Antigens, Neoplasm ; immunology ; Cancer Vaccines ; therapeutic use ; Dendritic Cells ; immunology ; Humans ; Immunotherapy ; methods ; Liver Neoplasms ; therapy

Dystonia is common in children with cerebral palsy. It can cause motor dysfunction, and is frequently associated with altered speech articulation, abnormal swallowing, and excessive drooling. Although trihexyphenidyl (Artane) is an anticholinergic agent with a long history of use in the management of dystonia in adults, information is limited regarding the use of trihexyphenidyl in children. This study reviewed the clinical experience of the use of trihexyphenidyl in children with cerebral palsy for dystonia, with special emphasis on benefits and tolerability.

Recent studies indicate that the activation of peroxisome proliferator-activated receptor gamma (PPARγ) can inhibit the invasion and metastasis of hepatocellular carcinoma (HCC) by inhibiting proliferation and adhesion of HCC cells,degradation of extracellular matrix and angiogenesis.Therefore,the mechanisms that PPARγsignaling pathway inhibits the invasion and metastasis of HCC may provide help for the clinical treatment,and is expected to improve the survival rate of HCC patient.

Objective To investigate the clinical characteristics and currently treatment status of intractable ulcerative colitis (IUC). Methods A retrospective analysis was conducted on the data of inflammatory bowel disease patients, who were hospitalized in Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, from January 1999 to December 2009. According to the reaction to glucosteroids (GCS) treatment, they were divided into GCS effective group and intractable group. The general data, lesion, clinical symptoms and laboratory findings of these two groups were compared.Further treatments and the results of intractable group were analyzed. Results Totally 234 UC patients were enrolled, of which 37.6％ (88/234) patients received GCS treatment, intractable group and effective group took up 23.9％ (21/88) and 76.1％ (67/88) respectively. There was no significant difference of lesion between two groups (P＞0.05). Compared with effective group, the proportion of intractable group was higher in moderately severe bellyache[38. 1 ％ (8/21) vs 13. 4％ (9/67), P＝0.012, OR＝3.97, 95％CI:1.29～12.23], anemia[61.9％(13/21) vs 32.8％(22/67), P＝0.018,OR＝3.32, 95％CI:1.20～9.20], thrombocytosis[57.1％(12/21) vs 29.9％(20/67), P＝0.023,OR＝3.13, 95％ CI: 1.14 ～8.61]and hypoalbuminemia[38.1 ％ (8/21) vs 11.9％ (8/67), P＝0.007, OR＝4.54, 95％CI: 1.44～ 14.32]. Some patients of intractable group could be remission through extending period of GCS treatment, adding the immunomodulators or biological agents and intestinal segment excision. Conclusion UC patients with moderately severe bellyache, anemia,thrombocytosis, hypoalbuminemia at the onset of disease, which may indicate relatively poor response to GCS treatment. Immunomodulators, biological agents and surgery are the further treatment for IUC patients.

With acute lymphoblastic leukemia in skeletal muscle symptom,part of these patients may be misdiagnosed as juvenile idiopathic arthritis. How to distinguish these children has significance for the timely and proper treatment and good prognosis. This article from the history and routine laboratory examination and ima-ging examination put forward early in the disease through the analysis of joint symptoms from juvenile joint pain,blood and imaging characteristics and preliminary identification of childhood leukemia from juvenile idio-pathic arthritis in order to decrease the rate of misdiagnosis.

Objective To investigate the bacterial infection status,etiology distribution and drug resistance of neurological rehabilitation hospitalized patients,to guide the clinical rational use of drugs,to provide a scientific basis for the development of effective prevention and control measures.Methods From January 201 1 to December 201 4,the clinical data of 334 hospitalized patients in department of neurological rehabilitation of our hospital were ret-rospectively analyzed.The pathogenic culture results were analyzed.Results There were 334 strains of pathogenic bacteria,83.53% of gram negative bacteria,47 gram positive bacteria(1 4.07%),8 fungi(2.39%).The top three infected gram negative bacterias were Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa.The main Gram positive bacteria was enterococcus.The detective gram negative bacterias were mainly sensitive to piperacillin penicillin/tazobactam and cefoperazone /sulbactam and imipenem,meropenem,cefepime,amikacin.The resistance rate of Escherichia coli to gentamicin,piperacillin and levofloxacin was more than 50%.The resistance rate of Kleb-siella pneumoniae to gentamicin and piperacillin was more than 50%.Conclusion The infection rate of urinary tract and respiratory tract is higher in patients with neurological rehabilitation ward,and the infection rate is higher,and the main part of gram negative bacilli,should be aimed at high risk patients and key links,strengthen the implementation of infection prevention and control measures,rational use of antimicrobial agents.

Objective To compare the effectiveness of patient-controlled propofol sedation (PCS) against propofol sedation with TCI during epidural anesthesia. Methods Thirty-two ASA Ⅰ -Ⅱ patients (18 male , 14 female) aged between 23-71 years, undergoing lower abdominal surgery or surgery on lower limb were randomly divided into two groups: PCS group ( n =16) and TCI group ( n = 16). Propofol sedation was started when epidural anesthesia was shown to be satisfactory. In PCS group a loading dose of propofol 0.5?g?kg-1 was given. The bolus dose was 0.3mg?kg-1 and the lock-out interval 2 min. There was no background infusion of propofol. In TCI group the initial target concentration of propofol was set at 1. 5?g?kg-1 target concentration was adjusted according to OAA/S score which was maintained at 3 during operation. Radial artery was cannulated and arterial blood samples were taken for determination of blood propofol concentration before and 5, 15, 30, 45 min after incision. OAA/S score was evaluated every 5 min and at the same time BIS and 95% SEF were recorded. The total amount of propofol infused during operation was recorded and whether the patient was satisfied with sedation was inquired. Results All patients expressed great satisfaction with the sedation in both groups. In PCS group the level of sedation was lighter and less propofol was consumed than in the TCI group. (2.5mg?kg-1 ?h-1 vs 3.8mg?kg?h-1, P

