Observe Impact Modified Guipitang Administration Combined with Hot Pressing of Traditional Chinese Medicine on Rehabilitation in Patients with Deficiency of Qi and Blood Syndrome Breast Cancer Postoperative / 中国实验方剂学杂志

Objective:To observe the rehabilitation effect of modified Guipitang administration combined with traditional Chinese medicine （TCM） hot pressing in patients with deficiency of Qi and blood syndrome breast cancer postoperative， and investigate its effect on immune function and tumor markers. Method:One hundred and fifty-four patients were divided into observation group （77 cases） and control group （77 cases） by random number table. Two groups were given comprehensive treatment measures after operation. Patients in control group additionally took Bazhen granules orally， 8 g/time， 2 times/day， for eight weeks. Patients in observation group additionally took Guipitang orally for syndrome differentiation， 1 dose/day for eight weeks. The chest， shoulders and upper limbs of the affected side were hot-pressed with TCM， 20 min/time， 2 times/ day， 5 days a week， the first 4 weeks. The occurrence of lymphedema， subcutaneous fluid， poor skin flap growth， sleep disturbance， shoulder joint dysfunction， etc. Were recorded in both groups. Before and after treatment， the scores of European organization for research and treatment of cancer quality of life questionnaire core-30（EORTC QLQ-30）， and scores of cancer-induced fatigue and Qi and blood deficiency were graded. T lymphocyte subsets （CD3⁺， CD4⁺， CD8⁺ levels and CD4⁺/CD8⁺）， regulatory T cells （Treg）， inhibitory T cells （Ts）， cytotoxic T cells （Tc）， human growth differentiation factor 3 （GDF3）， serum carbohydrate antigen 153 （CA153）， carcinoembryonic antigen （CEA） and human epidermal growth factor -2 （HER-2） levels were detected before and after treatment. Result:After treatment， the observation group incidence of lymphedema， subcutaneous effusion， poor skin flap growth， sleep disturbance and shoulder joint dysfunction was 8（10.39%）， 9（11.69%）， 11（14.29%）， 25（32.47%） and 8 （10.39%） respectively in the observation group， all lower than 18（23.38%）， 20（25.97%）， 23（29.87%）， 46（59.74%） and 19（24.68%） in the control group（<italic>P</italic><0.05， <italic>P</italic><0.01）. The scores of overall quality of life and function scores in the observation group were higher than those in the control group （<italic>P</italic><0.01）， hile symptom score was lower than that in the control group （<italic>P</italic><0.01）. The scores of cancer-induced fatigue deficiency of Qi and blood syndrome in the observation group were lower than those in the control group （<italic>P</italic><0.01）. The Tc， CD3⁺， CD4⁺， CD4⁺/CD8⁺ levels in the observation group were higher than those of the control group （<italic>P</italic><0.01）， while the Treg， Ts， CD8⁺ levels were lower than those in the control group （<italic>P</italic><0.01）. The GDF3， CA153， CEA， HER-2 levels in the observation group were lower than those in the control group （<italic>P</italic><0.01）. Conclusion:On the basis of conventional comprehensive interventions of western medicine， Guipitang combined with TCM hot pressing for breast cancer patients after surgery can reduce postoperative complications， reduce fatigue， postoperative symptoms and TCM syndromes. Besides， it can enhance the immune function of the body， improve the quality of life， promote postoperative recovery， and inhibit the expression of tumor markers， thus improving the prognosis of patients.

Clinical efficacy of sticking-needle acupuncture plus tendon-regulating manipulation in the treatment of acute ankle sprain / 针灸推拿医学（英文版）

Objective: To explore the treatment effect of sticking-needle acupuncture plus tendon-regulating manipulation on pain, swelling and joint dysfunction due to acute ankle sprain.Methods: A total of 80 patients with acute ankle sprain were recruited and divided into a control group and a treatment group according to the random number table method, with 40 patients in each group. Both groups received the same conventional interventions. The control group was treated with additional tendon-regulating manipulation, and the treatment group was treated with tendon-regulating manipulation plus sticking-needle acupuncture. The pain, swelling and joint dysfunction of the ankle were observed in both groups before and after 3 d, 7 d and 14 d of treatment. Results: Before treatment, there was no statistically significant difference in the visual analog scale (VAS) score of pain between the two groups (P>0.05). After treatment, the VAS scores of both groups showed a decreasing trend over time, and the differences within the groups were statistically significant (P<0.05). After 3 d, 7 d and 14 d of treatment, the VAS scores in the treatment group were lower than those in the control group, with statistically significant differences (P<0.05). Before treatment, there was no statistically significant difference in the degree of swelling between the two groups (P>0.05). After treatment, the degrees of swelling in both groups showed a decreasing trend over time, and the differences within the groups were statistically significant (P<0.05). After 3 d and 7 d of treatment, the degrees of swelling in the treatment group were lower than those in the control group, with statistically significant differences (P<0.05). There was no statistical difference in the degree of swelling between the two groups after 14 d of treatment (P>0.05). Before treatment, there was no statistically significant difference in the American Orthopedic Foot Ankle Society (AOFAS) ankle-hindfoot scale score between the two groups (P>0.05). After treatment, the AOFAS ankle-hindfoot scale scores of both groups showed an increasing trend over time, and all the differences within the groups were statistically significant (P<0.05). After 3 d, 7 d and 14 d of treatment, the AOFAS ankle-hindfoot scale scores in the treatment group were higher than those in the control group, with statistically significant differences (P<0.05). Conclusion: Based on the routine intervention, the addition of sticking-needle acupuncture and tendon-regulating manipulation was better in alleviating pain and swelling and improving joint function in patients with acute ankle sprain than the addition of tendon-regulating manipulation alone.

