Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; therapy

Objective To investigate the expression levels of forkhead transcription factor 3 (FOXP3) and cytotoxic T lymphocyte-associated antigen-4(CTLA-4) in the peripheral blood of children with newly diagnosed type 1 diabetes mellitus(T1DM),and explore their roles in the pathogenesis of T1DM. Methods Fifty children with newly diagnosed T1DM and 30 healthy children( control group) were select-ed. FOXP3 and CTLA-4 mRNA expressions were detected using real-time PCR. Soluble FOXP3 ( sFOXP3 ) and CTLA-4(sCTLA-4) protein levels in the serum were assayed by ELISA,and the levels of diabetes anti-bodies,HbA1C and C-peptide were determined using Western blotting,high performance liquid ion-exchange chromatography,and electrochemiluminescence, respectively. Results The expressions of FOXP3 mRNA and protein in T1DM patients were lower than those in the control group[0. 95 ± 0. 48 vs. 2. 11 ± 0. 79,(6. 27 ± 1. 49) ng/ml vs. (9. 02 ± 2. 37) ng/ml,respectively,both P <0. 01],while the expressions of CTLA-4 mRNA and protein were higher than those in the control group[2. 43 ± 0. 83 vs. 1. 94 ± 0. 84,(77. 88 ± 22. 34) ng/ml vs. (65. 97 ± 12. 11) ng/ml,respectively,both P<0. 01]. In T1DM patients,the expressions of FOXP3 and CTLA-4 genes presented positive correlation with the protein expression( r=0. 758,0. 396, P<0. 05), and FOXP3 protein expression presented correlation with CTLA-4 protein expression ( r =-0. 624,P<0. 05). Conclusion There are abnormal expressions of FOXP3 and CTLA-4 genes as well as their proteins in the peripheral blood of the children with newly diagnosed T1DM,and FOXP3 regulated the expression of CTLA-4 in T regulatory cells,indicating the involvement of immune mechanisms in the devel-opment of T1DM.

Non-responding pneumonia describes the situation, in which an inadequate clinical response is present de-spite antibiotic treatment. The incidence of treatment failure in community acquired pneumonia (CAP) can range up to 31%. At present, the diagnosis and treatment of this kind of disease remain a great challenge to CAP. For this reason, several stud-ies have attempted to establish risk factors and new strategies for the treatment of non-responding pneumonia. This article re-views the progress of the pathogeny and treatment of non-responding CAP.

A multi-channel meridian impedance detector used to the 3D meridian visualization positioning is presented. The detector is designed with the four-electrode method based on current driving according to low impedance of the meridian. The detector consists of power-supply module, sinusoidal signal generator, voltage-controlled current source, isolation amplifiers, filter circuit, amplitude detectors and so on.
Amplifiers, Electronic ; Electric Impedance ; Electrodes ; Meridians

Objective To investigate the feasibility of closed reduction assisted with Kirschner wires for irreducible femoral neck fracture.Methods From June 2008 to April 2011,32 patients with irreducible femoral neck fracture were treated.There were 15 males and 17 females,aged from 21 to 59 years (average,46 years).According to Garden classification,there were 6 of Ⅱ,16 of Ⅲ and 10 of Ⅳ.According to displacement direction of the femoral head showed by preoperative X-rays and CT scans,irreducible femoral neck fracture was divided into 3 types:angulation-impaction (11 cases),rotation-separation (15 cases) and abduction-impaction (6 cases).One to three Kirschner wires were penetrated into the femoral head to reduce the displacement in opposite direction of fracture displacement.After reduction was satisfied,guide pins were penetrated,and then the fractures were fixed with cannulated screws.Results Anatomic or nearly anatomic reduction was achieved in 30 patients after closed reduction assisted with Kirschner wires.Two patients underwent open reduction finally due to failure of closed reduction.The operation time ranged from 40 to 80 min,and the blood loss ranged from 20 to 50 ml.According to Garden index,anatomic reduction was achieved in 29 and acceptable reduction in 1.Among 30 patients who had undergone closed reduction,29 patients were followed up for 12 to 20 months.Bone union was achieved in 28 patients,and the fracture healing time ranged from 4 to 10 months.One patient with rotation-separation displacement before closed reduction underwent total hip replacement due to avascular necrosis of femoral head occurred at 15 months after closed reduction.Conclusion Closed reduction assisted with Kirschner wires is an effective method for irreducible femoral neck fracture,which can achieve satisfactory anatomic reduction rate and fracture healing rate.

Objectives:To understand the patients' cognition and satisfaction with public welfare in public hospitals.Methods:A questionnaire survey was conducted among 600 patients in Beijing municipal public hospitals and the data was statistically analyzed by SPSS 22.0.Results:Patients' understanding of public welfare was not ideal,the satisfaction was quite well,and the satisfaction of the patients in the experimental hospitals was more satisfactory than those in non-experimental hospitals.The patients have urgent needs on rational drug use,mutual recognition of medical results,smooth channels of patient rights,reduced medical expense and shortened waiting time.Conclusions:It should strengthen the publicity and governance of the public welfare of public hospitals to enhance the patients' understanding,breakthrough the urgent needs of public welfare to improve patients' satisfaction,and intensify the policy linkage and explore diversified implement forms of public welfare to improve service level.

Epilepsy is one of the major clinical features of tuberous sclerosis complex, and it is drug-resistant in the majority of cases.Surgical resection is an effective way to resolve the seizures.Precise preoperative evaluation is critical to the surgical outcome.Preoperative evaluation mainly aims to determine the range of the epileptogenic zone and the functional areas that should be preserved.Because of the complexity of the epileptogenic mechanism and brain network, there isn′t a single and specific measure that can accurately position the epileptogenic zone, so it is necessary to comprehensively evaluate and localize the epileptogenic zone by using multiple methods, including collection of a detailed medical history, symptomatic analysis during the attack of seizures, magnetic resonance imaging, positronemission tomography, electroencephalogram, neuropsychological evaluation, etc.In this paper, the rational use of above-mentioned approaches and comprehensive analysis of their results were summarized, which play an essential role in contro-lling seizures in children with tuberous sclerosis complex and refractory seizures.

Equity of the essential medicine system involves social justice,being important in health services availability equity.The essential medicine system,in practice in China,has to a certain extent improved the equity of health service availability,yet found with poor equity in the process due to differences in insurance,regional diversity,pricing of essential medicine,and poor implementation of the system at primary medical institutions.Such equity needs to be further improved in the future in such aspects,consistence of different insurance reimbursement percentages,further support to underdeveloped areas,encouragement of market competition,and better compliance of primary medical institutions in implementing the system.

Humans ; Positive-Pressure Respiration ; Respiration, Artificial ; Severe Acute Respiratory Syndrome ; therapy

Objective To investigate the resistance to fluoroquinolones and amikacin in escherichia coti isolates. Methods ESBLs-producers were detected by CLSI phenotypic confirmatory test and susceptibilities were tested by agar dilution method. Results 33. 8% of 361 isolates were ESBLs-producers. The resistant rate of ciprofloxacin,levofloxacin, amikaxin was 93.4%, 90.9%, 13.1% in ESBLs-produeers, and that was 69.5%,68.6 %, 19.7 % in non-ESBLs-producers, respectively. Conclusion Amikaxin is active against most escherichia coli isolates; those isolates are highly resistant to fluoroquinolones, especially, in ESBLs-producers.