Objective To study the early diagnostic indices of melioidosis by analyzing 49 cases. Methods Unconditional logistic regression analysis was used to analyze the clinical data of 49 cases of melioidosis and 98 cases of bacterial pneumonia who were admitted in our hospital and Peoples' Hospital of Hainan Province from December 1996 to December 2007. Their social characteristic,background diseases,clinical manifestations,laboratory findings,radiologic examination and complications were studied. Results Background disease (such as diabetes),hepatosplenomegaly,septic shock,sepsis et al were the main causes of melioidosis. Conclusion Chills,fever,hepatosplenomegaly,diabetes mellitus,septic shock and sepsis are all factors that should be considered with melioidosis.

Objective To investigate the diagnosis and treatments of delayed endolymphatic hydrops(DEH).Methods A restrospective study was conducted in 37 cases of DEH.who were tested with pure tone threshold,vestibular evoked myogenic potentials,high stimulation rate auditory brainstem response audiometry and vestibular ruction test.Conservative drug therapy was the major treatment.Results All the 37 patients had sensorineural hearing loss up to the medium-severe degrees at least.Twenty-five had hearing loss and endolymphatic hydrops on the same side,nine had contralateral type and three bilateral type.Ten cases had abnormal horizontal semicircular canal(HSCC) hydrops and saccular hydrops.Nine cases had abnormal HSCC function and nomal saccular function.Fifteen cases had abnormal saccular function and normal HSCC function.Twenty-five abnomalVEMP showed of loss of p13-n23,prolonged latencies of p13 and depressed amplitude cases with of p13-n23.18 cases were completely relieved from vertigo in a week.17 cases improved until totally relieved in two weeks,while the rest 2 cases that were subject to chemistry labyrinthectomy free of vertigo attack.Conclusion Pure tone threshold,EcochG,bithermal caloric test and vestibular evoked myogenic potentials are important diagnosis methods of delayed endolymphatic hydrops.Consevative drug therapy,especially diuretics and vascular dilation may play a major role in the treatment of delayed endolymphatic hydrops.

OBJECTIVETo explore the feasibility of human leucocyte antigen (HLA) haploidentical related T-cell undepleted allogeneic bone marrow transplantation (Allo-BMT) combined with Chinese medicine for the treatment of leukaemia.

METHODSFour patients with chronic myeloblastic leukemia (CML) and 4 with acute myeloid leukemia (AML) received allo-BMT with graft from 1 - 3 HLA-mismatched related donors. All patients were pre-treated with standardized conditioning regimen consisting of high dose Ara-c, cyclophosphamide (CY) and total body irradiation (TBI) or busulfan. Donors were given G-CSF 250 microg/d for 7 days prior to marrow harvest. To prevent GVHD, besides application of CSA and MTX, ATG 2.5 mg/kg was given everyday for 4 days before transplantation, and MMF 1.0 g per day starting from the 7th day after transplantation. Chinese medicine for replenishing qi and yin and strengthening Pi and Wei was administrated orally after transplantation.

RESULTSSuccessful haematopoietic reconstruction was seen in all patients. The median days for reaching of granulocyte >0.5 X 10(9)/L and platelet > 20 x 10(9)/L were 12 (range 10-14) and 20 (range 18-25) days respectively. GVHD of skin in various grade was seen in 7 patients, among whom only one advanced to grade IV; besides, 2 accompanied with GVHD of gut, one with hemorrhagic cystitis, one died for concurrent infection on the 81st day, and one left hospital of his own accord on the 46th day. The median follow-up duration was 18 (range 2-32) months, during this period six patients were alive in a disease-free situation.

CONCLUSIONCombined therapy of HLA haploidentical related T-cell undepleted Allo-BMT and Chinese medicine plus immunosuppressants with pre-harvest G-CSF application in doner could effectively reduce the incidence of acute severe GVHD and raise the disease-free survival rate in treating leukaemia.

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Marrow Transplantation ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Graft vs Host Disease ; prevention & control ; HLA Antigens ; genetics ; immunology ; Haplotypes ; Histocompatibility Testing ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; therapy ; Leukemia, Myeloid, Acute ; therapy ; Male ; Middle Aged ; Phytotherapy

OBJECTIVE: To study the relevance of the high stimulus rate auditory brainstem response(auditory brainstem response, ABR) test in recurrent vertigo, investigate the cause of recurrent vertigo, and provide important help for the clinical treatment. METHOD: One hundred and one cases with recurrent vertigo were retrospectively analyzed, and high stimulus rate ABR were tested and compared in attack episodes and intermittent episodes. RESULT: The abnormal difference between ABR I and V latency was selected as parameters. The abnormal rate of high stimulation ABR was 56.4% in patients with recurrent episodes of vertigo many times (2 and above), of which the highest rate was 71.9% in MV patients, and the second one was BPPV. The abnormal rate of high stimulation ABR was 14.9% in patients during medication or intermittent episodes. The abnormal rate in all groups decreased obviously as compared to attack episodes. CONCLUSION Abnormal rate of high stimulus rate ABR correlates well with recurrent vertigo significantly. The inner ear microcirculation may result in the attack of recurrent vertigo.
Adolescent ; Adult ; Aged ; Benign Paroxysmal Positional Vertigo ; Evoked Potentials, Auditory, Brain Stem ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Vertigo ; etiology ; Young Adult

