A family of hereditary protein S deficiency with the onset of pulmonary embolism and literature review / 中华儿科杂志

Objective: To explore the clinical characteristics and genotype of PROS1 gene related hereditary protein S deficiency (PSD) with the onset of pulmonary embolism in children. Methods: A family with pulmonary embolism was diagnosed as hereditary PSD in the Department of Pediatrics of Peking University First Hospital in November 2020, and the clinical data, including clinical manifestations, laboratory tests, imaging and genetic results, were collected for a retrospective research. The family members were also screened for protein S activity and PROS1 gene mutations. A literature search with "PROS1" "protein S deficiency" "homozygous" and "complex heterozygous" as key words was conducted at PubMed, China National Knowledge Infrastructure, and Wanfang Data Knowledge Service Platform (up to October 2021). Case reports of patients with PROS1 gene homozygous or complex heterozygous variants and related clinical features, protein S activity, and genotype were reviewed and analyzed. Results: The proband, a 14-year-old girl, was admitted to the hospital for a 9-day history of coughing and a 4-day history of chest pain in November 2020. After admission, laboratory tests showed that D-dimer was 8.38 mg/L (reference:<0.24 mg/L). An urgent CT pulmonary angiography confirmed bilateral pulmonary embolism and right lower pulmonary infarction, while an ultrasonography showed deep vein thrombosis in her left leg. Further examination revealed that protein S activity was less than 10%. The proband's second sister, a 12-year-old girl, was admitted to the hospital in December 2020. Her protein S activity was 8% and an ultrasonography showed deep vein thrombosis in her right leg. The protein S activity of the proband's father and mother were 36% and 26%, respectively. Trio-whole-exome sequencing detected compound heterozygous PROS1 gene variants (c.-168C>T and c.200A>C (p.E67A)) for the proband and her second sister, that were inherited from her father and mother, respectively. The proband's third sister's protein S activity was 28%; she and the proband's grandfather both carried c.200A>C (p.E67A) variants. The proband and her younger sister were treated with rivaroxaban and responded well during the 3-month follow-up. A total of 1 Chinese report in literature and 18 English literature were retrieved and 14 patients with protein S deficiency caused by homozygous or complex heterozygous variants of PROS1 gene were enrolled, including 8 male and 6 female patients. The ages ranged from 4 days to 35 years. Three patients experienced fulminant purpura or severe intracranial hemorrhage in early neonatal-period, while the remaining 11 patients developed venous thromboembolism in adolescence. Protein S activity was examined in 11 patients, and all showed less than 10% of activity. Missense variants was the most common type of gene variants. Conclusions: For children with pulmonary embolism, if there are no clear risk factors for thrombosis, hereditary protein S deficiency should be considered, and protein S activity should be examined before oral anticoagulant drugs. If protein S activity is less than 10%, protein S deficiency caused by homozygous or complex heterozygous variants should be considered.

Alteration of amplitude of low-frequency fluctuation in patients with abstinence of methamphetamine-dependent using functional MRI / 中华放射学杂志

Objective:To investigate the difference of brain activity intensity between abstinent methamphetamine-dependent (AMD) patients and healthy controls using amplitude of low-frequency fluctuation (ALFF).Methods:From April 2016 to March 2017, 29 male AMD patients from Pingtang compulsory rehabilitation center in Changsha City, Hunan Province and 31 healthy male controls were prospectively recruited. The general conditions of all AMD patients, including age of first use of MA, months of MA use, monthly MA consumption, MA use frequency of the last year and the last month, current months of drug withdrawal, times of drug withdrawal, self-assessment score of drug craving when taking drugs, smoking history (whether smoking and smoking years), drinking history (whether drinking and drinking years). The rest functional MRI data were collected. DPABI software package was used to preprocess the data and calculate ALFF value of each voxel in the whole brain of the subjects of two groups. Two samples t-test and alphasim multiple comparison correction were used. Nuclei with voxel level P<0.01 and voxel number>71 were considered as regions with significant differences between two groups, corresponding to corrected P<0.05. ALFF mean value was extracted for each region with significant differences. Taking smoking and drinking as covariates, the correlations between the mean ALFF values of regions with significant differences and MA use and abstinence were analyzed. Results:Compared with the healthy control group, it was found in the AMD group that ALFF value of left middle frontal gyrus was significantly lower ( t=-4.707), and that of right inferior frontal gyrus was significantly higher ( t=4.445). The results of correlation analysis showed that the ALFF value of right inferior frontal gyrus was negatively correlated with the frequency of MA use and the MA amounts used in the last month ( r=-0.396, P=0.034; r=-0.429, P=0.020). Conclusions:Abnormal brain activity intensity is found in AMD patients compared with healthy controls, with abnormalities mainly found in the prefrontal lobe, which is involved in cognitive, executive and emotion functions. The more MA is used, the more damages or alterations may exist in these regions.

