Objective To analyze the clinical features,epidemiologic information and outcome in confirmed cases of human infection with a highly pathogenic influenza A(H5N1).Methods The clinical features and epidemiologic findings in 2 confirmed cases of avian influenza A(H5N1)in Anhui province,in November 2005.Clinical data on vital signs,physical findings,laboratory tests and roentgenology were obtained by means of retrospective review of the hospital records.Epidemiologic data were collected through interviews of the patients and their relatives.Results In both cases,the diagnosis of influenza A(H5N1)was confirmed by means of viral culture and real-time polymerase chain reaction with specific primers for H5 and N1 in samples obtained from tracheal aspiration.All patients were previously healthy young women and resided in village.They had a clear history of di- rect contact with sick/dead poultry and prepared dead chickens at home for eating(removed feathers, washed,cut)hut no report of confirmed HSN1 animals in the village.The time between exposure and onset of illness were 5 days,no one else in family sick.The time between the onset of illness and hos- pitalization were 5 days and 6 days,respectively.Two patients have initial symptoms of high fever (typically a temperature more than 38℃).The prominent clinical features were those of influenza syndrome,including fever,cough,and shortness of breath.Upper respiratory tract symptoms were absent.The platelet counts were decreased.In both patients,there were marked abnormalities on chest radiography,radiographic changes include bilateral and unilateral lobular consolidations with air bronchograms,and had dramatic worsening of findings.Two patients developed acute respiratory dis- tress syndrome(ARDS)complicated multiple organ dysfunction syndrome(MODS)and died of pro- gressive respiratory failure.Conclusions Exposure to dead poultry within a week before the onset of illness was associated with Influenza A(H5N1)infection in humans,but no definitive evidence of hu man-to-human transmission has been found yet.Influenza A(HSNI)infection,characterized by fe- ver,an influenza-like illness with lower respiratory tract symptoms,carries a high risk of death.

Objective To survey the function and relation of cytokine interleukin-6 (IL-6) between depression,anxiety and rheumatoid arthritis (RA).Methods One hundred and twenty-one patients with RA were investigated.All of them were assessed by Hamihon Depression Rating Scale and Hamihon Anxiety Rating Scale.Results ① The rate of depression in RA patients was 44.6％,and the rate of anxiety was 32.2％,the rate of depression combined anxiety in RA patients was 30.6％.② Social factors:Unemployment [14 cases (26.4％) vs8 cases (11.9％),x2=4.14] and education [41 cases (83.7％) vs 37 cases (58.7％),x2=8.11]was significantly different between depression and non-depression patients (P＜0.05).Age,unemployment and education was significantly different between anxiety patients and non-anxiety patients (P＜0.05).③ Clinical factors:tender joint count,swollen joint count,disease activity score (DAS)28,health assessment questionnaire (HAQ),VAS,function of joint and C-reactive protein (CRP) was significantly different between depression patients and non-depression patients [6(2,21) vs 1(0,14);4(1,11) vs 2(0,8);24.0(2.5,36.25) vs 2.5(0,19.5);5(3,9) vs 4(0,7);89.8％ vs 9.7％;37.63(13.25,70.75) vs 11.29(2.05,36.78)] (P＜0.05).And anxiety patients and non-anxiety patients had the same results [6(3,25) vs 2(0,14);6(1.5,12) vs 2(0,7.25);25(5,36) vs 3(0,25);8(5,10) vs 5(1.75,7);91.4％ vs 64.5％;33.4(11.0,63.0) vs 16.8(2.5,54.3)](P＜0.05).④ Cytokine:IL-6 was significantly different between depression patients and non-depression patients (P＜0.05).JAK-2,JAK-3,Signal transducer and activator of transcription (STAT)-3,matrix Metalloproteinases (MMP)-3,MMP-13 were not different between depression patients and non-depression patients (P＞0.05).IL-6,JAK-2,JAK-3,STAT-3,MMP-3,MMP-13 were not different between anxiety patients and non-anxiety patients (P＞0.05).⑤ Correlation analysis:Education level was negatively related with the severity of depression (r=0.288,P＜0.05).Tender joint count,swollen joint count,DAS28,HAQ,VAS,function of joint,erythrocyte sedimentation rate (ESR),CRP,IL-6 was positively related with the severity of depression (r=0.348,0.268,0.481,0.318,0.381,0.417,0.397,0.311,0.249;P＜0.05).Education level was negatively related with the severity of anxiety.Tender joint count,swollen joint count (r=-0.244,P＜0.05),DAS28,HAQ,VAS,function of joint,ESR,CRP was positively related with the severity of depression (r=0.282,0.261,0.381,0.284,0.284,0.299,0.263,0.178;all P＜0.05).⑥ Risk factors:IL-6 was the only risk factor in RA patients with depression.Conclusion The rate of depression and anxiety in RA is 44.6％.Depression and anxiety is related with disease activity,pain and HAQ.IL-6 is a high risk factor that makes patients prone to develop depression in RA patients.

