Mycoplasma, Chlamydia, Rickettsia, Spirochetes and Actinobacteria were generally called "four pathogens and one bacterium". It was always difficult to be denominated and classified rightly in textbooks, while it was also a key interfering with students to grasp the concept of bacteria exactly. So we raise the question and hope to learn from each other by an exchange of views here.

Objective To observe the effect of exclusive pregnancy food exchange method on biochemical index and pregnancy outcome on pregnant women with abnormal glycometabolism,and evaluate its effectiveness on dietary guidance.Methods Sixty-seven pregnant women with abnormal glycometabolism who accepted physical examination and gave birth,were divided into traditional food exchange group (control group,33 cases) and exclusive pregnancy food exchange group (observation group,34 cases),and were given respective intervention until the childbirth.The blood biochemical indexes and the pregnancy outcome between two groups were compared.Results Fasting blood glucose (FBG),2 h postprandial blood glucose (PBG),glycosylated hemoglobin (HbA1c) and triglyeride (TG) in observation group after treatment were significantly lower than those before treatment (P ＜ 0.05 or ＜ 0.01).PBG,HbA1c and TG in control group alter treatment were significantly lower than those before treatment (P ＜ 0.01).After treatment,PBG,HbA1c and TG in observation group were significantly lower than those in control group (P＜ 0.01),after 3 months follow-up,differences still existed (P ＜ 0.01).The total incidence of pregnant women complications in observation group was much lower than that in control group [14.71％(5/34) vs.36.36％(12/33),P ＜ 0.05],there was no significant difference between two groups on neonatal complications (P ＞ 0.05).Conclusions Exclusive pregnancy food exchange method can improve pregnant glycometabolism and lipid metabolism of pregnant women with abnormal glycometabolism,and reduce the incidence of pregnant women and infant adverse pregnancy outcome.It is great worthy to popularize and apply in dietary guidelines.

Objective To observe the outcome of patients with ocular cicatricial pemphigoid (OCP) after amniotic membrane grafting or penetrating keratoplasty.Design Retrospective,noncomparative case series.Participants 3 consecutive OCP patients (4 eyes),were included.Methods For 3 patients (4 eyes) in this study,preoperative visual acuity was from HM/5 cm to HM/10 cm.The symblepharon (gradeⅢ) of 2 patients (3 eyes) were detached and amniotic membrane was transplanted,and bandage contact lens were used till 2 months after operations.The other patient (1 eye) was undergone penetrating keratoplasty with glycerol-cryopreserved cornea because of corneal ulcer and perforation.Main Outcome Measures Visual acuity,recovering of conjunctiva and cornea.Results Am- niotic membrane dissolved about 1 month after operation in 2 patients (3 eyes).Symblepharon changed from gradeⅢto gradeⅡ,visual acuity increased to 0.04-0.05,central corneal epithelium was regenerated significantly,and a little new vessel appeared at corneal lim- bus in 2 patients (2 eyes).The graft deliquesced in the patient with penetrating keratoplasty at 20 days after operation and undergone penetrating keratoplasty again after 1 month.In this patient,the graft molten induced the ocular contents run-off and became eyeball at- rophy eventually.Conclusion Our small sample study shows that the symblepharon detachment and amniotic membrane transplantation is effective for improving visual acuity in OCP with ocular surface dysfunction.However,because of various factors,penetrating kerato- plasty is ineffective for OCP with perforating corneal ulcer.