Screening potential prognostic biomarkers of long non-coding RNAs for predicting the risk of chronic kidney disease

Not much is known about the roles of long non-coding RNAs (lncRNAs) for chronic kidney disease (CKD). In this study, we included CKD patient cohorts and normal controls as a discovery cohort to identify putative lncRNA biomarkers associated with CKD. We first compared the lncRNA expression profiles of CKD patients with normal controls, and identified differentially expressed lncRNAs and mRNAs. Co-expression network based on the enriched differentially expressed mRNAs and lncRNAs was constructed using WGCNA to identify important modules related to CKD. A lncRNA-miRNA-mRNA pathway network based on the hub lncRNAs and mRNAs, related miRNAs, and overlapping pathways was further constructed to reveal putative biomarkers. A total of 821 significantly differentially expressed mRNAs and lncRNAs were screened between CKD and control samples, which were enriched in nine modules using weighted correlation network analysis (WGCNA), especially brown and yellow modules. Co-expression network based on the enriched differentially expressed mRNAs and lncRNAs in brown and yellow modules uncovered 7 hub lncRNAs and 53 hub mRNAs. A lncRNA-miRNA-mRNA pathway network further revealed that lncRNAs of HCP5 and NOP14-AS1 and genes of CCND2, COL3A1, COL4A1, and RAC2 were significantly correlated with CKD. The lncRNAs of NOP14-AS1 and HCP5 were potential prognostic biomarkers for predicting the risk of CKD.

Accuracy and prognostic ability of the SARC-F questionnaire and Ishii's score in the screening of sarcopenia in geriatric inpatients

Sarcopenia remains poorly managed in clinical practice due to the lack of simple and accurate screening tools. This study aimed to identify the cutoff values of the SARC-F questionnaire and Ishii's score using the variables age, grip strength, and calf circumference in older inpatients in China to compare the accuracy of the two methods and to explore their predictive ability for adverse outcomes (rehospitalization, falls, fracture, and death). Hospitalized patients (n=138) aged ≥60 years were included. The accuracy of the two tools was evaluated using the reference diagnosis recommended by the Asian Working Group on Sarcopenia (assessing patients with measurements of muscle mass, handgrip strength, and usual gait speed). Follow-up data were obtained by telephone and clinical visits combined with the inpatient medical record system after discharge for at least one year. The results showed that the SARC-F score reached the highest Youden's index when a score of 3 was set as the cutoff value. Ishii's score presented a higher accuracy than SARC-F (area under the receiver operating curve: 0.78 vs 0.64, P=0.01). The Kaplan-Meier survival analysis demonstrated a higher cumulative incidence of rehospitalization in sarcopenic individuals compared to non-sarcopenic individuals according to SARC-F (log-rank test, P<0.001). Cox analysis revealed that SARC-F was an independent risk factor for rehospitalization (adjusted hazard ratio: 4.23, 95%CI: 2.12-9.79, P<0.001). The SARC-F and Ishii's scores might facilitate the early detection of sarcopenia and help identify older adults at risk for adverse outcomes in clinical practice.

