[Sturge-Weber syndrome in port-wine stain patients: a retrospective study on the clinical features and screening strategy].

Objective: To investigate the clinical characteristics of Sturge-Weber syndrome (SWS) in the patients with Port-wine stain (PWS). Methods: A total of 279 PWS patients, 164 males, 115 females with a median age of first visit 17.00 (4.75, 56.00) months. Most of the PWS patients were referred to the Ophthalmology Department for screening eye problems when the cutaneous angiomas involved the ophthalmic division of the trigeminal nerve distribution. The intraocular pressure (IOP), cup to disk ratio (C/D), corneal condition and other essential measurements were examined to screen glaucoma or choroidal hemangioma. The differences of age, gender and vascular ectasia in the ipsilateral eyes were compared among PWS and SWS patients with chi-square test. The differences about the first visit time, IOP, C/D and corneal diameters were evaluated with independent-sample T test or nonparametric test followed by Mann-Whitney U test. Results: A total number of 66 out of 279 PWS patients (23.7%) were confirmed as SWS with glaucoma. The IOP of the ipsilateral eye with vascular ectasia in PWS and SWS was 13.00 mmHg (1 mmHg=0.133 kPa) (IQR: 9.75, 17.00) and 23.00 mmHg (20.00, 32.00), respectively (Z=-8.212, P<0.001); the IOP differences between the ipsilateral and contralateral eye in PWS and SWS was 1mmHg (0, 2) and 7 mmHg (3, 11) respectively; the C/D in the ipsilateral eye and the contralateral eye was 0.30 (0.30, 0.35) and 0.7 (0.6, 0.8) respectively in SWS cases with secondary glaucoma. Conclusions: There is a high proportion of SWS with glaucoma in ophthalmic division affected PWS patients. Fundus examinations were necessary for this type of patients. (Chin J Ophthalmol, 2017, 53:753-757).

[Diatoms Distribution in Ningbo Three-river Watershed during Summer].

OBJECTIVES: To explore the species, quantity and distribution of diatoms in Ningbo three-river watershed during summer and to provide scientific basis for forensic examination of drowning cases in the waters of Ningbo. METHODS: Water samples were collected in July and August of 2015. Fourteen water sampling points were selected from the Yao River, the Fenghua River and the Yong River. The morphological features of diatom species and dominant diatoms were distinguished by microscope. RESULTS: A total of 16 species of diatoms were detected in the Yao River, the Fenghua River and the Yong River. Melosira was the dominant species in the Yao River, and the quantity and richness were higher than in other rivers. The richness of Cyclotella in the Yong River was higher than in other rivers. The richness of Pinnularia and Licmophora were higher in the Fenghua River than in the Yao River and the Yong River. CONCLUSIONS: The species and proportion of diatom is different in each river. Database of the species and relative composition for the diatoms in corresponding river is established, which may provide data support for forensic examination of drowning cases in Ningbo three-river watershed.

Multicenter, double-blind, randomized clinical trial of parenterally administered Cefoselis versus Cefepime for the treatment of acute bacterial infections.

AIM: This study aims to evaluate the clinical efficacy and safety of intravenous Cefoselis injection for the treatment of acute moderate and severe bacterial infections. PATIENTS AND METHODS: A multicenter, double-blind, randomized clinical trial was carried out using Cefepime as control. Patients received 1.0 g of either Cefoselis or Cefepime for moderate infections or 2.0 g for severe infections at an interval of 12 hours for 7 to 14 days. A total of 276 patients (138 with Cefoselis, 138 with Cefepime) with respiratory or urinary tract infections were enrolled in the study. Up to 137 and 124 patients receiving Cefoselis and 132 and 125 patients receiving Cefepime were eligible for the ITT (intent to treat) and PP (per protocol) analyses, respectively. RESULTS: At the end of the treatment, the cure rates and effective rates were 59.68% (74/124) and 93.55% (116/124) with Cefoselis, and 56.00% (74/124) and 90.40% (116/124) with Cefepime. The bacterial eradication rates of the two groups were 90.32% and 93.85%, respectively. No statistical differences were observed on the above-mentioned parameters between the two groups (all p > 0.05). Adverse events, mainly mild aminotransferase elevation and mild leukopenia, were observed in 11.59% (16/138) and 13.77% (19/138) of patients with Cefoselis and Cefepime, respectively (p > 0.05). CONCLUSIONS: Cefoselis is an effective and safe choice against acute moderate and severe respiratory infections and UTI (urinary tract infection).

