Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Hepatitis B ; epidemiology ; Humans ; Incidence ; Infant ; Infant, Newborn ; Middle Aged ; Young Adult

Objective To investigate the clinical effectiveness of disease-syndrome combination therapy for anovulatory infertility through randomized controlled trial, thus to provide high-level evidence-based medical reference for the diagnosis and treatment of WHO typeⅡovulation disorder infertility. Methods Eighty-six patients with WHO typeⅡovulation disorder infertility were randomized into treatment group and control group , 43 cases in each group. Both groups were given the treatment for correcting endocrinic disorder if necessary. Additionally, by following the principle of combination of disease differentiation and syndrome differentiation , Zhuyun Recipe 1, Zhuyun Recipe 2, and Zhuyun Recipe 3 were separately given orally to the patients with kidney-yang deficiency (WHO type Ⅱ ovulation disorder without PCOS), patients with liver-kidney insufficiency(WHO typeⅡovulation disorder complicated with hyperandrogenitic lean-PCOS),and patients with kidney-deficiency complicated with phl egm-dampness (WHO type Ⅱ ovulation disorder complicated with insulin-resistant obesity-PCOS) in the treatment group respectively. The patients in the control group was given oral use of the first-rate ovulation induction drug Clomiphene. The treatment covered 3 menstruation cycles. Ovulation rate,pregnancy rate and alive fetus rate were used as the indicators for evaluating the effectiveness,and the safety was also monitored. Results(1)Of the 86 cases,5 cases dropped out(loss to follow-up or being excluded),with the drop-out rate being 6%. Of the 5 drop-out cases,3 were from the control group,and 2 were from the treatment group. (2)Ovulation rate of the treatment group was 70.7%,and that of the control group was 85.0%. The ovulation rate of the two groups was enhanced,but the difference between the two groups was insignificant(P > 0.05).(3)Pregnancy rate of the treatment group was 51.2%,and that of the control group was 30.0%, the differen ce being significant between the two groups(P < 0.05).(4)Alive fetus rate of the treatment group was 45.2%,and that of the control group was 22.5%,the difference being significant between the two groups(P < 0.05).(5)No adverse reaction was found in the two groups during the treatment. Conclusion The disease-syndrome combination therapy for WHO type Ⅱanovulatory infertility shows the advantages of higher pregnancy rate and alive fetus rate, which makes up for the disadvantages of low pregnancy rate and high abortion rate of Clomiphene.

Objective To investigate the correlations between temporomandibular disorder(TMD)and orthodontic treatment in adult patients.Methods Sixty adult orthodontic patients,aged from 20 to 29 years old,were divided into two groups according to Helkimo index.Group Ai =0 included 44 patients.Group Ai =Ⅰ included 16 patients.Before and after orthodontic treatment,temporomandibular joint disc positions were measured in MRI images.According to Helkimo index,the function of temporomandibular joint (TMJ) was evaluated.Results The incidence of TMD in Group Ai =Ⅰ (8/16) was much higher than in Group Ai =0 (9/44) (P ＜ 0.05).The anterior displacements of the temporomandibular joint disc were found.After orthodontic treatment,anterior space area of TMJ was increased and posterior space area was reduced(P ＞ 0.05).Conclusions Orthodontic treatment couldn't cause TMD,but it might induce and aggravate the symptoms of TMJ.

OBJECTIVETo determine whether an adenoviral construct containing bone morphogenetic protein-4 (BMP-4) gene can be used for lumbar spinal fusion.

METHODSTwelve New Zealand white rabbits were randomly divided into two groups, 8 in the experimental group and 4 in the control group. Recombinant, replication-defective type 5 adenovirus with the cytomegalovirus (CMV) promoter and BMP-4 gene (Ad-BMP-4) was used. Another adenovirus constructed with the CMV promoter and beta-galactosidase gene (Ad-beta-gal) was used as control. Using collagen sponge as a carrier, Ad-BMP-4 (2.9 multiply 10(8) pfu/ml ) was directly implanted on the surface of L(5)-L(6) lamina in the experimental group, while Ad-beta-gal was implanted simultaneously in the control group. X-ray was obtained at 3, 6, and 12 weeks postoperatively to observe new bone formation. When new bone formation was identified, CT scans and three-dimensional reconstruction were obtained. After that, the animals were killed and underwent histological inspection.

