Objective To investigate the epidemiology and clinical features of epidemic cerebrospinal meningitis of children in Shanghai area in the last 2.5 years. Methods A retrospective study was conducted in 27 hospitalized patients with epidemic cerebrospinal meningitis by analyzing the clinical manifestation,epidemiology and laboratory test fingdings from Jan.2006 to Jun.2008.Statistical analysis of the clinical manifestations of cases in serogroup A,B and C was performed according to Neisseria meningitidis infection. Results There were sporadic cases of children with epidemic cerebrospinal meningitis in Shanghai area in the last 2.5 years.The seasonal distribution illustrated the peak occurrence from Feb.to Apr.Among all these cases,92.6% were floating children.Common types(74.1%) were the predominant clinical manifestations and the others were fulminate types(25.9%).Four cases in each of serogroup A and B,and 8 cases of serogroup C were identified by serotyping on 14 Neisseria meningitidis strains and genotyping on the other 2 cases′ cerebrospinal fluid specimens.All the patients in serogroup A with meningococcal diseases were not vaccinated before and 25.0% of them belonged to fulminate types.Half of the cases had petechia on the skin and the prevalence of skin necrosis was 25.0% and 50% had complications of nervous system.No fulminate type was present in cases of serogroup B meningococcal disease and only 1 case had slight petechia on the skin.However,intensive convulsions occurred in 75.0% of the patients,and all of them had complication of nervous system,with a few had sequela.Among the patients in serogroup C meningococcal disease,62.5% patients were vaccinated with serogroup A Neisseria meningitidis.In serogroup C,Neisseria meningitidis infection was found in each age group,with petechia on skin,skin necrosis,immunity correlation fever and complications of nervous system in 87.5%,50.0%,75.0% and 12.5% of the patients,respectively. Conclusions 1.Epidemic cerebrospinal meningitis occurred sporadically in children in Shanghai area,the majority of patients were floating populations.2.Clinical manifestation was typical in patients of serogroup A meningococcal disease.Subdural effusion or ventricalitis was more common in patients of serogroup B meningococcal disease.In serogroup C,Neisseria meningitidis was the most prevalent serotype leading to epidemic cerebrospinal meningitis.More cases were found in patients infected with serogroup C,Neisseria meningitidis with severe shock and immunity correlation fever compared with the other groups.Prophylactic vaccination of serogroup C polyvalent meningococcal organism should be recommended.

Objective To investigate the relationship between children history of asthma and family history of asthma.Methods Three thousand and five hundred outpatients of asthma children were selected as investigation subjects.Family history of asthma was investigated in the form of questionnaire,and analyzed them from whether or not having family history of asthma,the first and second degree relative having family history of asthma.Results There was no family history of asthma in 1 659 cases(47.4%) and while 1 841 cases had family history of asthma(52.6%).The children who had family history of asthma were slightly more than those who had no family history of asthma.Among the 1 841 cases with family history of asthma,the first degree relatives with family history of asthma were more than those second degree relatives with fa-mily history of asthma.The incidence rate of relatives with family history of asthma on mother′s side was 59.9%,and the incidence rate of the father′s relatives was 40.1%.The incidence rate of mother′s relatives was higher than that of father′s relatives(P

Objective To analyse the effects of serum estradiol levels during controlled ovarian hyperstimulation (COH) on the outcomes of in vitro fertilization and embryo transfer (IVF-ET). Methods The clinical data of 472 patients undergoing IVF-ET with GnRH analogues recombinant FSH long protocol were retrospectively analysed. The area under the curve (AUC) of estradiol (E2) level was calculated during COH, and patients were categorized into groups according to the percentile of AUC of E2(AUCE2) during COH. The general characteristics and parameters related to the outcomes of IVF-ET were compared among groups. Results The 10th percentile and 90th percentile of AUCE2 were 3 347.0 pmoL/L and 14 414.3 pmol/L, respectively. Four hundred and seventy-two patients were divided into lower reaction group (AUCE2 3 347.0 pmol/L, n=48), normal reaction group (14 414.3 pmol/L>AUCE2 > 3 347.0 pmol/L, n=376) and higher reaction group (AUCE2≥14 413.3 pmol/L, n=48). There was no significant difference in age, body mass index, baseline follicle stimulating hormone level, time of treatment with gonadotropin, endometrium thickness on day of transfer and embryos transferred(P>0.05). Compared with lower reaction group and normal reaction group, the number of oocytes per retrieval and number of embryos frozen were significantly larger(P<0.01) and the mild/severe ovarian hyperstimulation syndrome rate was significantly higher in higher reaction group(P<0.05). There was no significant difference in fertilization rate, cumulative embryo score, high-grade embryo rate, clinical pregnancy rate and implantation rate among groups (P> 0.05). Conclusion Sustained snpraphysiological serum E2 levels during the COH process do not adversely affect the quality of oocytes and embryos, clinical pregnancy rate and implantation rate to some extent in IVF-ET.

