BACKGROUND: Community-acquired pneumonia (CAP) in autoimmune diseases (AID)-induced immunocompromised host (ICH) had a high incidence and poor prognosis. However, only a few studies had determined the clinical characteristics of these patients. Our study was to explore the characteristics and predictors of mortality in CAP patients accompanied with AID-induced ICH. METHODS: From 2013 to 2018, a total of 94 CAP patients accompanied with AID-induced ICH, admitted to Emergency Department of Zhongshan Hospital, Fudan University, were enrolled in this study. Clinical data and the risk regression estimates of repeated predictors were evaluated by generalized estimating equations (GEEs) analysis. An open-cohort approach was used to classify patient’s outcomes into the survival or non-survival group. RESULTS: The hospital mortality of patients with CAP occurring in AID-induced ICH was 60.64%. No significant differences were found with respect to clinical symptoms and lung images between survival and non-survival groups, while renal insufficiency and dysfunction of coagulation had higher proportions in non-survival patients (P<0.05). Both noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV) were performed more frequently in non-survival group (P< 0.05). By the multivariate GEEs analysis, the repeated measured longitudinal indices of neutrophilto- lymphocyte ratio (NLR) (odds ratio [OR]=1.055, 95% confidence interval [95%CI] 1.025–1.086), lactate dehydrogenase (LDH) (OR=1.004, 95%CI 1.002–1.006) and serum creatinine (sCr) (OR=1.018, 95%CI 1.008–1.028), were associated with a higher risk of mortality. CONCLUSION: The CAP patients in AID-induced ICH had a high mortality. A signifi cant relationship was demonstrated between the factors of NLR, LDH, sCr and mortality risk in these patients.

Objective To investigate the effect of enamel matrix proteins (EMPs) on gene expression in human bone marrow stromal cells (hBMSCs) by cDNA microarray. Methods hBMSCs were cultured in vitro by whole bone marrow technique. Those stimulated with EMPs at a concentration of 200 ?g/mL in vitro were classified as test group, and those normally cultured were served as control. Afer culturing for 5 days, a cDNA microarray containing 4 096 genes was used to detect and analyze the gene expression. Four differentially-expressed genes in cDNA microarray were determined by real-time PCR for validation of the microarray data. Results Twenty-seven genes of hBMSCs were differentially expressed in the presence of EMPs, among which 18 were up-regulated and 9 down-regulated. The result of real-time PCR was in accordance with that of the cDNA microarray. Conclusion cDNA microarray technique can screen the differentially-expressed genes in hBMSCs treated with EMPs, which lays a foundation for the research of molecular mechanism of EMPs in inducing the regeneration of periodontal tissue.

Child, Preschool ; Diagnosis, Differential ; Female ; Gonadotropin-Releasing Hormone ; therapeutic use ; Humans ; Hysteroscopy ; Pediatrics ; Puberty, Precocious ; diagnosis ; therapy ; Uterine Hemorrhage ; diagnosis ; etiology ; therapy ; Vaginal Diseases ; diagnosis ; etiology ; therapy

Objective To explore the clinical significance of mycoplasma pneumoniae(MP) antibody IgM positive with high titers.Methods Two hundred and sixty-seven cases of respiratory tract infections of MP with MP-IgM positive were confirmed in our hospital during Jun.2005 to Aug.2008,of which 63 cases with significantly increased titers of MP-IgM antibodies(MP-IgM≥1:1 280).A prospective observation and later analysis of the clinical manifestations of the 63 cases were carried out.Results 1.Among 63 cases,6 cases were diagnosed as upper respiratory tract infection,12 cases as acute bronchitis and 45 cases as pneumonia,respectively.2.The 63 cases pre-sented mainly with fever and cough,of them 59 cases had fever and 45 cases with paroxysmal cough,39 cases could be found crackles on physical examination.3.Extrapulmonary manifestations could be found in many cases,including heart complications in 21 cases,abnormal liver functions in 35 cases,gastrointestinal manifestations in 22 cases,neurological manifestations in 1 case,dermatological disorders in 7 cases and renal manifestations in 3 cases.4.Patterns of chest X-ray findings of the 63 cases with MP infections were varied,of which 45 cases showed pulmonary abnormality.Chest X-ray findings of the 45 children included 12 cases with interstitial infiltration,6 cases with lobar condensation,15 cases with patch shadows,4 cases with enlarged porta pulmonis and 8 cases with reticulonodular infiltrates.Three cases were complicated with pleural effusion and 2 children with segmental atelectasis.5.The cases were given azithromycin,10 mg/(kg?d),a daily dose for 5 days and intermitted for 4 days.All cases repeated the treatment courses for 1 to 4 times.The mean duration of fever was 6.6 days,cough could last 11.7 days and the crackles on physical examination could not be found 7.5 days later after treatment.The abnormality of chest X-ray findings dissolved in 38 cases 2-3 weeks later after treatment.Conclusions Cases of MP infections with high titers of MP-IgM positive had severe symptoms,of which more than 90% patients presenting with lower respiratory tract infections,mainly with pneumonia.Recovery of chest radiological finding was posterior to clinical improvement,so timely and regular chest X-ray examinations were essential after treatment and could avoid the false ceasing of treatment of the cases.Patients of MP infections with high titers of IgM antibodies positive have good prognosis.

