Objective To evaluate the relationship between asthma and rhinitis in children.Methods One hundred and thirty children with rhinitis were divided into two groups.Among them,60 displayed rhinitis alone and 70 displayed rhinitis associated asthma.The following parameters were analyzed between two groups: age,sex,history of eczema,familial history of smoking,familial history of asthma,sensitization to allergens,level of total serum IgE,blood eosinophil count.Logistic regression analysis was used to analyze the effect of covariates on risk of rhinitis or asthma.Results History of bronchiolitis,familial history of asthma,maternal asthma and sensitization to allergens h_1(greer labs inc),d_2(dermatophagoides farinae) were significantly more frequent in asthmatic subjects.In these patients,the total serum IgE and eosinophil count were higher.Logistic regression analysis showed that a high eosinophil count and total serum IgE significantly increased the risk of developing asthma in patients with rhinitis.Conclusions In subjects with rhinitis,the occurrence of asthma is related to history of bronchiolitis,familial history of asthma,atopy,total serum IgE levels and blood eosinophilia.In rhinitis subjects,these parameters will be taken into account to manage underlying asthma.

Objective To observe the effect of ciclosporin(CsA) treatment on children with refractory nephrotic syndrome(NS).Met-hods Combination treatment of CsA[3-5 mg/(kg?d)] and prednisone were given 55 cases with refractory NS,in which including steroid-dependent NS(SDNS) 3 cases,steroid-resistant NS(SRNS) 22 cases,frequent-relapses NS(FRNS) 30 cases.Concentration of CsA was maintained 100-200 ng/L.Course of treatment was 10 months,the dose was tapered gradually in 4 months.Scr,BUN,Alb,ALT,Ccr,Chol,24 hours urine protein quantitation was measured before and after CsA treatment.Side effect of CsA was observed at the same time.SPSS 13.0 software was used to analyze the data.Results Forty-one cases(74.5%) were complete remission,6 cases(10.9%) were partial remission,total effective rate was 85.5%.Remission rate was 97.6% in simple type NS,50.0% in nephritis type NS,100% in SDNS and FRNS groups,63.6% in SRNS group.In group minimal change disease(MCD),the remission rate was 100.0%,while 60.0% in group mesangial prolife-rative glomerulonephritis(MsPGN),and 42.9% in group focal segmental glomerulosclerosis(FSGS).Fifteen cases(31.9%) relapsed when the dose of CsA was tapering.The adverse effects included hairiness(55 cases),gum hypertrophy(16 cases),hypertension(9 cases),gastroi-ntestinal tract reaction(8 cases),but no obvious nephric adverse effects were observed during the treatment process.Conclusion CsA is safe and effective on refractory NS children,especially to those with SDNS,FRNS and MCD.

Objective To analyze the clinical features of unilateral oculomotor nerve palsy caused by multiple myeloma(MM).Methods A 79-year-old female diagnosed MM for 3 years was admitted due to the disease relapse.The patient presented left oculomotor nerve palsy,bone marrow biopsy showed 4.5％ of myeloma cells,the serum level of λ light chain was up to 18 g/L,and brain CT/MRI scan revealed left parasphenoidsinus lesion.A diagnosis of relapsing intramedullary and extramedullary MM,IgGλ type,stage ⅢA was made.Ten cases were retrieved from literature since 1990,the clinical features of 11 cases were analyzed as follows.Results Among 11 cases of unilateral oculomotor nerve palsy caused by MM,7 were males and 4 females with a mean age of (60 ± 12) years (40-79 years).The sub-types of MM were IgG type (7 cases),IgA type (2 cases),biclonal of IgG and IgA type (1 case),and IgD type (1 case).Oculomotor nerve palsy was presented as the initial manifestation of MM in 9 cases,as a sign of relapse of MM in 1 case,and during MM treatment in 1 case.In 7 cases,oculomotor nerve was the only cranial nerve involved,while in other 4 cases,the Ⅳ,Ⅴ,Ⅵ cranial nerves were also involved.Neuroimaging revealed parasphenoid sinus lesions in 9 cases,and myeloma meningitis in 2 cases.Most of the reviewed cases achieved significant clinical improvement after chemotherapy and/or radiotherapy,except 2 cases with myeloma meningitis.The case in our department was improved significantly and rapidly after receiving chemotherapy with bortezomib.Conclusion MM should be considered when unilateral oculomotor nerve palsy is presented with or without the history of MM,the disease is sensitive to chemotherapy in most circumstances.

