Macrophage activation syndrome (MAS)is a serious potentially life -threatening complication seen primarily in patients with systemic onset juvenile idiopathic arthritis (sJIA).Clinical symptoms include persis-tent fever,liver and spleen lymph node enlargement,cytopenia,hyperferritinemia,hypofibrinogenemia,hypertriglyceri-demia,coagulation disorders,and hemophagocytosis can be seen in the bone marrow.This article summarizes the characteristics of MAS occurring in the context of sJIA and discuss the recent advances in classification systems and management.

Aim To observe the effects of activation of aldehyde dehydrogenase 2 ( ALDH2 ) by ethanol on testis injury of type 2 diabetic rats. Methods Type 2 diabetic rats model were established by high-fat diet combined with low-dose streptozotocin ( STZ ) injec-tions. After the success of modeling, the rats were ran-domly divided into 3 groups ( n =6 ): normal control group (NC), type 2 diabetes group (T2DM) and eth-anol+type 2 diabetes group (EtOH+T2DM). Rats of EtOH + T2DM were treated with low-dose ethanol, then rats of NC and T2 DM were given normal diet for 8 weeks. After 8 weeks, the levels of the fasting blood glucose ( FBG ) , glycosylated hemoglobin ( HbA1 c ) and testosterone were tested, and the ratio of testis weight to body weight ( TW/BW ) was calculated. Morphological changes of testis tissue were observed by optical microscope. The levels of ALDH2 mRNA and transforming growth factorβ1 ( TGF-β1 ) mRNA in tes-tis tissue were measured. The expression of TGF-β1 in testis tissue was observed by immunohistochemical stai-ning, then the positive rate of TGF-β1 was calculated. Results Compared with NC, the levels of FBG, HbA1 c and TW/BW increased significantly and the level of testosterone decreased significantly in T2DM. The morphological observation showed that some semi-niferous tubules atrophied, spermatogenic cells de-creased and arrangemented loosely, Leydig cells de-creased in testicular interstitial. The level of ALDH2 mRNA in testis tissue decreased significantly, and the level of TGF-β1 mRNA and the positive rate of TGF-β1 in testis tissue increased significantly. However, compared with T2DM, the levels of FBG, HbA1c and TW/BW decreased, and the level of testosterone in-creased and the damage of testis tissue was attenuated in EtOH+T2DM. The level of ALDH2 mRNA in testis tissue increased significantly, and the level TGF-β1 mRNA and the positive rate of TGF-β1 in testis tissue decreased significantly. Conclusion Activating AL-DH2 can protect testis in type 2 diabetic rats, which may be related to the downregulation of TGF-β1 ex-pression.

The human cytomegalovirus (HCMV) is a widespread herpesvirus. Virus reactivation from latency can lead to stillbirth, miscarriage, fetal anomalies, and intrauterine growth retardation. During latent infection with the HCMV, the virus can be cleared by the immune response or apoptosis of host cells. However, the HCMV has developed several strategies to manipulate expression of its genes and the microenvironment of host cells. Recent studies have shown that latent infection with the HCMV is associated with viral: regulation of early expression of genes; evasion of cell death; evasion of the immune response; regulatin of non-coding RNAs. This review summarizes recent research progress on the mechanisms underpinning latent infection with the HCMV.
Animals ; Cytomegalovirus ; genetics ; physiology ; Cytomegalovirus Infections ; immunology ; virology ; Humans ; Viral Proteins ; genetics ; metabolism ; Virus Latency

Objective To investigate the dynamic changes and the clinical significance of T-cell subsets and serum soluble interleukin-2 receptor (sIL-2R)in neonates with hyperbilirubinemia.Methods Thirty-one neonates with hyperbilirubinemia, admitted to the hospital from Decembr 1,2006 to January 31, 2007, were enrolled and divided into two subgroups: severe jaundice group and mild jaundice group according to the bilirubin level. Thirty-two age-mached healty newborns were as controls(control group Ⅰ). The T-cell subsets and sIL-2R of peripheral venous blood samples from these neonates were measured and compared. Sixteen of these 31 neonates with hyperbilirubinemiawere followed up and another twenty-six age-mached healty newborns were as controls(control group Ⅱ ). The level of serum bilirubin in convalescence of sixteen hyperbilirubinemia neonates and control group Ⅱ were tested and analyzed also. Results The levels of CD3, CD4, CD4/CD8 in the neonates with hyperbilirubinemia were lower compared with those of control group Ⅰ [(54.0±5.1)% vs (62.0±4.7)%, (26.8±5.0)% vs (43.0±4.7)%, 0.8±0.1 vs 1.4±0.2] (P＜0.01), but was higher in convalescence than in peak phase[ (62.4±3.3)% vs (55.1±4.2)%, (43.6±2.5)% vs (26.1±4.4)%, 1.4 ± 0.1 vs 0.8±0.1] (P＜0.01). The peak level of sIL-2R in the hyperbilirubinemia group was (319.4± 185.2) kU/L, higher than that in the convalescence [(129.7±99.3) kU/L] and in the control group Ⅱ [(171.9±102.2) kU/L] (P＜0.01). The serum bilirubin level showed negative correlation with CD4/CD8 ( r = -0.99, P ＜ 0.01 ) and positive correlation with sIL-2R (r=0.95, P＜0.05). The sIL-2R level was negatively correlated with CD4/CD8 (r=-0.92, P＜0.05). Conclusions Neonates, when suffering from hyperbilirubinemia, are immunosuppressed which may recover with the alleviation of jaundice.