Objective To observe the expression of STEAP4 gene(a novel obesity-related gene) during the period of human preadipocyte differentiation and to explore the relationship between the STEAP4 gene expression and adipocytes differentiation,adipogenesis.Methods Human preadipocytes were cultured and differentiated into the matured adipocytes in vitro.Adipocytes morphology and lipid accumulation were observed during this process.Total RNA was extracted from adipocytes at various time points (preadipocyte,Day 0,Day 4,Day 6,Day 8,Day 11,Day 14,and Day 17) and the level of STEAP4 mRNA expression was measured by fluorescent real-time quantitative reverse transcriptase-polyme-rase chain reaction(RT-PCR).Results The level of STEAP4 mRNA expression remained high in preadipocytes.In the presence of differentiation medium (Day 4),there was a transient upregulation in the expression of STEAP4 gene.After that,with the human preadipocytes being differentiated into matured adipocytes,the expression of STEAP4 mRNA was downregulated and reached the lowest level in fully differentiated adipocytes.There was a significant difference between any 2 detected phases in the level of STEAP4 mRNA expression (Pa

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Hepatic Encephalopathy ; blood ; diagnosis ; etiology ; Humans ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Proteins ; blood ; Liver Cirrhosis ; complications ; Male ; Middle Aged ; Neuropsychological Tests ; Pregnancy Proteins ; blood

OBJECTIVETo investigate the effects of Ginkgo biloba extract (EGB) on the testosterone synthesis in the Leydig cells of type 2 diabetic rats.

METHODSThirty male SD rats were equally randomised into a normal control, a type 2 diabetic and an EGB group. Morphological changes of Leydig cells were observed by light microscopy (LM) and transmission electron microscopy (TEM), concentrations of serum luteinizing hormone (LH) and testosterone (T) were determined by enzyme linked immunosorbent assay (ELISA), and the mRNA levels in the steroidogenic acute regulatory protein (StAR), cytochrome P450 side chain cleavage (P450scc), cytochrome P450 17a-hydroxylase (P450c17), 17beta-hydroxysteroid dehydrogenase 3 (17beta-HSD3) and 3beta-hydroxysteroid dehydrogenase (3beta-HSD1) from the Leydig cells were examined by RT-PCR.

RESULTSCompared with the normal control, there was a significant decrease in the number and volume of Leydig cells, the levels of serum LH and T and the expression of mRNA in StAR, P450scc, 17beta-HSD3 and 3beta-HSD1 in the type 2 diabetes group. And the expression of the P450c17 gene showed a tendency of descending, but with no significance. Compared with the type 2 diabetes group, 12 weeks of EGB treatment caused very slight pathological changes in the Leydig cells, significantly increased the concentrations of blood LH and T, markedly elevated the levels of mRNA in StAR and P450scc and induced an ascending tendency of the expressions of P450c17, 17beta-HSD3 and 3beta-HSD1.

CONCLUSIONEGB enhances testosterone synthesis and secretion of Leydig cells by reducing the impairment of the testis in type 2 diabetic rats.

17-Hydroxysteroid Dehydrogenases ; genetics ; Animals ; Cholesterol Side-Chain Cleavage Enzyme ; genetics ; Diabetes Mellitus, Type 2 ; blood ; genetics ; physiopathology ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; drug effects ; Ginkgo biloba ; chemistry ; Hydroxysteroid Dehydrogenases ; genetics ; Leydig Cells ; drug effects ; metabolism ; ultrastructure ; Luteinizing Hormone ; blood ; Male ; Microscopy, Electron, Transmission ; Phosphoproteins ; genetics ; Plant Extracts ; pharmacology ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Testosterone ; biosynthesis ; blood

OBJECTIVEStudy the improvement of locomotive faculty of dystrophin/utropin gene double knock-out mice (dko mice) by transplanting bone marrow stem cells.

METHODSThe bone marrow stem cells of C57BL/6 mice (4- to 5-weeks age) were cultured in vitro for three days, before transplanted intravenously (1.0 x 10(7) for each) into 11 dko mice (7- to 8-weeks age). The dko mice were irridiated with 7Gy gamma-ray before transplantation. 8-9 weeks after transplantation, the locomotroy function, electromyography items and expression of dystrophin in transplanted mice and controls were observed.

