Objective To systematically review the literature evaluating efficacy and adverse events of propranolol for infantile hemangiomas (IHs).Methods We searched the Cochrane,Medline,Wiley,CNKI and Wanfang Databases for all studies on the response of IHs to propranolol only which were published between June 2008 and May 2013.Results A total of 23 studies were collected,including 14 case reports and 2 follow-up studies which were without random and control;another 6 studies were clinical controlled trials and 1 study was RCT.Total 716 patients were included,and never received other treatments before propranolol.Propranolol was initiated at a mean age of (4.5 ± 0.5)months at a mean dose of 2.1 mg/kg/day and for a mean treatment duration of (9.7±9.2) months.The effective rate for patients with IHs treated with propranolol was 97％ (691/716),and patients after treatment completion reported IHs recurred in 8.6 ％ of patients.The adverse effects rate was 31％(223/7167) which most common adverse events were changes in sleep (n=35),gastrointestinal reaction (n =52) and decreased heart rate (n =73),and 5 patients discontinued the treatment because of the serious adverse events.Conclusions This systematic review of 716 patients treated with propranolol for IHs show a high rate of efficacy and a low rate of serious adverse events,and it is a better treatment of infantile hemangioma,but we should pay more attention to the serious adverse events and strictly select indications.

Objective To analyze the clinical features and the application of bronchoscopy in diagnosis and treatment of children with bronchiectasis.Methods All cases with bronchiectasis were collected from in-patient department of the Children's Hospital Affiliated to Nanjing Medical University from December 2011 to November 2015.Clinical manifestations,results of bronchoscopy examination were retrospectively analyzed.Results Of the 33 children,32 cases (97.0％) had chronic cough and sputum.Lung infection was the main cause (50％,16/33 cases).High resolution CT showed signet ring sign and/or double-track sign in lungs,and bronchiectatic lesions were most commonly found in the lower lobes (60.6％).Eighteen cases underwent bronchoscope ciliary biopsy,and the number of cilia decrease was found in 2 cases,and cilia ultrastructure abnormalities were found in 6 cases,with 2 cases diagnosed as Kartagener syndrome.The treatment included the following:treatment of the underlying disease,aggressive treatment of infections,promotion of mucociliary clearance,and bronchoscopy.The symptoms of the most patients were relieved through the symptomatic treatment.Follow-ups after discharge,showed that 15 cases had a slight cough without obvious sputum,11 cases with recurrent lung infections,regular bronchoscope lavage treatment;4 cases underwent surgical lung resection and recovered well postoperative,and 2 cases died.Conclusion The bronchoscopy should be performed early in the children with bronchiectasis,which can clearly detect pathogens and causes,so as to undertake lavage treatment to improve clinical symptoms.

The humanistic nature of medicine determines that medical humanistic quality training must be car-ried out in the education of excellent doctors. Based on the requirements of excellent doctor"with the aim to culti-vate position competency", Yangtze University, as a pilot institution for the reform of excellent doctors training mode, adopts a comprehensive training mode of medical humanistic quality, incorporates the cultivation of excellent doctors ' medical humanistic quality into the teaching plan to ensure the implementation of medical humanistic qual-ity cultivation institutionally;sets up general education, imparts humanistic knowledge and strengthens humanistic cultivation;integrates medical humanistic quality education into professional education to elevate the height of ex-cellent doctors' medical humanistic quality; integrates medical humanistic quality into clinical practice as an im-portant clinical ability;reforms teaching methods of medical humanistic quality and emphasizes the quality of medi-cal humanistic education, and carries out the student characteristic activity of"Xinglin Cultural Festival"and"The 8 One" to shape the student healthy personality and cultivate their healthy psychology.

Objective:A new algorithm based on Hough transform (HT) was proposed to improve the accuracy and stability of the film image analysis of Automatic Quality Assurance (AQA) test, and to explore the influence of the resolution of film image on the test results.Methods:Nine pairs of films were obtained for AQA modules in this study. Firstly, the median filter was used to preprocess the grayed-out film image to remove noise interference. Then, a global threshold was utilized to binarize the image. The images were edge-detected and the film edge line was extracted by Hough transform. The film image was transformed to the correct position. Finally, the edge of the field shadow circle and the shadow circle of the tungsten ball were extracted by the edge detection method and Hough transform. The radial error was finally obtained by analyzing the concentricity.Results:There was no significant difference in the accuracy between the test results yielded by the HT method and the AQA software ( P>0.05). The difference in the standard deviation of the test results was statistically significant ( P=0.027), indicating that the algorithm increased the stability while ensuring the accuracy of film analysis. Increasing the resolution of film scanning failed to significantly improve the accuracy and stability of film analysis in both two methods. Conclusions:The algorithm used in this study can eliminate the human error caused by film scanning placement while ensuring the accuracy of film analysis, providing a more stable way for the AQA test of the CyberKnife system.

