Níveis mais Baixos de Fetuína-A Sérica estão Associados a um Maior Risco de Mortalidade em Dez Anos em Pacientes com Infarto do Miocárdio por Supradesnivelamento do Segmento ST / Lower Serum Fetuin-A Levels are Associated with a Higher Ten-Year Mortality Risk in Patients with ST-Elevation Myocardial Infarction

Resumo Fundamento A fetuína-A é um fator anti-inflamatório e anticalcificação envolvido no curso da doença arterial coronariana (DAC). Em alinhamento com essas funções, investigou-se a fetuína-A como marcador de risco cardiovascular em vários estudos. Porém, a associação entre a fetuína-A e o prognóstico dos pacientes com DAC ainda é controversa. Objetivos O presente estudo foi conduzido para identificar a associação entre o nível de fetuína-A sérica e doença cardiovascular (DCV) de longo prazo e a mortalidade global por infarto do agudo do miocárdio por supradesnivelamento do segmento ST (STEMI). Métodos Foram cadastrados no estudo cento e oitenta pacientes consecutivos com STEMI. A população do estudo foi dividida em subgrupos (mais baixo, ≤288 µg/ml; e mais alto, >288 µg/ml) de acordo com a mediana do nível de fetuína-A. Dados de acompanhamento clínico foram obtidos por contato telefônico anual com pacientes ou familiares. As causas das mortes também foram confirmadas pelo banco de dados de saúde nacional. P-valores bilaterais <0,05 foram considerados estatisticamente significativos. Resultados Durante um acompanhamento médio de 10 anos, foram registradas 71 mortes, das quais 62 foram devidas a DCV. Identificou-se um índice de mortalidade global e por DCV significativamente mais alto no grupo com nível de fetuína-A mais baixo que no grupo com nível de fetuína-A mais alto (44% versus 24%, p= 0,005; 48% versus 31%, p= 0,022, respectivamente). Nas análises de risco proporcionais por regressão de Cox, detectou-se que a fetuína-A era um preditor independente de mortalidade global e por DCV. Conclusões A baixa concentração de fetuína-A está associada ao prognóstico de longo prazo ruim pós-STEMI, independentemente de fatores de risco cardiovascular tradicionais. Nossos achados fortaleceram estudos prévios demonstrando consistentemente o papel determinante dos mediadores anti-inflamatórios em síndromes coronárias agudas.

Abstract Background Fetuin-A is an anti-inflammatory and anti-calcification factor involved in the course of coronary artery disease (CAD). In line with these functions, fetuin-A has been investigated as a cardiovascular risk marker in many studies. However, the association between fetuin-A and the prognosis of CAD patients is still controversial. Objectives The present study was conducted to identify the association between serum fetuin-A level and long-term cardiovascular disease (CVD) and all-cause mortality of ST-elevation acute myocardial infarction (STEMI). Methods One hundred eigthy consecutive patients with STEMI were enrolled in the study. The study population was divided into subgroups (lower, ≤288 µg/ml; and higher, >288 µg/ml) according to the median fetuin-A level. Clinical follow-up data was obtained by annual contact with the patients or family members by telephone. The causes of death were also confirmed by the national health database. Two-sided p-values<0.05 were considered statistically significant. Results During a median follow-up of 10 years, 71 deaths were recorded , 62 of whom died from CVD. Both CVD and all-cause mortality were found to be significantly higher in the lower fetuin-A group than the higher fetuin-A group (44% vs 24%, p= 0.005; 48% vs 31%, p= 0.022, respectively). In Cox regression proportional hazard analyses, fetuin-A was found to be an independent predictor of CVD and all-cause mortality. Conclusions Low fetuin-A concentration is associated with a poor long-term prognosis after STEMI, regardless of the traditional cardiovascular risk factors. Our findings have strengthened previous studies that consistently demonstrate the determining role of anti-inflammatory mediators in acute coronary syndromes.

Síndrome inflamatorio multisistémico asociado a COVID-19 en niños: serie de casos en un hospital pediátrico de Perú / COVID-19-associated multisystem inflammatory syndrome in children: case series at a pediatric hospital in Peru

