Objective To discuss the correlation of Wiskott-Aldrich syndrome (WAS) with autoimmune disease of the central nervous system and its possible pathogenesis by reporting one case of the disease and reviewing related literature.Methods One case of WAS complicated with demyelinating disease of the central nervous system was reported.The patient' s clinical symptoms,laboratory examinations (such as blood tests,immune function tests,etc) and imaging features were analyzed.The patient's blood DNA was extracted and performed gene testing.And related literature was reviewed.Results The patient showed typical clinical symptoms of WAS,including eczema,thrombocytopenia and immune deficiency,complicated with demyelinating disease of the central nervous system.The DNA testing showed C400G ＞ C p.(ALa134Pro) mutation,which is a missense mutation.The 134th amino acid in protein was changed from alanine to proline.The patient also showed the symptoms of demyelinating disease of the central nervous system,which drew our attention.This was the first report on WAS complicated with demyelinating disease of the central nervous system,which was perhaps caused by a gene mutation.Conclusions WAS complicated with demyelinating disease of the central nervous system is possibly resulted from the gene mutation,which leads to the expression disorder of WAS protein.And then non-red hematopoietic cells lead to signal transduction and cytoskeleton recombination disorders in response to environment stimulus,which produces lymphocytes immigration,signal transduction and immune synaps formation disorders.

Objective To construct a recombinant adenovirus contained respiratory syncytial virus F gene fragment. Methods The F gene fragment was amplified by RT-PCR. Then the recombinant shuttle plasmid pShuttle-CMV/F was constructed. The iinearized pShuttle-CMV/F was transformed into BJ5183-AD-1 electroporation competent cells which contained plasmid pAdEasy-1. The obtained homologous recom-binant plasmid was named pAdEasy/F, and transfected into 293 cells. Then the recombinant adenovirus rAd/F was obtained, and it was tested by electron microscope, RT-PCR, Western blot and immuno-fluores-cence assay(IFA). The vires titer and genetic stability were also studied initially. Results The recombi-nant adenovirus rAd/F was constructed, which was visualized as typical adenovirus morphology under elec-tron microscope. The transcription and expression of RSV F gene fragment integrated in the rAd/F were con-finned by RT-PCR, Western blot and IFA. Conclusion The recombinant adenovirus rAd/F contained RSV F gene fragment is successfully constructed and lay an important foundation for the further vaccine study.

China launched the nationwide resident standardized training (residential training) project since 2013 and has trained a large number of general practitioners. The primary health care institutions and general practitioners have played an important role during the prevention and control of COVID-19 epidemic, which not only presented the remarkable effect of residential training project, but provided new ideas for the further training program of general practitioners. It is proposed in this paper that we should adjust the training and assessment priorities in the following aspects: highlight the characteristics of general practice in the future training, so as to train general practitioners with more comprehensive ability, such as strengthening the ability to deal with public health emergencies, strengthening the consciousness and capability of scientific research, and increasing the proportion of humanistic quality training; At the same time, we should enhance career attractiveness of general practitioners to keep the excellent general residents stay for their career;All mentioned above will further improve the overall quality of general practitioners, and enable them to better deal with public health emergencies.

OBJECTIVEThe glucocorticoid dexamethasone (DEX) can induce palatal cleft; however, the mechanism involved remains unclear. E-cadherin is an important cell adhesion molecule, and it can significantly affect cell fate and embryonic development. Recent studies have indicated that E-cadherin expression in palatal epithelial cells is suppressed in normal palate fusion. This study aimed to determine whether the change in E-cadherin expression is related to the incidence of cleft palate in DEX-induced mice.

METHODSMice were divided into the experimental group and the control group. Pregnant mice were injected with DEX on E10.0-E12.0, whereas mice in the control group were injected with normal saline. Hematoxylin and eosin (HE) staining, immunohistochemistry, and real-time quantitative polymerase chain reaction were employed to evaluate the effect of DEX on fetal mouse palatal processes, particularly the changes in E-cadherin and β-catenin expression levels in the phases of the experimental and control groups.

RESULTSData indicated that the incidence of cleft palate in the DEX group was 43.59% (17/39), whereas that in the control group was only 3.03% (1/33). The results of HE staining showed that the obviously shortened palatal processes could not contact and fuse with one another in the DEX-treated mice model compared with those in the control group. The ectopic expression of E-cadherin in embryonic palatal mesenchymal cells was also analyzed. The expression levels of E-cadherin and β-catenin in the experimental group were higher than those in the control group.

CONCLUSIONThese findings indicated that DEX could induce E-cadherin gene upregulation and ectopic expression, as well as high β-catenin expression, thereby inhibiting the growth of mesenchyme cells and cleft palate.

