Staged Treatment with Chinese Herbal Medicine in a Controlled Ovarian Hyperstimulation of In Vitro Fertilization-Embryo Transfer Programme / 中医杂志

It is believed that kidney deficiency is the fundamental pathogenesis while liver constraint and spleen deficiency， and disharmony of chong （thorough vessel， 冲脉）and ren （conception vessel， 任脉） is the key pathogenesis of infertility patients who adopted controlled ovarian hyperstimulation of in vitro fertilization-embryo transfer （IVF-ET） programme. Therefore， the method of tonifying the kidneys dominantly and treating the liver and spleen simultaneously is proposed， and Chinese herbal medicine is suggested to be used in adjuvant treatment of staged IVF-ET controlled ovrian hyperstimulation. In the regulation stage， modified Liuwei Dihuang Pill （六味地黄丸） can be used to tonify kidney and supplement essence， fortify spleen and nourish liver； in the ovulation promotion stage， modified Wenjing Decoction （温经汤） should be used to warm kidney and assist yang， dispel stasis and nourish blood； in the pre-transplantation endothelial preparation stage， modified Shenling Baizhu Powder （参苓白术散） is suggested to fortify spleen and replenish qi， invigorate blood and resolve stasis； after the transplantation stage， modified Shoutai Pill （寿胎丸） or Taiyuan Decoction （胎元饮） can be taken to fortify spleen and tonify kidney， benefit qi and nourish blood.

Inflammatory brain lesions preceding primary central nervous system lymphoma: a case report and genetic analysis.

BACKGROUND: Primary central nervous system lymphoma (PCNSL) is an aggressive extranodal lymphoma exclusively occurring within the central nervous system. Inflammatory brain lesions as "sentinel lesions" of PCNSL are very rare. We present a rare case of PCNSL with preceding inflammatory lesions in an immunocompetent patient who underwent two biopsies, one craniotomy and two genetic testing. CASE REPORT: A 66-year-old male patient presented with left limb weakness and ataxia. Brain magnetic resonance imaging showed a contrast-enhancing lesion with perifocal brain edema in the near midline of right frontal lobe. Histological examination of a brain biopsy specimen revealed inflammatory lesion characteristics with infiltration of T-cell dominant lymphocytes and few B-cell. Given that the patient developed cerebral hematoma after biopsy, lesion resection by craniotomy was performed. An excised sample demonstrated mixed T-cell and B-cell infiltrating inflammatory lesions. Four months after total resection of the right frontal lobe lesion, another lesion appeared in the left frontal parietal lobe, which was diagnosed as diffuse large B-cell lymphoma by biopsy. In addition, genetic testing of the lesions at two different locations was performed, and the results showed that the inflammatory lesions had the same three gene (RELN, PCLO, and CREBBP) mutations as PCNSL. Interestingly, the three mutated genes are associated with tumor. CONCLUSION: Our present case is the first to demonstrate inflammatory brain lesions heralding PCNSL from genetic and pathological perspectives. This may help clinicians to select new auxiliary diagnostic methods for timely diagnosis of patients with suspected PCNSL.

Research advances on risk factors of coronary artery lesion in Kawasaki disease / 中国小儿急救医学

Kawasaki disease is an acute febrile rash disease with systemic vasculitis as the main lesion, which can lead to coronary artery lesion(CAL)in some children.Early diagnosis of Kawasaki disease can effectively prevent CAL.Previous studies on the risk factors of CAL in Kawasaki disease focused on leukocyte, neutrophil percentage, erythrocyte sedimentation rate, C-reactive protein, serum albumin, etc.In recent years, many new biomarkers have been found.This review summarized the newly studied risk factors, aiming to provide reference for timely treatment of Kawasaki disease and prevention of CAL.