RESUMEN La pandemia de COVID-19 ha traído una nueva afección grave e inusual denominada Síndrome Inflamatorio Multisistémico en niños, de la cual aún hay mucho por conocer. Presentamos una serie de 8 casos atendidos en el Instituto Nacional de Salud del Niño, Lima Perú. La edad media fue 5,1 años. La presentación clínica incluyó fiebre, problemas gastrointestinales agudos, afectación ocular y mucocutánea. Cuatro cumplieron criterios para Enfermedad de Kawasaki clásica. Todos tuvieron serología positiva para SARS-CoV-2, hemograma patológico, marcadores inflamatorios elevados y pruebas de coagulación alteradas. Cinco casos presentaron hipertransaminasemia y tres retención nitrogenada. Cuatro casos cumplieron criterios para Síndrome de Activación Macrófagica. Todos recibieron inmunoglobulina intravenosa, corticoides y ácido acetil salicílico. Ninguno desarrolló aneurismas coronarios. Solo uno presentó miocarditis, shock y requirió ingreso a Unidad de Cuidados Intensivos. La mayoría evolucionaron favorablemente. En todo niño con fiebre, síntomas gastrointestinales y dermatológicos; asociado a exposición al SARS-CoV-2, debe investigarse compromiso multisistémico.

ABSTRACT During the COVID-19 pandemic, a new, severe and unusual condition called Multisystem Inflammatory Syndrome in children emerged, from which there is still much to learn. We report 8 children admitted to Instituto Nacional de Salud del Niño, in Lima, Perú. Their mean age was 5,1 years. Their clinical presentation included fever, acute gastrointestinal symptoms, ocular and mucocutaneous involvement. Four patients met criteria for classic Kawasaki Disease. All the patients had positive serology for SARS-CoV-2, abnormal complete blood counts and coagulation tests, and elevated inflammatory markers. Five had elevated liver enzymes and three had kidney involvement. Four patients met criteria for Macrophage Activation Syndrome. All of them received intravenous immune globulin, corticosteroids and aspirin. No coronary aneurysms were identified. Only one developed miocarditis, shock and was admitted to the Pediatric Intensive Care Unit. Most patients recovered successfully. Every child with fever, gastrointestinal and dermatological symptoms, associated with prior exposure to SARS-CoV-2, should be investigated for multi-systemic compromise.

Ascorbate Effect of Lithium on Protein and Lipid Metabolism in Pigs

The aim of the study was to investigate the effect of a new anti-stress drug on protein and lipid metabolism in thecultivation and fattening of pigs. The experiment was carried out on 5 groups of pigs of Irish Landrace breed (4experimental and 1 control) with 10 heads in each in the period from 60 to 210 days of age. Animals of 1, 2, 3and 4 experimental groups daily during the entire period of rearing and fattening received lithium ascorbate inthe form of powder at a dose of 10, 5, 2 and 0.5 mg/kg of live weight, respectively. Weighing was carried outbefore the introduction of the drug, for the 4th month and before slaughter. Before setting the animals in theexperiment and on the 180th day of the experiment, blood samples were taken. Triacylglycerols, total protein andglobulins, and fractions of lipoproteins were determined in blood plasma. Acting on protein and lipid metabolism,lithium ascorbate activates the functions associated with the participation of α-, β - globulins in the transport oflipids, as well as in the performance of γ-globulins protective functions. Lithium ascorbate has a positive effecton lipid-cholesterol metabolism and, as a result, contributes to the increase in live weight and quality of meat.With the introduction of feed lithium ascorbate from the 60th day prior to slaughter at a dosage of 10, 5 and 2mg/kg of body weight, lithium ascorbate exhibits a pronounced adaptogenic and stress-protection properties,prevents the accumulation of lipoproteins of low and very low density and activates the production of high-densitylipoproteins. And in the control animals, it is is observed in the reverse reaction. The use of lithium ascorbateaffects protein synthesis. Given that γ-and β-globulins serve as raw materials for the production ofimmunoglobulins, it can be noted that the animals treated with lithium ascorbate had the best opportunities forhumoral specific protection for 180 days of experience, which contributes to the increase of nonspecific immunityand resistance. The revealed effects of lithium ascorbate indicate the prospects for the development of neweffective ways to increase stress resistance, nonspecific resistance and productivity of animals using drugs basedon organic lithium salts.

A clustering analysis based on clinical laboratory indications of patients with bunyavirus infection / 中国基层医药

Objective@#To execute a hierarchical cluster of clinical laboratory indicators in patients with bunyavirus infection.@*Methods@#From July 2015 to July 2017, 14 patients with bunyavirus infection in Zhoushan Hospital were selected.The blood routine, coagulation function and biochemical indicators were detected.Cluster analysis and grouping were carried out by hierarchical clustering method.@*Results@#Hierarchical clustering classification was eventually divided into 2 cases of A category[with TT high and BNP high as the main characteristics(TThighBNPhigh)] and 12 cases of B category[with TT low and BNP low as the main characteristics (TTlowBNPlow)]. The days of hormone drugs and dosage of hormone drugs in A category were (7.43±3.53)d, (489.19±173.02)mg, respectively, which were higher than those in B category[(5.20±1.03)d and (115.11±46.58)mg], the differences were statistically significant(t=2.76, 55.56, all P<0.05).@*Conclusion@#It needs probably to pay more days and dose of hormonal drugs for patients with TThighBNPhigh.