RESULTSIn 12 weeks after operation, new bone formation and fusion were observed on CT scans in the experimental group, without the evidence of ectopic calcification in the canal. Negative results were found in the control group. Histological analysis demonstrated endochondral bone formation at the operative site and fusion at early stage was testified.

CONCLUSIONSIn vivo gene therapy using Ad-BMP-4 for lumbar posterolateral spinal fusion is practicable and effective.

Adenoviridae ; genetics ; Animals ; Bone Morphogenetic Protein 4 ; Bone Morphogenetic Proteins ; therapeutic use ; Genetic Therapy ; methods ; Humans ; Lumbar Vertebrae ; surgery ; Rabbits ; Spinal Fusion

This study was aimed to investigate the characteristics of lymphocyte immune abnormality in children idiopathic aplastic anemia (IAA) in order to explore the immune pathogenesis of childhood IAA. The phenotypes of lymphocytes, the ratios of Th1/Th2 and Tc1/Tc2, the levels of CD25(+) and CD4(+)CD25(+) T lymphocytes in peripheral blood of IAA patients were measured at the onset of disease by flow cytometry and were compared with that in normal controls. The influences of those immunological indicators on prognosis of IAA were also analyzed. The results showed that there were 40 cases of severe aplastic anemia (SAA) and 12 cases of mild aplastic anemia (MAA). The levels of CD3(+) CD8(+) T cells in SAA group and MAA group were significantly higher than those in controls (p < 0.05). The levels of CD3(+) and CD3(+) CD4(+) T cells in MAA group were lower than that in SAA group (p < 0.05), but there were no difference was compared with control group. No differences of the levels of CD3(-)CD19(+) T cells were between the both SAA and MAA groups and the control group. The levels of CD3(-)CD56(+) T cells in SAA group and MAA groups were lower significantly than that in control group. As compared to control group, the levels of Th1 and Tc1 in SAA group and MAA groups increased significantly (p < 0.05), and the ratios of Th1/Th2 and Tc1/Tc2 in SAA group and MAA groups increased significantly (p < 0.05). The level of Th2 increased in SAA group. As compared to MAA group, the levels of Th1 and Tc1 and the ratios of Th1/Th2 and Tc1/Tc2 in SAA group increased significantly (p < 0.05). The levels of CD25(+) T lymphocyte in SAA group and MAA group increased significantly (p < 0.05), and were higher than that in normal controls, but levels of CD4(+)CD25(+) T lymphocyte and ratio of CD4(+)CD25(+)/CD4(+) in SAA group and MAA group had no significant difference. It is concluded that the abnormal lymphocyte immune function exist in the onset of childhood IAA. The polarization of Th1/Th2 and Tc1/Tc2 shifts to Th1 and Tc1 cells. These changes closely relate to severity of the disease. There is high level of CD25(+) T lymphocyte in children IAA. These changes reveal that abnormality of immune function plays an important role at the onset of childhood idiopathic aplastic anemia.
Adolescent ; Anemia, Aplastic ; immunology ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Lymphocyte Count ; Male ; T-Lymphocytes, Cytotoxic ; immunology ; Th1 Cells ; immunology ; Th2 Cells ; immunology

OBJECTIVEThe aim of this study is to investigate hepatic and renal toxicity of acrylamide (ACR) , the antagonistic effect and possible mechanism of N-acetylcysteine (NAC) on the toxicity.

METHODSForty female SD rats were randomly divided into four groups. All the rats were administrated by intraperitoneal(i.p.) injection and 1.5 hours later by gavage. The control group was administrated with 0.9% NaCl by i.p. injection and gavaged with 0.9% NaCl. The NAC group was administrated with 200 mg/kg NAC by injection and gavaged with 0.9% NaCl. The ACR group was administrated with 0.9% NaCl by injection and gavaged with 40 mg/kg ACR. The combined treatment group was administrated with 200 mg/kg NAC by i.p. injection and gavaged with 40 mg/kg ACR. The rats were administrated once a day for 2 weeks. After 24 hours of the last administration, the rats were decapitated. The blood was collected, the liver and kidney were separated. The body weight, organ coefficient and serum biochemical parameters were measured, and the pathological changes of the tissues were examined with a microscope. Then the expression of NF-κB p65, IκB-α and COX-2 were detected by Western blot.

