Objective To explore the clinical features, diagnosis, and treatment of Kawasaki disease in neonates. Methods The diagnosis and treatment of incomplete Kawasaki disease in one case were retrospectively analyzed. The related literatures were reviewed. Results Male infant had persistent fever with rash at 26 days after birth. The anti-infective treatment was ineffective. No abnormality was found in the first coronary artery ultrasonography. However, coronary artery dilatation was confirmed by ultrasonography after skin peeling at fingertips. After the treatment of gamma globulin and aspirin, the symptoms of fever and rash were improved. The left dilated coronary artery returned to normal after 3 month. The size of coronary artery and the corresponding indexes were normal in 6-months, 1-year and 3 year follow-ups. Conclusion Neonatal Kawasaki disease is rare and atypical.

Background and purpose:Breast cancer is one of the most common carcinoma among female patients with high mortalities. Drug-resistance is the major reason that leads to chemotherapy failure in clinical practice. MCF-7/ADR is a multi-drug resistant cell line that was established on the basis of breast cancer cell line MCF-7. This research aimed to investigate the anti-apoptotic effect of c-fos in resistant breast cancer cell MCF-7/ADR, and to compare with its sensitive counterpart MCF-7.Methods:Doxorubicin with various concentrations was used to treat MCF-7 as well as its MDR- counterpart MCF-7/ADR. The growth inhibitory rate of MCF-7 and MCF-7/ADR wasdetermined by MTT assay. Additionally, RT-PCR was used to test the expression of P-gp and c-fos mRNA in MCF-7 and MCF-7/ADR; The expression of c-fos mRNA was detected by RT-PCR after 3 μmol doxorubicin treatment;We further established cell lines that stably interfered with c-fos, named MCF-7/ADR/si-fos-8B, MCF-7/ADR/si-fos-3D. Flow cytometry and MTT assay were used to investigate the apoptosis rate and inhibitory rate in these above cells under the treatment of 5-FU, CDDP or γ-radiation. At last, RT-PCR and Western blot analysis were used to detect the expression of bax, bcl-2, puma, p53.Results:The expression of c-fos and P-gp (MDR-1) was up-regulated in MCF-7/ADR, compared with its sensitive counterpart MCF-7. Additionally, the resistant fold of MCF-7/ADR to doxorubicin was nearly 40; The expression of c-fos was gradually up-regulated after 3 μmol doxorubicin treatment; The sensitivity to drugs (5-FU and CDDP) was increased after c-fos interference while the apoptosis rate was also increased after 5-FU, CDDP and γ-radiation treatment. RT-PCR and Western blot analysis indicated that up-regulation ofbax,puma,p53 after c-fos interference while the expression of bcl-2 was down-regulated.Conclusion:c-fos may act as an anti-apoptotic protein in resistant breast cancer cell line MCF-7/ADR by regulating the expression of apoptosis related proteins, and may play a vital role in the formation of multi-drug resistance phenotype.

ObjectiveThe purpose of the study was to summarize the characteristics of cellular and humoral immunity in children with Kawasaki's disease (KD),and to explore the role of cellular and humoral immunity in the pathogenesis of KD.MethodsOne hundred and ninety-six subjects with KD were diagnosed and observed.The serum IgG,IgM,IgA and C3,C4 levels were detected by velocity scatter turbidimetry.The levels of T lymphocyte subsets,natural killer cells (NK cells),and B cells were analyzed by flow cytometry.Chi-square test,independent t-test and Spearman analysis were adopted to analyze data.ResultsOne hundred and seventy-two cases were diagnosed as typical KD,24 cases were incomplete KD,17 cases were refractory KD,179 cases responded to IVIG therapy,and 34 cases were CAL.The occurrence of coronary artery lesion (CAL) in the refractory KD group was 52.9％,which was evidently higher than those patients responding to IVIG therapy(14.0％,P＜0.05).In the group of KD,the level of CD19 absolute value(1165±556)/μl was higher than that in the control group(P＜0.05),the ratio of CD4/CD8 (2.19±0.77) was higher than that in the control group (P＜0.05),the levels of serum IgM ( 1.41 ±0.45) g/L,IgA (0.81 ±0.35) g/L,C3 ( 1.31 ±0.26) g/L were higher than those in the control group (P＜0.05),the levels of CD8 (671±308)/μl,NK (337±233)/μl absolute value were lower than those in thc control group (P＜0.05).In refractory KD subgroup,the levels of CD19 absolute value,serum IgM,C3 and the ratio of CD4/CD8 were higher than those in the subgroup responding to IVIG therapy(P＜0.05),while the levels of CD8,NK absolute value were lower than those in the latter(P＜0.05).In the CAL subgroup,the levels of CD19 absolute value,serum IgM,IgA and the ratio of CD4/CD8 were higher than those in the non-CAL subgroup (P＜0.05),while the levels of CD8,NK absolute value were lower than those in the latter(P＜0.05).The differences of all data between typical KD subgroup and incomplete KD subgroup were insignificant (P＞0.05).The severity grade of CAL was positively correlated with the ratio of CD4/CD8(P＜0.05).ConclusionThere are cellular immunity and humoral immunity disturbances in the acute stage of KD,while cellular immunity disturbances are more striking.Cellular immunity and humoral immunity are all involved in the pathogenesis of KD.The immunity dysfunction is more significant in refractory KD and CAL.The occurrence rate of CAL is high in refractory KD.The ratio of CD4/CD8 is relevant to the severity of vascular injury.

