Objective To explore the clinical characteristics and therapy of brucellar meningitis in children.Method One case of brucellar meningitis was reported and relevant literatures were reviewed.A 10 years old boy was admitted to hospital with a history of half a month fever and cough and 3 days headache.His family raised sheep,but he denied contacting closely with sheep and eating raw goat's milk and mutton.Results The course of this reported child was subacute.Clinical manifestations included fever,headache and meningeal irritation sign positive.The cerebrospinal fluid(CSF)findings were similar to those of tuberculous meningitis,where WBC count was elevated with predominant lymphocytes,glucose and chloride decreased and protein increased.The serum bacterium burgeri antibody was positive,agglutination titer was 1160.After brucellar meningitis was diagnosed,three antibiotics including rifampin,minocycline and ceftriaxone sodium and other symptomatic treatment were used.The CSF findings were normal 2 weeks later.This child taked orally minocycline,rifampin and trimethoprim-sulfamethoxazole for 8 weeks post discharge,the recovery was good.The domestic and foreign documents showed that the incidence of the nervous system complications of brucellosis in children was lower than that in adult.The main clinical manifestations were acute meningitis /meningocephalitis.Brucellar meningitis could be misdiagnosed as tuberculous meningitis,because the course of disease,clinical manifestations and CSF findings were similar.Therapeutic alliance including 3 kinds of antibiotics,which could easily pass through blood-brain barrier,was used to treat brucellar meningitis.The total course of treatment shouldn't be shorter than 8 weeks.Conclusions Brucellar meningitis should be screened through epidemiological investigation,serum agglutination test and cerebrospinal fluid culture,in case the reason of meningitis of meningoencephalitis is unknown,especially its clinical manifestation resembles to tuberculous meningitis.

OBJECTIVETo observe the therapeutic effect of Xinfeng Capsule (XFC) in treating adjuvant arthritis of rats and its effect on fas, fasL and bcl-2 expression in synovial membrane.

METHODSRats were randomly divided into the normal group, the model group, the model group, the methotrexate (MTX) group, the TPT group and the XFC group. Except for the rats in the normal group, animals were modelled to adjuvant arthritis with Freund's complete adjuvant, and the latter three groups were treated with MTX, Tripterygium wilfordii polysaccharide (TPT) and XFC respectively. The arthritis index (AI), change of body weight (BW) of rats were recorded, and the expressions of fas, fasL and bcl-2 in rats' synovial membrane were determined.

RESULTSCompared with before treatment, the AI in the three treated groups was lowered significantly (P < 0.01, P < 0.05). The BW increment in the XFC group after treatment was insignificantly different to that in the normal group (P > 0.05), while it was significantly lower in the other two treated groups than that in the normal group and the XFC group (P < 0.01). Compared with the model group, fasL expression was increased in the XFC group significantly (P < 0.05), but bcl-2 expression decreased, fas expression showed insignificant difference (P > 0.05). Comparison of the three gene expressions between the three treated groups showed no significant difference (P > 0.05).

CONCLUSIONXFC could decrease AI in rats with adjuvant arthritis in the same way as MTX and TPT, it effected better in increasing BW than the latter two. The effect of XFC might be performed by its action in enhancing fasL expression, inhibiting bcl-2 expression and promoting apoptosis of proliferated synovial membranous cell so as to restrain hyperplasia of synovial membrane.

Animals ; Apoptosis ; Arthritis, Experimental ; drug therapy ; metabolism ; Capsules ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Fas Ligand Protein ; Hyperplasia ; Membrane Glycoproteins ; biosynthesis ; genetics ; Phytotherapy ; Proto-Oncogene Proteins c-bcl-2 ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Wistar ; Synovial Membrane ; metabolism ; pathology ; fas Receptor ; biosynthesis ; genetics

Multimedia computing technology teaching is a new kind teaching method. It conquers many shortcomings such as poor video, poor expression in traditional teaching of microbiology. But it can also strangle the improvising creation of different teachers in teaching and then lead it to be typical " computer teaching" . So we should obey the teaching discipline in making multimedia computing technology courseware. It can lead many sections part from the class teaching if just emphasize the full use of video and audio. We should make the purpose obviously, and make it as easy as possible in teaching, and we should also explore the fixed regularity to make the teaching and studying integrated perfectly.

