OBJECTIVETo investigate the effect of noninvasive positive pressure ventilation( NIPPy) on the gene and protein expression of biquitin-proteasome of skeletal muscle in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).

METHODSSeven patients with AECOPD by NIPPV were used as the study group, meanwhile, 6 patients with AECOPD who refused NIPPV was the control group. The blood gas analysis, heart rate (HR) and mean arterial pressure (MBp) were monitored before and 14 days after treatment. A skeletal muscle biopsy was performed after 14 days of therapy. The mRNA expression of ribosomal protein S21 (RPS21), Ubiquitin, Ubiquitin combined with enzyme E2 (E2), Ubiquitin ligase E3 (E3) in skeletal muscle cell were measured by RT-PCR. The protein expression of mitochondrial aconitase (AC02), protease C3 (C3), ribosomal protein SLC16 (SLC16) were detected by Western blot.

RESULTSForteen days after treatment, the patients in NIPPV group got much better improvement in PaCO2, PaO2 and HR than that of the patients.in the control group (P < 0.05). The gene expression of RPS21,Ubiquitin, E2 and E3 in skeletal muscle cell on patients with NIPPV were obviously lower than that of the control group (P < 0.05, P < 0.01). Compared with that of the control group, the protein expression of C3 and AC2 increased significantly in the NIPPV group (P < 0.01). The protein expression of SLC16 was significantly lowered in the treated group (P < 0.01).

CONCLUSIONNIPPV can ameliorate the proteasome pathway and energy metabolic disorders in patients with AECOPD.

Humans ; Muscle, Skeletal ; metabolism ; Positive-Pressure Respiration ; Proteasome Endopeptidase Complex ; metabolism ; Pulmonary Disease, Chronic Obstructive ; metabolism ; therapy ; Ubiquitin ; metabolism

BACKGROUND: Because of scaphoid irregular shape and the wrist joint and adjacent bones overlap, so the diagnosis and treatment of scaphoid fracture and treatment became so difficult. Which imaging methods hold highest diagnosis rate, and which kind of surgical approaches with less impact on fracture healing are still under discussion.OBJECTIVE: To review the imaging examinations of scaphoid fracture and the research advance in surgical approaches.METHODS: The first author retrieved CJFD and PubMed databases for the literature addressing the imaging examinations and surgical approaches of scaphoid fracture published from 2005 to 2015 with the keywords of "scaphodl bone, fracture, iconography, surgical approach" in Chinese and English, respectively. The old and repetitive articles were excluded, totally 3021 articles were retrieved. In accordance with inclusion and exclusion criteria, finally 24 eligible articles were included for result analysis.RESULTS AND CONCLUSION: (1) The wrist joint at positions of pronation 60°, supination 45°, oblique and lateral can reveal the scaphoid from different angles on X-ray, which improves the diagnosis rate. At present, CT is the most reliable method, but there is a lack of quantization parameter for evaluating scaphoid fracture, especially for occult fracture. MRI can completely show the structure of scaphoid, even blood supply. Bone scintigraphy possesses a higher diagnosis rate than X-ray and CT examinations. (2) The surgical approaches of scaphoid fracture include volar, dorsal, radiocarpa approaches, but none is ideal. (3) The ideal surgical approach still needs a in-depth study, which can well reveal the scaphoid, achieve good reduction, reduce the damage to the remaining blood supply, confirm the position of scaphoid benifical for internal fixator implantation, and can be minimally invasive and easy to operate.

