The application of improved team-based learning based on the training goal of excellent doctors in ophthalmology internship class / 中华医学教育探索杂志

Objective:To evaluate the effect of the improved team-based learning (TBL) teaching method in the undergraduate probation course of ophthalmology based on the goal of cultivating excellent doctors.Methods:The undergraduates of clinical medicine were randomly divided into experimental group and control group. The control group ( n=50) was given conventional ophthalmology probation teaching, while the experimental group ( n=50) was given ophthalmology probation teaching of improved TBL teaching method. The theoretical examination performance and skill assessment results of students in the two groups were compared, and the subjective evaluation of the students on the teaching was also compared. SPSS 23.0 was used to conduct t-test and Wilcoxon's rank sum test. Results:The theoretical examination performance of experimental group (29.68±4.52) was better than that of control group (27.84±4.33), with significant differences ( P<0.05); the skill assessment results of experimental group (32.88±5.05) were also better than those of the control group (30.88±6.99), with significant differences ( P<0.05); the subjective evaluation of teaching effect in each item of experimental group was better than that of control group ( P<0.05). Conclusion:The improved TBL teaching method can not only improve students' theoretical knowledge and experimental skills, but also improve students' self-study and teamwork ability, which will provide a feasible educational reform plan for achieving the goal of cultivating excellent doctors.

Application of Microhaplotypes in Sibling Kinship Testing / 法医学杂志

OBJECTIVES@#To investigate the efficacy of different numbers of microhaplotype (MH) loci and the introduction of different reference samples on the identification of full sibling, half sibling and differentiation between full sibling and half sibling kinships, and to explore the effect of changing mutation rate on sibling testing.@*METHODS@#First, a family map involving three generations was established, and four full sibling identification models, five half sibling identification models and five models distinguishing full and half siblings were constructed for different reference samples introduced. Based on the results of the previous study, two sets of nonbinary SNP-MH containing 34 and 54 loci were selected. Based on the above MH loci, 100 000 pairs of full sibling vs. unrelated individuals, 100 000 pairs of half sibling vs. unrelated individuals and 100 000 pairs of full sibling vs. half sibling were simulated based on the corresponding sibling kinship testing models, and the efficacy of each sibling kinship testing model was analyzed by the likelihood ratio algorithm under different thresholds. The mutant rate of 54 MH loci was changed to analyze the effect of mutation rate on sibling identification.@*RESULTS@#In the same relationship testing model, the systematic efficacy of sibling testing was positively correlated with the number of MH loci detected. With the same number of MH loci, the efficacy of full sibling testing was better than that of uncle or grandfather when the reference sample introduced was a full sibling of A, but there was no significant difference in the identification efficacy of the four reference samples introduced for full sibling and half sibling differentiation testing. In addition, the mutation rate had a slight effect on the efficacy of sibling kinship testing.@*CONCLUSIONS@#Increasing the number of MH loci and introducing reference samples of known relatives can increase the efficacy of full sibling testing, half sibling testing, and differentiation between full and half sibling kinships. The level of mutation rate in sibling testing by likelihood ratio method has a slight but insignificant effect on the efficacy.

Research progress on the relationship between the Raf murine sarcoma viral oncogene homolog B gene mutation and lymph node metastasis of papillary thyroid carcinoma / 生物医学工程学杂志

In recent years, with the improvement of the sensitivity of examination equipment and the change of people's living environment and diet, the rate of thyroid cancer has risen rapidly, which has increased nearly five folds in 10 years. The pathogenesis, clinical manifestation, biological behavior, treatment and prognosis of thyroid carcinoma of different pathological types are obviously different. Papillary thyroid carcinoma (PTC) can develop at any age, which accounts for about 90% of thyroid cancer. It progresses slowly and has favourable prognosis, but lymph node metastasis appears easily. Whether PTC is accompanied by lymph node metastasis has an important impact on its prognosis and outcome. The Raf murine sarcoma viral oncogene homolog B(BRAF)gene mutation plays a crucial role in PTC lymph node metastasis. Having an in-depth understanding of the specific role and mechanism of BRAF gene mutation in PTC is expected to provide new ideas for diagnosis and treatment of PTC.

Expression of Peroxiredoxin-6 Gene in Patients with Acute Myeloid Leukemia and Its Clinical Significance / 中国实验血液学杂志

OBJECTIVE@#To study the expression of Peroxiredoxin-6 (Prdx6) gene in elderly patients with acute myeloid leukemia (AML) and its clinical significance.@*METHODS@#The expression level of Prdx6 in bone marrow cells of 33 cases of AML, 8 cases of CML and 11 cases of other blood diseases was detected by PCR. The correlation of the abnormal expression of Prdx6 with patient age and blood routine parameters was further analyzed.@*RESULTS@#the expression level of Prdx6 in elderly patients with AML (≥60 years) was significantly lower than that in younger patients (＜60 years) (P＜0.05); the expression level of Prdx6 in low WBC (≤1×10/L) group was lower than that in medium WBC (1-10×10/L) group or high WBC (＞10×10/L) group (P＜0.05); the proportion of WBC count (≤1×10/L) in elderly patients with AML reached 38.5%, which was significantly higher than that in younger patients (5%) (P＜0.05); the overall survival (OS) rate of elderly patients was lower than that of younger patients (P＜0.05).@*CONCLUSION@#The expression of Prdx6 in elderly patients with AML is low, moreover, it relates with low value of WBC in peripheral blood, suggesting that it may be one of poor prognostic factors for the elderly patients with AML.

