We collected the clinical information of 21 in-patients diagnosed as Lyme disease in Peking Union College Univemity Hospital from Apr. 1994 to Jan. 2008. The clinical manifestations, laboratory tests, therapy and prognosis were analyzed retrospectively. 16 of 21 (76%) patients had fever, 14 of 21 (67%) eases had skin lesion, 17 patients had nervous symptoms, 10 cases showed arthrosis and only 2 of 21 eases involved in heart. The antibiotics of penieilin,ceftriaxone and doxyeycline were used for therapy. All of the 21 patients improved clinically and discharged. 12 cases were followed up for 1 month to 12 years and 2 of them relapsed, both of whom were in Stage Ⅲ. 8 cases remained persistent symptoms. As the manifestations of Lyme disease are complicated, for clinical borderline cases the prompt detection of etiological agent may be useful for early diagnosis. The antibiotic therapy should begin as early as possible to avoid developing chronic Lyme disease.

Objective: To investigate association between psychosocial factors and anxious and depressive disorders in patients with diabetes mellitus. Methods: 172 patients with type 2 diabetes were inquired with a self-administered questionnaire about their socio-demographic characteristics, perceived stress caused by the disease, coping styles, social support. At the same time, anxious and depressive disorders were assessed with HAD.Results:Among our sample, 35 (20.3%) patients with anxiety, 33 (19.2%) with depression. After adjusting for gender, age, marital status, educational level and income, multivariate logistic regression analysis found the following results. Perceived stress from "Worrying about to be harmed by the disease"(OR=1.76,95%CI 1.12~2.77),"Social/family crisis caused by the disease"(OR=1.85, 95%CI 1.18~2.92),"Worrying about declining in body/physical function"(OR=2.16, 95%CI 1.28~3.67), "Declined economic condition"(OR=2.03,95%CI 1.27~3.26)and "Negative coping styles"(OR=1.94,95%CI 1.26~2.97)were significantly associated with anxious disorders. The perceived stress from "Social/family crisis caused by disease"(OR=1.79, 95%CI 1.09~2.96), "Worrying about declining in body/physical function"(OR=2.89, 95%CI 1.59~5.24)and "Negative coping styles"(OR=1.95,95%CI 1.23~3.11)were significantly associated with depressive disorders, while patients "Taking avoidant measures"(OR=0.52, 95%CI 0.30~0.90)were less depressive disorders.Conclusion: Anxious and depressive disorders in patients with 2 type diabetes were significantly associated with patients' perceived stress from the disease and their coping styles.

OBJECTIVE:To provide the support for pharmacists in their clinical pharmaceutical care.METHODS:The hospital pharmaceutical care system was set up by employing Visual FoxPro6.0and developing series of database according to the characteristics of clinical pharmacy.RESULTS&CONCLUSION:This system has the characteristics of convenience,flexibility,and fastness,which can result in more scientific and accurate pharmaceutical care.

BACKGROUND: In the central nervous system(CNS) of normal adults there are neural stem cells or neural progenitor cells, which are capable of self-renewing and multiple differentiating. In normal physiological conditions, intrinsic neural stem cells are in a resting state. What state will they be in during cerebral ischemia?OBJECTIVE: To observe the distribution, proliferation and differentiation of intrinsic neural stem cells in focal transient ischemia in rats.DESIGN: A randomized controlled exploratory trial based on the rats.SETTING: Neurobiological department, histological and embryological department of a medical college.MATERIALS: The experiment was conducted in the Neurobiological Department of Luzhou Medical College from July 2001 to July 2002. Altogether 41 healthy adult SD rats of either gender, weighting 250 g - 300 g, were selected.INTERVENTIONS: The focal ischemia model was made by blocking middle cerebral artery(MCA) and reperfusing for 0.5 hour, 3 hours, 6 hours, 12 hours, 1 day, 2 days, 3 days, 5 days and 10 days. Sham-operation group was treated by the same method, but the filament was not long enough to block MCA, and normal rats served as control group. The rats were sacrificed at given time points, and their brains were made into cerebral slices. The single-and double-labeled immunohistochemical staining was employed to detect the proliferation, distribution and differentiation of intrinsic neural stem cells.MAIN OUTCOME MEASURES: The distribution, proliferation and differentiation of intrinsic neural stem cells.RESULTS: Immunoreactivity of proliferating cell nuclear antigen(PCNA)was present in most ependymal cells in ventricular zone(VZ), and PCNA-positive cells were sparsely distributed in the parenchyma in normal and sham-operation groups. At 3 hours of reperfusion, PCNA-labeled cells were first detected in rostral subventricular zone. At 12 hours of reperfusion and onward, PCNA-positive cells appeared in some choroid plexus cells in bilateral lateral VZ. At day 3 to day 10 of reperfusion, PCNA-labeled cells significantly increased in infarct boundary in preoptic area, striatum and deep layer of frontoparietal cortex. PCNA-labeled cells were first detected in subgranular zone of dentate gyrus 3 days after reperfusion, and increased with time. A very small number of double-positive cells expressed with PCNA and glial fibrillary acidic protein(GFAP) were first detected in infract boundary in preoptic area on day 3 and onward. No double-PCNA and NF-positive cells were detected within 10 days of reperfusion.CONCLUSION: Focal cerebral ischemia activates intrinsic neural stem cells, which proliferate and differentiate, and migrate toward ischemic striatum and frontoparietal cortex. This may help clarify the mechanism of functional recovery after ischemia.

