Objective To investigate the distribution, clinical diagnosis and treatment methods of the extrapulmo-nary complications in children with mycoplasma pneumoniae (MP). Methods The clinical data of 1 100 patients confirmed the diagnosis of mycoplasma pneumonia and with the positive serum MP-IgM test were collected in this study. The distribu-tion and clinical characteristics and MP-DNA detection rates were compared between 417 patients with extrapulmonary com-plications and 683 cases without complications. The occurrence of various complications in a four-year period was analyzed. Clinical data were compared between fiberoptic bronchoscopy lavage group and non-surgical group. Results The MP-DNA detection rate and the length of hospital stay were higher in patients with pulmonary complications than those of patients without complications. The most common types of extrapulmonary complications were liver damage, skin rashes and gastrointestinal reactions , but less severe. Encephalitis, nephritis and myocarditis were rare complications, but severe and occult. The fatal hemophagocytic lymphohistiocytosis (HLH) was also visible in patients. Bronchoscopy lavage was conducive to the recovery of the disease. Conclusion MP pneumonia showed high incidence and risks of extrapulmonary complica-tions, which required careful clinical observation and inspection, the dynamic monitoring laboratory markers and comprehen-sive treatment as well.

This study was aimed to evaluate whether mesenchymal stem cells (MSCs) obtained from patients with myelodysplastic syndrome possess immunosuppressive effect. MSCs from bone marrow samples of MDS patients were isolated, cultured and expanded. MSCs were morphologically analyzed and their immunophenotype were determined by flow cytometry. Various amounts of MSCs were added into one-way mixed lymphocyte reaction. MSCs from MDS patients were tested for their ability to suppress in vitro proliferation of autologous and allogeneic peripheral blood lymphocytes (PBLs). The results showed that 3 x 10(3 - 1) x 10(5) MSCs from MDS patients could inhibit autologuous PBLs proliferation to (66.9 +/- 20.1)% - (30.2 +/- 5.9)% of maximal response, as well as inhibit allogeneic PBLs proliferation to (56.6 +/- 14.7)% - (20.5% +/- 9.7)% of maximal response, as compared with inhibitory ability of MSCs from healthy donors, there was no significant difference (P>0.05). It is concluded MSCs from patients with myelodysplastic syndrome also possess immunosuppressive activity.
Bone Marrow Cells ; immunology ; pathology ; Cell Proliferation ; Cells, Cultured ; Humans ; Immune Tolerance ; Lymphocyte Culture Test, Mixed ; Lymphocytes ; cytology ; Mesenchymal Stromal Cells ; immunology ; pathology ; Myelodysplastic Syndromes ; immunology ; pathology

OBJECTIVESTo study on the relationship between platelet Ca2+(i), CD62P, CD63, serum CD62P (SCD62P) and cirrhosis patients.

METHODSPlatelet CD62P, CD63 were determined with flow cytometry, SCD63P with ELISA, and Ca2+(i) in platelet was determined with fluorophotometry.

RESULTSPlatelet Ca2+(i), CD62P, CD63, and SCD62P levels in cirrhosis patients were (103.1+/-22.2)nmol/L, (47.6+/-20.0)%, (47.1+/-24.6)%, and (67.6+/-37.6)microg/L, and in controls were (57.6+/-13.1)nmol/L, (3.1+/-0.7)%, (2.5+/-0.7)%, and (24.0+/-6.5)microg/L, respectively. The levels in the former were higher than those in the latter (t > or = 6.148, P<0.05). The above levels in upper gastrointestinal haemorrhage group were much higher than those in the non-haemorrhage group (120.3nmol/L+/-18.8nmol/L vs 91.1nmol/L+/-14.3nmol/L, 64.9%+/-14.7% vs 34.6%+/- 11.9%, 70.9%+/-14.5% vs 30.2%+/-14.4%, and 103.6microg/L+/-14.9microg/L vs 40.8microg/L+/-24.0microg/L, respectively, t > or = 5.380, P<0.05). But the numbers of platelet between the two groups were no obvious difference.

CONCLUSIONSPlatelet in the cirrhosis patients is greatly active, and the detection of platelet CD62P, CD63, SCD62P has a certain value in judging the degree of cirrhosis.

