Objective: To establish the quality standard for Shenqinaoqing Granule(Radix Astragali, Radix Ginseng, Radix Angelicae Sinensis, Radix Polygoni Multiflori, etc.) Methods: Astragaloside I of Shenqinaoqing Granule was determined by TLC-scanning, Rhizome Astragali, Radix Ginseng, Radix Polygoni Multiflori, Radix Paeoniae alba were identified by TLC. Results: TLC spot developed were fairly clear, and the blank test showed no interference. Astragaloside I showed a good linear relationship in the concentration range of 0.50～5.05?g and the average recovery was up to 97.10%, RSD was 1.34%. Conclusion: The methods can be effecive for the quality control of the Shenqinaoqin Capsule.

Objective To explore the clinical and peripheral blood characteristics of childhood purulent meningitis complicated with subdural effusion. Methods A retrospective cohort chart review was performed. A total of 162 consecutive cases of purulent meningitis were identified in Shenzhen Children′s Hospital from January 2009 to De-cember 2013,all of them were divided into 2 groups according to whether complicating with subdural effusion, and the clinical characteristics of 2 groups were analyzed. The clinical characteristics were analyzed. The statistical data were determined by SPSS 17. 0 software. Results Forty-nine cases(30. 25%)of them were complicated with subdural effu-sion;and 37 cases (75. 5%)of them suffered from the disease in the first 10 days after the onset of the meningitis,and the incidence was 48. 84% (42 cases) in infancy. Fever,lethargy,seizures and bulging fontanelle were its common clinical signs,and there were no significant differences in the incidence between subdural effusion group and the control group(non-subdural effusion group),the white blood cell (WBC) count did not increase markedly and C-reactive pro-tein(CRP) was high in the subdural effusion group on the admission day(Z=1. 74,2. 10,all P<0. 05),but no differ-ence in platelet( PLT) . The PLT was high in the whole meningitis cohort,the ratio of cases whose PLT was higher than 300×109/L reached 93. 75%,but no difference between the 2 groups. There were many factors of WBC on admission, including age, cerebrospinal fluid culture results and the application of antibiotics before admission, but CRP was only affected by antibiotics. Conclusions Subdural effusion is common in infancy,and most occurred in the first 10 days af-ter onset of the meningitis. On admission day the CRP,was high, while WBC did not increase too much. If CRP rises for the second time it might predict the occurrence of subdural effusion in bacterial meningitis. The increased PLT may be considered as clinical feature of infectious diseases. The clinical implication of inflammatory pathophysiology in men-ingitis needs further investigation.

BACKGROUND: Cigarette smoking has been recognized as one of the high risk factors in carcinogenesis of lung cancer. Early diagnosis of lung cancer may be of clinical therapy value.OBJECTIVE: To explore the mutation of K-ras oncogene in bronchoalveolar lavage fluid(BALF) in order to reveal its relationship with cigarette smoking in lung cancer patients.DESIGN: Randomized controlled trial based on the patients.SETTING: Department of Toxicology, College of Radiology and Public Health of a university, and Department of Respiratory Medicine of a university hospital.PARTICIPANTS: The out-patients and inpatients in the Second Affiliated Hospital of Soochow University between June 1999 and September 2001 were included. The patients were confirmed to have lung cancer or innocuous diseases by fiber bronchoscopy through bronchoalveolar lavage(BAL) and cytological or pathological examination.METHODS: BALF samples were obtained from 37 smoking patients with lung cancer and 25 nonsmoking patients with lung cancer, and 20 with benign pulmonary diseases in the Second Affiliated Hospital of Soochow University. They were detected for K-ras codon 12 mutations using polymerase chain reaction with restriction fragment length polymorphism(PCR-RFLP).MAIN OUTCOME MEASURES: Codon 12 mutations of K-ras gene.RESULTS: K-ras mutation in patients with lung cancer was found to have an average frequency of 36% (22/62)but no K-ras gene mutation was detected in patients with benign pulmonary diseases. The mutation frequency in heavy smokers(69% ) was higher than that in moderate smokers(31%), mild smokers (25%) and nonsmokers (20%). The mutation was related to age and history of smoking, but not to sex and TNM classification.CONCLUSION: Cigarette smoking may be correlated with the mutation of K-ras gene. Early detection of K-ras mutation in BALF may be of clinical value, which helps the identification and diagnosis of smoking-related lung cancer.