Objective To explore the applicable nursing intervention mode of family treatment and nursing for children with hemophilia which was appropriate for local hemophilia treatment center (HTC).Methods The nursing intervention group,which consisting of nurses,hemophilia patients aged 2 ～ 18 and their parents,discussed and summarized the problems in family treatment and nursing for children with hemophilia,through literature review and expert consultation,developed comprehensive nursing intervention measures,which including individualized coagulation factors injection training,hemophilia classes,children hemophilia families sodality and follow-up visiting of the family treatment and nursing behaviors.The effect of nursing intervention was judged through measuring and comparing the family treatment and nursing behaviors.Results After intervention,among 22 items of family treatment and nursing behaviors,19 items were significantly improved than that of no intervention ( x2=59.88,36.47,96.30,13.57,34.67,55.06,55.06,21.85,22.69,45.69,39.33,68.25,11.99,35.39,35.39,17.24,81.51,85.75,13.57,respectively; P＜0.01 ).Before intervention,the incidence of "correctly record every bleeding and treatment" among the patients was 2 cases(3.85％ ),while after intervention,that was 48 cases ( 92.31％ ),and the incidence of "monthly report the bleeding and therapy nursing information to nurses" was raised from 5 cases (20％) to 52 cases ( 100％ ) after intervention,and the difference was statistically significant (x2=81.51,85.75,respectively;P＜0.01).Conclusions Comprehensive nursing intervention measures can improve the families' treatment and nursing behaviors of children with hemophilia and achieve the effective management of patients' information at the sam time,which is applicable for local hemophilia treatment center.

OBJECTIVETo analyze the change of tendency on schistosomiasis epidemics in China in the last 5 years.

METHODSData on schistosomiasis epidemics in the history and particularly in the last 5 years were collected. Tendency and the re-emerging status after 1998 were analyzed.

RESULTSData in 2003 showed that in 42%, 40% and 53% of the provinces, counties and townships with epidemics, the transmission of the disease has been interrupted or controlled. The number of estimated patients of schistosomiasis and areas with snails were also reduced by 92.74% and 73.56%, in 2003. The annual estimated number of chronic cases was around 800 000 and 31 321.5 hectare of snail infested areas were newly identified in recent 5 years. Among 20 national villages under longitudinal surveillance, 30%, 70% and 35% of the villages were presented a tendency of increase in the rates of human infection, bovine infection and Oncomelania snails infection, respectively. A total of 38 counties from 7 provinces have re-emerged in schistosomiasis transmission after those counties having reached criteria of transmission under control or interrupted. In 6 non-endemic counties, snails were presented, and 16 marshlands in Xan river were found with appearance of acute cases of schistosomiasis. More snail infested areas were found in Shanghai, Zhejiang, and Fujian. Both snail infested areas and newly infected cases were occurred in urban areas along the Yangtze River.

CONCLUSIONThe tendency of increase was presented in focal areas along the Yangtze River, due to changes of environmental, ecological, societal and economic status, as well as on the forces of control.

Animals ; China ; epidemiology ; Disease Reservoirs ; Humans ; Praziquantel ; therapeutic use ; Prevalence ; Schistosomiasis japonica ; drug therapy ; epidemiology ; prevention & control ; Snails ; parasitology

OBJECTIVETo evaluate the roles or effects of oviductus ranae (OR) or oviductus ranae eggs (ORE) in preventing and treating postmenopausal osteoporosis.

METHODSIn vivo experiment: Sixty female adult Wistar rats were randomly divided into 5 groups of 12. To provide an osteoporosis model 4 groups of rats were ovariectomized (OVX), with the 5th being sham operated. Medication commenced 7 days after the operation and lasted continuously for 12 weeks. Sham operated and OVX groups were given equivalent volumes of 5% Tween-80. The other three groups intragastrically received conjugated estrogens (CE), OR or ORE of the corresponding doses. At the 12th week, serum estrogen, bone gla protein (BGP), serum calcium, phosphorus, and alkaline phosphatase (ALP) were assayed; bone mineral densities (BMD) were measured and bone scanning was conducted; uteri were weighed, and weight, volume and length of the femoral bones were determined; and cortical thickness of femoral heads and area of bone trabecula were measured by image analyzer. In vitro experiment: Eighty 10-month old SD rats, with equal numbers of males and females, were randomly divided into 8 groups. Osteoblasts were isolated from neonatal rat calvariae, and the cells were exposed to various concentrations of serum from OR and ORE groups to study the impact of these sera on osteoblastic proliferation, ALP activity and mineralization. Osteoclastic numbers were determined using tartrate resistant acid phosphatase (TRAP).

