Therapeutic Window of Intravenous Immunoglobulin (IVIG) and its correlation with IVIG-resistant in Kawasaki Disease: a retrospective study

Abstract Objective: To investigate the optimal timing of initial intravenous immunoglobulin (IVIG) treatment in Kawasaki disease (KD) patients. Methods: KD patients were classified as the early group (day 1-4), conventional group (day 5-7), conventional group (day 8-10), and late group (after day 10). Differences among the groups were analyzed by ANOVA and Chi-square analysis. Predictors of IVIG resistance and the optimal cut-off value were determined by multiple logistic regression analyses and receiver operating characteristic (ROC) curve analysis. Results: There were no significant differences in IVIG resistance among the 4 groups (p = 0.335). The sensitivity analysis also confirmed no difference in the IVIG resistance between those who started the initial IVIG ≤ day 7 of illness and those who received IVIG >day 7 of illness (p = 0.761). In addition, patients who received IVIG administration more than 7 days from the onset had a higher proportion of coronary artery abnormalities (p = 0.034) and longer length of hospitalization (p = 0.033) than those who started IVIG administration less than 7 days. The optimal cut-off value of initial IVIG administration time for predicting IVIG resistance was >7 days, with a sensitivity of 75.25% and specificity of 82.41%. Conclusions: IVIG therapy within 7 days of illness is found to be more effective for reducing the risk of coronary artery abnormalities than those who received IVIG >day 7 of illness. IVIG treatment within the 7 days of illness seems to be the optimal therapeutic window of IVIG. However, further prospective studies with long-term follow-up are required.

Evaluation of Dominant Diseases of Traditional Chinese Medicine： A Case Study of Ischemic Stroke / 中国实验方剂学杂志

The present study explored the effective approaches to realize the leading role of traditional Chinese medicine （TCM） in preventing diseases， the synergistic role in treating serious diseases， the core role in the rehabilitation of diseases and summarized the experience to provide feasible plans for the evaluation of other dominant diseases of TCM. To evaluate the effectiveness， safety， and economy of TCM in the treatment of ischemic stroke， encephalopathy project team of the China Center for Evidence-based Traditional Chinese Medicine（CCEBTCM） established an evaluation group to determine the work plan and complete the evaluation work. The concepts of the evaluation involved high-quality evidence， expert opinion survey， expert interview， and drug catalog. Under the guidance of clinical experts and methodologists， the evaluation work was completed in accordance with four steps， i.e.， plan making， data collection and data extraction， evidence synthesis and evaluation， and report writing with the rapid review method. Through the review of TCM and western medicine experts， the advantage of TCM in the treatment of ischemic stroke was positioned in the convalescence period with the predominant effects of improving the neurological function defect and improving the daily living ability. In the convalescence period of stroke， TCM treatment could improve post-stroke motor dysfunction， post-stroke cognitive impairment， consciousness disorder， swallowing disorder， aphasia， constipation， urinary function， diplopia， etc.， and the advantages of acupuncture， Chinese medicine， and traditional exercise were more prominent. In terms of safety， TCM treatment of ischemic stroke showed lower incidence of adverse reactions， fewer adverse events， and a milder degree of related symptoms. In terms of economic performance， the combined treatment of TCM and western medicine played a synergistic role and made the treatment cost more reasonable. Compared with conventional intervention， the integrated TCM and western medicine rehabilitation program showed more economic and social benefits.

Current Status and Prospect of Discipline Construction of Herbgenomics / 中国实验方剂学杂志

