Objective To investigate the clinical effect and the prospect of Infliximab in treatment of intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD) patients.Methods Clinical features,inflammatory markers and coronary changes were observed in 2 cases of IVIG-resistant KD patients hospitalized in Peking University First Hospital,who were treated effectively by Infliximab.Relevant researches on the mechanism and progress of the Infliximab treatment for IVIG-resistant KD in the last 10 years were reviewed at the same time.Results Two KD patients hospitalized in Peking University First Hospital had been treated with 2 g/kg IVIG for 2 times and followed by methylprednisolone treatment.However,fever and other clinical manifestations occurred again after 2 days and 6 days when temperature returned normal.They both defervesced and all the symptoms were improved after 1 dose of Infliximab (5 mg/kg) by laboratory examinations.Four published literatures of the basic research and 9 retrospective or prospective clinical researches of Infliximab treatment of KD showed that Infliximab alleviated the inflammatory level in the KD patients significantly.Complete remission was up to 72.73％-92.11％.Those KD patients defervesced within 12 h,with dramatic improvement of symptoms and signs.Arthralgia also disappeared in the patients with arthritis.Only 1 case was complicated with hepatitis in the acute phase and cholecystitis in recovery time.A phase 3 randomised,double-blinded,placebo-controlled trial had been done to assess the addition of Infliximab to the standard therapy.Conclusions Infliximab is a feasible choice for IVIG-resistant KD patients.Efficacy and safety of Infliximab for KD treatment have been proved in the literature.However,Infliximab for KD treatment has not been indicated in the drug instruction,so the informed consent from the guardians and Ethics Committee is needed.

To observe the proliferation of T lymphocytes stimulated by CML and AML cells which were induced by rhGM-CSF and rhIL-4, and the secretion of IFN-gamma from proliferated T lymphocytes, the expression of CD80, CD86 and HLA-DR on CML and AML cells induced by GM-CSF and IL-4 was assayed by flow cytometry in vitro. Then one-way mixed lymphocyte reaction was carried out, with induced leukemia cells as stimulating cells and auto-T lymphocytes as reactive cells. The secretion of IFN-gamma from T lymphocytes was determined by double antibody sandwich ELISA. The results showed that GM-CSF and IL-4 significantly upregulated the expression of CD80, CD86 and HLA-DR on CML cells and CD80 and CD86 on AML cells, which could stimulate the T lymphocyte proliferation and high secretion of IFN-gamma (in CML group) of autologous T lymphocytes. It is concluded that the CML and AML cells induced by GM-CSF and IL-4 have the ability to present tumor specific antigen to auto-T lymphocyte.
Adult ; Aged ; Aged, 80 and over ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor ; pharmacology ; Humans ; Interferon-gamma ; biosynthesis ; Interleukin-4 ; pharmacology ; Leukemia, Myeloid ; immunology ; Lymphocyte Activation ; drug effects ; Male ; Middle Aged ; Recombinant Proteins ; pharmacology ; T-Lymphocytes ; drug effects ; immunology

Objective To study the effect of pelvic autonomic nerve preservation(PANP)on urination and sexual function in total mesorectal excision(TME). Methods Two hundred and forty cases of male rectal cancer patients,divided into the PANP who accept the pelvic autonomic nerve preservation in TME,and the control group of 120 patients who do not.The urination and sexual function were observed and compared.3-year-survival rate,local recurrence rates of the two groups were recorded. Results The urinary disorder rates,erective disorder rates and ejaculation disorder rates of PANP group were 30.8%,28.3%and 34.2%,while values of control group were 55.0%、60.0%and 62.5%.The difference between them had statistical significance(P<0.05).The 3-year-survival rate and local recurrence rate of PANP group were 9.4%and 75.0%.The 3-year-survival rate and local recurrence rate of control group were 9.0%and 65.0%.There was no significant difference between them(P>0.05). Conclusion The PANP technique in TME could improve the urinary and sexual function of male patients without affect the prognosis.