Association of interleukin-18 gene polymorphisms with Takayasu arteritis in a Chinese Han population / 中华医学杂志(英文版)

BACKGROUND@#Interleukin-18 (IL18) gene polymorphisms are related to many inflammatory and autoimmune diseases. However, a correlation analysis between IL18 -607C/A and -137G/C gene polymorphisms and Takayasu arteritis (TA) is lacking.@*METHODS@#This study enrolled 200 patients with TA as the case group and 334 region-, age-, and sex-matched healthy subjects as the control group. We genotyped alleles and genotypes at positions -607 and -137 of the IL18 gene and analyzed the distribution frequencies. Mann-Whitney U test, t test, Chi-squared test and Hardy-Weinberg equilibrium were performed.@*RESULTS@#After adjusting for risk factors, the adjusted odds ratios and 95% confidence intervals at position -607C/A were 0.533, 0.391 to 0.880 (P = 0.010); 0.266, 0.586 to 1.002 (P = 0.051); and 0.122, 0.552 to 1.420 (P = 0.613) under the dominant, additive, and recessive models, respectively. For the -137G/C polymorphism, the adjusted odds ratios and 95% confidence intervals were 1.571, 1.068 to 2.311 (P = 0.022); 1.467, 1.086 to 1.980 (P = 0.012); and 1.815, 0.901 to 3.656 (P = 0.095) under the dominant, additive, and recessive models, respectively. Moreover, regardless of the model used, we found no statistical difference in distribution frequency between the active and quiescent states of TA for the -607C/A (P = 0.355, 0.631, and 0.705, respectively) and -137G/C polymorphisms (P = 0.205, 0.385, and 0.208, respectively).@*CONCLUSIONS@#The IL18 -607C/A gene polymorphism may decrease the risk of TA, and thus is a protective factor, whereas -137G/C may increase the risk of TA, and thus is a risk factor. However, neither polymorphism was related to activity (active vs. quiescent) of TA.

Risk factors for prolonged glomerulonephritis after acute post-streptococcal glomerulonephritis / 中华实用儿科临床杂志

Objective:To investigate the risk factors for prolonged acute post-streptococcal glomerulonephritis(APSGN) in children, and to provide evidence for the prevention and treatment of chronic kidney diseases in children.Methods:A retrospective analysis was performed on the patients who were diagnosed as APSGN and hospitalized in the Department of Nephrology and Rheumatology of Hunan Children′s Hospital from January 2005 to August 2017 with complete clinical data, and follow-up time of more than 12 months.The patients were divided into the non-prolonged group and the prolonged group according to whether the disease course of the children exceeded 1 year. Logistic regression analysis of the high-risk factors for the prolonged disease was conducted. Results:Among 271 children included in the study, 197 cases were males, 74 cases were females; with the median age of 9.91 (7.66, 11.33) years old; there were 154 cases in the non-prolonged group (course of disease < 1 year) and 117 patients in the prolonged group (course of disease ≥1 year). Logistic regression analysis showed that duration of proteinuria ≥8 weeks, acute kidney injury, a large amount of proteinuria, and female were the risk factors for the prolonged APSGN (all P<0.05). Giving 1 point to the acute kidney injury duration of proteinuria ≥8 weeks and female, and 2 points to a large amount of proteinuria, the receiver operating characteristic curve analysis showed that for patient whose risk score was 3 points or more, the sensitivity of APSGN to be belonged was 43.6%, specificity was 86.4%, and positive predictive value and negative predictive value were 70.8% and 66.8%. Conclusions:Patients with a large amount of proteinuria accompanied by acute kidney injury or proteinuria duration ≥8 weeks, or female patients with a large amount of proteinuria, or female patients with acute kidney injury and proteinuria duration ≥8 weeks, but without a large amount of proteinuria, have a higher risk of prolonged APSGN.

