Three cases of Langerhans cell histiocytosis (LCH)with central diabetes insipidus as the first manifestation were reported, with the summary of their clinical manifestations, laboratory examinations, imaging examinations, pathological results, diagnosis process, and treatment response. All three patients presented with central diabetes insipidus in the early stage. The pituitary magnetic resonance imaging (MRI)showed thickened pituitary stalks, and all lost the normal high signal of the posterior pituitary. Two patients showed isolated hypothalamic-pituitary lesions, while one case showed pituitary and thyroid systems involvement. Pathological findings showed typical Langerhans cells, immunohistochemistry showed positive for S-100, CD1a, Langerin. The clinical manifestations of LCH manifested distinct heterogeneity, which is easy to be misdiagnosed and left out. The diagnosis should be confirmed by pathological examination. The biopsy of isolated hypothalamic-pituitary lesions is difficult. It is recommended to actively screen other organs to increase the probability of biopsy. LCH-induced neurohypophysis requires life-long hormone replacement therapy.

Objective:To report the diagnosis, treatment, and follow-up of a 21-hydroxylase deficiency boy with central precocious puberty caused by complex heterozygous mutation of CYP21A2 gene.Methods:The child was symptomatic of rapid growth and secondary sexual characteristics at the age of 6. The diagnosis of central precocious puberty was confirmed by serum testosterone, gonadotropin levels, and gonadotropin-releasing hormone (GnRH) stimulation test. 21-hydroxylase deficiency was diagnosed clinically based on the serum adrenocorticotropic hormone (ACTH), 17-hydroxyprogesterone levels, and images on the computed comography (CT) of the adrenal glands.Results:The CYP21A2 gene was detected to have a compound heterozygous mutation by Sanger sequencing and multiplex ligation-dependent probe amplification. During the 3 years follow-up, the effects of glucocorticoids, GnRH analogs, and recombinant human growth hormone were regularly monitored and evaluated.Conclusions:Glucocorticoid replacement followed the principle of the lowest effective dose. GnRH analogs showed an effective inhibition of the hypothalamus-pituitary-gonadal axis, while recombinant human growth hormone had no such growth-promoting effect.

Objective:To investigate the effect of paraformaldehyde fixation on measuring the protein-protein interaction by fluorescence resonance energy transfer(FRET)to resolve the problem of FRET efficiency calculation in excess-movement cells.Methods:The C terminals of TCR ? chain(TRA)and TCR ? chain(TRB)genes,which were ideal for protein-protein interaction research,were fused with ECFP and EYFP gene respectively by fusion PCR and transferred into target cell.A grou Pcells were fixed in paraformaldehyde(0.5%)for 0.5~1h and another left alive,then these cells were subject to ECFP/EYFP FRET calculation with confocal laser scanning microscope.The ECFP/EYFP FRET efficiencies in live and fixed cell were analyzed and compared.Results:There is no significant statistical difference between the ECFP/EYFP FRET efficiencies of live cell and cell fixed with lower paraformaldehyde concentration and shorter incubation time.Conclusion:fixation with low-concentration paraformaldehyde and short-time incubation has no distinct influence on measuring protein-protein interaction,and facilitated the FRET calculation in excess-movement cells.

OBJECTIVETo observe the effect of gastric dynamics by transcutaneous electrical acupoint stimulation (TEAS) combined general anesthesia when controlled hypotension dropped to 60% of the mean arterial prenssure (MAP) baseline, and to provide experimental evidence for organ protection in clinical controlled hypotension.

METHODSEighteen male beagles were randomly divided into three groups, the general anesthesia group (blank), the general anesthesia induced controlled hypotension group (control), and the general anesthesia combined TEAS induced controlled hypotension group (experiment), 6 in each group. Controlled hypotension was performed in the latter two groups with isoflurane inhalation and intravenous injection of sodium nitroprusside (SNP). The mean arterial pressure (MAP) was lowered to 60% of the MAP baseline and kept for 60 min. Controlled hypotension was not performed in Beagles of the control group. For Beagles in the experiment group, TEAS [2/100 Hz, (4 ± 1) mA] was applied to bilateral Hegu (LI4), Quchi (LI11), Zusanli (ST36), and Sanyinjiao (SP6) from stable physiological conditions to the end of maintaining stages. Changes of EGG frequencies and EGG amplitudes were monitored. Serum levels of gastrin (GAS) and motilin (MTL) were also detected at corresponding time points during and after experiment.