A clustering analysis based on clinical laboratory indications of patients with bunyavirus infection / 中国基层医药

Objective To execute a hierarchical cluster of clinical laboratory indicators in patients with bunyavirus infection.Methods From July 2015 to July 2017,14 patients with bunyavirus infection in Zhoushan Hospital were selected.The blood routine, coagulation function and biochemical indicators were detected.Cluster analysis and grouping were carried out by hierarchical clustering method.Results Hierarchical clustering classifica-tion was eventually divided into 2 cases of A category[with TT high and BNP high as the main characteristics (TThigh-BNPhigh)] and 12 cases of B category[with TT low and BNP low as the main characteristics (TTlowBNPlow)].The days of hormone drugs and dosage of hormone drugs in A category were (7.43 ±3.53)d,(489.19 ±173.02) mg, respectively,which were higher than those in B category [(5.20 ±1.03)d and (115.11 ±46.58)mg],the differences were statistically significant (t＝2.76,55.56,all P＜0.05).Conclusion It needs probably to pay more days and dose of hormonal drugs for patients with TThighBNPhigh.

Lupus eritematoso sistémico en actividad y cociente albúmina/globulina invertido, ¿hallazgo propio de la enfermedad? / Systemic Erythematosus Lupus and Albumin-Globulin Index, a specific finding in lupus flares?

Introducción: El lupus eritematoso sistémico es el modelo clásico de enfermedad autoinmune. En el desarrollo de la enfermedad intervienen varios tipos de inmunoglobulinas, con predominio de la IgG, IgM e IgA. Objetivo: Describir la utilidad del cociente albúmina/globulina como un indicador de actividad en el lupus eritematoso sistémico. Desarrollo: Se estima que el 50 por ciento de los pacientes con lupus eritematoso sistémico muestran una hipoalbuminemia con una hipergammaglobulinemia. La hipoalbuminemia en mayor medida está relacionada con la presencia de nefritis lúpica. La mitad de los pacientes con nefritis lúpica presentan proteinuria en el orden del síndrome nefrótico. Esta proteinuria iguala o invierte parcialmente el valor del cociente albúmina/globulina. El cociente albúmina/globulina invertido por sí solo es insuficiente para afirmar la presencia de actividad en el lupus eritematoso sistémico. Se deben excluir otras entidades clínicas causantes de hipergammaglobulinemia policlonal. Los criterios de actividad del lupus eritematoso sistémico incrementan la sensibilidad del cociente albúmina/globulina invertido. Conclusiones: La interpretación del cociente albúmina/globulina debe ir aparejada a la estimación de actividad por los criterios clínicos de mayor uso (SLICC, SLEDAI, BILAG). No en todos los pacientes con lupus eritematoso sistémico puede interpretarse como criterio de actividad, por lo que es necesario excluir otras entidades clínicas(AU)

Introduction: Systemic lupus erythematosus is the model of autoimmune disease. Several types of immunoglobulins are involved in the development of the disease, mainly IgG, IgM and IgA. Objective: To describe the potential use of the albumin/globulin ratio as an indicator of activity in systemic lupus erythematosus. Development: fifty percent of patients with systemic lupus erythematosus exhibit hypoalbuminemia with hypergammaglobulinemia. Hypoalbuminemia is mainly related to the presence of lupus nephritis. The half of patients with lupus nephritis develops proteinuria with values of nephrotic syndrome. The proteinuria equals or partially reverses the albumin/globulin ratio. The inverted albumin/globulin ratio is insufficient to establish the presence of lupus activity. Other clinical entities producing polyclonal hypergammaglobulinaemia should be excluded. The systemic lupus erythematosus activity criteria increase the sensitivity of the inverted albumin/globulin ratio. Conclusions: The interpretation of the albumin/globulin ratio requires the activity estimation by different clinical criteria (SLICC, SLEDAI, BILAG). The inverted albumin/globulin ratio cannot be interpreted as a stand-alone indicator of disease activity in every systemic lupus erythematosus patients(AU)

Serum proteinogram of the Campeiro horse / Proteinograma sérico de equinos da raça Campeiro

