Objective To investigate clinical characteristics of refractory systemic juvenile idiopathic arthritis(JIA)and the efficiency of glucocorticoid in therapy on this kind of disease.Methods Thirty-nine children with systemic JIA were divided into low dose group 0.5-1.0 mg/(kg?d)and high dose group 1.0-1.5 mg/(kg?d).And the efficiency was observed by change of active index after 10 and 20 days.Results The effective power was 58.8% and 72.7% after 10 days,respectively.After 20 days,the power was 76.5% and 90.9%,respectively.The power in high dose group was significantly higher than that in low dose group.It had no difference in statistical analysis for efficiency of 2 kind of glucocorticoid dosage to control fever,but it had obvious difference to control arthralgia,arthrocele,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP).Conclusion Glucocorticoid therapy is very effective to control the activity of disease in patients with systemic JIA.

Objective To explore the agreement of anterior chamber angle examination by slit lamp optical coherence tomography (SL-OCT) and gonioscope.Design Case series.Participants Thirteen patients with primary glaucoma (26 eyes) and 8 normal persons(16 eyes).Methods Anterior chamber angle was measured with SL-OCT and gonioscope in turns for temporal,nasal,superior and inferior quadrant.Results of two methods were analyzed and the data were analyzed with Pearson correlation coefficient and Kappa value.Main Outcome Measures Anterior chamber angle.Results The Pearson correlation coefficient of the two methods was 0.86(P=0.00)and the Kappa value is 0.75 (P=0.00).The specificity and sensitivity of detecting occludable angle were 94.7% and 89.4%.Conclusions Anterior chamber angle examination with SL-OCT and gonioscope are well consistent.The specificity and sensitivity for SL-OCT in detecting occludable angle is satisfying.SL-OCT can be regard as an objective assistant method for the diagnosis of angle closure glaucoma.

OBJECTIVETo observe the effect of Xinfeng Capsule (XFC) on ankylosing spondylitis (AS) patients' symptoms and signs, serum immunoglobulin levels, peripheral blood lymphocyte autophagy protein, autophagy gene, and to explore its mechanism.

METHODSTotally 59 AS patients were assigned to the treatment group (39 cases) and the control group (20 cases) according to random digit table. Patients in the treatment group received XFC, 0.5 g each pill, three pills each time, 3 times per day, while those in the control group received sulfasalazine (SASP), 0.25 g per tablet, 4 tablets each time, twice per day. Three months consisted of one therapeutic course. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) were statistically calculated. Serum immunoglobulins (IgG1, IgG2, IgG3, IgG4, IgA , SIgA, and IgM) were detected using ELISA. Changes of Beclin1, LC3-II, phosphatidylinositol 3-kinase (PI3K), Akt, the mammalian target of rapamycin (mTOR) were detected using Western blot. Serum autophagy related genes such as Atg1, Atg5, Atg12, Atg13, and Atg17 were detected using the polymerase chain reaction (PCR). The correlation between immunoglobulin subtypes and autophagy gene in AS patients using Spearman correlation.

RESULTSCompared with before treatment, BASDAI, IgG1, lgG3, and IgA decreased (P < 0.01); PI3K, Akt, and mTOR protein expressions decreased (P < 0.01); ATG1, ATG12, ATG13, and ATG17 mRNA expressions decreased, ATG5 mRNA expression increased (P < 0.01) in the treatment group. But BASDAI, IgG1, and IgA levels decreased (P < 0.05, P < 0.01); PI3K, Akt, and mTOR protein expressions decreased (P < 0.05); ATG1 and ATG13 mRNA expressions decreased (P < 0.05, P < 0.01) in the control group. Compared with the control group, BASDAI, IgG1, and IgA levels decreased (P < 0.05); PI3K, Akt, mTOR protein expressions decreased (P < 0.01); ATG12 and ATG17 mRNA expression decreased, ATG5 mRNA expression increased (P < 0.01) in the XFC group. Correlation analysis showed AS patients' IgG1, IgG2, IgG3, IgA, SIgA, IgM had negative correlation with ATG17; IgG4 and ATG17 were positively correlated (P < 0.05, P < 0.01).

CONCLUSIONXFC could elevate clinical efficacy of AS patients and enhance their autophagy, which might be achieved by acting on PI3K/Akt/mTOR signal, affecting autophagy gene and autophagy protein expression, taking part in the regulation of proliferation and differentiation of lymphocyte B, and strengthen humoral immunity.

