Objective To evaluate the effect of a specific cathepsin B inhibitor,CA-074 Me,on the expression of cathepsin B in coxsackievirus B1-induced polymyositis in guinea pigs,and to elucidate the protective mechanisms of CA-074 Me on muscle fibers.Methods Polymyositis model was established in 32 guinea pigs by infection with coxsackievirus B1,which were then equally divided into 4 groups: γ-interferon group treated with intraperitoneal γ-interferon (150 000 IU per kilogram per day) from week 5 to week 8,polymyositis model group receiving no treatment,pseudo-intervention group treated with intraperitoneal sodium chloride physiological solution,CA-074 Me group treated with intraperitoneal CA-074 Me (4 mg per kilogram per day) for 7 days,after the infection with coxsackievirus B1.Eight guinea pigs receiving no infection or treatment served as the healthy control group.Blood samples and muscle tissue samples were obtained from the guinea pigs in the γ-interferon group on week 8 and in the other 4 groups on week 5.The serum level of muscle enzymes including creatine kinase (CK),CK-MM,aspartic transaminase (AST) and l-lactate dehydrogenase (LDH) were determined.Muscle tissue samples were studied by hematoxylin and eosin (HE) staining,and Envision two-step method was used to quantify the expression of cathepsin B and to numerate CD8+ T cells.The apoptosis in muscle cells was detected by terminal deoxynucleotide transferase-mediated dUTP-biotin nick end labeling (TUNEL).One-way analysis of variance (ANOVA) was conducted to compare the serum level of muscle enzymes,inflammation score of muscle and apoptosis index of muscular cells,and Pearson chi-square test to compare the count of CD8 + T cells and cathepsin B expression,among these groups.Results Polymyositis model was successfully established by infection with coxsackievirus B1 in the 32 guinea pigs with a marked increase in the serum level of the tested enzymes,especially in that of CK.In detail,the serum level of CK was (410.7 ±167.9) U/L in the healthy control group,significantly lower than that in the polymyositis model group ((3537.3 ± 2141.6) U/L,P ＜ 0.05),pseudo-intervention group ((2222.0 ± 226.9) U/L,P ＜ 0.05),γ-interferon group ((973.8 ± 423.2) U/L,P＜ 0.05) and CA-074 Me group ((814.0 ± 268.4) U/L,P＜ 0.05).Compared with the pseudo-intervention group,the γ-interferon group and CA-074 Me group showed a slight increase in the serum level of all the four enzymes (all P ＜ 0.05).There was a significant elevation in the inflammation score of skeletal muscles in the polymyositis model group,pseudo-intervention group,γ-interferon group and CA-074 Me group compared with the healthy control group (1.75 ± 0.50,1.40 ± 0.55,2.38 ± 0.74 and 1.20 ± 0.45 vs.0.00 ± 0.00,all P ＜ 0.05),with the most intense infiltration of inflammatory cells observed in the γ-interferon group.Moreover,the number of CD8 + T cells,cathepsin B expression and muscular cell apoptosis index were all significantly higher in the polymyositis model group,pseudo-intervention group,γ-interferon group and CA-074 Me group than in the healthy control group (all P ＜ 0.05).Compared with the pseudo-intervention group,the CA-074 Me group showed less CD8+ T cells (42.3 ± 27.4 vs.68.0 ± 13.2,P ＜ 0.05) and lower expression of cathepsin B (31.3 ± 6.7 vs.37.5 ± 9.2,P ＜ 0.05),whereas the γ-interferon group exhibited elevated cathepsin B expression (49.3 ± 17.0 vs.37.5 ± 9.2,P＜ 0.05) and apoptosis index (40.1 ± 6.7 vs.25.4 ± 5.0,P＜ 0.05).Conclusions Cathepsin B is highly expressed in the guinea pig model of polymyositis,while CA-074 Me may protect muscle tissue in this model by downregulating the expression of cathepsin B and attenuating the inflammation and apoptosis induced by cathepsin B.

