Objective In order to determine the effect of colchicine(Col) on the changes of serum activity of tumour necrosis factor (TNF) induced by lipopolysaccharide(LPS) in rabbits.Methods Twelve New Zealand white rabbits were equally divided into 2 groups, namely group A and group B. Rabbits in group A were intravenously administered with 0.2ml/ kg of normal saline (NS) from 67h before LPS inje ction, while those in group B were given 0.5mg/ kg of Col instead of NS at the same time course.Endotoxic shock was induced by intravevous injection of 2?g/ kg of LPS after the challenge by Bacillus Calmette Gu?rin(BCG). Results Prior infusion of Col significantly decreased the peak levels of serum TNF activity ( P

AIM: To validate the alternations of flow velocity patterns in the infarct-related artery (IRA) during no-reflow phenomenon in a canine model of acute myocardial ischemia and reperfusion by transthoracic Doppler echocardiography (TTDE) combined with myocardial contrast echocardiography (MCE) by means of administration of Albunex. METHODS: Nineteen dogs first underwent 60 min myocardial ischemia and then followed by 60 min,120 min and 180 min reperfusion ( n = 6, 6 and 7, respectively). The perfusion defect area determined by MCE at 60 min myocardial ischemia was regarded as risk area (RAMCE). The perfusion defect area defined by MCE after reperfusion was considered as no-reflow area (NRAMCE). The ratio between NRAMCE and RAMCE ≥ 25 %was regarded as the development of no-reflow phenomenon and the ratio of NRAMCE to RAMCE＜25% was considered as the myocardial reflow. The coronary flow velocity parameters in IRA were determined through TTDE. RESULTS: Two dogs died during experiment and the remaining seventeen dogs completed throughout the procedure.There were seven dogs in reflow group and ten dogs in noreflow group. No significant difference was present in reflow group between at baseline and at 60 min reperfusion in systolic peak velocity (PVs), systolic velocity time integral (VT Is), corrected systolic flow duration (cFDs),diastolic peak velocity (PVd), diastolic velocity time integral (VT Id), corrected diastolic flow duration (cFDd),diastolic deceleration rate (DDR), corrected diastolic deceleration duration (cDDD) (P＞0.05), however, a significant difference was found in no-reflow group between at baseline and at 60 min reperfusion in PVs,VTIs, cFDs, PVd, VTId and cFDd (P＜0.05). The most marked alterations during diastolic phase were the increase of DDR and reduction of cDDD. CONCLUSION: The impaired microvasculature may profoundly affect the coronary flow velocity pattern in the IRA. The increase in microvascular resistance and decrease in coronary perfused pressure can contribute to the changes.Transthoracic Doppler echocardiography combined with MCE has the capability of noninvasive assessment of coronary flow velocity pattern in the IRA during no-reflow phenomenon.

Objective To analyze the epidemiologic feature of overseas imported malaria in order to provide the evidence for improving the surveillance and control of malaria in Wuhan City. Methods The epidemiological investigation data of overseas imported malaria cases were collected and analyzed with an epidemiological method including plasmodium species epidemic fo?cus distribution domestic distribution population characteristics attack?diagnosis interval clinical grading etc. in Wuhan City from 2008 to 2013. Results A total of 240 overseas imported malaria cases were reported including 180 cases from Afri?can countries and the proportion of Plasmodium falciparum infections was 82.22% and 60 cases from Southeast Asian coun?tries and the proportion of Plasmodium vivax infections was 76.67% and the proportions of the parasite species were significant?ly different between the two regions χ2=105.53 P 0.001 . The male and young adults were dominant. there were no statisti?cal significance between clinical grading and attack?diagnosis interval Z=-0.99 P = 0.32 vocational background χ2=10.61 P=0.10 then clinical symptoms aggravated the situation was occurred more easily among the first attack cases χ2=7.66 P 0.05 and the falciparum malaria cases χ2=24.27 P 0.001 . Conclusions The overseas imported malaria cases are increasing rapidly with years and the malignant malaria cases were more than other malaria cases in Wuhan City. Therefore the surveillance and management of the returnees from malaria endemic areas should be strengthened continually.

