Objective To investigate the prevalence of and risk factors for neurosyphilis in syphilitic patients with persistently positive nontreponemal serological tests after regular therapy.Methods Clinical data were collected from 248 syphilitic patients with persistently positive nontreponemal serological tests after regular therapy,and analyzed retrospectively.Univariate analysis,multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed to assess factors associated with neurosyphilis.Results Of the 248 patients,25 (10.1％) were diagnosed with neurosyphilis.As univariate analysis showed,the occurrence of neurosyphilis was associated with the degree of decline in serum toluidine red unheated serum test (TRUST) titers (x2 =20.663,P ＜ 0.05) and persistent positive serum TRUST titers (Z =-7.021,P ＜ 0.05),but not with gender,age,stage of syphilis,treatment protocols,initial serum TRUST titers,or the presence or obsence of neurological symptoms (P ＞ 0.05).Multivariate logistic regression analysis revealed that persistent positive serum TRUST titers were a risk factor for neurosyphilis (OR =4.685,95％ CI =2.552-8.601,P ＜ 0.05).ROC curve analysis showed that the best cut-off point of persistent positive serum TRUST titer was 1 ∶ 8 for predicting neurosyphilis,with the area under the curve (AUC) being 0.907.Conclusion Serum TRUST titers are somewhat valuable for predicting neurosyphilis in syphilitic patients after regular therapy.

Objective To investigate the relationship between diameter and drainage territory of tributaries of the hepatic vein and the clinical value of hepatic venous drainage territory evaluation before LDLT.Methods MSCT covering abdomen was performed on 68 donors.The images were transported and reconstructed in GE Advantage Windows 4.2 workplace and IQQA-liver CT images readout and analytical system.The tributaries of hepatic vein were marked,and the diameter and drainage territory were measured.Functional hepatic volume (FHV),and effective hepatic volume (EfHV) of donors and recipients according to the hepatic venous reconstruction results during the operation were calculated.The corresponding graft-to-recipient body weight ratio of recipients was calculated.Results In the tributaries of 220 hepatic veins studied,the coefficient correlation of diameter and drainage territory was 0.752 (P≤0.01),but there was significant difference in the drainage territory of the veins with same diameter.By using Chi-square analysis,venous diameter and drainage territory are classified and statistical frequency by 5 mm and 50 cm3 respectively,and there was statistically significant difference between them (X2 =61.97,P＜0.01).The mean value of drainage territory of RHV (RHVV) was 510.80 ± 168.33 cm3,and that of RFHV (drainage territory with reconstructed IRHV added) was 577.26± 156.72 cm3 respectively.The mean value of drainage territory of LHV (LHVV) was 292.70 ± 76.61 cm3,and that of LFHV (drainage territory with Ⅳ segment tributaries of MHV added) was 551.26 ± 111.82 cm3 respectively.In 25 grafts without MHV,the mean value of drainage territory of EfHV was 405.52-1038.43 cm3.In 43 donors donating grafts with MHV,the mean value of drainage territory of EfHV was 175.35-575.35 cm3.Conclusion There is significant difference in drainage territory of same diameter veins.Bigger diameter doesn't always mean bigger drainage territory.Hepatic vein drainage territory evaluation before LDLT has important clinical significance to formulate surgery scheme.

In 2012, a new SARS-like coronavirus emerged in the Middle East, namely the Middle East respiratory syndrome coronavirus (MERS-CoV). It has caused outbreaks with high mortality. During infection of target cell, MERS-CoV S protein S1 subunit binds to the cellular receptor (DPP4), and its S2 subunit HR1 and HR2 regions intact with each other to form a stable six-helix bundle to mediate the fusion between virus and target cell membranes. Hence, blocking the process of six-helix bundle formation can effectively inhibit MERS-CoV entry into the target cells. This review focuses on the recent advance in the development of peptidic entry inhibitors targeting the MERS-CoV S2 subunit.
Antiviral Agents ; pharmacology ; Coronavirus Infections ; drug therapy ; Dipeptidyl Peptidase 4 ; metabolism ; Drug Design ; Humans ; Middle East Respiratory Syndrome Coronavirus ; drug effects ; physiology ; Peptides ; pharmacology ; Spike Glycoprotein, Coronavirus ; metabolism ; Virus Internalization ; drug effects

AIM: To evaluate the different conditions inducing mouse embryonic stem cells (ESC) in vitro to differentiate into cardiomyocytes. METHODS: BRL conditioned medium was used to promote the growth of ESC and maintain them in an undifferentiated state. During the inducing process, retinoic acid (RA), DMSO, activin-A and TGF-? 1 were used as inducing reagents, and made up six kinds of differentiating medium. Then a three-step method inducing ESC cultured in hanging drops, in suspension and in plating was used to induce the differentiation of ESC. RESULTS: ESC were induced in vitro to differentiate into cardiomyocytes. Of all groups, the highest differentiating rate was observed in the group induced by activin-A (20 ?g/L) and TGF-? 1 (2 ?g/L). CONCLUSION: The inducing conditions including activin-A (20 ?g/L) and TGF-? 1 (2 ?g/L) is very valuable in inducing ESC differentiation into cardiomyocytes. [