With ever-increasing knowledge of biomechanics and anatomy of pelvis,more and more findings have been made on the integrated sacroiliac joint system.The sacroiliac complex plays a very important role i n the functions of pelvis due to its specia l biomechanical features.The sacro iliac screw internal fixation is bio mechanically superior to other fixation methods.[

BACKGROUND: High incidence rate in the morning and low incidence rate in the evening is the regularity of stroke; however, there are no clear reports on changes of concentration of plasma endothelins and its relationship with onset of cerebral thrombus.OBJECTIVE: To investigate dynamic regularity of plasma endothelins in patients with acute cerebral thrombus within 24 hours and its correlation with episode.DESIGN: Case-controlled study.SETTING: Center of Radio-immunology and Department of Laboratory of Affiliated Hospital of Medical College of Qingdao University.PARTICIPANTS: Totally 32 patients with cerebral thrombus were selected from Neurological Department of Affiliated Hospital of Medical College of Qingdao University from January 2002 to January 2003. There were 20males and 12 females with mean age of (61.5±4.1) years. Ten patients had history of diabetes mellitus combined with hypertension, 8 had history of hypertension, 1 had history of diabetes mellitus, and 13 did not have history of diabetes mellitus and hypertension. Another 30 healthy subjects were selected from the same hospital including 13 males and 17 females with the mean age of (58.1±6.25) years. Informed consent was obtained from all subjects.METHODS: Radio-immune analysis was used to determine the dynamic changes of plasma-endothelins level in 32 patients with cerebral thrombus and 20 healthy subjects at 2, 8, 14 and 20 o'clock.MAIN OUTCOME MEASURES: ① Plasma-endothelins level of patients in cerebral thrombus group and control group at the four time points within 24 hours; ② Plasma-endothelins level of patients with or without cerebral thrombus at the four time points within 24 hours.RESULTS: Totally 32 patients with cerebral thrombus and 30 subjects in control group entered the final analysis. ① Plasma-endothelins level in cerebral thrombus group day and night was higher than that in the control group (t=29.1-30.5, P ＜ 0.001). The level was the lowest [(69.96±3.92) ng/L] at 2 o'clock within 24 hours but the highest at 8 o'clock [(78.55±3.80) ng/L,(t=5.67, P ＜ 0.01)]. ② Levels of endothelins in patients with history of hypertension and cerebral thrombus were obviously higher than those in patients without history of hypertension and cerebral thrombus at 2, 8, 14 and 20 o 'clock within 24 hours [(73.28±7.89), (64.52±5.29) ng/L; (82.39±8.62),(75.81±5.14) ng/L; (81.39±8.62), (70.32±5.97) ng/L; (82.47±5.04),(65.27±5.14) ng/L, (t=2.11-5.17, P ＜ 0.05-0.01)].CONCLUSION: Plasma-endothelins level in patients with acute cerebral thrombus has rhythm changes within 24 hours. The changes are high in the morning and low in the evening, and this is accorded with high onset of cerebral thrombus in the morning.

ObjectiveTo investigate the alteration of Fc gamma receptors expressed on monocytes in childhood acute immune thrombocytopenia (aITP).Methods27 patients with aITP and 25 health controls were enrolled in this study.The expression of FcγR Ⅰ and FcγRⅢ on monocytes surface was determined by flow cytometry.Real-time PCR was performed to detect the levels of FcγR Ⅱ a and FcγR.Ⅱ b mRNA.The plasma concentration of IL-4 and IFN-γwas analyzed by ELISA.ResultsThe expression of FcγR I and FcγRⅢ on monocytes was significantly highet in ITP pationts than thatinhealth control group.Transcription levels of FcγR Ⅱ a mRNA and the ratio of FcγR Ⅱ a/Ⅱ b mRNA on monocytes were significantly elevated,while the inhibitory FcγR Ⅱ b mRNA was significant lower in aITP patients (P＜0.05) ; in comparison with healthy controls. After dexamethasone treatment,the stimulatory FcγR Ⅰ,FcγRⅢ and FcγR Ⅱ a mRNA were significantly decreased while inhibitory FcγR Ⅱ b mRNA was increased.(2)The higher levels of plasma IFN-y and lower IL-4 were to be found in aITP patients compared with healthy controls.Correlation analysis showed that the level of plasma IFN-γwas positively correlated with the elevated expression of FcγR Ⅱ a mRNA on monocytes,while the level of IL-4 was positively correlated with FcγRⅡ b mRNA.Conclusion The over expression of inhibitory FcγRs and the down-regulation of inhibitory FcγR Ⅱb mRNA on monocytes,and the imbalance of stimulatory and inhibitory FcγR might be involve in immunological pathogenesis of the acute ITP.The alteration levels of plasma pro-inflammatory cytokine IFN-γand anti-inflammatory cytokine IL-4 might be involved in imbalance expression of FcγR in acute ITP.Dexamethasone therapy could shift the balance between stimulatory and inhibitory FcγR toward inhibitory FcγR Ⅱ b in aITP patients.

