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

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.

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 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.

Objective To observe the effect of clindamycin for preventive infection in arthroplasty prophylac-tic.Methods 108 knee replacement patients were injected by 600mg intravenous clindamycin preoperation and con-tinue to use 1 -2 days after operation.The average postoperative hospitalization,postoperative outcome,body tempera-ture and blood after WBC changes of CRP and ESR in the fall of superficial infection trend,the average postoperative day,take out stitches after operation and the number of cases,postoperative deep infection early after infection (2 weeks)and delayed infection cases (within one year)were observed in order to evaluate the efficacy of preopera-tive antibiotics.Results 2 cases had superficial infection due to wound dehiscence (two times after suture recover-y),there was no complications of surgical wound in the other cases.In all cases,after operation,body temperature and blood WBC became to the normal level in seventh days,postoperative patients'CRP,ESR monitoring were significantly higher than those before operation (CRP:F =105.32,P =0.045;ESR:F =118.47,P =0.039),but on the 5 day after operation they were started to decline,CRP in the 21 postoperative day gradually returned to normal,and ESR gradually returned to normal after 6 months of operation.Preoperative HSS score was significantly lower than the post-operative score[(46.8 ±9.7)points vs.(91.7 ±3.4)points,t =6.38,P <0.05].Conclusion Clindamycin plays a definite role in prevention of infection,especially in the beta lactam antibiotic allergy cases,it can be preoperative antibiotic prophylaxis instead of cephalosporins.

Objective To evaluate the trend in prenatal diagnosis of single gene disorders (SGD) and role ofmultidisciplinary cooperative mode.Methods In January l,2012,amultidisciplinarycooperativemode for SGD diagnosis was established in the Peking University First Hospital,involving Departments of Obstetrics,Pediatrics,Neurology,Dermatology and Central Laboratory.For each pregnant woman with a family history of SGD for prenatal diagnosis,propositus should be diagnosed in the relevant departments,and then further diagnosed,managed and followed up by the Obstetrics Department.Up to December 31,2014,of 6 681 women for prenatal diagnosis,279 women had a family history of SGD:76 of them received chorionic villus sampling (CVS) at 11-14 gestational weeks,and 203 received amniocentesis (AC) at 16-22 gestational weeks.The trend in SGD diagnosis and the safety of CVS and AC were analyzed using Chi-square test.Results The proportion of SGD family history in AC group was 3.2％ (203/6 355),which stayed stable with 2.3％ (47/2 054) in 2012,3.9％ (78/2 023) in 2013 and 3.4％ (78/2 278) in 2014,and there was no significant difference between 2013 and 2014 (x2=0.571,P=0.463).In CVS group,the proportion of SGD family history was 23.3％ (76/326),showing an increasing trend with 18.2％ (8/44) in 2012,17.6％ (19/108) in 2013 and 28.2％ (49/174) in 2014,and there were significant differences between 2013 and 2014 (x2=4.067,P=0.046).The proportion of SGD family history in CVS group was higher than in AC group in year 2012,2013 and 2014 (x2＝42.626,44.531 and 201.400,all P=0.000).Among the 279 cases of SGD family history,no complications and adverse outcome were observed except an intra-uterine fetal death occurring 6 months after CVS in one woman,but 3 fetuses were found to have chromosome anomalies with one trisomy 18,one 45,X,and one mosaicism of 45,X/46,XY which was determined to be normal by AC.Conclusions SGD family history is one of the important indicators in prenatal diagnosis,and CVS is feasible for prenatal diagnosis of SGD family history as early as in the first trimester.Multidisciplinary cooperative mode is helpful in SGD family history diagnosis.

Objective:To construct CD106-targeted RNAi lentiviral vector plasmids. Methods:4 targets aimed at CD106(Target 1, 2, 3, 4)were designed. Oligo-DNA fragment containing short hairpin frame was synthesized and reannealed, and then cloned into lentivi-ral expression vector. PCR and sequencing analysis were made for verifying the positive clones. The virus packaging plasmids were trans-fected into 293T cells to harvest siRNA lentivirus. After infection in HN12 cells, Real-time PCR and western blot were performed to de-termine the expressing level of CD106. Results:PCR and sequencing revealed that siRNA plasmids was correctly constructed. Virus with a titer of 1 × 109 TU/ml was successfully packaged at least. CD106 expression in HN12 cells could be knockdown by virus infection sig-nifically, compared with negative control lentivirus. Conclusion: The recombinant lentiviral siRNA expressing vector targeting human CD106 gene has been successfully constructed and packaged. CD106 gene in cells may be down-regulated by lentiviral siRNA.

Objective To study the effect of interventional treatment of iliac and femoral vein stenosis concomitant with deep venous thrombosis. Method Fifty-three patients were divided into 5 groups. In group A after placing into inferior vena cava a filter,11 patients adopted Amplatz Trombectomy Device for thrombolysis or ORSIS thrombolysis and persistent thrombolysis through popliteal vein. In group B thrombus was taken out through guiding catheter and then persistent thrombolysis through popliteal vein after placing into inferior vena cava filters in 9 cases. In group C 13 patients adopted persistent thrombolysis through femoral arteries. In group D 8 patients received persistent thrombolysis through popliteal vein. In group E persistent thrombolysis through foot veins was carried out in 12 patients. Seventeen patients received implanted stents and balloon-expansion in iliac and femoral veins. Results Symptoms disappeared in 26 patients(49.0%), significantly improved in 21 patients (39.6%), improved in 3 patients (5.7%), did not improve in 3 patients (5.7%), respectively. The repatency of iliac and femoral vein was achieved in more than 80% of the 17 patients. Complications developed in 3 cases in the course of thrombolysis. Conclusion The effect of mechanical removal of thrombus, persistent thrombolysis through catheter and transluminal angioplasty is safe and satisfactory.

Objective To investigate the protective effects of atorvastatin on hyperphosphate-induced rat vascular smooth muscle ceils (RVSMCs) calcification and to discuss the mechanism. Methods RVSMCs were placed in various culture media, including normal phosphate medium, high phosphate medium, ZVAD-FMK medium and atorvastatin medium.Calcium content and cell protein content were quantified by the o-cresolphthalein complexone method and BCA protein assay respectively. Calcification was visualized by yon Kossa staining. And cell apoptosis was quantified by ELISA. Results (1)At day 3, 6, 9, RVSMCs calcification occurred more frequently in high phosphate medium than that in normal phosphate medium (P<0.05). (2)At day 6, RVSMCs calcification was significantly inhibited in 1.0 μmol/L and 2.0 μmol/LZVAD-FMK medium (P<0.05). And in 10 nmol/L and I00 nmol/L statin medium, RVSMCscalcium deposition significantly decreased (P<0.05). (3)RVSMCs apoptosis and calcification occurredfrequently in high phosphate medium. And atorvastatin significantly inhibited RVSMCs apoptosisboth in long-term and short-term (P<0.05). Conclusions Hyperphosphate can induce the calcium deposition of RVSMCs in vitro. Atorvastatin protects RVSMCs from phosphate-induced calcification by inhibiting apoptosis.