Objective To explore the clinical characteristics and treatment of methylmalonic acidemia(MMA) in order to improve our understanding of it.Methods We analyzed the clinical manifestations,laboratory examinations and treatments of 26 cases of methylmalonic acidemia in children.Results Twenty-four cases were involved in nervous system.Nine patients were involved in renal system.Eight cases of hematological involved.Liver enzyme elevated in 2 cases as well as the cardiac system were involved in 3 cases.One case was with pneumonia onset.The laboratory findings showed metabolic acidosis in 12 cases,hyperhomocysteinemia in 8 cases and remarkable elevation of urinary methylmalonic acid concentration in all cases.Some abnormalities in globus pallidus and cerebral white matter as well as diffuse cerebral atrophy were noted by the brain CT and MRI in 15 cases.Sixteen children have received therapy of vitamin B12,and supplementation of L-carnitine with restricted-protein diet.The follow-up for a period ranging from 3 months to 1.5 years( mean 8.5 months) of 15 cases with medical therapy showed a favorable outcome of nervous system improvement in 12 cases,however,2 patients died from severe metabolic acidosis.8 patients with renal involvement were normal in urine routine and renal function.Conclusion Methylmalonic acidemia has different clinical features,so early urine organic acids analysis by GC/MS method is essential Long-term and reasonable treatment after diagnosis is an effective way to improve the prognosis.

Objective:To discuss the important role of clinical pharmacists in the prevention of medication errors and rational drug use through medication reconciliation in endocrinology department. Methods: The medication reconciliation was given to the diabetic patients over 70 years old newly admitted in the endocrinology department from January to April 2016, and the consistency and appro-priateness of medication orders were verified and the results were collected and analyzed by the pharmacists. Results: Totally 84 pa-tients were enrolled into the research with the average age of (76. 3 ± 5. 0) and the average number of combined diseases of (3. 5 ± 1. 2). The average medications taken by the patients before the admission were (6. 7 ± 2. 9), and 22. 6% of the patients took tradi-tional Chinese medicines and 4. 76% of the patients took health products. The patients whose medications for 24h needed intervention accounted for 27. 38%, the medications orders needed intervention accounted for 3. 67%, and the intervention success rate of clinical pharmacist was 100%. Conclusion:To the patients over 70 years old with type 2 diabetes and multiple diseases treated with a variety of medications, medication reconciliation in 24 hours can effectively prevent the medication errors and promote the rational drug use.

Aging ; Arteriosclerosis ; pathology ; Blood Vessels ; pathology ; Cellular Senescence ; Humans ; Medicine, Chinese Traditional

Objective To investigate the effect of recombinant human erythropoietin (rhEPO) on the expression of glutamine synthetase (GS) of cultured rat retinal Müller cells in high glucose environment in vitro.Methods Mtüller cells were isolated from retinas of 10 Sprague-Dawley rats at postnatal day three to five by trypsin digestion,and were randomly divided into six groups,including normal control group,high glucose group,high glucose +5 U/ml rhEPO group,high glucose+ 10 U/ml rhEPO group,high glucose+ 20 U/ml rhEPO group,high glucose+40 U/ml rhEPO groups.After 48 hours,the apoptosis of retinal Müller cells were assayed by terminal transferase-mediated DNA end labelling assay,and the expression levels of GS protein were detected with semi-quantitative immunocytochemistry.Results Compared with the normal control group,the cell viability and GS protein were reduced while the cell death increased in Müller cells cultured in high glucose,the difference was statistically significant (t =27.4,P ＜ 0.01).Compared with the high glucose group,rhEPO treatment reduced the apoptotic Müller cells (t=857.2,2 374.6,2 473.2,2 537.7; P＜0.01),induced the expression of GS proteins (t=3.2,18.0,22.5,26.4; P＜0.05).Conclusions rhEPO can protect Müller cells from apoptosis under high glucose condition.The mechanism may be related to its function to up-regulate the GS protein expression,promote glutamic acid cycle,and reduce the excitotoxicity effects of high concentration of glutamate.

Aging is one of dangerous elements in cancer, diabetes, cardiovascular diseases, and neurodegenerative diseases. Qi deficiency and blood stasis is an important syndrome pattern in aging. The treatment methods of nourishing qi and resolving blood stasis is an important way to delay aging. Based on the theory that nourishing qi and resolving blood stasis can delay aging, many scholars have conducted lots of clinical and experimental researches nowadays. This article mainly analyzeds the theory and origin of nourishing qi and resolving blood stasis delaying aging, the current situation of clinical and experimentai researches on age-related diseases. The purpose of this article is providing a basis for anti-aging researches on Chinese herbal medicines that have the efficienoy of nourishing qi and resolving blood stasis, and further revealing aging mechanism.

Objective To observe the effects of irbesartan and amlodipine on insulin sensitivity in obese hypertensive patients. Methods 157 moderate hypertensive patients were divided into two greups,which received irbesartan or amlodipine for 16 weeks. The changes of blood pressure,heart rate and weight were observed. Insulin re-sistance was computed using the homeostasis model assessment (HOMA-IR). Results There was no difference in antihypertensive efficacy between the two groups(P>0.05). After 16 weeks of treatment ,the insulin resistance index decreased by 8.7±2.4 vs 6.1±2.6 (P<0.01) and body mass index decreased(28.1±3.8) kg/m2 vs (27.2± 3.2 ) kg/m2 (P<0.05 ) and mean heart rate raised by (73.1 ±10.0 ) kg/m2 vs ( 79.1±11.4) kg/m2 ( P < 0.01 ) in irbesartan group while no such changes were found in amlodipine treated group. Conclusions In obese hypertensive patients,irbsartan and amlodipine exert similar antihypertensive effect, but irbesartan may help to improve some obe-sity-related metabolize disorder,so the obese hypertensive patients may benefit more from irbsartan than from amlo-dipine.

