Extremely severe pancytopenia induced by low dosage of azathioprine in systemic lupus erythematosus patients is rare. A 40-year-old Chinese female was diagnosed with systemic lupus erythematosus. She suffered worse erythema, oral ulceration, raised erythrocyte sedimentation rate and high anti-dsDNA in August 2013. Then she was initiated on oral azathioprine 50mg/d and extremely severe pancytopenia was seen in September 2013. She was recovered by a series of treatments. Regular monitoring of blood counts is highly recommended to reduce the possible serious myelosuppression induced by azathioprine.

The study of peptide drugs has been an important direction in research and development of new drugs. However, lots of natural macromolecular peptides are limited in clinical use by their metabolic instability and low bioavailability. In recent years, the active small peptidomimetics open up a new hotspot of peptide drug development with the characteristics of low molecular weight, high bioactivity and structural modification. Many peptidomimetics are on the market or on the clinical study. This paper elaborated the small peptidomimetics approved by American Food and Drug Administration (FDA) from 2005 to 2014, and reviewed their researching status with source, synthetic method, chemical structure, marketing time, indication, clinical efficacy and safety. Research prospects in this field were discussed.
Biomedical Research ; trends ; Peptidomimetics ; United States ; United States Food and Drug Administration

Diagnosis, Differential ; Humans ; Medicine, Chinese Traditional ; Neoplasms ; complications ; therapy

Objective To study the ultrasonographic characteristics of Wilms′tumor (WT), aims at elevating the diagnostic level.Methods We retrospectively studied sonographic features in 30 cases of WT proved by operation and pathology.Results The tumors with heterogeneous pattern of solid and cystic tissue were shown in 22 cases.Seven cases demonstrate predominantly echogenic tumor. A huge cystic mass with numerous septas was shown in 1 case. The tumor extended into renal pelvis in 4, into renal vine in 1.The tumor metastasized to lymphnod in 1, to bilateral lungs in 1. Among 30 cases, the tumor was huge and grew beyond the renal profile in 26 cases, in 3 cases the tumors took up the renal sinus and made its structure turbulence, the renal shape was approximately normal.One case was extrarenal WT,the tumor located in retroperitonemu.Conclusions Sonographically, typical WT is a large heterogeneous mass within or without cystic areas, it also can be a pure cyst. It is easy to diagnose. When the tumor is limited to renal outline, it is easy to confusion with renal cancer. In addition, there are bilateral WT and extrarenal WT. The sonographic characteristics is similar among WT, clear cell sarcoma of kidney, malignant rhabdoid tumor and congenital mesoblastic nephroma. It is difficult to distinguish them from ultrasonography.

Objective To explore the preventive effect of feedforward control on unexpected extubation in patients with cerebral apoplexy.Methods The clinical data of 42 cerebral apoplexy patients during May 2010 and May 2011 were retrospectively reviewed to find out the risk factors of unexpected extubation.The feedforward control was used to manage 49 cerebral apoplexy patients during June 2011 to June 2012 to control the risk factors.The incidence of unexpected extubation was compared between pre-and post-use of feedforward control. Results After application of feedforward control,the incidences of unexpected extubation of gastric tube,deep vein tubes and urinary tubes reduce were significantly decreased compared to pre-use of feedforward control(all P<0.01).Conclusion The feedforward control on patients with cerebral apoplexy is effective in reducing the incidence of unexpected extubation and ensuring the intubation safety.

Objective To explore the diagnostic value of the dual-energy technique with dual-source in the evaluation of therapeutic effect of interventional therapy for hepatocarcinoma.Methods 8 rabbits with tumor growing well were treated with intervention operation,paralleled with double energy CT scan and focal area image,CT and color order change were measured by dual energy liver OVERLAY workstation.Meanwhile,The necrosis and survival of tumor were evaluated by dual energy CT after hepatocarcinoma intervention therapy.Results Taking pathologic diagnosis as gold standard,compared with imaging and pathological results in the order of black,red,orange and red,accuracies were 87.2％,72.3％,71.5％ and 83.6％ respectively.Sensitivities were 95.1％,37.4％,54.7％ and 63.8％ respectively.Specificities were 85.4％,86.3％,81.5％ and 85.8％ respectively.Positive predictives value were 61.4％,54.2％,62.4％ and 55.6％ respectively.Negative predictive values were 96.3％,76.2％,79.7％ and 91.3 ％ respectively.According to the Spearman relevance analysis,there was strong positive correlation between survival of tumor cells and image color scale (r =12.35,P ＜ 0.05).Conclusion The necrosis and survival of tumor cells in rabbit VX2 liver tumor model can be preliminarily reflected by dual source CT dual energy enhancement scanning.The results provide good reference to the application of dual-source and dual-energy in clinical diagnosis and treatment.