Objective To evaluate the clinical effect of one-stage posterior-anterior approach surgery for patients with cervical fracture and dislocation combined with locked facet.Methods A retrospective review was conducted on 21 cases of cervical dislocation and fracture combined with locked facet treated by one-stage posterior-anterior approach surgery between April 2011 and December 2012.There were 16 males and 5 females at age ranging from 23 to 61 years (mean,38.3 years).Posterior unlocking reduction by partial facetectomy and lateral mass screw fixation was performed,followed by anterior decompression,internal fixation and interbody fusion by titanium meshes.Outpatient or telephone follow-up was performed to evaluate bone fusion and recovery of neurologic function.Results Mean operation time was 140 minutes (130-210 minutes) and mean blood loss was 340 ml (range,150-600 ml).All incisions got primary healing with no operation-correlated complications.Five patients complicated with severe lung infection after surgery and one died of respiratory failure two week later.Titanium meshes achieved bone fusion within 3-9 months (mean,6 months) after surgery.At a mean follow-up of 17 months (range,12-30 months),there was no implant breakage and mesh displacement or collapse.According to the American Spinal Injury Association (ASIA) score,preoperative neurologic deficit restored by mean one grade at final follow-up.Conclusion One-stage posterior-anterior approach surgery is an ideal choice for cervical fracture and dislocation combined with locked facet,for it provides unlocking reduction,canal decompression,and rigid reconstruction of the anterior-posterior column.

Objective:To observe and compare the therapeutic effect of metoprolol by routine increasing dose method and rapid titration method on acute myocardial infarction (AMI).Methods:A total of 60 inpatients,who were di-agnosed with AMI within 24h and without contraindications for metoprolol,were randomly divided into two groups:routine therapy group (received metoprolol using routine methods,the dose was added in seven days)and rapid ti-tration group (metoprolol was added in three days using titration).The dosage maintained with 190 mg/d after both groups reaching the target dose of 190mg/d;then therapeutic effects were observed in both groups.Results: ①There were no re-myocardial infarction,rehospitalization caused by heart failure and sudden death etc.in both groups;② Patients received echocardiography in outpatients after three months.Compared with routine increasing dose group,there was significant reduction in left ventricular end-diastolic diameter [LVEDd,(55.00±7.56)mm vs.(50.00± 5.81)mm]and significant rise in left ventricular ejection fraction [LVEF,(49.13 ± 10.18)% vs. (57.84±10.34)%]in rapid titration group,P <0.01 both.Conclusion:Rapid titration method could make the pa-tients rapidly reach the targeted dose of metoprolol and inhibit renin release earlier,block the renin-angiotensin sys-tem,and improve myocardial remodeling and cardiac function.

Objective Evaluating the main risk factors of thyroid cancer systematicaly,to provide reference for the further development of thyroid cancer prevention strategies.Methods Such databases as PubMed,Cochrane Library,CBM,CNKI,VIP and WanFang were searched from the date of their establishment to June 10 2016 to collect the case-control studies on thyroid cancer.After study selection,assessment and data extraction was conducted by two reviewers independently,meta-analysis was performed by using the RevMan 5.1 software.Results Nineteen studies involving 4 813 thyroid cancer patients and 6 068 comparions were selected.The results of metaanalysis showed that:the risk factors of thyroid cancer mainly included history of benign thyroid disease [odds ratio (OR) =7.31,95％ confidence interval (95％CI,4.37,12.23)],family history of thyroid cancer [OR =5.13,95％CI (3.20,8.23)],high iodine diet [(marine animal food,OR =4.15,95％CI (2.47,6.99)],CT inspection history [OR =3.99,95％CI (2.10,7.60)],Negative emotions [sulking,OR =3.31,95％CI (2.23,4.91)],BMI greater than 25 [OR =2.62,95％CI (1.73,3.97)],high pressure and anxious [OR =2.60,95％CI (1.61,4.21)],getting along with people not harmoniously [OR =2.46,95％CI (1.59,3.81)],the number of pregnancies of women more than three times [OR =2.03,95％CI (1.50,2.76)],age of menarche less than 13,14 years old [OR =1.59,95％CI (1.06,2.37)].Conclusions Thyroid benign disease history,family history of thyroid cancer,high iodine diet,CT examination,BMI greater than 25,bad mood,social interaction,number of pregnancies and other factors are the independent risk factors for thyroid cancer.Corresponding prevention and control measures should be taken according to these risk factors.

