OBJECTIVETo understand the clinical features of gastrointestinal cow's milk allergy in children, and to assess the importance of cow's milk challenge.

METHODAn analysis was performed on the clinical manifestations and the challenge results of 50 children who received cow's milk challenges after admission to the department of gastroenterology, Children' s Hospital of Zhejiang University School of Medicine from January,2009 to December, 2012. The value of immunoglobulin E antibody was also analyzed among the 50 children, 25 cases were male and the other 25 were female. The youngest subject was 1. 6 months old, and the oldest was 20 months, most of the cases were younger than 6 months (36 cases).

RESULT(1) Diarrhea (27 cases, 54%) and hematochezia (25 cases, 50%) were the most common clinical features, vomiting, hematemesis and abdominal distention were rare. (2) Cow's milk challenges failed in 58% of the cases, 90% of whom showed delayed allergy. Diarrhea (19 cases, 73%) was the major later presentation, whereas the immediate hypersensitivity showed angio-edema, gastrointestinal symptom and rash. (3) The neutrophil count ((3.8 ± 2.8) x 10(9)/L vs. (2.5 ± 1.3) x 10(9)/L) was higher after challenge among children who failed the challenge. The change in the count of blood cell, neutrophil and platelet was studied, however, there were no statistical differences between the challenge-failed children and the passed ones. (4) Forty-seven cases had milk specific immunoglobulin E antibody test, and 5 showed positive results, 4 of whom were seen among the challenge-failed children.

CONCLUSIONDiarrhea and hematochezia was the most common clinical manifestation, and cow's milk protein induced proctocolitis was the most common disease in practice. It is important and necessary to perform cow's milk challenge.

Animals ; Female ; Gastrointestinal Diseases ; etiology ; Gastrointestinal Hemorrhage ; etiology ; Hematemesis ; etiology ; Humans ; Hypersensitivity, Immediate ; immunology ; Infant ; Infant, Newborn ; Male ; Milk ; Milk Hypersensitivity ; immunology ; Vomiting ; etiology

Objective To apply a hand function laserimager to evaluate the effect of acupuncture on hand dysfunction after stroke. Meth-ods From January to June, 2016, 18 stroke patients with upper limb dysfunction were divided into control group (n=9) and acupuncture group (n=9). The control group received routine medication and rehabilitation, while the acupuncture group received acupuncture in addi-tion. They were assessed with modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA) of upper limb motor function and modified Bathel Index (MBI) before and after three-week treatment, while the region of interest (ROI) of their hands was tested with the hand func-tion laserimager. Results The scores of MAS and FMA improved after treatment in both groups (t>4.44, P<0.01), and improved in the score of MBI in the acupuncture group (t=3.95, P<0.01). The scores of MAS, FMA, and MBI improved more in the acupuncture group than in the control group (t>3.17, P<0.01). Meanwhile, the scores of ROI decreased in the affected hands after treatment (t>7.78, P<0.001), and de-creased more in the acupuncture group than in the control group (t=-2.23, P<0.05). No significant difference was observed in the scores of ROI of the unaffected hands (t=-0.11, P>0.05) between groups. Conclusion The hand function laserimager, which responds to the blood perfusion of the hand, can be used as a tool to evaluate the hand function.

Objective To explore the relationship between music preferences and mental health in medical students and to propose countermeasures.Methods Music Preferences Questionnaire and Chinese college students mental health scale(CCSMHS) were used to test 538 randomly selected medical students and the data was analyzed by descriptive statistics,T test and variance analysis with SPSS 20.0 and the inspection level was α=0.05.Results ①Statistically significant (P＜0.05) differences were found on somatization,anxiety,depression,inferiority,paranoid,force,social withdrawal,reliance,impulse and psychotic tendencies in medical students with different preference of music style; ②Statistically significant (P＜0.05) differences were found on anxiety and inferiority in medical students with different preference of music type; ③Statistically significant (P＜0.05) differences were found on anxiety,depression,paranoid,force,social withdrawal and reliance in medical students with different participating ways of music; ④Statistically significant (P＜0.05) differences were found on somatization,anxiety,inferiority and paranoid in medical students with different attitude about participating music activities; ⑤Medical students with different preferences of music activities preferences did not have significant difference on factor of mental health(P＞0.05).Conclusion The relationship between medical students' mental health and music preferences is very close.By training and guiding music preferences of medical students in mental health education,we can improve their mental health effectively.