Objective To explore the effects of mesenchymal stem cells ( MSC ) treatment on platelet counts in mice with immune-mediated thrombocytopenia ( ITP) and the possible mechanism .Meth-ods ITP was induced by daily intraperitoneal injection of anti-platelet membrane CD 41 antibody (MWReg30) into BALB/c mice.The mice were then divided into experiment and control groups with 20 mice in each.Each mouse in experimental group was injected with 2×107 mesenchymal stem cells (MSC) through the tail vein .The numbers of blood platelets in mice from two groups were counted on days 5, 7 and 14 after MSC injection .Reverse transcriptase polymerase chain reaction ( RT-PCR) was performed to meas-ure T-bet and GATA-3 gene expression in peripheral blood mononuclear cells ( PBMCs ) at mRNA level on day 14.The levels of IFN-γ, IL-2, IL-4 and IL-10 in serum were detected by ELISA .Results The platelet counts in experimental group were significantly higher than those in control group on days 7 and 14 after MSC injection [(588.0±81.6)×109/L and (623.0±78.9) ×109/L vs.(317.0±90.1) ×109/L and (288.0± 87.8)×109/L ] (P<0.05).On day 14 after MSC injection, the T-bet expression at mRNA level in PBMCs from mice in experimental group was significantly lower than that in control group [(0.04±0.03) vs.(0.27 ±0.05)] (P<0.05), while the GATA-3 expression at mRNA level was higher than those in control group [ (0.14±0.04) vs.(0.07±0.05)] (P<0.05).Compared with control group, the concentrations of Th1 type cytokines such as IFN-γand IL-2 were remarkably down-regulated in experimental group [(3.1±1.7) pg/ml and (3.2±2.1) pg/ml vs.(10.3±4.8) pg/ml and (16.3±5.7) pg/ml](P<0.05), while the con-centrations of Th2 type cytokines such as IL-4 and IL-10 were up-regulated in experimental group [(88.6± 15.2) pg/ml and (38.3±11.8) pg/ml vs.(32.7±5.7) pg/ml and (22.1±3.4) pg/ml ] (P<0.05). Conclusion MSC treatment can effectively increase platelet counts in mice with immune-mediated thrombo-cytopenia, which may be associated with the suppression of Th 1-dominant response mediated by abnormal ex-pression of T-bet and GATA-3.

OBJECTIVETo observe the effect of Tongmai Recipe (TMR) on atherosclerosis (AS) in patients with early lower extremity arteriopathy disease (LEAD) caused by type 2 diabetes mellitus (T2DM).

METHODSPatients were randomly assigned to two groups. The 23 patients in the treatment group were treated by TMR and the 22 in the control group were given Cilostazo, all for 3 months. Before and after treatment, lower extremity vascular color Doppler image, blood levels of glucose, insulin, serum matrix metalloproteinase-9 (MMP-9) and interleukin-6 (IL-6) were measured.

RESULTSThe thickness of AS plaque and that of arterial intima-media obviously reduced (P < 0.01 and P < 0.05), insulin sensitivity improved noticeably (P < 0.01), and serum levels of MMP-9 and IL-6 lowered obviously (P < 0.05) in the treatment group after treatment, but these indexes were unchanged in the control group statistically.

CONCLUSIONTMR has remarkable action in reducing the thickness of AS plaque and intima-media of artery, its mechanism might be related with improving of insulin sensitivity and anti-inflammatory reaction, and reducing of serum MMP-9 level as well in patients.