Objective To investigate the effects of orexin-A on learning and memory of pentyleneterazol (PTZ)-kindled epileptic rats.Methods Adult Wistar rats were randomly divided into control group(normal saline,NS)and PTZ group.The PTZ-kindled rats were randomly divided into,orexin-A group and NS group administrated by intracerebroventricular(i.c.v.)injection of 10μl orexin-A(1.4 nmol/μl)or 10μl NS.Using Morris water msze experiment,the ability of learning and memory was measured in all rats.Results Eighty percent of rats in PIZ group were kindled successfully after intraperitoneal injection of 35mg/kg PTZ every day for 30 days.Compared to control group,the escape latency in the PTZ-kindled rats was significantly increased in place navigation test(PNT)(F=200.956,P<0.01),whereas a remarkable reduction of time spent in the target quadrant and number of pool circlings in 120 seconds Was observed during probe trials.Following injection of orexin-A,the latency of escape platform was significantly declined in both PTZ-kindled((39.73±2.03)8,(33.76±2.96)s)and NS rats,increased the number of crossing the platform(10.83±1.80)vs(4.67±3.34).In addition,the treatment with orexin-A markedly increased swim velocity and number of pool circlings in beth groups(P<0.01),particularly to the PTZ-kindled rats.Conclusion Spatial learning and memory in the PIZ-kindled rats can be improved by treatment with orexin-A.

Objective To investigate the relationship between the expression of estrogen receptor (ER),progesterone receptor(PR)and epidermal growth factor receptor(EGFR)in uterine leiomyoma and the recurrence after myomectomy.Methods Eighty cases underwent myomectomy were enrolled in this study.ER,PR and EGFR expression in uterine leiomyoma tissue and normal myometrium tissue were examined by immunohistochemical technique.All the patients were followed up regularly after myomectomy.Results The positive expression rate of ER,PR and EGFR in uterine leiomyoma tissue were significantly higher than those in normal myometrium tissue[88.8％(71/80)vs.48.8％(39/80),92.5％(74/80)vs.30.0％ (24/80),86.2％(69/80)vs.57.5％(46/80),P ＜ 0.05].The recurrence rates in ER,PR and EGFR positive expression patients were significantly higher than those in negative expression patients[42.3％(30/71)vs.22.2％(2/9),41.9％(31/74)vs.16.7％(1/6),42.0％(29/69)vs.27.3％(3/11),P ＜ 0.05].The recurrence times in ER,PR and EGFR positive expression patients were significantly shorter than those in negative expression patients(P ＜0.05).The expression of EGFR had positive correlation with ER and PR(r =0.837,0.702,P ＜ 0.05).Conclusions The recurrence of uterine leiomyoma may have correlation with high expression of ER,PR and EGFR in uterine leiomyoma.

Objective To improve the treatment level of serous otitis media(SOM)in children.Methods 56 patients were treated by positive pressure tympanic administration of ?-Chymotrypsin and Triamcinolone Acetonide through auripuncture into a single hole and 55 cases by myringotomy with grommet insertion.Results The total effective rate of serous otitis media by positive pressure tympanic administration through auripuncture into a single hole and by myringotomy with grommet insertion was 89.8%,90.8% respectively.But the former obviously had more advantages over the latter.Conclusion The technique is better in that it is safe,painless,economical,and non-traumatic.It is an effective method in treating serous otitis media in children.

Objective To provide anatomic data for operation of inserting the electron cochlear in young children. Methods Fourteen heads,28 sides specimens of young children of 1to-5-year old were dissected,through posterior tympanum approach,via mastoidectomy,posterior tympanoto to enter posterior tympanum.The related anatomy structures of the location of the electron cochlear inserted into the proper sites were observed and measured under surgical microscope. Results The round window was seated in superior part of the round window niche.The pyramidal eminence,tendo musculi stapedius,incudostapedial joint,base of stapes,cochleariform process,round window niche and promontorium tympani were all visible from different directions.The posterior arch of stapes was situated in the prozone of scala.Scala was situated in the posteroinferior scala vestibuli.The distance from the middle point of the anterior border of the round window niche to the inferior wall was(1.49?0.42)mm,to the posterior wall of the Scala tympani(0.90?0.31)mm,to the basal tissue(1.49?0.41)mm,to the pyramidal eminence(3.28?0.55)mm,to the lateral semicircular canal(7.41?0.90)mm,to the inferior margin of the base of stapes(3.09?0.53)mm.Conclusion It is considered that the location of the insertion should be at the middle point of anterior border of the round window niche anterior from 0.90mm to 1.49mm,deorsum from 0mm to 1.49mm.When the round window niche is not found,the location of the insertion has to be at the middle point of the inferior margin of the base of stapes deorsum 3mm.