Abnormalities, Multiple ; Child, Preschool ; Face ; abnormalities ; Hematologic Diseases ; Humans ; Male ; Vestibular Diseases

Objective To explore the relationship between the incisure changes in the intracranial vertebral artery (VA) segments on transcranial Doppler (TCD) and their diseased regions. Methods Incisure changes in VA intraeranial segments on TCD in 24 cases were found. Digital subtract angiography (DSA), computed tomography angiography (CTA)or coler Doppler flow imaging (CDFI)of carotid arteries were performed to confirm their diseased regions. Results (1)The group with end-systolic and pre-diatolic wide incisures was found in 9 cases: DSA or CTA showed 5 cases with severe stenosis, 2 cases with occlusion and 2 cases with congenital tenuity of the affected vertebral artery proximal part(VA-Pr). Within the above 8 cases, ipsilateral subclavian artery (SubA) was normal, 1 case was complicated with moderate stenosis of ipsilateral SubA,and 1 case was complicated with occlusion of contralateral SubA. Haemodynamics test showed (1)negative; (2)The group with systolic incisures was in 12 cases, and 12 patients were divided into two groups based on the haemodynamics test : ① positive group was in 6 cases. DSA showed that VA-Pr was normal but SubA had impaired with different degrees; ② negative group was in 6 cases. DSA showed VA-Pr was with occlusion in 4 cases and 2 cases was with congenital tenuity; The above 2 cases were complicated with stenosis of ipsilateral SubA and in 4 cases ipsilateral SubA were normal; (3) The group with small vibrated sharp waves on Doppler was in 3 cases, and DSA showed VA-Pr occlusion in 3 cases. In the 3 cases,one case was complicated with occlusion of ipsilateral SubA. Blood stealing was present in cervical muscular branches but not present between vertebral arteries . Ipsilateral SubA were normal in 2 cases. Haemodynamic tests showed negative. Conclusions VA incisures were not only present in the early subclavian steal syndrome (SSS) but also were found in the patients with impaired SubA . However, blood steal pathway is imperfect, and would be found in affected VA-Pr or congenital tenuity. Haemodynamic tests can help identify the above situation. The TCD screening method can be used in the routine diagnosis for SubA and VA from proximal to intracranial segments involvement, but there are limitations to some extent. It needs to combine with DSA and CDFI for diagnosis.

AlM:To provide a proper assessment of the clinical use of orthokeratology by observing and analyzing the ocular biometric changes of the eyes and the stereopsis of the myopia.
METHODS:Sixty eyes from 30 myopia ( from 8 to 17 years old) were fitted with orthokeratology. Stereopsis, visual acuity, near visual acuity, central corneal thickness, anterior chamber depth, average anterior corneal refractive power ( K value ) , and intraocular pressure were measured before the orthokeratology treatment and 3mo after it. Refraction was expressed as spherical equivalent ( SE) , and the subjects were divided into 3 groups according to refraction: low myopia group (SE<-3.00D), moderate myopia group (-3. 00D≤SE<-6. 00D), and high myopia group (SE≥-6. 00D).
RESULTS:All subjects had significant improvements in visual acuity and near visual acuity 3mo after the orthokeratology treatment (P<0. 01). ln the comparisons of any pair of the groups, there was no significant difference in the near visual acuity ( P>0. 05 ). Three months after the orthokeratology treatment, Naked eye near stereoacuity values of all subjects were decreased (P<0. 01). There was no significant difference in the comparisons of the differences of stereopsis between any pair of the groups ( P> 0. 05 ). There was significant correlation in stereopsis and anisometropia ( Pearson coefficient r = 0. 778, P < 0. 01 ). And with greater anisometropia, the stereopsis was higher. All subjects had significantly lower K values than before 3mo after the orthokeratology treatment ( P< 0. 01 ). There was no significant difference in central corneal thickness, anterior chamber depth, and intraocular pressure (P>0. 05).
CONCLUSlON:Orthokeratology could lower K value in a short time and change the corneal curvature to correct myopia, to improve visual acuity and near visual acuity. lt also has an influence on improving stereopsis. There are no obviously changes in patients' central corneal thickness, anterior chamber depth or intraocular pressure after the orthokeratology treatment, making it a safe and effective treatment for adolescent.

Objective To study the relationship and changes of cytokine interleukine-18(IL-18),tumor necrosis factor alpha(TNF-?)and interferon-gama(IFN-?)in viral myocarditis(VM).Method Changes of serum cytokine IL-18,TNF-? and IFN-? of 72 acute VM patients and 25 healthy children were detected by enzyme-linked immunosorbent assay(ELISA).Results 1.P-values represented the obvious significance of difference as comparing the concentration of serum cytokine IL-18,TNF-? and IFN-? of VM children with that of the control group(Pa