Objective To explore the methods of identifying factitious/fraudulent disorders (M?n-chausen syndrome), enhancing the understanding of their predisposing factors, clinical features, and underlying psychopathology. Method After a final diagnosis of factitious fever was made, data of 4 patients presenting with a puzzling fever of unknown origin were analyzed and compared with those of other cases reported in the English literature. Result It was confirmed that the elevated temperature recorded in the clinical charts of the 4 patients was faked by manipulating of the thermometer. Conclusion These 4 cases show the existence of factitious/fraudulent disorders in China, possibly related to an abnormal psychology, but the tricks employed by the patients are relatively simple compared with those used abroad.

Objective To explore a kind of biomedical signal pattern (BSP) with a new method called as state representation methodology (SRM ) .Methods Based on the heart sound signals ,ECG signals ,breathing ,as the important research problem for BSP description ,with some comparisons on several traditional methods ,in which support vector machines (SVM ) and response sur-face methodology (RSM ) etc .,using frequency slice wavelet transform (FSWT ) method to extract the BSP signal dynamic damping characteristics ,thus ,this paper proposes a new idea of SRM analysis .In the case of heart sound signal analysis ,the general steps of SRM evaluation method is given .Results In 40 cases of normal heart sounds SRM model is set up ,with 80 cases of abnormal heart sounds are compared ,the obvious differences of the SRM state distributions of the two groups are found .Conclusion The combi-nation of SRM with FSWT can provide a novel approach for BSP analysis ,and provide powerful development tool for the analysis of BSP .

Objective To promote preventive and therapeutic measures for osteoporosis by investigating the prevalence of low bone mineral density (BMD) in connective tissue disease patients who were taking corticosteroid and identify the associated risk factors of osteoporosis.Methods Thirty-eight female patients who had connective tissue diseases and were taking corticosteroid in PU MCH rheumatology outpatient clinic were studied and followed up from Oct 2006 to April 2007.Lumber spine and right femoral bone mineral density were determined bv dual energy X ray absortiometry (DEXA).Clinical information was obtained from a questionnaire of history and medical records.Duration and accumulative dosage of glucocorticoid intaking.menopause time were obtained retrospectively.Correlation analysis between BMD and clinical information was conducted.Results ① In 38 patients,23 (61%) patients showed a normal BMD,10 (26%) were osteopenia,3 (8%) were iu the osteoporotic range,while 2 patienLs (53%) had fragile fracture.② Compared with patients with normal BMD,subjects with low BMD had significantly older age,longer period after menopause and higher accumulated dose of corticosteroids.③ Postmenopausal women had significantly lower BMD in lumber and hip than premenopausal women.④ Either of vertebral and right hip BMD correlated negatively with the accumulated dosage of cortieosteroids by simple linear regression.⑤ The correlation between BMD and accumulated dosage of corticosteroids improved after correcting for the effect of age by partial correlation analysis (Pearson partial vertebral r=-0.8,P=0.009;right hip r=-0.3,P=0.010).⑥ A stepwise multivariate linear regression model was constructed to explore the relationship between the different clinicsl factors studied and a low BMD.Two statistically significant variables were menopause status (P=0.0000) and a higher steroid accumulated dosage (P=0.008).Conclusion Low BMD is common in connective tissue disease patients receiving corticosteroid.Risk factors for low BMD are postmenopause.duration and the accumulated dosage of glucocorticosteroid.The high prevalence of low BMD implies that more attention should be paid to the prevention and treatment of osteoporosis and fractures in connective tissue disease patients who are taking corticosteroids.

Adult ; Ear Canal ; Foreign Bodies ; Humans ; Male ; Mandibular Condyle

Antineoplastic Protocols ; Child ; Humans ; Neoplasm, Residual ; therapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; therapy

Objective To observe the intervention with electroacupuncture(EA) through regulating protein kinase(MAPK/ERK) pathway for cerebral ischemia rats.Methods SD rats were randomized into pseudo-operation group,model group and EA group.And the three groups were divided into 2-hour,one-day and 3-day subgroups according to the observation time.Focal cerebral ischemia(FCI) rat models were established by middle cerebral artery occlusion(MCAO) with heat-coagulation method.EA group received EA on Baihui(GV20) and Dazhui(GV14),qd,for 2 hours,one day and 3 days respectively.The learning and memory abilities of the rats in Y maze test and their neuroethological score were observed.Immunohistochemical method was used to observe the expression of phosphorylated extracellular signal-regulated kinase(p-ERK) after ischemia in CA1 area and CA3 area.Results In the model group,the neuroethological score was markedly increased,time for arriving the safe area in Y maze was prolonged(P

