Objective To explore the change and clinical significance of serum Cystain-C in children with Henoch-Schonlein purpura(HSP).Methods Thirty-three children diagnosed HSP according to the domestic criteria hospitalized in department of pediatrics were enrolled in patient group and 31 children outpatients during the corresponding time period as controls.Venous blood of each child in 2 groups was collected in the day of admission,serum Cystain-C was determined by enzyme-linked immunosorbent assay,plasma D-dimer was measured by gold standard double antibody sandwich method,and blood urea nitrogen(BUN) and serum creatinine(Scr) were detected by automatic biochemistry analyzer.At the same time each child undertook routine urine examination.Data was analyzed by Stata 8.0 software.Results 1.BUN and Scr of 2 groups were both normal.2.Proteinuria or hematuria was found in 15 of all 33 patients through routine urianlysis,and the detection rate was 45%.3.The pre-and post-therapy level of serum cystain-C[(3.83?0.83) mg/L,(3.76?1.02) mg/L] and plasma D-dimer [(1.93?2.05) mg/L,(0.77?0.79) mg/L] in HSP group were higher than that in controls [(1.21?0.43) mg/L,(0.13?0.07) mg/L] significantly (P0.05).5.In HSP group,the level of plasma D-dimer pretherapy was significantly higher than that of post-therapy(P0.05).Conclusion The level of serum Cystain-C can act as the significant indicator of early diagnosis and continuous observation of HSP nephritis.

Objective To explore the expression profiles and their clinical significance of microRNA (miRNA) molecules in different stages of chronic hepatitis B virus (HBV) infection.Methods The miRNA molecule expressions of 12 patients with chronic hepatitis B,12 chronic HBV carriers,12 inactive hepatitis B surface antigen (HBsAg) carriers,and 9 healthy controls were screened using miRNA microarray.The miRNA profiles were validated by the real time fluorescence quantitative polymerase chain reaction (PCR).The t-test was used for comparison between twogroups,whereas one-way ANOVA and SNK-q tests were used for multiple comparisons.Mann-Whitney and Kruskal Wallis H tests were used for comparison of two or more groups of data with skewed distribution.The receiver operation characteristic (ROC) curve was constructed to evaluate the diagnostic significance of miRNA molecules.Results Compared with the healthy controls,significant differences in the expression profiles of miRNA molecules were found in peripheral blood mononuclear cells of chronic HBV carriers (2 molecules up-regulated,and 18 down regulated) and chronic hepatitis B patients (33 molecules up-regulated and 19 down-regulated).No significant difference was found between inactive HBsAg carriers (2 molecules up regulated,and 3 down-regulated) and controls.The results of six miRNA molecules detected by real-time fluorescence quantitative PCR were basically consistent with the results detected by microarray.The area under ROC curve of the six miRNA molecules of hsa miR-4711-3p,hsa-miR-3191 5p,hsa-miR-5704-5p,hsa-miR 548ah-5p,hsa-miR-146a-5p and hsa-miR-29b-3p in distinguishing immune tolerance and clearance of chronic HBV infection were 0.994,0.984,0.967,1.000,1.000 and 0.996,respectively.Conclusions The different expression profiles of miRNA molecules could be used to distinguish the different stages of chronic HBV infection,and are closely related with the immune tolerance and activation in chronic HBV infection.

Objective To screen and analyze microRNA (miRNA) molecules associated with immune clearance in patients with chronic hepatitis B (CHB).Methods Twelve hospitalized CHB patients and 9 healthy individuals from Taizhou People's Hospital during June 2011 and August 2012 were enrolled.miRCURYTM chip was used to identify differential expression patterns of miRNA.The target genes of differentially expressed miRNA molecules were predicted by TargetScan,miRBase and miRanda databases,and their molecular pathways and functions were analyzed with bioinformatic methods.Results Compared with healthy individuals,52 differentially expressed miRNA molecules were identified in PBMCs of CHB patients,including 33 up-regulated and 19 down-regulated ones.With TargetScan,miRBase and miRanda databases,354 target genes were predicted in up-regulated miRNA molecules,and 1 935 target genes were predicted in down-regulated miRNA molecules.Gene ontology (GO) and Pathway analysis showed that several molecular pathways might be affected by up or down-regulated miRNA molecules.miRNA-mRNA network analysis showed that some target genes might be regulated by miRNA molecules like hsa-miR-520d-5p,hsa-miR-106a-Sp,hsa-miR-30a-5p and hsa-miR-29b-3p,and constituted a complex molecular network.Conclusion There are several miRNA molecules with abnormal expressions in CHB patients,which may be involved in immune clearance through the regulation of target genes and molecular pathways.

