Atherosclerosis is a chronic inflammatory disease of the vascular walls. As the essential mediators of inflammation, cytokines play important roles in atherosclerosis. Through widespread and penetrating studies, many cytokines, such as TNF-, IL-1, IL-6 and IFN-, are found involved in the development of atherosclerosis, as well as the related signal transduction pathways such as the NF- B pathway, the JNK / AP-1 pathway, and the JAK / STAT pathway. This implies that cytokines have a favorable perspective of clinical application. A few cytokines are identified as biomarkers, which help the early diagnosis of the disease and estimation of the risk of the clinical vascular events. Meanwhile, great progress has been made on the cytokine-targeted treatment of atherosclerosis, providing a novel therapy in the treatment of the disease.

Community health service institutions are the basic tentacles of medical services which directly indicates their relation to the quality and experience of health service.This paper focuses on the behavioral logic of community health service institutions under the background of new medical reform, and looks forward to a perspective on the grassroots practice caused by the reform of medical system through the behavioral analysis of the community health service institutions.The behavioral logic features of the community health service institutions were constructed based on the interview data Nanjing City using the grounded theory.It was found that the realization of public welfare orientation of the aforesaid institutions needs to be completed under the internal and external coordination.The degree of coordination among the interests, orientation, incentives and resource elements will determine the behavior orientation and basic operational practices in the community health service institutions.This study will provide a reference value for the cognition and optimization of healthcare reform policies.

Objective To investigate the incidence of the common respiratory viruses in children with respiratory tract infection and to compare the results among different ages and to analyze the relationship between wheezing of children and various viruses.Methods Nasopharyngeal secretions of 618 children with respiratory infection hospitalized were assayed for 7 respiratory viruses, including respiratory syncytial virus ,adenovirus, influenza A virus, influenza B virus, parainfluenza virus Ⅰ 、 Ⅱ、 Ⅲ.Results (1) A total of 166 cases, affected with viral etiology,were detected in 618 samples,and the total positive rate was 26.86％.The most common virus was RSV (17.96％), followed by PIV Ⅲ (5.99％), IFA (1.62％), ADV (0.81％), PIV Ⅰ (0.49％).Moreover, 1 case infected with RSV and PIVⅠ was included, with the positive rate 0.16％.(2)The positive rates were different in various ages, with 14d ～ ＜ 1-year 35.04％, 1 ～ ＜ 3-year 18.25％, 3 ～ ＜ 6-year 17.11％ and ≥ 6-year 9.26％.(3) There were differences of positive rate of viruses among different respiratory infectious diseases, and capillary bronchitis occupied the highest percentage(47.37％).(4)Among all the detected children, infants were more likely to whee in auscultation of lung, and RSV was the primary etiology.Conclusion RSV,which was the primary viral etiology in children with wheezing, was the most common virus leading to respiratory infection of children, followed by PIV Ⅲ.In the children with respiratory tract infection, the viral infection tends to occur in younger children.

Objective To explore the significance of hidden rheumatoid factor-IgM(HRF-IgM),anti-cyclic citullinated peptide antibodies(anti-CCP),antikeratin antibodies(AKA)combined test in the diagnosis of juvenile idiopathic arthritis(JIA).Methods The anti-CCP and rheumatoid factors(RF)were tested by enzyme linked immunosorbent assay(ELISA)in serum samples from 60 children with JIA,27 systemic lupus erythematosus(SLE),18 kawaski diseases and 50 healthy children who were enrolled to serve as normal controls.Indirect immumofluorescence method was used to test AKA.Using the QAE-Sephadex-A50 to separate RF then tested HRF-IgM by ELISA.Results Positive anti-CCP were found in sera of 13 patients with JIA(21.7%)and specificity 96.8%.RF were found lower test both with the JIA and other groups(?2=0.17 P=0.68).The results of AKA were similar to the anti-CCP,they were both lower sensitivity and higher specificity.There were 65% sensitivity and 85.3% specificity in the HRF-IgM,and great significant difference in positive rate in JIA and other group(?2=40.22 P=0.0001).Conclusions JIA children in the studied series has a higher detection rate and value of HRF-IgM as compared to the other control groups.HRF-IgM,anti-CCP,AKA combined test in JIA can prove to be a valuable reference index for diagnosing suspected JIA children.

