Clinical data and treatment of a patient with late-onset glutaric acidemia type Ⅱ who was admitted to the Department of Pediatric Intensive Care Unit (PICU) of Shenzhen Children′s Hospital were retrospectively analyzed.The patient is a female with the clinical manifestations of aggravated progressive proximal muscle weakness, accompanied by vomiting, abdominal pain and liver enlargement.A marked increase of transaminase, bilirubin and creatine kinase was detected, and hyperammonemia, hypoglycemia and metabolic acidosis were also observed in the patient.Blood amino acids and acylcarnitines spectra showed increased levels of various acylcarnitines.The muscle biopsy study suggested lipid storage myopathy (LSM), and the genetic test identified a homozygous mutation in the electron transfer flavoprotein dehydrogenase (ETFDH) gene.After treatment with Vitamin B 2, carnitine, coenzyme Q10 and plasma exchange, the motivate ability and biochemical parameters of the patient returned to normal.For patients with aggravated progressive proximal muscle weakness, hepatic dysfunction and increased serum creatine kinase levels, late-onset glutaric acidemia type Ⅱ should be considered.The key to early diagnosis and treatment of the disease is to improve the knowledge of it.

Objective To investingate the role of inflammation in coronary atherosclerosis and the relationship between the inflammatory factors and coronary risk score. Methods 56 patients with acute coronary syndrome were studied, among them 26 cases were diagnosed as acute myocardial infarction (AMI) and 30 unstable angina pectoris (UAP). The study group was compared with a control group of 30 cases who were identified as normal by coronary angiography. The concentrations of serum sICAM-1 and hsCRP were determined by ELISA assay. The coronary risk score was recorded in patients with UAP. Results Serum sICAM-1 levels were significantly elevated in patients with AMI or UAP compared with that of control group, while higher hsCRP level was observed only in the patients with AMI compared with those with UAP and the control group. By linear regression analysis, only serum sICAM-1 levels were correlated with coronary risk score (r=0.445, P

Objective To investigate the applied value of multi-slice CT(MSCT) in diagnosis of hip trauma.Methods The volume scans according to conventional pelvic scan were performed in 26 cases with hip trauma by SIEMENS Sensation 4 MSCT,then the images in thin slice of low and high contrast were reconstructed.After that,all the source images were transfered into CT 3D work stations,images such as multiplanar reconstructions(MPR).Maximum intensity projection(MIP), surface shade display(SSD) and volume rendering technic(VRT) were obtained. All images were observed and analysed by two radiologists.Results All post process images that obtained from the MSCT showed 19 patients with acetabular fractures ,8 with femoral head fractures ,7 with hips dislocation and 5 with piece of fracture in the hip joint. MSCT 3-dimension imaging could produce clear and comprehensive images of hip fracture and dislocation or piece of fracture .The rate of displaying hip trauma with thin slice MPR and MIP was 100%.Conclusion The MSCT thin slice MPR imaging is the best noninvasive imaging method in showing the hip joint. It is of high value in diagnosis of hip trauma in clinical practice.

OBJECTIVE:To prepare nicotine-?-CD inclusion compound and evaluate its quality.METHODS:The inclusion complex was prepared by saturated water solution method,and the preparation conditions were optimized by orthogonal test with the ratio of nicotine to?-CD(A),the inclusion temperature(B),the inclusion time(C)as factors and with the inclusion rate and the yield as indexes for evaluation.The formation of the inclusion complexes were verified by inclusion equilibrium constant analysis and its dissolution characteristics in vitro were investigated.The stability of nicotine-?-CD inclusion compound and the mixture of nicotine and?-CD were studied by conducting high-temperature,high humidity and high light tests.RESULTS:The optimum preparation conditions for the inclusion compound were established as:A was 1:3, B was 60℃and C was 2 hours.The inclusion rate of nicotine reached 65.28%;the yield was 79.55%,and the slow-release rate at 150 min was 92.26%.Under different temperature,humidity and high light conditions,the content of nicotine was always significantly higher in the inclusion complex than in the mixture.CONCLUSIONS:The inclusion technology is simple and the conditions were easily controllable,and the prepared nicotine-?-CD inclusion compound enjoys good stability and sustained-release property.

Objective To explore the conditions, safety and efifcacy of exchange transfusion for extremely severe hyper-bilirubinemia in term newborns requiring mechanical ventilation. Methods Ten full-term newborns of extremely severe hyper-bilirubinemia requiring mechanical ventilation were selected from January 2010 to March 2013 in the department of neonatology. After stable vital sign was achieved by the use of conventional life support, peripheral arterial and venous synchronous exchange transfusion was performed. The bilirubin, platelets, blood calcium, blood coagulation and blood gas were monitored before and after exchange transfusion. The effects and adverse events of exchange transfusion in newborns on mechanical ventilation were observed. Results There was no death in the study, and the replacement rate of total bilirubin was 50.5%. The main adverse event was thrombocytopenia (80%). There was a signiifcant difference in platelet counting before and after exchange transfusion (P<0.05). There was no signiifcant difference in blood coagulation, pH/HCO3-of the blood gas, prothrombin time (PT) and acti-vated partial thromboplastin time (APTT) before and after exchange transfusion. Conclusions It is relatively safe to implement an exchange transfusion in the full-term newborns with severe hyperbilirubinemia in newborns requiring mechanical ventilation, but the use of conventional life support is prerequisite because it stabilizes vital signs. The relatively ideal replacement rate of bili-rubin and the low incidence of adverse reactions are expected. However long-term prognosis of neural system is still unknown.

