Rheumatoid arthritis of the knee is a common disease, but suppurative arthritis caused by Gemella morbillorum in the same joint is rare. We report a case of suppurative arthritis caused by Gemella morbillorum in a patient with rheumatoid arthritis. Because the infection symptoms was not typical, the diagnosis was delayed, and the delayed diagnosis and therapy led to a poor outcome of the patient.
Arthritis, Infectious ; complications ; Arthritis, Rheumatoid ; complications ; Female ; Gemella ; isolation & purification ; Gram-Positive Bacterial Infections ; complications ; Humans ; Knee Joint ; Middle Aged

OBJECTIVEDry powder inhalers (DPIs) are increasingly being used to deliver drugs for the treatment of asthma. It is known that DPIs require a crucial minimal inspiratory flow. Previous studies have demonstrated that the peak inspiratory flow (PIF, L/min) through a DPI is dependent on the type of device, the age of the patient, and the level of bronchial obstruction. However, the peak inspiratory flow of healthy preschool children in China remains scant in the literature. The present study aimed to analyze the ability of inspiring flow through the resistance state of ordinary use inhaler in Shenzhen healthy preschool children by measuring the peak inspiratory flow through the different analogue dry powder inhalers and go further into the relationship between it and the age, weight and forced expiratory volume of the children.

METHODA survey in 370 healthy preschool children aged 3 to 6 years (75 children aged 3 years, 104 children aged 4 years, 100 children aged 5 years and 91 children aged 6 years) was carried out in Shenzhen. Peak inspiratory flow (PIF) was measured without and with resistances, which mimicked the internal resistances of several inhalers, Diskus, Turbuhaler, Autohaler, Surehaler by PIF meter (In-check DIAL) and then data PIF-N, PIF-D, PIF-T, PIF-A and PIF-S were obtained. Peak expiratory flow (PEF) was measured by PEF meter (MicroPeak, USA). These two measurements were made in a well-controlled setting, and at least three attempts were recorded to establish maximum achievement. Six spirometry parameters forced vital capacity (FVC), forced expiratory volume at 0.5 second (FEV 0.5), forced expiratory volume at 0.75 second (FEV 0.75), forced expiratory volume at one second (FEV1), maximal mid expiratory flow rate (FEF 25 - 75, PEF were measured by using COSMED spirometry of Italy and the FVC measurements should be around the quality control for spirometry in preschool children which we suggested and published in 2005. All data were expressed as mean +/- SD and analyzed with the statistical software SPSS 12.0 for Windows. Pearson's test was used for calculation of the significances of the correlation coefficients. Variance analysis was used for analysing the variability of inspiratory flows through the inhalers.

RESULTSResults were obtained from 295 children aged 3 - 6 years who successfully finished the tests. The PIF-N, PIF-D, PIF-T, PIF-A and PIF-S were significantly different among the groups aged 3 yrs, 4 yrs, 5 yrs and 6 yrs. The peak inspiratory flow significantly increased with age. The PIF-N, PIF-D, PIF-T, PIF-A and PIF-S in the children of 110 cm height and above were significantly higher than those in the children below 110 cm height, so were the parameters between the children of 120 cm height and above and the children below 120 cm. PIF correlated significantly with age, height and weight and the Pearson coefficient was 0.3 - 0.5. The PIFs in different inhalers varied because of the different inner resistances. The minimum and optimum PIFs in resistances of Diskus, Autohaler and Surehaler could be achieved in almost all subjects, but those in resistances of Turbuhaler could be achieved in only 87.5% subjects, most of whom aged 3 yrs or below 100 cm height. There were good correlations between the PIFs in different resistances and main parameters of ventilation function (FVC, FEV 0.5, FEV 0.75, FEV1, FEF 25 - 75, PEF), PEF was the best among them (Pearson correlative coefficient was 0.6).

CONCLUSIONThe inspiratory ability of the children can be predicted and assessed by using routine measurement of lung function of normal pre-school children. As to the pre-school children of varying ages, the variety of inspiratory ability should be considered completely in the selection of inhaler used during the treatment. The best inhaler suitable for them should be selected properly in order to obtain the best efficacy of treatment individually.

Child ; Child, Preschool ; China ; Female ; Humans ; Inspiratory Capacity ; Male ; Maximal Expiratory Flow Rate ; Metered Dose Inhalers

BACKGROUND AND OBJECTIVEMonitoring the therapeutic effects of radiotherapy for nasopharyngeal carcinoma (NPC) is critical to providing individualized treatment. This in-vivo study was initially designed to evaluate the therapeutic effect of radiotherapy using 18F-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET-CT) imaging.

