Volume 95  ·   Issue 01  ·  2015

Years go away, clouds scatter easily, time rushes. In 2015, we will celebrate the 100th anniversary of the Chinese Medical Association, and at the same time, we will commemorate the 100th anniversary of the founding of the Chinese Medical Journal as its journal. Turning over the century-old history of Chinese Medical Journal, many medical classics are worth remembering, and countless medical sages are worth remembering. Chinese Medical Journal is the first medical journal in the true sense of modern China. After a hundred years, it has witnessed the development of modern medicine in China and recorded countless wonderful chapters in the development of modern medicine in China. On the occasion of the 100th anniversary of the publication of Chinese Medical Journal, the first thing we should remember is Dr. Wu Liande, the founder and first editor-in-chief of this journal. More than 100 years ago, China was "full of sores, everyone lamented", and tuberculosis and plague were epidemic^[1]。 In response to the government's call, Mr Ng Liande, a Malaysian overseas Chinese and a Ph.D. from Cambridge University in the United Kingdom, devoted himself to the cause of medicine and epidemic prevention with enthusiasm for his motherland. He is the earliest advocate, organizer and practitioner of health and epidemic prevention in China. He initiated the establishment of the Chinese Medical Association and served as the first secretary and president. In November 1915, shortly after the establishment of the Chinese Medical Association, the Chinese Medical Journal was officially founded in Shanghai, and he personally served as the editor-in-chief. In his founding speech, he sent a message: "When we observe the rise and fall of a country, we should always measure it by magazines. When magazines are developed, the country will be strong."^[2]。 Since its founding 100 years ago, Chinese Medical Journal has always adhered to the purpose of serving readers, authors and medical and health scientific and technological personnel, promoting domestic and foreign medical academic exchanges and the development of medical science, keeping up with the world medical progress trend, and promoting the progress and development of Chinese medical science and technology as its own responsibility. Promoting new knowledge, new technology, new achievements and exchanging experiences have played an important role in improving the theoretical and professional level of Chinese medical staff and promoting the development and improvement of Chinese medical science.

In September 2014, the journal Lancet published a longitudinal study of fetal growth and development^[1]It is an update and supplement to the International Growing Child Standards issued by the World Health Organization (WHO) in 2006, which makes the growth of fetuses have an international standard. Human beings experience unfavorable factors during the fetal period, such as malnutrition, overnutrition, uteroplacental dysfunction, etc. Permanent or procedural changes in the structure and function of tissues and organs will affect the occurrence and development of chronic non-communicable diseases such as diabetes mellitus, metabolic syndrome, cardiovascular diseases, mental behavior abnormalities, asthma, tumors, osteoporosis, neurological diseases, etc^[2,3]However, the focus of obstetrics has always been on maternal safety. With the development of fetal medicine, people are more and more aware of the importance of paying attention to fetal growth and development.

At present, there is no dispute that hypertensive disorders during pregnancy are a group of hypertensive disorders that appear during pregnancy. However, for preeclampsia-eclampsia (PE-E) in this group of diseases, whether PE-E is only an idiopathic disease with idiopathic manifestations of pregnancy or a group of diseases with "syndrome" manifestations is a controversial topic that is being continuously discussed in depth. Whether it is from the change of disease terms to the constant change of diagnostic classification and diagnostic criteria, it can be said that the understanding of PE-E is constantly deepening. With the advancement of clinical research and basic research on different etiologies and pathogenesis of early-onset and late-onset preeclampsia, multiple factors and heterogeneity affecting the pathogenesis of PE-E and multiple pathways of pathogenesis are continuously revealed and discovered. From "pregnancy-induced hypertension syndrome" many years ago to "preeclampsia-eclampsia syndrome" today, the intrinsic meanings of the syndrome are very different. It is not only the parallel connection of PE and E, but the thinking of the cause of PE disease. This understanding helps us to have a deeper understanding of this disease that has been explored by researchers for centuries.

