Coronary arteriography under acupuncture anesthesia:a case report / 针灸推拿医学（英文版）

Acupuncture anesthesia is a technique by partially or completely replacing anesthetics with acupuncture in surgery based on the traditional acupuncture analgesia mechanism.It emerged in the 1950s,went viral in the 1970s and then gradually fell into decline.In the recent years,this technique has regained attention and further research.Acupuncture anesthesia can be classified as either pure acupuncture anesthesia or acupuncture-medication combined anesthesia.To expand the application of this technique,a patient with non-ST elevation acute coronary syndrome in urgent need of percutaneous coronary intervention (PCI) received pure acupuncture anesthesia because of an allergy to lidocaine,and the operation went successfully.This is the first time that pure acupuncture anesthesia and coronary arteriography were combined,which is of great significance in further study and development of acupuncture anesthesia.

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>

Geinsten inhibits the proliferation of VCaP castration-resistant prostate cancer cells / 中华男科学杂志

<p><b>Objective</b>To explore the inhibitory effect of genistein (GEN) on the proliferation of VCaP castration-resistant prostate cancer (CRPC) cells.</p><p><b>METHODS</b>VCaP CRPC cells were treated with GEN at the concentrations of 0, 12.5, 25, 50, 100, and 200 μmol/L for 24, 48, and 72 hours followed by determination of their proliferation by CCK-8 assay and their cycle by flow cytometry. The expression of Ki-67 in the cells was detected by immunocytochemistry and the levels of PSA, Cyclin D1, PCNA, and P53 determined by Western blot.</p><p><b>RESULTS</b>After 72 hours of treatment with GEN at 12.5, 25, 50, 100, and 200 μmol/L, the inhibition rates of the VCaP cells were (25.38±0.02)%, (31.14±0.29)%, (45.27±0.03)%, (52.19±0.05)%, and (68.21±0.19)%, respectively, all significantly higher than in the 0 μmol/L group (［10.08±0.02］%)(P<0.05). GEN caused the arrest of the VCaP cells in the G2/M phase (P<0.05) and inhibited the expression of Ki-67. The expressions of PSA, Cyclin D1, and PCNA were gradually down-regulated while that of P53 up-regulated with the increased concentration of GEN (P<0.05).</p><p><b>CONCLUSIONS</b>GEN inhibits the proliferation of VCaP CRPC cells by arresting the cell cycle with related protein expression changes.</p>

Variation analysis on serum uric acid level in hypertention with target organ damage / 上海预防医学

Objective To investigate the changes of the level of serum uric acid ( SUA ) in hypertension patients with target organ damage and its clinical significance. Methods From January 2013 to December 2014,a series of 1320 cases of primary hypertension in our hospital were included as a case group.According to the cases with or without target damage, they were allocated into two groups:organ damaged and organ non-damaged,with 100 healthy cases as control group.The SUC levels deteced were compared between the groups. Results Of the 1320 cases with target organ damage, 1091 cases (82.65%) were found to have level of SUA significantly higher than that in control group (P<0.05);SUA level in organ damaged group was higher than that in non-damaged group ( P<0 .05 );SUA level in cases with 3 or more target organs damage was significantly higher than that in cases with 1 and 2 target organs damage(P<0.05),indicating a significant positive correlation.The age of hypertensive patients,and their SUA TC,TG,LDL-C,BUN,Cr,FBG,LVMI,SBP,DBP(r>0, P<0.05), were positively correlated with SUA, which was significantly negatively correlated with HDL-C (r<0, P<0.05).Multivariate logistic regression analysis showed that the hypertension course(OR=5.669), SBP(OR=4.323),DBP(OR=4.215),LVMI(OR=4.323),SCR(OR=4.215) and target organ damage(OR=7.145) all had remarkable impact with SUA levels in patients ( P <0.05 ) . Conclusion The level of SUA in hypertension is generally elevated and closely related with target organ damage and glucolipid metabolic disorder, and the course of hypertension.

