OBJECTIVETo compare the conventional pulmonary function test results of children with asthma or cough variant asthma (CVA).

METHODSA total of 140 children, who were diagnosed with asthma or CVA from May 2010 to May 2011, were divided into acute asthma attack (n=50), asthma remission (n=50) and CVA groups (n=40); 30 healthy children were included as a control group. The forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), forced expiratory flow after 25% of vital capacity has been expelled (FEF25), forced expiratory flow after 50% of vital capacity has been expelled (FEF50), forced expiratory flow after 75% of vital capacity has been expelled (FEF75) and maximal midexpiratory flow (MMEF75/25) were measured.

RESULTSThe mean percent predicted values of all the above indices were lower than 80% in the acute asthma attack group, with FEF50, FEF75 and MMEF75/25 declining markedly; the mean percent predicted values of FEF75 and MMEF75/25 were lower than 80% in the CVA group. All the pulmonary function indices in the acute asthma attack group were lower than those in the control group. The mean percent predicted values of FVC, FEV1, FEF25 and MMEF75/25 in the asthma remission and CVA groups were lower than in the control group. All the pulmonary function indices in the acute asthma attack group were lower than in the asthma remission and CVA groups, but there were no significant differences between the asthma remission and CVA groups.

CONCLUSIONSThere is small and large airway dysfunction, particularly small airway dysfunction, in children with acute asthma attack. Children with CVA present mainly with mild small airway dysfunction, as do those with asthma in remission.

Asthma ; physiopathology ; Child ; Cough ; physiopathology ; Female ; Forced Expiratory Volume ; Humans ; Lung ; physiopathology ; Male ; Vital Capacity

China ; epidemiology ; Escherichia coli Infections ; epidemiology ; microbiology ; Escherichia coli O157 ; classification ; isolation & purification ; metabolism ; Humans ; Shiga Toxin 1 ; biosynthesis ; isolation & purification ; Shiga Toxin 2 ; biosynthesis ; isolation & purification ; Sorbitol

OBJECTIVETo investigate the clinical effect of atlantoaxial pedicle screw internal fixation for treatment of atlantoaxial dislocation.

METHODSSixteen patients with atlantoaxial dislocation were treated from Dec. 2005 to June 2007, included 10 males and 6 females, aged from 38 to 45 years old (means 40.5 years). Among them 12 patients combined with nerve injury, according to ASIA grade: there were 3 cases in grade B, 5 cases in grade C, 4 cases in grade D. All patients received preoperative CT, radiograph and skull traction. Intraoperative posterior approach general spine pedicle screw-rod orthopaedics fixation system used and iliac bone block were implanted in space of posterior atlantal arch and axial vertebral plate. The outcome and complications were observed in the near future.

RESULTSThere was no vascular or neural injury found. The patients were followed up for 12 to 24 months (means 18 months). All head pain, acid storm symptoms were improved after operation. According to the Odom's clinical efficacy evaluation standard, 12 cases were excellent, 4 were good. Eleven cases of 12 with nerve injury recovered significantly. By ASIA classification: 1 cases was in grade B, 2 cases were in grade C, 5 cases were in grade D, 4 cases were in grade E. No looseness or breakage of screw occurred. Bony fusion was achieved in all cases.

CONCLUSIONPosterior approach atlantoaxial pedicle screw internal fixation have the advantages of direct screw placement, short-segment fusion, intraoperative reduction, fixation reliable, high fusion rate, and it can restablish the upper cervical vertebrae stability and help to recover the spinal cord and nerve function.

Adult ; Atlanto-Axial Joint ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Bone Screws ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Joint Dislocations ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Treatment Outcome

BACKGROUNDBecause of lacking skills in scanning the normal fetal facial structures and their corresponding ultrasonic features, misdiagnoses frequently occur. Therefore, we studied the appearance features and improved displaying skills of fetal facial anatomy in order to provide basis for prenatal diagnosis.

METHODSTwenty fetuses with normal facial anatomy from induced labor because of other malformations except facial anomalies were immersed in a water bath and then scanned ultrasonographically on coronal, sagittal and transverse planes to define the ultrasonic image features of normal anatomy. The coronal and sagittal planes obtained from the submandibular triangle were used for displaying the soft and hard palate in particular.

RESULTSFacial anatomic structures of the fetus can be clearly displayed through the three routine orthogonal planes. However, the soft and hard palate can be displayed on the planes obtained from the submandibular triangle only.