"The Window Effect "of 1800MHz Electromagnetic Radiation on Oxidative Stress in Skin of SD Rats / 昆明医科大学学报

Objective To investigate the effect of 1 800 MHz electromagnetic radiation on activity of SOD and GSH－Px in the skin tissues of SD rats.Methods A total of 98 healthy SD rats with SPF level,aged 4 weeks, were randomly divided into radiation group and control group.The radiation group was totally exposed under 1 800 MHz electromagnetic wave with seven different power density of radiation of 0.1 mW/cm2,0.3 mW/cm2,0.5 mW/cm2 , 0.7 mW/cm2, 0.9 mW/cm2, 1.0 mW/cm2and 1.2 mW/cm2respectively.It lasted 21 days and for a period of 12 hours a day. After radiation,the activity of SOD and GSH－Px in the skin tissues were detected by enzyme marker. Results In radiation group,the activity of SOD and GSH－Px in the skin tissues of SD rats were decreased under 0.3 mW/cm2and 0.5 mW/cm21 800 MHz electromagnetic wave. Compared with the control group, there was a significantly difference in radiation group (P＜0.05) .While under other four 1 800 MHz electromagnetic waves, the activity of GSH－Px and SOD in the skin tissues showed no statistical difference between the two groups (P＞0.05) . Under 1 mW/cm21 800 MHz electromagnetic wave, the activity of GSH－Px showed no statistical difference between two groups (P＞0.05) . Conclusion The power density of 0.3 mW/cm2and 0.5 mW/cm21 800 MHz electromagnetic wave can reduce the activity of GSH－Px and SOD in the skin tissues of rats.

Experience and reference to China's trans-provincial healthcare from European cross-border healthcare management / 中国卫生政策研究

With the development of integration process, how to manage citizens' cross-border healthcare be-tween member countries in an organized way has become a major agenda for European Union (EU). Through great efforts over years,a well-functioning mechanism has been established by EU's social health insurance and has been of global interest. It's believed that China's trans-provincial healthcare management can learn a lot from this mechanism. This study aims to provide experiences and reference to China's trans-provincial healthcare management by overview EU's mechanism for cross-border healthcare and then analyzing the differences between China and European Union in terms of object of management,authorization,service institutions,types of healthcare services,and reimbursement of medical insurance in different places. This study suggests that it's necessary for each province to officially introduce relevant policies in order to speed up and facilitate the establishment of trans-provincial healthcare management mech-anism. Moreover,to achieve orderly seeking medical treatment, health insurance agencies should be endowed with approval power to authorize patient trans-provincial application. Meanwhile, the network of health institutions which are entitled to provide services to trans-provincial patients should be expanded. Along with such expansion,and given the lack of understanding on behaviors of health institutions in different provinces for a specific local health insurance agency,it's required that national trans-provincial healthcare management system should take an active role in putting such health institutions under supervision.

Effects of leukemia inhibitory factor receptor overexpression on stemness malntenance and lung metastasis in vivo of thyroid cancer stem cells / 中国组织工程研究