RESULTSFrom the second day to the end of the exposure, the body weight of rats in the ACR group was statistically lower than that in the control group (P<0.05) . Compared with the combined treatment group, the body weight in the ACR group statistically decreased in the second and third days (P < 0.05) . The liver and kidney organ coefficients in the ACR group were (4.159%±.371%) and (0.764%±0.068%) respectively, which increased statistically when compared with the control group (P < 0.05) . The contents of ALT, AST and Cr in the serum in the ACR group were (77.370±16.397) U/L、(379.410±57.817) U/L and (77.812±6.391) μmol/L respectively, which were not significantly different with those in the control group and the combined treatment group (P>0.05) . The content of BUN in the serum in the ACR group was (7.005±1.009) mmol/L, which was statistically higher than that in the control group (P<0.05) . Histopathology results showed unclear boundary and nucleus pyknosis in hepatocytes, loose and disordered structures of hepatic cords in the ACR group, but no obvious pathology changes were observed in the kidneys of each group. In the Western blot results, the expression of nuclear NF-κB p65 and COX-2 in the liver in the ACR group was statistically higher than that in the control group and the combined treatment group (P<0.05) , and the expression of IκB-α in the liver in the ACR group statistically decreased compared with the control group and the combined treatment group (P<0.05) . The expression of total NF-κB p65 in the liver in the ACR group was statistically higher than that in the control group (P<0.05) .

CONCLUSIONUnder the conditions of this experiment, ACR may induce hepatic toxicity through the activation of NF-κB signaling pathway, and NAC could antagonize the hepatic toxicity of ACR by inhibiting the NF-κB signaling pathway, whereas the toxic effect of ACR on kidney needs to be further studied.

Acetylcysteine ; pharmacology ; Acrylamide ; toxicity ; Animals ; Cyclooxygenase 2 ; metabolism ; Female ; I-kappa B Proteins ; metabolism ; Kidney ; drug effects ; metabolism ; pathology ; Liver ; drug effects ; metabolism ; NF-KappaB Inhibitor alpha ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Transcription Factor RelA ; metabolism

OBJECTIVEHemorrhagic cystitis (HC) is one of the common complications of hematopoietic stem cell transplantation (HSCT), which causes significant pain, prolongs hospitalization, and occasionally results in renal failure and death. This study aimed at investigating the incidence, risk factors, and outcome of HC in children post umbilical cord blood transplantation (UCBT) and peripheral blood stem cell transplantation (PBSCT).

METHODSFrom October 1998 to June the clinical records of 53 pediatric patients (aged 2-18 years with median age of 7.5 years) in our HCST center who underwent UCBT (n = 37) and PBSCT (n = 16) were retrospectively analyzed. Thirty out of 53 patients were diagnosed as hereditary hemolytic anemia (56.6%), and the others as haematological malignancies (43.4%): of whom 8 had acute lymphoblastic leukemia, 12 acute myeloid leukemia, 2 chronic myeloid leukemia and 1 non-hodgkin lymphoma. Conditioning regimen varied according to disease and clinical status, however based on cyclophosphamide (CTX, 120-200 mg/kg) and busulphan (BU, 12-16 mg/kg) in the cohort. Total body irradiation (TBI) or total lymphoid irradiation was added in 7 patients respectively. The patients were divided into regular treatment group (RTG) with 15 cases who received hyperhydration, alkalinizing, diuresis and Mesna during CTX infusion and prostaglandin E1 (PGE1) group (PEG) with 38 cases who received hyperhydration, alkalinizing, diuresis and Mesna plus prostaglandin E1 (0.03 microg/kg.h). The risk factors of HC were examined by univariate and multivariate analysis.

