Adolescent ; Adult ; Aged ; Carbon Monoxide Poisoning ; blood ; diagnosis ; Female ; Humans ; Lactic Acid ; blood ; Male ; Middle Aged ; Prognosis ; Young Adult

OBJECTIVETo investigate the best choice of operation opportunity and operation plan for limb fractures combined with severe craniocerebral trauma in children.

METHODSFrom January 2005 to July 2012,36 patients with limb fractures and severe craniocerebral trauma were received,including 24 males and 12 females aged from 1 to 13 years old (mean, 6.1 +/- 3.0). The time from injury to hospital was (18.0 +/- 15.0) h. Glasgow coma score were less than 8 with an average of 6.4 +/- 1.3. AIS-ISS score were 25.9 +/- 8.1. Thirteen patients were open fracture, 23 were closed fracture. Patients were divided into immediate operation group (21 patients) received fracture fixation with 24 h, the average time was (15.0 +/- 7.4) h, and delayed operation group (15 patients) received fracture fixation after 24 h, the average time was (165.4 +/- 114.6) h. All patients were treated by open reduction, and 33 cases by internal fixation, 3 cases were external fixation. Operative time, blood loss, fracture healing time and brain trauma,physical trauma, postoperative rehabilitation situation were observed and evaluated.

RESULTSAll patients were healed at stage I ,and no dead, aggravating of coma, disorders of breathing and circulation occurred during operation. Operative time,blood loss,healing time in immediate operation group was (44.5 +/- 25.3) min, (47.1 +/- 36.5) ml, (2.7 +/- 0.5) months, respectively; while in delayed operation group was (87.0 +/- 40.0) min, (112.7 +/- 67.5) ml, (3.8 +/- 1.2) months,respectively; and there were obvious differences between two groups. There was no siginificant meaning in Glasgow coma score and Fugl-Meyer motor function between immediate operation group (4.7 +/- 0.6, 97.9 +/- 2.7) and delayed operation group (4.7 +/- 0.5, 97.7 +/- 3.9) (t = 0.23, P > 0.05; t = 0.11, P > 0.05).

CONCLUSIONThe condition of limb fractures combined with severe craniocerebral trauma in children is seriously, comfortable surgical opportunity should according to particular case, and immediate operation can performed on the condition of stabled vital signs.

Adolescent ; Child ; Child, Preschool ; Craniocerebral Trauma ; surgery ; Extremities ; injuries ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation ; Fracture Fixation, Internal ; Fractures, Open ; surgery ; Humans ; Infant ; Male

Objective To explore the role of tissue inhibitor of metalloproteinase-1(TIMP-1) during renal senescence by using human TIMP-1 transgenic mice.Methods Renal histological changes of wild type mice and transgenic mice at the age of 3,12,24 months were observed by periodic acid-schiff(PAS)staining of paraffin sections.The numbers of F4/80 positive cells were detected by immunofluoreseence.The protein expressions of TIMP-1,TIMP-2,matrix metalloproteinase(MMP)-9,MMP-2,intercellular adhesion molecule-1(ICAM-1),transforming growth factor?1(TGF-?1),collagenⅢand collagenⅣwere detected by Western blot.The activities of gelatinases and TIMP-1 were examined by gelatin zymography and reverse zymography respectively.Results Focal renal fibrosis was found in two genotypes with aging.At the age of 24 months,compared with wild type,in kidneys of transgenic type,the expressions and activities of gelatinases were dowregulated (MMP-2:2.08?0.20 vs.3.39?0.43;MMP-9:4.02?0.82 vs.6.72?1.40,all P＜0.05);the expressions of collagenⅢ,collagenⅣ,ICAM-1,and TGF-?1 were upragulated(0.72+0.11 vs.0.57?0.09;0.84?0.13 vs.0.6?0.11,0.72?0.12 vs.0.53?0.07; 0.69?0.12 vs.0.45?0.09,all P＜0.05),and the numbers of F4/80 positive cells were increased (18.8?4.4 vs.12.7?3.6,P＜0.05)with the upregulated expression and activity of TIMP-1(1.10?0.18 vs.0.62?0.09;50.75?7.25 vs.20.64?3.50,P＜0.05).Conclusions TIMP-1 could promote age-related renal fibrosis through enhancing inflammation reaction by ICAM-1 upregulation.