Objective To investigated the inhibitory effect of an IgG-Fc region specific inhibitory peptide on the ANCA-accelerated apoptosis of neutrophils. Methods The peptide was prepared by solid-phase peptide synthesis and its biological activity was identified by rosette formation assay. ANCA was prepared from the sera of active Wegener's granulomatosis (WG) and microscopic polyangiitis (MPA) patients. Neutrophils isolated from the blood of healthy volunteers were primed with TNF-?(2 ng/ml) then incubated with ANCA. At different intervals(3, 6, 12, 18 hours) the neutrophils were harvested to assess the apoptosis by flow cytometric analysis of JC-1 staining, Sub-G1 population and fonnation TUNEL technique. Results Tg19320 bound tightly to human IgG dose-dependendy and inhibited statistically the rosette formation between SRBC-IgG and U937 cells(20.3% vs 53.2% ,P

ObjectiveTo evaluate the accuracy and value of the ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of agenesis of the corpus callosum in the newborns.MethodsConventional cerebral ultrasound screening was performed in 8086 newborns admitted to NICU in our hospital from January 2012 to June 2014 and agenesis of the corpus callosum was suspected or conifrmed in 31 newborns. The diagnostic accuracy of ultrasonography was assessed through the com-parison between the results of ultrasonography and MRI.ResultsIn 31 cases with suspected agenesis of the corpus callosum, ultrasonography showed 14 cases of complete agenesis of which 13 cases had the same diagnosis with MRI except one case of partial agenesis, meanwhile, ultrasonography showed 16 cases of partial agenesis of which 15 cases had the same diagnosis with MRI except one case of complete agenesis. One case of abnormal corpus callosum determined by ultrasonography was diagnosed as partial agenesis by MRI. MRI showed there were other brain malformations in 14 cases.ConclusionsUltrasonography and MRI has a high consistency in the diagnosis of agenesis of the corpus callosum in neonates, so the former can be used as a routine screening and the latter can be used as a method of accurate diagnosis. A combination of both has an important role in early diag-nosis and clinical evaluation.

[ABSTRACT]OBJECTIVETo study the changes of symptoms, signs and esophageal dynamics characteristics of laryngopharyngeal reflux diseases(LPRD) before and after treatment with esomeprazole and itopride.METHODS The suspected LPRD patients were took the diagnostic treatment with esomeprazole and itopride. Reflux finding score(RFS), reflux symptoms index(RSI) score and high-resolution esophageal pressure were evaluated before and after treatment. The patients were divided into pure LPRD group and LPRD with GERD group according to gastroesophageal reflux disease(GERD) questionnaire scores.RESULTS There were 38 patients confirmed with LPRD(pure LPRD group:12 cases, LPRD with GERD group:26 cases). The BMI, age, gender ratio had no statistical difference between the two groups(P>0.05). In LPRD group, RSI had significant difference before and after treatment(Z=-3.009,P<0.05), but the RFS had no statistical difference before and after treatment(Z=-0.976, P>0.976). In LPRD with GERD group, the RSI and RFS had significant difference before and after treatment(P<0.05). In LPRD group, the esophageal dynamic change had no significant difference before and after treatment(P>0.05), but in LPRD with GERD group, esophageal dynamic parameters of UESP, LESP, DCI, DL had significant difference before and after treatment(P<0.05).CONCLUSIONIn pure LPRD group, the reflux symptoms improved obviously after treatment, but the signs may need treatment for more time. Esomeprazole combined with itopride can improve the esophageal dynamics in LPRD with GERD group, but can not improve that in pure LPRD group. The results suggested that the LPRD and GERD have different pathogenesis.

Objective To investigate the effects of tg19320,a small peptide,interfering with IgG-FcγR interaction on the adhesion of neutrophils to endothelium and the expression of intercellular adhesion molecule 1 (ICAM-1)in endothelial cells and its possible mechanism.Methods Tg19320 was prepared by solid-phase peptide synthesis.ANCA IgG was isolated from the serum of active ANCA-associated systemic vasculitis(AASV)patients.When primary human umbilical vein endothelial cells(HUVEC)grew into connuence in cytokine-free eonditions,the cells were stimulated with TNF-α,human normal IgG,ANCA IgG and ANCA IgG+tg19320 respectively.HUVEC were pretreated with tg19320 for 45 minutes before being stimulated by ANCA IgG.Non-activated neutrophils was added to treat HUVEC and adhesion was measured by cell count.The expression of ICAM-1 mRNA and protein was assessed by real-time PCR and Western blot respectively.Soluble ICAM-1(sICAM-1)was determined using ELISA technique.Phosphorylation of IκB-α was assessed by Western blot. Results ANCA IgG significantly up-regulated the expression of ICAM-1 in HUVEC and promoted sICAM-1 release(P＜0.05),and TNF-α enhanced the effect of ANCA.These effects were almost completely abolished by tgl9320 both at protein and mRNA level.Furthermore,ANCA IgG increased the IκB-α phosporylation in HUVEC and tg19320could inhibit the effect. Conclusions ANCA IgG can modulate the expression of ICAM-1 and sICAM-1 release in endothelial cells.FcγR probably play a critical role in the ICAM-1 expression up-regulated by ANCA,which is mediated in part through NF-κB signaling pathway.Tg19320 has protective effect on endothelium in AASV in vitro.

