·Hemophilia is a rare disorder that occasionally has visual symptoms after diagnosis. The authors present a case in which visual symptoms led to the initial diagnosis, a 22-year-old man who represented with spontaneous fundal haemorrhage. There is no history of bleeding and trauma. The fundal haemorrhage was absorbed significantly without any treatment after 3 months follow-up. Hemophilia A was found to be the causative disorder in this previously healthy man. The authors present a rare case in which unilateral visual complaints led to the diagnosis of hemophilia A. Thus, though uncommon, hemophilia should be considered in the differential diagnosis of otherwise unexplained fundal haemorrhages.

OBJECTIVETo investigate clinical effects of minimally invasive fixation and bone grafting througn medial side for the treatment of Schatzker III tibial plateau fracture.

METHODSFrom April 2009 to August 2011, 18 patients with Schatzker III tibial plateau fracture were treated with minimally invasive fixation and bone grafting through medial side. There were 15 males and 3 females ranging in age from 64 to 73 years, with an average of (69.75 ± 1.22) years. Sixteen patients were caused by falling down, 2 cases were caused by traffic accident. Operative time and length of incision were be recorded. Clinical and radiological follow-up was performed after operation. Hospital for Special Surgery (HSS) score and Kellgren-Lawrence score were used to evaluate clinical effects.

RESULTSThe mean operative time was (45.32 ± 1.58) min, and the mean length of incision was (5.21 ± 0.65) cm. Postoperative X-ray showed excellent reduction. Eighteen patients were followed up for 10 to 13 months with an average of (11.5 ± 1.35) months. The mean HSS score was 86.51 ± 2.71, 12 cases got excellent results,4 good and 2 fair. Three patients were developed mild osteoarthritis according to the Kellgren-Lawrence system.

CONCLUSIONMinimally invasive fixation and bone grafting through medial side, not only could reduce surgical invasive, but also guarantee early function activities. It has advantages of keeping well after reduction. So it has the favorable future in clinic.

Aged ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Retrospective Studies ; Tibial Fractures ; surgery

Objective To investigate the expression of vascular endothelial growth factor (VEGF), angiopoietin and their receptors (VEGFR and Tie2) in aging mice kidney and the possible roles in aging mice. Methods Mice were divided as follows: 4-month old group (n=6), 9-month old group (n=6), 12-month old group (n=6) and 20-month old group (n=6). Paraffin sections of the mice kidneys were stained by PAS. The density of glomerular microvascular was determined by renal perfusion with fluorescent dyes. The level of VEGF, VEGFR2 (Flk-1), Ang-1, Ang-2, Tie2 mRNA expression and protein abundance in kidney was determined by real-time PCR, immunochemistry, immunofluorescence and Western blot. Results Compared with other three groups, in the 20-manth old group, the glomerulosclerosis index (GSI) increased remarkbly (2.48±0.79 vs 0.53±0.19, 0.69±0.18, 1.50±0.70, P<0.05); the fluorescence intensity in glomeruli decreased (P<0.05). lmmunohistochemistry demonstrated that the TGF-131 level in the aging kidneys showed an increase trend in the glomerular tubulointerstitium, and especially in the glomeruli. Real-time PCR results revealed that compared with 4-month old group mice, the mRNA expression of VEGF, Flk-1, Ang-1, Ang-2, Tie2 of the other three groups decreased, the gene levels of VEGF, Flk-1, and Ang-2 fell about 90%, 50% and 80% (all P>0.05), and the gene levels of Ang-1 and Tie2 fell about 75% and 40% in 20-month-old group (all P<0.05). Western blot domonstrated that the protein abundace of VEGF, Flk-1, Ang-1, Ang-2, Tie2 also declined with aging, the protein level of VEGF, Flk-1, Ang-1, Ang-2 and Tie2 dropped by about 35%, 50%, 15%, 13% and 21% respectively in 20-month-old group as compared to 4-month-old group (all P<0.05). Expression of above 5 factors and glomerular fluorescence intensity were negatively correlated with Scr (P<0.05). Conclusions The mRNA expression and protein abundance of VEGF, Flk-1, Ang-1, Ang-2, Tie2 in mice kidneys decreases with aging. Angiogenesis regulatory factors may play important roles in aging progression of the mice kidney.

Objective To study the changes of neutrophil surface molecule CD64 and inflammatory factor levels in patients with burn infection. Methods 46 cases of patients with burn infection who were treated in the department of burn in our hospital between March 2010 and October 2015 were selected as the observation group. Meanwhile, 46 cases of healthy people who underwent physical examination in our hospital during the same period were included in the control group. The levels of neutrophil surface molecule CD64, C-reactive protein (CRP), white blood cell count (WBC) and inflammatory factor [interleukin IL-6 (IL-6), interleukin (IL-8), tumor necro-sis factor (TNF-α) in the two groups of subjects were determined by flow cytometry and were compared. Results In the observation group, the levels of CD64, CRP, WBC and inflammatory factors were significantly higher than those in the control group (P < 0.05). Conclusion The levels of CD64, CRP, WBC and inflammatory factors in patients with burn infection are significantly higher than those in healthy people , which indicates that neutrophil surface molecule CD64, inflammatory factors and burn infection are closely correlated.