Application of Demirjian's and Cameriere's Method in Dental Age Estimation of 8-16 Year Old Adolescents from Hunan Han Nationality / 法医学杂志

Objective To apply Demirjian's and Cameriere's method for dental age estimation of adolescents from Hunan Han nationality, and compare the accuracy of the two methods. Methods A total of 480 orthopantomograms of?8-16 year?old adolescents from Hunan Han nationality?with no special diseases and good nutritional status were collected?by Xiangya Stomatological Hospital of Central South University from January, 2016 to July, 2017, among them 236 males and 244 females. The dental age of each adolescent was determined by Demirjian's method and Cameriere's method, respectively, and the paired t-test of the estimated dental age and the chronological age determined by the two methods was conducted by SPSS 20.0 software to compare the difference between estimated dental age and chronological age. Results Mean chronological age of males and females was 11.91 and 11.88 years, respectively. The estimated dental age determined by Demirjian's method showed an underestimate of chronological age by an average of 0.11 years （males） and 0.15 years （females）, while the estimated dental age determined by Cameriere's method showed an underestimate of chronological age by an average of 0.83 years （males） and 0.72 years （females）. Conclusion Demirjian's method is more accurate than Cameriere's method in dental age estimation of adolescents from Hunan Han nationality, therefore more suitable for dental age estimation of adolescents in this region.

Evaluation of inflammatory activity in thyroid associated ophthalmopathy by SPECT/CT with 99mTc-DTPA / 中南大学学报(医学版)

Objective:To evaluate the inflammatory activity in thyroid associated ophthalmopathy (TAO) by 99mTc-diethylene triamine pentaaceticacid (99mTc-DTPA) orbital single-photon emission computed tomography (SPECT)/CT.Methods:A total of 48 patients were enrolled from Xiangya Hospital of Central South University between October 2016 and March 2017.According to clinical active score (CAS),93 eyes were divided into a TAO active group (n=72) and a TAO inactive group (n=21).All patients underwent 99mTc-DTPA orbital SPECT/CT examination,and the DTPA uptake in extraocular muscle belly was supposed to be positive.The results of 99mTc-DTPA orbital SPECT/CT examination were compared with those of CAS score evaluation.Results:The uptake rate (UR) of 99mTc-DTPA in the TAO active group was higher than that in the TAO inactive group (P＜0.01).There was a linear positive correlation between UR and its CAS scores in all patients (r=0.767,P＜0.01).Five cases (7 eyes) showed inconsistent results between 99mTc-DTPA orbital SPECT/CT examination and CAS score.Among the 7 eyes,6 eyes showed myocarditis lesions in 99mTc-DTPA orbital SPECT/CT examination while its CAS was no more than 3;meanwhile,there was 1 eye with CAS＞3,but 99mTc-DTPA orbital SPECT/CT examination showed negative myocarditis lesions.Conclusion:99mTc-DTPA orbital SPECT/CT is consistent with the CAS score in evaluation of the disease activity of TAO;99mTc-DTPA orbital SPECT/CT may be more objective and accurate to evaluate TAO than CAS.

CT-guided percutaneous transthoracic needle biopsy for the diagnosis of non-small cell lung cancer: a retrospective analysis of its diagnostic accuracy / 介入放射学杂志

Objective To investigate the diagnostic accuracy of CT-guided percutaneous transthoracic needle biopsy (PTNB) for non - small cell lung cancer (NSCLC), and to discuss the factors affecting the diagnostic accuracy of puncture biopsy. Methods The clinical data of a total of 203 patients with pathologically-proved NSCLC, who received CT-guided PTNB during the period from January 1, 2010 to November 1, 2016, were retrospectively analyzed. CT - guided PTNB was performed in all patients before surgery, and tissue specimens were collected for pathological study. The diagnostic accuracy of needle biopsy was calculated, and the factors that might affect the diagnostic accuracy of needle biopsy were analyzed. Results (l)The coincidence rate of pathological results of CT-guided PTNB (small specimens) with surgical specimens (large specimens) was 92. 6％ (188/203). The squamous cell carcinoma and adenocarcinoma had the highest coincidence rates, which were 100％ and 97. 5％ respectively. The coincidence rate of large cell carcinoma type was 20％. No statistically significant differences in the coincidence rate of adenocarcinoma and squamous cell carcinoma existed between small specimens and large specimens (κ=0. 872, P=0. 250). (2)Chi square test showed that only the lesion size was an important factor that affected the diagnostic accuracy of needle biopsy (P=0. 008). Conclusion In diagnosing commonly seen NSCLC, CT - guided PTNB has high coincidence rate with surgical specimens, therefore, CT-guided PTNB is worth popularizing widely in clinical practice. The lesion size is an important factor that affected the diagnostic accuracy of needle biopsy. (J Intervent Radiol, 2018, 27:274-277)

Effects of Electroacupuncture at Baihui,Dazhui and Shenshu Acupoints on Ability of Learning and Memory and Synapses of Neurons in Hippocampal CA1 in SAMP8 Mice / 中国康复理论与实践

