OBJECTIVETo observe the therapeutic effect of traditional Chinese medicine (TCM) and Western medicine (WM) treatments on mycoplasmal pneumonia in children and the changes in the serum cytokines.

METHODSNinety children with mycoplasmal pneumonia were randomly divided into the treatment group and the control group. TCM was given orally and azithromycin at the daily dose of 10 mg/kg was administered intravenously in the treatment group. In the control group, only intravenous azithromycin was given. After a 7-day treatment, the response rate, time of symptom disappearance, and serum levels of IL-6, IL-8 and TNF-alpha were observed.

RESULTSThe total response rate was 93.33% in the treatment group and 73.33% in the control group, showing a significantly better therapeutic effect in the treatment group (P<0.05). The combined treatments also showed better effects in alleviating fever, coughing and rales (P<0.05), and resulted in more obvious reduction in the serum levels of cytokines (P<0.05).

CONCLUSIONCombined treatment with TCM and WM produce good therapeutic effects in children with mycoplasmal pneumonia.

Azithromycin ; therapeutic use ; Child ; Child, Preschool ; Cytokines ; blood ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Infant ; Male ; Phytotherapy ; Pneumonia, Mycoplasma ; blood ; drug therapy ; Treatment Outcome

Based on the deep analysis of existing fingerprint identification algorithms, this article proposes an integrative solution to adopt the fingerprint identification technology into EMRS Electronic Medical Records System. It may improve the security of EMRS and raise the working efficiency of physicians effectively.
Algorithms ; Dermatoglyphics ; Humans ; Medical Records Systems, Computerized

The user experience (EX) of current Electronic Medical Record systems (EMR) is needed to improve. This paper proposed a new method to enhance EX of EMR. Firstly, system template and text characterization are used to make the EMR data structured. Then, the structured date are mined based on mining the association rules of incremental updating data to find the association of the elements of template of EMR and the values of elements. Finally, with the help of mined results, the users of EMR are able to input data effectively and quickly.
Data Mining ; methods ; Electronic Health Records ; Information Systems ; Medical Records Systems, Computerized ; User-Computer Interface

Objective To explore the imaging characteristics and make the differential diagnosis of intraspinal extramedullary epidural lesions. Methods 23 cases with intraspinal extramedullary epidural lesions confirmed by puncture or surgical pathology were selected for retrospective analysis of the lesion morphology,MRI signs and the relationship between the lesion and surrounding tissues.Results Intraspinal extramedullary epidural lesions were more often located at thoracic spinal canal.The shapes of lesions were always various.The malignant tumors were irregular.It could damage the adjacent bone and grew surrounding the spinal cord.Leaping growth and multiple vertebral involvements could be seen in metastasis.The complex components of lesions were related to heterogeneous signal intensity on MRI,which could be presented with hypoGto hyperGintense on T1 WI and T2 WI.The angiolipoma showed hypoGto hyperGintense on T1 WI,and the hyperGintense signal could be suppressed with fatGsuppressed sequence.Meningioma tended to present with homogeneous signal on both T1 WI and T2 WI, with dural tail on contrast MRI.All of the lesions were moderately or significantly enhanced on contrast MRI.Conclusion Intraspinal extramedullary epidural lesions include a wide range of lesions,and the components of lesions are very complex.Among them,the distinctive MRI characteristics include the lesions containing fat and vascular components,besides malignant lesions invading adjacent tissues.Comprehensive analysis of the shape and signal of lesions,as well as the relationship between lesions,and surrounding structures is very helpful in differential diagnosis of intraspinal extramedullary epidural lesions.

OBJECTIVETo study the diagnosis and management of renal angiomyolipoma (RAML), and to identify risk factors affecting spontaneous angiomyolipoma rupture.

METHODSThe data of 68 patients with RAML from 1989 to 2002 were retrospectively reviewed. These patients were divided in two groups on the basis of tumor size, 35 patients in group A ( 4 cm).

RESULTSSeven patients were identified by image-guided percutaneous biopsy, and no major complications was noted. Sixteen patients with RAML were examined with angiography and 9 of 16 patients had got spontaneous rupture. 41.2% of patients were symptomatic, 4 cases (11.4%) in group A and 24 (72.7%) cases in group B (P < 0.01). There were significant differences in mean tumor size (11.6 cm +/- 5.1 cm vs 5.3 cm +/- 2.9 cm, P < 0.01) and mean aneurysm size (13.6 mm +/- 5.8 mm vs 2.6 mm +/- 3.0 mm, P < 0.01) between 9 cases of the ruptured tumor and 59 cases of unruptured tumor, 9 cases of the ruptured and 7 cases of unruptured tumor with angiography, respectively. Treatment consisted of conservative observation in 10 patients (no radiographic changes during the follow-up of 2 - 7 years); partial nephrectomy in 14 patients, tumor enucleation in 30 patients, total nephrectomy in 14 and posterior laparoscopic nephrectomy in 3 (no recurrence and complication correlation to operation during the follow-up of 2 - 144 months).

