Adult ; Churg-Strauss Syndrome ; complications ; Humans ; Male ; Myocardial Infarction ; complications

Objetive To explore the feature and influence of psychological trauma of severe physical violence (SPV) perpetrators with or without violent pedigree,and to provide theoretical basis in the intervention of domestic violence.Methods The cases of domestic violence were identified based on appeals for help to police stations,local Women' s Federations,Residents' Community Committee,Center of Community Health Services,the judicial branch of city governments.The subjects were screened,recruited and divided into the group of the abusers with violent pedigree(AP,n=136),the group of abusers without violent pedigree (ANP,n =105),the group of non-abusers with violent pedigree(NAP,n=105) and the group of non-abusers without violent pedigree(NANP,n =198).The features and influence of psychological trauma in four groups were compared.Results (1) In AP group,above 6 traumatic events got 66.1 percent.The median of the number of traumatic events in AP group was 7,and outstanding statistical significance existed among four groups(P＜0.01).(2)The scores of avoidance (1.37± 0.79) and intrusion(1.40±0.80) and added scores of IES-R(4.08±2.30) in AP group were significantly higher than the other groups,while the scores of hyper-vigilance (1.31 ± 0.88) were higher than NAP (0.95 ± 0.75) and NANP group(0.94±0.83).The scores of intrusion(1.22±0.83) and hyper-vigilance (1.14±0.85) in ANP group were significantly higher than those in the NANP group(P＜0.05).(3)The scores of witness DV,childhood emotional,physical and sexual abuse and the numbers of traumatic events were positively related with the traumatic symptoms.Conclusion The traumatic experiences are significantly correlated with severe physical violence behavior among violence perpetrator with violent pedigree.Some traumatic experiences may be the protective factors of domestic violence behavior.In the violent pedigrees,abusers have the most severe traumatic symptoms and their traumatic symptoms,especially intrusion and hyperarousal symptoms,are positively correlated with severe physical violence behavior.

Objective:To investigate the clinical efficacy of budesonide formoterol combined with tiotropium bromide in the treatment of asthma chronic obstructive pulmonary disease(COPD) overlap (ACO).Methods:From January 2016 to December 2018, 160 ACO patients who met the inclusion criteria in the Department of Respiratory Medicine, Linxi Hospital, Kailuan General Hospitalwere selected as the observation objects.Prospective cohort study was used for observation and analysis.The patients were divided into study group and control group with 80 cases in each group by random number table.Both groups received conventional treatment, on this basis, control group received budesonide and formoterol powder inhalation, 1 inhalation/time, 2 times/d, study group received tiotropium bromide 1 granule/time, once a day based on the control group.Both groups were treated for 12 months.The clinical efficacy, lung function, blood gas analysis, inflammatory factors and T lymphocyte levels were compared between the two groups.Results:The total control rate in study group was 87.5%(70/80), significantly higher than that in control group (70.0%(56/80)), the difference was statistically significant (χ 2=7.32, P<0.05). After treatment, the asthma control test (ACT) scores in both groups increased significantly, while ACT scores in study group((23.12±3.12) point )was significantly higher than that in control group ((20.45±4.28) point, t=4.51, P<0.05). After treatment, the COPD assessment test (CAT) scores in both groups decreased significantly, while CAT scores in study group ((14.25±3.03) point ) was significantly lower than that in control group ((18.69±3.52) point, t=8.55, P<0.05). After treatment, the forced expiratory volume in 1s (FEV1), FEV1%, FEV1 /Forced vital capacity (FEV1/ FVC) and Inspiratory capacity / total lung capacity (IC/TLC) levels in both groups increased significantly, while FEV1((2.20±0.47)L), FEV1%((68.62±7.89)%), FEV1/ FVC((67.63±7.59)%)and IC/TLC levels(48.84±4.86)%) in study group were significantly higher than those in control group ((1.93±0.49)L, (61.88±7.65)%, (62.88±8.41)%, (43.22±5.15)%)(t value were 3.56, 5.49, 3.75, 7.10, all P<0.05). After treatment, the level of partial pressure of oxygen (PaO 2) in both groups increased significantly, while PaO 2 level in study group((78.12±6.45) mmHg) was significantly higher than that in control group ((72.45±7.52) mmHg)( t=5.12, P<0.05). After treatment, the arterial partial pressure of carbon dioxide (PaCO 2) level in both groups decreased significantly, while PaCO 2 level in study group((46.73±7.13) mmHg) was significantly lower than that in control group((49.81±8.02) mmHg) ( t=2.57, P<0.05). After treatment, the levels of IL-6, hs CRP and TNF-α in the two groups were decreased significantly, while IL-6, hs-CRP and TNF-α levels in study group((15.35±6.72) ng/L, (18.14±7.62) mg/L, (56.84±4.92) ng/L) were significantly lower than those in control group((21.42±5.35) ng/L, (23.35±8.64) mg/L, (69.45±8.51) ng/L) (t value were 6.32, 4.05, 11.47, all P<0.05). After treatment, the levels of CD4 + and CD4 +/CD8 + levels in both groups increased significantly, while CD4 + and CD4 +/CD8 + levels in study group((44.20±6.02)%, (1.82±0.31)) were significantly higher than those in control group((38.52±5.56)%, (1.43±0.29)) ( t=6.20, 8.22, all P<0.05). CD8 + level in both groups decreased significantly, while CD8 + level in study group((23.62±7.89)%) was significantly lower than that in control group((27.42±7.65)%)( t=3.09, P<0.05). Conclusion:Budesonide and formoterol combined with tiotropium bromide in the treatment of ACO has good clinical efficacy, reduce the level of inflammation, relieve the clinical symptoms of COPD and asthma, improve the respiratory function and lung function of patients, and have a good effect on improving the cellular immune function.