Apoptosis Regulatory Proteins ; metabolism ; Autophagy ; drug effects ; Beclin-1 ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Lymphocytes ; drug effects ; Membrane Proteins ; metabolism ; Phosphatidylinositol 3-Kinases ; metabolism ; Spondylitis, Ankylosing ; drug therapy ; Sulfasalazine ; therapeutic use ; TOR Serine-Threonine Kinases ; metabolism

OBJECTIVETo investigate the relation between lipoprotein (a) (LP(a)) and cerebral infarction in young adults.

METHODSSerum LP(a) of 90 young adults (age below 45 years) with cerebral infarction was measured. Serum lipids include triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol, low density lipoprotein cholesterol, apolipoprotein A-I (ApoA-I) and apolipoprotein B (ApoB) were also measured. Other possible risk factors such as hypertension, smoking, drinking and family stroke history were reviewed.

RESULTSThere was no significant difference of serum LP(a) value between stroke patients and controls. TG (P < 0.01) and ApoB (P < 0.01) values in patients with cerebral infarction were significant higher than those in controls. Lipoprotein (a) was correlated with total cholesterol and low density lipoprotein cholesterol, with the values of correlation coefficient (r) 0.28 and 0.23 (both P < 0.01). After adjustment for age, sex, hypertension, smoking, drinking alcohol, family stroke history and other serum lipids, the odd radio for LP(a) and cerebral infarction was 0.74 (95% CI: 0.27 - 1.98). The odd radio for elevated TG was 3.57 (95% CI: 1.34 - 9.49); The odd ratios for hypertension, heart diseases and smoking as risk factors for cerebral infarction in young patients showed as: hypertension OR = 8.18, 95% CI: 2.54 - 26.33; heart diseases: OR = 8.51, 95% CI: 2.27 - 31.85; smoking: OR = 3.21, 95% CI: 1.27 - 8.13.

CONCLUSIONLP(a) might not be a risk factor for cerebral infarction in young patients while elevated triglyceride, hypertension, heart diseases and smoking were important risk factors in young adults with cerebral infarction.

Adult ; Age Factors ; Cerebral Infarction ; blood ; epidemiology ; etiology ; China ; epidemiology ; Female ; Humans ; Hypertension ; complications ; Lipoprotein(a) ; blood ; Logistic Models ; Male ; Risk Factors ; Smoking ; adverse effects ; Triglycerides ; blood

Objective To evaluate the clinical efficacy and safety of Yanhuning in the treatment of children ’ s hand -foot -and -mouth disease ( HFMD).Methods One hundred cases with HFMD were ran-domly divided into treatment group ( n=50) and control group (n=50). Patients in the treatment group were given 5-10 mg · kg-1 · d-1 Yanhu-ning +glucose injection 50-100 mL, once a day.Patients in control group were received 10 -15 mg · kg-1 · d -1 ribavirin +glucose injection 100 mL, twice a day.The course of treatment was 7 days for two group.After treatment, the clinical efficacy , clinical symptoms subside time ( herpes disappearance time , temperature returned to normal time, cure time) , alanine aminotransferase ( ALT) , blood urea nitrogen (BUN), creatinine (Cr)at different times (before treatment, after 24, 48 , 72 h ) and adverse drug reactions in two groups were compared.Results After treatment, the total efficiency of treatment group and control group were 96.00% and 84.00%, respectively , showing the better therapeutic effect of the treatment group than the control group.Herpes disappearance time , temperature returned to normal time , healing time of treatment group were shorter than those of control group , there was a significant difference (P<0.05).After treatment 24, 48, 72 h, the ALT, BUN, Cr of treatment group were lower than those of control group , more closer to normal ( P<0.05 ).The incidence of adverse reactions in treatment group and the control group was 12.00%and 16.00%, there was no significant difference ( P>0.05 ).Conclusion The Yanhuning for the treatment of HFMD of children had a good effect , and it can shorten the time of clinical symp-toms and hospitalization time.It can effectively reduce the content of ALT , BUN, Cr and have good effect.

OBJECTIVETo prepare monoclonal antibody (mAb) against prM epitope.

METHODSThe gene encoding prM was isolated using RT-PCR from brain of JEV infected mouse and cloned into prokaryotic expression vector pET-32a. Recombinant plasmid was transformed into E.coli BL21/DE3/LysS, then the transformed cells were expressed with the induction of IPTG. The expression and purification of the prM protein was analyzed by SDS-PAGE. The BALB/c mice were immunized with purified prM protein. Hybridoma cell lines secreting monoclonal antibodies against prM were established after cell fusion of mouse splenic cell and P3-X63-Ag8.653 cells. The specificity of mAb was identified by ELISA, Western Blot and Immunohistochemistry assay.

