causes showed that the artery recanalization rate in patients with valvular heart disease or cardiac myxoma was rather lower, but the intracranial hemorrhage rate and mortality in these patients were much higher. Conclusion Thrombolytic therapy can improve neurological deficit in cardiogenic cerebral embolism, and the therapeutic effect of mechanical adjuvant intra- arterial thrombolysis is definitely better.

A comparative study of intra-arterial thrombolysis combined with mechanical adjuvant in the treatment of ischemic stroke patients with acute large artery occlusion in either anterior circulation or posterior circulation / 中国神经精神疾病杂志

Objective To study the effect and safety of intra-arterial thrombolysis combined with mechanical ad-juvant in the treatment of acute large artery occlusive infarction of anterior circulation and posterior circulation. Methods Fourty-tow patients were divided into anterior circulation group (24 cases) and posterior circulation group(18 cases). The recanalization rate, NIHSS score (National Institute of Health stroke scale), GCS score ( Glasgow coma score,GCS), BI ( Barthel Index) excellent rate, symptomatic intracranial hemorrhage rate and mortality was analyzed after intra-arterial thrombolysis combined with mechanical aids therapy. Results The anterior circulation group was mainly caused by car-diogenic embolism (15/24, 62.5%) and posterior circulation group was mainly caused by atherosclerosis thrombosis (5/18, 72.2%). The NIHSS score was significantly lower after treatment (8.3±4.9 vs. 8.1±5.7) than before treatment(15.1±5.3 vs. 16.8±7.8)(P=0.001 vs. P=0.001), the GCS score was significantly higher after treatment(13.9±4.4 vs. 12.8±4.2)than be-fore treatment(9.5 ± 3.8 vs. 9.6 ± 3.7)(P=0.001 vs. P=0.021). The symptomatic intracranial hemorrhage rate was signifi-cant higher in anterior circulation group (5/24, 20.8%) than in posterior circulation group (0,0%) (P<0.05). Compared with the anterior circulation group, the recanalization rate trended to increase in posterior circulation group (P=0.830).The symptomatic intracranial hemorrhage rate in anterior circulation group (5/24,20.8%) was significant higher than in pos-terior circulation group (0,0%) (P<0.05), the mortality was similar between these two groups. Conclusions Intra-arterial thrombolysis combined with mechanical adjuvant therapy can improve neurological deficit in acute large artery occlusive infarction and increase the recanalization rate,which is more suitable for the treatment of posterior circulation infarction.

Increased production of circulating soluble co-stimulatory molecule CTLA-4 in patients with myas-thenia gravis / 中华微生物学和免疫学杂志

Objective To investigate the role of soluble cytotoxic T-lymphocyte associated antigen-4 (sCTLA-4) in the pathogenesis of myasthenia gravis (MG) in Fujian province.Methods A total of 80 patients with MG and 80 sex-and age-matched healthy controls were enrolled in the study .MG patients were divided into non-glucocorticoid treatment group and glucocorticoid treatment group , and the latter was further divided into immunosuppressive therapy group and thymusectomy group .Concentrations of sCTLA-4 in ser-ums from above mentioned groups were measured by enzyme-linked immunosorbent assay (ELISA).Results The concentrations of sCTLA-4 in both non-glucocorticoid treatment group and glucocorticoid treatment group were significantly higher than those in the healthy control group (6.03 ng/ml±3.58 ng/ml, 3.44 ng/ml± 2.36 ng/ml vs.0.49 ng/ml±0.95 ng/ml) (χ2=100.67, P<0.001), but sCTLA-4 concentrations in glu-cocorticoid treatment group were lower than those in non-glucocorticoid treatment group (Z=-3.37,P=0.001).With the treatment of glucocorticoid, the sCTLA-4 concentrations were reduced (6.03 ng/ml± 3.58 ng/ml vs.4.56 ng/ml±2.08 ng/ml;t=3.10, P=0.005), and the concentrations of sCTLA-4 were also decreased after thymusectomy therapy (3.86 ng/ml±2.53 ng/ml vs.2.59 ng/ml±2.37 ng/ml; Z=-2.21, P=0.04).However, there was no significant difference in the concentrations of sCTLA-4 before and after immunosuppressive drugs treatment (Z=-1.26,P=0.21).Conclusion The concentration of sCTLA-4 was increased in patients with MG , but with the treatment of glucocorticoid or thymusectomy it could be reduced .

