Application of health management mode based on symptom group management in nursing care of lung cancer patients after minimally invasive surgery / 中华健康管理学杂志

Objective:To explore the application effect of the health management mode based on symptom group management in the nursing of lung cancer patients after minimally invasive surgery.Methods:The lung cancer patients underwent minimally invasive surgery and were discharged from Shanghai Chest Hospital from April to August 2019 were selected as the study subjects. The patients were divided into control group and experimental group, with the intervention time of 1 month. Routine follow-up was carried out in the control group. The health management mode based on symptom group management was adopted in experimental group. According to the exploratory factor analysis method, three factors with characteristic value>1were extracted, and the symptoms with factor load≥0.5 were included in the symptom group, and post discharge nursing was carried out based on the symptom group, including establish health management archives, distribute symptom group manual, centralized teaching, WeChat communication, etc. Before and after nursing care, Anderson symptom evaluation form (Chinese version) was used to evaluate the symptom group score of patients and compare the interference of symptom group on daily life and the influence on quality of life.Results:A total of 40 cases (47.1%) in the control group and 45 cases (52.9%) in the experimental group were included. In the control group, 28 cases (70.0%) were male, 12 cases (30.0%) were female, the average age was (60.2±6.5) years, the average time of cancer was (8.0±2.0) months, and 21 cases (52.5%) had a history of smoking. In the experimental group, there were 30 (66.7%) males, 15 (33.3%) females, age (60.6±6.8), mean time of cancer (7.9±2.1) months, and 22 (48.9%) smokers. There was no significant difference in gender, age, average time of cancer and smoking history between the two groups (all P>0.05).There was no significant difference in factor load of those symptoms between the two groups before nursing, and there was no significant difference before and after nursing in the control group. After the intervention, the symptoms in the experimental group were less than before the intervention. The total scores of symptom group and disturbance of daily life in the experimental group were (32.4±10.3), (15.20±5.3), lower than those in the control group (44.3±11.5), (28.8±8.1), the quality of life score was (88.3±18.5), higher than that in the control group (64.2±16.5) (all P<0.05). Conclusion:The health management model based on symptom group management can improve the symptoms of patients with lung cancer after minimally invasive surgery, reduce the impact of symptom group on daily life and improve the quality of life.

The mediating role of resilience between coping styles and obsessive-compulsive tendencies in college students / 中华行为医学与脑科学杂志

Objective:To explore mediating effect of resilience between coping styles and obsessive-compulsive tendencies of college students.Methods:A total of 999 college students were selected by cluster sampling method and evaluated with Padua inventory(PI), Connor-Davidson resilience scale(CD-RISC) and coping style questionnaire(CSQ). Then SPSS 22.0 was used to analyze the date, and Mplus 7.4 was used to conduct structural equation modeling and Bootstrap mediated effect test.Results:The scores of the variables were as follows: the mature coping style(15.32±4.19), immature coping style(12.85±5.33), rationalizing coping(4.51±1.91), obsessive-compulsive tendencies(30.91±17.46), resilience(53.27±12.88). The mature coping style and resilience had significantly negative correlations with obsessive-compulsive tendencies( r=-0.21, -0.21; both P<0.01), immature coping style and rationalizing coping had significantly positive correlations with obsessive-compulsive tendencies( r=0.49, 0.29; both P<0.01). Resilience played a complete mediation role between mature coping style and obsessive-compulsive tendencies(-0.060, 95% CI: -0.117--0.005), and played a partial mediation between immature coping style and obsessive-compulsive tendencies(0.011, 95% CI: 0.001-0.027). Conclusion:Mature coping style negatively predict obsessive-compulsive tendencies through resilience, while immature coping style positively predict obsessive-compulsive tendencies through resilience.