Objective To study the induction of integrin molecules mediated by CYR61 in human peripheral blood mononuclear cells(PBMC). Methods A recombinant expression plasmid containing full length of human CYR61 labeled with human IgG Fc fragment was constructed and identified by DNA sequencing.COS7 was used as host cell for identification of secretary CYR61 expression,confirmed by Western blot method.The commercial lipofectin was adopted for recombinant plasmid transfection into PBMC.Real-time PCR was ultilized to analyze expression patterns of CYR61 and integrin molecules in transfected PBMC. Results The insert sequence was correct in the recombinant plasmid.Western blot test showed that CYR61 protein secreted into culture supernatant or was in COS7 cytoplasm.The recombinant plasmid was transfected into PBMC stimulated with phytohemagglutinine(PHA) to induce CYR61 expression and secretion.The results demonstrated that exogenous CYR61 transcribed rapidly after being incubated with PHA and reached the peak after 24 h.But the expression dropped down quickly to a very low level after 48 h.Simultaneously,integrin molecules expressed just after CYR61 transcription.In the set of integrin molecules tested in the study,?v,?M,?3 and ?5 expression were higher than the other integrin molecules(P

OBJECTIVEThis study aims to evaluate the quality of life (QOL) of patients who underwent resection of oral cancer and reconstruction by free anierolateral thigh perforator flaps (ALTF).

METHODSA total of 32 patients with oral and maxillofacial malignancies who had undergone the resection of oral cancer and reconstruction by ALTF were retrospectively analyzed. At 12 months postoperatively, the QOL of these patients was assessed by using the 14-item oral health impact profile (OHIP-14) and the medical outcome study short form-36 (SF-36) questionnaires.

RESULTSA total of 32 questionnaires were collected. In SF-36, the highest scoring domains were bodily pain (78.58 ± 14.82), physical functioning (72.08 ± 27.86), and the role of physical (60.00 ± 42.63), whereas the lowest scoring domains were role-emotional (41.67 ± 39.62), followed by mental health (50.75 ± 13.07) and health transition (54.17 ± 21.75). In OHIP-14, the lowest scoring domains were social disability (34.50 ± 11.32) and handicap (36.04 ± 12.05), indicating the functional recovery was better; and the highest scoring domains were physical pain (73.50 ± 18.96) and psychological discomfort (60.17 ± 20.66), indicating the functional recovery was worse.

CONCLUSIONThe ALTF is an ideal selection for the reconstruction of oral defects after cancer resection. In using this flap, the basic social need of patients after surgery can be satisfied. Moreover, the appearance and the functions of chewing, deglutition, and speech can be restored in varying degrees. Thus, ALTF can improve the patients' QOL.

Emotions ; Free Tissue Flaps ; Humans ; Mastication ; Mouth Neoplasms ; physiopathology ; psychology ; surgery ; Pain ; Perforator Flap ; Postoperative Period ; Quality of Life ; Reconstructive Surgical Procedures ; Retrospective Studies ; Surveys and Questionnaires ; Thigh