Adult ; Aged ; Arteriosclerosis ; diagnostic imaging ; drug therapy ; etiology ; Diabetes Mellitus, Type 2 ; complications ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Insulin Resistance ; Interleukin-6 ; blood ; Lower Extremity ; blood supply ; Male ; Matrix Metalloproteinase 9 ; blood ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Tibial Arteries ; diagnostic imaging ; pathology ; Ultrasonography

OBJECTIVETo explore the clinical effects of pedicled muscular flaps of brachioradialis in repairing wounds at proximal forearm resulted from hot crush injury.

METHODSFrom February 2003 to December 2008, 5 wounds at proximal forearm resulted from hot crush injury were repaired with pedicled muscular flaps of brachioradialis. The size of muscular flaps ranged from 6 cm x 4 cm - 9 cm x 5 cm. The wounds at donor sites were closed directly or by free skin grafts.

RESULTSAll the muscular flaps of brachioradialis were survived completely. 4 patients were followed up for 3 to 36 months. The cosmetic and functional results were satisfactory both in recipient areas and in donor sites.

CONCLUSIONSPedicled muscular flap of brachioradialis can not only repair wounds at proximal forearm resulted from hot crush injury, but also repair extensor muscle defects. It is an ideal method and is very practical.

Adult ; Barotrauma ; surgery ; Burns ; surgery ; Female ; Forearm Injuries ; surgery ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; transplantation ; Surgical Flaps ; Young Adult

OBJECTIVETo investigate the Epstein-Barr virus (EBV) infection, the expression of EBV latent membrane protein 1 ( LMPl) and oncogene bcl-2 in lung cancer patients.

METHODSEBERI in 108 cases of lung cancer were detected with in situ hybridization. EBV positive and negative lung cancer tissues were analysed for the expression of LMP1 and Bcl-2 by immnohistochemistry. The average area (AA) and integral optical density (IA) of each sample was measured with the digital medical image analyzing system.

RESULTSIn 108 cases of lung cancer, 36 cases were EBER1 positive and 7 cases were LMP1 positive. The expression of Bcl-2 was higher in EBV positive lung cancer tissues than that in EBV negative. The AA value was 58014.23 +/- 6918.45 and 38156.22 +/- 4096.79, while the IA value was 11.00 +/- 1.48 and 8.03 +/- 0.78 respectively. No statistic difference was fund in the expression of Bcl-2 betwen LMP1 positive and negative lung cancer tisssues.

CONCLUSIONEBV infection in lung cancer increased the expression of bcl-2, which may play a role in the occurrence or development of lung cancer. The increased expression of Bcl-2 may not be induced by LMP1. The exact mechanism need further study.

Adult ; Aged ; Epstein-Barr Virus Infections ; genetics ; metabolism ; pathology ; virology ; Gene Expression Regulation, Viral ; Herpesvirus 4, Human ; genetics ; physiology ; Humans ; Lung Neoplasms ; genetics ; metabolism ; pathology ; virology ; Male ; Middle Aged ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; Viral Matrix Proteins ; genetics ; metabolism

Objective To report the outcome of emergency repair of severe complex defect in forearm by transplantation of free flap and simultaneous functional reconstruction.Methods From Mar.1994 to Aug.2003,4 cases with severe complex defect in forearm was repaired by transplantation of free skin flap, free skin flap combined with fibula flap,or fibula osteocutaneous flap in emergency.Simultaneously the flexion and extension function were repaired by muscle transfer and/or tendon grafting,tenonectomy.Results All the cases were successful.Follow-up period ranged from 1 to 3 years postoperatively.The blood-supply,tex- ture and elasticity of transferred flaps were excellent with good bone healing.Opposition of thumb with four fin- gers was good.Sensory recovery of the hand was satisfactory.Conclusion Transplantation of free flap com- bined with simultaneous functional reconstruction is an ideal method in emergency repair of severe complex de- fect in forearm.