Objective To observe the clinical effect of percutaneous endovascular angioplasty ( PTA) for the treatment of diabetic lower extremity arterial disease( LEAD) , so as to provide a reference for the selection of the best treatment for diabetic lower extremity arterial dis-ease(LEAD). Methods In this parallel study, totally 60 patients were equally divided into the control group and the intervention group. The control group were treated by the conventional method, and the intervention group were treated by percutaneous endovascular angioplasty (PTA). The changes of ankle brachial index (ABI),average blood flow velocity of dorsalis pedis,pulsation index(PI) and the maximum walking distance were observated in 12 weeks and 24 weeks after the treatment. Results Compared with the control group, the ankle brachi-al index ( ABI) , average blood flow velocity of dorsalis pedis, pulsation index ( PI) and the maximum walking distance in the intervention group were significantly improved 12 weeks and 24 weeks after treatment, and the difference between the two groups was statistically signifi-cant (P<0. 05). And compared with thses data before treatment in the intra-group comparison, there were statistically significant difference (P<0. 05). However, the changes in 24 weeks and 12 weeks after treatment in the same group showed no significant difference (P>0. 05). Conclusion Percutaneous endovascular angioplasty ( PTA) is better than traditional drug therapy in the treatment of diabetic lower extremity arterial disease( LEAD) . It is a feasible clinical treatment of lower extremity arterial disease( LEAD) .

Objective To induce mouse embryonic stem(ES)cells to differentiate into insulin-secreting cells by means of a 5-step model system.Methods E14.1 mouse ES cells were cultured in the presence of leukemia inhibitory factor(LIF)for 2 days(step 1),then the cells were cultured in hanging drops to form embryonic bodies(EBs)and the resulting EBs were cultured in suspension for 6 days in the presence of basic fibroblast growth factor bFGF(step 2).Subsequently the EBs were cultured in the medium containing glucagon- like peptide 1(GLP-1),hepatocyte growth factor(HGF),nerve growth factor(NGF)and nicotinamide for 10 days(step 3).After that,the EBs were dissociated into single cells,and the cells were cultured in monolayer in the presence of GLP-1,betacellulin,activin A,bFGF and nicotinamide for 10 days(step 4).Finally,the cells were cultured in low-glucose medium containing nicotinamide for 4 days(step 5).Insulin and some other islet- related genes expressions were investigated using RT-PCR and insulin expression was also investigated by DTZ- staining and immunohistochemistry.The percentage of insulin-secreting cells was evaluated by flowcytometry and insulin concentrations were measured by RIA.Results mRNA expression of insulin became visible at step 3 and more evident at step 5.Additionally,at step 5,mRNAs of glucagon,somatostatin,pancreatic polypeptide(PP), pancreatic duodenal homeobox 1(PDX-1),beta-cell E box transactivator 2(Beta2)and neurogenin 3(Ngn3) were detected.DTZ-staining positive cells and insulin immunohistochemical staining positive cells were observed. The percentage of insulin-positive cells was(24.0?2.5)%(n=6).In the presence of 5.6 mmol/L and 25 mmol/L glucose,insulin concentrations were(0.05?0.01)?g/L and(0.13?0.02)?g/L respectively(n= 6).Conclusion E14.1 mouse ES cells can be induced to differentiate into insulin-secreting cells by the 5-step model system.Insulin-secreting cells can release insulin into culture medium when treated with glucose,and insulin concentrations increase with rising concentration of glucose.