Hepatitis B virus (HBV) infected pregnant women transmit the virus to their children, that is, mother-to-child transmission, which is the main cause of chronic HBV infection in China. Vaccination against hepatitis B is the most effective measure to prevent HBV infection. With the attention of governments at all levels and the efforts of medical staff and the whole society, the timely vaccination rate of the first vaccine of most newborns in China is>90%^[1]Great achievements have been made in controlling HBV infection, but there are still challenges in how to further reduce mother-to-child transmission of HBV.

Over the last 20 years, over-diagnosis of dystocia has been widespread not only in China, but all over the world. Including the diagnosis of prolonged incubation period latent phase, arrested active phase, and protracted second stage, all contributed to the increase in cesarean section rates. 2000 Gifford et al.^[1]It is reported that 25% of women in the United States who undergo cesarean section every year because of slow labor progress have been diagnosed with "protraction disorders" when the cervical dilation is only 0-3 cm. For a long time, we have been too demanding on the maternal delivery process, and always hope that the cervix will expand rapidly in the early stage of labor. In fact, the cervix will expand slowly in the early stage of labor, which will easily lead to over-diagnosis of dystocia. Moreover, the guiding role of partogram, which was widely recommended before this, for obstetricians and midwives needs to be considered. Most of the time, partogram is drawn retrospectively, rather than truly recorded and drawn, because the time of labor is difficult to determine. Therefore, how to judge that the parturient has really entered the active phase, how to determine the turning point of cervical dilatation during labor, and whether it is necessary to re-formulate a new labor chart or a new labor standard, these are all questions worth our consideration.

Preeclampsia is a unique disease of pregnancy, with an incidence rate of 7% ~10%. The number of maternal deaths directly caused by pregnancy is about 6.8/100,000 every year^[1]； It is often complicated by fetal growth restriction, iatrogenic preterm delivery, chronic fetal hypoxia and abnormal learning and memory ability of offspring. However, there is still a lack of effective early diagnosis and intervention measures for preeclampsia, and its etiology and pathogenesis are still unclear. According to the available data, maternal-fetal conflict may be the key link in the occurrence of preeclampsia.

To explore the effects of AKR1C3 on kidney damage of preeclamptic rats and elucidate the possible therapeutic mechanism of glyburide.

The rat model of preeclampsia was established by an intraperitoneal injection of Nw-nitro-L-arginine methyl ester hydrochloride (L-NAME). A total of 40 Wistar rats were randomly divided into 4 groups of preeclampsia (pregnant rats and L-NAME), treatment (pregnant rats, L-NAME and glyburide), non-pregnancy (L-NAME) and control (pregnant rats and NS) (n=10 each). The rats in treatment group received an intragastric dose of glyburide. Successful modeling was confirmed by measuring blood pressure and 24 h urine protein content and observing the structure of kidney under transmission electron microscopy (TEM). The methods of reverse transcription-polymerase chain reaction (RT-PCR) and Western blot were employed to detect the expression levels of AKR1C3, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA).

The blood pressures of all rats had no significant difference prior to modeling. After modeling, the blood pressure of preeclampsia group was significantly higher than those of control and treatment groups [(143.83±9.62), (120.83±4.31), (129.43±14.4) mmHg, both P<0.05]. The 24 h urine protein content of all rats had no significant difference prior to modeling. After modeling, the 24 h urine protein content of preeclampsia group was higher than those of control and treatment groups. The TEM observation of kidney slices verified the success of modeling. In preeclampsia group, the expression levels of AKR1C3 in protein and mRNA were significantly lower than control group [(0.48±0.09) vs (0.98±0.27), (0.05±0.02) vs (0.87±0.45), bothP<0.05]. Compared with preeclampsia group, the expression levels of AKR1C3 in protein and mRNA significantly increased in treatment group [(0.48±0.09) vs (1.05±0.20), (0.05±0.02) vs (0.22±0.06), bothP<0.05]. As compared with control group, the levels of SOD, CAT and GSH-Px were significantly lower while MDA was higher. Compared with preeclampsia group, the levels of SOD, CAT and GSH-Px in treatment group were significantly higher while MDA was lower.