Objective To observe the effect of electroacupuncture (EA) at Baihui (GV20), Dazhui (GV14) and Shenshu (BL23) acu-points on cognitive function and the synapse of neurons in hippocampal CA1 in SAMP8 mice,to explore the mechanism of EA in the treat-ment of Alzheimer's disease(AD).Methods A total of 24 seven-month-old SAMP8 mice were randomly divided into model group(n=12) and EA group (n=12), and the same age SAMR1 mice were as control group (n=12).The EA group accepted EA at Baihui, Dazhui and Shenshu for 30 days.They were assessed with Morris maze test.The expression of synaptophysin(SYN)and postsynaptic density protein 95(PSD95)in hippocampal CA1 region were detected with immunohistochemistry.The morphology and density of synapse in hippocampal CA1 region was observed with transmission electron microscopy.Results Compared with the model group,the latency of Morris maze de-creased in EA group(P<0.05),the time staying in the quadrant of the platform increased(P<0.05),as well as the number passing the origi-nal platform(P<0.05),with the more expression of SYN and PSD95 in hippocampal CA1 region(P<0.001),and more and completed syn-apse.Conclusion EA can improve the learning and memory ability of SAMP8 mice by increasing the expression of SYN and PSD95 to pro-tect the ultrastructure of synapses in hippocampal CA1 region.

The influence of purging fire and removing toxin on chemokines and adhesion factors related to inflammation induced by trimeresurus stejnegeri bites / 中国中西医结合急救杂志

Objective To investigate the influence of the purging fire and removing toxin method on chemokines and adhesion factors related to vascular endothelialitis injury induced by toxin of trimeresurus stejnegeri bite.Methods ① Animal experiment:50 healthy New Zealand white rabbits were chosen.According to random numbers generated by statistical software,they were divided into normal control group,model group,low,middle and high dose Sheshang capsule groups,10 in each group.Trimeresurus stejnegeri bite model was replicated by injecting 0.75 mL/kg snake venom into subcutaneous tissues of rabbits' right hind legs.And the same volume of normal saline was injected into the rabbit in the normal control group.After the model was established for 6 hours,the rabbits in low,middle and high dose Sheshang capsule groups received 174,348 and 522 mg· kg-1 · d-1 of Sheshang capsule solution respectively (the content of capsules was dissolved in normal saline to make liquid with 17.4,34.8 and 52.2 g/L Sheshang solution respectively,so the volume of gavage of each group was 10 mL· kg-1 · d-1);in the model and normal control groups,the same amount of normal saline was given by gavage,once daily for consecutive one week.24 hours after the last gavage,the blood of the rabbits was collected through an auricular border vein and the serum was separated by centrifuge ready for use.Meanwhile,the whole abdominal aorta segment of the rabbit was harvested and kept them in liquid nitrogen ready for use.② Cell experiment:human umbilical vascular endothelial cell (HUVEC) was cultured with MEM for 24 hours.The solution was replaced and according to the random number generated by statistical software,the cells were divided into blank control group,model group and low,middle,high dose Sheshang capsule medicinal serum groups,10 wells in each group.Trimeresurus stejnegeri toxin cell model was reproduced by addition of 5 mg/L snake venom into the cell culture medium.After 6-hour culture,the cells of model group and blank control group received 10％ normal rabbit serum,and the cells of low,middle and high dose Sheshang medicinal serum capsule groups received serum containing 5％,10％ and 15％ drug,respectively.After culture for 72 hours,the cells were collected and the total RNA was extracted.The real-time fluorescent quantitative polymerase chain reaction (qPCR) was used to detect the levels of mRNA of interleukin-8 (IL-8),monocyte chemoattractant protein-1 (MCP-1),intercellular adhesion molecule-1 (ICAM-1) and vascular endothelial cell adhesion molecule-1 (VCAM-1) in the vascular endothelial cells of rabbit aorta abdominalis and human umbilical vein,and the content of serum E-select element (CD62E) was measured by enzyme linked immunosorbent assay (ELISA).Results In model group,the expression levels of mRNA in IL-8,MCP-1,ICAM-1,VCAM-1 and the content of CD62E were all increased significantly in the endothelial cells of rabbit aorta abdominalis and HUVEC compared with those in control group [when the mRNA expression levels of IL-8,MCP-1,ICAM-1 and VCAM-1 in normal and blank control group were all being 1,the mRNA expression levels (2-△ △Ct) of the above mentioned inflammatory factors and adhesion molecule in animal model group were 3.96 ± 0.39,3.07 ± 0.27,3.71 ± 0.26,3.94 ± 0.26,and the mRNA expression levels (2-△ △Ct) of the above mentioned inflammatory factors and adhesion molecule in HUVEC model group were 3.53±0.70,2.24±0.48,3.13±0.44,2.80±0.13,respectively,all P ＜ 0.01].The content of CD62E in serum was increased significantly in model group compared with that in normal control group (μg/L:1.31 ± 0.22 vs.0.82 ± 0.13,P ＜ 0.01),the mRNA expression levels of IL-8,MCP-1,ICAM-1 and VCAM-1 were decreased significantly in low,middle,high dose Sheshang capsule groups compared with those in model group in endothelial cells of aorta abdominalis of rabbits and HUVEC [abdominal aorta:IL-8 mRNA (2-△ △Ct) were 1.13 ± 0.19,1.26 ± 0.16,1.27 ± 0.17 vs.3.96 ± 0.39,MCP-1 mRNA (2-△ △ Ct) were 1.79 ± 0.24,2.22 ± 0.38,1.76±0.19 vs.3.07±0.27,ICAM-1 mRNA (2 △△Ct) were 2.05±0.11,1.68±0.09,2.37±0.48 vs.3.71±0.26,VCAM-1 mRNA (2-△△Ct) were 1.59±0.08,1.40±0.11,1.84±0.11 vs.3.94±0.26;HUVEC:IL-8 mRNA (2-△△Ct) were 2.33±0.59,2.82±0.82,2.51±0.77 vs.3.53±0.70,MCP-1 mRNA (2-△△Ct) were 1.59±0.35,1.48±0.36,1.54±0.29 vs.2.24±0.48,ICAM-1 mRNA (2-△△Ct) were 1.46±0.38,1.77±0.65,1.73±0.50 vs.3.13±0.44,VCAM-1 mRNA (2-△△Ct) were 2.49±0.24,2.18±0.19,2.45±0.24 vs.2.80±0.13,all P ＜ 0.05].The contents of CD62E were decreased significantly in middle,high dose Sheshang capsule groups compared with the content in model group (μg/L:1.01 ±0.14,1.04±0.13 vs.1.31 ±0.22,all P ＜ 0.01),but there were no statistical significant differences among the three drug group (all P ＞ 0.05).Conclusion The therapy of purging fire and removing toxin can treat vascular endothelial injury by inhibiting the inflammatory response induced by Trimeresurus stejnegeri bites.

