Objective: To report the clinical manifestations and laboratory features of five patients with congenital thrombotic thrombocytopenic purpura (cTTP) and explore its standardized clinical diagnosis and treatment along with a review of literature. Methods: Clinical data of patients, such as age of onset, disease manifestation, personal history, family history, and misdiagnosed disease, were collected. Treatment outcomes, therapeutic effects of plasma infusion, and organ function evaluation were observed. The relationship among the clinical manifestations, treatment outcomes, and ADAMTS13 gene mutation of patients with cTTP was analyzed. Additionally, detection of ADAMTS13 activity and analysis of ADAMTS13 gene mutation were explored. Results: The age of onset of cTTP was either in childhood or adulthood except in one case, which was at the age of 1. The primary manifestations were obvious thrombocytopenia, anemia, and different degrees of nervous system involvement. Most of the patients were initially suspected of having immune thrombocytopenia. Acute cTTP was induced by pregnancy and infection in two and one case, respectively. ADAMTS13 gene mutation was detected in all cases, and there was an inherent relationship between the mutation site, clinical manifestations, and degree of organ injury. Therapeutic or prophylactic plasma transfusion was effective for treating cTTP. Conclusions: The clinical manifestations of cTTP vary among individuals, resulting in frequent misdiagnosis that delays treatment. ADAMTS13 activity detection in plasma and ADAMTS13 gene mutation analysis are important bases to diagnose cTTP. Prophylactic plasma transfusion is vital to prevent the onset of the disease.
Female ; Pregnancy ; Humans ; Adult ; Blood Component Transfusion ; Plasma ; Purpura, Thrombotic Thrombocytopenic/therapy* ; Mutation ; Purpura, Thrombocytopenic, Idiopathic ; ADAMTS13 Protein/therapeutic use*

Objective To study the anatomical structure of normal and scoliotic thoracic vertebrae in adolescents aged 12-15 years in Northern Shanxi Province, to provide detailed information for pedicle screw placement, and to provide data references for screw size design. Methods Totally 120 cases of normal thoracolumbar CT of 120 adolescents aged 12 to 15 years and 30 cases of adolescent idiopathic scoliosis were collected in Northern Shaanxi Province. The raw data of thoracolumbar tomographic images scanned continuously were imported into Mimics16. 0 software for analysis and measurement in DICOM format. Measurement indicators: pedicle width, pedicle height, pedicle length, transverse diameter of spinal canal, longitudinal diameter of spinal canal, transverse pedicle angle,maximum transverse pedicle angle, sagittal pedicle angle and pedicle area. Results Pedicle width:12-13 years old, T

Objective To propose a novel stereo-electroencephalography(SEEG) quantitative measure analyzing ictal high frequency (60-90 Hz) and calculating high frequency epileptogenicity index (HFEI) to localize epileptogenic zone and evaluate epileptogenic network. Methods The clinical presurgical evaluation and SEEG data of 15 patients who were performed SEEG electrodes implantation from April 2015 to March 2016 were analyzed retrospectively. Post-implantation head CT images and 3D MRI data were fused for accurately identifying and locating each electrode contact. Ictal SEEG quantitative measure HFEI was calculated and threshold was set. The epileptogenic network was divided into focal, regional, multiple regional and bilateral ones and the results were compared with the pathological results.Results The epileptogenic network was focal for four patients, regional for four patients, multiple regional for six patients and bilateral for one patient (7/15). In terms of the pathology,two cases with hippocampal sclerosis both showed regional network. In four cases with cerebral malacia, two cases showed multiple regional network and the other two cases showed focal network. In six cases with cortical malformation, three cases showed multiple regional network, the other three cases showed focal, regional and bilateral networks respectively. Conclusions We explored a novel SEEG quantitative measure based on the high frequency power analysis,which is objective and could localize epileptogenic zone and evaluate the epileptic network.

OBJECTIVETo investigate the prevalence, current treatment, and clinical characteristics of asthma, as well as the risk factors for this disease, among children aged 0-14 years in 2010 in urban Zhongshan, China.