The expression level of AKR1C3 decreases in kidney of preeclamptic rats and the mechanism is related with oxidative stress. Glyburide increases the expression of AKR1C3 and have therapeutic effect for preeclampsia.

To explore the protein expression and distribution of long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) in various maternal and fetal tissues in preeclampsia-like and normal pregnant mouse models during the middle trimester.

C57BL/6J mice were divided into preeclampsia-like experimental group with Nw-nitro-L-arginine-methyl ester injection and normal pregnancy control group with normal saline injection. Samples were taken at Day 14 of gestation. Immunohistochemistry was used to detect the LCHAD protein expression and distribution in various maternal and fetal tissues.

The mean arterial pressure was (115.6±3.3) mmHg (1 mmHg=0.133 kPa) in experimental group and (96.2±4.9) mmHg in control group (P<0.05). The urine protein contents were (97.0±4.3) μg/g body weight/24h in experimental group and (60.8±4.9) μg/g body weight/24h in control group (P<0.05). In both groups, LCHAD protein was expressed in maternal liver, kidney, heart and placenta tissues during the middle trimester. And maternal hepatic tissue, myocardial tissue, renal tubule and spongiotrophoblast showed a strong positive expression, placental labyrinth layer a moderate positive expression and glomerulus a weakly positive expression. LCHAD expression of maternal liver and placenta decreased significantly in experimental group (P<0.05). At Day 14 of pregnancy, LCHAD was expressed in fetal liver, kidney, heart, lung tissue and neural retina. And renal tubule, pulmonary epithelial tissue and neural retina showed a strong positive expression, fetal liver a moderate positive expression and myocardial tissue and glomerulus a weakly positive expression. There was no significant inter-group difference in fetal tissues.

LCHAD is expressed and distributed widely in maternal and fetal tissues during the middle trimester. And it may play an important role in maternal metabolism and placenta-fetus development during pregnancy. There is an abnormal protein expression LCHAD in maternal liver and placenta with preeclampsia-like changes.

To explore the serum levels of suppressor of cytokine signaling 3 (SOCS3), tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) in preeclampsia mothers and determine their clinical values.

A total of 40 preeclampsia mothers at International Peace Maternity and Child Health Hospital of China Welfare Institute Affiliated to Shanghai Jiaotong University from March 2011 to August 2013 were enrolled into observation group. Another 40 cases of mothers without pregnancy complications were selected as control group. Then the serum contents of SOCS3, TNF-α and IL-10 were detected and their correlations analyzed.

(1) The mRNA levels of SOCS3 of observation and control groups were 38±6and 100±16while the mRNA levels of TNF-α 226 ±40 and 100±19 respectively; (2) the proteins levels of SOCS3 of observation group were lower than those of control group (P<0.05) while the proteins levels of TNF-α of observation group were higher than those of control group (P<0.05); (3) the mRNA and protein contents of SOCS3 were negatively correlated with mRNA and protein contents of TNF-α and positively correlated with IL-10.

The serum content of SOCS3 decreases significantly in preeclampsia so that there is a down-regulation of Th1 type cytokine TNF-α and an up-regulation of Th2 type cytokine IL-10. And it may play an important role in the occurrence of disease.

To explore the current status of maternal age and hypertensive disorders in pregnancy related to maternal age in China.

The clinical data were collected from 39 hospitals in mainland China. All deliveries were performed after 28 weeks of completed gestation between January 1 and December 31, 2011. A total of 110 450 cases were enrolled and divided into 6 groups at 5-year intervals according to maternal age. The 25-29 age group was selected as a reference group. The odds ratio (OR) and 95% confidence interval (CI) were calculated by unadjusted binary-Logistic regression as appropriate.