BACKGROUND: Thyroid cancer stem cells are essential to the recurrence and metastasis of thyroid carcinoma. Leukemia inhibitory factor receptor (LIFR) shows a downward trend in a variety of malignant tumors, and its overexpression can inhibit the recurrence and metastasis of malignant tumors. OBJECTIVE:To explore the effect of LIFR on the stemness maintenance and lung metastasis of thyroid cancer stem cells in vivo. METHODS: Primary thyroid cancer cells TCLM were isolated from the lung metastases of a metastatic thyroid cancer patient. Serum-free suspension culture was used to form tumor cell balls. Flow cytometry was used to screen CD133+phenotype of metastatic thyroid cancer stem cell subpopulation TCLM-S. The overexpressed recombinant lentiviral plasmid containing LIFR and its negative control containing the empty plasmid were infected into thyroid cancer stem cells TCLM-S at the ratio of virus/cell number=20, and screened with 2.0 mg/L puromycin to construct TCLM-SLIFRand TCLM-Scontrolstem cells which stably expressed LIFR and its control. Real-time quantitative PCR (qRT-PCR) was used to detect the expression of LIFR in TCLM-SLIFRand TCLM-Scontrolstem cells. Flow cytometry was used to detect the percentage of CD133+phenotype cell subsets, western blot assay was used to detect the expression of tumor stemness related factors SOX2, Oct4, Nanog and tumor invasion and metastasis related proteins E-cadherin, matrix metalloproteinase (MMP)-2, MMP-7 in TCLM-SLIFRand TCLM-Scontrol stem cells. TCLM-SLIFRand TCLM-Scontrolstem cells were respectively injected into BALB/c nude mice by tail vein, and the lung metastasis model of thyroid cancer stem cells was constructed. The effect of LIFR overexpression on lung metastasis was observed. RESULTS AND CONCLUSION: Compared with TCLM-Scontrolcells, the expression of LIFR in TCLM-SLIFRcells was significantly increased, the proportion of CD133+phenotype stem cell subsets was significantly decreased, the expression of SOX2, Oct4 and Nanog were significantly decreased, the expression of E-cadherin was significantly increased, and the expression of MMP-2 and MMP-7 was significantly decreased. Moreover, the number of lung metastasis in nude mice given TCLM-SLIFRcells was significantly decreased as compared with those given TCLM-Scontrol cells.To conclude,LIFR overexpression can decrease the stemness and ability of lung metastasis in vivo.

Intracranial malignant solitary fibrous tumor/hemangiopericytoma:a clinicopathologic analyses of 16 cases / 临床与实验病理学杂志

Purpose To investigate the clinicopathologic characteristics, diagnosis, differential diagnosis and prognosis of malignant solitary fibrous tumor/hemangiopericytoma ( SFT/HPC). Methods Sixteen cases of intracranial malignant SFT/HPC were retrospectively studied. The clinical data, imaging features, histopathological and immunohistochemical characteris-tics were analyzed. Results The 8 male and 8 female patients were between 31 and 71 years of age ( mean 51). The median age was 51 years (range, 31-71 years). 16 malignant SFT/HPC cases were originated from intracalvarium. The imaging features showed intracranial neoplasms with relatively clear surrounding boundaries. Microscopically spindle shaped cells were hypercel-lular, and exhibited≥5 mitoses per 10 HPF. Cytological atypia was mild. The clinicopathologic characteristics included pattern-less growth pattern, storiform or fascicular growth pattern, solita-ry fibrous tumor-like regions and hemangiopericytoma-like re-gions. Tnere were 2 cases with abundant papillary structure and 2 with sarcomatous structure, 2 with focal necrosis, 2 with inva-ded cerebral tissues, and 10 with invaded meninges. Immuno-histochemically, 93. 75% ( 15/16 ) cases were positive for STAT6, with 15/16 showing diffuse staining. 87. 5% (14/16) cases were positive for CD34, with 37. 5% (6/16) showing dif-fuse staining. 81. 25% (13/16) cases were positive for BCL-2. 68. 75% (11/16) cases were positive for CD99. The Ki-67 in-dex ranged from 5% to 40% . Sixteen patients were followed up for 1-64 months, and 7 patients ( 43. 75% ) had recurrences. Conclusion Malignant SFT/HPC shares malignant behaviours. STAT6 is a specific marker for the diagnosis of this tumor. The prognosis of malignant SFT/HPC is related to the extent of tumor excision and long-term follow-up.

Application of failure mode and effect analysis on reducing the unplanned extubation rates for patients with severe craniocerebral injury / 中国实用护理杂志

Objective To explore the effect of failure mode and effect analysis (FMEA) on reducing the unplanned extubation rates for patients with severe craniocerebral injury. Methods FMEA model was used to analyze the main reasons of unplanned extubation patients with severe craniocerebral injury, 7 failure modes with higher RPN scores was selected. The nursing intervention for the fixation of the catheter were improved. The control group with 181 cases of patients without FMEA application were given routine care. FMEA group owning 196 cases were given the optimization process. The incidence rate of unplanned extubation of two groups was compared. Results After improvement of the nursing process of patients with severe craniocerebral injury for fixing the catheter, the RPN of 7 failure modes was lowered. Compared with the control group, the total rate of unplanned extubation in FMEA group decreased to 1.1% (9/832), less than 5.1% (40/779) of the control group. The statistical difference was significant (χ2=22.410, P 0.05). Conclusions The FMEA model can be effective in reducing the rate of unplanned extubation .