CONCLUSIONSIt is an important role that percutaneous biopsy guided by ultrasonography or computerized tomography performs in managing suspicious and/or indeterminate RAML. A higher probability of rupture is related to tumor and/or aneurysms size. Nephron-sparing surgery is the first choice for surgical treatment of RAML.

Adolescent ; Aged ; Angiomyolipoma ; diagnosis ; pathology ; therapy ; Biopsy, Needle ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; diagnosis ; pathology ; therapy ; Male ; Middle Aged ; Nephrectomy ; methods ; Rupture, Spontaneous ; Tomography, X-Ray Computed ; Ultrasonography, Interventional

OBJECTIVETo diagnose achondroplasia prenatally by FGFR3 gene detection.

METHODSSeventy-eight fetuses affected by short-limb dysplasias were recruited. Umbilical blood sampling was employed to obtain fetal blood for karyotyping and FGFR3 gene detection. Genomic DNA was extracted, and the exon 10 of the FGFR3 gene was amplified. PCR amplicons were analyzed by DNA sequencing and restriction fragment length polymorphism with Bfm I. The FGFR3 exon 10 from the parents of the positive fetuses was screened by the same method.

RESULTSIn 78 fetuses affected with short-limb dysplasias, 8 cases had G1138A heterozygotic mutation and normal karyotype, and were diagnosed as achondroplasia. The other 70 fetuses had normal nucleotide at nucleotide 1138 in exon 10 of FGFR3, therefore were excluded from achondroplasia. Only one father in parents of the 8 achondroplasia fetuses also had the G1138A mutation.

CONCLUSIONAchondroplasia could be diagnosed prenatally in the fetuses affected with short-limb dysplasias by using PCR-RFLP and DNA sequencing of the exon 10 of the FGFR3 gene.

Achondroplasia ; diagnosis ; genetics ; DNA Mutational Analysis ; Female ; Humans ; Male ; Polymorphism, Restriction Fragment Length ; Pregnancy ; Prenatal Diagnosis ; methods ; Receptor, Fibroblast Growth Factor, Type 3 ; genetics

BACKGROUNDIt has been shown that neurohumoral factors other than mechanical obstruction are involved in the pathophysiology of acute pulmonary thromboembolism (APTE). The aim of this study was to investigate the effects of thrombolytic drugs, a selective endothelin-1 receptor (ET-1R) antagonist alone or their combination on APTE in a canine model.

METHODSTwenty dogs were randomly assigned to five groups: sham, model, urokinase (UK), BQ123, and combination (UK plus BQ123). The dogs in the sham group underwent sham surgery. APTE was induced in the other four groups by intravenous injection of autologous blood clots. Dogs in the UK, BQ123 and combination groups received UK, BQ123 (a selective ET-1R antagonist), or UK plus BQ123, respectively. The dogs in the model group were given saline. Mean pulmonary artery pressure (mPAP), serum concentrations of ET-1, thromboxane (TXB2), and tumor necrosis factor (TNF)-alpha were determined at different time points following the induction of APTE.

RESULTSUK and BQ123 alone markedly decreased mPAP in APTE. By comparison, the reduction was more significant in the combination group. Compared with the sham group ((-0.90 +/- 0.61) mmHg), mPAP increased by (7.44 +/- 1.04), (3.42 +/- 1.12) and (1.14 +/- 0.55) mmHg in the model group, UK alone and BQ123 alone groups, respectively, and decreased by (2.24 +/- 0.67) mmHg in the combination group (P < 0.01). Serum ET-1 concentrations in the BQ123 and combination groups were (52.95 +/- 8.53) and (74.42 +/- 10.27) pg/ml, respectively, and were significantly lower than those in the model and UK groups ((84.56 +/- 7.44) and (97.66 +/- 8.31) pg/ml respectively; P < 0.01). Serum TNF-alpha concentrations were significantly lower in the BQ123 group than in the model, UK and combination groups (P < 0.05).

CONCLUSIONSOur results indicate that the selective ET-1R antagonist BQ123 not only reduces the increase of mPAP and serum ET-1 level, but also inhibits the production of TNF-alpha, and attenuates the local inflammatory response induced by APTE. Selective ET-1R antagonists may be beneficial to the treatment of APTE, particularly when used in combination with a thrombolytic agent.

Animals ; Dogs ; Endothelin A Receptor Antagonists ; Endothelin-1 ; blood ; Fibrinolytic Agents ; therapeutic use ; Peptides, Cyclic ; therapeutic use ; Pulmonary Embolism ; blood ; drug therapy ; pathology ; Random Allocation ; Thromboxanes ; blood ; Tumor Necrosis Factor-alpha ; blood

BACKGROUNDExtensive research toward creating a biological pacemaker by enhancement of inward depolarizing current has been performed. However, studies have mainly focused on inducing spontaneous activity and have not adequately addressed ways to improve pacemaker function. In this study we attempted to improve pacemaker function by altering connexin expression in rat mesenchymal stem cells (MSCs) to a phenotype similar to native sinus node pacemaker cells.

