Objective: To discuss the clinical features,diagnosis,pathogenesis and treatment of antiepileptic drug hypersensitivity syndrome(AHS).Methods: A retrospective analysis of one case of AHS was focused on his clinical data.Results: About six weeks after carbamazepine treatment the patient presented fever firstly.The highest temperature is up to 39.6℃.Subsequently he developed diffusible red maculopapular rash and swollen superficial lymph nodes.Physical examination found internal organs involvement(mainly liver and lung).Laboratory examinations showed that the leucocyte increased to 54.21?109/L,and the percentage and absolute count of eosinophil rose,while IgG and IgM decreased.The CT of thoracic part showed the lymph nodes of hilum of lung and mediastina swelled together with pleural effusion.A biopsy study of lymph node suggested the reactive hyperplasia which was not equal to lymphoma.The bone marrow smear showed granulocytic cell line hyperplasia and abnormal lymphocyte were observed.After discontinuing carbamazepine in time and applying corticosteroids,the temperature descended rapidly and the swollen lymph nodes recovered soon.Conclusion: AHS is an idiosyncratic reaction.It usually occurs within 2 to 8 weeks after initiation of antiepileptic drug therapy,and typically manifests itself as fever,eruption and internal organ involvements.Pathogenesis is still not definite.Important basis for diagnosis and differential diagnosis depends on clinical manifestations and laboratory examinations.Early recognition of AHS and timely discontinuing of the suspected drugs are the essential therapy.

Objective To observe the effect of flupentixol and melitracen tablets combined with Yueju pills in the treatment of functional gastrointestinal disorders ( FGID) .Methods According to the digital table ,308 patients with FGID were selected and randomly divided into 4 groups,77 cases in each group.The control group were given conventional treatment .The treatment group was divided into 3 groups:group 1:flupentixol and melitracen tablets was added on the basis of routine therapy;group 2:Yueju pills was added on the basis of routine therapy;group 3:patients in this group used conventional treatment combined with flupentixol and melitracen tablets and Yueju pills .The period of treatment was 6 week,then their clinical symptoms were compared .Results The effective rate in group 1,2,3 was 79.2%,62.3%,94.8%,respectively,which was significantly higher than 19.4% in the control group(χ2 =54.96, 29.24,89.18,all P<0.05);while compared each treatment group ,the total effective rate in group 3 was obviously higher than that in group 1 ang group 2(χ2 =8.27,24.08,all P<0.05),and the total effective rate in group 1 was higher than that in group 1(χ2 =4.09,P<0.05).Conclusion Flupentixol and melitracen tablets combined with Yueju pills are more effective for treating functional gastrointestinal disorders than that of single drugusing .

OBJECTIVE:To observe clinical efficacy and safety of Zishen jianpi huoxue decoction combined with Xiaoxintong capsule in the treatment of type 2 diabetes complicating with silent myocardial ischemia (SMI). METHODS:126 patients with type 2 diabetes complicating with SMI were selected and randomly divided into control group(62 case)and observation group(64 cases). Both group were given diet guidance and hypoglycemic drugs as sulfonylureas,biguanides. Control group was given Xiaox-intong capsule 10 mg,tid;observation group was additionally given Zishen jianpi huoxue decoction 400-500 ml,bid. Both groups received treatment for 7 d. Therapeutic efficacy of thoracic obstruction,improvement of coronary artery branch stenosis and times and duration of electrocardiogram ST segment low voltage outlet were observed in 2 groups. ADR was compared between 2 groups. RESULTS:Therapeutic efficacy of thoracic obstruction and improvement of coronary artery branch stenosis in observation group were significantly better than in control group,with statistical significance(P<0.05);the times and duration of electrocardiogram ST segment low voltage outlet in observation group were significantly lesser shorter than in control group,with statistical signifi-cance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Zishen jianpi huoxue decoction complicating with Xiaoxintong capsule shows significantly therapeutic efficacy in the treatment of type 2 diabetes complicating with SMI with good safety.

Objective To investigate the expression of CRKL in thyroid papillary micro-carcinoma and its clinical significance.Methods 120 patients with thyroid tissue specimens were collected,in which 30 cases of diam-eter >1 cm of papillary thyroid carcinoma,30 cases of thyroid papillary micro-carcinoma,30 cases of nodular goiter, 30 cases for specimen of thyroid disease patients without diabetes.Immunohistochemical(SP)method was used to de-tect samples in CRKL expression.Results In thyroid papillary micro-carcinoma and thyroid papillary cancer group, CRKL expression positive rates were 30.12% and 29.87% respectively,which were higher than that of nodular goiter and normal thyroid group 30.03% and 28.57%(χ2 =52.102,P <0.05);The average absorbance(A)value in thy-roid papillary micro-carcinoma and thyroid papillary carcinoma group which were respectively (0.516 ±0.100)and (0.496 ±0.201),were higher than that in nodular goiter and normal thyroid group (0.246 ±0.050)and (0.117 ±0.015),the difference was statistically significant(F =149.105,P <0.05).Conclusion CRKL is highly expressed in papillary thyroid micro-carcinoma and the clinical detection of CRKL is helpful to determine the surgical plan for papillary thyroid micro-carcinoma.