The role of TLR4/NF-κB signaling pathway in sleep deprivation induced Meniere's disease / 临床耳鼻咽喉头颈外科杂志

Objective:By detecting the levels of proteins in the Toll-like receptor-4/nuclear factor-κB （TLR4/NF-κB） signaling pathway and downstream proinflammatory cytokines in peripheral blood of patients with Meniere's disease （MD）, Pittsburgh Sleep Quality Index （PSQI） scores were collected to investigate the correlation between sleep disorders and MD and the role of TLR4/NF-κB signaling pathway in mediating sleep disorders inducing MD. Methods:Thirty-two MD patients and 20 family members of patients without middle ear and inner ear related diseases were selected. Basic data, PSQI and fasting peripheral blood of all subjects were collected. Enzyme linked immunosorbent assay.The levels of interleukin-1β（IL-1β）, tumor necrosis factor-α（TNF-α）, monocyte chemokine-1（MCP-1）, Toll-like receptor 4（TLR4） and nuclear factor-κB（NF-κB） in peripheral blood were detected by ELISA, and the data were statistically analyzed. Results:①PSQI score of MD group was higher than that of normal control group, and the difference was statistically significant（P<0.01）; The scores of every factors of PSQI in MD group were higher than those in normal control group, and the scores of factors 2, 4 and 6 were significantly different from those in normal control group. ②In the MD group, there were 18 patients with sleep disorders, with a prevalence rate of 56.25%, including 6 males with a prevalence rate of 50.00% and 12 females with a prevalence rate of 60.00%. ③The levels of five test indexes in MD group, sleep disorder group and non-sleep disorder group were higher than those in control group, and the levels of TLR4 and NF-κB in MD group were significantly different from those in control group（P<0.05）. The levels of IL-1β, TNF-α, TLR4 and NF-κB in sleep disorder group were significantly different from those in control group（P<0.05）. The levels of five test indexes in non-sleep disorder group were not statistically significant compared with those in control group. The levels of five test indexes in the MD sleep disorder group were higher than those in the MD group and the non-sleep disorder group, with no statistical significance. The levels of five test indexes in MD group were higher than those in non-sleep disorder group, with no statistical significance（P>0.05）. Conclusion:①Sleep disorders may be one of the important predisposing factors of some MD, and the effects of sleep disorders on MD are different between the sexes. ②Sleep disorders may activate TLR4/NF-κB signaling pathway to induce MD. The selection of TLR4/NF-κB signaling pathway related proteins and downstream pro-inflammatory factor inhibitors to intervene MD may provide a new idea for protecting the hearing balance function of MD.

T lymphocyte subsets combined with inflammatory indicators for auxiliary diagnosis and prognosis evaluation of sepsis / 中华预防医学杂志

