Objective To analyze the clinical features of infective endocarditis with positive antineutrophil cytoplasmic antibodies ,and compare with ANCA associated small vessel vasculitis(AASV). Methods Three IE patients with positive ANCA were analyzed, and 13 cases from literatures were reviewed. Results Sixteen patients had positive anti-PR3 ANCA, in which 2 cases had both positive (anti-PR3 and anti-MPO ANCA) ANCA. All patients had some clinical manifestations mimic AASV, including fever ( 13/16, 81% ), rash (8/16, 50% ), rapidly progressive glomerulonephritis (7/16, 44% ), splenomegaly (6/16, 38% ). Streptococcal species were identified in 12 patients, and cardiac valvular abnormalities were demonstrated in all patients. All patients except 2, who died of cerebral hemorrhage followed by cerebral infarction, recovered with antibiotic therapy. Conclusion Infective endocarditis sometimes can have the same clinical features as AASV, so physicians should carefully differentiate between them when dealing with patients with positive ANCA antibodies.

BACKGROUND: There are some reports about the relationship between atherosclerotic cerebral infarction and apolipoprotein E and B, but the results are still controversial. The relationship between apolipoprotein E and B and young adult atherosclerotic cerebral infarction has not been reported yet in China.OBJECTIVE: To investigate the relationship between the polymorphism of apolipoprotein E and B gene and young adults atherosclerotic cerebral infarction (ACI).DESIGN: A controlled case analysis of young adult atherosclerotic cerebral infarction patients.SETTING: Department of Neurology, Shengjing Hospital of Chinese Medical University.PARTICIPANTS: This study was conducted in the Department of Neurology, Shengjing Hospital of Chinese Medical University from January of 1998 to December of 2000. Thirty-six young adult patients with atherosclerotic cerebral infarction, including 30 males and 6 females, with the meaage of (41.6±6.54) years, and 100 healthy young adults, including 66 males and 34 females, with the mea age of (36.16±6.12) years were included in this study.METHODS: 8 Ml venous blood was collected after fasting for 12 hours to assay serum lipid and apolipoprotein. The gene polymorphism of apolipoprotein E and B were detected with PCR method. Enzymic method was used to detect total cholesterol, total triglycerides and high density lipoprotein-cholesterol (HDL-C). Apolipoprotein AI.B was measured with immunoturbidimetry method and lipoprotein (a) with ELISA method.Lipids, lipoprotein and apolipoprotein of six control blood samples couldn't be measured because of hematolysis.MAIN OUTCOME MEASURES: ① The distribution characteristics of genotypic frequency of apolipoprtein E and B in the two groups. ② The relationship between gene polymorphism of aoplipoprotein E and B and the level of blood lipids, lipoprotein and apolipoprotein. ③ The correlation intensity between genotypes of apolipoprotein E and B and onset of young adult atherosclerotic infarction.RESULTS: ① In ACI group, ε3/4 counted for 36.1% and ε2/4 for 27.7%, but was 12% and 7% in control group respectively. The gene frequency of ε4 was 0.320. All these values were higher than that in control group 0.95 (P ＜ 0.05). ② The levels of TG, TC, and LP (a) in ACI group were higher than that in control group. The level of HDL-C was much lower than the control group's (P ＜ 0.05-0.01). ③ ε4 allele caused the increase of the content of TG, TC, and LP (a) so as to induce the relative risk rates of decrease of HDL-C which were 8.23, 4.85, 29.9,4.39 (P ＜ 0.01-0.001) respectively. ④ AI content of the gene frequency of ApoB XbaⅠ X+X- was (1.01±0.30) g/L in ACI group, which was lower than (1.33±0.15) g/L in X-X- subgroup (t=2.55, P ＜ 0.05). The level of ApoA I in X+X group (244.3 mg/L) was remarkably different from that (183.0 mg/L)in control group (t=4.50, P ＜ 0.01). ⑤ Three cases had both ε3 and X+X-in ACI group, 10 had both ε3 and X-X-, 2 had both ε4 and X+X-, and 19 had both ε4 and X-X-. The risk of ACI was 2.85 with the linkage of allele ε4 and allele X-X- in ACI patients (x2=1.52, P ＞ 0.05).CONCLUSION: Allele ε4 is a genetic facilitated factor of young adults ACI. Xba Ⅰ X+X- is another probable genetic symbol. The correlation between atherosclerotic cerebral infarction of young patients during the combination of apolipoprotein E and B should be researched further.