Objective To investigate the effects of ketogenic diet ( KD) treatment on helper T cell subsets in children with intractable epilepsy( IP) . Methods Thirty-five children with IP and eighteen age-matched healthy subjects were enrolled in this study.The percentages of CD3+CD8-IFN-γ+( Th1 ) cells, CD3+CD8-IL-17A+(Th17) cells and CD4+CD25+Foxp3+(Treg) cells were analyzed by flow cytometry.Re-al-time PCR assay was performed to evaluate the expression of T-bet, ROR-γ, IFN-γ, IL-17A and peroxi-some proliferator activated receptorγ( PPAR-γ) at mRNA level in CD4+CD25-T cells and the transcription-al levels of Foxp3, GITR, CTLA-4 and PPAR-γin CD4+CD25+T cells.The concentrations of cyclooxygen-ases-2 (COX-2) and prostaglandin F2a (PGF2α) in plasma samples were measured by enzyme-linked im-munosorbent assay.The expression of IL-17A and IFN-γin plasma samples were detected by using cytomet-ricbeadarray(CBA).Results (1)ThepercentagesofTregcellsinperipheralbloodsamplesfrompa-tients with IP were lower than those in healthy subjects (P<0.05), which were significantly increased with the treatment of KD (P<0.05).The percentages of Th17 and Th1 cells in patients with IP were significantly higher than those in healthy children (P<0.05), but were remarkably decreased with the treatment of KD (P<0.05).Patients with IP showed decreased transcriptional levels of Foxp3, GITR and CTLA-4 in CD4+CD25+T cells as compared with healthy controls, but were up-regulated with the treatment of KD.The ex-pression of transcription factors including T-bet, ROR-γ, IFN-γand IL-17A in CD4+CD25-T cells in pa-tients with IP were higher than those in healthy subjects and were down-regulated after the treatment of KD (P<0.05).(2) The expression of PPAR-γat mRNA level in CD4+CD25-T and CD4+CD25+T cells were decreased in patients with IP as compared with those in heathy controls, but were increased after the treat-ment of KD (P<0.05).Correlation analysis showed that Treg cells had a positive correlation with PPAR-γ(r=0.61, P<0.05).However, the Th1 and Th17 cells were negatively correlated with PPAR-γ[Th1 (r=-0.54, P<0.05), Th17 (r=-0.64, P<0.05) ].(3) The levels of IL-17A and IFN-γin patients with IP were higher than those in healthy controls, but were decreased with KD treatment (P<0.05).The levels of COX-2 and PGF2αin plasma samples from patients with IP were higher than those in healthy controls ( P<0.05).A negative correlation was observed between COX-2 and PPAR-γ(r=-0.571, P<0.05). Moreover, PGF2αand PPAR-γhad a negative correlation as well (r=-0.586, P<0.05).Conclusion The treatment of KD might enhance the expression of PPAR-γthrough inhibiting the products of oxidative stress such as COX-2 and PGF2α, resulting in the rebalance of Th cell subsets and reduced expression of in-flammatory cytokines.

Objective: To investigate the expression of midkine (MK) gene in childhood acute lymphoblastic leukemia (ALL) and the clinical significance of MK thereof. Methods: The real-time PCR was used to assay MK gene expression in bone marrow of 15 normal children and 124 childhood ALL patients, including 73 patients in progression and 51 patients in complete remission. Three stratifications of progressing patients were established by prognostic factors such as white blood cell count, age, immunopherotype and response to the 7-day prednisolone prephase. Results: The significant statistic difference in MK gene expression was found between the progression group, the complete remission group and the normal group (P< 0.01). The MK gene expression was over-expressed in B-ALL than that in normal group. Furthermore, there was statistic difference between B-ALL and T-ALL (P< 0.01). But there was no difference in MK mRNA expression between the normal control and T-ALL. The assay in risk stratifications showed that the levels of MK gene were higher in standard risk group and mid-risk group than that in high risk group (P< 0.01 and P< 0.05, respectively). There was no significant difference between standard risk group and mid -risk group (P = 0.32). No correlations were found between MK level and age, gender or lactate dehydrogenase level in serum. The expression of MK was significantly lower in the group with higher white blood cells(WBC≥ 25×10~9/L) than that with lower WBC (WBC<25×l0~9/L) in peripheral blood (P< 0.05). Conclusion: The high level of MK was a favorable prognostic factor in childhood acute lymphoblastic leukemia patients.