Background High myopia can be corrected using laser therapy and intraocular lens(IOL)implantation.IOL implantation is more suitable than laser therapy for high myopia if the patients suffer from thinner cornea.Objective This clinical trail was to assess and compare the visual quality following phakic iris-claw intraocular lens (IOL) and implantable contact lens(ICL) implantation for high myopia.MethodsIris-claw phakic intraocular lens was implanted in 17 eyes of 10 patients with high myopia,and age-,refractive-matched 17 eyes of 9 patients were in implantable contact lens (ICL) implantation group.Uncorrected visual acuity,best correct visual acuity,contrast sensitivity under the 3,6,12 and 18 c/d spatial frequencies,wave-front aberrations,including RMS3,RMS4 and RMSh,were examined in 6 months after operation.Written informed consent was obtained from each patient before surgery.Results There were no significant difference in uncorrected visual acuity,best correct visual acuity between two groups(t=0.489,P>0.05;t=0.853,P>0.05).Non-glare CS under the 3 c/d,6 c/d,12 c/d and 18 c/d spatial frequencies were insignificantly different between two groups ( t = 0. 906, P > 0.05 ; t = 0. 103, P > 0. 05 ; t =0. 694 ,P>0. 05 ; t = 1. 583, P>0. 05), and the similar outcomes were found in glare CS ( t = 0. 323, P>0.05, t =0.041 ,P>0. 05, t = 0.024, P>0. 05; t = 0. 363, P>0.05) in postoperative 6 months. RMS3 and RMSh were significantly elevated in PIOL group compared with ICL group ( t = 11.40, P< 0. 05 ; t = 11.35, P < 0.05), but no evident difference was found in RMS4 between two groups( t = 0. 24,P>0. 05). Conclusion Both PIOL and ICL implantation for high myopia can achieve an equal visual acuity. But clinical outcomes of ICL implantation is much better than PIOL group. A long-term effect should be observed for the further evaluation.

Objective To compare the different effects of 1% diatrizoate meglumine,2.5% mannitol and water as oral contrasts in PET/CT scan in gastrointestinal tract delineation and 18F-fluorodeoxyglucose (FDG) uptake. Methods Sixty-one patients referred for PET/CT scan without gastrointestinal diseases were divided into three groups randomly ( random number method). One liter of 1% diatrizoate meglumine,2.5% mannitol,or water was orally taken by groups 1 (25 cases),2 (20 cases) and 3 ( 16 cases),respectively before scan. The scan was performed with GE Discovery LS PET/CT scanner in two-dimensional (2D) mode 50 min after 18F-FDG (5.55 MBq/kg) injection. Patients with abdominal lesions were excluded from this study. The degree of gastrointestinal filling and 18F-FDG uptake was evaluated by 3 nuclear medicine physicians using visual analysis according to a 4-grade classification method:none,mild,moderate,and high. Statistically analysis was performed by Kruskal-Wallis,Mann-Whitney and paired t tests.Results Both the differences of serum glucose and insulin levels were not significant before and after contrast taken in group 2. Group 2 had better gastrointestinal filling than that of group 1 and also better than group 3 except in rectum. The stomach,jejunum,ascending,and transverse colon were better filled in group 1 than in group 3. The degree of 18F-FDG uptake of group 3 was significantly higher than that of group 2 in stomach,jejunum and ileum (z= -3. 192,-3.290,-3.290,all P＜0.05),and was also significantly higher than that of group 1 (z = - 3. 603,P ＜ 0.05) in jejunum. The degree of 18 F-FDG uptake of group 3 was significantly lower than that of group 1 in ascending colon (z = - 2. 706,P ＜ 0. 05 ) and was significantly lower than that of group 1 and 2 in transverse and descending colon (z= - 3. 503,- 2.403,- 4.225,-4. 027,all P ＜0.05),and was also significantly lower than that of group 2 in rectum (z = -4. 128,P ＜0. 01 ). The maximum CT values in stomach,jejunum,ileum and ascending colon in group 1 were ( 132 ±23),(191 ±31),(313 ±47) and (374±53) HU,respectively,whose difference was significant (t = -7.088--1.781,all P ＜0. 01 ). Conclusion Oral iso-osmotic mannitol intake has better gastrointestinal filling and less physiological 18F-FDG uptake compared to diatrizoate meglumine and water.