CONCLUSIONSThe superficial soft tissues and deep bony structures of the fetal face can be recognized and evaluated by routine ultrasonographic images, which is a reliable prenatal diagnostic technique to evaluate the fetal facial anatomy. The soft and hard palate can be well demonstrated by the submandibular triangle approach.

Face ; diagnostic imaging ; embryology ; Humans ; In Vitro Techniques ; Ultrasonography

OBJECTIVETo study on needling safe depth of Fengfu (GV 16) with CT, so as to provide reference for safe needling depth of Fengfu (GV 16) in clinical acupuncture treatment.

METHODSForty-one adult volunteers were divided into 3 groups, a thin person group, a moderate person group and a fat person group according to Luo's indexes, and computer-aided tomography (CT) was used to measure the needling depth of Fengfu (GV 16).

RESULTSThe safe depths of perpendicular needling of Fengfu (GV 16) were different for persons of different somatotypes. The safe needling depth was (27.73 +/- 3.45) mm for the thin person group, (30.78 +/- 2.90) mm for the moderate person group, and (33.39 +/- 4.27) mm for the fat person group.

CONCLUSIONThe safe needling depth < or = the dangerous depth x 75% can be used for reference for the safe needling depth of Fengfu (GV 16) for different somatotypes persons.

Acupuncture Points ; Acupuncture Therapy ; Female ; Humans ; Male ; Neck ; Somatotypes ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the perinatal management and outcome of different types of fetal arrhythmia.

METHODSA retrospective analysis was conducted among the fetuses with arrhythmia identified by M-mode and pulsed Doppler echocardiography in a single institution between October 2003 and December 2010.

RESULTSA total of 130 fetuses were found to have fetal arrhythmia. The most common arrhythmia during pregnancy was extrasystole (n=59), followed by bradycardia (n=23), tachycardia (n=16), atrial flutter (AF, n=3), atrioventricular block (AVB, n=12) and other arrhythmia (n=17). The overall incidence of cardiac anomalies (commonly fetal bradycardia) was 9.2% in these cases. The prognosis of arrhythmia differed significantly between cases of different classifications. The type of fetal arrhythmia (P=0.024), presence of congenital heart defect (CHD, P=0.000) and fetal hydrops (P=0.008) were significant risk factors associated with termination of pregnancy.

CONCLUSIONFetal arrhythmias without CHD or hydrops under close monitoring often have good clinical outcome, while fetal bradycardia is associated with a high mortality rate. CHD and the presence of fetal hydrops are significant risk factors for pregnancy termination.

Adult ; Arrhythmias, Cardiac ; classification ; diagnostic imaging ; Female ; Fetal Diseases ; diagnostic imaging ; Heart Defects, Congenital ; diagnostic imaging ; Humans ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Retrospective Studies ; Ultrasonography, Doppler, Color ; Ultrasonography, Prenatal ; Young Adult

OBJECTIVETo evaluate the clinical characteristics and risk factors of clonal evolution after immunosuppressive therapy (IST) in children with severe/very severe aplastic anemia (SAA/VSAA).

METHODSThe clinical data of 231 children with newly-diagnosed SAA/VSAA who received IST were retrospectively studied. The incidence and risk factors of clonal evolution after IST were analyzed.

RESULTSThe 5-year overall survival rate of the 231 patients was 82.7%. Except for 18 cases of early deaths, 213 patients were evaluated for IST efficacy. Among the 231 patients, cytogenetic abnormalities for at least two chromosome metaphase were detectable in 14 (7.4%) patients, and PNH clones were detectable in either peripheral red blood cells or neutrophils for 95 patients. Among the 213 patients evaluated for IST efficacy, 15 patients experienced clonal evolution after IST. Five patients had PNH and trisomy 8 which were defined as favorable progressions, and ten patients experienced monosomy 7 and MDS/AML as unfavorable progressions. The 5-year accumulative incidence of favorable and unfavorable progression were (2.2±2.2)% and (4.8±3.3)%, respectively. Until the last follow-up, 100% (5/5) of patients with favorable progressions and 50% (5/10) of patients with unfavorable progressions survived. WBC>3.5×10/L, CD3T cell percentage>80%, dosage of antithymocyte globulin >3.0 mg/(kg·d) and no response to IST were related to unfavorable progressions by univariate analysis. Cox multivariate analysis revealed that an increased CD3T cell percentage (>80%) and no response to IST were independent risk factors for unfavorable progressions.

CONCLUSIONSThe children with SAA/VSAA who have an increased CD3T cell percentage at diagnosis or have no response to IST are in high risks of unfavorable progressions.