Objective: To explore the application value of T lymphocyte subsets combined with procalcitonin (PCT), C-reactive protein (CRP), neutrophil to lymphocyte ratio (NLR) and white blood cell count (WBC) in the auxiliary diagnosis and prognosis evaluation of sepsis. Methods: In a retrospective study, seventy-two patients with sepsis diagnosed and treated in Tianjin First Central Hospital from June 2018 to April 2021 were selected as the research objects, and included in the sepsis group were 46 males and 26 females, aged 68 (57.3, 80.3) years. In addition, 111 patients with local infection admitted to hospital during the same period were included in the local infection group, including 62 males and 49 females, aged 68 (51, 77) years. Sepsis patients were divided into survival group (43 cases) and death group (29 cases) according to the 28-day outcome. CD3+, CD4+, CD8+, CD4+/CD8+ ratio were detected by flow cytometry within 24 h after admission, PCT was detected by ELISA, CRP was detected by immunoturbidimetry, blood routine examination, blood lactic acid (Lac) and oxygen partial pressure (PO2) were detected by instrumental method. Multivariate Logistic regression analysis was used to evaluate the correlation between each indicator and sepsis, and receiver operating characteristic curve (ROC) was drawn to evaluate the diagnostic value of each indicator for sepsis. Multivariate Logistic regression analysis and Kaplan Meier survival analysis were used to evaluate the prognostic value of each index for patients with sepsis. Results: Peripheral blood CD3+, CD4+, CD8+, CD4+/CD8+ ratio and PLT in sepsis group were significantly lower than those in local infection group(Z=-8.184,P<0.001;Z=-7.210,P<0.001;Z=-5.936,P<0.001;Z=-2.700,P=0.007;Z=-6.381,P<0.001); PCT, CRP, NLR and Lac levels were significantly higher than those in local infection group(Z=-8.262,P<0.001;Z=-3.094,P=0.002;Z=-9.004,P<0.001;Z=-4.770,P<0.001). Multivariate Logistic regression model showed that PCT, NLR, CD3+, CD8+, CD4+/CD8+ were independent risk factors for sepsis. According to ROC curve analysis, AUC of sepsis patients diagnosed by each indicator were 0.862, 0.894, 0.858, 0.760 and 0.618, respectively. The cut-off values were 3.075 ng/ml, 10.715, 44.935×109/L, 27.463×109/L and 0.750, respectively. The NLR sensitivity was 80.6%, and the CD3+ specificity was 94.6%. The AUC of combined detection of PCT and NLR was 0.947, sensitivity was 87.5% and specificity was 91.9%. The combined detection AUC of PCT, NLR, CD3+, CD4+/CD8+ was 0.958, the sensitivity and specificity were 90.3% and 91.0% respectively(P<0.001). PCT and Lac in death group were significantly higher than those in survival group(Z=-2.302,P=0.021;Z=-3.095,P=0.002);Peripheral blood CD4+/CD8+ levels were significantly lower than those in survival group(Z=-3.691,P<0.001),Multivariate Logistic regression model showed that CD4+/CD8+ ratio was an independent risk factor for 28 d mortality in patients with sepsis (P<0.001). The ROC curve showed that the AUC was 0.758, and the Youden index reached the maximum when the cut-off value was 1.27, the sensitivity and specificity were 79.3% and 60.5%, respectively. Compared with patients with CD4+/CD8+ ≥1.27, 28-day mortality was significantly increased in patients with CD4+/CD8+<1.27 (P=0.032). Conclusion: The combined detection of PCT, NLR, CD3+ and CD4+/CD8+ can improve the auxiliary diagnostic efficiency of sepsis, and the ratio of CD4+/CD8+ in peripheral blood may have certain predictive value for the prognosis of sepsis.

Research progress on genetic pathogenesis of non-compaction of the ventricular myocardium in children / 中国小儿急救医学

Non-compaction of the ventricular myocardium(NVM), also known as cavernous cardiomyopathy, is dominated by left ventricular non-compaction(LVNC)in most patients.The incidence of NVM in childhood cardiomyopathy is second only to dilated cardiomyopathy and hypertrophic cardiomyopathy, and the pathological changes are prominent trabeculae and deep intertrabecular clefts.Most pediatric patients have serious complications, such as heart failure, serious arrhythmias, and thrombus.Therefore, it is particularly important to study the pathogenesis of LVNC in children.NVM may be caused by the cessation of myocardial compaction in early embryonic development, so the genetic pathogenesis of NVM is particularly important.This review aimed to elucidate the genetic pathogenesis of LVNC in children, and provide more ideas for the pathogenesis and genetic therapy of LVNC in the future.

Research progress on genetic pathogenesis of non-compaction of the ventricular myocardium in children / 中国小儿急救医学

Non-compaction of the ventricular myocardium(NVM), also known as cavernous cardiomyopathy, is dominated by left ventricular non-compaction(LVNC)in most patients.The incidence of NVM in childhood cardiomyopathy is second only to dilated cardiomyopathy and hypertrophic cardiomyopathy, and the pathological changes are prominent trabeculae and deep intertrabecular clefts.Most pediatric patients have serious complications, such as heart failure, serious arrhythmias, and thrombus.Therefore, it is particularly important to study the pathogenesis of LVNC in children.NVM may be caused by the cessation of myocardial compaction in early embryonic development, so the genetic pathogenesis of NVM is particularly important.This review aimed to elucidate the genetic pathogenesis of LVNC in children, and provide more ideas for the pathogenesis and genetic therapy of LVNC in the future.