Research on radix notoginseng for improving CKD rat renal fibrosis / 重庆医学

Objective To investigate the effects of notoginseng and guiding medicinals mediated notoginseng for improving the renal inter stitial fibrosis in rats with chronic kidney-disease(CKD)by regulating TGF-β signaling pathway.Methods A total of 100 male SD rats were randomly divided into five groups:normal group(NOR,n =20),model group(CKD,n =20),radix notogin-seng group(RN,n =20),radix notoginseng plus platycodi group (RNP) and radix notoginseng plus cinnamon group (RNC,n =20).Except for the NOR group,the CKD rat model in other groups was established by adenine gavage.After modeling,the NOR group and CKD group were given the same volume of normal saline by gavage,while the group RN,RNP and RNC were given corresponding drugs by gavage,for 4 weeks.After 4 weeks,the rats in each group were sacrificed for collecting serum and detecting the renal function(serum Scr,BUN),the renal tissues were taken for conducting HE and Masson staining.Then the renal tissue pathological damage severity was observed.The expressions of FN and LN in kidney tissue were detected by immunohistochemistry and the expressions of TGF-[β,α-SMA were detected by Western blot method.Results Compared with the NOR group,the model group exhibited the renal dysfunction(P＜0.01),renal interstitial severe fibrosis manifestation and increased collagen deposition(P＜0.05),and the expression of kidney tissues α-SMA(P＜0.01),TGF-β(P＜0.01),FN and LN were significantly increased.Compared with the model group,the renal function in various treatment groups was improved,Scr(P＜0.01)and BUN(P＜0.01)were significantly decreased,the renal interstitial fibrosis degree was reduced,collagen desposition was decreased(P＜0.05),renal tissue α-SMA(P＜ 0.05),TGF-β(P＜0.05),FN and LN expression were reduced to some extent,in which the effect of RNC group was stronger than that of the RN group and RNP group.Conclusion Notoginseng and guiding medicinals mediated notoginseng can retard the progression of renal interstitial fibrosis caused by adenine in CKD rat in varying degrees,its mechanism maybe reduce the expression of TGF-β protein.