OBJECTIVETo evaluate effectiveness therapeutic regimens for obstructive sleep apnea hypopnea syndrome (OSAHS) children at an acceptable cost.

METHODThis study was performed at Yuying Children's Hospital of Wenzhou Medical University from Mar. 2008 to Dec. 2010. Prospective random number table method was used for the analysis; 60 children with mild OSAHS were divided into Mild OSAHS Montelukast Treatment (MM) group and Mild OSAHS Adenotonsillectomy Treatment (MAT) group. 32 children in MM group were treated with leukotriene receptor antagonists (LTRAs), while 28 children in MAT group were treated with adenotonsillectomy. Also, 58 children with moderate and severe OSAHS were divided into severe OSAHS Montelukast Treatment (SM) group and severe OSAHS Adenotonsillectomy Treatmen (SAT) group. Twenty-two children in SM group were treated with LTRAs, while 36 children in SAT group were treated with adenotonsillectomy. All selected children were evaluated by polysomnography (PSG) and Obstructive Sleep Apnea-18 (OSA-18) items before and after a six-month treatment. Both records were taken and analyzed, surgical complications and the reason for non-remission after operation were also analyzed. Two therapies were compared based on economic consideration and therapeutic effect. Result (1) PSG: A significant change of a significant change of Apnea Hypopnea Index (AHI) was observed in MM group after the treatment (before receiving the treatment 4.56 ± 1. 26, and after receiving the treatment 3. 48 ± 1. 52, t =3. 50, P <0. 05). But for oxygen desaturation Index (ODI) (MM group 2. 18 ± 2. 19, and MAT group 1. 80 ± 2. 34) and Lowest Oxygen satuation (LSaO2) (MM group 91. 66 ± 2. 34, and MAT group 92. 79 ± 2. 18), there was no significant difference in MM group and MAT group after the treatment (ODI, t =0. 65, and LSaO2 t = - 1. 93, P >0. 05). (2) OSA-18 scores: Significant differences were found in sleeping disorder (before 14. 81 ± 6. 28, and after 10. 56 ± 3. 57), the degree of familial stress (before 13. 56 ± 3. 54, and after 8. 97 ± 2. 96), and OSA-18 total scores (before 52. 66 ± 1. 11, and after 42. 56 6. 48) in MM group after the treatment (sleeping disorder Z - 3. 14, the degree of familial stress Z = -4. 50, and OSA-18 total scores Z= -4. 01, P <0. 05). (3) In addition to the cost of drugs, groups with surgical treatment had a larger economic burden than those with LTRAs treatment. (4) Treatment was totally effective for 28 children (88%) in MM group, and 28 children (100%) in MAT group. Meanwhile, treatment also achieved an obvious effect on 2 children (9%) in SM group, and in 35 children (97%) in SAT group. In MAT group, 3 children improved (11%). And in SAT group, 7 children improved (19%), but treatment was found to be ineffective in 1 case (3%). Among those effective and ineffective cases in groups with surgical treatment, there were 9 children with nasal diseases.

CONCLUSION(1) Surgical treatment is recommended as the first choice for children with moderate and severe OSAHS. And for those who also suffer from nasal diseases, treatment combining drugs with surgery is necessary. (2) LTRAs therapy has a good effect for mild OSAHS. Surgery is also recommended when drugs could not achieve any obvious improvement in clinical symptoms of children with mild OSAHS.

Adenoidectomy ; Blood Gas Analysis ; Child ; Cost of Illness ; Humans ; Oxygen ; Polysomnography ; Prospective Studies ; Sleep Apnea, Obstructive ; surgery ; Sleep Wake Disorders ; Tonsillectomy ; Treatment Outcome