Objective To explore the clinical features and treatment strategy of severe anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis in children. Methods The clinical data and follow-up information of 4 children with severe anti-NMDAR encephalitis were retrospectively analyzed. Results Four patients (one male and 3 females) were 10 to 13 years old and one child had teratoma combined. In all patients symptoms at onset mainly were psychiatric syndrome and movement disorder, and then progressed to seizures, disturbance of consciousness and central hypoventilation respiratory failure in one month. The anti-NMDAR antibodies in cerebrospinal fluid were positive in all patients. The EEG showed focal or diffuse slow waves. The brain MRI showed no pathological changes at the diagnosis. The treatment included methylprednisolone and large doses of intravenous immunoglobulin (IVIG), ventilator for 5-95 days, and tracheotomy in 2 cases. One case died because of serious infection. In 21-27 months of the follow-up, one case had clinical recovery; 2 cases had the sustained use of immunosuppressive agents and anti-epileptic drugs and the clinical symptoms were significantly improved. The EEG and anti-NMDAR antibodies continued abnormal in the patient combined with teratoma. One patient relapsed. Conclusions The severe anti-NMDAR is more likely in older female children. The central hypoventilation respiratory failure occurs in the early course of the disease. Combination with tumor is high risk factor. Conventional hormone therapy and ventilator treatment is effective. The recovery is slow. It may be relapsed even one year later.

Objective To explore the correlations between quantitative parameters of dynamic contrast-enhanced MRI ( DCE-MRI) and nasopharyngeal carcinoma ( NPC) clinical stage.Methods 69 patients with NPC were selected from Oct 2013 to Oct 2015 in Shaoxing People's Hospital,39 men and 30 women,aged 39-76 years old,average 50.6 ±10.5 years old.All patients underwent clinical staging,DCE-MRI and histopathological examina-tion before treatment.Clinical stages were determined based on Chinese 2008 staging system.Value of the volume transfer constant ( Ktrans) and the extravascular extracellular space volume per unit volume of tissue ( Ve) was detec-ted by bi-compartmental pharmacokinetic model.The correlations between quantitative parameters and clinical stage were analyzed by Pearson correlation analysis.Results Mean Ktrans and Ve for NPC were (0.532 ±0.156) mL/min/100cm3 and (0.982 ±0.356),respectively.Ktrans of NPC showed negative correlation with clinical stage (r=-0.506,P=0.001),T stage (r=-0.326,P=0.014),N stage (r=-0.296,P=0.017) and M stage (r=-0.312,P=0.015),while Ve showed positive correlation with clinical stage (r=0.415,P=0.002),T stage (r=0.478,P=0.001),N stage (r=0.318,P=0.015) and M stage (r=0.346,P=0.011).Conclusion DCE-MRI quantitative parameters are significantly related to clinical stage of NPC,which has important values for clinical treat-ment and prognostic assessment.

Objective To explore the effect of dexmedetomidine combined with nutritional intervention on cognitive function recovery and prognosis of patients with severe cranial traumatic brain injury in ICU. Methods A total of 100 patients with severe cranial traumatic brain injury from February 20, 2016 to December 30, 2016 in our hospital ICU were selected and randomly divided into two groups, the control group were given nutrition intervention, the experimental group combined with dexmedetomidine and nutritional intervention. Results The difference of PACHE Ⅱscore, GCS score, mechanical ventilation time, and hospitalization timebetween the 2 groups was statistically significant (P<0.05); The recovery of cognitive function in the experimental group was better than that in the control group (P<0.05). Conclusion The value of dexmedetomidine and nutritional intervention in patients with severe cranial traumatic brain injury in ICU is higher.

ObjectiveTo standardize the process in making the model of acute regional cerebral ischemia in Sprague-Dawley rats, and to economize time and material.MethodsRegional cerebral ischemia rat's models were induced and modified according to Koizumi's method.ResultsThe time duration was controllable and the volume of cerebral infarct was determined by adverting the approaches such as the preparation of suture, anaesthesia of the animal, and the details of surgical operation.ConclusionThe acute regional cerebral ischemic model in rats made by Koizumi's method is stable and reliable, and is easy for the beginner to carry out under limited conditions.