The mean age of pregnant women at the time of delivery was 28.18±4.70 (14-52) years. The risk of hypertensive disorders in pregnancy increased in the 3 age groups above 30 years (OR: 30-34 age group=1.3, 35-39 age group=2.3, ≥40 age group=3.3). The risks of chronic hypertension and pregnancy-induced hypertension increased gradually with maternal age. The risks of preeclampsia and severe preeclampsia showed a U-type distribution. The risk was the lowest in the 25-29 age group and the highest in the ≥40 age group (OR=3.6 and 3.4). The rate of eclampsia was 0 in the ≥40 age group and the highest in the teenage group (OR=8.7). And it was higher in the 20-24 age group (OR=2.6). No significant difference existed between other age groups and the 25-29 age group.

The risk of hypertensive disorders in pregnancy increases gradually with age in pregnant women aged over 35 years. And the risks of preeclampsia and eclampsia rise in teenage pregnancy. Better management helps to reduce the incidence of eclampsia and improve the outcomes of pregnancy in pregnant women with advanced maternal age and teenages.

To evaluate the changes of carotid adventitial thickness (AT) and intima media thickness (IMT) and their relationship in metabolic syndrome (MS) patients using high-frequency ultrasound.

The values of mean AT and mean IMT were measured and calculated for 161 MS patients and compared them with 94 age and gender-matched controls as determined by high-frequency ultrasound between 2009-2011. And 161 patients were divided further into 2 groups of MS with plaque (MS-P, n=70) and MS without plaque (MS-NP, n=91).

MS-P and MS-NP patients had significantly higher values of mean IMT and carotid artery wall thickness than controls and MS-P patients had significantly higher values of mean AT than controls ((0.77±0.13) mm vs (0.66±0.11) mm, P<0.01). Moreover, MS-P patients had significantly higher values of mean IMT ((0.98±0.20) mm vs (0.76±0.10) mm,P<0.01), mean AT ((0.77±0.13) vs (0.69±0.13) mm,P<0.01) and carotid artery wall thickness ((1.61±0.16) mm vs (1.42±0.09) mm,P=0.002) than MS-NP patients. And mean AT was positively correlated with mean IMT in controls, MS-P and MS-NP patients (r=0.603, P<0.01,r=0.325, P=0.005 and r=0.344, P=0.004 separately).

For IMT and AT in MS patients with and without plaques, adventitia participates in vascular remodeling and may be distinguished by high-frequency ultrasound.

To explore the correlation between cystatin C (Cys C) and properties and features of coronary plague using 256-slice coronary computed tomography angiography (CTA).

From January 2013 to October 2013, a total of 184 patients with suspected coronary artery disease undergoing CTA for coronary artery lesions were enrolled. Based on the results of cystatin C levels, they were divided into normal Cys C concentration group (≤0.95 mg/L) and high Cys C concentration group (>0.95 mg/L). Based on the results of CTA, they were divided into single-vessel, 2-vessel and 3-vessel groups according to the number of diseased coronary arteries. And they were divided into mild stenosis (<50%), moderate stenosis (≥50%, <75%) and severe stenosis (≥75%) groups according to the severity of coronary artery disease. The Hounsfield units were used to determine the soft, fibrous and calcified plaques for assessing the relationship between cystatin C levels and narrow severity score, pathological changes limits, plague properties.

There were 95 with normal concentrations of Cys C and 89 with high concentrations of Cys C. A total of 1 112 plaques were detected and those with high concentrations of Cys C showed a higher proportion of non-calcified plaque (13.5% vs 8.8%, P<0.01) compared with normal group. The proportion of those with 1-vessel disease was lower (22.5% vs 37.9%,P<0.05) but 3-vessel disease higher (48.3% vs 33.7%,P<0.05) than in normal group. Multiple Logistic regression analysis revealed that high Cys C was a significant risk factor for multi-vessel disease (OR=17.483, 95%CI: 2.218-143.627; P<0.01).

For patients with coronary artery lesions, a high level of Cys C may be associated with severity of coronary atherosclerosis and plaque instability.

To explore the relationship between the degree of vascular stenosis and cognition in leukoaraiosis patients.

