Retrospective analysis of diabetic hyperosmolar hyperglycemia complicated with rhabdomyolysis / 中国基层医药

Objective@#To investigate the clinical characteristics and treatment strategies of diabetic hyperosmolar hyperglycemia (HHS) with rhabdomyolysis (RM).@*Methods@#The clinical data of 40 patients with HHS treated in the General Hospital of Shenyang Military Command from November 2013 to November 2017 were retrospectively analyzed.According to the serum levels of creatine phosphokinase and myoglobin, they were divided into RM group (12 cases) and non-RM group (28 cases). The clinical characteristics and treatment results of the two groups were compared.@*Results@#There were 12 cases in the RM group, 6 cases were diagnosed RM at the time of consultation, and 6 cases developed RM during the course of treatment.Compared with the non-RM group, RM group had lower systolic pressure[(98.3±17.8)mmHg vs.(128.0±18.1)mmHg, t=4.823, P=0.000], higher blood glucose level[(44.4±14.0)mmol/L vs.(32.6±8.1)mmol/L, t=2.717, P=0.016], and more acidosis, mainly manifested by lower pH[(7.16±0.15)vs.(7.32±0.13), t=3.355, P=0.002], lower bicarbonate[(12.92±5.23)mmol/L vs.(19.07±6.80)mmol/L, t=2.792, P=0.008], higher blood D-3 hydroxybutyric acid [(5.84±2.98)mmol/L vs.(2.55±2.13)mmol/L, t=4.012, P=0.000], and renal function was worse[creatinine (257.1±149.8)μmol/L vs.(148.1±85.3)μmol/L, t=2.925, P=0.006]. Individualized rehydration and low dose insulin were given to control blood sugar, and increasing blood pressure, kidney protection, correction of electrolyte disturbance, anti-infection and inhibition of gland secretion were given to the complications.Hydration and alkalization were given to 7 cases of RM, and continuous renal replacement therapy (CRRT) was given to 5 cases.In 10 cases of HHS with RM, creatine kinase decreased, renal function recovered, and 2 patients died.@*Conclusion@#It is very important to improve the understanding of RM in HHS patients, routinely monitor the dynamic changes of muscle enzymes, make a good early diagnosis and prevention of RM.Urine hydration and alkalization should be given in time after RM occurs, and CRRT treatment as early as possible can improve the survival rate of diabetic patients.

Prediction and identification of immunodominant linear B cell epitopes in N9 of avian influenza virus H7N9 / 中华实验和临床病毒学杂志

Objective@#To identify immunodominant linear B cell epitopes in neuraminidase of avian influenza virus H7N9.@*Methods@#By using protean algorithms of bioinformatic software DNAStar, antigenicity, hydrophilicity and surface probability of the H7N9 neuraminidase sequence was analyzed and their corresponding average indexes were calculated. Multiple regions containing potential linear B cell epitopes were predicted. Corresponding peptides were synthesized artificially and used in peptide-ELISA individually to check their reactivity to confirmed H7N9 positive human sera, and H7N9 negative human sera was used as control.@*Results@#Seven potential linear B cell epitopes, namely A to G, were predicted according to their relatively strong antigenicity, hydrophilicity and surface probability. All corresponding synthetic peptides reacted strongly with H7N9 positive sera.@*Conclusions@#Immunodominant linear B cell epitopes in neuraminidase of H7N9 were successfully predicted and confirmed. It will facilitate to clarify molecular basis of the antigen specificity and to make respective antibodies.

Prediction and identification of linear B-cell epitopes in the hemagglutinin of H7N9 avian influenza virus in human / 中华临床感染病杂志

Objective To predict and identify liner B-cell epitopes in the hemagglutinin ( HA) of human-infected avian-origin H7N9 influenza virus and analyze the specificity of H7 subtype.Methods Three serum samples collected at different times from the same patient who was confirmed to be infected with H7N9 influenza virus were provided by Shaoxing People’s Hospital, and one serum sample from healthy person was collected as the control.The extracellular region of HA protein was predicted by TMHMM Sever v.2.0.The potential B-cell epitopes were predicted by DNAStar Lasergene’ s Protean, BcePred and ABCpred tools, and the immunogenicity of the predicted B cell antigen epitopes was assessed by indirect enzyme-linked immunosordent assay ( ELISA ) .H7 subtype specificity was analyzed by comparing HA protein amino acid sequence with H7N9 and H1-H16 subtype influenza virus from Genbank using Clustal X 2.1 software, and Cn3D 4.3.1 software was used to detect the distribution and 3D structure of predicted epitopes on the HA protein of H7N9.Results The potential B-cell epitopes may be located in 172-183, 363-380, 452-472 and 491-506 of extracellular N-terminus of HA protein.ELISA showed that four predicted eptiopes specifically reacted with positive serums from patient.Multi-sequence alignment demonstrated that peptide 172-183 and 363-380 had higher H7 subtype specificity compared with amino acid sequences of other subtypes.Moreover, the predicted linear B-cell epitopes all located on the surface of HA protein according to the 3D structure analysis.Conclusion Four potential B-cell epitopes were identified, in which peptide 172-183 and 363-380 have higher H7 subtype specificity, and may be used in the design of epitope-based vaccines and diagnostics tests.

