ObjectiveTo explore the clinical manifestations of infant cytomegalovirus infection in different age. MethodThe clinical data of 237 infants who suffered from cytomegalovirus infection was analyzed retrospectively and divided into three groups: 0-3 months old (77 cases,group A) ,4-6 months old ( 65 cases , group B ) , 7-12 months old ( 95 cases , group C ). ResultsThe incidence of respiratory infection was the highest among all infectious organs in three groups, the numbers of patients who had wheeze in group A was less than that in the other two groups[24.7％(19/77) vs. 61.5％ (40/65), 61.1％( 58/95 )](P ＜ 0.01 ).The incidence of jaundice decreased gradually as the babies grew up[23.4％( 18/77 )→7.7％(5/65 )→1.1％( 1/95 )](P ＜ 0.05). There was no significant difference in diarrhoea and bleeding among three groups (P＞0.05 ). The proportion of alanine aminotransferase], aspartate amino transferase increasing was similar among three groups, but gamma-glutamyl transferase (GGT) was different, the proportion of GGT increasing was 77.9％ (60/77) in group A which was higher than that in the other two groups[10.8％ ( 7/65 ), 2.1％ ( 2/95 )].Granulocytopenia in group B was obviously decreased compared with the other two groups (P ＜ 0.05 ), anemia was easily occurred in group C (P ＜ 0.05 ). ConclusionThe injury of cytomegalovirus infection may be related to month old.

Objective To investigate the number, structure and demand of rehabilitation professionals hospitals above grade 2A in Jiangsu. Methods 176 hospitals above grade 2A in Jiangsu were investigated with questionnaire in the topics of general condition of department of rehabilitation medicine, structure of rehabilitation professionals and demand of rehabilitation professional. Results 64% of the hospitals has established department of rehabilitation. Rehabilitation professionals, such as the rehabilitation physician, therapists, nurses and engineer were in a total of 1657, and 231 professionals were needed further. Conclusion There are problems of lack of the department of rehabilitation medicine and rehabilitation professional, with the imbalance structure of professional in hospitals above grade 2A in Jiangsu.

Objective To investigate the clinical characteristics,treatment effect,long-term follow up results,guanosine triphosphate (GTP) cyrclohydrolase Ⅰ (GCH Ⅰ)gene and tyrosine hydroxylase(TH) gene mutations in patients with dopa-responsive dystonia (DRD).Methods The clinical features of 3 families with 4 affected members were analyzed and all of 4 patients were screened for mutations of the GCH Ⅰ gene and TH gene with DNA sequences.Results Four patients were females,average age at onset was (15.3 ± 5.6) years (range:from 9 to 20 years).The initial symptoms were a gait disorder,stiffness or tremor of the lower limbs in all patients presented with diurnal fluctuation.As the increase of disease duration,bilateral hand tremor was found in three patients,systemic torsion was found in one patient and torticollis was found in one patient.All patients' symptoms were in complete remission after administration of low dose of levodopa.Four patients were followed up for 0.5 to 10.0 years,and all were still responsive to the levodopa treatment and effective dosage was decreased as the increase of the disease duration.No longterm side effects of levodopa had occurred after long-term treatment.One patient was found to have c.607G ＞A(p,Gly203Arg) heterogenetic mutation in GCH I gene.Molecular analysis revealed a compound heterozygous mutation in the TH gene (p.Y447Ter and p.V468M) in one patient.No point mutations in both genes were found in other patients.Conclusions DRD patients have dramatic and sustained response to levodopa and no long-term side effects of levodopa after long-term treatment.The detection of GCH Ⅰ and TH gene mutations is helpful in early diagnosis but the negative results could not exclude the diagnosis of DRD.

