Objective To understand the relationship between clinical manifestations and Kashin-Beck disease(KBD) and their contribution to diagnosis of KBD and to construct the diagnosis model for KBD in adolescents.Methods A total of 2248 subjects under the age of 18 were collected from 6 KBD endemic and 1 non-KBD areas of the Shaanxi province in China.Analysis of 32 indicators,including gender,age,and KBD clinical indicators.Indicators of the distribution of measurement data between the two groups using t test and analysis of variance,x2 test with count data,multi-category ordered response variables Logistic regression analysis for model building.Results It showed the KBD prevalence rate in adolescent had an increasing tendency with age.Analysis of indicators between the two groups,in addition to the age factor(P ＜ 0.05),the difference of ankle pain,knee pain,wrist movement disorder and other 5 indicators(P ＜ 0.05) and the last bend,elbow movement disorder,syndactyly and other 9 indicators(P ＜ 0.01 ) were statistically significant.Sixteen clinical and radiographic features in the clinical manifestations were significantly related with the clinical severity grading with KBD(P ＜ 0.01 ).Four models on the diagnostic indictors were constructed by cumulative logit model for adolescent KBD (-21ogL,Score,Wald x2 test,P ＜ 0.01 ).Conclusions The establishment of the diagnostic model based on their contribution of the joint involvement in systemic performance-related indicators has an important role for clinical diagnosis of KBD.

Objective To prepare specific polyclonal antibodies to outer membrane protein (Opr) D_2 of Pseudomonas aeruginosa (PA),and explore the relationship between loss of OprD_2 and imipenem resistance.Methods The genomic DNA of PA was ex- tracted with phenol:chloroform.OprD_2 coding gene was amplified by PCR and prokaryotic expression vector pRSET-OprD_2 was constructed.OprD_2 protein was expressed by IPTG induction in E.coli BL21(DE3),and purified with SDS-PAGE.The new protein band was recovered and used as antigens to subcutaneously immunize two New Zealand rabbits to prepare poly- clonal antibody.The specificity of the antibody was determined by Western blot.The expression of OprD_2 in 32 clinical isolates of PA was detected with the prepared polyclonal antibody by Western blot.Results The vector pRSET-OprD_2 has been success- fully expressed in E.coli BL21 (DE3).The polyclonal anti-OprD_2 antibody with high specificity has been successfully pre- pared.Present results show that of the 27 imipenem-resistant PA clinical isolates,OprD2 protein was low-expressed in 5 iso- lates (18.5%) and normally expressed in 2 isolates (7.4%) but not expressed in 20 isolates (74.1%).Conclusions The loss or low-expression of OprD_2 is one of the essential mechanisms accounting for imipenem resistance in clinical isolates of PA.

Objective To investigate the relationship between high-sensitivity C-reactive protein(hsCRP), pulse pressure(PP) and microalbuminuria(MAU) in patients with essential hypertension.Methods Consecutive 60 patients with essential hypertension were classified based on the MAU level:patients with MAU(n=30) and the group of patients with normoalbuminuria(NMAU,n=30) with 30 healthy subjects as control.MAU,hsCRP,PP were determined.Results The level of hsCRP and pulse pressure in MAU group were higher than those in NMAU patients and healthy subjects (P

Objective To investigate the effects of early rehabilitative training program on patients with acute myocardial infarction(AMI).Methods One hundred and twenty-two patients with AMI were randomly divided into early rehabilitation group(n=62)and control group(n=60).In addition to routine treatment,patients in rehabilitation group received early rehabilitative training mainly by walking exercise for two weeks.Results There were no significant differences in ventricular arrhythmia(Lown≥Ⅲ), extension of infarction and heart rate variability(HRV)between the two groups(P＞0.05).Forty of 62 patients(64.5%)in rehabilitation group had their left ventricular ejection fraction(LVEF)more than or equal to 50% in the 3~(rd)～4~(th)week after admission,significantly higher than that in control group(45.0%, 27/60 ;P＜0.01 ).By the end of the 4~(th)week after admission,25.8% of the patients in rehabilitation group showed positive in treadmill test,significantly lower than that in control group(38.3%,P＜0.01). Occurrence of angina pectoris and reinfarction and fatality in rehabilitation group were significantly lower than those in control group(P＜0.05)during their hospitalization and follow-up period.Patients in rehabilitation group stayed at hospital for(16?3)days in average,significantly less than that in control group[(27?4) days],with statistically significant difference(P＜0.05).Conclusion Early rehabilitative training for patients with uncomplicated AMI is not only safe and feasible,but also useful in improvement for their prognosis and quality of life.