Epidemiological, clinical, laboratory and treatment data, as well as outcomes of 66patients diagnosed as brucellosis during 1984 to 2010 in Peking Union Medical College Hospital were retrospectively analyzed. Thirty-four (51.5%) patients had a history of close contact with sheep or cows infected with brucellosis, eight (12. 1% ) had eaten not-fully-boiled or roasted mutton, three (4. 5% ) had drunk or contacted with contaminated milk, and transmission route was unknown in 21 (31.8%). The most common manifestations were fever ( 97.0%, 64/66 ), loss of appetite and fatigue ( 93. 9%, 62/66 ),sweating (47.0%, 31/66), myalgia and arthralgia (54. 5%, 34/66 ), hepatomegaly (27.3%, 18/66),splenomegaly (37.9%, 25/66), increased erythrocyte sedimentation rate (ESR) (62. 1%, 41/66), and elevated C-reactive protein (65.4%, 34/52). Average interval from onset to diagnosis was 19. 2 weeks. All 66 patients were positive in serum agglutination test for BruceUa, and 28 (42. 4% ) positive in blood or bone marrow culture for Brucella. Sixty-five of 66 patients were treated by standard combined treatment with rifampicin, quinolone, minocycline and streptomycin, with all effective, and only four with mild liver damage in treatment who got better after discontinuing medicines and changing treatment regimen.

Objective To investigate clinical characteristics of smear- or culture-positive pulmonary tuberculosis (TB) in patients hospitalized at a general hospital to improve its diagnosis. Methods Clinical data of smear- or culture-positive pulmonary TB diagnosed in 50 patients hospitalized at Peking Union Medical College Hospital, Beijing during 2006 to 2009 were analyzed retrospectively. Results Seventeen (34%) of 50 cases of smear- or culture-positive pulmonary TB aged more than 60 years, with 30 males (32%), 16 retirees and nine farmers (18%). Their main symptoms included fever (80%), cough (94%) and sputum expectoration (92%), with elevated erythrocyte sedimentation rate (ESR) in 38 of 45 patients (84%). Chest X-ray examinations showed that lesions located mostly in the upper lobes or in both of the lungs diffusedly, with patchy infiltrations, nodular opacities and cavities. Acid-fast bacilli were demonstrated on sputum smear in 41 ( 82% ) and in specimens of six ( 12% ) cases obtained through bronchoscopy with brush or bronchoalveolar lavage fluid ( BALF), and M. Tuberculosis was cultured from sputum specimens in three (6%). Mean time interval between admission and diagnoses averaged 14 days.Conclusions Basic knowledge about prevention and control of pulmonary tuberculosis should be publicized comprehensively in general hospital keeping alert in its diagnosis with acid-fast staining for sputum smear as a routine test for patients with respiratory symptoms, and in some cases, bronchoscopy procedures ( brush or BALF) are reasonable options to improve its detection.

Objective To investigate the effect of magnesium sulfate on NF-κB p65,inflammatory cyto-kines in brain and serum of preeclampsia model rats by magnesium sulfate. Methods The healthy SD rats were randomly divided into 4 groups,normal pregnancy group(n = 10),magnesium sulfate control group(n = 10), preeclampsia(PE)model group(n = 10)and magnesium sulfate intervention group(n = 10). Blood pressure, urinary protein,blood urea nitrogen and alanine aminotransferase levels were detected in rats in each group. RT-qP-CR and ELISA were used to detect the expression of IL-1β,TNF-αand IL-6 in the brain and serum. Western blot assay was used to detect the expression of the NF-κB p65 in brain. Results The level of proteinuria,blood urea nitrogen and blood pressure in PE model rats were significantly higher than those in the normal pregnancy group and those in the magnesium sulfate intervention group at 20 days of gestation(P<0.05). Results of RT-qPCR and ELISA assay showed that IL-1β,TNF-α and IL-6 level in magnesium sulfate intervention group were sig-nificantly lower than those in PE model group(P<0.05),but still higher than those in the normal pregnancy group (P < 0.05). Western blot result showed that NF-κB p65 in the magnesium sulfate intervention group was lower than that in the PE group(P<0.05),but still higher than that in the normal pregnancy group(P<0.05). Con-clusion The prevention and treatment preeclampsia mechanism of magnesium sulfate may inhibit inflammatory cyto-kines through NF-κB p65 pathway in the preeclampsia model rats.

