Adolescent ; Basal Ganglia Diseases ; Calcinosis ; Child ; Female ; Humans ; Pedigree

Objective To investigate the correlation and clinical significance between CTGF of fibrosis marker and coronary heart disease .Methods Totally 102 cases of coronary heart disease patients by coronary artery angiography ensured were used as coronary heart disease group ,98 cases with age and sex strict matching of coronary heart disease were normal and were used as con-trol group;T test was used to analysis the difference with disease group and control group at base clinical data ,serum CTGF and TGF-β1 ,the correlation between coronary heart disease and serum CTGF level was evaluated by logistic regression analysis ,and clinical diagnosed value was evaluated .Results Triglyceride ,total cholesterol ,apolipoprotein A1 ,high density lipoprotein ,lipopro-tein alpha ,low density lipoprotein ,TGF-β1 and CTGF in coronary heart disease group were significantly higher than those in control group(P<0 .05) .Spearman correlation analysis showed that CTGF and TGF-β1 were positively correlated (r=0 .773 ,P=0 .002) . Serum CTGF can play positive role in the evaluation of the risk stratification of coronary heart disease .Conclusion Age ,smoking , hypertension ,total cholesterol ,apolipoprotein A1 ,high density lipoprotein ,low density lipoprotein ,lipoprotein alpha ,CTGF and TGF-β1 were influencing factors for coronary heart disease .Detection of CTGF in clinical work can be used as assessment coronary artery stenosis and severity index .

Objective To observe the dynamic levels of IL-2,IL-5 and IL-6 produced by Balb/ c mice infected with DEN_2 clinical strains and to study their relation.Methods The Balb/c mouse in- feetion model was established by multiple-site subcutaneous injection with various doses of DEN_2 clini- cal strain.Mouse plasma samples collected from different experiment groups at various time after in fection were tested for IL-2,IL-5 and IL-6 levels with sandwich ELISA.Results After primary in- feeted with DEN_2 B strain,the levels of IL-2,IL-5 and IL-6 of all experimental groups were not sig- nificantly higher than the normal control group while the levels of experimental groups increased sig- nificantly after re-infection.The level of IL-2 reached to peak[average value of(101 522.44?10 465.375)pg/ml]at the 4th day after re-infection(the 20th day after the primary infection),and then the level gradually reduced.The levels of IL-5 in the Balb/c mice of the group 1 and 2 reached to peak at the 1st day after re infection(the 16th day after the primary infection),and there was signifi- cant difference between these two groups and the control group(P＜0.05).The levels of IL-6 in all experimental groups reached to peak at the 1st and the 2nd day after re-infection.The peak value of the third group is the highest comparing with the normal control group(P＜0.05).Conclusion Th2 response was predominant in the second infection phase.

To study the value of high-fluorescent cell for the screening of malignant hydrothorax or ascites. The clinical diagnosis results and hydrothorax or ascites specimens of 400 outpatients registered from January to December in 2014 were collected, and high-fluorescent cells were counted with Sysmex XE-5000 blood cell analyzer, and then stained for microscopy. Receiver operating characteristic (ROC) curve was used to explore the sensitivity, speci-ficity, positive likelihood ratio and negative likelihood ratio of high-fluorescent cell for screening malignant hydrothorax or ascites. The numbers of high-fluorescent cells of the cancer patients were significantly higher than those of the non-cancer patients, with Z equal to -7.372 and P less than 0.05. The values of the area under curve (AUC), sensitivity, specificity, positive likelihood ratio and negative likelihood ratio were 0.801, 70.67%, 84.31%, 4.50 and 0.35 respective-ly. Detection of high-fluorescent may be used to screen malignant hydrothorax or ascites, and further exami-nation and follow-up have to be performed in case the number of high-fluorescent cells in the hydrothorax or ascites is not less than 68.

