Objective To learn the effect of individualized nutritional support in the treatment of severe acute pancreatitis and provide an effective nutritional support therapy for the disease.Methods 97 patients of severe acute pancreatitis were randomly divided into 51 cases of observation group and 46 cases of control group.The control group was given standard parenteral nutrition.The observation group was given the same heat and support stage of individual nutrition nitrogen.Hemoglobin (Hb),albumin (ALB),pre albumin (PA)and transferrin (TFN)of the two groups were detected before and after treatment.The recovery time of serum amylase,resumed oral intake time, hospitalization time and hospitalization expenses of the two groups were observed.The occurrence of gastrointestinal complications was observed in the two groups during the treatment period.Results Compared with before treatment, after treatment Hb,ALB,PA,TFN of the two groups were significantly increased (t =4.114,7.540,5.556,8.307 and 1.994,3.970,2.906,5.099,all P <0.05).After treatment,ALB,PA,TFN of the observation group were higher than the control group (t =2.249,2.256,3.630,all P <0.05).After treatment,recovery time of serum amylase,resumed oral intake time,hospitalization time and hospitalization expenses of the observation group were lower than the control group (t =3.191,5.245,4.846,8.762,all P <0.05).The incidence rate of gastrointestinal complications of the observation group was 11.8%(6 /51),and that of the control group was 15.2%(7 /46),the difference was not statis-tically significant (χ2 =0.248,P >0.05).Conclusion In the treatment of severe acute pancreatitis,individualized nutritional support has better curative effect,low incidence of complications,with good clinical application value.

Objective To investigate the value of transcranial Doppler(TCD)in the prediction of the outcome and determination of brain death in patient with spontaneous intracerebral hemorrhage. Methods The waveforms and the cerebral blood flow velocities of the bilateral middle cerebral arteries(MCA)were monitored and analyzed using EME TCD in 68 comatose patients with Glasgow scores ≤7. Results The results showed that persistence of retrograde diastolic flow or small systolic forward flow in bilateral MCA lasted for more than 1 hours were observed in 28 cases of comatose patients, which was a reliable indicator for predicting or confirming brain death. Asymmetrical TCD waveforms were characteristically associated with the localized brain damage. Conclusion TCD monitoring is a useful technique for predicting outcome and guiding treatment of patient with spontaneous intracerebral hemorrhage.

AIM:To examine the efficacy and safety of cryotherapy in the management of Fusarium corneal ulcer.
METHODS: Retrospective contract analysis of the clinical data of 41 patients ( 41 eyes ) who infected with Fusarium corneal ulcer. All of them underwent focal lesion keratectomy combined with amniotic membrane transplantation between January 2010 and May 2013. The cryotherapy treatment group of 22 cases (22 eyes), non-cryotherapy group of 19 cases ( 19 eyes ) . All the cases were followed up for 3 ~12mo. We analyzed the healing of corneal ulcer, corneal neovascularization, postoperative visual acuity, complications and ulcer recurrences.
RESULTS: There were no significant difference for the two groups at the cure rate and the recovery rate, the corneal neovascularization and postoperative visual acuity (P>0. 05). The total effective rate and corneal healing time in cryotherapy group was significantly higher than that in non - cryotherapy group ( P < 0. 05 ). The postoperative visual acuity of two group were higher than that of preoperatively ( P < 0. 05 ). There was no complication occurred in cryotherapy group while there was 1 patient of secondary glaucoma in non-cryotherapy group.
CONCLUSION: Cryotherapy is an effective and safe method for the treatment of Fusarium corneal ulcer.

Objective To study the effect of anticholinesterase agents on acantholysis in pemphigus vulgaris (PV) by using a mouse model.Methods Fifty-five neonatal BALB/c mice were divided into four groups:model group injected subcutaneously with the sera of patients with PV (n =15),pyridostigmine bromide group (n =15) and neostigmine methylsulfate group (n =15) subcutaneously injected with pyridostignine bromide and neostigmine methylsulfate respectively,in addition to the sera of PV patients,control group subcutaneously injected with sodium chloride physiological solution (n =10).The effect of anticholinesterase agents on acantholysis in PV was evaluated in terms of clinical presentation,histopathological manifestations and direct immunofluorescence findings.Results The injection of sera from PV patients induced characteristic changes of PV in neonatal BALB/c mice in the model group.The degree of acantholysis in the model group was higher than that in the pyridostigmine bromide group (H =21.584,P ＜ 0.001) and neostigmine methylsulfate group (H =20.641,P ＜ 0.001).No changes were observed in the control group.Conclusion Anticholinesterase agents can reduce the degree of acantholysis in the mouse model of PV.