The aim of this study to measure the fractions of the total serum proteins of the Campeiro horse and identify the influences of biological variants. Blood samples were taken in 138 horses of the breed Campeiro for measuring the concentration of total serum protein by the biuret method. Serum concentrations of protein fractions were measured by electrophoresis using agarose gel. Groups were formed according to age, sex and reproductive condition. The average values of serum fractions: albumin (2.85±0.36g/dl), alpha 1 (0.28±0.11g/dl), alpha 2 (0.26±0.08g/dL) beta 1 (0.57±0.15g/dl), beta 2 (0.89±0.28g/dL), gamaglobulinas (1.86±0.34g/dL), albumin/globulin ratio (0.75±0.18) and 2.5% percentile and 97.5% had slight differences in relation to the reference interval proposed for the species. They observed higher values of alpha 1 and 2 globulins in the group from that had six to eight years old and gammaglobulins in group above 13 years old. Serum protein concentrations were similar in horses and mares and between non-pregnant and pregnant. Sex and pregnancy status did not affect serum proteinogram. Alpha and gammaglobulins have higher values as the age increases. Serum proteinogram of Campeiro horses shows variations that have to be considered in the interpretation of laboratory tests.(AU)

Este trabalho tem por objetivo mensurar as frações das proteínas totais séricas de equinos Campeiros e identificar as influências de variantes biológicas. Foram colhidas amostras de sangue de 138 equinos, machos e fêmeas da raça Campeiro. A determinação da concentração de proteínas totais séricas foi realizada pelo método de biureto. As concentrações séricas das frações proteicas foram determinadas por eletroforese, utilizando-se gel de agarose. Formaram-se grupos em relação à idade, ao sexo e à condição reprodutiva. Os valores médios das frações séricas albumina (2,85±0,36g/dL), alfa 1 (0,28±0,11g/dL), alfa 2 (0,26±0,08g/dL), beta 1 (0,57±0,15g/dL), beta 2 (0,89±0,28g/dL), gamaglobulinas (1,86±0,34g/dL), relação albumina/globulina (0,75±0,18) e os percentis 2,5% e 97,5% apresentaram diferenças pontuais em relação aos intervalos propostos para a espécie. Observaram-se maiores valores de alfa 1, alfa 2 globulinas, no grupo de seis a oito anos, e de gamaglobulinas, no grupo acima de 13 anos de idade. O proteinograma sérico foi similar entre machos e fêmeas e entre fêmeas vazias e gestantes. Sexo e estado gestacional não afetaram o proteinograma sérico. Alfa e gamaglobulinas têm incrementos em função de idades crescentes. O proteinograma sérico de equinos Campeiros tem variações que devem ser consideradas em exames laboratoriais.(AU)

Pregnancy associated Sj(o)gren's syndrome characterized by hyperglobulinemia: a case report / 中华围产医学杂志

The diagnosis,treatment and pregnancy outcome of a case of pregnancy associated Sj(o)gren's syndrome characterized by hyperglobulinemia were reported here.The patient who had a history of repeated purpura and anemia was admitted at 26+4 weeks of gestation with premature rupture of membranes.Multiple prenatal examinations showed elevated globulin without any other symptoms such as dry mouth,dry eyes,etc.No relevant tests was offered to confirm the diagnosis before or during pregnancy.After admission,she was diagnosed as Sj(o)gren's syndrome through immunoelectrophoresis and autoimmune antibody test,and hydroxychloroquine was administered.The patient gave birth to a 870 g newborn baby at 27 weeks of gestation.The premature infant was transferred to the Neonatology Department and later discharged after 2.5 months of treatment.A 3-month postpartum follow-up revealed that the patient still suffered from hyperglobulinemia,abnormal erythrocyte sedimentation rate and rheumatoid factor level,therefore she continued oral hydroxychloroquine treatment and was regularly followed up.Clinicians should be alert to the possibility of Sj(o)gren's syndrome in gravidas with hyperglobulinemia.

Treatment research progress of primary immune thrombocytopenia / 中国基层医药

Primary immune thrombocytopenia is an autoimmune disease characterized by reduced platelets, accompanied by or without skin mucous bruises,epistaxis,internal bleeding,etc. Recent years,the treatment of primary immune thrombocytopenia developed very quickly, including the appearance of platelet receptor agonist - Eltrom-bopag. Here,we reviewed the treatment and research development of primary immune thrombocytopenia.

Treatment research progress of primary immune thrombocytopenia / 中国基层医药

Primary immune thrombocytopenia is an autoimmune disease characterized by reduced platelets, accompanied by or without skin mucous bruises,epistaxis,internal bleeding,etc.Recent years,the treatment of primary immune thrombocytopenia developed very quickly, including the appearance of platelet receptor agonist - Eltrom-bopag.Here,we reviewed the treatment and research development of primary immune thrombocytopenia.

