Objective:To study the clinical effect of corticosteroids (C S) with small dosage in the recurrence control of pemphigus. Methods: 25 cases of pemphigus were diagnosed by clinical and pathological examinati on.They were treated with CS at 60-80 mg/d in acute stage for symptom control.Th en,the dosage of CS was decreased by 5 mg in each following 2 weeks untill it re ached 2.5 mg/2 d. The treatment of 2.5 mg/2 d was continued for 1 year and was a ssisted with tripterygium polyglycoside, compound thalidomide, compound cyclopho sphamide (compounded with total saponins of ginseng), dapsone, and/or some kidne y-supplementing herbs. The patients were followed-up for 9~16 years.Re sults:No recurrence was observed in 16 cases(64%).Recurrence was found i n 9 cases(36%),among them 7(28%) were with light symptom and 2(8%) severe. Sever e side-effect was not found in all cases. Conclusion:The recurr ence of pemphigus may be controlled without severe side-effect by long-term us e of small dosage of CS assisted with proper immuno-inhibitors, immuno-regulat ors and/or some kidney-supplementing herbs.

Objective To assess the efficacy of gonadotropin-releasing hormone analogue(GnRHa)with or without recombinant human growth hormone(rhGH)treatment in Chinese short pubertal children with non-growth hormone deficiency.Methods Of 42 short pubertal children(14 males,28 females)without growth hormone deftcieney,the average age was(11.6±0.8)year.30 children were treated with slow release GnRHa with initial dose (100μg·kg-1·d-1,28d)and maintenance dose(60-80μg·kg-1·d-1,28d)labd rgGH with initial dose(0.15IU·kg-1·d-1)and maintenance dose(0.10-0.15IU·kg-1·d-1)for at least 1year.16 of them were still ongoing till the end of the second year.12 children were treated with GnRHa alone by initial dose(100μg·kg-1·d-1,28d)and maintenance dose (60-80μg·kg-1·d-1,28d),and 7 of them remained on it for 2 years.Dynamic changes including annual growth velocity(GV),bone age(BA)/chronologic age(CA)ratio,Tanner stage,height SDS for CA (HtSDSCA),height SDS for BA(HtSDSBA),and predicted adult height (PAHSDS)were observed.Results By the end of the first year tretment with combination therapy,the following parameters:GV,HtSDSCA,HtSDSBA,and PAHSDS all increased significantly(all P<0.05).Treatment with GnRHa alone did not yield significant changes in GV,HtSDSCA,HtSDSBA,and PAHSDS(all P>0.05).Changes in GV,HtSDSBA,and PAHSDS between these two groups were statistically significant(all P<0.05).By the end of the second year treatment,in the combination group,GV slowed from 6.7 to 5.5 cm/year(P<0.05).HtSDSCA,HtSDSBA,PAHSDS increased(all P<0.05).In the group with GnRHa treatment alone,GV slowed from 4.0 to 3.6 cm/year(P>0.05).HtSDSCA,HtSDSBA,PAHSDS increased(all P>0.05).Changes in GV,HtSDSCA,HtSDSBA,and PAHSDS between these 2 groups were statistically significant respectively(all P<0.05).Conclusion This combined treatment regimen significantly impreved the growth by increasing growth rate and delaying bone matumtion in pubertal chidren without growth hormone deficiency.Further study is needed to verify beneficial effects on the final height gain.