Objective:To study the anatomical correlation between dental arch and the volume of upper airway in patients with obstruc-tive sleep apnea hypoventilation syndrome(OSAHS). Methods: Dental arch architecture and upper airway volume were measured by cone beam CT(CBCT) in the subjects with OSAHS(n=22) and without OSAHS(n=19). The correlation between dental arch and the supper airway volume in OSAHS patients was analyzed. Results:The length of the upper dental arch and the height of palate in OSAHS patients were larger than those of the controls(All, P<0. 05). Cross-sectional area of nasopharynx and retropalatal and the total volume of upper airway were negatively correlated with the palatal height and upper dental arch length(P<0. 05), while positively correlated with upper dental arch of molar regions(P<0. 05). Conclusion:The abnormal shape of upper dental arch is related to the airway vol-ume of nasopharynx and retropalatal region in patients with OSAHS.

Objective To clarify the clinical features and genetic background of a kindred of primary pigmented nodular adrenocortical disease (PPNAD).Methods Detailed clinical characteristics and laboratory test results from a ten-year old girl diagnosed as PPNAD were collected.Seven members of her family were screened for Cushing syndrome and Carney complex,and their blood DNA was extracted and sequenced for PRKAR1A,PDE11A,PDE8B and CTNNB1 mutations with ABI3730.Results The girl presented with symptoms and signs of hypercortisolism,while no features of Carney complex were observed.Hypercortisolemia,suppressed corticotrophin and high urinary free cortisol level were revealed.Cortisol level could not be suppressed both in high and low dose dexamethasone suppression test.The diagnosis of adrenocorticotrophic hormone (ACTH)-independent Cushing syndrome was established.Image and pathology of adrenal glands were in accordance with PPNAD.Other family members showed no evidence of Cushing syndrome or Carney complex.DNA sequencing showed that the patient harbored a missense mutation,C18G.Her father and younger sister were proved to be carriers of this mutation.Conclusion A Chinese PPNAD family was identified clinically and genetically,and a novel missense mutation of PRKAR1A was found.

Objective To evaluate the diagnostic value of triptorelin stimulation test in disorders due to delayed puberty.Methods Triptorelin stimulation test was carried out in 128 teenagers with delayed puberty,due to idiopathic hypogonadotropic hypogonadism(IHH) in 77 cases and constitutional delayed puberty(CDP) in 51.Blood samples were obtained 15 min before and 0,30,60,and 120 min after tripotorelin administration,and the levels of LH and FSH were determined.An extended GnRH stimulation test was carried out in 3 patients with IHH.Results Peak LH,peak FSH,and LH increment were parameters with high diagnostic value.A cut-off point at 8.2 IU/L of peak LH showed a sensitivity of 87％ and a specificity of 80.4％ in the differential diagnosis of IHH and CDP.Conclusion Peak LH cut-off point at 8.2 IU/L of triptorelin stimulation test seems to be sufficient to confirm diagnosis of IHH and CDP.An extended GnRH stimulation test may distinguish hypothalamic from the pituitary hypogonadotropic hypogonadism.

Objective To analyze the research status and hotspot of occupational methanol poisoning at home and abroad. Methods ， The China National Knowledge Resource Database Wanfang Data Knowledge Service Platform and Web of Science were used as the data sources. The relevant literatures on occupational methanol poisoning published in domestic and foreign ， Results journals up to June 30 2021 were searched. The bibliometrics was used to analyzed the literatures. A total of 255 literatures were included in analysis. There were 187 Chinese articles and 68 English articles. Most of Chinese articles were ， ， published from 2001 to 2005 with an average of 26.7 literatures per five years until June 2021. Among them 72 literatures （ ）， ， were published in core journals 38.5% and 176 authors from 27 provinces autonomous regions and municipality directly ， under the central government published relevant literatures. The research contents mainly focused on the classification ， ， poisoning mode clinical manifestations visual impairment and poisoning prevention and treatment of occupational methanol - ， poisoning. Most of the English literatures were published in 2016 2020 with an average of 4.9 articles per five years until June ， （ ）， 2021. Among them 36 were published in SCI journals 52.9% and 57 authors from 11 countries published relevant ， ， ， literatures. The research contents mainly focused on the clinical diagnosis drug treatment intoxication mechanism visual Conclusion sequelae and brain injury of occupational methanol poisoning. The research on occupational methanol poisoning ， ， ， mainly focuses on clinical diagnosis clinical manifestations treatment and prognosis and pathogenesis. The focus of relevant research at home and abroad is different.

