Objectives Understanding the characteristic changes of Keshan disease (KD) in different epidemic period to provide reference basis for prevention and teatment. Methods On the basis of medical record as fundamental element, the relative conditions of Keshan disease's prevailing and spreading period were compared. Results In high incidence years, familial aggregation [accounted for 12%(6/50)] and seasonal aggregation were found, and KD cases occurred mainly from May to September, which was 78% (39/50)of the total cases in the whole year. Circulatory dysfunction(gallop rhythm, pulmonary role, jugular venous engorgement, cyanosis of lips) was more severe in high incidence years than that in low incidence years(X2=8.53,P<0.01). The average age of incidence was (4.07±1.46) years old in high incidence years and (6.11±2.71) years old in low incidence years. The type constitution in high incidence years was significantly different from that in low incidence years (X2=40.68, P<0.01), and chronic type of KD accounted for 22.85%(707/3094),46.09%(53/115), respectively, in high and low incidence years. Conclusions Making a further research of seizure of disease, and improving diagnosis and cure management level are also the important content for prevention and cure research work of Keshan disease at right time.

AIM: To explore the relationship of central retinal vein occlusion ( CRVO) and atherosclerosis ( AS) .
METHODS:Fifty cases of CRVO patients were chosen as the observation group in our hospital from October 2012 to October 2014, other 50 patients with AS ( non-CRVO) as control group. In the control group, 22 cases of AS mild stenosis, moderate stenosis in 24 cases, 4 cases of severe stenosis ( 3 cases implanted stent ) . According to the severity, two grade prevention primary prevention therapy, and cerebral vascular disease treating stroke, corresponding drug treatment was undergone. Two groups of patients were performed cervical carotid artery color Doppler ultrasound examination, including assessing plaque, carotid artery intima-media thickness ( IMT) , the degree of stenosis of internal carotid artery blood flow velocity and the systolic peak ( PSV ) , end diastolic blood flow velocity ( EDV) , resistance index ( RI) values for kinetic parameters etc. All the indexes of the two groups were compared with color Doppler ultrasound examination results, to evaluate the correlation between CRVO and AS.
RESULTS: In the observation group, 15 cases were detected of carotid artery with mild stenosis, 28 cases of arterial diameter reduced <50%, carotid artery moderate stenosis, arterial diameter was reduced from 50% ~69%, 6 cases of carotid artery stenosis, arterial diameter was reduced from 70% ~99%, 1 patient with ipsilateral carotid artery near occlusion. In the control group, 22 cases were of AS mild stenosis, moderate stenosis in 24 cases, 4 cases of severe stenosis ( 3 cases implanted stent ) . The eyes with CRVO increased IMT, PSV and EDV decreased, RI value increased (P<0. 05). Compared with the control group, hypertension, hyperlipidemia, hypercholesterolemia, diabetes mellitus in observation group were statistically significant difference (P<0. 05). The control group of 2a of follow-up showed no recurrence during CRVO.
CONCLUSION: CRVO and AS are highly correlated, the neck of Doppler ultrasound examination can clearly reflect the central retinal vein blood supply, the standard treatment for AS disease, can reduce the risk of CRVO, with certain clinical significance.

Streptomyces sp. A048 was cultured in a complete medium to the last stage of log phase,the hyphae were washed and collected by centrifugation. Then the hyphae were inoculated in liquid medium for chitinase production using two-step fermentation. Activity of chitinase produced by two-step fermentation was 1.1 times higher than that from one-step fermentation,and ferment cycle was for 54 hours,which was 66 hours shorter than that of one-step fermentation. The hyphae and the powder of chitin were co-immobilizated and cultured in liquid medium for 36 hours,activity of chitinase was 1.8 times higher than that from one-step fermentation,and ferment cycle was 54h shorter than that of one-step fermentation. By adding 0.4% cellulose to two-step fermentation,activity of chitinase was 18.52 U/mL that was 4 times higher than that from the control and 10 times higher than that from one-step fermentation. Two step fermentation with chitin and cellulose may be the optimal fermentation process to produce Chitinase from Streptomyces sp. A048.