Objective To develop an HPLC method for the measurement of n-3 fatty acid index of serum cholesteryl esters.Methods Serum triglycerides were hydrolyzed with ethanolic sodium hydroxide and cholesteryl esters (CEs) were extracted with hexane.The extracted CEs were analyzed by reversed phase HPLC with a UV detection at 205 nm.Cholesteryl eicosapentaenoate and docosahexaenoate ( major n-3 fatty acid cholesteryl esters) were identified by liquid chromatography-tandem mass spectrometry and cholesterol in each CE fraction was measured.Peak areas of CEs were corrected for cholesterol and CE n-3 index was calculated using the corrected peak area and expressed as the percentage of n-3 fatty acid CEs in total CEs.Results The HPLC analysis can be finished in 6 minutes.Triglycerides which interfere with the determination of n-3 fatty acid index, were hydrolyzed with ethanolic sodium hydroxide (4 mol/L) in 30 seconds.The within-run and total CVs for CE n-3 index averaged 0.66% and 0.90%, respectively.CE n-3 indexes of 70 volunteers and 36 coronary heart disease patients apparently healthy subjects and patients with coronary heart disease in Beijing Hospital appeared to be positively skewed and leptokurtic distribution ( skewness = 1.25, kurtosis = 1.70 ).The median of n-3 indices were 0.98% ( 0.37% - 2.40% ).The logarithm of n-3 index appeared to be normal distribution and the average is 0.003 7% with standard deviations of 0.15.The distribution of n-3 indices of gender groups was similar with the total.The medians of females and males were 1.08% (0.60% -2.40%) and 0.95% (0.37% -2.11%) respectively, and the former were significantly higher than the latter( t = - 3.021, P = 0.003 ).Conclusion A new method for the measurement of n-3 index of serum cholesteryl esters by HPLC has been established.It is simple and precise and can be used in predicting cardiovascular diseases risks and monitoring dietary intake of n-3 fatty acids.

Objective To study the influence factors of real-time shear wave elastography(SWE) on the elasticity of focal liver lesions (FLLs) measurement.Methods The mean Young's modulus of 160 FLLs were measured by SWE.The relation between elasticity with different aspects of FLLs were analyzed including postures (supine and left lateral position),respiratory phases (end of inspiratory and expiratory),the probe position (rib and intercostal space) and different operators.Results There were significant differences between different postures and respiratory phases in the elasticity measurement of FLLs by SWE (P ＜0.05).There was no significant difference between robe position and different operators in the elasticity measurement of FLLs by SWE(P ＞0.05).Conclusions The postures and respiratory phases can impact the elasticity measurement of FLLs by SWE.

Objective:To analyze the serum IgG titers to Aggregatibacter actinomycetemcomitans ( Aa ) and associated factors in patients with aggressive periodontitis (AgP).Methods:Venous blood samples were collected from 62 AgP patients and 45 periodontal healthy controls , unstimulated whole saliva and pooled subgingival plaque samples of AgP patients were also collected for the detection of Aa ( PCR method) .Serum IgG titers to Aa serotype c were measured by enzyme-linked immunosorbnent assay ( ELISA) .Results:The detection rates of serum IgG to Aa serotype c in the AgP patients and the healthy controls were both 100%.The AgP patients exhibited significantly higher IgG titers to Aa serotype c than the healthy controls (11.1 ±1.9 vs.9.1 ±1.8, P<0.01).There was no significant difference in serum IgG levels to Aa serotype c and in the prevalence of high-responding patients to Aa serotype c between the incisor-first molar type AgP patients and generalized AgP patients .Serum IgG titers to Aa serotype c in the Aa-positive AgP patients ( the patients who were Aa-positive in subgingival plaque or saliva ) were sig-nificantly higher than those of the Aa-negative patients (11.9 ±1.3 vs.10.7 ±2.1, P<0.05).Con-clusion:Serotype c was the main serotype of Aa in Chinese patients with AgP .Serum IgG responses in generalized AgP patients were comparable to those in incisor-first molar type AgP patients .

Objective To investigate the clinical value of the acoustic radiation force impulse imaging (ARFI) in the quantitative evaluation of fibrosis staging in chronic hepatitis B .Methods A total of 373 patients with chronic hepatitis B were grouped in accordance with the depth of the right anterior lobe and posterior lobe of the liver and underwent ARFI to measure ARFI values .Liver biopsy was performed in all patients to investigate the relationship between liver fibrosis stages and ARFI values in different groups . Results The ARFI values in different pathological grades with the same depth of the right anterior and right posterior lobe of the liver were statistically significant ( P < 0 0.01);the ARFI values between the middle and deep parts of the right anterior lobe and the same location of the right posterior lobe were statistically significant ( P <0 0.1);for the right anterior lobe ,the ARFI value of the shallow part showed statistical significance from that of the middle and the deep part ( P < 0 0.5 ) .Receiver operating characteristic (ROC) curve analysis for different sampling locations showed that the largest area under the ROC curve ,which was 0 8.18 ,existed in the middle part of the right anterior lobe ,indicating that it could be the optimal sampling location for the measurement of ARFI values .Liver stiffness at ARFI imaging was significantly correlated with liver fibrosis stage in chronic hepatitis B and spearman coefficient of correlation was 0 5.30 ( P <0 0.01) .The areas under the ROC curves for the chronic hepatitis B patients with severe liver fibrosis (≥ S3) and early cirrhosis (= S4) were 0 8.18 and 0 8.60 ,respectively .Conclusions ARFI imaging was promising for clinical application and could be utilized as a noninvasive method for the quantitative evaluation of fibrosis staging in chronic hepatitis B .