Effect of Yangxinkang Tablets in Regulating Autophagy on Myocardial Fibrosis in Mice After Chronic Heart Failure / 中国实验方剂学杂志

Objective: To study the effect of Yangxinkang tablets on myocardial fibrosis in mice after heart failure, and to explore its mechanism.Method: The model of chronic heart failure in mice was established by thoracic aorta constriction (TAC). After successful modeling, mice were randomly divided into sham operation group, model group, 3-methyladenine(3-MA,15 mg·kg-1) autophagy inhibitor group, Yangxinkang tablets high, medium, and low dose groups (1 170,585,390 mg·kg-1).The sham operation group received equal volume of distilled water. After 30 days, cardiac ultrasound was performed to collect hemodynamic parameters. Cardiac paraffin slices were stained with Masson to observe the morphological changes and fibrosis of cardiomyocytes. Western blot was used to detect lysosome-associated membrane protein(LAMP), microtubule-associated protein light chain 3 (LC3), Beclin-1 autophagyportein, α-smooth muscle activin(α-SMA),Collagen Ⅰ,Collagen Ⅲ protein expression.Result: As compared with normal group, the left ventricular ejection fraction (LVEF) and fractional shortening(FS) were significantly decreased(PPPα-SMA, Collagen Ⅰ, Collagen Ⅲ, LAMP, LC3, and Beclin-1 were significantly increased in model group (PPPα-SMA,Collagen Ⅰ,Collagen Ⅲ,LAMP,LC3 and Beclin-1 were decreased in 3-MA group, Yangxinkang high and medium dose groups(PConclusion: Yangxinkang tablets can reduce myocardial fibrosis and improve cardiac function in mice with heart failure probably by down-regulating autophagy.

MR structural and functional changes in patients with long-term abstinence of methamphetamine / 中华放射学杂志

Objective@#To investigate the changes of brain gray matter volume (GMV) and brain activity in patients with long-term methamphetamine (MA) abstinence compared with healthy controls.@*Methods@#This study included 44 abstinent MA patients and 40 demographically equivalent healthy controls. Structural magnetic resonance imaging (MRI) and resting-state functional MRI (rs-fMRI) were obtained on Siemens 3.0 T MR. Differences in GMV between abstinent MA group and control group were assessed using voxel-based morphometry (VBM) method. Within each region showed significant differences between two groups, the value of the fractional amplitude of low frequency fluctuation (fALFF) was calculated using the rs-fMRI data. Differences of fALFF between groups were also evaluated. Furthermore, partial correlation coefficients adjusted for age, years of education, smoking and drinking were calculated in the abstinent MA group to assess associations between the mean GMV and fALFF values in significant clusters and variables of MA use and abstinence.@*Results@#Compared with controls, abstinent MA group showed increased GMV in the right cerebellum crus and decreased GMV in the right calcarine. While fALFF values within bilateral cerebellum crus in abstinent MA patients were significantly increased. Moreover, GMV of the left cerebellar crus was positively correlated with the withdrawal time among abstinent MA patients.@*Conclusions@#Both structural and functional abnormalities were found in abstinent MA patients even after long-term abstinence. The positive correlation between GMV of left cerebellum crus and abstinent duration suggested that prolonged abstinence may be beneficial to brain recovery. The fALFF of the right calcarine was increased even with decreased GVM in the abstinent MA group. It indicates that the brain activity of this area is increased, which may imply that drug cue-induced craving is significant among methamphetamine patients even after long-term abstinence.

MR structural and functional changes in patients with long?term abstinence of methamphetamine / 中华放射学杂志

Objective To investigate the changes of brain gray matter volume (GMV) and brain activity in patients with long?term methamphetamine (MA) abstinence compared with healthy controls. Methods This study included 44 abstinent MA patients and 40 demographically equivalent healthy controls. Structural magnetic resonance imaging (MRI) and resting?state functional MRI (rs?fMRI) were obtained on Siemens 3.0 T MR. Differences in GMV between abstinent MA group and control group were assessed using voxel?based morphometry (VBM) method. Within each region showed significant differences between two groups, the value of the fractional amplitude of low frequency fluctuation (fALFF) was calculated using the rs?fMRI data. Differences of fALFF between groups were also evaluated. Furthermore, partial correlation coefficients adjusted for age, years of education, smoking and drinking were calculated in the abstinent MA group to assess associations between the mean GMV and fALFF values in significant clusters and variables of MA use and abstinence. Results Compared with controls, abstinent MA group showed increased GMV in the right cerebellum crus and decreased GMV in the right calcarine. While fALFF values within bilateral cerebellum crus in abstinent MA patients were significantly increased. Moreover, GMV of the left cerebellar crus was positively correlated with the withdrawal time among abstinent MA patients. Conclusions Both structural and functional abnormalities were found in abstinent MA patients even after long?term abstinence. The positive correlation between GMV of left cerebellum crus and abstinent duration suggested that prolonged abstinence may be beneficial to brain recovery. The fALFF of the right calcarine was increased even with decreased GVM in the abstinent MA group. It indicates that the brain activity of this area is increased, which may imply that drug cue?induced craving is significant among methamphetamine patients even after long?term abstinence.

