Objective To explore the effect of Chinese herbal medicine formula "tonifying kidney plus strengthening vital energy" on regulating CD40, CD40L protein and mRNA expression in spleen cell in mice with SHENXU. Methods The interaction of CD40L expressed by activated T cells with CD40 on monocytes, macrophages, or B cells is essential for the production of IL-12 and other cytokines. An experimental model of mice with SHENXU by corticosterone was established to observe the effect of Chinese formula on CD40, CD40L protein and mRNA expression in spleen cells or in ConA stimulated spleen cells by immunohistochemistry and RT-PCR. Results No significant differences were found among 5 groups of mice about the CD40 and CD40L protein expression in spleen cells. Both CD40 and CD40L expression detected by immunohistochemistry decreased seriously in ConA induced cells from SHENXU mice (18.9%?3.3% vs 15.8%?2.3%) as compared to that of normal controls(29.7%?4.2% vs 23.3%?1.3%), and so did the mRNA expression on ConA stimulated cells from SHENXU mice. They were restored in different degrees when the SHENXU mice were cured by different Chinese medicine. The effect of "tonifying kidney plus strengthening vital energy" was stronger than that of "tonifying kidney" and "strengthening vital energy" alone. Conclusions "Tonifying kidney plus strengthening vital energy" enhanced the expression of CD40, CD40L mRNA and protein, and this may be one of the mechanisms of improving the status of immune inhibition resulted by Corticosterone.

Aim To study the inhibitory effect of ginkgolide B (BN52021) on the PAF induced changes of chemotaxis of murine peritoneal macrophages and the related polymerization of F-actin.Methods Chemotaxis assays were performed using a modified 48-well Boyden chamber. Actin polymerization of murine peritoneal macrophages was analyzed by flow cytometry using a specific fluorescent stain. Results Peritoneal macrophages significantly migrated toward platelet-activating factor(PAF) through a micropore filter; however, in the presence of PAF receptor antagonist BN52021 (0. 01the actin polymerization of murine peritoneal macrophages induced by PAF in the presence of Ca2+ , but not in Ca2+ -free medium. Conclusion The results suggested that preventing polymerization of F-actin may be a pathway by BN52021 to inhibit the chemotaxis of macrophages, and this effect seems to be Ca2+dependent. The data further indicated that inhibition of PAF induced macrophage chemotaxis is an important mechanism underlying the anti-inflammatory action of BN52021.

BACKGROUND: Applying naloxone in acute brain injury can sustain the cerebral perfusion pressure(CPP), alleviate the cerebral edema and prevent the secondary brain damage to a certain degree. But the dosage and the administration of naloxone in clinical practices vary substantially according to the literatures.OBJECTIVE: To investigate the effect of different doses of naloxone on the changes in the absolute power values of electroencephalography(EEG) in acute brain injury, and study the protective effects of naloxone at different doses.DESIGN: Case-control study based on patients.SETTING: Neurosugery department of a hospital affiliated to a university PARTICIPANTS: From January 2002 to April 2003, at the Intensive Care Unit(ICU) of theNeurosugery Department of the First Hospital Affiliated to the Chongqin Medical University, 86 patients with moderate or severe acute closed brain injury were selected. Of all the patients, 59 were male and 27 were female, aged between 18 - 65.METHODS: According to the degree of injury graded by Glasgow Coma Scale(GCS), the 86 patients bearing acute brain injury were divided into 3 groups: GCS 3 - 5 group, GCS 6 - 8 group and GCS 9 - 12 group. Each group contained a naloxone treatment group and a matched control group. The naloxone treatment group consisted of a low-dose naloxone subgroup and a large-dose naloxone subgroup. The changes in the total power value of EEG before treatment and at the time of 30 minutes, 1, 2, 24, 48, 72 and 120 hours after treatment were measured respectively using quantitative EEG monitor.MAIN OUTCOME MEASURES: The changes in the total power value of the patients' EEG before and after treatment were observed and recorded.RESULTS: The difference between the total power of EEG of the GCS 9 - 12naloxone treatment group 1 hour after a naloxone treatment and that of the matched control group was statistically significant(P ＜ 0.05); The same comparison between the low-dose and the large-dose naloxone subgroups within the GCS 9 - 12 naloxone treatment group yielded no significant difference. In the GCS 6 - 8 naloxone treatment group, the difference between the total power of EEG 1 hour after a naloxone treatment and that of the matched control group was statistically significant, and the large dose subgroup was more significant than the low-dose group. In the GCS 3 - 5 naloxone treatment group, no significant difference between the total power of EEG of the naloxone group and that of the control group could be observed.CONCLUSION: The low-dose naloxone treatment is helpful enough on the intervention for moderate brain injury, and the large-dose naloxone treatment is better than the low-dose on severe brain injury. For the patients with exceptionally severe brain injury, both the two treatments are proved to have no therapeutic effects.