Clinical characteristics and risk factors of coronary artery abnormities in infants with Kawasaki disease / 中国小儿急救医学

Objective@#To analyze the clinical characteristics of Kawasaki disease in infants and explore the risk factors of coronary artery abnormities in Kawasaki disease.@*Methods@#The clinical data of 300 children with Kawasaki disease from January 1, 2018 to December 31, 2018 were retrospectively analyzed, including laboratory tests and coronary ultrasound results.The clinical characteristics of infants with Kawasaki disease and elderly children with Kawasaki disease were compared.The risk factors of coronary artery injury in infants with Kawasaki disease were analyzed.@*Results@#The majority of infants with Kawasaki disease were atypical Kawasaki disease, and the typical changes of conjunctival congestion, perianal changes and plaque were significantly higher than those of elderly children (P<0.01). Leukocyte count and platelet count were higher in the infant group, and the number of children with abnormal liver function was significantly higher than that in the older group (P<0.05). Coronary artery dilatation occurred in 11% of infants with Kawasaki disease, and most of them returned to normal within 3 months.Logistic model design was used to analyze the risk factors of coronary artery injury in infants with Kawasaki disease.It was found that boys and CRP increased significantly were the risk factors of coronary artery injury in infants with Kawasaki disease.@*Conclusion@#Infant Kawasaki disease has its own characteristics.The incidence of coronary artery injury is high.Timely diagnosis, differential diagnosis and symptomatic treatment may reduce the incidence of coronary artery injury.At the same time, follow-up should be maintained to monitor the changes of coronary artery by echocardiography.

Progress of minimally invasive treatment about fragility fractures of pelvis / 中国骨伤

With the serious aging of the population, the incidence of fragility fractures of the pelvis(FFPs) has gradually increased, which has become a public problem affecting the living quality of the elderly. When a surgical treatment is chosen, the procedure should be as minimal invasive as possible and avoid all surgical complications. In recent years, different techniques for percutaneous or less invasive fixation of the posterior pelvic ring have been developed. Their advantages and limitations are presented: sacroplasty, iliosacral screw osteosynthesis, cement augmentation, transiliac internal fixation, transsacral osteosynthesis, lumbopelvic fixation. The purpose of this paper is to review the classification and minimally invasive treatment of FFP.

MicroRNA-145-5p and microRNA-320a encapsulated in endothelial microparticles contribute to the progression of vasculitis in acute Kawasaki Disease.

Kawasaki Disease (KD) is an acute inflammatory disease that takes the form of systemic vasculitis. Endothelial microparticles (EMPs) have been recognized as an important transcellular delivery system. We hypothesized whether EMPs are involved in vasculitis in acute KD. Fifty patients with acute KD were enrolled, divided into two subgroups: those with coronary artery lesions (CAL) (n = 5) and those without CAL (NCAL) (n = 45). EMPs were measured using flow cytometry, and microRNA (miR) expression profiling was performed by microRNA array. The percentage of EMPs in acute KD was significantly higher than in controls (P < 0.0001). EMPs in patients with CAL rapidly increased after the initial treatment, and was significantly higher than those in NCAL (P < 0.001). In patients with CAL, we identified 2 specific miRs encapsulated in EMPs, hsa-miR-145-5p and hsa-miR-320a, which are predicted to affect monocyte function using in silico analysis, and were demonstrated to upregulate inflammatory cytokine mRNAs in THP-1 monocytes. In situ hybridization confirmed that hsa-miR-145-5p was preferentially expressed in CAL. EMPs may serve as a sensitive marker for the severity of vasculitis in acute KD. Moreover, these 2 specific miRs encapsulated in EMPs might be involved in inflammatory cytokine regulation and the pathogenesis of vasculitis in acute KD.

Advances in noncompation of the ventricular myocardium in children / 国际儿科学杂志

Noncompation of the ventricular myocardium is one of three major types of cardiomyopathy in children.More patients are diagnosed,with the understanding of this cardiomyopathy.Their clinical manifestation may vary a lot from without symptoms to severe cardiac dysfunction.This article describes the clinical characteristics of left ventricular noncompaction(LVNC) children and long-term prognosis of children at different ages.With the development of next-generation sequencing technology,more and more gene mutations have been found to cause LVNC.The article introduces the relationship between genotypes and clinical phenotypes in children.LVNC has poor long-term prognosis.At present,studies have showed the importance of family screening.For children carrying pathogenic genes mutations,they should be followed-up regularly even without clinical symptoms.