Herbgenomics is an interdisciplinary subject between traditional Chinese medicine(TCM) and genomics.It is a comprehensive discipline covering multi-omics research in both medicinal organisms of TCM and the relationship of TCM to human body.It has been widely used in the research fields of medicinal model organisms,synthetic biology of TCM,identification of TCM molecules and breeding of medicinal plant cultivars,pharmacokinetics,and the study on the geoherbalism and medicinal of TCM.With the release of important documents,such as the Law of the People's Republic of China on TCM and the Outline of TCM Development Strategy(2016-2030),the Chinese medicine industry has entered a new and high-level development opportunity and the herbgenomic research area has got a landmark achievement.The training of well-rounded students and researchers is a key point for the development of TCM industry and the reform of medical colleges and universities.Therefore,the establishment of herbgenomics is particularly important for the modernization of TCM.At present,many colleges and universities have set up the course of Herbgenomics among graduate students and undergraduates,and initially formed a distinctive herbal genomics talent training system.This paper introduces the herbgenomics from the progress of the research,the development of teaching courses,the background of the textbook,the main content and key technologies of the discipline and the prospect of discipline construction,in order to provide theoretical basis and methodological support for the discipline construction,personal training and scientific research of herbgenomics.

The anesthetic effects of small dose of midazolam or ketamine used for intemperants' endoscopy / 中国医师杂志

Objective To explore the safe and effective intravenous anesthetic regimen for intemperants' painless endoscopy.Methods 120 cases of intemperants,aged 25-65 years old,ASA grade Ⅰ or Ⅱ,were randomly divided into 3 groups (n =40):sulfentanyl group (group S),midazolam and sulfentanyl group(group MS),ketamine and sulfentanyl group (group KS).Group S were intravenous injected with sufentanil 0.1 μg/kg,propofol 1-2 mg/kg,etomidate 0.1 mg/kg.Group MS and group KS were additional intravenous injected with midazolam 0.01 mg/kg and ketamine 0.1 mg/kg on the basis of Group S respectively.The occurrence of hypoxia,cough,body movement and blood pressure were recorded,the use of vasoactive drugs and the recovery time were also recorded.Results There are no statistical significant difference of age,gender,and testing time among the three groups (P ＞0.05).Compared with the group S,the total dose of propofol,the incidence of hypoxemia and hypotension,the incidence of body movement and cough reaction in group MS and group KS were all lower (P ＜ 0.01).And compared with the group MS,the patients have lower incidence of hypoxemia and hypotension in group KS (P ＜ 0.05).All the patients were awake well (P ＞ 0.05).Conclusions Small doses of midazolam or ketamine combined with sulfentanyl,propofol and etomidate are safe and effective in the process of anesthesia during endoscopic diagnosis and treatment of intemperants.

Investigation and analysis of health-related quality of life in myasthenia gravis patients with myasthenia gravis quality of life-15 Chinese version / 北京大学学报(医学版)

OBJECTIVE@#To investigate the level and influencing factors of health-related quality of life in myasthenia gravis (MG) patients with myasthenia gravis quality of life-15 (MGQOL-15) Chinese version and to provide corresponding measures in one tertiary hospital of Sichuan Province.@*METHODS@#We collected the general data (gender, age, body mass index BMI, marital status, educational level and employee status), clinical data [Osserman type, myasthenia gravis composite (MGC), other immunopathies, disease duration, frequency of outpatient visits per month, ratio of disease cost to income each month and frequency of symptoms during the past month] and the MGQOL-15 Chinese version from 168 myasthenia gravis patients in one tertiary hospital of Sichuan Province.@*RESULTS@#The mean score of MGQOL-15 was 17.67±12.78. The score of the item "My occupational skills and job status have been negatively affected." was the highest, followed by "I have trouble using my eyes." and "I am frustrated by my MG." Single factor analysis showed that MG patients' QOL were different with different disease severity MGC (F=19.353, P<0.001), ratio of disease cost to income each month (F=5.831, P<0.001) and the frequency of symptoms during the past month (F=9.128,P<0.001). Multiple regression analysis showed that disease severity MGC (β=0.743,P<0.001), ration of disease cost to income each month (β=3.347,P<0.001) and the frequency of symptoms during the past month (β=2.216,P<0.003) were the main predictors of HRQOL in the MG patients.@*CONCLUSION@#Our study showed that the MGQOL-15 is helpful for clinicians to evaluate MG patients' QOL regularly, investigate the influencing factors and implement corresponding interventions the so as to improve the patients' quality of life. Disease severity MGC, ratio of disease cost to income each month and the frequency of symptoms during the past month were the main predictors of MG patients' QOL. Clinicians should pay more attention to MG patients' disease severity MGC and the frequency of symptoms during the past month.