BackgroundHigh myopia is one of leading causes of blindness,so far the pathogenesis remains unclear.Two single-nucleotide polymorphisms (SNPs) of rs6885224 and rs12716080 in CTNND2 gene were recently found to be associated with high myopia in Singaporean Chinese.But whether these SNPs are related with the pathogenesis of high myopia in Han Chinese is worth studying,Objective This study was to investigate the relationship between the genetic variations of the CTNND2 gene and high myopia in Han Chinese.MethodsA case-controlled association study was designed.Nine hundred and thirty-three individuals with high myopia and 1227age- and gender-matched normal subjects were included in this study.The 5 ml of periphery blood was obtained from all subjects for the extraction of genomic DNA.The target DNA was amplified using PCR and purified by the SNaPshot method.Four SNPs rs12716080,rs917012,rs6885224 and rs16901340 in the CTNND2 gene were genotyped.This study was approved by the Ethic Committee of Sichuan Provincial People Hospital.Written informed consent was obtained from each subject before his/her enrollment.Results The frequencies of the genotypes rs6885224,rs12716080,rs917012,rs16901340 SNPs were in Hardy-Weinberg equilibrium (HWE) ( P=0.181,0.085,0.732,0.313,0.264,0.663,0.084,0.196).There were no significant differences in genotypes frequency distribution ( in turn P =0.654,0.406,0.828,0.403 ) and allele frequency distribution of the CTNND2 gene ( in turn P =0.377,0.209,0.743,0.198) between the high myopia group and normal control group.The haplotypes (TA and GA)frequencies of rs12716080 and rs917012 in the high myopia group were significantly different from those of the normal control group(TA:0.784 vs.0.719;GA:0.087 vs.0.136) (x2 =6.115,P=0.013 ;x2 =6.634,P=0.010),but those of GG were similar between the high myopia group and normal control group ( 0.123 vs.0.143,x2 =0.889,P =0.346). ConclusionsThe SNPs rs12716080,rs917012,rs6885224 and rs16901340 in CTNND2 gene were not responsible for high myopia,however,the haplotypes of rs12716080 and rs917012 are susceptible for high myopia in Han Chinese.

AlM: To explore the judgment of pattern reversal visual evoked potential on visual function and injured part of children with spastic cerebral palsy.METHODS: There were two groups in this study. 30 children with spastic cerebral palsy ( quadriplegia: 15, diplegia:15) were selected as observation group, while 30 normal children were selected as control group with randomized controlled trial. The changes of half-view and full- view incubation period and amplitude were observed by pattern reversal visual evoked potential.RESULTS: Full-view pattern reversal visual evoked potential: the P100 incubation period of the observation group was 113. 55 ± 8. 14ms, and the P100 amplitude was 23. 08±15. 41μV. The P100 incubation period of the control group was 105. 05 ± 5. 58ms, and the P100 amplitude was 31. 65±7. 37μV. From the comparison on P100 incubation and P100 amplitude between two groups, the difference was statistically significant ( P<0. 05 ) . P100 incubation period of the spastic diplegia of full-view pattern reversal visual evoked potential was 112. 73±7. 22ms, and the P100 amplitude was 21. 03±12. 17μV. P100 incubation period of the spastic quadriplegia was 114. 37 ± 9. 02ms, and the P100 amplitude was 25. 14 ± 18. 06μV. From the comparison on P100 incubation and P100 amplitude between two groups, the difference had no statistically significance (P>0. 05). Compared to the control group, each eye and each view latency of observation group were higher, the difference was statistically significant ( P<0. 05). The change of the incubation period of the full-view and half - view pattern reversal visual evoked potential took place in the lesion of the visual pathway:including optic neuropathy, some optic nerve lesion, lesion after optic chiasma, and optic chiasma lesion. Among them, the lesion after the optic chiasma was the most common.CONCLUSlON:Pattern reversal visual evoked potential can help people to understand the visual impairment and injury of children with spastic cerebral palsy in order to identify the abnormal children and early intervention.

220.6 ?mol/L in serums.Conclusions TORCH infection is common in infantile hepatitis in hospital.The infection rates caused by CMV are higher than those caused by HSV,TOX,RV and the rate caused by TOX is lower than others,and then the injury of liver caused by CMV is more severe than others.Neonates less than 7 days always have more organs injuried than the elders.