RESULTSmAb against prM epitope of JEV was prepared successfully.

CONCLUSIONThe obtained prM specific mAb was valuable for the prevention and dignosis of Japanese encephalitis.

Animals ; Antibodies, Monoclonal ; analysis ; immunology ; isolation & purification ; Antibody Specificity ; BALB 3T3 Cells ; Cell Line ; Cloning, Molecular ; Electrophoresis, Polyacrylamide Gel ; Encephalitis Virus, Japanese ; genetics ; immunology ; Epitopes ; immunology ; Escherichia coli ; genetics ; Mice ; Plasmids ; genetics ; metabolism ; Prokaryotic Cells ; metabolism ; Sequence Analysis, DNA ; Viral Proteins ; biosynthesis ; genetics ; immunology ; isolation & purification

OBJECTIVETo study the application value of asthma predictive index (API)-based group therapy in wheezing children under 5 years of age.

METHODSA total of 239 wheezing children under 5 years of age were divided into API-positive (n=126) and API-negative groups (n=113). Each group was randomly assigned to inhaled corticosteroids (ICS) subgroup and montelukast sodium (leukotriene receptor antagonist, LTRA) subgroup. The ICS and LTRA subgroups received the same drug therapy at the same dosage within the first four weeks of treatment. In the stable period of disease, the ICS subgroup only received aerosol inhalation of budesonide suspension, while the LTRA group was orally given montelukast sodium only. Asthma symptom scores were assessed and recorded at different time points.

RESULTSIn the first four weeks of treatment, ICS and LTRA were effective both in the API-positive and API-negative groups; the two groups showed significant improvements in asthma symptom scores, and the asthma symptom score showed no significant difference between the ICS and LTRA subgroups of each group. After 24 weeks of treatment, the two therapies were still effective; in the API-positive group, the LTRA subgroup had a better treatment outcome than the ICS subgroup, but there was no significant difference in treatment outcome between the LTRA and ICS subgroups of the API-negative group.

CONCLUSIONSFor wheezing children under 5 years of age, therapeutic strategies can be chosen based on API in the stable period of disease, so as to better control wheezing.

Administration, Inhalation ; Adrenal Cortex Hormones ; administration & dosage ; Asthma ; diagnosis ; drug therapy ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Leukotriene Antagonists ; therapeutic use ; Male ; Psychotherapy, Group ; Respiratory Sounds ; diagnosis ; drug effects

OBJECTIVETo study the effect of methylprednisolone (MP) on reperfusion injury in severe uncontrolled hemorrhagic shock and explore the possible mechanism involved.

METHODSTwelve dogs were randomly divided into two groups, control group (Group I, n=6) and MP group (Group II, n=6). The animals were bled continuously from a femoral artery catheter to produce uncontrolled hemorrhagic shock models. Resuscitation with lactated Ringer's (LR) solution was initiated when mean arterial pressure (MAP) decreased to 20 mm Hg, and MAP was maintained at 30-40 mm Hg. MP (4 mg/kg) was injected intravenously in Group II when resuscitation began. While in Group I, normal saline (NS) was injected instead. The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) were measured before exsanguination (T(1)), when MAP decreased to 20 mm Hg (T(2)), 60 min (T(3)) and 120 min (T(4)) after resuscitation. Heart rate, MAP and cardiac output (CO) levels were recorded concomitantly.

RESULTSInfusion volume and hemorrhage volume shed from the superior mesenteric artery in Group I were higher than those in Group II (P<0.01 and P<0.05). After reperfusion, blood SOD levels decreased progressively and MDA levels increased rapidly in Group I. In Group II, blood SOD levels at T(3) and T(4) decreased as compared with that at T(1) but a stepwise increase was present. At T(4), blood SOD level was significantly higher in Group II than in Group I (Plt;0.01). At T(3) and T(4), MDA levels were markedly lower in Group II than in Group I. During reperfusion, MAP was more steady in Group II than in Group I and survival rate after 120 min (at T(4)) was higher in Group II than in Group I (P<0.05).

CONCLUSIONSMP has a protective effect on severe uncontrolled hemorrhagic shock and subsequent reperfusion injury. The mechanism mainly involves the anti-lipid peroxidation activity of MP.