Animals ; Cadherins ; genetics ; metabolism ; Cleft Palate ; chemically induced ; embryology ; Dexamethasone ; adverse effects ; Disease Models, Animal ; Epithelial Cells ; Female ; Glucocorticoids ; Immunohistochemistry ; Mice ; Pregnancy ; beta Catenin ; metabolism

Objective To analyze the pathological voice ,normal voice range chart crowd voice characteristics through tests and analyze the differences between the two groups of test‐related parameters chart range between indicators ,so as to explore the value of the test range map in the polyp of vocal cord .Methods One hundred and twenty patients with vocal polyps according to in‐clusion and exclusion criteria were selected .Sixty cases of normal voice were randomly selected .Germany XION DIVAS system dia‐gram test mode range were recorded for both groups ,with the strongest voice of the bass were measured at different frequencies , first obtain low VRP intensity curve ,then get high‐intensity curve VRP .The maximum frequency of the vocal cord polyp group and normal control group ,the minimum frequency ,maximum intensity ,most quietly strong ,maximum phonation time ,fundamental fre‐quency perturbation and dysphonia index of the data were compared statistically .Results Compared with the control one ,the mean maximum frequency of vocal cord polyp group were lower (P= 0 .029 6) ,the average minimum frequency were significantly higher ( P= 0 .000 3) ,frequency range reduced(P= 0 .022 9) ;vocal cord polyp average loudest group was stronger(P= 0 .003 9) ,the whis‐pered strength values were significantly higher (P = 0 .000 0) ,significantly limited the average sound intensity range than normal voice group group (P= 0 .006 9) .Classification index based on objective voice disorders ,in terms of frequency ,mild voice disorders at the maximum frequency .There was no significant difference in the minimum frequency ,frequency range with a normal voice group ;and in severe voice disorders average maximum frequency lower than the normal voice group ,the smallest than normal voice frequency was significantly higher frequency range than the normal group was significantly limited .In terms of strength ,mild im‐pairment in the loudest voice is strong ,most quietly strong .There was no significant difference with the normal voice group intensi‐ty range ;and in severe voice disorders average maximum sound intensity ,most quietly strong values were higher than normal voice group .However ,the average sound intensity narrow range than normal voice group .Conclusion The range map test can be quanti‐fied assessment of voice ,and can distinguish normal voice ,clinical pathological voice and the severity of damage ,which is an impor‐tant means of voice feature detection to provide an objective basis .

OBJECTIVE: To analyze the clinical features & variation features of cervical tuberculous lymphadenitis and to discuss its effective surgical treatment. METHOD: Retrospective analysis of 27 cases of cervical tuberculous lymphadenitis patients admitted to the hospital from January 2008 to December 2013. The cervical tuberculous lymphadenitis is classified based on the enhanced CT scanning conducted before operation and the preoperative evaluation of clinical characters of patients. The lymphaden ncisional biopsy was conducted on the type I patients with cervical tuberculous lymphadenitis. The lesion resection was performed on the type II and mixed type I + II patients. The regional cervical lymph node dissection was carried on the type III, the type IV and other mixed type patients. The negative pressure drainage ball was placed after operation, and the cavity was flushed with 5% povidone iodine solution. The antituberculosis therapy was performed after wound healing. RESULT: The analysis of the clinical features for 27 patients: the incidence rate on the left side, right side, both sides and middle-line is 63.0%, 25.9%, 7.4% and 3.7% respectively. The majority of patients whose lesion involving more than one region account for 62.1%; the patients whose lesion involving one region account for 37.9%. The most common is level V involved lesion (69.0%), then level IV (62.1%), level III (51.7%), level II (34.5%), level I (10.3%) and level VI (3.4%) in order. The analysis of the CT imageology features for 27 patients: the simple type is the majority (65.5%), and the most common is type III (24.1%), then the type I (17.2%), type II (13.8%) and type IV (10.3%) in order. The mixed type is minority (34.5%), but the two mixed is often (31.0%). The three mixed is only located on one side (3.4%). The recurrence never happened on the patients with resection and standard antituberculosis therapy. CONCLUSION For the cervical tuberculous lymphadenitis, the suitable surgical treatments shall be selected according to the lesion characteristics & location and CT imaging manifestations presurgical evaluation. The effective way to treat cervical tuberculous lymphadenitis is to conduct negative pressure drainage after operation, to flush the cavity with 5% povidone iodine solution and to perform antituberculosis therapy.
Antitubercular Agents ; therapeutic use ; Drainage ; Humans ; Neck ; Neck Dissection ; Recurrence ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node ; classification ; drug therapy ; surgery

Objective To evaluate the effect of intraoperative use of soluble hemostasis gauze on postoperative pel-vic infection in parturients undergoing cesarean section.Methods Data about cesarean section parturients in obstet-ric group(n=322)and gynaecology group (n =92)were surveyed by clinical follow-up and retrospective analysis method,obstetric group adopted bulk packing of gauze,gynaecology group adopted flat lay packing ,incidence of postoperative pelvic infection between parturients who used soluble hemostasis gauze with different packing meth-ods,as well as with different pieces were compared and analyzed.Results Pelvic infection rate in obstetric group and gynaecology group was 4.04%(13/322)and 0.00%(0/92)respectively,there was no significant difference be-tween two groups(P =0.082 ).In obstetric group,pelvic infection rate in parturients who used ≤3 pieces of solu-ble hemostasis gauze was 0,used >3 pieces was 11 .82%,there was significant difference between the two (P <0.001).Conclusion Rational use of soluble hemostasis gauze in caesarean operation can effectively avoid postopera-tive pelvic infection.