Bacterial pathogenic characteristics of respiratory tract infection in children in Suzhou, China: an analysis of 14,994 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the bacterial pathogenic characteristics of respiratory tract infection in children.</p><p><b>METHODS</b>The medical data from 14,994 children with respiratory tract infection who were hospitalized in Children's Hospital Affiliated to Soochow University between November 2005 and October 2014 were retrospectively reviewed.</p><p><b>RESULTS</b>Among the 14,994 sputum samples from the children with respiratory tract infection, 3,947 (26.32%) had a positive bacterial culture. The most common bacterial pathogen was Streptococcus pneumonia (12.79%), followed by Haemophilus influenzae (5.02%) and Moraxella catarrhalis (2.91%). The bacterial detection rates differed significantly in different years and seasons and children of different ages (P<0.01). The children who had not taken antibacterial agents before admission had a significantly higher positive bacterial culture rate than those who had taken antibacterial agents (P<0.01). There were significant differences in the bacterial detection rate among the children with different course of disease (<1 month, 1-3 months and >3 months) (P<0.05). The detection rates of Streptococcus pneumonia, Moraxella catarrhalis and Acinetobacter baumannii showed an increased trend with a prolonged disease course (P<0.05).</p><p><b>CONCLUSIONS</b>Streptococcus pneumonia is the most common bacterial pathogen causing respiratory tract infection in children, followed by Haemophilus influenzae and Moraxella catarrhalis. The detection rate of bacterial pathogens varies in different years and seasons and children of different ages. The course of the disease and application of antibacterial agents outside hospital can affect the detection rate of bacterial pathogens in children with respiratory tract infection.</p>

Propofol ameliorates calpain-induced collapsin response mediator protein-2 proteolysis in traumatic brain injury in rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Collapsin response mediator protein-2 (CRMP2), a multifunctional cytosolic protein highly expressed in the brain, is degraded by calpain following traumatic brain injury (TBI), possibly inhibiting posttraumatic neurite regeneration. Lipid peroxidation (LP) is involved in triggering postinjury CRMP2 proteolysis. We examined the hypothesis that propofol could attenuate LP, calpain-induced CRMP2 degradation, and brain injury after TBI.</p><p><b>METHODS</b>A unilateral moderate controlled cortical impact injury was induced in adult male Sprague-Dawley rats. The animals were randomly divided into seven groups: Sham control group, TBI group, TBI + propofol groups (including propofol 1 h, 2 h, and 4 h groups), TBI + U83836E group and TBI + fat emulsion group. The LP inhibitor U83836E was used as a control to identify that antioxidation partially accounts for the potential neuroprotective effects of propofol. The solvent of propofol, fat emulsion, was used as the vehicle control. Ipsilateral cortex tissues were harvested at 24 h post-TBI. Immunofluorescent staining, Western blot analysis, and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling were used to evaluate LP, calpain activity, CRMP2 proteolysis and programmed cell death. The data were statistically analyzed using one-way analysis of variance and a paired t-test.</p><p><b>RESULTS</b>Propofol and U83836E significantly ameliorated the CRMP2 proteolysis. In addition, both propofol and U83836E significantly decreased the ratio of 145-kDa αII-spectrin breakdown products to intact 270-kDa spectrin, the 4-hydroxynonenal expression and programmed cell death in the pericontusional cortex at 24 h after TBI. There was no difference between the TBI group and the fat emulsion group.</p><p><b>CONCLUSIONS</b>These results demonstrate that propofol postconditioning alleviates calpain-mediated CRMP2 proteolysis and provides neuroprotective effects following moderate TBI potentially by counteracting LP and reducing calpain activation.</p>

Attenuation of cardiac ischemia/reperfusion injury by transient low hydroperoxide pretreatment in rat / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To investigate how transient low dose of hydroperoxide pretreatment prevents cardiac ischemia/reperfusion injury.</p><p><b>METHODS</b>SD rats were divided into 4 groups: sham operation (Sham), standard ischemia/reperfusion (I/R), ischemic preconditioning (IPC) and IR preceded by low H2O2 treatment. Cardiac function and injury parameter were compared among groups.</p><p><b>RESULTS</b>IPC protected reperfusion injury and improved cardiac function. Low H2O2 treatment played a role in cardioprotection similar to IPC. Low H2O2 was indeed generated in the early phase of simulated ischemia and attenuated cytochrome c release induced by high Ca2+ in isolated mitochondria.</p><p><b>CONCLUSION</b>Low H2O2 plays a critical role in cardioprotection probably by inhibiting mitochondrial permeability transition.</p>

Urinary tract infections in the neonatal intensive care unit: clinical analysis of 229 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical features, distribution of pathogens, drug susceptibility, and treatment effectiveness in neonates with urinary tract infection (UTI) and admitted to the neonatal intensive care unit (NICU).</p><p><b>METHODS</b>The clinical data of 229 neonates who developed UTI during their stay in the NICU were retrospectively studied.</p><p><b>RESULTS</b>The main clinical manifestations of these children included fever/irregular body temperature, refusing to milk feeding, jaundice, vomiting, diarrhea, poor weight gain, and lethargy. The top three pathogens were Escherichia coli, Enterococcus feces, and Klebsiella pneumoniae. Escherichia coli and Klebsiella pneumoniae were highly resistant to ampicillin and most cephalosporins (≥ 85%), and were highly sensitive to imipenem (100%), meropenem (100%), cefoperazone/sulbactam and piperacillin/tazobactam (>90%). Enterococcus feces were highly resistant to penicillin (100%), rifampicin (84%) and gentamicin (79%), but were sensitive to vancomycin.</p><p><b>CONCLUSIONS</b>The clinical manifestations of neonatal UTI are often atypical and manifested as systemic symptoms. The main pathogenic bacterium is Escherichia coli, and the isolation rate of enterococci can also be high. Most pathogenic bacteria are resistant to penicillin and cephalosporins, and therefore decision-making on drug administration must be based on the results of drug sensitivity tests.</p>