Observation of clinical effects of mineral trioxide aggregate as direct pulp capping in immature permanent an-terior teeth / 口腔疾病防治

Objective@# To evaluate the clinical effects of mineral trioxide aggregate (MTA) as apulp-dressing agent in immature permanent anterior teeth. @*Methods @#68 perma nent anterior teeth with deep caries or accidental pulp exposure were randomly divided into treatment group (MTA) and control group (calcium hydroxide). The exposed pulps were treated permanently with direct pulp capping. The effect of potential clinical variables on the treatment outcome was evaluated clinically and radiographically during a 24-month follow-up. In order to assess the cumulative successes, data were analyzed with chi-square test and log-rank test (α= 0.05). @*Results @#The successful rate of the treatment group (91.4%) was higher than that of the control group (60.6%) significantly (P < 0.05). None of the gender, occlusal site, type of pulp exposure, site and diameter of pulp exposure had a considerable influence on the outcome (P > 0.05).@*Conclusion@# MTA as a biocompatable, osteogenesis-inducing and inflammation-controlling material appears to be suitable for direct pulp capping.

Establishment and validation of a dynamic finite element model of human head-neck / 医用生物力学

Objective To construct a three-dimensional (3D) dynamic head-neck finite element model which accords with the anatomical structure, and study its dynamic responses under the external force. Methods By using the neck CT images of a Chinese adult male volunteer and obtaining the 3D cervical point cloud data, the finite element model of cervical spine was established using ICEM-CFD and HyperMesh software. This model, including vertebrae, intervertebral discs, facet joints, ligaments and cartilage tissues, and combining with the established and verified head finite element model, was assembled as human head-neck finite element model with detailed anatomical structures. Results The model was validated by data of head-neck axial impact experiments reported in previously published literature. The simulation results showed that the neck deformation, head acceleration, head force and injury positions were preferably consistent with the experimental data. Conclusions The established 3D dynamic finite element model can be used to study head-neck dynamic responses and damage mechanism in the fields of traffic safety and impact injuries.

Establishment and validation of a dynamic finite element model of human head-neck / 医用生物力学

Objective To construct a three-dimensional (3D) dynamic head-neck finite element model which ac cords with the anatomical structure,and study its dynamic responses under the extemal force.Methods By using the neck CT images of a Chinese adult male volunteer and obtaining the 3D cervical point cloud data,the finite element model of cervical spine was established using ICEM-CFD and HyperMesh software.This model,including vertebrae,intervertebral discs,facet joints,ligaments and cartilage tissues,and combining with the es tablished and verified head finite element model,was assembled as human head-neck finite element model with detailed anatomical structures.Results The model was validated by data of head-neck axial impact experiments reported in previously published literature.The simulation results showed that the neck deformation,head acceleration,head force and injury positions were preferably consistent with the experimental data.Conclusions The established 3D dynamic finite element model can be used to study head-neck dynamic responses and damage mechanism in the fields of traffic safety and impact injuries.

Prognostic significance of serum sP-selectin,sICAM-1 and immunoglobulin in patients with hepatitis B cirrhosis / 中国免疫学杂志

