Objective We investigated female patients with idiopathic inflammatory myopathy (ⅡM),including polymyositis (PM) and dermatomyositis (DM) to understand if the activity and treatment of ⅡM affected the fetus outcomes as well as the correlation between pregnancy and the pathogenesis of ⅡM.Methods Questionnaires were designed,including patients' fertility,the activity and treatment of ⅡM during pregnancy and after childbirth,and the fetal outcomes.The questionnaires were conducted on 75 female patients (22-53 years old),who once hospitalized at Peking Union Medical College Hospital from 2007 to 2013.The mutual effect between the ⅡM disease activity,pregnancy and the fetus were compared by Chi square.Results Seventy-five patients (19 PM,56 DM) had 144 pregnancies,but only 18 of them became pregnant after the onset of the disease.There were two patients had onset of DM during pregnancy,and two patients suffered from DM after delivery or abortion within one month.The rates of abnormal pregnancy in patients with pregnancy before the onset of ⅡM was significantly lower than those with pregnancy after the onset of ⅡM (x2=10.21,P=0.001).Of the 18 pregnancies after the onset of ⅡM,7 had active ⅡM during pregnancy,3 of them flareddue to pregnancy.The 5 abnormal pregnancies (5/7) were seen in seven pregnancies totally,including two spontaneous abortion,one embryo diapause and two premature births.While of the other 11 pregnanciesin stable condition had only 2 abnormal pregnancies (2/11),including one fetus ended prematurely and one embryo diapause.The fetal outcomes were significantly related to the status of illness (x2=5.103,P=0.024).Two patients became pregant after the onset of the disease,both of them had stable disease before pregnancy.However,the disease became active during the pregnancies.One of them flared with rash during two pregnancies.The fetal end in embryo diapause and premature birth (33+4 weeks),respectively.Another flared with muscle weakness at five months of gestation.The fetal ended in premature birth (36+3 weeks).Two patients had onset of DM within one month following the delivery and voluntary abortion.Patients with active disease had taken medium to large doses of prednisone (30-60 mg) orally,in combination with hydroxychloroquine (0.2 bid) or without.In addition,two patients administrated with intravenous gamma globulin (IVIG) at low dose,whose illness condition had been well controlled.Conclusion Pregnancies after the onset of ⅡM tend to end with spontaneous abortion,embryo diapause,premature birth.The fetal outcomes are significantly related to disease activity.When ⅡM flared during pregnancy,IVIG might be the most effective and safe treatment,combined with corticosteroids.

Objective To explore the viral load levels after HIV/AIDS merges HBV/HCV infection and its relationship with T lymphocytes .Methods HIV RNA ,HBV DNA ,HCV RNA ,CD4+ T lymphocyte frequency ,CD8+ T lymphocyte frequency ,CD4/CD8 measured in HIV/AIDS simple infection group ,mixed HIV/HBV infection group and mixed HIV/HCV infection group .Ana‐lyze relationship of T lymphocyte and HIV RNA ,the correlation of HBV DNA/HCV RNA ,HIV RNA ,CD4+ T lymphocyte fre‐quency ,CD8+ T lymphocyte frequency ,CD4/CD8 .Results CD4+ T lymphocyte frequency of HIV/AIDS simple infection group , mixed HIV/HBV infection group and mixed HIV/HCV infection group showed negative correlated with their respective group′s HIV RNA(P<0 .05);CD8+ T lymphocyte frequency of HIV/AIDS simple infection group and mixed HIV/HBV infection group showed negative correlated with their respective group′s HIV RNA(P<0 .05);CD4/CD8 of HIV/AIDS simple infection group , mixed HIV/HBV infection group and mixed HIV/HCV infection group show negative correlated with their respective group′s HIV RNA(P<0 .05) .Conclusion T lymphocyte of HIV/AIDS patients drop faster ,leading to high viral load of HIV RNA ,HBV DNA and accelerating HIV disease progress with HBV infection .T lymphocyte of HIV/AIDS patients with HBV infection drop faster than with HCV infection .