Animals ; Betaine-Homocysteine S-Methyltransferase ; therapeutic use ; Homocysteine ; blood ; Hyperhomocysteinemia ; blood ; therapy ; Male ; Rats ; Rats, Wistar ; Recombinant Proteins ; therapeutic use

This paper summarizes the kinds of long term care facilities, service delivery organization, service model, service role and experience of long-term service system in the United States. It provides referral implications for China to explore and establish its own long-term care service system. . There is a variety of long-term care services such as short and long-term stay, adult day care, and home care services, with a gradual change from institutional services to home and community ones. Long-term care services are provided by paid both formal and mostly unpaid informal caregivers. Informal family caregivers are most frequently daughters (29. 3%), followed by spouses with (21. 2%). With the increased availability of the family and community-based services, the family caregivers are more likely to share long term care services with the paid formal ones. The United States has a well-structured long-term care service system whose access mechanism is rigorous and systematic, emphasizing the evaluation of service quality and effectiveness. Moreover, the U. S. long term care service system pays more attention on elders' wishes, respecting their preferences and rights of choice on the services. Based on the experience of the United States, China should primarily focuses on establishing a family and community-based long term care service system with a variety of service delivery facilities, give a full play to the community health facilities, social partners, and families. The Chi-nese government should not only give a focus to the service institutions and content diversification, but should as well establish a sound and detailed assessment and evaluation standard system to access the services and assure the effec-tiveness of service quality with a humanized concern.

Acupuncture Therapy ; Adult ; Behcet Syndrome ; therapy ; Female ; Humans

BACKGROUND:Chitosan has good filming and viscosity, it contains free amido, and can coordinate and cross-link with gelatin, thus natural semi-interpentrating polymer network structure can be formed among molecules through hydrogen bonds.OBJECTIVE: To prepare sponge-like wound-healing dressing of good porosity, hydrophilia and air permeability by means of frozen chitosan-gelatin mixture induced phase separation.DESIGN: A comparative observation.SETTING: Laboratory of the College of Science, Guangdong Ocean University. MATERIALS: Chitosan was deacetylated by 97.55%, Mη=1.85×106; Gelatin (CP grade) was produced by Shanghai Chemical Dispensing Factory; Glacial acetic acid, NaOH, formaldehyde and glycerin were all CP grade. XL30-EDAX scanning electron microscope (Philips, Dutch); 3365-type universal material testing machine. METHODS: ① By means of frozen chitosan-gelatin mixture induced phase separation chitosan solution of 0.2, 0.4, 0.5, 0.6 and 0.8 (mass fraction) was mixed with gelatin solution, then a small amount of glycerin to prepare sponge-like wound-healing dressing of good porosity, hydrophilia and air permeability. then a small amount of glycerin, and stayed quietly to deaerate. The samples were plated with gold as routine methods, and then the surface and sectional structures were observed under the scanning electron microscope. The effects of different proportion of chitosan and gelatin on the performance parameters (water retention, moisture absorption, avulsion intensity, air permeability rate) of the sponge-like materials were observed. ② Chitosan-gelatin mixtures of 18, 20, 22, 25, 24, 26 and 28 g/L (mass fraction) were used to prepare sponge-like materials, and the effects of different contents on the performances of the materials were observed. ③ The effects of cross-linking agent (formaldehyde) of different dosages (0.002, 0.004, 0.006, 0.008, 0.010, 0.012 and 0.014 in volume fraction) on the avulsion intensity of the materials were observed.MAIN OUTCOME MEASURES: ① Surface and sectional structures of the sponge-like wound-healing dressing; ② Effects of different proportion of chitosan and gelatin on the performance parameters of the sponge-like materials; ③ Effects of different contents on the performances of the chitosan-gelatin sponge-like materials; ④ Effects of cross-linking agent of different dosages on the avulsion intensity of the materials.RESULTS: ① It could be clearly seen from the surface that the chitosan-gelatin sponge-like materials were porous structure, whereas seen from the section, the pores were honey-comb formation or three-dimensional lamellar structure accumulated by porous lamellars. ② When the content of chitosan was greater, the section looked like honey comb;Whereas as the content of chitosan decreased and gelatin content increased, the section tended to parallel lamellar structure, the water content and water retention of corresponding samples had an ascending trend, but the alvusion iintensity increased at first, and then decreased. The mass fraction of 0.5 was suitable for chitosan in the prepared solution by comprehensively analyzing the performance parameters. ③ The lower the total concentration of chitosan and gelatin, the higher the water content, the easier for the formation of bigger self-chips on the surface, the porosity of the prepared materials increased, hydrophilia and water retention ability were increased, but greater cracks formed on the material surface, and avulsion intensity was smaller. As the concentration became higher, the viscosity of the mixture became greater, the excessive viscosity was not good for mixing uniform, thus the material surface was not plain enough, and the porosity was smaller, the hydrophilia and water retention ability were relatively decreased, and the materials were harder. The total concentration should be 22-25 g/L. ④ Once the dosage of cross-linking agent was too low, very few cross-linking points generated, and the intensity was too low; Once the dosage of cross-linking agent was too high, too many cross-linking points generated, and the net space was reduced, then water content and water retention value were decreased; Whereas overdosage cross-linking agent could increase the fragility of the sponge-like materials, manifested as the decrease of avulsion intensity. When formaldehyde of 0.01 in volume fraction, the avulsion intensity was the maximal, thus the dosage of 0.01 in volume fraction was the most suitable.CONCLUSION: The main factors that affect the structures and performances of the sponge-like wound-healing dressing are the proportion of chitosan and gelatin in the mixture, total concentration of the prepared solution, amount of powder and dosage of cross-linkage agent, etc. The best matching iss chitosan of 0.05 (volume fraction)/gelatin of 0.05 (volume fraction), total mass concentration of 22-25 g/L, amount of chitosan-gelatin powder mixture is 1∶1, and the dosage of cross-linking agent is 0.01 (volume fraction).

