Objective To study radiological characteristics of hand-foot-mouth disease(HFMD) in children. Methods The chest X-ray films of 1295 children patients of HFMD were analyzed,for the general X-ray manifestations and the evolution. Results A total of 1427 films was obtained from all patients, in which 1203 cases were normal and 224 cases were abnormal. The interstitial changes characterized the abnormal group, mainly as increased and vague lung markings, increased hilar shadows (137 cases).The parenchyma changes appeared as patchy exudative shadows(49 cases). Short-term dynamic observation was applied in 62 cases, 38 cases pulmonary disease progression manifested as normal and the interstitial type changing into the parenchyma type and the mixed type, the localized type changing into the diffuse type. Conclusions Most children patients of HFMD showed normal chest films, while the abnormal patients were characterized by interstitial and parenchyma pulmonary edema. Serial chest X-ray examination and short-term dynamic observation were important to identify the severe cases and assess patients' condition.

Seven meroterpenoids and five small-molecular precursors were isolated from Penicillium sp., an endophytic fungus from Dysosma versipellis. The structures of new compounds, 11beta-acetoxyisoaustinone (1) and isoberkedienolactone (2) were elucidated based on analysis of the spectral data, and the absolute configuration of 2 was established by TDDFT ECD calculation with satisfactory match to its experimental ECD data. Meroterpenoids originated tetraketide and pentaketide precursors, resepectively, were found to be simultaneously produced in specific fungus of Penicillium species. These compounds showed weak cytotoxicity in vitro against HCT-116, HepG2, BGC-823, NCI-H1650, and A2780 cell lines with IC 50 > 10 micromol x L(-1).

Objective Mild hypothermia provides protection for the brain and improves prognosis in the treatment of severe traumatic brain injury, which is widely acknowledged.The article aimed to analysis the prognosis and complications of long-term and short-term mild hypothermia on patients with severe traumatic brain injury. Methods According to the cochrane systematic review methods, thorough search was carried out in databases including Cochrane, Pubmed, Embase, CBM, CNKI, Wanfang and VIP.Eval-uation was made on the quality of selected documents, and Revman5.2 software was applied for meta analysis after data extraction. Results Long-term mild hypothermia achieved improved prognosis compared to short-term mild hypothermia ( GOS score 4 ~5 ) [RR=1.37, 95%CI (1.14, 1.64), P=0.0006].No significant difference was found between these two therapies in pneumonia in-cidence (P=0.94), arrhythmia incidence ( P=0.54) and stress ulcer incidence (P=0.99). Conclusion In comparison to short-term hypothermia therapy, long-term mild hypothermia therapy improved the prognosis of patients with severe traumatic brain inju-ry without obvious increase in the incidence of pneumonia, arrhythmia and stress ulcer.

Objective To evaluate the curative effect and safety of mild hypothermia on patients with traumatic brain injury. Methods According to the cochrane systematic review methods , the data bases such as Cochrane, Pubmed, Embase, CBM, CNKI, Wanfang and VIP database were searched. The quality of included documents were assessed to extract meta analysis data. Results Compared to the control group, there was no statistically significant difference in patients treated by hypothermia for 3 days or less in mortality , but the difference was statistically significant after the summary [RR=0.74, 95%CI 0.64~0.85,P<0.000 1]; And there was no statistically significant difference in improving neural function of patients treated by hypothermia for < 3 days , but hypothermia improves the prognosis after the summary [RR=1.40,95%CI 1.24~1.59,P<0.000 01]. The difference was statistically significant in the incidence of pneumonia (P=0.007), there was no statistically significant difference in the incidence of arrhythmia (P=0.06), but the difference was statistically significant after sensitivity analysis. Conclusions Patients treated by hypothermia for < 3 days is not valid for clinical outcomes , the duration of the treament up to 3 days may not reduce mortality rates, but can improve the prognosis, lasts longer than 3 days or until the pressure back to normal, reducing the mortality rate, improve the neurological prognosis;but increased incidence of pneumonia, whether to increase the rate of cardiac arrhythmias have yet to be determined.