Analysis of Variance ; Animals ; Disease Models, Animal ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Female ; Lipid Peroxidation ; Male ; Methylprednisolone ; pharmacology ; Probability ; Random Allocation ; Reference Values ; Reperfusion Injury ; drug therapy ; physiopathology ; Sensitivity and Specificity ; Shock, Hemorrhagic ; drug therapy ; physiopathology ; Survival Rate

OBJECTIVETo seek consciousness regaining methods at early stage for coma patients in neurosurgery.

METHODSPatients whose Galsgows Coma Scale (GCS) < 8 including cerebral contusion, cerebral hemorrhage and brain tumor were randomly divided into an observation group (218 cases) and a control group (237 cases). Conventional medicine and/or surgery were used in two groups. After vital signs became stable, Xingnao Kaiqiao needling method was applied at Shuigou (GV 26), Baihui (GV 20), Neiguan (PC 6), etc. and combined with exercise therapy in observation group, while no rehabilitation therapy was used in control group. The therapeutic effect between two groups was compared.

RESULTSAfter 30 days' treatment, the conscious rate of observation group (80.7%, 176/218) was higher than that of control group (46.8%,111/237), and there was statistics significance between them (P < 0.001).

CONCLUSIONEarly acupuncture combined with exercise therapy can improve the conscious rate of coma patients in neurosurgery, thereby decrease their mortality and disability rate.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Child ; Coma ; therapy ; Consciousness ; Exercise Therapy ; Female ; Humans ; Male ; Middle Aged

OBJECTIVETo deeply understand prognosis of pediatric cases with lupus nephritis (LN) treated in our hospital and analyze the prognostic factors.

METHODOne hundred and one patients were enrolled, who were diagnosed as lupus nephritis in our hospital during the period from Jan. 1996 to Dec. 2007. Clinical data were retrospectively analyzed; the observation was ended on 31(st) Dec. 2009. Patients were divided into renal biopsy group and non renal biopsy group; group A (type I + II LN), group B (type III + IV LN) and group C (type V LN); CTX group (cyclophosphamide) and MMF group (mycophenolate mofetil); remission group (complete remission and partial remission) and ineffective group (treatment failure and death). Medication non-compliance means (1) the interval of CTX pulse was more than 45 days or treatment course less than 6 times; (2) patients discontinued MMF or other immunosuppressant on themselves more than a week ago. SPSS 11.0 software Life-Tables method was used to analyze cumulative survival rates.

RESULT(1) Three and five years' patient survival rates were 93.59% and 87.80% respectively. Three and five years' kidney survival rates were 100% and 91.12% respectively. (2) Univariate analysis showed that induction remission were related to five factors, including whether received renal biopsy (χ(2) = 9.023, P = 0.003), different pathological types (χ(2) = 9.437, P = 0.009), different induction drug (χ(2) = 4.610, P = 0.032), treatment compliance (χ(2) = 18.716, P = 0.000) and proteinuria amount (χ(2) = 8.013, P = 0.046), and maintenance remission were related to the former four factors (χ(2) = 10.209, P = 0.001;χ(2) = 7.757, P = 0.021;χ(2) = 4.206, P = 0.04;χ(2) = 24.571, P = 0.000). (3) Multivariate analysis showed that maintenance remission was mainly related to medication-compliance (χ(2) = 9.818, P = 0.002). Poor medication compliance mainly occurred in non renal biopsy group (χ(2) = 9.569, P = 0.002). (4) In renal biopsy group, 15 cases showed a small amount proteinuria, 4 of them were proved as severe pathological type LN (2 cases type III, 1 case type IV and 1 case type V). (5) In group B, no medication non-compliance occurred, and the efficacy of MMF and CTX had no significant difference (P = 0.405).

CONCLUSIONThe main affecting factor of remission rate was medication compliance. In type III and IV lupus nephritis, the efficacy of MMF and CTX were no significant difference. The poor outcome of non-renal biopsy group may be due to unclear pathological classification and poor medication compliance. We strongly recommend that SLE patients with mild abnormal results of urinalysis should receive renal biopsy.

Adolescent ; Biopsy ; Child ; Child, Preschool ; China ; Female ; Follow-Up Studies ; Humans ; Infant ; Kidney ; pathology ; Lupus Nephritis ; diagnosis ; therapy ; Male ; Medication Adherence ; Prognosis ; Remission Induction ; Survival Analysis