Objective To observe the temporomandibular joint spaces changes after the plastic surgery of combined zygoma with mandibular angel.Methods We randomly selected 59 patients with prominent zygoma and mandibular angle,screening periodontal disease,TMJ pain and partial jaw.Bilateral zygomatic arch coarctation,jaw edge of the mandibular angle ostectomy and the mandibular body outer panel split were used.All patients accepted CT scan and three-dimensional reconstruction before operation,10 days after operation and 6 months after operation,and then image analysis softwares were used to measure the line distance of corresponding angle (0°,60°,120°,and 180°)at the TMJ sagittal plane.The 0° (EE 'pitch) and 60° (AA'pitch) represented for pre-space,the 60° and 120° (PP'pitch) was upper-space,the 120° and 180° (SS'pitch) was posterior-space.Results 0° and 60° had the same change trend,which slightly increased at 10 days after operation.The difference before operation and 10 days,6 months after operation were not statistically significant (P ＞ 0.05);120° and 180° had the same change trend,which increased at 10 days after operation.The difference between before operation and 10 days after operation was statistically significant (P ＜ 0.05),but the difference between before operation and 6 months after operation was not statistically significant (P＞ 0.05).Conclusions In the short term after plastic surgery of zygoma combined with mandibular angel,the TMJ upper and posterior spaces are changed,and the interspace reduced.This may indicate that the TMJ has compensatory ability,and short-term changes can return to normal.

Adult ; Blood Glucose ; analysis ; China ; Diabetes Mellitus ; blood ; epidemiology ; Female ; Humans ; Lipids ; blood ; Male ; Middle Aged

The aim of this study was to develop the data element standard directory of traditional Chinese medicine (TCM) clinical pharmacy information, to provide application standards and models of TCM clinical pharmacy for the electronic medical record (EMR). The developed line of work is as follows: initially establish research through four forms: literature analysis, questionnaires, discussion groups, expert advice. The research range from the Chinese herbal medicine research, herbal origin, harvesting, processing, identification of traits, physical and chemical identification, modern research, character, taste, Indications, clinical application, processing, dispensing medicine, Chinese medicine specifications, usage, dosage, caution, efficacy indications to small packaging applications, drug research, management and other related issues, including traditional Chinese medicine theory, application and hospital management information; according to the general and part 16 content of the national "Health Information Data Element Standards", and the basic method of extracting data element to study and develop the data element of TCM clinical pharmacy information from the defining content. Correspondingly propose the ideas and methods of construction of the "Data Element Standard Directory of TCM Clinical Pharmacy Information", sort out medicine clinical information data element standard catalog, divided into basic categories, clinical application class, management class three parts, and set norms and standards of identifying data elements, definitions, allowable value of traditional Chinese medicine clinical information, and discuss the sources and standards of information collection, leaving the interface, standardized and scientific terminology, docking with the existing standards, maintenance and management program and oter issues.
China ; Data Mining ; methods ; statistics & numerical data ; Database Management Systems ; standards ; statistics & numerical data ; Electronic Health Records ; standards ; statistics & numerical data ; Evidence-Based Medicine ; methods ; statistics & numerical data ; Humans ; Information Dissemination ; methods ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; methods ; statistics & numerical data

Objective To study the effects of Cad-Ⅱgene on osteogenic differentiation of human mesenchymal stem cells in vitro. Methods The human marrow mesenchymal stem cells (hBMSCs) were isolated and cultured in vitro before they were divided into 2 groups. In the transfeetion group, the hBMSCs were transfeeted with Cad- Ⅱgene;in the simple osteogenic inducement group, they were cultured in the condition medium. Then the expressions of Cad- Ⅱ protein were determined and the alkaline phosphatase (ALP) activities and the expressions of ostcocalein were measured at 3, 7, 14 and 21 days for comparison between the 2 groups. Results The ALP activity and positive expression of osteoealcin were regulated significantly higher in the transfeetion group than in the simple osteogenic inducement group at different times (P <0.05). The mineralized nodes began to appear at 14 days in the 2 groups and increased with time. Conclusion Cad-Ⅱgene transfeetion can promote differentiation of hBMSCs into the osteoblasts.

Objective To study the validity and reliability of Tengdao's swallowing standard for stroke pa-tients with dysphagia.Methods A total of 128 patients with postroke dysphagia took the swallowing test and then were divided into three sub-groups.Their scores on Tengdao's evaluation and their fluoroscopy results were analyzed using Spearman's correlation coefficient.Intra-class coefficients (ICCs)were used to examine the intra-rater and in-ter-rater reliability of Tengdao's evaluation.Results TenIgdao's evaluation possessed good validity and reliability.There was a high correlation between the scores in Tengdao's evaluation and fluoroscopy results. Conclusions Tengdao's evaluation is valid,reliable,simple and safe.It can be used in the clinic to evaluate the stroke patients with dysphagia.

Objective To evaluate the clinical performance of IPS e.max Press all-ceramic crowns and three-unit fixed partial dentures(FPDs)and to investigate the periodontal response to the presence of the restorations.Methods According to the inclusion criteria,19 patients with dental defects or singletooth loss were recruited,including 25 crowns and 6 all-ceramic FPDs.The modified United States Public Health Service criteria were used for follow-up evaluation.Plaque index(PI)and sulcus bleeding index (SBI)were recorded for the ceramic restorations and the control teeth.Results No crown and FPD fractures were observed during the evaluation period.There was no statistically significant difference regarding PLI and SBI scores between restorative teeth and the control teeth.And the difference between different recalled times of PLI and SBI of the restorations was no statistically significant.Conclusion IPS e.max Press crowns and three-unit fixed partial dentures exhibit a satisfactory clinical performance.