Adult ; Aged ; Antigens, CD ; blood ; Blood Platelets ; chemistry ; Calcium ; blood ; Female ; Humans ; Liver Cirrhosis ; blood ; Male ; Middle Aged ; P-Selectin ; blood ; Platelet Membrane Glycoproteins ; Tetraspanin 30

OBJECTIVETo evaluate the efficacy and safety of radix astragali and its compound prescription for treatment of β-thalassemia in children.

METHODSThis study was a randomized, controlled, double-blind clinical trial. Fifty-seven children with β-thalassemia were randomly assigned to radix astragali, compound prescription (radix astragali+ codonopsis pilosula + tortoise plastron) and placebo control groups after stratifying the patients according to disease type (intermedia and major). The parameters of hematology and safety were assessed after 12 weeks of treatment.

RESULTSAfter 12 weeks of treatment, the mean Hb elevation levels in children with β-thalassemia intermedia from the compound prescription and the radix astragali groups were 1.21±1.12 and 1.05±0.80 g/dL respectively compared with -(0.28±0.51) g/dL in the placebo control group (P<0.01). Mean Hb levels in the compound prescription and radix astragali groups were significantly higher than in the placebo control group (P<0.05). Therapy with both radix astragali and its compound prescription increased fetal hemoglobin, red blood cell, mean corpuscular hemoglobin and reticulocyte levels in children with β-thalassemia intermedia. The total effective rates were 64% and 62% in children with β-thalassemia intermedia from the compound prescription and radix astragali groups respectively, which was significantly higher than in the placebo control group (9%; P<0.01). Therapy with radix astragali or its compound prescription in children with β-thalassemia major had similar but less favourable effects than the same therapy in children with β-thalassemia intermedia. White blood cell, neutrophil, platelet and hepatic and renal functions were not adversely affected by the medicines.

CONCLUSIONSTherapy with radix astragali or its compound prescription is effective and safe in children with β-thalassemia.

Astragalus Plant ; adverse effects ; Child ; Child, Preschool ; Double-Blind Method ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Hemoglobins ; analysis ; Humans ; Male ; Prospective Studies ; beta-Thalassemia ; blood ; drug therapy

This study aimed to identify the differentially expressed genes after silencing of β-catenin in multiple myeloma transduced with β-catenin shRNA. The DNA microarray dataset GSE17385 was downloaded from Gene Expression Omnibus, including 3 samples of MM1.S (human multiple myeloma cell lines) cells transduced with control shRNA and 3 samples of MM1.S cells transduced with β-catenin shRNA. Then the differentially expressed genes (DEGs) were screened by using Limma. Their underlying functions were analyzed by employing Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses. Moreover, DEGs annotation was conducted based on the databases of tumor associated genes, tumor suppressed genes and the transcriptional regulation from patterns to profiles. Furthermore, the protein-protein interaction (PPI) relationship was obtained from STRING and the protein-protein interaction network and the functional modules were visualized by Cytoscape. Then, the pathway enrichment for the DEGs in the functional module was performed. A total of 301 DEGs, including 124 up-regulated and 117 down-regulated DEGs, were screened. Functional enrichment showed that CCNB1 and CDK1 were significantly related to the function of cell proliferation. FOS and JUN were related to innate immune response-activating signal transduction. Pathway enrichment analysis indicated that CCNB1 and CDK1 were most significantly enriched in the pathway of cell cycle. Besides, FOS and JUN were significantly enriched in the Toll-like receptor signaling pathway. FOXM1 was identified as a transcription factor. Moreover, there existed interactions among CCNB1, FOXM1 and CDK1 in PPI network. The expression of FOS, JUN, CCNB1, FOXM1 and CDK1 may be affected by β-catenin in multiple myeloma.
CDC2 Protein Kinase ; Cyclin B1 ; genetics ; Cyclin-Dependent Kinases ; genetics ; Forkhead Box Protein M1 ; Forkhead Transcription Factors ; genetics ; Gene Expression Profiling ; methods ; Gene Expression Regulation, Neoplastic ; Gene Regulatory Networks ; Gene Silencing ; Humans ; Multiple Myeloma ; genetics ; Oncogene Proteins v-fos ; genetics ; Protein Interaction Maps ; Proto-Oncogene Proteins c-jun ; genetics ; beta Catenin ; genetics

OBJECTIVETo analyze the epidemiological features of the index cases of severe acute respiratory syndrome (SARS) occurred in different cities in Guangdong province and to trace for the source of infection.