The safety and efficacy of tPA intravenous thrombolysis for treating acute ischemic stroke patients with a history of cerebral hemorrhage

Alteplase (tPA) intravenous thrombolysis is an effective treatment for acute ischemic stroke (AIS) when administered within 4.5 h of initial stroke symptoms. Here, its safety and efficacy were evaluated among AIS patients with a previous history of cerebral hemorrhage. Patients who arrived at the hospital within 4.5 h of initial stroke symptoms and who were treated with tPA intravenous thrombolysis or conventional therapies were analyzed. The 90-day modified Rankin scale (90-d mRS) was used alongside mortality and incidence of symptomatic intracerebral hemorrhage (SICH) rates to evaluate the curative effect of these therapies. Among 1,694 AIS patients, 805 patients were treated with intravenous thrombolysis, including patients with (n=793) or without (n=12) a history of cerebral hemorrhage, and the rate of incidence of SICH significantly differed between them (8.3 vs 4.3%, P=0.039). No significant difference was found in 90-d mRS measurements (41.7 vs 43.6%, P=0.530) and 90-d mortality rates (8.3 vs 6.5%, P=0.946). A total of 76 AIS patients with a history of cerebral hemorrhage received tPA thrombolytic therapy (n=12) or conventional therapy (n=64), and a significant difference was noted in the 90-d mRS scores between the two groups (41.7 vs 23.4%, P=0.029), while no significant difference was found in SICH measurements (8.3 vs 4.6%, P=0.610) and 90-d mortality rates (8.3 vs 9.4%, P=0.227). A history of cerebral hemorrhage is not an absolute contraindication for thrombolytic therapy; tPA intravenous thrombolysis does not increase SICH measurements and mortality rates in patients with a history of cerebral hemorrhage, and they may benefit from thrombolytic therapy.

Effects of trimetazidine on myocardial autophagy in rats with heart failure after myocardial infarction / 天津医药

Objective To observe changes of left ventricular function and the level of autophagy after treatment with trimetazine in rats with heart failure after myocardial infarction(MI). Methods Twenty healthy male Wistar rats with the ligation of the proximal part of the left descending branch were randomly and equally allocated into two groups,model group (M group) and trimetazine group (Q group). A sham group (S group) was made up by 10 sham-operated rats. Rats of trimetazine group were given trimetazine(15 mg/kg)once a day for 4 weeks.Then left ventricular function was measured by echocardiography,and hemodynamics was evaluated by Millar pressure-volume system.Serum levels of NT-proBNP and hs-TnT were tested by ELISA.Pathological changes and fibrosis of myocardium were observed by HE and Masson staining.The myocardial apoptosis level was observed by TUNEL, and expressions of autophagy related protein and gene in myocardial tissue were detected by Western blot assay and RT-PCR. Results Trimetazine treatment significantly improved left ventricular dilatation and dysfunction in rats with myocardial failure. Trimetazine treatment also significantly improved pressure overload and the compliance decrease of left ventricular in rats with heart failure after myocardial infarction. Trimetazidine reduced the edema,necrosis and myocardial fibrosis of cardiac myocytes in rats with heart failure.The results from ELISA showed that serum levels of NT-proBNP and hs-TnT were significantly lower in the trimetazine group than those of model group.Compared with model group,the cardiomyocyte apoptosis decreased significantly in the trimetazine group.The results from Western blot assay and RT-PCR showed that autophagic flow of myocardium was increased remarkably in the trimetazine group than that of model group. Conclusion Autophagy has a protective effect on myocardial cells. Trimetazine can improve cardiac function through up-regulation of autophagy in cardiomyocytes in MI rats with heart failure.