Objective To study the influence of Salviae Miltiorrhizae Radix et Rhizome (SMR) and Carthami Flos (CF) before and after compatibility on activitis of cytochrome P 1A2 (CYP1A2),cytochrome P2E1 (CYP2E1),and cytochrome P3A4 (CYP3A4) from rat liver microsomes.Methods Using caffeine,chlorzoxazone,and midazolam as the probe drugs ofCYP1A2,CYP2E1,and CYP3A4,the SD rats were randomized divided into four groups:control group,SMR (1.2 g crude drug/kg) group,CF (0.4 g crude drug/kg) group,and SMR (1.2 g crude drug/kg) + CF (0.4 g crude drug/kg) group.According to the above dose,rats were ig given drugs for 7 d.Rats were injected with caffeine,chlorzoxazone,and midazolam solution in tail vein 30 rain after the last administration,and the blood was collected at different time points.Metronidazole as internal standard,method has been established to determine the levels of caffeine,chlorzoxazone,and midazolam to evaluate the activities of CYP1A2,CYP2E1,and CYP3A4 by HPLC.Results Compared with control group,SMR increased the clearance rates (CL) of caffeine,chlorzoxazone,and midazolam,reduced the AUC,and t1/2 was also show a decreasing trend,but the difference was not significant.In CF group,CL of caffeine and chlorzoxazone was decreased,but the difference is not significant.CL of midazolam significantly decreased (P ＜ 0.01).AUC of chlorzoxazone increased,but the difference was not significant.AUC of caffeine and midazolam increased significantly (P ＜ 0.05 and 0.01).In SMR + CF group,the CL of caffeine and chlorzoxazone decreased significantly (P ＜ 0.05),the AUC of caffeine and chlorzoxazone increased significantly (P ＜ 0.05),and t1/2 also showed a decreasing trend,but the difference is not significant.Conclusion Compatibility of SMR and CF has an inhibitive effect on CYP1A2 and CYP2E1 in rats,and it could be one of the mechanisms ofinteractive synergy.

Objective To assess the role of muhi-detector row CT (MDCT) in preoperative evaluation of living renal donors. Methods The data of 104 potential donors who underwent MDCT were retrospectively analyzed. All the candidates underwent 64-MDCT examination. First,unenhanced scans were performed on the kidneys. After administration of Ⅳ contrast medium,enhanced CT images of the arterial phase, venous phase, and excretory phase were obtained. The enhanced scan scope was from the top of diaphragmatic muscle to pubic symphysis. The scanning data obtained was post-processed for reconstructed images. The anatomy and variations displayed in MDCT images on kidneys, ureters, arteries and veins were recorded. The findings in surgery constituted the standard of reference for imaging findings, and the recorded results from images were compared with the findings in surgery to assess the role of MDCT in evaluation of potential donors. Results MDCT examination was successfully performed on 104 candidates. Anomalies of kidneys and ureters were found in 8 donors before surgery. The prevalence of accessory arteries and early branching in image was 27. 2 % (28/103) and 12. 6 % (13/103) respectively. There were 3 candidates with double veins and 3 with retroaortie left renal vein found in preoperative assessment. Ninety-three candidates underwent successful donor nephreetomy. The anomalies and variations of kidneys and ureters in images were all confirmed surgically. The detection rate of the accessory renal artery (ARA) was 80 %. The ARAs measuring > 1 mm in diameter and early branching were all detected by MDCT.The findings of veins found in performed sides coincided with those of MDCT images. Conclusion MDCT can accurately assess the anatomic information and variations of the donors' kidneys, and facilitate triaging donors and planning operation proposal

Objective To explore the expression of anti-MICA antibodies and evaluate its influence on acute rejection and renal function in early period after renal transplantation. Methods A total of 29 sensitized subjects (PRA＞20 %) were enrolled in this study. All the patients underwent protein A immunoabsorption treatment and the expression of anti-MICA antibodies was detected before and after treatment. Triple immunosuppressive regimen consisting of tacrolimus, mycophenolate mofetil (MMF) and steroid was given to prevent graft rejection. The correlation between the expression of anti-MICA antibodies and acute rejection or serum creatinine (SCr) level was analyzed.Results The expression of anti-MICA antibodies was detected in 8 candidates (27. 6 % ,8/29) ,and 6 kinds of anti-MICA antibodies simultaneously expressed were found in one individual, 3 kinds in one case,and sole kind in 6 patients. There was no significant difference in acute rejection rate between positive anti-MICA antibodies group and negative group [37.5 % (3/8) vs 38. 1% (8/21), P＞0.05). The positive expression rate of anti-MICA antibodies in the recipients with PRA ≥40% was higher than that in those with PRA ＜40% [43. 8 % (7/16) vs 7. 7 % (1/13),P＜0.05]. The SCr level in patients positive for anti-MICA antibodies was markedly higher than that in those negative anti-MICA antibodies at the 1st week postoperatively ( 135.4 ± 21.4 vs 108. 6 -+ 31.6 μmol/L, P＜0.05). The SCr level in the patients with positive anti-MICA antibodies, however, was reduced to the normal range at the 2nd week after surgery (P＞0.05). The levels of anti-MICA antibodies were continuously decreased in the candidates undergoing protein A irnmunoadsorption treatment. Conclusion Higher expression of anti-MICA antibodies exists in sensitized recipients and possesses an influence on the recovery of renal function in early postoperative period. Protein A immunoadsorption can eliminate anti-MICA antibodies effectively in sensitized recipients.

