Objective To explore the clinical characteristics of pancreas damage in children with Henoch-Sch(o)nlein purpura (HSP).Methods The clinical data of 206 HSP patients was analyzed from February 2008 to July 2013.The serum and urine example was detected by the automatic biochemical analyzer and the clinical characteristics of them was analyzed.The pancreatic morphology of patients was observed by type-B ultrasonic,and the clinical feature of skin,joints,digestive tract and kidney damage were observed.The relationship between pancreas damage and other systems damage was analyzed.Results There was 58 cases suffering from pancreas damage in 206 HSP children:31 cases were male,27 cases were female.There was no patients with pancreatic edema and deformation of structure in 58 patients.The incidence of pancreas damage with HSP combined with abdominalgia patients was 39.7％ (50/126),which was obviously higher than that in the patients without abdominalgia 10.0％ (8/80) (x2 =14.355,P ＜ 0.01).The incidence of pancreas damage in mixed type of HSP [31.8 ％ (55/173)] was significantly higher than that in simple type of HSP [9.1％ (3/33)] (x2 =18.292,P ＜ 0.01).The mean hospital stay of the HSP patients with pancreas damage was 6-38 (10.39± 6.80) d,while without pancreas damage was 4-18 (8.51 ± 3.42) d,and there was no significant difference (t =5.790,P ＞ 0.05).Conclusions The HSP children usually combine with pancreas damage.If they have abdominalgia and multi-system damage,they are more likely to be accompanied with pancreas damage,which should be paid more attention.

Objective To investigate the genetic variants in the protein C (PC) and endothelial protein C receptor (EPCR) genes associated with the risk and outcome of acute respiratory distress syndrome (ARDS) patients in Chinese Han race.Methods Five tagSNPs (single nucleotide polymorphism,SNP) in the PC and EPCR genes were genotyped in patients with ARDS (n =275) and non-ARDS (n =337) in order to find the association between them in this case-control study.The SNPs were genotyped by SNPstream Beckman platform.Then,the correlation between the associated SNPs and plasma levels of activated protein C (APC) in patients with ARDS was investigated.The APC levels were measured using enzyme linked immunosorbent assay (ELISA) method.Results Association analysis rcvealed that two PC SNPs in perfect linkage disequilibrium,rs1799809 and rs1158867,were significantly associated with susceptibility to ARDS.T allele frequency of rs1799809 in ARDS patients was significantly higher than that in non-ARDS patients (OR =1.569,95％ CI:1.192-2.066).And the genotype frequencies of rs1799809 were also significantly different between these two groups (P =0.007).The association remained significant after adjustment for multiple comparisons.Haplotype consisting of three SNPs in the PC gene was also associated with susceptibility to ARDS.The frequency of haplotype CCC in the ARDS samples was significantly lower than that in the non-ARDS group (P ＜ 0.01).Moreover,ARDS patients canrying rs1799809 TT genotype showed lower serum levels of APC than patients with TC and CC genotypes (Padj =0.02).However,genotype and allele analyses of EPCR did not show any significant difference between ARDS and non-ARDS patients.Conclusions These findings indicated that common genetic variation in the PC gene was significantly associated with susceptibility to ARDS in Chinese Han race.The PC genetic variation influenced plasma concentration of APC in patients with ARDS.

Objective To investigate the association between Helicobacter pylori(H. pylori) infection and Autoimmune thyroid diseases (ATDs). Methods The literatures on the association of H. pylori with ATDs were retrieved by searching databases from the inception of each da?tabase to October 2015. Data extraction and quality assessment were completed by two authors. Meta analysis was performed using RevMan 5.3 software,calculating the odds ratio and 95%confidence interval. Results Twelve papers were included for the meta?analysis. The total sample size was 1 615,with 918 cases and 697 controls,respectively. Compared with the controls,H.pyloriinfection significantly increased the risk of auto?immune thyroid diseases development with a pooled of[OR=1.86,95%CI(1.18,2.94)]. H.Pylori?CagA infection significantly increased the risk of autoimmune thyroid diseases development with a pooled of[OR=2.66,95%CI(1.61,4.41)]. H. pylori infection is associated with Graves dis?ease[OR=3.37,95%CI(1.90?5.97)]and Hashimoto′s thyroiditis[OR=1.83,95%CI(1.22,2.76)]. The results of publication bias and sensitivi?ty analysis confirmed the reliability and stability of this meta analysis. Conclusion H. pylori infection may be associated with an increased risk of developing the autoimmune thyroid diseases.