Objective To evaluate contrast-enhanced fluid-attenuated inversion recovery (FLAIR) imaging in the detection of leptomeningeal lesions.Methods Seventeen patients with a variety of leptomeningeal lesions were analyzed.The MRI protocol included un-enhanced and contrast-enhanced FLAIR images and contrast-enhanced T_1WI,Comparisons between contrast-enhanced FLAIR images and T_1WI and between un-enhanced and contrast-enhanced FLAIR images were made to determine which sequence better depicted the lesions.Results Leptomeningeal lesions showed as either diffusely or locally abnormal hyper-intensity along sulci or cistern on three sequences.Comparison between contrast-enhanced FLAIR and T_1WI showed that only contrast-enhanced FLAIR revealed the abnormalities in 7,both revealed the abnormalities but the former was superior in 2 ,and both were conspicuous in 7. In 1 patient of tuberculous meningitis,diffuse abnormalities of sulci were shown only on contrast-enhanced FLAIR, abnormalities of cisterns were shown on both sequences but the former was superior.Comparison between un- enhanced and contrast-enhanced FLAIR showed that only contrast-enhanced FLAIR revealed the abnormalities in 9,both revealed the abnormalities but the former was superior in 3,and both were conspicuous in 4. In 1 patient of tuberculous meningitis,abnormalities of cisterns were shown only on contrast-enhanced FLAIR,diffuseabnormalities of sulci were shown on both sequences but the former was superior.Conclusions Contrast-enhanced FLAIR images were superior to un-enhanced FLAIR images and contrast-enhanced T_1WI in the detection of leptomeningeal lesions. Contrast-enhanced FLAIR images are helpful and should be considered when findings on un-enhanced FLAIR images and/or contrast-enhanced T,WI are inconclusive.

OBJECTIVE To investigate the effect of Shuzheng granules on diabetic foot pain,ulcer healing and lower limb blood supply of the patients with diabetic foot after taking interventional treatment.METHODS Patients with diabetic foot who had taken interventional therapy successfully were randomly divided into Shuzheng granules treatment group(n=22)and basic treatment group(n=21).The two groups were given the same regular basic treatment while Shuzheng granules was add-ed to the first group.Then the results including pain symptoms integral,ulcer healing extent,ankle-brachial index(ABI),ar-terial flow velocity and the artery diameter before and after the treatment of the two groups were compared.RESULTS The improvement in pain symptoms integral depth of ulcer,ulcer area,ankle-brachial index,arterial blood flow velocity,arterial diameter and hemarheology were better in the treatment group(P<0.05).CONCLUSION ShuZheng granules combined with basic therapy has advantages in ulcer healing,pain relieving and lower limb blood flow increasing for patients with diabetic foot after intervention.

OBJECTIVETo investigate the effects of lipopolysaccharide (LPS) on airway inflammation, airway remodeling and the expression of Toll-like receptor 4 (TLR4) mRNA in asthmatic rats.

METHODSTwenty-four SPF level SD rats were randomly divided into four groups (n = 6): control group, low dose of LPS group, high dose of LPS group and asthma group. Using ovalbumin (OVA) to sensitize and challenge to establish asthmatic rat model. Observed pathological changes of lung tissue by HE staining, inflammatory cell infiltration was observed by airway wall eosinophils (EOS) counts; airway resistance was determined; image analysis software was used to determine the thickness of airway wall, detected airway smooth muscle TLR4 expression levels by RT-PCR.