RESULTS8-9 weeks after transplantation, the dropping times of hauling wire were 3.09 +/- 2.47, compared with that of the control dko mice(16.78 +/- 3.60), there are distinct differences. About electromyography items, the duration of active potential and amplitude of maxim contractions were (4.99 +/- 1.62) ms and(2872 +/- 1474.33) microV, compare with those of control dko mice(3.69 +/- 0.40) ms and(1210.0 +/- 551.0) microV, respectively, about 7% fibers of the muscle tissue of transplanted dko mice expressed dystrophin protein.

CONCLUSIONS8-9 weeks after transplanted with homology bone marrow stem cells, the locomotive function and electromyography items of transplanted dko mice were obviously improved, and about 7% muscle tissue fibers of the mice expressing dystrophin protein were observed. It suggested that there is an ideal prospect for DMD therapy with bone marrow stem cells transplantation.

Animals ; Cytoskeletal Proteins ; biosynthesis ; deficiency ; genetics ; Dystrophin ; deficiency ; genetics ; Hematopoietic Stem Cell Transplantation ; Membrane Proteins ; biosynthesis ; genetics ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Motor Activity ; Muscular Dystrophy, Duchenne ; physiopathology ; surgery ; Utrophin

OBJECTIVEThe survival rate of cadaveric renal transplant in children has been improved following the development of transplantation technology and the application of immunosuppressive agents. In this study, the prognosis of renal transplantation, operative procedure and immunosuppressive agents administration in 21 children with end-stage renal disease (ESRD) were analyzed.

METHODSFrom January 1985 to December 2001, 21 patients (9 males and 12 females with a mean age of 14 +/- 2 yr, mean body weight of 33.4 kg and mean height of 136.5 cm) received renal transplantation because of ESRD were enrolled in the study. The patients with an average GFR of 8.28 ml/min were managed with dialysis for 13.4 months in average pro-transplantation. All cadaveric kidneys were from adults, which included 1 donor with one HLA mismatch, 3 with two mismatches, 5 with three mismatches and 4 with four mismatches. All transplantations were performed with anastomoses of the adults' renal artery and vein to the children's iliac externa artery and iliac externa vein. Biological inducement therapy was given in 4 cases. At the first 3 - 5 days post-transplantation, methylprednisolone was administered [7 mg/(kg.d)]. All patients received baseline diploid or triple immunosuppression therapy of cyclosporin A [6 - 8 mg/(kg.d)] or FK506 [0.18 - 0.25 mg/(kg.d)], mycophenolate mofetil [MMF 10 - 15 mg/(kg.d)] or azathioprine [1 - 3 mg/(kg.d)] and prednisone [0.4 - 0.6 mg/(kg.d)]. High-dose methylprednisolone [10 mg/(kg.d)] was administered to control the acute rejection.

RESULTSThe renal function of patients was restored 5.6 days in average after transplantations. The 1st, 3rd and 5th year survival rates of recipient/graft were 95.2%/95.2%, 86.7%/73.3% and 72.7%/63.6%, respectively. One case had super-acute renal rejection, 5 cases had acute rejection, 3 cases had delayed graft function and 3 patients died. The longest survival time was 12 years. The major complications included hypertension (47.6%), diabetes (19.4%), infection (19.4%) and drug-induced hepatic injury (14.2%). Catch-up growth was seen in most of the pediatric recipients.

CONCLUSIONRenal transplantation is the most ideal method to treat children with ESRD, and the growth of the pediatric patients will be improved after transplantation. Adult donor kidneys adapt to the school age patient. And the protocol of immunosuppressive therapy (prednisone plus MMF and FK506) should be applied.

Adolescent ; Adult ; Child ; Female ; Histocompatibility Testing ; Humans ; Kidney Failure, Chronic ; mortality ; therapy ; Kidney Transplantation ; Male ; Postoperative Care ; Preoperative Care ; Prognosis ; Survival Rate ; Time Factors

OBJECTIVETo explore the etiological factors of benign paroxysmal positional vertigo (BP-PV).

METHODSThe clinical data of 145 patients with BPPV were retrospectively reviewed. The impacts of gender and age on BPPV were analyzed. The relationship between the onset of BPPV and the internal ear ischemia was also explored.

RESULTSThe abnormality rate of auditory brainstem response (ABR) under high stimulus rate was 59.3% (86/145) in all the patients with, including 22.1% (32/145) in male and 37.2% (54/ 145) in female (P > 0.05). The abnormality rate of ABR under high stimulus rate were 37.9% (55/145) and 21.4% (31/145) in middle-aged (30-55 years) and old ( > 55 years) patients, respectively (P > 0.05).

CONCLUSIONThe onset of BPPV may relate to ischemic internal ear but is not relevant with gender and age.

Adult ; Age Factors ; Age of Onset ; Aged ; Evoked Potentials, Auditory, Brain Stem ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Time Factors ; Vertigo ; etiology ; pathology ; physiopathology ; Young Adult