METHODSA total of 10 336 children aged 0-14 years were selected from urban Zhongshan by cluster random sampling. The Third National Childhood Asthma Epidemiological Questionnaire 2010 was used to analyze the prevalence, current treatment, and clinical characteristics of childhood asthma, as well as the risk factors for this disease.

RESULTSAsthma was diagnosed in 179 cases (1.73%). The prevalence of asthma in male children was significantly higher than that in female children (2.25% vs 1.16%; P<0.01). Of the 179 patients, severe attacks were common in 104 cases (58.1%), 110 cases (61.5%) had slow onset, 102 cases (57.0%) had gradually relieved conditions, 61 cases (34.1%) suffered from asthma during seasonal transition, and 150 cases (83.8%) developed asthma due to respiratory tract infection. Among all asthmatic children, 71.5% had been treated with inhaled corticosteroids, and 71.5% had been treated with bronchodilator. The multivariate logistic regression analysis showed that a history of penicillin allergy, a family history of allergy, food allergy, eczema, allergic rhinitis, cesarean delivery, family mould, and perinatal passive smoking were independent risk factors for childhood asthma.

CONCLUSIONSThe prevalence of childhood asthma in urban Zhongshan is on a high level, and is associated with gender. The treatment of asthma has been standardized, but still needs further improvement. The onset of asthma attack is influenced by various factors.

Adolescent ; Asthma ; epidemiology ; etiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Risk Factors ; Seasons ; Time Factors

OBJECTIVETo investigate the incidence of wheezing and chronic cough in children aged 3-14 years in different living areas of Zhongshan, China.

METHODSAccording to the unified program of the 2010 national epidemiological survey of asthmatic children aged 0-14 years, a questionnaire survey of the children aged 3-14 years in rural and urban areas of Zhongshan was conducted.

RESULTSA total of 15 763 children were included in the survey. Among all participants, 8 248 were from the urban area, and 7 515 from the rual area; 8 306 were boys, and 7 457 were girls. The percentage of children with a history of wheezing was significantly higher in the urban group than in the rural group (6.6% vs 3.2%; P<0.05), and it was significantly higher in boys than in girls for each group (P<0.05). The urban group had a significantly higher percentage of individuals who had wheezing in the past one year than the rural group (2.8% vs 1.5%; P<0.05), and this percentage was significantly higher in boys than in girls for each group (P<0.05). Compared with the rural group, the urban group had a significantly higher percentage of individuals who had chronic cough (duration 1 year) (7.9% vs 3.1%; P<0.05). The above indices were relatively high in children under 6 years of age, and all but the percentage of girls who had wheezing in the past one year in both rural and urban areas showed significant differences between all age groups.

CONCLUSIONSThe incidence of wheezing and chronic cough varies with age, sex, and living area for children aged 3-14 years in Zhongshan, and it is relatively high under 6 years of age, in the urban area, and among boys.

Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Chronic Disease ; Cough ; epidemiology ; Female ; Humans ; Incidence ; Male ; Respiratory Sounds ; Surveys and Questionnaires

Objective To evaluate the efficacy and safety of sublingual immunotherapy with dermatophagoides farinae standardized extrace for the treatment in children with allergic rhinitis for 2 years.Methods Two hundred and forty children with allergic rhinitis to dermatophagoides ptero-nyssinus( Der P) were randomly allocated to receive either specific immu-notherapy(n=120)or medical treatment(n=120).Symptom and medica-tion scores were assessed to evaluate the clinical efficacy and safety in the baseline and after two year treatment.Results Immunotherapy reduced the symptom [the scores reduced from (10.76 ±1.08) to (3.46 ±0.85)] and medication score [the scores reduced from (1.28 ±0.68) to (0.28 ± 0.43)] in children with allergic rhinitis significantly ( P <0.05), and compared with the control group [ ( 9.76 ±1.14 ) and ( 1.09 ±0.35 ) ] , there was a statistical difference (P<0.05).Eleven local adverse reactions including allergic rash and nasopharyngeal itching occurred observation group, and ten cases of nasal bleeding, fatigue and drowsiness were found in control group, while no fatal systemic reaction occurred in both groups.Conclusion Dermatophagoides farinae standardized extrace for the treat-ment of allergic rhintis is efficacious to treat children sensitive to Der P, al-lergen individualization of dosage is recommended to improve tolerance and security.