The establishment of pediatric reference intervals for creatine kinase-MB and troponin Ⅰ / 中华检验医学杂志

Objective To establish the pediatric reference intervals for Troponin Ⅰ and Creatine kinase-MB (CK-MB).Methods Healthy children (223 boys and 162 girls) aged from 7 months to 12 years old were studied.Blood specimens were collected and centrifuged,all serum samples were kept refrigerated below-70 ℃.Troponin Ⅰ and CK-MB were measured on the UniCel DxI 800 immunoassay system (Beckman Coulter) on the same day.Nonparametric statistics was used to estimate the 99th percentile reference intervals.Results The children were divided into three groups (group A 128 cases; group B 128 cases;group C 129 cases) according to age.The upper reference limits for CK-MB were dependent of age,and the group A (7 months-1 years) was shown to be 13.41 μg/L,the group B (2-3 years) was shown to be 9.35 μg/L,the group C (4-12 years) was shown to be 5.48 μg/L.The upper reference limit for Troponin Ⅰ was independent of age or gender and shown to be 0.01 μg/L among 385 children.Conclusions Pediatric reference intervals for Troponin Ⅰ and CK-MB have been defined in healthy children at a relevant age group (7 months-12 years).It is effective for clinical diagnosis and treatment of myocardial damage for children by determining reference intervals for Troponin Ⅰ and CK-MB.

The level of CD+4 Foxp3+ regulatory T cells in patients with childhood acute leukemia and its relationship with the minimal residual disease of leukemia / 中华检验医学杂志

Objective To study the regulatory T cells (Treg-cell) frequencies in patients with childhood acute leukemia and evaluate its clinical application value by investigating the relationship between the increasing numbers of Treg cells and minimal residual disease of leukemia (MRD), Methods Foxp3-FITC/CD25-PE/CD4-PerCP/CD3-APC four-color staining flow cytometry was established to identify Treg cells. Treg cells frequencies both in 10 healthy controls and in 33 patients with newly diagnosed childhood acute leukemia ( B-ALL 17 cases, T-ALL 9 cases, AML 7 cases) were detected. The possibility of the accumulation of Treg cells being the prognostic marker for acute leukemia was evaluated by comparing the results of Treg cells frequency with that of MRD. Results The percentage of Treg cells in CD+4 CD+3 T cells was M = 8. 09% in normal bone marrows, which was significantly different from the results in the bone marrows of newly diagnosed childhood acute leukemia ( M = 12.77% , U = 3.41, P < 0.01 ), but it showed no significantly differences among B-ALL, T-ALL and AML groups. No association was observed between the expression of Treg cells and clinical-biologic characteristics studied. In addition, Treg cells frequency in MRD positive group was significantly different from that in MRD continuously negative group ( M = 14. 74% vs M=11.3%, t =252.5,P<0.05). Conclusions Consistent with results from solid tumor, the study identifies a significantly increased numbers of Treg cells in patients with childhood acute leukemia. The situation of accumulation of Treg cells is closely associated with MRD results during chnical remission. High level of Treg cells may cause poor prognosis and increase the possibility of relapse.

Dynamic determination of the location of conus medullaris by magnetic resonance imaging / 中国组织工程研究

BACKGROUND:Studies on the tip position of the conus medullaris in a population have been limited to autopsy and long ago. Therefore, it is necessary to dynamically study the position of conus medullaris (CM) in the Chinese population by magnetic resonance imaging (MRI).OBJECTIVE: To observe the variation in position of the CM in a living population without spinal deformity through MRI. DESIGN: A controlled observation.SETTING: Qingdao Municipal Hospital.PARTICIPANTS: Totally 1199 patients who complained of low back pain and underwent MRI examination in the Department of Radiology of Qingdao Municipal Hospital between October 1993 and December 2006 were recruited in this study. The involved patients, including 765 males and 434 females, were averaged (46±14)years ranging from 5 to 85 years old. Among them, 276 patients suffered from metastatic tumor on spinal vertebrae or trauma of spinal column. Patients with scoliosis or congenital diseases of spinal cord and spinal column were rejected. Another 30 volunteers were recruited via advertisement checked up in the Department of Radiology of Qingdao Municipal Hospital.All the volunteers, including 15 males and 15 females, were averaged (32±8)years, ranging from 19 to 52 years.Written informed consents of detected items were obtained from all the subjects.METHODS: Totally 1199 patients underwent lumbar vertebra MRI scanning by a GE Signa 1.5T supraconduction MRI machine. The tip position of the conus medullaris was observed by spin echo T1 weighted and median sagittal imaging.The MRI machine was located according to its corresponding relationship with vertebral body and intervertebral disc. All the volunteers were given the dynamic research conceming the tip of CM in middle, hyperflexion and hyperextension position.MAIN OUTCOME MEASURES: Dynamic observation of the location of tip of CM in the healthy volunteers and the patients who complained of low back pain.RESULTS: The above 1199 patients who complained of low back pain and 30 healthy volunteers participated in the final analysis. ①The mean conus position of the patients who complained of low back pain was the lower third of L1 (range: middle third of T12 to upper third of L3). The variation in conus positions followed a normal distribution. The conus position in female patients was significantly lower than that of male counterparts (t =18.127,P ＜ 0.01). No significant difference in conus position was seen with increasing age (F =0.530, P ＞ 0.05). ②The tip of the CM did not change in relation to the posterior edge of vertebrae when the spine was in hyperflexion or hyperextension position.However, it got close slightly to the posterior edge of vertebrae when in hyperflexion, and got away slightly from it when in hyperextension.CONCLUSION: The location of tip of CM of our group of population ranges from the middle third of T12 to the upper third of L3, and female population have a much lower conus position than that of male ones.