Prognostic role of preoperative albumin to globulin ratio in predicting survival of clear cell renal cell carcinoma

ABSTRACT Purpose: To investigate the prognostic role of preoperative albumin/globulin ratio (AGR) in predicting disease-free survival (DFS) and overall survival (OS) in localized and locally advanced clear cell renal cell carcinoma (RCC) patients. Patients and Methods: 162 patients who met the criteria specified were included in the study. The DFS and OS ratios were determined using the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were performed to determine the prognostic factors affecting DFS and OS. Results: Median follow-up period was 27.5 (6-89) months. There was a statistically significant relationship between low AGR and high pathological tumor (pT) stage, presence of collecting system invasion, presence of tumor necrosis, and a high platelet count (p = 0.012, p = 0.01, p = 0.001, and p = 0.004, respectively). According to the Kaplan-Meier survival analysis, both OS and DFS were found to be significantly lower in the low AGR group (p = 0.006 and p = 0.012). In the multivariate Cox regression analysis, collecting system invasion and tumor necrosis were found to be independent prognostic factors in predicting OS and pT stage was found to be an independent prognostic factor in predicting DFS (HR: 4.08, p = 0.043; HR: 8.64, p = 0.003 and HR: 7.78, p = 0.041, respectively). Conclusion: In our study, low AGR was found to be associated with increased mortality and disease recurrence in localized and locally advanced RCC.

Effect of gamma globulin on serum immune index in neonatal pneumonia / 中国医师进修杂志

Objective To study the effect of gamma globulin on serum immune index in neonates with neonatal pneumonia. Methods One hundred neonates with neonatal pneumonia were selected, and they were divided into control group and observation group by random digits table method with 50 cases each. The control group was treated with conventional treatment, and the observation group was treated with conventional treatment combined with gamma globulin. The treatment efficacy, various signs disappearing times, length of stay in hospital and immune indexes were compared between 2 groups.Results The total effective rate in observation group was significantly higher than that in control group:96.00% (48/50) vs. 72.00% (36/50), and there was statistical difference (χ2 = 10.71, P<0.01). The disappearing times of cough, crackles, perioral cyanosis and fever and the length of stay in hospital in observation group were significantly shorter than those in control group:(4.39 ± 1.46) d vs. (6.32 ± 1.61) d, (4.21 ± 0.93) d vs. (5.36 ± 1.08) d, (0.83 ± 0.15) d vs. (1.16 ± 0.22) d, (2.53 ± 1.04) d vs. (4.47 ± 1.13) d and (7.68 ± 0.87) d vs. (10.03 ± 1.18) d, and there were statistical differences (P<0.01). The IgG, IgA, IgM, CD4+and CD4+/CD8+levels after treatment in observation group were significantly higher than those in control group: (10.32 ± 2.86) g/L vs. (6.88 ± 0.83) g/L, (1.14 ± 0.13) g/L vs. (0.91 ± 0.25) g/L, (0.94 ± 0.21) g/L vs. (0.85 ± 0.27) g/L, 0.516 ± 0.068 vs. 0.385 ± 0.063 and 1.89 ± 0.35 vs. 1.57 ± 0.33, but the CD8+was significantly lower than that in control group:0.303 ± 0.046 vs. 0.349 ± 0.048, and there were statistical differences (P<0.05). Conclusions The gamma globulin can not only significantly improve the curative effect in neonates with neonatal pneumonia and promote the recovery of the clinical symptoms, but also improve the efficiency of cell immunity and humoral immunity ability. It is a kind of effective treatment.

Effects of large dose gamma globulin on cardiac function and immune regulation in patients with dilated cardiomyopathy and heart failure / 心血管康复医学杂志