A total of 101 leukoaraiosis patients from the Department of Neurology, The First Affiliated Hospital of Anhui Medical University between September 2013 and June 2014, divided into two groups: patients with cognitive impairment (SVCI)(n=54), and those without cognitive impairment (NC)(n=47). All patients were enrolled and examined by magnetic resonance imaging (MRI) scanning and magnetic resonance angiography (MRA) or computed tomography angiography (CTA). The cognitive assessments were made by MMSE (mini-mental state examination), CAMCOG-C (Cambridge cognitive examination-Chinese version) and CDR (clinical dementia rating). The severity of leukoaraiosis and vascular stenosis was graded by MRI and MRA/CTA scans.

The degree of vascular stenosis group and the severity of LA in SVCI were significantly higher than NC (2.0±0.8 vs1.1±0.6, 2.6±1.0 vs 2.0±1.0; P=0.020, P=0.003). As white matter level aggravated, cognitive function decreased and vascular stenosis deteriorated accordingly, and the score of MMSE (25±4, 24±6, 22±4) and CAMCOG-C (83±14, 80±14, 73±14) has a statistical significance (P=0.012, P=0.014). At the same time, the negative correlation was found in LA patients between cognitive function and severity of LA (r=-0.317, P=0.001) as well as degree of vascular stenosis (r=-0.284, P=0.004). Multivariate Logistic regression analysis revealed that, after controlling for various factors, both severity of LA (OR=2.025, 95% CI 1.307-3.954) and the degree of vascular stenosis (OR=1.812, 95% CI 1.129-2.908) were risk factors for cognitive impairment in leukoaraiosis patients.

Cognition of leukoaraiosis patients is correlated with both severity of leukoaraiosis and vascular stenosis.

The purpose of this study was to examine the safety and efficacy of the Reekross balloon catheter for recanalization of long CTO of iliofemoral arteries.

A retrospective analysis of patients with long CTO of iliofemoral arteries who underwent angioplasty with Reekross balloon catheter between January 2011 and May 2013 was performed. All lesions were TASC Ⅱ C and D. Sixty-eight patients (75 limbs) were enrolled with mean age of (69±12) years, 53 male and 15 female. The limbs of Rutherford Ⅲ, Ⅳ, Ⅴ and Ⅵ were 41, 13, 19 and 2. Technical successrate, ankle brachial index (ABI), complication rate, and cumulative primary patency rate were evaluated.

Technical success ratewas 90.7%. ABI increased from pre-procedure (0.41±0.12) to 3-day post-procedure (0.77±0.20)(t=-7.263, P<0.01). Follow-up was achieved in 56 cases (61 limbs) from 12 to 40 months, with a mean of (26.3±7.1) months. Primary patency rates at 3 months, 6 months, 12 months and 24 months were (98.4±1.6)%, (86.7±4.4)%, (80.0±5.2)% and (69.4±6.3)%.

The Reekross balloon catheter is safe and effective for successful recanalization of CTO of iliofemoral artery.

To explore the correlation between minimal apparent diffusion coefficient (minADC) and expression of Ki-67 in glioma.

Findings from 78 patients with pathologically proven gliomas (grade Ⅱ: n=28, grade Ⅲ: n=21, grade Ⅳ: n=29) were analyzed retrospectively. The minADC value of each tumor was determined on ADC maps. The Ki-67 labeling index (LI) of surgical specimen was measured. The results were analyzed statistically.

The mean value of minADC for gliomas of grade Ⅱ ((1.23±0.23)×10^-3 mm²/s) was higher than that of grade Ⅲ ((0.92±0.20)×10^-3 mm²/s) (P<0.01) and than that of grade Ⅳ((0.80±0.16)×10^-3 mm²/s)(P<0.01). But no significant difference existed between the mean value of minADC of grade Ⅲ and that of grade Ⅳ (P=0.069). There were significant negative correlations between minADC and different tumor grades (r=-0.678, P<0.01). The mean value of Ki-67 LI showed significant differences between grade Ⅱ(3.6%±2.3%), grade Ⅲ(14.8%±7.3%) and grade Ⅳ(29.9%±13.1%)(P<0.01). There were significant positive correlations between Ki-67 LI and different tumor grades (r=0.835, P<0.01). And a negative correlation existed between minADC and Ki-67 LI (r=-0.556, P<0.01).