Objective To evaluate the clinical efficacy of limited open reduction combined with percutaneous medial locking plate in treatment of Rüedi-Allg(o)wer type Ⅱ and Ⅲ closed tibial pilon fractures.Methods A retrospective case-control analysis was made on 45 cases of closed tibial pilon fractures treated surgically between June 2008 and December 2015.There were 33 males and 12 females,aged from 26-66 years (mean,44.6 years).All cases were unilateral tibial pilon fractures,among which 18 were on the left while 27 were on the right.Thirty-four cases were combined with fibular fractures.There were 14 cases of type Ⅱ fractures and 31 type Ⅲ fractures according to the Rüedi-Allg(o)wer classification.Using the Tscheme-Gotzen system to evaluate soft tissue injury,two patients were in grade 1,29 patients in grade 2,and five patients in grade 3.On the basis of surgical methods,the cases were divided into Group A,limited open reduction with percutaneous medial locking plate and Group B,conventional open reduction.The operation time,reduction quality,fracture healing time,American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale at final follow-up visit and complications were recorded and compared between the two groups.Results The operation time of Group A was shorter than that of Group B (P ＜ 0.05).All patients had been followed up for 12-24 months,among which Group A was 22.5 months and Group B was 20.0 months (P ＞ 0.05).Compared with Group B,Group A was superior in fracture healing time (P ＜ 0.05) and AOFAS ankle-hindfoot scale(P ＜0.05),but was inferior in reduction quality (P ＜ 0.05).Poor wound healing was observed in two cases in each group,yet there was no nonunion in all cases.Conclusion Compared with conventional open reduction,the limited open reduction combined with percutaneous medial locking plate has more advantages in operation time and fracture healing,which can achieve better ankle functions for closed tibial pilon fractures.

Objective To explore safety evaluation of the approaches of the percutaneous eilational tracheostomy(PDT)ane traeitional tracheotomy in the treatment of neurological patients. Methods The stuey eesign was a multicenter,prospective,raneomizee clinical trial. One huneree ane seventy-six cases with acute nerve trachea incision from Feb. 2010 to Feb. 2013 of 3 hospitals were selectee as our subject. They were raneomly eivieee into the traeitional group ane PDT group. The information inclueing operation time,the incieence of pneumothorax,subcutaneous emphysema,tracheal fistula,esophageal,trachea ane lung injury from complications such as infection were recoreee. Results The complication rate in traeitional group was 19. 51%(16 / 82),higher than that of PDT group(8. 51%(8 / 94),P = 0. 021). The surgery perioe in PDT group was(7. 5 ± 2. 3)min,shortee than that in traeitional group((41. 6 ± 5. 8)min,P = 0. 000). Conclusion The approach of percutaneous tracheostomy can quickly buile airway of neurological patients with character of simple, safe,ane it also can reeuce the incieence of respiratory complications.

Objective: We aimed to examine the feasibility and toxicity of EC-T dose-dense regimen and to demonstrate the suitable dose of epirubicin in a Chinese early-stage breast cancer population with high recurrence risk. Methods: 370 patients with early-stage breast cancer at high risk of recurrence were treated with EC-T dose-dense adjuvant chemotherapy and prophylactic administration of recombinant human granulocyte stimulating factor (G-CSF). The incidence of delayed chemotherapy, drug reduction and adverse reactions were retrospectively analyzed. Results: 370 patients completed the planned eight cycles of chemotherapy, 50 patients experienced chemotherapy delay, and 90 had chemotherapy dose reductions. Overall, 61.1% of the patients experienced grade 3 or 4 hematology toxicities, 4.1% of the patients experienced grade 3 gastrointestinal toxicity, 16.3% experienced grade 3 or 4 liver malfunction, and 1.9% experienced grade 3 alopecia. In the multivariate analysis, pretreatment epirubicin levels were associated with comprehensive and hematology toxicity risk (OR=1.268, P=0.046; OR=1.244, P=0.036). With G-CSF support, the probability of grade 3-4 dose limiting toxicity, i. e. neutropenia, abnormal liver function, and gastrointestinal adverse effects did not increase as the epirubicin dose level increased(P>0.05). However, there were no statistically significant associations between epirubicin grade and treatment delay (P=0.814) or dose reduction (P=0.282). Conclusions EC-T dose-dense chemotherapy shows tolerable toxicity. High dose level is not a limiting factor for this regimen. With G-CSF support, epirubicin 85-90 mg/m² is appropriate tolerance dose for Chinese early breast cancer patients with high recurrence risk.