OBJECTIVETo analyze the genetic relations of Shigella isolated from Shenzhen in 2001-2006 and develop primary molecular subtyping surveillance network of Shigella.

METHODSChromosomal DNAs from 55 isolated in agarose were digested with the restriction enzyme Xba I, and then were analyzed by pulsed-field gel electrophoresis. Pulsed-field gel electrophoresis (PFGE) patterns were clustered using BioNumerics software.

RESULTSAll 41 distinctive PFGE patterns were identified among 55 strains. 32 strains belonged to one cluster. Differences were observed in other strains.

CONCLUSIONBoth genetic-related clones and non-related clones of Shigella existed in Shenzhen. The development of PFGE molecular subtyping surveillance network would contribute to the active surveillance, outbreak investigation and source tracking for Shigellosis.

Bacterial Typing Techniques ; China ; Electrophoresis, Gel, Pulsed-Field ; methods ; Feces ; microbiology ; Humans ; Shigella ; classification ; isolation & purification

A total of 126 patients with type 2 diabetes mellitus were randomized into two groups:one received glimepiride 1 mg twice daily and the other 2 mg once daily.Fasing blood glucose(BG),BG 2 h after meals(breakfast,lunch and dinner)and HbA_(IC)were tested,△and standard deviation of the 4 point BG were calculated.It was found that two kinds of administration of glimepiride were equally effective in decreasing BG and once daily aministration could ease better the fluctuation of BG.

Objective To investigate the effect of recombinant chlamydiaphage phiCPG1 capsid protein Vp1 on Chlamydia trachomatis(Ct) after Vp1 was co-cultured with Ct (reference strains and clinical strains).Methods The recombinant chlamydiaphage phiCPG1 capsid protein Vp1 was expressed and purified.Equal amount of Ct standard strains (E/UW-5/Cx and D/UW-3/Cx) or clinical strains,which had been incubated with Vp1 protein at the concentration of 53 μg/ml for 3 h at room temperature,were inoculated into McCoy.After cell culture,idione stain and transmission electron microscope were used to observe the effect of Vp1 on the Ct.The effect of Vp1 protein on the cell line McCoy was determined by MTT assay,the responses of Escherichia coli BL21 and DH5α toward Vp1 protein were determined using broth microdilution assays.Results Vp1 had obviously inhibitive effect on Ct,the inhibition ratios were about 40％-70％in clinical strains,72％ in reference strain D and 78％ in E,respectively.Abnormally enlarged RBs were observed after Vp1-treatment and Vp1 could arrest chlamydial developmental cycle using electron microscope.There was no effect of Vp1 on McCoy cells or bacteria BL21 or DH5α.Conclusion The recombinant Vp1 from phiCPG1 has obviously inhibitive effect on the growth of Ct,it will be helpful for the treatment of Ct infection in clinic.

OBJECTIVETo investigate on the expression of some cytokines and other immunity makers right after the operation, the effect of femoral nailing on systemic immunity and sought to differentiate any differences between reamed and unreamed IMN.

METHODSFifty-nine patients presenting with acute femoral fractured including 55 male and 4 female, 32.1 years old on average, are divided into 2 group depend on ISS. All patients were treated by close reduction and intramedullary nail for fixation. In group 1, 23 reamed and 23 unreamed; in group 2, 7 reamed and 6 unreamed. Venous blood samples were taken at 24 hr pre-operationally, and 1 hr, 24 hr, 48 hr post operationally. Serum TNF, IL-6, IL-8, IL-10 were measured by enzyme-linked immunosorbent assay. CRP was measured by protein assay apparatus. We also collected venous samples from 22 healthy uninjured volunteers, which formed control group.

RESULTSAll immune marks were elevated post operation, for IL-6, IL-8, IL-10, this elevation began at 1 hr after operation, reached to the peak at 24 hr, and then down but never to the normal at 48 hr. For TNF and CRP, the level were raised at 24 hr, and then fallen at 48 hr. All mediators were raised significantly above the control group (< 0.05). Between reamed and unreamed patients both in group 1 and group 2, Although there was a trend towards higher levels of TNF, IL-6, IL-8, IL-10 and CRP in RFN than in the URFN, no significant difference was found except that there was a greater release of serum IL-10 in RFN than in URFN at 24 hr post operation (P = 0.047). Two patients have become SIRS, but the markers have shown no significant difference with those that have no SIRS symptoms.