Objective To understand the influence of personal feature on nurses' professional identity.Methods Nurses of 6 military hospitals were assessed and analyzed by general data questionnaire,Nursing Professional Identity Scale.Results Nurses' professional identity in military hospital was on the moderate level.Nursing age,department,monthly income,position,gender entered into the regression equation of nurses' occupation,which affected positively nursing professional identity.Conclusions The military nursing managers should raise the income of nurses appropriately,especially pay attention to training of professional identity of seniority nurses and local recruitment nurses,and enhance master concept in order to increase their understanding and recognition of their occupation.

Objective To investigate the clinical features and long - term prognosis of neonatal lupus erythe-matosus(NLE)and to improve the understanding of NLE. Methods The clinical manifestations and related serologi-cal tests of NLE children diagnosed from June 2010 to January 2014 were analyzed. Regular follow - up was carried out to detect the general condition,rash,blood routine,urine routine,liver and kidney function,complement,red blood cell sedimentation rate(ESR),auto antibodies,electrocardiogram,and ultrasound cardiogram. Results Among the 11 NLE cases,there were 6 male and 5 female patients. All had lesions on skin,3 cases had hematologic changes,7 cases were had liver damage,and 4 cases had heart impairment. The antinuclear antibody and anti - sjogren sydrome A/ Ro antigen (SSA/ Ro)were positive in all the patients. The anti - sjogren sydrome B antigen was positive in 5 patients. The anti -double stands deoxyribonucleic acid antibody was positive in 4 patients. Antibody against U1 - ribonudeoprotein was positive in 3 patients,and the level of ESR was higher in 5 patients. The antinuclear antibody and anti - SSA/ Ro anti-body were positive in all mothers. Only 1 mother had no symptom before pregnancy,7 patients had SLE,3 patients had sjogren syndrome. Seven patients received protect liver enzyme treatment,3 cases of glucocorticoid therapy,and 1 case had combined intravenous treatment with gamma globulin. Among the 11 cases,10 cases were followed up for 10 months to 4 years,while 1 case died from complete bundle branch block after 5 weeks of birth. At 1 year old,10 cases of cuta-neous lupus damage had liver damage were resorted to normal,and the rheumatic autoimmune related autoantibodies of 9 cases turned to be negative,but 1 case was diagnosed as Kawasaki disease when she was 1 year old. Conclusions One of the most common clinical manifestations of NLE was damage of skin,had the liver and blood system abnormity were common but usually not serious. Heart disease especially complete atrioventricular block was less. The long - term follow - up for children with NLE is necessary,and the majority of the prognosis is good,as only a few have the possibi-lity of developing other autoimmune diseases.

Background Horizontal sulcus-to-sulcus (STS) and white-to-white diameter are important parameters for designing the proper size of collamer implantable contact lens (ICL).Inappropriate size of ICL may induce the complications postoperatively.Several previous studies compare horizontal STS and white-to-white diameter in normal eyes have been reported,but seldom in high myopic eyes.Objective This study was to investigate the discrepancy of STS diameters in 4 axes and analyze the relationship between horizontal STS diameter and white-towhite diameter in high myopia eyes.Methods The STS diameters in 4 axes (45,90,135 and 180 degrees) and the white-to-white diameters were measured in 48 eyes of 26 high myopia patients using the 50 MHz ultrasound biomicroscopy (UBM),the Orbscan-Ⅱ topography system,and the IOL Master,respectively.The mean spherical was (-12.93±3.87) diopters (D) (-8 to-20 D).Statistical evaluation was performed using the one-way ANOVA for comparison of measurement.The agreement of three devices was assessed using the Bland and Altman method.Results The mean STS diameter at 45,90,135 and 180 degrees was (12.06±0.50) mm,(12.27±0.50)mm,(12.03±0.46) mm and (11.84±0.47)mm,respectively.The 90 degree STS was significantly larger than other STS diameters (all at P＜0.05).The 180 degrees STS was significantly shorter than other STS diameters (all at P＜0.05).However,there was no significant difference between 45 degree STS and 135 degree STS (P=0.817).The mean WTW was (11.56±0.40) mm with Orbscan Ⅱ z topography system and (11.98±0.41) mm with IOLMaster.The WTW measured with Orbscan Ⅱ z was significantly shorter than the 180 degrees STS (t =-4.384,P =0.000).The WTW measured with IOLMaster was significantly larger than the 180 degrees STS (t =2.368,P =0.000).Bland-Altman analysis showed not very well agreement for measurements of WTW,STS between Orbscan Ⅱz and UBM,IOLMaster and UBM,Orbscan Ⅱ z and IOLMaster,the width of 95％ confidence interval (CI) were-0.57 to 1.12 mm,-0.96 to 0.67 mm,-0.73 to-0.13 mm,respectively.Conclusions The STS diameters in 4 different axes are not identical with each other in high myopia eyes.The longest STS is in the vertical meridian,the shortest STS is in the horizontal meridian.The WTW diameter measured with both Orbscan Ⅱ z and IOLMaster are not precise for calculating the horizontal STS in high myopia eyes.Three instruments cannot be interchanged for calculating the size of ICL.