3D printing navigation template-guided percutaneous radiofrequency thermocoagulation for V2 trigeminal neuralgia treatment / 华西口腔医学杂志

OBJECTIVE@#This paper aimed to evaluate the effectiveness of the 3D printing puncture navigation template-guided percutaneous radiofrequency thermocoagulation for V2 trigeminal neuralgia treatment.@*METHODS@#A total of 52 patients with V2 trigeminal neuralgia were treated with radiofrequency thermocoagulation. A total of 32 patients were treated under the guidance of the 3D printing puncture navigation template (guide plate group), while 20 patients underwent puncture via pterygopalatine fossa routinely (routine treatment group). The puncture time, operation time, puncture success rate, and immediate postoperative pain were recorded. The degree of immediate postoperative pain was indicated by visual analogue scale (VAS). Barrow Neurological Institute (BNI) classification criteria were used to evaluate the efficacy, and the postoperative complications were observed. All patients were followed up for 1 year.@*RESULTS@#The two groups showed significant decrease in VAS after the operation (P0.05).@*CONCLUSIONS@#3D printing puncture navigation template-guided radiofrequency thermocoagulation may increase the operation success rate and reduce complication incidence. Therefore, this technique possesses clinical promotional value.

Speculating the Conditions and Characteristics of Morbidity of "Warm Haze" Based on Pathogenic Properties of Haze and SARS / 中国中医药信息杂志

Although haze and severe acute respiratory syndrome (SARS) are different, they are not only both closely related to climate, but also take respiratory symptom as their main clinical manifestation when they play pathogenetic roles. Based on the comparative analysis of the pathogenic properties of haze and SARS, this article speculated the conditions and characteristics of the morbidity of "warm haze", a newly serious infectious disease which consists of haze combines abnormally warm climate that potentially occurs, as well as proposes related early warnings and measures in order to provide reference for TCM in preventing newly infectious diseases and inspire a new thinking of TCM in preventing diseases which consist of both climatic and environmental factors.

Therapeutic Observation of Warm Needling plus Chinese Medication for External Application in Treating Post-stroke Shoulder Pain / 上海针灸杂志

Objective To observe the clinical efficacy of warm needling plus Chinese medication for external application in treating post-stroke shoulder pain. Method Two hundred patients with post-stroke shoulder pain were randomized into a treatment group and a control group, 100 cases each. The two groups both received rehabilitation training for shoulder joint. In addition, the treatment group was given warm needling plus Chinese medication for external application, while the control group was given warm needling. Visual Analogue Scale (VAS) for pain, upper-limb Fugl-Mayer Assessment (FMA) and Modified Barthel Index (MBI) were adopted to evaluate the two groups before and after the treatment. The clinical efficacies of the two groups were also compared. Result The total effective rate was 100.0％ in the treatment group versus 87.0％ in the control group, and the between-group difference was statistically significant (P<0.01). The VAS, FMA and MBI scores were significantly changed after the treatment in both groups (P<0.01). After the treatment, the VAS, FMA and MBI scores of the treatment group were significantly different from those of the control group (P<0.05, P<0.01). Conclusion Warm needling plus Chinese medication for external application and rehabilitation training can obviously reduce post-stroke shoulder pain, and enhance the upper-limb motor function and activities of daily living.

A Multicenter, Randomized, Double-Blind, and Placebo-Controlled Study of the Effects of Tongxinluo Capsules in Acute Coronary Syndrome Patients with High On-Treatment Platelet Reactivity / 中华医学杂志(英文版)

<p><b>Background</b>High platelet reactivity (HPR) during clopidogrel treatment predicts postpercutaneous coronary intervention (PCI) ischemic events strongly and independently. Tongxinluo capsules (TCs) are a traditional Chinese medicine formulation used as antiplatelet treatment. However, its efficacy against HPR is not known. The aim of the present study was to evaluate the effects of TCs in acute coronary syndrome (ACS) patients with HPR.</p><p><b>Methods</b>This multicenter, randomized, double-blind, placebo-controlled study prospectively analyzed 136 ACS patients with HPR who underwent PCI. The patients were enrolled from November 2013 to May 2014 and randomized to receive placebo or TCs in addition to standard dual antiplatelet therapy (DAPT) with aspirin and clopidogrel. The primary end points were the prevalence of HPR at 30 days and the mean change in P2Yreaction units (PRUs) between baseline and 30 days. Survival curves were constructed with Kaplan-Meier estimates and compared by log-rank tests between the two groups.</p><p><b>Results</b>Both groups had a significantly reduced prevalence of HPR at 30 days versus baseline, but the TC group, compared with the placebo group, had greater reduction (15.8% vs. 24.8%, P = 0.013), especially among patients with one cytochrome P450 2C19 loss of function (LOF) allele (χ= 2.931, P = 0.047). The TC group also had a lower prevalence of HPR (33.3% vs. 54.2%, t = 5.284, P = 0.022) and superior performance in light transmittance aggregometry and higher levels of high-sensitivity C-reactive protein (hsCRP), but the composite prevalence of ischemic events did not differ significantly (χ= 1.587, P = 0.208).</p><p><b>Conclusions</b>In addition to standard DAPT with aspirin and clopidogrel, TCs further reduce PRU and hsCRP levels, especially in patients carrying only one LOF allele. The data suggest that TCs could be used in combination therapy for ACS patients with HPR undergoing PCI.</p>