OBJECTIVETo evaluate the efficacy and adverse reaction of total glucosides of paeony (TGP) combined with sulfasalazine (SSZ) in the treatment of ankylosing spondylitis (AS).

METHODSSixty-seven AS patients were randomly assigned to 2 groups: the treatment group (34 cases) treated with TGP and SSZ, the control group (33 cases) with methotrexate (MTX) and SSZ. Changes of clinical efficacy related indexes including lumber pain index, morning stiffness time, peripheral joint pain index, thoracic expansion, Schober test, Bath AS disease active index (BASDAI), Bath AS functional index (BASFI), the levels of erythrocyte sedimentation (ESR) and C-reactive protein (CRP), and X-ray of sacroiliac joint were observed.

RESULTSThe clinical efficacy indexes were significantly improved after treatment in the two groups (P < 0.05). Except that the improvement of lumber pain index and peripheral joint pain index was better in the treatment group than that in the control group (P < 0.05), no significant difference was found in the other indexes between the two groups. The occurrence of adverse reation was less in the treatment group than in the control group (P < 0.05).

CONCLUSIONTGP treatment combined with SSZ shows favorable effect on AS with less and milder adverse reaction.

Adolescent ; Adult ; Antirheumatic Agents ; therapeutic use ; Drug Therapy, Combination ; Female ; Glucosides ; therapeutic use ; Humans ; Male ; Paeonia ; chemistry ; Spondylitis, Ankylosing ; drug therapy ; Sulfasalazine ; therapeutic use

OBJECTIVETo investigate clinical efficacy and significance of gluteal muscle contracture release for the treatment of gluteal muscle contracture induced knee osteoarthritis.

METHODSFrom January 2008 to June 2010,52 patients with gluteal muscle contracture induced knee osteoarthritis were reviewed. Among the patients,15 patients were male and 37 patients were female, ranging in age from 15 to 45 years, with an average of 35 years. Eighteen patients had left knee osteoarthritis, 30 patients had right osteoarthritis, and 4 patients had double knee osteoarthritis. All the patients were treated with gluteal muscle contracture release. Lysholm knee score was used to evaluate therapeutic effects before and after operation.

RESULTSAll the patients were followed up,and the duration ranged from 12 to 37 years,with a mean of 15 months. The Lysholm knee score improved from preoperative (68.12 +/- 0.78) points to postoperative (91.23 +/- 0.47) points at the last follow-up, the difference had statistical difference (t=31.269, P<0.01).

CONCLUSIONGluteal muscle contracture release is effective to relieve symptoms of gluteal muscles contracture and knee osteoarthritis. The patients with gluteal muscle contracture should be treated early so as to prevent effects of gluteal muscle contracture on knee joint, slow down degeneration of knee joint at early stage, and prevent occurrence of knee osteoarthritis.

Adolescent ; Adult ; Buttocks ; Contracture ; complications ; diagnostic imaging ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; etiology ; therapy ; Tomography, X-Ray Computed ; Young Adult

