Objective To evaluate the prognosis of the decompensated liver cirrhosis by means of MELD-Na score combined with serum cholesterol and endotoxin concentration.MethodsData of 156 hospitalized patients with decompensated liver cirrhosis was retrospectively analyzed.Patients were divided into survival and death group according to follow-ups at 6 months,12 months and 24 months.MELD-Na score was made among 156 patients by detecting relevant indicators.Serum cholesterol and cholesterol levels were measured,too.The relationship between decompensated liver cirrhosis prognosis and MELD-Na score combined with serum cholesterol and endotoxin concentration was analyzed.ResultsNinteen patients died at the follow-up for 6 months.Fifty nine patients died at the followe-up for 12 months.Seventy seven patients died at the follow-up for 24 months.There was significant difference on MELD-Na score,endotoxin concentration and serum cholesterol between the survival group and the death group (t =-9.68,-9.22,11.4,-4.65,-19.60,16.20,-20.0,-18.7,17.3,respectively,P ＜0.05).The best critical value of MELD-Na score to predicate death in patients with decompensated liver cirrhosis was 32 points.The risk of death would rise if MELD-Na score increased.The best critical value of plasma endotoxin to predicate death in patients with decompensated liver cirrhosis was ≥ 12 ng/L.The best threshold value of serum cholesterol to predict death in patients with decompensated liver cirrhosis was ≤ 1.70 mmol/L.ConclusionMELD-Na score,serum cholesterol and serum endotoxin were of higher prognostic value to judge the prognosis of patients with decompensated liver cirrhosis.

Antifungal Agents ; therapeutic use ; Fever ; Histiocytosis ; drug therapy ; etiology ; Humans ; Infant ; Lung Diseases, Fungal ; complications ; diagnosis ; drug therapy ; Male

Objective To summarize the cytological features of breast carcinoma by fine needle aspiration and differential diagonsis of breast hyperplasia and breast flbroadenoma. Methods Cytological features about 175 cases of breast cancer were analyzed,contrasted with 76 cases of breast hyperplasia and 93 eases of fibroadenoma. And 20 cases of low-diagnosis breast cancer were analyzed, compared with 13 cases of excessive diagnosis. Results The followings were found:disorderly arranged cells in 169 cases of breast cancer, about 96.9% in 175 cases,loose distance between the nucleus in 125 cases of all cases (about 71.4%). The percentage of small groups or scattered cells, medium size cells, round nucleus and irregular border nucleus was 34.3% (60/175) ,81.1% (142/175), 88.6% (155/175) and 28.6% (50/175) respectively. The nucleus/cytoplasm ratio was increased in 105 cases of all (about 60%). The nucleus/cytoplasm ratio was obviously reduced in 15 cases of all (about 8.6%). Big nucleolis were observed in 49 cases of all (about 28%). There was significant difference between nucleus size in 136 cases of all (about 77.7%). There was not myoepithelial cell in 168 cases of all (about 96%). The percentage of visible necrosis, scsttered round nucleus and integrity of cytoplasmic was 13.7% (24/175) ,89.7% (157/175), 66.9% (117/175) respectively. The cases of all above features were significantly more than those of breast hyperplasia and breast fibroadenoma (P <0.05). The percentage of large number of cells was 52.6% in 175 breast cancer cases,higher than 5.3% in 76 breast hyperplasia cases. There was a significant difference(P <0.05) between two groups. In 20 cases of low-diagnosis breast cancer the percentage of round nucleus with integrity of cytoplasmic, special arrangement cells was 70% (14 cases) ,35% (7 cases) ,higher than the cases in 13 excessive diagnosis cases. There was a significant difference(P < 0.05) between two groups. Conclusion The cell morphological characteristics of breast caner by fine needle aspiration are large number of cells, loose distance between the nucleus, disorderly arranged cells, small guoups or scattered cells, integrity of cytoplasmic, increased nuclear, round nuclear, irregular border nucleus,increased or decreased nucleus/cytoplasm ratio, big nucleoli, significant difference in nuclear size, no myoepithelial cell, visible necrosis. Most of breast cancer can be distinguished from breast hyperplasia and breast fibroadenoma by above characteristics. All those cytological characteristics are helpful to identify difficult case.

