Female ; Forced Expiratory Volume ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Male ; Positive-Pressure Respiration ; methods ; Pulmonary Ventilation ; Respiratory Insufficiency ; physiopathology ; therapy ; Treatment Outcome

Objective To explore the clinical characteristics, treatment and prognostic factors of cardiogenic shock in children. Methods A retrospective analysis was done on clinical features,management strategies and outcome in 36 children with cardiogenic shock in Intensive Care Unit of our hospital from February 1994 to December 2005. Results The clinical presentations of 36 patients varied with the different ages and different primary diseases. And the duration between the presentation and the onset of shock varied with the different primary diseases: the duration for paroxysmal supraventricular tachycardia (PST) was (62.2?12.9) hours, cardiomyopathy (CMP) was (42.0?23.0) hours, endocardial fibroelastosis (ECF) was (20.3?11.1) hours, and fulminant myocarditis (FMC) was (15.0?7.8) hours. At the early stage of shock, all patients showed soft heart sounds.Gallop rhythm was found in 15 cases (41.6%)and cardiopulmonary resuscitation was needed in 17 cases (47.2%).All cases had decreased ejection fraction(EF) and fractional shortening(FS) [(0.32?0.11), (0.14?0.05),respectively] on echocardiography.Cardiothoracic ratio increased in 35 cases (97.2%) and arrhythmia developed in 34 cases (94.4%). The duration from initial treatment to shock correction of was related to the prognosis (P=0.002, Wald=9.91).Fluid resuscitation in cardiogenic shock needed close monitor, and the amount of fluid was 5.25 ml?kg -1?h -1,4.48 ml?kg -1?h -1,4.75 ml?kg -1?h -1 in ECF,FMC and CMP,respectively. Conclusion The clinical presentations high in cardiogenic shock in children were various. Early bedside echocardiogram, chest X-ray and electrocardiogram would be helpful in diagnosis. The duration from initial treatment to shock correction was a strong prognostic factor for cardiogenic shock. Compared with other kinds of shock, fluid resuscitation had its features.

Objective To summarize the methods and outcome of surgical treatment of thyriod carcinoma(TC).Methods The clinical data of 126 cases of TC admitted between 1990 to 2005 to our 2 hospitals was analyzed.Results Among the 126 cases,there were papillary carcinoma in 94 cases(74.5%),follicular carcinoma in 20 cases(15.9%),medullary carcinoma in 5 cases(4%),anaplastic carcinoma in 4 cases(3.2%),lymphoma in 2 cases(1.6%) and squamous cell carcinoma was in 1 case(0.8%).Thyroid microcarcinoma(TMC) was found in 56 of 126 cases and all of them were papillary carcinoma.(Seventy)-eight cases were followed up for more than 5 years after operation and 36 cases for 3 to 5 years,and all have good quality of life.All of the 4 cases with anaplastic carcinoma died in 3 to 6 months.Two cases with medullary carcinoma and 1 case with squamous cell carcinoma died from pulmonary metastases 1 year after operation.Conclusions For differentiated TC,surgical treatment is the ideal treatment.However,for(anaplastic) TC,operation is not to be recommended,the choice of treatment is radiotherapy.

OBJECTIVE: To investigate the resistance phenotype of acinetobacter baumannii and the expression of ade efflux pump gene. METHODS: Non-repetitive 51 strains of Acinetobacter baumannii were collected in Peking Union Medical Hospital between Feb. 2004 and Feb. 2005. The active efflux system adeB structural gene and sequence were identified by PCR. RESULTS: The tested strains were not susceptible to common broad-spectrum antibiotics. Multidrug resistant Acinetobacter baumannii carried adeB active efflux pump gene. CONCLUSION: The multiple-drug resistance of Acinetobacter baumannii is independent of ?-lactamase. It maybe related to other drug resistance mechanism. The effect of active efflux system is possibly one of the major mechanisms of multidrug resistance of acinetobacter baumannii.

Objective Radiological findings of very rare hemangioendotheliomas in the orbit have not been reported.Radiological findings on different imaging studies of four cases with hemangioendotheliomas in the orbit were described and the literature was reviewed so as to understand features of hemangioendotheliomas in the orbit.Methods CT and MR imaging findings of four cases with hemangioendotheliomas in the orbit confirmed by histopathology were analyzed retrospectively.Results A mass was found in the superotemporal quadrant in the anterior extraconal space of the orbit in three cases and in the inferonasal quadrant in one case. CT studies revealed a homogeneously ovoid tumor with benign remodeling of the adjacent bone in three cases and a homogeneously irregular mass without any bony change in one case.MR imaging showed a mass in the orbit that was mildly hypointense on T_1-weighted sequences and hyperintense on T_2-weighted images with areas of flow voids representing vessels within the peripheral portion of the tumor in four cases.All four patients demonstrated significant enhancement immediately after intravenous administration of contrast material and a type D time-signal intensity curve (TIC)pattern on MR dynamic contrast enhancement scanning.Conclusions Hemangioendotheliomas in the orbit appeared as a hypervascular tumor predominantly in the extraconal space with areas of flow voids within the tumor and early significant enhancement of the tumor after intravenous administration of contrast material.MR imaging is the best method in demonstration of features of hemangioendotheliomas in the orbit and in diagnosis of these tumors.