RESULTSIn vivo experiment: The body weight of the four OVX groups increased significantly (P<0.01). Uterine weight of the CE group was the highest (P<0.01); Compared with the model group, estrogen level, BMD, bone scanning/bone imaging index weight of the femoral bones, cortical thickness of femoral heads in the OR and ORE groups increased significantly (P<0.05, P<0.01); femoral volume in the ORE group increased significantly (P<0.05); and the content of osteocalcin, phosphorus, and ALP in serum decreased significantly (P<0.05, P<0.01). In vitro experiment: Sera from OR and ORE groups had notable effects on the proliferation of osteoblasts (P<0.05 and P<0.01, repsectively) and stimulated the formation of calcium nodes (P<0.05, P<0.01), while the enhancement of ALP activity in osteoblasts was significant (P<0.05, P<0.01). The number of TRAP-positive cells was significantly reduced as well (P<0.01).

CONCLUSIONSOR and its eggs could effectively suppress OVX-induced osteoporosis in rats, and increase bone turnover possibly by both an increase in osteoblastic activity and a decrease in osteoclastic activity. The present study provides evidence that OR and its eggs could be considered a complementary and alternative medicine for the treatment of postmenopausal osteoporosis.

Acid Phosphatase ; metabolism ; Alkaline Phosphatase ; metabolism ; Animals ; Biomarkers ; blood ; Body Weight ; drug effects ; Bone Density ; drug effects ; Bone and Bones ; metabolism ; Calcification, Physiologic ; drug effects ; Cell Count ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Female ; Femur ; drug effects ; metabolism ; pathology ; Isoenzymes ; metabolism ; Male ; Materia Medica ; pharmacology ; therapeutic use ; Organ Size ; drug effects ; Osteoblasts ; drug effects ; enzymology ; pathology ; Osteoclasts ; drug effects ; enzymology ; pathology ; Osteoporosis ; blood ; drug therapy ; metabolism ; physiopathology ; Ovariectomy ; Ovum ; metabolism ; Rats ; Rats, Wistar ; Tartrate-Resistant Acid Phosphatase ; Uterus ; drug effects ; pathology

OBJECTIVETo analyse the relapse rate and risk factors of autoimmune hemolytic anemia (AIHA) and Evans syndrome.

METHODSFifty two cases of AIHA and Evans syndrome in remission being followed up for 1 - 14 years (median time 3.8 years) were analysed for relapse rate. The risk factors of relapse were analysed by case-control study.

RESULTSThe total relapse rate of these AIHA and Evans syndrome patients was 57.7%, and the median remission duration to the first relapse was 9 months. The relapse rates in patients with negative Coombs test, warm autoantibodies and both of warm and cold autoantibodies were 30.8% (4/13), 54.0% (13/24) and 86.7% (13/15), respectively. The relapse rate in patients with cold antibody was the highest (P < 0.05). The relapse rate in patients with antibody titer >or= 100 was 92.9% (13/14) and was higher than that in patients with antibody titer < 100 [59.5% (13/22)] (P < 0.05). Patients treated with prednisone and cyclosporin relapsed less than those treated with prednisone alone, and the relapse was related to the therapy course of prednisone and CsA.

CONCLUSIONBecause of the high relapse rate, AIHA and Evans syndrome should be treated according to the class of autoantibodies, and with longer course of prednisone and cyclosporin and prophylaxis of infection.

Adolescent ; Adult ; Aged ; Anemia, Hemolytic, Autoimmune ; etiology ; immunology ; Autoantibodies ; blood ; Child ; Cyclosporine ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Prednisone ; therapeutic use ; Recurrence ; Risk Factors ; Syndrome ; Thrombocytopenia ; etiology ; immunology

OBJECTIVETo study the clinical features of severe aplastic anemia (SAA) patients with complication of infection.

METHODSA retrospective analysis of prevalence of infection occurring in 229 SAA patients, their bacterial spectrum, and the effect of GM-CSF or G-CSF on the infection were done.

RESULTThe prevalence of infection in SAA patients was 86.0%, among which 54.2% was infected with gram-positive organisms, 40.0% with gram-negative bacilli and 5.8% with fungal infections. Septicemia occurred mostly with E. coli and Pseudomonas infection. Patient's neutropenia was significantly related to the infection. The patients with neutrophil count less than 0.2 x 10(9)/L had more frequent and severe infection. Age, hemoglobin level, subtype of T lymphocytes and antithymocyte globulin therapy were not related to infection. Prophylaxis usage of floxacin could not reduce patient' gastrointestinal infection. The total mortality of SAA patients with infection was 23.1%. Pulmonary infection and septicemia increased mortality, and GM-CSF/G-CSF therapy reduce mortality.

