Objectives To analyze the diagnosis and management of steroid-resistant nephrotic syndrome (SRNS) accompanied with irreversible leukoencephalopathy in children. Methods The clinical, laboratory and imaging data were retrospectively analyzed in a SRNS child accompanied with irreversible leukoencephalopathy. A literature review was performed. Results After clinical diagnosis of SRNS, glucocorticoid, immunosuppressant, and hemodialysis were administrated for 10 months. During the course of treatment, the seizures, visual problems, and hypertension were repeatedly occured. The cranial MRI showed bilateral occipital parietal lobe hyperintensity and right frontotemporal lobe hyperintensity on T2-weighted imaging and bilateral occipital parietal lobe hypointensity on T2-Flair imaging, which indicated that encephalomalacia was accompanied with gliosis. Conclusions A variety of reasons may induce leukoencephalopathy in children. The accompanied irreversible leu-koencephalopathy should be strongly considered in management of SRNS.

Objective To analyze the injury characteristics, using data from the National Injury Surveillance System (NISS), 2006 to 2008, to develop a injury prevention strategy. Methods 129 hospitals from 43 surveillance points in NISS were selected according to the DSP sample framework, also considering the capacity of local CDC. Results Relative information on 1 318 739cases were analyzed. The number of male cases were more than the females. The top three causes of injuries were as follows: falls (28.02%,29.36%,30.12%), traffic-related (23.07%,21.61%,21.44%)and blunt injuries (21.46%, 21.17%, 20.59% ). The major places where injuries occurred were: road/street (29.80%, 27.73%, 28.37% ) and at home (21.51%, 22.80%, 24.02% ). Recreation activities (35.63%, 41.93%, 42.13% ) and at work (24.43%, 22.60%, 21.44% ) were the two major activities when injuries took place. Most injury cases were unintentional (83.81%, 86.32%, 86.71% ) and mild (70.42%, 74.79%, 73.90% ). Rush hours that caused injuries to happen were between 7 to 10 AM.Conclusion Male injury cases were more than females. Falls, road traffic-related and blunt injuries were the major causes, with most of them were unintentional and minor.

OBJECTIVETo investigate the expression of long non-coding RNA HOTAIR in the plasma of breast cancer patients and its value in the diagnosis of breast cancer.

METHODSHOTAIR levels were measured in 24 tumor tissues and 70 plasma samples from breast cancer patients using quantitative real-time PCR. The correlations of plasma HOTAIR level with the clinicopathological features of the patients were analyzed. A multivariate logistic regression model was established to analyze the value of plasma HOTAIR in comparison with plasma CA153 and CEA levels for breast cancer diagnosis. We further detected HOTAIR levels in the plasma and breast cancer tissues of 24 patients before and after operation and investigated their correlation.

RESULTSBreast cancer patients had increased expressions of HOTAIR in the tumor tissues and plasma, and plasma HOTAIR level was significantly correlated with estrogen receptor (ER) level (P=0.004) and lymph node metastasis (P=0.010). Receiver operating characteristic (ROC) curve and the multivariable logistic regression model showed that the area under ROC curve (AUC) of plasma HOTAIR was 0.82 (P<0.001) for breast cancer diagnosis with a diagnostic sensitivity and a specificity of 73.3% and 93.3%, respectively. The diagnostic power and specificity of plasma HOTAIR was much higher than those of CA153 (AUC=0.66, P=0.030) and CEA (AUC=0.52, P=0.001), and the combination of the 3 markers further enhanced the diagnostic power (AUC=0.84) and specificity (96.7%). Plasma HOTAIR level was significantly reduced in the patients after the operation (P<0.0001) and showed a moderate correlation with its expression in tumor tissues (r=0.62, P<0.0001).

CONCLUSIONPlasma HOTAIR may serve as a potential biomarker for breast cancer diagnosis.