The value of minADC is useful for predicting glioma grade.

To compare the efficacy of mammography versus ultrasonography in detecting stages T1 and Tis breast cancer.

Mammography and ultrasonograhpy data were collected for 1 630 stages T1 and Tis breast cancer from July 2011 to July 2013. Chi-square test was used to analyze the detection rate and diagnostic rate of two methods.

Among 1 630 patients with 1 665 focus, 1 559 focus were detected by both methods. In term of detection rate, mammography had a higher rate in mostly fatty and scattered fibroglandular breast while ultrasonography offered advantages in extremely dense breast. And statistical significance existed among these groups (P<0.05). In heterogeneously dense group, the detection rate of two methods had no statistical significance (P>0.05). In term of diagnostic rate, mammography had a higher diagnostic rate in mostly fatty and scattered fibroglandular breast. On the contrary, ultrasonography was superior to mammography in heterogeneously and extremely dense breast. No statistical significance existed among these groups (P>0.05). Furthermore the focus were classified into mass and non-mass types based on mammographic images. As the volume of fibroglandular tissue increased, the amount of mass type focus increased while that of non-mass type focus decreased.

For stages T1 and Tis breast cancer, mammography has higher detection and diagnostic rates in mostly fatty and scattered fibroglandular breast while ultrasonography is better for heterogeneously and extremely dense breast. There are some correlations between fibroglandular and focus types based on mammographic images.

To compare liver regeneration after radiofrequency ablation versus irreversible electroporation (IRE).

A total of 10 pigs were divided into IRE and radiofrequency ablation groups. And two ablation foci were established in the liver of each pig. Computed tomography (CT)-guided IRE and radiofrequency ablation were performed. Cell death, liver regeneration and recovery speed were compared. Before ablation, immediately, 1 and 3 weeks after ablation, contrast enhanced ultrasound, CT and magnetic resonance imaging (MRI) were regularly performed. Immediately after ablation, 24 hours, 3 days, 3 weeks and 6 weeks, biopsy and pathologic examination were performed.

At 1-3 days after IRE ablation, apoptotic cells were detected in the ablation zone and numerous red blood cells were present in hepatic cords. Three days after IRE, fibroblasts were found. Three weeks after, most ablation lesions disappeared or significantly reduced. There was no formation of fibrous capsule. And indistinct boundary existed between the surrounding liver tissue and lesion. Immediately after ablation, coagulative necrosis of ablation zone in liver was confirmed. After 3 weeks, all lesions persisted in the radiofrequency ablation group. There was formation of fibrous capsule. Immediately after ablation, the ablation volume was similar between two groups on CT scan. Three weeks later, 6 ablation foci in IRE group disappeared while another 4 lesions shrank more than 50%. There was no significant volume reduction in the radiofrequency ablation group.

Compared with radiofrequency ablation, IRE resulted in faster liver regeneration and intact extracellular structure.

To observe the expressions of Nav1.2 and Nav1.6 in the hippocampal CA3 region of lithium chloride-pilocarpine epileptic rats to explore their potential roles in epileptogenesis.

A total of 90 healthy male SD rats were randomly divided into normal control group (physiological saline) and epilepstic group (lithium chloride-pilocarpine). According to different timepoints, the control and epilepstic groups were randomly divided into 3 subgroups of 24-hour, 7-day and 60-day. Then immunohistochemistry, Western blot and reverse transcription-polymerase chain reaction (RT-PCR) were employed to detect the expressions of Nav1.2 and Nav1.6 in hippocampal CA3 region of rats.