AIM: Using optical coherence tomography angiography (OCTA) to observe the changes and clinical significance of macular blood flow density in patients with diabetic retinopathy (DR).METHODS: Totally 47 eyes (28 patients) with diabetic retinopathy (DR) were enrolled in the DR group.According to the international clinical grading criteria of diabetic retinopathy, 30 eyes (19 patients) with non-proliferative diabetic retinopathy were classified as the NPDR group, and 17 eyes (11 patients) with proliferative diabetic retinopathy were classified as PDR group.A total of 46 (27 subjects) healthy eyes with matched age were enrolled in the control group.All the subjects underwent the 3mm×3mm scanning of macular retina by optical coherence tomography angiography (OCTA), obtaining 4 levels of macular blood flow density map.The macular blood flow density at 3 levels, including superficial retinal layer, deep retinal layer and choroidal capillaries layer, were measured.RESULTS: The macular blood flow density of superfical retinal layer, deep retinal layer and choroidal capillaries layer in DR group were 0.4963±0.0840, 0.4798±0.0801 and 0.5290±0.0528, respectively.Among them, the blood flow density of each layer were 0.5064±0.0843,0.4983±0.0766,0.5345±0.0529, respectively, for the NPDR group, and were 0.4786±0.0830, 0.4473±0.0778,0.5192±0.0526, respectively, for the PDR group.For the control group, the density of each layers were 0.5919±0.0704, 0.6301±0.0527, 0.5691±0.0169, respectively.The macular blood flow density was significantly different in the superficial retinal layer, deep retinal layer and choroidal capillary layer between the control group and the NPDR group, as well as the PDR group and the DR group (total P<0.001).Statistically significant difference was found between the NPDR group and the PDR group in the deep retina layer (P=0.029), but not in the superficial retina layer and choroid capillary layer (P=0.236, 0.268).CONCLUSION: Compared with the control group, the macular blood flow density of superficial retinal layer, deep retinal layer and choroidal capillary layer in the patients with diabetic retinopathy decreased significantly.It indicated that the macular ischemia existed in both retina and choroid.By quantitatively measurement of the macular blood flow, OCTA may be used for monitoring the progression of diabetes, and early detection of diabetic retinopathy.

Academic medical postgraduate recruitment and training is facing a new dilemma due to the overall implementation of resident standardization training and the combination of postgraduate education in professional master degree of clinical medicine and resident standardization training.We optimize and marry together journal club and lab meeting education methods in academic medical postgraduate training of obstetrics and gynecology on the basis of its teaching characteristics, and develop a new form of academic graduate student training of obstetrics and gynecology.This new method is expected to effectively improve the academic postgraduates' research interests, research capacity and the teaching quality of obstetrics and gynecology for academic postgraduates.

OBJECTIVETo investigate the effect of hypoxia on the human pulmonary artery smooth muscle cells two pore domain potassium channels TASK-1 and the regulation of non-receptor tyrosine kinase c-Src in this process.

METHODSThe cultured human pulmonary artery smooth muscle cells (hPASMCs) were divided into: normal group, hypoxia 30 minute group, hypoxia 6 hours group and hypoxia 48 hour group, and hypoxia 48 hour + PP2 group, hypoxia 48 hour + PP3 group, hypoxia 48 hour + bpV group. Flow cytometry was used to analyze the cell cycle, RT-PCR and Western blot technique were carried out to detect the expression changes of TASK-1 mRNA and protein in different groups.

RESULTS(1) Cell Cycle Show: Compared with normal control group, with prolonged hypoxia, the percentages of hPASMCs in S phases of cell cycle were increased. While compared with hypoxia 48 hour group, the percentages of hypoxia 48 hour + PP2 group hPASMCs in S phases of cell cycle were decreased. The expression of TASK-1 mRNA on hPASMCs in acute hypoxia 6 hour group was increased, while the expression of TASK-1 protein on hPASMCs in the acute and chronic hypoxia group was decreased, and the expression of TASK-1 mRNA on hPASMCs in the chronic hypoxia group was decreased; After pre-incubation of a potent and selective inhibitor of the Src family of protein tyrosine kinases PP2, the expression of TASK-1 mRNA and protein in hypoxia 48 hour group was increased, however after pre-incubation of the inhibitor of the Src family of protein tyrosine phosphatase bpV, the expression of TASK-1 protein in hypoxia 48 hour group was decreased.

CONCLUSIONHypoxia promotes human pulmonary artery smooth muscle cell proliferation, and non-receptor tyrosine kinase c-Src may participate in the expression of two pore domain potassium channels TASK-1 regulated by hypoxia. Therefore, we hypothesized that TASK-1 channels and c-Src participatein the acute and chronic hypoxic human pulmonary vasoconstriction.