Objective To evaluate the implementation and effectiveness of comprehensive control measures of schistosomia?sis in Caidian District, Wuhan City. Methods The data of implementation of the schistosomiasis control measures in Caidian District was collected and analyzed statistically. Results The number of Oncomelania hupensis snail environments and snail area decreased from 213 sites and 223.47 hm2 in 2003 to 59 sites and 51.20 hm2 in 2013, with the decreasing rate of 72.30%and 77.09%, respectively. The infection rate of schistosomiasis of human decreased from 1.58%in 2006 to 0.24%in 2013, with the decreasing rate of 84.81%. The positive rate of stool tests of cattle was 2.19%in 2006 while it was 0 in 2013. Conclusion The comprehensive control measures of schistosomiasis are effective.

Objective To investigate the possible association of IRAK4 polymorphisms with susceptibility to and prognosis of severe sepsis.Methods A total of 192 patients hospitalized in emergency department of Zhongshan Hospital from February 2006 to December 2009,and another 192 healthy volunteers were enrolled in this case-control study.Patients were excluded if they had metastatic tumors,autoimmune diseases,AIDS or received immunosuppressive drugs.This study was approved by the ethical committee of Zhongshan Hospital,Fudan University.Sepsis patients were divided into survival group(n =124)and non-survival group(n =68)according to the 30-day mortality.Primer 3 software was used to design the PCR and sequencing primers.Genomic DNA was extracted from peripheral blood mononuclear cells.Seven tagSNPs were selected based on the data of Chinese Han in Beijing from the Hapmap projectand genotyped by direct sequencing.We used x2 analysis to evaluate the significance of differences in genotype and allele frequencies between different groups.Results The distributions of all tagSNPs were consistent with Hardy-Weinberg equilibrium.The allele and genotype frequencies of rs4251545(G/A)were significantly different between severe sepsis and healthy control groups(P =0.015,P =0.035,respectively).Carriers of the rs4251545A had a higher risk for severe sepsis compared with carriers of the rs4251545G(OR =1.69,95％ CI:1.10-2.58).The allele and genotype frequencies of all SNPs were not significantly different between survivor group and non-survivor group.Conclusions These findings indicated that the variants in IRAK4 are significantly associated with severe sepsis susceptibility in the Chinese Han population.

OBJECTIVETo compare the effects of Shenfu Injection (SFI) and epinephrine (EPI) on catecholamine levels in a porcine model of prolonged cardiac arrest (CA).

METHODSAfter 8 min of untreated ventricular fibrillation, 24 Wuzhishan miniature pigs were randomly assigned to one of the three groups (n=8 per group) and received central venous injection, respectively: SFI group (1 mL/kg), EPI group (20 μg/kg EPI), and normal saline (NS) group. Cardiac output (CO), maximum rate of increase/decrease in left ventricular pressure (±dp/dt), serum levels of EPI, norepinephrine (NE), and dopamine (DA) were determined at baseline and at 0.5, 1, 2, and 4 h after restoration of spontaneous circulation.

RESULTSThe duration of cardiopulmonary resuscitation was shorter in the EPI and SFI groups than in the NS group (P<0.05). The EPI level increased significantly after restoration of spontaneous circulation (ROSC) in all three groups, and was significantly different between the EPI group and the other two groups immediately after ROSC (both P<0.01), but these differences gradually disappeared over time. There were no significant differences in NE or DA levels among the three groups, and there were no correlations between catecholamine levels and CO or dp/dt (P>0.05).