Biomarkers, Tumor ; blood ; Breast Neoplasms ; blood ; diagnosis ; Carcinoembryonic Antigen ; blood ; Female ; Humans ; Logistic Models ; Lymphatic Metastasis ; Mucin-1 ; blood ; Prognosis ; RNA, Long Noncoding ; blood ; ROC Curve ; Real-Time Polymerase Chain Reaction ; Receptors, Estrogen ; metabolism ; Sensitivity and Specificity

Objective To observe the improving effect in joint function of moderate skeletal fluorosis treated by traditional Chinese medication(main ingredient was Strychnine).MethodsFrom December 2007 to July 2009,120 moderate skeletal fluorosis patients met the inclusion criteria were divided into the treatment group(60 cases)and the control group(60 cases)in the skeletal fluorosis hospital of Xinzhou,the treatment group was given basic treatment and traditional Chinese medication,the control group wa8 given basic treatment and placebo.The treatment lasted 12 weeks,follow up 24 weeks.Before treatment,after treatment 4 weeks,8 weeks,12 weeks,36 weeks,a third party evaluate comprehensive function of both upper and lower limb and joint dysfunction.Results The main effect of both drugs was statistically significance in the scores of the upper forearm in the finger by touching the posterior contralateral ear, upper arm touched by the finger back in the opposite corner subscapularis function, lower limb function and single-joint dysfunction(F values were 4.08,14.32,35.81,13.02, all P<0.05), the main effect of time also was significant (F values were 82.63,72.82,277.33,328.16, all P<0.05),①the upper forearm in the finger by touching the posterior contralateral ear functions:At the time of 8,12 weeks,scores of the treatment group were lower than those of before treatment and control group (all P<0.05);At the time of 36 weeks,scores of the treatment group were lower than that 12 weeks(all P<0.05);At the time of 8,12,36 weeks, scores of the control group were lower than those of before treatment(all P < 0.05);②upper arm function, namely fingers touching the opposite corner subscapularis:At the time of 4,8,12 weeks, scores of the treatment group were lower than those of before treatment(all P<0.05); At the time of 36 weeks, scores of the treatment group were lower than that 12 weeks(all P<0.05); At the time of 8,12,36 weeks, scores of the treatment group were lower than those of the control group (all P<0.05);③Lower extremity functions: At the time of 8,12 weeks,scores of the treatment group were lower than those of before treatment and control group (all P<0.05);At the time of 36 weeks, scores of the treatment group were lower than that 12 weeks(all P<0.05) ; At the time of 8,12,36 weeks, scores of the control group were lower than those of before treatment (all P<0.05);④single joint functions:At the time of 4,8,12 weeks,scores of the treatment group were lower than those of before treatment(all P<0.05); At the time of 36 weeks,scores of the treatment group were lower than that 12 weeks(all P<0.05) ; At the time of 8,12,36 weeks, scores of the control group were lower than those of before treatment(all P<0.05);At the time of 4,8,12,36 weeks, scores of the treatment group were lower than those of control group(all P<0.05);⑤At the end of treatment and follow-up,the improvement rate in joint functions in the treatment group were 88.33% (53/60),93.33% (56/60); the control group were 28.07%(16/57),40.35%(23/57), (Fisher test, P<0.01,X2=56.21, P<0.01). ConclusionTraditional Chinese medication(its main ingredient is Strychnine), an effective drug for improving joint dysfunction in patients suffering from moderate skeletal fluorosis, is simple and effective.

BACKGROUNDMitochondrial dysfunction plays a pivotal role in the progression of left ventricular (LV) remodeling and heart failure (HF). Recombinant human neuregulin-1 (rhNRG-1) improves cardiac function in models of experimental HF and in clinical trials; however, its impact on mitochondrial function during chronic HF remains largely unknown. The purpose of this study was to investigate whether rhNRG-1 could attenuate the functional and structural changes that occur in cardiac mitochondria in a rat model of HF induced by myocardial infarction.

METHODSSixty adult rats underwent sham or coronary ligation to induce HF. Four weeks after ligation, 29 animals with LV ejective fraction ≤ 50% were randomized to receive either vehicle or rhNRG-1 (10 µg×kg(-1)×d(-1), I.V.) for 10 days, another 12 sham-operated animals were given no treatment. Echocardiography was used to determine physiological changes. Mitochondrial membrane potential (MMP), respiratory function and tissue adenosine triphosphate (ATP) production were analyzed. Cytochrome c expression and cardiomyocyte apoptosis were determined. Oxidative stress was evaluated by reactive oxygen species production using fluorescence assays and gene expression of glutathione peroxidase measured by real-time quantitative PCR.