RESULTSThe rat airway resistance and the EOS number of airway wall and the thickness of airway wall in asthma group, low dose of LPS group and high dose of LPS group were significantly higher than those in control group (P < 0.01). The above-mentioned parameters of high dose of LPS group showed significantly lower than those in asthma group and low dose of LPS group (P < 0.05). The expression of rat airway smooth muscle TLR4 mRNA in low dose of LPS group and high dose of LPS group were significantly higher than those in asthma group (P < 0.01). And the expression of rat airway smooth muscle TLR4 mRNA in high dose of LPS group was significantly higher than that in low dose of LPS group (P < 0.05).

CONCLUSIONTLR4 plays an important role in asthmatic airway inflammation and airway remodeling, LPS may play double-sided regulation in asthmatic airway inflammation and airway remodeling by activated TLR4.

Airway Remodeling ; drug effects ; Animals ; Asthma ; metabolism ; pathology ; physiopathology ; Inflammation ; metabolism ; Lipopolysaccharides ; adverse effects ; pharmacology ; Lung ; metabolism ; physiopathology ; Male ; Muscle, Smooth ; drug effects ; metabolism ; Rats ; Rats, Sprague-Dawley ; Toll-Like Receptor 4 ; metabolism

Objective To explore the effect of enhanced CT and enhanced MRI image fusion technique in making treatment decisions for primary liver cancer (PLC). Methods Clinical data of 55 patients with PLC who were treated in the Third Affiliated Hospital of Sun Yat-sen University between January 2013 and January 2015 were analyzed retrospectively. There were 42 males and 13 females, aged from 18-84 and with a median age of 52 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. All the patients underwent enhanced CT and gadolinium ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) enhanced MRI. CT and MRI images were fused by using flexible registration method based on finite element. Treatment decisions for these patients were discussed and made by HCC multidisciplinary consultation group. Discussion was conducted twice for each patient. The first discussion was based on enhanced CT images and the second was based on fused images. Changes of treatment decisions were observed and analyzed. Results Treatment decisions based on enhanced CT images included radical treatment in 8 cases, palliative surgical treatment in 35 cases and systemic medicine treatment in 12 cases. Treatment decisions based on fused images included radical treatment in 4 cases, palliative surgical treatment in 36 cases and systemic medicine treatment in 15 cases. Compared with those based on enhanced CT images, the conversion rate of radical treatment, palliative surgical treatment and systemic medicine treatment based on fused images was respectively 50%(4/8), 3%(1/35) and 25%(3/12). Conclusions Enhanced CT and Gd-EOB-DTPA enhanced MRI image fusion can change the treatment decisions for some patients with HCC, and it is of certain significance in optimizing the treatment protocols.

Objective The activation of NF-kappa B (NF-κB) signaling pathway plays an important role in the development of helicobacter pylori associated gastritis (HAG). The article aimed to investigate the effects of polygonum capitatum on the treatment of HAG in NF-κB signaling pathway and observe whether the regulation of NF-κB acetylation by silent information regulator 1 (SIRT1) affects the therapeutic effects of HAG. Methods The immortalized human gastric epithelial cells (GES-1) were cultured and the H.pylori stand- ard strain ATCC700392 was used for the replication of HAG cell model by 100∶1. The cells were divided into model group,drug group and normal control group. Cells were treated with 80 μg/mL in drug group,H.pylori and GES-1 were cultured together in model group and untreated GES-1 cells were taken as control group. Real time PCR was used to detect the mRNA levels of SIRT1,NF-κB/p65 and TNF-α. Western blotting was used to detect the expression levels of SIRT1,NF-κB/p65 and its acetylated protein in the total protein,as well as the expression levels of SIRT1 and NF-κB/p65 in cytoplasm and nuclear protein. Results At 12 h after the infection of H. pylori,the level of TNF-α in the supernatant was higher than that in the normal control group(P<0.05). The expression of SIRT1 de-creased in the cytoplasm of model group,while the expression levels of NF-κB/p65,acetyl-NF-κB p65(Lys310) and TNF-α in the nu-cleus increased (P<0.05). But after the treatment of polygonum capitatum,the expression of SIRT1 in the nucleus increased(P<0.05) while the expression of NF-κB/p65,acetyl-NF-κB p65(Lys310) and TNF-α decreased (P<0.05). Conclusion Polygonum capita-tum can activate the SIRT1 in the nucleus,which makes activated NF-κB/p65 in the nucleus carry out deacetylation modification in or-der to antagonize the cell damage induced by H.pylori.