Objective To investigate the influence of low calcium dialysate (DCa1.25) and midodrine hydrochloric (MHC) on blood pressure in hemodialysis patients. Methods Dialysate calcium concentration was changed from 1.5% (DCa1.5) to 1.25% in patients with hypercalcaemia pre- or post-dialysis.For patients with intradialytic hypotension(IDH), pre-dialysis antihypertensive drugs were ceased.If that didn′t work, MHC 2.5 or 5 mg was administered to them 30 minutes before dialysis were ceased.MHC was also administered to patients who had not taken antihypertensive drugs. The blood pressure (BP) and blood volume were recorded during dialysis. UCG and autonomic nerves function test including BP supine and standing test and sustained hand-grip test were measured as well. Results Twenty-one hemodialysis patients were involved in this study including male 9 and female 12. The average age was (54.4?14.2) years old,the time on dialysis (33.04?30.1) months. When DCa1.5 was changed to DCa1.25, 9 cases (42.9%) could maintain stable BP, but IDH occurred in 10 patients(47.6%) with symptoms such as swirl,sweat or cramp, one with lower extremities cramp and one with heart discomfort but without IDH. Patients with IDH had higher proportion of abnormal BP supine and standing tests compared with patients without IDH(50% vs. 0%, P

Objective To evaluate the prognostic accuracy of the score of toxic epidermal necrolysis (SCORTEN) scoring system in patients with toxic epidermal necrolysis (TEN) or Stevens-Johnson syndrome (SJS).Methods Clinical data were collected from 39 patients with SJS/TEN hospitalized in Peking Union Medical College Hospital during April 1992 and March 2014,and retrospectively analyzed.Among the 39 patients,13 had died,and the other 26 patients,who were matched to the dead patients in a ratio of 2:1 for age,all had a definite diagnosis and were discharged with improved conditions.The SCORTEN scoring system was used to evaluate the 39 patients with SJS/TEN and calculate expected mortality.The expected mortality and actual mortality were compared between different groups stratified by age in the 39 patients.The receiver operating characteristic (ROC) curve was drawn to assess the prognostic accuracy of the SCORTEN scoring system.Results According to the SCORTEN scoring system,15 out of the 39 patients scored 1 point,14 scored 2 points,6 scored 3 points,and 4 scored 4 points.The total number of expected deaths was 6.808,while that of actual deaths was 13.There was no significant difference between the expected mortality and actual mortality in every SCORTEN score-based group.The area under curve (AUC) was 0.832 8,indicating a good predictive ability of the SCORTEN scoring system.Conclusion The SCORTEN scoring system can predict mortality in TEN/SJS patients at early stage.

Objective: To analyze the clinical characteristics of hypophosphatemic osteomalacia induced by adefovir dipivoxil (ADV) in order to improve the understanding of the disease.Methods: A retrospective analysis was performed according to the medical records of 11 cases of ADV-induced hypophosphatemic osteomalacia.The medical history, laboratory indicators (ALT, AST, ALB, SCr, UA, blood glucose, blood pH, BE), bone metabolic markers (25OHD3, PTH, tP1NP, β-CTX, OC), urine indicators (urine pH, 24h urine Ca, 24h urine P, 24h urine Pro, urine Scr), DXA and skeleton ECT signs of the patients with hypophosphatemic osteomalacia induced by ADV were analyzed, and the symptoms, blood P, AKP level and urine routines were followed up after 1-month withdrawal and in July, 2016, respectively.Results: The mean ADV administration time of the 11 patients was (5.7±1.2) years, and the bone pain time was (2.2±0.6) years.The serum P was (0.45±0.99)mmol·L-1, 24h urine P was (17.9±4.8)mmol, AKP was (248±107)IU·L-1,the concentration threshold of renal phosphate was(0.31±0.10)mmol·L-1.After the one-month withdrawal of ADV, the bone pain in the patients were all relieved, and with the phosphorus supplement, the level of serum phosphorus was increased.In July of 2016, the average withdrawal time of ADV was (18.3±10.7) months, the serum phosphorus significantly increased and AKP significantly decreased when compared with that on the admission and 1 month after the ADV withdrawal (P<0.05), and the serum phosphorus of 2 patients returned to normal with the recovery rate of 20% (2/10).The regression analysis showed that the influencing factors on serum phosphorus on the admission were renal concentration threshold of phosphate and tP1NP (P<0.05);the influencing factor on serum phosphorus on the last follow-up was bone mineral density at the admission (P<0.05).Conclusion: Hypophosphatemic osteomalacia is a potential side effect of ADV, and ADV-induced renal injury is not completely reversible, which should be paid more attention in clinical work.