Zerumbone attenuates MPP+-induced cytotoxicity in human neuroblasto-ma SH-SY5Y cells by inhibition of oxidative stress / 中国病理生理杂志

AIM:To investigate the role of zerumbone ( ZER) in 1-methyl-4-phenylpyridinium ( MPP+)-in-duced cytotoxicity of human neuroblastoma SH-SY5Y cells. METHODS:Human neuroblastoma SH-SY5Y cells were cul-tured in vitro and the protective effect of ZER against MPP+-induced cytotoxicity was measured by CCK-8 assay. Flow cy-tometry was used to determine the apoptosis and reactive oxygen species (ROS). The expression of Parkinson disease pro-tein 7 (PARK7) was knocked-down by using PARK7-specific short hairpin RNA (shRNA). The protein levels of PARK7, nuclear factor E2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) were determined by Western blot. RESULTS:MMP+remarkably reduced the cell viability in a dose-dependent and time-dependent manner. The SH-SY5Y cell injury model was established by treatment with MPP+ at 600 μmol/L for 24 h. ZER up-regulated the protein levels of PARK7 and Nrf2 (P<0.05), alleviated apoptosis (P<0.05), and reduced ROS production (P<0.05) in the SH-SY5Y cell injury model. Meanwhile, N-acetyl-L-cysteine (NAC) had the similar functions. Moreover, significant reductions in the protein levels of Nrf2 and HO-1 ( P<0.05), and obvious increases in apoptosis ( P<0.05) and ROS level ( P<0.05) were demonstrated in PARK7-knockdown cells. CONCLUSION:ZER protects SH-SY5Y cells against MPP+-induced cytotoxi-city, which may be related to activation of PARK7/Nrf2/HO-1 pathway, and subsequent attenuation of oxidative stress and apoptosis.

Combination of R848 and Poly（I:C）promotes antigen presentation by DC and enhances killing effect of CTL on lung adenocarcinoma A549 cells / 中国病理生理杂志

AIM: To investigate the effect of R848(a Toll-like receptor 7/8 agonist)combined with poly-inosinic:polycytidylic acid [Poly(I:C),a Toll-like receptor 3 agonist] on dendritic cell(DC)maturation,and the killing effect of DC-induced cytotoxic T-lymphocytes(CTL)on human lung adenocarcinoma A549 cells.METHODS:Mononu-clear cells were isolated from human peripheral blood and induced to differentiate into DC.The whole-cell lysate of A549 cells,namely tumor cell lysate(TCL), was used as antigen.R848 combined with Poly(I:C)was used as adjuvant to stimulate the DC.DC surface markers were analyzed by flow cytometry.The DC stimulated by antigen was co-cultured with T-lymphocytes for 7 d to induce CTL.The culture supernatant and CTL were collected.The levels of interleukin-12(IL-12)p70,interferon-γ(IFN-γ)and tumor necrosis factor-α(TNF-α)in the supernatant were measured by ELISA.The CTL and A549 cells were co-cultured for 16 h,and the cytotoxicity was observed by LDH assay.RESULTS:The expres-sion of CD83 and CD80 on the DC surface,and the secretion of IL-12 p70 in DC-R848+Poly(I:C)group were significant-ly increased compared with DC-TCL group(P<0.01).In addition,the cytotoxicity of CTL for A549 cells in DC-R848+Poly(I:C)group was significantly enhanced compared with DC-TCL group(P<0.01).The secretion levels of IFN-γand TNF-αin DC-R848+Poly(I:C)group were significantly elevated compared with DC-TCL group(P<0.01).CONCLU-SION:R848 combined with Poly(I:C)significantly promotes DC maturation and activation, and enhances the antigen-presenting effect of DC and the cytotoxicity of DC-induced CTL.