Objective:To investigate the significance of serum sP-selectin,sICAM-1 and immunoglobulin in the prognosis of hepatitis B cirrhosis.Methods:162 cases of hepatitis B patients with cirrhosis were treated as the research object in clinical laboratory of Chizhou People′s Hospital from January 2014 to December 2016,and detected in the serum of soluble P-selectin(sP-selectin), soluble intercellular adhesion molecule-1(sICAM-1),immunoglobulin and serum related index.Comparison of liver cirrhosis and liver cancer patients mean difference,Pearson analysis of serum soluble P-selectin(sP-selectin),soluble intercellular adhesion molecule-1 (sICAM-1),the correlation of immunoglobulin and serum indexes,logistic regression analysis of risk factors of liver cirrhosis to hepatocellular carcinoma,the receiver operating characteristic(ROC)OR>1 parametric curve evaluation of predictive value of hepatocellular carcinoma to liver cirrhosis.Results:The levels of sP-selectin,sICAM-1,IgM,IgG and IgA in patients with primary liver cancer were significantly higher than those in compensated cirrhosis and decompensated liver cirrhosis(P<0.05).The levels of sP-selectin,sICAM-1,IgM,IgG and IgA in patients with decompensated cirrhosis were significantly higher than those in decompensated liver cirrhosis(P<0.05).sP-selectin,sICAM-1,IgM,IgG,IgA were significantly higher in patients with grade C and grade B(P<0.05)in patients with different grades of cirrhosis.SP-selectin,sICAM-1,IgM,IgG,IgA were significantly higher in patients with grade B(P<0.05).There was no significant difference in the expressions of sP-selectin,sICAM-1 and immunoglobulin in patients with multiple foci of carcinoma and primary hepatocellular carcinoma(P>0.05).SP-selectin,sICAM-1 and immunoglobulin in patients with stage Ⅱprimary liver cancer were significantly higher than those in stage Ⅰ(P<0.05).There was a positive correlation between sP-selectin, sICAM-1 and immunoglobulin in patients with liver cirrhosis(P<0.05).In liver cirrhosis was the transfer of primary liver cancer as the dependent variable for Logistic regression analysis,the results showed that ALT,AST,sP-selectin,sICAM-1,IgM,IgG,IgA were risk factors of liver cirrhosis to hepatocellular carcinoma.ROC curve analysis showed that the sensitivity and specificity of sICAM-1 and sP-selectin in diagnosis of liver cirrhosis were higher than other factors.Conclusion:Serum sP-selectin,sICAM-1 has a higher accuracy of clinical diagnosis of hepatitis B cirrhosis prognosis evaluation,diagnostic specificity and sensitivity of liver cirrhosis to hepatocellular carcinoma was higher than that of simple detection of immunoglobulin,the combined detection in the diagnosis of liver cirrhosis is worthy of clinical prognosis.

Diagnostic value of ultrasonographic examination for hepatic steatosis in obese children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the sensitivity and specificity of hepatic ultrasonography (US) for the diagnosis of hepatic steatosis in obese children, using ¹H magnetic resonance spectroscopy (¹H MRS) as the reference standard.</p><p><b>METHODS</b>A total of 162 obese children with age of 10.5 ± 2.2 years and BMI of 28 ± 4 were enrolled in this study. They accepted hepatic US and (1)H MRS examinations. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of US were calculated for the overall presence of hepatic steatosis by comparison with ¹H MRS results.</p><p><b>RESULTS</b>Using quantitative criteria of liver fat content (LFC) >5% determined by (1)H MRS, 95 children(58.6%)were diagnosed as having hepatic steatosis. The sensitivity and specificity of US in diagnosing steatosis were 91.6% (87/95) and 50.7% (34/67) respectively, with PPV of 72.5% (87/120), and NPV of 81.0% (34/42). Considerable overlap in LFC measured by ¹H MRS was observed between different grades from US findings: absent (LFC interquartile range: 1.3%-3.9%), mild (2.4%-10.7%), moderate (7.1%-20.2%) and severe (7.6%-28.8%) steatosis.</p><p><b>CONCLUSIONS</b>The US can yield a high sensitivity and low specificity in the diagnosis of hepatic steatosis in obese children, suggesting it can be used as a screening tool for hepatic steatosis. To improve diagnostics, ¹H MRS is needed to determine LFC.</p>

Research progress of chemistry and anti-cancer activities of natural products from Chinese Garcinia plants / 药学学报

Garcinia plants are one of the rich sources of natural xanthones and benzophenones which have attracted a great deal of attention from the scientists in the fields of chemistry and pharmacology. Recently, many structurally unique constituents with various bioactivities, especially anti-tumor activity, have been isolated from Garcinia plants. This concise review focused on the anti-cancer activity natural products isolated from Chinese Garcinia plants, and the research finding by authors and collaborators over the past several years were cited.

