Objective To investigate the serum concentration of vascular endothelial growth factor (VEGF) and its soluble receptor 1 (sFlt-1) in patients with systemic lupus erythematosus (SLE) and its correlation with clinic and pathologic parameters.Methods serum levels of VEGF and sFlt-1 in a group of 60 patients with SLE and 30 healthy controls were assessed by ELISA.Results The VEGF and sFlt-1 serum levels were higher in active SLE group than the control group (P＜0.01).The VEGF/sFlt-1 ratio in the control group was lower than that in the active SLE group.inactive SLE group and LN group (P＜0.01).Particularly the ratio increased in WHO class Ⅴ LN group compared to WHO classⅡ,Ⅲ,Ⅳ LN group (P＜0.05).The semm level of sFlt-1 was correlated to proteinuria (rs=0.6244,P＜0.01) and ESR (rs=0.4235,P＜0.01) and the serum levels of VEGF and sFlt-1 were correlated to the systemic lupus erythematosus disease activation index (SLEDAI) (rs=0.5046,P＜0.01 and rs=0.5152,P＜0.01,respectively).The serum level of VEGF was correlated with renal tissue activation index (RAI) (rs=0.3386.P＜0.05) and the serum levels of VEGF and sFlt-1 were not correlated to blood pressure,serum creatine,blood ureanitmgen,C3,C4,C-reative protein.The muhi-factors stepwise regression analysis indicated that serum VEGF was positively correlated with SLEDAI (R2=0.1 75,P＜0.05),serum sFlt-1 was positively correlated with ESR and proteinurine (R2=0.497,P＜0.05).Conclusion Serum VEGF and sFlt-1 are elevated in patients with active SLE and they can reflect the activity of the disease.The overcxpression of serum VEGF might be correlated to the proliferated glomerulonephritis and the overexpression of sFlt-1 contribhtes to proteinurla.The imbalance between these two factors may act an important role in SLE pathogenesis.

In order to find a new TPO-mimic peptide with similar activity to TPO while reducing the side effects, a TPO-mimic peptide (P1) screened from a random peptide library was restructured. The new structure of the TPO mimic peptide (P2) was synthesized. After coupling P2 with Dextran 10 and performing intermolecular oxidation, dextran-coupled and dimerized form of P2 were obtained, naming D-P2 and (P2)(2) respectively. The activities of the peptides in vitro were measured with MTT method. The results showed that the EC50 of P2 was 20 nmol/L, 700 times higher than P1. The EC50 of D-P2 and (P2)(2) were 0.35 nmol/L and 0.14 nmol/L, respectively. After administrating to the mouse, the peptides increased the number of platelets in the blood circulation obviously without influence on other blood cells. In conclusion, the TPO-mimic peptides have prospects in treating diseases related with thrombocytopenia.
Animals ; Female ; Male ; Mice ; Platelet Count ; Thrombopoietin ; analogs & derivatives ; chemical synthesis ; pharmacology

Objective TodiscusstheevaluationeffectivenessofADCofMR DWIinneoadjuvantchemotherapy (NAC).Methods ThirtyGninepatientswithlocallyadvancedbreastcancerwereenrolledinthisstudy.Allthesepatientswerediagnosedbypuncture biopsyandtreatedwithNAC.DWIwasperformedbeforechemotherapyandafter4cyclesofchemotherapyrespectively.Radicalresectionof breastcancerwasperformedwithinoneweekaftertheendof4cyclesofNAC.Accordingtotheclinicalefficacyorpathologicalresponse,the changesoftumorvolumeandtumorcelldensitybeforeandafterchemotherapyweremeasured.Theresponseoftumorwasdividedas clinicallyeffective,completeremission (CR)+partialremission(PR)andclinicalineffectiveness,stabilizationdisease(SD)+progression disease(PD)ormajorhistologicalresponse (MHR)andnonGmajorhistologicalresponse (NMHR),respectively.Toevaluatethe practicalutilityofneoadjuvantchemotherapy,theADCvaluesweremeasuredinallgroupsandanalyzedstatistically.Results Before NAC,therewasnosignificantdifferenceinADCvaluebetweenCR+PR (0.96±0.22)andSD+PD (0.93±0.14)orMHR (1.05±0.22), NMHR (0.99±0.14).TheratiosofCR+PRand MHR were56.4%and66.7%respectivelyattheendoftreatment,andtheADC valuesinallpatientswerehigherthanthatbeforechemotherapy.However,Therewasnosignificantdifferencebeforeandafterchemotherapy intheSD+PD (1.02±0.19)andNMHR (1.08±0.20)groups (P＞0.05),whileCR+PR (1.47±0.16)and MHR (1.62+0.13) groupsweresignificantlydifferentbeforeandafterchemotherapy(P＜0.05).Therateoftumorvolumechangewaspositivelycorrelated withΔADC (r＝0.539,P＜0.05).Conclusion TheADCvalue canbeusedtoevaluatethevolumeandpathologicalgradeof tumorafterNACbasedon MRIplainscananddynamicscan, whichishelpfulfortimelyandeffectivepredictiveevaluationof chemotherapyeffect.ADCvaluecanbeusedasearlyevaluationofNACforbreastcancerandprognosticindicators.