Clinical characteristics and prognosis of children with ventricular noncompaction / 中国小儿急救医学

Objective To investigate the clinical features and prognosis in ventricular noncompaction children. Methods Thirty-four cases who diagnosed with ventricular noncompaction were included in this study in Shengjing Hospital of China Medical University from January 2012 to May 2018. According to age, the children were divided into infantile type( age <1 year old) and juvenile type( age≥1 year old) . We ana-lyzed the clinical features,laboratory tests and prognosis. Results The average age at diagnosis was 3 years and 2 months. The sex ratio was 2. 4:1. Of these,32 cases were left ventricular noncompaction,1 was right ventricular noncompaction, and 1 was biventricular noncompaction. There were no statistically significant differences in family history,arrhythmia,and thrombotic events between infantile type and juvenile type. Heart failure was the first reason for most children,while older children often presented with fatigue when at diag-nosis. More than half of them showed significant left ventricular ejection fraction(LVEF) decreasing,and non-compacted layer to compacted layer(N/C) ratio showed negative correlation with LVEF(r= -0. 74, P<0. 001). Sixty-five percent(22/34) of the patients presented abnormal electrocardiogram. During the follow-up,one patient died of pulmonary embolism. No significant LVEF improvement was found in 35％(12/34) of the patient. The COX proportional hazards model showed that N/C ratio was an independent risk factor for poor prognosis of ventricular noncompaction(OR=14. 46,95％CI 1. 712 -120. 234,P<0. 05). Conclusion Children with ventricular noncompaction showed different clinical features and prognosis. Early diagnosis,treatment and long term follow up are key issues for the prognosis.

Clinical characteristics and risk factors of coronary artery abnormities in 320 children with Kawasaki disease / 中国小儿急救医学

Objective To compare the clinical features of classic Kawasaki disease (CKD) and in-complete Kawasaki disease (IKD),and to explore the risk factors of coronary artery abnormities in Kawasaki disease. Methods We collected the clinical data of 320 children with Kawasaki disease from July 1,2017 to June 30,2018,including 244 children with CKD (CKD group) and 76 children with IKD (IKD group). The risk factors of coronary artery abnormities in children with Kawasaki disease were explored. Results In ad-dition to coronary artery injury ( 5%), some patients showed other rare complications such as cholestasis (1. 6%),intestinal obstruction(0. 6%),atlantoaxial subluxation (0. 9%),macrophage activation syndrome (0. 9%) and Kawasaki disease shock syndrome (0. 3%). The age onset in CKD group was earlier than that in IKD group. WBC, CPR, NT-proBNP in CKD group were significantly higher than those in IKD group (P<0. 05). After one week of treatment,WBC and CRP decreased significantly in group IKD,and there was no significant difference in PLT count. Multivariate logistic model was used to analyze the risk factors of cor-onary artery abnormities in Kawasaki disease. It was found that 25-OH VitD reduction ( OR ＝2. 851,P <0. 05) was a high risk factor for coronary artery injury in KD. Conclusion Kawaski disease should be diag-nosed early, treated for organ damage and supplemented with vitamin D. After discharge, coronary artery changes should be monitored regularly.

Progress in Research on Bowel Preparation for Colon Capsule Endoscopy / 胃肠病学

Colon capsule endoscopy( CCE)is a new technique for the diagnosis of colonic lesions,it has many advantages such as high safety,good tolerance,etc. . Bowel preparation is an important procedure in CCE. The quality of bowel preparation is closely related with the accuracy of CCE. This article reviewed the progress in research on bowel preparation for CCE.