Objective: To explore effects of large dose gamma globulin on cardiac function and immune regulation in patients with dilated cardiomyopathy (DCM) and heart failure (HF).Methods: According to random number table, a total of 90 DCM + HF patients were divided into routine treatment group (n=45) and gamma globulin group (n=45, received gamma globulin based on routine treatment, 400 mg kg-1 d-1 intravenous drip for 5d).After three months, therapeutic effect, cardiac function, levels of cardiac troponin T (cTnT), cTnI, N terminal pro brain natriuretic peptide (NT-proBNP) and anti-cardiac myosin heavy chain auto-antibodies (AMHCA) IgG titer before and after treatment, incidence of adverse reactions were observed and compared between two groups.Results: After three-month treatment, total effective rate of gamma globulin group was significantly higher than that of routine treatment group (80.00% vs.57.50%, P=0.02);compared with routine treatment group after treatment, there were significant reductions in levels of cTnT [(0.54±0.18) μg/L vs.(0.31±0.12) μg/L], cTnI [(1.35±0.18) μg/L vs.(0.72±0.13) μg/L], NT-proBNP [(758.34±64.28) pg/ml vs.(708.34±60.22) pg/ml], and significant rise in left ventricular ejection fraction [LVEF, (39.35±6.23)% vs.(47.32±6.10)%] in gamma globulin group, P<0.05 all;compared with before treatment and routine treatment group after treatment, there was significant reduction in AMHCA IgG titer [(0.099±0.047), (0.092±0.045) vs.(0.069±0.032), P<0.05 both] in gamma globulin group;incidence rate of adverse reaction in gamma globulin group was significantly higher than that of routine treatment group (22.22% vs.6.67%, P=0.04), but the symptoms were mild, and they recovered after symptomatic treatment.Conclusion: Large dose gamma globulin can significantly improve cardiac function and possesses good immune regulation effect in patients with dilated cardiomyopathy and heart failure.

Analysis of the renal calculus composition and urine physical and chemical indexes / 中华检验医学杂志

Objective To explore the proportion of different types of stones in patients with kidney stones in Xinjiang, and to analyze the relationship between stone composition and urine physicochemical properties and protein composition.Methods Through a case-control study, 355 patients with kidney stones who were hospitalized in the Xinjiang Uygur Autonomous Region People′s Hospital from March to November 2010 were enrolled in the same period, and non-urinary tract diseases were hospitalized and excluded from other diseases or complications of the 30 cases of renal impairment in the control group.The composition of the stones was analyzed.The main components of the stones were divided into oxalate group, carbonic acid group, uric acid group and phosphate group.The physicochemical properties and protein composition of 24 h urine were analyzed by ion selective electrode method, enzymatic and immunoturbidimetric assay.The difference between the two samples was analyzed by t test, and the differences between the two groups were analyzed by F-test and LSD-t test.Results Compared with the control group(30 cases), urine pH(5.33±0.32) was significantly lower in the oxalate group (244 cases), 24 h urinary calcium and 24 h uric acid[(7.68±0.35) mmol, (3.48±0.23)mmol (pH=5.874,P9.436, P8.442,P<0.05).Conclusion There may be a correlation between renal stone composition with urine metabolic changes.

Steroid Pulse Therapy for Kawasaki Disease Complicated with Myocarditis.

Background: The clinical management of intravenous immunoglobulin-resistant Kawasaki disease shock syndrome (KDSS) is obscure. Case characteristics: Three children presented with intravenous immunoglobulin-resistant KDSS complicated with myocarditis. Outcome: All cases were successfully managed with steroid pulse therapy. Message: Steroid pulse therapy is effective in immunoglobulin-resistant KDSS.

Rowell's syndrome: a clinical observation and a follow-up analysis / 中华皮肤科杂志

Objective To investigate the characteristics,treatment and prognosis of Rowell's syndrome.Methods Clinical data were collected from 6 inpatients with Rowell's syndrome from July 2009 to July 2015,and retrospectively analyzed.Results All the patients were female,of them,2 developed skin lesions after sun exposure,2 had medication history,1 had Staphylococcus aureus infection before occurrence of skin lesions,and 1 had no obvious precipitating factor.Skin lesions spread from the face to the whole body in 4 cases,from the dorsal hauds to the whole body in 1 case,and were confined to the face,both hands and feet in 1 case.All the 6 patients had chilblain-like lesions in the digit tips,and 5 patients had fever.Among these patients,6 were positive for antinuclear antibodies (granular pattern),4 for anti-Sm antibodies,5 for anti-U 1RNP antibodies,4 for anti-SSA antibodies,2 for anti-dsDNA antibodies,and 1 was positive for both anti-SSA and anti-SSB antibodies.Histopathological examination revealed hyperkeratinization,mild hyperplasia,partial necrosis,many dyskeratocytes,liquifaction degeneration of basal cells in the epidermis,and perivascular infiltration of lymphocytes in the superficial dermis.After admission,1 patient was finally diagnosed with subacute cutaneous lupus erythematosus (SCLE),and 5 with systemic lupus erythematosus (SLE).All the 6 patients were treated with prednisone at a dose of 0.6-1.0 mg·kg-1 ·d-1,and 1 was also treated with gamma globulin (200 mg/d).During the process of glucocorticoid tapering,hydroxychloroquine was administered at 0.2 g twice a day.During 1-year follow-up,neither erythema multiform nor chilblain-like lesions recurred in 5 patients,and 1 patient was lost to follow-up.Conclusions Rowell's syndrome frequently occurs in women.Glucocorticoids are a mainstay of its treatment,and their tapering should be slower in patients with Rowell's syndrome than in those with lupus erythematosus.