Objective To summarize our experience in prevention and treatment of stricture after esopageal burns in the past thirty years.Methods There were 168 cases in this series.Of them,158 cases underwent surgical management in this study.Modified intraluminal stenting was used in 34 cases, colon interposition without resection of strictured esophagus in 77 cases,gastric transposion with resection of the stricture in 27,repair of cervical stricture with platysma myocutaneous flap in 22,and miscellane- ous operation in 12.Eleven cases experienced operation twice or more at our department.Results Twenty-nine cases recovered after treatment with intraluminal stenting,and 5 re-experienced stricture after stent removal.One of the 5 cases with failed stent responded to bougienage,and the remaining 4 cases re- quired esophageal reconstruction later.Of the 77 colon interpositions,5 cases died postoperatively,and complications of cervical anastomotic fistula occurred in 14 cases,anastomotic stenosis in 4,and abdomi- nal incision dehiscence in 2 cases.In the 27 cases with gastric transpositions,postoperative complications of anastomotic stricture occurred in 2 cases and empyema in 1 patient.There was a cervical leak in 3 ca- ses of the 22 cases treated with the repair of cervical esopageal or anastomotic stricture with a platysma myocutaneous flap.In the 12 cases treated with miscellaneous operation,one died of intestinal obstruc- tion.All the survivors had regular diet after discharge.Conclusions Intraluminal stenting can prevent the formation of caustic esophageal stricture.The location of the cicatricial esophagus dictates whether to perform concomitant esophagectomy during esophageal reconstruction.Platysma myocutaneous flap repair is an excellent method for the treatment of severe cervical esophageal or anastomotic stricture.

Objective Establish an overall performance evaluation index system for innovative medical devices transforming project,a major science and technology project in Zhejiang province.Methods The weight of indexes was calculated using Delphi method,analytic hierarchy process and weight of percentile method.Results A three-level performance evaluation index system was established.First level included 3 indexes,as condition index,process index and result index,with weight of 0.3401、0.4042 and 0.2557 respectively.Meanwhile,second level and third level included 13 and 38 indexes.Conclusions The index system provide a performance evaluation tool for the innovative medical devices transforming project.

Objective: To investigate the correlation between mild cognitive impairment (MCI) and bone metabolism level in the elderly. Methods: Fifty patients with MCI and ninety controls with normal cognitive function were recruited from Department of Gerontology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Plasma levels of calcium and phosphorus metabolism indicators, bone resorption markers and bone formation markers were measured. Cognitive function was assessed by mini mental state examination (MMSE) and Montreal cognitive assessment (MoCA). Results: Plasma level of osteocalcin was elevated in patients with MCI (P=0.001) compared with controls, while plasma level of calcium was decreased in the MCI group (P=0.045). Among patients with MCI, the score of MMSE positively correlated with plasma level of 25-hydroxy vitamin D3 (r=0.290, P=0.041), while negatively correlated with plasma level of parathyroid hormone (r=-0.349, P=0.025). Conclusion: MCI may be correlated with bone metabolism level in the elderly.

OBJECTIVETo study the syndrome of inappropriate ADH secretion (SIADH) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and the possible etiology.

METHODSThe clinical manifestation, laboratory examination, treatment and outcome of a patient with refractory anemia with excess blasts after allo-HSCT were presented.

RESULTSHyperacute graft-versus-host disease (GVHD) was developed in the patient after allo-HSCT followed by severe hyponatraemia (lowest serum sodium 103.7 mmol/L), natriuresis, hypo-osmolality of plasma, hyper-osmolality of urine, coma and twitch at day 17 after allo-HSCT. SIADH was diagnosed. The clinical condition was improved after restriction of water and administration of hypertonic saline, but SIADH was not controlled completely. Afterwards, graft failure was developed. Hyperacute GVHD and graft rejection occurred again after the second transplant. The patient died of secondary infection.

CONCLUSIONSIADH after allo-HSCT is a rare fatal acute complication of central nervous system. Numerous transplant-related causes are probably associated with the development of SIADH. Early accurate diagnosis and treatment promptly is of great importance.

Adolescent ; Graft vs Host Disease ; prevention & control ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Inappropriate ADH Syndrome ; etiology ; Male ; Transplantation Conditioning ; Transplantation, Homologous

Objective To explore the ameliorative effects of standardized tertiary rehabilitation(STR)on the quality of life(QOL)of stroke patients with hemiplegia.Methods Eighty-two stroke patients were randomly divided into two groups:a rehabilitation group(R group)and a control group.All patients were given routine inter- nal medicine treatment,but STR was also administered to the R group.The QOL of all of the patients was assessed with the brief scale of quality of life(QOL-BREF)at the beginning,and at the end of the Ist month,3rd month and 6th month after stroke.Results There were two deaths in the control group,but no deaths in the R group.At ever- y stage,the R group returned better scores for physiological health,psychological state,social and environment rela- tionships,the subjective QOL and health items,and in comprehensive self-evaluation.QOL scores,except for social relationships,were consistently,significantly higher in the R group.The R group's QOL scores improved obviously in the first 3 months after stroke,and then more slowly in the next 3 months.Conclusions STR markedly improved the QOL of stroke patients.Their QOL scores improved obviously soon after stroke,but slowly later on.

Objective　To explore the effect of video-assi sted thoracic surgery (VATS) on common diseases of chest. Methods　Video-assisted thoracoscopic surgery was performed on 131 patients with ches t diseases from April 1994 to December 2000 in which 109 cases were spontane ous pneumothorax and hemothorax, 10 pulmonary tuberculoma, 5 pulmonary carcinoma , 3 esophageal carcinoma, 2 localized benign mesothelioma, 1 pulmonary hamartoma and 1 myasthenia gravis. Results　There was no operative death in all cases. Four patients with spontaneous pneumothorax complicated persist ent air leak(more than 7 d) and 1 patient with hemopneumothorax formed hemoth orax after the operation, which was stopped by the second VATS. The others recov ered well without any postoperative complications. Conclusion　 VATS is characterized by safety and mild tissue injury in the operation, and les s pain, fewer complications, rapid recovery and short duration of hospitalizatio n after the operation.