Objective To investigate the assoiation between rheumatoid arthritis(RA)and the pres- ence of the shared epitope(SE)of HLA-DRBI gene in Han nationality of Neimenggu population.Methods The method of DNA amplification with sequence-specific primers(PCR-SSP)was used to determine 17 alleles of HLA-DRB1*01,*04,*10 genotypes in 80 RA patients and 110 healthy controls from the Han nationality population in Neimenggu.Results The frequencies of SE were significantly increased in RA patiens com- pared with controls(48.8%:20%,P＜0.01).Epitope analysis revealed that the most predominant allele subtype of DR4(*0405)was usceptible sequence in Neimenggu patients with RA(28.8%:12%,P＜0.01).No statisticall significant difference of other subtypes of DR1,DR4 nd DR10 was noted including DRB1*0101(2.5%:0.9%), *0102(2.5%:0),*0103(1.25%:0.9%),*0104(2.5%:0),*0401(6.25:1.8%),*0402(3.75%:0.9%),*0403 (1.25%:1.8%),*0404(2.5%:1.8%),*0406(2.5%:2.7%),*0407(1.25%:0.9%),*0408(3.75 %:0.9%),*0409 (1.25%:0),*0410(2.5%:0.9%),*0411(0:0)and *1001(8.75%:4.5%)respectively.Logistic regression analy- sis showed that the disease of patients with SE homozgote was more severe than that of patients with heterozy- gote(P＜0.01).Conclusion The results suggest that there is an association between SE of HLA-DRBI gene and susceptibility and severity of RA,especially,HLA-DR4 subtypes are strongly associated with RA in Han nationality in Neimenggu population.

Objective To investigate the changes in the glutamate transporter EEAC1 mRNA expression and the injured nerve cell apoptosis after rat cerebral ischemia/reperfusion injury is treated with mild hypothermia. Methods The middle cerebral arteries(MCA)of Sprague-Dawley rats were occluded for 30 minutes,and reper- fused for 90 minutes.Using DIG-labeled CRNA probe and TUNEL,the positive rate of glutamate transporter EE- AC1 mRNA expression and apoptotic cell rate were determined in the sham-operated group,the control group and the mild hypothermia group,respectively.Results The positive rate of EEAC1 mRNA expression and apoptotic cell rate were significantly lower in sham-operated group than those in the control group(P

To investigate the therapeutic effects and associated complications of allogeneic peripheral blood stem cell transplantation (allo-PBSCT). 40 patients with various malignant hematopoietic diseases received allo-PBSCT. The preparative regimens were based on BUCY2 or modified BUCY2. The acute graft-versus host disease (aGVHD) was prevented by cyclosporin A and short-term MTX regimen in all patients. Two patients from donors with one fully mismatched HLA on DRB1 locus and 4 from unrelated donor also administered Zenapox (CD25 MAb) at dosage of 1 mg/kg every day on the day before transplantation and day 4 after transplantation. These 6 patients were also treated with mycophenolate mofetil (MMF). Transfusion of the donor cells: The median of the transfused nucleated cells was 5.38 x 10(8)/kg and that of the CD34+ cells was 7.8 x 10(6)/kg respectively. All the patients gained hematopoietic reconstruction except one who died of infection before engraftment. Seven patients got II degrees-IV degrees aGVHI) and the incidence was 17.5%. Fourteen patients got cGVHD and the incidence was 53.8% in the patients who survived over 6 months. Twenty-eight patients had fever or other characteristics of infection. The median follow-up time was 13.8 months. The incidence of transplantation related mortality (TRM) was 17.5% and 2 patients relapsed (5.0%). It was concluded that allo-PBSCT can reconstruct hematopoiesis quickly and is a favorable therapeutic method for leukemia.
China/epidemiology ; Cyclosporine/*therapeutic use ; Follow-Up Studies ; Graft vs Host Disease/*prevention & control ; Leukemia/*therapy ; Leukemia, Lymphoid/therapy ; Leukemia, Myeloid, Acute/therapy ; *Peripheral Blood Stem Cell Transplantation/adverse effects ; Sepsis/epidemiology ; Sepsis/etiology