Cell Hypoxia ; Cell Proliferation ; Cells, Cultured ; Humans ; Myocytes, Smooth Muscle ; cytology ; Nerve Tissue Proteins ; metabolism ; Potassium Channels, Tandem Pore Domain ; metabolism ; Pulmonary Artery ; cytology ; RNA, Messenger ; Vasoconstriction ; src-Family Kinases ; metabolism

Adefovir dipivoxil (ADV) is a nucleotide anti-hepatitis B virus drug, which is able to effectively repress the replication of hepatitis B virus (HBV). ADV is a reverse transcriptase inhibitor. However, with the prolonged period of using, many kinds of HBV genetic mutants will occur and therefore resistance to ADV will be created. The purpose of this review is to draw the attention to the molecular mechanism of resistance to ADV.
Adenine ; analogs & derivatives ; pharmacology ; Animals ; Antiviral Agents ; pharmacology ; Drug Resistance ; genetics ; Hepatitis B virus ; drug effects ; genetics ; Humans ; Mutation ; Organophosphonates ; pharmacology ; Reverse Transcriptase Inhibitors ; pharmacology

Objective:To compare the modified Qjng Long Bai Wei needling method and ordinary acupuncture method in the effects of improving the levels of interleukin (IL)-1β,IL-6 and tumor necrosis factor (TNF)-α in the treatment of knee osteoarthritis (KOA),and to determine the advantage of the modified Qing Long Bai Wei needling method for KOA.Methods:One hundred KOA patients were randomized into a treatment group and a control group by using the random number table,with 50 cases in each group.The treatment group was intervened by the modified Qing Long Bai Wei needling method,and the control group was given ordinary acupuncture.The two groups were observed before and after the treatment to determine the changes in the levels of IL-1β,IL-6 and TNF-α in synovial fluid,and the clinical efficacies were compared between the two groups.Results:The total effective rate and clinical recovery rate were 97.9％ and 52.1％ respectively in the treatment group,versus 85.1％ and 25.5％ in the control group,and the between-group differences were statistically significant (both P＜0.01).After the treatment,the levels of Ib1β,IL-6 and TNF-cα in synovial fluid changed significantly in both groups (all P＜0.01);there were significant differences in the levels of IL-1β,IL-6 and TNF-α in synovial fluid between the two groups (all P＜0.01).Conclusion:The modified Qjng Long Bai Wei needling is an effective method for KOA and it can significantly improve the levels of IL-1β,IL-6 and TNF-α in synovial fluid.

Objective To investigate the factors which may affect the secretions of human leptin and free fatty acids (FFA) by measuring plasma glucose, serum insulin, leptin and FFA levels during reduced sample number intravenous glucose tolerance tests (IVGTT) in the subjects with different status of insulin resistance and ? cell function. Methods According to oral glucose tolerance test, 7 normal, 10 overweight/obese individuals, 12 subjects with impaired glucose tolerance (IGT) and 11 with type 2 diabetes mellitus (DM) were recruited. During IVGTT, serum insulin, leptin and FFA levels at 12 time points were simultaneously measured. Results Compared to the stable secretion of leptin, during 180 min in the IVGTT, the FFA secretion showed a "U" shape profile. The correlation analysis showed that the average serum leptin and FFA levels in 3 h were independent to fasting plasma glucose concentration. The partial correlation coefficient of leptin and insulin decreased after being adjusted for FFA (before r=0.77, P0.05). Conclusion The changes of serum FFA levels in IVGTT are more significant than those of leptin after glucose loading. Fasting plasma glucose levels do not significantly affect the average serum levels of leptin and FFA. On the contrary, insulin manifests such action but does not affect the secretion profile of these parameters.

Objective To explore the relationship between serum leptin level and the hypothalamuspituitary-gonad ( HPG) axis in female adolescents with anorexia nervosa ( AN). Methods Sixteen newly diagnosed female adolescents with AN in Shanghai and Zhejiang province were investigated, and their serum leptin, FSH, LH and body composition were measured before and after 18 weeks treatment, and their menorrhea cycles were observed. The rhythm of 24 h serum leptin secretion was studied in 4 patients with AN. Twenty-six, healthy females with normal weight and without contraceptive medication were studied as controls. Results (1) All of 16 patients had amenorrhea, 3 primary amenorrhea and 13 secondary amenorrhea. At admission LH in 14 patients and FSH in 12 patients were below the low limit of the normal reference range (1.5 U/L and 4. 6 U/L respectively), and among them 5 patiend had both 15% weight gain and significantly increased serum leptin level (P