Immunohistochemisty showed that, at 24 hours, the expression of Nav1.2 had no significant difference (P=0.492) while Nav1.6 significantly increased as compared with controls (0.398±0.019 vs 0.313±0.017, P=0.034). At Day 7, both Nav1.2 and Nav1.6 had no significant change (P=0.157, 0.109). Nav1.2 significantly decreased at Day 60 (0.117±0.009 vs 0.155±0.010, P=0.002). But Nav1.6 significantly increased (0.400±0.009 vs 0.318±0.010, P=0.018). Western blot showed that Nav1.2 protein had no significant difference at 24 hours (P=0.472) while Nav1.6 significantly increased (0.419±0.027 vs 0.290±0.007, P=0.001). At Day 7, Nav1.2 and Nav1.6 proteins had no significant change (P=0.517, 0.514). At Day 60, Nav1.2 protein significantly decreased (0.209±0.077 vs 0.339±0.080, P=0.024) while Nav1.6 significantly increased (0.772±0.029 vs 0.489±0.014, P=0.001). RT-PCR showed the same results as Western blot and immunohistochemisty. Nav1.2 mRNA had no significantly difference at 24 hours (P=0.453) while Nav1.6 mRNA significantly increased (2.250±0.117 vs 0.998±0.139, P=0.001); at Day 7, both Nav1.2 mRNA and Nav1.6 mRNA had no significant change (P=0.493, 0.624). Nav1.2 mRNA significantly decreased at Day 60 (0.718±0.056 vs 1.000±0.026, P=0.027). But Nav1.6 mRNA significantly increased (2.445±0.167 vs 1.003±0.060, P=0.001).

Both Nav1.2 and Nav1.6 are involved in the formation of chronic spontaneous recurrent seizures. And Nav1.6 also plays an important role in acute phase of seizures.

To prepare the magnetic near infrared fluorescent (NIRF) bifunctional molecular probe with human holo-transferrin (Tf) as a targeted ligand and detect human transferrin receptor (hTfR) actively.

Molecular probe Tf-cy5.5-IO was prepared and purified by conjugating Tf, superparamagnetic iron oxide (IO) and near infrared fluorescent dye (cy5.5). The particle size and morphology was determined by transmission electron microscopy (TEM), zeta potential and particle sizing analyzer. Human serum albumin (HSA) was used for conjugating with cy5.5 and IO as control. hMSCs and HeLa (as a positive control) were divided into 4 groups: A non-labeled, B Tf-cy5.5-IO, C HSA-cy5.5-IO and D competition assay to confirm the targeted connection. The fluorescent signals from intracellular probe were detected with laser scanning confocal microscope (LSCM) and flow cytometry. Intracellular iron was detected with iron concentration assay and TEM. MRI and NIRF imaging of 2×10⁵ cells were performed respectively. Enhancements of R2 value and average intensity (AI) were analyzed qualitatively.

The conjugation between IO, Tf and cy5.5 was confirmed with a molar ratio of 1∶2.89∶7.89. The hyperdense aqueous diameter of probe was 23.39±2.42 nm. LSCM showed the fluorescence from Tf-cy5.5-IO and cy3-labeled monoclonal antibody against hTfR in cells and two markers were localized in intracellular compartments of similar appearance. After co-incubating with Tf-cy5.5-IO, the intracellular iron and average intensity were significantly higher than cells of other groups (P<0.01). MRI and NIRF images showed that, after incubation, intracellular Tf-cy5.5-IO decreased the T2WI signal of human mesenchymal stem cells (hMSCs) and AI on NIRF image increased. Enhancements of R2 value and AI were higher in B group than those in other groups (P<0.05).

Tf-cy5.5-IO probe can recognize and conjugate with hTfR specifically. And targeted imaging in vitro of hTfR expressed in hMSCs may be performed by MRI and NIRF multimodal imaging.

To explore the prevalence and related factors of essential tremor (ET) in permanent residents of Hetian, Xinjiang.