Biomechanical analysis of the acetabular buttress-plate: are complex acetabular fractures in the quadrilateral area stable after treatment with anterior construct plate-1/3 tube buttress plate fixation?

OBJECTIVE: The acetabular buttress-plate has been widely used in treating difficult cases with satisfying clinical results. However, the biomechanical properties of a postoperative acetabular fracture fixed by the buttress-plate are not clear. The purpose of this study was to evaluate the biomechanical properties of stability after the anterior tube buttress-plate fixation of complex acetabular fractures in the quadrilateral area. METHODS: A construct was proposed based on anterior construct plate - 1/3 tube buttress plate fixation for acetabular both-column fractures. Two groups of six formalin-preserved cadaveric pelvises were analyzed: (1) group A, the normal pelvis and (2) group B, anterior construct plate-1/3 tube buttress plate with quadrilateral area fixation. The displacements were measured, and cyclical loads were applied in both standing and sitting simulations. RESULTS: As the load was added, the displacements were A<B, increasing in line. In the 600 N physiological loading, the differences were significant (standing position: p = 0.013; sitting position: p = 0.009) between groups A and B. CONCLUSION: The anterior construct plate - 1/3 tube buttress plate fixation provided a better stable construct for early sitting. The standing mode yielded more significant differences between the groups. Placing a 1/3 tube buttress-plate via an anterior approach is a novel method of providing quadrilateral area support in this setting. .

Quantitative assessment of intrahepatic fat content in children and adolescents with non-alcoholic fatty liver disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To quantitatively evaluate clinical significance of intrahepatic fat (IHF) content in children and adolescents with non-alcoholic fatty liver disease (NAFLD).</p><p><b>METHODS</b>Ninety-three obese children were enrolled in this study. Physical parameters, liver function, serum lipids, glycemic and insulin related parameters were measured. Liver B-mode ultrasound (US) examination was performed. IHF content was quantified by 1H magnetic resonance spectroscopy (1H MRS). Three subgroups were classified according to the conditional diagnostic criteria for obese children: simple obesity (n=31), NAFLD-1 (US fatty liver and normal alanine aminotransterase, n=33) and NAFLD-2 (US fatty liver and elevated alanine aminotransterase, n=29). Twenty healthy age- and sex-matched children served as a control group. IHF content among the four groups was compared. The relationship of IHF content with other common clinical laboratory parameters and independent factors influencing increased IHF content were investigated.</p><p><b>RESULTS</b>IHF content measured by 1H MRS was 0.80% (0.4%-1.0%), 2.9% (1.7%-4.30%), 14.0% (7.2%-17.5%) and 18.8% (14.0%-29.1%) respectively in the control, simple obese, NAFLD-1 and NAFLD-2 groups. There were significant differences in IHF content between the groups. Univariate correlation analysis demonstrated that IHF content was positively correlated with waist circumference, hip circumference, waisttohip ratio, body mass index, systolic blood pressure, diastolic blood pressure, alanine aminotransferase, aspartate aminoreansferase, γ-glutamic acid transtetase, triglyceride, low-density lipoprotein, OGTT 2-hour plasma glucose, fasting insulin, 2-hour insulin and insulin resisfence, and negatively correlated with high-density lipoprotein. Multivariate linear regression analysis demonstrated three independent risk factors for increased IHF content: increased waist circumference, increased 2-hour plasma glucose and decreased high-density lipoprotein levels.</p><p><b>CONCLUSIONS</b>IHF content determined by 1H MRS can reflect early hepatic fatty infiltration and is closely related to the occurrence and progress of NAFLD in obese children and adolescents. There is a significant correlation between most of common clinical laboratory parameters and IHF content, and waist circumference, high-density lipoprotein and OGTT 2-hour plasma glucose are independent factors impacting IHF content.</p>