CONCLUSIONSAA patients were at high risk of infection which was significantly associated with severe neutropenia. GM-CSF or G-CSF therapy exerts an assistant role to antibiotics in controlling the infections.

Adolescent ; Adult ; Aged ; Anemia, Aplastic ; complications ; Anti-Bacterial Agents ; therapeutic use ; Bacteria ; isolation & purification ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infection ; drug therapy ; etiology ; Male ; Middle Aged ; Time Factors

OBJECTIVETo investigate the correlations between Fas-1377 and -670 polymorphisms and survival in Chinese women with breast cancer.

METHODSPolymerase chain reaction-restriction fragment length polymorphism assay (PCR-RFLP) was used to detect the polymorphism of Fas gene in 310 breast cancer patients with a long-term follow-up (median 10.5 years, range 0.2 - 16.1 years). Survival curves were analyzed by Kaplan-Meier method.

RESULTSThe polymorphism of neither Fas-1377 nor Fas-670 was significantly correlated with the overall survival in this series of 310 cases (P > 0.05). However, among 146 patients without lymph node metastasis, the 5-year overall survival (OS) rate was significantly lower in the patients with Fas-1377 AA genotype than that in the patients with Fas-1377 GA or GG genotype (OS: 66.7% vs. 95.4%, P = 0.03). Among 117 patients with lymph node metastasis, both the Fas-1377 and Fas-670 polymorphisms were not significantly correlated with OS (P = 0.42).

CONCLUSIONAmong breast cancer patients without lymph node metastasis, patients with Fas-1377 AA genotype may have a worse survival, while patients with Fas-1377 GA or GG genotype may not be so.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Apoptosis ; Breast Neoplasms ; genetics ; metabolism ; pathology ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Middle Aged ; Polymorphism, Genetic ; Prognosis ; Survival Rate ; Young Adult ; fas Receptor ; genetics ; metabolism

OBJECTIVETo observe the efficacy and side effect of DA/HA regimen chemotherapy for the treatment of refractory and relapsed paroxysmal nocturnal hemoglobinuria (PNH).

METHODSEight patients with refractory and relapsed PNH were treated with DA/HA regimen chemotherapy. Three patients were treated with DA (DNR 40 mg/d, i.v.drip, the first and the second day; 20 mg/d, i.v.drip, the third day; Ara-C 100 mg/d, i.v.drip, for 5 days) and 5 patients with HA (HHT 2 - 3 mg/d, i.v.drip, for 5 days; Ara-C 100 mg/d, i.v.drip, for 5 days).

RESULTSAll the 8 patients responded well: the PNH clone was diminished in five patients. Hemolysis was remitted in 6 cases. Five patients showed improvement in hematological parameters. The dosage of corticosteroid was decreased in all of them. No serious side effect was revealed.

CONCLUSIONDA/HA regimen chemotherapy was safe and effective for refractory and relapsed PNH patients.

Adolescent ; Adult ; Cytarabine ; administration & dosage ; Daunorubicin ; administration & dosage ; Drug Therapy, Combination ; Female ; Glycosylphosphatidylinositols ; analysis ; Harringtonines ; Hemoglobinuria, Paroxysmal ; drug therapy ; Humans ; Male

DPP4 is a serine exopeptidase that is immobilized on the cell membrane and plays a crucial regulatory role in various physiological and pathological activities within the human body.In addition to acting as a transcription factor to regulate the tran-scription and expression of downstream target genes,DPP4 also functions as a transcription-independent regulator through pro-tein-protein interactions.In recent studies,DPP4 has been strongly linked to various diseases,and several substances with the potential to target DPP4 have been identified.This paper mainly reviews the multifunctionality of DPP4 in regulating vari-ous aspects of energy metabolism,inflammation,tissue repair and carcinogenesis in the body.It also reviews the screening of in vitro inhibitors of DPP4 and its research progress in regulating chronic liver disease,based on the pathological development process of chronic liver disease.