Quantitative evaluation of inhibitory effects of epileptic spikes on theta rhythms in the network of hippocampal CA3 and entorhinal cortex in patients with temporal lobe epilepsy / 生理学报

Epileptic spike is an indicator of hyper-excitability and hyper-synchrony in the neural networks. The inhibitory effects of spikes on theta rhythms (4-8 Hz) might be helpful to understand the mechanism of epileptic damage on the cognitive functions. To quantitatively evaluate the inhibitory effects of spikes on theta rhythms, intracerebral electroencephalogram (EEG) recordings with both sporadic spikes (SSs) and spike-free transient period between adjacent spikes were selected in 4 patients in the status of rapid eyes movement (REM) sleep with temporal lobe epilepsy (TLE) under the pre-surgical monitoring. The electrodes of hippocampal CA3 and entorhinal cortex (EC) were employed, since CA3 and EC built up one of key loops to investigate cognition and epilepsy. These SSs occurred only in CA3, only in EC, or in both CA3 and EC synchronously. Theta power was respectively estimated around SSs and during the spike-free transient period by Gabor wavelet transform and Hilbert transform. The intermittent extent was then estimated to represent for the loss of theta rhythms during the spike-free transient period. The following findings were obtained: (1) The prominent rhythms were in theta frequency band; (2) The spikes could transiently reduce theta power, and the inhibitory effect was severer around SSs in both CA3 and EC synchronously than that around either SSs only in EC or SSs only in CA3; (3) During the spike-free transient period, theta rhythms were interrupted with the intermittent theta rhythms left and theta power level continued dropping, implying the inhibitory effect was sustained. Additionally, the intermittent extent of theta rhythms was converged to the inhibitory extent around SSs; (4) The average theta power level during the spike-free transient period might not be in line with the inhibitory extent of theta rhythms around SSs. It was concluded that the SSs had negative effects on theta rhythms transiently and directly, the inhibitory effects aroused by SSs sustained during the spike-free transient period and were directly related to the intermittent extent. It was indicated that the loss of theta rhythms might qualify exactly the sustained inhibitory effects on theta rhythms aroused by spikes in EEG. The work provided an argumentation about the relationship between the transient negative impact of interictal spike and the loss of theta rhythms during spike-free activity for the first time, offered an intuitive methodology to estimate the inhibitory effect of spikes by EEG, and might be helpful to the analysis of EEG rhythms based on local field potentials (LFPs) in deep brain.

Measles Outbreak in Pediatric Hematology and Oncology Patients in Shanghai, 2015 / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Despite substantial progress toward measles control are making in China, measles outbreaks in immunocompromised population still pose a challenge to interrupt endemic transmission. This study aimed to investigate the features of measles in pediatric hematology and oncology patients and explore the reasons behind the outbreak.</p><p><b>METHODS</b>We collected demographic, epidemiological, and clinical data of immunocompromised measles children. All suspected measles cases were laboratory-confirmed based on the presence of measles IgM and/or identification of measles RNA. The clinical data were statistically analyzed by t-test for continuous variables and Fisher's exact test for categorical variables.</p><p><b>RESULTS</b>From March 9 to July 25 in 2015, a total of 23 children with malignancies and post hematopoietic stem cell transplantation (post-HSCT) were notified to develop measles in Shanghai. Of these 23 patients with the median age of 5.5 years (range: 11 months-14 years), 20 (87.0%) had received 1-3 doses of measles vaccine previously; all patients had fever with the median fever duration of 8 days; 21 (91.3%) had cough; 18 (78.3%) had rash; 13 (56.5%) had Koplik's spot; 13 (56.5%) had complications including pneumonia and acute liver failure; and five (21.7%) vaccinated patients died from severe pneumonia or acute liver failure. Except the first patient, all patients had hospital visits within 7-21 days before measles onset and 20 patients were likely to be exposed to each other.</p><p><b>CONCLUSIONS</b>The outcome of measles outbreak in previously vaccinated oncology and post-HSCT pediatric patients during chemotherapy and immunosuppressant medication was severe. Complete loss of protective immunity induced by measles vaccine during chemotherapy was the potential reason. Improved infection control practice was critical for the prevention of measles in malignancy patients and transplant recipients.</p>

