Child ; Clinical Laboratory Techniques ; Humans ; Microbiological Techniques ; Viral Load ; Virus Cultivation ; Virus Diseases ; diagnosis

Objective To evaluate the clinical significance of 18F-FDG PET/CT in localization and etiologic diagnosis of suspected pacemaker-related infection(SPRI).Methods Fifteen SPRI patients (10males,5 females,age range:45-86 years) were included in this retrospectively study.18F-FDG uptake in device-related region and abnormal 18F-FDG uptake out of the device region were visually interpreted.Final diagnosis was decided according to modified Duke's criteria and imaging interpretation.Diagnostic efficiency of 18 F-FDG PET/CT on SPRI was evaluated.Results Of 7 patients with suspected pocket infection,5 patients had hot spot of 18F-FDG in the pocket site,either in superficial skin and/or deep soft tissue.Of 9 patients with suspected infective endocarditis,a diffuse FDG uptake was demonstrated in 3 patients in the area of left atrium,right atrium,and right ventricle;another 3 patients had abnormal FDG uptake in other sites rather than in the implantation regions,and the rest 3 showed negative PET/CT results.In patients with SPRI,18F-FDG PET/CT diagnosed 7 cases of pocket infection,8 cases of infective endocarditis,14 cases of pacemaker-related infection.Conclusions 18F-FDG PET/CT imaging is useful in localization and etiologic diagnosis in SPRI patients.It might guide the clinical SPRI management.

Child, Preschool ; Diagnosis, Differential ; Humans ; Male ; Myositis Ossificans ; diagnosis ; diagnostic imaging ; pathology ; physiopathology ; Prognosis ; Tomography, X-Ray Computed

Objective To investigate the value of 99Tcm-MDP imaging for the differential diagnosis between infection and aseptic loosening after total hip arthroplasty.Methods During February 2008 to August 2011,74 patients (32 males,42 females,average age (64.3±11.2) years) with hip pain after arthroplasty underwent 3-phase (blood flow,blood pool and bone phases) 99Tcm-MDP imaging.All patients had measurements of serum C reactive protein (CRP) and erythrocyte sedimentation rate (ESR).Joint infection was defined as either increased peri-prosthetic soft tissue activity during perfusion and blood pool phases or increased peri-prosthetic bone activity during uptake phase,or positive in all 3 phases.Aseptic loosening was defined as having negative 99Tcm-MDP in all 3 phases.Clinical diagnosis was chosen as the gold standard.The blood flow-pool imaging was compared with the serum examinations.x2 test was used for statistical analysis.Results There were 74 symptomatic joints in 74 patients,including 24 joint infections and 50 aseptic loosening.For the detection of peri-prosthetic infection,combined perfusion-blood-pool phase was more accurate than bone uptake phase (90.5％ (67/74) vs 55.4％ (41/74) ;x2=23.159,P＜0.001),with the sensitivity of 91.7％ (22/24)vs 70.8％ (17/24) and specificity of 90.0％ (45/50) vs 48.0％ (24/50),respectively.The blood flow-pool imaging was also more accurate than CRP (73.0％ (54/74) ;x2 =7.656,P＜0.05) and ESR (71.6％ (53/74) ; x2 =8.633,P＜0.05),respectively.Conclusion 99Tcm-MDP perfusion/blood flow-pool imaging is an accurate modality for differentiating peri-prosthetic infection from aseptic loosening in patients with hip pain after arthroplasty.

Objective To investigate the correlation of the vascular endothelial growth factor (VEGF) gene variations in the promoter region with the sporadic Alzheimer' s disease (SAD) in Chinese Han population for better understanding the mechanism of SAD. MethodsThe polymorphisms of 279 SAD Chinese Han patients from Northern China were analyzed by comparing with those from 317 healthy individuals using the method of polymeraee chain reaction-restriction fragment length polymorphism ( PCR-RFLP) or direct sequencing.The commercial statistics package SPSS 11.5 was used to compare the distribution of the allele and the genotype, and to analyze their correlations with SAD. ResultsThree polymorphism sites were found for the VEGF promoters in the Chinese Han sample group including -2578C/A,- 2549I/D and- 1154G/A.- 2549I/D and- 2578C/A exhibiting strong linkage disequilibrium. Individuals with the A allele at position -2578 had an insertion of 18 nucleotides at -2459I/D, whereas CC homozygotes did not contain th es were found between the SAD patients and the controls in the 3 VEGF polymorphisms. After adjusting the data for gender, age and the ApoE ε4 allele using Logistic regression, the - 1154G/G genotype of the VEGF promoter might increase the risk of SAD in Chinese Han population.Among the subgroup without the ApoE ε4 allele, -2549D/-1154G haplotype might increase the risk for SAD (OR = 1.325, 95％ CI 1.023--1.716, P=0.033). ConclusionsThree polymorphism sites ( -2578C/A, -254911D, and -1154G/A) are found in the VEGF promoter regions in Chinese Han population. The-1154G/G genotype of the VEGF promote appears to increase the risk of SAD in Chinese Han population.In the absence of ApoE ε4, the -2549D/-1154G haplotype of the VEGF promoter appears to affect the risk for SAD.