RNA has received more attention in the field of forensic medicine and the development of the new biological markers based on RNA shows great significance in the analysis of complex cases. circular RNA (circRNA) is a kind of non-coding RNA which is widely reported recently. Although the regulatory mechanisms of generation and expression are not fully clear, the existing research indicates that circRNA has important biological functions. CircRNA has a cell-type-specific expression with great stability and a high expression level, which makes it meaningful in forensic applications potentially. In this paper, the research progress, the generation and regulation of circRNA as well as its biological characteristics and functions are summarized, which will provide references for related studies and forensic applications.
Forensic Sciences ; Humans ; RNA ; RNA, Circular

· AIM:To investigate the prevalence and related factors of dry eye in primary school pupils in Lanzhou,Gansu Province.· METHODS:From October to November 2016,1347 pupils in two primary schools in Lanzhou,Gansu Province,were randomly selected as subjects.Every pupil was carried on the questionnaire of dry eye and eye inspection to confirm the diagnosis of dry eye.Besides,the prevalence and influencing factors of dry eye in pupils were analyzed by chi-square test,Mann-Whitney U test and logistic regression model.· RESULTS:A total of 1 268 pupils took part in this study and the inclusion ratio was 94.14％;271 individuals were diagnosed as dry eye,and the prevalence rate was 21.37％.Statistical analysis showed that the risk factors of dry eye were male,senior pupils,often using eye drops,poor reading habits,wearing contact lenses,video terminals last for a long time,learning pressure.· CONCLUSION:Dry eye has become one of the main diseases that plagued pupil's life and learning.It should cause wide attention.Considering the above factors,rational use of eye and improve lifestyle will help to reduce the damage to eye of pupils.

Objective To study the occurrence site characteristics of middle cerebral artery aneurysm (MCAA ) in volume CT digital subtraction angiograhy(VCTDSA) .Methods The image characteristics in 72 cases of MCAA from May 2009 to January 2011 were retrospectively analyzed ,according to the running of middle cerebral artery ,the occurrence sites of aneurysm were divided into four categories :M1 segment ,M2 bifurcation ,M2 distal and M3-M5 segment ,the aneurysm number was conducted the statistics and the image characteristics were analyzed ;two neuroradiologists adopted the double-blind method to measure the MCAA angle in bifurcation of M2 segment and compared it with the bifurcation angle in the normal middle cerebral artery ,the difference between them were statistically analyzed .Results (1)M1 segment aneurysms were 7 cases(9 .70% ) ,M2 bifurcation aneurysms were 58 ca-ses(80 .56% ) ,M2 distal aneurysms were 5 cases(6 .94% ) and M3-M5 segment aneurysms were 2 cases(2 .78% ) .(2)The angle in M2 bifurcation of the normal middle cerebral artery was(99 .30 ± 22 .96)° ,M2 bifurcation aneurysm angle was(139 .26 ± 27 .61)° , the difference between them showing statistical significance (P<0 .01) .(3)The difference between left and right of M 2 bifurcation angle in the normal middle cerebral artery had no statistical significance (P>0 .05) .(4)The M2 bifurcation angle in ruptured aneu-rysm was(133 .98 ± 30 .24)° ,which in unruptured aneurysms was(144 .53 ± 21 .81)° ,the difference between them had no statistical significance(P>0 .05) .Conclusion MCAA mainly occurred in M2 bifurcation .There is significant difference in M2 bifurcation an-gle between the aneurysm group and non-aneurysm group ,M2 bifurcation angle is increased ,the probability of aneurysm occurrence is increased .