Objective To investigate the impact of polyclonal neural cell adhesion molecule antibody (P-NCAM-Ab) on the potency of botulinum toxin A (BTX-A).Methods Ninety male Sprague-Dawley rats were randomly divided into 3 equal groups:a normal control group,a BTX-A group and a P-NCAM-Ab group.The rats in the normal control group were injected with 100 μl of saline solution in their right gastrocnemius,while those in the BTX-A and P-NCAM-Ab groups were injected with 100 μl of BTX-A (0.5 U).In addition,the rats in the P-NCAM-Ab group were also injected with 100 μl of P-NCAM-Ab (the dosage was 20 U) at the same site on the 3rd day after the BTX-A injection.The rats' gastrocnemius muscle strength was evaluated with a self-made system for evaluating neuromuscular function before and after the toxin injection,on the 3rd day,as well as 1,2,4,6,8,10 and 12 weeks after the BTX-A injection.Any wet weight changes in the muscles were observed,and immunochemistry methods were employed to observe any structural changes in the motor endplates and nerve fibers at the different time points.Results After the saline injection,the average gastrocnemius muscle strength of the control group increased with time,while strength in the BTX-A and P-NCAM-Ab groups demonstrated a decrease in strength followed by a gradual increase.The average gastrocnemius muscle strength of the rats in the BTX-A and P-NCAM-Ab groups was significantly lower than that of the control group at all time points.Compared with the BTX-A group,the muscle strength of the P-NCAM-Ab group rats decreased further.Strength recovery in the BTX-A and P-NCAM-Ab groups was significantly slower than in the control group.The wet weight percentage in the BTX-A and P-NCAM-Ab groups at first decreased and then recovered with time.After the BTX-A injection,the average wet weight percentage of the P-NCAM-Ab group rats was significantly lower than that of the BTX-A group after 3 days,and 1,2 and 4 weeks.Karnovsky-Roots AchE staining showed that the motor endplates' color in the BTX-A and P-NCAM-Ab groups deepened gradually,though the color of the P-NCAM-Ab group was lighter than that of the BTX-A group at each time point.The mean optical density of the motor endplates' positive reaction area increased with time in both groups,but the P-NCAM-Ab group was lower than that of the BTX-A group at 1,2,4,8 and 12 weeks.Counting the nerve fibers dyed by gold chloride showed similar trends with both experimental groups significantly different from the control group.Conclusion P-NCAM-Ab can increase the potency of BTX-A and prolong its action.

Objective: To observe the effects of follistatin (FST)on the skeletal muscle wasting of cancer cachexia mice and the expressions of Mstn, LncRNA-MALAT1 and Caspase-3, and to elucidate its associated molecular mechanisms.Methods:Thirty-two BALB/c mices were randomly assigned into:healthy control (HC) group,FST prevention (FP)group,FST treatment (FT)group and cancer cachexia (CC)group.The murine colon adenocarcinoma CT26 cells were inoculated subcutaneously into the mices in FP, FT and CC groups to establish the cancer cachexia models. The body weight, spontaneous activity and tumor growth were daily monitored.The mice in FP and FT groups were administrated with FST intraperitoneally on day 6 and 12 after inoculation.The samples were collected on day 20.The tumor and gastrocnemius weights of the mice were detected. The biochemical metabolism indexes and myofiber cross-sectional area of gastrocnemius tissue were detected.The mRNA expression levels of Mstn,Caspase-3 and LncRNA-MALAT1 were examined by Real-time PCR.The protein expression levels of Mstn and Caspase-3 were measured by Western blotting method. Results:Compared with CC group,the body weights,spontaneous activities,gastrocnemius weights and myofiber cross-sectional areas were increased (P <0.05);the serum levels of glucose,total protein and albumin of the mice in FP and FT groups were increased (P <0.05).The protein and mRNA expression levels of Mstn and Caspase-3 in gastrocnemius of the mice in CC group were significantly higher and the expression level of LncRNA-MALAT1 was significantly lower than those in HC group (P < 0.05).The mRNA and protein expression levels of Mstn and Caspase-3 in FP and FT groups were reduced and the expression level of LncRNA-MALAT1 was increased compared with CC group (P < 0.05).The prevention effect in FP group is better than FT group (P < 0.05). Conclusion:FST may alleviate the muscle wasting of the mice with cancer cachexia by inhibiting the expression of Mstn,thus upregulating the expression of LncRNA-MALAT1 which in turn to suppress the expression of Caspase-3.