Survey and research on basic medicine knowledge of non-medical students in university / 中华医学教育探索杂志

Objective To research into the current situation of basic medicine knowledge grasp of non-medical students in local comprehensive university and to discuss the significance and necessity of launching basic medicine knowledge education in comprehensive university.Methods Random sampling was used to survey non-medical students of 1-3 grades in three gorges university with questionnaire.SPSS 13.0 software was used to do statistical analysis.Results 89.1％ undergraduates had consciousness to deal with slight illness and slight wound by themselves and 95.4％ undergraduates would prepare some drug to use when necessary.But only 37.2％ undergraduates knew the medicine classification management method of our country and 94.2％ undergraduates might abuse common medicine.96.7％ undergraduates thought that popularizing basic medicine knowledge by selected courses in university was necessary.Conclusions Most undergraduates lack basic medicine knowledge and potential medicine safety hazard like abuse medicine is existed.Education on basic medicine knowledge in university is of great significance in improving the life quality and basic quality of undergraduates.

Clinical analysis of paradoxical cerebral embolism from pulmonary embolism / 中华急诊医学杂志

Objective To explore the diagnosis and treatment of cerebral embolism from pulmonary embolism (PE).Methods The clinical data of 5 cases with PE accompanied by cerebral embolism covering a period from October of 2007 to July of 2011 were retrospectively analyzed.Results In this study,the average age of 5 cases (all female) was 46.5 years old.PE was diagnosed through enhanced CT and ECT in lung among all 5 cases.Moderate to severe pulmonary hypertension was confirmed by echocardiogram.Two cases was patent foramen ovale and one was congenital atrial septal defect.Each patient was diagnosed to be new-onset cerebral infarction by MRI.Three cases underwent cerebral arterial thrombolysis.All of them survived and long-term anticoagulant treatment with Warfarin.INR was adjusted between 2.0 and 2.5 by change of Warfarin dose.Among them,one patient had cerebral embolism again just 3 days after the latest cerebral embolism; the other 4 patients did not suffer from cerebral embolism during the follow-up.Conclusions Paradoxical cerebral embolism is common.For clinical patients with PE,especially pulmonary hypertension accompanied by systemic circulation arterial embolism or unexplained systemic cerebral arterial embolism,paradoxical cerebral embolism should be considered.

Clinical characteristics of hypothyroid myopathy in 8 patients / 中华内分泌代谢杂志

Eight cases of hypothyroid myopthy admitted in Zhanshan Hospital Xiamen University from 1995 to 2011 were retrospectivrely analyzed.The main clinical features were proximal muscle weakness,susceptibility to fatigue,and elevation of muscle enzymes.Electromyography revealed no specific findings.All patients obtained clinical recovery after thyoid hormone replacement.Hypothyroid myopathy should be considered in cases of muscle weakness and elevation of muscle enzymes.

Isolation of cultured endothelial progenitor cells in vitro from PBMCs and CD133(+) enriched cells / 华中科技大学学报（医学）（英德文版）

Two isolation methods for sorting of endothelial progenitor cells (EPCs): from peripheral blood mononuclear cells (PBMCs) and CD133(+) enriched cells were compared, by defining the cell morphology, phenotype, reproductive activities and function in vitro, to provide a reference for clinical application of EPCs. PBMCs from healthy subjects were used either directly for cell culture or for CD133(+) sorting. The two groups of cells were cultured in complete medium 199 (M199) for 7 to 14 days and the phenotypes of EPCs were analyzed by FACS. The proliferation of differentiated EPCs was studied by MTT assay, and the VEGF concentration was measured using an ELISA kit. ECM gel experiment and migration assay were performed in vivo. The results showed that PBMCs produced more colony-forming units (CFU) than CD133(+) enriched cells from the same volume of blood (P<0.01). From day 7 to 14, the two groups showed decreased expression of hematopoietic stem cell markers and increased level of endothelial markers, but CD144(+) cells in CD133(+) group were less than in PBMCs group (P<0.01). PBMCs group secreted more VEGF than CD133(+) group on the day 7 (P<0.01). As compared with CD133(+) group, PBMCs group had more potent potential of proliferation and vascularization in vitro. It was concluded that CD133(+) sorted cells showed a lower capacity of differentiation, secretion, proliferation and vascularization in vitro, suggesting that CD133-negative cells may be a preferential way to get EPCs for clinical therapy.

Comparative analysis of cultured endothelial progenitor cells in vitro from PBMCs and enriched CD133~+ cells / 中国病理生理杂志