Adolescent ; Anemia, Aplastic ; drug therapy ; genetics ; immunology ; mortality ; Child ; Child, Preschool ; Chromosome Aberrations ; Clonal Evolution ; Female ; Humans ; Immunosuppressive Agents ; therapeutic use ; Infant ; Male ; Proportional Hazards Models ; Retrospective Studies

BACKGROUNDMesenchymal stem cells (MSCs) transplantation is of therapeutic potential after ischemic injury in both experimental and clinical studies. Clinically, elderly patients are more vulnerable to acute myocardial infarction (AMI). But little is known about the characteristics of young donor-derived MSCs transplanted to old patients with AMI. The present study was designed to investigate the effect of transplanted MSCs from rats of different ages on the improvement of heart function after AMI.

METHODSMSCs from Sprague-Dawley (SD) rats were isolated and cultured in vitro. The apoptosis characteristics of MSCs were observed under conditions of ischemia and anoxia. SD rats underwent MI received intramyocardial injection of MSCs from young donor rats (n = 8), old donor rats (n = 8), respectively. AMI control group received equal volume physiological saline. Immunofluorescence was used to observe the differentiation of the grafted cells into cardiomyocytes. Four weeks after cell transplantation, reverse transcriptase-polymerase chain reaction (RT-PCR) and immunohistochemistry for vascular endothelial growth factor (VEGF), VIII-factor immunohistochemistry for vessel density, TUNEL, caspase-3 for cardiomyocyte apoptosis, echocardiography and hemodynamic detection for heart function were performed.

RESULTSThe apoptosis rate of the old donor-derived MSCs group was significantly higher than that of the young donor-derived MSCs group under conditions of ischemia and anoxia (P < 0.05). Engrafted MSCs survived, proliferated and differentiated into myocardium-like cells. VEGF gene expression and capillary density in the old donor-derived group were lower than those in the young donor-derived group but higher than those in the control group (P < 0.05). The transplantation of old donor-derived MSCs attenuated apoptosis of cardiomyocytes in the peri-infarct region compared with the control group and the effect was elevated in young donor-derived MSCs (P < 0.05). The heart functions (left ventricle ejection fraction (LVEF), left ventricle fractional shortening (LVFS)) were improved more significantly in the old donor-derived MSCs group than in the control group and the heart function in the young donor-derived MSCs group further improved (P < 0.05).

CONCLUSIONSYoung donor-derived MSCs can improve heart function significantly through angiogenesis and decreasing cardiomyocyte apoptosis when transplanted to the infarcted area.

Age Factors ; Animals ; Apoptosis ; Caspase 3 ; metabolism ; Cells, Cultured ; Flow Cytometry ; Immunohistochemistry ; In Situ Nick-End Labeling ; Male ; Mesenchymal Stem Cell Transplantation ; methods ; Mesenchymal Stromal Cells ; cytology ; Myocardial Infarction ; physiopathology ; surgery ; Myocytes, Cardiac ; cytology ; enzymology ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

The effect of adventitia on the occurrence and development of atherosclerosis (As) is getting more attentions. Fibroblasts, mast cells, dendritic cells, vasa vasorums, vascular-associated lymphoid tissues, and vascular peripheral nerves are related to the occurrence and development of As. This essay summarizes studies on the changes in adventitia in As process and its effect on the occurrence and development of As, as well as the latest progress.
Adventitia ; drug effects ; metabolism ; pathology ; Animals ; Atherosclerosis ; drug therapy ; metabolism ; pathology ; Disease Progression ; Humans

OBJECTIVETo study the value of prenatal ultrasound in the diagnosis of fetal malformations.

METHODSWe retrospectively analyzed the clinical data of 993 cases of neonates and induced babies with malformations who were labored in our hospital from January 1999 to October 2006.

RESULTSThe incidence rate of fetal malformation was 22.5 per thousand in our study group. The detection rate of prenatal ultrasound was 79.02% (1 062/1 344), among which the detection rate of the severe malformations (87.58%, 860/982) were significantly higher than that of the minor malformations (55.80%, 202/362) (P < 0.005). The false negative rate was high for the extremity malformations (39.46%) and facial malformations (31.91%), especially the acrosclerodermas, simple cleft palates, and ear deformities.

CONCLUSIONPrenatal ultrasound is sensitive for fetal severe malformations, while the detection rate is low for fetal minor malformations.

Congenital Abnormalities ; diagnostic imaging ; False Negative Reactions ; Humans ; Retrospective Studies ; Ultrasonography, Prenatal