Humans ; Subacute Sclerosing Panencephalitis

Female ; Humans ; Infant, Newborn ; Lower Extremity ; Pregnancy ; Pregnancy in Diabetics ; Thrombophlebitis ; etiology ; therapy

OBJECTIVETo study the factors influencing short-term prognosis of tuberculous meningitis (TBM) in children.

METHODSThe clinical data of 137 hospitalized children with TBM between January 2007 and February 2011 were retrospectively reviewed. A total of 30 potential factors influencing short-term prognosis of TBM were evaluated by univariate analysis and multivariate logistic regression analysis.

RESULTSClinical staging showed that of the 137 children 21 cases (15.3%) were in the early stage, 67 cases (48.9%) in the medium stage and 49 cases (35.8%) in the late stage of TBM. The univariate analysis revealed 8 factors associated with a poor short-term prognosis: clinical stage of TBM (late), coma, positive Babinski signs, cranial nerve involvements, paralysis, seizures, obvious abnormalities in brain computed tomography (CT) or magnetic resonance imaging (MRI) and elevated protein concentrations in cerebrospinal fluid (CSF). Factors associated with a favourable short-term prognosis for TBM included glucocorticoid steroids therapy, positive reaction of PPD skin test and an increased length of stay in hospital. Multivariate logistic analysis revealed two independent risk factors for a poor short-term prognosis: clinical stage of TBM (late) (OR: 11.168, 95%CI: 3.521-35.426) and positive signs of meningeal irritation (OR: 4.275, 95%CI: 1.043-17.521). An increased length of stay in hospital was shown as a favorable factor (OR: 0.893, 95%CI: 0.825-0.968).

CONCLUSIONSLate-stage TBM and positive signs of meningeal irritation suggest a poor prognosis, while an appropriately longer length of stay in hospital may contribute to a favorable short-term prognosis for children with TBM.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Prognosis ; Retrospective Studies ; Tuberculosis, Meningeal ; complications ; diagnosis

A 3-year-old boy had abnormal liver function, which was found in physical examination, for 5 months before admission. He had no symptoms such as anorexia, poor appetite, and jaundice, had normal growth and development, and showed no hepatosplenomegaly. Laboratory examination revealed significantly reduced ceruloplasmin (35 mg/L), as well as negative hepatotropic virus, cytomegalovirus, and Epstein-Barr virus. There were normal muscle enzymes, blood glucose, and blood ammonia and negative liver-specific autoantibodies. The boy had negative K-F ring and normal 24-hour urine copper (0.56 μmol/L). The ATP7B gene testing for the boy, his sister, and their parents detected two novel missense mutations in the boy and his sister, i.e., compound heterozygous mutations in exon 7 (c.2075T>C, p.L692P) and exon 13 (c.3044T>C, p.L1015P), which were inherited from their father and mother, respectively. Wilson's disease was confirmed by genetic diagnosis in the boy and his sister. The boy and his sister were given a low-copper diet. The boy was administered with penicillamine for decoppering and zinc supplement against copper uptake. His sister received zinc supplement alone because no clinical symptoms were observed. The boy showed normal liver function in the reexamination after 3 months of treatment.
Adenosine Triphosphatases ; genetics ; Alanine Transaminase ; blood ; Cation Transport Proteins ; genetics ; Child, Preschool ; Copper-transporting ATPases ; Female ; Hepatolenticular Degeneration ; genetics ; physiopathology ; Humans ; Liver ; physiopathology ; Male ; Mutation, Missense ; Physical Examination

OBJECTIVETo describe the prevalence of depressive and/or anxiety symptoms in patients with some neurological diseases in the general hospitals of major cities in China.

METHODSA hospital-based cross-sectional study was conducted in four big cities in China in 2004. 1197 eligible subjects with Stroke, Parkinson's disease and Epilepsy were recruited from the outpatient or inpatient departments within three months. Face-to-face interview was used in data collection together with the self-completed Hospital Anxiety and Depression (HAD) scale for depressive and/or anxiety symptom, were screened. Subjects getting a HAD score of 9 and above were further assessed for depressive and/or anxiety disorders with Hamilton anxiety scales and Hamilton depression scales by the licensed psychologists or psychiatrists.

RESULTSThe prevalence rates of "self-scaled" depressive and/or anxiety symptoms were 19.5%, 24.1% and 21.9% respectively in patients with stroke, Parkinson's disease and epilepsy. Among cases with "self-scaled" depressive and/or anxiety symptoms, the prevalence rates of depressive and/or anxiety symptoms were 50.8%, 73.1% and 38.6% respectively; less than 17% of subjects had obtained a diagnosis of depressive disorders and had been treated but only 4% of the subjects having obtained a diagnosis of anxiety disorders and been treated prior to the study. The sex specific prevalence varied over the somatic diseases. In patients with Parkinson's disease, the prevalence of "self-scaled" anxiety symptom was significantly higher in females than in males (21.1% vs. 12.2%; chi2 = 5. 679, P = 0.017),and the total prevalence of "self-scaled" depressive and/or anxiety symptoms was also higher in female (30.3% vs. 20.5%; chi2 = 4.978, P = 0.026); in patients with stroke while the prevalence of depressive and anxiety symptoms in female was higher than that in male (52.2% vs. 20.0%; chi2 = 6.009, P = 0.014), and a higher prevalence of depressive symptoms in female patients with epilepsy was also reported (32.4% vs. 13.6%; chi2 = 4.108, P = 0.043).

