Objective To explore the clinical characteristics of myasthenia gravis(MG)in children.Methods One hundred and six children with MG in Children′s Hospital of Chongqing Medical University from Apr. 2002 to Apr. 2007 were concluded in the study.The data of laboratory examinations,including virus antibody,autoantibody test,immunity function,chest X-ray or chest CT,MRI,ECG and repetitive nerve stimulation, and treatment of cholinesterase inhibitor,glucocorticoids and high-dose immunoglobulin were reviewed.Results Among 106 children,male-to-female ratio was 1 to 1.16,male 49 cases,female 57 cases.The course of disease was 3 days to 11 years.The age of onset of all 106 children with MG varied from 10 months to 14.3 years old and the mean age was (4.74?3.32) years old.The most common age of onset was less than 3 years old(55.7%).There were 41 cases newly diagnosed children and 65 cases received irregular treatment or relapsed after treatment.The ocular muscular symptoms were mostely found at the onset(84.0%);brainstem type was involved at the onset(2.8%),generalized type was involved at the onset(13.2%);58 out of 106 cases(54.7%) had upper respiratory tract infection before the onset with MG; 41 out of 52 cases with MG had abnormal immune function or auto antibody-positive,myocardial enzymes increased in 45 cases increased in varying degrees,thymoma were not found by use of sternum or CT or MRI in 69 cases,repetitive nerve stimulation of 7 out of 11 cases were abnormal; 17 cases (16.0%) of the children received single pyridostigmine treatment,10 cases (9.4%) received co-adrenal hormone and before steroid given IVIG therapy respectively were satisfied with the efficacy,and gravis symptoms were improved;61.3% of the cases had a relapse who underwent irregular treatment or relapse after treatment,before relapse 37 cases (56.9%) received single cholinesterase inhibitor treatment, 28 cases (43.1%)for co-adrenal hormone, after adrenocortical hormone and pyridostigmine treatment.The prognosis of 72 patients(67.9%) with MG was usually good; the causes of relapse resulted from infection (30 cases, 46.2%), irregular drug use (22 cases,33.8%), and drug withdrawal and infection (13 cases, 20.0%).Conclusions As early as age of onset,the disease easily repeated,to be early co-adrenal hormone therapy group is the children′s clinical features of MG.

Objective To explore the treatment protocols and the occurrence and developmental rule of subcutaneous multiple inflammation and indurations by facial injection lipolysis,and to summarize the treatment experience.Methods Six cases of subcutaneous indurations were females patients with facial injection lipolysis,and the lesions increased slowly after about one month.The local temperature raised and pinching pain appeared in the facial area.The other secondary post-traumatic swelling and scleroma areas were treated with piercing or cutting,spread to the surrounding tissues.Red scleroma became osmosis,by local open decompression,debridement,irrigation and drainage lasting almost 3 months.The area had burst out mucoid funicular materials gradually.Results The facial injection lipolysis caused regionally red swelling and scleroma gradually with 1 month of continuous irrigation drainage.The red scleroma area was limited with debridement again after maturation,closed incision after discharge mucus-shape substance by its organization.In the redness induration period,pathological results showed the homogeneous materials without structure could be seen in the fibrous tissue,with surrounding hyperemia,hemorrhage associated with inflammation.Festering burst period showed that local tissue presented suppurative inflammation,multiple abscesses and granuloma formation.Conclusions Conservative treatment can lead to swelling,bursting and developing into deep tissues.Surgical treatment can spread redness scleroma area and lead to a large area of skin depression,soft tissue scar and deformity.

Objective To introduce transforming growth factor ?(TGF ?) and the relationship between TGF ? and graft rejection. Methods Relevent articles in recent years were reviewed.Results The immunodepressive function of TGF ? could resist transplant organ rejection injury in early postoperative period ; meanwhile TGF ? also caused fibroblast migration and promoted matrix deposition by increasing collagen production and decreasing collagen breakdown via inhibition of collagenases,which resulted in transplant organ fibrosis and arteriosclerosis, gene polymorphisms of the TGF ? were associated with it. Moreover,ischemia reperfusion injury and immunodepressive drug also affected production of TGF ?.Conclusion TGF ? as a pleiotropic and multifunctional cytokine contributes to the development of acute and chronic rejection.

Linguistics ; methods ; Medicine, Chinese Traditional ; methods ; standards ; Terminology as Topic ; Translations

Cardiomyopathy, Dilated ; diagnosis ; therapy ; Europe ; Humans ; United States

Objective To investigate the epidemiology of fungemia and provide evidence for clinical therapy.Methods A retrospective survey was conducted with 42 cases of fungemia in our hospital from Jan 2002 to Jan 2011.Results Forty cases candida fungemia accounted for 95.2％ in 42 fugemia.The main pathogen agent was non-Candida albicans in candida fungemia,which were candida albicans(14.3％),candida parapsilosis (38.1％),candida glabrata (35.7 ％),candida tropicalis (2.4％).Eleven uneffecfive cases accounted for 26.2％.Multiple-factor analysis showed that neutropenia time ＞ 7 days,antibiotic using time ＞ 7 days and fungal infection history correlated with bad prognosis.Our study also showed that chemotherapy regiments including hormone、combining with other organs fungal infection and non-Candida albicans were risk factors of bad prognosis.Conclusion The main pathogen agent of fungimia is candida,especially non-Candida albicans.Neutropenia time ＞ 7 days,antibiotic using time ＞ 7 days and fungal infection history correlate with poor prognosis.