METHODS18F-FDG PET-CT imaging was performed on all of the 10 nude mice bearing NPC xenografts before radiotherapy, and early-phase and delayed-phase PET-CT images were performed on 7 of the 10 mice. All mice were randomly divided into either a control group or a radiotherapy group. The 5 mice in the control group were immediately killed after the imaging and pathology were performed. After receiving radiotherapy of 12 Gy, 5 animals in the radiotherapy group were given 18F-FDG PET-CT imaging on days 2, 4, and 6, and then were killed for pathologic evaluation. Regions of interest (ROI) technology was used to measure the tumor target/non-target (T/NT) ratio and the volume of the tumors.

RESULTSThe average T/NT ratios of early- and delayed-phase imaging were 1.806 +/- 0.532 and 1.777 +/- 0.597, respectively, with no significance (P > 0.05). For the radiotherapy group, the average T/NT ratios for 18F-FDG PET-CT before radiotherapy, and on days 2, 4, and 6 after radiotherapy, were 1.735 +/- 0.466, 1.818 +/- 0.396, 1.096 +/- 0.101, and 0.604 +/- 0.108, respectively, The tumor volumes were (1.48 +/- 0.27) cm3, (1.57 +/- 0.31) cm3, (1.59 +/- 0.31) cm3 and (1.60 +/- 0.29) cm3, respectively. The average T/NT ratios of day 6 after radiotherapy and the other time points were significant (P < 0.05). The average death ratio of the tumor cells was (93.00 +/- 7.42)% after 6 days of post-radiotherapy.

CONCLUSIONS18F-FDG PET-CT imaging can be used for the early assessment of radiotherapeutic effect of NPC in vivo. Day 6 after radiotherapy may be an appropriate time point for the imaging. However, the T/NT ratio measurement of delayed-phase imaging might make no sense for the diagnosis of NPC.

Animals ; Carcinoma, Squamous Cell ; diagnostic imaging ; pathology ; radiotherapy ; Cell Line, Tumor ; Fluorodeoxyglucose F18 ; Humans ; Ki-67 Antigen ; metabolism ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Multimodal Imaging ; methods ; Nasopharyngeal Neoplasms ; diagnostic imaging ; pathology ; radiotherapy ; Neoplasm Transplantation ; Positron-Emission Tomography ; Random Allocation ; Tomography, X-Ray Computed ; Tumor Burden ; radiation effects

Objective To evaluate the effect of follow-up intervention of enterostomal therapist(ET) on the quality of life of Miles patients in colostomy convalescent.Methods Totals of 80 Miles patients with rectal cancer in our hospital from December 2010 to June 2012 were selected and randomly divided into intervention group (n =40) receiving ET follow-up intervention nursing,and the control group (n =40) receiving routine nursing.Life quality was observed respectively in discharge,1th month discharge,3th month discharge and 6th month discharge.Results No significant difference was found in the life quality scores between intervention group and control group when discharge [(46.88 ±9.18) vs (42.71 ± 12.11) ; t =-1.734,P ＞0.05)].While the life quality scores in the 1th month discharge,3th month discharge,and 6th month discharge of intervention group were respectively higher than those of control group [(49.58 ± 8.43) vs (42.71 ± 12.11),(57.92 ± 7.05) vs (42.71 ± 12.11),(71.87 ± 9.57) vs (54.17 ± 7.78)],and the differences were statistically significant (t =-2.947,-6.864,-9.084 ; P ＜ 0.01).Conclusions The special follow-up intervention of ET can improve the quality of life of patients with colostomy.

UNLABELLEDMorbidity of chronic lung disease in young children is relatively high, and could increase in the future. Pulmonary function testing is used for clinical assessment of patients with suspected or obvious pulmonary disease to assess the severity of dysfunction and to evaluate therapeutic effectiveness. In the recent few years, forced expiratory parameters assessing lung function have been measured in older children. In order to assess abnormalities of lung function in preschool patients with respiratory disorders based on changes of forced expiratory parameters, adequate reference values are needed. However, such data in healthy preschool children remain scant in the literature.

OBJECTIVEThe aim of this study was to characterize the spirometry of preschool children and establish the normal lung function prediction equations for Chinese preschool children.