METHODSStandardized individual case inventory was adopted to conduct investigation on index cases and on persons who had close contact with index cases in Guangdong province. Data on the epidemiological characteristics, secondary cases and the links among index cases were analyzed.

RESULTSBetween November 16, 2002 and April 16, 2003, there had been 13 index cases of SARS including 3 cadres, 3 farmers, 2 retirees, 2 workers and 1 shop attendant, reported from 13 cities in Guangdong province. Between November 2002 and January 2003, there had been 7 cities reported to have identified index cases of SARS with 6 of them being infected in their own cities and 1 imported from Guangzhou city. All of the cases had no close contacts to similar patients but 6 of them later caused 2nd or even 3rd generation cases of SARS. Most cases hit young people (7/13) with a sex ratio of 1:0.6. The fatality rate of index cases was high (4/13).

CONCLUSIONNo evidence showed that there was direct transmission among the index cases. Data regarding the geographical origin of those index cases led to the assumption that the infection had started in six cities of Pearl river delta region and the Hong Kong Special Administrative Region.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Contact Tracing ; Female ; Hong Kong ; epidemiology ; Humans ; Male ; Middle Aged ; Prevalence ; Severe Acute Respiratory Syndrome ; epidemiology ; transmission

OBJECTIVETo evaluate the disadvantage of nonstandard operation for thyroid papillary cancer, and the value of re-operation.

METHODSEight hundred and ninety three thyroid papillary cancer patients (332 patients who received nonstandard operation received re-operation and 561 patients who received first standard operation in Zhejiang Cancer Hospital from January 1990 to January 2000) were retrospectively reviewed.

RESULTSPathological results confirmed that there were 53.9% cases with residual cancer in re-operative specimen. The parathyroid was preserved in 74.1% cases in re-operation and 93.0% cases in standard operation (P < 0.01). The recurrent laryngeal nerve was injured in 3.3% cases in reoperation and 1.2% cases in standard operation (P < 0.05). The positive neck lymph node was 39.2% and 37.4% (P > 0.05), the 5-year local recurrence rate was 7.5% and 3.7% (P < 0.01), the total 5-year and 10-year cum-survival rates were 90.2%, 84.4% in patients with re-operation and 94.0%, 92.5% in patients with standard operation. The 10-year cum-survival rate were 67. 8% in patients with recurrence and 92. 9% in patients with non-recurrence in primary site respectively. Statistical analysis showed that the cancer recurrence influences the survival rate significantly (P < 0.01).

CONCLUSIONSIn consideration of the higher residual tumor rate in patients who received nonstandard operations, the re-operations were necessary. But the re-operation could also leads to higher recurrence rate and more functional injuries. The standardized primary operation should therefore be formulated and advocated.

Adolescent ; Adult ; Aged ; Carcinoma, Papillary ; surgery ; Child ; Female ; Humans ; Male ; Middle Aged ; Reoperation ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; methods ; Young Adult

OBJECTIVETo study the effects of high frequency oscillatory ventilation (HFOV) combined with incremental positive end-expiratory pressure (IP) on respiratory and circulatory functions, and lung histopathology of dogs with smoke inhalation injury.

METHODSAfter being treated with conventional mechanical ventilation, 12 dogs were inflicted with severe smoke inhalation injury and divided into group HFOV and group HFOV+IP according to the random number table, with 6 dogs in each group. Then they received corresponding ventilation for 8 hours respectively. Blood gas analysis results (pH value, PaO2 and PaCO2 levels) and hemodynamic parameters [heart rate, mean arterial pressure (MAP), pulmonary arterial pressure (PAP), central venous pressure (CVP), cardiac output (CO)] were recorded before injury, immediately after injury, and at post ventilation hour (PVH) 2, 4, 6, and 8. The dogs of two groups were sacrificed at PVH 8. A healthy dog without any treatment and a dog with smoke inhalation injury but no subsequent treatment were sacrificed in addition. Lung tissues of all dogs were obtained for histopathological observation. Lung injury score examination was conducted in both groups. Data were processed with rank sum test, analysis of variance of repeated measurement, and LSD- t test.