Association between FADS1 rs174537 polymorphism and serum proteins in patients with aggressive periodontitis / 北京大学学报(医学版)

Objective:To investigate the potential association between FADS1 rs1 74537 polymorphism and serum proteins in patients with aggressive periodontitis,which may provide benefits for diagnosis and treatment of aggressive periodontitis.Methods:A total of 353 patients with aggressive periodontitis (group AgP)and 1 25 matched controls (group HP)were recruited in the study.Genotyping of FADS1 rs1 74537 and serum biochemical indexes were tested at the study’s start.The relationships between the levels of TP,GLB,ALB,A/G and genotyping were analyzed.Results:(1 )The detection rate of allele G in group AgP was higher than that in group HP(68.1% vs.61 .2%,P=0.046,OR=1 .35,95% CI 1 .00-1 .83 );the detection rate of genotype GG in group AgP was higher than in group HP(45 .5%vs. 34.4%,P=0.029,OR=1 .60,95%CI 1 .05 -2.44).(2)In group AgP,the patients with GG geno-type exhibited significantly lower TP,GLB than the patients with GT+TT genotype [(77.08 ±7.88)g/L vs.(79.00 ±4.66)g/L,P=0.007;(28.1 7 ±7.63)g/L vs.(29.88 ±3.49)g/L,P=0.007)and the higher A/G(1 .72 ±0.22 vs.1 .67 ±0.22,P=0.040),but there was no significant difference in ALB between the patients with GG genotype and the patients with GT+TT genotype.In group HP,there were no significant differences in TP,GLB,A/G and ALB between individuals with genotype GT+TT and with genotype GG.(3 )Compared with individuals with genotype GT+TT in group HP,the AgP pa-tients with genotype GT +TT exhibited significantly higher TP,GLB [(79.00 ±4.66 ) g/L vs. (75.20 ±4.53)g/L,P<0.01;(29.88 ±3.49)g/L vs.(26.55 ±2.94)g/L,P<0.01 )and the lo-wer A/G(1 .67 ±0.22 vs.1 .88 ±0.30,P<0.01 ),but there was no significant difference in ALB. There were no significant differences in TP,GLB,A/G and ALB the between the AgP patients with ge-notype GG and the healthy subjects with the same genotype either.Conclusion:FADS1 rs1 74537 poly-morphism is associated with aggressive periodontitis.The patients with genotype GG in group AgP had relatively lower TP,GLB and higher A/G.Genotype GG might be a risk indicator for aggressive periodon-titis by reducing host defense capability and contributing to inflammatory response in the occurrence and development of aggressive periodontitis.

Influence of large dose γglobulin on myocardial cardiac myosin heavy chain own IgG antibody titer in patients with dilated cardiomyopathy heart failure / 心血管康复医学杂志

Objective:To explore influence of large dose γ globulin on myocardial cardiac myosin heavy chain (CM‐HC) own IgG antibody titer and therapeutic effect in patients with dilated cardiomyopathy (DCM) heart failure (HF) .Methods :A total of 160 DCM + HF patients hospitalized in our department of cardiology from Mar 2011 to May 2014 were selected .According to random number table ,they were randomly and equally divided into routine treatment group (n=80 ,RT group) and γglobulin group (n=80 ,received large dose γ globulin therapy based on RT group) .Cardiac function indexes ,IgG antibody titer and serum levels of cTnT and cTnI were observed and com‐pared between two groups before and after treatment .Results:Compared with before treatment after six -month treatment ,there were significant reductions in LVEDd [ (67.50 ± 5.50) mm vs .(56.50 ± 2.50) mm] and LVESd [ (55.50 ± 6.80) mm vs .(43.50 ± 2.30) mm] ,and significant rise in LVEF [ (33.50 ± 3.50)% vs .(53.50 ± 8.50)% ] in γglobulin group ,and only LVEF significantly rose [ (32.80 ± 4.20)% vs .(41.50 ± 5.50)% ] in RT group , P< 0.05 all;compared with RT group after six -month treatment , there were significant reductions in LVEDd [ (63.50 ± 2.50) mm vs .(56.50 ± 2.50) mm] and LVESd [ (51.60 ± 4.80) mm vs .(43.50 ± 2.30) mm] , and significant rise in LVEF in γglobulin group , P<0.05 all .On one ,three ,five and six months after treatment , IgG antibody titer significantly reduced in γglobulin group and they were significantly lower than those of RT group (P<0.05 all) .After six -month treatment ,cTnT and cTnI levels of both groups were significantly lower than those of before treatment ( P< 0.05 all ) , compared with RT group , there were significant reductions in cTnT [ (0.55 ± 0.10)μg/L vs .(0.26 ± 0.02)μg/L] and cTnI levels [ (1.20 ± 0.40)μg/L vs .(0.60 ± 0.10)μg/L] in γglobulin group , P<0.05 both .Conclusion:Large dose γglobulin can significantly improve myocardial function ,re‐duce myocardial CMHC own IgG antibody level and serum concentrations of cTnT and cTnI in DCM + HF pa‐tients ,so it’ s worth extending .