Objective To investigate the cause and countermeasures of frequent shocks in patients with implantable cardioverter defibrillators (ICD). Methods Eighty ICD patients with heart failure and malignant ventricular arrhythmias were followed up, including sixty-two male and eighteen female patients. There were 35 patients with single-chamber ICD, 23 with dual-chamber ICD and 22 with three-chamber ICD. Patients in this study were followed up for 1-6 years to analyze the reasons for ICD discharge. According to the specific circumstances, patients were treated. Results Twenty-three pa-tients in 80 patients suffered from shock treatment. Ten patients (12.5%) experienced frequent shocks. The causes of fre-quent shock included repeated episodes of ventricular tachycardia, invalid shock due to increased defibrillation threshold (DF) and false identification of the frequent episodes of paroxysmal ventricular tachycardia or arrhythmias. The management included the identification process adjustment of ventricular tachycardia and supraventricular tachycardia, increased num-bers of beats of ventricular tachycardia judgment and increase the basic pacing rate. The anti-arrhythmic drugs should be combinedly used, especially metoprolol and amiodarone. The ICD shock was significantly reduced after parameter optimiza-tion and anti-arrhythmic therapy. Conclusion The ICD shocks were effectively reduced with rational use of anti-arrhyth-mic drugs and valid ICD programming.

Objective To investigate the expression of microRNA-548ah (miR-548ah) and microRNA-4804 (miR-4804) in peripheral blood mononuclear cells (PBMCs) of patients with chronic hepatitis B virus infection and their clinical significance.Methods PBMCs were collected from 29 patients with chronic hepatitis B (CHB),30 hepatitis B virus carriers (HBVC),26 inactive HBsAg carriers (IASC) and 28 healthy controls in Taizhou People's Hospital during September 2012 and August 2013.Expressions of miR-548ah and miR-4804 in PBMCs were detected by fluorescence real-time quantitative RT-PCR (qRT-PCR).Receiver operating characteristic (ROC) curve was used to evaluate the expression of miR-548ah and miR-4804 in distinguishing immune tolerance phase and clearance phase of HBV infection.Pearson correlation analysis was performed to assess the correlations of miRNAs expression with clinical markers alanine aminotrans ferase (ALT) and HBV DNA loads.Results There were significant differences in expressions of miR-548ah and miR-4804 in PBMCs between CHB,HBVC,IASC groups and control group (F =28.16 and 83.17,P ＜ 0.01).Compared with control group,miR-548ah was up-regulated in CHB group(P ＜ 0.01),and down-regulated in HBVC and IASC groups (P ＜ 0.01) ; miR-4804 was up-regulated in CHB group (P ＜ 0.01),down-regulated in HBVC group (P ＜ 0.01),while there was no significant difference between IASC group and control group in miR-4804 expressions(P ＞ 0.05).The areas under ROC curve (AUCs) of miR-548ah and miR4804 in differentiation of immune tolerance and immune clearance were 0.966 and 0.997,and the sensitivities and specificities were 89.7％,96.6％ and 99.6％,100.0％,respectively.No significant correlation was found between the expression of miR-548ah,miR-4804 and ALT,HBV DNA loads (r=0.14,0.18,-0.20 and-0.19,P＞0.05).Conclusion miR-548ah and miR-4804 may be involved in the immunopathogenesis of CHB,and their expression levels in PBMCs are helpful in differentiation of immune tolerance and immune clearance in HBV infection.