Background Fundus photography is a traditional method for detecting local retinal nerve fiber layer (RNFL) defects,but the evaluation of its result depends on the observer's experience.The spectral domain optical coherence tomography (OCT) exhibit the defects of RNFL very clearly.Objective This study was to evaluate the diagnosis value and correlation between topographic profiles of localized RNFL defects determined by spectral domain and time domain OCT with fundus photography.Methods Forty-one normal eyes of 41 subjects and 55 eyes of 55 glaucomatous patients with localized,wedge-shaped RNFL defects identified by two glaucoma specialists in fundus photographs were enrolled in the clinical study.The angular location and width of RNFL defects determined on the images of fundus photography,Cirrus HD-OCT and Stratus OCT were analyzed respectively using Pearson's correlation coefficient and linear regression analysis.This study followed the Helsinki declaration and was approved by Ethic Committee of Shenzhen Eye Hospital.Written informed consent was obtained from each individual before the clinical examination.Results Seventy-five RNFL defects were identified in 55 eyes by two glaucoma specialists unanimously with the defect position at superior-temporal and inferior-temporal quadrants.The sensitivity of Cirrus HD-OCT and Stratus OCT to determining RNFL defects were 88.0% and 69.3% respectively and their specificities were 92.7% and 97.6% respectively.The angular locations of RNFL defects by Cirrus HD-OCT and Stratus OCT were highly correlated with those by fundus photography(r=0.993,r=0.992,P＜0.001);while the angular widths of RNFL defects by Cirrus HD-OCT and Stratus OCT were moderately correlated with those by fundus photography(r=0.420,r=0.432,P=0.019,P=0.002).No significant differences were found in the defect width of RNFL between Cirrus HD-OCT or Stratus OCT and fundus photography(Cirrus HD-OCT:P=0.114;Stratus OCT:P=0.074),and significant difference was found in that between Cirrus HD-OCT and Stratus OCT(P=0.002).Conclusion Spectral domain OCT and time domain OCT can localize RNFL defects with high sensitivity and specificity.The measure value of Cirrus HD-OCT and Stratus OCT for RNFL defects shows a good diagnostic agreement with fundus photography.

Background Glaucoma is primarily characterized by the damage of retinal ganglion cells.The macular ganglion cell complex (GCC)thickness can be quantitatively measured using spectral domain optical coherence tomography(SD-OCT). Objective This clinical study was to explore the macular GCC thickness change in primary open-angle glaucoma (POAG) patient with SD-OCT. Methods A serial case-controlled study was designed.A total 101 eyes of 101 POAG patients and 41 normal eyes of 41 age- and refract power-matched normal subjects were cnrolled in the study.POAG patients were assigned to normal perimetry POAG group,early stage POAG group,advanced POAG group and late stage POAG group.Average macular GCC thickness(GCC-Avg),superior GCC thickness(GCC-Sup) and inferior GCC thickness (GCC-Inf)of subjects were measured by SD-OCT and compared among POAG patients and normal controls.Peripapillary retinal nerve fiber layer(RNFL) thickness was measured with time domain OCT(TD-OCT).The correlation between GCC thickness with RNFL thickness or mean deviation(MD) of perimetry were evaluated and analyzed.Informed consent was obtained from each patient prior to entering this study.Results GCC-Avg thickness,GCC-Sup thickness and GCC-Inf thickness were significantly decreased in the normalperimetry POAG group and early stage POAG group compared with the normal control group (GCC-Avg:t =5.411,10.247,P ＜ 0.01 ; GCC-Sup:t =6.171,9.484,P＜ 0.01 ; GCC-Inf:t =5.281,8.592,P ＜ 0.01 ).Also,GCC-Avg thickness,GCC-Sup thickness and GCC-Inf thickness were significantly decreased in the advanced POAG group compared with the early stage POAG group ( GCC-Avg:t =4.246,P＜0.01 ; GCC-Sup:t - 2.419,P - 0.019 ; GCC-Inf:t =4.636,P＜0.01 ),and GCC-Avg thickness,GCC-Sup thickness and GCC-Inf thickness were significantly decreased in the late stage POAG group compared with the advanced POAG group (GCC-Avg:t=2.095,P=0.040;GCC-Sup:t=2.756,P＜0.01:GCC-Inf:t =2.018,P =0.040 ).The positive correlations were seen between GCC-Avg thickness,GCC-Sup thickness,GCC-Inf thickness and RNFL-Avg thickness,RNFL-Sup thickness,RNFL-Inf thickness respectively( r =0.802,0.825,0.856,P ＜ 0.01 ).MD value of perimetry was positive correlated with GCC-Avg thickness in POAG patients ( r =0.601,P ＜ 0.01 ). Conclusions SD-OCT can quantitatively measure and differentiate the GCC thickness in POAG patients.The GCC thickness gradually decreases with the development of POAG.There exist a well correlation between visual field defect and RNFL thinning.