Due to factors such as an aging population, the Hospital Authority(HA) of Hong Kong is facing a contradiction between limited health resource supply and continuously increasing demand. In order to effectively address challenges, the HA prompted three measures to bridging the demand-supply gap. The HA relied on its management system advantages to continuously increase its capital construction to enhance the service capacity of public health institutions; transformed service delivery mode so as to improve the experience, quality, and efficiency of service delivery; established cooperation with private service providers and communities to shunt population health demand. The practices of HA can provide reference for public hospitals and their sponsors in other regions of China.

OBJECTIVE: To investigate the age distribution characteristics of intestinal segmented filamentous bacteria (SFB) in children and their relationship with intestinal mucosal immunity. METHODS: The fresh feces of 177 children and the ileocecal fluid of 47 children during colonoscopy were collected. The SFB was determined by real-time PCR. The concentration of secretory immunoglobulin A (sIgA) was determined by enzyme-linked immunosorbent assay. The numbers of interleukin 17A (IL-17A) cells and intraepithelial lymphocytes in the terminal ileum mucosa and the expression of transcription factors associated with the differentiation of T helper (Th) cells, T-box transcription factor (T-bet), forkhead box P3 (FOXP3), and retinoid-related orphan receptor gamma t (ROR-γt), were determined by immunohistochemistry. RESULTS: The positive rate of intestinal SFB in these children was 19.2% (34/177). Trend analysis showed that the positive rate of SFB was correlated with age: the rates for children aged 0-, 1-, 2-, 3-, 4-, 5-, 6-, and 7-15 years were 40%, 47%, 32%, 15%, 12%, 13%, 15% and 4% respectively (P<0.001). The concentration of sIgA in intestinal fluid was significantly higher in SFB-positive children (n=24) than in SFB-negative children (n=23) (P<0.01). The number of intraepithelial lymphocytes in the terminal ileum mucosa and the expression of T-bet, FOXP3, and ROR-γt were not significantly different between the SFB-positive group (n=12) and the SFB-negative group (n=11), but the number of IL-17A cells in the terminal ileum mucosa was significantly lower in the SFB-positive group than in the SFB-negative group (P<0.05). CONCLUSIONS Intestinal SFB colonization in children is age-related, and the colonization rate is relatively high in children under 3 years old. In SFB-positive children, the secretion of intestinal sIgA is increased, while the number of IL-17A cells in the terminal ileum is reduced.
Adolescent ; Age Distribution ; Bacteria ; Child ; Humans ; Immunity, Mucosal ; Intestinal Mucosa

OBJECTIVETo compare the efficacy and safety of standard or reduced doses of bortezomib combined with adriamycin and dexamethasone (PAD) in patients with multiple myeloma (MM).

METHODSEighty-two newly diagnosed or refractory/relapsed patients received bortezomib [either 1.2-1.3 mg/m(2) (standard dose) or 1.0-1.1 mg/m(2) (reduced dose) on day 1, 4, 8 and 11], and adriamycin (10 mg/m(2)) plus dexamethasone (40 mg/m(2)) on day 1-4 at 3-week intervals for 1 to 6 courses. The International Myeloma Working Group Criteria were used to evaluate the response. Adverse events were graded according to the National Cancer Institute Common Toxicity Criteria (Version 3.0).

RESULTSTwo courses of standard dose of PAD resulted in a similar response rate of partial and very good partial complete remissions (PR) compared with reduced dose (80.0% vs 80.8%, P=0.728). Grade III- Ⅳ neutropenia and thrombocytopenia were higher with standard dose than that with reduced doses of PAD (21.1% vs11.1%, P=0.270; 10.5% vs 6.3%, P=0.619, respectively). Grade III-Ⅳ bortezomib-induced peripheral neuropathy, herpes zoster, fatigue or abdominal distention were significantly higher with standard dose than that with reduced dose of PAD (15.8% vs 1.6%, P=0.037; 26.3% vs 6.3%, P=0.028; 36.8% vs 14.3%, P=0.046; 15.8% vs 1.6%, P=0.037, respectively).