RESULTS(1) The PaO2 levels in both groups were significantly decreased immediately after injury, compared with those before injury (with t values respectively 4.960, 5.310, P values all below 0.01). The PaO2 levels in both groups from PVH 2 to PVH 8 were significantly increased, compared with those observed immediately after injury (with t values from 4.930 to 6.050, P values all below 0.01). At PVH 2, 4, and 8, PaO2 levels in group HFOV+IP were significantly higher than those in group HFOV (with t values from 3.775 to 5.774, P values all below 0.01); no statistically significant differences were observed in pH value and PaCO2 level at each time point between two groups (with t values from 0.002 to 0.997, P values all above 0.05). (2) There were no statistically significant differences in MAP, PAP, and CVP within two groups at each time point (with F values from 1.316 to 4.959, P values all above 0.05). In group HFOV, heart rate from PVH 2 to PVH 8 was significantly lower than that observed immediately after injury (with t values from 3.780 to 8.970, P values all below 0.01). In group HFOV+IP, CO at PVH 4, 6, and 8 was significantly lower than that observed immediately after injury (with t values from 3.990 to 11.200, P values all below 0.01). There were no statistically significant differences in MAP, PAP, and CVP between two groups at the same time point (with t values from 0.089 to 2.123, P values all above 0.05). At PVH 4, 6, and 8, heart rate in group HFOV+IP was higher than that in group HFOV (with t values from 2.931 to 7.229, P < 0.05 or P < 0.01), while CO was lower (with t values from 4.297 to 11.206, P values all below 0.01). (3) Compared with those of the healthy dog, inflammatory cell infiltration and bleeding in the lung were observed in alveolar space in both group HFOV and group HFOV+IP, while the degree was less serious than that of the dog with smoke inhalation injury only. Compared with those of group HFOV, inflammatory cell infiltration in group HFOV+IP was less significant, the alveolar structure was relatively intact, and no thickening of alveolar walls was observed. The lung injury score in group HFOV [(3.27 ± 0.24) points] was higher than that of group HFOV+IP [(2.79 ± 0.31) points, t = 27, P < 0.05].

CONCLUSIONSHFOV combined with IP can improve gas exchange and alleviate pulmonary injury without any adverse effect on blood gas analysis or hemodynamic parameters. Therefore, it may be considered as an appropriate mode of ventilation for the treatment of smoke inhalation injury.

Animals ; Blood Gas Analysis ; Burns, Inhalation ; physiopathology ; therapy ; Disease Models, Animal ; Dogs ; Hemodynamics ; High-Frequency Ventilation ; Male ; Positive-Pressure Respiration ; Smoke ; adverse effects

OBJECTIVETo study the expression of tau-related protein in spinal cord of Chinese patients with Alzheimer's disease.

METHODSGallays-Braak stain and immunohistochemical study for tau protein (AT8) were carried out in the spinal cord tissue (T2, T8, T10, L2 and S2 segments) of 3 Chinese patients with Alzheimer's disease. Seven age-matched cases without evidence of dementia or neurologic disease were used as controls.

RESULTSNeurofibrillary tangles were identified in the neurons of anterior horn in 2 Alzheimer's disease cases but none was observed in the controls. Tau-positive axons and astroglia were detected in all Alzheimer's disease cases. Tau immunoreactivity in spinal cord of the patients correlated with that in brain tissue.

CONCLUSIONThe expression of tau-related protein is demonstrated in the spinal cord of Alzheimer's disease patients suggesting that axonal transport defect may play a role in the pathogenesis of Alzheimer's disease.

Aged ; Alzheimer Disease ; metabolism ; pathology ; Axonal Transport ; Axons ; metabolism ; pathology ; Humans ; Male ; Neurofibrillary Tangles ; metabolism ; pathology ; Phosphorylation ; Spinal Cord ; metabolism ; pathology ; tau Proteins ; metabolism