Mutation Analysis of MR-1, SLC2A1, and CLCN1 in 28 PRRT2-negative Paroxysmal Kinesigenic Dyskinesia Patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Paroxysmal kinesigenic dyskinesia (PKD) is the most common subtype of paroxysmal dyskinesias and is caused by mutations in PRRT2 gene. The majority of familial PKD was identified to harbor PRRT2 mutations. However, over two-third of sporadic PKD patients did not carry anyPRRT2 mutation, suggesting an existence of additional genetic mutations or possible misdiagnosis due to clinical overlap.</p><p><b>METHODS</b>A cohort of 28 Chinese patients clinically diagnosed with sporadic PKD and excluded PRRT2 mutations were recruited. Clinical features were evaluated, and all subjects were screened for MR-1, SLC2A1, and CLCN1 genes, which are the causative genes of paroxysmal nonkinesigenic dyskinesia (PNKD), paroxysmal exertion-induced dyskinesia, and myotonia congenita (MC), respectively. In addition, 200 genetically matched healthy individuals were recruited as controls.</p><p><b>RESULTS</b>A total of 16 genetic variants including 4 in MR-1 gene, 8 in SLC2A1 gene, and 4 in CLCN1 gene were detected. Among them, SLC2A1 c.363G>A mutation was detected in one case, and CLCN1 c.1205C>T mutation was detected in other two cases. Neither of them was found in 200 controls as well as 1000 Genomes database and ExAC database. Both mutations were predicted to be pathogenic by SIFT and PolyPhen2. The SLC2A1 c.363G>A mutation was novel.</p><p><b>CONCLUSIONS</b>The phenotypic overlap may lead to the difficulty in distinguishing PKD from PNKD and MC. For those PRRT2- negative PKD cases, screening of SLC2A1 and CLCN1 genes are useful in confirming the diagnosis.</p>

A study on effects of Sheshang capsule on blood coagulation function of patients bitten by Trimeresurus stejnegeri snake / 中国中西医结合急救杂志

Objective To investigate the mechanism of traditional Chinese medicine (TCM) Sheshang capsule for treatment of blood coagulation dysfunction in patients bitten by Trimeresurus stejnegeri snake. Methods A prospective study was conducted. Seventy Trimeresurus stejnegeri snake envenoming patients whose manifestations conformed to the diagnostic criteria of the fire toxin syndrome in TCM were assigned into therapy group and control group by random number table (each, 35 cases). The basic treatments (including wound disinfection, intramuscular injection of 1 500 U tetanus antitoxin, conventional dose of antibiotics, 10 mg dexamethasone, 40 mg omeprazole) and 10 Jidesheng Sheyao tablets three times a day were applied in the control group. In the therapy group, the basic treatments the same as those of the control group were given, and in the mean time 5 Sheshang capsules (the drug was prepared in our hospital including ingredients:rhubarb, coptidis rhizoma, pleione bulbocodioides, elecampane inula root, bayberry bark, borneol and so on) were administered three times a day. The therapeutic course in the two groups was 1 week. The levels of platelet α-granule membrane protein (CD62p), thromboxane B2 (TXB2), platelet factor 3 (PF3) and von Willebrand factor (vWF) in serum were measured by enzyme linked immunosorbent assay (ELISA) before and after treatment. Results Before treatment, there were no significant differences in CD62p, TXB2, PF3 and vWF between therapy group and control group [CD62p (μg/L):3.81±1.64 vs. 3.52±1.43, TXB2 (μg/L):13.04±1.67 vs. 13.31±1.14, PF3 (μg/L): 2.84±1.08 vs. 2.88±1.23, vWF (μg/L):12.36±2.42 vs. 11.89±2.08, all P>0.05]. After treatment, the levels of CD62p, TXB2 and PF3 were increased, while vWF decreased compared with those before treatment in both groups, the level changes in therapy group being more remarkable [CD62p (μg/L): 6.73±1.77 vs. 5.81±1.62, TXB2 (μg/L):18.65±1.77 vs. 17.90±1.68, PF3 (μg/L):5.61±1.48 vs. 4.77±1.24, vWF (μg/L):3.87±1.01 vs. 4.58±1.09, P < 0.05 or P < 0.01]. Conclusion The Sheshang capsule is capable of treating patients with blood coagulative disorder after Trimeresurus stejnegeri snake bite, and its mechanism is possibly related to the improvement of platelet activation function and amelioration of the damage of vascular endothelial cells.

Epidemiological analysis of childhood asthma in Yichang City, China / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the prevalence, epidemiological characteristics, and risk factors for childhood asthma in Yichang City, China and to collect evidence for the early diagnosis and preventive treatment of asthma.</p><p><b>METHODS</b>Preliminary screening questionnaires were distributed to more than 90% of children in 5 kindergartens, 10 primary and secondary schools, and 5 communities in Yichang City to detect children with suspected asthma. These surveyed children were selected by cluster random sampling. A further questionnaire survey was conducted for suspected cases. Meanwhile, a similar number of sex- and age-matched non-asthmatic children were selected for the case-control study. Information from returned questionnaires was entered into a database for statistical analysis.</p><p><b>RESULTS</b>A total of 11 000 questionnaires were distributed, and 10 456 (95.1%) questionnaires were returned. The prevalence rate of asthma among children in Yichang was 3.47%, significantly higher in boys than in girls (P<0.05). A total of 107 out of 363 children with asthma had a history of drug allergy, and 152 cases had a family history of allergy. The majority of asthmatic children had irregular onset-prone seasons and hours. Respiratory tract infections were the most common trigger of asthma attacks, accounting for 93.1% of all onsets; family history of allergy, history of early use of antibiotics, history of housing renovation, and history of passive smoking were the major risk factors for asthma.</p><p><b>CONCLUSIONS</b>Prevention of respiratory tract infections may reduce the frequency of asthma attacks; reducing the use of antibiotics during early childhood, decreasing the frequency of housing renovation, and advocating for smoking cessation among parents have preventive effects on asthma.</p>