Objective:To explore the process of how depressed patients regulate themselves around the cores of mindfulness therapy-cognition, non-judgement and living in the present.Methods:The phenomenology of the qualitative research was adopted. The themes are analyzed, organized and refined through semi-structured in-depth interviews with 23 depressed patients, and using the Cloaizzi 7-step analysis.Results:A total of four themes are analyzed: multiple psychological experiences, mindfulness therapy to change thinking patterns, to promote self-identity, and to form self-coping strategies.Conclusions:Depressed patients are often passive and affected by negative emotions and automatic thoughts when they first participate in mindfulness therapy. Based on patients′ processual experience of participating in mindfulness therapy, health care professionals should focus on the patients′ self-regulation process and develop regulative strategies so as to help patients better understand and adapt to mindfulness therapy, reduce the recurrence of depression, and improve their qualities of life.

Objective:To understand the applicability of different thyroid volume correction methods for school-age children in Wuhan, and to explore the appropriate thyroid volume correction methods for school-age children in Wuhan.Methods:From May to August 2019, Hongshan, Hanyang, Hannan, Jiangxia and Dongxihu districts of Wuhan were divided into five sampling areas according to five directions: east, west, south, north and middle. One primary school was selected from each area, and 40 non-boarding students aged 8 - 10 years old (gender balanced) were selected from each primary school as survey subjects. Random urine sample and household edible salt sample were collected to detect urinary iodine and salt iodine contents, and the height, weight and thyroid volume of the children were measured. At the same time, the thyroid volume was corrected by height corrected volume index 1 (HVI1), weight and height corrected volume index (WHVI), body mass index corrected volume (BMIV), body surface area corrected volume (BSAV) and height corrected volume index 2 (HVI2).Results:A total of 1 000 children aged 8- 10 years old were investigated, including 499 boys and 501 girls; among them, there were 269, 321 and 410 children aged 8, 9 and 10 years old, respectively. The median urinary iodine was 247.50 μg/L; the median salt iodine was 23.20 mg/kg; the height, weight and thyroid volume were 140.00 (133.00, 146.00) cm, 31.00 (27.00, 37.00) kg and 2.56 (2.13, 3.21) ml, respectively. A total of 30 children with goiter were detected, and the goiter rate was 3% (30/1 000). The thyroid volumes of boys and girls were 2.57 (2.16, 3.28) and 2.56 (2.10, 3.16) ml, respectively, and the difference was not statistically significant ( U = - 0.981, P > 0.05). The thyroid volumes of children aged 8, 9 and 10 years old were 2.31 (1.98, 2.81), 2.68 (2.13, 3.30) and 2.74 (2.28, 3.35) ml, respectively, and the differences were statistically significant ( H = 47.585, P < 0.01). Spearman correlation analysis showed that the original thyroid volume was positively correlated with height and weight in children aged 8, 9 and 10 years old ( P < 0.01). After HVI1 correction, no correlation was found between thyroid volume and height in children aged 8 years old ( P > 0.05), but thyroid volume was positively correlated with weight ( P < 0.01); thyroid volume was positively correlated with height and weight in children aged 9 and 10 years old ( P < 0.01). After WHVI correction, the thyroid volumes of children aged 8, 9, and 10 years old were negatively correlated with height and weight ( P < 0.01). After BMIV correction, the thyroid volume was positively correlated with height in children aged 8, 9, and 10 years old ( P < 0.01); thyroid volume was negatively correlated with weight in children aged 10 years old ( P < 0.05). After BSAV correction, thyroid volume was positively correlated with weight in children aged 9 years old ( P < 0.05). After HVI2 correction, thyroid volume was positively correlated with weight in children aged 9 years old ( P < 0.01). The thyroid volume obtained by the 5 correction methods were all smaller than the original thyroid volume, and the thyroid volume after BSAV correction was the closest to the original thyroid volume, with a difference of 0.87% - 13.87%. Conclusions:The thyroid volume of school-age children in Wuhan is affected by age, height, and weight, judgment of goiter should be corrected for these factors. BSAV is relatively independent and stable, it can eliminate the effect of height and weight on thyroid volume. It is initially considered that BSAV is suitable for the correction of thyroid volume in school-age children in Wuhan.