Comparative studies on the composition and antibiotic-resistance of pathogenic bacteria between children with community-acquired and hospital-acquired pneumonia / 中华预防医学杂志

<p><b>OBJECTIVE</b>This research was to explore the difference between children with community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) in the composition and antibiotic-resistance of pathogenic bacteria.</p><p><b>METHODS</b>241 CAP and 116 HAP with positive sputum culture who were hospitalized from January to December in 2008 in Children's Hospital Affiliated to Suzhou University were selected in this study. The bacteria were identified by traditionally manual method and antibiotic sensitivity tests were performed by K-B method. The chi-square or Fisher's exact test were used for statistical test.</p><p><b>RESULTS</b>In 241 CAP, Streptococcus pneumoniae and haemophilus influenza accounted for (42.2%, 106/251) and (12.4%, 31/251) infection, respectively; however in 116 HAP, Enterobacteriaceae and Non-fermenters accounted for (88.2%, 127/144). In addition, methicillin-resistant Staphylococcus aureus weren't isolated, however, its detection rate was 66.7% in HAP. The drug resistance was 1.5 times higher in HAP than that in CAP for several types of antibiotics, such as ceftazidime (37.5% (6/16) vs 75.6% (31/41)), cefepime (37.5% (6/16) vs 78.0% (32/41)), aztreonam (50.0% (8/16) vs 90.2% (37/41)), cefoperazone/sulbactam (12.5% (2/16) vs 51.2% (21/41)) and piperacillin/tazobactam (12.5% (2/16) vs 56.0% (23/41)). Klebsiella pneumoniae isolated from HAP had higher drug resistance than that isolated from CAP against some antibiotics, for example, gentamicin (0 vs 63.6% (7/11)), SMZ + TMP (20.0% (1/5) vs 63.6% (7/11)) and cefoperazone/sulbactam (0 vs 54.5% (6/11)). We also found Enterobacter cloacae isolated from HAP showed high drug resistance than that isolated from CAP against imipenem (0 vs 46.7% (7/15)), aztreonam (9.1% (1/11) vs 60.0% (9/15)) and cefoperazone (18.2% (2/11) vs 80.0% (12/15)) and Pseudomonas aeruginosa from HAP had higher resistance than that from CAP against gentamicin (0 vs 50.0% (9/18)), amikacin (0 vs 38.9% (7/18)), ceftazidime (0 vs 55.6% (10/18)), cefepime (0 vs 50.0% (9/18)) and cefoperazone (33.3% (2/6) vs 94.4% (17/18)). The detection rates of ESBLs for Escherichia coli were 84.6% (11/13) and 93.3% (14/15) in CAP and HAP, respectively (χ(2) = 0.553, P > 0.05); while for Klebsiella pneumoniae, they were 81.3% (13/16) and 95.1% (39/41), respectively (χ(2) = 2.767, P > 0.05).</p><p><b>CONCLUSION</b>CAP was mainly comprised of Streptococcus pneumoniae and haemophilus influenza; while HAP was mainly comprised of Enterobacteriaceae and Non-fermenters. The drug resistance of gram-negative bacilli was higher in HAP than that in CAP.</p>

Neonatal lupus erythematosus: a report of 7 cases and review of 87 cases of China / 中华儿科杂志