Comparison analysis of muscle enzymes in children with myocarditis and Duchene/Becker muscular dystrophy / 中南大学学报(医学版)

OBJECTIVE@#To compare the changes in muscle enzyme between children with myocarditis and Duchene/Becker muscular dystrophy (DMD/BMD), and to seek the explanations for variation.
@*METHODS@#The retrospective analysis for 83 myocarditis children (myocarditis group) and 69 DMD/BMD children (DMD/BMD group), who were collected from Department of Pediatric of Shengjing Hospital affiliated to China Medical University since January 2008 to May 2015, was carried out. At the same time, 24 healthy children from the Department of Pediatric Development served as a control group. The examination indexes included creatine kinase (CK), creatine kinase-isoenzyme MB (CK-MB), creatine kinase isoenzyme MB mass (CK-MB mass), cardiac troponin I (cTnI) and high-sensitive-cTnT (hs-cTnT).
@*RESULTS@#1) In the myocarditis group, the CK increased from 100 to 1 000 U/L, reached a peak after 5 days, which lasted for a week and then dropped to the normal; the CK-MB reached a peak after 5 to 7 days and dropped to the normal a month later; the CK-MB mass reached a peak on the first day and dropped to the normal after 3 weeks; the cTn reached to a peak after 5 days and dropped to the normal after about 17 days; hs-cTnT reached to a peak on the first day and dropped to the normal after about 19 days. 2) In the DMD/BMD group, the CK increased significantly and 27 cases had a CK value of more than 10 000 U/L. After the treatment for 1 to 2 weeks, their enzyme rose again after a slight drop. In terms of cTnI, 6 cases showed a moderate increase, 5 of them couldn't drop to the normal level until more than 3 weeks later; the hs-cTnT increased in the 45 cases, which lasted for more than 3 weeks in the 31 cases of them and showed a tendency of persisting increase.
@*CONCLUSION@#The cTnI and hs-cTnT rise significantly and possess wider observation window than CK and CK-MB mass in myocarditis children, with more sensitive and specific changes. The myocardial damage can occur before myasthenia and keep this trend for a long time in the DMD/BMD children. The trend of cTnI change in myocarditis children is similar to hs-cTnT, while hs-cTnT in DMD/BMD children is more sensitive than cTnI.

Factors associated with intramedullary MRI abnormalities in patients with ossification of the posterior longitudinal ligament.

STUDY DESIGN: A retrospective clinical study of 113 patients with ossification of the posterior longitudinal ligament (OPLL), who underwent either anterior or posterior surgery between 2006 and 2009. OBJECTIVE: To evaluate the risk factors affecting the intramedullary spinal cord changes in signal intensity on magnetic resonance imaging (MRI) for the patients with OPLL. SUMMARY OF BACKGROUND DATA: The relationship between the intramedullary spinal cord changes in signal intensity on MRI and neurological deficits, as well as the surgical outcomes, has been described. To obtain better prognosis, early surgery should be conducted in patients with OPLL who have potential abilities to develop intramedullary spinal cord changes in signal intensity on MRI. Various factors may be affecting the development of intramedullary spinal cord changes in signal intensity on MRI. MATERIALS AND METHODS: The clinical and radiographic data of 113 patients with OPLL who underwent either anterior or posterior surgery between 2006 and 2009 were reviewed. Age, sex, complication, mean occupying ratio of OPLL (the greatest thickness of OPLL divided by the anteroposterior diameter of the bony spinal canal), duration of symptoms, type of OPLL, preoperative Japanese Orthopedic Association (JOA) score, and range of motion of the cervical spine were collected. Logistic regression analysis was used. RESULTS: Changes in the intramedullary signal intensity on MRI were observed in 33 of the 113 patients. Statistical results show that duration of symptoms, occupying ratio of OPLL, preoperative JOA score, kyphosis, and instability of the cervical spine are the relevant risk factors for intramedullary spinal cord changes in signal intensity on MRI, with regression coefficients of 2.437, 0.953, -1.952, 2.093, and 1.516, respectively. For patients with OPLL, the longer the duration of the symptoms, or the higher occupying ratio of OPLL, or the lower preoperative JOA score, the greater the likelihood of intramedullary spinal cord changes in signal intensity on MRI. CONCLUSIONS: As intramedullary spinal cord changes in signal intensity on MRI indicated severe damage to spinal cord and poor prognosis as we described before, early surgery is suggested for patients with OPLL who manifest one of the following factors: prolonged symptoms, high occupying ratio, low preoperative JOA score, kyphosis, or instability of the cervical spine. These factors are closely related to the intramedullary spinal cord changes in signal intensity on MRI.