Effect and safety of rosuvastatin for prevention of contrast-induced acute kidney injury after percutaneous coronary intervention in patients with diabetes associated with mild-moderate renal insufficiency / 解放军医学杂志

Objective To explore the safety and efficacy of rosuvastatin on development of contrast-induced acute kidney injury (CIAKI) due to application of diuretic furosemide after coronary or peripheral vascular intervention during perioperative period in patients with diabetes mellitus (DM) associated with mild-moderate renal insufficiency (MMRI). Methods From Dec. 2008 to Oct. 2011, 2998 patients from 53 centers in China were enrolled in a TRACK-D project. Of them 650 patients with type 2 DM and concomitant MMRI, who received furosemide, were divided into rosuvastatin group (n=321) and control group (n=329), and all underwent coronary/peripheral arterial diagnostic angiography or left heart ventricular angiography. Patients in rosuvastatin group were treated by percutaneous intervention with rosuvastatin 10mg/d every evening for five days (two days before and three days after operation), while those in control group did not receive any statins before operation and within 72 hours after operation. Serum creatinine (Scr) was measured 48 hours before and 48 and 72 hours after exposure to contrast medium, and the incidence of CIAKI was simultaneously observed. Clinical follow-up of cardiovascular events was done at the 30th day after treatment, including heart function aggravation, all-cause mortality, renal dysfunction-induced dialysis and hemofiltration, etc. Results Baseline data were similar between the two groups. Patients randomized to the rosuvastatin group had a significantly lower incidence of CIAKI compared with controls (5.0% vs 9.7%, P=0.024). Clinical follow-up done at the 30th day after treatment indicated that there was no statistical difference in incidence of dialysis, hemofiltration and all-cause mortality between rosuvastatin group and control group. Conclusions Rosuvastatin may significantly reduce the risk of CIAKI in patients with DM associated with MMRI and receive the furosemide during the perioperative period.

Thrombin generation increasing with age and decreasing with use of heparin indicated by calibrated automated thrombogram conducted in Chinese / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Calibrated Automated Thrombogram(CAT) is a test to monitor the generation of thrombin. It can be described by four parameters: lag time, peak thrombin, endogenous thrombin potential (ETP) and time to peak (ttPeak). This study aims to determine the normal ranges of CAT parameters in Chinese, and evaluate whether thrombin generation is correlated with the concentration of heparin/low molecular weight heparin.</p><p><b>METHODS</b>Plasma from 120 healthy subjects were collected to determine the normal rangea of CAT parameters in Chinese. Normal plasma pool (NPP, n=25) spiked with different concentrations of heparin or enoxaparin were used to detecte CAT parameters. The overall and age specific normal ranges of CAT parameters were calculated using descriptive statistics method with mean±2SD. The correlation between CAT parameters and age or concentrations of heparin, enoxaparin were analyzed with linear regression model.</p><p><b>RESULTS</b>The normal ranges for lag time, peak thrombin, ETP, ttPeak in the subjects were 3.648±2.465 min, 367.39±151.93 nmol/L, 2277±1030 nmol/L•min and 6.372±4.280 min respectively. Age was linearly correlated with lag time (r=-0.6583, P<0.0001), peak thrombin (r=0.4863, P<0.0001), ETP (r=0.3608, P<0.0014) and ttPeak (r=-0.6313, P<0.0001). The values of ETP/peak ratio were linearly correlated with concentrations of heparin.</p><p><b>CONCLUSION</b>The normal ranges of four CAT parameters for Chinese were determined. CAT parameters are associated with age. ETP/peak ratio could be used to monitor the process of anticoagulation therapy.</p>