<p><b>OBJECTIVE</b>To acquire more knowledge about neonatal lupus erythematosus (NLE).</p><p><b>METHOD</b>Seven cases with neonatal lupus erythematosus who were seen in this hospital from 1990 to 2009 are reported in this paper and 87 cases reported previously from 1980 to now in China were reviewed. The clinical manifestations, serum autoantibodies, treatment and results of long-term follow-up are analyzed and summarized.</p><p><b>RESULT</b>Totally 94 cases were summarized. Male/female ratio was 48/46; 73 cases had skin rash; 23 had heart abnormality, among whom 13 had cardiac conductive problems including 8 cases of atrioventricular blockage (AVB) (3 degree I, 3 degree II and 2 degree III) and 5 cases of right bundle branch block cases (RBBB). Nine cases had anatomical abnormality including 5 cases of atrial septal defect (ASD), 2 cases of ventricular septal defect (VSD) and 2 cases of atrial enlargements. Forty-four cases had hematological problems including 28 with thrombocytopenia, 11 with leukocytopenia and 34 with anemia. Thirty cases had hepatic abnormality, including 24 liver dysfunction, 22 hepatomegaly, 6 splenomegaly and 3 cholestasis. Three cases had nephropathy; 3 had elevated creatine kinase; 2 had nervous disorder. Among the 94 cases, 86 (91.5%) were positive for anti-SSA, 51 (54.3%) anti-SSB, 16 anti-ds-DNA, 14 anti-U1-RNP, 13 anti-Sm (+), 6 anti-RNP and 4 anti-rRNP(+). Among the corresponding mothers, 39 cases (44.8%) were asymptomatic before pregnancy, 35 had SLE, 5 had SCLE, 3 had Sjogren syndrome, 2 had chilblain, photosensitivity and arthralgia, respectively, 1 had rheumatoid arthritis and 1 had psoriasis. During pregnancy, 8 mothers developed SLE. Totally 48 mothers (51.1%) suffered from LE. Together with 15 mothers who had transient skin rash during the pregnancy, there were 23 mothers (59%) who had new clinical manifestation among the 39 asymptomatic mothers. Twenty NLE cases accepted glucocorticoid treatment, 4 of them were treated with intravenous immunoglobulin. Sixty-eight cases were followed up for up to 12 years, 58 cases were healthy, 5 cases improved and 3 died. Two cases still had grade III AVB without pacemaker.</p><p><b>CONCLUSION</b>NLE is a rare acquired autoimmune disease. Although nearly half of the mothers were asymptomatic before pregnancy, more than half of them developed LE or other symptoms. The clinical presentations in Chinese cases include a transient rash, cardiac lesion while grade III AVB was rare, hematological changes and liver impairments which were common but not serious. Anti-SSA and/or anti-SSB were the most related autoantibody. Most patients with NLE have relatively good prognosis.</p>

Effects of amino acid substitutions of penicillin-binding proteins 2B, 1A, 2X on minimal inhibitory concentration of beta-lactams against Streptococcus pneumoniae / 中华儿科杂志

<p><b>OBJECTIVE</b>To observe the effect of amino acid substitution in conserved sequence of penicillin-binding protein (PBP) 1A, 2B, 2X on antimicrobial activity of beta-lactams against Streptococcus pneumoniae (SP).</p><p><b>METHOD</b>Minimal inhibitory concentration (MIC) of 6 beta-lactams was determined by the E-test in 59 SP strains. The penicillin-binding protein genes pbp1a, 2b, 2x in every SP strain were amplified by nested-polymerase chain reaction (nPCR), then the PCR products were sequenced using automatic genetic analyzer directly. To analyze the amino acid substitutions, the DNA sequences were converted to protein sequences and aligned by Clustalx software. According to amino acid substitution in conserved sequence of PBP2B, 3 phenotypes were observed, including: PBP2B phenotype I (no amino acid substitution); PBP2B phenotype II (Glutamine 432-->Leucine and/or Threonine 445/451-->Alanine/Serine, Glutamic 481-->Glycine, 1 strain had proline insertion between residues 431/432); PBP2B phenotype III (Alanine 624-->Glycine with the addition of phenotype II). According to amino acid substitution in conserved sequence of PBP1A, 3 phenotypes were observed, including: PBP1A phenotype I (no amino acid substitution); PBP1A phenotype II (Threonine 574-->Asparagine, Serine 575-->Threonine, Glutamine 576-->Glycine, Phenylalanine 577-->Tyrosine, 574TSQF-->NTGY); PBP1A III (Threonine 371-->Alanine/Serine, Proline 432-->Threonine with the addition of 574TSQF-->NTGY). According to amino acid substitution in conserved sequence of PBP2X, 4 phenotypes were observed, including: PBP2X phenotype I (no amino acid substitution); PBP2X phenotype II (Histidine 394-->Leucine or Threonine 338-->Alanine); PBP2X phenotype III (Threonine 338-->Alanine, Isoleucine 371-->Threonine, Arginine 384-->Glycine and Leucine 546-->Valine); PBP2X phenotype IV (Methionine 339-->Phenylalanine, Methionine 400-->Threonine with the addition of PBP2X phenotype III).</p><p><b>RESULT</b>Among 59 SP strains antibacterial activities distribution (sensitive strains, intermediate strains and resistant strains) of 6 beta-lactams were penicillin (12, 29, 18); amoxicillin(49, 9, 1); cefuroxime (16, 16, 27); ceftriaxone (47, 1, 11); cefotaxime (47, 3, 9); imipenem (49, 10, 0). beta-lactam antibiotics insensitive strains (intermediate + resistant strain) in PBP2B phenotype III, PBP1A phenotype III, PBP2X phenotype III and IV were significantly increased, the MIC(50) of these strains were significantly higher than that of the others.</p><p><b>CONCLUSION</b>The amino acid substitutions in or vicinal conserved sequence of PBP of SP increase MIC for beta-lactam antibiotics.</p>