Objective: To investigate the protective effect of dimethylsulfoxide (DMSO) on axon degeneration. Methods: Cultured rat superior cervical ganglia were treated with DMSO (100%, 10 μl) per well to disconnect axons from the cell bodies. SCGs in DMSO control group were treated with a mixture of DMSO (10 μl) and medium (2 ml) per well; in positive control group were transfected with herpes simplex virus over-expressing Wlds protein and the cell body was eliminated; and in blank control group were treated with 10 μl PBS. The separated axons were fixed with 4% poly formaldehyde at 0, 4, 8, 12 and 24 h after treatment with DMSO for immunostaining with specific antibody to microtubulin. Thus, the changes of axonal structure were investigated. The axonal protein was collected and the degeneration of neurofilament was detected by Western Blotting. Results: In DMSO disconnected group, the axonal morphology and structure showed no obvious change at 12 h post disconnection, but slight degeneration was observed at 24 h post disconnection. The degradation of microtubulin was obviously slowed down and their axonal structures maintained intact 12 h later. The neurofilament could be detected 12 h after disconnection. The above changes in disconnected group were similar to those in positive control group. No obvious protective effects on axonal degeneration were observed in blank and DMSO control groups. Conclusion: Local high concentration of DMSO can delay axonal degeneration, which indicates that DMSO can be used for adjuvant treatment of neurodegenerative diseases.

Objective To summarize the sonographic characteristics of Peutz-Jeghers syndrome in children and investigate the diagnostic value of ultrasound.Methods Retrospective analysis of sonographic characteristics of 19 cases with pathologically-confirmed Peutz-Jeghers syndrome were conducted.ResultsExcept for one child,other 18 patients all had more than one polyp with the maximum of sixteen.The polyp with the smallest size of 0.8 cm×0.5 cm×0.8 cm was found in left colic flexure,while the largest one was found in superior rectal with a measurement of 7.6 cm×2.7 cm×3.6 cm.The polyps showed radiatiform echotexture.And hypoechoic and hyperechoic components were present alternately.Blood flow was easily identified within these polyps by color Doppler sonography.Intussusceptions were observed in 11/19 patients.Among them,10 cases were located at small intestine.The sonographic finding was a concentric structure with a polyp at the top.Conclusions The sonographic appearence of Peutz-Jeghers syndrome is characteristic.Before surgery,ultrasonographic examination could achieve a accurate diagnosis for Peutz-Jeghers syndrome.

Objective To describe the sonographic appearance of mesenchymal hamartoma of the liver(MHL)and to analyze the diagnostic value of ultrasound.Methods Eleven surgically and pathologically confirmed cases of MHL from January 2005 to May 2011 in the Beijing Children′s Hospital were retrospectively reviewed.Results Ultrasound examinations showed 9 cystic hamartomas,including 7 multiseptate cystic and 2 monocystic lesions.Of the 7 multiseptate cystic hamartomas,4 had a honeycomb appearance and 3 had irregularly-distributed multiple cysts with varied septations.Of the 2 monocystic hamartomas,1 had a large cystic portion while the other was mainly solid with approximately 4% cystic portion of the tumor.Two cases in this group were solid,presenting with a well-defined homogenous mass.Conclusions Ultrasonography is an effective imaging modality for the diagnosis for MHL.A mixed or a mainly-cystic liver mass found in a child less than 2 years old should be suspicious for MHL.

This article brought forward the adverse vocational education model-organizing lower level of undergraduates to participate in the work of public health specialty. This model enhanced their understanding of this work and urged more students to devote themselves in this area. Besides, questionnaires were used to know how alumni performed and what was needed for a future professional of public health.