CONCLUSIONSSFI did not significantly affect endogenous catecholamine levels during cardiopulmonary resuscitation after prolonged ventricular fibrillation. However, SFI improved oxygen metabolism, and produced a better hemodynamic status compared with EPI. SFI might be a potentially vasopressor drug for the treatment of CA.

Animals ; Cardiac Output ; drug effects ; Cardiopulmonary Resuscitation ; Catecholamines ; blood ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Epinephrine ; pharmacology ; therapeutic use ; Heart Arrest ; blood ; drug therapy ; Heart Ventricles ; physiopathology ; Injections ; Lactic Acid ; blood ; Sus scrofa

Objective: To compare the long-term outcomes of intersphincteric (trans-internal and external) sphincter resection (ISR) and abdominoperineal proctocolectomy (APR) for low-grade rectal cancer. Methods: We used a meta-analytic approach to compare these procedures . Published reports comparing ISR and APR for low rectal cancer in Pubmed, Medline, EMBASE and Cochrane, China Knowledge Network (CNKI), China Biomedical Literature Database, and Vipers databases between January 2005 and January 2023 were searched and those meeting the eligibility criteria were selected for extraction of data for analysis. Inclusion criteria were as follows: (1) all reports comparing ISR and APR for low rectal cancer before January 2023; and (2) prospective randomized controlled studies or well-designed cohort studies. Exclusion criteria were as follows: (1) full text not available; (2) duplicate publications, missing primary outcome indicators, and unknown data; and (3) invalid statistical analysis. Results: Sixteen studies with 2498 patients were included in this study. Compared with the APR group, patients in the ISR group were relatively younger (weighted mean difference [WMD]=-1.82, 95%CI=-2.94 to -0.70, P=0.01), had tumors farther from the anal verge (WMD=0.43, 95%CI=0.18 to 0.67, P<0.01), and lower pathological T-stage (T3-4 stage: OR=0.54, 95%CI=0.36 to 0.81, P<0.01). In contrast, there were no statistically significant differences between the two groups in gender (P=0.78), body mass index (P=0.77), or pathological N stage (P=0.09). Compared with the APR group, patients in the ISR group had a lower rate of postoperative complications (OR=0.77, 95%CI=0.60 to 0.99, P=0.04), shorter hospital stay (WMD=-4.30, 95%CI=-7.07 to -1.53, P<0.01), higher 5-year overall survival (HR=0.54, 95%CI=0.33 to 0.88, P=0.01), and higher 5-year disease-free survival (HR=0.65, 95%CI=0.47 to 0.90, P<0.01). Five-year locoregional failure (HR=0.66, 95%CI=0.40 to 1.10, P=0.11) and time to surgery (WMD=-9.71, 95%CI=-41.89 to 22.47, P=0.55) did not differ significantly between the two groups. Conclusion: ISR is a safe and effective alternative to APR for early-stage low-grade rectal cancer.
Humans ; Prospective Studies ; Rectal Neoplasms/pathology* ; Rectum/surgery* ; Proctectomy ; Anal Canal/pathology* ; Treatment Outcome

BACKGROUNDOpen reduction and internal fixation with plate and screws are the gold standard for the surgical treatment of humeral shaft fractures, this study was to compare the mechanical properties of anteromedial, anterolateral, and posterior plating for humeral shaft fractures.

METHODSA distal third humeral shaft fracture model was constructed using fourth-generation sawbones (#3404, composite bone). A total of 24 sawbones with a distal third humeral shaft fracture was randomly divided into three Groups: A, B, and C (n = 8 in each group) for anteromedial, anterolateral, and posterior plating, respectively. All sawbones were subjected to horizontal torsional fatigue tests, horizontal torsional and axial compressive fatigue tests, four-point bending fatigue tests in anteroposterior (AP) and mediolateral (ML) directions and horizontal torsional destructive tests.