Preparation and release mechanism of tectorigenin intragastric floating sustained-release tablets / 中国中药杂志

To investigate the preparation technology and release mechanism of tectorigenin intragastric floating sustained-release tablets. The tablet was produced by wet granulation compression method, with hydroxypropyl methyl cellulose (HPMCK15M), cross-linked polyvinyl pyrrolidone (PVPP), octadecanol and sodium bicarbonate as excipient. The prescriptions were screened and optimized by orthogonal experimental design with in vitro floating capacity and drug release characteristics as the evaluation indexes. The optimization results were as follows: tectorigenin 33.3%, HPMCK15M 16.7%, PVPP 20.0%, octadecanol 13.3%, sodium bicarbonate 5%, and starch gel 10.7%. The prepared tablet can be floated within 10 s in the artificial gastric juice, lasting for 12 h in vitro, with a cumulative release rate of 70% in 10 h. The analysis of Rritger-Peppas equation showed that the sustained-release tablet had two advantages of both drug diffusion and skeleton dissolution. The tablet had good appearance and compressibility, as well as favorable floating capacity and drug release characteristics.

Relationship Between Clinical and Immunological Features with Magnetic Resonance Imaging Abnormalities in Female Patients with Neuropsychiatric Systemic Lupus Erythematosus / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Conventional magnetic resonance imaging (MRI) is the preferred neuroimaging method in the evaluation of neuropsychiatric systemic lupus erythematosus (NPSLE). The purpose of this study was to investigate the association between clinical and immunological features with MRI abnormalities in female patients with NPSLE, to screen for the value of conventional MRI in NPSLE.</p><p><b>METHODS</b>A total of 59 female NPSLE patients with conventional MRI examinations were enrolled in this retrospective study. All patients were classified into different groups according to MRI abnormalities. Both clinical and immunological features were compared between MRI abnormal and normal groups. One-way analysis of variance was used to compare the systemic lupus erythematosus disease activity index (SLEDAI) score for MRI abnormalities. Multivariate logistic regression analysis investigated the correlation between immunological features, neuropsychiatric manifestations, and MRI abnormalities.</p><p><b>RESULTS</b>Thirty-six NPSLE patients (61%) showed a variety of MRI abnormalities. There were statistically significant differences in SLEDAI scores (P < 0.001), incidence of neurologic disorders (P = 0.001), levels of 24-h proteinuria (P = 0.001) and immunoglobulin M (P = 0.004), and incidence of acute confusional state (P = 0.002), cerebrovascular disease (P = 0.004), and seizure disorder (P = 0.028) between MRI abnormal and normal groups. In the MRI abnormal group, SLEDAI scores for cerebral atrophy (CA), cortex involvement, and restricted diffusion (RD) were much higher than in the MRI normal group (P < 0.001, P = 0.002, P = 0.038, respectively). Statistically significant positive correlations between seizure disorder and cortex involvement (odds ratio [OR] = 14.90; 95% confidence interval [CI], 1.50-151.70; P = 0.023) and cerebrovascular disease and infratentorial involvement (OR = 10.00; 95% CI, 1.70-60.00; P = 0.012) were found.</p><p><b>CONCLUSIONS</b>MRI abnormalities in NPSLE, especially CA, cortex involvement, and RD might be markers of high systemic lupus erythematosus activity. Some MRI abnormalities might correspond to neuropsychiatric manifestations and might be helpful in understanding the pathophysiology of NPSLE.</p>