Effect of expiratory load on neural inspiratory drive / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Neural respiratory drive is usually measured during inspiration, even in patients with chronic obstructive pulmonary disease (COPD) in whom the primary physiological deficit is expiratory flow limitation. The purpose of the study was to test the hypothesis that inspiratory muscle neural respiratory drive could be used to assess expiratory load.</p><p><b>METHODS</b>Ten healthy young men, (26 ± 4) years old, were asked to expire through a tube immersed in water where an expiratory load was required. The load was judged by the depth of the tube in water and the different loads (0 cmH2O, 10 cmH2O, 20 cmH2O and 30 cmH2O) were randomly introduced. Each expiratory load lasted for 3 - 5 minutes and inspiration was unimpeded throughout. Diaphragm electromyogram (EMG) and transdiaphragmatic pressure were recorded by a catheter with 10 metal coils and two balloons. Incremental cycle exercise with and without an expiratory load at 30 cmH2O was also performed.</p><p><b>RESULTS</b>Neural drive during expiratory loaded breathing was larger than during unloaded breathing but neural drive did not increase proportionally with increasing expiratory load; neural drive during expiratory loading at 0, 10, 20 and 30 cmH2O was (10.1 ± 3.1) µV, (16.7 ± 7.3) µV, (18.4 ± 10.7) µV and (22.9 ± 13.2) µV, respectively. Neural drive as a percentage of maximum at the end of exercise with or without load was similar ((57.4 ± 11.0)% max vs. (62.7 ± 16.4)% max, P > 0.05).</p><p><b>CONCLUSION</b>Neural respiratory drive measured at inspiration does not accurately quantify expiratory load either at rest or during exercise.</p>

Sixty-two severe and critical patients with 2009 influenza A (H1N1) in Shanghai, China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pandemic influenza A (H1N1) emerged rapidly in China in May 2009. Preliminary comparisons with seasonal influenza suggest that pandemic 2009 influenza A (H1N1) disproportionately affects younger ages and causes generally mild disease. To characterize disease progress, comorbidities, and treatment outcomes among consecutive severe and critically ill patients in a hospital served as a reference center for the care of patients with H1N1 in Shanghai, China.</p><p><b>METHODS</b>A retrospective study on 62 severe and critically ill patients with 2009 influenza A (H1N1) was conducted in Shanghai Public Health Clinical Center. Demographic data, symptoms, comorbidities, disease progression, treatments, and clinical outcomes were collected for analysis.</p><p><b>RESULTS</b>Sixty-two severe or critically ill patients were admitted to the hospital with confirmed 2009 influenza A (H1N1) infection. The median age of the study cohort was 40 years old with a range from 18 years to 75 years, and 67.7% were males. All patients presented with fever and respiratory symptoms. At presentation, 34 patients (54.8%) had comorbidities such as smoking (29.0%), hypertension (29.0%) and hepatitis B virus infection (9.7%). The median time from symptom onset to hospital admission was 6 days (interquartile-range 3 - 14 days) and 23 critically ill patients were admitted to Intensive Care Unit after admission. All the patients received neuraminidase inhibitors (oseltaminir), while 60 patients (96.7%) were treated with antibiotics, and 39 (62.9%) with corticosteroids. Twenty-three critical cases received noninvasive mechanical ventilation on the first day of admission, and 3 of them ultimately required invasive ventilation. Four death reports (6.5%) were filed within the first 14 days from the onset of critical illness with the primary causes of severe acute respiratory distress syndrome, hypoxemia, or complications, secondary infection and sepsis, pyopneumothorax and stroke.</p><p><b>CONCLUSIONS</b>Severe illness from 2009 influenza A (H1N1) infection in Shanghai occurred among young individuals. Critical cases were associated with severe hypoxemia, multisystem organ failure, and a requirement for mechanical ventilation. Most patients had a good prognosis.</p>