An increase in hyaluronan by lung fibroblasts: a biomarker for intensity and activity of interstitial pulmonary fibrosis?

The purpose of the present study was to clarify the roles of hyaluronan (HA) production of lung fibroblasts in the pathogenesis of pulmonary fibrosis. Quantitative and comparative assessments of the HA levels in bronchoalveolar lavage fluid (BALF) and lung fibroblast-conditioned media (F-CM) were made at various stages during the development of bleomycin-induced pulmonary fibrosis in rats. In bleomycin-treated animals, the HA levels in F-CM increased significantly (P < 0.01) on day 1 after bleomycin treatment, peaked on day 3, and then gradually declined and returned to control values on days 14-28. The HA concentrations of BALF in the bleomycin group were significantly increased (P < 0.01) on day 3, were maximal on day 7, and thereafter gradually decreased, remaining significantly above normal values (P < 0.01) on day 14, but returning to control values by day 28. In the bleomycin group, the HA levels both in BALF and in F-CM were significantly correlated with the cell components in BALF and there was a significant correlation between the HA concentration in BALF and in the F-CM. Lung fibroblasts were activated and produced increased HA which resulted in excessive accumulation of HA in the lung in the early stage of pulmonary fibrosis; the increased HA synthesis of lung fibroblasts and enhanced HA concentrations of BALF might reflect the intensity of alveolitis and the disease activity.

[Effects of smoking on the lipid peroxides antioxidation and alpha 1-antitrypsin].

OBJECTIVE: Detecting free radicals and alpha 1-antitrypsin (alpha 1-AT) from healthy smoker's blood to study the action of free radicals in smoking induced diseases. METHOD: Thiobarbituric acid method (TBA), RIA, 5-5'-dithio-2-dinitrobenzoicacid (DTNB) method, Ellman method and enzyme linked immunosorbent assay were used to detect the lipid peroxides (LPO), superoxide dismutase (SOD), glutathione peroxidase (GSH-px), glutathione (GSH) and alpha 1-AT. RESULT: In the blood of nonsmokers, LPO was 4.9 +/- 2.5 mumol/L, SOD was 878 +/- 302 ng/g Hb, GSH-px was 120 +/- 35 U, GSH was 3.4 +/- 0.7 mmol/L, alpha 1-AT was 75 +/- 11 mg/L, in the blood of smokers, they were 6.1 +/- 3.0 mumol/L, 780 +/- 282 ng/g Hb, 112 +/- 34 U, 3.1 +/- 0.8 mmol/L, 71 +/- 15 mg/L respectively. The LPO content in the blood of smokers was significant higher than that of nonsmokers (P < 0.01), but the SOD GSH-px GSH and alpha 1-AT contents measured was significant lower (P < 0.05 or P < 0.01). CONCLUSION: The increase of oxidation and decrease of antioxidation, activity of alpha 1-AT and imbalance of protease and antiprotease might play important roleg in smoking induced diseases.

Citric acid increases viable epidermal thickness and glycosaminoglycan content of sun-damaged skin.

BACKGROUND: Recently, there has been an exponential increase in the use of alpha-hydroxy acids in dermatologic practice. Their inclusion in a myriad of cosmetic preparations underscores their popularity. Among the clinical effects of alpha-hydroxy acids are their ability to prevent the atropy resulting from potent topical corticosteroids, improve the appearance of photoaged skin, and correct disorders of keratinization. Despite this range of desirable effects, very little is known about the specific changes produced by various alpha-hydroxy acid preparations in the epidermis and dermal extracellular matrix. Previous work by others has demonstrated the ability of another alpha-hydroxy acid to increase viable epidermal thickness, and dermal glycosaminoglycans. OBJECTIVE: In this study, we examined the effect of 20% citric acid lotion, as compared with vehicle alone, on skin thickness, viable epidermal thickness, and dermal glycosaminoglycan content. Biopsy samples were harvested after 3 months of treatment. RESULTS: Image analysis of biopsy sections revealed increases in viable epidermal thickness and dermal glycosaminoglycans in treated skin. CONCLUSIONS: Topical citric acid produces changes similar to those observed in response to glycolic acid, ammonium lactate, and retinoic acid including increases in epidermal and dermal glycosaminoglycans and viable epidermal thickness. Further studies of citric acid and other alpha-hydroxy acids are warranted to clarify their clinical effects and mechanisms of action.