Objective:To summarize the clinical characteristics, diagnosis and treatment of caspase recruitment domain-containing protein 9 (CARD9) gene deficiency associated invasive candidiasis, and report a novel mutation in CARD9 gene.Methods:The clinical characteristics, laboratory tests, treatment and the outcome of follow-up in a boy with invasive candidiasis were described. The boy′s main clinical manifestations were central nervous system infection and retroperitoneal mass. Whole-exome sequencing was performed and Sanger sequencing was verified to identify the CARD9 gene mutations in the patient and his parents. A literature search for “CARD9”and “invasive candidiasis”was conducted in PubMed, Wanfang and CNKI databases from their establishment to May 2020.Results:A 10-year-old boy suffered onset symptom of chronic diarrhea, which lasted for two months. The symptom was followed by progressive neurological symptoms such as headache, vomiting, seizures and disorder of consciousness. His unusual medical history was absent. Candida albicans were cultured several times in cerebrospinal fluid and blood, and yeast-like fungi were found in the stool high power field of vision. Cerebral magnetic resonance imaging indicated obstructive hydrocephalus and abdominal CT scan showed retroperitoneal mass and thickening of the intestinal wall. The whole-exome sequencing analyses of blood samples from the boy and his parents were performed. The results showed that there was a homozygous mutation of c.952-12_956delinsAG in the CARD9 gene, which was an unreported pathogenic mutation. This was confirmed by Sanger sequencing. There was no significant relief from intravenous combined antifungal medications. After lateral ventricular drainage surgery and injection of amphotericin B into the lateral ventricle, improvement of clinical symptoms and cerebral spinal fluid abnormalities was observed after nine weeks, and the retroperitoneal mass shrank. At follow-up after four-month oral combined antifungal medications, the child had no complaint except fatigue. However, cerebral spinal fluid analysis showed increased protein level and decreased glucose. Persistent hydrocephalus and periventricular white matter abnormal signals were revealed on the brain magnetic resonance imaging and the smaller retroperitoneal mass than before on the abdominal CT scan. In addition to this case, totally 21 cases with CARD9 gene deficiency associated invasive candidiasis have been reported worldwide, most of which featured central nervous system infections.Conclusions:CARD9 gene deficiency is an autosomal recessive primary immunodeficiency that confers human susceptibility to fungal disease. The associated invasive candidiasis often affects the central nervous system and makes the patient severely ill. Adequate systemic antifungal therapies should be given, and patients with hydrocephalus need surgical treatment. A novel mutation is reported that expands the variant diversity of CARD9 gene. For patients with unexplained invasive candidiasis, including those without a history of previous recurrent infection, genetic testing is recommended for primary immunodeficiency including CARD9 gene deficiency.

AIM: To identify the differences of gene expression between human age-related cataract and clear lenses. METHODS: The RNA were extracted from human age related cataract and clear lens epithelial cells, labeled with cy3/cy5 as probes, then were hybridized to cDNA chip containing 8 064 genes. The differential expressions of the genes were screened. Furthermore, a primary classification of these genes function was given. The expression levels of the identified genes were further evaluated by real time polymerase chain reaction. RESULTS: 286 genes expression were observed to increase and 438 genes expression were observed to decrease in cataractous lens epithelial cells as compared with normal lens. According to functional analysis, the changed genes in cataract lens are associated with lens structural components, cytoskeleton, cell cycle, apoptosis and stress responses. CONCLUSION: These data suggest that there are differences in gene expression between cataract and clear human lens epithelial cells. The majority of genes changed in cataract exhibited decreased expression. Processes associated with the down-regulated genes may reflect the inability of the lens to maintain its homeostasis and transparency.