Inhibitory effects of epileptic spikes on theta rhythm in rat pilocarpine model of temporal lobe epilepsy / 生理学报

Epilepsy clinically has an inhibitory impact on cognitive function, but whether it is associated with epileptogenesis is unclear. Since the epileptic spike characterizes temporal lobe epilepsy (TLE), the present study was aimed to analyze the transient effects of sporadic spikes (SSs) on theta rhythm during epileptogenesis. The local field potentials (LFPs) were recorded in CA1 area in four rats with the pilocarpine injections during exploration, and theta phase stability and power were globally estimated around SSs, also during prolonged period without SS (both as experiments) as well as pre-injections (control). Finally, the LFPs were simulated by changing the average excitatory and inhibitory synaptic gain values (including slow and fast inhibition loops) with the help of simplified dynamical model of CA1 networks, and then theta phase stability was evaluated in several cases. It was found that the SSs could have negative impacts on theta rhythm both transiently and persistently, which may be dependent on the temporal courses leading to epilepsy, being acuter in early stage than later stage, but even in latent stage, theta power was strong. The simulations partly demonstrated that the synaptic imbalance concomitant with the occurrence of SSs might be related to the dynamics of theta phase stability. The results indicate that the SSs might have persistent negative impacts on the cognition rhythm, and the effects might alter during epileptogenesis, leading to the cognitive dysfunction.

Clinical characteristics and molecular epidemiology of the novel influenza A (H1N1) infection in children in Shanghai / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the epidemiological features, genetic drift in the epitopes of hemagglutinin (HA) of the novel influenza A (H1N1) virus and oseltamivir-resistant variants characterized by H275Y and N295S mutations in children in Shanghai since the outbreak.</p><p><b>METHOD</b>Between June 2009 and May 2012, a prospective surveillance study was carried out in Shanghainese children who attended the outpatient clinic of Children's Hospital of Fudan University for influenza-like illness. One-step real-time fluorescence quantitative RT-PCR was performed to detect seasonal influenza A and influenza B virus and the novel influenza A (H1N1) virus in the respiratory samples. Genetic drift from the vaccine strain in HA epitopes of the novel influenza H1N1 virus and the molecular markers associated with oseltamivir resistance in neuraminidase (NA) were analyzed.</p><p><b>RESULT</b>Out of 3475 enrolled cases, the novel influenza A (H1N1) virus was confirmed virologically in 222 (6.4%) otherwise healthy children with 133 (59.9%) being boys and 89 (40.1%) girls. The median ages of children with the novel influenza A (H1N1) virus infection during the first wave from August 2009 to February 2010 and the second wave from December 2010 to February 2011 were 53.5 months and 32.0 months, respectively (Z = -4.601, P = 0.000); 119 (46.9%) had the close contact with persons suffering from fever or respiratory infection, of whom, 68 (57.1%) contacts were family members and 47 (39.5%) contacts were classmates. During the outbreak in 2009-2010 season, 66 (40.9%) were exposed to primary index cases, school students were the major exposure subjects, accounting for 50.0%. The nucleotide sequences of HA1 gene were highly homologous between the vaccine strain A/California/07/2009 and Shanghai circulating novel influenza A (H1N1) strains and only S83P mutation in epitope E of HA was detected inclusively in the circulating strains. The H275Y and N295S amino acid mutations associated with oseltamivir resistance were not found in the circulating novel influenza (H1N1) strains.</p><p><b>CONCLUSION</b>Two major waves of the novel influenza A (H1N1) outbreaks occurred in Shanghainese children during 2009-2011. Institutional children were the major affected individuals during the 2009 pandemic wave. Households and schools were the main sites of transmission among children during influenza pandemic. Influenza vaccination should be enhanced in children and their close family contacts. The novel influenza A (H1N1) virus in Shanghai has not undergone significant genetic changes. Oseltamivir is effective for the treatment of the novel influenza A (H1N1) virus.</p>

Intervention impacts of self-confidence training on the self-esteem of patients with social anxiety disorder / 中华行为医学与脑科学杂志