Objective To report the clinical and magnetic resonance imaging(MRI)features of 5 eases with idiopathic orbital myositis.Methods Four females and one male,aged 27 to 57 years,presented department of neurology in the First Hospital of Peking University in October 2008 to September 2009.The duration of disease Was between 3 months and 4 years.Recurrent course appeared in 3 of them.0rbital MRI Was performed in all of them.After diagnosis they underwent long.term corticosteroid treatment.Results All patients presented ocular pain,asymmetrical and incomplete ophthalmoplegia and mild proptosis.EMG revealed no significant decline in repetitive stimulation.Muscle biopsies of limb muscle were unremarkable.Creatine kinase and thyroid function test were in normal limits.MRI revealed unilateral.focal or difluse enlargement and enhancement of extraocular muscles,involving 1 extraocular muscle in 2 cases,2extraocular muscles in 2 cases,more extraocular muscles in 1 case.No evidence indicated bone destruction or cavernous sinus abnormalities.Five Cases showed improvement and remission after long-term administration of steroids.Conclusion Persistent and asymmetrical ophthalmoplegia is connnon in orbital myositis.Extraocular muscle swelling characterized the MRI changes.

To investigate the status of application of Chinese Hypertension Prevention and Treatment Guideline (Guideline) by general practitioners (GPs) in Shanghai.A questionnaire survey was conducted among 260 GPs from 8 communities in Xuhui District of Shanghai during March 2011 to December 2012.Among all participants,94.2％ knew the Guideline.The overall correct rate was 56.2％; that of epidemiology,diagnosis,treatment,two-way referral and community management of hypertension was 49.2％,54.5％,60.6％,56.9％ and 32.3％,respectively.There were significant differences in correct rates of the questionnaire between GPs with different age,gender,education and community (P =0.000,0.035,0.000,0.000).The correct rates of epidemiology and treatment in GP teaching bases (58.5％ and 62.6％) were higher than those in non-teaching bases (39.2％ and 58.4％) (P =0.002,0.040).But there was no difference in overall correct rate between these two groups (P =0.095).The results indicate that the understanding and application of Hypertension Guideline by General practitioners in community is insufficient.Teaching hospitals should carry out systematic,comprehensive,sustained,targeted training course in order to improve the diagnosis and treatment levels of hypertension for general practitioners in community.

Objective To evaluate skin barrier function in patients with atopic dermatitis (AD),and to assess its relationship with claudin-1 expression.Methods Totally,11 patients with AD and 11 healthy human controls were recruited in this study.A Tewameter TM210 was used to measure transepidermal water loss (TEWL) value,and high-frequency ultrasound to determine epidermal thickness and density,in lesional and non-lesional skin of the patients and normal skin of the healthy controls.A double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) was performed to determine the serum level of free claudin-1 in these subjects.One-way analysis of variance and t test were carried out to compare these parameters in different groups,and Pearson's correlation analysis to estimate the relationship between different parameters.Results The TEWL value was significantly higher in lesional skin than in nonlesional skin of patients with AD and normal skin of the healthy controls ((36.9 ± 34.2) vs.(9.1 ± 6.0) and (4.4 ± 3.1) g·m-2·h-1,both P＜ 0.05).The epidermal thickness in AD lesions was (0.23 ± 0.04) mm,significantly higher than that in nonlesional skin ((0.18 ± 0.03) mm,P ＜ 0.01) and normal control skin ((0.18 ± 0.02) mm,P ＜ 0.01).Ultrasound images revealed a characteristic subepidermal low echo-genic band in the AD lesions.The patients with AD showed a significantly lower serum level of claudin-1 compared with the healthy controls ((0.80 ± 0.88) vs.(1.73 ± 1.85) μg/L,P ＜ 0.05).Moreover,the serum level of claudin-1 was negatively correlated with epidermal thickness (r =-0.61,P ＜ 0.01),but positively correlated with the inverse of TEWL (1/TEWL,r =0.44,P ＜ 0.05).Conclusions The impaired skin barrier function,which may be evaluated by TEWL,1/TEWL and epidermal thickness,is associated with the expression of claudin-1 in patients with AD.

Objective To explore the relationship between TLR3 mRNA expression on peripheral blood mononuclear cells(PBMCs)and acute rotavirus(RV)diarrhea.Methods Sixty-one children with acute RV diarrhea served as study subject,the expression of TLR3 mRNA on PBMCs was detected by real-time fluorescence quantitative RT-PCR.the concentrations of IFN-γand TNF-α in serum were measured by the method of Enzyrme-linked immunosorbent assay(EUSA).Results The expression of TLR3 on PBMCs and the serum levels of IFN-γ and TNF-α in the serious diarrhea group were 0. 820±0.051,(33.67±12.88)Pg/ml, (62.21±14.65)pg/ml,respectively,while it were 0.717±0.040,(24.01±10.06)pg/ml,(50.99± 12.18)pg/ml in the slight diarrhea group,and 0.525±0.029,(12.52±5.19)pg/ml,(28.65±7.44)pg/ml in the control group.Compared with the control group.the expression of TLR3 on PBMCs and the serum levels of IFN-γ,TNF-α in the serious and slight diarrhea group were significantly higher(P<0.01).There were significant differences between the serious and slight diarrhea group(P<0.01).There were positive relationship between the expression of TLR3 on PBMCs and tHe serum IFN-γ,TNF-α levels(r=0.431,P< 0.05,r=0.372,P<0.05).Conclusion The expression of TLR3 on PBMCs in children with acute rotavirus dialThea iS up-regulated,TLR3 and its mediated immune response are associated with the development of acute rotavirus diarrhea.

AIM To investigate the effect of allicin on the regulation of VEGF mRNA expression in human hepatocellular carcinoma cells. METHODS Hepatocellular carcinoma cells were treated with the concentration 10 ?g?L -1 allicin in culture medium,and then the relative VEGF mRNA level at 8 h in human hepatocellular carcinoma cells was evaluated by reverse transcriptase polymerase chain reaction using HPRT(hypoxanthine phosphoribosyltransferase)as an internal control standard. RESULTS The expression of VEGF gene mRNA was inhibited obviously by allicin. Compared with control group, the relative expression level of VEGF gene mRNA was decreased by about 66 36%( P