Objective To explore clinical and radiological outcomes of treating displaced fractures of proximal clavicle by open reduction and internal fixation with an inverted anatomic locking plate for distal clavicle.Methods From August 2013 to August 2015,12 patients with displaced fracture of proximal clavicle were treated in our hospital by open reduction and internal fixation with an inverted anatomic locking plate for distal clavicle.They were 11 men and one woman,with an average age of 43.5 years (range,25 to 62 years).There were 9 fresh and 2 old fractures.According to the Edinburgh classification,10 fractures were classified as type 1B1 and 2 as type 1B2.After fixation,the 180° inverted plate on the ipsilateral side was placed on the superior aspect of proximal clavicle.The medial fragment was fixed with 2 to 4 pieces of 2.7 mm multidirectional locking screw and the lateral fragment with 2 to 3 pieces of 3.5 mm locking screw.X-ray and CT were performed to assess union,delayed union,nonunion,and hardware failure.Functional outcomes were assessed by Constant-Murley scores and Disabilities of the Arm,Shoulder and Hand (DASH) scores at final follow-ups.Results There were no significant neurovascular injuries intraoperatively.All patients were followed up for an average of 15.6 months (range,12 to 24 months).All fractures healed after an average of 14.3 weeks (range,8 to 24 weeks).At final follow-ups,the mean Constant-Murley score was 96.0 points (range,84 to 100 points) and the mean DASH score 1.9 points (range,0 to 14.8 points).There were no such significant complications as infection,reduction loss or implant failure.Conclusion Displaced fractures of proximal clavicle may be treated with an inverted anatomic locking plate for distal clavicle on the ipsilateral side because of rigid fixation,fine stability and good chance for early rehabilitation.

OBJECTIVETo evaluate the expression of epidermal growth factor receptor (EGFR) gene copy number and the expression of ERCC1 and BRCA1 proteins in patients with non-small-cell lung cancer (NSCLC) and the correlation between them.

METHODSThe status of EGFR gene copy number was determined by in situ hybridization (FISH), and the expression of ERCC1 and BRCC1 proteins was examined by immunohistochemistry (IHC). The relationship of EGFR gene copy number with the expression of ERCC1 and BRCA1 and the clinical pathologic features were analyzed.

RESULTSFISH-positive EGFR expression was identified in 40 of 166 samples (24.1%). More FISH-positive EGFR in the female than male patients (31.9% vs. 18.6%, P = 0.048), and non-smoker than smoker (32.8% vs. 16.7%, P = 0.045). FISH-positive EGFR was not associated with age, pathological type, clinical stage and metestasis status (P > 0.05). The expression of ERCC1 protein was identified in 60 of 132 samples (45.5%). The expression of ERCC1 protein varied significantly in tumors of different pathological types (P = 0.046), but not associated with age, gender, clinical stage, metestatic status and smoking status (P > 0.05). The expression of BRCA1 protein was identified in 46 of 131 samples (35.1%). The expression of BRCA1 was not associated with age gender, pathological type, clinical stage, metestatic ststus and smoking status (P > 0.05). There was a moderate correlation between the expressions of ERCC1 and BRCA1 (r = 0.449, P < 0.001), but EGFR gene copy number was not correlated with the expression of ERCC1 or BRCA1 protein.

CONCLUSIONSFISH-positive EGFR expression is associated with gender and smoking status, but not correlated with the expression of ERCC1 and BRCA1 proteins. There is a moderate correlation between the expressions of ERCC1 and BRCA1.

Adult ; Aged ; Aged, 80 and over ; BRCA1 Protein ; metabolism ; Carcinoma, Non-Small-Cell Lung ; genetics ; metabolism ; pathology ; DNA-Binding Proteins ; metabolism ; Endonucleases ; metabolism ; Female ; Gene Dosage ; Gene Expression Regulation, Neoplastic ; Genes, erbB-1 ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Lung Neoplasms ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Sex Factors ; Smoking ; Young Adult