METHODSA survey in 343 healthy preschool children (184 boys and 159 girls) aged 3 to 6 years (73 children aged 3 years, 96 children aged 4 years, 91 children aged 5 years and 83 children aged 6 years) was carried out in Shenzhen in 2004. Eleven flow volume tests parameters, i.e., forced vital capacity (FVC), forced expiratory volume at 0.5 second (FEV(0.5)), forced expiratory volume at 0.75 second (FEV(0.75)), forced expiratory volume at one second (FEV(1)), maximal mid expiratory flow rate (FEF(25%-75%)), peak expiratory flow (PEF), forced expiratory time (FET100%) were measured by using COSMED spirometry produced in Italy. Stepwise multiple regressions and non-linear regressions were carried out with the statistical software SPSS10.0 for Windows to identify the best predictors of lung function parameters using standing height, weight, age and gender as potential determinants.

RESULTSSpirometric tests could be successfully carried out by using imagery methods in the following percentages of children: 69.9% of 3 to 4 years old, 70.8% of 4 to 5 years old, 92.3% of 5 to 6 years old and 91.6% of 6 to 7 years old children, 77.7% of the selected population (217/279) of children performed at least two acceptable tests respectively. The average forced expiratory time (FET) was 1.61 +/- 0.52 sec (x +/- s), the 5th percentile value was 0.9 sec, 18 of 279 (6.5%) children produced a FET less than 1 second. Forced expiratory volume in 0.50 and 0.75 sec (FEV(0.5), FEV(0.75)) were thus measured necessary in preschool children. All lung volumes and flow rates increased with age, height as well as weight growth in both gender groups. The correlation among most lung function parameters was higher in height than in age and weight in boys. Whereas the correlation among most lung function parameters was higher in age than in height and weight in girls. The regression equations of lung function were established. By comparison with the equations derived from this study and from studies by Nystad, it was found that there was a difference between the predicted values.

CONCLUSIONSpirometric testing is feasible in preschool children by using imagery methods and may be useful for both clinical practice and research. The correlation among most lung function parameters was higher in height than in age and weight in boys. Whereas the correlation among most lung function parameters was higher in age than in height and weight in girls.

Age Factors ; Body Height ; Body Weight ; Child ; Child, Preschool ; Feasibility Studies ; Female ; Forced Expiratory Volume ; Humans ; Male ; Peak Expiratory Flow Rate ; Reference Values ; Regression Analysis ; Respiratory Function Tests ; methods ; Spirometry ; statistics & numerical data ; Vital Capacity

Objective To express and purify HBoV VP2 protein,and the monoclonal antibody against HBoV VP2 protein was prepared with hybridoma technique.Methods The HBoV VP2 cloned into vector pET-30a was expressed in E.coil.After purified by immobilized metal affinity chromatography,the BALB/c mouse was immunized with purified protein as antigen.The positive hybridoma cells were screened with hybridoma technique and ELISA assay. Isotype and titer of the monoclonal antibody were detected.Results The recombinant HBoV VP2 protein was expressed and purified,and then the monoclonal antibody was obtained with hybridoma technique.The titer of the IgG monoclonal antibody was up to 1 ∶ 4 × 105.Conclusion Monoclonal antibody against recombinant HBoV VP2 protein was prepared and the antibody titer was high.This work may provide a new method in rapid diagnosis and study of HBoV.

Objective To establish the methods of LAMP assay in human bocavirus(HBoV) and use to detect clinical samples. Methods Establish LAMP assay for HBoV by using primer explorer V4 (LAMP primer design software) on line to design LAMP primer for sequence NP1 of HBoV. Evaluate its sensitivity and specificity. Results Comparing with traditional PCR, LAMP shows good specificity and higher sensitivity until 10 copy. By LAMP assay we get 5 positive samples in 76 clinical swabs from the children with respiratory infections. Conclusion LAMP assay for detection of HBoV is sensitive, efficient,rapid and simple. It is a new way to detect HBoV in clinical test.