TheStandardized Manipulations of Acupuncture and Moxibustion has been published and gradually standardized the clinical practice. It provided a solid foundation for the standardization of acupuncture and moxibustion therapeutic effects. It also provided powerful convictable effects on the accuracy and scientificity of acupuncture and moxibustion clinical practice, which gained well-acceptance from patients. In the treatment of certain diseases, acupuncture and moxibustion have become irreplaceable so that acupuncture and moxibustion can be strongly promoted both at home and abroad. There were some common problems occurred during the establishment of the national standardization onStandardized Manipulations of Oral and Lip Acupuncture. This article reviewed, analyzed and discussed questions occurred during the standardization establishment. The results showed that according to the principle of standardized production, a rigorous, scientific and reasonable text standard can be established. Advices or opinions gained during the process can be used as references for future standardization establishment. It was concluded that the standardization of acupuncture had great guidance in the acupuncture clinical application. It is an arduous and long-term mission to achieve and strengthen the position of international standardization of acupuncture and moxibustion. The government should increase the effort on investment and promotion of acupuncture and moxibustion standardization. Conversation and cooperation should also be strengthened with international communities to promote the standardization implementation.

Arthropathy, Neurogenic ; Child ; Coxa Vara ; Hand Deformities, Congenital ; Humans ; Male ; Synovitis

Objective: To explore the relationship of fibroblast growth factor-23 (FGF-23) and soluble klotho (sKL) with cardiac valve calcification in patients with continuous ambulatory peritoneal dialysis (CAPD). Methods: 147 CAPD patients from the dialysis center of the First Affiliated Hospital of Soochow University were enrolled. The concentrations of FGF-23 and sKL were measured by enzyme-linked immunosorbent assays (ELISA). Echocardiography was applied to evaluate cardiac valve calcification. The patients were divided into normal cardiac valve group (group A) and cardiac valve calcification group (group B). SPSS 23.0 software was used for data analysis. Results: The incidence of cardiac valve calcification in CAPD patients was 54.42%. The risk of cardiac valve calcification showed positive correlation with age, dialysis age, serum creatinine, corrected calcium, serum phosphorus, serum alkaline phosphatase, parathyroid hormone, and the level of FGF-23 (P=0.045, P=0.022, P=0.006, P=0.024, P=0.000, P=0.017, P=0.022, P=0.000), and negative correlation with urea clearance index, the level of sKL and residual renal function (P=0.045, P=0.000, P=0.011). Multivariate Logistic regression analysis showed that the increase of FGF-23 (OR=5.007, 95% CI 1.446-17.339, P=0.011) and serum phosphorus (OR=7.433, 95% CI 1.558-35.470, P=0.012) were two independent risk factors for cardiac valve calcification in CAPD patients, and the decrease of sKL (OR=0.310, 95% CI 0.108-0.891, P=0.030) was another independent risk factor as well. Receiver operator characteristic curves (ROC) indicated that to predict cardiac valve calcification in patients with CAPD, the optimal cut off points of FGF-23 and sKL were 2 172.64 pg/mL (sensitivity was 91.3%, specificity was 91%) and 231.88 pg/mL (sensitivity was 88.8%, specificity was 92.5%), respectively. Conclusion: The high level of FGF-23 and low level of sKL are two independent risk factors for cardiac valve calcification in CAPD patients. FGF-23 and sKL can be used to diagnose cardiac valve calcification in CAPD patients.

Objective: To observe the clinical efficacy of electroacupuncture (EA) plus Tanbo-plucking the trigger points for scapulohumeral periarthritis (SP). Methods:A total of 80 patients with SP were randomized into an observation group and an EA group by the random number table, with 40 cases in each group. The EA group was treated with EA therapy, and the observation group was treated with EA therapy plus Tanbo-plucking the trigger points. After treatment, the visual analog scale (VAS) and Melle scores of the two groups were compared to evaluate the improvement of shoulder pain and functional activity, and meanwhile the clinical efficacy was observed. Results: After treatment, the total effective rate of the observation group was 95.0％ and the cure and markedly effective rate was 72.5％. The total effective rate of the EA group was 87.5％ and the cure and markedly effective rate was 42.5％. There was no significant difference in the total effective rate between the two groups (P>0.05). The cure and markedly effective rate of the observation group was higher than that of the EA group, and the difference between the two groups was statistically significant (P<0.05). After treatment, the intra-group differences in VAS and Melle scores of both groups were statistically significant (bothP<0.001). The inter-group differences in the changes of the VAS and Melle scores after treatment were statistically significant (bothP<0.001). Conclusion: EA plus Tanbo-plucking the trigger points has a better curative effect than EA therapy alone in the treatment of SP.