Objective To analyse the value of video-EEG (VEEG) in the infantile spasms (IS)children treated with adrenocorticotrophic hormone (ACTH). Methods The clinical data of 65 children with IS in our hospital from Jan 2005 to Dec 2009 were collected and the characteristics of VEEG were analyzed before and after treated with ACTH. Results All the 65 cases appeared hypsarrhythmia in the interphase before treated with ACTH. Cluster spasms and the characteristics of VEEG were recorded. After treated with ACTH,40 of 65 cases (61.5%) with epileptic seizure were controlled,in whom 27 cases (67.5% ,27/40)with hypsarrhythmia disappeared or improved obviously. The other 25 of 65 cases (38.5%) with epileptic seizure were uncontrolled,in whom only 5 cases (20. 0% ,5/25) with hypsarrhythmia disappeared. The rate of hypsarrhythmia disappeared or improved was significantly different between the epileptic seizure controlled and uncontrolled children (x2 = 13. 888, P ＜ 0. 000). Conclusion VEEG is not only important to make a definite diagnosis for IS,but also can provide an evidence in evaluating the effect of ACTH in IS children.

Objective To explore the impact of ketogenic diet (KD) on follicular helper T cells(TFH) in children with intractable epilepsy.Methods Thirty-three cases with intractable epilepsy were selected between Jul.2013 and Jan.2014 in Shenzhen Children's Hospital,19 boys and 14 girls; average age was 39.6 months,and seventeen age-matched healthy children who took a physical examination in the same hospital were assigned as the healthy control group.Blood samples were collected from the children with refractory epilepsy before and after 1 week of KD treatment.The proportions of the various stages of B cells and TFH cells were detected by flow cytometry.The plasma concentration of interleukin-21 (IL-21) was determined by enzyme-linked immunosorbent assay(ELISA),and realtime quantitative PCR(RT-PCR) was performed to detect the levels of peroxisome proliferator-activated receptor gamma (PPAR-γ),B-lymphocyte-induced maturation protein-1 (Blimp-1),B-cell lymphoma 6 (Bcl6) and IL-21 mRNA expression in CD4 + T cells.Results (1) The number of TFH cells in children with intractable epilepsy [(3.57 ± 0.58) ％] was remarkably decreased after KD treatment(P ＜ 0.01),while there were no difference between after KD treatment and healthy control group[(4.93 ±0.70)％ vs (5.03 ±0.63)％,P ＞0.05].(2) The levels of transcription factor Bcl6 expression after treatment were significantly decreased,while inhibitory factor Blimp-1 expression increased (P ＜ 0.05).(3)The plasma concentration of IL-21 had a trend to decrease (P ＞ 0.05),while there were no difference before and after KD treatment,and levels of IL-21 mRNA expressions in CD4 +T cells were significantly decreased after the treatment (8.28 × 10-3 ± 1.19 × 10-3 vs 1.72 × 10-2 ± 0.81 × 10-2,t =3.08,P ＜ 0.05).(4) There was no significant difference in CD27-IgD + B cells before and after KD treatment (P ＞ 0.05),CD27 + IgD + B cell and CD27-IgD-B cells had a trend to decrease after KD treatment(P ＞0.05),and CD27 + IgD-B cells and CD27 + IgD-CD38 high plasma cells were significantly decreased after KD treatment (P ＜ 0.05).(5) The number of TFH cells were correlated positively with the number of CD27 + IgD-B cells and CD27 + IgD-CD3g high plasma cells (r =0.785,0.745,P ＜ 0.05).(6) The levels of PPAR-γmRNA in CD4 + T cells expression were significantly up-regulated after KD treatment (3.49 × 10-3 ± 1.10 × 10-3 vs 2.28 ± 10-3 ± 1.30 × 10-3,t =3.41,P ＜0.05),and the number of TFH cells and PPAR-γgene expression was correlated negatively (r =-0.619,P ＜ 0.05).Conclusions KD might down regulate TFH cell number and function through inducing PPAR-γexpression and could inhibit B cell differentiation,which might be one of the factors for hypogammaglobuinemia by KD treatment.