Effect of leptin on bone metabolism in rat model of traumatic brain injury and femoral fracture / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To observe serum and callus leptin expression within the setting of fracture and traumatic brain injury (TBI).</p><p><b>METHODS</b>A total of 64 male SD rats were randomized equally into 4 groups: nonoperated group, TBI group, fracture group, and fracture+TBI group. Rats were sacrificed at 2, 4, 8 and 12 weeks after fracture+TBI. Serum leptin was detected using radioimmunoassay, and callus formation was measured radiologically. Callus leptin was analyzed by immunohistochemistry.</p><p><b>RESULTS</b>Serum leptin levels in the fracture group, TBI group and combined fracture+TBI group were all significantly increased compared with control group at the 2 week time-point (P less than 0.05). Serum leptin in the combined fracture +TBI group was significantly higher than that in the fracture and TBI groups at 4 and 8 weeks after injury (P less than 0.05). The percentage of leptin-positive cells in the fracture+TBI callus and callus volume were significantly higher than those in the fracture-only group (P less than 0.01).</p><p><b>CONCLUSIONS</b>We demonstrated elevated leptin expression within healing bone especially in the first 8 weeks in a rat model of fracture and TBI. A close association exists between leptin levels and the degree of callus formation in fractures.</p>

Involvement of endoplasmic reticulum stress in development of fatty liver fibrosis induced by methionine-choline-deficient diet in rats / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study role of endoplasmic reticulum stress in the development of fatty liver fibrosis induced by methionine-choline-deficient diet in rats.</p><p><b>METHODS</b>Non-alcoholic steatohepatitis was induced by 10 weeks- methionine-choline-deficient diet (MCDD), Markers of endoplasmic reticulum stress were determined by immunoblotting and real-time PCR.</p><p><b>RESULTS</b>The number of apoptotic hepatocytes, The expression levels of endoplasmic reticulum stress markers were increased significantly in MCDD group compared to control group (probability value less than 0.05 or probability value less than 0.01), while ratio of hepatocyte proliferation/apoptosis was decreased in MCDD group (probability value less than 0.01). The number of hepatocytes apoptosis, and the expression levels of endoplasmic reticulum stress markers were decreased significantly 2 weeks after the feeding with normal diet in MCDD group (probability value less than 0.05 or probability value less than 0.01).</p><p><b>CONCLUSION</b>MCDD induces endoplasmic reticulum stress and fibrosis in rats.</p>

Clinical features and prognosis of the mild cases of pandemic influenza H1N1 virus infection / 中华预防医学杂志

<p><b>OBJECTIVE</b>Analyze the clinical characteristics of the mild cases of pandemic influenza H1N1 virus infection, as well as the relationship of clinical characteristics and patient genders.</p><p><b>METHODS</b>A total of 245 influenza A (H1N1) patients confirmed by viral nucleic acid detection were included in the study. The patients' personal information, signs and symptoms, lab and iconography data, disease course, negative seroconversion duration of new influenza A (H1N1) viral nucleic acid after antiviral treatment and hospitalization stay were analyzed. Measurement data were analyzed using one-way analysis of variance (ANOVA) by software SPSS 11.5. P < 0.05 was defined as statistically significant.</p><p><b>RESULTS</b>(1) Among the 245 patients, 130 were males and 115 were females, yielding a sex ratio of 1.13:1. Almost 52.0% (127/245) of the patients came from Australia, and 64.5% (158/245) were between 18 and 40 years old. (2) Clinical manifestations included fever (98.4%, 241/245), cough (80.8%, 198/245) and throat congestion (95.9%, 235/245), and lab findings were characterized by elevated C-reaction protein (CRP, 71.0%, 174/245) and neutrophil (52.2%, 128/245). (3) Female patients had significantly lower serum Prealbumin (pre-A) levels than male patients [(245.04 ± 75.3) vs (273.34 ± 92.18) mg/L, F = 5.55, P = 0.019]. (4) The patients' serum CRF levels significantly decreased after the treatment [(4.06 ± 3.47) vs (14.54 ± 14.68) mg/L, F = 6.18, P = 0.016], while the levels of CD3, CD4 and CD8 were significantly increased after treatment [(1451.23 ± 443.97) vs (819.97 ± 375.75) cell/µl, F = 32.61, P = 0.000; (771.33 ± 251.92) vs (435.36 ± 215.35) cell/µl, F = 44.43, P = 0.000; (593.16 ± 237.19) vs (342.47 ± 180.12) cell/µl, F = 28.518, P = 0.000, respectively]. (5) Approximately 30.6% (75/245) of the patients had abnormal signs on chest CT iconography, and 22.0% (54/245) had obvious signs indicating pneumonia. The average disease course was (3.9 ± 1.2) days, the average hospitalization stay was (5.0 ± 1.4) days, and the negative seroconversion duration of the mRNA after antiviral treatment was (3.8 ± 1.4) days.</p><p><b>CONCLUSION</b>The influenza A (H1N1) virus was characterized by fever, cough and throat congestion, with elevated CRP and neutrophil being the most significant lab findings. The influenza A (H1N1) strain was able to affect multiple organs, including being able to affect hepatic synthesis of pre-A as well as immune functioning. The influenza A (H1N1) influenza virus strain was mild clinically, with short disease course and good prognosis.</p>