Objective To discuss the psychological behavior intervention methods on reducing the violence behavior of schizophrenia patients. Methods 120 schizophrenia patients were admitted from January to December, 2007 and randomly assigned into the behavior intervention group (group A), the psy-chological support group (group B), the health education group (group C) and the control group (group D) with 30 cases in each group. Group A received routine nursing plus behavior intervention, group B was giv-en routine nursing plus psychological support, group C adopted routine nursing plus health education, group D only received routine nursing. The intervention effect was evaluated with MOAS and the relapse rate of violence behavior went through statistics. Results After intervention, the scores of MOAS decreased sig-nificantly in group A, B, C and D compared with those before intervention. The reduction of MOAS scores in group A, B and C was significantly higher than that of group D, with the highest reduction score in group A and group B and C followed subsequently. The relapse rates of the violence behavior in group A, B and C were significantly lower than those of group D. Conclusions Routine nursing, health education, psycho-logical support and behavior intervention can all reduce and decrease the violence behavior and the inci-dence of the violence behavior, among which behavior intervention proves to be the most effective, and psy-chological support and health education go subsequently.

0.05).Conclusion The variety of ECoG on patients with intracranial tumors undergone surgery is helpful to prognosticate postoperative early epilepsy.

The relaxation therapy is a common method in the psychological rehabilitation in the injured and disabled patients,which can release the negative emotions,improve the quality of sleep,decrease the pain of the injured and disabled parts of the body and build up the confidence of life of the patients after the earthquake.After the long-term practice of the psychological rehabilitation in the injured and disabled patients and the experience of the psychological rehabilitation in the injured and disabled patients after the 5·12 Earthquake,the author thinks during the relaxation training psychotherapy of the injured and disabled patients after the earthquake,the choice of technique and procedure of the relaxation therapy should depend on the specific situation of the patients.The author introduces a idiographic method of the relaxation therapy and some suggestions of the implied treatment after the relaxation which is suitable for the injured and disabled patients.

Objective:To analyze the clinical features and CYP17A1 gene mutation of 17α-hydroxylase/17, 20-lyase deficiency (17OHD). Methods:The clinical data, laboratory examination and genetic results of 6 children with 17OHD in the Department of Endocrinology, Children′s Hospital Affiliated to Capital Institute of Pediatrics from March 2014 to December 2019 were enrolled and analyzed retrospectively.Meanwhile, the clinical types of all congenital adrenocortical hyperplasia (CAH) patients were calculated and then the incidence of 17OHD was calculated.Results:The 6 cases were from 5 families, and the age at diagnosis was ranged from 1 year and 6 months to 15 years old, in which 2 cases were 46, XX and 4 cases were 46, XY.Their gender were all female.Three cases presented with hypertension (50.0%), 4 cases with hypokalemia (66.7%), and 1 case with labia mass (16.7%). The gonad developed into a testis in patients with 46, XY, and patients with 46, XX had ovarian hypoplasia.The laboratory tests revealed an decrease in the cortisol at 8 AM in all cases, ranging from 0.62 to 5.93 mg/L.Five cases displayed an increase in adrenocorticotropic hormone (ACTH) in the range of 84-271 ng/L, and 1 patient with normal ACTH (58 ng/L) had a peak cortisol of 1.75 mg/L after the ACTH challenge test.Elevated progesterone was detected in 6 patients with a normal 17 hydroxyprogesterone level.Further results proved low levels of testosterone and estradiol, and high levels of luteinizing hormone (LH), and follicle stimulating hormone (FSH). CT scan showed mild adrenal hyperplasia in all cases.Among 114 CAH patients during the same period, the incidence of 17OHD came second at 5.3%.The CYP17A1 gene mutation results indicated that 2 unrelated patients were homozygous mutation for p. Y329fs (c.985_987delTACinsAA), 2 siblings were compound heterozygous mutations for p. Y329fs and exon 1-7 deletion, 1 patient was compound heterozygous mutations of p. Y329fs and p. R416C (c.1246C>T), and 1 patient was homozygous mutations for p. L465P (c.1394T> C), which was first reported in China. Conclusions:17OHD is not rare in CAH.Female children with hypokalemia, hypertension, and hypogonadism can lead to diagnostic suspicion of 17OHD.The p. Y329fs mutation in Chinese 17OHD children is a hotspot.The p. L465P (c.1394T>C) mutation is a new mutation in China and it could enrich the mutant spectrum of CYP17A1 gene in China.