RESULTSIn the horizontal torsional fatigue tests, the mean torsional angle amplitude in Groups A, B, and C were 6.12°, 6.53°, and 6.81°. In horizontal torsional and axial compressive fatigue tests, the mean torsional angle amplitude in Groups A, B, and C were 5.66°, 5.67°, and 6.36°. The mean plate displacement amplitude was 0.05 mm, 0.08 mm, and 0.10 mm. Group A was smaller than Group C (P < 0.05). In AP four-point bending fatigue tests, the mean plate displacement amplitude was 0.16 mm, 0.13 mm, and 0.20 mm. Group B was smaller than Group C (P < 0.05). In ML four-point bending fatigue tests, the mean plate displacement amplitude were 0.16 mm, 0.19 mm, and 0.17 mm. In horizontal torsional destructive tests, the mean torsional rigidity in Groups A, B, and C was 0.82, 0.75, and 0.76 N·m/deg. The yielding torsional angle was 24.50°, 25.70°, and 23.86°. The mean yielding torque was 18.46, 18.05, and 16.83 N·m, respectively.

CONCLUSIONSAnteromedial plating was superior to anterolateral or posterior plating in all mechanical tests except in AP four-point bending fatigue tests compared to the anterolateral plating group. We can suggest that anteromedial plating is a clinically safe and effective way for humeral shaft fractures.

Biomechanical Phenomena ; Bone Plates ; Fracture Fixation, Internal ; Humans ; Humeral Fractures ; surgery ; Humerus ; surgery ; Models, Anatomic ; Stress, Mechanical

BACKGROUNDMalignant tumor is the most common complication occurred in transplant recipients. It is widely recognized that immunosuppressive treatments increase the risk of cancer in transplant recipients. The efficacy and safety of rapamycin (RPM) in combination with low-dose calcineurin inhibitor (CNI) in treating 15 renal allograft recipients which developed urothelial carcinoma were observed.

METHODSImmunosuppressive regimen in all recipients was altered with rapamycin to replace mycophenolate mofetil (MMF) or azathioprine (Aza). The initial loading dosage was 2 mg/d, and the next dosage was 1 mg/d. The dosage of rapamycin was carefully adjusted according to the blood drug level and concentration of the drug was maintained at 4 - 6 microg/L. In all the 15 patients, the calcineurin inhibitor was reduced down to one third of the original dosage after the rapamycin blood concentration became stable. Surgical treatment and intravesical instillation chemotherapy were carried out in all patients. Recurrence of the tumor was monitored throughout the study. Post-transplant renal function and side effects were also closely monitored.

RESULTSAmong the 15 patients, 9 had no tumor recurrence in 2 years, 2 had tumor recurrences twice, and 4 had once. There was no acute rejection observed during RPM treatment. Post-transplant renal function in 11 patients was improved, with a decreased creatinine level. Hyperlipoidemia and thrombocytopenia were the most frequent adverse events which responded well to corresponding treatments.

CONCLUSIONAmong the renal allograft recipients with urothelial carcinoma, combination of rapamycin and low dose calcineurin inhibitor treatment is effective and safe.

Adult ; Azathioprine ; therapeutic use ; Female ; Humans ; Immunosuppressive Agents ; therapeutic use ; Kidney Transplantation ; adverse effects ; Male ; Middle Aged ; Mycophenolic Acid ; analogs & derivatives ; therapeutic use ; Sirolimus ; therapeutic use ; Urinary Bladder Neoplasms ; drug therapy ; pathology ; Urothelium ; pathology

Adult ; Aged ; Bone Marrow Transplantation ; Chromosome Aberrations ; Female ; Humans ; Leukemia, Myeloid, Acute ; genetics ; immunology ; therapy ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; Psoriasis ; complications ; genetics ; immunology ; Transplantation, Homologous