Objective To explore the effect of self-confidence training on social anxiety and self-esteem of patients with social anxiety disorder.Methods 80 patients with social anxiety disorder were randomly divided into the study group and the control group.The study group was given the Self-confidence Training twice a week for five weeks and the control group was not given any training.Social Anxiety Subscale of the Self-Consciousness Scale and Self-Esteem Scale were used to evaluate the effect before the intervention and after the intervention for three months,six months.Results The social anxiety and self-esteem had significant differences between the two groups (F=20.422,P＜0.001 ; F=11.239,P=0.001),they had a tendency to change over time (F=120.080,P＜0.001 ; F=143.503,P＜0.001),and the role of the time factor was different between two groups (F=18.777,P ＜0.001 ; F =24.864,P＜0.001).Further pairwise comparisons revealed that the study group showed significantly decrease in social anxiety ((10.00 ± 3.05) vs (13.42 ± 2.76),(9.53 ± 3.72) vs (13.21± 2.48)) and improvement in score of self-esteem((28.75 ± 4.19) vs (24.27 ± 3.84),(29.50 ± 4.85) vs (24.15 ±3.55)) than control group on post-test and delayed-test (P＜0.001).Conclusion Self-confidence training can reduce social anxiety and improve self-esteem for patients with social anxiety disorder.

Profiles of innate immune receptors and cytokines in peripheral blood mononuclear cells in children with measles / 中华儿科杂志

<p><b>OBJECTIVE</b>The aim of this study was to explore the roles and clinical significance of innate immune receptors and cytokine in children with measles.</p><p><b>METHOD</b>The children with measles hospitalized in the department of infectious diseases, Children's Hospital of Fudan University during 2009-2011 were enrolled into measles group, while the healthy children examined in well baby clinic were enrolled into control group. The mRNA expression of TLR2/3/4/7, melanoma differentiation-associated gene-5 (MDA-5), retinoic acid-inducible gene I (RIG-I), IFN-α/β and IL-10 in peripheral blood mononuclear cells were detected by real-time PCR. The protein levels of IFN-α, IFN-β and IL-10 in plasma were measured using ELISA. SPSS 13.0 software was applied to analyze the difference between two groups.</p><p><b>RESULT</b>Data from a total of 98 patients in measles group and 59 children in control group were collected. The mRNA expressions of TLR2, MDA-5 and RIG-I had no statistical significance between two groups (P > 0.05, respectively). The relative mRNA expressions of TLR3, TLR4, TLR7 in measles group (2.25 ± 0.74, 2.05 ± 0.72, 2.12 ± 0.29) were significantly lower than those in control group (2.09 ± 0.78, 1.90 ± 0.75, 1.87 ± 0.68) (P < 0.01; respectively). Both IFN-α and IFN-β had significantly decreased mRNA expressions in measles patients (2.41 ± 1.31, 2.47 ± 1.26) compared with those in controls (2.22 ± 0.48, 2.35 ± 0.64)(P < 0.01 respectively); however, IL-10 mRNA levels significantly increased (2.49 ± 0.58 vs. 2.62 ± 0.95) (P < 0.001). The IL-10 levels in plasma in measles group were significantly higher during the whole period of fever [<5 d group: 29.89 (25.82-38.15) ng/L and ≥ 5 d group:34.55 (28.26-38.70) ng/L] than that in control group [25.15 (24.20-27.38) ng/L] (P < 0.05 respectively).</p><p><b>CONCLUSION</b>TLR3/4/7 mRNA expression was low in peripheral blood mononuclear cells of measles patients. Levels of IL-10 were significantly raised in the early stage after infection and lasted for a long time, and reduced IFN-α levels in plasma were associated with the fever durations of measles patients. These results indicated that multiple TLRs and cytokines may participate in the immune response after measles virus infection.</p>

The first confirmed pediatric case with H7N9 avian influenza virus infection in China / 中华儿科杂志