ObjectiveTo explore the association between hepatic steatosis and the liver tissue expression of HBsAg and HBcAg in chronic hepatitis B (CHB) patients.MethodsFrom January 2005 to June 2008,a total of 147 CHB patients with hepatic steatosis diagnosed by liver biopsy and other 149 CHB patients without hepatic steatosis but with similar HBV DNA titer were enrolled.The differences of HBsAg and HBcAg immunostaining and liver injury in these two groups were compared.The data were analysed using t test and chi square test.ResultsCompared with non-steatosis group,the average age and body weight index of hepatic steatosis group were higher (t values were -3.31and -6.57,both P＜0.01).The percentage of moderate to severe hepatic inflammation in liver,obvious hepatic fibrosis and the strong positive HBsAg staining was lower (30.6％ vs 15.4％ ； 26.5％vs 12.8％； 23.1 ％ vs 6.7 ％； x2=9.63,8.92,15.76； all P＜0.01),and the percentage of strong positive HBcAg staining was also in downtrend.Compared with degree F1 and F2 of liver steatosis,the percentage of HBsAg and HBcAg strong positive staining in liver tissues of degree F3 and F4 was in downtrend.ConclusionsHepatic steatosis affected the expression of HBsAg and HBcAg in liver tissue of CHB patients.As hepatic steatosis appeared and became more severe,both expression of HBsAg and HBcAg and the degree of liver injury were in downtrend.

Objective To investigate the diagnostic value of the acoustic radiation force impulse (ARFI) technology and AST/PLT ratio index (APRI） for the assessment of the liver fibrosis in chronic hepatitis C patients.Methods 107 patients with chronic hepatitis C were included,the subjects were underwent liver biopsy,liver function,blood count,as well as real-time acoustic elastography examination.The APRI was calculated according the following formula,APRI =AST (ULN)/PLT (109/L).ARFI and APRI were compared by correlation with liver fibrosis stage in chronic hepatitis C.Referring to the histologic fibrosis stage on liver biopsy,all the ARFI and the APRI value were assessed by using ROC curve analysis.The corresponding cut-off values,sensitivity and specificity were also calculated and compared.Results The mean values of ARFI and APRI were (1.26 ± 0.27)m/s and 0.30 ± 0.46 for the patients with S1,(1.45 ± 0.51)m/s and 0.29 ± 0.21 for those with S2,(2.03 ± 0.54) m/s and 0.59 ± 0.56 for those with S3,(2.29 ± 0.82) m/s and 0.63 ± 0.35 for those with S4,respectively.ARFI (r =0.61,P ＜0.001) had a better correlation with liver fibrosis stage in chronic hepatitis C than APRI (r =0.49,P ＜0.001).Cut-off points of ARFI and APRI were 1.529 m/s and 0.170 for S≥2,1.780 m/s and 0.277 for S≥3,1.780 m/s and 0.446 for S =4,respectively.Accordingly,the areas under the ROC curves for ARFI and APRI were 0.779 and 0.724 for S≥2,0.866 and 0.786 for S≥3,0.790 and 0.779 for S=4,respectively.Conclusions As a non-invasive technology,ARFI is more accurate when applied to evaluate liver fibrosis in patients with chronic hepatitis C than APRI.ARFI technology has potential value for quantitatme evaluation of the liver fibrosis for chronic hepatitis C.