Objective:Clinicopathological features, treatment and prognosis of urinary and male reproductive system soft tissue sarcoma (STS) and sarcomatoid carcinoma in adults were compared.Methods:A retrospective analysis was performed on the clinical data of 73 patients with STS and 15 patients with sarcomatoid carcinoma in adult urinary and male reproductive system in the First Affiliated Hospital of Zhengzhou University. There were 59 males and 14 females in STS group, with a median age of 41 (18-78)years old. The maximum tumor diameter ranged from 0.5 to 19.0 cm. The primary tumors were located in testis and peritesticular (23 cases), kidney (23 cases), prostate (15 cases), bladder (8 cases), ureter(3 cases), other parts(1 case). There were 18 cases of lymph node metastasis and 8 cases of distant metastasis. Among 73 patients with STS, 66 patients underwent surgical resection, of which 31 patients underwent radical resection. Among the 66 patients who underwent surgery, 3 patients received neoadjuvant chemotherapy; 22 patients received adjuvant chemotherapy; 5 patients were treated with adjuvant radiotherapy. Among 7 patients with STS did not receive surgical treatment, 2 patients received radiotherapy combined with chemotherapy, 2 patients received chemotherapy alone, and 3 patients received symptomatic support treatment.There were 11 males and 4 females in sarcomatoid carcinoma group, with a median age of 65 (23 - 84)years old. The measurable tumor diameter ranged from 0.4 to 16.9 cm. The primary tumors were located in kidney (6 cases), bladder (5 cases), ureter(2 cases) and prostate(2 cases). There were 2 patients of lymph node metastasis and 4 patients of distant metastasis. Of the 15 patients with sarcomatoid carcinoma, 12 patients underwent surgical resection, of which 5 patients underwent radical resection. 2 patients were treated with adjuvant therapy after operation. Among the 12 patients who received surgical treatment, 2 patients had distant metastasis before operation, all of which originated from the kidney. Among the 3 patients without surgical treatment, 1 patients received systemic chemotherapy and 2 patients received symptomatic supportive treatment. There was no significant difference in gender, tumor maximum diameter, distant metastasis and operation, chemotherapy, radiotherapy and operation combined with chemotherapy ( P>0.05) and there were significant differences in age, tumor primary location and lymph node metastasis ( P<0.05) between STS and sarcomatoid carcinoma patients.The categorical variables of the two groups were compared by χ2.With Kaplan-Meier method for univariate survival analysis, the Cox was used for multivariate analysis. Results:The median follow-up time was 18.3(0.3-90.4) months.In STS group, there were 14 patients of synovial sarcoma, 11 patients of liposarcoma, 15 patients of rhabdomyosarcoma, 16 patients of leiomyosarcoma, 10 patients of other types, and 7 patients of spindle cell sarcoma without specific classification. Among 66 patients with STS, 8 patients recurred, 14 patients metastasized after operation, 4 patients recurred and metastasized after operation. The 7 patients without surgical treatment all progressed. Among the 10 patients of sarcomatoid carcinoma without distant metastasis before operation, 3 patients recurred and 3 patients metastasized after operation. Two patients of renal sarcomatoid carcinoma with distant metastasis were treated with nephrectomy and chemotherapy. One of them had overall survival (OS) up to 2 years, and one recurred 2 months after operation. The 3 patients without surgical treatment all progressed without remission. The median OS of STS patients were 59.3 (95% CI 24.1-94.5) months and that of sarcomatoid carcinoma patients were 8.7 (95% CI 6.1-11.2) months. The OS of STS patients were better than those of sarcomatoid carcinoma patients ( HR=2.874, 95% CI 1.118-7.386, P=0.022). Conclusions:The onset age of STS in adult urinary and male reproductive system was lower than that in sarcomatoid carcinoma. The primary lesions of STS were mainly in testis, peritesticular and kidney. The primary lesions of sarcomatoid carcinoma were mainly in kidney. Among STS, leiomyosarcoma was the most common type.STS and sarcomatoid carcinoma should be diagnosed and treated with surgery quickly, and systemic therapy should be performed for patients who cannot be treated with surgery.