Human cancers arise from an imbalance of cell growth and cell death.Critical factors that control the balance are those regulate the cell cycle.Several molecular effectors have been identified to be able to regulate specific phases of the cell cycle,including cyclins,cyclin-dependent kinases (CDKs) and CDK inhibitors.Notably,deficiency of two G1-checkpoint CDK inhibitors-p21 (CDKN1A) and p27 (CDKN1B)-has been implicated to be correlated with initiation or progression of many human malignancies or cancer cells drug-resistance.However,contradict reports also suggested that p21 and p27 could promote tumor progression.Here,we summarized the historic and recent studies on these two CDK inhibitors,including their identification as well as their roles in carcinogenesis and drug resistance.

Objectives To investigate the associations of serum superoxide dismutase ( SOD) , malondialdehyde (MDA), and uric acid (UA) with blood pressure and the prevalence of hypertension in a Chinese population. Methods We measured serum superoxide dismutase (SOD), malondialdehyde (MDA) and uric acid (UA) in 506 randomly selected participants. For database management and statistical analysis, we used the SAS 9.13 Software. Results Compared with normotensive participants, hypertensive patients had significantly lower serum levels of superoxide dismutase activity ( =0.0002), and higher serum levels of malondialdehyde and uric acid ( <0.05) .Univariate analysis indicated that serum superoxide dismutase activity was negatively associated with blood pressure, and serum levels of uric acid (P 0.0001);while serum levels of malondialdehyde was positively associated with blood pressure, and serum levels of uric acid (P 0.05) . There was significant difference in systolic (Ptrend=0.02) and diastolic blood pressure (Ptrend=0.04) between three groups defined by tertiles of serum levels of superoxide dismutase, with a lower blood pressure in the highest tertile than in the lowest tertile. Furthermore, the systolic (Ptrend=0.01) and diastolic blood pressure (Ptrend=0.003) in the highest tertile, which defied by the serum levels of malondialdehyde, were significantly higher than those in the lowest tertile. Conclusions Hypertensive patients have a disturbed oxidative and anti-oxidative balance. Oxidative stress may play a role in the pathogenesis of hypertension in Chinese.

Objective To understand the practice of experiential teaching in the core midwifery curriculum. Methods Phenomenology as a qualitative research method was utilized and fifteen students participated in the non-structured interviews. Results Four themes were found: comprehension of knowledge;professional thought; teacher- student relationship;gratitude. Conclusions Experiential teaching can increase the teaching effect of core midwifery curriculum, and develop good ideological and professional qualities.

BACKGROUND:Diabetic lower limb ischemia is prone to involve distal lower limb arteries, and a conventional treatment is often unable to obtain the ideal effect. OBJECTIVE:To investigate the effect and safety of umbilical cord blood stem cel transplantation in the treatment of diabetic lower limb ischemia. METHODS: A diabetic rat model of lower limb ischemia was established, and along the femoral artery, five points
were selected for injection of human umbilical cord mesenchymal stem cel suspension, 20 μL per point. At 1, 2, 4 weeks after transplantation, transcutaneous oxygen pressure, vascular density and vascular endothelial growth factor level in the ischemic region, and incidence of adverse reactions were recorded. RESULTS AND CONCLUSION:At 1, 2 and 4 weeks after transplantation, the transcutaneous oxygen pressure, vascular density and vascular endothelial growth factor level in the ischemic region were found increasing, which were significantly different from those before transplantation (P < 0.05). At different time after transplantation, al animals had no inflammatory reactions such as skin bleeding and dermatitis, and local red, sweling, hot, pain, and had no tumor-like growth in organs. These findings indicate that umbilical cord blood stem cel transplantation can safely and significantly improve symptoms of diabetic lower limb ischemia, which has certain application feasibility. Cite this article:Xie LH, Xing L, Zheng H. Feasibility of umbilical cord blood stem cel transplantation for the treatment of diabetic lower limb ischemia. Zhongguo Zuzhi Gongcheng Yanjiu. 2016;20(1):78-82.

Breast Neoplasms ; Female ; Humans ; Neoplasms, Second Primary ; Risk Factors

ObjectiveTo investigate the effect of dexmedetomidine on the median effectivetarget effectsite concentration (EC50) of remifentanil required for preventing body movement in response to skin incision made under propofol sedation.MethodsForty ASA Ⅰ or Ⅱ patients aged 20-50 yr weighing 45-58 kg scheduled for elective breast tumor excision were randomly allocated into 2 groups ( n =20 each):group remifentanil (group R) and group remifentanil + demedetomidine ( group RD).Sedation was induced with propofol TCI at target plasma concentration of 3.0 mg/L in both groups.In group RD dexmedetomidine 1.0 μg/kg was infused iv over 10 min before start of propofol TCI,while in group R equal volume of normal saline was infused instead of dexmedetomidine.Remifentanil TCI was started with target effect-site concentration set at 3.0 and 2.5 μg/L in groups R and RD respective at 13 min after beginning of propofol TCI.Skin incision (3 cm in length) was made when the target concentrations of propofol and remifentanil TCI were reached.Body movement was assessed by a nurse not involved in this study.EC50 and 95％ confidence interval (CI) of remifentanil were determined by up-and-down technique.The target effect-site concentration was increased or decreased by 20％ depending on the response of the previous patient to skin-incision.ResultsThe EC50 of remifentanil for preventing body movement in response to skin incision performed under propofol sedation was 1.7 μg/L (95％ CI 1.5-1.9 μg/L) and 2.5 μg/L (95％ CI 2.2-2.7μg/L) in groups RD and R respectively.The EC50 of remifentanil was significantly lower in group RD than in group R.ConclusionDexmedetomidine 1.0 μg/kg can decrease EC50 of remifentanil for preventing body movement in response to skin incision made under propofol sedation.