CONCLUSIONIt was of great importance to remind the healthcare providers and health policy makers that high prevalence of depressive and/or anxiety symptoms was found in patients with somatic diseases but with low percentages of previous diagnosis or treatment in the departments of neurology at the general hospitals in urban China.

Anxiety ; epidemiology ; China ; epidemiology ; Cross-Sectional Studies ; Depression ; epidemiology ; Female ; Humans ; Male ; Nervous System Diseases ; psychology ; Prevalence ; Urban Population

ObjectiveTo observe the thyroid status of pregnant women during the 1st and 2nd trimester of gestation,and its role in brain and neural development of their offspring's.MethodsFrom 2008 to 2009,pregnant women from nine townships of two counties in Wushi and Baicheng in Aksu prefecture of Xinjiang were selected as research subjects according to the survey standard.After informed consent signed,their urinary iodine,serum thyroid stimulating hormone(TSH) and free thyroxin(FT4) were analyzed.The value of thyroid hormone of normal pregnant women was used in diagnosis of subclinical hypothyroidism and hypothyroxinemia in pregnant women.From 2010 to 2011, The brain and neural development status among offspring born by those pregnant women were evaluated with DDST.In accordance with the results of Denver Development Screen Test (DDST) screening,pregnant women were classified into survey and control groups,and the survey group was the suspicious and abnormal of the result of DDST screening(delay),the control group was normal of the result.According to gestational age,pregnant women were divided into 4 gestation groups:G1(6 to 13 weeks),G2(14 to 18 weeks),G3 ( 19 to 23 weeks) and G4(24 to 28 weeks).ResultsA total of 396 cases of pregnant women during the 1st and 2nd trimester of gestation were investigated(survey group 102 cases,control group 294 cases).The median value of urinary iodine concentration among pregnant women in survey group was 152.4 μg/L The prevalence of subclinical hypothyroidism and hypothyroxinemia among pregnant women was 10.78％(11/102) and 3.93％(4/102),respectively.In control group,the median value of urinary iodine concentration was 180.0 μg/L The prevalence of subclinical hypothyroidism and hypothyroxinemia among pregnant women was 7.48％ (22/294) and 4.42％ (13/294),respectively.During the pregnant period from G1 to G3,the median serum TSH of pregnant women in DDST survey group (2.24,3.49,2.85 mU/L) was higher than that of DDST control group( 1.59,2.70,2.28 mU/L).Especially,the difference of TSH between the two groups during the period of G3 was statistically significant (t =4.906,P ＜ 0.05 ).ConclusionsHypothyroidism tendency of pregnant women during the period from gestation week 19th to 23rd may be an important factor in the development of brain abnormalities of their offsprings.

Objective To explore the impact of chronic complications of type 2 diabetic mellitus (T2DM)on quality of life(QOL)among T2DM outpatients in urban China.Methods A cross.Sectional study was carried Out in 1524 T2DM outpatients recruited from 15 hospitals in 4 major cities of China.Questionnaire interviews were used to collect data on general characters and complications of T2DM.SF-36 questionnaire(version 1)was used and self-completed by patients under the help from interviewers for those having difficulties in reading.T test,one-way ANOVA and generalized linear model were used to explore the association between complications of T2DM and quality of life.Results Complication Was a significant predictor leading to poorer SF-36 subscale scores(decreased by 4.68-16.06 scores)and two summary scores (PCS,MCS).The scores of role-physical subscale(decreased by 22.45％)and role-emotionsl subscale(decreased by 16.28％)decreased much more than the other subscales in patients with complication.Overall,QOI Was reduced by 11.02％in patients with complication.The QoL had a gradual decrease with the increasing number of complications.The average scores descended from 2.82 to 10.33 in the eight subscales with the increase of one complication.Conclusion Having complication or multiple complications seemed to be predietors of poor QOL among T2DM outpatients.

OBJECTIVETo explore the impact of sulfur dioxide (SO(2)) on hydrogen sulfide (H(2)S)/cystathionine-γ-lyase (CSE) and H(2)S/mercaptopyruvate sulfurtransferase (MPST) pathways in the pathogenesis of hypoxic pulmonary hypertension.

METHODSThirty-two male Wistar rats were randomly divided into four groups: control group (n = 8), hypoxic group (n = 8), hypoxic + SO(2) group (n = 8) and hypoxic + hydroxamate (HDX) group (n = 8). After 21 days of experiment, the concentration and production of H(2)S in lung tissues were measured respectively for each rat. The protein expression of CSE and MPST in intima and media of small pulmonary arteries in rats was detected with immunohistochemical method.