RESULTSCompared with sham-operated animals, vehicle treated HF rats exhibited severe LV remodeling and dysfunction, significant mitochondrial dysfunction, increased mitochondrial cytochrome c release, increased myocyte apoptosis and enhanced oxidative stress. Short-term treatment with rhNRG-1 significantly attenuated LV remodeling and cardiac function. Concomitant with this change, mitochondrial dysfunction was significantly attenuated; with ATP production, MMP and respiratory function restored, cytochrome c release and apoptosis inhibited, and oxidative stress reduced.

CONCLUSIONThe present study demonstrated that rhNRG-1 can significantly improve LV remodeling and cardiac function in the failing heart, this beneficial effect is related to reducing mitochondrial dysfunction, myocyte apoptosis and oxidative stress.

Animals ; Apoptosis ; drug effects ; Blotting, Western ; Echocardiography ; Heart Failure ; Mitochondria ; drug effects ; metabolism ; Myocardial Infarction ; drug therapy ; metabolism ; pathology ; Neuregulin-1 ; therapeutic use ; Rats ; Rats, Wistar ; Reactive Oxygen Species ; metabolism ; Real-Time Polymerase Chain Reaction

OBJECTIVETo observe serum troponin I (TNI) level in patients with hypertrophic cardiomyopathy (HCM).

METHODSix hundreds and twelve HCM patients were analyzed prospectively from January 1990 to November 2007.Ultracardiography were detected for all the patients. The diagnostic criteria of HCM is ventricular wall thickness more than 15 mm. Serum TNI level was measured in 116 patients with HCM. Clinical data including age, gender, history, main symptoms, NYHA grade, coronary angiograph, electrocardiogram and echocardiography were compared between patients with normal and increased TNI levels.

RESULTSIn 116 patients who detected TNI, 62 of them (53.4%) had a degree higher than normal. The median TNI value of all these patients is 0.07 ng/ml (0 - 4.38 ng/ml). Sixty-nine patients (59.5%) had undergone coronary angiography. Only 9 of them (13.0%) could be diagnosised as coronary heart disease. The TNI values of HCM patients with or without coronary heart disease were similar. The factors related to a higher TNI value included maximal depth of ventricule (P < 0.05), significant T inversion (P < 0.01) and chest pain (P < 0.05). Compared to all the 612 patients, the ones who detected serum TNI were likely to have chest pain (45.7% vs. 34.5%, P < 0.01) and significant T inversion (75.9% vs. 30.1%, P < 0.01).

CONCLUSIONIncreased serum TNI could be seen in half of HCM patients, especially in those patients with chest pain or significant T inversion. It is therefore important to different these patients from patients with acute coronary syndrome.

Adult ; Cardiomyopathy, Hypertrophic ; blood ; diagnosis ; Coronary Disease ; diagnosis ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Troponin I ; blood

OBJECTIVETo investigate the expression of translationally controlled tumor protein (TCTP) in human breast cancer tissues and its clinical significances.

METHODSThe expression of TCTP in 94 human breast cancer and the corresponding adjacent normal mammary tissues were detected using immunohistochemistry.

RESULTSThe expression rate of TCTP was 64.89% in human breast cancer tissues, significantly higher than that in normal benign mammary tissues (39.36%, P<0.001). TCTP overexpression was positively correlated to the tumor size, clinical stage, lymph node metastasis and histological grade of breast cancer (P<0.05). Patients with positive TCTP expression had a significantly shorter mean survival time than those with negative expression (P<0.001).

CONCLUSIONTCTP may play an important role in the tumorigenesis and development of breast cancer, and can be an important prognostic factor for this malignancy.

Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Breast Neoplasms ; metabolism ; pathology ; Female ; Humans ; Middle Aged