MK801 controls form-deprivation myopia by nitric oxide-cyclic GMP signaling pathway in guinea pig / 中南大学学报(医学版)

OBJECTIVE@#To investigate the mechanism of myopia following intravitreous injection of MK801 (dizocipine maleate) intravitreous injected.@*METHODS@#Three-week-old guinea pigs were divided into six groups: group A (control), group B (3 weeks form-deprivation in right eye), group C ( 3 weeks form-deprivation in right eye + saline), group D (3 weeks form-deprivation in right eye + MK801 1ng), group E (3 weeks form-deprivation in right eye + MK801 10 ng), group F (3 weeks form-deprivation in right eye + MK801 100 ng). The refraction and axial length of the eyes were measured. ncNOS was measured by hybridization in situ, and cyclic GMP (cGMP) concentrations by radioimmunochemistry. The correlation between MK801 concentration and diopter degree, axial length of the eyes, and levels of ncNOS or cyclic GMP were analyzed with linear correlation in the groups C-F.@*RESULTS@#Diopter degree was decreased, axial eye length was shorted and levels of ncNOS and c-GMP were decreased in groups C, D, E and F dependent on the concentration of MK801. The diopter degree had positive correlation with MK801 concentration (r=0.702, P<0.05), while the axial eye length and the levels of ncNOS and cGMP were negatively correlated (r=-0.736, -0.637, -0.725, P<0.05)@*CONCLUSION@#MK801 injected into the vitreous humor can restrain myopia by down-regulated the expression of the nitric oxide-cyclic GMP signaling pathway. The effect is concentration dependent.

Genetic diagnosis of Liddle's syndrome by mutation analysis of SCNN1B and SCNN1G in a Chinese family / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Liddle's syndrome is a rare autosomal-dominant monogenic form of salt-sensitive hypertension. This study aimed to screen the gene mutation in β and γ subunits of the epithelial sodium channel (ENaC) of a Chinese family with Liddle's syndrome, an autosomal dominant form of hypertension.</p><p><b>METHODS</b>DNA samples from the proband with early-onset, treatment-resistant hypertension and suppressed plasma renin activity were initially screened for mutations in the C-terminal exons of the ENaC β or γ subunit genes, using amplification by polymerase chain reaction and direct DNA sequencing. We also screened the C-terminus of SCNN1B and SCNN1G in family members, and screened for the mutation in 150 controls.</p><p><b>RESULTS</b>Genetic analysis of the β ENaC gene revealed a missense mutation of CCC to TCC at codon 616 in the proband, her mother and her grandmother. One hundred and fifty randomly selected controls had not the mutation, indicating that this is not a common genetic polymorphism. There was no mutation of the γ ENaC gene in any of the individuals examined.</p><p><b>CONCLUSIONS</b>Through direct DNA sequencing analysis, we established the diagnosis of Liddle's syndrome for the proband and her families, and provided tailored therapies to this abnormality. These results provide further evidence that Pro616Ser is a critical amino acid that has a key role in the inhibition of sodium channel activity.</p>

Effects of Yishen Jiangzhuo Granule on the bone metabolism of patients with stage 3-4 chronic kidney disease and its correlation with the immune indices / 中国中西医结合杂志