ObjectiveTo observe the effect of moxibustion with medicine cake on mRNA expression of matrix metalloproteinases-2,9 (MMP-2，MMP-9)in artherosclerosis (AS) plaques of rabbits, and to explore the effect of moxibustion with medicine cake to the stability of artherosclerosis plaques of rabbits.MethodsAS rabbit models were established by feeding high-fat diet. 75 New Zealand big-eared rabbits were divided into 5 groups, blank group (blank control group), model group (AS model group), direct moxibustion group (AS model + moxa cone direct moxibustion), moxibustion on medicine cake group (AS model + moxibustion on medicine cake), western medicine group (AS model + atorvastatin), 15 rabbits in each group. Then the mRNA expression of MMP-2, MMP-9 was detected in the atherosclerotic plaques of rabbits with in situ hybridization.ResultsThe expressions of MMP-2, MMP-9 in the atherosclerotic plaques of rabbits were all be controlled in direct moxibustion group, moxibustion on medicine cake group, western medicine group (P<0.01 or P<0.05). The expressions of MMP-2 and MMP-9 in the moxibustion on medicine cake group and western medicine group were obviously lower than those of the direct moxibustion group.ConclusionThe expression of MMP-2, MMP-9 in the atherosclerotic plaques of rabbits can all be controlled in direct moxibustion group, moxibustion on medicine cake group, and western medicine group; as well as the plaques can all be made stable. The efficacy in the moxibustion on medicine cake group and western medicine group is superior to that of the direct moxibustion group.

Objective To analyze the feasibility of rapid prenatal diagnosis in the advanced maternal age women with or without positive serologic screening results.Methods We conducted a retrospective study of the women who underwent a mid-trimester amniocentesis in Peking University First Hospital from January 1,2001 to December 31,2012.Maternal age,indication for invasive prenatal diagnosis,karyotyping and pregnancy outcome were documented.Using a young population with high risk in serologic screening (S) as the standard,chromosome abnormalities in the advanced maternal age (A) group and the advanced maternal age with high risk in serologic screening (A+S) group were compared with the S group.Chromosome abnormalities were divided into detectable (D) and undetectable (U) during rapid prenatal diagnosis.Results Of 9 606 cases,222 (2.3％,222/9 606) cases with chromosome abnormalities were detected,23.0％ (51/222) of which were undetectable by rapid prenatal diagnosis.The detection rate of detectable chromosome abnormalities was 1.8％ (57/3 177) in group A,1.4％(13/925) in group A+S,and 1.8％(57/3 250) in group S (x2=0.662,P＞0.05).The rate of undetectable chromosome abnormalities was 0.5％ (15/3 177) in group A,0.3％ (3/925) in group A+S,and 0.5％ (16/3 250) in group S (x2=0.452,P＞0.05).The most common indications for undetectable chromosome abnormalities in the young population were abnormal history of pregnancy,abnormal family history and chromosome abnormality history (16.4％,9/55),and abnormal ultrasound in the advanced maternal age population (4.4％,3/68).Conclusions The performance of rapid prenatal diagnosis in the advanced maternal age population with or without high risk in screening without abnormal findings in ultrasound,was similar to the young population with high risk in screening.Fluorescent in situ hybridization may be integrated into the strategy of prenatal diagnosis for this group of women.

Objective To establish a mouse model of prostate cancer expressing human PSCA for the development of new anti-tumor drugs or vaccines. Methods The total RNA of DU145 cells,a human prostate cancer cell line,was isolated by using TRIzol reagent according to the (RT-PCR),the first-strand cDNA was synthesized using the SuperScript First-Strand synthesis system. The human PSCA gene was amplified with the primers and cloned into the plasmid pcDNA3.1 to generate pcDNA-PSCA. DNA sequencing was used to confirm the constructs. The mouse prostate tumor cell line RM-1 cells,syngeneic to C57BL/6,were transfected with pcDNA-PSCA plasmids followed by selection using G418. RT-PCR analysis was performed to examine the validity of the constructs. Expression of PSCA on the cell surface was determined by staining with anti-PSCA antibody,and the anti-PSCA antibody was detected using an FITC-conjugated goat anti-rabbit IgG antibody,and analyzed by flow cytometry. 4-6-week-old male C57BL/6 mice purchased from the Laboratory Animals Center were inoculated with different amounts of RM-PSCA cells to search for suitable cell population which can form tumor in mouse,and the mice were monitored twice a week. The growth and the survival time of mice were measured,respectively. The tumor volume was measured by vernier caliper according to the formula:V=0.5a×b~2,where a and b are the long and short diameters of the tumor,respectively. Results The plasmid pcDNA-PSCA was successfully constructed and the PSCA was successfully expressed in RM-PSCA 7~# and RM-PSCA 28~# cells by RT-PCR and confirmed by flow cytometry. 1×10~5 RM-PSCA cells were sufficient to get tumor growth in 100% of inoculated mice. The tumor grew quickly and the volume of the tumor reached 12000 mm~3 within 34 days. All the mice died within 40 days and their mean survival time was 37 days. Conclusion A PSCA-expressing tumor model in mice has been successfully established. It can be used to evaluate the activities of drugs or vaccines.