ObjectiveTo investigate the clinical efficacy of acupuncture in treating Tourette's syndrome.MethodEighty patients were allocated, using a random number table, to a treatment group of 40 cases and a control group of 40 cases. The treatment group received acupuncture and the control group, Western drug treatment.ResultThe YGTSS score decreased significantly in the two groups of patients after treatment(P<0.01). After treatment, the range of decrease in the YGTSS tic score was larger in the treatment group than in the control group; there was a statistically significant difference (P<0.05). The total efficacy rate was higher in the treatment group than in the control group (P<0.05). The incidences of adverse reactions were significantly lower in the treatment group than in the control group.ConclusionThe effect and safety of treatment for Tourette's syndrome are higher in the treatment group than in the control group.

Objective To explore the effect of postnatal infection on SOX10 expression in cerebral white matter in immature rats. Methods A total of 96 newborn SD rats were randomly divided into hypoxia group, lipopolysaccharide (LPS) group, and control group. At day 3 and 6 after birth, the rats in LPS group and hypoxia group were intraperitoneally injected with 0.25 mg/kg of LPS while the rats in control group were injected with normal saline. Meanwhile the rats in hypoxia group were maintained in a hypoxic tank under atmospheric pressure and thermostatic water bath at 37℃for 2 hours of ventilation with mixed gas con-taining 8%O2 and 92%N2 at a rate of 2 L/min starting 3 days after birth. At day 7, 10, 14, 21 after birth, eight rats in each groups were sacriifced and the cerebral white matter was extracted. HE staining was performed to observe the pathological changes of cerebral white matter by light microscopy. The expression of SOX10 in cerebral white matter was determined by immunohisto-chemical and Western blotting analysis. The expression of TLR-4 was determined by Western blotting. Results In LPS group and hypoxia group, the SOX10 positive cells and expressions of SOX 10 and TLR-4 were increased at day 7, reached the peak at day 10, and then gradually declined. There were signiifcant differences between any two time points (P<0.05). In control group, there were a few positive cells and limited expressions of SOX 10 and TLR-4 and there were no differences between any two time points (P>0.05). At each time point, the difference in the SOX10 positive cells and the expressions of SOX 10 and TLR-4 were statistically signiifcant among three groups (P<0.05) in the order of hypoxia group>LPS group>control group and there were signiifcantly differences between each groups (P<0.05). Conclusions Postnatal infections can lead to cerebral white mat-ter lesions in immature rats. The existence of both hypoxia and infection can aggravate the brain injury. The high expression of SOX 10 may have the protective effect.

Objective To analyze the clinical features and laboratory data of 10 patients with macrophage activation syndrome (MAS) complicating systemic onset juvenile idiopathic arthritis (soJIA),which were characterized by acute severe liver injury.Methods Data of 10 patients with soJIA/MAS from Nanjing Children's Hospital were collected retrospectively.The clinical features,laboratory findings,treatment,outcomes and prognosis were analyzed.Results In the total 10 patients,female (6/10) outnumbered male.Their age ranged from 1.5 to 9.5 years old (average 5.2±2.6).The most remarkable clinical manifestations were severe liver injury without systemic features,representing as hepatomegaly (10/10),splenomegaly (2/10) and strikingly increased transaminase (10/10,median:ALT 1 445 U/L,AST 885 U/L).Central nervous system dysfunction and hemorrhages were recorded in 20％ of the patients.Two patients had pulmonary infection.Laboratory data showed that platelet count was less than normal or precaution value (10/10,≤262×10g/L).Hyperferritinaemia (10/10,median:17 329 mg/ml) and soluble CD25 elevation (median:3 140 U/ml) were common in the soJIA/MAS patients.Evidence of macrophage hemophagocytosis was found in 90％ of the patients (9/10) who underwent bone marrow aspiration.Pathological findings of liver biopsy from 1 patient revealed massive infiltration of mononuclear cells in the portal tracts.Nearly all patients (9/10) received intravenous pulse methylprednisolone therapy,combined with cyclosporine A and high-dose intravenous immunoglobulin.Eight patients had good outcome.Only 2 patients were complicated with severe interstitial lung disease during 12-months follow-up.Conclusion MAS should be considered when patients with soJIA represents acute severeliver injury without systemic features combined with other laboratory data.Intravenous pulse methylprednisolone and cyclosporine A therapy may improve the prognosis of soJIA/MAS.