Objective To investigate the special features of disabled children and their medical care before admission to social welfare institution.Methods A retrospective analysis of 306 cases was performed for the types of disabilities, growth and development, nutritional state, success rate in treatment of severe cases, and etc.Results In all of 306 cases (the ratio of male∶female equal 1.6∶1), 49 cases (16.01%) had intelligence disability, 17 cases (5.56%) had extremity disability, 6 cases (1.96%) had vision disability, 7 cases (2.29%) had hearing or speech disability, 158 cases (51.63%) had multiple disability, but no cases had psychiatric disability. Besides, 69 cases (22.55%) had severe but incurable or untreated congenital disease. 23 severe cases were successfully treated and there were 10 deaths. 296 cases were transferred to the state welfare institution after medical observation or treatment.Conclusion Living environment for disabled children is extremely bad, social adaptability is poor, most of them have growth retardation, malnutrition, poor immunity, susceptible to acute diseases and the mortality rate of these children is higher.

Objective To investigate the effects of 5-Aza-2'-deoxycytidine (5-Aza-CdR) on the apoptosis of A549/DDP cells and the expression of hMLH1 gene.Methods A549/DDP cells were treated with 5-Aza-CdR at 0.5,5,50 μmol/L.The growth curve of A549/DDP cells was investigated by MTT assay.The methylation status of hMLH1 gene was detected by methylation specific PCR (MSP).The expression of hMLH1 mRNA was evaluated by FQ-PCR.The apoptosis rate of A549/DDP cells was analyzed by flow cytometry.Results A549/DDP cells treated with 5-Aza-CdR showed a slow growth in comparison with the control cells,and the growth rates were decreased with the increasing of 5-Aza-CdR concentration.The apoptosis rate after treatment was higher than that before treatment in A549/DDP cells (P ＜ 0.05),and had a positive correlation with 5-Aza-CdR dose (P ＜ 0.001).hMLH1 mRNA expression level was increased in a 5-Aza-CdR concentration dependent manner (P ＜ 0.05).hMLH1 promoter in A549/DDP cells was methylated and hMLH1 mRNA was negatively expressed before treatment,but the mRNA was positively expressed after treatment with 5-Aza-CdR.Conclusions 5-Aza-2'-CdR can induce apoptosis of A549/DDP cells by inducing demethylation of hMLH1 promoter and thereby enhancing hMLH1 gene expression and its tumor suppressor function.

OBJECTIVE: To understand the prevalence rate and the relativity of allergic rhinitis and recurring respiratory infection of preschool children in Shenzhen, and to investigate and analyse the prevalence rate, predisposing factor, allergen, therapy, turnover on allergic rhinitis and recurring respiratory infection of preschool children. METHOD: The ENT doctors examined the investigated children and recorded them, then delivered questionnaires to the children's parents and explained to them. The result was analyzed statistically. RESULT: The prevalence rate of allergic rhinitis of preschool children in Shenzhen was 20.1%, the prevalence rate of recurring respiratory infection was 13.7%, the prevalence rate (18.0%) of allergic rhinitis combined recurring respiratory infection was higher than that (7.80) of cases with non-allergic rhinitis combined recurring respiratory infection. The difference had a statistical significance (P < 0.05). CONCLUSION We initially understood the epidemiologic situation of allergic rhinitis and recurring respiratory infection of preschool children in Shenzhen, providing epidemiologic datas for the standardization of prevention and cure for allergic rhinitis.
Allergens ; Child, Preschool ; China ; epidemiology ; Humans ; Respiratory Tract Infections ; epidemiology ; Rhinitis, Allergic, Perennial ; epidemiology ; Rhinitis, Allergic, Seasonal ; epidemiology ; Surveys and Questionnaires