Objective To explore the diagnosis,treatment and pathology of malignant brain tumor in children.Methods The clinical data of 61 children with malignant brain tumor were reviewed,including their age distribution,diagnosis,operation route(according to the position of the brain tumors),chemotherapy [using bischloro-nitrosourea(BCNU),teniposide(VM-26) and temozolomide]and radiotherapy (part and whole brain irradiation,three diamensions conformal therapy,gamma knife and X-kinfe).Results Of 61 cases,which including 37 boys and 24 girls whose mean age was 11.3 years,24 cases were supratentorial tumors and 37 cases were infratentorial.Forty-five tumors received total or subtotal recession,10 cases with major recession,and 6 cases with partial recession.After operation,39 cases (63.9%) received radiotherapy,and 29 cases (47.5%) with chemotherapy.Follow-up of 49 cases were achieved,in which 22 cases died and 27 cases survived.Conclusions Surgical removal is still the chief treatment for malignant brain tumor in children.The exairesis profect should be formulated according to the specificity of each case.Radiotherapy methods should be related to post-operational images(CT or MRI).And it was different from the brain tumors in adult.It is good to prolong survival duration for some chosen cases with optimal chemotherapy.

Objective To analyze the trend of disease constitution of hospitalized neonates in China-Japan Friendship Hospital and provide a scientific basis for the focus adjustment of perinatal health.Methods Six hundred and ninety-eight neonates were admitted during Jan.2004 to Dec.2008.Relevant data of all cases were retrospectively collected.The discharge diagnosis of the neonates was counted accor-ding to the year,and the trends of the neonatal disease constitution of the 5 years were analyzed.Results 1.The first 10 diseases of hospita-lized neonates were centralized,and the first 3 diseases including premature infants,neonatal hypoxic-ischemic encephalopathy(HIE) and neonatal hyperbilirubinemia accounted for 42.84% of the neonate diseases.2.The characteristics of neonatal disease constitution were as fo-llows:the disease constitution of premature infants always located within the first 3 diseases;the location of neonatal HIE went ahead from number 8 to number 1 or 2,and its constitution proportion increased from 4.93% to more than 15.00%(P

Objective To explore the application of self-expanding stent and seperable detachable coil for interventional therapy in patients with wide-necked intracranial aneurysm.Methods 32 patients with wide-necked intracranial aneurysm received the interventional therapy by self-expanding stent and seperable detachable coil.After operation,the situation of the aneurysm occluded were observed by DSA immediately and followed up.Results The stents were successfully deployed in the 32 patients.The seperable detachable coils were occluded in the aneurysms in 29 cases.After operation immediately,the DSA showed that the aneurysms in 18 cases were completely occluded by seperable detachable coils,7 cases were 95% occluded,4 cases were 90% occluded.In the other 3 cases,the aneurysms were too small to be filled by seperable detachable coil,the stents were used only.All the parent arteries were no stenosis.18 h after operation,1 case died from multiple hemorrhage caused by thrombasthenia.Follow-up from 3 months to 1 year,DSA re-examination in 21 cases.Compared with the image immediately after operation,the imagings of DSA were no change in 12 cases,residual necks were disappeared in 5 cases and increased in 1 case.In the 3 cases which stents used only,the aneurysms were no development completely in the 2 cases and decreased in 1 case.6～18 months followed up in 26 cases,the rebleeding and cerebral infarction were no occurred.Conclusions The self-expanding stent is very flexible,secure,and effective.It can good support for the wide-necked aneurysms to be occluded by seperable detachable coils and effective promoting the small aneurysms healing.

OBJECTIVE To investigate and analyze the application of prophylactic antibiotics in perioperative period in hospital.METHODS Totally 2 055 cases under operation were investigated prospectively from Jun to Dec in 2005.RESULTS The rate of antibiotics usage was 99.95% among the 2 055 cases.The usage of antibiotics in aseptic wound was 99.92%,and in aseptic-contaminative and contaminative wound was all 100%;72.47% of the patients received single antibiotic treatment,25.84% and 1.12% received 2 to 3 kinds of antibiotics combined therapy respectively.The mean time of the usage of antibiotics during perioperative period was 8.16 days,and that for aseptic,aseptic-contaminative and contaminative wound was 8.1,8.2,and 8.2 days,respectively.29.65% Patients were given antibiotics in 0.5-2 hours before operation,68% were given after operation.The duration of antibiotics therapy less than 48 hours was only 3.45%.The rate of wound infection was 0.75% in patients. The rate of wound infection of aseptic,aseptic-contaminative and contaminative operations was 0.29%,1.33% and 3.42%,respectively.CONCLUSIONS Application of prophylactic antibiotics during perioperative period in hospital is not reasonable.The problem is improper time that given antibiotics,improper kind of antibiotics selected and too long duration of the antibiotics therapy.It is necessary that the antibiotics administration should be standardized.

Xanthine-Xanthine oxidase ( X-XOD) added to the culture medium of cultured cardiac cells in rats may damage cell membrane. Electrophysiological findings indicated that APA, MDP, OS,Vmax, were decreased and the SDF was increased. Astragalus polysaccharide (APS) could protect the cells from being damaged by X-XOD. APS recoverted all the de-creased cardiac functional parameters in free-radical-damaged rats by X-XOD. APS had anti-free-radical damage action on the cultured my-ocardiocytes and the myocardial contractility of the isolated rat working heart.

Acupuncture Points ; Acupuncture Therapy ; history ; methods ; China ; History, Ancient ; Humans ; Medicine in Literature