Treatment of thoracolumbar fractures by rehabilitation exercise using knee pads on the orthopedic traction bed / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the clinical effectiveness in treating thoracolumbar fractures adopting the rehabilitation exercise utilizing knee pads on the orthopedic traction bed.</p><p><b>METHODS</b>From June 1996 to June 2006, we studied the clinical effectiveness of thoracolumbar fractures utilizing knee pads on the orthopedic traction bed for rehabilitation exercise. The cases surveyed total 209, 163 of which had full data. There were 98 males and 65 females with the age from 17 to 74 years (mean, 14.5 years). Consulting time after injury from 30 min to 7 days. Fracture site in T11 had 8 cases, in T12 24 cases, in L1 73 cases, in L2 33 cases, in L3 8 cases, in L4 3 cases, in T12 and L1 14 cases. Compression degree of vertebral anterior border: full compression had 1 case,more than 4/5 had 23, more than 2/3 had 67, more than 1/2 had 40, in 1/3 had 46.</p><p><b>RESULTS</b>Among them, 8 cases with legs paresis no recovery in nerval function or stopping recovery changed methods, and underwent surgical treatment. Others 155 cases were followed up from 2 to 12 years with an average of 3 years and 4 months. The average height of vertebral anterior borders of the 169 injured compressed had increased from 1.55 cm before treatment to 2.70 cm after treatment with an average of 1.15 cm. The height of the injured vertebral anterior borders had recovered from 50.5% (1.55/3.07) before treatment to 89.4% (2.70/3.02) after treatment. Kyphosis angle of the injured vertebral bodies had recovered from 13.25 degrees to -1.6 degrees in average. Twenty-three cases associated with dislocation basic reduction.</p><p><b>CONCLUSION</b>Rehabilitation exercise using knee pads on the orthopedic traction bed can obtain satisfactory clinical effect in treating thoracolumbar fractures, the method is easy. At 3, 7, 10 days after treatment, the height of bed should be adjusted according X-ray.</p>

Imaging Features of Pediatric Pentastomiasis Infection: a Case Report

We report here a case of pentastomiasis infection in a 3-year-old girl who had high fever, abdominal pain, abdominal tension and anemia. Ultrasound scanning of the abdomen revealed disseminated hyperechoic nodules in the liver and a small amount of ascites. Abdominal MRI showed marked hepatomegaly with disseminated miliary nodules of high signal intensity throughout the hepatic parenchyma on T2-weighted images; retroperitoneal lymphadenopathy and disseminated miliary nodules on the peritoneum were also noted. Chest CT showed scattered small hyperdense nodules on both sides of the lungs. The laparoscopy demonstrated diffuse white nodules on the liver surface and the peritoneum. After the small intestinal wall and peritoneal biopsy, histological examination revealed parenchymal tubercles containing several larvae of pentastomids and a large amount of inflammatory cell infiltration around them. The pathological diagnosis was parasitic granuloma from pentastomiasis infection.