Objective To evaluate the intervention effects of low-fluoride brick tea in the population, and to provide data for the prevention and control of the brick-tea type fluorosis. Methods Eighty-six Kazakh families with 5-12 years old children were selected and divided into two groups in the severe brick-tea type fluorosis areas of Akesai County of Gansu Province. Forty-six households were intervened by drinking low-fluoride brick tea as intervention group and another 40 households drank general brick tea as control group. The fluoride content in water, tea and urine was monitored and the total daily fluoride intake of adults and children was calculated by the fluoride content of the tea before and during intervention. The baseline prevalence of dental fluorosis was surveyed in all Kazakh school students aged 5 - 12 years before intervention, dental fluorosis prevalence were surveyed in two groups after the intervention. The fluoride content in water, urine,tea, and brick-tea samples was detected by iron electrode method, and dental fluorosis was diagnosed by Dean's method. Results The fluoride content of water were 0.36,0.50 mg/L respectively before and 42 months after intervention. The total daily fluoride intake of adults and children in the intervention group (being 4.39,5.12,5.38,4.49 mg in adults and 1.90,2.33 in children, 2.33, 1.94 mg for four calculations) were lower than those in control group (8.42,9.07,8.35,7.92 and 3.65,3.93, 3.62,3.43 mg). Except the second batch (530.4 mg/kg), the average fluoride content of the other 3 batches of low-fluoride brick tea(239.3,222.88,154.7 mg/kg) was lower than that of 4 batches of market brick tea(366.9,412.2, 286.0,379.6 mg/kg). The fluoride content of low-fluoride brick tea samples was in accordance with the national standard(< 300 mg/kg) in 16 of 21 samples in 4 the batches, and the qualifying rate was 76.19%(16/21). Only 5 of 21 market brick tea samples in 4 batches was qualified, accounting for 23.80%(5/21), both were significantly different(χ2= 11.52, P < 0.01). In 12, 36, 42 months after intervention, urine fluoride content in the intervention group of adult(1.84,1.23,1.77 mg/L) and children(1.55,0.65,1.10 mg/L) was less than that of the control group (adults: 3.37,3.68,3.02 mg/L, children: 2.64,1.64,2.62 mg/L), both being statistically significant (t value were 2.94,2.43,3.91,3.29,2.31,4.42, P < 0.01 or 0.05). The detective rate of dental fluorosis was 69.02%(127/184)at baseline among children. After the intervention, it lowered to [44.83% (13/29) in the intervention group, significantly lower than that in the control group[71.88%(23/32), χ2 = 4.60, P < 0.05]. Conclusion Low-fluoride brick tea can reduce the fluoride intake of the residents who drink brick tea, and alleviate excessive fluoride and the damage of high-fluoride.

Leukemia is a type of malignant tumors of hematopoietic system with the abnormal increased immature leukemia cells showing metastasis and invasion ability. Liver is one of the main targets of the leukemia cells spread to, where they may continue to proliferate and differentiate and cause liver function damage, even liver failure. Our previous studies showed that Angelica polysscharides (APS), the main effective components in Angelica sinensis of Chinese traditional medicine, was able to inhibit the proliferation and induced differentiation of the leukemia cells, however, its effect on the liver during the treatment remains elucidated. In the present study, the human leukemia NOD/SCID mouse model were established by implantation human leukemia K562 cells line, then the leukemia mouse were treated with APS, Ara-c or APS + Ara-c respectively by peritoneal injection for 14 days, to explore the effect and mechanism of the chemicals on the mouse liver. Compared to the human leukemia NOD/SCID mouse model group with the treatments of APS, Ara-c and APS + Ara-c, We found that severe liver damage and pathological changes of the liver were able to alleviate: First, the number of white blood cells in the peripheral blood was significantly lower and with less transplanted K562 leukemia cells; Second, liver function damage was alleviated as liver function tests showed that alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBiL) were significantly reduced, while the albumin (Alb) was notably increased; Third, liver antioxidant ability was improved as the activities of the antioxidant enzymes glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) were significantly increased, and the contents of GSH and malonaldehyde (MDA) were decreased significantly in the liver; Fourth, the inflammation of the liver was relieved as the level of IL-1beta and IL-6, the inflammatory cytokines, were decreased significantly in the liver. Fifth, liver index was increased as the pathological observation showed that leukemia cells with diffused infiltration into the liver lobules were significantly reduced and with a remarkable increase of apoptotic positive cell rate by TUNEL test. Furthermore, the APS + Ara-c combined administration showed an even more significant positive effect. In conclusion, the APS, Ara-c therapy reduced the accumulation of leukemia cells within the liver, reduced the liver function damage and levels of inflammatory factors, improved antioxidant capacity of the liver tissue and thus alleviate the pathological changes of the liver. Moreover, the APS + Ara-c combination therapy may have an additive effect.
Angelica ; chemistry ; Animals ; Antineoplastic Combined Chemotherapy Protocols ; pharmacology ; Cell Line, Tumor ; Cytarabine ; administration & dosage ; Humans ; K562 Cells ; Leukemia ; drug therapy ; Liver ; drug effects ; Male ; Mice ; Mice, SCID ; Polysaccharides ; administration & dosage