Objective To explore the influence of allergic rhinitis (AR) on patients with systemic onset juvenile idiopathic arthritis (SoJIA).Methods The study involved 44 cases with SoJIA from Department of Pediatrics,Renji Hospital affiliated to School of Medicine of Shanghai Jiaotong University from July 2008 to November 2013.The Clinical and laboratory data of all patients were recorded respectively.This was a retrospective cohort study.According to the diagnosis of allergic rhinitis (AR),children were subdivided into AR group (16 cases) and Non-AR group (28 cases).ACR Pediatric criteria (ACR Pedi) 30/ 50/70 and related indicators of SoJIA between the two groups were compared.In the AR group,the correlation between AR scores and DAS28 was analyzed.When SoJIA of the two groups relapsed,the AR group (the treatment group) received anti-rheumatism for arthritis as well as nasal spray and oral antihistamines for AR.The non-AR group (control group) only received the anti-rheumatism for arthritis.The improvement of SoJIA between the two groups was analyzed.The continuous variables were analyzed by Student's t-test or the MannWhitney U-test as appropriate.Categorical data were compared between different groups by the Chi-square test.Correlations were determined by Pearson or Spearman's ranking.Results ① In the retrospective analysis:the physician's and patients'/parents' general assessment on a 10 cm visual-analogue scale (VAS),number of joints with res-triction of movement,number of swollen joints,ESR,serum ferritin(SF) and childhood health assessment questionnaire (CHAQ) score were significantly elevated in the AR group compared with Non-AR group at the disease onset [(6.7±1.0) cm vs (4.8±1.9) cm; (6.5±1.4) cm vs (3.2±1.5) cm; 4.1±2.7 vs 2.7± 1.7; 3.4±2.4 vs 1.4±1.5; (87±35) mm/1 h vs (61±40) mm/1 h; (888±1 043) μg/L vs (311±324) μg/L; 1.6±0.5 vs 0.7±0.3,respectively; all P＜0.05].At the 3 and 6 months follow-up after disease onset,the proportion of patients who reached ACR pedi 50,70 in AR group were lower than the Non-AR group,while the cumulative glucocorticoid dose was higher in the AR group than that of those without AR [at 3 months 38％ vs 71％; 13％ vs 46％; (76±35) mg/kg vs (43±36) mg/kg,respectively; at 6 months 25％ vs 71％; 19％ vs 64％; 127±57 vs 67±58,respectively,all P＜0.05]; In the AR group,at the disease onset,3 and 6 months follow-up after disease onset,the scores of AR was positively correlated with DAS28(r=0.741,0.703,0.680,respectively; all P＜0.05).② In the prospective study:when SoJIA was relapsed,systemic feature score,the physician's and patients' /parents' general assessment on a l0 cm VAS,number of joints with restriction of movement,number of swollen joints,ESR,SF and CHAQ score were significantly elevated in the treatment group compared with the control group [3.8±1.5 vs 2.1±1.1; (5.6±1.5) cm vs (4.5±1.6) cm; (4.6±1.9) cm vs (3.1±1.5)cm; 3.9±1.9 vs 2.5±1.4; 2.4±0.9 vs 1.5±1.2; 92±27 vs 53±37; 565(339,1 192) μg/L vs 171(85,284) μg/L; 13(0.8,1.6) vs 0.7(0.5,1); respectively; P＜0.05].The improvement rate of the physician's and patients'/parents' general assessment on a 10 cm VAS,number of swollen joints,number of joints with restriction of movement,ESR and CHAQ score at the follow-up 3 months were higher in treatment group than the control group [71(55,86)％ vs 46(0,75)％; 67(45,81)％ vs 28(-4,62)％; 92(77,96)％ vs 70(27,88)％; 65(48,81)％ vs 0(-17,67)％; 100(46,100)％ vs 42(0,100)％; 67(49,85)％ vs 37(0,75)％; P＜0.05].At the follow-up 6 months,the improvement rate of ESR,patients'/ parents' general assessment on a 10 cm VAS,number of joints with restriction of movement and CHAQ score were higher than control group [94(85,96)％ vs 73(33,85)％; 89(65,99)％ vs 63(5,85)％; 100(100,100)％ vs 100(0,100)％; 91(69,100)％ vs 72(11,91)％; respectively,P＜0.05].Conclusion AR may exert an adverse influence on SoJIA.SoJIA patients who are treated with combined with AR may have better outcome than those who are only treated for arthritis.

Trypsin was purified from crude material of pig pancreas by AOT/isooctane reversed micellar system.The influence of the main operating parameters such as ethanol concentration in forward and backward extraction,pH,KCl and AOT concentration,temperature were investigated.Forward and backward extraction recovery of trypsin reached almost 90% and neared 100%,respectively.Finally,about 88% of total yield was obtained,and the specific activity of trypsin was increased to over 1800U/mg with purification factor of 5 folds more.In AOT-isooctane reverse micellar extraction system,denaturation or precipitation of proteins always occured due to strong electrostatic interaction between AOT-proteins molecules.It had been resolved by adding ethanol into reverse micellar system,and no denaturation was observed.Otherwise,the phase separation time was shortened significantly because of ethanol added.It was only 10 minutes or less to reach phases separation after forward and backward extraction.If this method can be applied in industry,efficiency will be greatly improved.