Objective:To explore the effects and mechanism of Salvianolic acid B(SalB)on Parkinson's disease(PD).Methods:Forty-eight C57BL/6 male mice were randomly separated into control group(control)withoutdrugs,model group(MPTP)with intraperitoneal injection of 1-methyl-4-phenyl-1,2,3,6-tetrah-ydropyridine(MPTP),SalB control group with intraperitoneal injection of SalB,and SalB treatment group(MPTP+SalB).Construction of PD mouse model by intraperitoneal injection of MPTP,and treatment with intraperitoneal injection of SalB.Pole climbing test was applied to assess behavior differences.The time of first black stool excretion and water content of feces were measured to evaluate intestinal dysfunctions.The number of tyrosine hydroxylase(TH)positive cells in substantia nigra and the level of Toll like receptor 4(TLR4)in colon were analyzed by immunohistochemistry.The pathological changes of colonic mucosa were observed by HE staining.The levels of calprotectin(CP)and tumor necrosis factor-α(TNF-α)in colon were determined by ELISA.Western blot was used to determine the level of TH in midbrain,the protein level of TH,tight junction protein(ZO-1),and protein level of TLR4/MyD88/NF-κB signaling pathways which express in colon.Results:Com-pared with the Control group,the climbing time,T-turn time and the first black stool excretion time in MPTP group increased while the fecal water content and the number of TH positive cells in substantia nigra were decreased.Accompanied by TLR4 positive cells in colon,pathological injury score of colonic mucosa,levels of CP and TNF-α in colon increased,expression of TH in midbrain and expression of ZO-1 in colon decreased.Expressions of TLR4,MyD88,Nuclear NF-κB p65 and p-NF-κB p65 in colon increased.Com-pared with MPTP group,SalB treatment shortened the climbing time,T-turn time and the first black stool excretion time in SalB treat-ment group,increased the fecal water content and the number of TH positive cells in substantia nigra,lowered TLR4 positive cells in colon,enhanced expression of TH in midbrain and colon,reduced the pathological injury score of colonic mucosa,significantly decreased levels of CP and TNF-α in colon,enhanced expression of ZO-1 in colon,inhibited expressions of TLR4,MyD88,Nuclear NF-κB p65 and p-NF-κB p65 in colon.Conclusion:SalB can protect the nerves and intestines and alleviate the intestinal inflamma-tion of PD mice,which may be related to the inhibition of TLR4/MyD88/NF-κB signal pathway.

BACKGROUNDThe importance of diagnosis of thyroid dysfunction during pregnancy has been widely recognized. Our study was designed to compare two different detection reagents between Abbott and Roche and to establish the gestational related reference intervals for thyroid function tests (TFT) in Chinese women and to assay the reference ranges with the American Thyroid Association recommended standard.

METHODSSerum samples were collected from 693 normal pregnant Chinese women and divided into five groups according to their gestational age: 9-13, 16-20, 24-28, 32-34 and 37-40 weeks. Thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels were determined by two different detection reagents: Abbott Architect I 2000 and Roche Cobas Elecsys 600. The reference ranges of the TFT indexes were calculated according to the National Academy of Clinical Biochemistry (NACB). The 2.5th and 97.5th percentiles of each stage were calculated, and the results were analyzed by one-way analysis of variances, t-test, and Spearman correlation analysis.

RESULTSThyroid hormone levels varied greatly among different gestational stages. TSH levels, as assessed via two different TSH ELISA kits showed consistent changing pattern during pregnancy and displayed linear correlation (P < 0.001). In 9-13 gestational weeks, TSH levels were significantly lower than that of other groups; and in 37-40 gestational weeks, it was higher than that of other groups (all P < 0.001). TSH reference ranges determined by Roche detection reagent in each group were higher than those by Abbott detection reagent (P < 0.01 respectively). FT4 levels were higher in 9-13 gestational weeks than that of other groups (P < 0.001). FT4 levels determined by Roche reagent were higher than Abbott reagent in 9-13 weeks, (P < 0.001), and lower in 24-28 and 37-40 weeks (P < 0.001 and P = 0.016, respectively). The TSH level was correlated with FT4 levels in 9-13 gestational weeks by detection reagents (for Abbott reagent, r=-0.319 for FT4 P < 0.001; for Roche reagent, r=-0.352 for FT4, P <0.001).