Objective To evaluate the impact of fish oil (ω-3 fatty acids) parenteral nutrition (PN) on outcomes for non-ICU postoperative patients.Methods PubMed,Embase,Cochrane,China National Knowledge Infrastructure (CNKI) and Wanfang Database etc.were searched to retrieve the eligible studies published from January 2010 to June 2016.The studies included were randomized controlled trials (RCTs) that evaluated the effects of supplementation of fish oil (Omegawen) in PN regimens for postoperative patients on clinical outcomes.The methodological quality assessment was based on Jadad scale and Schulz allocation concealment tool.Meta-analysis was conducted by RevMan 5.3 software.Results 19 RCTs,1 170 surgical patients,were included.Meta-analysis indicated that short-term fish oil supplementation significantly reduced the incidence of infectious complications [RR =0.44,95％ CI (0.31,0.64),P ＜0.000 1] and shortened the length of hospital stay [MD =-0.85,95％ CI (-1.67,-0.03),P=0.04],while with no significant effect on mortality [RR =0.42,95％ CI (0.07,2.63),P =0.36] and total expenditure of hospitalization [MD =-216.60,95％ CI (-718.94,285.75),P =0.40].Sensitivity analysis showed similar results.Conclusion According to existing evidence,fish oil in PN for surgical patients could reduce the incidence of postoperative infectious com-plications and shorten the length of hospital stay.

ObjectiveToinvestigatethecorrelationbetween-2578C>Apolymorphismofvascular endothelium grow th factor (VEGF) gene and carotid atherosclerosis in Chinese Han population in Shandong, China. Methods A total of 384 subjects aged 45-85 in Chinese Han population in Shandong, China w ere enroled. They were divided into either an increased intima-media thickness (IMT) group ( n=248) or a control group (n=136) according to the vascular ultrasound results. The baseline clinical data, such as the demographic data, vascular risk factors, and blood biochemical indicators in both groups were colected. Polymerase chain reaction w as used to detect the VEGF gene -2578C>A polymorphism genotype and alele. Multivariate logistic regression analysis was used to identify the independent risk factors for increased carotid IMT. Results The proportions of hypertension ( 70.6%vs.59.6%;χ2 =4.793, P=0.032), diabetes (18.4%vs.29.0%; χ2 =5.281, P=0.027), hyperlipidemia ( 45.2%vs.33.1%; χ2 =7.883, P=0.006), previous previous stroke or transient ischemic attack (29.0%vs.16.9%;χ2 =6.294, P=0.009), smoking (35.9%vs.19.9%;χ2 =10.708, P=0.001), as w el as total cholesterol ( 4.82 ±1.25 mmol/L vs.4.57 ± 0.94 mmol/L; t= -2.072, P= 0.039 ), triglyceride ( median, interquartile range; 1.71[0.84-2.22] mmol/L vs.1.53[1.08-2.59] mmol/L;Z= -2.560 P=0.010), low-density lipoprotein cholesterol (2.86 ±1.01 mmol/L vs.2.64 ±0.85 mmol/L; t= -2.407, P= 0.033 ), and high-density lipoprotein cholesterol (1.58 ±0.72 mmol/L vs.1.43 ±0.46 mmol/L;t= -2.183, P=0.030) in the increased IMT group, and there w ere significant differences compared w ith the control group. There w as significant difference in genotype frequency betw een the 2 groups (χ2 =10.131; P=0.006). There w as significant difference in C alele frequency between the increased IMT group and the control group (78.2% vs. 70.2%;χ2 =6.068, P=0.014). Multivariate logistic regression analysis showed that CC genotype (odds ratio 1.132, 95%confidence interval 1.021-2.141;P=0.029) w as an independent risk factor for increased carotid IMT. In 248 patients w ith increased IMT, 213 had at least 1 plaque, 76 (39.6%) of them w ere 1-2, 107 (43.15%) w ere 3-4, and 30 (12.1%) w ere 5-8 in plaque index. There w ere no significant differences in frequencies of genotypes (χ2 =6.766, P=0.149) and alele (χ2 =0.185, P=0.667) in the different plaque index groups. Conclusions -2578 single nucleotide polymorphism in the VEGF gene promoter is associated w ith carotid atherosclerosis, and C al ele may be its genetic susceptibility factor in Chinese Han population in Shandong, China.

Recurrent spontaneous abortion (RSA) was one of the most difficult infertile diseases which was usually defined as consecutive still birth for more than three times during the first 20 weeks of gestation. Various factors and pathogeneses were thought to play a role in RSA. Recent studies had indicated that the disorders of blood vessel growth and the secondary abnormal blood perfusion may contribute to the occurrence of RSA. However, blood vessel growth was linked with the regulation of angiogenesis related factors. To provide references for the clinical prevention and treatment, the purpose of this paper was to evaluate the association between solubility vascular endothelial growth factor receptor-1(sflt-1), thrombospondin 1(TSP-1) and ovary, endometrial abnormal blood perfusion in cases of RSA.