Living near a Major Road in Beijing: Association with Lower Lung Function, Airway Acidification, and Chronic Cough / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The effects of near-road pollution on lung function in China have not been well studied. We aimed to investigate the effects of long-term exposure to traffic-related air pollution on lung function, airway inflammation, and respiratory symptoms.</p><p><b>METHODS</b>We enrolled 1003 residents aged 57.96 ± 8.99 years living in the Shichahai Community in Beijing. Distances between home addresses and the nearest major roads were measured to calculate home-road distance. We used the distance categories 1, 2, and 3, representing <100 m, 100-200 m, and >200 m, respectively, as the dose indicator for traffic-related air pollution exposure. Lung function, exhaled breath condensate (EBC) pH, and interleukin 6 levels were measured. As a follow-up, 398 participants had a second lung function assessment about 3 years later, and lung function decline was also examined as an outcome. We used regression analysis to assess the impacts of home-road distance on lung function and respiratory symptoms. As the EBC biomarker data were not normally distributed, we performed correlation analysis between home-road distance categories and EBC biomarkers.</p><p><b>RESULTS</b>Participants living a shorter distance from major roads had lower percentage of predicted value of forced expiratory volume in 1 s (FEV1% -1.54, 95% confidence interval [CI]: -0.20 to -2.89). The odds ratio for chronic cough was 2.54 (95% CI: 1.57-4.10) for category 1 and 1.97 (95% CI: 1.16-3.37) for category 2, compared with category 3. EBC pH was positively correlated with road distance (rank correlation coefficient of Spearman [rs] = 0.176, P < 0.001).</p><p><b>CONCLUSIONS</b>Long-term exposure to traffic-related air pollution in people who live near major roads in Beijing is associated with lower lung function, airway acidification, and a higher prevalence of chronic cough. EBC pH is a potential useful biomarker for evaluating air pollution exposure.</p>

Knowledge-based analysis of functional impacts of mutations in microRNA seed regions.

MicroRNAs are a class of important post-transcriptional regulators. Genetic and somatic mutations in miRNAs, especially those in the seed regions, have profound and broad impacts on gene expression and physiological and pathological processes. Over 500 SNPs were mapped to the miRNA seeds, which are located at position 2–8 of the mature miRNA sequences. We found that the central positions of the miRNA seeds contain fewer genetic variants and therefore are more evolutionary conserved than the peripheral positions in the seeds. We developed a knowledgebased method to analyse the functional impacts of mutations in miRNA seed regions. We computed the gene ontology-based similarity score GOSS and the GOSS percentile score for all 517 SNPs in miRNA seeds. In addition to the annotation of SNPs for their functional effects, in the present article we also present a detailed analysis pipeline for finding the key functional changes for seed SNPs. We performed a detailed gene ontology graph-based analysis of enriched functional categories for miRNA target gene sets. In the analysis of a SNP in the seed region of hsa-miR-96 we found that two key biological processes for progressive hearing loss ‘Neurotrophin TRK receptor signaling pathway’ and ‘Epidermal growth factor receptor signaling pathway’ were significantly and differentially enriched by the two sets of allele-specific target genes of miRNA hsa-miR-96.

Value of anti-neutrophil cytoplasmic antibody in diagnosis of Kawasaki disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the value of anti-neutrophil cytoplasmic antibody (ANCA) in diagnosis of Kawasaki disease (KD).</p><p><b>METHODS</b>Serum ANCA was detected in 30 children with typical Kawasaki disease (TKD) and in 16 with incomplete Kawasaki disease (IKD) in the acute and the recovery phases respectively. Twenty-five healthy children were randomly selected as a control group. An ultrasonic cardiography (UCG) was performed on children with KD in the acute phase.</p><p><b>RESULTS</b>The mean positive rate of serum ANCA in the acute phase in KD children was 65%, with 69% in IKD children and 63% in TKD children, which were obviously higher than that in the control group (P<0.01). The positive rate of serum ANCA in the recovery phase in KD children was significantly lower than that in the acute phase (33% vs 65%, P<0.05). The positive rate of serum ANCA in the acute phase in children with KD was significantly higher than that detected by UCG (P<0.01). The incidence rate of coronary artery lesions in children with positive ANCA was obviously higher than that in children with negative ANCA (43% vs 13%; P<0.05).</p><p><b>CONCLUSIONS</b>Serum ANCA may be used as a reference index for early diagnosis of KD and secondary coronary artery lesions in children.</p>