AIM:To explore the diagnosis and treatment methods of radioaction-induced optic neuritis ( RION) through the clinical dates of 17 patients.
METHODS: It was a retrospective case series study. From August 2008 to October 2013, 17 cases (24 eyes) of Rion clinical dates from Chinese PLA General Hospital were studied. The diagnosis methods including visual acuity, pupil, fundus, visual field, fundus fluorescein angiography (FFA), visual electrophysiological testing, and head MRI. To analysis the clinical date of patients with diagnosis of RION by statistical description.
RESULTS: The deterioration degree of vision: 13 eyes were classified as Ⅳ, 9 eyes as Ⅲ, 2 eyes as II. Ten eyes RAPD ( + ) , visual electrophysiology is extinguished. The retina of 5 eyes showed flame hemorrhages and cotton wool spots exudation. Optic nerve head edema in one eye. T1 - weighted MRI enhanced in 19 eyes which showed optic nerve of the intracranial and intratubal segments abnormal changed, optic chiasm and pituitary stalk signal abnormalities and enhancement of the optic nerve. Tortuous optic nerves and rough edges were observed in 5 eyes. Treatment effect: 4 eyes of visual acuity improved, 1 eye from blindness to light perception,1 eye from 0. 08 to 0. 2, 1 eye from 0. 4 to 0. 6,1 eye from 0. 04 to 0. 15, the rest of the cases did not see any improvement.
CONCLUSION: The unique clinical manifestation of RION can provide objective basis for clinical diagnosis in time, but there have not been proven any effective treatments.

ObjectiveTo compare the clinical efficacies of acupuncture, auricular point sticking, and the combination of the two methods in treating primary dysmenorrhea by using randomized controlled method, for selecting the optimal treatment in treating primary dysmenorrhea, and to explore the nursing care method for primarydysmenorrhea from the perspective of Chinese medicine. MethodNinety patients with primary dysmenorrhea were randomized into an acupuncture group of 30 cases (group A), an auricular point sticking group of 30 cases (group B), and a combined group of acupuncture plus auricular point sticking of 30 cases (group C). The patients were given treatment 7 d ahead of the menstrual period, a menstrual cycle as a treatment course, totally for 3 courses. The pain score and clinical efficacies were observed and compared among the three groups for statistical analyses.Result The pain scores were significantly changed in the three groups after intervention (P<0.05), there were significant differences in comparing the pain scores among the three groups after intervention (P<0.05), group A and C were superior to group B (P<0.05), and group C was superior to group A (P<0.05). The total effective rate was 96.7% in group A, versus 93.3% in group B and 100.0%in group C, and the rank-sum test showed thatZ=7.675,P=0.022 (P<0.05).ConclusionThe three treatment methods are all effective in treating primary dysmenorrhea, while combining acupuncture and auricular point sticking can approach the optimal effect.

Objective To explore the molecular types of methicillin-resistant Staphylococcus aureus (MRSA) strains present in major hospitals in Qingdao area, using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) methods, trying to find out the epidemiological characteristics of these MRSA isolates. Correlation of the PFGE types with microbiological phenotypes and clinical data was also studied. Methods 360 isolates of MRSA were procured during 2003 to 2007 from major hospitals in Qingdao. PFGE technology was applied to comparatively analyze the chromosomal DNA digested with endonuclease Sma Ⅰ . Comparison of DNA fragments patterns from each MRSA strain and cluster analysis were performed with the Bionumericus version ' 2.0' software. A dendogram was generated using PFGE macrorestriction fragments on gel images. Data was used to predict the possibility of each PFGE type via SPSS software version 11.0, using the variables as predictors including groups on patient's age, gender, source and the site where MRSA was isolated. Antibiotic sensitivity patterns of these MRSA isolates were determined by K-B tests, and a correlation between these patterns and PFGE types was investigated. Housekeeping genes were amplified with PCR and sequenced in representative strains of variant PFGE types to identify their allelic profile. Results 5 types of PFGE patterns (M0-M4) were identified with MI being the predominant and M2 next to it which was significantly correlated to the isolates from wounds. M3 type strains were mainly isolated from ICU wards and there were a few cases complied with M4 type with no correlated variant factors found in this study. A unique pattern of MRSA isolates with its M0 distinct from other types had not been reported. No significant association was found between PFGE individual types,gender or age groups. M1 and M2 types were the major proportional PFGE patterns among different hospitals. No vancomycin-resistant isolates were detected among 360 MRSA strains. No significant association was found between individual antibiotic resistance and specific PFGE types. Data from MLST analysis showed that the aUelic profiles of M1 and M3 type strain had the same ST239 linage which was commonly present in China. For M2 and M4 representative strains, the allelic profiles were ST5 and ST240, respectively. ST45 and ST398 were corresponding to two PFGE patterns clustered as M0 type. Conclusion Nosocomial infection due to MRSA was evenly distributed among different age groups and no gender bias was observed. The PFGE types of MRSA strains isolated in major hospitals in Qingdao were highly correlated with the sources of isolates and ST239 isolate seemed the prevalent and widespread one. Strategies should be designed to further monitor and prevent or minimize the spread of ST5 MRSA isolates and the like, in Qingdao area.