CONCLUSIONReduced dose of PAD appears to result in a similar overall response rate, but a better tolerance and safety compared with standard dose.

Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Boronic Acids ; administration & dosage ; adverse effects ; therapeutic use ; Bortezomib ; Dexamethasone ; administration & dosage ; adverse effects ; Doxorubicin ; administration & dosage ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; drug therapy ; Pyrazines ; administration & dosage ; adverse effects ; therapeutic use ; Treatment Outcome

OBJECTIVETo investigate the prevalence of influenza virus infections in children in 2006 using the real-time PCR method.

METHODS(1) Consulting the most conserved sequence NP gene of influenza virus, after comparing with the NP gene sequences of influenza virus in GenBank, one pair of specific primers and one TaqMan probe were designed for each subtype of influenza virus by the software Primer Express. The sensitivity of influenza was evaluated by testing known positive samples which had been two-fold diluted. The specificity of real-time PCR for influenza virus detection was assessed by cross testing 60 isolates of influenza A, 16 isolates of influenza B, and by testing a variety of other respiratory viruses positive samples; (2) 281 nasopharyngeal aspirate samples were detected by real-time PCR and virus isolation; (3) the 12 301 specimens from the patients of Guangzhou Children's Hospital were tested by using the real-time PCR method. Furthermore, the real-time PCR reagent was evaluated by comparing with the result of virus isolation.

RESULTS(1) The sensitivity of real-time PCR developed in this study for influenza A detection was 1:2(22) and for influenza B was 1:2(20) in two-fold serially diluted way. (2) No positive results were found in cross testing of other viruses positive specimens. (3) Influenza virus was detected from 1687 cases (13.71%) out of the 12 301 cases, including 773 cases (45.8%) positive for subtype A and 914 cases (54.2%) positive for subtype B; 455 out of 525 (86.7%) of influenza B positive specimens and 70 out of 525 (13.3%) of influenza A (H1N1) positive specimens were from patients seen during January to April; 419 out of 1118 (37.5%) specimens positive for influenza B and 699 out of 1118 (62.5%) specimens positive for influenza A (H1N1) were from patients seen from May to August. Influenza virus could be identified from 1380 samples by the methods of virus isolation, accounting for 81.80% of the 1687 positive samples detected by real-time PCR. All the influenza virus subtype A was H1N1.

CONCLUSIONThe real-time PCR method developed in this study was sensitive and specific for detecting influenza A and B in clinical specimens. During 2006, influenza A and influenza B co-circulated. The predominant virus was influenza B from January to April, peaking in April. Influenza A (H1N1) prevailed from May to August, with the peak in June.

Child ; China ; epidemiology ; Epidemics ; Humans ; Influenza A Virus, H1N1 Subtype ; isolation & purification ; Influenza, Human ; epidemiology ; virology ; Polymerase Chain Reaction ; methods ; Prevalence ; RNA, Viral ; isolation & purification ; Sensitivity and Specificity

OBJECTIVEObesity is a major risk factor for type 2 diabetes, many indexes can be used to describes obesity and predict diabetes. This research attempts to identify the best indicator of obesity to screening diabetes in Chinese population.

METHODSA cross-sectional data of 8121 subjects aged 35-60 years were included in this research belongs to the Diabetes Appropriate Technology Intervention Study. Anthropometric indicators including body weight, height, waist circumferences (WC), body fat index (BFI) and visceral fat index (VFI) and blood biochemical indicators after an overnight fast [fasting blood glucose, total cholesterol, high-density lipoprotein (HDL) cholesterol, and triacylglycerol] were measured. BMI (body mass index) and Weight to Height Ratio was calculated.

RESULTSSubjects with obesity had a higher risk of physician diagnosed diabetes (OR=2.50, 95% CI 1.83-3.43), new diagnosed diabetes (OR=4.23, 95% CI 2.91-6.15) and pre-diabetes (OR=1.75, 95% CI 1.31-2.34) compared to those with normal Body mass index (BMI). There was a significant trend of increased risk of all diabetes status with increased waist circumference (WC). The waist-to-height ratio (WHtR) yielded the most significant association with new diagnosed diabetes and physician diagnosed diabetes than other indices.

CONCLUSIONCentral obesity is significantly correlated with diabetes. VFI was most correlated with pre-diabetes while WHtR is an efficient screening index than BMI and WC in Chinese community diabetes screening.