<p><b>UNLABELLED</b>OBJECTIVE To explore the changes of bone gla protein (BGP) and tartrate resistant acid phosphatase (TRACP) in patients with stage 3 -4 chronic kidney disease (CKD) before and after treatment, to study their correlation with interleukin-17 (IL-17) and regulatory T cells (Treg), and the effects of Yishen Jiangzhuo Granule (YJG) on the bone metabolism.</p><p><b>METHODS</b>Fifty-three patients with stage 3-4 CKD were randomly assigned to the treatment group and the control group using random digit table. The following parameters in blood were detected: Treg (CD4+ CD25+ CD127lo) using tri-chrism fluorescent labeling by flow cytometry; levels of TRACP, BGP, and IL-17 by double antibody sandwich ELISA. The hemoglobin (HGB) content was detected using Beckman-Coulter heme/analysis. The urinary contents of creatinine (UCr) were determined using reversed HPLC. The blood contents of calcium (Ca), phosphate (P), blood urea nitrogen (BUN), serum creatinine (SCr), and plasma albumin (ALB) were determined using automatic biochemical analyzer. Then the calcium-phosphate (Ca x P) product was calculated on the basis of blood contents of Ca and P. The clearance rate of endogenous creatinine (CCr) was calculated on the basis of blood BUN and SCr contents.</p><p><b>RESULTS</b>(1) There was no obvious change in CD4+ CD25+ CD127lo in the two groups before and after treatment (P > 0.05). Compared with before treatment in the same group, there were statistical difference in the levels of CD4+ and TRACP in the two groups, as well as the IL-17 level in the control group (P < 0.01, P < 0.05). But compared with the healthy group, statistical difference was shown in each index (except CD4+) (P < 0.01). Compared with the control group after treatment, there was no statistical difference in each index of the treatment group after treatment (P > 0.05). Compared with before treatment in the same group, the levels of Hb, ALB, and CCr increased (P < 0.05, P < 0.01), and the SCr level decreased in the two groups after treatment (P < 0.05). Compared with the control group after treatment, the SCr level decreased and the CCr level increased more obviously in the treatment group (P < 0.05). There was no correlation among the levels of IL-17, TRACP, BGP, and Treg between before and after treatment in the two groups.</p><p><b>CONCLUSIONS</b>YJG could improve the kidney function and delay the progression of micro-inflammation of stage 3 -4 CKD patients. It could not improve the level of CD4+ CD25+ CD127lo. It also showed no effects on bone metabolism. The CD4+ T cells were differentiated to Th17 cells in stage 3-4 CKD patients. Their immunity was in a state of anergy but continually activated. The inflammatory factors in patients with stage 3-4 CKD play important roles in inducing the activation of osteoclasts.</p>

Expression of cyclic guanine monophosphate and the ultrastructure change in retina of guinea pig with form-deprivation myopia / 中南大学学报(医学版)

OBJECTIVE@#To explore the expression of cyclic guanine monophosphate (cGMP) and the ultrastructure change in retina of guinea pig with form-deprivation myopia and the underlying mechanisms.@*METHODS@#Three-weeks-old guinea pigs were distributed in 3 groups: an untreated group (Group I), a myopia 2-weeks group (Group II) and a myopia 3-weeks group (Group III), animals underwent monocular form-deprivation by facemask for 2 and 3 weeks. The right eyes were deprived and the left eyes were self-controlled. The refraction and axial length of the eyes was measured. Retina was observed by electron microscope. The expression of cGMP was detected by radioimmunochemistry.@*RESULTS@#Deprived eyes in guinea pig showed significant development of myopia, the refraction and axial length was increased. The pathological changes in ultrastructure of retina were aggravated with the development of myopia. The expression of cGMP was significantly up-regulated in the deprived eyes compared with self-control eyes(P<0.05).@*CONCLUSION@#Form-deprivation can up-regulate the expression of cyclic GMP, which might play an important role in the development of myopia.

Role of plasma C-reactive protein and white blood cell count in predicting in-hospital clinical events of acute type A aortic dissection / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A few recent studies have reported that inflammation is associated with the prognosis of acute aortic dissection (AD). There is, however, no systemic investigation regarding the role of plasma C-reactive protein (CRP) and white blood cell (WBC) levels in predicting in-hospital clinical events of acute type A AD.</p><p><b>METHODS</b>The levels of high-sensitivity CRP and WBC counts were systemically determined after admission in 36 patients with acute type A AD. The variations of plasma CRP and WBC levels in different time windows (admission, 1, 2, 3, 4, 6, 8 days) in patients with acute type A AD were analyzed between patients with events and without events.</p><p><b>RESULTS</b>During hospitalization, five patients died, and increased levels of CRP and WBC were found in patients died with acute type A AD compared with patients survived (P < 0.01, respectively). Medical treatment may significantly decrease inflammatory response in survived patients with acute type A AD. Additionally, patients with complication of pleural effusion showed higher CRP and WBC levels (P = 0.046, P = 0.018, respectively). Lower WBC levels were found in survived patients treated medically (P = 0.001). Moreover, mean CRP and WBC levels had positive correlations with aortic diameter (r = 0.364, P = 0.000; r = 0.333, P = 0.000, respectively) and age (r = 0.270, P = 0.000, respectively), while negative correlations with the time from onset of symptoms to hospital admission (r = -0.229, P = 0.000, r = -0.200, P = 0.002, respectively). Univariate analysis showed that age ≥ 65 years, CRP ≥ 12.05 mg/L, WBC ≥ 12.16 × 10(9)/L, aortic diameter ≥ 48 mm, pleural effusion and diastolic blood pressure ≥ 105 mmHg were associated with hospital mortality. While CRP ≥ 12.05 mg/L, WBC ≥ 12.16 × 10(9)/L, aortic diameter ≥ 48 mm were strongly associated with hospital mortality in multiple Logistic regression analysis.</p><p><b>CONCLUSIONS</b>The results suggested that CRP and WBC were preferred markers for predicting the clinical events in patients with acute type A AD, especially death during hospitalization. Therefore, further study enrolling larger cohort, prospective study would be warranted.</p>