Objective To explore the relative signal transduction pathway of angelica polysaccharide(APS) inducing K562 cells toward erythroid differentiation. Methods K562 cells were divided into control group and ASP group, the control group cells were routinely cultured and APS group cells were treated with APS(final concentration is 100-500mg/L). By using of benzidine staining and spectrophotometry, the characteristics of erythroid differentiation of K562 cell induced by APS were detected;By using of laser confocal microscopy, the distribution of JAK_2 and STAT_5 in K562 cells was observed;By using of Western blotting, the expression of JAK_2 and STAT_5 in nucleus and cytoplasm of K562 cells was detected, By using of imm～uno～pre～cipi～ta～tion, the phosphorylation change of JAK_2 in cytoplasm was tested. Results After being induced by APS, the benzidine staining positive rate of K562 was increased.With increasing the concentration of APS, hemoglobin synthesis in K562 cells was promoted accordingly. After being cultured for 12 hours, 24 hours and 48 hour, the expression of STAT_5 in nucleus of K562 cells induced by APS was significantly higher than that of control group, however, expression of STAT_5 in cytoplasm of K562 cell induced by APS was obviously lower. The expression of JAK_2 in K562 cells was not different between APS group and control group, but the JAK_2 phosphorylation level of APS group was much higher than that of control group.Conclusion APS can induce erythroid differentiation of K562 cells, and the mechanisms may be that APS can promote the phosphorylationthe of JAK_2, then stimulating nuclear translocation of STAT_5.

Accidents, Occupational ; statistics & numerical data ; Acute Disease ; China ; epidemiology ; Humans ; Occupational Diseases ; epidemiology ; Poisoning ; epidemiology

OBJECTIVE: To establish an HPLC method for the determination of the concentration of vancomycin in human serum. METHODS: Serum samples were centrifuged after serum protein was precipitated by 20% metaphosphoric acid. The separation was performed on Hypersil C18 column with mobile phase consisted of acetonitrile-0.012 5 mol?L-1 potassium dihydrogen phosphate buffer (10 ∶ 90) at flow rate of 0.8 mL?min-1. The detection wavelength was set at 236 nm and column temperature was set at 25 ℃. RESULTS: The average relative recovery rate of vancomycin in low, medium and high concentrations (2.5,30.8,150.4 mg?L-1) were 99.8%, 101.1% and 98.9% respectively. The inter-day and intra-day RSD were less than 2.5%(n=5). The limit detection of vancomycin in serum was 2.0 mg?L-1. The linear range was within 2.0～170.0 mg?L-1(r=0.999 8). CONCLUSION: The method is simple, accurate, and rapid for the monitoring and phamacokinetic studies of vancomycin in human serum.

Objective To study the effects ofautologous bone marrow mononuclear cells (BMMCs)transplantation during coronary artery bypass gafting (CABG) on myocardial infarct size. Methods Forty myocardial infarction patients diagnosed by coronary angiography (CAG) and SPECT and confirmed at surgery were enrolled and randomly assigned CABG alone (group Ⅰ) or CABG with intramyocardial or intracoronary injection of autologous BMMCs (group Ⅱ), 20 cases in each group. Baseline and followed up evaluations included SPECT and NYHA-FC before and after 6 months operation, recorded the major adverse cardiac events (MACE) at the same time. The number of autologous BMMCs injected was (6.84 ± 2.88) ×107 in group Ⅱ. Results There was no procedure-related complication during 6 months followed up in all patients. After 6 months operation,left ventricular ejection fraction in group Ⅱ was significantly higher than that in group Ⅰ [(57.40 ±5.21)% vs. (50.75 ±5.88)%,t =3.79,P＜0.05],NYHA-FC in group Ⅱ was significantly improved than that in group Ⅰ [(1.30 ± 0.47) grades vs. (1.85 ± 0.59) grades, t = 3.27, P ＜0.05],SPECT showed myocardial infarct size in group Ⅱ was significantly lower than that in group Ⅰ[(14.57 ±5.20)% vs. (20.45 ±5.18)% ,P ＜0.05]. Conclusion Autologous BMMCs transplantation during CABG is safe and feasible, which can reduce the myocardial infarct size in patients with myocardial infarction.