Objective To construct the eukaryotic expression vector PCI-dhfr-λ1 and PCI-dhfrSP163-λ1 which linked the enhancer SP163 with interferon λ1.Then express the interferon λ1 in CHO (dhfr-) cells.Methods Using PCR method to introduce the restriction enzyme sites and through the fusion PCR binding the enhancer with the interferon λ1.After sequenced,λ1 and SP163-λ1 was inserted into PCI-dhfr forming the expression vector PCI-dhfr-λ1 and PCI-dhfr-SP163-λ1 which was constructed successfully confirming by sequencing.Then the expressing vectors were transfected into CHO(dhfr-) cells using liposome transfection method and interferon λ1 protein was assayed with indirect immunofluorescence and Western Blot.Using cytopathic effect inhibition evaluated the antiviral activity of interferon λ1.Results Successfully constructing the eukaryotic expression vectors of interferon λ1 and the vectors could express interferon λ1.The result of immunofluorescence showed the enhancer developed the expression of interferon λ1.Detecting the interferon λ1 in CHO (dhfr-) cells after transfecting 48 hour using Western Blot.The cytopathic effect inhibition showed the expressed interferon λ1 has the antiviral activity.Conclusion Successfully expressed the interferon λ1 in CHO(dhfr-) cells and the protein possesses antiviral activity,which may supply a valuable basis for building the stable cell line of interferon λ1.

OBJECTIVETo investigate the impact of heart valve calcification (HVC) on cardiovascular outcomes in patients on maintenance hemodialysis (MHD).

METHODSWe enrolled 302 Chinese patients on MHD between 2009 and 2011 including 99 with HVC identified by echocardiography screening. All the patients were followed up for 2 years and survival analysis was performed with all-cause mortality, cardiovascular mortality and new onset cardiovascular events as the endpoints. Cox regression analysis was used for analyzing the impact of heart valve calcification on the cardiovascular outcomes of the patients.

RESULTSThe mean age of the total patients was 58.2∓15.0 years when receiving the initial MHD, and 53.6% were male patients. The overall mortality, cardiovascular mortality and new on-set cardiovascular events in HVC and non-HVC groups were 30.3% vs 16.3%, 22.2% vs 6.9%, and 48.5% vs 25.6%, respectively (P<0.05). Kaplan-Meier survival analysis showed a significant difference in all-cause mortality (P=0.006), cardiovascular mortality (P<0.001) and new-onset cardiovascular events (P<0.001) between HVC and non-HVC groups. After adjustment, Cox regression analysis identified HVC as a risk factor for increased all-cause mortality (HR=1.88; 95%CI: 1.11-3.19), cardiovascular mortality (HR=3.47, 95%CI: 1.76-6.84) and cardiovascular events (HR=1.64, 95% CI: 1.09-2.47).

CONCLUSIONSHVC is an independent risk factor for increased cardiovascular mortality and new cardiovascular events in patients on MHD.

Adult ; Aged ; Calcinosis ; pathology ; Echocardiography ; Female ; Heart Valve Diseases ; mortality ; pathology ; Heart Valves ; pathology ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Renal Dialysis ; Risk Factors

Objective To assess the prevalence,demographic characteristics,risk factors and protective factors on major depression disorder(MDD)among the affected people in the epicenter,7 months after the 2008-earthquake in Wenchuan,China.Methods Stratified multistage cluster randomization was conducted to choose 14 503 subjects aged 15 years or over in the city of Dujiangyan,Beichuan county and Qingchuan county,Sichuan province.We used the general health questionnaire(GHQ-12)as the screening instrument,and the structured clinical interview for DSM-Ⅳ-TR axis Ⅰ disorder-patient edition(SCID-Ⅰ/P)as the tool for diagnosis.Results There were 180 persons diagnosed as MDD with other 13 asymptomatic ones.The point prevalence of MDD was 1.27% and the lifetime prevalence was 1.36%.Risk factors were including:being female(OR=1.56,95%CI:1.136～ 2.143,P＜0.05),co-morbidity with somatic diseases(OR=4.02,95%CI:2.75-5.90,P＜0.05),wounded in the earthquake(OR=3.29,95%CI:1.92-5.65,P＜0.05),property loss up to 10 000-20 000 Yuan(OR=2.09,95%CI:1.18-3.69,P＜0.05),property loss up to＞20 000 Yuan(OR=2.54,95%CI:1.38-4.68,P＜0.05),death or missing of family members(OR=3.79,95%CI:2.08-6.89,P＜0.05)and in middle-age(OR=2.31,95%CI:1.38-3.86,P＜0.05)etc.Having had a job seemed to be a protective factor(OR=0.60,95%CI:0.43-0.83,P＜0.05).Conclusion Major depressive disorder appeared to be a common psychiatric disease in these quake-stricken areas,that causing serious problems.Sustained follow-up and care provided to the affected people in these areas were of extreme importance.