Objective To explore correlates of health-care seeking behavior in patients with irritable bowel syndrome (IBS).Methods Four thousand permanent residents were recruited from eight urban communities and rural villages in Guangzhou and Huizhou, Guangdong province during 2009 by cluster stratified sampling for face-to-face questionnaire survey, including symptoms of bowel disease,behavior of seeking for health-care, demographic characteristics, coping style, life events and medical history.IBS was identified based on the Rome Ⅱ Criteria.Patient with IBS were divided into two groups,one seeking health-care at hospitals or clinics and the other non-seeking health-care.Univariate and multivariate logistic regression analysis was used to compare difference between the two groups and explore its related factors.Results A total of 237 IBS patients were identified based on the Rome Ⅱ Criteria, 53 of them (22.4% ) had sought health-care due to their symptoms.Results of multivariate logistic regression analysis showed that preference in seeking for health-care, abdominal pain lasting for more than one hour in each episode and extra-gastrointestinal symptoms were main factors related to their seeking for health-care,adjusted for age and gender, with odds ratios (ORs) of 1.81 (95% CI: 1.27 -2.58), 1.41 (95% CI:1.01 - 5.14 ) and 2.14 ( 95% CI: 1.06 - 4.33 ), respectively.Conclusions Extra-gastrointestinal symptoms and abdominal pain lasting for more than one hour in each episode correlate their health-care seeking behavior in patients with IBS, as well as their preferences in seeking for health-care.

Objective: To explore the necessity of multi-slice CT (MSCT) and echocardiogram in diagnosing multiple cardiac myxoma or myxoma originated from special site of heart via analyzing medical imaging features. Methods: A total of 14 patients with multiple cardiac myxoma or myxoma not originated from left atrium fossa ovale were studied; the patients had operation conifrmed diagnosis in our hospital from 2003-02 to 2015-12, the imaging features of MSCT and echocardiography were analyzed and compared. Results: There were 12/14 patients diagnose by echocardiography with the accuracy of 85.7% and 11 patients diagnosed by MSCT with the accuracy of 84.6%. MSCT and echocardiography had similar pre-operative accuracy and complimentary advantages for diagnosing multiple cardiac myxoma or myxoma not originated from regular site of heart. Echocardiography was superior for examining the motion, pedicle position, shape and attachment point of cardiac myxoma; MSCT may exclude pulmonary embolism and coronary artery disease at meanwhile. Conclusion: Unconventional cardiac myxoma not only has similar image signs to typical single myxoma from left atrium, but also has the speciifc features; MSCT combining echocardiogram examinations could make more accurate diagnosis and provide a better condition for surgical treatment.

Research in immunotherapy has achieved important progress in tumor treatment. Programmed cell death receptor 1(PD-1) is mainly expressed on the T lymphocyte surface and serves as an important immune regu-lator. The interactions of PD-1 and its ligand, PD-L1 are involved in tumor-induced immunosuppression. Some of the approved antibody preparations targeting PD-1/PD-L1 signaling showed significant clinical benefits.