Disease Management ; Hospitals ; standards ; Humans

Objective To construct the adeno-associated virus (AAV)vector of mouse carrying T-bet gene,which was applied to mouse model of asthma by nose,and to investigate the immunomodulatory effects of T-bet delivery on asthma.Methods Forty healthy Balb/c mice (aged 6-8 weeks) were randomly divided into 4 groups:control group (group A),asthma model group(group B),model/control recombinant adeno-associated virus carrying enhanced green fluorescent protein(rAAV-eGFP) intervention group (group C) and model/rAAV-T-bet virus intervention group(group D),with 10 mice in each group.In group B,group C,and group D,Balb/c mice were sensitized by intraperitoneal injection with OVA and challenged by nebulized OVA.In group C and group D,Balb/c mice were intervened with the isodose rAAV-eGFP and rAAV-T-bet,while in group B,the mice were intervened with the same amount of saline,both of them were dropped into the nasal cavity.Twenty-four hours after the last injection,the mice were sacrificed and the samples were obtained.The total cells in bronchoalveolar lavage fluid (BALF) were counted,and the types of cells were analyzed by Wright-Giemsa staining.The levels of interferon-γ (IFN-γ),IL-4 and IL-5 in BALF were determined by enzyme-linked immunosorbent assay.The expressions of T-bet,GATA-3 and Foxp3 protein in the lungs of asthmatic mice were detected with immunohistochemical technique.Results 1.The level of specific transcription factor T-bet in group B and group C were distinctly lower than that of group A (all P ＜ 0.05),while the level of GATA-3 was significantly higher than that of group A(all P ＜ 0.05).In group D,the expression of T-bet protein was stronger than that in group B and group C,however,the expression of GATA-3 decreased obviously (all P ＜ 0.05).The results of Foxp3 were similar to T-bet.2.In group D,the mice had suppressed levels of IL-4 [(158 ± 55) ng/L] and IL-5 [(68-± 22) ng/L] compared with those in group B and group C(all P ＜0.05).The level of IFN-γ[(113-±35) ng/L] increased compared with those in group B and group C (all P ＜ 0.05).At the same time,the number of total cells and eosinophil in BALF were both obviously lower than those of group B and group C (all P ＜ 0.05).Conclusions On the basis of building mouse model of asthma,intranasal administration of rAAV-T-bet can deliver T-bet gene to airway successfully and efficiently,and plays an immunomodulatory role in immune confusion of asthma.

Adult ; China ; epidemiology ; Circoviridae Infections ; epidemiology ; virology ; DNA, Viral ; analysis ; Female ; Genotype ; Hepatitis, Viral, Human ; virology ; Humans ; Male ; Substance Abuse, Intravenous ; virology ; Torque teno virus ; genetics ; isolation & purification

To investigate the positive rate of anti-SARS antibody in children and adults without SARS, 197 paediatric patients under 14 years old from inpatient and outpatient department of our hospital, 156 healthy children pupils from primary school, 453 adult patients over 18 years old from inpatient and outpatient department of our hospital and other 502 healthy adult blood donors were selected. Anti-SARS antibodies were determined by anti-SARS specific antibody detection kit and ELISA method. The results showed that both the positive rates of IgG antibody in paediatric patients and healthy children were about 2% (4/197 and 3/156), while the positive rates in adult patients and healthy adults were about 0.2% (1/453 and 1/502). The difference between the positive rates of children and adults was significant (chi(2) = 11.61, P < 0.001). IgM antibody was negative in all the samples. It is concluded that the anti-SARS IgG antibody positive rate in children was obvious higher than that in adults. This may be the cause why the cases with SARS in children is much less than in adults.
Adult ; Age Factors ; Aged ; Antibodies, Viral ; blood ; Child ; Child, Preschool ; Female ; Humans ; Immunoglobulin G ; blood ; Male ; Middle Aged ; SARS Virus ; immunology

OBJECTIVETo explore the efficacy and adverse effects of clofarabine for relapsed/refractory acute lymphoblastic leukemia in children.

METHODSTwenty-six pediatric patients with relapsed/refractory acute lymphoblastic leukemia were treated with clofarabine. There were 22 males and 4 females, with a mean age of 9.5 years (ranging from 4 to 17 years). They received clofarabine 52 mg/m2 intravenously over 2 hours daily for 5 days. Thirteen patients received two cycles and one patient received three cycles.

RESULTSIn the first cycle of clofarabine, complete remission was obtained in 11 children (42%) and partial remission was obtained in 7 children (27%). Eight children (31%) were considered unresponsive. In the second cycle, 11 (85%) of the 13 children obtained complete remission, 1 (8%) partial remission and 1 (8%) was unresponsive. One child received three cycles and obtained complete remission in each cycle. The common adverse events were myelosuppression, infection, liver dysfunction and gastrointestinal adverse reactions. There were no chemotherapy-related deaths.

CONCLUSIONSClofarabine is effective in the treatment of children with relapsed/refractory acute lymphoblastic leukemia and its adverse effects can be tolerated. Clofarabine could be a promising new treatment for relapsed/refractory acute lymphoblastic leukemia.

Adenine Nucleotides ; adverse effects ; therapeutic use ; Adolescent ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Arabinonucleosides ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; Recurrence