Objective To evaluate the effects of the range and the frequency of the compression load on the accuracy for discerning target stiffness differences in ultrasound elastography.Methods Quantitative ultrasound elastography was achieved by integrating two compression force sensors,a laptop computer and a clinical ultrasound elastographic system.The force sensors and the ultrasound probe were assembled in a 3D printed mounting bracket for continuous monitoring of compression loads during ultrasound elastography. Both the force measurements and the elastographic maps were acquired and displayed on the laptop computer in real time.Four targets of the same diameter(10.4 mm),the same depth (3 cm) and different stiffness levels (8,14,45 and 80 kPa) were examined by a HITACHI preirus,L74M linear-array transducer.Each target was evaluated 45 times with two different method(i.e.,freehand elastography and quantitative elastography),yielding 1 80 evaluations.The data were divided into the following three groups:group Ⅰ(80 kPa vs 45,14 and 8 kPa),group Ⅱ(80,45kPa vs 14,8 kPa)and group Ⅲ(80,45 and 14 kPa vs 8 kPa).Area under ROC curves(AUC)were calculated for different stiffness levels.Results In group Ⅲ, quantitative elastography yielded an greater AUC level than that of freehand elastography(P =0.0379).In group Ⅰ and group Ⅱ,two methods yielded the similar AUC levels (P = 1 .000).However,quantitative elastography was able to discern 8 kPa and 14 kPa targets (P <0.001),while freehand elastography was hard to differentiate them(P =0.258).Conclusions In comparison with freehand elastography,quantitative ultrasound elastography is able to improve the accuracy for discerning different target stiffnesses.

OBJECTIVETo segment veins from brain susceptibility weighted images with inhomogeneous background and veins, noises and complex structures.

METHODSBased on vessel enhancing filtering, an adaptive threshold segmenting method and an adaptive threshold region growing method were proposed. The former method was used to exactly segment part of veins from the original images. Taking the veins segmented by the former method as seeds, the later method was used to extract nearly all the veins.

RESULTSFor simulation data with serious noises and interferences, correct rate above 90% was achieved. And for clinical data, the veins were extracted accurately and the structures of veins were displayed clearly.

CONCLUSIONSThe methods can extract veins from the brain susceptibility weighted images exactly and avoid false segmentation of the other structures effectively. The methods are very robust and stable.

OBJECTIVETo introduce algorithms for effective segmentation of teeth MRI-UTE image.

METHODSTo construct second-segmentation algorithm process based on layer-dependent multi-constrained method. Firstly, a level set method was used to segment the initial boundary from the region determined by user in the reference slice. Secondly, both crown and root of the tooth were segmented by the improved level set method which took the information of the former layer's result as constraint conditions. Finally, the improved level set based on the information of the former and later layer's results was executed for the second time to improve the accuracy of segmentation, in which, the parameter of the overlapping ratio was considered.

RESULTSThe accuracy was 86.98% for the first-segmentation and was increased to 88.35% for the second-segmentation. Compared to the two other methods, the accuracy of the algorithms provided was improved significantly (P < 0.05).

CONCLUSIONSThe proposed algorithms can effectively achieve the segmentation of teeth MRI-UTE image and has a great improvement on accuracy.

This review focused on the diagnosis and clinical features of multiple sclerosis (MS) in China. We have identified the published researching information from 1976 to 2008 in China. The key issues related to the diagnosis and clinical features of MS in China were summarized. The first patient with MS in China was reported in 1926 from Xiehe hospital. Case reports on MS have been increasing during recent decades. Almost all the patients with MS were confirmed by the McDonald criteria (1977) before 1984. After the year of 1992, even to this day, the Poser criteria were widely used in China. Although the new diagnostic criteria, McDonald criteria (2001), were presented in 2001, only few papers published in Chinese were reported. The most frequent initial symptoms or signs of the patients with MS were optic nerve, motor weakness and sensory symptoms. The most frequent location of MS lesions over the course was found to be the spinal cord, followed by the cerebrum and optic nerves. Almost all patients had been treated with corticosteroids. This review supported previous observations in Chinese patients with MS. However, further studies are needed to understand epidemiologic features of MS in China.
China ; epidemiology ; Humans ; Multiple Sclerosis ; diagnosis ; epidemiology ; physiopathology ; therapy

Intervertebral disc degeneration is considered as a primary cause of clinical low back pain, however the molecular mechanism is not clear yet. Recently, researches on the molecular basis of intervertebral disc degeneration have become a hotspot. The special structure and biomechanics properties of the disc contribute to its propensity toward degeneration. Intervertebral disc degeneration is associated with the changes of the cytological behavior,including the increase in cell death and the degradation of extracellular matrix. However, the mechanism of cell death including cell apoptosis and autophagy in intervertebral disc degeneration remains unclear. Further study on the molecular mechanism of intervertebral disc degeneration is the foundation of improving and treating the intervertebral disc degeneration in the future. Although some progresses are made in the aspect of biological study, the biological environment of intervertebral disc itself is still a challenge for the development of biological treatment. This article is to review the latest advance on the biological characteristics of normal intervertebral disc and the cell death in the process of the intervertebral disc degeneration.
Animals ; Apoptosis ; Cell Death ; Extracellular Matrix ; metabolism ; Humans ; Intervertebral Disc ; cytology ; metabolism ; Intervertebral Disc Degeneration ; metabolism ; physiopathology