The hybrid PET/MR has been gradually applied in clinical practice.However,the hybrid PET/MR is a com plex advanced technique,and it brings to the new challenges,especially regarding the workflow and scan protocols.The guidelines for hybrid PET/MR in brain imaging include information related to the indications and contraindications,preparation before examination,procedures of examination (PET imaging,conventional MRI brain imaging and special MRI imaging for brain disease),application of radiopharmaceutical and MRI contrast-enhanced agent.The purpose of the guidelines is to offer a framework that would be practical and helpful for clinical PET/MR brain imaging.In PET tracers,the guidelines only limit to the 18 F-FDG.

AlM:To observe the changes of corneal endothelium after phacoemulsification cataract surgery in different types of cataract patients.
METHODS: Randomly selected age-related cataract, diabetic cataract and cataract of high myopia 30 eyes of 30 cases, respectively, in our hospital. All patients underwent phacoemulsification combined with intraocular lens implantation, corneal endothelial density and the percentage of hexagonal cells were measured by corneal endothelial cell instrument without touching before surgery and one week after surgery.
RESULTS: The difference of the preoperative corneal endothelial cell density and the percentage of hexagonal cells among three groups were not statistically significant (P>0. 05). One week after surgery, the cell density in three groups were respectively 2 496. 86 ± 298. 96/mm2 , 2 379. 51 ± 375. 13/mm2 , 2 425. 38 ± 312. 68/mm2 , the percentage of hexagonal cells were respectively ( 46. 20 ± 12. 03)%, (43. 44±13. 99)%, (44. 35±8. 13)%. Both the cell density and the percentage of hexagonal cells one week after surgery were lower than those before operation. There were significant difference in three groups ( P <0. 05). Both the measurements in diabetic cataract group and cataract of high myopia group after surgery were lower than those in age-related cataract group, the cell density and the percentage of hexagonal cells in diabetic cataract group were lower obviously compared with those in age- related cataract group and the difference was significant (P<0. 05).
CONCLUSlON:The tolerance of corneal endothelial cell to phacoemulsification cataract surgery is lower in cataract with diabetes and high myopia. Corneal endothelium should be assessed preoperatively and protected intraoperatively.

ObjectiveTo investigate the effect of the displacement of the selected silver clip in the different respiratory state achieved by active breathing control ( ABC ) system on the displacement of the geometry constituted by all of the silver clips at the border of the cavity in external-beam partial breast irradiation (EB-PBI).MethodsTwo sets of CT images in state of moderate deep inspiratory breathing hold (mDIBH),deep expiratory breathing hold (DEBH),and free breath (FB) were acquired in the same CT simulation assisted by ABC system for each of the 27 patients after breast conservative surgery.All silver clips in the cavity were delineated based on each set of CT images.Thereafter,the irregular geometry based on the silver clips as the vertices was automatically formed.Four selected clips located at the top,bottom,lateral border and medial border of the cavity were correspondingly manually registered based on automatic registration of the CT images acquired in the same or different state of respiration including mDIBH,FB,and DEBH.The displacement of center of the geometry in the direction of right-left (RL),anterior-posterior (AP),and superior-inferior (SI) separately based on automatic registration and manual registration was evaluated.The difference of the displacement was analyzed by Kruskal-Wallis H-test and Kolmogorov-Smirnov Z-test.Results When registered between mDIBH and mDIBH,FB and FB,DEBH and DEBH,the differences of the displacement of the center of geometry were not statistically significant (H =0.00 - 1.76,P=0.184-0.954). When registered between mDIBH and DEBH,the differences were statistically significant ( Z =11.31 - 23.00,P =0.000 - 0.001 ).There were statistically significant differences in the displacement of geometry center based on the selected silver clip between different registration forms in AP and SI directions (Z=4.76-25.54,P=0.000-0.029).ConclusionsThe difference of intrafraction displacement of the geometry constituted by the clips between the same respiratory states in the three dimensional direction is not statistically significant,but the difference is statistically significant between the different respiratory states in AP and SI directions.