·AIM: To investigate whether Erigeron Breviscapus (vant) Hand-Mazz (EBHM) EBHM has neuroprotective effect against N-methyl-D-aspartate (NMDA)-induced neuron death in retinal ganglion cell layer (RGCL).· METHODS: 60 healthy SD rats were randomly divided into four groups. 6 animals were normal control group (group A). The others were divided as group B (EBHM group), group C (normal saline+NMDA group) and group D (EBHM + NMDA group). Each group had 18 rats.10nmol NMDA was intravitreally injected to induce partial damage of the neurons in RGCL in the right eyes of Groups C and D. Same volume PBS was intravitreally injected into the left eyes as self-control. Groups B and D were pre-treated intraperitoneally with 6g/L EBHM solution at a dose of 150mg/kg body weight/day seven days before and after NMDA treatment. Group C were administrated intraperitoneally with 9g/L normal saline at the same time of EBHM injection. Rats were sacrificed at 4,7,14d after NMDA treatment. Flat whole retinas were stained with 5g/L cresyl violet and neuron counting in RGCL from both eyes were observed. Each subgroup had 6 rats.· RESULTS: There was no significant difference of neuron counting in RGCL between the right eye and the left eye in group A (P=0.200). There was no significant difference between normal control group and EBHM group either in the right eyes or in the left eyes at 4, 7 and 14 d respectively after intravitreal injection of 10nmol NMDA in group C and group D. (P=0.636, P=0.193). Neuron counting of RGCL in group C and D was significantly decreased in the NMDA-treated eyes at 4, 7 and 14d after intravitreal injection (P＜0.001). There was no significant difference between self-control eyes group and normai control group(P＞0.05). However, neuron counting was significantly higher in the EBHM+NMDA group than normal saline +NMDA group at 14days after intravitreal injection (P=0.044), but was lowered than normal control group (P＜0.05).· CONCLUSION: EBHM has no effect on neuron counting of RGCL when administered alone in normal rats.The results indicates that EBHM plays a partial protective role in NMDA-induced neuron loss in RGCL in the rats.

Adolescent ; Bile Ducts, Intrahepatic ; abnormalities ; Cholestasis, Intrahepatic ; etiology ; Humans ; Male

Carcinoma in Situ ; pathology ; Carcinoma, Squamous Cell ; classification ; pathology ; Cervical Intraepithelial Neoplasia ; classification ; pathology ; Diagnosis, Differential ; Female ; Humans ; Precancerous Conditions ; classification ; pathology ; Uterine Cervical Neoplasms ; classification ; pathology

OBJECTIVETo analyze the clinical effect and related risk factors of Gartland type II-III supracondylar fractures of humerus in children in the emergency closed reduction and percutaneous Kirschner wire fixation.

METHODSFrom January 2008 to June 2013,112 children of Gartland type II to III supracondylar humeral fractures were treated in children in emergency closed reduction and percutaneous K-wire fixation, including 72 males and 40 females with an average age of 6.2 years old ranging from 2 to 11 years old. Among them,74 cases were in Gartland type II fractures,38 cases were in type III; The duration from injury to surgery time was 2.5 to 8 hours (averaged 4.6 hours). Elbow cast was applied after operation with the elbow extended of 100 degrees for 4 to 6 weeks, then the gypsum and Kirschner wires were removed.

RESULTSAll patients were follow-up from 6 to 60 months (averaged 12 months). All fractures reached clinical healing. The final follow-up was assessed by Flynn criteria, the result was excellent in 86 cases, good in 23 cases, general in 3 cases, excellent and good rate was 97.3%. Three patients had mild cubitus varus deformity without orthopedic treatment. No pin tract infections, iatrogenic ulnar nerve injury, compartment syndrome, and complications such as Volkmann ischemic contracture occurred.

CONCLUSIONClosed reduction and percutaneous Kirschner wire fixation had advantages of exact reduction, firm fixation, fewer complications ,less pain in children undergoing emergency surgery, and.high success rate, so it is a safe and efficient treatment for humeral supracondylar fracture in children.

Bone Wires ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Reconstructive Surgical Procedures

The safety of drugs has been the important issue that has caught the mutual attention of clinicians and patients. Kidney is one of the important organs in drug metabolism. The study is based on hospital information system (HIS) data from 20 nationwide general hospitals, indicated by Scr and BUN. Generalized boosted models (GBM) based on propensity score method were used to balance confounding factors. The study contrasts changes on renal function between used Shuxuening injection patients and the unused to explore whether Shuxuening injection affects renal function in clinical. The results showed that Shuxuening injection is likely to affect Scr in logistic regression (P value is 0.035); after the logistic regression based on propensity score method (P value became 0.513, 0.590), no differences were found between the two groups; before and after the logistic regression based on propensity score method (P value was less than 0.05), Shuxuening injection possibly affects BUN. Nevertheless, this study is a retrospective analysis. Logistic regression based on propensity score method can control the known confounding factors very well, while there may be the unknown ones. Therefore, the further exploration is required to monitor whether Shuxuening injection affects really BUN, which will provide clinical guidance for Shuxuening injection safe application.
Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Hospital Information Systems ; Humans ; Kidney ; drug effects ; metabolism ; Male ; Middle Aged ; Retrospective Studies

Administration, Inhalation ; Animals ; Female ; Male ; Pesticides ; analysis ; toxicity ; Rats ; Rats, Wistar

OBJECTIVETo study the proliferation and apoptosis of tetramethylpyrazine (TMP) on leukemic U937 cells and its possible mechanism.