Increased factor XIIIa transglutaminase expression in dermal dendrocytes after treatment with alpha-hydroxy acids: potential physiologic significance.

BACKGROUND: Topical alpha-hydroxy acids (AHAs) have been shown to improve photoaging in human skin. OBJECTIVE: We studied factor XIIIa transglutaminase expression in dermal dendrocytes (DDs) and mast cell degranulation after treatment of the skin with AHAs. METHODS: Skin biopsy specimens obtained from patients after 4 to 8 months of treatment with lotions containing 25% AHAs were evaluated for factor XIIIa transglutaminase expression with immunoperoxidase and electron microscopy. Immunoperoxidase-stained sections were studied by means of semiquantitative methods and image analysis. Mast cell degranulation was studied by image analysis. RESULTS: Increased factor XIIIa transglutaminase expression was seen after treatment with AHAs. All treated sites had increased scores compared with control sites by semiquantitative methods. Seventy-five percent of treated sites showed an increased mean area over control sites of factor XIIIa transglutaminase positivity with image analysis. These results correlated with an increased level of mast cell degranulation in treated sites and with activation of DDs as seen by electron microscopy. CONCLUSION: Treatment of the skin with AHAs leads to mast cell degranulation and increased expression of factor XIIIa transglutaminase by activated DDs. Mast cell degranulation may lead to activation of DDs and increased factor XIIIa transglutaminase expression, via the action of tumor necrosis factor-alpha. We speculate that clinical and histologic improvement in photoaged skin after treatment with AHAs may be somehow related to this process.

Effects of alpha-hydroxy acids on photoaged skin: a pilot clinical, histologic, and ultrastructural study.

BACKGROUND: alpha-Hydroxy acids (AHAs) have been reported to improve aging skin. The mechanisms of action of AHAs on epidermal and dermal compartments need clarification. OBJECTIVE: Our purpose was to determine the effects of AHAs on photoaged human skin by clinical and microanalytic means. METHODS: Patients applied a lotion containing 25% glycolic, lactic, or citric acid to one forearm and a placebo lotion to the opposite forearm for an average of 6 months. Thickness of forearm skin was measured throughout the study. Biopsy specimens from both forearms were processed for analysis at the end of the study. RESULTS: Treatment with AHAs caused an approximate 25% increase in skin thickness. The epidermis was thicker and papillary dermal changes included increased thickness, increased acid mucopolysaccharides, improved quality of elastic fibers, and increased density of collagen. No inflammation was evident. CONCLUSION: Treatment with AHAs produced significant reversal of epidermal and dermal markers of photoaging.

[A comparative trial of hemodynamics and pulmonary function in patients with chronic lung disease complicated with or without pulmonary hypertension during exercise].

In order to determine the hemodynamics and pulmonary function during exercise, 20 patients with chronic lung disease complicated with (group A) or without (group B) pulmonary hypertension were studied. FEV1% in group A was lower than that in group B at rest, the increase in VE, VO2, O2-pulse in patients with pulmonary hypertension were lower than in patients without it during exercise. We speculated that exercise ability in patients with chronic lung disease may be effected by not only ventilation but also increased pulmonary arterial pressure.

20-item neonatal behavioral neurological assessment used in predicting prognosis of asphyxiated newborn.

From January 1989 to June 1990, 13 institutions in our country studied jointly the application of a 20-item neonatal behavioral neurological assessment (NBNA) in asphyxiated babies. Of 145 cases, 125 were followed up to 1-2 years of age. The results showed that in predicting prognosis, the sensitivity and specificity of NBNA score at 7 days after birth were 88.9% and 82.6% and 12-14 days, 84.6% and 97.4% respectively. Its value in predicting prognosis is superior to Sarnat degree, cranial CT and B ultrasound. This method is practical, economical and reliable. It is worth popularizing.

[CT in hypoxia brain damage in asphyxia-prognostic estimation].