Objective:To evaluate the impact of health education intervention on promoting rural residents to join new rural cooperative medical system(NCMS)and their intention of joining NCMS based on Health Belief Model in project areas in Henan and Jilin Provinces.Methods:Quasi-experiment study was used to evaluate intervention impact.Following the evidence-based approach,according to needs assessment,a half-year health education intervention was implemented among farmers in the experimental counties in Henan and Jilin Provinces respectively.A questionnaire survey was conducted among farmers in intervention and control counties before and after intervention,and intervention impact was evaluated by comparing the indicators' changes in intervention and control counties.Results:After health education intervention,the knowledge level of farmers in two intervention counties increased by 29.0% and 37.8% respectively,their scores of perceived threatens of health risk and perceived barriers of joining NCMS among the respondents were decreased.Meanwhile,their score of perceived benefit of joining NCMS were increased,and the rate of willingness to join NCMS increased remarkably in both intervention counties.Conclusion:Health education was effective and helpful in increasing farmer's knowledge,understanding and cognitive level of NCMS,and it should play an important role for the sustainable development of NCMS.

Aim To explore the influence of atorvastatin on the ultramicrostructure of the membrane surface of the rabbit endothelial cells in rabbit atherosclerosis(AS)in the nanometer level.Methods A total of 44 male New Zealand white rabbits were randomly divided into 3 groups:control group consisting of 12 rabbits,AS group consisting of 16 rabbits and atorvastatin group consisting of 32 rabbits.By the end of 2nd,6th week 6~8 rabbits of each group were sacrificed and the middle segments of thoracic aortas were obtained to be observed with atomic force microscope.Results The control group vascular endothelial cells(VECs)were fusiform in shape and aligned regularly.Their size were about 11.96 ?m?3.72 ?m and their macroaxis were in parallel with the direction of hemokinesis.VECs in the atherosclerotic group were in deformity and bigger than those of the control group.They aligned irregularly and their volumes changed to be swelled.The membrane protein of VECs in the control group was composed of many round and elliptical eminences,which were almost in the same size.and with distinct boundary lines.The membrane protein of VECs in the atherosclerosis group was composed of many irregular eminences in different size.It was vague among the eminences in which there were many holes.But the VECs of atorvastatin group were better than those of atherosclerosis group.The ultramicrostructure of the membrane surface of the atorvastatin group VECs was obviously improved.Meanwhile,the mean roughness(Ra)of membrane protein of three groups was compared.The Ra of the atherosclerosis group was significantly higher than that of the control group and the atorvastatin group(P

Objective:To construct nucleotide vaccine based on HSP65 gene of mycobacterium tuberculosis.Methods:The gene encoding heat shock protein 65 kilodalton was amplified from genome of mycobacterium tuberculosis H37Rv strain by polymerase chain reaction(PCR) and correctly inserted into corresponding sites of eukaryotic expression vector pcDNA3.1(-) after restriction endonuclease digestion.The experimental mice was vaccined by this recombinant plasmid DNA.Results:The gene fragment inserted into the vector pcDNA3.1(-) was the HSP65 gene of mycobacterium tuberculosis H37Rv strain,which was confirmed by partial nucleotide sequencing.There was specific antibody produce in experimental mice vaccined by the recombinant plasmid DNA and this could protect mice against infection of mycobacterium tuberculosis.Conclusion:The successful construction of recombinant eukaryotic expression vector based on HSP65 gene of mycobacterium tuberculosis,such recombinant plasmid DNA induced specific antibody production in experimental mice,lays the foundation for further researching in prevention and treatment of tuberculosis.

Objective To study the correlation of expression of DNA topoisomerase Ⅱ alpha (TOP2A)with expressions of human epidermal growth factor receptor 2 (HER2)and phosphatase and tensin homolog (PTEN)and gene mutation of phosphatidylinositol 3-kinase (PI3K)in breast cancer so as to provide reference for prognosis of the cancer and evaluation of drug efficiency.Methods This study enrolled totally 96 breast cancer patients. Tumor specimens were resected.The gene expressions of TOP2A,HER2 and PTEN were analyzed using branched DNA-liquid-chip,and PI3K gene mutation was detected by xTAG-liquid-chip.Correlations between gene expressions and gene mutation were further explored by Spearman correlation analysis so as to clarify the relationship between TOP2A and HER2 signaling pathway gene.Results Co-expression of TOP2A and HER2 was strong,and TOP2A tended to be highly expressed in the presence of high expression of HER2 (P =0.01).The expression of PTEN was not significantly correlated with the expression of TOP2A,whereas the mutation of PI3K had a positive association with the high expression of TOP2A (P =0.004).Conclusion Anthracycline drug resistance factor TOP2A may be related to the critical factors of HER2 signaling pathway,suggesting that HER2 expression and PI3K mutation may be key factors in regulation of TOP2A expression,which would provide important evidence for chemotherapeutic resistance.

Objective To study the effects of Danshen Shujingwan on cervical cord compression in rats. Methods 60 healthy male SD rats of 8 weeks old were randomly divided into 6 groups: sham group (N group), model group (M group), DSW groups of high, medium and low dosages, and group treated with Jingfukang (J group), with 10 rats in each. The cervical cord compression models were established by transplanted silica gel. From 7 d after model establishments, the rats were respectively treated with drug by gavage for 30 d. They were observed pathologically. Results The extent and scope of damage were less in the treatment groups than in the model group (P<0.001), while the number of normal neurons remained more in the treatment groups (P<0.01).Conclusion DSW can decrease the damage after cervical spinal cord compression, protect the neurons from injuring.