OBJECTIVE: To investigate the effect of Salvia Miltiorrhiza injection (SMI) on peritoneal dialysis solution (PDS) induced injuries of peritoneal structure and function in a rat model, and to observe the relationship between the failure of peritoneal dialysis and expressions of aquaporin-1 (AQP-1) and zonula occluden-1 (ZO-1) in peritoneal tissues. METHODS: Fifty-six SD rats were randomly divided into normal control group, 1.5% PDS group, 4.25% PDS group, 1.5%PDS+1% SMI group, 1.5%PDS+2% SMI group, 4.25% PDS+1% SMI group and 4.25% PDS+2% SMI group. Two-hour peritoneal dialysis test was performed in rats in different groups by intraperitoneal injection for 8-week. Then rats were killed on the 8th week, and the bloods and peritoneal tissues were gathered. The rate of ultrafiltration, clearance rates of urea nitrogen, creatinine and glucose of peritoneum and content of total protein in PDS were detected. Peritoneal membrane histology was evaluated by light microscopy and transmission electron microscopy. Expressions of ZO-1 and AQP-1 proteins in peritoneal tissues were detected by immunohistochemical method, and AQP-1 protein expression was also detected by Western blotting technique. RESULTS: Compared with normal control group, using of 1.5% PDS and 4.25% PDS caused the changes of structure and function in peritoneum, such as pathological change of peritoneum, decreasing of the rate of ultrafiltration (P<0.05), clearance rates of creatinine and glucose (P<0.01) and the expression of ZO-1 protein (P<0.05), and increasing of the expression of AQP-1 protein (P<0.05). Compared with the simple PDS groups, the pathological damage of peritoneum was lessened and the rate of ultrafiltration and clearance rates of creatinine and glucose were increased in the 1.5% PDS+2% SMI group and 1.5% PDS+2% SMI group. Expression of AQP-1 protein was decreased by 1.5% PDS+2% SMI as compared with 1.5% PDS (P<0.05).[JP] CONCLUSION: SMI can relieve the injuries of function and structure of peritoneum by down-regulating the expression of AQP-1 protein.

Sinus histiocytosis with massive lymphadenopathy( SHML) is also called Rosai-Dorfman disease.It is a kind of benign lymphoid tissue proliferative diseases with unknown etiology.SHML appeared mostly in children and adolescent.It has diverse clinical manifestations accompanied with multiple organ inju-ry,and no clear laboratory indicators could support the disease,being a rare disease in pediatrics,easyot miss diagnosis.Thsi article reviewde the latest progress on diagnostis and treatment of SHML,to improve teh un-derstanding of the disease.