This study was purposed to analyze the characteristics of morphology, immunology, cytogenetic and molecular biology of leukemia cells in 12 AML patients with Ph(+) and their correlation with survival of patients. 12 patients with Ph(+) AML were diagnosed according to diagnostic criteria of WHO and existence of t(9;22) (q34;q11) or t(9;22) abnormality, meanwhile no evidence of CML chronic phase was observed. The results showed that 8 out of 12 cases were confirmedly diagnosed to be AML by morphologic and immunophenotypic examination, 4 cases were diagnosed as myeloid and B lymphocytic mixed acute leukemia. The Ph chromosome was detected in 10 cases by chromosome analysis at the first time of diagnosis, and some of the cases had coexistence of complex chromosome and/or normal karyotype. BCR-ABL transcript was detected in all 12 cases, including 7 cases with b3a2, 1 case with b2a2, 1 case with b2a2 variants, 2 cases with e1a2 and 1 case with e18a2. The 12 cases all got complete remission after chemotherapy and/or gleevec treatment, out of them 3 cases received chemotherapy and gleevec treatment, but 2 cases died; 9 cases received allogeneic hematopoietic stem-cell transplantation (allo-HSCT), 1 case died from relapse, among them 1 case died from transplant complications. The median survival was 24 (8 - 80) months, the overall survival of 3 years was (51.4 ± 17.7)%. It is concluded that the Ph(+) AML is a acute myelogenous leukemia with poor prognosis, but long-term survival may be achieved with HSCT as quick as after complete remission from gleevec and chemotherapy treatment. Meanwhile, the detection of BCR-ABL gene and it variants may be give more opportunity for diagnose and treatment, which can be used as routine screening for newly diagnosed leukemia.
Adult ; Child ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; diagnosis ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; Prognosis

In order to investigate the expression of serum sHLA-G in hemophagocytic syndrome (HPS) patients and to evaluate its clinical significance, the clinical data of HPS patients in Capital Medical University Beijing Friendship Hospital during the period from September 2008 to July 2010 were collected. They were divided into infection-associated HPS, tumor-associated HPS and rheumatological disease-associated HPS according to cause of diseases. The serum concentration of sHLA-G in HPS patients and 25 healthy controls was measured by enzyme-linked immunosorbent assay (ELISA), the correlations between sHLA-G level and laboratory indicators were analyzed. The results showed that the level of serum sHLA-G in HPS patients was significantly higher than that in healthy controls (p = 0.003), but the difference was not statistically significant between HPS groups of different causes (p = 0.233). The positive correlation of sHLA-G level in HPS patients with platelet count was found, but there was no positive correlation of their sHLA-G levels with WBC, Hb, Plt, ALT, AST, LDH, Alb, TBil, DBil, IBil, Cr, BUN, TG, fibrinogen and ferritin levels detected on same day. It is concluded that the the increase of serum sHLA-G levels in HPS patients may be caused by different factors such as infection, tumor, T cell activation and over-stimulation of several cytokines. sHLA-G can inhibit NK cell activity, resulting in formation of abnormal immune storm, and may be play a role in the pathogenesis of HPS.
Adolescent ; Adult ; Case-Control Studies ; Child ; Child, Preschool ; Female ; HLA-G Antigens ; blood ; Humans ; Killer Cells, Natural ; metabolism ; Lymphohistiocytosis, Hemophagocytic ; blood ; Male ; Middle Aged ; Young Adult

OBJECTIVETo study the potential relationship between HHV-6 activation and acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic cell transplantation (HSCT).