Objective To evaluate the clinical feasibility of grading of ureteral stricture in renal allograft.Methods The clinical data of 9 case of ureteral stricture after renal transplantion from February 2015 to September 2015 were retrospectively analyzed and relative articles were reviewed to evaluate the significance of ureteral stricture grading.The diagnosis of ureteral stenosis was made by serum creatinine elevation,ultrasound of allograft kidneys and presence of stricture on a pyelogram.Grade 1 ureteral stenosis was defined as graft function deterioration with presence of hydronephrosis on ultrasound,but no obvious stricture identified on a pyelogranm.Grade 2 was defined as serum creatinine elevation,presence of hydronephrosis on ultrasound,and a focal (＜1 cm) distal ureteral stricture at the ureteral anastomotic site on a pyelogram.Grade 3 was defined as serum creatinine elevation,hydronephrosis on ultrasound,and a long segment (＞1 cm) distal ureteral stricture extending to proximal ureter or pelvis on pyelogram.Results One case,6 cases and 2 cases were classified to grade 1,2 (stricture length ＜1 cm) and 3 (＞1 cm),respectively.One case of grade 1,6 cases of grade 2 and 1 case of grade 3 were successfully dilated by balloon dilation catheter and endoureterotomy.One case of grade 3 was converted to open reconstructive surgery.Surgery success rate of grade 1 and 2 was 100％ (7/7) and 100％ (6/6) 6 and 9 months after surgery,respectively.Ureteral stenosis did not recur in one case of grade 1 and 6 cases of grade 2 during a follow-up period of 12 months after surgery.However,one case of grade 3 reoccurred 6 months after surgery,and reoperation was performed and there was no recurrence up to now (10 months).Conclusion Wuzhi tablet acted as an effective agent that makes rifampicin containing anti-tuberculosis chemotherapy possible and safe by stabilizing blood concentration of tacrolimus in post-renal transplant tuberculosis patients,which also reduced the dosage of tacrolimus as well as the risk of acute rejection greatly.

ObjectiveTo investigate the individualized treatment for traumatic liver rupture. MethodsClinical data of 58 patients with traumatic liver rupture diagnosed and treated in the CAPF Sichuan Provincial Corps Hospital between April 2011 and December 2013 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. Among the 58 patients, 31 were males and 27 were females with the age ranging from 2 to 76 years old and the median of 44 years old. According to the American Association for the Surgery of Trauma (AAST) grading for liver injury, 33 patients were with GradeⅡ liver injury, 16 with GradeⅢ liver injury and 9 with GradeⅣ liver injury. After admission, all patients underwent routine abdominal examination and abdominocentesis for the closed liver rupture. In addition, blood routine, coagulation function, hepatic and renal function, abdominal ultrasound and computer tomography (CT) were also examined emergently to know about the location, size and depth of liver rupture, blood loss, underlying diseases and combined injuries. The individualized treatments, including non-surgical treatment and surgical treatment were performed according to the AAST grading criteria for liver injury and the comprehensive conditions of patients.ResultsNon-surgical treatment was given to 24 patients in which 9 cases were found having obviously increased ascites by ultrasound and CT examination 3-7 d after treatment. Laparoscopic exploration was then performed on the 9 patients. During the operation, 5 were found with mild bleeding and the bleeding was stopped successfully with electrotome, cavitron ultrasonic surgical aspirator or titanium clip. And the rupture bleeding of the other 4 cases were found stopped. Two patients received CT scan 2-3 weeks after treatment and were found with encapsulated effusion near the right liver lobe and 1 case with effusion in hepatic and renal recesses. All these 3 patients underwent CT-guided puncture drainage and were cured. A total of 34 patients underwent emergency exploratory laparotomy. Among these patients, 25 underwent debridement of devitalized liver tissues and wound suture, 6 underwent regular segmental hepatectomy or hepatic lobectomy, 2 underwent hepatic artery branch ligation and wound suture, and 1 underwent greater omentum iflling and suture. After the treatment, 1 patient developed perihepatic abscess and was cured after puncture drainage. All 58 patients recovered and were discharged. Forty-ifve patients were followed up for 1-6 months. No recurrence of bleeding, bile leakage, infection, hepatic insufifciency and other complications were observed.ConclusionsIndividualized treatment can be applied for traumatic liver rupture. Patients with small and shallow liver rupture may receive non-surgical treatment under a close observation and patient with unstable vital signs and progressive bleeding at the liver rupture may receive surgical treatment. Both treatments can achieve good curative effects.