60 newborns with severe asphyxia 3-12 days after delivery were examined by CT. Low density in brain was found in 55 newborns (91.7%), and cerebral hemorrhage in 34 (56.7%). To detect MDI CDCC measurement by Balay's modification was done in 54 babies of whom 44 cases were within normal limits (MDI > 70). Low intelligence was found in 10 babies (16.7%), and 6 (14%) died. No cerebralplagia was found. No intelligence change was found in normal or mild CT changes. In 50 babies with severe or moderate change in CT scan, 16 (32%) showed poor prognosis (P < 0.05). Sensitivity and specificity for CT were 100% and 22.8% respectively, but the value of neonatal behavioral neurological assessment (NBNA) was 83.3% and 93.2%. We conclude that the mortality rate and poor prognosis are related to the degree of involvement of brainwhite matter or hemorrhage, and that CT examination is valuable in estimating the prognosis especially in combination of NBNA.

[The comparison of left and right heart function with lung function in patients with rheumatic valvar heart disease].

According to the characteristics of changes of heart and lung function at different stages 25 patients with rheumatic valvar heart disease could be classified into three stages: 1. The stage of normal lung ventilation and volumes; 2. Stage of obstructive ventilatory function; 3. The stage of mixed ventilatory defects associated with right heart failure. As pulmonary artery pressure increased right ventricle work became elevated and left ventricle work decreased. There was an inverse correlation of vital capacity with per minute work of right ventricle.

Twenty-item behavioral neurological assessment for normal newborns in 12 cities of China.

Based on the method of Brazelton and Amiel-Tison for behavioral neurological measurement in the newborn and our own experience, we formulated a 20-item neonatal behavioral neurological assessment (NBNA). For setting up a practical method and a normal range of its scores in China, we examined 714 normal newborns (male 369, female 345), with NBNA at the age of 2-3, 12-14, 26-28 days for a total of 2,142 times, in 12 provinces of China from May to October 1988. NBNA contains 5 clusters: behavior (6 items); passive tone (4 items); active tone (4 items); primary reflexes (3 items); and general assessment (3 items). Each item has 3 scales (0,1,2). Twenty items have a maximum of 40 scores. Among the 2,142 times examined, 90.4% of the 714 newborns had 39-40 scores, 97% greater than 37 and none below 35. Measurements of the first, second and third time revealed that the total scores increased with age. The difference was statistically significant. The abilities of auditory and visual orientations and active neck tone improved obviously with age. NBNA shows distinct stability and reliability. The score is not influenced by geographic location; the scoring system is simple and the manipulation takes only ten minutes.

[Effects of nifedipine on pulmonary hypertension in patients with chronic obstructive pulmonary diseases--a comparison with oxygen administration].

We evaluated the effects of the calcium channel blocker nifedipine (Nf) as a vasodilator compared with oxygen administration on pulmonary hypertension and right ventricular performance in 15 patients with COPD. 1. Compared with baseline, sublingual administration of Nf (average dose 39.3mg) decreased mean pulmonary artery pressure (mPAP) and total pulmonary vascular resistance (TPVR) significantly. Cardiac index (CI) and oxygen transport were increased. PaO2 were unchanged and PvO2 were slightly increased after administration of Nf. 2. Compared with oxygen administration, Nf caused significant fall of TPVR. CI and oxygen transport increased. 3. In eleven of 15 patients, continued hourly Nf doses (from 20 to 60mg) produced a significant reduction in mPAP and TPVR. All patients but one did not produce symptomatic systemic hypotension. We considered that higher dose (30mg) of Nf was required to produce marked hemodynamic response in patients with COPD without any side effect.

Alpha hydroxy acids: procedures for use in clinical practice.

Alpha hydroxy acids and alpha keto acids applied topically in lower concentrations reduce the thickness of hyperkeratotic stratum corneum by reducing corneocyte cohesion at lower levels of the stratum corneum. This property permits efficient clinical control of dry skin, ichthyosis, follicular hyperkeratosis, and other conditions characterized by retention of stratum corneum. Applied topically in higher concentrations, these acids cause epidermolysis. This property provides a new alternative for treating seborrheic keratoses, keratoses commonly known as "age spots," actinic keratoses, and verrucae vulgares; all of which lesions involve distinct epidermal hyperplasia as well as retention of stratum corneum. Facial wrinkles can be modified with topical alpha hydroxy acids, applied in higher concentrations as office procedures, and concomitant daily home application of lower concentrations.