Objective Congenital nephrogenic diabetes insipidus (CNDI) is a rare disease, the aim of this article is to help better understanding of this disease. Methods The clinical features, genetic analysis and treatments of two siblings with CNDI were retrospectively analyzed, and related literatures were reviewed. Results Both brothers had polydispia, polyuria and low concentrate urine continuously, and they both had a mutation in AQP 2 conifrmmed with Sanger sequencing. This novel frame shift mutation caused arginine of 254 to histidine, and prolonged AQP 2 protein. Conclusions Gene analysis can help diagnosis of CNDI. Amiloride is useful option for treatment.

Objective To analyze the genetic changes and detailed clinical presentations of 5 maturity-onset diabetes of the young (MODY) cases in order to enhance the knowledge about MODY in children.Methods Seventy-eight patients initially diagnosed as diabetes mellitus between January 1 and December 31,2015 in Capital Institute of Pediatrics were retrospectively studied.Nine of them were suspected of MODY,and 5 patients were diagnosed as MODY through gene test.Clinical informations were collected including age,gender,main complaint,family history,body mass index (BMI),fasting blood glucose,fasting blood insulin,2-hour blood glucose and insulin after oral glucose tolerance test and glycosylated hemoglobin.The blood glucose was monitored dynamically in 2 patients.Targeted capture panel was designed to capture the 16 genes related to MODY,including 12 genes from MODY1 to MODY13 type and 4 genes with weak evidence of MODY according to Human Gene Mutation Database Exome capture,and Next-Generation sequencing on a HiSeq2000 (Illumina) was performed.After bioinformatics analysis,all prioritized variants detected in patients were validated by Sanger sequencing,including the probands and their parents.Results Five patients were confirmed as MODY by molecular diagnosis,accounting for 6.4％ of all the 78 patients in 2015.The ratio of male to female was 2 ∶ 3.The ages at diagnosis ranged from 2 to 11 years old,and the median age was 3 years old.Two cases were found to have abnormal blood glucose in physical examination.The rest 3 cases were discovered with abnormal blood glucose during hospitalization because of pneumonia (1 case)or diarrhea (2 cases).In 4 cases,their mothers had gestational diabetes history,in 1 case the father suffering from diabetes.BMI ranged 15.68-23.40 kg/m2.Fasting blood glucose was 6.3-7.2 mmol/L.Fasting blood insulin was 0.5-8.0 IU/L.Glucose tolerance test results showed that blood glucose of the patients was 8.6-10.8 mmol/L after 2 hours.The level of glycosylated hemoglobin was 5.5％-6.7％.Blood glucose was 3.9-13.0 mmol/L.All the 5 confirmed patients were caused by GCK gene mutation (MODY2 type).The mutations detected were located at Exon7 (2 cases),Exon4 (1 case),Exon5 (1 case),and Exon10 (1 case).Conclusions All the confirmed MODY patients were identified either through medical exam or infectious disease,and all had positive family history.Their BMI ranged widely.Fasting blood glucose was slightly elevated and glycosylated hemoglobin was normal or slightly elevated,but fasting blood insulin was normal in all the patients.Abnormal glucose tolerance test results were found in all 5 patients.Glycosylated hemoglobin was normal or slightly elevated.MODY2 was the only subtype detected in this group,which indicated that the common type in children was different from that in adults.

Objective To report clinical characteristics and genetic results of two sisters suffered from congenital adrenal cortex hyperplasia (17-α-hydroxylase deficiency), and relevant literatures were reviewed. Methods Clinical manifestation and laboratory examination data of two sister cases of 17-α-hydroxylase deficiency enrolled in Capital Institute of Pediatrics in March 2016 were analyzed. Sanger sequencing and MLPA for CYP17A1 genes were performed and the parents' genes were also verified. Results The two patients were four years and 10 years old, both suffered from hypokalemia after infections, and hypergonadotrophin gonad hypofunction. One case was with slightly high blood pressure. Laboratory test results showed potassium fluctuation tendency in 1.9~4.0 mmol/L, 17-OHP and DHEA was decreased. Enhanced CT showed different degree of adrenal gland enlargement. Chromosome examination of the older sister is 46, XY. Both sisters demonstrated heterozygous mutation of CYP17A1 gene. The molecular genetic analysis suggested a c.985_987delTACinsAA from father and a deletion spanning exons 1-7 of the CYP17A1 gene from mother. Conclusion 17-α-hydroxylase enzyme deficiency can be diagnosed before adolescence. Clinical hypokalemia with unknown reason and high blood pressure may indicate the disease. The diagnosis can be confirmed with gene sequencing of CYP17A1.