Objective To observe the changes in gut mucosal barrier and gut-origin bacteria-endotoxin translocation in acute necrotizing pancreatitis (ANP) rats. Methods Wistar rats were divided randomly into normal group (n=6), sham operation group (n=30) and ANP group (n=39). ANP was introduced by infusion of artificial bile into biliopancreatic duct. Morphology of pancreas and intestine were observed and tight junction on ileum epithelia were assessed by cryofracture replicas electroscopy. Plasma levels of D-lactic acid and endotoxin were examined at various time points. The rates of bacterial translocation to abdominal organs were also calculated. Results Mucosal and tight junction damages of the gut were found during early stage of ANP. Simultaneously, plasma D-lactate levels increased and endotoxemia occurred. The rate of bacterial translocation to organs was 59.5% 72h after ANP occurred. Conclusions Gut barrier function can be injured in the early stage of ANP, and resulting in gut origin bacteria-endotoxin translocation, which may be the originator of systemic inflammatory reaction and secondary infection of the pancreas.

OBJECTIVE: To evaluate the improvement of speech perception in Chinese-native cochlear implant (CI) children using frequency modulated system (FM system). METHOD: The mandarin speech perception (MSP) system was used to evaluate 11 cases with severe and profound hearing loss who were fitted cochlear implants. Listeners were asked to repeat MSP words presented in quiet and several different signal-to-noise ratio (SNR) conditions and percent correct word repetition was determined. Performance was evaluated under FM system and without FM (CI only). In addition, the listeners' subjective performance changes in the experiment were also observed. RESULT: (1) There was significant main effect of the device condition (with FM and no-FM) (F = 72.938, P < 0.01), a significant main effect of signal level (F = 230.715, P < 0.01), a significant interaction effect between the signal level and the device condition (F = 40.893, P < 0.01). (2) Listeners answered the question in a louder voice, showed more confidence, when using with FM system. CONCLUSION FM system could improve the speech reception in a complex environment for Chinese-native CI children.
Child ; Cochlear Implantation ; Cochlear Implants ; Humans ; Noise ; Signal-To-Noise Ratio ; Speech ; Speech Perception ; Speech Therapy

Objective: To identity patterns of psychological abuse and neglect among male and female adolescents, and to examine the relationship between psychological abuse and neglect with mobile phone dependence. Methods: A total of 1 070 adolescents from 5 middle schools in Ganzhou and Wuhan were investigated with Child Psychological Abuse and Neglect Scale (CPANS), Mobile Phone Addiction Index Scale (MPAI) and demographic questionnaire. Latent profile analysis (LPA) was used to construct typologies of psychological abuse and neglect involvement in male and female adolescents. Results: Three latent classes were identified for boys: low level psychological abuse and neglect group (56.68%), medium level psychological abuse and neglect group ( 29.80 %), high level psychological abuse and neglect group (13.52%). For girls, four latent classes were identified including low level psychological abuse and neglect group (49.38%), medium level psychological abuse and neglect group (29.01%), high level psychological abuse and neglect group (11.12%); high level psychological abuse group (10.49%). Adolescents who suffered from psychological abuse and neglect were more likely to be dependent on mobile phones. Among them, boys dependence on mobile phones was manifested as out of control, withdrawal, escape and inefficiency[Medium level： B(95%CI )=0.28(0.12-0.44)，0.29(0.11-0.46)，0.35(0.16-0.53)，high level： B(95%CI )=0.37(0.16-0.59)，0.42(0.19-0.65)，0.33(0.07-0.59)，0.50(0.25- 0.74 )， P ＜0.05], while girls showed evasion and inefficiency in high levels of psychological abuse[ B(95%CI )=0.34(0.01-0.67)，0.46(0.14-0.78)， P ＜0.05]. Conclusion There are heterogeneous differences in psychological abuse and neglect between male and female adolescents, and the relationship between each category and mobile phone dependence varies. The results provide suggestions for adolescent mental health intervention.