Adipose Tissue ; physiology ; Adult ; Aged ; Asian Continental Ancestry Group ; Blood Glucose ; Body Mass Index ; China ; epidemiology ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; epidemiology ; etiology ; pathology ; Female ; Humans ; Male ; Middle Aged ; Obesity ; complications ; Waist Circumference ; Waist-Hip Ratio

Objective:To study the clinical features, diagnosis, treatment and genetic characteristics of neonatal-onset protein C deficiency (PCD).Methods:The clinical data of a newborn patient with severe PCD admitted to our neonatal department was reviewed. Databases including CNKI, Wanfang Database, CMB, VIP database, PubMed, Embase and SCI database were searched using" infantile", " neonate ", "newborn", "protein C deficiency" and "purpura fulminans" as key words. Published cases of PCD were analyzed.Results:The patient was a full-term female infant who developed multiple symptoms within 2 days after birth. The symptoms included thrombocytopenia, intracranial hemorrhage, purpura fulminans (PF), disseminated intravascular coagulation (DIC), celiac hemorrhage, hypertension, portal and iliac vein thrombosis, purulent meningitis and retinal detachment. Protein C activity was less than 10%. Genetic tests showed compound heterozygous mutations c.314G>T (p.c105f) of paternal origin and c.1218G>A (p.m406i) of maternal origin in PROC gene. According to ACMG guidelines, the mutations were strongly suspected pathogenic variants and consistent with an autosomal recessive (AR) inheritance pattern. The patient was discharged after 6 weeks of treatment at parents' request of withdrawal. A total of 25 articles on 29 patients with relatively complete clinical data were retrieved, including 18 males and 11 females. 4 patients were preterm and 25 full-term. 28 patients showed symptoms within 7 days after birth. The common clinical features were cutaneous PF and splanchnic thrombi. 22 cases documented protein C activity and ranged from 0 to 25%. 16 patients had PROC gene abnormalities and compound heterozygous mutations were found in 10 patients. Among the 22 patients with prognostic data, 11 died (9 within 3 months after birth), the remaining survivors suffered from sequelae including severe intellectual motor development disorder, epilepsy and blindness.Conclusions:The main clinical manifestations of neonatal-onset PCD include PF, DIC, multi-organ hemorrhage and thrombus. The disease is acute and severe, with rapid progression, poor prognosis and high fatality rate. Protein C activity and PROC gene testing may help establish the diagnosis.

OBJECTIVETo discuss the correlation between sonographic appearance of different degrees of acute unilateral testicular ischemia and histological changes of the testis after reperfusion.

METHODSThirty-two male rabbits were equally divided into a control (sham operation) group and 3 ischemia groups. Unilateral testicular ischemia models were established under the color Doppler ultrasound (CDU) observation and allocated according to different degrees of ischemia to Group A (with homogeneous echoes and slightly decreased flow signals), B (with heterogeneous echoes and obviously decreased flow signals) and C (with radial or small-shredded low echoes and absence of flow signals). Then contrast-enhanced ultrasonography (CEUS) was performed, followed by reperfusion of the ischemic testes. A month later, the histological changes of the testes were observed and the correlation of the histological changes with the sonographic and CEUS manifestations was analyzed.

RESULTSConcerning the CEUS parameters such as the arrival time (AT), reperfusion rate, time-to-peak (TTP), half descent time (DT/2) of the ischemic testes, Groups A and B showed significant differences from the control group (P < 0.05). The peak-base difference (PBD) was significant in Group B (P < 0.05) but not in A (P > 0.05), and no enhancement was seen in Group C. As for Johnson's scores obtained 1 month later, Group A exhibited no significant difference (8.70 +/- 0.39) (P > 0.05), Group B showed significant difference (6.01 +/- 0.88) (P < 0.05), and Group C extremely significant difference (3.16 +/- 1.05) (P< 0.001) from the control group (9.10 +/- 0.11).

CONCLUSIONCEUS is superior to CDU in evaluating the perfusion of testicular ischemia. Sonographic appearances of testicular ischemia are significantly correlated with histological changes of the testis after reperfusion. Ultrasonography helps to predict the spermatogenetic function of ischemic testes after reperfusion.

Animals ; Disease Models, Animal ; Ischemia ; diagnostic imaging ; pathology ; Ischemic Preconditioning ; Male ; Rabbits ; Reperfusion Injury ; diagnostic imaging ; pathology ; Testicular Diseases ; diagnostic imaging ; pathology ; Testis ; diagnostic imaging ; pathology ; Ultrasonography, Doppler, Color