RESULTSAs for the pressure control effect of TEAS combined general anesthesia in the controlled hypotension, during the process of controlled hypotension (T1-T4), MAP levels of two controlled pressure groups remained relatively stable, and were kept at 60% of the MAP baseline. When the blood pressure dropped to the target low MAP and maintained at 60 min (T1-T4), EGG amplitudes of Beagles in all the three groups showed decreasing tendency. But it was more obviously lower than its basic level in the control group (P <0.05), while it was not obviously decreased in the experiment group (P < 0.05). EGG frequencies of Beagles in all the three groups showed no obvious change during this stage. By the end of the MAP rising stage (T8), the EGG amplitude of the experimental group was significantly higher than that of the control group and the blank group (P < 0.05), while it didn' t show any obvious increase in the control group. During this period, EGG frequencies of the two controlled hypotension groups decreased more than those of the blank group. Two h after rising blood pressure (at T9), EGG amplitudes and frequencies in the two controlled hypotension groups basically restored to their respective baselines and levels of the blank group at T9. At 2 h (T9) after controlled hypotension, serum levels of GAS and MTL were lower than those of basic levels in the two controlled hypotension groups (P <0.05). However, serum levels of GAS and MTL had an increasing trend in the two controlled hypotension groups at 24-72 h (T10-T12). Besides, the increasing speed and amplitude was better in experiment group than in the control group at T10-T12. However, there was no statistical difference between the two groups (P > 0.05). At 72 h (T12) serum levels of GAS and MTL had basically restored to their basic levels in the two controlled hypotension groups and that of the blank control group.

CONCLUSIONEGG amplitudes could be effectively improved in TEAS combined general anesthesia for controlled hypotension at 60% of the MAP baseline, the recovery of the serum GAS level accelerated, gastric power improved and stomach protected.

Acupuncture Points ; Anesthesia ; methods ; Anesthesia, General ; Animals ; Arteries ; Dogs ; Gastrins ; Hypotension, Controlled ; Male ; Motilin ; Nitroprusside ; Transcutaneous Electric Nerve Stimulation

OBJECTIVETo evaluate the effect of health education on lung function and quality of life in stabilized patients with chronic pulmonary disease (COPD).

METHODS117 stabilized COPD patients were randomly devided into 4 groups with numbers as 31,26, 20 and 40 identified as Groups 1 to 4. Patients in Group 1 did not receive health education, but Groups 2,3 and 4 received one, two, three or more times health education in file. FEV1, FEV1%, FEV1/FVC and SGRQ score were compared pre and 6-month post the health education program.

RESULTSHealth education seemed successful in delaying the decline of FEV1, FEV%, FEV1/FVC and groups 2-4 were superior to group 1(P < 0.05) while groups 3 and 4 were superior to groups 1 or 2(P < 0.05). Health education was effective in raising the SGRQ score among the stabilized COPD patients with groups 2-4 superior to group 1 (P < 0.05) while groups 3 and 4 superior to groups 1 or 2 (P < 0.05).

CONCLUSIONHealth education could effectively delay the decline of both lung function and quality of life in stabilized patients with COPD.

Aged ; Aged, 80 and over ; Chronic Disease ; Female ; Health Education ; Humans ; Lung ; physiology ; physiopathology ; Lung Diseases ; physiopathology ; Male ; Middle Aged ; Quality of Life ; Recovery of Function

OBJECTIVE: To make a distinction between myocarditis and the reaction to some pathological state of myocardium. METHODS: Myocardium of 26 cases with sudden cardiac death were stained and LM light microscopies with immunohistochemical method 10 cases with normal myocardium were contrasted. RESULTS: A great deal of stained positive monocyte of immunohistochemistry emerged in the parasetions of myocarditis patients with various farms and stacking(> 15). CONCLUSION The stain of immunohistochemistry can be used as one of the indications for diagnosing non-typical myocarditis.
Adolescent ; Adult ; Antigens, CD ; Antigens, Differentiation, Myelomonocytic ; Death, Sudden, Cardiac/pathology* ; Female ; Humans ; Immunohistochemistry/methods* ; Male ; Middle Aged ; Myocarditis/pathology* ; Myocardium/pathology*

OBJECTIVETo investigate prevalence of human immunodeficiency virus (HIV) infection and risk factors for its transmission among injection drug users (IDUs) in Liangshan Yizu Autonomous Prefecture of Sichuan Province, China.