By cluster random sampling, the local residents (≥ 10 years) at the age of 45 years and above in Hetian, Xinjiang received an epidemiological survey covering 1 city and 7 counties. Hetian City, Yutian County, Moyu County and Luopu County were randomly selected. According to the diagnostic standard of ET, the ET patients were screened face-to-face to understand the factors related to the pathogenesis of ET. And for this case control study, a ratio of 1∶1 was used to randomly select healthy subjects without ET as the control group. Both groups were matched with regards to gender, nationality and age (±2 yr). The EpiData 3.1 software was employed. And the data were independently entered to analyze the prevalence of ET in various age groups. The statistical software SPSS 19.0 was used for single factor analysis and multivariate conditional Logistic regression analysis.P<0.05 was statistically significant.

A total of 5 932 patients responded to the questionnaire and there were 216 cases of ET patients. The total prevalence rate of ET was 3.64% in those aged over 45 years old and the prevalence rate over 45 years of age was 3.76% for males and 3.52% for females. The prevalence of 45-54, 55-64, 65-74 and ≥75-year old were 3.08%, 3.72%, 4.08% and 4.31% respectively. Multivariate conditional Logistic regression analysis showed: the pesticide exposure history (B=2.664, χ ²=86.773, P<0.05,OR=14.347, 95% CI 8.192-25.127) and family history (B=3.191, χ ²=61.430, P<0.05,OR=24.303, 95%CI 10.943-53.972) were associated with increased risk of ET while occupation, education, sports, social activities, drinking tea, eating habits and the incidence of ET had no obvious correlation.

ET has a prevalence rate of 3.64% in Hetian, Xinjiang, And it has a rising trend with advancing age. The pathogenesis of ET is probably correlated with age, pesticide exposure history and family history. Thus theoretic rationales may be provided for early prevention and treatment of ET in the area.

single fiber electromyography (SFEMG) selectively records the action potential of individual muscle fibers by using a special needle electrode with a very small recording area. Domestic Cui Liying et al^[1]The value of SFEMG in amyotrophic lateral sclerosis, myasthenia gravis (MG) and inflammatory myopathy were studied^[2,3,4]。 The two most clinically valuable parameters in SFEMG examination are fiber density (FD) and neuromuscular junction jitter values; FD can reflect the redistribution of muscle fibers in motor units, and jitter value is the most sensitive index to evaluate the function of neuromuscular junction at present. Because single fiber needle (SFN) is expensive, it is often reused after sterilization and sterilization. In recent years, the application of invasive medical devices may bring about iatrogenic infection, which has attracted widespread attention. For example, routine disinfection cannot eliminate the potential prion infection risk during repeated use of SFN. Therefore, the clinical application of SFN is limited. In 2000, it was reported abroad that the jitter value of neuromuscular junction was recorded by concentric needle electrode (CNE)^[5]。 Subsequently, the literature reported that CNE-recorded neuromuscular junction jitter values, called CNE-recorded single-fiber electromyography^[6,7,8]。 However, because the action potentials recorded by CNE are not real in the sense of individual muscle fibers, recently Stålberg et al^[9,10]This is referred to as jitter recording with CNE (CNE-jitter).

Neonatal lupus erythematosus (NLE) is a rare neonatal disease associated with maternal autoantibodies entering the fetus through the placenta^[1]。 NLE was originally reported by dermatologists Mccuistion and Schoch in 1954^[2]。 1980 Weston et al.^[3]It is suggested that maternal anti-Sjogren's syndrome A (SSA) and anti-Sjogren's syndrome B (SSB) antibodies may be associated with the pathogenesis of NLE. Subsequently, it was found that other autoantibodies, such as anti-U1 ribonucleoprotein (U1RNP) antibody, anti-calreticulin antibody, and anti-fodrin antibody, were associated with the pathogenesis of NLE. The main clinical manifestations of NLE are skin lesions and congenital heart block (CHB), which can also involve the liver and blood system, but simultaneous involvement of more than two systems is rare. This article will summarize the research progress of neonatal lupus in epidemiology, pathogenesis, clinical manifestation, treatment and prognosis.