Objective To observe the effect of cognitive training combined with swallowing training real-time electrical stimulation on dysphagia and cognitive impairment after stroke. Methods 40 patients with dysphagia and cognitive impairment after stroke were randomly divided into observation group (n=20) and control group (n=20). The observation group accepted swallowing training (including routine vocal training and swallowing training real-time electrical stimulation) and cognitive training. The control group accepted routine vocal training and neuromuscular electrical stimulation. The cognitive function and swallowing function were accessed with Mini-Mental State Examination (MMSE) and Video Fluoroscopy Swallowing Study (VFSS) respectively before and 1 month after stroke. Results After treatment, the MMSE scores and the time for a bolus to pass the pharynx improved in both groups (P<0.05), and the observation group was superior to the control group (P<0.05). Conclusion Cognitive training combined with swallowing training real-time electrical stimulation can promote the recovery of swallowing function of patients with dysphagia and cognitive impairment after stroke.

Aim To investigate the effect of indirubin derivative PHⅡ-7 and TRAIL on proliferation in breast cancer cell MCF-7 and its MDR counterpart MCF-7/ADR and the mechanism.Methods Growth inhibition rate was examined respectively by MTT assay under treatment with TRAIL or PHⅡ-7 or in combination. Cell apoptosis and ROS production were examined by flow cytometry.The change of TRAIL receptors(DR4/DR5 )in mRNA was analysed by realtime PCR.Re-sults IC50 of PHⅡ-7 on MCF-7 and MCF-7/ADR was (4.49 ±1.55 ),(3.44 ±0.90 )μmol · L-1 respec-tively;MDA-MB-231 was TRAIL sensitive cell line, and apparently TRAIL induced apoptosis in MDA-MB-23 1 .Low concentration of PHⅡ-7 in combination with TRAIL could augment TRAIL-induced cytotoxic effect including apoptosis while TRAIL or PHⅡ-7 treatment alone had limited cytotoxity to those cells.Besides, PHⅡ-7 at this concentration had little toxicity to hu-man peripheral blood mononuclear cells even if in com-bination with TRAIL.PHⅡ-7 generated ROS produc-tion inside MCF-7 and MCF-7/ADR cells and up-regu-lated DR4/DR5 expression concentration dependently. Once upon ROS scavenger NAC involved,the effect of TRAIL receptors up-regualtion by expression was abro-gated.Conclusions PHⅡ-7 at low concentration could improve the sensitivities of breast cancer cell MCF-7 and MCF-7/ADR to TRAIL,the mechanism of which may be the ability of ROS production by PHⅡ-7 help up-regulated TRAIL receptor DR4,DR5 .Our re-search set a solid foundation for PHⅡ-7 in combination with TRAIL in future clinical application.

Objective: To investigate the multi-imaging diagnostic values, especially MSCT technology in patients with congenital aortic diverticulum with its clinical application. Methods: The MSCT ifndings in 12 patients with congenital aortic diverticulum were retrospectively analyzed. Results: There were 9 patients with right aortic arch and 1 with left aortic arch, all of them having coexisted aberrant subclavian artery which initially dilated like aneurysm by diverticulum changing (Kommerell diverticulum), and there was 1 patient with incomplete double aortic arch with atresia of left arch combining retro-esophageal aortic diverticulum (RAD) and 1 patient with ducts diverticulum. Echocardiogram only made the suggestive diagnosis of speeding up blood lfow or right aortic arch in 4 patients. While MSCT accurately displayed the diverticulum for the location, morphology and with or without other complications. The post-eroanterior chest radiograph indicated “double aortic node” as the special sign in 8 patients. The echocardiogram, X-ray and MSCT for correctly diagnosing the aortic diverticulum were as 0, 72.7% and 100% respectively. Conclusion: MSCT is a rather ideal non-invasive diagnosing method for aortic diverticulum, meanwhile X-ray could also make suggestive diagnosis; if MSCT and X-ray joint with echocardiogram examination may provide the effective supplement for valve structure and hemodynamics condition in relevant patients.

Objective To study the distribution of apolipoprotein E(apoE) genotypes and alleles in children with primary nephrotic syndrome(PNS),and to investigate the relationship between apoE gene polymorphism and disturbance of serum lipid metabolism.Methods Forty-six children with PNS were compared with 39 age-sex-matched healthy children.Serum levels of total cholesterol(TC),triglyeride(TG),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),apoA_1,apoB and apoA_1/B were detected,and polychain reaction single-strand conformation polymorphism(PCR-SSCP) combined with gene sequence determination was used to confirm the apoE genotypes in two groups.Results 1.Serum TC,TG,HDL-C,LDL-C,apoB and apoA_1/B in PNS group were higher than those of control group,respectively(P