The combination of flow cytometry and automated cell image analyzer in determining the nature of ascites and pleural effusion nature / 中华检验医学杂志

Objective To explore the clinical value of flow cytometry( FCM) and DNA automated cell image analyzer ( AICM) in determine the character of ascites and pleural effusion.Methods This was a cross-sectional study.203 ascites and pleural effusionsamples were random selected from PLA hospital inpatients between August 2013 to June 2014 .The DNA content of sediment cells were detectedthrough the FCM and AICM respectively benign and malignant disease were differentiated according the counts and proportion of aneuploid cells.The sensitivity, specificitywere calculated byROC curves.Results The sensitivity, specificity and accuracy of flow cytometry cell in detectingtumor cells were 78.6%,80.0% and 79.2%%, while the sensitivity, specificity and accuracy of image analyzer were 83.5%,78.6% and 81. 3%respectively.When FCM and AICMwere combined ,the sensitivity, specificity and accuracyincreased to 92.2%, 86.3% and 89.6%.Conclusions Compared toconventional cytology test, the sensitivity and specificity were significantly high when the two methods were combined .Therefore, the combination method can be used to assist in clinical identification of the nature of ascites and pleural effusion and to help the diagnosis of disease.

The impact of obstructive sleep apnea hypopnea syndrome on nonalcoholic fatty liver disease in the nonobese elderly / 中华老年医学杂志

Objective To investigate the impact of obstructive sleep apnea hypopnea syndrome (OSAHS) on development of nonalcoholic fatty liver disease (NAFLD) in the non-obese elderly.Methods A total of 91 non-obese elderly patients were divided into 3 groups,29 cases with mild to moderate SAHS (mild-to-moderate OSAHS group),31 cases with severe OSAHS (severe OSAHS group),30 cases without OSAHS and matched with age,sex and BMI (control group).The changes in NAFLD severity index including serum liver enzyme levels,Type Ⅲ procollagen peptide (PⅢ P)and liver/spleen CT ratio were observed,and the influence factors for the changes were analyzed.Results Serum alanine aminotransferase (ALT),aspartate aminotransferase (AST)ALT/AST ratio and serum PⅢ P levels were significantly higher in severe OSAHS group than in mild-to-moderate OSAHS and the control group(F=25.71,15.15,18.64,respectively,all P＜0.01).There was no significant differences in serum liver enzyme ALT,AST and P Ⅲ P levels between mild-to-moderate OSAHS and the control groups(all P＞0.05),and the ALT/AST ratio was significantly higher in mild-to-moderate OSAHS group than in the control group(P＜0.01).The Liver/spleen CT ratio was significantly lower in OSAHS groups than in control group,while the ratio was lower in severe OSAHS group than in mild-to-moderate OSAHS group(all P＜0.01 or 0.001).Serum PⅢ P level was significantly higher in OSAHS groups than in control group(F=31.46,P＜0.01),while PlⅢ P levels were not significantly different between the mild-to-moderate OSAHS group and the control group(P ＞ 0.05).The correlation analysis showed that the liver/spleen CT ratio in OSAHS group was negatively correlated with AHI(r=-0.785,P＜0.001),but was positively correlated with the lowest oxygen saturation(r=0.517,P=0.001).The ALT/AST ratio and serum P Ⅲ P level in OSAHS patients were positively correlated with AHI (r=0.463,0.770,both P＜0.001),but were negatively correlated with the lowest oxygen saturation (r=-0.395,-0.514,P＜0.01 or 0.001).The multiple regression analysis showed that AHI was the only variable that affected liver/spleen CT ratio and serum P Ⅲ P level in OSAHS patients.Conclusions OSAHS patients in the non-obese elderly are always complicated with NAFLD,characterized by abnormal liver enzymes,hepatic steatosis and fibrosis.The severity of lesion is increased with the deterioration of OSAHS.AHI may play an important role in the development of NAFLD in the non-obese elderly with OSAHS.