Endomyocardial Fibrosis ; Humans ; Infant

Objective To investigate the relationship between plasma pro-brain natriuretic peptide (N-pro-BNP) level and heart function, as its well as change before and after interventional therapy. Methods Fifty-eight children with left to right shunt congenital heart diseases were enrolled from July, 2004 to Jan, 2005. Clinical heart function were categorized and plasma N-pro-BNP concentration were detected. The ejection fraction (EF), fractional shortening (FS) and left ventricular and diastolic dimension (LVDd) were measured by two-dimensional echocardiography. The relationship between plasma pro-BNP concentration and the echo parameters, and its change before and after interventional therapy were analyzed. Results The plasma N-pro-BNP concentration, LVDd, EF and FS before and after intervention were 194.7?154.7 ng/L vs 561.0?594.2 ng/L (P

Objective To investigate the value of imaging in the diagnosis of reflex sympathetic dystrophy(RSD).Methods The clinical manifestations and imaging findings of RSD in five patients were analyzed.Results The onset of clinical symptoms of patients was followed by an injury in all cases.Severe pain,swelling,limited range of motion and vasomotor instability were main complaints.Patchy bone demineralization could be found both on plain radiographs and CT.CT scan was superior to plain radiographs in detecting bone demineralization.Increased scintigraphic uptake in the involved extremities were demonstrated in all four patients who examined by bone scintigraphy.Bony erosions which were not easily visible on plain radiographs could be clearly seen on MRI in one patient at early stage.Conclusion Patchy bone demineralization on plain radiographs and CT is the most outstanding imaging finding in RSD.Bone scintigraphy and MRI can help early in diagnosis of the disease.

Objective To enhance the understanding of the clinical features,diagnosis,treatment and prognosis of reflex sympathetic dystrophy (RSD).Method Three patients with RSD in PLA General Hospital were analyzed.Results In the three patients the symptoms appeared following an injury,they had severe pain,swelling,limited range of motion,vasomotor instability,skin changes,patchy bone demineralization,and increased scintigraphic uptake in the peripheral joints of involved extremities.Two of them had shouder hand syndrome and one had obvious skin thickening.The patients showed better responses after the treatrment of physiotherapy,nonsteroidal antiinflammatory drugs,corticosteroids and tricyclic antidepressants.Conclusion Early diagnosis is very important and appropriate treatment must be initiated as early as possible for RSD patients.

Pseudomyxoma peritonei is a rare kind of clinical disease,mainly characterized by mucus exocrine cells grown in the peritoneum or omentum sticky which caused lots of jelly-like ascites.There is no obvious clinical specificity performance for pseudomyxoma peritonei,which is always misdiagnosed.By enhancing the awareness of pseudomyxoma peritonei,improving the relevant checks and reasonably extracting specimens for pathological examination can improve diagnosing rate of pseudomyxoma peritonei.Using complete cytoreductive surgery or major debulking surgery combined with intraperitoneal hyperthermic perfusion chemotherapy help to improve the survival of patients with pseudomyxoma peritonei.

Objective To evaluate the efficacy and safety profile of methotrexate (MTX), leflunomide (LEF) and low-dose MTX and LEF (MTX + LEF) combined treatment for psoriatic arthritis (PsA). Methods This was a 24 weeks, two-center, open-labeled, controlled trial All subjects fulfilled the moll and wright criteria for definite PsA. Subjects were given one of the 3 regimens, MTX, or LEF, or MTX + LEF. The primary end point was proportion of psoriatic arthritis response criteria(PsARC)response. The secondary end point was proportion of modified 20% improvement of American College of Rheumatolngy (ACR20) response. Results At week 24, the percent of patients achieving PsARC in MTX, LEF and MTX + LEF group were 75.0% ,68. 8% ,83.3% respectively, and the percent of patients achieving ACR20 were 66. 7% ,50. 0% ,83. 3% respectively. At week 24, tender joint counts, swollen joint counts, patient's assessment of pain, patient's global assessment (PGA), physician' s global assessment, health assessment questionnaire(HAQ)were significantly improved compared with base-line values(P <0. 05). At week 24, the improvement of patient's assessment of pain, HAQ, ESR were better in the MTX + LEF group compared with LEF group while the improvement of patient's assessment of pain, PGA, HAQ, ESR were better in the MTX group compared with LEF group (P < 0. 05). The incidence of treatment related adverse events was 38.5%, 38. 9% and 35% in MTX, LEF and MTX + LEF group respectively. There was no serious adverse reactions. Conclusion Low dose MTX + LEF regimen showed similar good efficacy and safety profde for PsA patients.

ObjectiveTo explore the diagnostic and differential diagnostic points in a patient with rheumatoid arthritis (RA) complicated with fever and pulmonary diseases. MethodsFull clinical analysis was performed for a 55-year old patient with arthritis, fever, and wheeze. ResultsThe clinical pictures of the patient were consistent with those of RA. Computed tomography(CT) revealed interstitial lung diseases and intrapulmonary cavities. Antifungal agents were given experimentally, and the intrapulmonary cavities disappeared finally, thus the patient was diagnosed as RA, concurrently complicated with interstitial lung disease and pulmonary fungal infection. ConclusionThe possibility of pulmonary fungal infection should be considered in RA patients who presented with fever and intrapulmonary cavities.