Objective:To analyze the clinical characteristics and diagnosis and treatment of children with Kasabach-Merritt phenomenon (KMP).Methods:A retrospective analysis was conducted on the clinical data and follow-up data of 8 patients diagnosed KMP in Beijing Children′s Hospital, Capital Medical University from January 2016 to January 2019.The clinical data included laboratory examination, diagnosis, treatment and prognosis.Results:Among the 8 children with KMP, 6 cases were male and 2 cases were female.The median onset age was 4 (0-17) months, 2 cases of neonatal onset.The median onset to the diagnosis time was 59 (34-140) days; 6 cases with bone destruction; 6 cases had misdiagnosis and mistreatment history, they were misdiagnosed as idiopathic thrombocytopenic purpura, Evans syndrome, abnormal bone and joint development; 4 cases were Kaposiform hemangioendothelioma; 8 cases were used alone or combined with the application of hormones, Sirolimus, and Vincristine, 7 patients underwent interventional therapy.All patients survived with a median follow-up period of 487 (112-1 033) days.Median time of platelet count returned to normal was 24.5 (7-60) days, and median time of fibrinogen returned to normal was 20 (7-30) days.Median time of D-dimer dropped to a normal was 105 (40-240) days.Conclusions:Children with concurrent platelet count and coagulation abnormalities should be considered with KMP.Doctors need to identify the potential visceral vascular lesions.Early diagnosis and treatment are important, which can improve the clinical prognosis of patients.

The clinical and laboratory data of a patient with chronic refractory immune thrombocytopenia (ITP) who had a significant increase in the proportion of inhibitory T cells in the hematological oncology center of Beijing Children′s Hospital Affiliated to Capital Medical University in February 2018 and regularly followed up in the outpatient department received a retrospective analysis.This 8-year-old patient′s clinical features were 6 years of skin and mucous membrane bleeding spots and petechiae recurring, with occasionally nasal epistaxis.Physical examination: cardiopulmonary abdomen and nervous system examinations are normal, and no superficial lymphadenopathy is touched.Blood routine indicated that the platelets were 2.00×10 9/L, and white blood cell count and hemoglobin level were normal.Bone marrow suggested that hyperplasia was significantly active, with more than 300 megakaryocytes.The patient was diagnosed with ITP, and he was treated with first-line treatment with gamma globulin and oral Corticosteroids.The first-line treatment with high-dose Dexamethasone therapy was repeated, and the second-line treatment was low-dose Rituximab combined with high-dose Dexamethasone.Evaluations had been conducted with every relapsed course, and Cyclosporine was administered orally on the basis of the highly suppressive T cells.After half a month, the child achieved partial remission and continued for 3 months, and then reached a complete remission of 6 months (till this paper). It is suggested that, with ITP as an immunological disease with high heterogeneity, the immune abnormality index is expected to become a breakthrough in the development of precise treatment.

OBJECTIVETo investigate the effects of total flavonoids of Litsea Coreana (TFLC) on the gap junction (GJ) intercellular communication in TM3 testicular Leydig cells and whether TFLC can reduce the cytotoxicity of oxaliplatin (OHP) in vitro.

METHODSWe detected the effect of TFLC on the dye spread of the in vitro cultured TM3 cells by parachute assay, observed changes in the expression of connexin 43 (Cx43) total protein in the TFLC-treated TM3 cells by Western blot, and determined the effects of TFLC on the expression of Cx43 on the membrane of the TM3 cells by immunofluorescence assay and on the cytotoxicity of OHP by MTT assay.

RESULTSTFLC obviously enhanced the GJ function with the increasing of the TFLC concentration in the TM3 cells. Western blot and immunofluorescence assay confirmed that TFLC significantly enhanced the expression of Cx43 total protein and Cx43 expression on the membrane of the TM3 cells. MTT assay showed that at a high cell density (confluent with GJ formation), 20 microg/ml TFLC enhanced the GJ function of the TM3 cells and reduced the cytotoxicity of OHP (P < 0.05), while at a low density (preconfluent with no GJ formation), TFLC exhibited no effect on the cytotoxicity of OHP (P > 0.05).

CONCLUSIONTFLC increases the Cx43 expression and GJ function in normal TM3 Leydig cells, and the enhancement of GJ function reduces the cytotoxicity of OHP.