The correlation analysis between clinical biochemical indexes and cataract of middle aged and senior / 中华检验医学杂志

Objective A large sample of multi-factor Logistic analysis of clinical biochemical indicators from elderly cataract patients were done to find the characteristics of possible changes in potential factors for cataract-related indicators and explore the pathogenesis of cataract from the perspective of laboratory diagnosis.Methods A retrospective case control study was conducted .Cataract patients from Eye-Ear Nose Throat Hospital of Fudan University were collected during June 2011 to July 2015 and routinely tested for 14 clinical biochemistry indicators including ALB , GLU, TP, GLB, BUN, URCA, Cr, LDH, ALP, Ca, Na, K, Cl, and P.The mean age of the 3 527 cataract patients (1 804 males, 1 723 females) was (64.47 ±11.29) years.Those data were reserved by LIS (Laboratory Information System) system and were retrieved for large data analysis . The control group was filtered from hospitalized patients besides cataract patients during January 2014 to July 2015.The mean age of the 3 333 control subjects ( 1 770 males, 1 563 females ) was ( 64.04 ±9.03 ) years.Biochemical indicators between cataract group and control group were analyzed by independent student′s t-test and Logistic regression .Meanwhile , the objects were divided into 3 groups according to the age (40-59 years,60-79 years,≥80 years) for independent student′s t-test with the control group respectively .Results There are no statistical difference in age ( t=1.663,P=0.096) and gender ( t=2.63,P=0.105 0) between cataract group and control group ( P>0.05).The results of Logistic regression between cataract group and control group were as follow : ALB (OR=1.053,95%CI=1.019-1.088),BUN(OR=1.113,95% CI=1.076-1.152),Cr(OR=1.007, 95%CI=1.003-1.010),GLB(OR=1.049,95% CI=1.018 -1.081),GLU(OR=1.175,95% CI=1.139-1.211),Cl(OR=1.059,1.032 -1.088),Na(OR=1.180,95% CI =1.150 -1.212).Those might be enrolled as risk factors for cataract (P<0.05).The level of ALB, GLU, Na and Cl in cataract group according to different age groups were significantly higher ( t=8.780,t=4.670, t=9.695, t=6.415, P<0.05) than that of control in 40-59 age group;the level of ALB, BUN, Cr, GLU, Na and Cl in cataract group was significantly higher ( t=4.974, t=9.414, t=4.123, t=6.906, t=14.741, t=9.212, P<0.05) than control in 60 -79 age group; the level of BUN, Cr, GLU, Na and Cl in cataract group was significantly higher (t=6.077, t=4.906, t=2.626, t=5.459, t=3.424, P<0.05) than control in 80-age group.Conclusions The level of ALB, BUN, GLB, Cr, GLU, Na and Cl in peripheral blood of cataract patients was significantly increased which suggested that those change might associated with the pathogenesis of cataract .

Curative effect of gamma globulin for the early treatment of severe or almost severe hand -foot -mouth disease / 中国基层医药

Objective To study the efficacy of gamma globulin in the early treatment of severe or almost severe hand -foot -mouth disease.Methods 80 children with severe or almost severe hand -foot -mouth disease were randomly divided into treatment group and control group by the random number table.The treatment group received the treatment of early gamma globulin,whereas patients in the control group received conventional therapy.The effective rate of the treatment group was higher than that of the control group(95.0%vs 77.5%,χ2 =5.165,P <0.05).The recovery time of body temperature and hemogram,rash and other adverse symptoms disap-peared in the treatment group were significantly shorter than those of the control group[(2.1 ±0.9)d vs (3.0 ± 1.1)d,(1.9 ±0.8)d vs (2.8 ±1.1)d,(4.1 ±1.3)d vs (6.2 ±2.1)d,(2.6 ±0.8)d vs (4.8 ±1.5)d,t =3.934,3.723,5.378,7.357,all P <0.05].Conclusion Early application of gamma globulin is effective and safe in treating severe hand -foot -mouth disease,which can relieve symptoms,control the disease quickly and improve prognosis.