BACKGROUND: The source of bone marrow mesenchymal stem cells (BMSCs) is limited, and the cellular morphology,proliferation and multi-directional differentiation capacities can vary during serial passages in BMSCs in vitro.OBJECTIVE: To study the effects of fibroblast growth factor (FGF) on cellular morphology, proliferation and differentiation of serially passaged BMSCs.METHODS: (1) BMSCs were isolated from Sprague-Dawley rats and cultured. These cells were passaged six times in vitro, and the cellular morphology was observed and photographed. (2) BMSCs at passage 6 were seeded into 96-well plates and randomly divided into control group and FGF treatment group. The proliferation of cells in both groups was detected with cell counting kit-8 kit at days 1, 2, 3, 4, 5, 6, 7 after culture. (3) BMSCs at passage 6 were seeded into 6-well plates and randomly divided into control group and FGF treatment group. After 7 days treatment with growth medium or growth medium containing FGF, the cellular morphology was observed and photographed. And then the cells of both groups were treated with osteogenic induction medium, adipogenic induction medium and chondrogenic induction medium for the next 7 days. The osteogenic, adipogenic and chondrogenic related genes (RUNX2, ALP, OCN;PPARγ2, AP2, ADIPOQ; SOX9, collagen II, aggrecan) were detected with real-time PCR. The protein expressions of RUNX2, PPARγ2, SOX9 were detected with western blot assay. (4) BMSCs at passage 6 were seeded into 6-well plates and randomly divided into control group and FGF treatment group. After 7 days treatment with growth medium or growth medium containing FGF, the cells were cultured with osteogenic induction medium, adipogenic induction medium and chondrogenic induction medium for the next 14 days. Then, alizarin red S staining, oil red O staining and alcian blue staining were performed.RESULTS AND CONCLUSION: (1) After in vitro passage for six times, the cellular morphology changed obviously, and FGF treatment recovered the characteristics of primary cells. (2) Compared with the control group, the cell proliferation in the FGF treatment group was significantly increased (P < 0.05). (3) Compared with the control group, the expression of osteogenic, adipogenic and chondrogenic related genes (RUNX2, ALP, OCN; PPARγ2, AP2, ADIPOQ; SOX9, collagen II, aggrecan) was increased significantly in the FGF treatment group (P < 0.05). The protein expressions of RUNX2,PPARγ2, SOX9 were also higher in the FGF treatment group than the control group (P < 0.05). (4) Compared with the control group, the number of extracellular calcium nodules, the number of intracellular lipid droplets, and the expression of acid acidic mucopolysaccharide were significantly increased after FGF pretreatment. To conclude, FGF pretreatment can preserve the stemness of BMSCs serially passaged in vitro.

Wet age-related macular degeneration (AMD) is one of major causes of blindness in elder people.Intraocular injection of anti-vascular endothelial growth factor (VEGF) -A regimen has made big breakthrough for the treatment on choroidal neovascularization of wet AM D,while long-term follow-up and necessary retreatments are the key issues to remain obtained visual acuity.Multiple strategies of wet AMD have been used in following-up and retreating based on the visual acuity,optical coherence tomography (OCT),ophthalmoscope and fluorescein fundus angiography (FFA) in abroad.However,there also are major differences in the patient' s composition,treatment habits and distribution of medical sources in China from Western.So we suggest to standardize the follow-up and retreatment strategies about intravitreal injection of VEGF-A for wet AMD as to achieve a better effectiveness.OCT-guided individual follow-up and retreatment strategies should be very helpful for maintaining a long-term efficacy,minimizing the treatment time and reducing medical cost.