Child, Preschool ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; virology ; Male

Adolescent ; Antibodies, Antinuclear ; blood ; Child ; Female ; Humans ; Sjogren's Syndrome ; diagnosis ; immunology ; therapy

Objective To understand the clinical characteristics of primary small vessel vasculitis with involvement of lungs in children and analyze the causes of misdiagnosis.Methods Clinical data from 16 patients with primary small vessel vasculitis were collected and their pathological,antineutrophil cytoplasmic antibody(ANCA),pulmonary lesion manifestations,image and misdiagnosis were further analyzed.Results Among 16 cases,9 cases were microscopic polyarateritis(MPA) and 4 cases were Wegeners granulomatosis(WG) and 3 cases were Churg-Strause syndrome(CSS).The ages of onset were from 3 to 14 years old with average age of 7.5 years old.Seventy-five percent(12/16) were ANCA positive.The patients with lung involvement had cough,chest pain,dyspnea,hemoptasis and asthma.Findings on lung X-ray films were variable.Some showed multiple patch shadows,others showed single or multiple masses or nodular shadows with or without cavity formation.After the treatments with corticosteroid and cyclophosphamide,10 cases turned better;including 8 cases with normal on lung X-ray films.Three cases given up;3 cases died.Conclusion It is very difficult to make diagnosis of primary small vessel vasculitis with involvement of lungs and should be paid more attentions to this issue.

Objective To investigate curative effect thymoleptics with couple therapy for the patients with postpartum depression (PPD) Methods 27 patients first time diagnosed with PPD consistent with DSM-Ⅳwere randomly divided into study group and control group.The study group received regular thymoleptics with couple therapy,a control group were administered solo thymoleptics.Hamilton Depression Rating Scale(HAMD-17) and Edinburgh Postnatal Depression Scale (EPDS-10) and OLSON marriage quality questionnaire assessed the efficacy of each group before treatment and after 12 weeks treatment.Results (1) According to the total effective rate,there was no significantly differences in two groups after 12 weeks treatment from evaluation of HAMD-17>(P0.05),but complete remission of study group was higher than control group (78.6% ,46.2% ;P<0.05).(2) After 12 weeks treatment there were significantly differences in mean scores of HAMD-17 and EPDS-10 between two groups (P<0.05).The most decreased scores of HAMD-17 and EPDS-10 was found in the study group,and mean scores of each group was lower than pretherapy(P<0.05).(3) There was no significant difference on the scores of eight factors in OLSON marriage quality questionnaire between the two groups before treatment (P>0.05).After 12 weeks treatment the study group had higher score than control in seven factors in addition to sexual life factor (P<0.05).Conclusion Thymoleptics with couple therapy can improve the marriage quality and increase curative effects outstrip solo thymoleptics for the patients with postpartum depression.

Objective To investigate whether intrathecal administration of corticotrophin releasing factor(CRF) has an efficacy on visceral hypersensitivity in irritable bowel syndrome model rat.Methods Thirty rats were randomly divided into three groups(n=10 ).After establishment of irritable bowel syndrome rat model were intrathecal injected with CRF or preemptive peritoneal injected with CP-154526,which is inhibitor of CRF-1 receptor,and the control group to give saline.After experiment all rat with the method of rectal balloon distention,the perception thresholds and the number of abdominal withdrawal reflexes (AWR) of different balloon volume were observed.Results The perception threshold of intrathecal administration of CRF group was(0.62±0.10)ml and higher than other two groups [(0.52±0.09)ml,(0.56±0.08)ml;F=3.25,P＜0.05].At the same time,the number of AWR to the lower balloon content (1.0 ml) was(9.10±1.97)in intrathecal administration of CRF group slightly lower than other two groups[(14.4±1.71),(15.6±2.32);F=29.4,P＜0.01],but no difference was found to the higher balloon content (1.5 ml and 2.0 ml).Besides,the areas and OD value of c-fos positive neurons in cornu posterius medullae spinalis in group with intrathecal administration of CRF were significantly lower than other two groups (P＜0.05).Conclusion Intrathecal administration of CRF can degrade the visceral hyperensitivity in irritable bowel syndrome model rat,and lower expression of c-fos in CNS is probably involved in the process.

Objective Analyzing NNT epidemiological characteristics and the influeutial factors in Guangdong province from 2001 to 2005 in order to formulate the strategies for elimination NNT.Methods To make descriptive study on the data collected from NNT surveillance system. Results 2832 cases were concentrated in the Pearl River Delta and the west of Guangdong.About 72.04% NNT cases occurred in the migrant children.Through analyzing the data of the year of 2004 and 2005,73.81% of migrant NNT cases occurred in the Pearl River Delta.The cases happened in the Pearl River Delta accounted for 90.18% of whole cases.Most of local cases occurred in the west of Guangdong,which accounted for 39.04% of local cases.The cases occurred all around the year.A seasonal peak of NNT was found from June to August.Most of the onset of disease were during 2～10 days after birth.There were a higher ratio of reported male cases to the female.The ratio was 2.08∶1.Most of the NNT cases were happened to the infants who delivered at home and most of the midmives who were responsible for delivery lacked of training.99.75% mothers did not kown or administe the tetanus toxoid vaccine. Conclusion The elimination of neonatal tetanus is a difficult task in Guangdong province.Publicity to the mass should be strenghtened.The cooperation between sectors should be conducted for NNT eliminodion.