Antineoplastic Agents ; toxicity ; Cell Communication ; drug effects ; physiology ; Cell Count ; Connexin 43 ; metabolism ; Flavonoids ; pharmacology ; Gap Junctions ; drug effects ; Humans ; In Vitro Techniques ; Leydig Cells ; drug effects ; ultrastructure ; Litsea ; chemistry ; Male ; Organoplatinum Compounds ; antagonists & inhibitors ; toxicity ; Proteins ; metabolism

Objective: To explore the echocardiographic cardiac geometric morphology and hemodynamics in premature infants at different gestational age with the inlfuencing factors.
Methods: A total of 150 premature infants and 150 full-term control infants were enrolled in this study. Based on gestational age, premature infants were divided into 3 groups:①(28-32+6 ) weeks,②(33-34+6 ) weeks,③(35-36+6) weeks; and full term control infants were divided into 2 groups:①’(37-38+6) weeks and②’ (39-41+6) weeks respectively. An iE33 Philips ultrasound examination was conducted to measure left ventricular end-diastolic diameter (LVEDD), LVESD, interventricular septum thickness, posterior wall thickness, left ventricular end-diastolic volume (LVEDV), LVESV, stroke volume, LVEF, left ventricular fractional shortening (LVFS), cardiac output, stroke index, cardiac index, left ventricular mass, left ventricular mass index (LVMI), left ventricular relative wall thickness, left ventricular remodeling index (LVRI) and LVEDVI.
Results: With adjusted body surface area, all parameters for cardiac geometric morphology and hemodynamics were similar among different groups,P>0.05. The day-old age (P=0.001), height (P=0.001) and body weight for low weight born infant (P=0.012), for normal weight born infant (P=0.003), for giant infant (P=0.016) were the independent inlfuencing factors for LVMI. The impact of anthropometry and the basic life indexes were similar on LVRI among groups (χ2=42.88,P=0.076), while the covariates were different on LVMI among groups (χ2=123.6,P<0.001).
Conclusion: Cardiac morphology and hemodynamics measured by echocardiography has important clinical meaning for assessing the development and maturity of neonatal hearts in premature infants.

Objective: To explore the correction factors of lung cancer caused by radon exposure in a uranium mine, and estimate the excess relative risk (ERR) coefficient of lung cancer caused by radon in the uranium miners. Methods: Male miners who worked in a uranium mine more than one year in Hunan Province from 1958 to 2018 were selected. This study preliminarily estimated the ERR coefficient of lung cancer caused by radon in the miners with different corrections using the Possion regression model. Results: This study cohort included 4 851 uranium miners, with 187 miners died with lung cancer from 1958 to 2018, and cumulative follow-up of 207 251 person-year. The ERR coefficient of lung cancer caused by radon without correction factors was estimated to be 0.21%/WLM (95%CI: 0.04%/WLM-0.27%/WLM). In the final model, the exponential correction factors of radon-induced lung cancer were time since exposure and exposure rate. In this model, if time since exposure was 45 years and the average exposure rate was 0.14 WL, the estimated ERR coefficient was 1.73%/WLM (95%CI: 0.36%/WLM-3.11%/WLM). The ERR decreases by about 60.00% for every 10 years since exposure, and increases by about 30.00% for every one WL increase exposure rate. Conclusion: The correction factors of lung cancer caused by radon in uranium miners in this mine were the time since exposure and exposure rate. It was preliminarily estimated that the ERR coefficient of lung cancer caused by radon in the occupational radon exposed population in this uranium mine was 1.73%/WLM (95%CI: 0.36%/WLM-3.11%/WLM).

Background:Epilepsy is a chronic disorder characterized by recurrent seizures and has significant psychological and social consequence for everyday living.Epilepsy affects various aspects of ones' social life.The present study aimed to investigate the influence of marital status on the quality of life of adult Chinese patients with epilepsy.Methods:This study surveyed 805 Chinese adults who have been clinically diagnosed with epilepsy for longer than 1 year in 11 hospitals in Beijing.In this survey,532 (66.1％) participants were married.All of them completed the case report form with enquiries on demographic data,social factors,and illness.The marriage status of adult epileptic quality of life was the dependent variable,and demographic data and clinical data were independent variables,analyzed through the multiple linear regression analysis methods.The patients' quality of life was assessed using the Quality of Life in patients with Epilepsy-31 items (QOLIE-31) questionnaire,the Patient Health Questionnaire-9 items (PHQ-9),and the Generalized Anxiety Disorder-7 items (GAD-7).Results:The PHQ-9 and GAD-7 scores in the unmarried group (PHQ-9 =6.0 and GAD-7 =5.0) were significantly higher than that of the married group (PHQ-9 =4.0 and GAD-7 =3.0).The scores of married adult patients with epilepsy on QOLIE (61.8 ± 15.3) and social function (70.9 ± 22.7) were higher than the scores of the unmarried patients aged between 20 and 44 years.The scores of married adult epileptics on the QOLIE (58.4 ± 14.6) and the energy/fatigue (62.1 ± 20.4) were higher than the scores of the unmarried patients (QOLIE =58.4 ± 14.6 and the energy/fatigue =62.1 ± 20.4) aged between 45 and 59 years.For the adult epilepsy patients,depression,anxiety,seizures within the last year,disease course,medical expense category,and marriage* age are negatively correlated with the quality of life.Occupation,educational level,and average monthly income are closely related to the quality of life.Conclusions:Married adult epileptic patients have better quality of life than that of unmarried adult patients in young and middle-aged age groups.Unmarried adult patients with epilepsy are more anxious and depressed than married adult patients.