Serum levels of 25-(OH)D3 and immunoglobulin in children with bronchiolitis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the changes in the serum levels of 25-(OH)D3 and immunoglobulins in children with bronchiolitis, and the clinical significance of these changes.</p><p><b>METHODS</b>Serum levels of 25-(OH)D3 were measured using ELISA in 35 children with bronchiolitis in the acute and recovery phases and 20 healthy children. Serum levels of immunoglobulins were determined by rate nephelometry.</p><p><b>RESULTS</b>Compared with the healthy children, serum 25-(OH)D3, IgG and IgA levels in children with bronchiolitis in the acute phase were significantly lower and, in contrast, serum IgE levels were significantly higher (P<0.05). Serum 25-(OH)D3 levels increased and serum IgE levels decreased significantly in the recovery phase compared with the acute phase in children with bronchiolitis (P<0.05). However, compared with the healthy children, serum 25-(OH)D3 and IgA levels were significantly lower and serum IgE levels were significantly higher in children with bronchiolitis in the recovery phase (P<0.05). Serum 25-(OH)D3 levels in children with bronchiolitis in the acute phase were positively correlated with serum IgG (r=0.36, P<0.05) and IgA levels (r=0.63, P<0.01), and negatively correlated with serum IgE levels (r=-0.72, P<0.01). A negative correlation was found between serum 25-(OH)D3 and IgE levels in children with bronchiolitis in the recovery phase (r=-0.34, P<0.05).</p><p><b>CONCLUSIONS</b>Serum 25-(OH)D3 levels decrease and there is immunoglobulin level imbalance in children with bronchiolitis, suggesting that 25-(OH)D3 and immunoglobulins may play important roles in the pathogenesis of bronchiolitis.</p>

Influence of L-carnitine on the effect of erythropoietin in treatment of patients with renal anemia during hemodialysis treatment / 中国基层医药

ObjectiveTo explore the influence of L-carnitine on the effect of erythropoietin in treatment of patients with renal anemia during hemodialysis treatment.Methods40 uremic patients with chronic renal failure underwent bemodialysis(HD) in were randomly divided into treatment group and control group,20 cases each.Control group was given EPO 9000u/week subcutaneous injection in the blood after dialysis,while regular oral iron,folic acid.Treatment group on the basis of the control group to 1.0g L-carnitine added 20ml 0.9％ sodium chloride injection intravenously 3 ～ 5 min,2 times per week.Both groups were treated for 3 months.Before treatment and after 4 weeks and 3 months treatment.The hemoglobin(Hb),hematocrit (Hct),serum ferritin (SF),serum thyroxine(iPHT) and compared.ResultsAfter 4 weeks of treatment,Hb,Hct levels increased compared with before treatment( all P ＜0.05).Hb after 3 months compared with the two groups before treatment were significantly higher(all P ＜0.05),and Hb increase of the treatment group significantly higher than the control group ( P ＜ 0.01).ConclusionL-carnitine could improve the treatment of erythropoietin in hemodialysis patients with renal anemia.

Effects of different anesthetic and analgesic protocols on cellular immune function and stress hormone level in patients undergoing lobectomy for esophagus cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of different anesthetic and analgesic protocols on the cellular immune function and stress hormone in patients undergoing lobectomy for esophagus cancer.</p><p><b>METHODS</b>Sixty ASA I or II patients undergoing lobectomy for esophagus cancer were randomly divided into two groups to receive postoperative general anesthesia and intravenous analgesia (group A, n=30) or intraoperative general anesthesia combined with thoracic epidural anesthesia with postoperative epidural analgesia (group B, n=30). The cervical venous blood samples were obtained from the patients at 30 min before anesthesia induction (T(0)), 2 h after skin incision (T(1)), and at 4 h (T(2)), 24 h (T(3)) and 48 h (T(4)) after the end of operation. The T-lymphocyte subsets (CD4(+) and CD8(+)) were analyzed by flow cytometry, serum concentrations of sIL-2R and IL-2 determined by ELISA, and the levels of growth hormone (GR), prolactin (PRL), IL-8 and cortisol (Cor) measured by radioimmunoassay. Visual analogue scale (VAS) was used for assessment of the postoperative analgesic effects.</p><p><b>RESULTS</b>The VAS scores were significantly lower in group B than in group A at T(2) and T(3) (P<0.05). The percentage of CD4(+) cells and the CD4(+)/CD8(+) ratio in the two groups began to decrease significantly at T(1) (P<0.05), reducing to the lowest level at T(2) in group B and at T(3) in group A. From T(1) to T(4), the percentage of CD4(+) in group B remained significantly higher than those in group A (P<0.05), and from T(3) to T(4), the CD4(+)/CD8(+) ratio in group B were significantly higher than those in group A (P<0.05). The IL-2 level in the two groups began to decrease significantly at T(1) (P<0.05), reaching the lowest level at T(2) in group A and at T(3) in group A. IL-2 level was significantly higher in group B than in group A from T(3) to T(4) (P<0.05). sIL-2R level in group A began to increase at T(1) and peaked at T(3), showing significant differences from the T(0) level, but the level showed no significant variations in group B compared with the T(0) level. From T(2) to T(4), sIL-2R level was significantly higher in group A than in group B (P<0.05). The levels of GH, PRL and Cor increased significantly, while IL-8 decreased in the two groups from T(1) to T(4) (P<0.05), but remained stable in group B.</p><p><b>CONCLUSION</b>General anesthesia combined with thoracic epidural anesthesia may reduce the perioperative stress reaction and adverse effect on cellular immune function in patients undergoing lobectomy for esophagus cancer.</p>