Objective To investigate whether baicalein inhibits the proliferation, cell cycle of and pseudopod formation in A431, a skin squamous cell carcinoma cell line, by suppressing the expression of ezrin protein. Methods A431 cells were grouped to be transfected with ezrin-targeting siRNA (siRNA group), treated with baicalein of 5, 10, 20, 40 μmol/L, respectively (baicalein group), or remain untreated (control group). After additional culture, wound healing assay and Transwell assay were performed to observe the migration and invasion of A431 cells, RT-PCR to detect the mRNA expression of ezrin in A431 cells, Western blot and immunoflu-orescence to measure the expression of ezrin protein and its phosphorylation. The pseudopod formation in A431 cells was observed by using scanning electron microscopy. Results After 24-hour culture, wound healing assay displayed that the percent wound closure was 13.3 ± 1.7, 7.6 ±1.6 and 5.9 ± 1.3, respectively, in A431 cells treated with baicalein of 5, 10, 20μmol/L, significantly lower than that in untreated A431 cells (16.3 ± 2.3, all P < 0.01), and the inhibition of baicalein on the migration of A431 cells was concentration-dependent. In the Transwell assay, a significant decrease was observed in the number of A431 cells per high power field permeating through the artificial basement membrane in the groups treated with baicalein of 5, 10, 20 μmol/L for 48 hours compared with the control group (46.5 ± 3.8, 34.3 ± 3.4, 25.3 ± 2.3 vs 56.3 ± 3.8, all P < 0.01), whereas no significant difference was noted between these baicalein-treated groups and siRNA-transfected group (28.3 ± 2.1, all P > 0.05). RT-PCR analysis showed that the mRNA expression of ezrin in baicalein-treated A431 cells significantly decreased compared with that in untreated cells (all P< 0.01), but showed no difference from that in siRNA group (P > 0.05). A statistical difference was also observed in the expression of ezrin and phosphorylated ezrin protein between baicalein-treated A431 cells and untreated cells (all P< 0.05), but not between 40 μmol/L baicalein-treated A431 cells and siRNA-transfected cells (P> 0.05). Furthermore, the suppression of baicalein on ezrin protein and mRNA expression was concentration dependent. The number of pseudopod per cell was significantly lower in 20 μmol/L baicalein-treated A431 cells and siRNA-transfected cells than that in untreated A431 cells (5.3 ± 1.9, 4.5 ± 2.8 vs 22.6 ± 2.8, both P < 0.01), while no significant difference was observed between the former two groups of cells (P > 0.05); the length of pseudopodia also reduced in baicalein-treated cells. Conclusions Baicalein may inhibit the proliferation and invasion of A431 cells by directly or indirectly suppressing the expression of ezrin and phosphorylated ezrin, which in turn contributes to the effect of baicalein against tumor proliferation and metastasis.

objeetive To consecutively understand the current national clinical testing quality and enforce quality-control of auto-antibody detection.Methods Hospitals or departments were recruited by letters or telephone communications:The autoantibodies examined for quality control survey included anti-nuclear antibodies (ANA),anti-double-stranded DNA (A-dsDNA)antibody,anti-extractable nuclear antigens(A-ENA)antobodies,anti-mitochondria antibody(AMA)/anti-smooth muscle antibody(ASMA),and anti-CCP antibody.Each autoantibody was tested in 3 samples, and altogether 15 samples in total for testing.Sample designation and testing results data analysis were double-blinded.Results Fifltv-five hospitals/departments participated in this survey.The accuracy rates for this survey were 92%,89%,96%,72%respectively for ANA,A-dsDNA,AMA/ASMA,and anti-CCP.Anti-ENAs were further divided into anti-RNP,Sm,SSA,SSB and Scl-70 subgroups,and the accuracy rates were 98%,89%,92%,75%and 77% respectively.Conelusion Compared to the previous 3 national surveys.accuracy rates in our country's autoantibody testing is increaseing steadly with more testing items included each year.This indicats that the quality of auto-antibody testing is improving across the country.

Objective To improve the understanding of severe anaphylactic reactions to infliximab retreatment. Methods Delayed hypersensitivity to infliximab in two patients with ankylosing spondylitis who had previously received infliximab and resumed after discontinuation over 4 years were reported and the related literatures were reviewed. Results Two patients ( 1 male, 1 female ) who were diagnosised with ankylosing spondylitis for more than 10 years, both individuals had received infliximab treatment during a clinical trial approximately 4-5 years prior to further therapy. On day 6 after subsequent infusion, one patient had pruritic skin rash covering her whole body, followed by flustered, dyspnea, hypotension and anaphylactic shock, she was successfully treated with epinephrine and glucocorticoid. Another patient experienced a skin rash and itching 9 days after reinfusion, he was successfully treated with antihistaminics.Conclusion A distant infliximab retreatment is associated with high rates of reinfusion reactions, including fever, urticaria, myalgia, arthralgia,even hypotension, dyspnea, laryngeal edema and anaphylactic shock.We recommend careful monitoring of those patients who receive infliximab retreatment, particularly after a lengthy interval.