CONCLUSIONSTo the patient not injured severely, using IMN for treatment will make the inflammatory mediators re-released on higher level than normal, which will be balanced by immunity itself soon, so IMN won't make any damage severely. And no significant difference were found between reamed and unreamed nail. But the changing of IL-10 show us that after IMN, especially the reamed nailing, the level of anti-inflammatory mediators will show the difference more apparently between RFN and URFN while the patient got injured more severely. Under this condition, the RFN will aggravate the restrain of immunity.

Adult ; Biomarkers ; blood ; Female ; Femoral Fractures ; immunology ; surgery ; Fracture Fixation, Intramedullary ; adverse effects ; methods ; Fractures, Closed ; immunology ; surgery ; Humans ; Interleukin-10 ; blood ; Interleukin-6 ; blood ; Interleukin-8 ; blood ; Male ; Middle Aged ; Monitoring, Immunologic ; Postoperative Period ; Tumor Necrosis Factors ; metabolism

Objective:To observe therapeutic effect of small dose spironolactone combined valsartan and amlodipine on obese patients with hypertension and its influence on serum levels of visfatin and leptin.Methods:A total of 106 obese patients with hypertension treated in our hospital from Mar 2016 to Mar 2017 were selected.They were ran-domly and equally divided into routine treatment group(received valsartan,amlodipine and routine treatment)and combined treatment group(received small dose spironolactone based on routine treatment group),both groups were continuously treated for eight weeks.Systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass in-dex(BMI),waist circumference(WC)and serum levels of aldosterone,visfatin and leptin before and after treat-ment were measured and compared between two groups.Results:Compared with before treatment,there were sig-nificant reductions in levels of SBP,DBP,serum aldosterone,visfatin and leptin in two groups after eight-week treatment,P=0.001 all;compared with routine treatment group after eight-week treatment,there were significant reductions in levels of SBP[(138.67 ± 9.34)mmHg vs.(127.52 ± 8.74)mmHg],DBP[(93.27 ± 8.26)mmHg vs. (86.43 ± 7.98)mmHg],serum aldosterone[(155.73 ± 16.43)ng/L vs.(121.49 ± 13.76)ng/L],visfatin[(28.49± 4.13)ng/ml vs.(22.31 ± 3.64)ng/ml]and leptin[(15.67 ± 4.82)ng/ml vs.(12.43 ± 3.74)ng/ml]in combined treatment group,P=0.001 all.Total effective rate of combined treatment group was significantly higher than that of routine treatment group(96.23% vs.83.02%),P=0.026. There was no significant difference in incidence rate of adverse reactions(11.32% vs.7.55%)between two groups,P=0.740. Conclusion:Small dose spironolactone combined valsartan and amlodipine possesses significant therapeutic effect on obese patients with hypertension,and it can reduce their serum levels of visfatin and leptin,which is worth extending.

Objective To study the infection status and the molecular characteristics of Vibrio parahaemolyticus isolated from diarrheal patients in Shenzhen, in 2007 to 2008 and to provide evidence for the prevention and control of diarrheal diseases caused by Vibrio parahaemolyticus. Methods More than 80 fecal specimens from four sentinel surveillance hospitals were collected and cultured each month. A total of 361 isolates of Vibrio parahaemolyticus were sero-typed and examined by real-time PCR for the presence of two major virulence genes, tdh and trh. Of 361 strains, 60 O3: K6 strains isolated from six suspected outbreaks in August, 2007 and in September, 2008 were typed by pulsed-field gel electrophoresis (PFGE). Results 4384 stool samples were detected in four sentinel surveillance hospitals and with 361 Vibrio parahaemolyticus strains isolated that belonged to 28 serotypes. Serotype O3:K6, O4:K8 and O1:KUT accounted for 67.90%, 7.50% and 6.10%, respectively. Of 361 strains, 337 strains belonged to tdh + trh- , 11 strains were tdh-trh- and 13 strains were tdh + trh +. The most prevalent serotype which caused diarrheal diseases was tdh + trh-in Shenzhen. The 60 isolates were discriminated into twenty different PFGE patterns, which belonged to three clones. Among the 60 isolates, most of the PFGE patterns of isolates from the suspected outbreak locations were identical and some strains isolated from different year were different. Conclusion Vibrio parahaemolyticus isolates in Shenzhen were dominated by O3:K6 strains. Most of these isolates carried tdh gene and few carried trh gene. Meanwhile, the identical patterns of isolates from 6 suspected outbreaks locations demonstrated that Vibrio parahaemolyticus outbreaks occurred in July 2007 and in September 2008 in Shenzhen. However, the dominated strains' PFGE patterns were different each year, indicating that the sources of Vibrio parahaemolyticus had a multiplex nature and the multiplex sources such as water, sea food and pickled products should be integrated monitored. Laboratory based surveillance of diarrheal diseases could contribute in establishing early warning system for the better prevention and control of diarrheal diseases.