METHODThe inhibitory effect of TMP on the proliferation of U937 cells was detected by CCK-8 assay. The cell apoptosis and cycle distribution were examined by the flow cytometry. The mRNA expressions of bcl-2 and P27 were determined by the Real-time PCR. Western blot was carried out to detect bcl-2, caspase-3, cyclin E1, CDK2 and P27 expressions.

RESULTTMP inhibited the proliferation of U937 cells in a dose-and-time dependent manner, with IC50 value of 160 mg x L(-1) at 48 h. In addition, TMP could induce the apoptosis of U937 cells and block the cell cycle in G0/G1 phase. According to the results of Real-time PCR and Western blot, TMP could down-regulate the expression of apoptosis-related molecule bcl-2, cycle-related protein cyclin E1 and CDK2 and up-regulate caspase-3 and P27.

CONCLUSIONTMP shows the effects in inhibiting the proliferation of leukemic U937 cells and inducing the apoptosis. Its mechanism may be related to the impacts on the cell cycle distribution, down-regulation of the bcl-2 expression, which finally activates caspase-3, starts the apoptosis path and causes the cell apoptosis.

Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cell Proliferation ; drug effects ; Cyclin-Dependent Kinase 2 ; analysis ; Humans ; Leukemia ; drug therapy ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Pyrazines ; pharmacology ; therapeutic use ; U937 Cells

Objective To compare the local control (LC), long-term overall survival (OS), and clinical adverse reactions in esophageal carcinoma patients receiving concurrent chemoradiotherapy at different radiotherapy doses.Methods A total of 373 esophageal carcinoma patients who received concurrent chemoradiotherapy in our hospital during 2004-2013 were included in this retrospective study.These patients were divided into<60 Gy group (n=99), 60 Gy group (n=155), and>60 Gy group (n=119) based on the dose of radiation.The Kaplan-Meier method was used to calculate LC and OS rates;the log-rank test was used for survival comparison and univariate prognostic analysis;the Cox model was used for multivariate prognostic analysis.Results The 3-, 5-, 7-, and 10-year sample sizes were 97,96,56, and 38 in the<60 Gy group, 146,141,72, and 17 in the 60 Gy group, and 118,115,56, and 20 in the>60 Gy group.The 3-, 5-, 7-, and 10-year LC rates were 55.3%, 51.4%, 48.9%, and 48.9% in the<60 Gy group, 65.1%, 60.1%, 55.1%, and 55.1% in the 60 Gy group, and 49.4%, 45.1%, 37.7%, and 37.7%(8-year) in the>60 Gy group (P=0.020).The 3-, 5-, 7-, and 10-year OS rates were 35.4%, 26.1%, 22.0%, and 22.0% in the<60 Gy group, 49.0%, 41.3%, 32.1%, and 28.9% in the 60 Gy group, and 31.1%, 25.2%, 14.5%, and 12.9%(8-year) in the>60 Gy group (P=0.000).The univariate analysis showed that for stage Ⅱ esophageal carcinoma patients with gross tumor volume (GTV) ≤44 cm3, the LC rate was higher in the 60 Gy group than in the<60 Gy group (P=0.040,0.035), and the OS rate was higher in the 60 Gy group than in the other two groups (P=0.001,0.003 and P=0.045,0.006).Similarly, for stage Ⅲ esophageal carcinoma patients with GTV>44 cm3, the LC rate was higher in the 60 Gy than in the>60 Gy group (P=0.011,0.015), and the OS rate was higher in the 60 Gy group than in the other two groups (P=0.045,0.006 and P=0.033,0.002).The incidence rates of acute radiation esophagitis and radiation pneumonia were significantly higher in the>60 Gy group than in the other two group (P=0.007,0.033).Furthermore, the multivariate analysis indicated that radiotherapy dose, T stage, and N stage were independent prognostic factors for esophageal carcinoma (P=0.004,0.008,0.037).Conclusions Concurrent chemoradiotherapy at 60 Gy is most efficacious for patients with esophageal carcinoma, and the radiotherapy dose of>60 Gy significantly increases the incidence of adverse reactions.