METHODSPeripheral blood samples were collected before and weekly after HSCT from 72 consecutive recipients. HHV-6 DNAemia was monitored by nested polymerase chain reaction (PCR). The genotypes of HHV-6 were identified by Hind III restriction assay.

RESULTSOf the 72 patients, HHV-6 DNAemia were detected in 45 (62.5%) on a median of day 14 (range, 7 - 63 days) after HSCT. Grade I - IV aGHVD occurred in 40 (55.6%) on a median of day 26 (range, 9 -73 days). The median onset time of HHV-6 DNAemia was significantly earlier than that of aGHVD (P = 0.018). Compared with that in HHV-6 DNAemia negative [HHV-6(-)] patients, the cumulative incidence of grade I - IV aGHVD was higher (68.9% vs. 33.3% , P = 0.003) in HHV-6 (+) patients. Cumulative incidence of grade II - IV aGVHD in HHV-6 (+) cohort was also higher than that in HHV-6 (-) cohort (35.6% vs 14.8% , P = 0.027). Cumulative incidence of grade I - IV aGVHD was higher in patients with both HHV-6 and CMV positive (CMV+/HHV-6+) than in those with either CMV (CMV+/HHV-6-) or HHV-6 positive (CMV+/HHV-6+) and neither of them positive (CMV-/HHV-6-) [78.9% (30/38), 55. 6% (5/9) , 14. 3% (1/7) and 22. 2% (4/18), respectively, P = 0. 0001]. Cumulative incidence of grade II - IV aGVHD in CMV+/HHV-6+ group was also higher than that in CMV+/HHV-6-, CMV-/HHV-6+ and CMV-/HHV-6- groups [42.1% (16/38), 22.2% (2/9), 0% (0/7) and 11.1% (2/18), P = 0. 008].

CONCLUSIONSPatients with HHV-6 activation or HHV-6/CMV co-infection maybe involved in the occurrence of aGVHD after HSCT.

Cytomegalovirus ; genetics ; isolation & purification ; Genes, Viral ; Graft vs Host Disease ; etiology ; virology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Herpesvirus 6, Human ; genetics ; physiology ; Humans ; Polymerase Chain Reaction ; methods ; Postoperative Complications ; etiology ; virology ; Roseolovirus Infections ; etiology

OBJECTIVETo assess the efficacy and safety of hyaluronate sodium (HS) for internal derangement of temporomandibular joint by means of systematic review on relevant randomized controlled trials.

METHODSAfter identifing the study question of the efficacy and safety of HS for internal derangement of temporomandibular joint, Medline, Cochrane Controlled Trials Register, EMBASE, OPEN SIGLE and CBM were searched electronically till October 3rd 2010. Hand-searching covering 19 dental journals in Chinese were also performed. Risk of bias assessment, with Cochrane Collaboration's tool, and data extraction of included studies were conducted by two reviewers in duplicate. Meta analysis was done with Revman 5.0.23 and the quality of evidence was evaluated by GRADE.

RESULTS10 randomized controlled trials met the eligibility criteria and were included. All these studies had unclear risk of bias. When compared with negative control, HS showed a significant advantage on maximal mouth opening in short and long-term (P < 0.05), and clinical overall assessment in short-term (P < 0.05), but its effect on pain control and long-term effect on clinical overall assessment had no extra benefit (P > 0.05). Additionally, when compared with glucocorticoids, the participants who received HS injection would get a better clinical overall assessment in short-term and less adverse drug reactions (P < 0.05), but presented a similar temporomandibular joint pain relief and maximal mouth opening (P > 0.05).

CONCLUSIONTo a certain extent, HS had good efficacy and better safety than controls when treating internal derangement of temporomandibular joint. However, as the quality of some included studies were limited, more randomized controlled trials are needed to reinforce the conclusion.

Glucocorticoids ; Humans ; Hyaluronic Acid ; Temporomandibular Joint