<p><b>OBJECTIVE</b>To understand the clinical and epidemiological aspects of avian influenza A (H7N9) virus infection in children.</p><p><b>METHOD</b>The clinical data of the first confirmed pediatric case of avian influenza A(H7N9) virus infection were collected, and the epidemiological information, presenting symptoms, laboratory investigation, management and outcome were analyzed. The data of the pediatric cases were also compared with those of the adults cases.</p><p><b>RESULT</b>The case reported in this paper was a previously healthy 3.6-year-old boy residing in rural area of Shanghai. He had onset of fever and mild rhinorrhea on 31 March 2013 and he was afebrile and well since April 3. Influenza A (H7N9) virus was detected in his nasopharyngeal sample collected on 1 April through national Influenza-like Illness surveillance using real-time reverse transcriptase PCR and virus culture.His family raised domestic poultry with no apparent disease and there was no virological evidence of H7N9 infection. Monitoring and testing of 16 contacts had not found any secondary infection.</p><p><b>CONCLUSION</b>The clinical course of H7N9 avian influenza virus infection in children was relatively mild as compared to adult cases. The source of infection and detail of exposure for children have not been known yet. Continued surveillance studies of mild and severe respiratory disease and subclinical infection are essential to further characterize the epidemiology and clinical spectrum of this emerging H7N9 virus infection in children.</p>

Clinical analysis of children with severe hand-foot-and-mouth disease in Shanghai / 中华儿科杂志

<p><b>OBJECTIVE</b>To retrospectively analyzed the clinical features and epidemiology of children with severe hand-foot-and-mouth disease during 2009 and 2010 in Shanghai to investigate some risk factors with fatal cases.</p><p><b>METHOD</b>All the clinical records and laboratory results of serious patients were collected. A retrospective study was performed.</p><p><b>RESULT</b>A total of 748 serious patients were enrolled into this study, and the ratio of male to female was about 1.7:1; 724 patients were categorized into stage 2 with 254 patients in 2009 and 470 in 2010; 24 patients were categorized into stage 3 with 17 in 2009 and 7 in 2010. The rate of severity in 2010 (1.5%) was lower than in 2009 (6.3%) (χ2=12.836, P<0.01). Seven patients of stage 3 died, with the fatality 29.2%, which was higher than in stage 2 (P<0.01). The children aged between 3 months 10 days to 12 years 9 months with onset median age of 25 months. Among them, 77.1% patients aged between 1 and 4 years which also accounted for 79.2% of the fatal cases (19/24). But there was no significant difference between the age and the severity (χ2=0.804, P>0.05). Fever (100%), vomiting (57.0%) and myoclonus jerk (62.3%) were the most frequent symptoms occurred in those serious cases. The average period of fever in children of stage 2 and 3 was (4.10±1.40) d and (5.05±1.05) d, respectively, which indicated significant difference between the two groups (t=3.173, P<0.05). The average values of white-blood-cell counts and blood glucose in fatal patients were (14.8±6.25)×10(9)/L and (8.63±3.51) mmol/L. They were higher when compared to those in stage 2 with the white-blood-cell counts of (11.8±4.23)×10(9)/L and blood glucose of (5.51±2.14) mmol/L (P<0.05). But there was no significant difference in C-reactive protein or cerebrospinal fluid white-blood-cell counts; A total of 182 patients were enrolled for MRI study during the acute stage with 37 (37/182, 20.3%) presented abnormal findings. Among them, most frequent findings were hyperintense lesions seen in brain stem (11 cases). A stage 3 case who died presented brain edema on MRI examination.</p><p><b>CONCLUSION</b>The epidemic of HFMD has some correlation with the area, season, health condition of the family and gender of the children. Children under 4 years of age especially those who lived in rural areas were susceptible to the HFMD. Frequent vomiting or myoclonus jerk may indicate the central nervous system involvement. But persistent high fever may indicate tendency to deteriorate. Some laboratory examinations can help find the fatal cases at an early time.</p>

Evaluation of the efficacy and prognostic factors for colorectal liver metastases treated with transcatheter arterial chemoembolization / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The aim of this study was to evaluate the therapeutic efficacy and to determine the prognostic factors of TACE in patients with colorectal liver metastases (CRLM).</p><p><b>METHODS</b>The clinical data of 183 patients with unresectable CRLM treated with TACE from Jan. 2002 to Dec. 2008 were retrospectively reviewed. Log-rank method was used for univariate analysis and Cox proportional hazard model was used for multivariate analysis of the prognostic factors.</p><p><b>RESULTS</b>The median survival time was 22 months, and the 0.5-, 1-, 2-, 3-, 5-year survival rates were 93.9%, 81.1%, 39.8%, 18.2%, and 3.9%, respectively. Multivariate analysis showed that tumor involved more than one lobe of the liver, and elevated CEA and CA19-9 levels were independent risk factors for the overall survival (P < 0.01). Females, more times of TACE, combination with regional therapy and received phase II resection were related with a good survival (P < 0.01) in CRLM patients after TACE treatment.</p><p><b>CONCLUSIONS</b>Transcatheter arterial chemoembolization is an effective therapy for unresectable colorectal liver metastases. Patients with tumor spread more than one lobe of the liver, high CEA and CA19-9 levels are independent poor prognostic factors. Females, patients received more times of TACE, combined with regional therapy and received phase II resection may have a good survival.</p>

