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.

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.

Acute Disease ; Adolescent ; Adult ; Bridged-Ring Compounds ; poisoning ; Cardiomyopathies ; etiology ; therapy ; Creatine Kinase ; blood ; Creatine Kinase, MB Form ; Electrocardiography ; Foodborne Diseases ; blood ; complications ; therapy ; Glutamyl Aminopeptidase ; blood ; Humans ; Isoenzymes ; blood ; Male ; Middle Aged ; Nausea ; etiology ; Seizures ; etiology ; Treatment Outcome

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.

Objective To investigate the refraction change and nursing character in myopic amblyopia during the perceptual learning treatment. Methods Refraction of 54 children (98 eyes) with myopic amblyopes were selected,which were selected from the amblyopia clinic between 2007 and 2009, the spherical diopter, astigmatism and spherical equivalent were collected before and after perceptual learning,the refractive dynamic was compared according to the degree of amblyopia. Results The spherical average annual growth of myopic amblyopia during treatment was 0.52D, the growth of astigmatism was 0.03D;the spherical equivalent average annual growth was less than 0.50D accounted for 57.14%. The dynamic changes of spherical or SE of mild, moderate and severe amblyopia had significant difference, but the cylinder had not significant difference in change. Conclusions The treatment of perceptual learning in patients has little effect on the growth of refraction in myopic amblyopia, however, it is still necessary to pay close attention to refraction changes of in myopic amblyopia in the course of treatment.

Objective To investigate the protective effect of chloroquine on endotoxemia mice and its inhibition on the release of cytokines induced by LPS. Methods A total of 40 mice of Kunming species were randomly divided into four groups: LPS group received LPS at 10 mg/kg, chloroquine group received chloroquine at 20 mg/kg, LPS plus chloroquine group received chloroquine at 20 mg/kg first, then LPS at 10 mg/kg and control group received only 0.9%sodium chloride at 200 ?l/20 g. The mortality was observed within seven days after injection via caudal vein. ANA 1 cell lines were cultivated in vitro . After chloroquine was first added into the cells for 3 hours, the releases of TNF ? and IL 6 in the supernatants induced by different concentrations of LPS were measured. Results Chloroquine could decrease the death of mice due to endotoxin. Mortality dropped from 100% to 50% ( P

Objective Antibiotic resistance has increasingly been recognized as the major cause of treatment failure for Helicobacter pylori infection. The study was designed to compare the propensity of Helicobacter pylori to develop in vitro resistance to five commonly used antibiotics and to investigate the rates of resistance to these five antibiotics. Methods The serial passage tests were done in 7 sensitive Helicobacter pylori strains (2 type strains and 5 clinical isolates) to induce the resistance to amoxycillin, tetracycline, furazolidone, metronidazole or clarithromycin in vitro. The agar dilution tests detecting the minimal inhibitory concentration (MIC) were performed in 165 strains of Helicobacter pylori isolated from 2000 to 2001 to determine the resistance rates to the 5 antibiotics mentioned above. Results Serial passage tests showed that 5 of 7 strains of Helicobacter pylori were induced to be resistant to metronidazole and tetracycline; the inducible multiple of metronidazole was the highest. No strain was induced to be resistant to clarithromycin, but the inducible multiple of one strain was relatively high. No strain was induced to be resistant to amoxycillin or furazolidone, and the inducible multiple of furazolidone was the lowest. The resistance rates of Helicobacter pylori to metronidazole, clarithromycin, amoxycillin, tetracycline and furazolidone were 49.7% (82/165), 7.3%(12/165), 1.2% (2/165), 2.4%(4/165) and 1.2%(2/165), respectively. Conclusions Our study indicate that it is quite easy to induce the resistance to metronidazole,not difficult to clarithromycin, and relatively difficult to furazolidone or amoxycillin. The relative degree of difficulty in inducing the resistance to the drugs other than tetracycline is associated with the resistance rates detected, the fact that may help predict the changing trend of resistance rates in general population.