METHODSA community-based survey was conducted to investigate demographic characteristics, pattern and frequency of sharing injection equipment, and sexual behaviors in IDUs. Blood samples were also collected from them to detect for antibodies against HIV and syphilis.

RESULTSA total of 379 subjects were recruited with informed consent for study through community outreach and peer recruiting methods. Their prevalence of HIV infection was 11.3% (43/379). Ethnicity, frequency of sharing syringes and cotton swab during the past three months and syphilis infection associated with HIV infection by univariate analysis using chi-square test. Multivariate logistic regression analysis showed odds ratio of frequency of sharing syringes for HIV infection during the past three months was 2.28 (95% CI 1.18 - 4.43), and that for syphilis infection 3.10 (95% CI 1.48 - 6.48).

CONCLUSIONFrequency of sharing syringes during the past three months associated with syphilis and HIV infection.

Adolescent ; Adult ; China ; epidemiology ; Disease Transmission, Infectious ; Female ; HIV Infections ; epidemiology ; transmission ; Humans ; Logistic Models ; Male ; Needle Sharing ; adverse effects ; Prevalence ; Sexual Behavior ; Substance Abuse, Intravenous ; virology

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

Objective To analyze the normal anatomy of petrosal vein and the space adjacent relationship between the petrosal vein and the homolateral trigeminal nerve by balanced turbo field echo (B-TFE) Cine-MR imaging and enhanced T1 high-resolution isotropic volume excitation (e-THRIVE)imaging.Methods Forty-one patients with facial spasm and epileptiform neuralgia were selected and taken a scan with ACHIEVA NOVA DUAL A-serial 1.5T MR machine using the BTFE and e-THRIVE series.The space adjacent relationship between the petrosal vein and the trigeminal nerve in cerebellopontine angle were observed.Results The 82 sides of petrosal veins and homolateral trigeminal nerves (41 cases) were displayed well.Petrosal veins were located in cavitas subarachnoidealis,partly in free state; the number of trunk ofpetrosal vein could be 1,2,3,respectively,responding to 70 (86%),10 (12%),2 (2%).The petrosal veins located in the dorsal-lateral of trigeminal nerve were found in 74 sides (37 cases,91%,by BTFE,e-THRIVE series),the petrosal veins located in the ventri-lateral of trigeminal nerve in 6 sides (3 cases,7%,by e-THRIVE series),and the petrosal veins located in the right upon trigeminal nerve in 2 sides (1 cases,2%,by BTFE series).Conclusion B-TFE MR imaging and e-THR/VE imaging,showing the petrosal veins and trigeminal nerves clearly and evaluating their relationship accurately,can provide information of topographic anatomy before microsurgical vascular decompression.

Objective To survey the apparent diffusion coefficient (ADC) value and fractional anisotropy (FA) value ofpontine cistern section of the trigeminal nerve, and understand the characteristics of various parameters of trigeminal nerve pontine cistern section. Methods The distances from pontine cistern section of the trifacial nerve to 0, 3, 6 and 9 mm of brain stem in 50 healthy volunteers were recorded, and fusion images of magnetic resonance diffusion tensor imaging (DTI) with B-TFE or THRIVE were achieved to improve the spatial resolution of the pontine cistern section of the trifacial nerve; their ADC value and FA value were recorded, separately. Tracing image formation was noted in the pontine cistern section of the trigeminal or trifacial nerve. Results The ADC and FA results of the left side and right flank of pontine cistern section of the trifacial nerve in these healthy volunteers were not statistically different (P＜0.05). The closer to the brain stem, the more asymmetrical tendency of distance from pontine cistern section of the trifacial nerve to 0, 3, 6 and 9 mm of brain stem between both sides. DTI indicated that the ADC values between each 2 distances from pontine cistern section of the trifacial nerve to 0, 3, 6 and 9 mum of brain stem between both sides were significantly different: the ADC values increased along with the distance elevating gradually, but rotated suddenly at the line of 6-9 mm. The FA value increased in 0-6 mm along with the distance reducing gradually, and the neighboring 2 distances had remarkably statistical difference, but the FA value no longer obviously changed from the line of 6-9 mm. Conclusion DTI can distinguish the two-sided trigeminal nerve brain pond section clearly, and may realize each item of DTI. Regular changes are noted in FA and ADC values along with the different distances from pontine cistern section of the trifacial nerve to 0, 3, 6 and 9 mm of brain stem,indicating that DTI enjoys perspective in being clear about the discrimination of cranial nerve CNS section, the change-over portion and the PNS section, and in detecting the cranial nerve vascular compression.