99Tcm-MDP bone scan for the diagnosis of SAPHO syndrome / 中华核医学杂志

Objective To investigate the clinical value of bone scintigraphy for the diagnosis of synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome. Methods The characteristics of SAPHO syndrome on 99Tcm-MDP imaging of 8 cases were retrospectively analyzed. Results The 99TcmMDP bone scan was positive for all patients. Seven cases were found lesions in the costoclavicular region, 3cases involved with unilateral sacroiliac joint, 2 cases involved with spine and 1 patient with extremity. Four lesions were found without relevant clinical symptoms. Conclusion Bone scintigraphy is useful for the diagnosis of SAPHO syndrome, especially for those lesions with no clinical symptoms.

Detection of sarcoglycanopathy with 99Tcm-MIBI gated myocardial perfusion imaging / 中华核医学杂志

Objective To investigate the clinical value of 99Tcm-MIBI gated G-MPI in detecting the myocardial damage in sarcoglycanopathy.Methods 99 Tcm - MIBI G - MPI was performed in 8 patients (3 males,5 females,age ranged from 10 to 30 y) with sarcoglycanopathy confirmed by clinical results and molecular pathology and 4 healthy persons as control group.Quantitative gated SPECT (QGS) software was used for processing and interpretation.Myocardium of left ventricle was divided into 7 segments and 20 subsegments.A five-point scoring system was used to evaluate the myocardial damage.Results Seven patients showed positive results in G-MPI (7/8).Fifty-nine sub-segments of injured myocardium were detected in the 140 sub-segments of 7 abnormal patients.One abnormal segment was observed in 1 patient,two abnormal segments were detected in 2 patients,and ≥3 abnormal segments were observed in 4 patients.Enlarged left ventricles were detected in 5 patients (5/8),and the LVEF of 3 patients among them decreased to (43.1 ±2.8)％.Conclusion 99Tcm-MIBI G-MPI can detect myocardial damage in sarcoglycanopathy as a direct and non-invasive method,and can be used in the early diagnosis and long-term follow-up in sarcoglycanopathy.

Expression and clinical significances of hedgehog signaling pathway in non-Hodgkin's lymphoma / 中国实验血液学杂志

This study was aimed to investigate the expression and clinicopathologic significance of Gli1 and Gli2, 2 factors of Hedgehog(Hh) signaling pathway, in non-Hodgkin's lymphoma (NHL). Gli1 and Gli2 mRNA and protein in 18 cases of NHL and 10 cases of reactive lymphadenitis were amplified and identified by real-time PCR, and were assayed by immunohistochemical staining respectively. The results showed that (1) Gli1 and Gli2 mRNA in NHL group (RQ 2.05, 2.31) were expressed higher than that in reactive lymphadenitis group (RQ 0.82, 0.89). Gli1 mRNA activated level was positively related with Gli2 (r = 0.63, p < 0.01). In addition, Gli2 also positively correlated to clinical stages of NHL (p = 0.03), but the expressions of Gli1 and Gli2 mRNA had no significant correlation to B symptoms, blood β(2)-microglobulin, age and sex. (2) The positive expression rate of Gli1 and Gli2 protein in NHL group were 80% and 68% respectively, which were extremely higher than that in reactive lymphadenitis group. Gli1 protein level was positively related with Gli2 (r = 0.62, p < 0.05). Both Gli1 and Gli2 protein expression positively correlated to clinical staging of NHL (p = 0.05, p = 0.01). It is concluded that the Gli1 and Gli2 of Hh signaling pathway have been found to higher express in patients with NHL, and have significance for clinical staging and predicting prognosis of NHL. To further investigate the role of Hh signaling pathway in NHL will contribute to elucidate the occurrence and development of NHL, and provide a favorable method for therapy of NHL.