Objective:To investigate the effect of enteral nutrition support on quality of life and therapeutic effect in patients with metastatic colorectal cancer.Methods:A total of 100 patients with metastatic colorectal cancer admitted to Anqing Petrochemical Hospital from Jan. 2020 to Dec. 2023 were selected and divided into parenteral nutrition group and enteral+parenteral nutrition group with 50 cases each using random number table method. The parenteral nutrition group received parenteral nutrition, and the parenteral + parenteral nutrition group was supplemented with enteral nutrition. The therapeutic effect, nutritional indexes, intestinal flora, survival time and quality of life before and after treatment were compared between the two groups.Results:The effective rate of enteral + off-site nutrition group was 76.00%, that of parenteral nutrition group was 54.00%, and that of enteral + off-site nutrition group was higher than that of parenteral nutrition group ( P<0.05). There were no significant differences in nutritional indexes, flora imbalance grade or QLQ-C30 score between the two groups before intervention ( P>0.05). After the intervention, the albumin and total protein in the enteral + parenteral nutrition group were (38.76±6.02) g/L, (64.09±6.71) g/L, the number of normal microbiota disorder cases was 46, the survival time was (17.055±4.33) months, the physical function score was (74.59±7.55) points, and the emotional function score was (78.94±7.96) points, cognitive function score (88.95±9.03) points, role function score (85.49±8.61) points, social function score (81.45±8.27) points. In the parenteral nutrition group, the albumin was (34.51±5.47) g/L, the total protein was (58.91±6.55) g/L, the number of normal microbiota disorder cases was 33, the survival time was (12.48±3.59) months, the physical function score was (67.21±6.81) points, and the emotional function score was (73.55±7.78) points, cognitive function score was (83.47±8.55) points, role function score was (80.14±8.26) points, social function score was (76.93±7.827) points, and enteral + off-site nutrition group was higher than parenteral nutrition group ( P<0.05). In the enteral + off-site nutrition group, the transferrin was (1.45±0.57) g/L, and there were 2 cases of class II flora dysregulation and 2 cases of class III flora dysregulation; in the off-site nutrition group, the transferrin was (1.71±0.61) g/L, and the number of class II flora dysregulation was 8 cases and the number of class III flora dysregulation was 9 cases. Enteral + off-site nutrition group was lower than parenteral nutrition group ( P<0.05) . Conclusion:Enteral + parenteral nutrition support Enteral nutrition support can help improve the treatment effect of metastatic colorectal cancer, improve the nutritional status and survival time of patients, and improve the quality of life of patients.

OBJECTIVE: To analyze the clinical, familial and hereditary features of myotonic dystrophy to improve the knowledge and provide molecule evidence for gene diagnosis and prenatal diagnosis of myotonic dystrophy or dystrophia myotonia (DM) families. METHODS: Clinical data of 2 DM families were collected based on the probands. The number of trinucleotide CTG repeat in the 3' untranslated region of myotonic dystrophy protein kinase (DMPK) gene on chromosome 19 was determined by DNA sequence and repeat fragment. RESULTS: Except for 1 subclinical patient, another 5 patients progressed slowly with the features of myotonic muscular weakness and atrophy. One patient had hatchet face, 1 had cataract and diabetes mellitus, and the other 3 were bald. Electromyologram showed 3 patients had myotonic discharge and myopathic abnormalities. The number of trinucleotide CTG repeat in the 3' untranslated region of DMPK gene of 5 patients exceeded 50. CONCLUSION DM can be anticipated. Gene analysis can verify the disease and identify subclinical patients. It helps to prevent the DM births by hereditary consultation performing prenatal diagnosis.
Adolescent ; Adult ; Female ; Humans ; Male ; Myotonic Dystrophy ; diagnosis ; genetics ; Myotonin-Protein Kinase ; Pedigree ; Polymerase Chain Reaction ; methods ; Protein-Serine-Threonine Kinases ; genetics ; Trinucleotide Repeats