This study was aimed to collect relevant provisions of bulging disease medical records in the Ming and Qing dynasties to excavate the syndrome differentiation, drug law and medication frequency analysis. A database was established to analyze relevant provisions. The results showed that the syndromes of liver stagnation and spleen deficiency, dampness-heat accumulation, spleen-yang deficiency are the most common type. The mainly used drugs are from the category to eliminate dampness and water, and to tonify the deficiency. The top three used drugs are poria, atractylodes, and dried citrus peel. It was concluded that medications used in the Ming and Qing dynasties were mainly targeted to the disordered zangfu-organ, which was mainly about the spleen and the stomach. The syn-drome differentiation is the mixture of deficiency and excess. And deficiency is the main part. The medication should combine tonification and reducing. And tonification should be paid attention to. The syndrome differentiation and treatment should be coordinated and the primary and secondary aspect should be identified. These rules provide ref-erence effect for the clinical practice and scientific research of bulging disease treatment.

Objective : To assess the health risks of polycyclic aromatic hydrocarbons（PAHs）exposed through cereal,fried and grilled foods in Hangzhou. Methods : A cross-sectional study was conducted to collect food consumption data of three inconsecutive days among 1 769 subjects selected by probability proportional to size sampling method from two districts in Hangzhou.Fifty samples of fried and grilled food and twenty samples of cereal were collected from five districts in Hangzhou. They were tested for B（a）P,PAH2,PAH4 and PAH8 by high performance liquid chromatography coupled with triple quadrupole gas chromatography-tandem mass spectrometry. The probabilistic models were established for the evaluation of PAHs exposure by @risk software and then margin of exposure（MOE）was calculated. Results : The contents of B（a）P in one sample of fried and grilled food exceeded the limit. The median contents of PAHs ranged from 0.20 to 3.64 μg/kg. The median exposures of B（a）P,PAH2 and PAH4 from both two kinds of foods were 1.54,3.54 and 8.13 ng/（kgbw·d）in the mixed model,1.61,3.76 and 8.09 ng/（kgbw·d）in the non-parameter model. The MOEs of≤95% PAHs exposure level in one kind of food or ≤90% PAHs exposure level in both kinds of foods were more than 10 000. The MOEs of ≥97.5% exposure level of B（a）P,≥95% exposure levels of PAH2 and PAH4 in both kinds of foods in the mixed model,and ≥95% exposure levels of B（a）P,PAH2,PAH4 in both kinds of foods in the non-parameter model were less than 10 000. Conclusion The health risk of PAHs exposure was very low in more than 90% of the population in Hangzhou. However,for high-end consumers,97.5% or 99% exposure level in one kind of food and 95% exposure level in both kinds of foods had a potential health risk.

Objective To investigate the relationship between trace elements and rachitis in children.Methods Three hundred and twelve patients with rachitis and 297 healthy children were selected for this study.Blood zinc(Zn),iron(Fe),plasma copper(Cu),calcium(Ca),magnesium(Mg),lead(Pb) and cadmium(Cd) were assayed by atomic absorption spectrophotometer.Results The levels of Zn,Fe,Cu of rachitis in blood were significantly lower than those of healthy children,while the levels of Mg,Pb were higher.There were significant differences between 2 groups(P

Objective:To investigate the mechanism responsible for lost sensibility of tyrosine aminotransferase(TAT)to dexam- ethasone(Dex)in human hepatoma cell line SMMC-7721 through examining the cDNA sequence of TAT and the status of glucocorticoid receptor(GR)pathway.Methods:The TAT cDNA fragment containing the full length of coding sequence was amplified by reverse transcription-polymerase chain reaction(RT-PCR)and was sequenced.The expression of TAT mRNA was determined by real-time quantitative PCR to observe the influence of Dex on expression of TAT mRNA in SMMC-7721 cells.The experiement with HepG2 cells was performed as the control.Reporter genes(GRE-tk-LUC and GRE-MMTV-CAT)were transiently transfected into SMMC-7721 cells by electroporation.The induction efficiencies of LUC and CAT genes expression by Dex were examined and compared between SMMC-7721 cells and HepG2 cells.Results:The results showed that there was a same-sense mutation(Gln576Gln)in TAT cDNA se- quence.TAT mRNA could be induced by Dex,with the maximal induction level being 2.22-folds in SMMC-7721 cells,which was signifi- cantly lower than that in HepG2 cells(15.1-fold increase,P