METHODSTo generate a biological pacemaker, MSCs were transduced with a cardiac pacemaker gene-hyperpolarization-activated cyclic nucleotide-gated channel 4 (HCN4), via transfection with a lentiviral vector. Funny current (I(f)) in HCN4(+) MSCs was recorded by voltage-clamp. Overexpression of connexin 45 (gene Gja7) in MSCs was achieved by transfection with the plasmid pDsRED2-N1-Gja7-RFP. Double-immunolabelling with anti-connexin 43 and anti-connexin 45 antibodies were used to identify the gap junction channels. The effects of the genetically modified MSCs on cardiomyocyte excitability were determined in MSCs cocultured with neonatal rat ventricular myocytes. Spontaneous action potentials of neonatal rat ventricular myocytes were recorded by current-clamp.

RESULTSHigh level time- and voltage-dependent inward hyperpolarization current that was sensitive to 4 mmol/L Cs(+) was detected in HCN4(+) MSCs, confirming that HCN4 acted as I(f) channels in MSCs. Connexin 43 and connexin 45 were simultaneously detected in CX45(+) MSCs. Beating frequency was (82 +/- 8) beats per minute (n = 5) in myocytes cocultured with non-transfected control MSCs, versus (129 +/- 11) beats per minute (n = 5) in myocytes cocultured with HCN4(+) MSCs. Myocytes cocultured with MSCs cotransfected with HCN4 and connexin 45 had the highest beating frequency at (147 +/- 9) beats per minute (n = 5).

CONCLUSIONThese findings demonstrate that overexpression of connexin 45 and subsequent formation of heteromeric connexin 45/connexin 43 gap junction channels in HCN4 expressing MSCs can improve their function as cardiac biological pacemakers in vitro.

Animals ; Animals, Newborn ; Biological Clocks ; physiology ; Cells, Cultured ; Connexins ; genetics ; metabolism ; Electrophysiology ; Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels ; Mesenchymal Stromal Cells ; cytology ; metabolism ; physiology ; Myocytes, Cardiac ; cytology ; metabolism ; physiology ; Potassium Channels ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction

Objective To investigate the rehabilitation promoting factors in stroke patients and to provide references for the design and implementation of effective intervention for rehabilitation of stroke patients.Methods In-depth interviews were conducted among eight stroke patients,and interview data were collected and analyzed.Results Five themes were identified through analysis and classification of the interview data:practical rehabilitation goals,effective rehabilitation training behaviors,overcoming abandonment behaviors and negative emotions,suitable support system,and proper self-adjustment.Conclusion The rehabilitation promoting factors for stroke patients are performing effective rehabilitation training towards effective rehabilitation goals.In this process,patients need to rely on appropriate social support and patients' self-adjustment to overcome abandonment behaviors and negative emotions.These factors form a force to promote rehabilitation during the process of rehabilitation.

BACKGROUNDEven carrying an identical gene mutation, inter- and intra-family variations have been noticed worldwide in the presence and the severity of left ventricular hypertrophy and sudden death in patients with hypertrophic cardiomyopathy (HCM). Modifier genes may contribute to the diversity. Angiotensin-converting enzyme 2 (ACE2) gene has been established to be associated with parameters of left ventricular hypertrophy in community based male subjects. The objective of the present study was to investigate the association of ACE2 gene polymorphisms with the phenotype of HCM.

METHODSA total of 261 consecutive HCM patients and 609 healthy controls were enrolled into this study. The polymorphism of rs2106809 and rs6632677 were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and confirmed by sequencing. Logistic regression model and multivariate analysis were used to determine the odds ratio (OR) and 95% confidence intervals (CI) of variations of ACE2 for HCM.

RESULTSThe T allele of rs2106809 and C allele of rs6632677 conferred increasing risk for HCM (OR 1.34, 95% CI 1.01 - 1.77, P = 0.04; OR 1.11, 95% CI 1.03 - 1.21, P = 0.002, respectively), and the 2 single nucleotide polymorphisms (SNPs) were in strong linkage disequilibrium (LD), the TC haplotype was independently associated with a higher OR for HCM (OR = 1.59, 95% CI 1.21 - 1.87) after adjusted for conventional risk factors. And the risk alleles were associated with thicker interventricular septal thickness of HCM ((20.0 +/- 6.3) mm vs (17.9 +/- 5.5) mm, P = 0.03 and (21.3 +/- 5.9) mm vs (17.9 +/- 5.8) mm, P = 0.04, respectively). No association was found between the two polymorphisms with female patients with HCM.

CONCLUSIONMinor alleles of ACE2 gene might be the genetic modifier for the magnitude of left ventricular hypertrophy in male patients with HCM.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cardiomyopathy, Hypertrophic ; genetics ; Humans ; Hypertrophy, Left Ventricular ; genetics ; Male ; Middle Aged ; Peptidyl-Dipeptidase A ; genetics ; Polymorphism, Genetic ; Sex Factors