Objective To explore ihe physiological changes of the late-onset depressive(LOD) persons during sleep.Methods 15 cases of LOD patients formed a group and 10 healthy aging persons formed a control group.Hamilton Depression Scale (HAMD) was used to score the severity of depression and polysomnographic recorders were used to monitor the whole night long.The subjective feelings of the sleep and the daytime mental status were assessed in the morning.Results Compared with the controlde group, the LOD patients obviously possessed a disordered sleeping process: sleep efficiency was lower( ( 59.20 ± 2.90 ) %, ( 77.09 ± 1.55 ) %, P ＜0.01 ); their sleep latency was longer( (54.00 ± 4.97 ), ( 24.00 ± 2.91 ), P ＜ 0.01 ); the numbers of rapid eye movement(REM) sleep phase and rapid eye movement latency(REML) were strikingly different(P＜0.01 ).Compad with the control group, the LOD patients' awakening time and percent were significantly increased.Not only were the time and percentage of S2 sleep phase much higher, but the time of slow wave sleep was shorter.Besides,REM sleep activity, its density, and its intensity were raised (P ＜ 0.05 ).Conclusion There is a disturbance of the objective physiological indexes happening among the LOD patients.The increase of S2 sleeping time and percentage and the disinhibition of REM sleep can be used as the diagnosis indexes of LOD patients' specificity.

To make a preliminary study on the mechanism of Coptidis Rhizoma(CR) and Rehmanniae Radix(RR) before and after the combined administration in treating type II diabetes mellitus. The type I diabetes animal model in rats was established by fat emulsion and intraperitoneal injection with streptozotocin, in order to compare the hpyerglycemic and hypolipidemic effects of CR, RR and their combined administration of different ratio. The urinary metabolic profiling in rats of Coptidis Rhizoma and Rehmanniae Radix before and after the combined administration was analyzed by using the gas chromatography-mass spectrometry. The differences among groups in metabolome were analyzed by the principal component analysis (PCA). The biochemical index results indicated that both CR and RR before and after the combined administration could lower high blood glucose, hypertriglyceride and high cholesterol. According to the analytical results of PCA of the rats' urine samples, the CR group was the most close to the normal group, with no significant difference in CR and RR group of different combination ratios. Twelve differentiated metabolites were identified to be related to type II diabetes. Compared with the normal group, the CR-treated group showed significant increase in seven differentiated metabolites. Among CR and RR drugs with different combination ratios, CR played a major role and thus acted as the monarch drug. Whereas RR served as the ministerial drug and assisted CR to show the efficacy. This study laid a foundation for the explanation of the combination mechanism of traditional Chinese medicines.
Animals ; Blood Glucose ; metabolism ; Diabetes Mellitus, Type 2 ; blood ; drug therapy ; urine ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Male ; Rats ; Rats, Wistar ; Rehmannia ; chemistry

Objective To investigate application of diffusion tensor tractography (DTT) on evaluating motor dysfunction degree of patients with cerebral infarction and explore the relationship between infracted focus and cortical spinal tract(CST).Methods Forty patients with cerebral infarctions in the different periods and 30 healthy volunteers were enrolled our study.They all underwent DTT check and then established CST.Meantime,all the patients were measured ADL score according to activities of daily living (ADL) on admission and two months after the onset.Results DTT image was made for both in patients and health control people.The CST was built in people in control group and its shape was like the adults'.Its shape was from the precentral gyrus down to internal capsule and continued to pontine and medulla oblongata.Each successive was form good consistency.The DTT image of patients' health side was like normal and injury corticospinal tract was affected by influence of infarction area at different level,manifested as loss of discontinuity and anatomical configuration consistency.Based on the degree of CST,there were 9 cases in grade Ⅰ,20 cases in grade Ⅱ and 11 cases at grade Ⅲ.DTT image showed that the damage level of CST had an negative relation with ADL score at 2 month after therapy (r =-0.914,P ＜ 0.05).Conclusion DTT can show the spatial positions of infarctions and CST at non-invasive lesion and analyze the influence of infarctions and corticospinal tract.Therefore,it can serve as the objective proof for judging the injury of the motor function and evaluating prognosis.