RESULTSCompared with control group, the mean pulmonary artery pressure (mPAP) in rats of hypoxic group was increased significantly [(33.38 ± 6.32) mm Hg vs. (16.74 ± 3.81) mm Hg, P < 0.01]. Compared with hypoxic group, the mPAP in rats of hypoxic + SO(2) group was decreased significantly [(29.65 ± 2.53) mm Hg vs. (33.38 ± 6.32) mm Hg, P < 0.01]. However, compared with hypoxic group, the mPAP in rats of hypoxic + HDX group was increased significantly [(39.44 ± 6.26) mm Hg vs. (33.38 ± 6.32) mm Hg, P < 0.01]. Compared with control group, the concentration [(2.02 ± 0.43) µmol/g vs. (3.11 ± 0.42) µmol/g, P < 0.01] and production [(19.64 ± 3.48) nmol/(g·min)vs. (28.20 ± 5.95) nmol/(g·min), P < 0.05] of H(2)S were decreased significantly in rats of hypoxic group, respectively. When treated with SO(2), hypoxic rats showed an increased concentration [(2.73 ± 0.20) µmol/g vs. (2.02 ± 0.43) µmol/g, P < 0.01] and production [(26.24 ± 1.92) nmol/(g·min) vs. (19.64 ± 3.48) nmol/(g·min), P < 0.01] of H(2)S in lung tissue compared with those without receiving SO(2) treatment. When treated with HDX, hypoxic rats showed a significant decrease in concentration [(1.64 ± 0.23) µmol/g vs. (2.02 ± 0.43) µmol/g, P < 0.05] and production [(13.94 ± 3.63) nmol/(g·min) vs. (19.64 ± 3.48) nmol/(g·min), P < 0.05] of H(2)S in lung tissue compared with those without receiving HDX treatment. As for the expression of CSE in small pulmonary arteries (SPAs), compared with control group, the expression of CSE in intima [(0.31 ± 0.02) vs. (0.36 ± 0.01), P < 0.01] and media [(0.27 ± 0.01) vs. (0.30 ± 0.01), P < 0.01] in rats of hypoxic group was decreased significantly. While compared with hypoxic group, the expression of CSE in intima [(0.35 ± 0.02) vs. (0.31 ± 0.02), P < 0.01] in SPAs of hypoxic + SO(2) group was increased significantly. With HDX treatment, the expression of CSE in intima [(0.26 ± 0.01) vs. (0.31 ± 0.02), P < 0.01] in SPAs of hypoxic group was lower than that without HDX treatment. As for the expression of MPST in SPAs, compared with hypoxic group, the expression of MPST in media [(0.32 ± 0.02) vs. (0.29 ± 0.01), P < 0.01] in SPAs of hypoxic + SO(2) group was increased significantly.

CONCLUSIONSO(2) might upregulate H(2)S/CSE and H(2)S/MPST pathways in pulmonary arteries of hypoxic rats.

Animals ; Cystathionine gamma-Lyase ; metabolism ; Hydrogen Sulfide ; metabolism ; Hypertension, Pulmonary ; enzymology ; physiopathology ; Hypoxia ; metabolism ; physiopathology ; Male ; Pulmonary Artery ; metabolism ; physiopathology ; Rats ; Rats, Wistar ; Sulfur Dioxide ; pharmacology ; Sulfurtransferases ; metabolism

Objective To know the contract nurses'professional pressure features in one 3A hospital, nd analyze the factors of influencing the contract nurses'professional pressure.Methods 235 contract nurses ere randomly investigated by a nurse working stress scale and a self-designed general information questionnaire. Nother 125 registered nurses were regarded as the controls.Results The score of contract nurses'working ressure was(85.32±20.49),with low wage and other welfare for ranking first in priority.There was a tatistical meaning compared to the registered nurses(P<0.05).The difference had statistical meanings in the cores of different departments,reasons for selecting the nursing work,attitude to present department,work atisfactory,attitude for switching to another trade,satisfaction degree of wage,numbers of night shift among the ontract nurses(P<0.05).Conclusions The contract nurses'working pressure belongs to the middle level. He stressors for ranking first in priority are low wage and other welfare.Attitude to work.attitude to present epartment,satisfaction degree of wage and objective support have obvious inflences to contract nurese'working ressure.

Objective To investigate the utilization of oral health services and to analyze the factors associated with oral health services for the community residents. Methods Household health interview and oral health condition survey were conducted to obtain information about oral health services. The respondents were recruited by a multi-stage random cluster sampling procedure. Multiple dummy regression analyses were performed for the assessment of the relative effect of behavioural factors on dental attendance. Results A total of 2003 families, 4459 people participated in this study. The people seeking dental treatment accounted for 11.3% (502/4459) per year. Young people ( OR = 2. 072), having medical insurance system ( OR =2. 835 ), short distance to see dentist ( OR = 3. 535 ) , oral health awareness ( OR = 2. 595 ) , poor selfassessment of oral health status (OR =2. 014 ) were the main factors which influenced dental attendance of community residents. Conclusions The utilization of oral health service was low, particularly for middleaged people and the elderly. Oral health education and medical insurance system should be strengthened.