Objective To observe the final adult height (FAH) outcome and influencing factors in Turner′s Syndrome(TS) children treated with recombinant human growth hormone ( rhGH ).Methods Thirty TS children treated with rhGH were compared with 16 TS children without rhGH treatment and were followed up to achieve their FAH.Comparisons were made regarding predicted adult height (PAH),height standard deviation score for chronological age( HtSDScA ),height SDS for BA( HtSDSRA ),and growth velocity ( GV ) between rhGH treatment and without treatment groups and between the onset and by the end of rhGH treatment group.The factors determining FAH were also evaluated.Results FAH in rhGH treatment group was obviously improved as compared with untreatment group[ ( 149.5±6.3 vs 142.4±5.2) cm,P＜0.01 ].FAH in treatment group was positively correlated with height standard deviation score for chronological age ( Ht0 SDSCA ),Hto SDS for BA ( Hto SDSBA ),height age ( HA0 ) at preliminary diagnosis,and correlated with duration of rhGH therapy,duration of estrogen-free rhGH therapy,and PAH0SDS at preliminary diagnosis.Stepwise regression analysis indicated that duration of estrogen-free rhGH therapy and PAH0 SDS were the variables with the greatest identified influence on FAH (F =11.56 and F =86.91,P＜ 0.01 ).FAH in the 45,XO group was significantly different from the mosaicism group (45,XO/46,XX ) [ ( 147.2 ± 6.3 vs 153.3±6.4) cm,P =0.038].Conclusion rhGH treatment is efficacious in improving FAH of TS children,but a variability in the magnitude of the response to rhGH is recognized.Duration of estrogen-free rhGH therapy and PAH0SDS are the variables with the greatest identified influence on FAH,and karyotype may be one of the influence factors.rhGH treatment should be initiated as early as possible and sufficient course of estrogen-free rhGH therapy is needed to yield a satisfactory FAH.

Objective:To investigate the potential association between FADS1 rs1 74537 polymorphism and serum proteins in patients with aggressive periodontitis,which may provide benefits for diagnosis and treatment of aggressive periodontitis.Methods:A total of 353 patients with aggressive periodontitis (group AgP)and 1 25 matched controls (group HP)were recruited in the study.Genotyping of FADS1 rs1 74537 and serum biochemical indexes were tested at the study’s start.The relationships between the levels of TP,GLB,ALB,A/G and genotyping were analyzed.Results:(1 )The detection rate of allele G in group AgP was higher than that in group HP(68.1% vs.61 .2%,P=0.046,OR=1 .35,95% CI 1 .00-1 .83 );the detection rate of genotype GG in group AgP was higher than in group HP(45 .5%vs. 34.4%,P=0.029,OR=1 .60,95%CI 1 .05 -2.44).(2)In group AgP,the patients with GG geno-type exhibited significantly lower TP,GLB than the patients with GT+TT genotype [(77.08 ±7.88)g/L vs.(79.00 ±4.66)g/L,P=0.007;(28.1 7 ±7.63)g/L vs.(29.88 ±3.49)g/L,P=0.007)and the higher A/G(1 .72 ±0.22 vs.1 .67 ±0.22,P=0.040),but there was no significant difference in ALB between the patients with GG genotype and the patients with GT+TT genotype.In group HP,there were no significant differences in TP,GLB,A/G and ALB between individuals with genotype GT+TT and with genotype GG.(3 )Compared with individuals with genotype GT+TT in group HP,the AgP pa-tients with genotype GT +TT exhibited significantly higher TP,GLB [(79.00 ±4.66 ) g/L vs. (75.20 ±4.53)g/L,P<0.01;(29.88 ±3.49)g/L vs.(26.55 ±2.94)g/L,P<0.01 )and the lo-wer A/G(1 .67 ±0.22 vs.1 .88 ±0.30,P<0.01 ),but there was no significant difference in ALB. There were no significant differences in TP,GLB,A/G and ALB the between the AgP patients with ge-notype GG and the healthy subjects with the same genotype either.Conclusion:FADS1 rs1 74537 poly-morphism is associated with aggressive periodontitis.The patients with genotype GG in group AgP had relatively lower TP,GLB and higher A/G.Genotype GG might be a risk indicator for aggressive periodon-titis by reducing host defense capability and contributing to inflammatory response in the occurrence and development of aggressive periodontitis.