Objective:To evaluate the positive rate of the bronchodilation test (BDT) in asthmatic children with normal forced expiratory volume in 1 second (FEV 1), forced vital capacity (FVC) and FEV 1/FVC, so as to improve the recognition of the importance of the BDT test in asthmatic children with normal FEV 1, FVC and FEV 1/FVC. Methods:Children aged 5-14 who were diagnosed with asthma in the outpatient clinic of Shandong Provincial Hospital Affiliated to Shandong University from September 2018 to August 2019 and willing to receive pulmonary function and BDT examinations were enrolled.Data of pulmonary function of children with normal FEV 1, FVC and FEV 1/FVC were collected to analyze the rate of positive BDT results and the status of small airway function. Results:A total of 1 631 asthmatic children with normal FEV 1, FVC and FEV 1/FVC were enrolled in this study, including 1 414 children with normal pulmonary function and 217 children with small airway dysfunction.Fifteen minutes after the bronchodilator was inhaled, 127 children (87 males and 40 females) showed positive BDT results, accounting for 7.8%.Among these children, 62 cases (28.6%) with co-existing small airway dysfunction showed positive BDT results.The improvement rate of FEV 1 was 8.0% to 11.9% in 132 cases (8.1%). The FEV 1 before bronchodilator inhalation accounted for (98.5±10.3)% of the predicted value.Fifteen minutes after terbutaline sulfate inhalation, the improvement rate was 13.5% (12.5%, 16.2%). The improvement rates of forced expiratory flow at 50% of FVC exhaled (FEF 50, r=-0.339, P<0.01), forced expiratory flow at 75% of forced vital capacity exhaled (FEF 75, r=-0.400, P<0.01), maximum mid-expiratory flow(MMEF, r=-0.375, P<0.01) were negatively correlated with their baseline values.The improvement rate of FEV 1 was not associated with its baseline value ( r=-0.128, P=0.153), but negatively correlated with the baseline value of MMEF ( r=-0.231, P<0.01). Conclusions:BDT results are positive in some asthmatic children with normal FEV 1, FVC and FEV 1/FVC.It is recommended that BDT testing should be conducted as much as possible in the diagnosis and follow-up of children with typical or atypical asthma.In this way, the diagnosis can be confirmed and the current optimal results can be obtained.Meanwhile, small airway function testing is helpful for comprehensive assessment of asthma and its control level.

Objective:To explore the relationship between the type of mutation and clinical features, prognosis, and clinical characteristics of chronic granulomatous disease (CGD) caused by compound heterozygous mutations in the NCF2 gene in children. Methods:The clinical data of 1 case of neonatal CGD caused by compound heterozygous mutations of NCF2 gene at Tianjin Children′s Hospital in August 2019 was analyzed, and domestic and international literatures were searched to summarize the clinical characteristics, gene mutation type and prognosis of CGD caused by NCF2 mutation. Results:The diagnosis of CGD was confirmed by the presence of compound heterozygous mutations c. 196_197insA (p.Arg66Glnfs23X) and c. 1180T>G (p.Tyr394Asp) in the NCF2 gene, accompanied with the clinical manifestations of fever, cough, multiple clumps and nodules in the chest CT at 25 days after birth, and the neutrophil respiratory burst test stimulation index(SI) 23.This new mutation was not reported in the Human Genetic Mutation Database.The child had a residual portion of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity and was followed up until the age of 9 months with an antifungal drug without recurrent infection.A total of 101 cases of CGD patients with NCF2 gene mutation were reported in domestic and international databases.Totally, 33 cases had SI results, with 22 cases below 3, 11 cases above 3, and 8 cases of missense mutations. Conclusions:c. 196_197insA and c. 1180T>G are new mutations in NCF2 gene that can lead to CGD.CGD patients containing missense mutations in the NCF2 gene may have more residual NADPH oxidase activity.