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 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.

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.

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

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

Objective To evaluate clinical efficacy of single center intracavitary isolation procedure for treating elderly Standford type B aortic dissection.Methods 46 consecutive patients aged ≥ 65 years with Standford B aortic dissection,who underwent membrane stent intracavitary isolation treatment,in Tianjin Chest Hospital between 2010-2015 were enrolled in this study.All enrolled patients received examinations of echocardiography,contrast-enhanced CT,hepatic and renal functions,and the blood and urine routine tests before the procedure.After the procedure,the contrastenhanced CT of whole aorta was annually rechecked for all patients in the four time points of predischarge,3,6,12 months after operation.Deadline date of the follow up was December 2015.The outcomes of whole aorta CT and survival rate were analyzed.Results Successful stent implantation was performed in all patients (100 ％).Two (4.3 ％) patients died in the perioperative period,and one died due to the new aortic dissection at the last 8 months after operation.Overall survival rate was 89.1％(41 cases)during the follow-up period(95％CI:52.5-63.6 and 32.6-38.9,all P＜0.05).Conclusions The short and long term outcomes of intracavitary isolation procedure for treating Standford B aortic dissection are satisfactory in elderly patients.Perioperative blood pressure control,strict image measure,and carefully selecting the appropriate scaffold model are the keys for successful operation.

Objective To explore the clinical presentation,etiology of sepsis,common positions of in-fection and anti-infectious treatment of pediatric acute leukemia with septicemia resistance to carbapenem. Meth-ods A retrospective chart review of all pediatric acute leukemia with septicemia cases of Beijing Children 's Hospital from December 2011 to September 2015 were analyzed. All cases were selected based on the clinical presentation,at least one Gram-negative bacteria positive result of blood culture and were resistant to carbapen-em. The basic clinical characteristics and the results of blood culture and antimicrobial susceptibilities were ana-lyzed. Results All 45 cases with fever,among them 8 cases under went continued fever,The other 37 cases fe-ver days were ( 6. 1 ± 5. 2 ) d. Twenty-six cases had agranulocytosis. Agranulocytosis time from 2 to 79 days, mean days(15. 2 ± 16. 2)d. Significant difference of fever time between agranulocytosis team and non-agranulo-cytosis team was significant(P=0. 011). Twenty-three cases had infection positions among 45 cases. Lung,di-gestive tract,mouth and crissum were the common positions of infection. The quantum of blood culture samples were 711 parts. There were 162 parts resistant to carbapenems. The primary pathogens were pseudomonas aerugi-nosa,klebsiella pneumoniae, enterobacter cloacae and Escherichia coli. Among those 45 cases, 36 cases were cured,9 cases were ineffective treatment. Conclusion Pseudomonas aeruginosa, klebsiella pneumoniae, enter-robacter cloacae and Escherichia coli accounted for the most of G-bacteria infections resistant to carbapenem in our center. The incidence of septicemia was related to the level of granulocyte and duration of agranulocytosis.

The disequilibrium of histone acetylation and deacetylation may cause tumor.Histone deacetylases (HDACs) maintain the equilibrium between histone acetylation and deacetylation by catalyzing the deacetylation of histone.They are related to many regulation processes containing transcription of oncogene,cell proliferation and differentiation,apoptosis and so on.HDACs inhibitors have become the hot field of researches,more than ten different HDACs inhibitors are testing for the treatment of both hematological and solid malignancies and show obvious anti-tumor activity.

Objective To investigate the effect of mild hypothermia on cerebral oxygen metabolism in a rat model of chronic cerebral hypoperfusion and reperfusion. Methods Twelve healthy SD rats weighing 170-210 g were randomly divided into normal body temperature group (group NT, n = 6) and mild hypothermia group (group MH, n = 6). Arterio-venous fistula was established by end-to-end anastomosis between the right common carotid artery and right external jugular vein according to Yassari. Mild hypothermia was induced in group MH before reperfusion and maintained for 3 h. The rectal temperature was reduced to 32 ℃ while in group NT rectal temperature was maintained at about 37 ℃ . Cerebral blood perfusion (CBP) was assessed by using a lasser Doppler perfusion image system before reperfusion (T_1), immediately after reperfusion (T_2) and 24 h after reperfusion (T_3). Venous and arterial blood samples were collected from superior sagittal sinus and femoral artery respectively for blood gas analysis at T_(1-3) . Cerebral arterial venous O_2 saturation difference (Sa-vO_2), cerebral O_2 extraction rate (CERO_2) and cerebral arterial-venous lactic acid concentration difference ( Da-vL) were calculated. Results In NT group left CBP was significantly decreased at T_2 as compared with the baseline value at T_1 , while at T_3 bilateral CBP was decreased. In MH group bilateral CBP was significantly decreased at T_2 but returned to baseline level at T_3. CERO_2 was significantly decreased at T_2 as compared with the baseline value at T_1 in MH group. Da-vL was significantly increased at T_3 in NT group. Compared with group NT, bilateral CBP was significantly decreased, CERO_ and Da-vL were significantly decreased at T_2 ,while no significant change was found in Sa-vO_2 in group MH. Conclusion Mild hypothermia is beneficial for the balance of cerebral oxygen metabolism in the rats with chronic cerebral hypoperfusion and reperfusion.

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.