Objective To describe the distribution of injuries among the elderly through hospital based National Injury Surveillance System (NISS), and to provide basic information for prevention of injury among the elderly. Methods Data on injuries among the elderly aged 60 years and above was descriptively analyzed from the Chinese NISS from 2006 to 2008. Using the data of NISS from 2006 to 2008, information was collected on those cases who were diagnosed as injuries for the first-time in the site hospitals. Information included demographic characteristics, features of the injury events, and clinical characteristics of injuries. SPSS 16.0 software was used for data analysis.Results The leading causes of injuries among the elderly were: falls, road traffic injuries, and blunt injuries, which were in total accounting for more than 70% of all the injuries among the elderly. Most of the injuries occurred at home (46.25 %, 44.44%, 46.23 % ), on the roads ( 30.95%, 28.51%, 28.61% )and in the public residences (8.89%, 11.57%, 11.25% ). Recreation activates (42.14%, 48.09%,48.59%) ,housework/study (21.15%, 18.21%, 18.15%) and driving (13.67%, 13.80%, 13.56%) were the three major activities when injuries took place. Most injuries among the elderly were unintentional (91.34%, 92.84%, 93.09% ). The leading causes of suicide of the elderly were poisoning and sharp injury. The most common natures of injuries were bruise (36.07%, 38.18%, 38.50% ), fractures (25.65%, 22.47%, 23.77% ), and sharp/bite/open injuries ( 17.19%, 18.21%, 17.46% ) while the most injured part of bodies were head (26.32%, 25.59%, 25.90%), lower limbs (25.74%, 25.70%, 25.26%)and upper limbs (21.01%,21.14%,21.37%). Most of the injuries were minor ones (60.53%,65.09%,63.58% ), and patients mostly went home after treatment (64.11%, 68.53%, 67.99% ). Conclusion According to NISS, the proportion of injuries among the elderly in all injuries kept increasing from 2006 to 2008, while distribution of injuries among the elderly being stable. Falls was the most common injury type for the elderly which also brought along bad outcome. Falls was the priority for injury prevention among the elderly.

Objective To describe the distribution of road traffic injuries through hospital based National Injury Surveillance System (NISS). Methods Data of road traffic injuries was descriptively analyzed from Chinese NISS from 2006 to 2008. Results In 2006-2008, road traffic injury was the second leading cause from NISS among attendants in ERs or clinics of the hospitals,with males (64.63%, 64.07%, 64.38% ) more than females (35.37%, 35.93%, 35.62%). People aged 30-44 (36.04%, 34.82%, 34.28% ), 15-29 (30.74%, 31.57%, 30.13%), 45-64 (20.28%, 20.70%,22.80% ) years were seen more than other age groups. The majority of road traffic injuries were unintentional (98.34%, 99.07%, 99.07% ), and mostly injured in head (35.21%, 33.74%, 35.77% )and lower limbs (24.08%, 24.54%, 23.95%) which mainly as bruise (56.47%, 57.92%, 58.89%) and fractures (17.70%, 15.84%, 15.88% ). The severities of injuries were mainly minor ones (63.69%,67.24%, 65.68% ), and mostly went home right after treatments (59.43%, 63.76%, 62.80% ).Conclusion The distribution of road traffic injuries from NISS kept stable from 2006 to 2008. Young and middle aged men were the focus population for road traffic injuries intervention. Further improvement ofNISS, multi-sectional collaboration-based advocacies and education programs as well as the enforcement of road safety law seemed the good practices for road traffic injury prevention.

Huperzine A is a potent,reversible,and blood-brain barrier permeable acetylcholinesterase irhibitor.The aim of this study was to compare the pharmacokinetics,tolerability,and bioavailability of two formulations with the established reference formulation of huperzine A in a fasting,healthy Chinese male population.This was a randomized,single-dose,3-period,6-sequence crossover study.The plasma concentrations of huperzine A were determined by liquid chromatography tandem mass spectrometry.Tolerability was assessed based on subject interview,vital sign monitoring,physical examination,and routine blood and urine tests.The mean (SD) pharmacokinetic parameters of the reference drug were Cmax,1.550 (0.528) ng/mL;t1/2,12.092 (1.898) h;AUC0-72h,17.550 (3.794) ng.h/mL.Those of the test formulation A and test formulation B were Cmax,1.412 (0.467),1.521 (0.608) ng/mL;t1/2,12.073 (2.068),12.271 (1.678) h;AUC0-72h,15.286 (3.434) ng.h/mL,15.673 (3.586) ng.h/mL.The 90％ confidence intervals for the AUC0-72h and Cmax were between 0.80 and 1.25.No adverse events were reported by the subjects or found with results of clinical laboratory test.The test and reference products met the regulatory criteria for bioequivalence in these fasting,healthy Chinese male volunteers.All three formulations appeared to be well tolerated.