Actins ; metabolism ; Animals ; Brain ; cytology ; metabolism ; Cell Culture Techniques ; methods ; Cells, Cultured ; Immunohistochemistry ; Pericytes ; cytology ; metabolism ; Rats ; Rats, Sprague-Dawley ; Receptor, Platelet-Derived Growth Factor beta ; metabolism ; Staining and Labeling

This study was purposed to investigate the apoptosis-inducing effect of Annexin A2 gene (AnxA2) on multiple myeloma (MM) cells and its mechanisms. The human MM cell lines U266 and RPMI8226 were transfected by using siRNA targeting at AnxA2; the expressions of AnxA2 mRNA and protein in the siRNA-transfected cells were detected by real-time PCR and Western blot, respectively; the cell apoptosis was assayed by flow cytometry. The results showed that silencing AnxA2 gene by siRNA resulted in decreased expressions of AnxA2 gene and protein, increased apoptosis of U266 and RPMI8226 cell lines (P < 0.05), at the same time resulted in down-regulation of apoptosis-related gene expressions including p65NF-κB, IL-2, IL-6 (P < 0.05), and up-regulation of P53 gene expression (P < 0.05). It is concluded that the AnxA2 silence plays a promoting role in apoptosis of MM cell lines U266 and RPMI8226.
Annexin A2 ; genetics ; Apoptosis ; genetics ; Cell Line, Tumor ; Humans ; Multiple Myeloma ; genetics ; pathology ; RNA, Small Interfering ; genetics

Objective To find out the differences of dietary patterns among freshmen coming from urban and rural areas that might have influenced their bone mineral density and body mass index (BMI).Methods With stratified random sampling method,dietary patterns and their bone mineral density,BMI of 1319 freshmen were studied.Results (1) The ratios of urban freshunen who chose "western food" pattern ( x2=31.548,P=0.000; x2=13.068,P=0.001 ),"animal food" pattern ( x2=8.279,P=0.016; x2=41.137,P=0.000) or "calcium food" pattern (x2=37.254,P=0.000; x2=15.651,P=0.000) were higher than that of rural freshmen,and the ratios of rural freshmen who chose "Chinese traditional" pattern (x2=36.194,P=0.000; x2=25.936,P=0.000) were higher than that of urban freshmen.(2) The average height,weight,BMI,speed of sound (SOS) of male freshmen from rural areas were lower than that from the city and the differences were statistically significant (P＜0.05).Among those female freshmen,only height and weight were significantly different (P＜0.05).(3) In both rural and urban frestunen,the factor scores of "westem food" pattern had a positive correlation with BMI,with the correlation coefficients as 0.187,0.192,0.551,0.465 (P＜0.001).The factor scores of "calcium food" pattern were positively related to bone mineral density (SOS values)with correlation coefficients as 0.680,0.342,0.841,0.786,P＜ 0.001 respectively.The factor scores on "Chinese traditional" pattern were negatively correlated with BMI,with correlation coefficients as -0.223,-0.093 (P＜0.05) which were positively related to bone mineral density (SOS values) in both rural and urban male freshmen,with correlation coefficients as 0.905,0.711 (P＜0.001).Conclusion Different dietary patterns chosen by urban and rural freshmen had a significant impact on both bone mineral density and BMI.

Objective To understanding the influencing factors of compliance of weight management of chronic heart failure patients' so as to explore the intervention measures to improve the compliance.Methods Depth interviews was used,totals of eight chronic heart failure patients' compliance information with weight management were collected and the results were analyzed by a phenomenological analysis method.Results The main influencing factors of weight management compliance of chronic heart failure patients were the lacking of knowledge,behavior habit,complication,reduction of physical comfort and sense of uncertainty in illness.Conclusions Strengthening health education,psychological counseling to decrease the uncertainty in illness,improving physical comfort,playing the role of the family support system,will be helpful to improve chronic heart failure patients' compliance of weight management.