Association between job stress and blood lipids among university staff in Yunnan province / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the association between job stress (effort-reward imbalance model)and blood lipids among university staff in Yunnan province.</p><p><b>METHODS</b>A cross-sectional survey was conducted among 1244 university staff in Yunnan province. The job stress was measured by the validated Chinese self-reported Effort-Reward Imbalance Questionnaire (ERI). Blood lipids were measured in all participated staff members.</p><p><b>RESULTS</b>After adjustment for relevant confounding factors, it was found that the risk of increased serum triglyceride was 3.5 folds higher in male staffs with high extrinsic effort compared those with low extrinsic effort (OR = 3.45, 95%CI: 1.32 - 9.04) while the risk of increased serum low density lipoprotein-cholesterol was 2.9 folds higher in male staffs with high overcommitment compared those with low overcommitment (OR = 2.86, 95%CI: 1.03 - 7.96). The risk of elevated serum triglyceride increased in proportion to increasing job stress: 3.5 folds increase in male staffs with moderate job stress (OR = 3.43, 95%CI: 1.24 - 9.53) and 4 folds increase in male staffs with high job stress (OR = 4.16, 95%CI: 1.42 - 12.17) compared those with low job stress. However, there was no significant association between job stress and lipid profile in female staffs.</p><p><b>CONCLUSION</b>Our results show that job stress (effort-reward imbalance) is positively associated with abnormal blood lipids in male university staffs.</p>

Influences of two different endolymphatic infusion ways to cochlear morphology and function in guinea pigs / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the influence of two different endolymphatic infusion ways on cochlear morphology and function.</p><p><b>METHODS</b>Forty healthy pigment guinea pigs (250 - 350 g) with normal Prey's reflex were divided into A and B group with 20 animals respectively. The right ears served as treated ears and the left ones as control ones. In group A, 5 microl of adenovirus 5-enhanced green fluorescence protein (Ad5-EGFP) suspension was infused into the scala media through an opened cochleostomy on the lateral wall of the scala media (LWS). In group B, the same volume of Ad5-EGFP suspension was infused into the scala media through punctured round window membrane and the basilar membrane (RBM). Cochlear morphology was examined under scan electric microscope and phalloidin staining was used to observe the hair cells in the infused ears after the animals were sacrificed. Auditory brainstem thresholds of the ears of all the animals were measured before and after treatment.</p><p><b>RESULTS</b>All the animals recovered well after operation. The holes on the lateral wall of the scala media and punctures on the round window membrane were healed completely. EGFP labeling appeared in the organ of Corti and lining wall of the stria vascularis indicated that adenovirus suspension was injected into the scala media using LWS (succeed in 14 animals accounted for 70%) and RBM (in 8 animals accounted for 40%) ways. Viruses were inoculated into the scala media with only locally inflammation reaction. In group A the hearing threshold decreased significantly in the treated ears compared with the control ears after the operation [(33.1+/-10.3) dB, (9.4+/-3.9) dB, F=46.34, P=0.0005]. However, in group B there was no significantly different between the treated ears and the control ears after the operation [(2.5+/-3.8) dB, (2.5+/-3.8) dB, F=0.00, P=1.000]. Phalloidin staining indicated that in group A the extension of hair cells loss was bigger than in group B. In some animals of two groups, EGFP labeling appeared in the extra-lymphatic system indicating that some of the injected suspension leaked out of the scala media.</p><p><b>CONCLUSIONS</b>Ad5-EGFP could be infused into the scala media through LWS or RBM and adenovirus could infect the lining cells of scala media and supporting cells in the basal membrane successfully without causing immunoreaction in the whole cochlea. LWS caused more hair cell loss and hearing loss than RBM. However, the cochlear morphology could be recovered completely after surgery. The positive inoculation rate was relatively higher that through LWS than that through RBM.</p>

Etiology of pneumonia in hospitalized patients less than 3 years of age / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To understand the etiology of pneumonia in hospitalized patients less than 3 years of age.</p><p><b>METHODS</b>A total of 316 children with pneumonia admitted to the Children's Hospital of Suzhou University in Jiangsu Province from March, 2006 to January, 2007 were enrolled in this study. Sputum samples were obtained by deep nasotracheal aspiration technique for bacterial and viral cultures.</p><p><b>RESULTS</b>Of the 316 samples, specific microbial etiology was obtained in 192 cases (60.8%). Bacterial infection was found in 162 cases (51.3 %), viral infection in 19 cases (6.3%)and compound infection with virus and bacteria in 11 cases (3.5 %). Haemophilus influenzae was the most common agent (46 cases; 14.6%) in bacterial infection, followed by Streptococcus pneumoniae (32 cases; 10.1%). Respiratory syncycial virus (RSV) was the most common agent (12 cases; 4.0%) in viral infection, followed by adenovirus (11 cases; 3.6%).</p><p><b>CONCLUSIONS</b>Bacterial infection was a leading cause of pneumonia in children less than 3 years of age in Suzhou area. Haemophilus influenzae was the most common agent, followed by Streptococcus pneumoniae.</p>