Objective To evaluate the remote effect of local injection of botulinum toxin by use of the F-wave measures. Methods The F-wave responses as well as M-waves were recorded before injection, and at 1 week,12 to 24 weeks after local injection of botulinum toxin type-A (BTX-A) in 26 patients, including 19 with hemi-facial spasm (HFS),5 Meige syndrome and 2 torticollis spasmodicus (TS).The following parameters were analyzed: M-wave latency (ML) and amplitude (Mamp), F-wave minimal latency(Fmin) and average latency(Fave),amplitude (Famp), duration (Fdur), persistence (Fper) and chronodispersion (Fchr). The above parameters were obtained through the electric stimulation of ulnar and tibial nerves, and recorded from the abductor digiti minimi and extensor digitorum brevis, respectively. Results No definite F-wave was obtained by electric stimulation of ulnar nerve at 1 week after injection in 3 HFS patients (5 nerves). The Fave recorded from electric stimulation of ulnar and tibial nerves prolonged significantlyand Fdur from ulnar nerve increased significantly at 1 week after injection, but were not significantly different from those of pre-injection when recorded at 12 to 24 weeks after injection. No significant correlation of the altered F-wave parameters was found with the dosage of BTX-A. Conclusion Fdur and Fave could sensitively assess the remote effect of the local injection of BTX-A, the remote effect might be correlated with the distance between injected muscle and tested muscle, rather than the dosage of BTX-A.

Background: Integrative traditional Chinese and western medicine may be a new approach to improve the eradication rate of Helicobacter pylori (Hp).Aims: To compare the efficacy and safety of Weifuchun tablet versus bismuth combined with standard triple regimen as the first-line therapy of Hp infection.Methods: A total of 141 patients with Hp infection and na(i)ve to treatment were randomly assigned into 3 groups receiving a 14-day eradication therapy.In standard triple therapy group, esomeprazole, amoxicillin and clarithromycin were given twice a day;while in Weifuchun group and bismuth group, Weifuchun tablet and bismuth potassium citrate were added, respectively, to the standard triple therapy.Hp eradication was assessed by 13C-urea breath test at least 6 weeks after the end of treatment.Hp isolates were tested for resistance to antibiotics.Results: One hundred and twenty-eight patients completed the study.Hp eradication rates in Weifuchun group, bismuth group and standard triple therapy group were 83.7%, 91.8% and 79.1%, respectively by ITT analysis and 88.4%, 97.8% and 84.6%, respectively by PP analysis.The eradication rate of Weifuchun group was lower than that of bismuth group and higher than that of standard triple therapy group, but the differences were not statistically significant (P>0.05).Only PP eradication rate of bismuth group was significantly higher than that of standard triple therapy group (P<0.05).The resistant rates of Hp to clarithromycin, amoxicillin and metronidazole were 33.3%, 2.9% and 70.5%, respectively.For eradication of clarithromycin resistant strains, bismuth group was superior to Weifuchun group and standard triple therapy group (100% vs.60.0% and 66.7%, P all <0.05).All three eradication regimens showed good compliance, and no significant difference in incidence of adverse events was found between the three regimens (P>0.05).Conclusions: Weifuchun tablet combined with standard triple regimen is safe and effective for use as first-line treatment for Hp infection, however, the eradication rate is relatively low in cases infected with clarithromycin resistant strains.Bismuth combined with standard triple regimen is a good alternative in areas with high clarithromycin resistance and regions where tetracycline is unavailable.

Humans ; Medicine, Chinese Traditional ; methods

BACKGROUND: After local injection of Botulinum toxin type-A (BoTX-A), not only the function of the neuromuscular conjunction was affected, but also the changes occurred remote from the injected site. F-waves result from the back fire of the motoneuron activation, which may indirectly reflect the functional state of the motoneurons.OBJECTIVE: To evaluate the remote effect of local BoTX-A injection by F-wave test.DESIGN: Self-control study based on patients with movement disorders.SETTING: Neruologic clinic in a university hospital.PARTICIPANTS: Twenty-six patients with movement disorders not received previous local BoTX-A were selected from Neurological Clinic in Renmin Hospital of Wuhan University between September 2002 and July 2003, including 19 cases with hemificiospasm, 5 Meige syndrome and 2 torticollis spasmodicus.INTERVENTIONS: F- and M-waves of ulnar and tibial nerves were recorded before 1, 12 - 24 weeks after local injection of BoTX-A in 26 patients.MAIN OUTCOME MEASURES: The following parameters were analyzed:latency(ML) and amplitude (Mamp) of M-wave, minimal (Fmin) and average latency (Fave), amplitude of negative peak(Famp), duration (Fdur), persistence (Fpcr) and chronodispersion (Fchr) of F-wave.RESULTS: No definite F-response of ulnar nerve stimulation was obtained 1 week after injection in 3 HFS patients (5 nerves) . Fave prolonged significantly on ulnar and tibal nerve and Fdur increased significantly on ulnar nerve 1 week after injection, but there was no significant difference 12 - 24 weeks later, compared with before injection. No significant correlation of the altered F-wave parameters was found with the dosage of BoTX-A.CONCLUSION: Fdur and Fave could sensitively assess the remote effect,which correlates with distance away from the injected muscle, rather than the dosage of BoTX-A.