10.3969/j.issn.1007-3969.2013.04.009

Objective To analyze the relationship between HBsAg level and HBV DNA level as well as illness severity in patients with HBV-related acute-on-chronic liver failure (ACLF).Methods One hundred and nineteen patients with chronic hepatitis B (CHB group) and 98 patients with ACLF(ACLF group) were enrolled.HBsAg and HBeAg were assayed with Roche electrochemical luminescence method.HBV DNA was quantified using a real-time polymerase chain reaction (PCR) assay.HBsAg and HBV DNA levels were compared between two groups and between HBeAg-positive and HBeAg-negative patients in ACLF group respectively,also the correlationbetween HBsAg and HBV DNA was studied.Results The proportions of HBeAg-negative patients were 68.4％(67/98) and 42.9％(51/119) in ACLF group and CHB group respectively,and there was significant difference between two groups (P ＜0.01).There was no significant difference in HBV DNA between two groups (P ＞ 0.05).HBV DNA in HBeAg-positive patients was higher than that in HBeAg-negative patients in two groups(P ＜ 0.05).There was no significant difference in HBsAg between HBeAg-positive patients and HBeAg-negative patients in ACLF group (P ＞ 0.05 ),but they were higher than that in HBeAg-positive patients in CHB group (P＜ 0.05).HBsAg was correlated to ALT,AST in HBeAg-positive patients (P ＜ 0.05).No significant correlation was found among HBsAg and HBV DNA as well as biochemical changes (P＞ 0.05).There was no significant difference in the ratio of different HBsAg levels among the patients of different HBV DNA in ACLF group (P＞ 0.05).Conclusion The level of HBsAg does not directly correlate with serum HBV DNA level,and has no directly correlation with the severity of the disease in patients with HBV-related ACLF.

Objective To study programmed death-1 (PD-1) and T-cell immunoglobulin mucin3 (Tim-3) co-expression on peripheral blood mononuclear cells (PBMC) and hepatitis B virus (HBV)-specific CD8+ T cells in patients with chronic HBV infection and its correlation with liver inflammatory activities.Methods One hundred and sixty subjects with chronic HBV infection who visited the outpatient and inpatient Department of Infectious Diseases in the Third Affiliated Hospital of Sun Yatsen University were enrolled,including 63 cases of mild or moderate CHB (MCHB),31 of severe CHB (SCHB),55 of acute-on-chronic liver failure (ACLF) and 11 inactive HBsAg carriers.Twenty healthy subjects were enrolled as controls.Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect HBV DNA,enzyme-linked immunosorbent assay (ELISA) to measure HBV serological markers,and flow cytometry to detect human leukocyte antigen (HLA)-A2 and determine the expression of PD-1 and Tim-3 on PBMC and HBV-specific CD8+ T cells.Cell counts of Tim-3+,PD-1+,and Tim-3+/PD1+ PBMC and HBV-specific CD8+ T cells were compared among different groups,and their correlation with commonly used inflammatory activity indicators were studied.Analysis of variance and Kruskal-Wallis test were used for measurement data with gaussian distribution and skewed distribution,respectively.Spearman correlation analysis was used to assess the association between Tim-3/PD-1 expression and inflammatory activity indicators.Results The frequency of Tim-3+/PD-1+ PBMC was 0.25 ％ in ACLF group (P=0.0049),0.24 ％ in SCHB group (P-0.0025) and 0.13％ in MCHB group (P=0.0006),which were significantly higher than that in control group (0.03％),and the frequency of Tim-3 /PD-1-PBMC in the three groups were significantly lower than that in control group (P =0.0000),but the differences between HBsAg carriers (0.10％) and controls (0.03％) were not statistically significant (P=0.28).Among 160 subjects,78 were HLA-A2 positive.The frequency of Tim-3+/PD-1+ HBV-specific CD8+ T cells was 68.72％±17.21％ in ACLF group,and 59.66％± 19.25％ in SCHB group,which were significantly higher than that in HBsAg carrier group (33.93％ ± 10.80％,P=0.0000,P=0.0054).The frequency of Tim-3 /PD-1-HBV-specific CD8+ T cells in ACLF group was 2.80％,which was significantly lower than that in HBsAg carrier group (27.24％,P=0.0004).The frequency of Tim3+/PD-1+ HBV-specific CD8+ T cells was positively correlated with alanine aminotransferase (r=0.26,P=0.022),aspartate aminotransferase (r=0.28,P=0.012) and total bilirubin levels (r=0.36,P=0.001); and inversely correlated with albumin level (r=-0.35,P=0.002) in serum.Furthermore,it was positively correlated with international normalized ratio (INR,r=0.34,P =0.045) and model for end-stage liver disease score (r=0.43,P=0.027) in ACLF group.Conclusions Co-expressions of Tim-3 and PD-1 on PBMC and HBV-specific CD8+ T cells are significantly upregulated in patients with CHB,and correlated with liver inflammatory activities.These findings indicate that Tim-3 and PD-1 co-expression may involve in disease activity and liver failure in CHB.