Observation on therapeutic effects of acupuncture combined with TDP irradiation and chinese herbal steaming and washing therapy for treatment of carpal tunnel syndrome in early stage / 中国针灸

<p><b>OBJECTIVE</b>To search for an effective therapy for carpal tunnel syndrome in early stage.</p><p><b>METHODS</b>Sixty cases were randomly divided into an observation group 1 (21 cases), an observation group 2 (22 cases) and a basic treatment group (17 cases). The patients in three groups were treated with oral administration of Vitamin B1, Vitamin B12, compound Vitamin B and small splint for wrist protection as basic treatment, and the observation group 1 was also treated with acupuncture on local points as Laogong (PC 8), Yuji (LU 10), Hegu (LI 4) and Waiguan (TE 5) etc. combined with TDP irradiation, and the observation group 2 was treated with herbal steaming and washing on the affected part using Safflower and Lopseed etc. Electromyography, visual analogue scale (VAS) and clinical effect of three groups were observed before and after treatment.</p><p><b>RESULTS</b>The changes of electromyogra phy had no significant difference before and after treatment in all groups (all P > 0.05), the VAS scores in two ob servation groups were superior to that in basic treatment group (both P < 0.05). The excellent and good rates were 90.5% and 86.4% in the observation group 1 and the observation group 2 respectively, both higher than that of 64.7% in the basic treatment group.</p><p><b>CONCLUSION</b>Acupunture combined with TDP irradiation and Chinese herbal steaming and washing therapy both have significant therapeutic effects for treatment of carpal tunnel syndrome in early stage.</p>

Diagnosis and treatment of the metacarpophalangeal joint locking caused by sesamoid turned-over dislocation of the thumb / 中国骨伤

<p><b>OBJECTIVE</b>To introduce diagnosis and treatment of the metacarpophalangeal joint (MPJ) locking caused by sesamoid turned-over dislocation of the thumb.</p><p><b>METHODS</b>Five cases with metacarpophalangeal joint locking were involved in the study, male 4 and female 1. The average age was 35 years old(ranging from 18 to 47 years). All the patients received manual reduction under local anaesthesia. But only three were successful, others patients were reduced by operation. Metacarpophalangeal joint locking caused by sesamoid turned-over dislocation with the volar plate and the short flexor muscle of the thumb tendon were reveded. The metacarpophalangeal joint locking was released after reduction of sesamoid turned-over dislocation of the thumb.</p><p><b>RESULTS</b>The mean follow-up time was 15 months (3-34 months). The mean range of MPJ flexion was 45 degrees (35 degrees - 60 degrees). The signs for pain and swelling were released. Satisfactory thumb opposition can be seen.</p><p><b>CONCLUSION</b>It was one of the important reasons of the metacarpophalangeal joint locking caused by sesamoid turned-over dislocation of the thumb.</p>

Cloning and expression of a new glucoamylase gene / 生物工程学报

According to the reported gene sequence of Rhizopus oryzae glucoamylases, the glucoamylase gene containing four introns was cloned from the total DNA of the natural Rhizopus arrhizu. Specific primers were designed to delete introns by overlapping PCR and a new cDNA sequence of Rhizopus arrhizu glucoamylase was obtained. The accession number in gene bank is DQ903853. This gene is successfully expressed in the Picha pastoris, producing a new protein with a high activity of glucoamylase.