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 .

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.

·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

Objective To explore the expressions and significances of p 53、bcl-2、Ki-67 and apopto-sis in keratoacanthoma(KA)and well differentiated squamous cell carcinoma (WDSCC).Methods The expres-sions of p53、bcl-2、Ki-67 were detected by immunohistochemical technique in 44 cases of KA and 20 cases of WDSCC.Apoptosis was identified by using terminal deoxynucleotidyl transfers ( TdT) -mediated dUTP -biotin nick and labelling(TUNEL)method.Results The positive expressive rates of p53 in proliferative、mature and re-gressive of KA were 22.23%、26.18% and 6.52%, which was lower than the positive rate of WDSCC (41.82%).Significant differences were found between every period of KA with WDSCC in p 53 expression;The intensity of expression and pattern were similar in KA of Ki -67 and p53.There were a positive correlation be-tween p53 and Ki-67 expression rate(r=0.986,P<0.001).The bcl-2 staining showed weak expression in 1 case in WDSCC and 2 cases in KA ,but only a few positive tumor cells was limited to basal cell layer in KA .The average apoptosis rate in KA was 21.72%,which was apparently higher than in WDSCC (9.925%).There were a negative correlation between the apoptosis rate and proliferation rate of Ki -67(r=-0.824,P<0.001).Con-clusion The proliferation and apoptosis in KA can coexist .However ,the apoptosis will occupy a dominance posi-tion in regressive phase ,which results in the regression of tumor .The expressions of p53、Ki-67 and apoptosis would be a certain significance in differentiated KA and WDSCC .

Objective To explore the effect of the midwife-leading labor pain management model on the pregnancy outcomes and pain control satisfaction.Methods The randomized grouping and single blind trial design were performed.One hundred and ten pregnant women were recruited and randomized into the control group (n=55) and intervention group (n=55).The control group received the routine prenatal examination by the outpatientdepartment obstetric doctors and intrapartum nursing care during labor.On this basis the intervention group participated in the labor pain educational course in the midwife clinic,and received the repeated pain assessment and pain management intervention during labor.Results There was no statistical difference in the delivery mode between the two groups(P＞0.05).The cesarean section rate without indication in the intervention group was significantly lower than that in the control group,the difference was statistically significant(x2 =6.798,P＜0.05).The average each item score of the labor pain education and pain control satisfaction in the intervention group was significantly higher than that in the control group,the difference was statistically significant(P＜0.01).Conclusion The midwife-leading labor pain management model can reduce the cesarean section rate without indication,and improves the satisfaction of labor pain education and pain control in pregnant women and parturients.

Objective To explore the reliability of relevant electrocardiogram(ECG) indexes in evaluating isoprenaline(ISO)-induced rat acute ischemic myocardial injury and provide reference for future scientific applications of these models. Methods Seventy male Wistar rats were randomly equally assigned to ten groups according to their body weight: 5,10,20,40,80,160,320,640, 1280 and 2560 μg/kg dose groups. All rats were tail intravenously given corresponding doses of saline diluted isoprenaline according to their body weight. Standard limb Ⅰ , Ⅱ, Ⅲ-lead ECG of all rats were recorded before, immediately after and 1,24,and 72 hour after injection, respectively.Changes of heart rate, T-wave amplitude of Ⅱ -lead and Q-T interval were measured. Results Significant differences were found in heart rates, T-wave amplitudes and Q-T intervals at different time points(F = 15.03,11.28,13.64, all P ＜ 0.01 ), while differences among the ten ISO-dose groups were statistically insignificant (F= 1.45, 1.17,1.09, all P ＞ 0.05). No interaction between observation time and ISO dose was observed on heart rates, T-wave amplitudes and Q-T intervals(F= 0.79,0.82,0.59, all P ＞ 0.05). Immediately after injection of ISO, the heart rates were significantly increased compared with that of pre-injection in all groups(all P ＜ 0.05), of which 320 and 640μg/kg dose groups increased most significantly [(550 ± 47), (521 ± 43)times/min]. T-waves decreased significantly compared with that of pre-injection (all P ＜ 0.01 ), and 20 μg/kg dose and above groups decreased particularly evident, and partly inverted. Q-T intervals of rats in each group were significantly shorter than that of pre-injection(all P ＜ 0.01 ), and 320, 640, 1280 μg/kg groups shortened more pronounced[(0.070 ± 0.006),(0.072 ± 0.005), (0.068 ± 0.005)ms]. One hour after injection, the heart rate of rats in each group decreased,except 320 and 640 μg/kg dose groups[(518 ± 43), (487 ± 36)times/min], which were still higher than that of pre-treatment[(450 ± 40), (448 ± 51 )times/min, all P ＜ 0.05], the rest groups no longer had significant differences (all P ＞ 0.05). ECG T-wave in each group was significantly recovered compared with that of instantly medication (all P＜0.05), and 40 μg/kg dose and above groups recovered more than a big margin, but there were still differences compared with that of pre-treatment (P ＜0.05), while T-waves of 40 μg/kg dose and below groups had returned to the level of pre-treatment. Q-T interval in each group had varying degrees of recovery, except 1280 and 2560 μg/kg dose groups[(0.080 ± 0.004), (0.076 ± 0.011 )ms]which were still less than that of pre-treatment[(0.086 ± 0.007),(0.085 ± 0.006)ms, all P ＜ 0.05], other groups had no significant difference compared with that of pre-treatment (all P ＞ 0.05). Twenty-four hours after injection of ISO, the heart rates of 1280 and 2560 μg/kg dose groups [(389 ± 31 ), (398 ± 23)times/min]decreased significantly compared with that of pre-treatment[(427 ± 43), (438 ±26)times/min, all P ＜ 0.05], while other groups had returned to the level of pre-treatment. Seventy-two hours after injection of ISO, the heart rates, T-wave amplitudes and Q-T intervals of all doses groups had returned to the level of pre-treatment (all P ＞ 0.05). Conclusions There has no significant ST segment in the electrocardiogram of rat.Isoprenaline has an exact effect on shortening Q-T interval. T-wave amplitude and Q-T interval can be used as reliable indexes of ECG for assessment of this animal model.