Establishment of a rotary aerobic culture system for in vitro culture of mouse testis / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish an in vitro model of cultured mouse testis using rotary aerobic culture.</p><p><b>METHODS</b>Rotary aerobic incubation with optimized culture conditions was used for in vitro culture of mouse testis, and the morphology of the cultured testicular tissues was compared with that cultured in Transwell chambers. The changes in the testicular tissue structure were examined using HE staining, and the cell proliferation was assessed with BrdU staining. Testosterone concentrations in the culture medium were tested with radioimmunoassay and the expression of the functionally related proteins in the testis was detected using immunohistochemistry.</p><p><b>RESULTS</b>The testicular tissue cultured by optimized rotary aerobic culture presented with more intact histological structure with the size of the testis ranged from 0.3 to 0.8 mm(3). In the two culture systems, the prolifeation index of the spermatogonia increased and that of Sertoli cells decreased with time, and such changes in spermatogonia and Sertoli cell proliferation indices became statistically significant at 3 days (P<0.05) and 5 days (P<0.05) of culture, respectively, as compared with those at 1 day. The concentration of testoerone in the culture media decreased significantly with incubation time (P<0.05). At 3 days of culture, the protein expression of 3β-hydroxysteroid dehydrogenase, cytochrome P450 17α-hydroxylase and cholesterol side-chain cleavage enzyme was detected in Leydig cell cytoplasm and vimentin expression in Sertoli cell cytoplasm.</p><p><b>CONCLUSION</b>An in vitro model of cultured mouse testis has been successfully established using rotary aerobic incubation.</p>

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>

All-transretinoic acid regulates Th1/Th2 balance in CD4+ T cells when GATA-3 is deficient / 生物医学与环境科学（英文）

The essential effect of vitamin A on immune function occurs through various mechanisms including direct effect on Th1-Th2 balance modulation. However, it is unclear whether or not vitamin A can regulate Th1-Th2 balance under a strong Th1-polarizing condition. Therefore, the purpose of our study was to examine the effect of vitamin A metabolite all-trans retinoic acid (ATRA) on Th1-Th2 differentiation in CD4+ T cells under GATA-3 deficiency, which can induce Th1-polarizing condition. In the present study, GATA-3 deficiency T cells were induced by siRNA and checked by real-time quantitative PCR and western blot. GATA-3 deficiency CD4+ T cells and normal CD4+ T were treated for 48 h with or without ATRA. The expression of Th1 and Th2 cytokines were detected by qPCR and ELISA. The results would contribute to clarify the knowledge of the role of vitamin A in regulating Th1-Th2 balance under some special conditions, and help to explain the mechanism of immune regulatory function of vitamin A.

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>

Mortality and morbidity of acute hypoxemic respiratory failure and acute respiratory distress syndrome in infants and young children / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Acute hypoxemic respiratory failure (AHRF) often develops acute respiratory distress syndrome (ARDS), and its incidence and mortalities in critically ill pediatric patients in China were 2% and 40% respectively. This study aimed at prospectively investigating incidence, causes, mortality and its risk factors, and any relationship to initial tidal volume (V(T)) levels of mechanical ventilation, in children £5 years of age with AHRF and ARDS.</p><p><b>METHODS</b>In 12 consecutive months in 23 pediatric intensive care units (PICU), AHRF and ARDS were identified in those requiring > 12 hour intratracheal mechanical ventilation and followed up for 90 days or until death or discharge. ARDS was diagnosed according to the American-European Consensus definitions. The mortality and ventilation free days (VFD) were measured as the primary outcome, and major complications, initial disease severity, and burden were measured as the secondary outcome.</p><p><b>RESULTS</b>In 13 491 PICU admissions, there were 439 AHRF, of which 345 (78.6%) developed ARDS, resulting in incidences of 3.3% and 2.6%, and corresponding mortalities of 30.3% and 32.8% respectively along with 8.2 and 6.7 times of relative risk of death in those with pneumonia (62.9%) and sepsis (33.7%) as major underlying diseases respectively. No association was found in V(T) levels during the first 7 days with mortality, nor for V(T) at levels < 6, 6 - 8, 8 - 10, and > 10 ml/kg in the first 3 days with mortality or length of VFD. By binary Logistic regression analyses, higher pediatric risk of mortality score III, higher initial oxygenation index, and age < 1 year were associated with higher mortality or shorter VFD in AHRF.</p><p><b>CONCLUSIONS</b>The incidence and mortalities of AHRF and ARDS in children £5 years were similar to or lower than the previously reported rates (in age up to 15 years), associated with initial disease severity and other confounders, but causal relationship for the initial V(T) levels as the independent factor to the major outcome was not found.</p>