Nucleotide sequencing of E/NS1 gene segment of dengue type 1 viruses isolated in Guangdong Province / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To analyse the genetic relationship of local strains of dengue type 1 viruses isolated in different years and regions from Guangdong Province, and to explore the genetic links with strains of adjacent countries by comparing with the sequences of relevant strains in Genbank.</p><p><b>METHODS</b>The viral RNAs were extracted and used for one-step reverse transcriptase polymerase chain reaction (RT-PCR) to amplify the partial nucleotide fragments in E/NS1 gene junction which were then cloned into the plasmid pBluescript II SK for sequencing, the results were analysed by DNASTAR software.</p><p><b>RESULTS</b>The phylogenetic tree of the sequenced 14 strains of dengue type 1 viruses branches into two genotypic groups. The nucleotide sequences showed a maximal homologies of 99.2% with Indonesia strains, 100% with Philippines strains and 98.8% with Thailand strains.</p><p><b>CONCLUSIONS</b>The dengue type 1 viruses of Guangdong Province are closely related to the Philippines, Indonesia and Thailand strains, which may indicate the possibility of importation from those countries.</p>

Analysis on the epidemiologic features of Dengue fever in Guangdong province, 1990-2000 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To determine the epidemiological characteristics and risk factors of Dengue fever in Guangdong province in 1990-2000, and to develop the strategy for its prevention and control.</p><p><b>METHODS</b>Sequential of the partial nucleotide fragments in E/NS1 gene junction was analysed.</p><p><b>RESULTS</b>A total of 9,747 cases were reported with three deaths in Guangdong province, 1990-2000. The average incidence was 1.27 per 10,000 (range: 0-9.75 per 10,000). Outbreaks were commonly seen, with 13 cities (61.9%) involved, but most of the cases occurred in Guangzhou, Chaozhou, Zhaoqing and Foshan cities. Numbers of cases reported monthly were gathered with sporadic imported cases reported from January to June while the period of epidemics was from July to December. Sex ratio of patients was 1.04, but all age group was susceptible. Four sero-types of Dengue virus were found during these epidemics. The partial nucleotide fragments in E/NS1 gene junction of 12 isolated viruses were sequenced and 2 sub-gene types were identified in Guangdong province. The clinical symptoms seemed typical. Social and natural factors were responsible for the epidemic of Dengue fever in the regions.</p><p><b>CONCLUSION</b>The epidemic of Dengue fever in Guangdong was closely related to the situations of neighboring countries, indicating the possibility of importation of virus from these countries. The epidemics usually started with imported cases. However, the endemic nature of the disease had not been identified yet.</p>

Influence of Astragalus Injection on expression of myocardial perforin with murine actute myocarditis caused by Coxsackievirus B3 / 中成药

Objective: To investigate the effect and mechanism of Astragalus Injection (Radix Astragali) on acute murine myocarditis caused by Coxsackievirus B 3. Methods: Acute viral myocarditis was induced in 24 Balb/c mice by injection of Coxsackievirus B 3m (CVB 3m ) intraperitoneally. Half of the mice were administered Astragalus Injection(10g/kg?d). Heart and blood samples were obtained from all mice on the 8th day after CVB 3m infection for histopathological study, detection of myocardial perforin expression by reverse transcription polymerase chain reacton(RT PCR) and measurement of serum CK MB level, respectively. Results: (1) Astragalus treated mice showed a significant reduction in myocardial lesion compared with that in untreated mice. (2) Myocardial perforin expression by semi quantitative RT PCR in Astragalus treated mice was much lower than that in controls(1.10?0.07 vs 1.31?0.12, P

Effect of cyclophosphamide on proliferation and apoptosis of rat mesangial cells in vitro / 中国病理生理杂志

AIM: To investigate the effect of cyclophosphamide(CTX) on proliferation and apoptosis of mesangial cells(GMC) of rat in vitro. METHODS: GMC proliferation was detected by MTT method, GMC apoptosis was examined by inverted microscopy for phase-contract and fluoroscopy and flow cytometry analysis. The levels of Fas and Bcl-2 were also detected by immunohistology. RESULTS: The proliferation of GMC were inhibited by CTX, methylprednisolone(MP), low molecular weight heparin(LMWH). Apoptosis of GMC was induced by CTX, the apoptosis rate of GMC was 8.2%, and the Fas level was increased. CONCLUSION: CTX could inhibit proliferation and induce apoptosis of GMC possibly by enhancing the Fas level.