Objective To investigate the epidemiology of fungemia and provide evidence for clinical therapy.Methods A retrospective survey was done with the 42 cases of fungemia in our hospital.Results 42 cases of fungemia include 35 cases acute lymphoid leukemia,6 acute myloid leukemia.95.2％ of the fungemia pathogen agent was monilia.8 cases combined with bacterial septicemia,accounting for 19.0％.Drug sensitivity test showed that 2 cases were intermediary to Fluconazole,1 patient was resisdence to Amphotericin B but sensitive to Voriconazole,Itraconazole and fluorocytosine.The main risk factors of fungimia included using wide-spectrum antibiotic,neutophil less than 0.5 × 109/L,central venous indwelling catheter,age and the time of in hospital more than 15 days.Conclusion The effective measure to reduce fungemia morbitity is controlling risk factors.Timely and effectively antifungal therapy is also needed.

Objective To compare the clinical efficacy of intramedullary pin versus plate fixation for displaced mid-shaft clavicle fractures.Methods The databases,PubMed,CENTAL and CBM,were searched according to the standards of the Cochrane Collaboration for all the randomized controlled trials (RCTs) and clinical controlled trials (CCTs) comparing intramedullary pin with plate fixation for treatment of displaced mid-shaft clavicle fractures.In addition,hand search was also conducted in relevant journals.Time limit for search was from the beginning till December 2013.Trial quality was assessed using the modified Jadad scale and effective data were pooled for Meta analysis with software RevMan5.2.7,including wound infection,hospital stay,wound size,intraoperative blood loss,operation duration,implant irritation,implant problems,delayed union,malunion,nonunion,total complications and Constant scoring.Results Three RCTs and 7 CCTs with 697 patients were included in our study.The modified Jadad scoring showed fine quality of the 10 trials.Intramedullary fixation was significantly superior to plate fixation in wound size,intraoperative blood loss,operation duration,hospital stay,wound infection,and symptomatic hardware (P ＜ 0.05),but led to a significantly higher rate of implant problems (P ＜ 0.05).However,no significant differences were identified in total complication rate,delayed union,nonunion,malunion or Constant score (P ＞ 0.05).Conclusions The superiority of intramedullary fixation for displaced mid-shaft clavicle fracture lies in its advantages of minimally invasion,such as limited incision,less intraoperative bleeding,shorter operation time and hospital stay,less wound infection and implant irritation.Ahhough intramedullary fixation may lead to a higher rate of implant problems,it shows no significant differences from plate fixation in bone healing and functional recovery.

OBJECTIVE: To supply reference for the implementation and popularization of clinical pharmacist system as well as the establishment of the quality standards and assessment system for the pharmaceutical care in China.METHODS: By literature reviewing method,the pertinent literature about quality standards and assessment system of pharmaceutical care at home and abroad since 1990s were retrieved systematically,sorted and analyzed.RESULTS & CONCLUSIONS: The quality assessment of the pharmaceutical care can help enhance the level of pharmaceutical care,demonstrate the value of clinical pharmaceutical care,and facilitate the establishment and evolvement of the clinical pharmacist system.When drawing useful experiences from such countries like American and Britain,China should attach great importance to the cooperation between schools of higher learning and practitioners and the application of scientific methods and taking into consideration of the practical situation of the hospitals in carrying out clinical quality assessment for pharmaceutical care.

Objective To investigate the effects and mechanism of Panax Notoginseng saponins (PNGS) on rat liver during cold preservation. Methods Using isolated perfusion of rat liver model (IPRL), Fura 2 method was used to measur the concentration of calcium ion in hepatic cells which had been preserved in DMEM solution with different concentration of PNGS added and cold preserved for 2 hours. Liver function, metabolic products of oxygen free radicals, energy substance and aucount of biliary flow as well as morphological study were measured from liver tissue which had been cold preserved in lactate riuges’s solution containing different dosages of PNGS for 24 hours and 30 minutes reperfusion.Results The contents of intracellur calcium of the rat hepatocytes,MDA, AST, ALT, LDH were lower than those in the control group,but SOD, ATP, TAN, EC and bile production were higher than those in the control group( P 0.05). Conclusion PNGS relieve the injury of the rat liver during cold preservation. The mechanism might through inhibition calcium overload, improve the energy metabolism, play a role against free radical injury realize.