RESULTSIn all, 11 of the 53 transplanted patients developed HC (21%) with a median onset time of day +15 (rage day +2 - +25). HC was classified as early in 4 (36%) and late in 7 (64%), and scored as grade Iin 2 cases (18%), grade II in 4 (36%) and grade III in 5 (46%). There was no significant difference between RTG and PEG in the incidence of HC, however, the incidence was much higher in the group of patients who were > or = 6 years old, positive group of graft-versus-host disease (GVHD) and group of cytomegalovirus (CMV) infection than that in the group of patients who were < 6 years of age (32% vs. 8%, P < 0.05), negative group of GVHD (35% vs. 7%, P < 0.05) and CMV non-infected group (62% vs. 13%, P < 0.05), respectively. Furthermore, by multivariate analysis, > or = 6 years old (OR = 3.53, P < 0.05) and CMV infection (OR = 4.31, P < 0.05) were significant risk factors for HC. Three of 11 patients were treated with bladder irrigation. All patients recovered from HC in a median 12.8 days (range 2-53 days).

CONCLUSIONOlder age (> or = 6 years) as well as CMV infection were the risk factors of HC. Both hyperhydration and Mesna were effective in preventing HC, while addition of PGE1 could not reduce the incidence of HC. The prognosis of HC in children post HSCT was satisfactory.

Adolescent ; Age Factors ; Anemia, Hemolytic, Congenital ; metabolism ; therapy ; Body Water ; metabolism ; Child ; Child, Preschool ; Cystitis ; epidemiology ; etiology ; prevention & control ; therapy ; Cytomegalovirus Infections ; complications ; physiopathology ; Female ; Fluid Therapy ; methods ; Hematologic Neoplasms ; metabolism ; therapy ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Incidence ; Male ; Mesna ; therapeutic use ; Multivariate Analysis ; Protective Agents ; therapeutic use ; Retrospective Studies ; Risk Factors ; Treatment Outcome

Adolescent ; Adult ; Aged ; China ; epidemiology ; Diarrhea ; epidemiology ; virology ; Female ; Humans ; Male ; Molecular Epidemiology ; Rotavirus ; genetics ; Rotavirus Infections ; epidemiology ; genetics

Objective To apply barcode technology to the patient information management in the hyperbaric medicine unit to sim plify the workflow of outpatient registration and facilitate access to patient's information.Methods The barcode designed by some hospital and its use were introduced,and then compared with the traditional way on time consuming,patient satisfaction and etc.Results Barcode technology enhanced the nurse's efficiency and the patient's satisfaction.Conclusion Barcode technology simplifies the working flow in the hyperbaric oxygen outpatient,increases medical service quality,decreases medical disputes and meets the requirements for appointment treatment,and thus is worthy promoting practically.

Objective To investigate the prevalence and major risk factors of peripartum thromboembolic disease in different regions of Guangdong province.Methods Data from 169 218pregnant women in different regions of Guangdong province from January 2005 to June 2010 were analyzed retrospectively.The prevalence and epidemiological characteristics of thromboembolic disease during pregnancy or puerperium were investigated.Results Of the studied population,( 1 )20 l cases ( 1.3‰ ) suffered from thromboembolic disease during pregnancy or puerperium including 128 cases of deep vein thrombosis (DVT),68 cases of cerebral venous thrombosis (CVT) and 5pulmonary embolism,the prevalence rates were 0.8‰,0.4‰,and 0.02‰ respectively.(2) Risk factors in different regions showed that,in the Pearl River Delta area,the major risk factors for DVT would include previous or family history of thrombosis,pregnancy complications,with medically involved diseases,prolonged bed rest and pregnancy weight gain ＞ 15 kg etc.While in castern,western,northern parts of Guangdong,the major risk factors for DVT would include pregnancy weight gain ＞ 15 kg,prolonged bed rest,preeclampsia,cesarean section and complications during pregnancy.In Pearl River Delta region,the major risk factors for CVT would include eclampsia,preeclampsia,pregnancy complications,prolonged bed rest ＞3 days,past history or family history of thrombosis.While eclampsia,preeclampsia,advanced age or younger age,pregnancy weight gain ＞15 kg,complications during pregnancy were the major risk factors for CVT in the eastern,western or northem parts of Guangdong.Conclusion Prevalence and major risk factors of peripartum thromboembolic disease in different regions of Guangdong were different.It was crucial to take effective measures in pregnant women with different epidemiological characteristics and risk factors to prevent and reduce the incidence of peripartum thromboembolic disease.