To study an automatic plan(AP) method for radiotherapy after breast-conserving surgery based on TiGRT system and and compare with manual plan (MP). The dosimetry parameters of 10 patients and the evaluation of scoring table were analyzed, it was found that the targets dose of AP were better than that of MP, but there was no statistical difference except for CI, The V5, V20 and V30 of affected lungs and whole lungs in AP were lower than all that in MP, the Dmean of hearts was slightly higher than that of MP, but the difference was not statistically significant, the MU of AP was increase by 16.1% compared with MP, the score of AP evaluation was increase by 6.1% compared with MP. So the AP could be programmed and automated while ensuring the quality of the plan, and can be used to design the plans for radiotherapy after breast-conserving surgery.
Breast Neoplasms/surgery* ; Female ; Humans ; Mastectomy, Segmental ; Organs at Risk ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated

BACKGROUND: Autophagy plays a crucial role in chemotherapy resistance of triple-negative breast cancer (TNBC). Hence, autophagy-related gene 5 (ATG5), an essential molecule involved in autophagy regulation, is presumably associated with recurrence of TNBC. This study was aimed to investigate the potential influence of single-nucleotide polymorphisms in ATG5 on the disease-free survival (DFS) of early-stage TNBC patients treated with anthracycline- and/or taxane-based chemotherapy. METHODS: We genotyped ATG5 SNP rs473543 in a cohort of 316 TNBC patients treated with anthracycline- and/or taxane-based chemotherapy using the sequenom's MassARRAY system. Kaplan-Meier survival analysis and Cox proportional hazard regression analysis were used to analyze the association between ATG5 rs473543 genotypes and the clinical outcome of TNBC patients. RESULTS: Three genotypes, AA, GA, and GG, were detected in the rs473543 of ATG5 gene. The distribution of ATG5 rs473543 genotypes was significantly different between patients with and without recurrence (P = 0.024). Kaplan-Meier survival analysis showed that patients carrying A allele of ATG5 rs473543 had an increased risk of recurrence and shorter DFS compared with those carrying the variant genotype GG in rs473543 (P = 0.034). In addition, after adjusting for clinical factors, multivariate Cox regression analyses revealed that the AA/GA genotype of rs473543 was an independent predictor for DFS (hazard risk [HR], 1.73; 95% confidence interval [CI], 1.04-2.87; P = 0.034). In addition, DFS was shorter in node-negative patients with the presence of A allele (AA/GA) than in those with the absence of A allele (P = 0.027). CONCLUSION ATG5 rs473543 genotypes may serve as a potential marker for predicting recurrence of early-stage TNBC patients who received anthracycline-and/or taxane-based regimens as adjuvant chemotherapy.
Adult ; Aged ; Anthracyclines ; administration & dosage ; adverse effects ; Autophagy-Related Protein 5 ; genetics ; Bridged-Ring Compounds ; administration & dosage ; adverse effects ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Genetic Association Studies ; Genetic Predisposition to Disease ; Humans ; Kaplan-Meier Estimate ; Middle Aged ; Neoplasm Recurrence, Local ; drug therapy ; genetics ; pathology ; Polymorphism, Single Nucleotide ; genetics ; Taxoids ; administration & dosage ; adverse effects ; Triple Negative Breast Neoplasms ; drug therapy ; genetics ; pathology