AIM: To compare the methods of two currently employed isolation methods for endothelial progenitor cells (EPCs): from total peripheral blood mononuclear cells (PBMCs) and from enriched CD133~+ cells, by defining the cell morphology, phenotype, reproductive activities and function in vitro, providing a reference for clinic application. METHODS: PBMCs from the healthy subjects were used for CD133~+ sorting or not. The two groups of isolated cells were suspended in complete medium M199 for 7 d to 14 d. EPCs phenotype were characterized by FACS. The proliferation of differentiated EPCs was studied by MTT assay, and VEGF concentration was measured using an ELISA kit. Matrigel experiment and migration assay were imitated vascularization in vivo. RESULTS: PBMCs produced more colony-forming units (CFU) than CD133~+ cells from the same volume of blood (P<0.01). From 7 d to 14 d, the two groups show decreased expression of hematopoietic stem cell markers and increased level of endothelial markers, but CD144~+ cells in CD133~+ group were lower than those in PBMCs groups (P<0.01). Cells in PBMCs group secreted more VEGF than that in CD133~+ group on 7 d (P<0.01). Compared to CD133~+ group, PBMCs group showed more potential of proliferation and vascularization in vitro. CONCLUSION: CD133~+ sorted cells show a lower capacity of differentiation, secretion, proliferation and vascularization in vitro, which is unable to differentiate to mature endothelial cells, indicating that it's not a preferential way to obtain EPCs for clinic therapy.

Clinical study of zoledronic acid combined with radiotherapy for bone metastases malignancy / 中国综合临床

Objective To evaluate the efficacy of zoledronic acid combined with radiotherapy for metastatic bone tumours. Methods Eighty patients with metastatic bone tumour by meta were randomly derided into two groups study group(n=40), and the eantrol group (n=40). The study group received 4 mg zoledronic acid infusion for 15 minutes combined with radiotherapy (DT 30Gy/10f/2w) ,control group was only treated with radiotherapy. The primary effective parameters were pain scores, quality of life, KPS scores and pain relief rates. The vital signs, bi-ochemical and hematological parameters were determined. Results The overall response rates of study group and control group were 97.5% and 72.5% ,respectively(P<0.05). The overall response rate of movement capacity im-provement was 87.5 % in the study group and 65.0% in the control group(P<0.05). There was statistical signifi-cance of QOL and KPS in two groups (P<0.01). An adverse event of mild systemic skeletal pain was recorded after pamidronate infusion and completely reversed after 8 hours. Conclusion Zoledronic acid combined with radiothera-py is effective and safe for treating malignant tumour with mestastatic bone tumours. It is a better way to treat meta-static bone tumors at present.

Content Measurement of Bulb Total Alkaloid and Saponin in Zhejiang Fritillariae and Thuubergii / 浙江中医药大学学报

[Objective] To mensurate and compare with the mensuration of alkaloid and saponin in the flower,pedicel and bulb of fritillariae thuubergii,make full use of all parts of fritillariae thuubergi.i[Method]To mensurate the mensuration of alkaloid and saponin in the three parts of fritillariae with the twophase titration method and gravimetric method.[Result]The mensuration of alkaloid in the flowers of fritillariae thuubergii is 0.182%,while it is 0.047% and 0.341% in the pedicel and bulb separately,and the mensuration of saponin in the flowers of fritillariae thuubergii is 5.112%,while it is 8.840% and 1.724% in the pedicel and bulb separately.[Conclution] The difference of major component in the fritillariae thuubergii offers the foundation to make full use of the flowers,pedicel and bulb.

The Effect of Language Techniques in Pharmacology Teaching / 中华医学教育探索杂志

This article discusses the important effect of language techniques in the pharmacology teaching,according to the peculiarity of this speciality and the experience of author,and the concrete language techniques to activate the class to attract the students' attention and to improve teaching effect from the aspects of the basic request of language expression in class,the scientificity and the logicality and the enlighten and techniques of teaching language in pharmacology class.It also explains the importance of language techniques in the pharmacology teaching from many aspects.

Clinical applications of misoprostol / 中国药理学通报

Misoprostol, a prostaglandin E1 analogue, have variety clinical applications. In early 80's, misoprostol is currently licensed primarily to prevent non-steroidal anti-inflammatory drug-associated gastric and duodenal ulcers. Further work shows the drugs have protection to hepatic and renal and prevention of inflammatory and allergic disorders. When combined with mifepristone,complete abortion rate is 95%. On the other hand, misoprostol is also an effective agent for cervical ripening and labor induction. It have no serious side effect, as a result, misoprostol is a drug of high effect and low toxicity, deserving popularization, but man and pregnant woman must prudent.

Analgesia synergism of asarum and verapami / 中国药理学通报

AIM To research synergetic analgesic effect of asarum and verapamil. METHODS Acetic acid caused body turning experiment and hot plate induced pain experiment were used to observe analgesic effect, and the influence of action potential of toad sciatic nerve was observed by nerve chamber and multi media MS 302 system. RESULTS Asarum and A V compound has remarkable analgestic effect of pain in mice induced by acetic acid and hot plate. It also inhibited action potential transmission of toad sciatic nerve. Verpamil has faint analgestic effect but was not able to inhibit action potential transmission of toad sciatic nerve. A V compound had greater effect of analgesia and inhibition of nerve action potential transmission than its components asarum and verapamil. CONCLUSION Asarum and aerapamil have analgesia synergism.