Metabolism-based interaction of diphenytriazol and flavone compounds / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To observe the metabolism-based interaction of diphenytriazol and flavone compounds.</p><p><b>METHODS</b>Flavone compounds kaempferol, isoharmnten and Elsholtzia blanda benth extract were chosen as the substrate of glucuronidation in the phase II metabolism. The metabolism was investigated in different rat liver microsome incubates pretreated with beta-naphthoflavone (BNF), diphenytriazol and tea oil (control). The concentrations of residual substrate were determined by HPLC. Quercetin and kaempferol were coincubated with diphenytriazol in control microsome to evaluate the inhibition for phase I metabolism. The concentration of diphenytriazol was determined by HPLC.</p><p><b>RESULT</b>The phase II metabolic activity of kaempferol, isoharmnten and Elsholtzia blanda benth extract in diphenytriazol-treated microsome was more potent than that in BNF-treated microsome (P<0.01). The phase I metabolism of diphenytriazol was markedly inhibited by quercetin and kaempferol, with the inhibition constants (Ki) (12.41 +/-0.26)microg . ml(-1) and (7.97 +/-0.08)microg . ml(-1), respectively.</p><p><b>CONCLUSION</b>Diphenytriazol demonstrates metabolism-based interaction with flavone compounds in vitro.</p>

Multicentric prospective randomized controlled study of efficacy of mannitol,furosemide and albumin in reducing intracranial pressure in patients with severe brain injury / 中华创伤杂志

Objective To compare the effect of difierent combinatio of mannitol, furesemide and albumin in reducing intracranial pressure in 451 patients with severe traumatic brain injury (sTBI). Methods A total of 451 patients with an admissiou Glasgow Coma Scale of or less from 5 medical centers were randomly divided into 5 groups, ie, Group A(250 ml 20% mannitol each time as control), Group B(125 ml 20% mannitol each time), Group C(alternate use of 250 ml 20% mannitol each time or 40 mg furosemide), Group D(alternate use of 125 ml 20% mannitol each time and 20 mg furosemide)and Group E(alternate use of 125 ml 20% mannitol and moderate or large dose of albumin). We monitored intracraniai pressure continuously and observed the changes of intracranial pressure, electrolytes, hemato-crit and renal function after use of 5 combinations of mannitol. Furosemide and albumin. Results Man-nitol and furosemide could independently reduce intracranial pressure after 1-3 hours (P<0. 05). Semis mannitol plus furosemide or albumin could more signifieantly reduce intracranial pressure, with statistical difference compared with full dose of mannitol. Semis mannitol and alternate use of mannitol and furose-mide in aspect of intracranial pressure reduction and persistence time(P<0. 05). Alternate use of man-nitol and furosemide begot higher incidence rate of electrolyte abnormality, compared with the other com-binations (P<0. 05). Rebound rate of intracranial pressure was higher in full dose of mannitol than other combinations (P<0. 05). Incidence of renal function abnormality was higher in combination involved al-bumin than alternative use of mannitol and furosemide as well as combination of semis mannitol and furo-semide (P<0. 05). Abnormality of electrolyte and renal function wag reversible. Conclusion The use of 125 ml 20% mannitol each time plus 20 mg furesemide is more reasonable than other combina-tions. Meanwhile, semis mannitol combined with moderate or large dose of albumin has certain advantages too.

Investigation and analysis of anxiety in relatives of patients with severe brain injury at acute period / 中国基层医药

Objective To investigate the anxiety in the relatives of patients with severe brain injury at acute period and discuss the effective solving pathway.MethodsA questionnaire-based survey was conducted in 120 relatires of patients with severe brain injury during March 2006 to March 2007 by using state-trait anxiety inventory (STAI).Results Comparison of anxiety score between relatives of patients and normals,the scores of state anxiety and trait anxiety in the relatives of patients[(52,40±8.42),(46.73±7.56)]were significantly higher than those in normal people[(38.97±8.45),(41.31±7.54),P＜0,01].And between relatives of man and woman,the Scores of state anxiety and trait anxiety in the relatives of patients in female were significantly higher than those in male ones(P＜0.01).The scores of state anxiety and trait amv,iety in the 51～65 old group were significantly higher than ihosein 31～50 old group and 17～30 old group(P＜0.01).The scores of state anxiety and trait anxiety in the little educated group were significantly higher than that higher educated group(P＜0.05,P＜0.01),and higher in those having self-medical service than in those having public medical service.The scores for,mate is signkfigantly higher than that other roles(all is P＜0.05).Conclusion The relatives of patients with severe brain injury have anxiety of different degrees.Medical staff should pay attention to the relatives anxiety,and so to better the relationship of medical staff and patient