Objective To explore the association between the infection of human cytomegalovirus(HCMV),herpes simplex virus typeⅠ(HSV-Ⅰ),HSV-Ⅱ,toxoplasma(TOX) and serum hepatitis B virus(HBV)these 5 pathogens and low body weight and pneumonia,and explore the clinical value of nested polymerase chain reaction (PCR) examining newborns infected with pathogens.Methods Forty-six newborn infants with low weight and 66 newborn infants with pneumonia were selected.And 1 mL pripheral blood of every newborn infant was drawn.Classic phenol-chloroform-isoamyl alcohol-protease digested,after neonatal serum extraction of DNA in peripheral blood through 2 pairs of pri-mers,the outer primer amplified larger DNA fragments and the inner primer amplified small fragments,in the amplified products.HCMV,HSV-Ⅰ,HSV-Ⅱ,TOX and HBV of the viral DNA in highly conservative district to design primer respectively and amplify its viral DNA,nested PCR was used to detect of these pathogens DNA in infants of low body weight and pneumonia,and to detect positive rate of infection.Screening for birth defects in infants in these virus infection.SPSS 10.0 software was used to analyze the relationship between infection of 5 pathogens.Results The infective rate of HCMV in 46 infants with low body quality was 91.3%,the infective rate of HSV-Ⅰwas 8.7%,the infective rate of HSV-Ⅱwas 15.2%,the infective rate of TOX was 8.7%,and the infective rate of HBV was 15.2%.Among 66 infants with pneumonia,the infective rate of HCMV was 83.3%,the infective rate of HSV-Ⅰwas 6.1%,the infective rate of HSV-Ⅱwas 16.7%,the infective rate of TOX was 6.1%,and the infective rate of HBV was 7.6%.The infective rate of HCMV was higher than that of other 4 pathogens,these infection rates were different statistically in these 5 kinds of pathogens(Pa=0).Conclusions Five kinds of pathogens both low pathosens screening is necessary newborns infants with low body weight and pneumonia,and for the early diagnosis and prevention of these pathogens.

[Objective] To investigate the incidence and risk factors for posttransplantation anemia (PTA) following kidney transplantation. [Methods] A retrospective cohort study reviewing the medical records of the patients who received a renal transplant at our center from January 2004 to June 2008 was performed. All possible risk factors for PTA were recorded. Outcomes among the patients with PTA were compared with those without PTA using t-test and chi-square analysis methods. Logistic regression analysis was done to rank the relative risk of potential variables and calculate the 95% CI. [Results] Prevalence of PTA in our center was 31.0% (hemoglobin <120 g/L or Hct< 0.38 for males, < 110 g/L or Hct < 0.35 for males). Univariate and Logistic regression analysis revealed that the risk factors for PTA after kidney transplantation were female (RR=8.738; 95%CI 2.558～29.853; P= 0.001), creatinine level (RR=1.035; 95%CI 1.018～1.052; P<0.001) and acute rejection (RR=19.827; 95%CI 2.056～191.19; P=0.01); [Conclusions] PTA is a frequent complication after kidney transplantation. Great attention should be paid to this complication considering its negative effect on graft function. Female, impaired renal function and acute rejection are risk factors of anemia in kidney transplantation recipients.

Objective To observe the function of immature CD8α+ dentritic cells (DCs) in vitro. Methods The bone marrow and spleen of C57BL/6(H-2b) and Balb/c (H-2d) mice were got to prepare immature CD8α+ DCs and spleen lymphocytes,and treated by mytomycin. MTT test was used.MLR group, MLR plus variable density syngeneic CD8α+ DC group, MLR plus variable density allogeneic CD8α+ DC group,MLR plus variable density CD8α+ DC supernatant group,CD8α+ DC plus syngeneic T cell group and negative control group were established. MLR group was set up by responder cell ratio of 0.2,0.5,0.8,1.0,to build the MLR plus syngeneic and allogeneic CD8α+ DC experimental groups. Culture supernatant from different density (1 × 105/ml - 5 × 106/ml) of CD8α+DCs was added into MLR to build CD8α+ DC supernatant group. CD8α+ DCs were co-cultured with syngeneic T cells to build CD8α+ DCs plus syngeneic T cells group. 2 × 105/well responder cells served as the negative control group. ELISA was used to detect the concentrations of IFN-γ and IL-10 in the DCs could both suppress MLR (P＜0. 05), and the difference was not statistically significant (P＞0. 05). When CD8α+ DCs were increased, the suppressive effect was enhanced. When CD8α+ DC/responder cell ratio ＞0. 2, the inhibitory effect could be observed, and this effect reached the peak when the ratio was 1.0. The CD8α+ DCs had weak ability to stimulate syngeneic lymphocyte proliferation in vitro, and certain stimulating effect could be seen only when CD8α+ DC/responder cell ratio ＞2 (P＜0. 05). Its culture supernatant also showed suppressive effect (P＜0. 05), and the supernatant with a cell density of 5 × 105/ml showed the maximum effect. IL-10 concentration in the concentration was 1.0 ± 1.2 pg/ml. Conclusion The in vitro function of immature CD8α+ DCs was immunosuppression/tolerance,and they could secret high level of IL-10. The CD8α+ DCs and their culture supernatant could suppress MLR in vitro.