CONCLUSIONAccurate evaluation of TFT in pregnant women should be based on the gestational-related reference intervals in Chinese population, and different detection reagents should also establish their own reference intervals.

Adult ; Female ; Gestational Age ; Humans ; Luminescent Measurements ; Pregnancy ; physiology ; Reference Values ; Thyroid Function Tests ; Thyroid Gland ; physiology ; Thyrotropin ; blood ; Thyroxine ; blood

By making use of 19 keywords,the paper searches the APP Store for APP related to imaging diagnostics and interventional radiology,analyzes parameters like APP classifications,satisfaction,publisher identity and downloads with statistical methods.The result shows that mobile learning APP,which facilitate imaging diagnostics and interventional radiology doctors with mobile learning,are more popular.

Objective: To evaluate the outcomes of splenectomy in the treatment of relapsed/refractory autoimmune hemolytic anemia (AIHA). Methods: Retrospective analysis was performed in 30 cases with relapsed/refractory AIHA who were treated with splenectomy in our hospital. The pre- and post-operative blood routine indexes and responses were followed up. Results: Among the 30 relapsed/refractory AIHA patients, 20 were pure AIHA (including 13 patients with warm antibody AIHA, 2 with warm-cold double antibody AIHA and 5 with Coombs negative AIHA) and 10 were Evans syndrome. The short-term response was evaluated 10-14 days after operation, and the overall response rate (ORR) of short-term response was 90% [12 cases in complete response (CR), 6 cases in partial response (PR)] in 20 therapeutic evaluable cases. Among 13 patients with long-term follow-up data, except 3 patients with Evans syndrome died (2 cases were refractory to splenectomy, 1 case relapsed after surgery), the ORR of 10 patients with relapsed/refractory pure AIHA at 6 months and 12 months were 90% (9/10) and 70% (7/10), respectively, with a median follow-up of 14 (4-156) months. At the end of follow-up, 3 cases had maintained CR for more than 3 years. Conclusion: The short-term response of splenectomy as a second-line treatment for relapsed/refractory AIHA is satisfactory, and long-term outcome of splenectomy is up to 70% at 1 year. Approximately one-third of patients could maintain sustained remission.
Anemia, Hemolytic, Autoimmune ; Antibodies, Monoclonal, Murine-Derived ; Humans ; Retrospective Studies ; Rituximab ; Splenectomy

PURPOSE: ORM1-like 3 (ORMDL3) belongs to a highly conserved protein family which is anchored as transmembrane protein in the endoplasmic reticulum. Gasdermin B (GSDMB) is adjacent to ORMDL3 on chromosome 17q21.2 and belongs to the gasdermin-domain containing the protein family (GSDM family). Recent reports suggest that GSDMB and ORMDL3 are associated with asthma in several populations. However, genetic association studies that examined the association of GSDMB and ORMDL3 gene variants with asthma showed conflicting results. To assess whether combined evidence shows the association between GSDMB/ORMDL3 polymorphism and asthma. METHODS: A bibliographic search from MEDLINE identified 13 original articles using the search keywords 'GSDMB', 'ORMDL3', and 'asthma'. An updated literature-based meta-analysis involving 6,691 subjects with asthma, 9,281 control individuals, and 1,360 families were conducted. Meta-odds ratios (ORs) and 95% confidence intervals (CIs) based on the fixed effects model or the random effects model depended on Cochran's Q-statistic and I2 values. Data from case-control and TDT studies were analyzed in an allelic model using the Catmap software. RESULTS: We selected and identified 3 SNPs of ORMDL3 associated with asthma (rs8076131: OR=1.10; 95% CI, 1.02-1.20; P=0.012. rs12603332: OR=1.15; 95% CI, 1.05-1.25; P=0.002. rs3744246: OR=1.10; 95% CI, 1.02-1.17; P=0.008) and 1 SNP of GSDMB associated with asthma (rs7216389: OR=1.37; 95% CI, 1.27-1.47; P<0.01). Publication bias was estimated using modified Egger's linear regression test proposed by Harbordetal and revealed no evidence of biases. Furthermore, cumulative meta-analysis in chronological order showed the inclination toward significant association for rs7216389 and rs12603332 with continually adding studies, and the inclination toward null-significant association for rs3744246 and rs8076131. CONCLUSIONS: Moderate evidence exists for associations of the ORMDL3 rs8076131, rs12603332, and rs3744246 and GSDMB rs7216389 variants with asthma. Large sample size and representative population-based studies and TDT studies with homogeneous asthmatic patients and well-matched controls are warranted to confirm this finding.
Asthma* ; Bias (Epidemiology) ; Case-Control Studies ; Endoplasmic Reticulum ; Genetic Association Studies ; Humans ; Linear Models ; Polymorphism, Single Nucleotide ; Publication Bias ; Sample Size